HomeMy WebLinkAboutZ-11469TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
~ONCOP,~FO~L'IiNG PF', iL :\ ~;~i~[~
No. Zl1469
THIS IS TO CERTIFY that the
! [ Land
/ / Building(s)
Use( )
located at 800 West Creek Drive
February 7, 1983
Cutchogue
Street Hamlet
shown on County tax map as District 1000, Section 103 , Block 13
Lot 006 , does~a~ol~onform to the present Building Zone Code of the
Town of Southold for thc fc!!c;;-ing
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above ~conforming C/Land /Z/Building(s)
/~/Use(x~ 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 pro~4sions 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-FAMILY DWELLING.
The Certificate is issued to
of the aforesaid building.
MAE HALLDEN
( owner, -lc ~e~ ~rr-terramt)
Suffolk County Department of Health Approval not applicable
UNDERWRITERS CERTIFICATE NO.
'not applicable
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.
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hal~
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
%~structions
A. This application must be filled in typewriter OR ink, and submit-ted in duplicate to the Building inspec-
tor with the following; for new buildings or new use:
1. Fina~ survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or toDograoh c features.
2. Final apDrova of Health Deot. of water supply anci sewerage disoosal--{S-9 form or equal).
3. Approval of eiectricai installation from Board of Fire Underwriters.
4. Commercial buildings, industrial buildings, Multiple Residences and Similar buildinos and installa-
tions, a certificate of Code comoiiance from the Architect or En0ineer resoonsible f~r the building.
5. Submit Planning Board approval 'of comoleted site plan re~uiremer~ts where 'applicable.
B. For existing buildings (prior to Aoril 1957), Non-conformin~ uses, or buildings and "pre-existing"
lano uses:
1. Accurate survey of peoperty showing ali property lines, s[reets, buildings and unusual natural or
topograph ic 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 pe~inent informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
New Building ............. Old'or Pre-existing Building ...~ ..... Vacant Land'. ............
Location of Prope~ . ~st C=~ A~., ~~t Ne~ ~o~k 11935
Hou~ No. Street Hamlet
Owner or Owners of Prope~ ~ ~.
Cou n~ Tax Map No. 1000 Section . .[0.3...0.0 ........ B lock ... 0~3, 00 ...... Lot..0.0~, DO0 .........
Subdivision ................................. Filed Map No ........... LOt No ..............
Permit No ........... Date of Permit .Applicant
Health Dept. Approval ........................ Labor Dept. Approval ........................
Unde~riters Approval .Planning Board Approval ......................
R eque~ for Tempora~ Ce~ificate - . Final Ce~ificate .......................
Fee Submitted $ 5.00
Con,ruction on above de~ribed building and perm c pplicable co,es and regulations.
Rev. 10-10-78 *~e k~ ~y be ob~ fr~ ~ily f~ng ' ~al~ ~ Cuttle.
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