HomeMy WebLinkAbout1000-74.-3-10
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Southald, N.Y. 11971
(516) 765-1938
April 29, 1986
Mrs. Virginia Hairston
P.O. Box 304
Peconic, NY 11958
Re: Set-off for
Virginia Hairston
Dear Mrs. Hairston:
Enclosed, for your reivew, is a copy of the survey for your
proposal prepared by Mr. Van Tuyl. Also, enclosed is a copy of
his memorandum to the Planning Board.
As is noted in the memorandum, it is a mathematical impossiblity
to meet all the dimension requirements. Therefore they complied
with the setback requirements, however, the lot areas vary from
the Board of Appeals resolution.
Mr. Van Tuyl suggests that the resolution be amended, but
this can not be done without a new application and re-hearing by
the Board of Appeals.
Confirmation and procedure for application to the Zoning Board
of Appeals with regard to this may be obtained by contacting the
Building Department.
If you have any questions, please don't hesitate to contact
our office.
Very truly yours,
3r2 LtUUr;;:r{Ui<J/J [<c / ~/
BENNETT ORLOWSKI, JR., CHAIRMAN
SOVTHOLD TOWN PLANNING BOARD
(J2nJL_'--
By Diane M.Schultze, Secretary
enc.
cc: Board of Appeals
Buildina DpDRrtmpnr
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RODERICK VAN TUYL, P.C.
218 FRONT STREET
GREEN PORT. NEW YORK 11944
516-477-0170
TO
Southold Town Planning Board
Town Hall
Southold, NY 11971
Att: Diane Schultze
DATE April 14, 1 986
Hairston division
Peconic
SUBJECT
Dear Diane:
Enclosed are the six copies of the revised plan for
set-off for Virginia Hairston at Peconic, per your letter of
March 21st to her.
It will be noted that all of the dimension requirements
could not be met, especially as to area ( the sum of the minimums
is more than actually exists), but we have held to the 175-foot
front of the main tract, the 15 feet, more or less, from the house
on that tract, and the 4 feet, more or less, from the shed on the
smaller tract. The proposed limitations produce a mathematical im-
possibility, and it is thus that we have delineated the intention
of the Board's ruling.,.
We trust that this will be acceptable, with per~ps
only an amendment to the resolution.
Yours trul~
~"2.. V ___t~
Roderick Van Tuyl, PC
APR 1 r. 1QR6
Item # ML5N72 ',C Wheeler Group Inc. 1982
FOLD AT (-) TO FIT DRAWING BOARD ENVELOPE # EW10P
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Southold. N.Y. 11971
(516) 765-1938
March 21, 1986
Mrs. Virginia Hairston
P.O. Box 304
Peconic, NY 11958
Re: Set-off for
Virginia Hairston
Dear Mrs. Hairston:
The Planning Board is is receipt of a copy of the
Board of Appeals decision with regard to the above mentioned
application.
Would you please have the survey amended to reflect
conditions No. 1,2, and 6 and submit six (6) to the Planning
Board office so we may proceed with finalizing this application.
If you have any questions, please don't hesitate to contact
our office.
Very truly yours,
~ o,wLtJ/JJU / (~civv
BENNETT ORLOWSKI, JR., CHAIRMAN
SOUTH OLD TOWN PLANNING BOARD
By Diane M. Schultze, Secretary
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Southold Town Board of Appeals
MAIN ROAD - STATE: ROAD 2S
SOUTHOLD. L.I.. N.Y. 11971
TELEPHONE 15161765-1809
ACTION OF THE ZONING BOARD OF APPEALS
Appeal No. 3196
Application Dated December 5, 1983
TO:
Mrs. Vir9inia Hairston
P.O. Box 304, Carroll Avenue
Peconic, NY 11958
At a Meeting of the Zoning Board of Appeals held on March 10, 1986,
the above appeal was considered, and the action indicated below was taken
on your Request for Variance Due to Lack of Access to Property
New York Town Law, Section 280-a
Request for Special Exception under the Zoning Ordinance
Article , Section
[Xl Request for Variance to the Zoning Ordinance
Article III, Section 100-31, Bul k Schedul e
[J Request for.
