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HomeMy WebLinkAboutColonial Village MR 168SUPERVISOR'S OFFICE 16 South Street C-reenporf, N. Y. Tel. Greenpod BUILDING DEPARTMENT TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. TOWN CLERK'S OFFICE MWn Street S~thold, N. Y. Tel. Southold $-3783 BUILDIN~ INSPECTOR'S OFFICE CERTIFICATE OF OCCUPANCY BUILDIN~ ~ ~ No, MeRe ~.71 D,~'~ THIS CERTIFIES that the building located et S/l~ Noz'th Loo_~ PYT P~ N/S Nain St. Street' Map No. vv~r . Block No. vv~rv , Lot No. ~ ~q~,,tl~n~l~l _ g~V. in the Town of Southold. conforms substantially to the approved plens end spedf;cefions heretofore fl~d ;n this office with Application for Building Permit dated Ra~ ~ 19 ~, pursuant to which Building Permit N~-R- 1 AR , dated Re~ ~] 19 ~, was issued, and conforms to all of the require- ments of the appllceb~ provisions of the law. The occupancy for which this ~rfificate is issued is~ n.e~a~.~e 6 ~e~ent occu~c~ anar~ment~ This ce~ificafe is issued ~fl~k P. R~h A/C ~n~] V~]]~ff~ ~ne (owner, lessee or Senant) of the afore~id building. HoD.Approval Oat. 17, 1966 by R.Villa Building Inspector (The Certificate of Occupancy w~ll be issued only after the Buildln9 Inspector is convinced of the completion of the constru~Jon in cornpliance with the Idulfiple Residence Law and with other laws, ordinances,or regulations affecting the premises, and in conformlty with the approved p~ans and speclficefions.) FORM NO. 5 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN CLERK'S OFFICE SOUTHOLD, N. Y. At:t:idavit: ot: Final Cost: o1: Consl:ruct:ion STATE OF NEW YORK i COUNTY OF ....... . .~.?:..~. ~.0...]:~. ....................... being du y sworn, deposes and says: (applicant or agent) that he (she) is the applicant (or agent of the applicant) named in the Application. for Building Permit doted ................... ~.9.]g..~.*......?..~ ....... 19...6..6. ...... relating to construction or other work to be performed on, or in connection with, the premises located at .g]./~..):~[.~.$.~...~.o..~...g..~...]g.y.t)...~R.~... that the estimated cost stated in said application of the construction or other work described there n was £.O.Z'.L~ ~,~fl ~kO.~.~.~g..~ ................................................... Dollars ($..~.9..~.g...O.O.n ............. ); that the actual final cost of such construction or other work was * ' - ($ .~...~...~..~:2~2 /~, ) and that the ..=.~ ....... Dollars ............................. said construction or other work was performed in acc~)~ce with the applicable pr~sions of I~)~. (applicant or agent) Sworn to before7 Permit No. ]vi °~ ° Filed Cost ,68 ,~o s~-~o~oo .............................. J~lJJdJt~l ,n SuftoJk County $. ~9+Q.0.Q., .......... Permit Fee Paid $..]....]:~'..,..0...0. ............ Final Cost $ ............................ Additional Fee $ ........................... (Costs for the work described in the Application for Building Permit include the cost of all o~f 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 f~r Building Permit, no portion of the fee paid upon the filing of the ~pplication will be refunded.) TOWN OF SOUTHOLD Multiple Residence Law Permit PERMIT NO. ~8 J~.~ ~ 19-~---APPLICATION NO. ~ JJ~l~t, ~3 19 6~ LOOATION ~ g[.O.¥ Of~' I/~ ~ Stt So~t::Old - 5/5 of lioz~ Application having been made on covering construction on a ~ ~pt,~tl~SX" 2.~ , 196~ , for a permit (6 a~artment) (new, altered, or converted] multiple residence building, by or in behalf of CO].OD.%8'I V~].la~:e lnc (Fred. , for e dwelling located as above stated, end ~e said application having been exami~d and recommended for approval on ~~ 2~ , 19~, a PERMIT is hereby issued for the pe~orman~ d the (architectural, st~cfuret, mechanical, etc.) work described in the above numbered application end any ~compenying plans and s~cificefions. If no work is pe~ormed within one year from the time of its issuance, this PER~IT shell expire by/imitation. Approved FORM NO.I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No.../......~.,,,,~,. ............. Disapproved o/c .................................................... .............................. ................................. APPLICATION FOR BUILDING PERMIT Date ................... , .... INSTRUCTIONS o. 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 agrees to comply with all applicable laws, ordinances, building code and ~;egulations. (Sig~'atur. e of applicant, or name, if a corpora¥i~)'~')' ........ ( ddress of opplicant)~ ..................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises .....~..~.....~~ ~...c~E...; ......................................... If opplic~is a corporate, si~nature of~ly authorized officer. (Name and title of corporate of?icer) 1. Location of land on which 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 ..~.~~~'......~....¢~..~~ ......................................... 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 ......~....~',~...2...~?..~....' ............................... 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 ............................................................................................................................................. 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 ....~.~....~..¢~...'." '-- "--' ..... Rear ..../~..?....~...x.. Depth ..~..~.. .............. Height ..,4..5' ............. Number of Stories .... ~.~.....~=. ................................................................................................... 9. Size of lot: Front ......~./.~..~. ......... Rear ..~.,/....~....~. ................... Depth .../...~..,,,~...x. ................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 ]. Zone or use district in which premises ore situated .............................................. 12. Does proposed construction violate~..~ ~ .~ ~. h _~°n? zoning Iow, ordinance orJ~gulation> ......~... ................................................... lB. Nome of Owner of pre~ise$(...~ff-~'.~x4~...~.~....Address~'....~...~.?.,. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................................ ................................... being duly sworn, deposes and says that he is the applicant (Name of indiv,dual ~.i.g,~g.~_apl ~_._~.,._~ ~. ~__._~ ~' ~lication) above named. He is the ........ ~..~. ~,~.~,¢.,~x,~,.-~,r.. ~.... ....................................................................................................... (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 ...Hn f ~ -- 19~ .~. ....... ...... , . ...... ....................... nt "'//'" ~// (Sianature of a hcant Notary Public/~.~~~--Cou y(~-~. (Signatu pp' ) l&'. ', SUFFOLK COUNTY ~PART~ENT OF HEALTH Riverhead, New York ~Ailding Permit .TYPE OR PR~ LEGTRI% IN DF 14 ~ Health Department Plan No. ADulieation for AD~rova~ of Commercial Sewaee Dis:,osal Syate TOI The ~uffolk County Department of Health Date ./~/~/~ & Application for approval of commercial sewage disposal system is hereby requested, (game a~d ;id_- ~f street, and name-and distance to nearest intersecting street Hamlet __~ 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 County DeP~Health, Suffolk Applicant's Signature~ .,(;/'fl~....~/ ..~j Title /~~ (Builder . Ocher) Address ' )' ' Tel. No. ~-~'- ~ ~ Head~ for inspection Inspected by z Date .... ~~ Installation ,ati,factory . Yes ~ 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 systea 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. OCT ! ? 1966 SCHD - S-13 N. 6¢49' 30' u_. 66*,4*9' ~0" z L~ TOWN SCALE: ROAD ,t,