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Home My WebLink About2318-zFO~M NO. 4 TOWN OF SOUTHO/D BUILDING DEPAR'rMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 1902 Date . ~ul¥ 30 , l~ 6k THIS CERTIFIES that the building located at ..... .~..~.~.!'.~.f).o..ti..._~..~.~.~. ........... Street Moose Cove eat Map No ....................... Block No ....................... Lot No..]:..~.., ........ g..~.~.~.'.~..O..~.~.~L...~t..~..*. ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... ..~..~..Z.'..q.~.......~.~. ....... , 19..~..)'.~... pursuant to which Building Permit No. ~'2~18 dated ................................ .J~.Jl~.~..~..~........~.,~.., 19..~.~., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ...... ~..t.~..e.....q .~..e... ~, ,~..t..Z. ~..~.*..~.! ?: ~.~ .......................................... ................................................. The certificate is issued to ..~J~.~.t~/...~,C~..'l;j,~ ..................... .(~t~.~ ............. ~ ................................. (owner, lessee or tenant) of the aforesaid building. H. D. Appr oval June 30 1965 by R. Villa ........ ............... L Building Inspector ~ FOEM NO. ~ BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE Kf:PT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORI(AUTHORIZED) N°. 2318 Z Permission is hereby granted to.', ........... ;,..B~Ut,,I~o:Ld ............ -.....: ......... .................. to ...liullL~l..aev..ene..i'e~l,lli~..d~e$1$.~...: ............................... ,.....~ .................................. ~ ........ at premises located at ,. ~.t.....~t~ ....... ~o~lae'..Ol~'l~.]~,.~ ........... ................ ~ ........... ...-; ................ ' .......... Bee~.£oo.t,..Pa~ht ........ ,.C~t;e~c~ r ....~,,g.,; ............................... ~ ........ 19..,(~, and, approved by the pursuah~ to application dated .................... ~,~......,~ ................. ' ' Building Inspector Fee ~...1~.,,~ ........ · ......... Building in~Pect;~:::; ~GHD SUFFOLK COIR~Y DEPARTmeNT OF HEALTH Date ?/2~/6~ Building Permit No._, 2318Z TO~,~IOM IT MAY CONCERN: The sewage disposal facilities for a structure located at Lot 16 Dee~[oot Path~ Moose Cgve~ Cutcho~ue , (Give deed location) have been inspected by this Department and found to be satisfactory. District Engineer TOWN OF SOUTHOLD ~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. ~ ...................................... , ~ ........ Approved ........................................ , ]9 ........ Permit No ................................. .................................. ................................ Application No ............................. APPLICATION FOR BUILDING PERMIT Dat ...................... , .......... 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, end giving o 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 port 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 f(~r removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of'applicant, or name, if a corporation) (Address of applicant) State whethe~r appJicont is owner, lessee, agent, architect, engineer, general contractor, dectrician, pbmber or budder. ' 'i'~~'"'"i'-''-''''-'''-''''-''' '- ''-'''''''':;::~:r' ~f ~r~m i~s ~ ~ .................................... .................................................. If applicant is a corporate, signature of duly authorized d~ff cer. (Name and title of corporate officer) I. Locationof andonwhchproposedwork!~bed e MopNo~ ~t~ Lot No' /(~ Municipality 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. Estir~ated Cost ..../..~...~..~..~.!.' ...................................... Fee ....... ./....~...~ ..................................................................... (to be paid on filing this application) 5. If dwelhng, number o dwelhng un.ts .............................. Number of dwelhng un.ts on each floor ......................... If gc]rage, number of cars ......~.. ~ .................................................................................................................. 6. If bbsiness, commercial or mixed occupancy, speci fy nature.end extent' of each type of use ............................. 7. Dimbnsions of existing structures, if any: Front.....~'~..~. ............... Rear ...~...¥. ................ Depth ~,4,~.1 ...................... Height ......~;;~....~...~ .......... Number of Stories .../...~ ............................................................................................ Dimensions of same structure with alterations or additions: Front ................................ Rear ............................. Dep(h ............................ Height ................................ Number of Stories ........................................ 8. D~mens~ons of entire new construction: Front ................................ Rear ............................ Depth ......................... Height ............................ Number of Stories .................................. 9. Size.of lot: Front /' ~) ~ Rear /..~. O I ,~ ! ........................................................ Depth / 10. Date of Purchase ........................................................ Name of Former Owner .................................................... 11. Zone or use district in which premises ore situated ............................................................................................. 12. Doe§ proposed construction,,~ ~. '.,,~, ~ , violate ,¢ny zoning la, w, ordinonceQr/~...~..# . ,regular°n? .................................................. 13. Nam.'e of Owner of premises ~..:././.~..Address ...~ ....... Phone No NaMe of Architect ......................... .~..r ...... ~,~ ........... .~,~ddress ............. 7/~ .................. Phone No ................. Name of Contractor*~~..~~ddress ...~..~ .......... Phone Ncx~.~"~.,.~...~..: PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali set-back dimensions fr~ property lines. Give street and block numbers or description according to deed, and show street names and indic whether interior or corner lot. STAT OFi S S COUN..- pF ..,.....~3 ' ' .................. : ......... ~....~.-~ .............. being duly sworn, deposes and says that he is the applicc (Name of individual signing a,pp~lication) above named. He is the ....... ~~~ ................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly a~j~.~9~iz, ec~,~perform or have performed the said work and to make and f this applicgtion; that all statemenl~o~i~l¢,~,[j~'~sy~pplication are true to the best of his knowledge and bell, and that tee work will be perforr~.ifC-¢h'e~c~t~ ~l~t~forth~b~in the application filed therewith.