HomeMy WebLinkAbout13654-Z Bldg 11 Unit AFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.~!~.Lq~ ..........
Date August 31, 1987
THIS CERTIFIES that the build~g . .~Pb.~b..~b.k~9 ............ ..............
l~.+:~-~o.~-~. 2555 YOUNGS AVENUE SOUTHOLD
--u.~,u. u. · * uF;, ~ y ~ ~0~ ................... Street Ham~t
County Tax Map No. 1000 Section .. P.~ ...... Block ..... QQ J ....... Lot 28 & 29
Sub~vi~on FOUNDERS V~LLAGE ...Fged Map No. .Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
Dec. 27, 1984 pursuant to which Building Permit No. 13654Z
dated J an. 2, 1985 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 .........
BUILDING # 11 Unit A IN MULTIPLE DWELLING
The certificate is issued to LIZDA REALTY, LTD.--FOUNDERS VILLAGE (owner, I~ ~mv~X,~X X
of the aforesaid building.
Suffolk County Department of Health Approval .. S- 54 Au g. 5, 1987
UNDERWRITERS CERTIFICATE NO P E N D I N G
PLUMBERS CERTIFICATION DATED: MICHAEL DUFF, INC. July ]3, 1987
Building Inspector
Rw. 1/81
I~OB,~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISF..~ UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 13654 Z
Permissio~ is hereby gronted to:
...... ~/~.w~..ff~.,:z:~ .... ~/~, ..........
...... ~.o../.. ....... ..D..~.~/.a.a...,4~. ....
.... ~.~..,...~.~ ......... z~..~.7..../.. .......
- ,- - - 0 '~ ' (..~,,~ -
~./5....~..v.....E...~.$...~.~¢..~.¢.~ ....... ~.~/~.~.....~:...~....~t...~ .............. /.......
.,,,,,,,, ,oco,ed o, .~,./.~ ........ ./..~,~.~.~..,,~-.v.........L.~.~,~...?....~.,.,..P.,. ......
~.,~.~.....Y.,z/,~....~.~...,~,.~.,~. ....................................................
County Tax Map .o. 1000 Section .~.. .......... Block ...1~/.. ........... Lot No.(~.~..~....~-~
pursuant to application dated ..'~.~-".~.: ....... /....~. .......................... 1~..~..i and approved by the
Building Inspector.
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Depar~,,ent
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted -, Ilmmmm to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of ail 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 srmilar buildings and installa-
Lions, 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.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty 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 pert!nent informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
5. Updated C.O. $15.00
Date .... ~%f~l ...............
$15.00
New Building X Old or Pre-existing Building Vacant Land ..........
Location of Property .B.u.i. 1..d.i.n. cj. 2.1 ....... A., 2555 Youngs Avenue, Southold
, Unit . .........................................
House No. Street Hamlet
Owner or Owners of Property ~.~.7.~.a.R.(~.al~..y LTD. - Founders .~.i[..].9.g.e
County Tax Map No. 1000 Section 063 Block 00.~ ....... Lot..2.8 &..2.9 ,
Subdivision ...F.o. qn. ~,e.~.s,..V.~.l.[,gg.o ............ Filed Map No ........... Lot No ..............
PermitNo. 13654Z. Date of Permit 1./..2/8.5. .Applicant Lizda Realty, LTD.
Health Dept. Approval Labor Dept. Approval ....
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building and permit meets all applicable codes and regulation[
Rev. lO-10-Ta ~/~ /~" Project Director
15A OTIS STREET
Michael Duff, Inc.
PLUMBING AND HEATING CONTRACTORS
LICENSED AND BONDED
·WEST BABYLON LI, NY 11704 ·
(516) 491-9393
Town of Southold
Building Dept.
Main Road
Southold, N.Y. 11971
The undersigned plumber certifies installation is in
accordance with the Town of Southold [~lumbing Code and
the New York State Building CoDstruction Code, and that
solder containing less than .2 of 1% was used for any
piping of potable water.
Location
~unders Village Bldg. #11
2555 Youn~s Ave.~ Southold~ N.Y.
Building Permit # ]----~ /~ ~-~Z
Name & address of owner Lizda Realty Ltd.
4601 Delafiel~ Ave., Bronx, NY
Plumber's Signature ~----Y~ ~,.-~c,.-'--~.
Address 15A Otis St.
License #
West Babylon~ N.Y.
153-P
Sworn to before me this
Notary Public
~;lllllm~ted In Suffolk ~ l~sio~ Expires March
INFORMATION FOIl BUILDING DEPARTMENT
WE ARE IN THE PROCESS OF ISSUING A CERTIFICATE
OF COMPLIANCE FOR THE ELECTRICAL INSTALLATION
AS COVERED IN AN APPLICATION FILED WITH OUR
THE NEW YORK B~ARD OF FIRE UNDERWRITERS
~,c~,o~,o. ~/~ c p ~ -
L ~ION
DATE [ [ - ' ~//~SPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1000635
BUREAU OF ELEi~TRIcrrY
[---I~ 85 JOHN STREET, NEW YORI~, NEW YORK 10038
,...... .,.t-,..., ,.,..,. ,,,.,.,....,,o..,,,o.o...,,,., ,.,.,../. N 32409
THIS CERTIFIES THAT
mdy the e/sctrlea/equipment as d~cr/bed b~hn~ and i~troduc~d by the app//e,mt nenud on the abo~ ~ppflt~t/on ~umber/n th~ premt.e, o/
Fonndere VLlla~B, LiMe l~alty Ltd.,Younp Avenue, So. of Fiddle ~ad B/S Railroad Avenue,
~q~t.-A Bide. ~11 ~outhold, N.Y.
