HomeMy WebLinkAboutZ-10597 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
210597 July 23 1
No . Date ................................,1~...
THIS CERTIFIES that the building .
Location of Property 5.200. N.assau..P.o1A.t .Roal1, Cutchog.ue,. N.ew. Ynrk.... .
House Na. - Street Hamlet
County Tax Map No. 1000 Section ..1.11 .......Block .....g.........Lot ....l5 .
Subdivision ..Nassau •Poiat .Clu•b •gro•p,IrkjlFd Map No. } 56......Lot No. .}46•
conforms substantially to trli~ •.vnn~~~~L~gF~~~S~~r~~t8~t~if~~~•t~~~tl~s~~t}t'i~e$at~flr to
, , . ,April .23, , , , • , , 19 . 5.7pursuant to~cth11~1t~i~k~vP.ancy .1059.7...... .
dated Jatly .23 .................198 ,was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .
, ,Priya.te , Ona-Family, Dwelling ,with ,l}ccessory, ,Struc tµre,(2 , far ,C~~~,age )
The certificate is issued to Cl•i~f.t:ord• .J , • E•vent• nd • W&,
St~~2~xx .
Towne
of the aforesaid building.
Suffolk County Department of Health Approval N/.$ .
UNDERWRITERS CERTIFICATE NO.... N./A .
Building Inspector
Rev. 1/a1
BUILDING DEPAF.Ti•'.EI~IT
TOlt'i1 OF SGUTHOLD, N. Y.
HOUSING CODE INSPECTIOI'1 REPORT
Locatiori 5200 Nassau Point Road, Cutchogue, New York
nuWber E~ street Municipality
Subd1v1510n Nassau Point Club Prpl~pI~.. 156 Lot(s) 146
Name of O~m er(s) Clifford J. Ever,k and Wf.
Occupancy R-1 Owner
type (o4m er-tenant)
Admitted by: Mr. Everet Accompanied by: Same
key available Suffolk Co. Tax No. 1.11-8-15
SOllrCe Of request Clifford J. Everet~ Date 7/20/81
Di'~.LIi1G:
Type of construction Wood framed ,stories 2
Foundation Cement dock Cellar Partia drawl space Rest
Total rooms, 1st. F1 5 2nd. F1 3 3rd. F1
Bathroom{s) 2 Toilet room(s)
Porch, type Deck, type wood Patio, type
Breezeway Garage Utility room
Type Heat oil Fired ~Jarm Air Hotwater x
Fireplace(s) 1 No. Exits 3 Airconditioning
Domestic hot•~~ater Yes Type heater Tankless
Other Rear Yard Fenced in
ACCESSORY STRUCTURES:
Garage, type coast. wood 2 car Storage, type coast.
Sti:imming pool Guest, type coast.
Other
VIOLATIOI:S: Housing Code, Chapter 52
Location Descriptior. Art. Sec.
Kitchen Gas Stove No Shut Off V 52-52-E6
Remarks•
Inspected by: Date o£ Insp.duly 22, 1981
• Time start3`15 end 3:30
Curtis W. Horton j
FORM NO. 6 ~V ~
TOWN OF SOUTHOLD ~oV F"~~,4
Building Department ~
Town Hall
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 Inspec-
torwith 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, acertificate 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 or land use $5.00
3. Copy of certificate of occupancy $1.00
Date .
New Building .........n..~ ..Old or Pre-existing Building/,~............ Vacant Land .
Location of Property ...I ~i ~ S S. ! ~ ~ l.L:/e.. ~ ~a
House No. a Street Hamlet
n f~~l
Owner or Owners of Property ~ .C .t~? N ~ .
County Tax Map No. 1000 SennctionAA..//.(.~......... Block Lot ~.r...... .
Subdivision.~wtl~../".~G~Z./'.'4~ry6.~FiledMapNo. ~.1~_6....LotNo. .~.~ry......
Permit No. Date of Permit .........:Applicant .................................11 ^ /
Health Dept. Approval Labor Dept. Approval
Underwriters Approval ........................Planning Board Approval `Kh
Request for Temporary Certificate .....................Final Certificate ~ `~r~\~\
Fee Submitted $ .:3 r~`°
Construction on above described building and permit meets a I ap 'able codes and regulations.
~ ~ ~ ~
Applicant.
Rev. 10-10-78