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Home My WebLink AboutZ-11920TOWN OF SOUTHOLD OFFICE OF BUILDING INSI~ECTOR TOWN It.iLL SOUTtIOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES No. Zl1920 September 14, THIS IS TO CERTIFY that the /i/ Land /x/ Building(s) I-I Use(s) located at 215 Walnut Place Mattituck 1983 Street Hamlet shown on County tax map as District 1000, Section 142 , Block 01 Lot 015 , does{not,conform to the present Building Zone Code of the Town of Southotd for the following reasons: Th~ property has insufficient area; the dwelling has insufficient front and side yard setbacks. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /i/Land /!/Building(s) /--/Use(s) existed on the effective date the present Building Zone Code of the Toxin 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 Building Inspector's'Office, the occupancy and use for which this Certifi- cate is issued is as follows: a private one-family dwelling.* The Certificate is issued to of the aforesaid building. SOFHIE C. WELLS ( owner, rg~--s-e%- or ~t~nant) Suffolk County Department of Health Approval no record UNDERWRITERS CERTIFICATE NO. no record NOTICE IS HEREBY GIVEN that the owner of the above premises H-iS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine ff the premises comply with all applicable codes and ordin- 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 cedes and regula- tions. *c.o. z2715 issued 5/17/67 for accessory building, pursuant to Building Permit 3323Z, issued 11/21/66. Building lns~ector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 featu res. 2. Sworn statement of owner or previous owner as to use, occupancy end 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 ~r 3. Copy of certificate of occupancy $1.00 ! land use $/~'/$5.00 Date ..--~L. ~ New Building ............. Old or Pre-existing Building(~) .... =/Vacant Land ............ Location of Property ............. L. ~...~r~..~. ..... ~/~ ~ .~.,.~.u...~.~).. N, .~.-../~. F~--".~. tYou~e No. Street / Ham/et Owner or Owners of Property x ,.~,: ................................ County Tax Map No. 1000 Section ~'....//"2/~'O",...., . . . . . Block . . [ ............ Lot ..... / ,~'~' ...... .... Subdivision ................................. Filed Map No. ' .Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. .... ¢f,4,//~ ............. Labor Dept. Approvat .... 4~.//~_, .............. Health Dept. Approval ..... · /'~/./:~...--. ............ Planning Board Approval .. Underwriters Approval Request for Temporary Certificate ..................... Final Certificate . ../. .... - ......... Fee Submitted $ ............................. Construction on above described building and permit'me_ets all appl~cable_,co_des and regulations. Applicant~.~, .~ .... STATE OF NEW YORK ) ) COUNTY OF SUFFOLK ) SS: BARBARA MEMOLA, being duly sworn, deposes and says that she is the Executrix of the Will of Sophie C. Wells, dec'd.; the applicant for a pre-exisiting Certificate of Occupancy; that deponent knows of her own knowledge that the dwelling house on said premises was constructed and occupied prior to 1957; that no changes have been made subsequent to the enactment of the zoning ordinance; that attached hereto is a survey of said premis es. Subscribed and sworn to before me this day of July, 1983. (Barbara Memola) Notary public. wALNUT AVENUE 17 °£ 4 '50 "E. 5o. oo C) N. N/F 50.00 ' BORD/N KS Owner(s) Name(s) do(es) hereby state: CONSENT TO INSPECTION · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town · ~vhich is shown and designated on the Suffolk County tax map as District 1000, Section ~2~,, Block C~\ , Lot \~ That the undersigned (has) (have) filed, or caused to be filed, au applina- tion in the Southold Town Building Inspector's Office for the following: That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon· to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances· rules or regulations of the Town of Southold. (signatUre) ~ (print name) (signature) (print name)