HomeMy WebLinkAboutZ-14203TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN tLiLL
SOUTHOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORMING PREMISES
THIS IS TO CERTIFY that the
/~ Land Pre C.O. #- Z14203
/ / Building(s) Date- Feb. 6,1986
/--/ Use(s)
located ~ 2650 Bungalow Lane Mattituck
Street Hamlet
shown on County tax map as District 1000, Section 123 , Block 08
Lot 024.1 , 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 /Z/Building(s)
/Z/Use(s) ekisted 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 story, one fam-
ily, seasonal wood framed dwelling with attached garage and wood
deck. Property situated in the A-Residential-Agricultural Zone
with access across an unopened R.O.W. to Bungalow Lane.
The Certificate is issued to
of the aforesaid building.
ROSS, FREDERICK A,
(owner,
Suffolk County Department of Health Approval
UNDERVq:tITEfiS CERTIFICATE NO.
N/R
N/R
NOTICE IS HEREBY GIVEN that the owner of the above premises I-LiS
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.
Building inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted 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 featu res.
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 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.P~q~.~.,..%9~ ....
New Building ............. Old or Pre-existing Building .... ~. ....... Vacant Land .............
Location of Property .. ?.a.r..~..A.¥e..~.e...~.~.t.e.~..s .~.o.~. ......................... .H.a.t.~..~.~.c?....
House No. Street Ham/et
Owner or Owners of Property Freder±ck A. Ross
County Tax Map No. 1000 Section [23.8-24-~ Block Lot
Subdivision Survey Attached .Filed Map No. .Lot No.
PermitNo ........... Date of Permit .......... Applicant Frederick A. Ross
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ×
Fee Submitted $ 15.00
Construction on above described building and permit meets all .~.~i ~
C~ ~(~ ~-~0~ :~c<,~ ~.~ap licab odesand regulations.
~O ~-~ tH~..~ ~ Applicant .....
(k c .........................
Rev. 10-10-78
AFFIDAVIT
STATE OF NEW YORK)
)
COUNTY OF NASSAU )
SS. :
I, Frederick A. Ross~ make this Affidavit in
support of my application for a Pre-existing Certificate
of Occupancy for County Tax Map 123-8-24.1. I have
personal knowledge of the structures on this property
consisting of a summer cottage with attached garage,
all of which was constructed prior to April 23, 1957
and is now in habitable condition.
Frederick A' Ros~/
Sworn to before me this
~ day of December, 1985.
N~a'ry Public
JANET S. SCHNEIO~
NOTARY PUBLIC, Smm of N~wYm'k
No. 4818081. Nassau
Term Expir~Maf~h
OR 0.7594
GREAT
FREDERICK
pEcoNiC
SURVEY FOR
ARTHUR ROSS a BETTE H. ROSE
,~IT M~4TTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
I000 - I~$ - 08 - ~4. I
SCALE~ 1'~ 30'
DEC. L'-~. 1985
THE SUFFOLK COUNTY CLERKS OF~'IC~
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