HomeMy WebLinkAbout24396-z FORM NO. 4 _
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26456 Date: 05/17/99
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property: 3310 LITTLE NECK RD CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 103 Block 9 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 4, 1997 pursuant to which
Building Permit No. 24396-Z dated OCTOBER 2, 1997
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 ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to KENNETH & NANCY DE LOISELLE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-461500 08/07/98
PLUMBERS CERTIFICATION DATED 12/28/98 GEORGE J. BERRY, JR.
Building Ina ctor
Rev. 1/81
FORM NO. f
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° 24396 Z Date ..........V4. ..a..................... 19.!••••�
Permission is hereby gran* to:
...... .... .............. . ...........................
... ...... ..... ........ .. .. ..... .. ..................................
to ......
•••�Grf (IGG� ...
... . . . . :. .z .. �.. ..... ........
..................................................................................................................
.................................................... ... ....... ...................
.. .. ... .... ........
at premises located at ... ................... .... ........ `.... . ....... . rLG� .r.
County Tax Map No. 1000 Section ....1.Q.. ..., B//looc/ck ...... ......... Ljot No. ..1 z ......
pursuant to application dated ..........
..x•................. 19./...1..L., and approved by the
Building Inspector.
Fee $...
.... ........................
Building Inspec*0
Rev. 6/30/80
ruin NO. o
TOWN OF SOUTHOLD
j BUILDING DEPARTMENT
7 i TOWN HALL
765-1802
�---- — -� APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the build
inspector with the following: for new building or new use:
1. Final survey of .property with accurate location of all buildings, property lin-
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 fo �-
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contain_
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buil,
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
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 applica
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 Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - .251;-
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. .. . . . . . . .. Old Or/Pre-exisying uil ng. . . . . . . .
Location of Property AAq. . . . ..Gr.7�l:..Nca? . . ... . . . . .�4*Jt�B�r yr. . . . . . . . . . . .
House No. Street
�� Stree_ttJ Hamlet
Onwer or Owners of Property.. . l�< +�l�C ll+ .�`l ti�c . . .5?4!pl s.� 'J . . ... . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. .. . .. . . .. . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . .
Subdivision. . . . ... . . . . . . . . . . . ... . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . ot. ..�.�. ..��. . . . . . . . . .
Permit No. 2�JY -.Z. . .Date Of Permit. . . . . . .. . . . . . . . .Applicant. ./ C^�4).d �: . .GL+LIS u
Health Dept. Approval. . . . . . . . . . . .. . . .. . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . ... .. . . . .. . . . . . . . .
Request for: Temporary Certificate. ... . . .. .. . Final Certicate. . . . . . . . . . .
r
Fee Submitted: $. x .`ao . .
APPLICANT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: l ,
DATE ' �� INSPECTO
��o�Og�lfFOt�eaG�
Town Hall,53095 Main Road y Z Fax (516)765-1823
P. O. Box 1179 .+- Telephone(516)765.1802
Southold,New York 11971 �if� a0b
1 � �
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE: I;Zl�� 'g
BuildingPermit No.
Owner: J&L 1S L(�
(please print)
Plumber: C9Cc> 2$ r 'V. Fe_.r'r ,,p
(plea print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(7DA&ers vr
ture)
Sworn to before me this
day of be'�a, 19-
8.4kpAA c_.
Notary Public, County N'f1rYNan�sie FIwY
a7AMltf
Ilt-�w�
�fy�l
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE, 1
100@121 BUREAU OF ELECTRICITY
7 40 FULTON STREET, NEW YORK, NY 10030
Date AUGUST 07,1998 q (icoYron ,Vo. onfite 15073597/97 N 461500
THIS CERTIFIES THAT YERPSIT NO. 24396
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
KEN DeLOISELLE, 3310 LITTLE NECK ROAD, CUTCHOGUE, NY
in the following location; ❑ Basement ® 1st Ff. ❑ 2nd Ft. Section Block Lot
was examined on AUGUST 03,:'.998 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT I OTHER AMT. K.W. AMI. K.W. AMT. K.W. AMT. K.W.
4 6 1 7 1 3 1 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. OIL N.P. GAS N P. AMT, NO. A.W.G. AMT. AMP. AMT. AMP3. TRANS. AMT. H.P. SYSTEMS
pMT. WAii3
NO.OF FEET
SERVICE DISCONNECT NO.OF S E R V I C E
METER ry0.OF CC GOND. A.W.G. A W.G. A W e
AMT. AMP. TYPE EQUIP. I ®45V I 0 SW 9 0 SW 3 0 4W PER D OF G0.GOND. NO.OF lIILFG OF HI-LEG NO.OF NEUTRALS Of NEUTRAL
OTHER APPARATUS:
PADDLE FAN-1
WHIRLPOOL BATH-1
G.F.C,I:-i
TRACK LIGHTING:-8
PAUL R. BURNS LIC.#3897- L
PO BOX 1061
SOUTHOLD. NY, 11971-0932 GENERAL MANAGER
11
NPer _
This certificate must not be 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 IN ANY MANNER.
