HomeMy WebLinkAboutZ-16033TOV~ )? SOUTIlOLD
OFFICE OF BUILDING INSI~ECTOI%
TOWN IIALL
SOUTItOLD, NEW YOF, K
CE[ITIFICATE OF OCCUPANCY
NONCONFORMING PREMISES
TIIIS IS TO CERTIFY that the
[W~ Land Pre C.O. #- Z-16033
/~ Building(s) Date- August I I , 1987
/-I Use(s)
located at 4735 Westphalia Road
Mattituck, New York
Street Hamlet
shown on County tax map as District 1000, Section 113 , Block 13
Lot 0 I , does{not)conform to the present Building Zone Code of the
Town of Southold for the following reasons:
On the basis of information presented to the Building Inspector's Office,
it has been determined that the abovemonconforming /--x/Land /~/Building(s)
[-~[Use(s) existed on the effective date the present Building Zone Code of the
Town of Southold, and may be continued pursuant to and subject to the appli-
cable provisions of said Code.
IT IS FURTHER CERTIFIED that, based upon information presented to
the Buildin~ Inspector's Office, the occupancy and use for which this Certifi-
cate is issued is as follows: Property contains I story, one family, wood framed
dwelling with attached porch; barn with basement; 2nd barn with attached shed; all
situated in 'A' Residential Agricultural zone with access to Westphalia Road; a
Town maintained highway.
The Certificate is issued to
of the aforesaid building.
SALLY W. WELLS
(owner,
Suffolk County Department of tlealth Approval
UNDERWtIITEf{S CEP~rlFI(, I E NO.
N/A
N/A
NOTICE IS ItBH, EBY GIVEN that the owner of the above premises I-L%S
NOT CONSENTED TO AN INSPECTION of thc premises by the Building Inspec-
tor to determine ff the premises comply with all applicable codes and
ances, other than the Building Zone Code, and therefore, no such inspection
has been conducted. This Certificate, therefore, does not, and is not intended
to certify that the premises comply with all other applicable codes and re~ula-
l'" n
IC~,TION
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ~ ~ 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.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty 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.
Fees:
1. CertJficate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $]0.00
2, (~ertificate of occupancy on pre-existing dwelling $ 50. O0
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5. Updated C.O. $ 50.00 Date . .3. u. 1.y..1.5.,..1.9.8.7. ...........
NewConstruction ...... Old or Pre-existing Building X Vacant Land
Location of Property ~9 #) Weptphalia Road~ Mat~ituck
Hou~ No. Street Hamer
Owner or Owners of Property . ,S ,a .l ,l ,i e. . ,W : , .We.l, ,1.s ...........................................
CounW Tax Map No. 1000 Section .. 113.00 Block 13..00, Lot 00,1.q00
Subdivision ................................. Filed Map No ........... Lot No .............
Permit No Date of Permit Applicant .
Health Dept. Approval ........................ Labor Dept. ApprovaJ .......................
Underwriters Approval Planning Board Approval . ..
Request for Temporary Certificate ..................... F Mai Certificate ......................
Fee Submitted $ 50.00
Construction on above described building and permit meets all applicable codes and regulations.
Appli ........................
cant,. Sallie W.
Rw. 10-10-78
~t Co Z 11,03Z
STATE OF NEW YORK)
SS.:
COUNTY OF SUFFOLK)
SALLIE W. WELLS, residing at (No #) Westphalia Avenue,
Mattituck, New York 11952, being duly sworn, deposes and
says:
I am the owner of premises located on Westphalia Road,
Mattituck, New York, Suffolk County Tax Map #1000-113.00-
13.00-001.000, as shown on the enclosed survey.
The premises was purchased on January 10, 1946 by
myself and my husband, Norman L. Wells, from Arthur H.
Penny, who told us the house was built around 1912, and the
barns were built between 1912 and 1915.
To my knowledge and belief, no other alterations were
made to the premises that would require a Certificate of
Occupancy.
I make this affidavit to the Town of $outhold for a
Certificate of Pre-Existing Use for the residence and barns.
SALLIE W. WELLS
d~to before me this