HomeMy WebLinkAboutColonial Village MR 177SUPERVISOR'S OFFICE
16 South Street
Greenporf, N. Y.
Tel. ~reenport 7-0550
BUILDING I'NSPECTOR'S OFFICE
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
C0L0]IIAL ¥ILIAGg BLDG f
CEI TIFICATE OF OCCUPANCY
TOW'N CLERK'S OFFICE
Idaln Street
Seutho]d, N. Y.
TeL Southold 5-3783
No. 182 Date Sept 23 1968
THIS CERTIFIES that the building located e+ ]>~t ]~,0,~/, l/8 ]e&~LZt St (&tqnlB
Map No. Fe ~Oh . , B~ck No. ~ , Lot No. ~ 8outhol~l
in the Town of So~oM, conforms substantially to the approved plans and specifications heretofore fi~d in
o~ce with Appli~fion for Building Permit dated ~ ~1 19~ pursuant to which
Building Permit No. ~e~e !~ dat~ ~ 31 ~ ~, was issued, and conforms to ,11 of the require-
ments of the appllcabb provisions of ~e law. ~e occupan~ for ~ich this certificate is ~ssued is
~tt~le ~,tdenee . ~ent oecup~e7
This ce~ificate is issued to Colonial Village Ina (Fred ~eh) ~e~
Iowner, le$1ee or +enact)
o~ the a{ore~id building.
1~+, 1968 by R. Vllla~_.
(The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the completion of the
construction in compliance w~th the k~ultiple Residence L~w and with other laws, ordinances.or regulations affecting
the premises, and in conformity with the approved p~ans and specifications.)
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Riverhead, New York
Building Permit No.
TYPE OR PRINT LEGIBLY IN INK
~ ~ ~, Health Department Flan No.
Application for Approval of Commercial Sewage Dis~fal System
TO: The Suffolk County Department of Health
Application for approval of commercial sewage disposal sy~6em is hereby
requested.
(Name and side.of street,~name and distance to nearest intersect'lng street
Village
I hereby certify that this commercial sewage disposal system has been con-
structed in accordance with plans approved by the Suffolk County Department of
Health on (date) and with all the requirements of the latest
bulletins on sewage disposal of the Suffolk County/Department of Health.
Applicant's Signature~ ~~/~,~-z~ Title/~
Address. ~/~4/~' Tele. No.
Ready for inspection
FOR USE OF HEALTH DEPARTM~.NT ONLY
Inspected by -~ !~ Date ? '//3-~
Installation satisfactory - Yes /~ $ 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.
Date
SCHD - s-13
6/58
Dlstrlct ~~,_
]LrOR~f NO, J.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y,
Disapproved a/c ........~ ....................... ~ .......................... ~ ..........
Applicotion No...'.....~....£ ..............
APPLICATION FOR BUILDING PERMIT
Dat ... Z ............................. ,
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 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 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 or alterations, or for removal or demolition, as herein described.
The applicant to comply with all applicable laws,
agrees ordinances building code, housi,~/code, and regulations.
(Signat~/re of applicant, or name, if a corporation)
....... ...........................
State whether applicant is owne~ lessee, agent, architect, engineer, general contractor, electrician, plumber dr' ~ufLd.e.r..
....... ................................
(Name and title of corporate officer)~
1. Location of land on which proposed work will be done. Map No.~~ot No.: ........................
Street ond Number ~~...~.~ ......... ~.6..~,~,,,,. ....................................
/ Municipalqty
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....~~ .............................................................................................
b. Intended use and occupancy ...~..~ ..........................................................
/
3. Nature of work (check which applicable): New Building ..1~....... ....... Addition .................. Alteration ..................
Repair .................. Removal ................ Demolitian .................. Other Work (Describe) ........................................
4. Estimated Cost ........ .~..~.~....~.~.. ................................ ~ Fee .......................................................................................... (to bepaidon filing this application)
§. If dwelling, number of dwelling units ........ ~ .......... Number of dwelling units on each floor ...~. ......................
If garage, number of cars .............................................................................................................................................
If business, commercial or mixed occupancy, specify nature and extent of each type of use/'~.
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 ....................... Rear ................. Depth ...~..~.. ...............
Height ..J.~ ............ Number of Stories ....1~,~,-~... ............................................. .; ...................................................
Size of lot: Front .~, .~..1~....~ ............ Rear ...~.~....~ ................. Depth ...~'...~...~..~. .............
Date of Purchase ........................................................ Name of Former Owner ........................................................
Zone or use district in which premises are situated ....~-~ .........................................................................'~
Does proposed construction violate any zoning law, ordinance or regMlation?~,~ ................................................
Name of Owner of premise~~/,~....~. Address ..~-.~!...~.'.... Phone No .....................
