HomeMy WebLinkAboutZ-14652TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN I-Li L L
SOUTHOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORMING PREMISES
THIS IS TO CERTIFY that the
/~/ Land Pre C.O. #- Z14652
/ / Building(s) Date- July 16, 1986
/-/ Use(s)
located ~ 390 Park Way Southold
Street Hamlet
shown on County tax map as District 1000, Section 70 , Block 10
Lot 39 , does.~not~conform to the 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 that the above nonconforming /]/Land /l/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: Property contains a one and one half
story, one-family, wood-framed dwelling with an attached garage
and a cyclone fence across the rear. All situated in the "A"
Residential-Agricultural Zone with access to Park Way.
The Certificate is issued to JOHN M. & EDWARD J. PETERS
of the aforesaid building.
(owner,
Suffolk County Department of Health Approval
UNDER%VRITERS CERTIFICATE NO.
N/A
N/A
NOTICE IS HEREBY GIVEN that the owner of the above premises HiS
NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec-
tor to determine if the premises comply with al! 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.
Buildin~ inspector
M-3561
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
JUN 3 0 1986
BLDG, DEPT.
TOWN OF SOUTHOLD
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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.
Bo
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 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
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
$15.00
Date..~q~.~3.,.~ ........
New Building ....... ~.~q~,~ld or Pre-existing Building ...~ ....... Vacant Land .............
Location of Property . ~,..~.ap..o.~..S.o.u..~,[~t?.o.o..d..a.~..S.o.~.~ .h.o.]..~. .... .~./..s..~.a.r.¥. ~.~a.~....
House No. Street Ham/et
Owner or Owners of Property .... ~.o.h?...~... ?.e..~.e?.s., .a.~.d...~.d.~.a?..~.. ~..., .~.e.~.e?. s. ..............
County Tax Map No. 1000 Section ....0.7.0 ........ Block ..... .i.0. ....... Lot ..... 0.3.,9 ........
Subdivision ....... ~.ap..o..~..S.o.~.h?.O.o.' .d .......Filed Map No. G:~I .~/./...Lot ,o .... .2. .........
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 $... ,1,.5...qO,, ,~., .~, .t.~. ,'~-, ,~, ......
Construction on above described building a.nd perr~t meets all applic~ co,¢es and regulations.
C
s.' ...............................
Rev. 10-10-78 t~.~
M-3561
STATE OF NEW YORK )
)
COUNTY OF SUFFOLK )
SS:
JOHN M. PETERS, being duly sworn, deposes and says
that he is the applicant for a pre-existing Certificate of
Occupancy; that deponent knows of his own knowledge that the
dwelling house on said premises was constructed and occupied
prior to 1957; that no changes have been made subsequent to
the encactment of the zoning ordinance; that attached hereto is
a survey of said premises; the said premises are occupied as
a one family residence.
(Jo n M. Peters)
Subscribed and sworn to
before me this ~2~-day
of June, 1986.
N~ta~y Pub.lie.
NOTARY I"UBUC, State of New York
z_o~ /