HomeMy WebLinkAbout9425-zFOIgM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPAIITMENT
Town Clerk's Office
$outhold, N. Y.
Certificnle Of Occupnncy
, o A'~ri! 10
No..Z.9%9.. ..... Date ............................ , lg..7.~
THIS CERTIFIES that the building located at ~5.1.~.. ~.o.o.s. ~...T.r.~?.I. ........ ~t~x
Map No... 6.Qlf) ..... Block No ........... Lot No, 10
conforms substantially to the Application for Building Permit heretofore filed in this office
dated August 2~ 19.7..7.
..... ' ................. , pursuant to which Building Permit No..9~.5~..
dated .. Au~.s;~.. · 22 ....... , 19.7.7., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is Private One Family ])welling
The certificate is issued to David & Josephine Lampus
(owner, ~a~3~x
of the aforesaid building.
Suffolk County Department of Health Approval
Robert Ao Villa
UNDERWRITERS CERTIFICATE No ..... ~4255~5 ................................
HOUSE NUMBER . ,. ~].~ ....... Street Moose Trail
Cutchogue, New York
Building Inspector
County Tax Map Number
1000-1
BUll
SOUTH:~6, Fl,, Y.
BUILDING PERMIT
N? 9 25 Z
Permission is hereby granted to:
Ge o ,...~.:hi. ez-.s..~:~.~d~r ."~ne'.".A/'~" 9avid...&, Jo sephine Lampus
........ ~;~h~.~t~ ..................................................
to ~-.~. ........... ,..':. ~ ..~ ¢~ ~>~(.~...,~:¢~:;~¢~.~r...d~,~o.'[.l~~ . g ................................................................................
at premises located at ...t~....~(~...-¢4~->~;~e ........ Z~'.'~'?~/-~-./-'V'~4"~".'" '~'~'~''~/' ''~'~'~'~ .....
............................................ l~o.s~..:.~,e,~.~. ......... ~u. tot~og~e ...........................................................
pursuant to application dated ................................. :~.~t.g...,~. ........ , 19..7.~..., and approved by the
Building Inspector.
FOl~l NO. 6
TOWN OF SOUTHOLD
Building Delm~tment
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building
Inspector with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and
installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey o'f property showing all property lines, streets, buildings and unusual natural
or topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in-
formation required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3, Copy of certificate of occupancy $1.00
Date . 2vIa~..c b... 2.6 ~ ...1.9.~. ~. ............
New Building ..~.e..W .......... Old or Pre-existing Building ............................ Vacant Land ............................
Location Of Property I~Q.t2 ~Q ~Q.Q~.~..QQ.V...e, .'r. ~Q.Q~..¢. ~..r'..a.,~.~.~....C.~.~..9..h..9~li!~.~. .....................
Owner Or Owners Of Property ~...a.~±~ ~.amg..q.s. anct Jose~..h.±ne. r.am~g,.q.s....
Little ~egk P~'~e~'~s ...........................................................................
Subdivision ...~l,0. Q~q.~....~.pZf~ ..................................... Lot No..~.0. ...... Block No ............. House
Permit No. ~.~., Date Of Permit ....8./...~..2../.7..7. Applicont Geo. Ahlers~ Builder, Inc.
Health Dept. Approval ..Z....~..~i ..........c.~.f ........... Labor Dept. Approval ................................................
Underwriters Approval .~...,~..~.. ..... ~ .......... Planning Board Approva
Request For Temporary Certificate Final Certificate
Fee Submitted ~...~?.../....~
Construction on above described building and permit meets all applicable codes and regulations.
Applicant ...Q.~.9~_~..e._.A.~..e. tcD., ~D,~..~.~.e..~..,....I..n..o.... ...........................
Sworn to before me this t/~/ ~
................ day of ............................................
