HomeMy WebLinkAbout25635-zNO. 4
TOM OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27135
Date: 06/13/00
THIS CERTIFIES that the building NEW DWELLING
SOUTHOLD
Location of Property: 13780 SOUNDVIEW AVE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 54 Block 3 Lot 4
Subdivision Filed Map No. __Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 8, 1999 pursuant to which
Building Permit No. 25635-Z dated MARCH 22, 1999
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is ONE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE AND ATTACHED DECK
AS APP?J~D FOR.
The certificate is issued to RAYMOND & CECELIA KRUPSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-99-0009
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
03/21/00
N-521196 04/13/00
01/10/00 PECONIC PLUMB.& HEATING
thorized Signa~e
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 25635 Z Date MARCH 22 99
Permission is hereby granted to:
WALTER SMITH (KRUPSKI)
13780 SOUNDVIEW AVE
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTACHED TWO CAR
GARAGE AND ATTACHED DECK AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 054
pursuant to application dated MARCH
Building Inspector.
13780 SOUNDVIEW AVE
Block
8 99
SOUTHOLD
0003 Lot No. 004
and approved by the
Fee $ 1,178.20
~~S~'g~ature
ORIGINAL
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (Prior to April 9, 1957) non-conforming uses, or buildings and
qpre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Qccupancy on Pre-existing Buildinz - $100.00
3. Copy of Certificate of Occupancy - ~ .25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.....~Zf.~....... .................... ·
New Construction...........~'~ Old Or Pre-existing Building ................ .
Location of Property.. ~.7.~ ....... ~.f~.~. ~..ay. ................. ~ ~/~ a .................... ~7~o?.~. ....
House No. Street Hamlet
Onwer or O~ers of Property ...... ~ .......... /. ~ ~ ~ .............
County Tax Map No 1000, Section...~.~ ..... Block...~.~ ....... not ..... ~ ............
Subdivision..~.~.. ........... ~iz~6 Map ......... ~%~ Lot ..... 2 ............. . ·
Permit No..~f.~f..!..Date Of Pe~it..~f~+2~f .... Applicant..~.~Y~. /~g~'
Health Dept Approval Underwriters Approval ..
Planning Board Approval .....
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted:
~0 ~ 7/3f ~PLICANT
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1],95099
BUREAU OF ELECTRICITY
[~ APRIL 13,20G0 40 FULTON STREET, NEW YORK~,~N~Y~O~O~3~8
i~vJ~ J=~/99 N 521196
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant nam'e~ on the above applicaHon number is in the premises* of
RAYMOND KEUPSHI, 12780 SOUN-DVIEW AVE., SOUTHOLD~ NY "
in the following Iocat~iL~a~s~,t ~ lst FI. ~-~ 2nd Fl. ~2~c~/a~C/OlJT Section Block LOt 7
was examined on and found to be in compliance with the National Electrical Code.,
FIXTURE RECEPTACLES
OUTLETS
72 52
SWITCHES
66
FIXTURES
FLUORESCENI' OTHER
4
RANGES OVENS DISH WASHERS EXHAUST FANS
DRYERS SYSTEMS DIMMERS
NO. OF FEET
E
E R
NO OF CC COND
PER ~
OTHER APPARATUS:
1.5 TON AIR CONDITIONERS-1
4 TON AIR CONDITIONERS-1
PADDLE F/~S P-3
WELL PUMP F--1
WHIRL POOL BATH-1
MOTORS:i-i,5 HoP,~i-4 H.P.,2-F H.P.
~LEOARDS.~2-1 CIR. 60
G.F.C.I:-6
SMOKE DETECTOR: -5
<<< Continued on Page 2 >>>
AWG
OF NEUTRAL
2/0
This certificate must not bo altered In any manner; return to the office of the Board if incorrect· Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED ~N ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS AG ,2
BUREAU OF ELECTRICITY
Date A~l~t~ 1~.on~35
THIS OBRlIF:ll::$ THAT
only the electrical equipment as described below and introduced by the applicant named on tho above application number is in the premises of
RAYIqOND K~UPSHI, 12780. 8OUNDVIEW AVE., SOUTHOLD, NY
in the foHowing locat~IL~a~l~t ~ lst F1. ~] 2nd Fl. GAR/A~T~C/OUT Section Block Lot 7
was examined on and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS ! OVENS DISH WASHERS EXHAUST FANS
OUTLETS FLUORESCENT OTHER
DRYERS
SYSTEMS
NO. OF FEET
E
OTHER APPARATUS:
PER ·
R V ~ C
OF Itl-LEG
NO. OF NEUTRALS
This certificate must not be altered In any manner; return to the office of the Board If Incorrect. InspectOrs may bo identified by their credentials,
COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED tN ANY MANNER,
JIM SAGE ELEC. INC.