Application of VIRGINIA HAIRSTON for Variances to the Zoning Ordi-
nance, Article III, SectIon JOO-31,ll"ulk Schedule, for approval of two
parcels (with existing dwellings) having insufficient area, width and
depth. Location of Property: u West Side of Carroll Avenue, Peconic,
NY; identified on the Suffolk County Tax Maps as District 1000, Section
74, Block 3, Lot 10. f
WHEREAS. a public hearing was held and concluded on February 6,
1986, in the Matter of the Application of VIRGINIA HAIRSTON under
Appeal No. 3196; and
WHEREAS, the board has considered all testimony and documentation
entered into the record concerning this APplication; and it is noted
that there has been no public opposition; and
WHEREAS, the board members have personally viewed and are familiar
with the premises in question, existing structures, and the surrounding
area; and
WHEREAS, the board made the following findings of fact:
1. The property in question is identified on the Suffolk County
Tax Maps as District 1000, Section 14, BLock 3, Lot 10, and is
located along the westerly side of Carroll Avenue, approximately
262 feet south of C.R. 48, at Peconic.
2 .
(65,427
located
The subject premises contains a total area of 1.501 acres
sq. ft.) with 288 ft. frontage along Carroll Avenue and is
in the Residential and Agricultural Zoning District.
3. By this application, appellant proposes a set-off division
of land with insufficient. lot area and width as follows: (a) Lot
#1 of 20,424 sq. ft. in area and 95' width, with an existing
single-family one-story frame house set back 57I feet from the
front property line along Carroll Avenue; (b) Lot #2 of 45,003
sq. ft. in area and 193' width, with an existing two-story single-
fami ly frame house set back approximately 57' from Carroll Avenue
(CONTINUED ON PAGE TWO)
DATED: March 20, 1986.
Form ZB4 (rev. 12/81)
CHAIRMAN, SOUTHOLD TOWN ZONING BOARD
OF APPEALS
Page 2 - Appeal No. 3196
Matter of VIRGINIA HAIRSTON
Decision Rendered March 10, 1986
and 24 feet from the proposed division line, and an accessory
10' by 13:1:' storage shed proposed to be located 3' from the
division line.
4. It is noted for the record that a Certificate of
Occupancy of Nonconforming Premises #Z13922 was issued October 10,
1985 and that the sUbject premises does have separate sewage
systems and water wells for each dwelling.
5. It is also noted for the record that by letter dated
October 23, 1985, the Southold Town Planning Board has
recommended an alteration in the proposed division line to
increase the size of proposed Lot #1 and decrease the size of
proposed Lot #2, and to _which this board agrees.
6. It is the opinion of this board that in view of the
circumstances of the existing dwellings, separate sewage systems
and water wells and viewing the area of the existing parcels to
the south of the L.I.R.R.. applicant's reasoning is not unreason-
able and is unique.
In considering this appeal, the board also finds and
determines: (a) the practical difficulties are sufficient to
warrant a granting of the variance; (b) the circumstances
are unique in that there are two existing dwellings with
separate sewage systems and water wells; (c) there are parcels
of a similar or smaller size existing immediately to the south
[along property of the L.I.R.R.; (d) that in view of the
manner in which the difficulty arose, there is no other method
feasible for appellant to pursue other than a variance; (e)
the granting of this variance as amended will not change the
character of the district; (f) the granting of this variance
will not be detrimental to adjoining properties; (g) the
relief requested will not cause an effect of any increased popu-
lation density; (h) the public health, safelty and welfare
of the publicand the interests of justice will be served by
granting the application as amended and indicated below.
