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Home My WebLink AboutColonial Village MR 172SUPERVISOR'S OFFIOE 16 South Street Greenporf, N. Y. Tel. Greenpor+ 7-05S0 BUILDING DEPARTMENT TOWN OF $OUTHOLD SUFFOLK COUNTY, N. Y. TC)~N CLERK'S OFFICE Main Street So~thoJd, N. Y. Tel. Southold 5-3783 BUILDIN~OFFICE 8outhold ~ Ii.Ye CERTIFICATE OF OCCUPANCY GoXoa:Lal V~ll~fe Xno Bldf ,l' 6 No. 3_~j, . Date Al~4Ult 2E) 1967 THIS CERTIFIES +hat +he building located e* ]~Fe~v&t,o BDIdL fim~t W~) ~ htn ~t, Map No. ~ , B~ck No. ~ , Lot No. in +he Town of So~old, co~o~s subste~iel~ te +he np~ved plans end specifications heref~ore fi~ in ~is ~ w~ Appli~flon for Building Permit dated ~ ~ 19~,' pu~ua~ fo whi~ Building Permit No.~, doted ~ 19 ~ was issued, end conforms to all of ~e r~uim- monte of the appli~bb provisions ~ ~e law. ~e occupancy for ~;ch this ~ificate is issued This ce~flcate is issued ~d~lok P. ~oh ~ ~lontal V~lale (ow.er, les,ee or tenent) of fhe efore~id buildimg. H.D.app~v~ ~ ~, 1967 bY R. V~~_,~.~n ~spe~or [ ~ding (l~e Ce~flcete of Occupancy wilt be issued only after the Building Inspector is convinced of the completion of the construction in compliance with +he Multiple Residence Law and with other laws, ordinances .or regulations affecting the premises, end ~n conformity with the approved p~ans end specifications.) COUNTY DEPARTMENT OF HEALTH Riverhead, New York ~zilding Permit No. TYPE OR PRINT LEGIBLY IN INK ~ealth Department Plan No. Application for Approva1 of Commercial Sewage Disposal ~stem TO~ The Suffolk County Department of Health Date Application for approval of commercial sewage disposal system is hereby requested. (Name and side of street, and name and distance to nearest intersecting street Village I hereby certify that this commercial sewage disposal system has been con- structed in accordance with plans approved hy the Suffolk County Department of Health on (date) and with all the requirements of the latest bu~e~ins on sewage disposal of the Suffolk County Department oflHealtb. ~ (Builder - Owner) Ready for inspection ~stallation satisfactory - Yes j I No Based on the information stated hereon by the applicant and other information made available, it is the opinion of this Department that this system with proper maintenance can be expected to function satisfactorily and is not likely to cause a nuisance, provided designed sewage flow is not exceeded. Structural features are not included. SCflD - FORM NO. 5 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Affidavit of Final COst of Construction STATE OF NEW YORK ~ ss.: COUNTY OF .............. .~..~ ~.~..o.. ,1. ,~. ................. ............................... ]~.~.:r3,.~..~.,...P~l..(~l$ ............................... , being duly swam, deposes and says: (applicant or agent) that he (sl~ is the applicant (or agent of the applicant) named in the Application for Building Permit dated ...~a,~'c2~..,],._54 ....................... 19...67 ..... relating to construction or other work to be performed on, or in connection with, the premises located at i~.V.~. ~g.~e .Q.~:~...~D.~...n....St.. BofLsseau Ave° · that the estimated cost stated in said application of the construction ~.6.~,~ ~1.~ ,; -..~.;.~Z.; ............. , or other work described therein was ........ ~.(~r O.O0,.00 ........................................................................ Dollars ($ ...... ~.~t~0O.~0~....); that the actual final cost of such construction or other work was Fo t ~ .......... . ........ r..z..~.~.~...~hp.~;~..~r.d .......... ~.O./.1.O.~) ................ Dollars ($.....g'.9,.O.Q.O.~.gO ) and that the said construction or other work was performed in accordance with the applicab~ro~,~ of)aw. ............. ...... (applicant or agent) Sworn to b~,~' me Permit No. Filed Cost $.....~..~.0....0...o.. ..... Permit Fee Paid $.....J../..~.:..O....O. ...... Final Cost $......~...~.F...O....o...o. ..... Additional Fee $ ....... ...0... ............... (Costs for the work described in the Application for Building Permit include the cost of ali o! the construction 9~nd other work done in connection therewith, exclusive of the cost of the land. If the final cost is less than the estimated cost stated in the Application ~or Building Permit, no port~on of the fee paid upon the filing of the 5pplicotion will be refunded.) PERMIT NO. LOCATION TOWN OF SOUTHOLD Multiple Residence Law Permit II,,~,e X~ ll. aFeh 1~ 1967 APPLICATION NO. 1.