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Home My WebLink AboutZ-34376FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA/~TMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY NO: Z- 34376 Date: 05/26/10 THIS CERTIFIES that the building DWELLING & ACCESSORY Location of Property 165 WICKHAM AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 140 Block 0003 Lot 033 Subdivision Filed Map No. __ LOt No. __ conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursue%hr to which ~KTIFICATE OF ~C~/P~NC"~ I~3MBER Z- 34376 dated mY 26, 2010 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 ONE FAMILY DWELLING WITH UNHEATED PORCH AND ACCESSORY GARAGE.* The certificate is issued to MADELEINE M CASE (OWNER) of the aforesaid building. N/A N/A N/A ~zed ~ignature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD EOUSING CODE INSPECTION REPORT MAP NO.: LOT (S) M~ELEINE M CASE STOP, I~S: 1.5 # EXITS: 2 UTILITY RO~ (S): ACCESSORY STRUCTURES: C~, I'YPE OF C~.: WOOD FRAME S~, ~ C~ST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. GOERGE GILLEN ~ START: Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~.VN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 2010 '[0't/N 0[ $0[IIH0[I} This application must be filled in by typewriter or i~k and submitted to the Building Depamnent with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planting Board Approval of completed site plan requirements. 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. ]~ees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00 Date. May 14, 2010 New Construction: Location of Property: Old or Pre-existing Building: X (checkone) for a I 1/2 story frame dwelling and detached frame garage 165 Wickham Avenue Mat tituck House No. Street Hamlet Owner or Owners of Property: The Estate of Madeleine M. Case Suffolk County Tax Map No 1000, Section 140 Block 3 Lot 33 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 100.00 Underwriters Approval: Final Certificate: X check one) Abigail A. Wickham, Agent CONSENT TO INSPECTION The Estate of Madeleine M. Case Owner(s) Name(s) , the undersigned, do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at 165 Wickham Avenue, Mattituck, New York 11952 which is shown and designated on the Suffolk County Tax Map as District 1000, Section 140 , Block 3 , Lot 33 That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: a 1 1/2 story frame dwelling and detached frame garage That the undersigned do(es) hereby give consent to ihe Building h~spectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, roles and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, roles or regulations of the Town of Southold. Dated: May 14, 2010 Abigail A. Wickham, Agent (Print Name) (Signature) (Print Name /~oo 3 _.TOWN OF SOUTHOLD PROPERTY RE¢:ORD CARD OWNER STREET /~' I~ VILLAGE DIST.' SUB. LOT' ~c~. ~ND i~. TOTAL DATE REMARKS AGE BUILDING CONDITION N~ NOR~L BELOW ABOVE F~ Acre Molue Per Value ~re Till~le 1 Tillable Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD DEPTH House Plot BULKH~D Total ~ ~ D~K COLOR , M. Bldg. Extension Extension Ext. Walls Extension Fire Place F~mdation ¢ ,~ Bath / Dinette Basement :loors K. Interior Finish Heat LR. DR. Type Roof Rooms 1st Floor BR. Porch ~ ~' '~'~) '- / ~ ~ t/ ~ ,-o ~ ~ ),ecreation Room Rooms 2nd Floor FiN. B. Porch Dormer Breezeway Garage Driveway Patio Total REF ONLY: /O00-1d<9-O~-O~ SEC.,S/-/Z) JOB H/CA~/-/AA'/ AVf-A/Uf- SURVEY OF PR~TY Situated at i~IA TTI TUCK TO VIIN OF SOU THOZD SUFFOLK COUNTY NEW YORK Scale: 1"=2,0' Surveyed Smith, Jung 8~ Professional Land Surveyor 120 Medford Avenue Potchogue, NY 11772 Phone: 531-475-3192 Survey Certified To: ,~oNdTANTII~03 7~lAzOGLOL'I Dates Surveyed:/IP,~/z. /~,