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Home My WebLink AboutZ-14156TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREI~ISES THIS IS TO CERTIFY that the /~ Land Pre C / / Building(s) Date- /-/ Use(s) located at 5195 Old North Road Southold Street Hamlet shown on County tax map as District 1000, Section 51 , Block .3 Lot 5 , 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 ~X/Land /Z/Building(s) /--/Use(s) existed on the effective date /he 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 potato barn and is ~it,~t.~d Jn t.h~ ~-~e. sidential ~_~ricultural zone with access n~ 4 ~in~f-.h 1~n~d ~ a tnwn maintained road. to t~ The Certificate is issued to of the aforesaid building. Walter & Frank Sawicki (owner, k~x~:kex 9R xt j~ ~ fin t ) Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICA~fE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises PLAS 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 CERTIFI'CATE 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 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 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. 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 ...J...].].~.J..~ ........ New Building ............. Old or Pre-existing Building ~J Vacant Land Location of Property ....'~-. f.~..~....~ .L~ .~.. ~ ~. g?.¥.. [~,~A/~. J,.~ ..... .~(~ !J.,"r, ff~..~.~__~ ...... House No. Street Ham/et Owner or Owners of Property .. W.~..~-. '.~.~.~ .~. ?...~./..~...CV'..~...,%./~..u..;.~k J~ ................ County Tax Map No. 1000 Section .... .~.~ .l ...... Block ......... 5. .... Lot ...... 5% ...... 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 building and permit meets all applicable codes and regulations. .......... STATEMENT OF OWNERSHIP The following undersigned hereby stipulate that they are the owners of a piece of property situated on Old North Road, Southold, New York, designated on the Suffolk County Tax Map as District 1000, Section 51, Block 3, Lot 5. DATED DATED PALTER S~W~ C]~ I FRANK SAWICKI STATE OF NEW YORK, COUNTY OF SUFFOLK, ss: On the Y--/_ day of ~ , 1985, before me personally came ~~ , to me known to De the individual described in and who executed the foregoing instrument, and acknowledged that ~ ..e. xecuted the same. Res[dir~g m ~d;?~, 0mw ..~/ ~OT~Y ' PUBLIC On the ~. day of ~ , 1985, before me me the individual describe~ in and who executed khe foregoing instr~ent, and acknowledged that ~ execu%ed the same. .~ O~RY PUBL C BLDG. OEPT. TOWN OF SOUTHOLD The following affadavit is to stipulate that the property described in the Statement of Ownership, designated on the Suffolk County Tax Map as District ±000, Section 51, Block 3, Lot 5, comprises of .70 acre situated on the north side of the Old North Road, Southold, New York, which is improved by one concrete storage building for use in agricultural operations. DATED DATED WALTER SAWICKI FRANK SAWICKI STATE OF NEW YORK, COUNTY OF SUFFOLK, ss: On the ~ day of ~~. , 1985, before me personally came ~M~. . ~~/~_~,~ to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that /~ executed the same. ~STAT~ OF NE~ YOR~, COUNTY OF On the ~ day of ~~ -- , 1985, before me personally came ~~ ~~~ , to me known to be the individual described in and who executed the foregoing instr~ent, and acknowledged that ~ executed the same. ' DEC 16 1985 BLDG. DEPT, TOWN OF SOUTHOLD