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30559-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31150 Date: 09/09/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 780 WINDJAMMER DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Nap No. 473889 Section 79 Block 4 Lot 10 Subdivision Filed Nap No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 9, 2004 pursuant to which Building Permit No. 30559-Z dated AUGUST 11, 2004 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 WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to EDWARD C & ANN W VEPROVSKY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 5025 08/27/04 PLUMBERS CERTIFICATION DATED N/A Authorized Signature Rev. 1/81 f Form No-6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOArN HALL 765-1802 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 2.110 of I% 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 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 buildutg $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $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. JC /YI _ 71 2 000 New Construction: Vp _Old or Pre-existing Building: jam,, (check one)/ / { / Location of Property: l6 (7 r�lt' M& `R N,' Ve 70 u7f40/q House No. / Street f� Hanilet Owner or Owners of Property: AV V EQfJ�A fit% Y EPRO V5 _ Suffolk County Tax Map No 1000, Section _Block 00©JjC —Lot Subdivision pp pp / Filed Map. _ Lot: P6mutNo. 3��Jr_/_ _Z _-Date9f�ernut._-Q_-/�" 0` _Applicant: _ Health Dept. Approval: Underwriters Approval: Planning Board Approval: _ Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ _��'oo c,o IS0 120 C_ � Applicant Signatufe �yOF SOUryO 3oss9 ,Z 'rCOUNT1 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ X FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE °� . s INSPECTOR �O.*OF SO(/tyo6 ,3 oss9 z © TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING PQ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: \ DATE %?- �� �s INSPECTOR �•" � 765.1802 BUILDING DEPT. INS [ ] FOUNDATION IST [ ] ROUG LBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION l REMARKS: DATE ®� INSPECTOR Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street • Center Moriches, New York 11934 • Tel: 631-878-3500 • Fax: 631-878-3764 Application: 5025 Date:8/27/04 Issued to: Veprovsky Address: 78 Windjammer Dr Village: Southold Introduced By: Avey Electric License#:2069-ME was examined and approved up to the above date and was in compliance with the NEC Attic 1st Floor Residential❑x Pod❑x Det Gerage Basement 2nd floor Ca nT ercial❑x Hot Tulh Pddtion Switches Receptacles Fixtures G.F I. Range Hood Whirlpool 1 2 1 1 Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon RangelAmps Monoxide Furnace OilSmoke Bell Gas Heat Zones Detectors Transformers Meter Amps Phase Motors 1 Other Equipment: Inground Pool Out,Res This certificate must not be altered in any manner 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. 30559 Z Date AUGUST 11, 2004 Permission is hereby granted to: EDWARD C VEPROVSKY 780 WINDJAMMER DRIVE SOUTHOLD,NY 11971 for CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD, FENCED TO CODE at premises located at 780 WINDJAMMER DR SOUTHOLD County Tax Map No. 473889 Section 079 Block 0004 Lot No. 010 pursuant to application dated AUGUST 9, 2004 and approved by the Building Inspector to expire on FEBRUARY 11 , 2006 . Fee $ 150 . 00 zz�'� C�b" Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD PROPERTY RECORD CARD �(- 0o v OWNER STREET a VILLAGE DIST. SUB. LOT Ww-JCg/ AfI 0 V ' Iovsk 1701S FORMERQWNER Da" z(A,/ C( N E ACR. I / E' S r4,)��n " $ W TYPF BUILDING .,r /�, ��rs t �Peld RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS J Qp eo o arilV 54 [ 3o L , 3+ta oU S m0 /1 . T'4 fi - New wa )Le ladis d-Lae 9 4 ro —L I Z2 -ZU✓%CrC tb VeProvskV � COO AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Vnlue Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total r.. v DOCK M. Y.■M■■■.■■■■■■■.■■■■■■■■■.■ `} I■.■■■EM.■■■■■■■.■■ mom No iA sr s No IMMUNE MOM 0 No mom ME MEMEME MEMO 0 ■■.MMMEMNOMMMEMO.■MO. ..MEMO NINE■■■■■■■■■■■■■■■■■■■Ill■■■■■■Ill No mom 0 ME ME 0 0 MEN.■■■■■M IM-■ 0!E■t0■EM■ME ZZIMCEM, ■E mo No CIUIUVEMI Guallm C■■■ENE EIFETARN IMEMOii�iiiii ■■■■© NMITI■R1®a■IONONE ■■ • ■■MEARN■ml!-=■;:rEM■MML:M■.MM■E■ ■�■MENUMMEM■■■■�ilEM■■MSI■■■EM■M■ �i■■■i■wii■i■iii■i■i■iiM■■■■■u Interior Finish FROM- ���� FIELD INSPECTION REPORT DATE COMMENTS d FOUNDATION(1ST) a ------------------------------------ rA FOUNDATION(2ND) ,m 0 ROUGH FRAMING& PLUMBING }Z _1 INSULATION PER N.Y. b STATE ENERGY CODE 7/7 41 FINAL -7 O� ADDITIONAL COMMENTS �o L z m z m 1 O z m x ) d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT n''j — 9 200 Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey i/ www. northfork.net/Southold/ PERMIT NO. Check t/ Septic Form N.Y.S.D.E.C. Trustees Examined 20A4_ Contact: Approved 7 /11 2000 Mail to: Disapproved a/c ho �3v- 7GGS Expiration 9/II 20 0,6 Building Inspector APPLICATION FOR BUILDING PERMIT Date 20611 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 streets or areas, and waterways. 