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Home My WebLink About1000-140.-2-15 _g z TOWN OF SOUTHOLD Rental Permit jV 0121 Owner 5350 CR 48 LLC Occupied as Single Family Dwelling Located at 5350 CR 48 Mattituck 140.-2-15 Maximum Permitted Occupancy 7 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. 3/18/2024 Code Efo ce e t Official This Notice must be posted by the main entrance at all times t � I SOI TOWN OF S cow 631 ?8T-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O [ DATE INSPECTOR Town Hall Annex qw Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 e= ; Southold, NY 11971-1179 ° ► `�M"�" Tel: 631-765-1802 `SCTM# /` D / Date __,�..w... , _.... i. ... .. �,R��. �� _. ... _ �. ..... _-.W .. �.----- o.. w � � Owneri ,. Phone... ... _.._.,, .. _.. _m. .. ..._ ...__.G .. _. ..._..__.w _..., .. _w .__.... ww a .. [Address Visible _.. .,� .r! - Inspector Hamlet. .. ... ... .. .. ._ ..._._ ._.- _ . ...... ,._ ............... ....... M Floor Level Quantities _ . 1 Sub ,....... Smoke Detectors not located in bedrooms . ..�� w��. w Carbon Monoxide Detectors _..,,. ..t._....a. . _1 t Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress .. -_..---- �.....w_ Occupant Count BuildingSystems Maintained &OperationalCondition of Property mm.! Heating [Building interior Q Hot water 'Building exterior .. ....w......��. .... ..� .._ _ ��. .,._. .w..... . Electrical Pro p arty clean, maintained&safe 'Mechanical Handrails&guards installed&secure Pool SafetyPool on Site !Surface water alarm Date of CO issuance f Door alarms Pool completely enclosed �..�� ....� . _.�,..� . �_.._..�. .. . ... ..... .�.. ._.--�,� ��w�a.W......�� .. .�...�.. .. Self closing/latching gates Pool fence t...._ fence o code requirements CO s for all items present Prior Rental Comments TOWN OF SOUTHOLDRental Permit z AP0121 Owner 5350 CR 48 LLC Occupied as Single Family Dwelling Located at 5350 CR 48 Mattituck 140-2-15 Maximum Permitted Occupancy 7 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. 1,2 1/20/2022 � --1-- �� Code Enforce� fficiai This Notice must be posted by the main entrance at all times Z / Town Hall Annex "CIS SOUTHOLD TOWN 54375 Main Road Rental Inspection PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 �0 1 " Fax 631-765-9502 :1u SCTM # � r „ vG Owner � aa gr Address Hamlet r I ' ,- o , Address vlslble� Jj„ r✓ �°�✓ LEVELS Smoke Detectors # bedroom detectors excluded Carbon Monoxide DeteoZo (#;). Fire Extinguishers(#) Exits (#) BEDROOMS a Smoke Detector Alarms (#) ° Carbon Monoxide Alarms(#) Egress(windows) (Y dN, ,✓✓r✓ <,a „ ,,, ON OF QRgP,ERTY. BUILDING SYSTEMS Heating system maintained/operational„ 000lni,OTi r is N n` mita ned ' " ' Builc(ingfenor is clean%maintained Hot water system maintametl„/operational Electrical system maintained%operationalr 9' Qp rtY ° Pr„ is cl ah/safe"j, ?"""o 'Mechanical system rn ihti«' tH,a o a M y, r o a ,Presentm , �Y^^""WW�� p E ,,,✓ _P�kk.FLq.� r� X71' /✓ �%`lo)I�or i✓�� i 9n ✓, < ry+N�t if r✓✓ �f//rar' i 1 49e 1N � 7. i' 0 Pool present G ✓ pool is co„ ia(a enclosed ' Pool surface alarm and/or.door"alarm8,high �t Barnerts a.mm resent POOL GATES Y/N A)I openings inybarner less than Self-closing, self-latching ` ' Max;2" clearance @ bottom.of barrier Latch on pool side of gate nts height Barrier capable ofei � ckpd&child- requirements prwhen, neded COMMENTS: r TOWN OF SOFT 0L Rental Permit iN Permit No. 0121 Owner 5350 CR 48 LLC Occupied as Single Family Dwelling Located at 5350 CR 48 Mattituck 140-2-15 Address Village s/B/L Maximum Permitted Occupancy 7 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. 