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TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD'., NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORAING PREMISES
THIS IS TO CERTIFY that the.
LU Land Pre C.O. #- Z-17131
Q Building(s)
Q Use (s) Date-July 28, 1988
located at 4600 Main Road Laurel. - New York "
Street Hamlet
shown on County tax map as District 1000 , Section 125 Block
03 Lot 12 does (not) conform to the present Building Zone
Code of the Town of Southold for the following reasons :
Insufficient total area; front yard set-back
On the basis of information presented to. the Building Inspector' s
Office , it has been .determined that the above nonconforming U Land
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 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 2 story 1 family wood
framed dwelling, with attached shed; an accessory two car garage wood fencing; all
situated in the 'A' Residential Agricultural zone, with access to Main Road; a
State maintained road.
The Certificate is issued to RUTH D.YOUNG
(owner,
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.B
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 a G�iiii 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:
1. Certificate of occupancy $25 . 00 -- BUSINESS $50 . 00 ACCESSORY $10.00
2. Certificate of occupancy on pre-existing dwelling $ 50 . 00
3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ 10 .0 0
4.Vacant Land C.O. $ 20 . 00
1988
5.Updated C.0. $ 50 . 00 Date . , July, is . . .. . . . . . . . . . . . .
NewCons truc tion , , , , , Old or Pre-existing Building .X. . . . . . . . . . Vacant Land . . . . . . . .. . . . .
H(Qao
Location of Property .(,No #) ,Main.Road:.Mattituck. . , . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . .
House N0. Street Hamlet
Owner or Owners of Property , , ,Ruth,D:.Young. . . . , , . _ . .
County Tax Map No. 1000 Section . . . . . . . . . . Block . 3. . . . . . . . . . . . . Lot. . 12. . . . . . . . . . . .
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 $ .50;00. , . . .
Construction on above described building an ermit eets all appli able codes and regulations.
Applicant . . . .4. . . . . . . . . . . . . . . . . . . . . . . . . .
N B. YOUNG R.
--aa Rev.10.10-78
� , J) SQ�a
STATE OF CONNECTICUT)
SS. :
COUNTY OF LITCHFIELD )
JOHN B. YOUNG, JR. , residing at (No#) Lake Waramaug,
New Preston, Connecticut 06777, being duly sworn, deposes
and says:
That my mother, RUTH D. YOUNG is the owner of premises
located at (No #) Main Road, Mattituck, New York, Suffolk
County Tax Map #1000-125. 00-03 . 00-012 . 000, as shown on the
enclosed survey.
She and my father, JOHN B. YOUNG, SR. obtained this
propertyWAR S ed0 from my grandfather, JOHN YOUNG. The
residence/an garage were built in 1949 and no alterations
were made to the premises since that time that would require
a Certificate of Occupancy.
I make this affidavit to the Town of Southold fo ff
Certificate of Pre-Existing Use f r the re -dence/anc� e
garage.
l
OHN B. OUP, JR.
Sworn to before me this X
(-2_ day of
� 1988.
-, A
Notary Pub is
d)ly Vommission Expires March
aff-young
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MAIN ROAD ( S..R.. 25 )
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SURVEY OF
}, PROPER
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AT MATTITUCK
TOWN OF SOUTHOLU
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W00DED cE •�4.4' �' S UFFO L K COUNTY, N. Y
s.r• 1000 - 125 - 03 - 12
STORY Scale 1 ff = 30'
o, 2 pME HOSE `�
June 30, 1988
10.0.
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FIRST AMERICAN TITLE .INSURANCE
apREpG COMPANY OF NEW YORK
Z = 3 TITLE NO. 131-S-1949
° 6A Q SOU.THOLD SAVINGS BANK
3 DONALD McBRIDE
VERONICA' McBRIDE
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TOWN OF SOUTHOLD
00,. Z
140' LLAK o I �' ti° s6$
EY ° Prepared In accordance with the minimum
HARD P 3 standards for Nlle surveys as established ® .$1� N.Yam- L/C. NO. 49668
NlofF by the L.I.A.L.S. and approved and adopted l '�"
for such use by The New York Stole Lond ECONIC' SURVEYORS, P.C.
Title Assoc/ali.on.. (5161 765 - 5020
P. O. BOX 909.
MAIN ROAD
SOUTHOLD, N. Y. 11971
88- 431