Accordingly, on motion by Mr. Boehringer, seconded by
Mr. Grigonis. it was
RESOLVED, the relief for insufficient lot area and width
BE AND HEREBY IS GRANTED under Appeal No.3196 in the Matter of
the Application of VIRGINIA HAIRSTON. SUBJECT TO THE FOLLOWJNG
CONDITIONS AND LIMITATIONS:
1. That the division line be placed not closer than four
feet to the south of the existing .shed" structure. providing
for a minimum lot width of 110+ feet and minimum lot area of
25,660 sq. ft. for proposed Lot #1; and
2. That the subject division line be placed to allow for
a minimum northerly sideyard setback of the two-story dwelling
on proposed Lot #2 to be 15 feeta-providing for a minimum lot
wi dth of 175 feet and minimum lot area of 39_, 985 sq. ft.; and
3. The uses of each parcel shall be limited to single-
family uses as provided by Article III, Section 100-30(A) of
the Zoning Code; and
t1f1 That the provisions of Column "A" of the Bulk Schedule
of t~ Zoning Code shall apply to this property in the future;
5. That there be no further lot area or width reductions
to less than that granted by this application;
6. Applicant shall furnish a final survey certified by
a licensed surveyor or engineer indicating compliance with all
of the above and all setbacks of all structures~ lot sizes, etc.
Vote of the Board: Ayes: Messrs. Goehringer. Grigonis
and Sawicki. (Members Doyen and Douglass were absent.) This
resolution was duly adopted.
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GERARD P. GOEHRINGER, ~AIRMAN
March , 1986
-+!-,t/lesTOU
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COUNTY OF SUFFOLK
PETER F. COHALAN
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES
To: ~#,..v.:1'/ .s'U"TAY~V
7>~;'f}4/A"/~6 ~,.<1'2>
~ 3"? S- ;II'?#,,;V AO~?:>
5I?urH.:1'A?> / ,e/.,K //:97/
Dear A de;'Me7T" c:::>"./,,AlS'~" .
We are in receipt of your letter dated
referenced project.
DAVID HARRIS. M.D.. M.P.H.
COMMISSIONER
Da te /&1 -,;2 ff- -P;5""
t//;e64V/;' ~/lj/,~7"4'.-/ .5t';6;;);'~/S~
Re :711f' ~""I?.:1' - 4'~~- C> 3 - /0
~c:: 7" /. /y~:r- concerning the above
"
~ 1. This Department has no objection to your designation of lead agency status.
2. This Department is in agreement with your initial determination.
,a3.
This Department does not agree with your initial determination. See
Comments.
fJ\o~t7
4. Insufficient information is available for technical comments.
~ 5. There is no record of an application to this Department.
A more accurate project location is needed.
(Suffolk County Tax Map #)
6. This Department has received an application and it is:
Complete
Incomp 1 ete
Othe r:
1if 7. It appears that the project can be served by: 5&~ cI?AIf"w-'Ai73
Sewaqe Disposal System
Sewer System and Treatment Works
Subsurface Sewage Disposal System(s)
Other:
COUNTY CENTER
RIVERHEAO. N. Y. , 1901
548-3318
'"
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Water Supply System
A Public Water Supply System
Individual Water Supply System(s)
Other:
J!i! 8. Conrnents:
The Health Department's primary environmental concern pertaining
to development is that the applicant comply with the requirements of the
Suffolk County Sanitary Code especially Article V and VI, and relevant
construction standards for water supply and sanitary sewage disposal.
These considerations are to be revie\~d completely at the time of
application. Full consideration in placement of water supply wells
and disposal systems is given to state and town wetland requirements.
The Health Department maintains jurisdiction over final location of
disposal and well systems and the applicant should not undertake to
construct any water supply or disposal system without Health Department
approval.
Other portions of the Suffolk County Sanitary Code also apply to
commercial development such as Article XII. The Lead Agency is requested
to forward a copy of this form to the applicant with its findings.
Tk ?,hI/",seJ/ et1p,;S'/m e>r //eyer7 ~es "",T rtMh/'A?
