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Home My WebLink About1000-108.-4-8 x TOWN OF SOUTHOLD Rental Permit 0043 Owner Ubaldo Gonzalez Irr Trt Occupied as Single Family Dwelling Located at 19475 Route 25 Mattituck 108.4-8 Maximum 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. 4/18/2024 _ Code fog e ent of This Notice must be posted by the main entrance at all times so TOWN OF' SOUTHOLD BUILDING D 63 -765 1802 INSPEC 101m [ FOUNDATION 1ST [ ] ROUGH PLSG. C l FOUNDATION 2ND [ ] INSULATION/CA [ ] FRAMING / STRAPPING [ ] FINAL FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI ] ELECTRICAL (ROUGH) ELECTRICAL (FI ] CODE VIOLATION [ PRE C/O [ REMARKS: 6A-z�w, 490513 1 Q 4,e, Con-4flOCJ 9 "Sbrl �vv&r- aj swl DATE INSPECTOR 41 Town Hall Annex Town of Southold 54375 Main Road u" Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 " Tel: 631-765-1802 ...... SCTM# Date a Owner Phone r� d Visible Ad4dress .. . .,.,,._ Y1 .. .. _...�. .. ..... ....... ...., Hamlet....._ _ .. ._._ ._w. -w_.. _ ...... Inspector Floor Level Quantities Sub 1 2 3 ...��.� Smoke Detectors(not located in bedrooms) ..1��. .1. . . ............. .�_a„ .,�a. .., ..��„ .. .�..awb .� �... . .�„ ...... y .,. Carbon Monoxide Detectors ...., Fire Extinguishers Exits . Bedrooms 2 3 4 5 an. ,... „ ...., .W ,........ �.. _ 6 Smoke Detectors � Egress.� � l OccupantCount.,..... ....... .__ .. .�.�...�..... ...�.�., .. .... �.�.�..._ �..� ��.. ............ ._ �...m .. . ,.._.. .....�.._._ �........, B wilding Systems Maintained &Operational Condition of Property eating Building interior Hot water �.w...�. 1 H ._.. � Building exterior ��.1 ,..........., ..w. Mm,n..� �. n a.. ........, � Electrical Property , ,ained,�w Pro ert clean maintained &safe (M _... �w.... . .. . ... . ...... . a.. .... � guards &sec 6 echarncal Handrails& uards .. _ secure Pool Si Safety Pool on te W�aMm�ww .��w .._.. ..a.,..e,.... .... W. .,w .., ._.. .. ,.� w..... . , ,,... ......,,. _.ro . Surface water alarm Date of CO issuance ,o. .1-11..1 ,,,,�� aA�w........M, ....,.... �� . . �. .,,,e.. , .,_�,.. �...,,. ....�r..�.. Door alarms Pool completely enclosed Self closing latching gates . Pool fence to code requirements e .... w.. �.. �.. .... .. .....G / .. CO s for all ite p sent Prior Rental „ ' ms re ............ .. ..... Comments _...... .�........... �..., ,...ww.... a �,,, _.... . . ....... ._ ..,.. ._.... .. ..._.. .. .. _. ...... ....... ..... ,.. . ...,.... ...._.�._ .. ....._. . _....._..... _..�..... . ..... .......row.. .m...�.. ...m.......� .,w.. �.,.................. . .... ... ..._ ......_ _.. mm...a.� _...._. ...... ...... _. .... ......... . ... __. TOWN OF SOUTHOLD Rental Permit Y 0043 Owner Ubaldo Gonzalez Irr Trt Occupied as Single Family Dwelling Located at 19475 Route 25 Mattituck 108-4-8 Maximum 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. 