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Home My WebLink About4841-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...Z..4~61... Date ...Peb-'uary... lQ, ........ , 19.72. private R.O.W. off south THIS CERTIFIES that the building l,ocated at .side..of. SoundAvent~ .... Street Map No.. XXXX ...... Block No... XXXX...Lot No. XXXX.,..bia~tituak,. Naw .Yo=k.. conforms substantially to the Application for Building Permit heretofore filed in this office. . dated .. J.u.!y...6., .......... , 197.0.. pursuant to which Building Permit No iSilZ/z~a~L~ dated .. J. uly..7, ............ , 1970.., 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 ... private, one. family..dwelling .................................... The certificate is issued to .. T.h..o~.. S..a,..~.~'~,n ................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval February..10,..1972.,..l~b~;t. l...Villa FOIl3[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PRFg~ISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4347 Z Permission is hereby granted to: ~..~.?...!':.. ~.::!?.~....A./..c......!~?.~:L.a...~.~,~n.... ................ 7.!:Y......5......~...l...~. ........................... ................ lJ,l.w~,'"b.o~l,..., lt.,,~, ............................ I~l. ne.v on~ fc~il~y d'~el]ing pursucm4' to application dated ................................ ~.~.~.~ ............. , 19..;.,;.., and approved by the Building Inspector. JJJJ~J PI:J'I~ llt~l~t ~4} ~F~ ~ ~ ~e0eWe ~. ~.J.?.~.~ .......... , ../.-.~.;; ........ ; ......... ; ..................... .:t. ...................... Building InspectorI TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ............... ~....~s~ze..a~ ................................. to ........ .l~lh~.6....ll~...i~el...f. el~l~...~wa3.1tng ........................................................................... at premises located at ............ ..... ~.~...gaml ......... i, ia,~t~ttnw, k ............. ~,z, .......................................................... : ....... pursuar~t to application dated ............................... ~.y..L...~ ........., 19.~.., and approved by the Building Inspector. ~1 ~ ~llt~"ll~t~ I~l]l~,lttl ~l'Id ~ ~ ~ ~ F. ~.!9.~.~ .......... Building Inspector ~FORM ,NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CL~RK'S OFFICE SOUTHOLD, N. Y. isapproved . . ......... ...... ^ ( Buildh"Ig Inspect<n') APPLICATI(~N FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot ~)lan showing location of lf~t and of buildings o n 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. Up(m approval of this applicatkm, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept ~ the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole o~ in part for any purpose whatever until a Certificate ~f Occupancy shall have been granted by the Building Inspector. APPLICATION IS I-II~Y MADE to the Building Department for the issuance of a Building Permit pursuant ~o the Building Zone Ordinance of the Town of S~utho Id, Suffolk County, New York, and other applicable Laws, Ordirmnces ,or Regulations, for the construction ,~f buildings, additions or alterations, or for removal or demo- liti°n' as herein described' The applicant agrees to~ ii~i', iiii.n~nces' building cOde'h,mlsing code, arid regulations. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ....... . ..0~'..-.. ~u:i~de~. ....................................................................... Name .of ,owner of premises ..... Th~l~la~. ~'.~. Gt~X~llltkI1 .................................................... If applicant is a corporate, signature of duly auth,orize d ,~fficer. (Name and title of corporate officer) 1. I~ocation of land on which proposed work will be done. l~fap NO ..... ~ ........ Lot No.. XX ......... Street and Number ....P~..~...R...Q,~,. 0.ff. ~/$...$o.und. Ava.../4a.~tl~;uck ........................ Municipality 2. State existing use and occupancy ,of premises an d intended use and ,occupancy of proposed construction. a. Existing use and occupancy ...g&¢al%~> .................................................... b. Intended use .and ~ccupancy ..... 0~. ~l~y. ~weLllng,: ........................ '. ~ .......... 3. Nature of work (check which applicable): New Building . ~ .... Addition ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. Estimated C~st ....... 12.~.~0~ ................ Fee ....].0. ........................................... (to be paid ~n filing this application) 5. If ,flweIling, number of dwelling units . .0ile ..... Number ,of dwelling units on each floor .............. If garage, number ,of cars .......................................................................... 6. If business~ .commercial ~r 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: Frcmt ... -~0 ........... Rear ...be(~ ........ Depth . .~.2. ~. .... Height ............ Number of Stories ............................................................. 9. Size of Lot: Front ...~.~..+ ....... Rear ........ .].~.0. ~. Depth . -36-~ .&..290.. 10. Date of Purchase ...... .1.96.9 ................... Name of Former Owner .... ~T. F. af~i_vlsF~ ........... 11. Zone ,or use district in which premises are situated... '.~&f!. d~.$~ ...................................... 12. Does proposed construction violate any z~ning law, ,ordinan~c~p~ rsg.ul.a~!~m? ..... IlO 13. Name ,of Owner.of premises . .Thas. J.o. G~rmal~. A, ddress D~.X.. t:I.~-ll~ .......... Phone No ............ Name of Architect ............................. -~ddress ...................... Ph, one No ............ Name of Contracbor .. I~om~-.P-l~I:Lries- .I.l~ .... Address ...................... Phone No ............ Thao fiorman PLOT DIAGRAM Lo~ate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give s~eet and block number ~r descripti, on according to deed, and show street names and indicate whether interior or c~rner )ct. See filed plan~ STATE OF NEW YORK, )S.S. COUNTY OF .S%;~.f.o.-]:k .... ) ................ .T.h.o.s...J.;..~.o.~aZ~ .................. being duly sworn, deposes and says that he is the appli- (Name ~)f individual signing application) cant above named. He is the ....... 0w'ae~ .... ~u. llde.l~ ................................................. (Oontractor, agent, corporate officer, etc.) of said owner ~or ,owners, and is duly antborized to perform 'or have performed the said w~rk and to make and file this application; that all statements contained in th is application a~e true to the best of his knowledge and belief; .and that the w~rk will be perfc~'med in the mann er set forth' in the application filed therewith. Sworn to before me this .......... .1.1~... day of ....... A~ril ..... 19.6.9. N,o'tary Public, .. ~ ...... Cou~nty No. 52-81258~0 ~T~rm ~Xpires M'arch EV) LLE York of applicant) BUREAU iOF ELE~,TRICITY 8S JOHN STREET. NEW YORK. NEW YORK 10038 9ZOZ90 .:~;~ De~embe~' ~?. ~971 ~pp.,~,i.,,.~o.o..r~. 533093 N tlmtth"el~'~ricdequW~mentan~ ' -~ -,* -~. off s/s ~ound Ave., Coun~r7 Side Homes, w/s~e r.~.,,~ , ~....,t~.,~ecembe~ 1~, 1971 rnaoes: Oil 1-1/ShP,, l.~/12hp . ~... apnliance feeder/S: 1-3#6. 1-2#14, · · - ~U~- ~ ~r ' IbC. , c~ti~ m~l m~t be altered in any manner~ return oUFFOLK CLUNTY ~EPaI{TMm~T OF HmALTH Date 10/13/71 Bldg. Permit No. 48~1 Z TO WHOM IT MAY CC~v~RN. The sewage disposal facilities for a structure located at W/s private P.0.W. off S/s Sound Ave. ('throu~Eh Jazombek farm) (Give deed location) Mattituck, Y.Y. have been inspected by this department and found to be satisfactory. District Engineer SUFFOLK COUNT~' DEPARTMENT OF HEALTH ~ EASTERN DiS?RICT H.D.Ref. No. ~O ~ County Center, Riverhead, New York , PA 7-4700 ~ APPLICATION FOR APPROVAL OF INSTALLED PRIVATE SEWAGE DISPOSAL AND WATER SUPPLY SYSTEMS Inspection for approval is requested, pertinent installation data herewith. 1-Name of Owner Thom~;s [~orman Address2 Oriole h'a Dix ii. ills , Pho~ iiA'/-O'/l~ 2-Name of BuilderCOU~r~lce ~, . ,~. ay~ !iaur, paug~e~ w v Address >P~, hot:or '~'~, ...... 7-Sewage System ins~all~ed byNarang°hi ~ Son~ , Addres~ale Ro~:d~ Sgony ~ooK~ N.i. 8-(a)Deed location of property W/s Private i~.o.:~, ot'l' o/s ~o~a ~venue (b)Hamlet or Village- P?sC~i~UCK (c)Town 9-Septic tank-Gal~ ~ft.~ ft,Liquid Depth~f~.=v 10 Cesspools {:}~t;::o:t~e_L tb~B~:~s ~el::.~let li~)e;~t 3) pool__(e) 1__2 (f)H ft. in; Diem ~t., l~.(g)Finished grade to cover 1]~ (h)Backfill Material ~1~ g ll-Water Supply: Public Syst~ ; Private Well' If Private the following questions are to b$ gB~wered: ~le~ b ~l,,loD ~ Do . 12-Private Water Supply. Sy~ ~st~z ~.2 Y -- ~r .. Address i, ouue ~p~, xoc~y i-u., ~... z. ~.m / ,o < of Laurel 3-Subd iv .L ap 4-Section No, 5-Lot Number 6-Bldg. Permit No. t+~± Phone 751-1002 3 13(a)-Total Depth of Well ,(b)Depth to Static Water Level -14-Diameter of well pipe in. 15-Name of Laboratory ::Owen? Lp. hs 16-Method of Disinfection Chlorinated -twice !7-Date ready for inspection 'JJ 1]. ~hone The undersigned CERTIFIES: Above .systems have been constructed and are in compliance with the Suffolk County Health Department's current Standards, Bulletins and Amendments thereto. COU~i~RYS.I~E ~,~:±~ ~OtI. 18-Date ] O-1~-71, ,Signed /Owner - Builder EXEC. V. P. 19-Insert sketch of location of Water & Sewerage ~acilities with accurate dimensions. C ,, ! .. ,. : ,~ .5-6731 ' STREET , ,~. ~ ~',' / /JO' ~/c ~V ........................... ~R H~{ D~NT USE ONLY I I-- ' Inspected by / --(-~__ Date )/ ~/) 9 '- · Based upon th~'info~ation ~ated above, satisfactor~un~ip~ng ot the above systems can be expected with proof mainten~an~c~ 7/ ~ ~~ ~' t~,r.