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Home My WebLink About4375-zTOWN OF $OUTHOLD BUILDING DEPARTMI~,NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z?-~87 ..... Date ........... Mal,.. ~8 ........ , 19.~. THIS CERTIFIES that the building located at . .i[,0,1~,. I/~. ~®ak~ter. I~t Map No.. ~ ........ Block No... ~-~ ..... Lot No..~ .... l~tSt'~i~ ............... confOrms substantially to the Application for Building Permit heretofore filed in this office dated .......... J~-~ ~ '9 .... , 19..~. pursuant to which Building Permit No. dated ............. ~ttl~.. '9', 19.69, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . i~.$Tate. Mm .fltl~1.1~'. d~e~ .¢~oh:L~e. Ho~e..v~.tb. ~(~d~t~o~) ..... The certificate is issued to .D~d. &. Jeal~. CO~peF ..... Owle3~ ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · NOW.. ~... ~.. I~..R. ~ ...... UNDERWRITERS CERTIFICATE No.. R,R, ...................................... HOUSE NUMBER .... .~.$~0 ..... Street . ~e~k~mtel~..llOa5 .old. l~tlm~ .i[O~l.. Matt, uilding Inspector / FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 375 z Permission is hereby granted to: ..... ~.].~L · &.. Jem:. · ~l~a.. ......................... .................... l~t-ti.~M~ ...................................... ........................... I1.~:,, ........................................... at premises located at .................. ~O. eM.~.....l~....Lu~/~..~l~..(~t~l~..~lll~) .... ....................................................... II~t;t.tu~....Z,;Z. ................... ~ ................................................ pursuant to application dated ................................. ~T~.~'. ......... ~...., 19...~-~, and approved by the Building Inspector. Fee $...~.~.~. ........ SUFFOLK COUNTY DEPARTHENT OF HEALTH Date ~r~ ~ ~ Bldg. ~ermtt No. NOV 7 1969 TO WHOM IT HAY CONCERN: The sewase disposal facilities for a structure located ~ ..... "' District Engineer BUILDING DEPARTM~T ~ . .~ , ~.~_~ _ ~ ~ CLE~ ~1~ ~&~/,~ ~ ~. ' ~'~ ~'~ ~' .~: Examin~ A~r~ed ~ .............. ~( ., ],..f.~... . _ ......... ,~,~ ,o....~.~...~..~.....~/~. ~ ~ ~ ~~ _ $. ai~nnrov~a/c ...... ~ ....... ~ .... ~ -// ~~~ k ~- ~ ~/~.~ ...... ~ .......... ~...~.~ '~ __ ~, ....................................................................................... ~ ~'~ ~ -. ~ ........,~/;(_ ~ ~ ~- .................. ~ ........... ~ ................ ~ ................... ~ ........... Y~ ~. ) (Buildi~ I~or) /~ ~ ~ ~, ~-~'~ ~ , : ~.. 69' .. ~ ~ ........................ , ~ ............ : INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or in ink and Submitted Jn duplicate to the Building Inspector. · b. Plot plan showing location of lot and of buildings on premises, relationsh p 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 thle 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. ~. No building shall ? .o. ccu,,pi.,ed, or u. sed in whole or Jn part for any purpose whatever until a Certificate of Occupancy shall have been granted Dy rna aui,aing inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the ~uild!n.g. Zone. O.r,dinance of .~.e Town of, Southol. d., Suffolk C. ounty, New York, and other applicob · Laws, Ordinances or Kegu~ar~ons, tar the construchon of builoings, additions or alterations, or for removal or demolition, as heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. ~.~,~C~._ ~/ /,~ ? Donald & Jea~ Cooper (Signature of applicant, or name, if a corporation) Okddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................... .o...~...e= s .. Name of ~-,ner of ,,ro,~;-=o ~Done.].d & ,Te&n Coo ez' .... . ....... If applicant is a corporate, signature of duly authorized officer. · . ~ (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ......... ~ ........................ L°t No.: ~ ................. Street and Number ............... ~..~.e~.~`~.~.~j~/..~]`~t~g`~j~t~.j~..t;`1'~e~ .................................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... T&OS. nt; ].and b. Intended use and occupancy ......... .9.~.e.. ff..~..~. .dye jL (mobile Home .......... ~a'. ........ ~,..~.~. ......................................... .). .......................... f o 9. 10. 11. 12. 13. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .................. Removal ..................Demolition .................. Other Work (Describe) ........................................ Estimated Cast ...... ~..a.~.~.~...--+ ..................................... Fee ...1...0..~..0..0. ............................................................................ (to be paid on filing this application) If dwelling, number of dwelling units .....o..~...e. ................. Number of dwelling units on each floor ............................ If garage, number of cors ............................................................................................................................................. If business, commercial or m~xed 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 olterations or additJons: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ Dimensions of entire new construction: Front ......... .6~. ...................... Rear ....... .~.~.. ................ Depth ....~.2./....1..~. ..... Height .................... Number of Stories ........................................................................................... (~c)o.~...S.O,..~.t,.) Size of lot: Front .....~.(~..~ .............. Rear ..... .~ .0. 9. .--. ................... Depth ....~.~/....,~?r.,.~.+.. .... Date of Purchase .......... .1.9.~..9 ..................................... Name of Former Owner ....... .D...a:..T..~....0..o...o.~..e..~. .................... # # Zone or use district in which premises are situated ........ ~L.....Z'~.Em~,~I::L~ ............................................................... Does proposed construction violate any zoning law, ordinance or regulation? ........... ..~..O. ............................................ Name of Owner of premisesl~O~c..~.~...C~O~er...Address ........ ~I,~,.~:L.t;?~C~, .............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...... S~la~ .................................... Address ....._-M4Lt,:t~1.~=C~, ................ Phone No ..................... ~ x, ~.v( ~ -1, ~ ~., 1 .1 COUN~ ~ ....~.~ ........... ~ ' ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property liras. Give street and block number or description according to deed, and show strut nan. s and Indicate .............................. .~.~.~....0.~.9.~.~.~. ........................................ being duly sworn, deposes and says thot he is the applicant (Name of individual signing application) above named. He is the ................ O'~'~e~ ............................................................................................................................. (Contractor, agent, coq~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make ond file this application; that all statements contoined 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 inthe application filed therewith. '. Sworn to before me this .......... , ........ S~... dd,y.o~ ............. ~..,T.~L~. ........ ;......, m... ~q//._ ~_..~6,a~l ,.. ~,. - /~_ ..~...;,~.....~ ............................................. Notary Public~~i~Count~ ~'~ (Signature of applicant) ~' NO. 52-8~.25850, Suffolk Cou, gtff ~'~Tn ~.xpires ,March 30, 19.~.~ v wicKERT FORMERLY ~0 0 Z c. 0 ~ ',~ ~> 0 ~ i11 · ~.04, DA'VID COOPER SURVEY FOR DAVID COOPER AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COI. JNTY, N.Y. SCALE: I''= 50' JUNE 30, ~969 LAND SURVEYOR