2/18/2022 -) Code Enforce_ Official This Notice must be posted by the main entrance at all times F 01 '�► jg � `° Town Hall Annex SOUTHOLD TOWN 54375 Main Road = PO Box 1179 Southold, C= Rental Inspection NY 11971-1179 Tel: 631-765-1802 4 Fax 631-765-9502 f io roii rirjo' / //i r l , l %///19,r% 14, %,�� i q��////(yl R Irr//%'%f T�IP %, RJ1Ihli�% �� f� LEVELS ////ir ,r Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers'(#), Exits (#) c „ r / /j�BEDROOMS Smoke Detector Alarms`(#) Carbon Monoxide Alarms (#) Egress;(windows) (Y/N) BUILDING SYSTEMS / CONDITION OF PROPERTYka Heating system maintained/operational Building Interior is clean/maintained Hot water system maintained/operational Building Exterior is clean /maintained Electrical system maintained/operational Property is clean /safe/maintained Mechanical system maintained/operational` Handrails &,guards present POOLS 41 YC POOL BARRIERS Y/N Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min. 48"high resent POOL GATES Y/N All openings in barrier less than 4" Self-closing, self-latching Max.'2" clearance @ bottom of barrier Latch on pool side of gate, meets height Barrier capable of being locked'& child- requirements,,, proof when unattended COMMENTS`: TOWN OF SOUTHOLD Rental Permit Permit No. 0043 Owner Ubaldo Gonzalez Irr Trt Occupied as Single Family Dwelling Located at 19475 Rt 25 Mattituck 108-4-8 Address Village S/13/1- Maximum /B/LMaximum Permitted Occupancy 8 I 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. 5/2/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OYSOUTHOLD .RENTAL PERMIT AP-PLICATIQN f Rental Permit Fee$200(Application must be renewed every two years) P Section A. Property Information: a Rental Property Address: Tax Map Number: 1000 SECTION 17,E , 0 OB:LOC - �� LOT e., --3 SECTION B. OWNER INFORMATION: Property Owner Name:�. w �! in r la k m Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) r-ckr-d ��: � .� 42" Telephone Number(s): .5d '7 3 7 97 Z p Y Pro ert Owner Email Address: ...,.,..............................,. .._........ __..�...,�.� Page 1 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." ! a Rental Dwelling Unit Identifier: 0, .. Requested Maximum number of persons allowed u4rupy-Dwelllr Unit. Number of rooms in Rental Dwelling Unit: i �e 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. ❑ 1 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) H h _. r certify under penalty of:perjury,the following; .1, I am the owner of the property identified in "Section A"of this application. 1 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 . k 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. i 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 of20- Official NotaP ry ublic Signature and Original Notary Stamp 9 \OTRALorio1T McBrideMc Page 4 Of 4 STATE OF NEW YORK T No.01 MC6368447 IL �'�� F. Qualified in Suffolk Count• A°"`° Commission Expires December It.2021 �� pI�X11I1 pppp � uw:TC) I "� ��i m aa�n �� µ'N �rr p..,F TC �„'9�.�rY" T U�II�' �� cw ID ft �� n I 11, � [,z- 1765m,10802 �m "y�{✓1" ;� �� lnonn fl�VBMM u1 6.5 Iai 8 INSPECT,101 iI ATION FRAMING C , RAPPING m FIREPLACE Y u" w 1O'U% aI Eli.w�I p o ' �, I , _. � m 71" ° IIIIVIIIVupppiyW�^.. V i "qa "� �a y� l "�c1 kj7'•�"a;, �, �iw d c nC��dl765-1802 FRAMING 'I N -7Su,, P E C T I ON FOUNDATION 2ND INSULATION / s-rRA,,PPING FINS L �,zdwl FIREPLACE lil Iivio0or—.lRE SAFETY IP �FIRE FIESISTANT 'T'i II III ELECTRICAL. (ROUGII) ELECTRICAL (F U�E VIOLATION CAULKING RTARKRK S. Cot/ -M-1 ED ..... . A TE ONSPECTO 0 .- � ... 