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Home My WebLink About1000-117.-3-1 a 3 TOWN OF SOUTHOLD '- Rental Permit 0116 F�- Owner Nancy Wickham Occupied as Single Family Dwelling Located at 179 Old Harbor Road New Suffolk 117.-3-1 Maximum Permitted Occupancy 8 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. 5/29/2024 cede e Official This Notice must be posted by the main entrance at all times Tgj 0 00sookTHHOLD46LING 1 631 ?85 1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSUTATION/CAt [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY N! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE I ] ELECTRICAL (ROUGH) [ ] ELECTRICAL ICAL (FI [ ] CODE VIOLATION [ ] PRE C [ I a o CIK DATE 4�, rA *VM INSPECTOR — t v — - - tA t? 114 TOWN OF SOUTHOLD—BUILDING DEPARTMENT u Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax(631) 765-9502 litt ://N ��ww sout�h� )I(Itown� . 51909 4 rec RENTAL PERMIT APPLICATION Rental Permit Fee$300 (Application must be renewed every two yar a q v F .., MAY 2 8 224 Section A. Property Information: Rental Property Address: 179 Old Harbor Rd, New Suffolk, NY 11956 Tax Map Number: 1000 SECTION 117.=BLOCK 3 -LOT-1 SECTION B. OWNER INFORMATION: Property Owner Name: Nancy Wickham Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 213 Ewing St Same Princeton, NJ 08540 Telephone Number (s): Daytime: 443-990-2067 Evening: Same Emergency: 631-603-7610 Property Owner Email Address: nancyewickham@gmaii.com Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: W9* T LfAn C4 �tL�li�eC� l� Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s): Daytime 2): Evening 1.e Emergency Email Address: '�'�" 1 " 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): Daytime Evening Emergency 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): Daytime Evening Emergency Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property:,,,,_1 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 allowed to occupy Dwelling Unit: 8 Number of rooms in Rental Dwelling Unit:_12 Use and Dimensions of each room in Rental Dwelling Unit: Kitchen 18x23, Living Room: 12x23, Den 10x11, Bedroom 1: 11x11, Bedroom 2: 11x14, Bedroom 3: 18x20, Bedroom 4: 11x17 and 7x12 (L-Shaped), Bath 1: 50, Bath 2: 50, Bath 3: 11x18, Bath 4: 6x8, Laundry Room 10x15. 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 licensed architect, a 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. ❑ I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ✓ I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. '-fe( 1 STATE OF NEW same✓u� COUNTY OF SWW-G " I, Nancy E. Wickham, 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 to any change to the information regarding Authorized Agent, Managing Agent,or Site Manager. Property Owner's Name:_Nancy E. Wickham Property Owner's Signature: p Y Swn before me this eday of klaa, 2014 Offici otary Public Signature and Original Notary Stamp =NEW NO BLIC JERSEY98 JANUARY 6,2027' Page 4 of 4 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P. O. Box 1179 " Southold, NY 11971-0959 rt� BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seal re aired for Archited or Engineer, Licensed Home Inspector must provide c2py of valid current certification Rental Property SCTM Number: 1 Rental Property Address: Owner/Name, NAACY W l Rental Dwelling Unit Identifier: Number& Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 — 100 sqft., Bedroom#2—90 sgft., etc.) t a v, Property Description (Include all improvements indicated on survey) 2 l I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold, the Residential Code of New York State, the Building Code of New York State, the Plumbing Code of New York State, the Fuel Gas Code of New York State, the Fire Code of New York State,the Property Maintena ce Code of New York State and the Energy Conservation Construction Code of New � AEG A, try f/ �Av "'2 Print Name and Title 9 a1 a re Please place Professional Seal: 031676 �C F N�' t ltt . . Town of Southold 5/29/2024 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45224 Date: 5/29_......../2024 ... THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: k 179 Old Harbor Rd New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-3-1 Subdivision _.w._..._ Filed Map No. Lot No. conforms substantial_ ....... . ly to the Application for Building Permit heretofore filed in this office dated 3/24/2023 pursuant to which Building Permit No. � m 49308 dated 5/2 5/2023 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: additions nd alter ticLn IgigtliQg jj Av t(j _ istia , n! f j_j�j6 dwe1l,irr�Ls a pp�i c� for. The certificate is issued to Wickham,Nancy of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. .._........