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_ TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN H_9LL
SOUTHOLD, NE`'~' YOP.K
CERTIFICATE OF OCCUPANCY
NONCONFORMING PREn'USES
THIS IS TO CERTIFY that the
/X/ Land Pre C.O. Z-15892
Building(s) Date- June 29, 1987
/ /Use(s)
located at 2620 Hobart Road Southold, New York
Street Hamlet
shown on County tax map as District 1000, Section 064 Block 03 ,
Lot 09 doesinot~conform to the present Building Zone Code of the
Town of Southold for the following reasons:
Insufficient total area; non-conforming accessory garage in
side yard.
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming /X/Land /x /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 iru`ormation 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 family, wood
framed dwelling; accessory garage and situated in 'A' Residential Agricultural Zone
with access to Hobart Road; a Town Maintained Road
The Certificate is issued to JAMES & EMMA FORD & OTHERS
(o~~mer, 1 ~~Xt~i~a~i~
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDER«TR.ITEttS CERTIFICATE NO. N/A
A7OTICE IS HEREBY GI~TEN that the owner of the above premises H_AS
NOT CONSENTED TO AN Il~'SPECTION of the premises by the Building Inspec-
tor to determine if 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 ~n~ith all other applicable codes and regula-
tions.
_
~uii~in~ :nspecLOr
M-3632 ~"x~- ~
- - ~~s~ a~c~
FORM NO. 6
TOWN OF SOUTHOLD
Building Department Epr,
Town Hall ttit' gpl)THOLD
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
torwith 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-
bons, acertificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where app?icable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of pYUperty 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:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling x3c~ $50.00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
Date , ,June 1987
New Building .............Old or Pre-existing Building X....... Vacant Land .
• Location of Property ~~SS~, _ , ,Hobart. Road, $pt;iiho~d ,
House No. S[reet Hamlet
Owner or Owners of Property JAMES ,B; ,FORD, and EMIKA. W, FORD; ux. and others
County Tax Map No. 1000 Section ...O,F24. , , , , , , , , Block Lot .009
Subdivision , ,Founders, Estates. , - , , , , ,Filed Map No. .834......Lot No. 25....... .
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 $ .50.00
Construction on above described building a ermit meet applicabl codes and regulations.
Applicant . /~~.?..'~4!tr!
(Francis M. Tully
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' STATE OF NEW YORK ) i
bI- 3632 ) SS
COUNTY OF SUFFOLK )
FRANCIS M, TULLY, being duly sworn, deposes and
says that he is the attorney-in-fact for JAMES B. FORD and EMMA
W. FORD, his wife, the applicants 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 long
prior to 1957; and that no changes have been made subsequent to
the enactment of the zoning ordinance; that attached hereto is a
survey of said premises. Premises are occupied as a one family
dwelling.
(Francis M. Tull
Subscribed and sworn to
before me this ~~~day
of June, 1987.
pp
/J
Notary Public.
NOt~Rt~N~at
~N Y~at~
~ X61850 Qeepfind in SunoiM Oounh q
Commission Ext++~eS j~
M-3632
FORM NO. 6 t
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
torwith 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-
lions, acertificate 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:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling x$X~p $50.00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
Date , ,June . _ ..1987....
New Building .............Old or Pre-existing Building X Vacant Land .
• Location of Property Iiobart Road, $puthold ,
House No. Street Hamlet
Owner or Owners of Property JAMES. B. FORD and EMMA W. FORD, ux.. and others
. . .
County Tax Map No. 1000 Section ..064 , , , , , , , , , Block ...03 , , . , , , , Lot ,009
Founders Estates
Subdivision ............Filed Map No. a34, , , . , .Lot No. ...25....... .
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 $ 50.00
Construction on above described building and it meets all licable odes nd regulations.
Applicant ..`~!~f~ G~ ~ .
(Francs M. ully
n.~. io~io~~a