Notary Public .................................... County
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~f' BUREAU OF ELECTRICITY
~ 85 JOHN STREET. NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
only the elsctrlcol ~luipme~t ~s d~cri~ed ~ a~d introduced by the applicant nammt on tke abo~ application ~mb~r in th~ pr~mlses o~
David Lampus~ Moose T~a~l~ Cu~ohogue~
in the following Ioc~tlon; ~ Basement [] 1st Fl. [] 2nd FI. Section Block Lot
~,~.~i~o. ~ar'ch 1~, 1979 andfoundtobeincompliancewiththerequirementsofthlsgoard.
FIXTURE fiXTURES
SWITCHES
~3 30 21 23
[URNACE MOTOI~
RANGES OVENS ~SH WASHERS EXHAUST FANS
TIME CAOCKS ~INIT HEATERS MUtTI-OUTLET DIMMERS
SYSTEMS
NO, OF FEET
SERVICE DISCONNECT S E R V I C E
1-Smoke
3/0
3/O
B.J, Hlectl'ic Co,
Stillwater Ave.
Cutchogue, N.Y. 11935 Llc. 505E ~11~ ~Nd
~h;s ce~ificcte re.st not be cltere4 in cn¥ mcene~;. ~etum tc ~he office o~ the ~oc~
. ~COP? ~ B~UIU)ING D!PA~TMENT, THIS COPY OF CERTIFICATE MUST NOT BI ALB .m ~/&ANNER.
TOWN CLERK'S OFFICE
~proved ........................................ , 19~ Permit No. ~ ............................
Di~pproved a/c ......... ~..2~'..~......~......~ ..
..................... .............................. <
.........................
INSTRU~IONS
a. This application must be completely fill~ in by ~pewriter o~ in ink and s~mi~ed in triplicate to the Building
Inspector, with 3 ~t~ of plans, occurote plot plan to ~le. Fee occording to schedule.
b. Plot plan showi~ location of lot and of buildings on premises, relationship
areas, and giving a detailed de~ription of Ioyout ofprope~ must be drawn on the diagram ~hich is
c. The work covered by ~his a~lication may n~ be comme~ed before i~uance of Building Permit.
d. Upon apparel of this application, the Building Inspector will issue a Building Permit
shall be kept on the premises available for inspection thr~gh~t the work.
e. No building shall be ~cupi~ or used in whole or in pa rt for any purpose whatever until a Ce~ificate of ~u~ncy
shall have ~een granted by the Building Inspector.
APPLICATION IS HEREBY ~DE to the Building Depa~ment for the issuance
Building Zone O~inance of the Town of Southold, Suffolk County, New York, and other applica~l~ Laws, O~inance~
Regulations, for the construction of buildings, additions or alterations, or for removal
~e applicant agrees to comply with all applicable I~s, ordinances, ~uilding
admit authorized in~ectors on premise~ a~ in ~uildings for n~essa~ inaction.
................
{b~tum
.....
(~ddm~ o{ applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
,ome o, ow.er o, ...........................................
If applicant is a co,orate, ~ignature of duly authorized officer.
.~...~~....,_..~........~ --..----.. ....................... u ~ ~ ~ u s
~ame and titl~ of co,orate officer)
Builder's License No .............~.,.../. ................................
Plumber's License No .......... .~...~../......~... .................
Electrician's License No..~.ff~..'~.~....~......~ ...........
Other Trade's License No ...............................................
Location of land on which proposed work will be done. Map No.: ...~.,.,~..,,~,.,~,. ..................... Lot No ....../.~...
Street and Number ...~.~.....~ .......... ~ ........................ ~~1~..
~' Municipality
2. State existing use and occupancy of premises and intended use and occupaocy of proposed (;onstruction:
Exisiting use and occupancy ....................................................... .; .......................................................................
Intended use and occupancy ............ .~~....~.~'' ' .....................................................
I
"3; "%lature of work (check which apPlicable): New Building ..~.. .......... Addition .................. Alteration .................
Repair .................. Removal .................. Demolition ............. : ...... Other Work ....................................................
(Description)
4. Estimated Cost . .~.~..~.. ................. ~ ................... Fee ..........................................................................................
(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 ................................ Depth ....................
Height ........................ Number of Stories ...................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front ..7.~.. ........................... Rear .....7..~. ................. Depth ..~.~.....'~.. .........
!
