HomeMy WebLinkAbout1000-97.-9-9 �3
TOWN OF SOUTHOLD
Y Rental Permit
tk
� 0084
Owner Jonathan Baker & Sarah Mastracco
Occupied as Single Family Dwelling
Located at 3015 Skunk Lane Cutchogue 97.-9-9
Maximum 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.
6/2/2023
o6eErye a O_ cial
This Notice must be posted by the main entrance at all times
D NG DI
TOWN OF SOUTHOLD BUIL
831 ?85► 18 2 ca(I
'l
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INBULATION/CAl
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
I l FIRE RESISTANT CONSTRUCTION [ ] IRESISTANT'
I l ELECTRICAL (ROUGH) ] ELECTRICAL I
I ] CODE VIOLATION ] PRE C/O
n
Town Hall Annexi � Telephone(631)765-1802
54375 Main Road "P' xt(631)76" 9502
P.O.Box 1179 w 41,3
Southold,NY 11971-0959
Y
BUILDING DEPARTMENT �rti
TOWN OF SOUTHOLD ,
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
!rof i real seal re cq rd ec fc�r architect or n ineer licensed borne ns ectorr rause prgtgLde
g9py of valid current cerci ication
Rental Property SCTM Number: 97-9-9 .
Rental Property Address: 3015 Skunk Lane Cutcho ue NY 11935
Owner/Name: Jonathan Baker and Sarah Mastracco
Rental Dwelling Unit Identifier: 1
Number &Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.)
Bedroom #1 - 132 SF„ Bedroom #2 - 164 SF, Bedroom #3 - 130 SF
Property Description (Include all improvements indicated on survey)
Two story sin le famil detached house with existin barn detached ara e
and garden shed.
No change since last rental permit 0084.
1 certify that I have done a physical inspection of the subject rental dwelling unit and find that it
fully complies with all the provisions of the Code of the Town of Southold,the Residential Code
of New York State,the Building Code of New York State,the Plumbing Code of New York State,
the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New
York State.
Jonathan Baker, RA (Owner)Owner oLEO A/7
( , , -6L
Print Name and Title �� '" Original Signature
Please place professional seal:
TOWN OF SOUTHOLD
Rental Permit
ZA
0084
Owner Jonathan Baker & Sarah Mastracco
Occupied as Single Family Dwelling (date corrected 8/21/21)
Located at 3015 Skunk Lane Cutchogue 97-9-9
Maximum 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.
6/15/2021 John Jarski
Code Enforcement Official
This Notice must be posted by the main entrance at all times
CTOWN OF S
r., crr 765.1802
a .
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL R&��
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
i
--own-
INSPECTOR
TOWN OF SOUTHOLD
Rental Permit
s Permit No. 0084
Owner Jonathan Baker & Sarah Mastracco
Occupied as Single Family Dwelling
Located at 3015 Skunk Lane Cutchogue 97-9-9
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
rp-
kHallAnnex �� Telephone(631)765-1802
aint �;, Fax(631)765-9502
If �i r...
P.O.Box 1
Southold,NY 11971-0959
rJOWN,OF$OUT"'
" "
BUILDING DEPARTMENT
TOWN OF SO TDOLD
RENTAL PERMITAPPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION -BLOCK
SECTION B.
OWNER INFORMATION:
Property Owner Name: �"�` Vt,C'"
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number(s): Daytime&46- Evening Emergency
Property Owner Email Address:
Page 1 of S
�r w tl
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 how � 1
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SO 'OLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: AJ
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Evening Emergency_
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): Daytime Evening Emergency
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: /V
Address of Managing Agent(no P.O. Boxes):
Page 2 of 5
Town Hall Annex �t� Telephone(631)765-1802
54375 Main Road Pax(631)765-9502
P.O.Box 1179 � µ rre
Southold,NY 11971-09591
BUILDING DEPARTMENT
TOWN OF SO HOLD
Mailing Address of Managing Agent: NA
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, 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. w°
Requested Maximum number of persons allowed to occupy Dwelling Unit: 11 qf
Number of rooms in Rental Dwelling Unit: 10
Use and Dimensions of each room in Rental Dwelling Unit: �.
1
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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 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 flaws 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 Town 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)
c G` 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
Page 4 of 5
Town Hall Annex ° Telephone(631)765-1802
54375 Main Road � � �q� Fax(631)765-9502
P.O.Box 1179 �
Southold,NY 11971-0959
� o
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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 as to any change to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name: on �
Property Owner's Signature:
JDorn to before me this 111._day of Q , 20��
1
Official tary Public Signat r and Original Notary Stamp
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2L,0q,
Page 5 of 5
TOWN OF SOUTHOLDWILDING
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ FINAL
4
[ ] FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
i
DATE INSPECTORK 7/9,fo
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SURVEY OF PROPERTY
COUNTY,AT CUTCROGUE
TOWN OF SOUTHOLD
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SAMANTHA KIRBY
LA S 777ZE INSURANCE COMPANY
N CHASE BANK
AREA=49,552 SO. FT.
