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Home My WebLink About1000-140.-2-27 TOWN OF SOUTHOLD Rental Permit 1095 a� Owner Michael & Emily Arseneau Occupied as Single Family Dwelling Located at 645 Wickham Avenue Mattituck 140.-2-27 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. i 3/18/2024 Code o _e � Official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 i P.O_Box 1179 Southold,NY 1 197 1-0959 ' BUILDING DEPARTMENT TOWN OF SOUTHOLD �N "h RENTAL PERMIT APPLICATION MM Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental roperty Address: VE M iv—f1 -[L)C4 W d Tax Map Number: 1000 SECTION 0 BLOCK '7— _-LOT - SECTION B. OWNER INFORMATION: OM I Property Owner Name: _ —C' Property Owner Legal Address: Property Owner Mailing Address: ��.,.�...w..,__..�......_.. ____._..,. � � Emergency� _� 3� � � S� Telephone Number (s): Daytime Evening, Ogg_ _. Property Owner Email Address: C � ' COVI-1 Page 1 of S Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ° Southold,NY 1 197 1-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening ......�Emergency.._._, -___. Email Address: w..� ..__.__..... SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, B, Q 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." ��— VP7 Rental Dwelling Unit Requested Maximum number of persons allowed to occupy Dwelling Unit: . Number of rooms in Rental Dwelling Unit: _1 1. .� Use and Dimensions of each room in Rental Dwelling Unit: BEON)ow-t ��! �� a`�1r 1�2,,��....�.E'....,..�G°r VC� V�� l� C/ rr x ' P'� iv �� .�r v'` 11�3' Page 3 of 5 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ° BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): _ ....... Mailing Address of Authorized Agent: Telephone Number(s): Daytime m _ Evening_ _ __ Emergency _ Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: _ Telephone Number (s): Daytime-___ Evening Emergency_ _ vR � 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: M.._.„_, Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex „ Telephone(631)765-1902 5437.5 Main Road Fax(631)765-9502 P.O_Box 1179 Southold,NY 1 1971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. l 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) I w1cm .._. certify under penalty of perjury, the following: 1. 1 am the owner of the property identified in "Section#Pta * *4"+k' e "lax" 2. The property owner's legal address set forth in "Se "",,,of f �on i my legal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 Town Hall Annex ; Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 a , BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. I 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: �) J�� . �D• Property Owner's Signature: $worn to before me this,:3 day of f ' �?. � 20 ZZ Official N ary Public Signature and Original Notary Stamp of NW y in Page 5 of 5 zv WXOF SOUTHOL6 13UILDING j owl 631 R85 1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION TND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ rFIRE L FIREPLACE & CHIMNEY SAFETY WE [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATI [ ] PRE C/O [Vf I , 2,00— olo V441too W, c..- . o ,�.. p ............. DATE w2aeto INSPECTO No No.: vouw ME,MATTINCK, Left Co 2nd k')cH 645 Wickham Ave ............................................. ........ ..... .................. F' s. a i �•r Case No.: .: Cftv: , 'rrimx lad: :ass a LeadE....._.._..WLLLJ.ARM.:..:..BANK.PIA ..._.......... .. _... _.._.......... ......._...............ww . ..... ....... . ....... . ...._ ._..... i r 4 645 Wickham Ave sm r �K w.� e y� �cr fay, A" i�p t .,i�,,.. ri a 12.. '��¢.v ��n Dirt✓...,t.0 �.v e,ar yo o,C nv ag uTx�v:,I'."a.r x sx n�ml' ,u.: n w..ti dur 1^ v...pr.,I%rr oX �•^^^^ ' B 9� Fie NO.: as a15r Case No.: IH oft rF ...... 9 � auLJN LaupidiYy 22'9 " 9l 41, ee: :w�ww ua.r��.:��rvm�p��'I�uw r,'iiU�Yunirraraw:c:'r.+.ir,ma dW M ..aeW_ka'W r�raxd. ownmum1, .na'a�m'y'„ren�a.R.m utiN+t n ^� TOWN OF S UT LD Pk'OPERTY R O, )`l�` OWNER STREET VILLAGE l DIST SUB. LOT FORMS OWNER AC x � J0111/ ? !�-I 5 W E TYPE OF BUILDING a � RES. ' SEAS. VL. FARM COMM. CB, MI{' . Mkt. Value LAND IMP. TOTAL DATE REMARKS 1- } f /AJ {r ✓1J tr a.lf �lALQi'fS7J P CKlqI r- LJ i _ / LIP T AGE I BUILDING CONDITION l 3�� = L � _ter � � - £ � � . ; NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre € ; (,� _ I� {_ (�7 .'