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Home My WebLink AboutZ-11656TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY N&iNCC +FOR-dfI-ltG-FRE-3i$BS No. Z11656 5/5/83 THIS IS TO CERTIFY that the Land Building(s) /_X/ Use() located at 1650 Hortons Lane Southold Street Hamlet shown on County tax map as District 1000, Section 063 , Block 01 , Lot 014 doesfmnk�conform to the present Building Zone Code of the Town of Southold for the following reasons: a'one-family dwelling use is a permitted use on a lot in this !A' Zoned District. The accessory building was built and has a Certificate of Occupancy.* On the basis of information presented to the Building Inspector's Office, it has been determined that the above rfo`lhconforming /_/Land / / Building(s) / X/Use(z) 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: a one -family dwelling. The Certificate is issued to JERRY E. & JOAN M. JACOBS (owner, lessee-or-ex�i� of the aforesaid building. Suffolk County Department of Health Approval n/a UNDERWRITEtiS CER'T'IFICATE NO. n/a NOTICE IS HEREBY GI�TEN 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. *Permit 6896Z, C.O. Z6525 Building inspector 0 FORM NO. 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 submitted in duplicate 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 peoperty 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 Date .. MAY, 4., 1983 , New Building ............. Old or Pre-existing Building(Y) "Vacant Land ............ Location of Property $�S.. ?. 50 , , , ,r otoils ,Lane Southold House No. Street Hamlet Owner or Owners of Property . ,Terry, E. Jacobs and Joan M, . Jacobs , his wife County Tax Map No. 1000 Section ... 63.......... Block .....1 ......... Lot ... 14:. . Subdivision .................................Filed Map No. ..........Lot No. ............. Permit No. .......... Date of Permit ..........Applicant .................................. Health Dept. Approval ........................Labor Dept. Approval ......................,. . Underwriters Approval ........................Planning Board Approval ................... ,, Request for Temporary Certificate .....................Final Certificate .....✓ :....... Fee Submitted $ .... :..... /................ e� � ' � ..Q � (6 S, � al�aq ✓�y�`� Construction on above described building and per ir/mo�ee s all app!{cablodes an�drrecgulations. Applicant . - ..¢�rr��<. ... aZ "'l.. ...... Rev. 10-10.78 M-3396 STATE OF NEW YORK ) SS: COUNTY OF SUFFOLK ) RENSSELAER G. TERRY, JR., being duly sworn, deposes and says that deponent is the attorney for Jerry E. Jacobs and Joan M. Jacobs, his wife, the applicants for a pre-existing Certificat of Occupancy; that deponent knows of his own knowledge that the dwelling house on said premises was constructed and occupied long prior to 1957; and that no changes have been made subsequent to the encactment of the zoning ordinance; that attached hereto is a survey of said premises Subscribed and sworn to before W is �� day of , 19 3. i G iTl1NKEftw V9* (Rensselaer G. Terry, 3allp� „8 �oiy5 0b� 0,, N 0A r9 M �j11'L tANdpf 91'11 1d sa°A1A"0' 10`l pa AB pJ• S 0� 0v ��o Old $ 'f la�ppo dais al�p►1 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEVE' YORK CERTIFICATE OF OCCUPANCY THIS IS TO CERTIFY that the Land Building(s ) Use* / located at i Co 3/5/q�_3 V&' t Street Hamlet shown on County tax map as District 1000, Section 3 Block , Lot , does 04C onform to the present Building Zone Code of the Town of Southold for the following reasons: rvw 41 2e 4 -7�" /62 6-A On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /_/ Land /_/ Building(s) )Z/Usekexisted 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: [' The Certificate is issued to (owner, of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CER'T'IFICATE NO. A/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. Building inspector Y 1�z TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER 11 STREET* VILLAGE I DISTRICT I SUB I LOT FORMli� OWNER E W , 7' ACR E G TYPE OF BUILDING