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Home My WebLink AboutColonial Village MR 179SUPBRVISOR'S OFFICE 16 South Street ~reenport, N* Y. Tel. Greenporf 7-05S0 BUILDING DEPARTMENT TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. TOV~N CLERK'S OFFICE Mai. Street Southeld. N. Y. Tel. Southold $-3783 BUILDING I'NSPECTOR'S OFFICE CERTIFICATE OF OCCUPANCY Apt house Ili 8 (i~R, HoXyo~ke House) No. 1B~ THIS CERTIFIES that the building located at W~. R.l~.l~e (A~nte~/a?.~ Ii~ ~4~ ~eet, ~ap No. ~ , Block No, m , Lot No. ~ ~ ~ the Town of Sou~old, confo~s subdantielly to the app~ved plans and specifications heretofore fi~d in this o~ce wi~ Application for Building Permit dated A_--.~ ~ e ~6~ ,~ 19~ pursuant to which Building Permit No.~, dated ~ 19~, was issued, end conforms fo all of the require- ments of the epplicebM provisions of the law. ~e occupancy for which this ~ificafe is issued is This certificate is issued te owner, lessee or tenant) of the aforesaid building. H,D.Approv81 Auf 21t 1969 by R. Villa. ( Bo additional fee required) (The Cer~ficafe of Occupancy will be issued only after the Building Inspector is convinced of the completion of the construction Jn compliance with the MulfTple Residence Law end with other laws, ordinances .or regulations affecting the premises, and in conformity with H~e approved p~ans and speclficafions.) FORM NO. 5 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN CLERK'S OFFICE SOUTHOLD, N. Y. AflCidavit of Final Cost of Construction STATE OF NEW YORK t ss.: COUNTY OF ....... ,.q D.EF D..T.~ ....................... FREDERIC P. RICH .................................................................................................... , being duly sworn, deposes and soys: (applicant or agent) that he (she) is the applicant (or agent of the applicant) named in the Application. for Building Permit dated ................... ~.pN.i-'l......1.8 ....... 19..69 ...... relating to construction or other work to be performed on, or in connection with, the premises located at ........ A~.~.~,....W'...~.~r....(.?..'C.?....~.:..0..t.~....) Soul;hold .~./..S......~.a..~.~.....S..~..~..e..¢..~ ....... ; that the estimated cost stated in said application, of the construction or other work described therein was ....... f&f.t~...th~.ee...Thonsand. ................................................ Dollars ($..~.~.,..0.Q..0.....O..Q ........ ); that the actual final cost of such construction or other work was Fifty Three Thousand Do a-~ ($ 53,000.00 ) and that the said construction or other work was performed in accordance with the applicableg~ o.f,, law. ................... ...... (applicant or agent) Sworn to before me ........... .................. ~/ Notary Public Permit No. M.~,....!.29 ................. Filed Cost $..~...~..L .0..0..0.. ............ WALTER a. KAPP NOTARY PUBLIC, $!~te of New Permit Fee Paid $..1...2.Q.e...0Q.. ............ Final Cost $ ............................ Additional Fee $ ........................... (Costs for the work described in the Application for Building Permit include the cost of an ~ the construction and other work done in connection therewith, exclusive of the cost of the land. If the final cost is loss than the estimated cost stated in the Application for Building Permit, no portion of the fee paid upon the filing of the ~pplication will be refunded.) S~FFOLK COUNTY DEPARTMENT OF HEALTH Riverhead, New York TYPE OR PRINT LEGIBLY IN INK Building Permit No. Health Department Plan No. A_~plication for Approval of Commercial Sewage Disposal System TO: The Suffolk County Department of Health Date '/~/E.~/~ Application for approval of commercial sewage disposal system is hereby requested. (Name, s~ide of street, name and d~stance to nearest intersecting street) Village I hereby certify that this commercial sewage disposal system has been constructed in accordance with plans approved by the Suffolk County De- partment of Health on (date) and with all the requirements of the latest bulletins on sewage disposal of the Suffolk .Count~:Deoartment of Health. ~p;'~.:.