PO BOX 38
GREENPORT, NY, 11944~0038
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New Yo~k 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
Building Permit No. ~ ~7-~ 2%
/$~ y /w~ ~~ l~ ~J~ P ~ /~ ~
Owner: t' ;'~
(please prin ; ~,
Plu~er: ~O~/C
(please priht~ 'L /
I certify that the s01der used in the water supply system
contains less ~han 2/10 ~of ~*~ead~~. ~ ~3~.~.~..~~ --
~ {P~u~S Stgna~e)
Sworn to before me this
Notary Public, ~ ~ /~/ 6) ~/0 County
BARBARA STEPNOW~
No. 01ST~7~
Raymond H. Krupski
13780 Soundview Avenue
Southold, New York 11971
Southold Town Building Department
Main Road
Southold, New York 11971
To Whom It May Concern:
I, Raymond H. Krupski, do hereby acknowledge that I am solely
responsible for the landscaping, front walk, and driveway at the newly
constructed residence at 13780 Soundview Avenue in Southold, New
York.
Respectfully submitted,
Raymond H. Krupski
State of T~ff/&0
County of ¢
On this 3~aday of~/ 2000,
before me-7--~
the undersigcodVNotary pub!jc, personall' ' "y
appeared
/~Personally known to me'
To be the person(s) whose name(s)
Subscribed to the wittfirn instrm~nt, and
acknowledged that
executed it.
WI~ial seal
N;tary'~fi~re /
765-1802
BUILDING DEPT.
/ INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ]INSULATION
] FRAMING [ I FINAL
] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ]/I;OUNDATION 1ST [ ] ROUGH PLBG.
/
[//] FOUNDATION 2ND [ ] INSULATION
INSPECT~
765-1802
BUILDING DEPT.
[ ]
INSPECTION
FOUNDATION 1ST [ ~ROUGH PLBG.
[ ? F/OUNDATION/2ND [ ] INSULATION
[ ~ FRAMING [ ] FINAL
] FIREPLACE & CHIMNEY
DATE ~/~,__~ INSPEC
765-1802
BUILDING DEPT.
INSPECT!O
[ ]/F/OUNDATION 2ND [ ~j~INSULATION
/~/[~ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [. ] I~LATION
[ ] FRAMING ~ [~/] FINAL
[ ] FIREPlACE&CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
FOUNDATION 2ND
[ ] FRAMING
[ ] RQUGH PLBG.
[. ]~$ULATION
[ r] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS. ~_~ ~
I NSPECTO~~,/~
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND ]
[ INSULATION
/
[ ] FRAMING [~/]/FINAL
[ ] FIREPLACE.~CHIMNEY
DATE ,~/~/~) INSPECTO~
~ R,qPORT DATE
m~DATION (
~UGlt FRAI~ &
PLDI~ING
ISI]I~TION PER N. ¥.
STAI~Elfl~RGY
CODE
II Il
ti B
FORH NO. I
TONN OF SOUTItOLD
BUILDING DEPARTHENT
TOI~I BALL
SOIITItOLD, N.Y. 11971
TEL: 765- 1802
~raised ................. , 19 ....
... ~¥(~ 5-
m,~,ed ...... ,3=..I.9. .... ,gq?. Pc=it a,. & .............
Disapproved a/c..... .......................... .. ·
...................................
INSTRUCTIONS
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORH ...................
NOTIFY:
C~LL . Z ~. .'Y..-.
~IL TO: .~.f.¥.,ff.?.,rA.
./.q .~..o...~.../..7.7. ~ .............
a. 'his application must be caapletely filled in by typewriter or in ink and sehnitted to the Building Inspector vii
3 sets of plans, accurate plot plan to scale. Fee according to sehadule.
b. Plot plan shoaing lceation of lot and of lmildings on premises, relationship to adjoining prts0ises or public
streets or areas, and giving a detailed description of layout of property mast be dr,~,m on the dingran ~ahich is part of
this application.
c. 2he work covered by riffs application r~y ant be ccraneaced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. ~kw_h
pomit shall be kept on the premises available for inspection thret~ghont the ~ork.
e. No Imilding shall he cecupied or used in ~hole or in port for any purpose ~aatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
'~APPLICA~tlt TS ~ I to the Building Depernmnt for the isanm~ce of a Building Penait pareuant to the
Building Z~e Ordinance of the Toan of Southold, ~uffolk Ceanty, ~ York, and other applicable La~a, Ordin~cee or
P, eg¥1atlons, for tim construction of buildings, mlditions or alterations, or for resnoval or demolition, as herein
&scribed. lhe applicant ag~es to cc~ply vith all applicable la~s, ordise~es, Imilding code, housing code, and
regulations, and to admit ~athorized inspectors un premises and in Imilding for necessary inspections.
