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Home My WebLink AboutZ-11121FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the buildingn...(.2. ! ........................................... Location of Property 3725 Wlckham AYenue Hattituck hi, Js'~ '~'oi .......................'sb¢~,i ....................... County Tax Map No. 1000 Section . . 1..07 ....... Block . .0. 9. ........... Lot . .0. 0..7 ............ Subdivision...X. ........................... Filed Map No..X. ...... Lot No.X ............. Requirements for a private one-family dwelling built ppior to conforms substantially to the Certificate of Occupancy ..... A.p.r.l.1..2..3 ....... , 1~5.7.. pursuant to which-l~'mWl%~wfit No.. $.1.1.1.~ ............. dated ...l.u.g.u.a..~..9. ................ 19 .8.2., 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 ......... The certificate is issued to ............. 4q .ri.i.e..C. :..D.a. 1. ~r ............................... (owner,.le~ee of the aforesaid building. Suffolk County Department of Health Approval ...... .n./.~ ................................ UNDERWRITERS CERTIFICATE NO .............. .~./. ~ ................................ Building Inspector Rev. 1/81 BUILDING DEPARTMENT TO~'~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location Subdivision ~72~ Wickham Avenue (nu~nber & street) Map No. Mattituck (Municipality) Lot(s). Name of Owner(s) Annie C. Daly Occupancy R-1 (type) Admitted by: Florence Sinit unoccupied (owner-tenant) Accompanied by: same Key available Suffolk Co. Tax No. 107-09-007 Source of request Gary Flanner 01ssn', Esq. .Date D~LLI~IG: Type of construction wood Foundation cement block Total rooms, 1st. FI 4 Bathroom(s) 1 Porch, type wood open Breezeway Type Heat oil fired Fireplace(s) Domestic hotwater Other Deck, Garag% Warm Air No. Exits 2 yes #stories 2 CellarPartial Crawl space rest 2nd. FI 2 3rd. FI Toilet room(s) 1 type Patio, type Utility room Hotwater x Airconditioning Type heater tankless ACCESSORY STRUCTURES: Garage, type const, wood, Swimming pool Other one-car Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 _Location Descriotion Art. Sec. kitchen ~aslstove--no shut off V 52-52-B ~ garage door needs fixing III 52-30-A Remarks: Curtis W. Hort~n Time start 11:15 end 11:38 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 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. 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 New Building ............. Old or Pre-existing Building(Z). ~-~.. =/Vacant Land ... House No. ~ Stree~ ~ Hamlet Owner or Owners of Proper~ .~~ ~.~.~.,..~ County Tax Map No. 1000 Section .. Z~. ~.~~BIock ....... ~ ...... Lot ..... ~ ........ Subdivision ........... ~ ................... Filed 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 $ .................... Construction on above described building and permit~mee~s all app~cable~.co~es and regulations. ..... OLSE, H,.ES..Q.. Applicant.: ._.~RY. ~ER ......... ~- ~¢~9 ~///~/ P.O.~x38 .......... ~, ~ ~ o ~ ~in Road ~7 ~attituck, L I., N.Y. i!95~ ~ ~