5. LIC. NO. 49618 I
ANY ALTERAPON OR ADD1770N TO SUS SURVEY IS A KOLAPON , P.C.
of SECnoN 72090£ THE NEW YORK STATE EDUCA WN LAW. � ;' Jd (637) 765 1x897
EXCEPT AS PER SECRON 7209-SUBD1WS10N 2. ALL CERMCABONS
HEREON ARE VAUD FOR IVIS MAP AND COPIES TNEREOF ONLY 1F P.O. -0 .....
SAID NAP OR COPIES BEAR THE)UPRESSED SEAL OF 7HE SURVEYOR 1230 ATA ?R r T:J'w LET
WHOSE NGNATURE APPEARS HEREOv. SOUTHOLD, N.Y. 11971
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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- 332611 Date: 09/0,9/QB
THIS CERTIFIES that the ®l DWELLING AND ACCESSORIES
Location of Property 3015 SKUNK LA CUTCHOGUE
.............. " .................. ...... .......
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 097 Block- 0009 Lot oog
subdivision Filed Map No. Lot NO.
conforms substantia-l-ly to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9,....-1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 33261 to SEPTEMBER 9, 2008
was issued, and conform to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ONE FAMILY DWELLING WITH PORCH, ACCESSORY BARN AND FOUR ACCESSORY
............... ....... ............ ,.,,,._,.,-m—------ ...........................--1-1 ----------------
STORAGE BUILDINGS.*
................ ...... ..... ..................
'The
ifs to is -issued to SAMANTHA ICI
. ............. ...........
(OWNER)
of the aforesaid building®
SUFFOLK COUM'Y
DR" AR7?MT OF HEALTH AP13ROVAL N/A
ELECTRICAL CERTIFICATE No. N/A
PLUMBERS CXRTIFICATION DATED N/A
....................
*PLEASE SEE ATTACHED INSPECTION REPORT.
-----------
ior-i.ze
mature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LXX2MOM- 3015 SKUNK LA CUT(MOGtIlE
SUBDrVISICK- NAP NO. LOT (S)
RAM OF Olom (S)z SAMANTHA PI
............. .......................-
OCCOPANCY: SINGLE FAMILYSAMANTHA KIRBY
........... -1111,11,..........
AWCrTTm
® jiLL DUNBAR AM'CWATrm BY:
---...............
KEY AVAILABIR: SWF.
® TAX MAP NO.: 97-9-9
SOURIM OF REG4JZS`r: DATE- —09,19kl0.D S
.......... .......... ............. ...... ............
DWELLING�
TYF8 OF CM.MTRUrnOff; WOOD FRAME STOPM&S: 2 0 zrm, 3
rMmmr1ov. BRICK AND CEMENT BLOCK CXLZM� PART CZAW. SPACE-
...............- ------— ..............
TOMAL PJXM. IST FT.R.: 5 2)bW FLR.- 2 3RD ELK.. 0
ONVUROMIS).- , -2.0 TOIINT FOON(S)® 0.0 UTZIrrr PtOON(S):
PORCH
® O TI
YES IMCK TYPE. FATIrm-
- -------- --------
F33XRPLPJM: NO GARACE-
lxmrp-STIC "ar"xrsR. YES 'TYPE HHATHR; OIL AIRC(MIMC1113M:
..........
TYPE 0.8 '= BASEBOARD WOOM AIXs R07VMFR YES
OTHER.
. .........
..........
ACCESSORY STRUCTURES:
GARACM� TYPE OF CKMGT.:; STORWE, TrM CG=r. 4 ACCESSORY BUILDINGS
SWIRMEW pcm.-� GUEST, 77M CONST..
QTHMw ACCESSUT4:1 FRAMEPARN (24,3 X 43.3)
......................
---------- ------......... ---
VIOLATIONS- CHAPTER 4S N.Y. STATE UNIFORM FIRE PR ION BUILDING CaDE
LOCATIONR IT
J)ESC IF TQ ARl'. SEC
REHAPK-1- RF- N PE Eta 9/3/08
......................
7RMSF7HC`T9D BY'-. LL. DW.TN ON INSFECTTM: 08
GEGRGE GILLEN 1111110 S ill"ART: LRD:
------ ............. .......--------
� Town of Southold 5/26/2020
P.O.Box 1179
...... ......
53095 Main Rd
0� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41156 Date: 5/26/2020
THIS CERTIFIES that the building ALTERATION
Location of Property: 3015 Skunk Ln,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 97.-9-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/19/2018 pursuant to which Building Permit No. 42897 dated 7/26/2018
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: ,
BARN REPAIRS AS APPLIED FOR
The certificate is issued to Baker,Jonathan&Mastracco, Sarah
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42897 03-09-2020
PLUMBERS CERTIFICATION DATED
v... it ori-ed signature