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Z-15073
TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the /x / Land / / Building(s) F/ Use(s) Pre C.O. #- Z15073 Date- November 7, 1986 located at 49250 Uounty Roaa #48 Southold, N.Y. Street Hamlet shown on County tax map as District 1000, Section 055 , Block 03 Lot 05 , doesfnot)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 F1 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: Property contains a one story_, one fami ly dwelling; an accessory garage and all situated in the A-Res;rlantiai Agriculturai zone with access to County Road #48; a county maintained road. The Certificate is issued to of the aforesaid building. EVELYN EBERHARDT owner,��xt Suffolk County Department of Health Approval N/A UNDER -WRITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises 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 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. �uiidin- inspector FORM NO.6 TOWN OF SOUTHOLD 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 to am. 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 property 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 m Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 /o/1 /k6 5.Uodated C.O. $15.00 Date ...... l ............... New Construction......OldorPre-existingBuilding ...X........ Vacant Land Location of Property ,49250 County Road 1148 Southold: N.Y. House No. Street Hamlet Evelyn Eberhardt Owner or Owners of Property............................................................. County Tax Map No. 1000 Section ... 055 . Block .. 03........... Lot...... 5........ . Subdivision .................................Filed Map No. ..........Lot No. ............. Permit No. .......... Date of Permit ..........Applicant ......................... . ....... . 1 11 Health Dept. Approval ........................Labor Dept. Approval ........................ Underwriters Approval ........................Planning Board Approval ...................... Request for Temporary Certificate .....................Final Certificate ....................... Fee Submitted $ ..... ? .................. Construction on above described building and permit meets all applicable codes and regulations. Applicant °......�.Qr.•...4 .................... Rw. 1e -10-7e R.<.30G)7 C o �1_ 15073 TITLE NO C,14" .1 .,,, nm].reled rmr-elxr eI(an.1y t 1w cr .s survey wee "'" .".d n eccorrler r.a w'th r,I, ax et inP Lcxfe . P'• -«'Uro •o! L end 9,r d by V,a Naw York SLeta Aeeoc.ecrr.. r of Protesaror mI Lend Surveyors Seal cen.a,r.eoors ensu nn, only Lo U.e pa•'eo 4.• wrx�m vne sur-vey ie prepared. er.. I o• r .e bdlel( Lo Lne bele nor'peny ywen,n,«,cel egsrcy dx] ._... Iend nq necu.. on ,soad hereon C:erc n�ec. -ns are not c.-a.,arcr�d ne !11 adrl none� sr..uc one or s.rtos«p Mnt nw.wre' ..- - BORN & NONACC19 P.C. CONSULTANTS • SURVEYORS • PLANNERS 72 E. OLD COUNTRY RD. I SE CON(--) STREET MweOEA, N.Y. 11509 HOL.BROOK. N.Y. 11 516 - 742-4001-8 516 - 921-2211 LOT: S BLK. ,j e, MAP OF: S!/FFOLK COUNrY L,4N0 /INO rrY N/I SITUATED AT SOUrHOL D /VfW YORK CERTIFIEO TO: f so sF 4- , a•-/24 REVISIONS: UNADIIlIA4IZELIAL IE:RATI(JIVI rtJ SUCCESSO TO: ALIUTICIN TO 1HIS SURVEY i', A RIIF;'A D SEAL SHALL NUT HF. I DANK n 9CINACCI VIOLATION OF SEClIUN -l2DL3 11 JACLI .l H(].'N II IE NEW Y(]RK 'SlA1F I II.JC.A WILLIAM H 1>11 1 NE LS 6BAL OWN 11( IN i AW H E HAwx"til SI DATE WILLIAM HAWXHLJR T I)1 BEA4ING/1 LANC1 EAAI V Y AF[1(-1F ANU E M SUCCESSO TO: RIIF;'A D SEAL SHALL NUT HF. I DANK n 9CINACCI Ct /NSIDERE U A VALID 1 RL1E'C:OFlY JACLI .l H(].'N B Sl WILLIAM H 1>11 1 NE LS 6BAL OWN 46- JOB NO. H E HAwx"til SI DATE WILLIAM HAWXHLJR T ,'ll ___ r,. ,1 e" 00 T os ooh 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) Use(s) Pre C.O. #- Date - located at--iIQ�;b S±!!� A.. iU.y. Street Hamlet shown on County tax map as District 1000, Section _0�;I;_, Block O 3 It Lot ©.T , doesinotjconform to the present Building Zone Code of the Town of Southold for the following reasons: On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming K/ Land /_/ Building(s) /_/Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may bontinued 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- The Certificate is issued to (owner, lessee or tenant) of the aforesaid building. r f Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO. ly1�h NOTICE IS HEREBY GIVEN that the owner of the above premises 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 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. :wilding inspector —- the ____ STATE OF NEW YORK) ) ss.: COUNTY OF SUFFOLK) EVELYN EBERHARDT, being duly sworn, deposes and says: That she resides at 293 East Main Street, Centerport, New York 11721. That she is the daughter of Helen and Anthony Gawelko, the former owners of premises situated on the west side of Middle Road, Southold, which said property is shown on the Suffolk County Tax Map as District 1000, Section 055.00, Block 03.00, Lot 005.000. That said premises were conveyed to Helen and Anthony Gawelko on October 19, 1949. That Anthony Gawelko died on July 29, 1983 at which time the subject premises passed to Helen Gawelko. That Helen Gawelko died on July 23, 1984, that her will was probated on August 23, 1984 and the property passed to their three children, Timothy Gawelko, Evelyn Eberhardt and Geraldine Carstensen. That Timothy Gawelko purchased the subject premises from his two sisters. That Timothy Gawelko died intestate on October 1, 1985. That Letters of Administration were issued to your deponent on October 25, 1985. That Helen and Anthony Gawelko built a one -family dwelling on the subject premises in late 1949 or early 1950. That no alterations or additions to said dwelling or its use have been made since 1957, the date of the adoption of the Southold Town Zoning Ordinance. That annexed hereto and made a part hereof is a survey of the premises prepared by Bohn & Bonacci, P.C., dated April 30, 1986. This Affidavit is made to induce the Town of Southold, through its appropriate officials, boards or employees, to issue a certifi- cate of occupancy for said dwelling, knowing and intending that the said Town, its officials, boards or employees will rely upon and be induced to act by reason of the representations made herein. (Evely Eberhardt) Sworn to before me this 13 ;4ayr Septembe 1986. Pu is KAREN NERBER� NOTARY PtLIKt� CSSION r OMMI