HomeMy WebLinkAbout17753-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19484 Date NOVEMBER 1, 1990
THIS CERTIFIES that the building 6NE FAMILY DWELLING
Location of Property 475 WILLIS CREEK DRIVE MATTITUCK N.Y_
House No. Street Hamlet
County Tax Map No. 1000 Section 115 Block 17 Lot 17.15
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 12, 1988 pursuant to which
Building Permit No. 17753-Z dated SANUARY 11, 1989
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 GARAGE AS APPLIED FOR.
The certificate is issued to SAL TUSA
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-2I-NOV. 1, 1990
UNDERWRITERS CERTIFICATE NO. N-098358 - OCTOBER 20, 1990
PLUMBERS CERTIFICATION DATED NOVEMBER 1 1990- SAL TUSA
~~V
Building Inspector
Rev. 1/81
Fosas xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N o li ~.7 5 ~ z Date ...~.u~.~:yw.~.....ll I9.,~2..9
Permission is hereby granted to: U
..4?~Y.~.~r........
to ..4.eo.~c~r~cis~!."..0.r...~....
CG
.~.sl...,...4-°... ~ ~ ..a
•
~ .
ct Premises located at ...~:.Z.+~......`ri~.,~KX~v~.....4,~-4:R.1:~-..~.....r ..............~)..ktAA~f.4~r~.........
i
Cvunh~ Tax Map No. 1000 Section~....~.~..~........ Block ......L.7......Q..pLot No.....J.7~.~.~......
pursuant to application dated 194..4..., and approved by the
building Inspector. u
Fee S••~~•~•..~
..~..Cl.?!..D.lr...
.
Building Inspector
Rev. 6/30/80
•
' TOWN OF SOUTHOLD
BUILDING DEPART2IENT
TOWN HALL
SOUTIIOLD, NEW YORK 11971
765 - (802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE / r .
.y ...OLD OR PRE-E%ISTING BUILDING......VACANT LAND....._..
HEW CONSTRUCTION
Location of Property...,~.7+~....it'!~r'L=~~ `"~~~^..'~''•~~~./~"+~•-c~......
HOUSE NO. ..~~/./,~//--JJ^^~~ STREET HAMLET
Owner or Owners of Property.~~ ~'.l.`:~~
County Tax Map No. 1000 5ecCion Block Lot ~~:!'f .
Subdivision~C~~~~~KK4!~1~::y!/'J~<T~+~'FG~J)d//j/~Map?~,~ .Lot~C~~~//~~~~,,...... ~~,~~pp
Permit No. ~~.~j/.~` ..Date of Permit .!,l.!~~~.Applicant .Y!':m~ ./.!:.J/Z...... ~
Health Dep[. Approval Underwriters Approval._............
Planning Board Approval
Request for Temporacy Certificate Final Certificate
Fee Submitted: $
APPLICANT..
rev. 10/14/88
~•uo~ ~
cow l9~%y
' ~IZr,:T~,` TEL.7C,5-180?
`p`?,,{{~~,~ ~0~~ s T0~'N OIL SOUTIIOi.I3
/~ri-}jE;,`;y~~ ' '~c OI~I'iCL OI' BUILDING INSI'I:CTOR
o ''~G.. [~B' s'j~+° ~ I'.O. UOX 1 17 9
P''"~'r'"~ ~ TOWN IfALL
Qa J,.v~l
~ ~ SOlITIIOI.D, N.Y. i 197 i
Y
October 12,. 1990
Mr. & Mrs. S. Tusa
475 Willis Creek Drive
Matttituk, N Y. 11952
'1'o S•ihcm This, ' i~9ay Concern,
We arc unable to complete your Certificate
of occupancy because oL- the fo1lo~~iny reasons.
An application for Certificate of Occupancy
is not nn fil.c.
Dlo Underwriters C~:rtificate on fi1c.
lg~ '['he chccA: .i:;(~acck~lxkas~/not on file.) $25.00
Dto fleal.th Dept. 1lpproval on file.
No final insl~~ect:ion hay becu made.
Plc;a:>r, contact our office on t}xis matter.
Thank you for your cooperation.
ISu.il<lir.cl Pcrtni.Y. 1 7 7 5 3 Z
Duildiny Ocpt.
~`'"gg/ tlo Plumber ;;older Certificate on L-ile.
! al.l pormiL•s involv.i.ng plumbincl being
~v 11~
.issued after :1pri.1 1,1)84 )
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TEL. 7G5-1802
Oc~VFFOG`-~0~' TO'4°?N OF 50~3'TIIO]LD
" •f , , , ~c OFFICE OF BUILDIPIG INSPECTOR
~ P.O. BOX 728
v' ~ ~ r" TOWN HALL
y0~~1 ~ SOUTHULD, N.Y. 11971 ,
C E R T I F I C A T I O N
Date ~ b
Building Permit No.~~~~7~!
Owners~jQ~ ~t/~si9
(please print)
Plumber
(please print)
I certify that the solder used in the water supply system
contains less than 2110 of lg lead. ,
_ ~ (plumber's signature)
Sworn to before me this
~_day of IJ O b-Pr~(
19 Q U, Notary Public `
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JOHN D. STRODE
ATTORNEY AT LAW
BII EAST MA[N STREET
P. O. BOX 149
RIVERHEAD. NEW YORK 11901
618 ]2]-2322
Janaury 6, 1989
Mr. Victor Lessard
Southold Town Hall
Southold, New York 11971
Dear Mr. Lessard:
Permission is hereby given to Sal Tusa to use the southerly
most part of my property which currently serves as a right of
wav and as access for Martin Suter.
