HomeMy WebLinkAbout1000-106.-11-16 -
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Rental Permit
1% j - 0082
Owner 1400 Bayview Ave LLC
Occupied as Single Family Dwelling
Located at 1400 Bayview Ave Mattituck 106-11-16
Maximum Permitted Occupancy 2
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.
7/28/2021
Code Enforc7ffra Official
This Notice must be posted by the main entrance at all times
SOUTHOLD TOWN Town Hall Annex
54375 Main Road
� Rental Inspection
PO Box 1179 Southold,
NY 11971-1179
"O Tel: 631-765-1802
w.
Fax 631-765-9502
SCTM # �U
Date, , , Z
Owner. (/l2 Phone S 3 I b
Address : Zip
Hamlet 0J inspectoe1
liligill''i 11 ill,i
Address Visible„from street? j
LEVELS S.UB 1 2 3
Smoke Detectors (#- bedroom detectors excluded)
Carbon Monoxide Detectors (#)
Fire Extinguishers(#)
Exits (#)
BEDROOMS 1 3 4 ' 5
Smoke Detector Alarms (#)
Carbon Monoxide Alarms (#)
Egress (windows) (Y/N)
BUILDING SYSTEMS CONDITION OF PROPERTY /N
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 l POOL BARRIERS Y/N
I
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
SIEMENS! limil;
COMMENTS:
to iva�eur
vieal4ve,
-If 161
-71J �121
v
TOWN OF SO THOLD
t4'
Rental Permit
PermitNo. 0082
Owner 1400 Bayview Ave LLC
Occupied as Single Family Dwelling
Located at 1400 Bayview Avenue Mattituck 06-11-16
Address Village S/B/L
Maximum Permitted Occupancy 2
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary anc 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 nspection.
6/13/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
Town Hall Annex hone(631)765-1802
�� � 7 Telephone
54375 Main Road Fax(631)765-9502
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Prop A r ztr
Renta o e (,—t L C tz
Tax Map Number: 1000 SECTION 1067 -BLOCK -LOT—A?--
SECTION
OT- -SECTION B.
OWNER INFORMATION:
Property Owner Name:, P
Property Owner Legal Address: Property Owner Mailing Address:
i"
Telephone Number(s): Dautim e ,,°- 7 & Emergen: /
Property Owner Email Address. � , .. °� ��i c W f�
Page 1 of 5
son
Town Hall'AInnex Telephone(631),765-1802
54375 Main Road �
Fax(63f)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
BgIILD1NO DOA! TMgNT
TOWN"00'sibUTHOLD
Section C.
U h irl a 'A nt.Informtion.
Name of Authorize ' Agent of dwelling!unit, If any: b�.,;, ,,, �^
Address of Authorized Agent (no P.O. loxes)., 16 / 7
G1 l
Mailing Address of Authorized Agent:
Telephone Number(s): EM,erg nN,
-7 aLjj,,01jnj'
Email Address. w
Section
Managing,Agetiit Illlnforrnat n:
Name of Authorized Agent of dwelling unit, if any:
Address of Author ted Agent (n6,P.O. Foxes)':
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime. Evening Emergency
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SECTION E.
SITE MANAGER,INFORM, AT,l!l K: (required for rental Properties containing-g or more recital units)
Name of Mana �
g ng'Agent of dwelling u.n�t,,if!•any: "
Address of Managing Agent (no P.O. Boxes):
Page 2 of 5
Town-Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
BUILDING DEPARTMENT
ENT
Mailing Address of Managing Agent: .
, � dzl6-976 '
Telephone Number(s): Dayrt e 7., E'venin Eme genr
Email Address:
w
Ij
Number of Rental g Dwellin 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 Urlit `
(for example, 'Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensionsofeach
roomo . �a
For properties with multiple Rental Dwelling Unit5-use'°"R ntal Perm t.A.plio tion
Addendum."
Rental Dwell`un g Unit Identifier:
_
_ ........ ._.....
Requested Maximum num r o persons a Iowe-dk0_-0_ we I In--g Uniter °
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit
LA
�� �► �,,
,
Page 3 of 5
o
Town HallAnnexTelephone(631)765-1802
54375 Main Road 'Fax(631)765-9502
Y.O.Box 1 179
Southold,NY 11971-0959
�VIVY
BOLVi'NG DEPARTMENT
TOWN Off' S 146
SECTION G.
INSPECTION;.
Pursuant to°the Town Code ofthe TowaofSouthold:C-haptRr: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 licensed architect, a licensed ,
professional engineer or a home inspector who has a valid New York State Uniform Fire
Prevention-Building Code Certification is *equhdd statingthat,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 hekopnty-: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
0-I'l am s-v.bmitting a-completed Town,Qf.�outhold.derti.fio-ation form;from::a licensed,
architect or a licensed professional engineer:`
SECTION H.
