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Home My WebLink About5229-zFOKM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ot~ice Southold, N. Y. Certificate Of Occupancy No. Z6288 ...... Date ....... Jail.. JID .... , 19..~.~ THIS CERTIFIES that the building located at Ii/S ¥oungs Av~ ..... Street Map No. ~ ..... Block No. ~ ... Lot No. ~ . I~d;~;it~aak. It,I/, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... April %319.71. pursuant to which Building Permit No. ~229Z. dated ..... kpri~....13. , 19.7:I , 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 . Pr~.vat~. swimm~mg, t~ool...with ~ea~asorya ................... The certificate is issued to . ~qalnaond l~ta;~a~laskl ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval I~ ~R, ................. UNDERWRITERS CERTIFICATE No...p~lad&ng ............................... HOUSE NUMBER ... ~+8~ .. Street . ,Young~ Ava ............................ iiuilding Inspector / TO~N 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) 5229 Z Permission is hereby granted to: ~..I~L~....~,,.'L.~.. ~,1~ ~ to .... ~J~...zm~..~..~e~..-..~ ~Jt~.-J~es~ez~) ....................................... at premises located at ..... JJ'~"~'~J~l~ll*'~ ............................... ,; .................................................... ................................................... tlet*.:t:~il: ...... tl~.,~ ...................................................................... pursuc~t to application dated ..................................... ~jv~......$3,, I9,~,~.., and approved by the Building Inspector. ~ { -' Buifding Jns~,~r ' ~ SURVEY FOR RAYMOND A ~ PEARL A. MAZGULSKI MATTITUCK TOWN OF' SOUTHOLD SUFF. CO., N. $Cu'Ft~OLO SCALE: I" h",~TEI'~-COUNTY TITLE GUARAN = 40* ,~,~OATGAGE CO, JULY 27~ 1959 ~,'7 ~/ -' ~N~R LAr~D SUF:VEYO~,N,Y,S, ,/ ? Approved .......................... .~.! ........... , 19.~.J ..... Permit No. ~--~.~.c~ Z.-- Application No.....'~....'~....'~...~.. ......... APPLICATION FOR BUILDING PERMI'! ' INSTRU~IONS % a. ~is applicati~ must be co~letely fill~ in by ~ewriter or m ink and submi~ in ~plic~e to tbe Building In~r. ' b. PI~ plan showin~ I~ation of lot a~ of buildi~s on premiss, relationship to adjo n ~ prom ~ or pub c ~ts or a~s, and givi~ a ~ailed ~ri~i~ of I~t of pm~ must ~ drawn ~ the di~ram ~ich is ~ of ~is applicati~. c. ~e wo~ c~er~ by this pppli~tion may not be commenc~ ~fom issu~e of Buildi~ P~it. d. UD~ ~r~al of this applic~i~, t~ Building Ins~ctor will i~ue a Building Pe~it to the applicant Such ~rm t shall ~ k~t on ~e promises available for ns~ct ~ throughout t~e p~ of t~e work. e. No buildi~ s~ll ~ ~cupi~ or used in whole or in pa~ for any pu~e whatever until a Ce~ificate of ~c~ncy shall h~ been gmn~ by the Building In--tar. APPLI~TION I$ ~EBY ~DE to the Building Pediment for the i~uonce of Q Gu d ~ Pe~it ~muant to the Building Zone Ordinance of the T~n of S~thold, Suffolk ~oun~, New York, and ~her applicable ~, O~i~nces or ~ulations, for the construction of buildings, additions or alterations, or for remova or demolition, as heroin ~ri~d. ~e applicant ~rees to comply with all applicable la~, ordinances, building c~e, housing c~e, and regulations. ......... ....... ..................................... (A~re~ of ap~icont) Statewh~th~ar~)~w. ner, less//~j, agent, a~hitect, engineer, general contractor, electrician, plumber or builder. ......... .................. . ......... - ~ '/)'~' I/ x ", ......................... \ Name of owner of Premises ....~~.~.~.~....~.....~/.~.....~-'-~...~.. ~.~1~.....;...' ................... If applicant is a corporate, signat~of duly authorized officer. ~'/~ ,~ (Name and title of corporate officer) Location of land on which proposed work will be done. AA~p No.: ....... .....F. ...... '. ................... Lot No.: Street ~a~ Number ~..~4~:~ ....... ~.~.~.' .... // ...................................... State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ~..~-5~'..r..~'.~ 10. 11. 12. 13. 3. Nature of work ~h~'J~vhich applicable): New Building .................. Addition .................. Alteration .................. Repair .................. ~emoval ..................Demolition .................. Other Work (Describe)/~.~r~.~p_.__~. 4. Estimated Cost ...... .~..~}:J~ ................... .....L..: ...... 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, Jf 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 ............................ D~oth ........................ Height .................... Num_berl of Stories ...................................................................................................................... Size of lot: Front ....-/..~e~--'/~ ............. Rear ........ Z~..~.. ................. Depth ....... ~....~...~. ............ Date of Purchase ............ i ........................................... Name of Former Owner ........................................................ Zone or use district ,in which premises are situated ..................................................................................................... Does proposed construction violate any zonina law, ordinance~4~, re.g_ulation? .....~..~.. ............................................ 'Nome of Contracto ~ Address Phone N~ 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 Y~RK, .~ / tee COUNTY OF ' .(..~.~/~'.x-~.,..~.~-~(~dC~ ............... .'?.,being duly sworn, d~oses and soys t~t he is the applicant above named. He is the ...................... ~.~.~.~..~ .............. J~s .................. ................................................. (Contractor, , * ' , .) of said owner or owners, and is duly authorized ~ Refform or hgve perfo~ed the said work and to ~ke and file this application; tha( all st~emen~.contained-in t~{~ a~plicafi~ am ~um te the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to~fore me this ' ..... ............... , / .' / ..................... ~ot~ ~ublic, ....~.....J....~.... Coun~ ~~Si~nomre o{ ~pplicant) ~ ~ ADELE PAYNE -- ' No~ ~bMc, State of New Yo~ Residing in S~ffolk Coun~ No. 52-3041000 ~mm[ssion ~pires March 30, 1~7~