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Home My WebLink AboutZ-11712TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN PLiLL SOUTHOLD, NEW YOP~K CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the /--I Land / / Building(s) located at ~,(~.~ ' ' ' Sireet ' ' Hamlet shown on County tax map as District 1000, Section Lot _~, does{not)eonform to the present Building Zone Code of the Town of Southold for the following reasons: dis~ric~ On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /Z/Land /Z/Building(s) /;/Use{~) 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 Building Inspector's-Office, the occupancy and use for which this Certifi- cate is issued is as follows: a one family dwellin~ The Certificate is issued to '1~-~11'i~m ~._ .~t~ Elsie (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERI~q~ITE~S CERTIFICATE NO. I~/A NOTICE IS HEREBY GIVEN that the owner of the above premises IL~S NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if 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 codes and regula- tions. Buildin~ inspector 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 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. 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 /r ~'/ 2. Certificate of occupancy on pre-existing dwelling land use $ ! $5.00 3. Copy of certificate of occupancy $1.00 NewBu din Date ...~ .'~.,-~d~''~ ~ /~;2~ .. · ' g ............ ;~/O_~ld//,~,Pre-existing Building(Z). _..~'_,. ~. 'Vacant Land ~ ........... Location of Prop,e~t,j ./7~....~ ~-~-.~'- ~/,~,~F[-/ ~ .~...~..~.~ C~' ~z~X~O .,~.J ~'./V~' . :~ '~ I~l~u~ No. ~t~" '~ '/7~ 7,~z~-/f ' b';~'/ ',y"~''AT. Owner or Owners of Property ..~/,"~.//..~t'/T] County Tax Map No. 1000 Section .... ~7'~ ....... Block .... .~. ........ Lot...~¢? ......... ............... F,,ed Permit No ........... Date of Permit .......... Applicant., ................................. Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. ~ .., Request for Temporary Certificate ..................... Final Certificate .... /~..- ......... * Fee Submitted $ ........ '~. .................... Construction on above described building and perm~t~me,ets all appt~cab)l~codes and regulations. Applicant . . ..~.,/,Z~,/~. ~ .,.~.. ~, /~.~//~ ~ ...... STATE OF NEw YORK : : COUNTY OF SUFFOLK : SS WILLIAM E. YOUNG, residing at (no number) Bayview Road, Southold, New York 11971, being duly sworn, deposes and says: THAT he is the owner of the premises situated at the corner of Bayview Road and Smith Drive, North, Southold, New York; THAT he purchased the property on January 28, 1955 from ~eorge W. Smith & Sons; THAT the premises has been used as a one family dwelling since January 28, 1955. Sworn to before me this 6~ay of June, 1983 RUDOLPH FI. No, 52-~.65530 Commission Expires March 30, 198 William E. Young 1111 WASHINGTON DRIVE ~/"'~ ~l'~ PHONE CENTERPORTo N.Y. 11721 ~' LAND SURVEYOR (E16) 423-0117 LIC. NO. 4~O21 TITLE SURVEY ONLY FOR ROBERT & NORMA SIEBER GUARANTEED ONLY TO US LIFE TITLE INS. CO.~ OF N.Y. VoAo MAP OF G~SE NECK SCALE 1 i.. = 25. ~. ' DATE 5/16/83 NOTE: NO ESTABLISHED QRADE STREET MAINTAINED BY TOWN S 57 00' E I00/0 N 51° BAY VIEW ROAD