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.
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22831 Date JANUARY 10, 1994
THIS CERTIFIES that the building ACCESSORY
Location of Property 1700 PECONIC LANE PECONIC N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 75 Slock 1 Lot 10
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 15, 1988 pursuant to which
Building Permit No. 17152-Z dated JUNE 21 1988
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 ACCESSORY INGROUND SWIMMING POOL & FENCE AS APPLIED FOR.
The certificate is issued to DIANE DAOSKOSKI
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - JANUARY 10 1994
PLUMBERS CERTIFICATION DATED N/A
ui ding Inspector
Rev. 1/81
]PO]B.M NO. D
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)
N~ 017152 Z Date ....5~1?.a.l 19.C~~'
Permission is hereb granted to:
`~~u.....~.~~~
to .L~r~47.~1~!.li.~.....tZv......~.crGs?C',:4+~•••••.. ..~'.~r......:'~ f:~!"
.~~wf.</Y,.~.-...
.
at Premises located at .......~~0 .........•r~-B..~'f..G.iC..a.........1...
..................................................:-4..cif.,G:~r.....................................................................................
.............................................................................l..................................................................................
County Tax Map No. 1000 Section/'..........~,l..~l...... Block LL.ot No............~.j.~......
pursuant to application dated .....fU...~~ 19Gl+Cl.., and approved by the
Building Inspector.
a®
Fee $.1...Y.® .yr
........:..y/.... .,....::1,1.
ildi ctord~~~/ Z
n~
Rev. 6/30/80
Form Na. 6 ~ s,"
6 f r
TOWN OF SOUTHOLD
BUILDING DEPARTMENT r?
TOWN HALL ~ FG®
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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 irstallatio: from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 19 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-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. ees
_ 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,
• "'dditions to accessory building $25.00. Businesses $50.00.
certificate of Occupancy on Pre-existing Euilding - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4.. .Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
New Construction......../.-ry. Old Or e-existing Building.. 1. C'.'(:u+ _ • . • . • .
Location of Property... l .l d ~ l ~.C'U?:~
~ C-....~ }~:~.~-.........t ~.GO,}V.~. ~ .
House No. Street Hamlet
)nwer or Owners of Property...!?.~~.~.~....f_.1.~',c7Ss~:~,:1~,.,
;ounty Tax Map No 1000, Section ..............Block..... ........Lot......................
>ubdivisionJJ.~J........ ......................Filed Map............Lot...........
.Date Of Permit ................Applicant.............................
fealth Dept. Approval ..........................Underwriters Approval.........................
Tanning Board Approval
equest for: Temporary Certificate..........: Final Certicate........... '
C3
ee Submitted:
C.~ ~aa~3~ APPLICANT
~ C
(516) 765-01802 o~oSpFFO~kcoG
VICTOR LESSARD, Principal 'y< SCOTT L. HARRIS, Supervisor
CURTIS HORTON, Senior y Southold Town Hall
VINCENT R. WIECZOREK, Ordinance p T P.O. Box 1179, 53095 Main Road
ROBERT FISHER, Assistant Fire d ~ 0!~ Southold, New York 11971
'h0,~ ~ ~0 Fax (516) 765-1823
Building Inspectors Telephone (516) 765-1800
THOMAS FISHER
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 26, 1992
Diane llroskoski
Box 162
Peconic, N.Y. 11958
Re: Building Permit # 17152-Z-TNGROUND SWIMMING POOL
Premises: 1700 Peconic Lane, Peconic, N.Y.
Suff. Co. Tax Map #1000-75-1-10
Dear Mrs. Droskoski:
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
On April 25th, 1990 you were notified that your pool had
passed the final inspection, and was advised to return the CO
application with your check in the amount of $25.00 along with
the Underwriters Certificate for the electrical work so that we
could issue the CO.
According to the Code of the Town of Southold, a
Certificate of Occupancy is required before using the pool.
Please file the necessary paperwork immediately so that we
can clear up this matter so that further action does not have to
be taken.
If you have any questions, please do not heistate to call
me at 765-1802.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Gar ~ Fi~~
Building Inspectar
GJF:gar
(Cert. Mail)
o~VFFULK~OG
VICTOR LESSARD ~ ~ Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR = z P.O. Box 1179
(516) 765-1802 ~ ~ Southold, New York 11971
PAX (516) 765-1823 y0 ~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 25, 1990
Diane Droskoski
Box 162
Peconic, N.Y. 11958
Re: B.P. ~17152Z POOL AND FENCE
Dear Mrs. Droskoski:
Our inspector did the inspection of your pool yesterday.
Your pool passed the inspection. I am enclosing an ap-
plication for your Certificate of Occupancy. The fee is $25.
