HomeMy WebLinkAboutZ-9701FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
Date ....0.9 .~9.b.e.~...'1 ................... 1979.
THIS CERTIFIES that the building ................................................
27~5 Wickham Avenue Mattituck
Location of Property ..........................................................
House No. Street
County Tax Map No. 1000 Section .. ? .~.9 ....... Block ..... 9.2. ....... Lot...99E ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
Requirements for a one family dwelling built prior to
conforms substantially to the~
Certificate of Occupancy ~c~-~e~4
· ...A.p.I?:I.~...~.3 ........, 1 ~5.7.. pursuant to whicl~No ......... .~?.1.~.: .......
dated ... 9.~.~.9.k~r. ? .............. 19.7.9., 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 .........
........................ .ojo. ?. Z .~..~.~.y., .~..e.~.~..~.n~ .................................
The certificate is issued to ........... .J.o..h-D....R.....Al..b.12.MGht .............................
[owner:~l~J~
of the aforesaid building.
Suffolk County Department of Health Approval ............ .~/.R. ..........................
UNDERWRITERS CERTIFICATE NO ..................................................
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 2745 Wickham Avene
(number & street)
Subdivision
Mattituck
~ap No.
(Municipality)
Lot(s),
Name of Owner(s) John R. Albrecht
Occupancy R - 1
(type)
Admitted by: Self
Unoccupied
(owner-tenant)
Accompanied by: Self
Key availableWickham office
Suffolk Co. Tax No. 139-02-00~ ·
Source of request'WilliamWickham
. Attorney-at-Law
Date Sept. 20~ 1979
D¥~ELLING:
Type of construction Wood framed #stories
Foundation Cement block Cellarpartial Crawl space.
Totsl rooms, 1st. F1 5 2nd. F1 .5rd. F1
Bathroom(s) One Toilet room(s)
Porch, type Deck, typ~ Patio,
Breezeway Garage Utility room
Type Heat Gas ~Warm Air Hotwater X
Fireplace(s) Yes No. Exits 2 Airconditioning
Domestic hotwater Yes Type heater 8as
Other
ACCESSORY STRUCTURES:
Garage, type const..Wood/1
Swimming pool
Other
car
Storage, type const.
Guest, type const..
One
X
,VIOLATIONS: Housing Code, Chapter 52
Location Description Art. i Sec.
Kitchen No shut-off for gas stove V . 52-52'B2
Cellar No rail Narrow sten~ ]~di~g ~ II 52-27-B~
cellar
Garage Door frame & side door in poor III 52-~1-C
Remarks:
~' ~~--- Date of Insp. October 1, 1979
Inspected
by:
Curtis Horton Time start 11:30 end 12:15
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
$outhold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing alt property lines, streets, buildings and unusual natural or
topographic featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date . .S.e.?~??.e.~...2.0.,..3:..9.7.9 ....
New Building ............. Old or Pre-existing Building .Z.X.Z. ........ Vacant Land .............
Location of Property 1.~9..~. )...~.e.s.~...s.~.4e...~.~.c.~..h.a.m...Ay.e..o.~..C.~.e..e.~., .... .~.a.~.~$.~p. qk. .......
House No. next to new bridge Street Hamlet
Owner or Owners of Property . . .A.l.b..r.e.qh..t,..J.o.b.n' .R.: ,..S.r.: ...............................
County Tax Map No. 1000 Section .. ~.3.9. ......... Block ., .~ ........... Lot .Q03 ............
Subdivision ................................. Map No ............... Lot No ...............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .... .~.... ..............
Fee Submitted $..5, OD .......................
/
Construction on above described building and permit,~e~ all ~ppl[cable codes and regulations. Jo~ ~.~h~'~ ,-~ - ~ · S
.
R~. 10-10-78 ' ; / 7~
~T