11 Ro vv r I� 55 �` e. .V J y9u L m � Y i u pa. IJ � P ry � O A G Ca m vii c QQOH ry r_ I; MOM y r W: m � CgrMto r�l S � m f Fr r, E�I �� a �ro as r rn " .'�„; C �� 'J � i ii°r"�M4 ti�� Y �m• �t C'S .m 'y��°��...:. rv� q�d PA II k r M W- jj ,ryry q yJ P y nb tlx Nm xx J� L v 1-7 u _.� n, the � y 5 {{ ti 7 r ".d wv a 1 � - � 5wfit ,,� c�,��p fill11 1 M It v� � .� �” P i� off, I •"°+`� s� u w r -i � !I I z � � ab IIV a R �� u FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20141 Date AUGUST 13, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 19475 AMAIN ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot_ 8 Subdivision Filed Map No. Lot No. � � conforms substantially to the requirements for a Private One Family Dwelling built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCC. Z- 20141 dated AUGUST 13, 1991 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 ONE FAMILY DWELLING * The certificate is issued to ESTATE OF ANNE I. NEVILLE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL— N/A UNDERWRITERS CERTIFICATE NO. __ N/A PLUMBERS CERTIFICATIQN DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Building ng Inspector Rev. 1/81 BUILDI_dG DEPA.RT:-Ii*N T01lid OF SOUT`IOLD, N. Y. HOUSING CODE INSPECTION REPORT Location strO ez�_._...m rtm"Irr IC r "r. 4 7 lO l Subdivision Map No. Lot(s) Name of Owner(s) ESTATE OF ANNE I. NEVILLE Occupancy_ A-1 RES I;typej downer-tenant) Admitted by: ROSIE NEVILLE�Accompanied by:—SAME Key available Suffolk Co. Tax No, 108-4-8 Source of request LAWRENCE M. STORM, ATTY Data JUNE 3, 1991 DY�'LLING: Type of construction WOOD FRAME #'sror.ias 2 Foundation BRICK & STONE Cellar 1/2 Crawl space 1/2 Total rooms, lst. F1 5 2nd. Fl 5 3rd. Fl - - Bathroom(s) 1Toilet room(s) 1 Porch, type ENCLOSED ON Deck, type Patio, type_ Breezeway G,j �,�,,go Utility room Type Heat ELECTRIC 'darm Air Hotwater Fire lace s) NONE No. Exits _ 4� Aircondition�- P ( ung Domestic hotwater YES Type heater LILCO GAS Other 2 REAR ENTRYWAYS ACCESSORY STRUCTURES: Garaoe�mmm^ type const. NONE Storage, type const. — Swimming pool Guest, type const. Other VIOLATIONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION �— — ... ..-.� & BUILDING CODE ius .I "a�n T?G >c :rind.:,on Art. � Sec. EYTRRIOR BXTERIOA STAIRS, PORCHES, ENTRANCE PLATFORlLS CUAIx�&". ?.. FIRE ESCAPES AND THE RAILINGS THEREON SHALL � .� .. HE ]242_5 C C MAINTAINED IN A SAFE AND SOUND CONDI i�1N — �- 4 EXTERIOR SURFACES SHALL BE MAINTAINED IN GOOD C1IAEI F 13' �.�..0@I'D F�"'fiC�1� �"7Td�,1•"+h1E".�" tl7!3" IC3ETaP�"D[T:Y�E,a�LS"AAW"C_., 1.-... .__.y k.-- pp� TO DETERIORATION SHALL BE TREATED WITH A N _PROTECTIVE COATING OF PAINT OR OTHER PRESERVATIVE. Rem Inspected by -_Date of Ins -NNE 26, a AUG 12, 1991 Time start 9:00 — end 9:30 am _1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23370 Date NOVEMBER 23, 1994 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 19475 MAIN ROAD MATTITUCK, NEW YORK House No. Street _.....