~ 'S:C. ~:;"-~k.-:;zz /~ /';/14',./ 7.> 4-:r- $...~e. ..z;, t!"'/.,./,';T,~
6'ur re"",;"0<5 /';'~c. ~ 74'40' T" ?:h,~ A"J'/"" ,Ie. cr.;?o#"c.
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"'TesT" .;t",/e. ~~ ....s ""!Ju/~e.P.
Further comment may be provided upon completion of the application
revi ew.
Name
~","re,< tf'. ~....A/;>~~Y
S-rr- 3'3;>5~ -/
Phone
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Southold. N.Y. 11971
(516) 765-1938
October 23, 1985
Mrs. Virginia Hairston
1675 Carroll AVenue
Peconic,NY 11958
Re: Set-off for
Virginia Hairston
Dear Mrs. Hairston:
The following actions were taken by the Southold Town
Planning Board, Monday, October 21, 1985.
RESOLVED that the Southold Town Planning Board declare
itself lead agency under the State Environmental Quality
Review Act for the set-off of Virginia Hairston located at
peconic. An initial determination of non-significance has been
made.
RESOLVED that the Southold Town Planning Board make the
following recommendation to the Board of Appeals regarding the
set-off for Virginia Hairston located at Peconic:
That the layout be re-drawn to provide more area in
lot no. 1. Enclosed is a sketch illustrating the Board's
recommendation.
This recommendation is made to even out the proposed lots
and provide more area for possible future expansion of the dwelling
on lot No.1, which appears to have less livable floor area than
the 850 square foot minimum
If you have any questions, please don't hesitate to contact
our office.
Very truly yours,
~Qr~
BENNETT ORLOWSKI, JR., CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Diane M.Schultze, Secretary
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Southold, N.Y. 11971
(516) 765-1938
October 1, 1985
Environmental Analysis Unit
DEC, Building 40, Room 219
SUNY
Stony Brook, NY 11794
Gentlemen:
Enclosed find a completed Short Environmental Assessment
Form and a copy of the map of the subdivision of Virginia
Hariston, located at Southold, tax map no. 1000-74-3-10.
This project is unlisted and an initial determination of nonsignif
has been made. We wish to coordinate this action to confirm our
initial determination.
May we have your views on this matter. Written con~en~s on
this project will be received at this office until October 4, 1985.
We shall interpret lack of response to mean there is no objection
by your agency in regard to the State Environmental Quality Review
Act, and our agency will assume the status of lead agency.
Very truly yours,
~o ~~,Tl. <Qr~I~
BENNETT ORLOWSKI, JR., CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Diane M. Schultze, Secretary
enc.
cc: Department of Health Services
~~(9/64)
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.. ~T 10 NUMBER
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION . .
DIVISION OF RECULATORY AFFAIRS _
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only SEP 26 1985
P'.RT I Project Information (To be completed by Applicant or Project sponsor)
,. Applicant/sponsor I 2. Project Name
VirQ"inia Hairston
3. Project location:
Municipality I?U.aIJj~ New York County S~~",I/r'
.
4. Is proposed action: -Fe It.
o New o Expansion 0Cl Modification{alteration d i VI <> '\On line,. ,
S. Describe project briefly: The of the property is desirous of dividing the existing property
owner
into seperate parcels with their own deeds.
6. Precise location (road intersections, prominent landmarks. etc. or provide map)
Map provided.
7. Amount of land affected:
Initially J 5 acres Ultimately acres
6 Will proposed ac~n comply with existing zoning or other existing land use restrictionsl
o Yes No If No, describe briefly Own . . variance due to lack of
er requlres a zonlng
sufficient area.
9. What is present land use in Vicinity of project?
[J2 Residential D Industrial 0 Commercial D Agriculture o Parkland/open space D Other
Describe; .
10. Does action involve a permit/approval, or funding. now or ultimately, from any other Bovernmental agency (Federal, state or local)?
