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Home My WebLink AboutZ-11560TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK March 23, 1983 CERTIFICATE OF OCCUPANCY i4eNCONFORMING PREMISES No. Z11560 THIS IS TO CERTIFY that the Land Building(s) Use(g) located at 2905 Bayshore Road Greenport Street Hamlet shown on County tax map as District 1000, Section 053 , Block 06 , Lot 004 , does(xot)conform to the present Building Zone Code of the Town of Southold for the following reasons: the use as a one -family dwelling is permitted in this 'A' Residential -Agricultural Zoned District. On the basis of information presented to the Building Inspector's Office, it has been determined that the above =Xconforming /_/ 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 private one -family dwelling. The Certificate is issued to LAWRENCE A. MITCHELL (owner, 4essee-�-t-ens-nt) of the aforesaid building. Suffolk County Department of Health Approval n/a UNDERWRITERS 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. _C_BuildinLT inspecior Premises at 4145 Bayshore Road Greenport, New York STATE OF NEW YORK) ss.: COUNTY OF SUFFOLK) I, LAWRENCE A. MITCHELL, residing at 4145 Bayshore Road, Greenport, New York, being duly sworn, deposes and say: That I am the present owner of the premises located at 4145 Bayshore Road, Greenport, New York, and designated on the Suffolk County Tax Map as District 1000, Section 053, Block 06, Lot 004, and am familiar with the condition of same; That the structures situated thereon have been designed, arranged and physically occupied as a single family dwelling with detached garage; That at this time I am living at the subject premises; That the condition of the existing structures on the premises is good; I make this deposition in the knowledge that the Building Department of the Town of Southold will rely on the accuracy thereof in issuing a pre-existing certificate of occupancy. cce- Yr'' Lawrence A. Mitchell Sworn to before me this 15fh day of March, 1983. Notary Public - Q KATHY M. KLtNGE atPUBLIC, State of New Vk IN. $ 2 4657592, Suffolk Cam4 Gwakdee fawn March 3% In - 5 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 March 11, 1983 .......................... New Building ............. Old or Pre-existing Building ... XX...... Vacant Land ............. Location of Property 5— (M5 Ba shore Road Greenport Y House No.............. ........... Street ......................... Hamlet Owner or Owners of Property ......Lawrence ..A.. Mitchell .ence ......tche ............................... 04 County Tax Map No. 1000 Section ....053.. , , , Block ............... Lot ............... . Subdivisionr� of Wickham Park 644 50 ....................Filed Map No. ..........Lot No. ............. Permit No. .......... Date of Permit ..........Applicant .................. I ............... Health Dept.Approval ........................Labor Dept. Approval ........................ Underwriters Approval ........................Planning Board Approval ...................... Request for Temporary Certificate .....................Final Certificate .... , , xx Fee Submitted $ .15.00 ...................... Construction on above described building and permit meets all applicable codes and regulations. Applicant....................... ........ . Irving L. Price, Jr. - Agent for Rev. 10-10-78 Lawrence A. Mitchell (t6Co� 2Q a(3g8 � is •} j e � >r -.fid' i jj 3+ e 3 ,.t "i"p... r` atw'si/ +moi 'iw OL VWAMk see „� . R f�yyK t,& 4th '1 C