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 a permit shrill 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 what so ever until the Building Inspector iAues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. 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 removal or demolition as herein described.The applicant agrees to comply with all applicable laws, ordinances,building code, housing code,and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. #LL CONSTRUCTION SHALL CH(7ui s L--7> MEET THE REQUIREMENTS OF THE OCCUPANCY OR (Signature of applicant or name,if a corporation) CODES OF NEW YORK STATE. USE IS UNLAWFUL---PL) JNDERNITERSCERTIFICATE WITHOUT CERTIFICATE (Mailing address of applicant) State wheftMicant is owner, lesse pe Od6er, general contractor, electrician, plumber or builder Cern-J7�'Ac�JP Name of owner of premisesAPPRQ AS NOTED _ (As on the tax roller#e B.P.t If applicant is a corporatt , signature of duly authorized officer FEE: 101 BY: = �M77� �t 5 NOTIFY BUILDING DEPARTMENT AT (Name and title of corporate officer) 765-1802 8 AM TO a PM FOR THE FOLLOWING INSPEQTIONS: Builders License No. is i/7_1-/I 1. FC'JNDATION • TW-1 REQUIRED Plumbers License No. FOR POUREI) CONCRETE Electricians License No. AIN STORM WATER RUNOFF ROUGH - FRAMING 8 PLUMBING Other Trade's License No. PURSUANT TO SECTION 45 10C 3: INSULATION OF THE (C -'i-% v )DE. 4. FINAL -OMPLC- NS' -VCT100 MUST 1. Location of land on which proposed work will be done: CSTRUCt F- L ALL CONSTRUCTI'vt� SHALL MEET THE 7�t) --DR, R6II(0Na1Aa (1F THE C07ES OF NEW House Number Street YORK41MAtNE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. County Tax Map No. 1000 Section fr Block Lot Subdivision wq7� Filed Map No. 2 Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ?i 3>orzs �' 2� �cc8 b. Intended use and occupancy zees, E 3. Nature of work(check which applicable): New Building Alteration Repair Removal Demolition ther Work (Description) 4. Estimated Cost Ajz 4vo.01) Fee --01-6V,60 (To be paid on filing this application) 5. If dwelling, number of dwelling units 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. Dimensions of existing structures, if any: Front >�' Rear 7& ' Depth -3�F/ Height "IS/ Number of Stories 1 Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front /%l> ' Rear / Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ?ESnax „g� 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO >( 13. Will lot be re-graded? YES X NO—Will excess fill be removed from premises? YES ,i' NO 14. Names of Owner of premisesgvx i> vemovsKy Address 7sr) ".,a:, ywwm Dz. Phone No. :7615- G.;5�5r Name of Architect Address Phone No Name of Contractor Address yo mo 9 . >uY. Phone No. 73'/-7GG S 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO2L ITd'19T200 '"k * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 41 jogr' , . ,M 16. Provide survey, to scale, with accurate foundatiou;q AWtpverty lines. 17. If elevation at any point on property is at 6 .I�ju$t)j(q*T j*graphical dat'p�n;stuyey.I-.�,� STATE OF NEW YORK) y0.% '.;300 1G ' COUNTY 0&” being duly sworn, deposes and says that(s)he is the applicant (Name of induddual.signing contract)abpvs"nemed, (S)He is the (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 performed in the manner set forth in the applicatioD MgAe y4"4.,`, .�fl` "re IAIAT?F Swo ttybefore me this ��7--1t,VVrruu, 2f n ti da7of S C Notary Public Signature of Applicant Claire L. Glow Notary Public, State of New Volk No. 01GL4879505 Qualified In Suffolk County Commission Expires Dec.8, c-, FROM :LEWIS 2 NICLES,LTD. FAX NO. :631 765 4096 Sep. 04 2003 03:50PM P1 �.. a ,Ni"'f�r ni ��•"Mf ��f•Y ... R':.'�r` Y:r,.• y . 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'..."e'+W WVY>.,>v E�N''p O• r. >a +Ym T`±�4' e�.'.-.sew^ : sic�sae> Ib'1(32' ..» >>. « s• MAT 3 . . _ ...r .EJi. —•— v > _ m . . 1995 RECTANGLE 6• RADIUS 1%-GROLNDSP1V1'*L' .G POOL MILL BE CONSTRL<TED Of STEEL WALLS SLPPORTING A LNER TILAT N ILL HOLD APPROXINAATLY 21500 GALLO\S Of NATER f'EVCE 'All L BE AT LEAST /' HIGH WITH SFI F CLOSI'`G GATES TKAT RILL NLET TON\ CODES 1 Tr nrJ.nr4T'T" TJTvr rY�Ts� r Y 1 T -LL-� -- �- Applicant/ Date, Owners Name:.. �4� CL . . .0 Reviewed: M/ Architect/ 1 Date Cniineer: Submitted: SCTM M District: 1,000 Section: �� Block: _ Lot:�_ Project Subdivision location: T 1 r $in&le&separate Required cer(frication: 1 Nnt i1/ Req ' Req Zoning Oistrict:�k") (Lot size: ua: _1 (Lot coverage -Proposed ) Req 1 [front Yud Proposed:_`J'*(Siyard �_ Proposed: [Rear Yard ,� 1'ro�scd• I Project Description: G� ENCARER.MM Permit'. $ Q[1IRE'D FOR REVIEW N.A. YM Number Suffolk Cougty Health-Dept. New York State, D. E:C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Piano Elevation??? ��� �6 7 Flood Zone: -- N n