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HomeMy WebLinkAboutZ-12367TOWN OF SOUTH©LD OFFICE OF BUILDING INSPECT©R TOWN HALL SOUTItOLD, l~EW YOrlK CERTIFICATE OF OCCUPANCY NON CONFORMING I R L .~1 ISES TttIS IS TO CERTIFY that the /~X/ Land / X/ Building(s) /--X/ Use(s) located at Midlothian Avenue No. Z12367 March 16, Fishers Island 1984 Street Itamlet shown on County tax map as District 1000, Section 009 , Block 04 l~ot 023 , does~not)conform to the present Building Zone Code of the Tovrn of Southold for the following reasons: the property has insufficient total area; the dwelling has insufficient rear yard setback; this is a two-family dwelling. (-)n the basis of inforrnation presented to the Euilding Inspector's Offic(~, it has been determined that the above nonconforming /~/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: a private two-family dwelling. The Certificate is issued to of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO. ARTHUR J. PAQUETTE & HIS WIFE (oxvner, no record no record 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 refula- tions. Buildin~~ Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Depar[,,,ent Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Ao 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. 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. Fees: 1. Certificate of occupancy ,5.00 ~ ~_/ 2. Certificate of occupancy on pre-existing dwelling land use $/ $5.00 3. Copy of certificate of occupancy $1.00 Date December 30, 1983 New Building ............. Old or Pre-ex.[~tiDg Bu.ilding ×× Vacant Land ............. £~laio~nlan '~ ~'e' .... Location of Property ................. .O.c.e.a. ~.~.c..~. y.e.~.~.e. .............. .~.~..s.h.e.~.s...~.s.[.9 .~.' House No. Street Ham/et Owner or Owners of Property .......... .~.~..~..u.~..~......~.a.q .~.e~.~.e..~..~.~ .. ...................... County Tax Map No. 1000 Section 009 Block 04 Lot 023 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 $. ~ .5...0.0. ...................... Construction on above described building and permit rne~li~~ons. ~ il,[~i~m H. Pr~[c~, ~-~. Attorney/Atent ~.~o-~o.?a for Arthur J. Paque~te, Premises at Oceanic Avenue and Midlothian Avenue, Fishers Island STATE OF CONNECTICUT) COUNTY OF New Haven ) ss.: Oxford ARTHUR J. PAQUETTE, SR., being duly sworn, deposes and says: That I reside at 19 Evening Star Drive, Seymour, Connecticut; That I am the present owner of the premises located at Oceanic and Midlothian Avenues, Fishers Island, New York, and desig- nated on the Suffolk County Tax Map as District 1000, Section 009; Block 04, Lot 023, and am familiar with the condition of same; That the structure situated thereon has been designed, arranged and physically occupied as a two-family dwelling; That at this time the premises is occupied; That the condition of the existing structure on the premises is good; That I make this affidavit in the knowledge that the Building Department of the Town of Southold will rely on the accuracy thereof in issuing a certificate of occupancy for pre-existing use. Sworn to before me this day of December, 1983. Arthur J. ~U~.~r. /