%A
.4
cz
Town Hall,53095 Main Road
P.O. Box 1179 Fax(516)765-1823
Southold,New York 11971 A Telephone(516)765-1802
q J*
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
May 4, 1999
Kenneth Deloiselle
3310 Little Neck Rd.
Cutchogue, NY 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file. ) $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT #— 24396-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
C
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0,= PiZOPEP-7-Y MUTHCRIZEP ALMADON 01 AD0fftQA
"oqoT JLOINIS SURVEY 15 A VIOLATION Of
WECTION 72N OF THE NEW TOM STALE
?,PV.CATJON LAW.
SeEYd COPIES OF THIS SU"FY MAP NOT M=Sq
KEAIAIPTH INANCY DELOISELLE VE MND MVEYOrS INKED StAt Ot
fM&OSSED SEAL SHALL NOT BE WNSIDERED
AT IQ PE A VALID TRUE COPY.
rIUARANTEES,IK�rATCD%:KnN SMALL
C PKY TO THE PERSON FJR WHIM THE SURVEY
0 PiEPARED, AND ON H!S E- TO T"
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TOW14 Oic SOUT-HOLD,IV Y IME COMPANY, GOVERNMENIAl AG1.11
FENDING INSTITUTION LISTED
(0 THE ASSIGNEES Of WE VNOING IN'
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MON/GUARANTEES ARE NOT IRAN.4
M ADDHHOHAL�571--' w�-
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on an� ro�er-ty
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH P BG.
[ ] FOUNDATION 2ND [ ] IN TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE l G INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROdrxH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ l FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR aJjA
765-1802
BUILDING DEPT.
INSPECTION
[ FO DATION IST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE AAC-H--IMNN�EY
R ARKS:
DATE /C D-� 7,NSPECTOR-:::�"
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ` ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMAR
y
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29AZUTMORLM ALrtuuuN Gx ADompEE
E ;.I%✓C Y�[wi F02 19 THIS SURVEY Ls A VIOLATION Of
IK'EwN 7209 Of THE NEW YORK STATE
,, ` NNETH a �N,4AjcY /DELOISELLE VABONUW
J rONES OF THIS SEMWY MAP NOT CSARINQ
VNE SAND SURVEYOR'S INKED SIAL OR
�• _�_ -__ __.__ ._. _____-._�_. 9MI1055ED SEAL SHALL NOT RE CONSIOLdED
(/^ GT G dR AE A VAUD TRUE[OPT.
cr1/{ V rG HO�UG• T+UMANIFFS IN:ICATED H_TEON SHALL a"
'L•
° MY TO THE PERSON EOR WHOM THE Su°vEf
T�/7^. U MEWED, AND ON Y.:S ESHA:f TO THE f
OWN �� S o o : f'�QL D'/V y ITILE CO/MANY.GOYERWfNTAL AGENC. ....
SEEDING INSTITUTION LISTED HT:E-0N, w� i
•- �_ _ LO THE ASSIGNEES Of THE LENDING 'Z'
TNTION,GUARANTEES APE N:3T TRANSE' ++ 1
M ADOITIONAL ItL 7'1n '
OWMEEL
= r f S✓oran}Ef;l w 777g
T.fIG -1fP
1
om aro✓ .%rcr�r a Pv:thir. ;✓d' ��. as veyFd Cc1:oik•r 210, 1=70.
BOARD OF IIRALTH . . . . . . . . . . . . . . .
PORN NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
_--- - TOWN OF SOUTHOLD SURVRY . . . . . . . . . . . . . . . . . . . . . . . .
IMlLDINC DRPAnmurNT - C111:CK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN IIALL SEPTIC CORM
SOu'1'ItoLD, N.Y. 11971
TIQ.: 765-I1f02 NO'fTFY:
CALI. . . . . . . . . . . . . . . . . . .
liocniiixxl. ...!� HAIL TO: . . . . . . . . . . . . . . . . . .
Appieved _Ci. .A...... 19417(.. Permit Nei ............ ..
Ulsnpproverl arc ......................?LICA'nOIN
................................
...................................... ..�.../f//q
n21 bisioector)
A POR Itummuc, Fiti i'f
..Date. . . . . . . . . . . . . . . . . 19. .
