HomeMy WebLinkAboutZ-10710FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Z10710
No .................. Date .... 09.t,.qb.e.r..1 ................... 19 .SJ.
THIS CERTIFIES that the, building ................................................
Location of Property . 5.5.0.~..W.J-.q~4 .h.a.m..~. y.e.n.u.e., ......... H.a..t.t.~.~.u..c.k.,..~.e.u..~.o.r.k .......
House No. Street Hamlet
County Tax Map No. 1000 Section . .1.0.7. ....... Block ....4 ........... Lot ....2.,.1. ..........
Subdivision ........................ ...Filed Map No .... Lot No ..............
., R~qu,~r,e. mer~ts~f.9,r, a~Private O~ne-FamllyDwellingBuilt
conforms substantially to [ne ,~l~aC.a~..~r.l~m~a~v4j-u~r~t, tl~r~~~ ....
. C,av, t&f.;tcat,~ of, .Occupancy Z I0? 10
.l~e.+O.p' .t.o.. gp.~.~..1..2.3. , 195.7. pursuant to wnxca-,,,*a~g-t,o~m~r-,r~,-. ............ ., .......
dated . .O.c..t, .o.b.e?...1 ................ 198. !., 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 .........
......... Pri.v. ate..One,-Famil¥..Dwelling..~lth. ~ix. A~ess.o.~.y.S.g.~.~.~.u.~.~$..~.
The certificate is issued to George V. Dickeraon~ Philemon T. Dickerson & Harold
..................... ioh; e;, .....................
of the aforesaid building. Feinberg
Suffolk County Department of Health Approval N/R
UNDERWRITERS CERTIFICATE NO. N/R
# 2 Car Garage, Metal Pole Barn, Combination Cement Block and Wood
Storage, Large.Wood Stroage, 2 Story Dwelling and 1 Story Dwelling
(Non-habitable) . (Non-habitable)
. ....
Building Inspector
Rev. 1/81
Location
Subdivision
BUILDING DF-OART~'~NT
TOY,%' OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
5505 Wickham Avenue, Mattituck, New York
(number & street) (Mu~nicipality)
~Iap No. .Lot(s)
Name of 0~mer(s)
Occupancy
Admitted by:.
George V. Dickerson, Philemon T. Dickerson & Harold
Feinberg
Philemon T. Dickerson
( own er- t en~',t )
Accompanied by:. Same
R-1
(type)
Mrs. Dickerson
Key available
Suffolk Co. Tax No30.7-4-2'1
Source of request Richard F. Lark
Date August 18, 1981
DVf~LING:
Type of construction
Foundation Brick
Total rooms, 1st. F1
Bathroom(s) 3
Porch, typ~ Screened
Breezeway.
Type Heat Oil Fired
Fireplace(s) 2
Domestic hotwater
Other
Yes
Wood burning stove,
Wood framed #stories
Cellar Partial Crawl space
8 2nd. F1 3 3rd. F1 2
Toilet room(s) 1
in Deck, typq Patio, type
Garage Utility room- 2
Warm Air -4~%e~-- Steam
No. Exits 8 Airconditioning
.Type heater Oil Fired
attached wood shed
3
Rest
ACCESSORY STRUCTURES: six
¢arage, type const. %S~o~ge, tftPoeraC~nst. Me6a'l ~ole barn
~o~bi~ation Qement block & wood s o ag - g -- -- --
-~w~m_m~g-~e~- _~e~_~y~-~<~,-Large Wood Storage
Other 2 Story dwelling, 1 story dwelling.
VIOLATIONS: Housing Code, Chapter 52
.Location Description Ar~. Sec.
Kitchen Gas Stove no shut off V 52-52, B1
Outside Needs paintin~ badly III $2-31-B
Rec.Room Flue pipe to wood burner too long of a run V 52-53-H1
~lnrth ..... fl~¢ ~e~.~ doors bad III 52-30-A~C
Corner of Dwelli.og Floor bad, bath bad. needs lo.ts
of repairin~
Cellar Cellar steps, broken'~ II 5'2-27-A
2Car Garage Falling to ground III 52-~.0-A
2 Story Dwelling Non-habitable till major reoairs s'e ma~le52-83
~on-h~Ltabl~
1 Story Dwel.ling ~one nz±z ma.lor reoairs are made fIII 52-83
Large Wocd Stora~e~Needs repairing III 52-31,B,C
Remarks:
Inspected by: .. ~/~' Date of Insp. Sept. 10, 1981
.j:; . Curtis W. Horton Time start 3:00 ' 'end 4:30 ·
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, 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. Commemial buildings, Industrial buildings, Multiple Residences and similar buildings and installer
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 all 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 ...~.u. cj.u.s.~..~.8.,..:]:..9.8.~. .....
New Building ............. Old or Pre-existing Building .... .X ....... Vacant Land .............
Location of Property Old Road (Wickham Avenue or Middle Road) Mattituck
House No, Street Ham/et
Owner or Owners of Property .G.e..°T.g.e...V:..D.i..c.k.e.r.s..o.n/. Philemon T. Dickerson & Harold
.............................. ~&[h~erg
County Tax Map No. 1000 Section ............... Block ............... 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 Temporaw Certificate ..................... Final Certificate ......
Fee Submitted $..5...0.0. .......................
Construction on above described building and pe/4~[~,e~ts ad ~pR;lmaD~e~3es ar~ regulations.
Apphcant/~'//~/ / ~/ ~-~ ~//'
Rev. 10-10-78