HomeMy WebLinkAboutZ-12171TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSt'L'CTr-)R
TOWN ItALL
SOUTttOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFOtllMING PREMISES
THIS IS TO CERTIFY that the
/--/ Land
/--X/ Building(s)
/-/ Use(s)
located at 3640-0 County Road 48
No. Z12171
December 30,
?econic
1983
Street Ha~nlet
"shown on County tax map as District 1000, Section 069 , Block 04
Lot 007 ., does{not)conform to the present Building Zone Code of the
Town of Southold for the following reasons:
The dwelling has insuf£icient front yard setback; and
the detached garage has insufficient side yard setback.
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming /--/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 Building Inspector's-Office, the occupancy and use for which this Certifi-
cate is issued is as follows: a private one-family dwelling and
detached garage.
The Certificate is issued to
of the aforesaid building.
LAURA CASE.
(owner,
Suffolk County Department of Health Approval
no record
UNDER\%qllTEfiS CERTIFICATE NO.
no record
NOTICE IS ItEREBY GIVEN that the owner of the above premises }LiS
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.
FORM NO. 6
TOWN OF SOUTHOLD
B~ilding 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.
Bo
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.
Fees:
1, Certificate of occupancy $5.00 /
2, Certificate of occupancy on pre-existing dwelling
/
3. Copy of certificate of occupancy $1.00
land use --?re-Existing C.O. $15.00
Vacant land C.O. $ 5.00
Date.. , .~.... ,...~..~./.t.~.. ~'.~....
New Building ............. Old or Pre-existing Building .... A ..... Vacant Land .............
Location of Property .........................
House No. Street Ham/et
Owner or Owners of Property .. ~~,~ ...... .~..-..~l~,¢Z._ ......................
County Tax Map No. 1000 Section .... '.~..~:[ ...... Block .... ~ ........ Lot...'-/ ...........
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 $ ............................. ~,j~_.., '-'~'~ C~ ~ ~
Construction on above de~ribed building and~it meets all applicable codes and regulations.
M-3438
STATE OF NEW YORK )
)
COUNTY OF SUFFOLK )
SS:
RENSSELAER G. TERRY, JR., being duly sworn,deposes and
says that he is the attorney for Laura D. Case, the applicant
for a pre-existing Certificate of Occupancy; that deponent knows
of his own knowledge that the dwelling house on said premises was
constructed and occupied long prior to 1957; and that no changes
have been made subsequent to the enactment of the zoning
ordinance; that attached hereto is a survey of said premises;
premises are occupied as a one family residence.
Subscribed and sworn to
before me this ~O~-day
of December, 1983.
Notary Public. ~/
HELEN M. GATES
~ Public, State of New
No. 4725686
(~tJalified ~ Suffolk Couftty
AREA-- .,t.5879 ACRES
1§6,291 SO. FT.
SURVEY FOR
JAY 1~. GUILD
4 T PECONIC
TOWN OF SOUTHOLO
SUFFOLK COUNTY, N Y.
SC,fiLE : I
NOV, 5, 1.9,~3
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.¥.K $. I.. lC. NO.
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