Please return the application along with your check. Also
please send us a copy of the Underwriters Certificate for the
electrical work.
Yours truly,
Secretary
oS~EFOLi(COG
VICTOR LESSARD ~ y` Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR = Z P.O. Box 1 179
~ Southold, New York 11971
(516) 765-1802 N
PAX (516) 765-1823
yo~~ol ~ ~a~~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 11, 1990
Diane Droskoski
Box 162
Peconic, N.Y. 11958
RE: B.P. #171522 Pool and fence
1700 Peconic Lane, Peconic
Dear Ms. Droskoski:
I am writing to you regarding the above permit. You are
in violation of the Code of the Town of Southold. Your permit
has expired and you have never had a final inspection and have
not obtained a Certificate of Occupancy.
Please call our office immediately so that this matter can
be finalized. Thank you.
Yours truly,
r~~ !fie (fee--
Secretary
IEt,D Ir.st°E;..iuN ~~uATE ~ ;;o~rntcrrr~ ~
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FOUIJDATION (1st)
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FOUNDATIOtJ ( 2nd ) -
2.
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ROUGH FRAME &
PLUMBING \
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3. xi
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IIJSULATION PER N. Y. y
STATE ENERGY ~
CODE
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FINAL
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ADDITIONAL COMMENTS: x
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17/ Sz,
7ss-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU ION
[ ]FRAMING [ FINAL
REMARKS:
(r ~/J~
DATE ~ T ~ INSPECTOR ~~'~V
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` J 2 ~ 765-1802
C 1. L BUILDING DEPT.
NSPECTION
[ ]FOUNDATION 1ST ~ ] ROUGH PLBG.
FOUNDATION 2ND (]INSULATION
[ }FRAMING (L]'F'INAL
REMARKS: ~ UI.eY ~
DATE ~ ~ INSPECTOR~~ W ~
1..
BOARD OF HEALTH
+ - 3 SETS OF PLANS
FORM N0. 1 SURVEY .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FoRrt
' TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
TEL.: 765-1802 CALL
Examined r`~/~j/........, 194. IL TO:(3.0•!t'~ 1(002.. ((~;~;p.. .
Approved ...tal¢~!........, 19~~Permit No. l ~~5~~ ~ .,""°,~,°`1."°~.! ~1
Disapproved a/a(c ~ f 5 ~ 4~~~~g~
a BLDG. Dli+'}',
i TOWN OF SOUTHOLD
CCU CY O (BU(~""g Inspector)
APPLICATION FOR BUILDING PERMIT
s
rr y~°@° Date 15~~
~TU 1 ~j~T~~~Cn~ INSTRUCTIONS
~1
~ T p completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, a a e to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
fi. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
sAiall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for iemoval or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housinti code, and regulations, and to
admit authorized inspectors on premises and in building for necessary ins ctions.
~~IMAIIE®IATELY",~ (ignatureoiap~i.~~~`m~~~.acorporationj...
ENCLOSE POOL TO CODE ~ rC.,c) n! 1 G 1 • •
UPON COMPLETION •JG'COri//~ •~,g„/•~• • •~~•L• • • • •
BEFORE "WATER"
• (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
A~' b AS
Name of owner of premises .~/.~/.~?.2... S .~A.S • • • • • • DATA: ~ • S;R k•
(as on the tax roll or es Od
FEE: BY:
If applicant is a corporation, signature of duly authorized officer. NOTIFY B MIG DEPA AT
_ 785.1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
(Name and title of corporate officer) 1. FOUNDATION - TVYO REQUIRED
~ / FORPOUREDCONCRETE
Builder's License No. ........~G4! ~C.~`• • • • • 2. ROUGN - PP.AMIN6 d~ PLUMBING
S. INSULATION
Plumber's License No . 4. FINAL - CONSTRUCTION MUST
BE COMPLETE ROR C.O.
Electrician's License No. ALL CONSTRUCTION SHALL MEEt
_ THE REGlMR6NENTS pF Tt1E N.Y.
Other Trade's License No. STATE CONSTRUCTION 8 ENERGY
CODES. NOT ~ FOR
1. Location of land on which proposed work will be done. DESIGMORCONSTRUC110NEHRORS
~ :7. A.Q ~
C.o•iv~ ~,..~i.:~iv:e l"~:'.~:c?•vl cam...................... .
Ilouse Number ~ Street Hamlet
County Tax Map No. 1000 Section Block ~ • , • , . • , • , • , , , Lot .
Subdivision Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises and i~~nt))e~~nded use and occupancy of proposed construction:
a. Existing use and occupancy ~iuti~:'~• • •F'~"•''•`-e-~ • • • • ,
b. Intended use and occupancy ~~~........~.~"J
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