.................
(Signarth-e of applicant, or nane, if a corporation)
.&..~.~./..~...~._..~e.,~//.q .~....~.7...././..~2./..
(l~laillng address of applicant)
State ~dmther applicant is oaner, lessee, agent, architect, engineer, general contractor, electrician, plnmlmr or ~il~r
~ of ~r of pr~s ........... ~d~ ...
(~ m ~ t~ mi1 or latest ~)
If a~limt is a co~ratim, siam of &ly ~tt~ri~ officer.
(Nam and title of corporate officer)
Builders License lIO ......................
Phmbers License No ......
Electricians License Ro ..........
O~l~r Trade's License No ................ .. ..
Location of land on ~hida proposed ~ork vi11 be &x~ ..............................................................
House N~ber Street
County Taxlgap No. 1000 Section ~ff/~,Oo Block O_?~oo Lot
aivision . .~'.??..~.~../~. ?.o..4.. ~...~.Z x~ ...... Fn~ .~ m..~g.7.~ ..... ~t ... ~.Z .......
(~)
State existing tree and occupancy of ln~miaes and intended use and se~ of proposed construction:
a. Existing use and occupancy ................................
3. llature of ~ork (check ~tdch spphcable): ~ Buildin~ .......... Mdition .... ~.,,r :serow ..........
Repair ............ ~1 ~ ~litim ............ Otlmr
.................. ................
(to ~ ~id ~ fili~ this ~li~ti~)
5. If ~lli~, ~r of ~lliq mtts ...... (. .... ~r of ~mlling mlts ~ ea~ H~r ................
If ~ra~, ~r of ~rs ..................
~. ~ ~i~,~, ~i,~ o~ ~-- ~, ~t~ ~ ~ ~,~ o~ ~,~, ~ o~ ~ ...... ~/~ ...........
7. Di~nsi~s of ~sti~ st~s, if ~: ~ ....... :, ~ar ............... ~pth .................
l~i~t ........................ :. ~r of Stories ......................
Bim~i~ of ~ st~ ~th alterati~s or ~itt~s: ~t ............... ~ar ...............
~pth.. .................. ~i~t . ............... . .. . ~r of Stories ........... . . ..
~i~ ......... :.~: ........... ~, o~ s~o~i,, ....... ~ ..........
I I. ~ or ~ district in ~i~ ~i~s m si~t~ ...... !7~ ~.(~(J. ~ ....................................
12. ~s ~M mt~ti~ violate ~ ~i~ 1~, o~i~e ~ ~lati~: ...... ~. .............
13. ~ill lot ~ ~ ~ffX gill mss fill ~
I~. ~s of ~r of ~s .......... ~ ......................
~ of ~tr~tor ........... ~ ................... , .... ~ress ............................... ~ ~ ................
15. Is fids p~ ~in ~ f~t of a rial ~tl~? t ~ .......... ~ ..~...
,~ ;'' PLOT DIAO~H
~eate clea~ly ~ disti~tly 1 ~ildi~s. i~r ~isti~ or ~ ~ i~iate all ~t~ d~,si~s
~ ~r~ li~s. Oi~ st~t ~ bl~ ~r or ~seripti~ ~o~i,g to ~. ~ ~ strut ~s ~ i~i~te
~r J,terlor or ~r lot.
..................................... ..................... I~i~ ~aly ~,
(~ of i~ivi~ si~iug c~tract);
I~ is the ' . .............................................................
(~tr~tor, ~n~, cor~ra~e officer, etc.)
o~ aid ~r or ~rs, ~ is ~ly ~thori~ to ~rfom or h~ ~r~o~ ~ aid ~a m~ to m~ ~ file this
a~l. ieati~; ~at all star--ts c~ta[~ in ~ts a~li~ti~ are
that ~e ~ will ~ ~rfo~ in tl~ m~r ~t forth in ~e a~ti~ti~ fil~ t~.