HomeMy WebLinkAbout13654-Z Bldg 13 Unit BFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
N~z 15802
,, .................. Date June 3, 1987
THIS CERTIFIES that the building..M.u..1 .r.i.p. 1..e.p.w.e..1.1.i.n. $ ..........................
Locati~.~o ..... ,. 2555 YOUNGS AVENUE SOUTHOLD
House No. Street
County Tax Map No. 1000 S~ction 063 . .Block 001 .Lot 28 & 29
Subdivision FOUNDERS VILLAGE .Filed 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 .... 1.3. 6. .5 .4 .Z ............
dated J an. 2, 1 9 8 5 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 #'13 Unit B in Multiple Dwelling. '
The certificate is issued to LI ZDA REALTY LTD.
..................... ioy.;'r)ie~&~t~r~i~ X X ...................
of the aforesaid building.
Suffolk County Department of Health Approval ....#.S.-. 5. 4. .................................
UNOERWRITERS CERTIFICATE NO. N 8 0 5 7 5 1
PLUMBERS CERTIFICATION DATED: March 30, 1987-Michael Duff
........
Building Inspector
R~v. 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 Depa, u~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 mm to the Building Inspec-
tor 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 sifnilar buildings and installa-
tions, 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 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 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
$15.00
Date .... 3./. ~ f.8.7. ...............
New Building X Old or Pre-existing Building Vacant Land
Location of Property .B.u.i. 1..d.i.n.q 3,3 .,.U.n. ~.~. B.., .2.5.5. 5...Yp.u.n. c~.s..A.y .e.n.u.e. ~..S.o.u.~h..o.l.d. ..........
House No. Street Hamlet
Owner or Owners of Property . .L.i..z.d.a..R..e.a.l.~Tf, .L.T.D.... 7..F.o..u.n.d.e.r..s..V.i. 1..19.g.e. ...............
County Tax Map No. 1000 Section . .0.6.3. .......... Block .0,0, ,[ ........... Lot.. ,2.8..&.. ,2,9 ......
Subdivision...F.o.u.n..dp.r.s...V.i.]~ 1..ag.e ............ Filed Map No ........... Lot No ..............
PermitNo. 13654~ Date of Permit 1./..2/.8.5...Applicant Lizda Re.a. lty;LT.D..
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval . N 805751 .Planning Board Approval
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant .~...~~,~~ .................
Project Director
1-3 TonA/C flhtc
1-G.~.C.I. 1-~molm Da~cector
panelboards: 1-II)cir. 1.~Oaml~
Iiorth Shore Electric Contractors Inc.
lil Central Avent,~
East Farminsdala, Il.Y, 11735
This certificate must not be altered in any manner; return to the offke of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE AL.TERED IN ANY MANNER.