HomeMy WebLinkAbout1000-102.-2-4 TOWN OF SOUTHOLD
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Rental Permit
0050
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Owner Gekee Wickham
Occupied as Single Family Dwelling
Located at 2180 Depot Lane Cutchogue 102,24
Maximum Permitted Occupancy 6
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
6/20/2023 ,3
Code E Ifo ce� t Official
This Notice must be posted by the main entrance at all times
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TOWN OF SOUTHOLD BUILDING Di
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631 -765-1802
INSPECTION
FOUNDATION 1ST [ ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATIOWCAL
[ 1 FRAMING / STRAPPING [ j FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY WE
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit
[ ] CODE VIOLATION [ ] PRE C/O [ L4 F
DATE INSPECTOR
q s Town Hall Annex
_ SOUTHOLD TOWN
54375 Main Road
PO Box 1179 Southold,
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/"i, Rental Ins ection NY 11971-1179
Tel 631-765-1802
Fax 631-765-9502
SCTM # Date
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oke Detector Alarms #) . . ..._. _m_.. .. ..__ .._. _,
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Egress (windows) (Y/N .__
BUILDING CONDITION OF PROPERTY Y/N
Y/N
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Heatic�W s, stem maintained/operational Building Interior is clean /maintained
Building Exterior is clean /maintained
Hot waters stern maintained/operationala
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Mechanical s stem maintained/operational s & guards present
COMM NTS°
Rental Inspection Form 4/7/2021
T OWN OW SOUTHOLD
Rental Permit
Permit No. 0050
Owner Gekee & Thomas Wickham
Occupied as Single Family Dwelling
Located at 2180 Depot Lane Cutchogue 102-2-4
Village
Maximum Permitted Occupancy 6
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
6/7/2021
Code Enforct Official
This Notice must be posted by the main entrance at all times
Gekee Wickham
PO Box 1122
Cutchogue, NY 11935
April 30th, 2021
Certification
I hereby certify that the information in the current permit for the property
located at :
2180 Depot Lane, Cutchogue, NY 11935
(Tax Map Number 1000-102.-2-4)
has not changed.
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Signed "�
Gekee Wickham
Owner
Vd TOWN OF SOUTHOL
Rental Permit
-Ay Permit No. 0050
Owner Gekee & Thomas Wickham
Occupied as Single Family Dwelling
Located at 2180 Depot Lane Cutchogue 102.-2-4
Address Village S/13/1-
Maximum
/B/LMaximum Permitted Occupancy 6
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two(2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
5/13/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
Town Hall Annex I t Telephone(631)765-1802
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54375 Main Road Fax(631)765-9502
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P.O.Box 1179
Southold,NY 11971-0959 ��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD { P,
RENTAL PERMIT APPLICATION
TOWN
„T,
Rental Permit Fee $200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
2180 Depot Lane, Cutchogue, NY 11935
Tax Map Number: 1000 SECTION 102• BLOCK -2 LOT -4
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Gekee Wickham
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
28700 Main Rd, Cutchogue, NY 11935 PO Box 928, Cutchogue, NY 11935
Telephone Number(s): 631-255-6667
Property Owner Email Address: gek2@yahoo.com
Page 1 of 4
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: N/A
Address of Authorized Agent (no P.O. Boxes):,
Mailing Address of Authorized Agent:
Telephone Number (s):
Email Address:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: N/A
Address of Authorized Agent (no P.O. Boxes):„
Mailing Address of Authorized Agent:
Telephone Number(s):
Email Address:
SECTION E.
SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any: N/A
Address of Managing Agent (no P.O. Boxes):..__
Mailing Address of Managing Agent:
Telephone Number(s):
Email Address:
Page 2 of 4
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property:® ONE
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example,
Unit 1, Unit 2, Unit 3 or Apt A, B, C); the use of each room in the Rental Dwelling Unit
(for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each
room.
For properties with multiple Rental Dwelling Units use "Rental Permit Application
Addendum."
Rental Dwelling Unit Identifier:
Requested Maximum number of persons allowed1t6 occupy Dwelling Unit: —�
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
SECTION G.
INSPECTION:
Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety
inspection by Code Enforcement Official is required. If the owner chooses not to have said
inspection performed by the Town, a certification from a NYS licensed architect, a NYS licensed
professional engineer or a home inspector who has a valid New York State Uniform Fire
Prevention Building Code Certification is required stating that the property which is the subject
of the rental permit application is in compliance with all of the provisions of the code of the
Town of Southold,the laws and sanitary and housing regulations of the County of Suffolk and
by the laws adopted by the New York State Fire Prevention and Building Code Council.
XI am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold.
Page 3 of 4
❑ I am submitting a completed Town of Southold certification form from a licensed
architect, a licensed professional engineer, or a licensed home inspector who has a valid
New York State Uniform Fire Prevention Building code Certification.
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
-L_J "�, certify under penalty of perjury,the following:
1. 1 am the owner of the property identified in "Section A" of this application.
2. The property owner's legal address set forth in "Section B" of this application is my legal
address and I understand the Town will use the address for service pursuant to all
applicable laws and rules. I further acknowledge that I will notify the Town of Southold
Building Department of any changes of address within five (5) days of any changes
thereto.
3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and
agreed to abide by the same.
4. 1 will notify the Town within five (5) business days s to any change to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name: JC-6t Vq
.. ..: ._.
