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Home My WebLink AboutZ-9126FORM NO. { TOWN OF SOUTHOLD BUILDING DEPARTMENT Town ClerVe Office Southold, N. Y. Certificate Of Occupancy No. .29126 ..... Date ..July ... 24 ................ . 19.78 THIS CERTIFIES that the building located at . 1.65 • Wickham ..Ave ....... Street IREEMS e• ONE FAMILYe •e- •1 1 • 1 t..aVl'1 au��a��>.r��w'��.•�+ra��r��i�•r� dated . July ..... 24.......... / 19.. 78 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 ....... PRIVATE ONE. FAMILY DWELLING ................................ . The certificate is issued to ............ •Henry 'J: • Romanowski . • • • • • • • • • • • • • • • • • • • (owner, of the aforesaid building. Suffolk County Department of Health Approval ...... Pre -Existing ............... UNDERWRITERS CERTIFICATE No . ...............Pre-Existin HOUSE NUMBER ....16§....... Street ....... �kham• Ave • • • • • f, Mttituck,.. New Y k ............... Housing Code Inspection July 21, 1978 165 Wickham Ave R-1 Mattituck, New York Tax Roll: Henry J. Romanowski unoccupied Upon receipt of an application for a Pre -Existing Certificate of Occupancy I made an inspection of the buildings on the above captioned premises. I was admitted to dwelling by Mr. Romanowski who accompanied me during this inspection that began at approxi- mately 10:30 A.M. The dwelling is a one story wood framed structure constructed on a cement block foundation. Ground floor contains a kitchen, dining room, living room, two bedrooms and a full bathroom. Second floor is a completed attic and contains two rooms and full bath- room. 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 an oil fired hot water heater. A wood framed one car garage is located in the rear yard area. I found no violations of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. , Inspection completed at approximately 1,0-750 A.M. submitted, Building Inspector 2/�- Y//4F FOaat NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in tTipik6te to the Building Inspector 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 installations, 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 property 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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 �� / 9�� g �% Date .......... ..... ................ New Building .................... Old, orjPre-existing B ilding .... /..�................... Vacant Land .............................. Location Of Property ..1.N..1. .1.\. .1. !.1 .... V.. i .(,.. .j...�..lt2fI.J.1 C. !�.j.....1."..: .:..... Owner Or Owners Of Property ..... '.. .lU..n�.y....�....!......�..... ... Subdivision................................................................ Lot No............. Block No............. House 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 $....✓ :.G ............... Construction on above described bui Applic ldin�& permit is pplicable codes and, regulations. ant .��.....C?T1'N�r.rfJ ... Sworn to before me this o (, l....!.. day of . d ....t l.f.�A.. Not ry Public ..... ... .. ..... .. ... County (stamp or seal) OA leis -/ 751 eel 1 a (o STATE OF NEW YORK) ) ss.: COUNTY OF SUFFOLK) and says: JOHN R. McNULTY, being duly sworn, deposes That I am an attorney at law and a life long resident of the Town of Southold. I am fully familiar with the property located at Wickham Avenue, Mattituck, Town of Southold, Suffolk County, New York, and has been familiar with the property prior to 1957. That the property has existed in its present enactment of state prior to the/Zoning Ordinance of the Town of Southold, to wit, 1957. That based upon my knowledge, I know that the premises for which the Certificate of Occupancy 9.f pre-existing use is requested has existed and has 1 dwelling prior to the enactment of thi Town of Southold, 1957. Sworn to before me y of/_ J�ULY�1"978. NARY PUBLIC CATHLEEN Q OATES Nopq PUM $we of Now Yak Na 2- 629 �9 o. a in=22°3'S".'',sr