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Home My WebLink AboutZ-13202 FORM N0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z13202 February 6, 1985 Date THIS CERTIFIES that the building 0 n e ,family, ,d w e 1,1 i ng, , , , , , , , , , , , , , , Location ofPtoperty .645 Hickory Ave: & 1870 Cedar Ave. Southold House No. Street ~ ~ ~ ~ ~ Namlet County Tax Map No. 1000 Section ? ........Block ~ .........Lot ......24........ . Subdivision .Goose , B ay ,Estates.... , , , , , .Filed Map No. 1 1 7 6 , , ,Lot No. 9 5 , , 9 9 , , , , , Requirements for a private one family dwellin built rior to conforms substantially to the ~,pg)Rc7~gi~Iq~'gl~{J~gi~c]~~~g~~~glrgl~gp71}~~j~p/~¢'p}~~ig~~ Certif' upancy ....ADr'~.1, .23........ , 1957. pursuant to which ~~i~1~cNo. 2?.202......... dated February , 6, , , , , , , , , , , , , , 19$ 5 . ,was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . .......One family dwelling The certificate is issued to ..FrM1`'IA,FLY1gN,,,,,,,,,,,,, (owner, a,{xeq~) of the aforesaid building. Suffolk County Department of Health Approval , N / A UNDERWRITERS CERTIFICATE NO N / A. . Affidavit Edward Flynn Survey 11/28/84 ' Building Inspector Rw. 1/87 FORM N0.6 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 wbmitted in $up~tcythe 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 unuwal natural or topographic features. 2. Final approval of Health Dept. of water wpply 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, acertificate 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), Nonconforming uses, or buildings and "pre-existing" land uses: 1. Accurate wrvey of property showing all property lines, streets, buildings and unuwal 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 $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 / 02~' Date New Building .............Old or Pre-ex~;ipg ~ Idinvr ......~~7~ Vacant Land . +~4~ ~ 9 Location of Property , r. A . , , , ~ , ,CEDyR ~?Yr So a 7'/fo ~ D ; /y~ Housb No. trees ~ Ham/et Owner or Owners of Property .........~M ~.g.. . F~rNV... . County Tax Map No. 1000 Section ~ Block !Z.... , Lot ......°1..~ . Subdivision .~~.'.°.°.5.~ , Bs?wr: S , , , , ,Filed Map No. . 7 6 a ..Lot No. ~S SJ. Permit No. Date of Permit ..........Applicant . Health Dept. Approval ........................Labor Dept. Approval . ; . Underwriters Approval ........................Planning Board Approval . Re uestforTem ora Certificate .....................Final Certificate (nlZr^-r"1crsTi~G q P rY ~ ov Fee Submitted $ .~+f ` Construction on above described building an rmit all le codeg and regulations. APplican J. OFRIAS, JR. Rev. to-tone ATTORNEY AT P,t,~ C,O. # Z ! 302 01 737 ROANORE A d~d/~S ~ (S~ 1~ 8~7Z7-36481901 l~ d,s c a 7 AFFIDAVIT STATE OF NEW YORK COUNTY OF SUFFOLK Edward Flynn being duly sworn deposes and says: That my mother, Emma Flynn, has lived in Southold, New York in the house on the northeasterly corner of Cedar Avenue and Hickory Avenue for well over 40 years. I also lived in that house for almost all of my pre-adult life. My personal knowledge of that house goes back over 40 years, and I am also Yamiliar with the house and property as it stands at the present time. Based on my own personal knowledge and recollection I can state that the ouse and property as it presently stands, and as shown on the survey done by Roderick an Tuyl, PC on November 28, 1984, is the same as it had been for a considerable period f time prior to April, 1957. I make this affidavit for submission to the Southold Town Building Department n support of the application for a Certificate of Occupancy on apre-existing dwelling nd I know that the Building Department of the Town of Southold will rely upon the nformation contained herein. / Edwar ynn worn to before me this 3 r gy of , 1985 PHWP J. OFRIAS, JR. ATTORNEY AT LAW ]3] AOANDK£ AVENUE RIVERMEAD. NEW VORR 1901 otary Public ~~p 7, per, pa, ~~t ~ 9Enb d R1w [at