HomeMy WebLinkAboutZ-12914 TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, NEV6' YOP~K
CERTIFICATE OF OCCUPANCY
NONCONFORMING PRENTISES
THIS IS TO CERTIFY that the Pre C.O. # 212914
/X/ Land Date October 22,1984
/X/ Building(s)
/ /Use(s) -
located at 575 GilletteDr. East Marion
Street Hamlet
shown on County tax map as District 1000, Section 038 Block 04
Lot 002 does~not~conform to the present Building Zone Code of the
Town of Southold for the following reasons:
Insufficient Total Area, Insufficient Front Set-back
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming /~/Land /g /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: One story one family dwelling. situated
in an A-Residential-Agricultural Zoned Sub-Division approved Zone with
attached garage & porch. Property also contains fencing and accessory
shed. Property has access to Gillette Dr; a Town Maintained Rd.
The Certificate is issued to RACHEL C. DUELL
(owner, ieas'e~or-t2nantj
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UI`TDER~~rR.ITEt~i,S CERTIFICATE NO. N/A
NOTICE IS HEREBY GIVEN that the owner of the above premises H_AS
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.
Buiidin~ Lnspector
~ C~ is 2-~ \Q 1'j N
. ,~~{„t,,,,~ .
FORM NO. 6
TOWN OF SOUTHOLD
Building Department - /~o Z
Town Hall
' Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submittedieeteto the Building Inspec-
torwith 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 installs-
- 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.
BU. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of gitoperty 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
2. Certificate of occupancy on pre-existing dwelling ~ land use --Pre-Existing C . 0. $15 .00
3. Copy of certificate of occupancy $1.00 Vac ant land C . 0 . $ 5.00
Date ~ ' .
New Building .............Old or Pre-existing Building .....V...... Vacant Land .
Location of Property ~ ~S ~~-~E<~, . , , . , , , , , , E~f-`~T , f7~l~
House No. ~ ~ ~ Street ~Hamlef
Owner or Owners of Property C,,aC/E~,~,,~,~,,j
County Tax Map No. 1000 Section ~ 3 , , Block ! Lot ...~d.~ .
Subdivision . ~-lQ.r?.. his/->tlo2 , . , , ...Filed Map No. Z~,3, g .Lot No. . ~,Z . .
Permit No. Date of Permit , . ,~~-~C~'C. G ~C/~L~
...Applicant..
Health Dept. Approval :...............Labor Dept. Approval .
Underwriters Approval .......::...............Planning Board Approval _ .
Request for Temporary Certificate .......-...........Final Certificate .
Fee Submitted $ ~:~......C1 al' swrrtn+-i~~
Construction on above described building and permit meets all applicable codes and regulations.
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G?I.LETTE DR?'~lE u o
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AFFIDAVIT
STATE OF iJEW YORK]
SS:
COUN"iY OF NEW YORK}
RACHEL C. DUELL, being duly sworn, deposes and states as follosas:
That I am the owner of certain permises located 'mown as 575 Gillette Drrve,
East Marion, New York, shown on the Suffolk Tax Map as district 1000 -
section 38 - block 4 - lot 2. That said house was built approximatel;~
thirty-five years ago and in my opinion is fit for-a"i.ne use of a single
',-:;rnliy residence. I submit this Affidavit in support of my application for
Certificate of Occupancy.
~ C-~
Swn tt co lefor me this 9th
day of Octob 1984.
9,~
i
" /
o c
GARY PLANNER OLSEN j
Notary Public. StatR of New Yolk
N o. 52-295: ib0
:3uaf'rfied in Sutfolk County
Co~~~~sslon Ercpires March 30, 19
GARY PLANNER OLSEN
COUNSELLOR pT LAW
MAIN ROAD
MATTITUCK. N!W YORK
H!!R