DYes KJ No If yes, list agency(s) and permit/approvals
11. Does any aspect of the action have a currently valid permit or approval?
o Yes LX No If yes, list agency name and permit/approval type
u. As result of proposed action will existing permit/approval require modification?
Q y., 0 No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant/sponsor name: MrS. Vi-r~ini~ HAirston Date: AUQ". 15. 1985
Signature; mA.A J~~ ~', " ~ ~L ~ r:-
7
If the action Is In the Coastal Area, and you are a state agency, complete the
Coastal Assessment Form before proceeding with this assessment
OVER
PART II
EnvlronmentMssment (To be completed by Agency) "-
.~
A. Does action excerl any Type I threshold in 6 NVCRR, Part 617.121
DYes t:J No
B. Will action receive coordinated review as provided for Unlisted Actions in 6 NYCRR, Part 617.7l
involved action.
[] Yes ~ No
If yes, coordinate the review process and use the FUlLJlONG FORM EAF.
If No, a negative declaration may be superceded by c"nother
C. Could action result in ANY adverse effects on, to, or arising from the following: (Answers may be handwritten. if legible)
(1. Existing air quality, surface or groundwater quality or quantity, noise levels. existing traffic patterns, solid waste production or disposal, potential for ffosion.
drainage or flooding problems? Explain briefly:
NO
No
C2. Historic, archeological, visual or aesthetic, or other natural or cultural resources; agricultural districts; or community or neighborhood character? Explain briefly:
No
C3 Vegetation or fauna, movement of fish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
No
C4. ^ community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain brief I".
No
C5 Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly.
No
C6. Secondary, cumulative, or other effects not identified in C,-C6l Explain briefly.
None
C7. A change in use of either quantity or type of energyl Explain briefly.
None
PART III Determination of Significance (To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or othf~rwise
significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occL.lrring;
(c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting
materials. Ens~re that explanations contain sufficient detail to show that all relevant adverse impacts have been identified
and adequately addressed.
o Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then
proceed directly to the FULL/LONG FORM EAF and/or prepare a positive declaration.
IX! Check this box if you have determined, based on the information and analysis above and any supporting documentation,
that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide here, and on
attachments as necessary, the reasons supportng this determination:
Agency Name
Prepm', Signot"re/T;t1e f j/~ ~ %:.. 4-4 7~
Agency Preparer's Name
c.
Date 12-/...,
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Southold. N.Y. 11971
(516) 765-1938
October 8, 1985
Mrs. Virginia Hairston
1675 Carroll Avenue
peconic, NY 11958
Re: Set-off for
Virginia Hairston
Dear Mrs. Hairston:
The Planning Board reviewed the above mentioned application
at the Monday, October 7, 1985 meeting.
It was the consensus of the Planning Board to conduct a
field inspection of the premises prior to any'further action
or recommendations.
Very truly yours,
~ eyltJwA.U)(L~
BENNETT ORLOWSKI, JR., CHAI~~
SOUTHOLD TOWN PLANNING BOARD
By Diane M. Schultze, Secretary
cc: Board of Appeals
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Southold Town Board of Appeals
MAIN ROAD - STATE ROAD 25
SOUTHOLD, L.I.. N.Y. 11971
TELEPHONE (516) 765.1809
APPEALS BOARD
MEMBERS
GERARO P. GOEHRINGER, CHAIRMAN
CHARLES GRIGONIS, JR.
SERGE DOYEN, JR.
ROBERT J. DOUGLASS
JOSEPH H. SAWICKI
September 13, 1985
Mrs. Walter Hairston
Carroll Avenue, Box 304
Peconic, NY 11958
Re: Appeal No. 3196 - Variance for Insufficient Lot Area
c
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Dear Mrs. Hairston:
On September 12, 1985, your variance application was
given an up-to-date review, and it was the consensus of the
board that once you have made an application to the Planning
Board and the Planning has in turn submitted their comments
to us, we will then be in a position to advertise this
matter for a public hearing.
