HomeMy WebLinkAboutZ-13226TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TO~N FLiLL
SOUTHOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORl%%ING PREi¥IISES
THIS IS TO CERTIFY that the
/--~ Land Pre C.O. #- Z13226
/--/ Building(s) Date- Feb.22 1985
/-/ Use(s) '
located at 425 Pine Tree Rd.
Cutchogue
Street
shown on County tax map as District 1000, Section
Hamlet
104 , Block 01
Lot 008 , does.inot~conform to the present Building Zone Code of the
Town of Southold for the following reasons:
'Insufficient Total Area
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming /~/Land /l/Building(s)
/i/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 Building Inspector's Office, the occupancy and use for which this Certifi-
cate is issued is as follows: Property contains a One Family;One Story;
wood framed dwelling with accessory shed. This property situated
in the A-Residential Agricultural Zone with access to Pine Tree Rd.
a Town maintained road.
The Certificate is issued to
of the aforesaid building.
BOURGUIGNON, MYRTLE A.
(owner,
Suffolk County Department of Health Approval
UNDER%~rFtITEfiS CERTIFICATE NO.
N/A
N/A
NOTICE IS HEREBY GIVEN that the owner of the above premises I-LiS
NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec-
tor to determine if the premises comply with al! 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.
~uiiding ~Inspe ctor
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
15 5
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 p=operty showing all property lines, streets, buildings and unusum 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. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
$15.00
Date . .~e,b.~.qa,~.7..1.5., .1.9.8.5. .......
New Building ............. Old or Pre-existing Building ..... x. ...... Vacant Land .............
Location of ProperW ...4;Z.5. ~'.~-~e, .T.r.e.e, ?.o.a~,..~a.s..~a.u..~.q~.nt. ..................... ~
House No. Street
Owner or Owners of Property ... ~.~.~,~e, ~,...]~o.u.]:;~o.~.~,Aqq ...................................
County Tax Map No. 1000 Section . 3,0.~. .......... Block . .1 ............ Lot...8 ............
Subdivision ................................. Filed Map No ........... Lot No ..............
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 $ .].A..QQ .......................
Construction on above described building and permit meets all applicable codes and regulations.
Rev. 10-10-78
STATE OF NEW YORK)
.SS:
COUNTY OF SUFFOLK)
LURA KRUEGER, residing at Wells Road, Peconic, New York,
being duly sworn, deposes and says;
Deponent is acting as Attorney in Fact for MYRTLE A.
BOURGUIGNON, under Power of Attorney dated August 6, 1984, copy of
which is attached hereto.
Deponent has consulted with William M. Beebe, Builder, New
Suffolk Lane, Cutchogue, New York who constructed the residence for
Louis and Myrtle Bourguignon. Mr. Beebe's records show that he commenced
construction in November, 1956 and completed the residence in March,
1957. Mr. Beebe also moved the shed from a previous home of the
Bourguignons to its present location, within the same time period.
Deponent makes this application to the Building Department
of the Town of Southold to issue a Certificate of Pre-Existing Use
for both the residence and the shed.
Sworn t~ before me this
1/ L/ ~ b' // // b' / ~
f Not~ar~ Pu]~iic
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