1 NSTROCT IONS
t
it. 'Illus apldicaLion nest be ctxlyfletely tilled in by tyMirl Ler or in ink,i;iO sulxnrtted to the Buiidiol, )nspecto
:1 rets of plana, accurate plot' Irian to scale. Fee according to schedule. '+
b. Plot plan allowing location of lot and of Imildinga or premises, relaticxulnip' o rxljoining pronisen or lxdolic
::beets or mens, and giving n detailed description of layout of properly mist lie drawn on the dingran which is lom t.
Ibis viplication.
c. 'file work cmered by thiN opplication my noL lie comiaoced Before issmince of Building Permit.
if. Ulxxl allf,rwval of this alolrlicatior, the Building Inspector will isrnue a Building PenniL to the atyl icant. So
lie"ilit sl14111 he kepton tine loranises available for inspection thi-vogllo t the work.
e. No lioildiog sliall be occupied or used In wloole or in lcrrt for arty pNrixose viiatever until a Cer Li(ical.e of
Occupancy shall have been granted by the Building Tnspector.
I
Al'19.I(:A'1'I(N IS IEIMIIY ME to tine Wilding Depirtnent for the i.nmunnce of n Wilding Permit filo-mmot 10 the
Iklilding 7.rxoe Ordinance of Ute 7txm of Soutinold, Suffolk County, New York, aril other applicable I,liws, Ordifinmen or
Itcgulations, for tine Construction of Imildings, arkliLiuos or aheratiais, or for remwal or (10,01 Mon,.an herein
descrilx:cl. 'the applicant agrees to canply with il.lalifAicable lmcs, Nrdinancen, building cote, housing code, and
regulations, mid to aliiil: authorized inspectors ou limnises surf in Ixuilding for Necessary inapectious.
...... ................................ ........... .
(Siglialure of riirplicant, or nau.i, if a cotIvn':d io
............ ............................ ... ......
Muting address of applicant)
SIale wlielbe-r applicant: is owner, lessee, niteut, archilecL, engineer,I erleral contractor, a .ctricinu, pludar or Ixi
��
... .. ... ...................i. ..,.....[./......r..+..,..1.._..(.,.....-....J....... ...... ...................... .............
tl:n.e ul' as x:r of:•pronises .lt.P/.h41P_(1[I-.> .....-..'........................... ... ..... .. .
(as on the tax roll or Intent deed)
ll' npplic;mL in n cotporntio, nignaLure of duly milliori?cd offi(er,
.... .. ... ..... ....................................:......
Mux! aid I.it le of amlxrrate officer)
� 3� 3 - H
Builders License No. .......................
Plodiera License Ho. ..... ....................
Klect:ric.icmn license No. .................. ....
r
Ul6e.r '1'rixk's Li cea:.e No. ............ ........ �
1. 1twntiou of Im.l on which prolxoned work will Ix! ..... ... ... ... ... .......... ...... ...... ........ ... .. . . . .
...iL !�+I [ p
..fi.(.... . ... ........ ...... ..........Cf."
ILnrre N,mdier Street: O� lkxnleL
QiuuLy Tax Kip Mo. I(XXI Section ...`,9. ...... 111o:k .../.......... .. InL 112,........,-
Suklivision .................. .................... Filed T4np Ido. ...... ......... Int ...............
(Nine)
2. Stale exist iog u!ie and cxxvpmx:y of pre+ni nes mx1 inter Kle(1 use cal occulamc:y of prnlx)sed construction:
a. Rxial iug use all oc:c pnocy "¢"............................................................
6. Int axka use and ocarhmx:y .v�.... ...7....�...... ................. ...,r<ts,x1 .. ..y..,.,........
wi�lwAUj
'l. Rd uu: of 7n) ( ((lx!ck rArlcll s{Kd ic(761e); tknr lk1[ldhq; luldlL full .,. ....,,.
MIN)ir .I..,,., ,... Ilea(lonl Ikm.11 ikon ,,, ,,. I. ..I. Outer 4)lk . . .. ..........I. ...,,,. .I ... ..'
4. fiat.ivmt ed Gin I: ....... . . .... fee .,
........ ....... . .. ..
++
(it) Ix! Iwid oil filing Ihio npplicati(xn)
'i. If rAxa Ilog, r..drer of rk+el IIng olliln . .... .. ... .. IAn l x!r of (AA!I llnli units ext eneh fIoor .. . . . I.. ... ... ..
If Ilnr age, r.alxer of earn ...11� ...... ..................... ...
6. Ir Ixalli,ean, r(.merc.inl or nnlxed occulunx.y, ulx:(:il'y nnlrtio I'M extant of curl tylia of tine.. .. .. . ....... ... ... ..
