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Home My WebLink AboutZ-10302FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office .... Seuthold, N.Y. Certificale Of Occupancy No. ZlO~O? Date December 15, 19 80 THIS CERTIFIES that the bugding ................................................ Location of Property 2000 Nas sau Point Road, ........... C.u..~9.h.o.g~..e .......... f.l~e 'N'o] ....................... 'S'treet Ham/et County Tax Map No. 1000 Section 104 .Block 10 .... Lot 010-03.1 Subdivision..N?.s.s..n.u..P.O..t.~.~....Pro. p.: ........ Flied Map' No ......... Lot No.. ?.7.9..N.../~...l.~O conforms substantially to the ~e~~B~e8- ~aP~m~e~e~~e~e~-i'Or tO ~ Certificate o£ Occupancy ....A??.i.3:. ?~., .........19..-'.'pursuant to which l~k~al~aermit-N~.-. .......... .~. ~.V.v~. ?... dated ...D..eg.e.~.b..e.~..3.~.t ........... 19. ~ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... The certificate is issued to Robert ¥. Campm~n & Ors. ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO...N./.I~. ........................... /7' Building Inspector Re~ 4/7g BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location d~oO ,A/,~u /~o/~7- /~o~ (number & street) Subdivision ZM~ ~,j~-('~[,,M ~Map NO. 0ccup~cy /~--/ ~l~ ~ (type) Admitted by: Key av ail able ~/f~ ~/Z~ Source of request//~n-/d~z/c/ (Municipalit]Y) Lot(s) (owner-tenant) Accompanied by: Suffolk Co. Tax No.. Date / DWELLING: Type of construction / Total rooms, 1st. Fl~-~z g~ 2nd. F1 Bathroom(s) ~ Toilet room(s) - Porch, type.~/~ ~Z-~¢L._ Deck, typ~ -- Patio, type Breezeway. -- Garage Utility room Type Hea~Warm Air o~z~/~ Hotwater Fireplace(s~//~y~/f_No. Exits -7-~ Airconditioning Domestic hotwater 7/-~· ~ype heater ~ Other #stories Crawl space~_~ 3rd. F1 ACCESSORY STRUCTURES: Garage, type const.SD~w,,~.eStorage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Remarks: ~ Inspected . ~ Date of Insp. ~ t(/ c~) ' Time start 2Or end J: o FORM NO. 6 TOWN OF SOUTHOLD Building Deportmmtt 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 triplicate to the Building Inspector with the following; for new buildings or new use: 1. Final su~ey 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, o 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 o'f property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner os to use, occupancy and condition of buildings. 3. Dote 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 3. Copy of certificate of occupancy $1.00 $5.00 Date December 10,1980 New Building .................... Old or Pre-existing Building .....X ..................... Vacant Land ............................ ~L,o~.ation O_f P.r.ope_rt, y ~.~..-q~.~.~-~`1~"~`i~ad~:.Amez~.er1~A~f~N~s`~ei~;...~wned Dy ~assau Fo~n~ C~UD ~roperties ~nc.. Owner Or Owners Of Property --.F~r6~-~...Ev.C.~s~u~ ............................................................................. S .Di,.s.~.ict 1000, Section 104, Blcok 10, Lots 10 and 11 uoalvms~on ................................................................ Lot NO ............. Block No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board A~oproval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets oil applicable codes and regulations. Applicant ............... ~ ....... Anthony B. ............. Sworn to before me this for P, ic]~Bz'd Wa].~ .// /~ ..... ~Qt~... day of ....Z~0.~,...198.~ ........... (stamp or seal) i '/, Notary Public .......~.t~.9~]¢, .............. County STATE CF NEW YORK ) COUNTY OF SUFFOLK) ANTHONY B. TOHILL, being duly sworn, deposes and says: 1. That he is the attorney for Richard Wall who has contracted to purchase premises located at Nassau Point Road, Cutchogue, New York. 2. That upon information and belief, the subject premises are improved by a one-family residence which was constructed prior to 1957. Sworn to before me this 10th day of December, 1980. Not&ry Public ANTHONY B. TOHILL i'"'!AP OF PlZOPEP..T o~[CVr_'c f~ FOP_ , -.,.. } ~_ v~ [], ~;;,J NLll'dEN T