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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-30934 Date: 05/26/05
THIS CERTIFIES that the building ADDITION
Location of Property: EQUESTRIAN AVE FISHERS ISLAND
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 9 Block 6 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 18, 2005 pursuant to which
Building Permit No. 31143-Z dated MAY 18, 2005
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 DECK, ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to PHILIPPE KRAKOWSKY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
~uth riz Signature
Rev. 1/81
~ n L5 7d;, 1, -I' It'
Form No. 6
TOWN OF SOUTHOLD I
BUILDING DEPARTMENT z MAY 2 5 2M
TOWN HALL L _
765-1802 i . w7
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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.
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. Fees
I. 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 Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. ~oZ 3 /o New Construction: C{~ Id or Pre-existing Buildin (check one)
Location of Property: rrlufstr,th 4l /lsl4l -CSLWb
House No. Street Hamlet
Owner or Owners of Property. i e )Ct r`ko~a-S lie 1
Suffolk County Tax Map No 1000, Section 1) O IT- Block (p Lot 7 _
Subdivision Filed Map. Lot: \
Permit No. y3 Date of Permit. :5- / 0 5'Applicant: PAT-21(l, 6rc i nIP ~C g n1 1
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for. Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ a S
Applicant Signature
Co X3073`{
05/25/2005 08:01 FAI 631 788 7798 1IT::'.' JVE 2002
J
7rs-isos
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION iST [ ) ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [4-1-11WAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE ~ -~l •3 INSPECTOR L
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. 31143 Z Date MAY 18, 2005
Permission is hereby granted to:
PHILIPPE KRAKOWSKY
90 ROCKLAND AVENUE
YONKERS,NY 10705
for
CONSTRUCTION OF A DECK ADDITION WITH COVERED SCREEN AREA AS
APPLIED FOR. THIS PERMIT REPLACES BP 27473.
at premises located at EQUESTRIAN AVE FISHERS ISLAND
County Tax Map No. 473889 Section 009 Block 0006 Lot No. 004
pursuant to application dated MAY 18, 2005 and approved by the
Building Inspector to expire on NOVEMBER 18, 2006.
Fee $ 150.00 , T
ut orized S' ture
ORIGINAL
Rev. 5/8/02
~0 GG
Fax (516) 765-1823 y W x Town Hall, 53095 Main Road
p P.O. Box 1179
Telephone (516) 765-1800 g V Southold, New York 11971 % SOUTHOLD TOWN
LANDMARK PRESERVATION COMMISSION
July 23, 2001
TO: Southold Town Building Department
FROM: Southold Town Landmark Preservation Commjs<on
RE: Equestrian Ave.-Fishers Island
Tax Map: 1000-9-6-4
The Landmark Preservation Commission has reviewed the submitted plans
for the addition of a larger deck on the above mentioned residence. The
Commission approves the addition.
Thank you.
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FORM NO. 1
TOWN OF SOUTHOLD FEB 2 3
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971 TEL.: 765-1188002~~
Examined 3 114'3 Application No
Approved C ~D
9 . Permit No............ 3 ar G 3t1.
Disapproved a/c A0
..c.
(Build' g 1 Spector)
APPLICATION FOR BUILDING PERMIT
.
Date 19..
fE8 /9 zw I
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildin_
Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street
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.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permi
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 Occupanc\
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th,
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
n gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t,
admit authorized inspectors on premises and in buildings for necessary inspections.
~VlIILA.Cn,hf (1t~cant, or name, corp
(Signature of api .4tQ....g~~r
oration)
~o BOX 3 - ' /-/S"CeY ,ZstHNt)/Ny /D
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
6C/vc61 ou72r~e e e-
Name of owner of premises . L/SH A JJ-) le t~/~/ • %(/LA K GLVS K/
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No.
Plumber's License No. -P
Electrician's License No.
Other Trade's License No .
I. Location of land on which proposed work will be done .
Ej .C~ Si 4tE ............t/t,/S... S/ANv..,. !Ny.... 3 9
House Number Street Hamlet
County Tax Map No. 1000 Section 0.0..9 Block v........... Lot....... 7..........
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Wa'f/Z 00.tiP/Erg sl Jt~-'C'E
a. Existing use and occupancy U t
r/t 1) 7-6. Hm5_
b. Intended use and occupancy ..y US T~ LL CI ~7 coy c F l~~ LK ITT fk . . .