-_. __ Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 8 Subdivision _ Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 3, 1992 pursuant to which Building Permit No. 20417-Z dated FEBRUARY 5, 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued isPORCH ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING m_ AS APPLIED FOR. The certificate is issued to JOAN P. HILLIARD & UBALDO GONZALEZ (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-333177 - NOVEMBER 10, 1994 PLUMBERS CERTIFICATION DATED OCT. 11, 1994 - HARDY PLUMBING & HEATING Bui 'ili.ng Inspector Rev. 1/8_l a„ "w 0 , ii ., di+ 0 d s 0o Ar�J S Ln ^� 4 tox 6 a0. w a (`..... q �y do t "7 rw qw hn „ . c.. S. 125.00' � cr Q N E. N tbz a rt a 9 co � w o Ca p to Q7 LLJ J ! I a ;" w _ of o wcy o ►_- ,s� Ra t7f^ z " .2 d W125.0d z coa. we y;v x T t - 12 5.G c +r x ! Qui 4u erer _Others ;`r QZm P "oz`" y�, r ^ a- ��kr 'C ��a� 6��`"l f � ""��I� a4„•w�^7r rsw. a r xwa � ., • , � du "� d 9.. w tw� �«; � ' - w.. � ".. CL .1 1 Lq TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER VILLAGE DIST.I SUB. LOT FORMER OWNER N i ACR. evy „ S W TYPE OF BUILDING - i i SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND {MP_ TOTALE REMARKS m f t t g t b m = , L AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARP'_. Acre Value Per Value Acre Tillable I Tillable 2 f Tillable 3 Swampland FRONTAGE ON WATER L_ Brusnland i FRONTAGE ON ROAD — g House Plot DEPTH .. BULKHEAD i Total 1 DOCK b i _ 4 F COLOR I i -- m— _ I _ 1 RIM a _ a R _ j I e� x s , f m: M. Bldg, _ - - Foundations Bath Dinette i _— - t 'Basement I � K- Extension Extension „¢ Ext. Walls nterior Finisl Extension e Place j ec. Type Roof i Rooms l st Floor BR Z SL Porch Recreation Roo 1 Rooms 2nd Floor i FIN. B i Dormer Breezeway Driveway I - - - Corcge I Patio I O. B Total — t, f . ° rd M, N o o °+ ID (DrDw � 0 c °r N CD v cn Q O O o a Ep O 3 CD O1 CD- CD o K let m n' <. O ol ccn zy X S cn Qcn �• 0_ N V z � O M Q CD 0 .0 O wow �+ CCD (D ro O O O O O CD ~ (� rD s (n CD r+ ell � * 0 0 0 3 � Q N 0(D CDd n o n� m Q-CD CD a ce — n h � N C)- CDCL O c C7 rD Q =3 m CD Q s CSD c C 0 O C� 4�1 ~ m < cn c� O O c Fn 0 tFQC.,� „ Town Hall Annex SOUTHOLD TOWN 54375 Main Road PO Box 1179 Southold, Z-- Rental Inspection NY 11971-1179 w O �w Tel: 631-765-1802 Q` µ Fax 631-765-9502 wm . % -12 y%?Jl,1F✓ l%N% /// �i //r/J///,/,////i %/i/�rrr,, r1irr,6r, _�� l J7/ %` Y/ ' � 'i/%�f S $ CII%✓ ,,//i,ir,///r�,ri,%/, ...... f/ I/!o lddr $s� � lale� torn' trete %D10,IiU/riJlOr01G%!ri//r LEVELS Smoke Detectors (# bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits'(# 'f / fir!//i�� r%f/�// ///��1!. ✓�i%%/� ii iii�j/�ii�% � /i%'/��i j �o'%%rr / ......BEDROOMS Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows) ,(Y/N) BUILDING SYSTEMS (Y)N CONDITION OF PROPERTY N Heating systemmaintained/operational Building Interior is clean/maintained Hot water,system maintained/operational Building Exterior is clean /maintained ` Electrical„system,maintained/operational Property is clean/safe/maintained Mechanical system,maintained/operational Handrails&guards present POOLS 1 POOL BARRIERS Y/N Pool present Pool is completely enclosed Pool, surface alarm and/or door alarm Barrier is a min. 48”high resent POOL GATES Y/N All openings in barrier less than 4" Self-closing, self-latching Max:2" clearance.@ bottom of barrier Latch°on pool,side of gate, meets height Barrier capable of being locked&child- requirements"'',, proof when unattended COMMENTS: 7