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Home My WebLink About13753-z FoRM NO. 6 TOWN'OF SOUTHOLD I~uilding Department Town Hall Soqthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1, Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4, Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 / / 2. Certificate of occupancy on pre-existing dwelling q/r land use ~/5-/$5.00 3. Copy of certificate of occupancy $1.00 Date ......................... New Building .~.d.~.J..'c~?.~ .... Old or Pre-existing Building ............ Vacant Land ............. Loc ti nofP ty 1080 p~l: Rd. #1.5 (~ick .Rd.) t~ttituck a o roper ................................................................. House No. Street Hamlet Owner or Owners of Property . .D?.~.a.[.~. ,~'....a~..~..]~)..=.o.~.~,. ~....S.~? .............................. County Tax Map No. 1000 Section Z13 Block 06 Lot 015 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..&37537. Date of Permit 3/],]./.85 Applicant JDo,~ald ~'. Sha~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .... a.~a. qh.e.0,. ............ Planning Board Approval ...................... Request for Temporary Co,cate. ,,.,. ................. Final Certificate .. ?. ................... Fee Submitted $ ................. Construction on above described building and permi_tJ~eet$ all applicable codes and regulations. Applicant ....... .~.. ~. ~~.' .............. Rev. 10-10-78 VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-1802 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York t 1971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD MAY 19, 1988 TO WHOM IT MAY CONCERN: The Pre-CO dated April 5, 1985 indicated a Temporary CO existed at 1080 Holbrook Lane & 15 Wicks Rd, Mattituck under the name of Donald F. & Dorothy R. Shaw. Since the issurance of this Pre-CO, the Temporary CO has been replaced by a permanent Certificate of Occupancy dated 8/22/86 under Building Permit 13753Z w~ich replaced Permit 12060Z. VL:lmr Very truly yours, Victor Lessard Executive Administrator TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /3 7~.% ~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ~D~,~day of ~_~o~-~ , Notary Public, ~ ~(2~/-~ County Notary/ Publi(f -----~, -- --~ -:THE NEW YORK BOARD' oF:FIRE .:UNDERWRITERS::?:!---'~%~::::- :::i-00Z375 -:::=-. _- .: - . ~ N .b'TREE-T, NE'~N YORK.~IEW ~'ORK 10038 Z :" -, :' _-=_ -:_:..-- :--:.---=-= ;::._.:_:~ :.~ ~,,~ - :; ~,~.,~.,,o.o?: :.~:0,.~?~::.-._:-:-:~:_ ~"-:683~~ '_Ikmald F,' ~<~a~, Holbrook !ane, last Hoise Cox Neck Iane Mill~_r Ro~d, ~ttituckk,: N.Y. a~sexarni~eden c~:~ I"C~ ' ~,.'~.~ '¢~.985 ~ndfoundtobeincompIi~nce~v~th~requ&rernen~softhL~B~d. ~.F.1. ~is D. ~a~e, Jr. P, O.~ ~:/~Y. ~1t~ Lic[ ~2 ~~f~ll~ :- p~ ,FECTION FOUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING COMMENTS INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT, INSPECTION FOUNDATION lST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING R[MARKS: [ ] FINAL DATE INSPECTOR 65' $outho!d Town Board o£ Appeal$ Appeai'No. Application TO: ACTION OF THE ZONING BOARD OF APPEALS 3O46 Dated October 5, 1982 Filed October 7, 1982 .Enviro~ent?a$~Inc~ as agen~ for Mr. and Mrs. Donald Shaw 3075 Indian Neck Lane Peconic, NY 11958 [Appellant (s) ] At a Meeting of the Zoning Board of Appeals held on October 21, 1982 the above appeal was considered, and the action indicated below was taken on your [X] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinanc~ Article , Section J [ ] Request for Variance to the Zoning Ordinance Article , Section [ ] Request for The public hearing on this application was held on October 21~ 1982. Application for MR. AND MRS. DONALD SHAW by Environment East Inc~., 3075 Indian Neck Lane, Peconic, NY for a Variance for approval of accDss, New York Town Law, Section 280-a. Location: Rights-of-Way located 6ff the east side of Jackson's Landing Road (referred to as Miller's,- Young's and Wick's Rights-of-Way), Mattituck, NY; subject parcel known as 1080 Private Road #15 [Wick's Road]; bounded on the north by Manos; east by Manos, Right-of-Way, and Roundtree; south by Howard's Branch of Mattituck Creek; east by Schipani, Davis, McCarthy and Rohren; County Tax Map Parcel No. 1000-113-6-15. The board made the following findings and determination: By this application, appellants seek approval of access over private rights-of-way: (1) extending along Miller's Road [or Bungalow Lane] in excellent condition and having a width of 25 feet; (2) extending along Young's Right-of-Way, having a width of 20 feet, and (3) extending further along Wick's Road [east of Young's] a length of approximately 457 feet and a width of 20 feet, to the parcel in ques- tion. The board, after inspection of the rights-of-way in question, has found that Young's and Wick's Rights-of-Way are in fair condition and need improvement. In considering this appeal, the board determines that the variance request is not substantial in relation to the requirements of the laws; that the circumstances are unique; that by allowing the variance no substantial detriment to adjoining properties would be created; that the difficulty cannot be obviated by a method feasible to appellants other than a variance; that no adverse effects will be produced on available governmental facilities of any increased population; that the relief requested will be in harmony with and promote the general purposes of zoning; and that the interests of justice will be served by allowing the variance as indicated below. On motion by Mr. DATED: October 26, 1982. . ~Q~F°rm ZB4 (rev. 12/81} Grigonis, seconded by Mr. Doyen, (CONTINUED ON PAGE TWO) CHAIRMAN, SOUTHOLD TOWN OF APPEALS it was ZONING BOARD Page 2 - Appeal No. 3046 Matter for M~. and Mrs. Donald Shaw Decision Rendered October 2.1, 1982 RESOLVED, that Appeal No. 3046, application foriMR. AND MRS. DONALD S A~ for approval of access to the parcel in q~stlon, be and hereby IS APPROVED SU~ECT TO THE. FO.