7. Ilia.!tintexln of extallug aLrtx:torea, if any: Pr(xrl.... ...II..I...... Item ........... Depth .....• .. .........
Ik!Il;hl. .... .(( 'r(..;...I....,.... Il,.dx!r of Scor fell .. ..1............... ...
I liaeoniexrs of.wue ulna:ture with nllernl'Acon or ixklil:loon: Front: . . . .. .. . ....... Item ........ ..... ..
Ikgdh . ................... Iiei1;J(L . ...... ... .. ...... .. IAnlxer of ;dories .. .............
11. Illaenui(x''{, Af` ent he lu:w ccxrntru:l.ioo: PraLL . ... ......f.. .... W.-tor .. . . . . ......... fleplIt . ...... . .. ... .
Ik!itfo: . ..... .............. ..... llnlatr of fi toriell .. .. ................
9. Size of lot.: Flool: .. .................. Iloar . . ... ... ........ 11101 /r.. ..
IG. "lie of Rochase ...I......�.QV �... . Wuie or For wr anter ... Qyrt -d U
II. 7<xxe or tote district in tAllcdt.pronines are nihalteil . ... ........... ............. ....................... .. . ....... .
12. - [axon proixa:ed coosI:I1x:l.iOn violate ally zrxllog )I", ordloatwe or ielpduLion: .. j.................
I1. Will lot. ItIa regrikled .... ............ Will ese.ess Fiji ie Teamed faun pnrxrdneut YES
I ,. Ihnen of GQaxlr of rrem(ues ... .!`ti'1':'... d ...�..(d /uklrcnn ..... .f...� y1 I / r ,
r i n.. Y w 33(D yl.' �.d. Ilunxn Ike.
III f{K! of Architect: ......., ...........I...... Arklresn V.L-e 3?... ...............:. Ilxxne No. ... ... .. .. .
IIr.1e of Gxltr'nclor .. ................................. Mklreas .... .... ... ....................Merle Ito. . ... . .... .
I'i. In Ihin prolx!t Ly within 30(1 feet of.in Li(htl wtlsrxl? * YF.a ..... ..... ill .....
*IF YI?S, :XASl1YRll 1"m -Imisiles issmil-V my 11{6 lil'(plium. r
PLOT II lAGRAII
II)CIDLC clearly Nxl distinctly all Ixrlldiogn, 1A1el.Ler exisLing or proposed, nrxl hvilents all net-hack dlatelinionn
fru,, properly lines. Give atreot nix] hlrx:k u.drer or (kescriptioo uccording to (leeed, nix] enixx' street nines aril Ilxlicnte.
(Arcthcr interior or'enrrx!r lot. '
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(32)
l;fAro. tee tx l
(XAINIY (H'
. . ... .. . .. ... ... ........ ........... x!init duly memo, dels)nes aril nnyn that lie in the appl i(rnd
(Iluie of irxlivldoal nigning coot.ract)
nlxrvc una:d, .
Ill! it, Ito: .. . . .. ... ...... ... ... ...... ...... ... ... ..... . .. ... ..
.... .........•............:..... . ..
((ln a.nwtur, n{lent, corlwale officer, etc..) .
of said exa x!r tit mrx:rx, aixl in duly oothorize4l to Ixufonn or Irnvo Ixu'fonrrd the paid arnlc JIM to ardao urxl file Ihin
appi icarl.iva; Lhoi. all aL:o.L+nentn axdnilx!d in Thin fill[)] icatiou fou Lioe Lo the Itimt: oC Ilia hlxnle(Iga taxi Ind ielonxl
Otto the mo k will Ixe Ix!rfotnerl ill iho nca,,xanet: lot ill ill the oppt ienl_iun filed tiloteaith.
;Anna
It, ly,!(p.(....no ihl!t
ikd ary IN-bl c ..
�... ... ,. ... I.
�Ly - (tiigu,rt ire of Appl feast )
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MArzN YXIST+Mk� Gsrn"eXS ✓ /{ - ' _ _--___ _ ._ .
-jFg" w•i' x� edFFlrS
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PrP6 T y�(I�t{vNLn \�Ra,E:LE �,r-.!si.MtT
`-- FRwr i,5' �ro ail wwr .ca
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A7iNIfJE .Sii c.,w..W< •<a...n - � y ".�,.,�,
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T C/hK• Ri-oiSfA-uar? _-_ __ __�.�'T/�I-F' � �A-'rnR- Iw.1�7keA,�r-{S LL...,.V _ -_ - __—____ -.- ___ _ __ - .. _
F %2"cor s+uFr.a*,7- ua g2 '/INK Li ti (crAa.+az manna o i v l uu 1 C Kd *?�
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