Name of Architect_,~'~,~,,/,/~.~:~"'~ .................. ~2j~..-,~-~. ........... Address i~iiiiiiiiii PhonePh°ne NoN° .....................
Name of Contracto~,~.~.~.~..r...~~...Address .....................
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 number or description according to deed, and show street names and indicate
whether interior or corner lot.
10.
12.
STATE OF NEW YORK,
COUNTY OF ................................
................... ~~: ................. being duly sworn, deposes and says that he is the applicant
above named. Ne 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 ail 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~x~. ~ ~ ~me this ~_~
............ af ...... ................... , -
appJican't'i
NOTARY PUBLIC, St~'.o J/ New York
CommNi~ioSn2'~.xplr es
/
FORM NO. 5
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Afl:idavit: of Final Cost: ot: Const:ruct:ion
STATE OF NEW YORK ~ ss.:
COUNTY OF ....$....1~...~...0.~ ...........................
~ ........... ..~..~...~..D..]$.~...I.(.~....~........~..Z...D..~.. ................................................ , being duly sworn, deposes and says:
(applicant or agent)
that he (~) is the applicant (or agent of the applicant) named in the Application. for Building
Permit dated .................... ..]~...~'.....3..1: ........... 19...6..~. ..... relating to construction or other work to be
known as the Jeremiah Vail House
performed on, or in connection with, the premises/located at ....~.¥~'..Road..m~f...~Z~....M..~.~,....B.t
..~..~....l~...l_~....~..~.~..)....$..O...U:.~..h..O..,]'~hat the estimated cost stated in said application, of the construction
or other work described therein was ........ F...o.?...t.~.....~...:~...~....~..h.o_~.~...i~....~. ..................................................
Dollars ($..i~.~.t~0 ................. ); that the actual final cost of such construction or other work was
~ ........ ,~)~.~..-.~,i~e,..~2LO. LtS~Z3~1. ............................... Dollars ($...~cJ.,.0..0.Q....0.0. ....... ) and that the
said construction or other work was performed in accordance with the applicable provisions of law./
(applicant or agent)
Sworn to before me
th s ..'~'.../. ,. ~fsloy of.~.~.~ff~l~..e.~.~ ....... 19~.
........................ .........................
Permit No. ]~ e..~..,....1..~. ~.. .............
Filed Cost $.~1'.~ ~ I~DO .............
Permit Fee Paid $...1...1.~.~..0~... ...........
Final Cost $, ~l,9..~ .O..0..Q .: .O..0. .....
Additional Fee $ ...........................
(Costs for the work described in the Application for Building Permit include the cost of all o~ the
construction and 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 for Building Permit, no portion of
the fee paid upon the filing of the application will be refunded.)
TOWN OF $OUTHOLD
Multiple Residence Law Permit
PERMIT NO. 1'~ F~I~y 31 196~ APPLICATION No.'J~J~] J~' 31 19 ~
LOCATION l~l~ate Road off )i~ l~n St~et (~ I~a~-) Sou~*h_~ld
Application having been made on ~ --~'J , 19 (~ , for a permit
covering construction on a
(new, altered, or conve~ed)
multiple residence building, by or in behalf of CO~
O~ ~o~d N.~ , for a dwelling located as above sfa~d, and the said
application havin~ been exami~d and recommended for approval on ~ ~1 , 19~, a PERMIT
;s hereby issued for the pe~ormance of the
(architectural, structural, mechanical, etc.)
work described ;n the above numbered application and any accompanying plans and specifi~tions.
I~ no work is p~Hormed wffh;n one yea~/from the time o~ its issuance, this PERMIT shall expire by I;mlfafiee.
Approved. 19 ~
Fl1~ estlmate
S ,ooo
E~f~rcemenf ~
Fee l~J.d
TOWN OF SOUTHOLD
APPLICATION FOR BUILDING PERMIT PURSUANT
TO MULTIPLE RESIDENCE LAW
New Multiple Residence Building
APPLICATION NO.
May 31 I~. 68
LOCATION Pvt Road N/S Main Road Southlld
House Number Street
Height: one story Area:
(I) Type of Occupancy Mult Ret Perm~uent occuoanc¥ apt$
(Permanent or -Tra ns;el{f )
(2) Type of Consh'ucfion
(Fireproof or Non-fireproof)
[3) Estimated Cost of Construction $br9..GOO
(4) State what disposition will be made of waste and sewage
(Public sewer, private sewer, cesspool, etc.)
Private system
(5) Occupancy (in detail) as follows:
Story
(include
Cellar & Persons fo be
Basement} Apartments Rooms Accommodated
CorB
Second
Th;rd
Fourth
Fifth
Sixth
Seventh
TOTAL ~ 20
DIAGRAM.
The sald mend and premises are situated es follows:
N
see filed plans
The north point
of the diagram
MUST agree with
the arrow
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