I
Ml~/ZL?6Mi.U7s D/-j 6~_X15T/ NL/_ v C-'\
I
3. Nature of work (check which applicable): New Building Addition ...V/1'.... Alteration .
Repair Removal Demolition Other Work
~7 D D U (Description)
4. Estimated Cost........! . Fee
t X TES fc e (to be paid on riling this application)
5. If dwelling, number of dwelling units . E?t K , , , Number of dwelling units on each floor
If garage, number of cars .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use
7. Dimension] of existing structures, if any: Front Rear Depth
Height (0 . )9ff !A(-- ' 4.. Number of Stories
Dimensions of same structure with alterations or additions: Front a? ~ Rear
Depth 0D Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number ofStories
9. Size of lot: Front Rear Depth
10. Date of Purchase N ne f Former Owner
11. Zone or use district in which premises are situated eQ
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be regraded /V1 Will excess fill be removed from premises: Yes No
14. Name of Owner of premises Address Yor:r-ces lPhone No.~l~`f'.Rla1`
Name of Architect Address Phone No................ .
Name of Contractor li1~~sH CourPgerfue , . , , , Address &Pf0 J?~ r.NV... Phone No.(r~'/.:7S1~-~>>`~. .
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK, S.S
COUNTY OF ..50SFN/-.K. , .
- .0.1q.40. MF Q.. K.. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the 0.0.A.-.1.7-Pe . l. (2TG~
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be per ed in the manner set forth in the application filed therewith.
Sworn to befthis r- t
Ru
day o A
T5>,.;
lF^ t-tL County
Notary Public . . . . . . . . . . . .
THOMAS F. DOHERTY JR.
.
Notary Public Stale of Now Ynrk Iure of applicant)
No. 4806559
r~
Ousl;fiaa in Sutfol Sutlolk County (Signat
Tcfm Expires 1231491~
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/ MON.
POLE
N/F
/ ROWLAND OSWALD
ET-AL
NOTES:
/ :.PPP C SEPT
LoCnno ATS w ON. I COORDIHLIE DIST4I4CES ARE IJEASUREE, FROM 11~ COAST &
6E0DEfIC SURVEY TRIAHGUL4TI0[J STATI;dJ "PR~jS"
POLE PREIPERTf IS L6CATED III THE TOWN OF SUIJTHCLD, C01-161T1
OF SUFF?ELK, DISTRI',T 1000, SECTION 00'?, BLO,--K F., L'JT
#4,
N = 1d532~ w = 3236 20
3 IOTAL ARFA = G 31E A:RES
MON. (BURIED)
^'Lry rybo
b
5 O s, N/F
/ 2p HENRY L. FERGUSON
)N
N/F MUSEUM
HENRY L. FERGUSON
MUSEUM
I.P. SURVEY MAP
PROPERTY TO BE CONVEYED TO
MON.
LISA POSEY KRAKOWSKY
nl- LI,SIy M ~rq. O
& PHILIPPE KRAKOWSKY
~G
Y 20 20 Id 0 20
A GP A I EQUESTRIAN AVENUE
GRAPHIC SCALE IN FEET l FISHERS ISLAND, NEW YORK
GUARANTEED TO, "
REVISIONS 111I M - CHANDLER. PALMER 6c KING
LISA POSEY KRAKOWSKY PHILIPPE KRAKOWSKY DATE DATE DESCRIPTION ff' Eff
CITIBANK, N A Y, = Archi a t.,e Enginaenng and Surveying
COMMONWEALTH LAND TITLE INSURANCE COMPANi 110 GNON)WAY NMWW. M Op]Gp 140-!!!Y =7 FM
IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR
TITLE SURVEYS OF THE NEW YORK STATE LAND TITLE
ASSOCIATION.
DATE DATE, AUGUST 19, 1998
SCALE: SCALE: 1" = 20'
SHEET SHEET 1 OF 1
0
io -
a
12'
i
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- - - - - - - - - ~
II /
Proposed Deck Plan i~ I
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win ar`: C ~zx
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xY'., ~ :.'anti
CticU9 ANCY
II USE IS UNLAWFUL
WITHOUT CERTIFICATE
- - OF OCCUPANCY
UNDERWRITERS CERTIFICATE
/F REQUIRED
n f' 31143 re
MUM M NOTED
DATE: 12 OI B.P. k
FEE: DE
LIE NOTIFY BUILDING DEPARTMENT AT
786-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2 ROUGH - FRAMIW & PLUMBING
3. INSULATION
4. FINAL - CONSTF'w4TICN MUST BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
Proposed Deck Elevation 3-, Proposed Deck Elevation CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS
\2
Out Of Time Architecture
8 EAS' 8 EAST TWELFTH STREET, 6TH FL. NEW YORK, NEW YORK 10003 TEL (212) 206 0642 / FAX (212) 243 6420
KRAKOIA KRAKOWSKY RESIDENCE (THE PRETTY HOUSE) FISHERS ISLAND, NEW YORK1
DECK/SC. DECK/SCREENEDPORC 5 ~,aNe N. % SCALE: 11/4^
Oc[ober2OW October 2000 A01 CHITECT: Alemandra Dim
o'48za Q 9T~OF NEVJ'(O