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Home My WebLink AboutZ-17064TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the /7 Land /-X7 Building(s) Z22 Use(s) located at 4900 Peconic Bay Blvd. Pre C.O. #- z-17064 Date- July 6, [988 Laurel, N.Y. Street Hamlet shown on County tax map as District 1000, Section 128 , Block 04 , Lot 04 , does(not) conform to the present Building Zone Code of the Town of Southold for the following reasons: Insufficient total area; front & rear yard set-backs; less than minimum habitable space. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming ~X7 Land /~./ Building(s) ~--7 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 apPlicable 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 Certificate is issued is as follows: Property contains a one story, one family wood framed seasonal dwelling; with screened porch; all situated in 'A' Residential Agricultural zone, with access to a Private R.O.W. The Certificate is issued to MARY ROSS (owner,X~LV~K~g~x~~ 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 ordinances, 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 regulations. Building Inspector' 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 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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: Additions $25 .00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$ ~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons truction ...... Old or Pre-existing Building ............ Vacant Land ............. Locat on of Pro er · P ty · · 'Z~/' ~. ................... --~. · ¢-.r. · .~¢..-.~.~.. House No ~ .~ L/Street ........................ · /.) ~j_ / .) .., ....__. ~ Ham/et Owner or Owners of Property . ~ ~. .~. . . .~. 2 : . ~..~.. ..Q. .~.. ............. · .-/..~.~- ....... Block ....~. .......... Lot .... ~. .......... County Tax Map No. 1000 Section 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 $ ............................. Construction on above described bu ilding and p~..F~t~ts all appl~, ab~es an_d regu ,ations. Applicant .... ~..~,.,~1.~~...~.~ ................. Rev. 10-10-78 MAR I 2 ~LDG DEPT. ~,, I'F".,' OF 'g,...UT~-,tOL Form No. 6 TOWN OF SOUTI[OLD BUILDING DEPARTMENT TOWN I~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY · \. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3.Approval of electrical installation from Board of Fire Underwriters. 4.Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6.Submit Planning Board Approval of completed site plan requirements. :J. For existing buildings (prior to April 9 1957) non-conforming uses, or buildings and pre-existing" land uses: 1.Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date March // , 1999 .';ew Construction ........... Old Or .Pre-existing Building Location of Property 155 Birch Drive, Private Road, J6 ....................... · ......... .... Laurel House No. Street Hamlet Onwer or Owners of Property.. ' ...................................................... County Tax Map No 1000, Section 128.00 .Block.04.00 ............. · .Lot 004.000 Subdivision ..... ............................... Filed Map .... .N/.A....Lot. N~A Permit N~ N/A .................. Date Of Permit ...... .N~.A. ...... Applicant. .N/.A !{eel Lh Dep~ Approval N/A · ' ......................... Underwriters Approval. ?lanning Board Approval..N./..A ................... !{equest for: Temporary Certificate ........... Final Certicate ........... ?ce Submitted: $100.00 ...... ..................... :.. RICHARD ROSS, being duly sworn, deposes and says: 1. I reside at 231 Park Avenue, Huntington, New York; 2. I am fully familiar with the premises - 4900 Peconic Bay Boulevard, Mattituck, New York; 3. My parents, Mary J. Ross and Ray J. Ross, purchased the premises in 1949. 4. From the time of the purchase, I visited the premises every summer. tion. 5. The property is a single-family dwelling of fram construc- 6. There have been no structural changes made on the property since the house was conveyed to my parents. I make this affirmation knowing that the Town of Southhold relies on the statements made herein. RICHARD~SS Sworn to this 27th day of June, 1988. GLORIA F. THELEN NOTARY PUBLIC, State of New York No. 52-9312200, Suffolk County ~omm~son Expires May 31., Z 0 v 0 d . (- C I ...; Z A '% ,_.,.i %? > ~ ~ ~~ ' a5 ,.4 0 0 ,,, ~ 0 0 ~ ~ U Z '" --.% ~ ~-% u i-.-< :-:::r.,. a, o, ~ _i "~ ~ uJ 0 ~-~,-. U_ u.I Z u- 0 ~: ~ o ~,3 rn T