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Home My WebLink About1000-107.-9-7 z TOWN OF SOUTHOLD 3 Rental Permit Permit No. 0083 Owner Sing Inman Occupied as Single Family Dwelling Located at 3725 Wickham Avenue Mattituck 107-9-7 Address Village S/13/1- Maximum /B/LMaximum Permitted Occupancy 6 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. 6/19/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times ,_j UW Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 re �� EC FINE i BUILDING DEPARTMENT 2 201 TOWN OF SOUTHOLD )( "� RENTAL PERMIT APPLICATION �.R 'k:`� TOWN g k')': Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION d L -BLOCK 07 -LOT_,0 0 �= SECTION B. OWNER INFORMATION: Property Owner Name: kq 1-n,017 Property Owner Legal Address: Property Owner Mailing Address: 'q ceye)7o e�'z f Telephone Number(s): Daytime Evening- Emergency f Property Owner Email Address: �� / �G�✓ 5 '9 (2ec—?vwc) Page 1 of 5 ,4f S ' 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 TOWN OF SO FOLD Section C. Authorized 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): Daytime Evening Emergence Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent{no PO. Boxes). Mailing Address of Authorized Agent: Telephone Number(s):Daytime. Evening Emergency. p 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):. 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 TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime. Evening. Emergency Email Address: 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, Q 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 ,o , a I Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: t�2' Number of rooms in Rental Dwelling Unit: 19 0 -- Use and Dimensio s of ach rao Renta ,V r q Dwelling Unit- .... , . G Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 l79 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 licensed architect, a 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 ❑ 1 am submitting a completed Towyn of Southold certification 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) j certify under penalty of perjury, the following: 1. 'I 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 x address and I understand the Town will use the address for service pursuant to all Page 4 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 TOWN OF SO OLD 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 Cade of the Town of Southold and agreed'to abide by the same. 4. I will notify the Town within five(5) business-days as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: �22 Property Owner's Signature: T- Sworn t efore mLthis� ay of 20 i Official Notary Public Signature and Original Notary Stamp `F �f. Page 5 of 5 a Wt Vol. � TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST "[ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ], INSULATION'' [ ] FRAMING /STRAPPING [XFIRE INA444 A�w�FIREPLACE & CHIMNEY [ SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: TOWN OF SOUTHOLD BUILDING 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ]�MNAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ]:ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAU ING MCA REMARK i S S �- «/ � VDAA)LA Ap l ✓ &k 1 DATE INSPECTOR NVIdNVHs Aq ufilsao,ale3s of jo hexa aq of paaluelen6 lou,q alewlxaldde ale sluawajnmw Ild'jallas aql to uolsslwlad g3lm aoualuanuo3 jq papinad sl lI'samleapS—nAnils fiupspoa jo uopewlxojdde ue sl ueld joog slyl I 58l�; Y�M'w lxr 'hi �V,� ; izvpLn s iu r a4 „y 1. ll f ml " r LL O O Tw , VJ N"dNVHS fq u61sap ale3s W io 33exa aq W paalueien6 lou v alewixwdde we sluawainseaw pV-tapas atp4o uolssIuued ipµn aaualuanuo3 loj popMad sl lf'saimeei q sajnmi4s 6u.ggxa jo uopewlxoadde ue sl uejd loot'sjql ..._ ., ... r_.:.... . i - o Ll r,ala i I'I . 1i I I d O 0 c N o o CO =1 _I .�� Z m c N o °o o y �' Ouw f. w m s 3 Q a- o °� a- ,„„ ., Z o' Z N p A O o 0 rn Zs O D r —c m — -I � r � I ro Z o r” Ln Z cn m Q H m an < D A STM., 0 0o �,1 C Z �\ C m \ m ' m , _.. .i.. _._ __.�..�. .. .e._ " OJ 'il T 0 � i0 7\ z 7\ r �.R � n O O F .. � � � o i Ln w,� r IJ"T IIgII�� CCC T .... a O Imm �r p �Zk Z � r w ww � ark„ O E a' d`"V mei r4.I • Z ICIII)l y �m Vlra N „,w _. .. L E° L LL w C N I O ,...