HomeMy WebLinkAboutZ-12364TOWN OF SOUTtlOLD
OFFICE OF BUILDING INSI'i~CTOR
TOWN HALL
SOUTttOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORMING PR t,;MISES
THIS IS TO CERTIFY that the
/X_--/ Land
/ / Building(s)
/-/ Use(s)
Date: March
Z12364
15, 1984
located at On a ~rivate road off No. Bayview Rd. Southold
Street Hamlet
shown on County tax map as District 1000, Section 080.00, Block 01.00
Lot 022. 009 does(not)conform to the present Building Zone Code of the
Town of Southold for the following reasons:
Insufficient total area. A~zoned
On the basis of information presented to the Buildin~ Inspector's Office,
it has been determined that the above nonconforming /~//,and /~/Buildin~is)
/--/Use(s) existed on the effective date the present Buildin~ Zone C()de 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: Has access to prgpe, rty on .app~roved
private road, Paradise Shores Rd., off No. Bayview Rd., Southold
The CertLficate is issued to Frank J.
of the aforesaid building.
Small Jr. & Anne M. Small
(owner, lessee or tenant)
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO.
N/A
NOTICE IS HEREBY GIVEN that the owner of the above premises I~,'~S
NOT CONSENTED TO AN INSPECTION of the premises by the Building Insp~c-
tot to determine ff 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 regula-
tions.
STATE OF NEW YORK :
: SS
COUNTY OF SUFFOLK :
Chicago Title Insurance Company
Title No. 8308-05796
FRANK J. SMALL, JR., residing at 90 South Park Avenue
Rockville Centre, New York, being duly sworn, deposes and
says:
THAT he is the owner of premises located on a Private
Road off North Bayview Road, Southold, New York;
THAT he has owned the premises since July 21, 1972;
THAT he knows that the house on the premises was
built prior to the Southold Town Zoning Ordinance in 1957;
Sworn to before me this
28th day of December, 1983
) .., .>'m ..',
' ,/~otary
Frank J. l~mall, Jr.
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
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.
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.
Co
Fees:
1. Certificate of occupancy $5.00 /
2. Certificate of occupancy on pre-existing dwelling/ land use --?z-e-Ex±s t±ng C. 0. $15.00
3. Copy of certificate of occupancy $1.00 Vacant land C.0. $ 5.00
Date ..........................
New Building ............. Old or Pre-existing Building .... .x. ...... Vacant Land .............
Location of Property ..... .O.n...a.p.r.i.v~..tg.' .rg.a.d..o.f.f..No....B~3 .y.~i.'..egv'' . .1~.,..S.o.u..t~.o.l.d....N..c=~..Y. qr.k. ....
House No. Street Ham/et
Frank J. Small, Jr. & Anne M. Small
Owner or Owners of Property ............................................................
CounW Tax Map No. 1000 Section . .0.8..0...0.0. ...... Block .... 0.1....0.0 ...... Lot..0.2.2....0.0.0. ......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant . .F.r.~..k..J.,..S.m.e..1.1~..~.r..&..hJ~D.e..~. Small
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 meets all applicable codes and regulations.
Applicant .~~ t~.~e.~.',. ~~ ..............
Rev. 10-lO-78 for Frank J.SmallJ~. & Anne M. Small