Height ..../..~.. ......... Number ~of Stories ..........~... .......
9. Size of lot: Front .... /....~'/~... ....................................... Rear ........ ./...~...~...~ ................... Depth ..~...~...~.....~. ............
10. Dote of Purchase ........................................................ Nome of Former Owner ........................................................
1 I. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: .~ ........................
13. Will lot be regradec~ ....~ .............. Will excess fill be removed from premisesL( ) Yes (~ No
14. Name of Owner of premises ~-~.~.~.-~..~ddress P~~~'~lone No. ~....~/.~...~...O.../'~
Name of Architect .............................................................. Address ................................ Phone No .......................
Name of Contractor~ .............................. ss ..~,.~--,~... Phone No.~..,~..~.?~...d.~.OI..
PLOT DIAGRAM
Locate clearly and distinctly oil buildings, whether exi,~ting or proposed, and indicate oil set-bock 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,
COUNTY OF ..... ~.g.~.~. :9. ~.k.. ..........
............................... ~..A'V~.t;'.I,I~P,~ .............................. being duly sworn, deposes and says that he is the applicam
(Name of individual signing controcf)
above named.
He is the ....i~.gl~...~D.~...~.~'.~,g.~..Q~'. ............................................................................................................
(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
thor the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
........... ~.~.~1,... day of ............ .~.. g.g.g,~..~. ................. , 19.2..7..... ,.~ /~~~~ ~.~-.~
Notary Public, . .............. :~ ............ =..~.~,.~.~g.~.J~ County .............
(Signature of applicant)
No. 52-8125850, Suffolk
~k~m ~xpires Mer~h ~0, 19,.~..~
TEL
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICI'~
FOR APPROVAL
(
~PROVED
OF CONSTRUCTION ONLY
Lot I0 ~o.
Area ~ 40' 020s~'"
YOUNG & YOUNG
400 OSTRANDER AV£NU£, RIVERHEAD, NEW YORK
SURVEY FOR:
DAY/D L2 £AMPUS ~ JOSEPH/NE LAMPUS
LOTNO. I0, "LITTLE NECK PROPEt~TIES['
AT EAST CUTCHOGI~E tGU~ANT~D TO
TOWN OF ~UTHOLD
SUFFOLK CO, NY.
A?R I'0 F',I I, 37
APPLICANT:
ADDRESS TEL ....
r~
Lot I0
AreO
YOUNG & YOUNG
400 OSTRAND£R AVENU£~ RIVERHEAD~ NEW YORK
ALDEN W, yo~iJNG HOWARD W, YOUNG
SURVEY FOR:
D,~VID L2 L,~MPUS ~ ,/OSEPHINE LAMPUS,
LOTN~ I0, "LITTLE NECK PF~OPEt~TIES['
. , r ., , RE~>~WNO HOUSING
ZoNIN~
&
"Atterahon of this Document
exc~,~, by ~ l.lcensed Prefer.
~ion~f Engineer, J$ Illegal".
Section 72~, Sub~ 2~
N. Y. ~a~ Edu~ L~.
.r re-us~ of dmwl~ ~ ~
Office Qt
Go.-'don 1E. Ahl~z.s, P. E.
.~ ~ _;7 2 YT .... "" -
.t
except by a Licensed
slonal Engineer, is Illegal",
Section 7209, Subdl¥isloe 2,
N. Y. State Ed~ L~.
Office Ot ~~'
Gordon K. ,ll~lere, p. E.
Ottice Of
C~ordon K. Ahlet,, P. E.
APPROVED AS NOTED
DATE:_
"Alteration of thls Document
exceki by a Lti:ensed Profes-
sions! Engineer, Is IIl~,~al".
Seclion 72l~l Subdtvlll~ll 2~
N. Y~ ~tale EduCation Lew.
.r re-u~e of drOwll~l ~
9t~eer Approval vold~ ~ '~1~
Office Qi
Gordon K. Ahl~s, P. E.
C-,o:do~ 1[. Jl~lere, p. g.
Office Of
Gordon K. 'Ahlors, P. E,'
Office, O!