�"` Q � Tillable ' R Woodland FRONTAGE ON ROAD Meadowland DEPTH i House !" BULKHEAD _ Total DOCK t .. s vv a y� C3P, TRIM , 3 z � I i I � E i ] . IL I , t e � � I I _ IL _ E I I I , s t 140.-2-27 1110 NI. [Slag. / f Extension e 99 I �r t i i i Extension Extension i Foundation o Bath , �; 2 Dinette Porch P _ Basement �v Floors I k 'K. 1 PSh rJ� '� i Ext. Walls Interior Finis �� a-f h i Breezeway j Fire Place m I eats DR. Garage X/ = 3 0 ° 3 c 1— ='Type Roof I s., 1kom, T --,LB R. Patio I 'Recreation Room 1ocros 2nd Floor r'I RlN. B O. B. !Dormer I Driveway € Totalr j- _ s I i FORM NO. a TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . . . Z8M . . Date . . . . Apri3. . . .20L . . . . . . . . . . .. 19. . .78 THIS CERTIFIES that the building located at . . .645 .WickbAm Ave. . . . . . . Street Map No. . . . , . . . . . . . . Block No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . conforms substantially to the dated . . April . _ . 23 . . . . . . .. 19. 5.7 pursuant to which � x . ,2 dated April . . . 24 . . . . . . . .. 19. .7.8, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . ��YArr.01M .IFA=Y. JX=VQ , . . . . . . . . . . . . . . . ,. . . . . . . . . . . . . . . . The certificate is issued to . . . Donald.R.. Gilderelaeve .dc.w96 . . . . . . . . . . . . . . . . . . . (owner, t of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . . . 645. . . . . Street . . . . . . . Xiekham•Avs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ttl .,. .N York . . .119§2. . Building Inspector Housing Code Inspection April 20, 1�97&1 645 Wickham Ave R-1 Mattituck, N.Y. Tax Roll: Donald R. Gildersleeve & wf. occupied: owner Upon receipt of an application for a Pre-Existing Certificate of Occupancy I made an inspection of the buildings on this premises. I was admitted to dwelling along with Walter Dohm by Mrs. Gilder- sleeve and began this inspection at approximately 11 :00 A.M. The dwelling is a one story wood framed structure constructed on a poured concrete foundation and contains two bedrooms, living room, dining room, full bathroom, kitchen and enclosed front porch entry. A recent addition on rear of d ej oon, di in area, b ox , �is addition was constructed '; .µn Permit # 2796Z o wh c° i "su « uent Certificate of Occupancy # Z2207 was Heat is furnished to all rooms from an oil fired hotwater furnace located in full cellar. Domestic hotwater is furnished to all plumbing fixtures from a gas fired hotwater heater located in cellar. A wood framed two car garage in rear yard area was added to under Building Permit #6384Z to which subsequent Certificate of Occupancy #Z5322 was issued. The following violations of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. were found: Entries- Front and side entries to dwelling, no means of c n r5l ing light in rooms at point of entry. Article V, Section 52-56 B.2. Inspection completed at approximately 11 : 15 A.M. Respectfully submitted, EDWARD HINDERMANN Building Inspector FORM No. 4 N (D PLftN5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ...A...2PAQ7......... Date ........................A-04Ust....]"7........ 1SA5... THIS CERTIFIES that the building located at WIS.....Widk 1M.A!I A............................... Street Map No. .......XXX....... Block No. ...Rom........... Lot No. ..=........ :tt .UQ)A.......X.w.Y.w................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................sT i'I0. .......21....... .. 19.65.. pursuant to which Building Permit No. 2796..Z. dated .......................... O.....21..........., 19.45., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued its ........ .Y...dwolling.........................."...........,..»...»...».....,..,......,...........,......,.,........ Thecertificate is issued to .... . ........ .. 1er............................»........».,.. (owner, lessee or tenant) of the aforesaid building.