In the interim, the Building Department has required
an affidavit from you sworn before a notary public indicating
the uses of the buildings on the two proposed lots, how it
is occupied, and the interior condition. They will base
the issuance of a preexisting Certificate of Occupancy for
the premises "as is" upon the information given in the
affidavit.
Please don't hesitate to call at any time if you have
any questions.
Yours very truly,
cc:
Planning
Building
Board /
Department
GERARD P. GOEHRINGER
CJI'! RMAN
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Southold Town Board of Appeals
MAIN ROAD - STATE ROAD 2S
SOUTHDLD. L.I.. N.Y. 11971
TELEPHONE (5161 765-1809
APPEALS BOARD
MEMBERS
GERARD P. GDEHRINGER, CHAIRMAN
CHARLES GRIGONIS, JR.
SERGE DOYEN, JR.
ROBERT J. OOUGLASS
JOSEPH H. SAWICKI
December 28, 1983
Mr. and Mrs. Walter Hairston
Carroll Avenue, Box 304
peconic, NY 11958
{!
Re: Appeal No. 3196
Variance for Two Parcels
Dear Mr. and Mrs. Hairston:
o
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At a Special Meeting of the board held on December 19, 1983,
the following action was taken concerning your proposed subdivi-
sion:
RESOLVED, that Appeal No. 3196, application of WALTER AND
VIRGINIA HAIRSTON for approval of insufficient area and width
of two proposed parcels with existing dwellings, BE TEMPORARILY
HELD IN ABEYANCE PENDING REVIEW AND RECEIPT OF COMMENTS from
the Southold Town Planning Board on the proposed subdivision
layout.
Once we have received the above comments, your variance
application will promptly be placed on our next available agenda
after publication in both the Suffolk Times and L.I. Traveler
for public hearing.
please don't hesitate to call our office if you have any
questions.
/
cc: Planning Board
Yours very truly,
GERARD P. GOEHRINGER
CHAIRMAN
By Linda Kowalski
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Stl' ? ~ 1985
Southold Town Planning Board
Town Hall
Southold, New York 11971
Re:
Gentlemen:
The fOllowing statements are offered for your consideration
in the review of the above-mentioned minor subdivision and its
referral to the Suffolk County Planning Commission:
(1) No grading, other than foundation excavation for a
residential building is proposed.
(2) No new roads are proposed and no changes will be made in
the grades of the existing roads.
(3) No new drainage structures or alteration of existing
structures are proposed.
Yours truly,
y~~~
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FORM NO.3
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
Sfp ""
<, v 1~85
NOTICE OF DISAPPROVAL
File No. ...............................
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APPLICATION FOR APPROVAL OF PLAT
SEP 26 1985
To the Planning Board of the Town of Southold:
The undersigned applicant hereby applies for (tentative) (final) approval of a subdivision plat in
accordance with Article 16 of the Town Law and the Rules and Regulations of the Southold Town
Planning Board, and represents and states as follows:
1. The applicant is the owner of record of the land under application. (If the applicant is not the
owner of record of the land under application, the applicant shall state his interest in said
land under application.)
2. The name of the subdivision is to be . Same. as .Preaent. .des~ation..................
. . V :.~ ~ e. ~ .ty ..~ f.. Y.i.~ ~.i. ~.i.~. .~ !I.i. :.S. t .O.'"!. .~. .~ ~.~ ne!11.~ ~.t.. il.t. .~ ?~ ~.t.~. .q f.. ~.a.1 ~.~:. . ~ai rston)
3. The entire land under application is described in Schedule "A" hereto annexed. (Copy of deed
suggested. )
4. The land is held by the applicant under deeds recorded in Snffolk County Clerk's office as
follows:
Liber . .:3).7.$............. Page. ./.'1.4.............. On .2.I,~t/",.,a-..../.9.5o..;
Liber ........................ Page
......................
On
........................
Liber ........................ Page
......................