DECLARATION: signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK) -
I (TfiId m certify'l�ndel penalty of perjury,the following:
�
1. 1 am the ow . r of t e property identified in "55t1on thisfthis application.�
e
2. The property owner's legal address set forth'in� Section B` of this a pllcati6n 15'my legal
address and I understand the Town will use the address for service pursuant to all
Page4 of 5
k
ap
Town Hall.Anr�ex: Telephone.(631)r765-1802
54375,Main Road Fax(63l)716 a-9502
P.O.Box 1179 „
Southold,NY 11971-0959
BUILDING ITAR"t'MI N,T
TOWN OFO 040
appkaaWe Oa ws air�d4 oVe s^ Q fiArtl er ackrm wrledge tfm t @ WH rT 6fy tAa e,
Departrn&A (5) of any
°d i
3,' VI,It vvle read i,§, >d j Y copy of haptel) Q07, Code:,,)d'4t"le Town of
+d l il�Gd
4, -U wN �,Gotify the Town Mthin five business rays as to any change
to the
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u� dx�ru�9�aw����o�����o�o���'�a�a� a�t:g �w�Va�uY�arr ,00Uir�� �:uw��� � e���„ ��Il��irY��uu��e�ra.
Property Owner's Signature:
1 ._.:l�.i _ 1� jY j4 ^ y^ .: X~
Sworn to before m h'
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Official ' i ture and Originai Notary F�tamp
A ES R.WALSH
O"TAIL dLdS,LN , Butte pI New o
No. tl1 WA6bb1262'Suf[a Jc Co my
°on lisslon Expires
Page.5 of 5
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Towo Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
CA
P.O.Box 1 179
Southold,NY 11971-0959 �
BUILDING DEPARTMENT
TO 'OF" D 0. OL
RENTAL PERMIT APPLICATION ADDENDUM
Rental Dwellin,g,Unit Identifier,
Requested maximum;;nu'mber,-of;.ersons allowed-to occupy each.d,welling unit:., .
Number of Rooms in Rental Dwelling Unit: „
Use and Dimension of each room: t
a a
' r
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:,
Number of Rooms in Rental Dwelling'Unit
Use and Dimension of each room:
w
Rental Dwelling Unit Identifier: i
a
q -w -
Re uested maxim`m puma er,p, Pplin sUnit we t occupy ea b�we _ J
Number,of Rooms n Rene p g - ;
Use and Dimension of ea- irooir: �
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' TOWN OF SOUTHOLMOUILDING DEPTu
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] I L
[ ] FIREPLACE & CHIMNEY j FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
MARKS:
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Town of Southold 6/13/2019
" w4 53095 Main Rd
Southold,New York 11971
E EXISTING
CERTIFICATE OF OCCUPANCY
No: 40445 Date: 6/12/2019
THIS CERTIFIES that the structure(s)located at: 1400 Bayview Ave,Mattituck
SCTM#: 473889 Sec/Block/Lot: 106.41-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40445
dated_ 6/12/2019 was issued and conforms to all the requriements of the applicable provisions of the law.
'The occupancy for which this certificate is issued is:
wood frame one family dwellillg yj!hx rxnf died bas rnent and glass cncicsed parch.
Note-, BP 43116 "as built"alterations COZ-40444
The certificate is issued to 1400 Bayview Ave LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
_. - Aaa h i Signature .........
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1400 Bayview Ave,Mattituck
SUFF.CO.TAX MAP NO.. 106.41-16_ - _.._. . ...SUBDIVISION:
NAME OF OWNER(S): 1400 Bayview Ave LL
OCCUPANCY:.
ADMITTED BY:................-_ .�. ...... ....�. ... ...�� .....
SOURCE OF REQUEST: 1400 Bayview Ave LLC DAT 6/12/2019
DWELLING:
#STORIES: 2 #EXITS: 1
FOUNDATION.- cement........... -
• block CELLAR: partial CRAWL SPACE:
2 TOILET ROOM(S):
....._ UTILITY ROOM(S):
BATHROOM(S): �.
PORCH TYPE: glass enclosed DECK TYPE: PATIO TYPE:
BREEZEWAY: — . ..,_ FIREPLACE: — I G....
.-.... ARAGE:
DOMESTIC HOTW TER: yes TYPE HEATER: AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: HOT WATER:
#BEDROOMS: 1 #KITCHENS: I BASEMENT TYPE: unfinished
..... ........._ .
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:
SWEVIMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/10/2019
TE%1E START: 9:55am END: 10:15am
sd11t Town of Southold 6/12/2019
P.O.Box 1179
CID 1 53095 Main Rd
, �;.' Southold,New York 11971
CEWrIFICATE OF OCCUPANCY
No: 40444 Date: 6/12/2019
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 1400 Bayview Ave,Mattituck
SCTM#: 473889 Sec/Block/Lot: 106.-11-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/26/2018 pursuant to which Building Permit No. 43116 dated 10/9/2018
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 built"walteration to an existin one fam-ily dNyelline as an allied for.
The certificate is issued to 1400 Bayview Ave LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43116 5/23/2019
PLUMBERS CERTIFICATION DATED 1/31/2019leWal w.
lath rl ed l` tgnature