7/23/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times 30/1 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765- 502 P.O.Box 1179 Southold,NY 11971-0959 , ` Zr BUILDING DEPARTMENT TO Off" OVITA RENTAL P'ER'MIT APPLICATION �s in t IFee$200 (Appi�axtion must be �°e�ae�red every two years) Section A Property Information: Rental PropertY.Addres /; C , � C4 tic, Tax Map Number: 1000 SECTION - -LOT dd I " R LI ; 1 SEC71ON P. OWNER IIII NFM"MTION` Property Owner Name: LC- Property Property Owneer Lai U Addre' s's:, ;1Pr6pertq OwneeW Owner: ailing Address: C S,B mo L a.., 0. 0.164y, 78 k -11 `^ Telephone Number Cs) Daytime Evening_ � Emergen Property cy �i Owner Email Address: (2 0 -7L Page 1 of 5 f 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 HO Section C. Authorized Information: Name of Authorized Agent of dwelling unit, if any: 0.� nor + r v Address of Authorized Agent (no P.O. Boxes): q 1.5 ,tea gC �+ Mailing Address of Authorized Agent: m0. 78k CA'at%,qa e N• • t k l O 1.2- C t Telephone Number(s): Daytime -15'66 70 [nC �i!rgen+ y � o . Email Address: Q�D S. rATCS E — : P Se tion D Maua i geint IIIri�io' rl°natio m' - Nairne of Authorized Agent of dwelling unlit, if any: GC.. We Address of Authaflzed-Agent-(-no P.O; Boxes) Mailing Address of Authorized Agen�0 -6, 7 " �G G 76 Is Telephon e urnber(s): Daytime_ ,Evening Emergent Email Addes � , � SECTION E. Sn III;: ( IIImINIOIhll `ION: (required for rperties containing 8 or more rental units) Name of Managing Agent of dwr .unit, if any: Address of Managing Agent (no P.O. Boxes):< Page 2 of 5 Town-Hall Annex., Telephone(6..31)765-1802 5.4375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 BUIt.. INP;DEPARTMEiiaT TOWN OF SOUTH6LIP Mailing Address of Managing Agent: �a. " `�� N<N 761.21 Telephone Number(s): Daytime " .Evening_: Emergent y t ,. . 1: mail Address , A. �� rr w r, e SECTION F. PROPERTY [3E t IPTION: Number of Rental (Dwelling Units on property4 � ��- 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.. s Folr,dpf operties�with multiple` erit l Dwell.ing-Units use:".Rental.Perm it"Applicat on" Rental Dwelling Unit Identifier: P Requested Maximum number'of perso"n's"alloWe Dellwrlg On Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit:: . ._ w' Page 3 of 5 i Town Hall Annex Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1 179 � Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD SECTION G. INSPECTION: Pursuant to the.Town:Code of the Town of Southold. -7, ,(Recital Pfoperties), 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_:B ildi.ng;Co.d.e,Certification is.required stating that,the.pro.perty which. isthesubject 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,Suffglk,.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. . L,. . o'f S-ou��: oid c�. ti�fu�r°at,le a f��u°�� fr� o�mri iie'en se(i , d I aur �su.�7q�niiti�n� a comps eted� owo�. _ • { F111 chi'(e:ct o1' 'a hce9"Vsed profs°srw' onai engin1"er�, SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) cztir- certify under penalty of perjury,the'fog. y Ili:6 1. 