_w. 49308 5/13/2024 4KKil ..... ..... n... .......___ � .... PLUMBERS CERTIFICATION DATED 4/17/2024 em .. Susskraut i° »W r� t Town of Southold 7/21/2019 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 40528 Date: 7/22/2019 THIS CERTIFIES that the structure(s)located at: 179 Old Harbor Rd,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-3-1 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40528 dated 7/22/2019 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frarne oneapaat ..d ellallgm it :_BP 7 move dweljhg tonew loc4fion.onwine Lot Q( -3 L9_RP..I.LL42 deck Lidd toj.qtqhqia,M«�ttec etc d��r and alteration to dwellin C" 8 �P 2 r�nc l,el z ¢ `O, 4 t?1.1 1? ).E 7 aar e tlr iti a f t7 CJ a The certificate is issued to Wickham,Nancy ,...�......�� (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. .......w�._.w............... dSignature uh � _. BUILDING DEPARTMENT TOWN OF SOUTHOLD DOUSING CODE INSPECTION II i.PQR— LOCATION: 179 Old Harbor Rd,New Suffolk X SUFF.CO.TA MAP NO.:....._1.17.-3-.�w_. ........_.. .._.....SUBDIVISION: w.�_�_�_�.�.�.._�_�_.....m_m.w.w.....�....w,_..._.......................__�...._... ckh....... .......—_._,,,,,,,. —.—__.....................�... .� ............_......M.M....� ,_ .�....w..w. .��,.�_....�. ................. .��.w.�..� m,Nancy NAME OF OWNER(S)• Wi.._......a�.............._.,._......._....._...__.... www..._._._., ._.._..__.........._. OCCUPANCY: ADMITTED BY: ...._...ww'w......Nancy _. ..�.w............�H.µ .._ .w _.v Y.µ........... .w ...DATE: .......7/22/2 _r SOURCE OF REQUEST: Wickham N DWELLING: #STORIES: 2 #EXITS: 2 FOUNDATION:..............._.. cement block CELLAR: partial CRAWL SPACE: 2 ... ......... TOILET R 1 UTILITY ROOM(S): PORCH TYPE: ww.._._.._._._._�__...e._............... BATHROOM(S): DECK TYPE:S) ..,. .. PATIO TYPE: front slate BREEZEWAY: FIREPLACE: 1 GARAGE: _ DOMESTIC HOTWATER: x TYPE HEATER: _electric AIR CONDITIONING W Wmmmmm TYPE HEAT: oil WARM_._.............._ �............ww__.�...._w._._._..... ...._.............��. AIR: forced hot µ .....,._..ww ......._.ww__._mmmm_. w air HOT WATER: ................ ....... #BEDROOMS 4 #KITCHENS. � 1 BASEMENT TYPE: unfinished OTHER: __._.._.__�. w._ .._...._.n.n.._..�_.�..___ ...�w_www....._..__._.....�. ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: . _w_._� . _.__...................,� �.......... ._ww......_ OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/3/2019 TIME START: 10:43am END: 11:15am FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . . . .Z14882. . . . . . Date . ,Se ?tember 17... . . . . . . . . . . . . . .. 1986 . THIS CERTIFIES that the building , construct deck , add to kitchen & alteration Location of Property 105 Old Harbor Rµoad New Suffolk,* N. Y. House OU�a, tweet "Hamlec County Tax Map No. 1000 Section . .1?7. . . . . . .Block . . .0 3. . . . . . . . . .Lot . . 0 01, , , . ,. , , , , Subdivision . . . . . . . . . . . . . . . . . . . . . . . „ . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated S Q A em l�e r'. .8 , . . . . . . . . , 19 .8.1.pursuant to which Building Permit No. . . 1 J 4,4,�Z. . . . . . . . . . . . dated October 30 , . , , , , , , , , , , 19 . $1,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 . . . . . . . . . cQr�*;:trur,�. deglt.,. .4q0. .tQ. ki.tRbpp. .& .��.ter�t.�,9�. t,q ,existing dwell?ng.•. . . . The certificate is issued to . . . . . . . . . .Virginia. L . Wickham Towner,�t�sxe�x>rcte �¢x x x of the aforesaid building. Suffolk County Department of Health Approval , . . . . . . . „ . . . . . . . /A. . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . .P,e n d ing . . . . « . . , . * . . Building Inspector Rev.1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29480 Date: 05 30 03 THIS CERTIFIES that the building ADDITION Location of Property: 179 OLD HARBOR RD NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 3 Lot 1 Subdivision Filed Map No. I Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 2 2002 pursuant to which Building Permit No_ 28879-Z dated NOVEMBER 4, 200 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 DORMER ADDTTTON TO AN EXISTING; ONF FAMTT,Y DWFT,TiTNG; AS APPLTFT) FOR. The certificate is issued to PETER P WICKHAM _ _w (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL .._...N,/A ELECTRICAL CERTIFICATE NO. NIA_ PLUMBERS CERTIFICATION DATED �µ _ �N A ...............