~ ~...~-'~.~-~,Y/L~'~ ~ z~' ,/ .V / >' Applicant s Signature~? :~¥<~ .+7~,:~6~ Title /9~- ~ (Builder - Qwne~) Address Ready for inspection FOR USE OF HEALTH DEPARTMENT ONLY Inspected by ~. 6 ~90~ ~ Date Installation satisfactory Yes ~ ; No Based on the information stated hereon by the applicant and other information made available, it is the option of this Department that this system with proper maintenance can be expected to function satis- factorily and is not likely to cause a nuisance, provided designed sewage flow is not exceeded. Structural features are not included. Date District Engineer ACHD - S-13 6/58 TOWN OF $OUTHOLD APPLICATION FOR BUILDING PERMIT PURSUANT TO MULTIPLE RESIDENCE LAW New Multiple Residence Building APPLICATION NO Street Distance from Nearest ~,orner Height: /._~"- (Permanent or Transient} (2) Type of Construction ~ ~ ~ ~/~ ~ ~~ ~3) Estimated Cost of Construction~ ~~~'~ire~°°f or Non-fireproof) (4} State what disposition will be made of w~sfe end sewage ~~ - (Public sewer, prlvefe ~wer, cesspool, etc.) (5) Occupancy (in detail) as follows: Story (include Cellar & Persons to be Basement) Apartments Rooms Accommodated Cor B First ~'./.~//~ _.~_ .~. /~ / ~ Second ~ ' ' ~rd FouHh Fifth Seventh DIAGRAM. The sald.land and premises are situated as follows: N Page I The north point of the diagram MUST agree with tha arrow ~FORM ,NO. I TOWN OF SOUTHOLD BUILDING DI~-PA R"I'M~q"I' TOWN CL~RI~"S OFFICI~ SOUTHOLD. N. Y. Examined 19 ':," lq Approved .......... ~.t, ......... 19 ....Permit No .................... Application No.. Disapproved a/c ~..A~.:~ ~ ........................ __ APPLICATI(~ FOR BUILDING P~.RMIT Date i ~../..~.. ........... 19~.2 INSTRUCTIONS a. This applicati,on must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of 1~t and ~f buildings o n 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 this application. c. The work covered by this application may m3i be commenced before issuance of Building Permit. d. UI~Yn approval ,of this application, the Building In spector will issue a Building Permit to the applicant. Such permit shall be kept ~n the premises available fo r inspection throughout the progress of the work. e. No building shall be occupied or used in whole o~ in part f~r ~ny purpose whatever until a Certificate ~f Occupancy shall trove been granted by the Building Inspect~a'. APPLICATION IS I-IJ~Y MADE to the Building Department for the issuance of a Building Permit pursuant 4o the Building ~one Ordinance of the Town of Svathold, Suffolk (~unty, New Y~rk, and other applicable Laws, Ordinances ,or Regulations, for the construction of build ings, additions o~ alterations, or for rermoval or demo- lition, as herein described. The applicant agrees to com ply with all applicable laws, ~rdinances, building code, housing cede, a~d regulations. ~/~ ' ' -' . .~..~.~-4~.~...~.....//// State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder .............. ~ ................................................................... If applicant i~-4~ corporate, signatq~ of duly j~th,orize d .~fficer. (Name a.nd title of corporate officer) 1. Doeation of land on which proposed w, ork will b e done. Map No ................. Lot No .............. Street and Number ....... ~ ~unieipality 2. State existing use and ~ccupancy ,of prodded use and ,occupancy of proposed construction. a. Existing use and occupancy .... .~...~.//'g~.~_.~F~ ........................................................... b. Intended use .and ~ccupancy .............................. ~..~~ / 3. Nature of work (check which applicable): New Building . ./~'..... Addi'don ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. E~stimated Cost .....