,~,ectlon Block Lot
~.e~i~ A,~et 28. 1987 an~foundtobelncornpliancereiththerequlrementsofthi~Sonrd.
RXTUm~
OUTLITS
DRYBS
RXTUEES EANOlS
SWITCHlS
26 18 18
FURNACE MOTORS FUTURE API~ANC~ FHO~S
DiSH WASHIRS IX-HAUST FANS
TIM~ OOC](S MULTI.QUTS~T
SYSTIMS
NO.O~ FlIT
OTI~R AIq~ARATUS:
1-3 Ton A/C Unit
1-G.F.C.I. 1-~h Detector
Panelboarde: 1-11cir. 150,wa
S E R V I C E
2/O
2/0
North Shore Electric Contractors, lac.
141 Central Avenue
Eaet Fama~n~dale, N.Y. 11735
Lic. 160g
This cerlificate mu~t not be aJtered in any manner; return to the office of the Board if incorrect.
may be idemified
their credentiols~
COPY FO~ BUILDING DEPARTMENT. THIS COPY OF CERTIFI~
INSPECTION
[ ] FOUNDATION 'IST [ ] ROUGH PI. BG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
REMARKS8
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 'IST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [~II~SULATION
[ ] FRAMING [ ] FINAL
REMARK~S: ~
765-1~02
BUILDING DEPT.
INSPECTION
FOUNDATION ~,ST [ ]'~ROUGN PLBG,
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
I NSPECTOR~/~~/
7rd-180Z
BUILDING DEPT.
iNSPECTION
FOUNDATION ~S~r [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
FIELD INgPEC~ION
FOUNDATION ,1st)
COMMENTS
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
3o
INSULATION PER N.
STATE ENERGY
qODE
FINAL
ADDITIONAL COMMENTS:
~pproved ~'~/',(..
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
...~. .....,1 Permit No .......
(Building Inspector)
Date .........' .... 19 .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspectoz, with 3
ets 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
~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
ation.
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 issued a Building Permit to the applicant. Such permit
hall 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
hall 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
luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
{egulations, for the qonstrucfion of buildings, additions or alterations, or for removal or demolition, as herein described.
?he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
dmit authorized inspectors on premises and in building for necessary inspections. ,,
...... .k~..-A~..~.....~ .~.o..L..r,/ .... k.T.D.: ..........
(Signature of applicant, or name, if a corporation)
~! .~/.. ~ .~.~.4 E,.,..~.~....A.~. ¢.... ~:.~?... ~, .~., ....
(Mailing address of applicant) I~ H'> I
';tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nameofownerofpremises. L1'7-'D~' A E~kr'/ LTD -
Builder's License No .......................... /~\,
Plumber's License No..~....~.. ~ .......
Electrician's License No. %...~... ~..
Other Trade's License No .......................
· Location of land on which promised work will be done ........... ,w [Y' · - .J · ·/.: ~. · ] .... ~.-..~t.. ,~.~ ./...~,..
House Number
County Tax Map No. 1000 Section....~..~. ........... Block .... ] .............. Lot .'~-..~.;.2..~.j .~....~/.(~
Subdivision .............. ............. . .......... Filed Map No ............... Lot ...............
(Name)
:. State existing use and occupancy of premises and intendedx and occupancy of proposed construction:
a. Existing use and occupancy .... . .~. ~..t4...~ . . . .0~......°~... ................. ... ?.. ...........
b. Intended use and occupancy .... C..0..~...~..~..~. )..1~ .~..~. ~ ........................................
(as on the tax roll or latest deed)
!f applican[ is a cotp~ration, s~nat~e of duly authorized officer.
........ ...... ....
(Name and title of corporate officer)
,/
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition ............. Other Work . .
4. EstimatedCost t,l '° r ~'l O~ ~ I~.~. c;,< ~ ~,::W'/ f 6ocr
.~. " (to be paid on filing this application)
5. If dwelling, number of dwelling units .../'~. i ........ 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 ..................
D~pth ...................... Height ...................... Number of Stories .......... :..
8. Dimensions of entire new construction' Front I ~'~.. t Rear r,__,,. /d 0 t ...... :' '
'.t?; · ..............
10. ~DateofPurch. ase ....'~.}.~.~.~. ......... ~,Na,rneofFormer6~v~;r ~.. ~.~'ii~ ......
11. ~one or use clistrict in which premises are situated ./Yl '~ ~ .............
12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~ .........................
13. Will lot be regraded - · -~. · ............ Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .................... Address ................... Phone No .......... ' ......
Name of Architect ........................... Address ................... Phone No ................
Name of Contractor ., ........................ Address ................... Phone No ................
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.
$TATE OF NEW ATLRK .
:OUNTY or...~'~..g..{.}~ ~ ....... S.S
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
'teisthe ...C~.. ~
tractor, agent, corporate officer, etc )
>f said owner or owners, and is duly authorized to perform or have performed the said work and to make and ~e this
~pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
.york will be performed in the manner set forth in the application filed therewith.
;worn to before me this
............ · ~-~. .... ~ of ~.~.~ .-<%-~. ..... 19..~
qotary Public ........ ~~;' '~-/.'.~-~'~.-County/~1% ,,~
.... ,, , ~ p ~, ature of applicant)