�� _..... __ ..e.. /th Rev. 1/81 t t" ` Town of Southold 7/21/2019 P.O.Box 1179 53095 Main Rd :r4 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40527 Date: 7/22/2019 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 179 Old Harbor Rd,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-3-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/3/2019 pursuant to which Building Permit No. 43873 dated 6/17/2019 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: "' ,.bui;,t"""air udtatalaaxgrn a itpPll .,a1 The certificate is issued to Wickham,Nancy of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43873 6/27/2019 ...�... ............. ..... PLUMBERS CERTIFICATION DATED ..,.__. 0 o, Signature....................................__ L LIW L. OF, �611 e.1 oolcu I/IN5 ROQ- saohi Cl qA-,E, i 1 —=—AR aj--N,- A�EA u u 74 OA CA, OB ------------------ Yea 'T ol Ri GARAGE RAI 0 OH �LL L im 7t; Ldh� ol OaI �ALL LA Y fi LLALea K-IN ,�F'Q---R Al H 1 ---------- All = � oTOWN OF SOUTHOLD CD ca Rental Permit Permit No. 0116 Owner Nancy Wickham Occupied as Single Family Dwelling Located at 179 Old Harbor Road New Suffolk 117-3-1 Address Village S/B/L Maximum Permitted Occupancy 8 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. 7/22/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times ° , w ✓� 4 el v Town Hall Annex " Telephone(631)765-1802 54375 Main Road �� Fax(631)765-9502 P.O.Box 1179 �gF_ Southold,NY 11971-0959 �� m I, f,w 9 EYE D BUILDING DEPARTMENT DD TOWN OF SO HOLD RENTAL PERMIT APPLICATION TOWN OF S t J Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: I'1 01 d fl c.r o-r S"CFO 0< SCD Tax Map Number: 1000 SECTION BLOCK LOT SECTION B. OWNER INFORMATION: Property Owner Name: e1, � Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 1 _ W 155 Telephone Number(s): Property Owner Email Address: ,;,,,,, I ' �k Page 1 of 4 r Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any:Pu , S Address of Authorized Agent (no P.O. Boxes): 1 635 New Svc �k CXkkdkDSue N 11935 Mailing Address of Authorized Agent: Telephone Number(s): � ) Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: AJOA e 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: /y0-Ae 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: �nt're �O t�S2 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 allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: ? tVtt" 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. ❑ 1 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) Iy1 ..J� cCk-r4lo-yn , 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: Property Owner's Signature: Sworn to before me this�day of Il Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01BU6185050 Page 4 of 4 Qualified in Suffolk County Commission Expires April 14, 2 oV IA-AJbryTOWN OF SOUTHOLD BUILDING . 765-18 2 INSPECTIO14 [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING ` [ ] [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING l DATE INSPECTOR t FLOO _ RPL/kN SKETCH r Prorroe r.' .'a�rwcY Wickham Ne O.: . 016-16510 Address:l lk C Id Tial am Rat 3150 17417 City' New Suffolk _ State: 7 7l :11956 Lender:Quicken Loops Inc,. 31.0 10'9 .09 Uncovered 9' a 4o 1, ' Deck oy .5 Co Bedroom -. Study 'Otakh 24.0' .,. O C. in 45G a r. ig Bedroom os ,S6 uan 4.6 , e# nyUl$aryR;r LlvingRoam .SZL LEVEL2 DkIng Room .p ..u4uGt;&neu'w ao r e, Bedroom"""'ir'F�. t ,. t4ek. ..r .. e Family Room �9t 4rrtiAe Rehr. Bgh 4.5' �. :. 16.0" 2Y':rY 16.5' L�VaI ryil UnWV9red Patio 34.5 220' 24.0' 24.0' o UNFINISWD BASEMEN rn N N 05rr )� V c k rar9d 24.0' 14 34.5' �"craacrranCar ' 'GLAl First Floor _ 1553.75 1553.75 First Floor GLA2 Second Floor 523.50 523.50 20.5 x 24.0 492.00 BSMT Basement 1337.25 1337.25 15.5 x 28.0 434.00 P/P rear Deck 485.25 13.5 x 19.5 263.25 Side Porch 58.50 9.5 x 35.0 332.50 Front patio 192.50 736.25 2.0 x 16.0 32.00 GAR, Garage 576.00 576.00 1 Second:Floor 4.0 x 6.0 24.00 4.0 x 6.0 24.00 4.0 x 12.5 50.00 , 11.5 x 37.0 425.50 TOTAL LINABLE (rounded) 20:77 9.Calculations Total(rounded) 2077 8 �� O 6 3 a a �.. �. + ®.� * 7>'' v 0 0 0 � :, 1 , a m „a CL CL r — O n Cj I O p b Q - 9- � p r 0 O D m �. CD tA — tm r>-nd m '-0 n I� o - - Ln a s , M m 3L) M — o r ^ �� any!• G , ti �n CiO r -n m a AAi W Cxa � 1 UO ,V 00 A r 0 ¢cn m mEa ...