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Home My WebLink AboutTesting 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 sp 54375 Main Road Fax(631)765-9502 ti 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 r w 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 oo per� me, CA�� toy- _ ,L _ Ll TOWN OF SOUTHOLD BUILDING DEPT.o� 765-18012 s �P INSPEC11111111111��riON III. IFOU111411DA-riam is r �� „� 1111 ,,, 1,,,,I IIPLIIBG III' „III IFOU111411DAT11101114 21N11D ��„ „IIS INSULATION III„ „III lll: III /s r1I IPIP I ,,, d III„ „III IlIIlll: lIllIu IIIIIIIII ��„ I'11111:111E SAFETY 1111IMS11PEc nia IlIll llf Ill: llf° III II " IIS " III° " 111 11 ��, IIP:111 Ilf;;; TAlI °III'° III IRM110N II[ „III � � � I � � �� ,,,,, r� i ��„ „IIS IIIII „ ...... .....4 DATE10 INSPECTOR o, f cr?s� 6 7 3 BR 11x11 BR 10x13 LR 14x14 MR 11x8 r u. 8 Kitchen 15x9 BR 7x9 Bathroom 7 x5 DR 10x8 6 FLOOR PLAN DEPOT LANE HOUSE 1 Master BR 11x8 1 2 Small BR 7x9 1 3 LR 14x14 2 4 BathRrn 7 x 5 1 5DR 10x8 1 B BR 11 x 11 1 7 BR 10 x 13 1 8 Kitchen 15 x 9 1 rt2, w 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 --- ........ _. _ ,2 Authorized Signature . TOWN OF SOUTHOLD PROPERTY REC Ri I a-- ac, � OWNER STREET �.' VILLAGE I DIST.1 SUB. LOT ,.,. G i� � 3 r. FORMER OWNER EG ACR. t S�yd � i3A C6/U W ? TYPE OF BUILDING ;RES SEAS. IVL. FARM 'COMM. CB. MISC. Mkt. Value LAND IMP= TOTAL DATE REMARKS f ;Y 3 eg1= BU LDING CDITION _ .� 3.3 r1 9 /�o L _ �_. h ti to NEW NORMAL BELOW ABOVE u FARM Acre Value Per Value Acre Tillable 1 ilk Tillable 2 Tillable 3 Woodland Swampland _ FRONTAGE ON WATER -- FRONTAGE ON ROAD Brushland � ; House Plot DEPTH -ke�-.:�� B ULKHEAD I I � , Total EDOCK �Z-4 y � - f ,e I I �l v � g s l S I f 102.-2-4 11/2015 102-2-4 2/0I M. Bldg, - _ � - Foundation = a th Dinette 8 F 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 I Patio � - 0. B- 1 Total }- i 1