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Home My WebLink AboutZ-15740TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN ILiLL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORA%ING PREK,IISES THIS IS TO CERTIFY that the /--~ Land Pre C. O. #- Z- 15740 / %/ Building(s) Date- May 8, 1987 /-/ Use(s) located at Fishers Island Street Ha~nlet sho%vn on County tax map as District 1000, Section 009 , Block 0 1 Lot ]6 , does.~not)conform to /he 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 thai the above nonconforming /-X/Land /l/Building(s) /_/Use(s) existed on the effective date the present ]Building Zone Code of. the Town o£ Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED thai, based upon information presented to the Building Inspeclor's' Office, the occupancy and use for which lhis Cer!ifi- cate is issued is as follows: Property contains 2 story, one family, woodframed dwelling, with enclosed porch and situated in the 'A' Residential Agricultural zone with access by Private Road. The Certificate is issued to of the aforesaid building. JEAN M. LEUCHTENBURG (owner, Suffolk County Department of Health Approval N/A UNDER\~q~ITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises l-LiS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordLn- ' 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. 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 I m 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 $I5,00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date .......................... NewC ~''t-~'~e~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ... ?.~,s, ,h,e,r.s,, .~ .s,l.a?, .d ............................................... House No. Street Ham/et Owner ox~[~ of Property . .J.e.a.n...~....~.e.u.c.D. ~.e.n.b.u..rg ................................... County Tax Map No. 1000 Section . .~.~..~.' ......... Block . .(~ ~; .......... Lot..[,~ ............ Subdivision .... ~/.A. ......................... Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval . .N./.A. ................... Labor Dept. Approval ...N./, ,A .................. Underwriters Approval . .N./.A, ................... Planning Board Approval .N,/, ,A .................. Request for Temporary Certificate ....N./.A. .............. Final Certificate . ?./..A .................. Fee Submitted $ .].5,0D ....................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .~'.'..c~...'~,.., L~N~.~...~..~..~ ............... Rev, 10-10-78 In the Matter of Title Being Conveyed from Barbara Kane Javelera to Jean M. Leuchtenburg Situate on Fishers Island and known as Mansion House Cottage C STATE OF NEW YORK) SS.: COUNTY OF SUFFOLK) AFFIDAVIT and say: I, RICHARD S. BAKER, having been duly sworn, do depose I am over the age of twenty-one (21) years and now reside on Fishers Island, which has been my residence for over thirty (30)1 years last past. I am familiar with the Mansion House Cottages, which I believe were originally built in or about 1917. I have examined the survey of Chandler & Palmer dated September 1964 of subject premises and certify that there have beer no exterior changes or additions to the structure on the premises subsequent to 1964. I further certify that I believe said struc- ture has remained unchanged since prior to 1957. -1- I am not related in any manner to Barbara Kane Javelera nor to Jean M. Leuchtenburg and have no pecuniary interest in subject premises. Subscribed and Sworn to Before me this day of April 1987 ,5-