~..,°OO~- .Fee ..../..?-r~... (to be paid ~n filing this application) 5. If dwelling, number of dwelling units . .~a ..... Number of dwelling units on each floor If garage, number of cars . } ................................................................... · ..... 6. If business, commercial ,*r mixed occupancy, specify nature and extent of each tYpe of use~.. ~j[..~..~._C~.. 7. Dimensions of existing structures, if any: Fr.~nt .............. Rear ............. Depth ............. Height ................ Number of Stories ........................................................ Dimensions of same structure with alterations or additi.ons: Front .............. Rear ............... Depth ................ Height ................ Number of Str~ries ..................... 8. Dimensions ,of entire new construction: Front .../i~.~. ....... Rear ./~..~. ..... Depth ~.. ...... Height ./.-~... .... Number of S~ories . .~....-'~.. .................................................... 9. Size of }ot: Front ................ Rear ............... Depth .. 10. Date of Purchase ............................... Name (~f Former Owner ............................. 11. gone ,or use district in which premises are situated .................................................... 12. Does proposed construction violate any 7oni~ng law, ordinance~or regul~tioa!?' ....~..e2 ................... 13. Name .of Owner.of premises ~C~h~.~. A, ddress ~.~..g/~. Phone No ............ Name of Architect .................. ~.- g a,~ ~... Address .....l ......~ ......... Phone No ............ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or 'proposed, and indicate all set-back dimensions from property lines. Give s~eet and block number .er description according to deed, and show street names and indicate whe%her interior or corner ~ot. STATE OF ~ Y,O,R~,z )S.S. COUNTY OF ~...) (Name ,of individual signing applicati, on) cant above named. He is the ........................... ~ ................................. (Oontractor, agent, omoporate officer, etc.) of said owner .er ,owners, and is duly auth.drized %0 perS,~$rm or have performed the said work and to make and file th~s application; that all statements contained in th is application ave true to the best of his knowledge and belief; and that the w, erk will be performed in the mann er set forth! in the application filed therewith. Sworn., t,o before .... medaythisof ... ~lgn urn./~~ Notary Public, t NOTARY PUBLIC, State ol New York No. 52-8125850, Suffolk Coq/9~ Ierm Expires March 30, 19~ TOWN OF SOUTHOLD Multiple Residence Law Permit PERMIT NO. L~,e 'J~ &~l~ 18 ~9 ~ APPLICATION NO, 1~9 &J)F 18 19 6~ LOCATION J~. RoO.Jd., (Aims b/ay ext) ll/qJ l~/n Rd & E/6 Boisseau Ave, Bout. hold Application having been made on covering construction on a ~ &pr11 18 , 1969 . for a permif (new, altered, or converted) multiple residence building, by or in behalf of ~ut~ld Ne[. , for a dwelling Iocq~d es above sfa~, and ~e said application hevine been exemi~d end recommended for approval on Ap~ 18 , 19 6~, · PERMIT is hereby issued for ~e pe~ormen~ ~ the ~2~ ~oFk (archi~ctur~l. stmcfure~, mechanlcal, etc.) work descried in the above n~bered application and any ~ompanylng plans and s~cificafions. If no work is peffor~d wffhin one year from the time of i~ issuance, this PER~IT shall exp'm by hmltafion. Approved &~'~ ~1~ 19 69 Perm:it ~ X.R. 129 F/led Es%lnmte Fee pald I 120e00 Enfarcemen+ Officer SUFFOLK COUNTY DEPARTMENT OF ~e propped arrangements for sewage ~ispo~ were approved on the above ~te in accordance with plus an~ Nli~c*iun on file in the office of the Suffolk County ~nzer~ ~ ner~b5 ~iv~ for the filin~ ~ ~., ~hi:~ ............ , ..t appears in t~e of[ice ~ is ~rants~ ~is ~,~, ~ 1 does not include structural features and ~ conJi ~icn that the proposed facilities are installed la co~ ~orm:t~ ~ith these plans. ~ ~istr~c% Engineer