~..~ S-Se BUILDING DEPARTMENT ~_._. .',~ ...... ,~;..~...:~ .~ ~.--,..~....~ / ..... '.L,: .. ~..~, .................. , ........... 7..T ........ ,. ,': ..... , ~ (~s~oO ~ - ' ' ~' APPLI~TION;FOR BUILDING Suly 6, 1970 Date, ............................................................ , 19 ............ 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 aj;~Icoble Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal_.j:m'i~a~olition, as herein described. The applicant agrees to comply with all applicable laws, ordinanc~d regulations. ........ Z..O. zial~...~/z~..,...D.i~..Uill~.,..l~.Y. ....... 1,!.7.1.6. .... (Address of applicant) Stote whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. o~e r Name of owner of premises .................................................. If applicant is a corporate, signature of duly authorized officer. ~ _ . (Name and title'ofcorporateoff,cer) -- /'~,~ ~'/7 7-,~1~" 1. Location of land on Which proposed work will be done. Map No.: .................... ]........ ......... ~" Lo;t,N~.:,: ....................... Jazombeck Farm etc) Nlunicil~lity 2. State existing use a.nd occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... .~..iLC.~JI.~ .......................................................................................................... 3, It~l~m ~ walk (check whici~ applicable): New Building,................xx Addition ........... ....... Alteration ................... lRepair .................. Removal .................. Demolition .................. Other Work (Describe) ................ : ....................... 4. Estimated Cost .~..0.>J).0J] ............................................. Fee ................................................... (to be paid on fi!lng this application) 5. If dwelling, number of dwelling units ........... o~e .......... Number of dwelling units on each floor ...g~,~ .................. If garage, number of cars Trane . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ....Tt~.l ................. Rear ...~,~ ...................... Depth .~.:J:.l. ............ Height nj! Number of S[orJes ~:J. 1 . Dimensions of same structure with a.lterations or additions: Front ................ .])...J:..1. ............. Rear Depth ........ ~i~. ................ Height ............ ~,~.~, ........ Number of Stories ....... ~.]-. .................. 8. Dimensions of entire n~w construction: Front ........... .~.1~. .................... Rear ...~...~.....~..0. .............. Depth ....... ,~.~ ............. Height .....].~ ........... Number of Stories ..... P.~. ............................... 9. Size of lot: Front ..~..S. ...................... Rear ....]...4..~..+. ........................ Depth ...~..6..S....~....Z..?.0. ....... 10. Date of Purchase ..... 6,.-.5.-.69 ..................................... Name of Former Owner ...$.gl~..h.~.e...l=..a...~.[.n..s...k..~ .................. 11. Zone or use district in which premises are situated resd. 12. Does proposed cor{struct~on violate any zoning law, ordinance or regulation.;' ........... .n...o. ............................................ 13. Name of Owner of premisesT..~...°..s.......~.:....G...O....r~...a...n......Address 2 Oriole Wav,Dix H~lls BA7-0712 ........................... r ................ none No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locote clearly ond distinctly all buildings, whether existing or proposed, and ndicate a sera, ack dimensions from property lines. Give street and block number or description according to deed, and show strut names and indicate !~.. ed~ether nteror or corner lot. / · STATE OF NEW YORK, ice COUNTY OF lta,~sa~ .................. J'""" ....................... l'ltotaa&..J.,..~or2an ................................... being duly sworn, deposes and s~ys that he is the applicant ,(Name of individual s~lgning!c~plicoti~n) ~ · ' - ' above named. He is the ...... O'~ql~.l: .... : (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 timidest of his know edge and belief; and tha~ the w~k will be performe.~d in the manner set forth in the appl~i~/~je~ew th. Swam to before me this ~'~ ~ ' c..-~/~'f ........... ........... ..... 70 Natal/P-bi,c, ....................... . ~:~...~.. ~,~le~ In Suf~, k County . ' ~.~,~ . ~m,. r.:Xplres March 31), 1972 KEY MAP SCALE= 1"=200~ LAKE SURVEY FOR THOMAS d. GORMAN 8, MARY G.'GORMAN LAUREL . TOWN OF SOUTHOED SUFF. - CO., N.Y. kUARANTEED'TO, I~I~icR'¢OU'NTY TITLE EUAR&NTY SCALE' I"~ /~O~TeA6E CO: " ~0'' TRE:BANK OF aAaYLON APRIL 5, 1969 YouNe aYOUNe dUNE 4, 1971 AUG. 27, DEC,": 8', IC~,~', 3' X 5' DOOR, *., , h u~ , ~ ' ', - ' ALL CO~N ~D BRIC[ 2 x~ x~ 1/2 T IRVING E PA~Om~ ~KHI~CT RICHARD B. THOMAS~ GORMAN ~ MARY G TOWN OF SOUTHOLO SCALE, I~ = ~0' APRIL 5, 1969 GORM