~ ~Z' 1~ 1967 irfT. R.O.ii. Off Il/il Ya~n St; - ¥/ BoXlseau i~e~ Southold~ 1~,¥. Application having been made on covering construction on · ~ l~l~h 1_~ , 19.6.d~, for a'permit (new, altered, or converted) multiple residence building, by or in behalf of , ~or a ~wefl~ng IocafeJ .s above stat~, an~ ~e s4i~ appficafion ~aylnG ~een exami~ and recommen~e~ ~or approval:on ~ ~ 19~. PER~IT is hereby iss~d ~or ~e pe~orman~ of the ~t~ ' .' (archl~ct~r~l, structural, mechanical, etc.) work described in the above numbered application and any ~companying plans and s~cifications. If no work is pe~or~d wffhin one year from the time of ih ~suanCe,.. tMs PERMIT ~all expire by ~mitafion. Approved ~lt:Fe.h l~ 19 6~ FXled E.t~ate $ ~9,000o E~f~cement Officer - Fee p&~d$ Subject to f~mal approval of Health d®pt NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No...'./'...?...~ ............. Approved ........................ :.t. ............. , 19 ........ Permit No ..................... Disap~roveda/c ~ '~ ~ /~ ~ ....... ................................. 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 i~or 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 Bui~ing Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the censtruction of buildings, additions or alterations, or for removal or der~olition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and re4/ulations. (Sigq~rure of applicant, or n~'me, if a corporation) o, app cant) .......... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................................................. If appl~j..~ a corp_ora/~,.~tu~y authorized officer. " (Name arfd title of corporate off~r) 1. Location of land on wh, ich proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number./.~.~-.~...' ............ ~ .............................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..~.~ .c.~ ................................................ b. Intended use and occupancy .~ ......... ~....~ .......................................................................................... 3. Nature of work (check which applicable): New Building /'"'"/ Addition Alteration Repair .................... Removal .............. .. Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ....... ¢?~.~...~ ................................ Fee .......................................................................................... (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 ............. "--7; ............................................................................................................................ 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 ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...../...~....'e/~.. .......... Rear .../....d......<~.. ............ Depth ..2:...~.. .................... Height ..../._.~77... .............. Number of Stories ..... 9. Size of lot: Front ..~../....O. ............... Rear .~...~.~.~...~.:~ ......... Depth ../....'~...(. ..................... 10. Date of Purchase ................. Ncme of Former Owner ........................................................ 11. Zone or use district in which premises are situated .............................................. ~;~ ............................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .~.o. .............................................. Name' of Architect ..~?~ ........................ Address ~-~:~~f 'r"/'Z' 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ S S COUNTY OF ................................ ~~ ............ being duly sworn, deposes and says that he is the applicant ................ i~l'~me"~f individual signing appl~~ above named ............. He is the ........................................................................ (Contractor, agent, corporate office]""~'l], c.) ................................. of said owner or owners, and is duly authorized to perform or hove 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 ..... ....-..~.C.c~.~.?.-------. ............. , ~ ./'~/~....?.~.'z;J.:.... Co~9, :~, (Signature of applicant) Notary PubJic,~....i ...~.:,.z~..~''m~' ''''''~''~''~' .... Ir Daniel Smith~ an officer of G.W.Smith & Sons Inc~ Builders of building ~ 6 - Colonial Village Inc.~ Permit # M.R. 172~. located on a private road off North Side of Main Sty Southold~ N.Y. do certify to the Building Inspector of the Town of Southold~ Southold, N.Y. that the above cited building does comply with the requirements of the New York State Multiple Residence Law. Sworn to be~i~ore me ~-~ Notar ~ ' "~' ' ~': · Y~'P~ WALTER A t ' i ' Z Z r L ~ ./ C. CPLOhJ OF i