On
.......................,
Liber ..,.....,............... Page
On
. . . . . . . . . . . . . . . . . . . . . . . ,
Liber ........................ Page .,..,....,......,..... On .,..,..,.,."........,.,
as devised under the Last Will and Testament of ..\'ff.Jlt~.:r: .J;.~~.1.~;y. )I.a,~~?:t.~I)...........
or as distributee
........................................................................
.................................................
..............................................
5. The area of the land is .... ,1. '. ~ . . . . . . . . . .
acres.
6. All taxes which are liens on the land at the date hereof have been paid except ,.,..,....,.
.,.........,.,... None. Existing............. .. .".,.,....,...,.,....,..,..,...............
7. The land is encumbered by . ,~'? ~~:r:~€:~.ge. o!1; .~J:1~, .P.:r:oP~.:r:t7............,....,...."....
mortgage (s) as follows:
(a) Mortgage recorded in Liber ...,.....",., Page,...,.,.",.,..,.. in original amount
of $. , , . . . . . . . . . .. unpaid amount $ ..... . . . . . . . . , . , . . . ,. held by .,....".,...,...,....
.............. ad'dress ..................
..............................................
(b) Mortgage recorded in Liber ......... Page .,.,.".,....,.,'...... in original amount
of ..,........... unpaid amount $...... , . , . . . . . . . . . . . ,. held by .,....,.,.............
. . . . . . . . . . . . .. address ................. ................".....,.",...,..............
,
.
.
(c) Mortgage recorded in Liber .............. Page ................ in original amonnt
of .............. unpaid amount $...... . . . . . .. .. . . . . . .. held by ......................
. . . . . . . . . . . . . . . . . . . . .. address .........................................................
8. There are no other encumbrances or liens against the land except . None . . . . . .. .. . . . . .. .. .
Th I d I. . h f II' . d" Zone "A", Peconic
9. e an les 10 t e 0 owmg .zomng use Istncts .......................................
located on Carroll Avenue
........................................................................................
10. No part of the land lies under water whether tide water, stream, pond water or otherwise, ex~
Not Applicable
cept ...................................................................................
II. The applicant shall at his expense install all required public improvements.
12. The land (does) (does not) lie in a Water District or Water Supply District. Name of Dis.
trict, if within a District, is .............................................................
13. Water mains will be laid by .. N.q~..fl.p'p'l~c.a,l:1~~........................................
and (a) (no) charge will be made for installing said mains.
14. Electric lines and standards will be installed by . ~~~. AR~l~c.~~~:. . . .. .. .. . . .. " .. .. . . ..
.....................................
and (a)
(no) charge will be made for installing said
lines.
IS. Gas mains will be installed by . N.o:1; . APp.Uca.hle. .........................................
and (a) (no) charge will be made for installing said mains.
16. If streets shown on the plat are claimed by the applicant to be existing public streets in the
Suffolk County Highway system, annex Schedule "E" hereto, to show same.
17. If streets shown on the plat are claimed by the applicant to be existing public streets in the
Town of South old Highway system, annex Schedule He" hereto to show same.
18. There are no existing buildings or structures on the land which are not located and shown
on the plat.
19. Where the plat shows proposed streets which are extensions of streets on adjoining sub.
division maps heretofore filed, there are no reserve strips at the end of the streets on said
existing maps at their conjunctions with the proposed streets.
20. In the course of these proceedings, the applicant will offer proof of title as required by Sec.
335 of the Real Property Law.
21. Submit a copy of proposed deed for lots showing all r<,strictions, covenants, etc. Annex
Schedule "D".
. .
.
.
FORM NO.6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
SEP 26 I.''''
"'wJ
Instructions
A. 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 features.
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.
B. 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 features.
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.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date .~" .,(~; ./?- r.$. . . . . .
New Building ............. Old or Pre-existing Building .. +~I? . . . . .. Vacant Land .............
Location of Property . .l97~ . . . . . . . . . . . . . . . . . . . QlI-:r'9n. 4-Y~I).\l~. . . . . . . . . . . . . . . . . . . f~99I).~9. . .
