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HomeMy WebLinkAbout1000-115.-3-7 TOWN OF SOUT OLD SO Rental Permit Permit No. 0030 Owner Angel Chorno Occupied as Single Family Dwelling Located at 160 Sunset Avenue Mattituck 115-3-7 Address Village S/13/1- Maximum /13/LMaximum Permitted Occupancy 8 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 4/10/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times so Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 cou m BUILDING DEPARTMENT TOWN OF SO OLD RENTAL PERMIT APPLICATION ,,: :s ." TOWN OdaO U:L,b Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION BLOCK LOT SECTION B. OWNER INFORMATION: Property Owner Name: ' ' Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) P1 / 4,d Telephone Number (s): Property Owner Email Address: .. Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: " Address of Authorized Agent (no P.O. Boxes): (6 '2v Mailing Address of Authorized Agent: Telephone Number (s): Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s): Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number (s): Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier (for example, Unit 1, Unit 2, Unit 3 or Apt A, B, C);the use of each room in the Rental Dwelling Unit (for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier:, 47' a Requested Maximum number of persons a16wed to occupy Dwellingit: 'W � - Number of rooms in Rental Dwelling Unit: z Use and Dimensions of each room in Rental Dwelling Unit: SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety inspection by Code Enforcement Official is required. If the owner chooses not to have said inspection performed by the Town, a certification from a NYS licensed architect, a NYS licensed professional engineer or a home inspector who has a valid New York State Uniform Fire Prevention Building Code Certification is required stating that the property which is the subject of the rental permit application is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. Page 3 of 4 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect, a licensed professional engineer, or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building code Certification. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) certify under penalty of perjury, the following: 1. 1 am the owner of the property identified in "Section A" of this application. 2. The property owner's legal address set forth in "Section B" of this application is my legal address and I understand the Town will use the address for service pursuant to all applicable laws and rules. I further acknowledge that I will notify the Town of Southold Building Department of any changes of address within five (5) days of any changes thereto. 3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and agreed to abide by the same. 4. 1 will notify the Town within five (5) business days s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: Property Owner's Signature. " Sworn to before,me-this,,�day of , 20H Official Notary Public Signature and Original Notary Stamp / Page 4 of 4 �, � .�°' { i �VK *wLoloo TOWN OF SOUTHOLD BUILDING D 765-1802 IIIIIIIIIIIIIIIIIIIIIIIIIII INS IIIIIIIIII I1 ,ON I 1111������"OUIIIMIIII)A"riiiioiiiiq iiia s r I 1111 1111,,1 P1111 ,111111111 1111:::."1118 111 I1111 ""'111r"'111 IIIPIII�')11111111 111MA1111 , ilii "11 1111 ACIIIE & C111411111111VIN111EY1111!!!!!!°1111 1 X1IE 11117Y 11111114 11911111111E IIII° 11111 , 1 IIIA°°r cams I'RUCTION I IIII' IIRllf m% l I III °°1111°° V 111111111111111.. 1111 X1111 11111111 lh _ REMARK&: J DATE YJYf )M-j r 1�0 C'�04(61*v TOWN OF SOUTHOLD BUILDING D IIIIIIIIIIIIIIIIIIIIIII INS 'P ' Iiilllllllllllll,illl T� IONIII FOUNDATION 1°°°1111 1�:)L U ['110N 1N NINSULAT101114 Fl�lAMING / S I RAPPI111MG PFNAI FIREPLACE 0I IIII [1111° 1E SAFETY IM FIRE RESISTA INIT CONS I,RUCTION FIRE RESIS rANI IIII ELS 1111 1CAL 11 i t EIlll uEC I RICAL III A' CODE V11110LATION CAULK114G REMARKSII DATE INSPECTOR / l�r1 ,r r i p s I� © I k i I� Il ti a to ND t G, � m FORM NO. 4 TOWN OF SOUTHOP BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 7,6308 . . , . . Date . January 21 •, 19. 75 THIS CERTIFIES that the building located at . . O, "pA .Ave. . . . . . . . . Street Map No. xK. . . . . . . . . Block No. XX. . . . . . .Lot No. . me x. . . .1Mat.t1tu0k . .V.•X% . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . .Hareh. . 1$ 19.73. pursuant to which Building Permit No. .6441z . dated . . . . . . . . . . Mar. . 27. . . ., 1973. ., 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 . .PriVata .on*. family.d *Mag. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .-Tobn A.Mary. P*Aro. . . . . 4imaxt1. . . . . . . . . . . . . . . . . . . . . a . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. .19190.417. . . . .PPIA . .11 . .1974. , „ . . . . . . . . . , HOUSE NUMBER . . . . . 1-09 . . . . . Street . . . . . VZ + t. :V . , . . . . . » » . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . » . . . . . . . » . . . . , . . . ;Building Inspector , . w. d,�..a axe u.L tl ' Town of Southold Annex 8/16/2012 w., «' P.O.Box 1179 54375 Main Road Southold,New York 11971 Ot CERTIFICATE OF OCCUPANCY No: 35890 Date: 8/16/2012 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 160 Sunset Ave,Mattituck, SCTM#: 473889 SectBlock/Lot: 115.-3-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this ofliced dated 7/31/2012 pursuant to which Building Permit No. � 37439 dated 8/13/2012 . 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: "as bui t„alte _qtion for hjLfw-,Qmin basement bathroom onsegQnd floor, k gpnd stowadditions to an existing one farm elljag as=jjeA fix. The certificate is issued to Pedro,Mary (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. N198417 12/13/84 PLUMBERS CERTIFICATION DATED ,�.A,uti r` Si , tore �. TOWN sOF SOUTHOLD PROPERTY RECORD CARD e VILLAGE 1 DIST.! SUB. LOT 1 � OWNER STREET a t Lj ¢ FORMER O V E � N j I - o 3 ' I TYPE OF BUILDING 3 RES. G 9� SEAS. VL. ; FARM comw CB. MICS. kt, Value = �- j TOTAL DATE I LAND � IMP, REMARKS1 21 g a = 0 1 r � z - - - �av AGE BUILDING CONDITION v NEW NORMAL i BELOW ABOVE � t ' _ _ I ,_ ti FARM Acre Value Per Value Acre l ' Tillable FRONTAGE ON WATER t � Woodland € FRONTAGE ON ROADS ' Meadowland E E DEPTH - Houw.-Plgf, Total DOCK O-LC- 11.47 r- A T✓FF t TRIM N d � t 3 E , I _ _ {a _ s , 115-3-7 10/12 �. M BIS i i L' , Extension .SO ' `f- 1 I F 71 • Extension 3 E Extension Foundation Both Dinette , C ' Porch — � Basement Floors _ -I< I � Interior Finish LR. Porch ,Ext. Walls q(o j �. - - - Fire Place lea D . Breezeway _4 Garage type Roof Rooms 1st Floor BR �t 9 - YP i � - Patio Recreation Roomer. Rooms 2nd Flo , (N. B 0. B. s Dormer I Driveway - Total 3 4- X . �