1 am the owner of the property identified in Section A of thf ,,; pplcat�or�; i 2. The property owner's legal address set forth in "Section,R" of this ap,i5poi s py legal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 r Town Hall Annex Telephone(631):765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 1 BUILDING DEPARTMENT TOWN OF i$OUTHOLD applicable laws and rules. I further acknowledge that I will notify the Town of Southold ' '9dil'-ding Department of any changes of address within`five (5)days of any changes = A thereto: 3 i have read and received a cbpyof Chapter 207'of the Code of the Town=-of 5outh'old,and 1iree 'to abidebythe 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,', p ' Pro ertYOwner s-Name: Property Owner's Signature: Sworn to before me this day of 20J 01,011 1117 IPA' w.. ficial blot y Public Signature d Original Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NOn 01 CDWS306900 4 UALIFIED IN SUFFOLK OUt:ITY COMMISSION EXPIRES,JUNE 30,2029, Page 5 of 5 `4L4C 1 I qo Z l ,<00,TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ]j FIREPLACE & CHIMNEY [v�F'IIRE SAFETY INSPECTION [ ] FIRE RESISTANT'CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING Now ),I Qw :�ry :�r_ 1 'v !I DATE • INSPECTORaf- - o -Tl F'N Sp4 � F ^�1 r ou�,mw� 1 9L 75; 17-7'r-\t NQ7 �c�ur e Lt 9 d w 1,4c..-_ SSS b Crit y 8 G L C. Q0 I U �d ti lL ►— 3 spa.. '� ate-- oo a 'I I � k f 1 1 t i r 1 I ,r w k; mo -n Z > rn C, 0 M!, m .3 CL m Ln (D uj 06 G' >E- (D 2 1) �:, r �, ,,, r- U) i ZU) -Ti o W CD ...... .......o neo ...... 'Ti m T'L M Jul m 0 0 T' Z we :mr Ln G) G) m m 0 m m LA Lp CD -------- -n PU "V ol -n m 0 181L ;mu M (D co < C: F I o r- 0 (D CD Z C5 G) (D O ........... -n O 0 < CD m m m IMM m X ;mo 0 0 z z m m 0ub yy ----------- zn, in CD cy 03 -------------— CU —I O d Gl 1 0 0 x O fl C n m t�Dl O p M N S X „;y„ '�„ 7 7 N to // •" W W 0 0 ... ...�.�. ..° ... � ........ NH Gdp ryM � � LL Viµ, (l it � T' f� � wv•,�" all✓.,r i ��«w �f %/�i/ ` 0�„1� � � � ``�� fr„ /� /�/ r� n✓nib ��. 1�� 1 vCPl .. o T —...W d" O (D CD rO ...._ ,a.,. .�, �, _•..�,..._°....... _ O 00 0 0 � rt O \\ I ys .._...,u ... 1 :�u O 7o 7 Z O O p —• .+ S { N rt �• N — — — to an O — 'p 3 . T T to � il9l — T .... . ..... r y.0 r— i ., �,__ � ry•—. _ ._.. ..._.. .—. -........ _. ..... a ..-... .. .. . ° , �.,,.... .. �..... .,., —.._.- l JEL.., TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YOPK CERTIFICATE OF OCCUPANCY No. Z12269 NONCONFORMING PREMISES February 16, 1984 THIS IS TO CERTIFY that the Land Building(s) Use(s) located at 5350 County Road 48 Mattituck Street Hamlet shown on County tax map as District 1000, Section 140 , Block 02 Lot 015 , does!,not)conform to the present Building Zone Code of the Town of Southold for the following reasons: the property has insufficient area. The dwelling has an insufficient front yard setback. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming bF/Land Building(s) /_/Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as followsx a private one-family dwelling with accessory garage in the rear yard. This property is located in the 'A' Residential-Agricultural Zone. The Certificate is issued to ROY L. WINES, JR. & VIOLET A. WINE (owner, of the aforesaid building. Suffolk County Department of Health Approval no record UNDERWI�ITERS CERTIFICATE NO. no record NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z--23466 Date JANUARY 23 L995 THIS CERTIFIES that the building ACCESSORY Location of Property 5350 COUNTY ROAD #48 MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 140 Block 2 `Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 9, 1994 pursuant to which Building Permit No. 22482—Z dated NOVEMBER 21, 1994 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 AN ACCESSORY STORAGE BUILDING IN THE REAR YARD AS APPLIED FOR. The certificate is issued to GARY & GAIL DOROSKI (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED _N/A � Buil ing Inspector Rev. 1/61