House No. Street Hamlet
Owner or Owners of Property .V:j.:rlliJ;lill-.ijll-i:r~tQI)...........................................
County Tax Map No. 1000 Section 74:-~.:-+9....... Block... 0.3........ Lot.. .O.la.........
Subdivision. . . .7.",. . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. .;J....... .Lot No. . ;1-9. . . . . . . . . .
Permit No. .......... Date of Permit ......... .Applicant . . .l;A'r(l.. Y~rg:j.I).t~. !l~tr(lj;9I).. . . . . . . . .
Health Dept. Approval . . . . . . tl.J:... . . . . . . . . . . . . . . Labor Dept. Approval .. . !:I.';".. . . . . . . . . . . . . . . . . .
Underwriters Approval. . . . . . t< ..e... . . . . . . . . . . . . . .Planning Board Approval . f~I).sl~I).g. . . . . . . . . . . . . .
Request for Temporary Certificate. . . . . . . . . . . . . . . . . . . . .Final Certificate
Fee Submitted $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Construction on above described building and permit meets all applicable codes and regulations.
P1.: . ..; . .F'
Applicant... ~~ X7"~........................
Rev. 10-10-78
-----.------
,
.....
.
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22, The applicant estimates that the cost of grading and required public improvements will he
$, , ,9, , , , " as itemized in Schedule "E" hereto annexed and requests that the maturity of the
Performance Bond be fixed at ... . . . . . . . . . . . years. The Performance Bond will be written by
a licensed surety company unless otherwise shown on Schedule "F".
DATE ,,~~,':~~, ~.5!""""""""" 19,$5,
,MRS. ,VIRGINIA ,HAIRSTON.,,,,,,,,,,,,,,,,,,,.
(Name of Applicant)
By~,d~"""",
(Signatu# and Title)
, , , , )/;'7;5, ,Q'l-:rr9,J,:!., j\.:v:e,I)\l~" )?'i'99nk I-I,.X. , , , .
(Address)
STATE OF NEW YORK, COUNTY OF
QUEENS
. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . ., ss:
On the "~?,"""""'" day of, , A'!l$~~t, , , , , , , ' , , , , , , , , , , , " 19??, , , " before me personally came
,Mr~", ,Vil'g:i,rri-Ol, Ji!lil'.s:t;QJ;l, , , , , , , , , , , , , , , ., to me known to be the individual described in and who
executed the foregoing instrument, and acknowledged that ,aIle, , , , , , , , executed the same,
IlOl: JlIANrr.\ IlVAAan
MY ~ .....".......
No. .. t7. ...
Cll.wII"- .. ~ ClIunt,
c...mlaololl Erp/no ..... ao, It.!'
STATE OF NEW YORK, COUNTY OF
'/. ., '~c4
'~
. ~i~~y' Publi~ ' , ' , ( "" , , , , , , , , , , , , , , , , , , , , , , , , .
........ ....................
S8 :
On the """""""" day """""" of
. . . . . . . . . . . . . .,
19""", before me personally came
. . , , , , , , , , , , , , , , , , , , . to me known, who being by me duly sworn did de-
pose and say that, , , , , , , , , , " resides at No, """"""""""""""""""".,......,..".
. . . , . . . , , , , . . , , . , . , , , , , , , , , . that """"."",."":"",, is the "',"',"
""""""""" of
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
the corporation described' in and which executed t he foregoing instrument; that ............ knows
the seal of said corporation; that the seal affixed by order of the board of directors of said corporation.
and that....... ..... signed.............. name thereto by like order.
Notary Public
......................................
.
f\ nI. C)i>\'J'X-\
. SEP 261985
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TOWN OF SOUTHOLD ~
Sulfollr. Coanty. New York 516 . 765.1801 N~ _16943 .
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. . Southold. N. Y. 11971 IT/A'/-' If} 19L
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Education l.ew.
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