~LgWING.. CONDITIONS. 1. That the entire access road known as Mlller?s Road or BUngar low Lane is hereby approved and accepted in its preseflt condition; however, this road shall be maintained at all times in its present good condition; 2. That access roads known as Young's Right-of,Way and Wick's Road shall be improved in the following method: Surfaced with a minimum depth of two incheslof packed three-quarter-inch stone blend so as to afford accessi for emergency vehicles. Such stone blend may be either applied to the ground sur- face and shaped, or the surface may be excavated to p~rmit.the application of packed stone blend to a depth of two i~ches, 3. That the above requirements shall be inspected and approved (by the road inspector or the Board of Appeals); 4. That no certificate of occupancy shall be i~sued for the construction of any buildings or structures, for vacaht land, or for any existing buildings or structures, on these premises to which this access is referred, until all of the conditions set forth herein have been complied with. Location of PrQperty in Question: 1080 PrivatelRoad No. 15 (also known as Wick's Road), Mattituck, NY; County Tax Map Parcel No. Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Grigonis, Douglass and Sawicki. This resolution was unanimously adopted. RECEIVED AND FILED BY TkE SOUTiiOLD TOWN CLERK APPROVED ': 'FORM NO. 1 ,/// TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ~amined .. ~4.0-~.c~. ~t..., 19~' / pproved ....~....O,~. It.., Permit No..k '~,~'- ~ ~ ~' isapproved a/c ..................................... (Building Inspector) APPLICATION FoR BUILDING PERMIT INS.T~UCTIONS BLDG. DEPT. TOWN OF SOUTHOLD elveo ..... ~ Date F..elP.m3..a.rY..6,..1.9~$.., 19... a. This application must be completely ~[lle[ i; b~ i~v~ter or in ink and submitted'~0 the Building Inspector, with 3 ts of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showh~g location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ion. 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 issued a Building Permit to the applicant. Such permit xll be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy .11 have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit purscant to the ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~mit authorized inspectors on premises and in building for necessary insp~,Zs3, -. -- ~ - (Signature of applicant, or name, if a corporation) (Mailing address of applicant) 11964 tare whether applicant is owner, lessee, agent, architect, efi~neer, general contractor, electrician, plumber or builder. Donald F. and Dorothy R. Shaw qame of owner of premises ..................................................... (as on the tax roil or latest deed) If applicant is a corPoration, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done.N9~.~.h. .s..id.~ .9~..W.e. ~: .$~7,r~¢h .0~ .~.~t'c:l.tuok. Creek ...... al: en~l of Ho[brook Lane (W:Lcks Rd. ) ................ House Number Street Hamlet County Tax Map No. 1000 Section ................. Block .................. Lot .................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed const~ction: Res~den=e (priam) .......................... a. Existing use and occupancy .......................................... Residenoe (~r~a~) ........... b. Intended use and occupancy ....................................................... air ;..; ......... . .~ mgval .............. Demoht~on ......... Other Work ............. ~' , ~. ,~ (Description) Estimat~i~o~t~ .~ .~.~ ~ .0.0~~. ' Fee 4 ' ~ ~" (to be paid on filing this application) 5. If dwelling, number of dwelling!units .... .o.n.~ ........ Number of dwelling units on each floor ............... ~ number of cars If garage, . ....................................................................... 6. If business, commerctal or m~xe,d occupancy, specify nature and extent of each type of use ..................... R ' pth 7. Dimensions of existing structures, if any: Front [*~'~iI~-0~:.'1~) ear ..... . ......... De .. ~'. ...... , . Dimensions of same structure with alterations or additions: Front".~..~ .............. Rear .... . .............. Height Number of Stories Depth ................................................ .................. - 8. Dimensions of entire new construction: Front . .~.~..~ .......... Rear ............... Depth lleight ............... Nm{her of Stories ....... : ................................................ 10, Date of Purchase .~0..1Y. ~.~ ¢..1~?.4 ................ Name of Former Owner I~,tlo¢ o. ~. tlo~'o. 8~nd~ ......... 11, Zone or use district in Which premises are situated . 12. Does'proposed construction viqlate any zoning law, ordinance or regulation: no .............................. 13. Will lot be regraded ..... !10:! .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises l)o~*ld.P. &. l),l~th¥.lgAddress $O1~. 5~.~. 1~. l)~l;tk~l:~otthone No.. ? .4 .~ 7 .1.0 .5 .'/ ...... Locate clearly and distinctly al property lines. Give street and blocl~ interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, ~S.S COUNTY OF ................. l~on&ld I~. ~h~ i being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract above named. : .... ' .- ~' - (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly 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 mannler set forth in the applicMi0n filed th'er~wi[h. Sworn to before me this Notary Pubhc .................. C unty