�.. _.. 13 m W 6 IUN I r. ' CS7 oa -n � LD c I 11, fD P (D (A ^r O f S S G f l � vii (n O En mrI LA VY h^ e \\ C ........ . �,�..� ...�.�..,..�.. .',..m. ...,......�..,...... .......a �..... W „ A I ' V . t � J I 1 .......... Town of Southold 7/21/2019 53095 Main Rd Southold,New York 11971 ...................................................... PRE, EXISTING CERTIFICATE OF OCCUPANCY No: 40528 Date: 7/22/2019 -........... THIS CERTIFIES that the structure(s)located at: 179 Old Harbor Rd,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-3-1 .......... Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40528 dated 7/22/2019 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood firanic one family dwelling. Notes. BP 575 niove dwell in to new locatioii on same lot COZ-3 89: BP 11442 dec1c,add to kite e a t-i 11 g chqLi& age —m--1 E L and alteration to dwelling COZ-14882;BP 28879 dormer addition CO7,29480;BP 43873 air conditioner COZ-40527. The certificate is issued to Wickham,Nancy --- (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTM, CATION DATED N ................... *PLEASE SEE ATTACHED INSPECTION REPORT. . ................... U li iiz �d Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD 110USING CODE INSPI4X]JON I EPOR'r LOCATION: 179 Old Harbor Rd,New Suffolk SUFF.CO.TAX MAP NO.: 117.-3-1 SUBDIVISION• NAME OF OWNER(S). Wickham,... Nancy OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Wickham,Nancy � DATE 7/22/2019 DWELLING: #STORIES: 2 #EXITS: 2 FOUNDATION: cement block CELLAR: partial CRAWL SPACE: .. ..m......................�.., ............. BATHROOM(S): TOILET ROOM(S) 1 UTILITY ROOM(S): PORCH TYPE: �. DECK TYPE: PATIO TYPE: front slate BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: �x TYPE HEATER: electric AIR CONDITIONING: TYPE HEAT: oil WARM AIR: forced hot air HOT WATER: #BEDROOMS .. ....... _ .. 4 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/3/2019 TIME START: 10:43am END: 11:15am FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold,N.Y. Certificate Of Occupancy No. . . . .Z14882. . . . . . Data . .Se�tembe.r . ? . . . . 198.6 . THIS CERTIFIES that the building , construct deck , add to kitchen & alteration Location of Property 105 Old Harbor Road New Suffolk,* N.Y House Vo. r'et H,am' County Tax Map No. 1000 Section . .117. . . . . . .Block . . .03- 1 - 11 , . .Lot . . .001. . , , . . . , , , . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. , . . . . , . .Lot No. .. . . . . . . . . . . , conforms substantially to the Application for Building Permit heretofore filed in this office dated S Q p t em$Q r, ,8., . . . . . . . . , 19 .8.1. pursuant to which Building Permit No. . . 1 1.4,4.2 Z. . , . , . . , . , , , dated October. 3.0, 19 . $.1,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 . . . . . . . . . cRtrtiG The certificate is issued to . . . . , . . . , „V i r.g i n i a. L i c k h a to (owner : wxmP)xxx" . . . . . . . . . . . . . . . . . of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . . . .N/A, „ . . . . . , . . . , . _ . , UNDERWRITERS CERTIFICATE NO. . . . , . . . , . . . Pending . . . . , » . . . . . . . . . . Building Inspector Rev.1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29480 Date: 30/43 THIS CERTIFIES that the building ADDITION Location of Property: 179 OLD HARBOR RD NEW SUFFOLK (HOUSE NO. ) (STREET) (HAMLET) y p 3889 Section 117 Block 3 Lot 1 Count Tax Ma No. 4""" Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 2, 2002 pursuant to which Building Permit No_ 28879 dated NOVEMBER 4 2002 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 DORMER ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PETER P WICKHAM (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENY OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A nth rized 8i na g ture Rev. 1/81 F FBI xy Town of Southold 7/21/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40527 Date: 7/22/2019 THIS CERTIFIES that the building AS BUlL,T ALTERATION Location of Property: 179 Old Harbor Rd,New Suffolk SCTM#: 473889 See/Block/Lot: 117.-3-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/3/2019 pursuant to which Building Permit No. 43873 dated 6/17/2019 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: °as built"airnditi nas'stem as applied for. The certificate is issued to Wickham,Nancy of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43873 6/27/2019 PLUMBERS CERTIFICATION DATED 110) zle 1 Signature