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Home My WebLink AboutColonial Village MR 158SU PBRVISOR'S OFFICE 16 South Street Greenport, N. Y. Tel. Greenport BUILDING DEPARTMENT TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. TOW~N CLERK'S OFFICE Main Street S~uthold, N. Y. Tel. Southold 5-3783 BUILDING rNSPECTOR'S OFFICE Tel.~~ Southold CERTIFICATE OF OCCUPANCY No. THIS CERTIFIES that the building located a+ =~ ~_~_ ~& ~/ .u · Street, Map No. ~ , Block No. ~r~r~r , Lot No, - in the Town of Southold, conforms substantially fo the approved plans and speclflca+ions heretofore fi~d in this o~ce with Application for Building Permit dated ~ ~ 19~, pursuant to which Building Permit No. ~ ~ . dated ~ I~, was issued, and conforms to a~l of the require- ments of the applicab~ provisions of the law. ~e occupancy for which this ~H~ficate is issued is This ce~ificafe is issued ~ ~-~:~ ~. =~-~ ~-~--* o~ the a~oreMid buildln~. [The Certlf;cete of Occupancy will be issued only after the Building Inspector is convinced of the completion of the construction in compliance wTth the Multlple Residence Law and w~th other laws, ordinances ,or regulations affecting the premises, and in conformity with the approved p'lans end specifications.) TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ , 19 ........ Permit No ........................ Application No....,.~..~...]..,,,¢'. ,~,. ...... Disapproved a/c .............................. ~ .......... ~ ......................... ........................ i /;;;i ................................. APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 propertymust be drawn on the diagram which is part of this application. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work· e. No building shall be occupied or used in whole or in part for any purpose whatever until o Certificate of Occupancy shah 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, ordinanc~%/build~gg~od~nd regulations· ..... ......... (/....~'' /¢ignaCu-re of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. .................................................................................................................................................... Nome of owner of premises EC..~.¢/~'t'/ ¢ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done· Map No: ............................................Lot No: .................... Street and Number ........... t.,~.: ............. 7' ................................. ~ .............. ' ................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................... , ............................................................................................. · _el D b. Intended use and occupancy ....~.. ~.~..' ......... .~.....~...' ............................................................................................... 3. Nature of work (check which applicable): New Building ....../~... ........ Addition .................. Alteration .................. Repair ................. j~, Removal .................... Demolition .......... ~1~.... Ot~r Work (Describe) ...................................... (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 aad't'ons: Front ................................ Rear ................................ Depth .............................. Height .............................. ,Number of Stories ...... ~ ................................. 8. Dimensions of entire neW construction: Front ..... ~.. .................... Rear 9. Size of lot: Front ............................ Rear ............................ Depth ................................ 11. Zone or use district in which premises are situated ....... .~..~.(....~..~.~ ............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...................................................... 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK.. m_ ~ o ,- COUNTY OF ...~~ ...... , ~'~'. ...................... ~~-/~ ........................... being duly sworn, deposes and says that he is the app icant (N~of.~_ individual signing application) above name~He is the ................................................................................................................... (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 that the work will be performed in the manner set forth in the ~plication filed }herewith. Sworn to before me this ~ ............ ....... ......... , ~,~. ~, ~ ~.~z ~ ~ . , ~ ........ :.;[~t-..~,:~.~:~. ~..:..~ ............. Notary Public,~~.**~~:iL:~.~u~// ('Signature of ~ii~'an,) '" ~ ~ ~ --/Q~: .' i~ ;,'4 County ./v/a /.~ jc,4.z../...-- f ,, -' .cO '-o" · . SC~D SUFFOLK COUNTY DEPARTMENT OF HEALTH Building Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at ' (Give deed location) have been inspected by this Department and found to be satisfactory. bis~rict Engineer TOWN Z TOWN OF $OUTHOLD Multiple Residence Law Permit PERMIT NO, lr)8 ,1'~ ~. 19 6~ APPLICATION NO, LOCATION il_./~=g M~l~'l ~n.~; ~mtvmmn T~_. & ~.~.. Application having been made on covering construction on a ~ . i'9~_____, for a (new, altered, or conveHed) multiple residence building, by or in behalf of _'~P~,r'l~?t~.lr P_ l~tq (o~,..,) , for a dwelling located as above stated, and the said application having been examined and recommended for approval on ~1'I]z~ If , 196~, a PERMIT is hereby issued for the performance of the (archltecture/I, structurat, mechanical, etc.) work described in the above numbered application and any accompanying plans and specifications. If no work is performed wffMn one year from the time of its issuance, this PERMIT shall expire by limitation. /f · EnfOrcement Officer Water supply & So. rage diaposal subject to approval by Suf£olk County Department of Health. &" ,4, ¸:1 I[ -I h --¥-: - I L- 0 I woo ~, .,-,,,' o z a ., / . £, /v'. ): .. /~.~ '1