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Z-12962
TOWN OF SOUTHOL.D OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK 'CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the C.0. # Z 12 9 6 2 . Land Date November 5 , 1984 /_/ Building(s) / / Use(s) located at 290 Pvt . Rd. #4 , Town Harbor Terrace Southold Street Hamlet shown on County tax map as District 1000, Section 66 Block 1 , Lot 33 doe<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 59Land /_/ 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 information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- One family , two story frame house with attached cate is issued is as follows: garage and a concrete patio in the- rear . Property has a bulkhead; bath house, stairs and deck; on the water. side . Property has access to Town Harbor. Terrace; a private road. Property located in "A" Residential-Agricultural Zone. The Certificate is issued to Jenifer Heyward Wood .(owner, )1XXXU�XibM) OIL 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 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. v % Buiidinc; inspector 1 JOANN B. WALKER Mr. Victor Lessard Building Department Southhold Town Hall Main Road Southold, NY 11971 I Joann Walker, being duly deposed, do hereby affirm the following: I have personally inspected the premises on Town Harbor Terrace designated as Tax Map #66-1-33 and I have at my request, hired a professional engineering firm to do the same. Based on his report and my own individual inspection, the house is in liveable condition and habitable. I further affirm that to the best of my knowledge no changes have been made to the dwelling since 1957 and to date. ann B . Walker State of New York County of New York Sworn to before me this 2nd day of November 1984. NOTARY PUBLIC IDA DURAN NOTARY PUBLIC, State of New York No. 43-4746179 Qualified in Richmond County Certificate Filed in New York Coun Commission Expires march 3o,19 �� FORM NO.6 TOWN OF SOUTHOLD Building Department Town Hall 8iouthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 0 A. This application must be filled in typewriter OR ink, and submitted p ieate-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 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling land use --Pre-Existing C . O . $15 • 00 3. Copy of certificate of occupancy $1.00 Vacant 'land C . O . $ 5 . 00 Date AL . . . . A . . .. . . . . . . . . . . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building. . . . . './. . . . . Vacant Land . . . . . . . . . . . . . Location of Property �� . . . W/�. . . R►':�?or .� ! . . . . . . . . . . . hQ.f�. House No. l Street Hamlet Owner or Owners of Property . VAJ.d . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section . . 66. . . . . . . . Block/ . . . . . . . . . . . Lot . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . .Lot No. . . . . . . . . . . . 76 ax-A l /0"-o � f !'✓o o c/ Al . Permit No. . . . . . . . . . . Date of Permit . . . . . . . . .Applicant .-fir 62 4X4_G4J7"a.�. Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval Underwriters Approval . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . . . Fee Submitted $ . �.✓C� �... . . . . . . . . . . . . . . . . . . . Construction on above described building-and permitXtA4_40 ll applicable codes and regulations. Applicant r1. . . �C . .R .�G�✓©� Rev.10-10-78 OI s-o J ON . r o r1 t ���._`'�,-.,� v1 \\\ ,,i 7' Cs Llc�)•,:��':"� :t1 ¢'v ,rl``;�:' ��' �1;'• c,;G!�I/"z%?1;fG'_�: `T�la �`".._...�_,`� � .... r r �_. ..�i,'* t�i`R+- �/'.`.�i1.' 1 .:..�Lrf� /- . i t• it \�� _ L..,C. .,�::c'� .._'.:.ri`'.'�'c1�j':>. — F47�•,d` ir�;t,,.Y� F�i. `r' i