Property Owner's Signature:
Sworn to before me this day of 1 2019
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Official NqJfry Public Signature(#d d Original Notary Stamp
TRACEY L. DWYER Page 4 of 4
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2
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TOWN OF SOUTHOLD BUILDING DEPT.o�
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DATE10 INSPECTOR
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BR 11x11 BR 10x13
LR 14x14
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Kitchen 15x9
BR 7x9 Bathroom 7 x5 DR 10x8 6
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1 Master BR 11x8 1
2 Small BR 7x9 1
3 LR 14x14 2
4 BathRrn 7 x 5 1
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B BR 11 x 11 1
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TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD. NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORMING PREMISES
THIS IS TO CERTIFY that the
Land Pre C.O. #— Z15524
x'% din g (s) Date— December 19 1986
/ Use(s)
located at 2180 Depot Lane, Cutchogue, N.Y.
Street Hamlet
shown on County tax map as District 1000, Section 102, Block 02
Lot 004 , doesknot)conform to the present Building Zone Code of the
Town of Southold for the following reasons:
Insufficient lot area. Because of 'A' Agricultural 'A' Residential
two acre zoning.
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming /_/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 appli-
cable 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 Certifi-
cate is issued is as follows: One family, one story wood frame home
of insufficient lot area on Depot Lane, a town maintained road;
.
The Certificate is issued to GEORGE & PEGGY DICKERSON
r, ?�Y�]C13$i7t�$3f�I4�XX
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 ordin-
ances, 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 regula-
tions.
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. 21.3389 . , . . . . . . . Date , w , . .Ap. .i1» „25 . . . . . . . . . . . . . . . .. 19 $5.
THIS CERTIFIES that the building . , . . . Addition. , . . , , » . . . . . .
Location of Property218Q . . . . . . . . . . . . . e of ne Cut! hog ue
House No. LaStreet .Hamlet
County Tax Map No. 1000 Section .10.2. . . . . . . .Block , .92
. . . . . . . Lot
Subdivision . . . . . . .X. . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . » .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
Ap r i 1 8 , . . . 19q?. pursuant to which Building Permit No. . . , 116»2 4 Z ,
dated . . . . . . . . . . . .APx?l. . . .22. . . . 19 .$?,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 . . , . . . . . .
. . . . . . . . . . .Adan,tipn tr9. Fiii3iisting. Dwelling. . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . „
The certificate is issued to , . . » . . . (G,.R,) . Rol?Qrt .4 .Peqgy, DICKERSON
(o wn er,le�sae-as seaar�Fl
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . NJA. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . , .N.6.7.9 7U. ., „ . . , . . . . , . . » , . . . . . . . . . ,
» . . . . . . . . . . .. . . . . . .
Building Inspector
Rev.1181
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27702 Date: 05 21/01
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2180 DEPOT LA CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 102 Block 2 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 25, 2001 Pursuant to which
Building Permit No. 27292-Z dated MAY 7, 2001
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 ACCESSORY STORAGE BUILDING AS APPLIED FOR.
The certificate is issued to GEKEE Y WICKHAM
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
a
WAu orized Signature
Rev. 1/81
t'UAM Lvv. Y
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27703 Date: Oar 21,/01
THIS CERTIFIES that the building ,ALTERATION
Location of Property: 2180 DEPOT LA CU° CHOGU'
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 47388.9 Section 102 Block 2 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 25 2.001 pursuant to which
Building Permit No. 27319-Z dated MAY 17, 2001
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 ALTERATION TO EXISTING ACCESSORY STORAGE 'BUI'LDIN'G AS APPLIED FOR.
The certificate is issued to GEKEE Y WICKHAM
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H-071044 04/04/0
PLUMBERS CERTIFICATION DATED N/A
k�horizeld Signature
Rev. 1/81
Town of Southold 5/15/2015
P.O.Box 1179
7
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37562 Date: 5/15/2015
THIS CERTIFIES that the building SOLAR PANEL
Location of Property: 2180 Depot Ln, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 102.-2-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/26/2015 pursuant to which Building Peri nit No. 39638 dated 4/2/2015
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:
r(,x)f mounted sola�_l�a�l �sw,Matt�lr� ist;u�s?oxae fa�r�i :.W�vae��ii7g��„�plr�i�d Irl,
The certificate is issued to Wickham, Gekee
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39638 4/28/2015
PLUMBERS CERTIFICATION DATED
--- ........ _. _
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Authorized Signature
. TOWN OF SOUTHOLD PROPERTY REC Ri I a-- ac, �
OWNER
STREET �.' VILLAGE I DIST.1 SUB. LOT
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FORMER OWNER EG ACR.
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S�yd � i3A C6/U W ? TYPE OF BUILDING
;RES SEAS. IVL. FARM 'COMM. CB. MISC. Mkt. Value
LAND IMP= TOTAL DATE REMARKS
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3
eg1= BU LDING CDITION
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NEW NORMAL BELOW ABOVE u
FARM Acre Value Per Value
Acre
Tillable 1 ilk
Tillable 2
Tillable 3
Woodland
Swampland _ FRONTAGE ON WATER
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FRONTAGE ON ROAD
Brushland � ;
House Plot
DEPTH -ke�-.:��
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ULKHEAD I
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Total EDOCK
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102.-2-4 11/2015
102-2-4 2/0I
M. Bldg, - _ � - Foundation = a
th Dinette
8
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Extension zBosernent Floors K_
Extension lit, Walls Interior Finish - LR. 1
Place Heat DR.
vision ,Fire
'Type Roof l Rooms 1st Floor BR.
Porch Recreation Room Rooms 2nd Floor ,Fih1. B=
Porch
rr-ier
,= Driveway
Breezeway
4
Garage
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Patio
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Total }-
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