HomeMy WebLinkAboutZ-5834 �i
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No.Z.5834. . . . . . . Date . . . . . . . . . . . . Mar. . . .26. . . . . ., 19 r�1o, .
THIS CERTIFIES that the building located at F-assau -Point .Road. . . . . . . Street
Map No.Nass., •Pjt oc o . . . . . . . . . .Lot No. 1+0. . . . .Cutchogue . . . N.y,. . . . .
conforms substantially to the 'jLi�aj§ � � g code
c�°a 'edl� . � 19. pursuant to which dx �t V-o.occupa.mcy
Z5S3
before •�p�31 �23� ��• 4
dated . . . . . . . .;x;ax . . . . .26• • • •, 19.74., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy forwhich this certificate is
issued is Private. one .family. dwe1ling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to - -Ma rgare$. .(Rob•$) Rehm• • • • owner. . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .pre.o. .exis,ting. . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. .pre—. existing. . . . . . . . . . . . . . . . . . . . . . . ... . . .
HOUSE NUMBER . . .585z,.. . . . . . . Street -Naseau• Point• -Rd• • • • • • • • • • • • • • • • • • • • • • .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspe for
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HOUSING CODE INSPECTION
March 25 , 1974
#5854 Nassau Point Road
Cutchogue, New York
Subdivision: .Nassau Point Club Properties
Map #156 Lot 140
Tax Roll: Robert Rehm
Upon request of the Southold Town Building Depart-
ment, I made inspection of this one story framed
dwelling and found no violations of Chapter 52 Housing
Code, Town of Southold.
I was admitted to building by Mrs. J. Halmsley
and began inspection at approximately 1 : 05 P.M.
The building consists of living room, kitchen,
full bathroom, and two bedrooms . Heat is supplied to
each room from a forced warm air furnace located in
partial full cellar.
Inspection completed at approximately 1:20 P.M.
Respectfu submitted,
EH:mm ' Edward Hindermann
Building Inspector
FORM NO. 6
TOWN: OF SOUT14OLD
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 $1.00
Date .....YJAr.0h...15.,...19.7. .........
New Building ................ Addition ................ Old or Pre-existing Building ..X........... Vacant Land
Location Of Property ...ATE.ssa�.Lip..Pu�Y] ..OT..I, . ��. .. t�$..�I�!✓ a... 1. .R�. ..C.R1X�tiY.a.... .�. ...
Owner Or Owners Of Property ......L`'ias'Bare.t..E1eax1a;c..Rehm..............................................................
Amended Map A of Nassau Point
Subdivisionmap. .... Lot®4o. ..1.40... Block No. ............ House No.............
Permit No. .................... Date Of Permit ................. .Applicant ...................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning .Board Approval .........................................
Request For Temporary Certificate ........................................ Final Certificate .:.......I..............................
Fee Submitted $ ....5.,9.......................
Construction on above described 'building a erm ee If ap a codes and regulations.
Applicant ...........
Sworn to before me this on,Esq. , as attorney for
Margaret Eleanor Rehm
day of Nr rzh ...19.7. ............. (stamp or seal)
Notary Public ., . ...C,...............
to 6�1. i uffk
No`ary i'!.I';:iiC, S��?i' OS iVCI: YOYi:
RCSi;}i�ig iil SU4f0i'�. 0!;;i.iy V 11
Commission E;:;,'a2s 'Aach 30, I9-70 4F
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