` .........Building Inspector .. .. .. .. ,.. ................. C b . t a i. ai " r �u b F q P g FORM NO. 2 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN CLERKS OFFICE � �� SOUTHOLD, N. Y. BUILDING PERMIT, (THIS PERMIT MUST BE KEPT ON�THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED} . = Date . .............. Permission is .hereby grantee( to: .................. ......................... ....... ............................................ 6 to ...... . .:...................»................... .».. ............................................................................ ...........................................................,.........I............. atpremises located at...... .............:.......a....................................................,..... .........................................,.................. *ttl'Yr;uak...................... ..................................................... ... ........................................................».............».....,...».............................................,............... .; , .. 19AS., wid approved by the pursuant to application dated ............................ .... ..... .... Building Inspector , Fee $.... w............... . :.... ..........................,,..... .:»......».»....,....». Building Inspector , y .., r .�..__. a ... V*Wf NO. 4 ry TOWN OF SOUTHOLD BUILDING DEPARTMM Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z22 . . . . . Date . . 44y. .?7. . . . . . . . . . . . . . . . 19 73 . THIS CERTIFIES that the building located at . . . .§45 ;40. Aq . . . . . Street MapNo. . . . . . . . . . . . . Block No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . .March 2 19.?3. pursuant to which Building Permit No. . , . , . . . . �`�z dated . . , . rob. b . . . . . . . . . . . ., 19.?3., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issuedis . "go for Car « . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . » , . . , . . . . , Doz eve The certificate is issued to . . . . . . . , xdm Mdilder . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval X&R « . . . . . . . . . . . . . . . . . . » . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . °It`. . . . . . . . . . .. .. . . . . . . . . . . . . HOUSE NUMBER . . 64 `. . . . . . . . Street ..le.. . . . . Ar s tt. . . .. . q i. .... . . . . ;'Bud g Inspector « f FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. „ Z 15235 Date . . .February. .2, .1987. . . . . . . THIS CERTIFiIES that the building . . . . . . .RE C K ADDITION . .. . µ . . . . Location of Property 645 WICKHAM AVENUE MATTITUCK, NEW YORK House IUo. Street «Hamlet County Tax Map No. 1000 Section 1.4 .Block . . . 2. . . . . . . . . .Lot . . . 2. . .. . . . . . . . . . u Subdivision . . . . . .r. . . . . . . . . . . . . . . . . . . . . . .Filed Map No . . . . . . .Lot No. . . . . . . . . . . . conforms substantially to the Application for Budding Permit heretofore filed in this office dated January 2 8 , 19 8 7 « « pursuant to which Building Permit No . . 1.5 . . 6 Z . . February 2 , 1987 dated . . . . . .�.y . . . . . . . . ,was issued, and conforms to all of the requirements e of the applicable provisions of the law The occupancy for which this certificate is issued is . . . . . . . DECK ADDITION TO EXISTING ONE FAMILY DWELLING � � � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to TIMOTHY J. & BARBARA S. BRIGHAM. + • . . . . (owner,YeYs9"Z*1rRX of the aforesaid building. Suffolk County Department of Health Approval . , „ . « . . N/A< . . , , . . « . . . « . . . . . , . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . AIM/. . . « . . . . . . . . . . « . . . . . . PLUMBERS CERTIFICATION DATED: N/A � Building Inspector Rev Will Iq i ��I�...';�,i�uuuuuuuuuuuu,,,,,,r�� I ... .... �V � �iln�i��;oa�l; � ii Illill m: „ � �:, ��, N,P a IJ �� ,i �(� ° �� t�, 1 I I s 1 � i � �� 1� `�w,,,,, �. � �i�/ i�� l � , � �, 1�, ,�� ' � ��. ww � uuu ,� � i �� i �� / 1i ��,,, �� /� � /, � � �� /�, ��i/%%�/�%/,,,i,�/�� ,� .10��s�d�� I ��/ J � �, �I r�/ ,, ��i �� 5�/�� ,i /i�rr rig ////�j/� D////�/, riiiiiio��f %��j/�� ,,,�� :% ��/ .....:� i/� %��% ��/ !i�� ,%' ,,�% ,�,//�% �j r/'f� iirrr �i o% rir/ii�� , rrr ,�/ i iir r iri�irrii j�//�� i�r�r ire�� rrrrr� � r�� ,,; s f 3 ,�„, � ,„ r fi J� ,f I 1 >, r t i a f �: m cJ r r/ � j r f r/ �� r% /� %1 ( r�� j� it iij/1 f- r„ �� ,,;,,,, �/� i ... > t r/rti / u r r /✓�/rro i/ i arwyr M