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Home My WebLink AboutZ-16538 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the Land Building(s) Users) located at 150 Goldin Lane Pre C.O. Date-Dec. Southold, New York #- Z- 16538 23, 1987 Street Hamlet shown on County tax map as District 1000, Section 135 , Block 02 , Lot 019 , does(not) conform to the present Building Zone Code of the Town of Southold for the following reasons: Insufficient Total Area; front yard set-back rear yard set back On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming ~ Land ~7 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 applicable 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 Certificate is issued is as follows: Property contains ] story, one family wood framed dwelling with permits (addition) l108Z CO Z811; permit 4195 Z for foundation all situated in 'A' Residential Agricultural zone with access to Goldin Lane; Southold, Permit #16691Z CO Z16536; Permit #4795 - CO Z-16537 The Certificate is issued to THE~SA CZECH (owner, of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premise~ HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordinances, 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 regulations. Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ 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 building.~ 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 featu res. 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 $25.00 -- BUSINESS $50.00 ACC[SSOR¥ $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons t pu, c,_t~ion ...... O~d or Pre-existing Buildin§ .... X ...... Vacant Land ............. Locat on of Property .-~. ~J~ ~. ~/'1¥ j~ .~.~))t/~2' ¢'-' ..... _ ............................... House No. Street Ham/et Owner or Owners of Property . i /. ~..~21~ .~.' ...~. ~ ...... .~,,~ .~, ,~,:~,~,,~ :~, ,// ....................... County Tax Map No. 1000 Section .. ,/..'~ 5.~i ..... Block ..... ~-, ....... Lot ..... Z ~,' ....... Subdivision ............. ............. Filed Map No../~..'./;c/ ..... Permit No..~/.~. ,~.~... Date of Permit .~//~,- .Applicant .... /~d .~, Health Dept. Approval .... */~.-~.! ............ ,.Labor Dept. Approval .... ./~ ~./. ............. Underwriters Approval ....... ~Z.. ~. ~.,: ......... Planning Board Approval...~.,. ~/~., ........... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building an~it meets all applic~th~codes a~d regulations. Applicant ..... ..................... Rev. 10-10-78 suRWyED FOR:- LOCATED AT ~o~OC ~o~ ~/~//,/~ ~ MAP OF ~~ SC~ 1" = ~ SUFFOLK CO. TAX MAP DATA:- DIST. /~ , SEC. BLK. ~ LOT ~/~. OFFSETS FROM STRUCTURES TO RELATIVE BOUNDRY LINES, ON SURVEY, ARE FOR A SPECIFIC USE ONLY, AND SHOULD NOT BE USED FOR CONSTRUCTION OF FENCES OR OTHER STRUCTURES. Z?~4 xJ/~'/,'.J~ //,Jc. DRAWN BY/~ , SUFFOLK COUNTY N.Y. , CO. CLK. NO. FILE NO. f/ SURVEYED WILLIAM R. SIMMONS JR. P/O BOX 377 JAMESPORT, L. l., N.Y. 11947 PAGE ~-~ GRID ~-"~::~