HomeMy WebLinkAboutZ-7039 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z7039 . . . . . Date Ma�: . .?0. . . . ., 19. 76
THIS;CERTIFIES that-the building,located,at- YTassau. PoAnt. R.q'ad. . . . . . Street
Map No. Va.s.-sr. Ptv .lbi6 ~No. . . :Lot No 1- :& Pt: .1.42 Cutchogue. N.Y.
require mex t;6 for. one �fam ly dwell.i & housing code
conforms substantially to the �� X
built certificate of occupancy
date bol:ore..Anr. l.:.:23, 19 57. pursuant to which $4Ie41` o. lC3
dated . . . . . . . . . . . . . . . 19. r
, was issued, and conforms to all of the require-
ments of the, applicable provisions of the,:,law. The occupancy.for which this certificate is
issued is . Private .olne. divel?1-z'g. . . . . . ... . . . . . . . . . . . . . .
. . . . : . . . . . . . . . . .
The certificate is issued to . .Robert. A .Rehm. . . . .owner. of. record
('owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . . . . .. . . .. . .
UNDERWRITERS CERTIFICATE No. . pre.- .Px sting . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . . . - 5-7-3Q. . . . . Street . . . .Nas.say.. Point. Road . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . .
Building Inspector
HOUSING CODE INSPECTION
May 20 , 1976
5730 Nassau Point Road R-1
Cutchogue, N.Y.
Subdivision: Nassau Point Club Prop.
Amend A, Map 156 , Lot 141 and 1/2 of 142
Tax roll : Robert Rehm
Occupied, owner
Upon receipt of an application for a Pre-Existing Certificate
of Occupancy; I made an inspection of this one story framed
dwelling. I was admitted to building by Mr. and Mrs. Rehm
who accompanied me during this inspection which began at approxi-
mately 12 :45 P.M.
The building consists of two bedrooms, living room, dining
room, den, laundry room, kitchen and two full bathrooms . Heat
is furnished to all rooms from an oil fired forced warm air
furnace located in cellar of building' s cement block foundation.
Cellar is partial with crawl space balance of building' s founda-
tion. An attached two car garage is on the north end of building.
I found no violations of the Housing Code, Chapter 52 , Town
of Southold, New York.
Inspection completed at approximately 1 :15 P.M.
;esictfully sub tted,
dward Hindermann
EH:mm Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Clerks Office
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
Inspector 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
installations, 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 in-
formation required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5,00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date .... 76..............
New Building ................ Addition ................ Old or Pre-existing Building .....X........ Vacant Land ..............
Location Of Property ..Nassau Point Roads Cutchogue, New York
... .. ................
Owner Or Owners Of Property .......Robert E. and Margaret Rehm
............................................................... ....... . .. ...................
� ssau Point Club ro - s and part o Lot
Subdivision N gsas�...I.nc.:.�... b rog............ No. ..14.1./. Block No. House No.............
PermitNo. .................... Date Of Permit ....................Applicant ..................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning Board Approval ........................................
Request For Temporary.Certificate ........... Final Certificate X
............................. ..........................................
Fee Submitted $ ...5. 00
.................................
Construction on above described building and p 't meets all applicable s and regulations.
Applicant ...... . . ............ ...... ..`......................
Sworn to before me this
............17th May, 1..76 a of :......... ......... (stamp or eol rl,L7,7D
3y
Notary I' ....... Coun CgON .Z 113o f
Cj ,D 1 State
Sotary 5BWZ9 Suffolk ar 30 99F
N°C'omission Expires
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