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Home My WebLink AboutColonial Village MR 163SUPERVISOR'S OFFICE 16 South Street Greenport, N. Y. Tel. Greenporf 7-05~0 BUILDING DEPARTMENT TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. TOWN CLERK'S OFFICE Main Street Southold, N. Y. Tel. Southold 5-3783 CERTIFICATE OF OCCUPANCY BUILDING f 2 No. ~-~8 Date ~t 11 19_6~ (Ann* s Wa~') THIS CERTIFIES that the building located et P'VT R.O.W N/El Main Road Street, Map No. T~r , Block No. z3a[ , Lot No. ~ 8og. tholdt N,g, in the Town of Sou~old, conforms substantially to the approved plans and specifcetions heretofore filed in Sis office with Application for Building Permit dated ~ ~ 19 65 pursuant to which Building Permit No..~.J.~. dated ~ 19 6~, wes issued, and conforms to ell of the require- ments of the eppllceblo provisions of the law. The occupancy for which this cerfificefe is issued is Thk ce~i~cafe is issued ~ ~ed~ak ~. Riah ~e Colonisl Vi]la~e [ow.or, lessee or ~e.e.q o~ fke e~oreseld ~uildi.g. H,D,Approval Elept, 28~ 196~ by ~. V~lla (The Cer~if;cete of Occupancy will be issued only after fha Building Inspector is convinced of the completion of the construction in compliance with the Multiple Residence Law end with other laws, ordinances.or regulctlons effectlng the premises, end in conformity with the approved ptens end specifications.) FORM NO. 5 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Afl:idavit: of Final Cost: Cons{:rucEon STATE OF NEW YORK ~ ss' COUNTY OF ...S:~f',f'.o]J~ ........................ }" ............ ~...,~....e.....~,~.'..~.!:~.....~.....~..~. .................... being duly deposes and / (applicant or agent) sworn, says: that he (she) is the applicant (or agent of the applicant) named in the Application for Building Permit dated ........................ ~[0,~.....]-.7 ....... ]9...6.~. ...... relating to construction or other work to be performed on, or in connection with, the premises located at ~Z'..~...H..a.~.n Street ...S. OL~I;h~C~....N~.'~.o ......... ; that the estimated cost stated in said application of the construction or other work described therein was ....... ~O~'.~;~r...lq~....~,Q.lL~.~.~.d.... Dollars ($.~..9..~..O..Q..O.~..O..Q ..........); that the actual final cost of such construction or other work was ........................................................................................ Dollars ($ ................................ ) and that the said construction or other work was performed in accordance with the applicable p~ns of law. Sworn to befoFe/me Permit Fee Paid $..115',.00 ............ Final Cost ~.9. j..O..O...O..'. ............ Additional Fee $ ............................ (Costs for the work described in the Application for BuL!ding Permit include the cost of all of the construction ~nd other work done in connectio~ therewith, exclusive of the cost of the land. ~f the final cost is less than the estimated cost stated in the Application for Building Permit, no portion of the fee paid upon the filing of the application will be refunded.) S~D SUFFOLK CO03~1~f DEPAEI~ENT OF HEALT~ S EP Z B Date TO ~HON IT NAY COMCE~: The sewage disposal facilities for a structure located at have been inspected by this Department and fouad to be satisfactory. District Engineer TOWN OF $OUTHOLD Multiple Residence Law Permit PERMIT NO. '~_1~ 1_~,_~ I~,,~ ~ 19~_~ LOCATION 1~/~ l&=4~ Re_; Rn'rrl'.hnl~: APPLICATION NO. 1~3 N~_~ ~ 196~ Application having bean mede on ~'~' 2~ , 19 ~ , for a permit covering construction on a ~_~_ (new, altered, or converted) multiple residence building, by or ;n behalf of C~]"IOZt~La]. ~].~.l~e ( ~11'~"~k R~.eh) , for a dwelling Ioof ed as above sfa~, and ~e said appl~cefion having been exami~d and recommended for approval on ~ ~ , 19~, a PERMIT is hereby issued for the performance of the (architectural, structural, mechanical, etc.) work described in the above numbered application and any accompanying plans and specifications. h< no work is performed within one year from the time of its issuance, this PERMIT shaft expire by limitation. Approved E~f~rcement Officer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined .............................. , 1 Application No. /'~ / ............................ Approved ................. i:..k. .................... , ~' ~ ~ 1~2 ........ Permit N ............................... Disapp roved a/c.~ .................................... .~. i:~~~__ ..... .................. ...................... (Building Inspec~r) 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 property must be drawn on the diagram which is part of thi~ applica- tion. c. The work covered by this application m~y not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applica,nt. 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 pa rt 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances/grid regulations. ~ ~- .~ "~'~,~ppplicant, or name, if (~ corporation') ...... (Address of applicant) ~ State whether applicant is owner, lessee, agent, archite, ct, engineer, general contractor, electrician, plumber or builder. Name of owne~ o~/f Premises .-~~~ ........................................... iiiiiiiii iii iiiiii i ii ii if applicant is,~,-~orporate, sigggture of du.~ authorized officer. - (Name and title of corporate officer) x/ 1. Location of land on which proposed work will:be dor~f. Mop No, f~¢~'f~.~ot No.: ...................... Street and Numbe~~.. ~~ ..................................................... -- Municipality ......... 2.State existing use and occupancy of prem/i4es and intended use and occupancy of proposed construction. o. Existing use and occupancy .... .~...~....~..~ ............ ~ .............................................................................. b ,ntended use and occupanc . ,~. Nature of work (check which applicable): New Building .................... Addition .................. Alteration .................. Repair ............... ,~,emova] .................. Demolition .................. Other 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 ............ .m ......................................................................................................... ,~ / ----//~ ............... 6. If business, commercial or mixed occupa.ncy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Dep~ .............................. 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 ...... ~.....~...d,~... ......... Rear .............. Depth ..~....~'... ..................... Height ....,Z~...-~'..../. .............. Number of Stories .... ~...~ ........... 9. Size of lot: Front .............................. Rear ................................. Depth .............................. 10. Date of Purchase .......................................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .................................................................................................... Does roposed construction v olate any zonin~ Jaw ordinance or rent~lotionP Name of Architec~.~.~......' Address ..~._.~...~...' Phone No ................... Name of Contra~r,~...~...:.~.~..'~Address ..~~..~...:.~. Phone No .................. PLOT DIAGRAM Locate clearly and distinctly ali 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, ) c c COUNTY O~ ..................... ) .... // ............ .~....Z~../~....C.~g duly sworn, deposes and says that he is the applicant qp~) ication)., above named. He is the ...... r.~..~c~.A<~<'...~ .4~... ...................................................................................................... (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 application filed therewith. Sworn to before me this /~"~ // ., .... ....... day of. /2 A .---/' .... >; ............... . ....... ........ Notary Public .~~~.. County ,~-~/~/ (Signature of app ca.nt) No. 52-CS!8!C0 Su,fo~k sUFFOLK COUNTY DEPARTMENT OF ' -,.. J~l( The proposed arrangements for sewage di~_sposal ---v---r. 7 ~lication o~ fil~, in the office of th~ Suffolk County of Health. · ~ ~ ' fcr the filing of these platen Con~ent ~s ::~r~,, ~-~v~n ~ ,~ ~is endorseze:~% a:~uears in the office of ~v' ~is approval does not include structural features and ~ condition that the proposed facilities are inst~lsd Z Z DP. ELI M'INAI;;~Y LAYOUT "COLONIAL VtLLAG.E .AT, ~.~OtJTMOL, D" 'I'OWN-O ~ ~'1'"1~t0 I..,D~"' ' '~; 'N,""Y', '~ ii j,,~, ,'= I~0't ,~?,: ~ 7 .r