� H qn En — +, Via.+ f it 4 1` _ O I a n lie CR 02 LL O — 0 00 t� 3 Su _m a 0 uk ti pµ. u �II I o u OII <<h d �4p 9111 i r m v i .N N N v — m O 12 Q p W ►+� 2 m C7 n Q FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z 1 1 121. . . . . . . . . . Date , . . . . .Au$us t. 9. . . . . . . . . . . . . . . . 108 THIS CERTIFIES that the building=. . J.? ... . . . . . . . . . . . . . . . . . . . . . . . „ » „ , „ . , , , . . , . . . Location of Property 3725 . . Wickham AVenue , . A Mattituck . House No. Street Hemet County Tax Map No. 1000 Section . .197. . . . . . .Block q9. , m . , , . . , .Lot , .CC7. . . . . . . . . . . . . Subdivision . . .X. . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. X . . .Lot No.X. . . . . . . . . Requirements for a private one-family dwelling built ppior to conforms substantially to theMiSZit[!Crd'ated Certificate of Occupancy 195.7 . pursuant to which ding fermtit No. .Z 1.1.1.2 I. . . . . . . . . . . . dated . .August 9 . , . „ , , 19 8.2 ,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 a, private one-fatly .dwelling and detached one-car garage. The certificate is issued to . „ „ „ , . . „ , , . . ,Annie, C. . Daly , (osntwvn(+ of the aforesaid building. Suffolk County Department of Health Approval . , . . . . ?? r. . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . .. . . nir. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev.1/81 BUILDING DEPARTMENT TOUN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location ;22, Wic chain Avenue Mattituck (numoer & street) (Municipality) Subdivision clap No. Lot(s) Name of Oivmer(s) Annie C. Daly Occupancy'_ 11-1 unoccupied type) -7—owner-tenant Admitted by: Florence Sinit Accompanied by: same Key available Suffolk Co. Tax No. 107-09-007 Source of request Gary Flanner Olsen, Esq.. Date DWELLING: Type of construction wood #stories 2 Foundation cement block Cellarpartial Crawl space rest Total rooms, lst. Fl q 2nd. F1 2 3rd. F1 Bathroom(s) 1 Toilet room(s) 1 Porch, type wood open Deck, type Patio, type Breezeway Gare,ge Utility room Type Heat__Qi fared 'farm Air Hotwater X Fireplace(s) No. Exits 2 Airconditioning Domestic hotwateres Type heater tankless Other - ACCESSORY STRUCTURES: Garage, type const. wood, one-car Storage, type const. Swimming pool Guest, type const. Other 11I0L,:TI0NS: Housing Code, Chapter 52 S,,ocation Description Art. Sec. kitchen gaa�stove--2o :phut off p `- °� garage door needs fixingIII !;12-30-A, Remarks• Inspected by: /d mate of Insp. 8/5/82 Curtis W. Horton Time start I 15 end 11 :,-3H FORM?d0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .. .. : :........... Date ................ ........... .. 19..62.. THIS CERTIFIES that the building located atd�.....� gK4T.4..A" "! :.... Street . ....... MapNo. ......Aj!t........ Block No .......A.*..k....... Lot No. .... ...... .............................,.................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ?.,...•........................ 19..§;� pursuant to which Building Permit No. ,.„ 2 dated .,•.....»:....� ». .•.. ...,•...•»••»•-.......••••. 19...A2 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 ........ ..... ............................................. ........ .„....„.„ „»„.,... The certificate is issued to .........„.,........,.........4�l4<2X90..RfA.-PAI1OY.....A'PAINN................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector 1 FORK NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION[ OF THE WORK AUTHORIZED) N° 1742 Z Date ... ..... ...... ............ ,,.. ..��...,..... 196'2... Permission is hereby granted to• StanleY' Sepkb ----A/f, .Gw0.., .ey,..... .......... tIry k. . ............ ......................... to ... dwell-Ing. .......... ........ .......... atpremises located at _]VfJ-•ftdrda.'8--ft08d.. ... ... .. ......... .. . . ..... ............................................... ......... .. ............... ............... ....... ..fttU k... . ........ ... pursuant to applicotion dated ...................................A�aY . .... .......19..62., and approved by the Building Inspector Fee $. . ................. Building In.sp6tor