If you have any further questions, please do not hesitate to
call.
Very truly yours,
j
f~
JOHN D. STRODE
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BLDG. DEPT.
TOWN OF SOUTH0ID
water supply and sewage disposal systems for LOT
this residence will conform to the standards of (,~e~idcis..~~
the Suffolk County Department of Health Services.I,~ ~ -y--/ZZ v6~
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6~~,~! 765 1802
/~1 BUILDING DEPT.
~I~
1 NSPECTtt~?N
(]FOUNDATION i5T [ ] ROUGH PLBG.
(]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
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DATE INSPECTOR _~'~-L-G~~J
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765-1802
BUILDING DEPT.
rNSPEcTroN
[ ]FOUNDATION 1ST [ ] ROU H PLBG.
[ }FOUNDATION 2ND [ INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: / ~9~t1/'
-
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DATE r INSPECTO
~77~~3
765-1802
BUILDING DEPT.
[ JY FOUNDATION 1ST ( ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~~G~n d~ti-
DATE ~ ~ / INSPECTO
17 ?~,3
765-1802
BUILDING DEPT.
INSPECTI®N
[ ] FF UNDATION i5T [ ] ROUGH PLBG.
[rJ FOUNDATION 2ND INSULATI
[ ] ON
[ J FRAMING [ ]FINAL
REMARKS;
DATE ~ 7 INSPECTOR
l 7~~~ ~sS-~so2
BUILDING DEPT.
.INSPECTION
[ ]FOUNDATION iST [ ] ROUGFI PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ~ FINAL
REMARKS: y~~-d~ti)
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DATE D INSPECTOR
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vss-1802
BUILDING DEPT.
f NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ INAL
REMARKS:
DATE ® / Cl INSPECTOR
1
BOARD OF HEALTH
3 SETS O.F/PLANS - • . • • - -
• FORM NO. t SURVEY . .
TOWN OF SOUTHOLD CHECK ~ 5.40..
BUILDING DEPARTMENT SEPTIC FORM
TOWN BALL NOTIFY
P,OUTHOLD, N.Y. 11971 CALL ?•^0--y". y
TEL.: 765-1802
MAIL T0:
Examined ~.LI. 19$9.
Approved 19 ~9. Permit No. ~ ~ ~.7.5~
Disapproved a/c
...................................r. u-'.,........
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ,~~~OG 19
INSTRUCTIONS s
a. This application must be completely filled in by typewriter or in ink and submitted to the Building 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 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.
ry. 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 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
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 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.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State w~h}ether applicpant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~I~~/i
Name of owner of premises ~~~..,r•" •J~ .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUS SUFFOLK COUNTY LICENSED
Builder's License No. ~ .
Plumber's License No, l~+?9•~e I ,
a '
Electrician's License No.Q~i)~~~ ~ •
Other Trade's License No .
I . Location of land on which proposed work will be done. /.~/%~.CIC./.~~,r4°~iC°. ~/.~'!~,.~7.`~,rA~•~lld~,.
House Number Street r Hamlet
Ccunty Tax Map No. 1000 Section .J~~........... Block / Lot .,i .
q' i p Lot
Subdivisioi>~,A.jO.L~./.'tj0(R.~.. lbw'. ~~G,~~led Ma No. ! ~
(Name)
2. State existing use and occupancy gof~premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . ~!~/+Y~~!?Y..~~ 13/~ .
b. Intended use and occupancy ~C~~'/,~~:~'N.~,~G...~~.~'!~G~a~'1!~r .
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THE NEW YORK BOARD OF FIRE UNDERWRITERS ='~It~~• ~ ~
I rllll`r_~ ~f
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Do[e C)(:'i1tINN.~i !i9, 1`9 ii°tl Application No. on file ~-e~(a1MFi$'F(fS?J )S (7 d3~`}`~~?{
THIS CERTIFIES THAT
only the electrical equipment as described 6ebw and introduced 6y the opplicont homed on the obove opplfcotion number in the premises of
'I`t?;i74r ,;AS., HT,I,E,!`3 Ic P;i;4, {)f{, 1§A't"P €'1'(y(,"'X.r 7~{. `Y~
p~ ~ i
in the following location: ~ Basement LJ 1st FL 1=1 2nd F4. t>~L Section Blork Lot
wos examined on and found to be in contp(ianee with the rerluiremenls q(this Roard.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLE$ SWITCHES INCANDESCENT FIUORESCENi OTHER AMT. K W AMi K.W. AMT. K.W. M1i K W AMT. H P.
)I „A
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W Oll H P GAS H. P. AMi NO. A. W. G AMT. AMP MIT. AMPS TRANS. pMi. N p SYSTEMS pMi WAITS
NO.OF FEET
I {d)
SERVICE DISCONNECT NO.OF S E R V I C E
AMI AMP TYPE METER IgTW I,6'JW 3,9'~W 3,9'4W NO. OF CC COND A W G. A W G A W G.
EQUIP. PEP % OF CG COND NO OF HI-lEG Op MI LEG NO OF NEUtRAlS OF NEUTRAL
OTHFR APPARATUS:
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13taltt'ht]A, i'd'/, ~37Eh GE4iERAC^rEyLNAGER
Per rr~• =l t _ .,w
This certificate must not 6e altered in any manner; return to the office of the Board if incorrect. Inspectors may be ideh}if(ed by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE,MUST NOT BE ALTERED IN ANY MANNER.