HomeMy WebLinkAbout1000-120.-3-8.19 TOWN OF SOUTHOLD
Rental Permit
0280
Owner Michael & Kerri Spieler
Occupied as Single Family Dwelling
Located at 145 Old Field Court Mattituck 120.-3-8.19
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.
8/28/2024
Code E o e ent oi�i
This Notice must be posted by the main entrance at all times
JZOW4�
f so
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
Apik
INSPr%;TION
[ ] FOUNDATION 1ST/ REBAR [ j ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ j ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ j PRE C/O [Pf'RENTAL
REMARKS: I -#aSc;
su if- �QL
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�AT� IN'�"rPErl fiO
Town Hall Annex
Town 8f Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
Tel: 631-765-1802
SCTM#
Date
Owner �, Phone
Address
.., �.. oC�....... Visible
_. .. � . ......... _....�. ... . . .. , ,..,,_. .....v
Hamlet
I_............. ......,.� . .......... a ...._... Inspector
Floor level Quantities ....... ..... ......... _....._ __...... ............ .... .......
Sub 1 2 3
�.. ( n bedrooms) . ...._._.Smoke Detectors not located,.'..,....... ,._.�..�._. ....� a _�,_ ._._._ ...__.... �a. .a� . .��... . ._.u��. .. .
Carbon Monoxide Detectors
_-..—.._...... ..... .... ..v.._. ........_.
Fire Extinguishers
........ ...�.....�aa
Exits
Bedrooms 2
1/
Smoke Detectors
Egress
Occupant Count _,.u.. + ...
Building stems S Mamtamed &0.
y Operational Condition of Property
Heating �.
Building interior
Hot water Building exterior
r Electric...aw�...�_�.,_..�....�_.... _w.. _ e. .............. Property clean, maintained me,.
d &safe
Mechanical Handrails&guards installed
& secure
Pool Safety Pool on Site
Surface water alarm ........Date of CO is
��. �..� ..���_�....�...�._�....P,._,... .......a�.�
suance of p„Ar
...w_ � .........�Pool completely....�
Door alarms enclosed
Self closing/latching gates Pool fence to code requirements
. ....... Pr10-.w. ...... ..
[C� or �m ,�. .
CO s f all items present � � r Rental � �. .rcm
Comments
I
i
TOWN OF SOUTHOLD
} Rental Permit
0280
Owner Michael & Kerri Spieler
Occupied as Single Family Dwelling
Located at 145 Old Field Court Mattituck 120-3-8.19
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.
6/29/2022
Code Enforcement Official
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD
Rental Permit
o �
yam' oo�¢ Permit No. 0280
Owner Michael & Kerri Spieler
Occupied as Single Family Dwelling
Located at 145 Old Field Ct Mattituck 120-3-8.19
Address S/B/L
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.
1/22/2020 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 11 971-0959
oqufffox
BUILDING DEPARTMENT
TOWN OF SOFT HO
SEP 2 5 2019
RENTAL PERMIT APPLICATION
rn j 11,I)V P
Rental Permit Fee$200(Application must be renewed every two years),,,-, -.y"';"
Section A.
Property Information:
Rental Pro
ert Addre -
car A4k
-hluc,
Tax Map Number: 1000 SECTION --LOT__?
11W
SECTION B.
OWNER INFORMATION:
Property Owner Name: r
Property Owner Legal Address: Property Owner Mailing Address:
I - !S\o)nnnav1 Av&
gpLV_kr,y1 ,e_
Telephone Number(s): Davtime. 0.4S(I
5_[ _ '&ening Emergency
Property Owner Email Address: r
Page 1 of 5
,;< Telephone(631)765-1802
Town Hall Annex s
54375 Main RoadCV3 Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
I BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION INSTRUCTIONS
Rental Permit Fee $200 (Application must be renewed every two years)
The items listed below are required to be submitted with the completed
application.
Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of
all smoke&carbon monoxide detectors.
Certificates of Occupancy and Pre-Certificates of Occupancy: Certificates of
occupancy or Pre-Certificates of Occupancy for each rental dwelling unit.
[7�Certification of Code Compliance(forth enclosed): Must be submitted by a
license architect or engineer or license home inspector if an inspection by Town of
Southold Inspector is declined.
[� Rental Permit Fee: $200.00
so
Town Nail Annex Telephone(631)765-1802
v=
« A1,1
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 t
<.�,z
BUILDING DEPART ENT
TOWN OF SO OLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytimevening 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:
Requested Maximum number of persons allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
�aDeh (91 ISS,
v
21-
Page
Page 3 of 5
Telephone(631)765-1802
Town Hall Annex
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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 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 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 l79
Southold,NY 11971-0959
F
BUILDING DEPARTMENT
TOV;N 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.
1�J I am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
❑ I 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)
1iC�aGC
certify under penalty of perjury,the following:
A i
1. 1 am the owner of the property identified in "Section-A"of'this ap lica'tion.
2. The property owner's legal address set forth in"Section`B"`of this`40p'li6tion is my legal
address and I understand the Town will use the address for service pursuant to all
Page 4 of 5
Town flail Annex Telephone(631)765 1802
Pax(63!)705'nJ02
54375Main Road
P.C".Box ll?9
Southold,NYl|97l-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
applicable laws and rules. Ufurther acknowledge that Iwill notify the Town ofSouthold
Building Department of any changes of address within five (5) days of any changes
thereto.
]. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and
agreed toabide bythe same.
4. |will notify the Town within five (5) business days as to any change tothe information
regarding Authorized Agent, Managing Agent, orSite Manager.
Property Owner's Name. ^
Property Owner's Signature: ^~-'
_
Sxvo tm before nnethisc >�*� ay of ZO/ �
Official Notary Public Signature and Original Notary Stamp
so
# TOWN OF SOUTHOLD BUILDING DEPT.
co 765-1802
-INSPECTION ,
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ` ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] NAL &VW
ptll-
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT-CONSTRUCTION' [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) =[ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
lov,ol
126,
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DATE /Akt-400 INSPECTOR
m4mlvck,
r4f soo`o
* # -TOWN OF SOUTHOLD BUILDING DEPT.
�ycou765-1802
. .
INSPECTION
- j
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] `FOUNDATION-2ND [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [7] FIRE
INAL/4w"FIREPLACE & CHIMNEY " [. SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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ACR. _ REMARKS ,3
�i^'4✓ C a �r^^r Vim. � r.. ../ '�� — _ .—. -_.---- --- ------ — .-
TYPE OF BLD.
t �.Fr" PROP. CLASS,-, fy
LAND _.._ IMP. TO FAL DATE ! - lX"Z?Y 4o t_ tr'rr
-- --- 5 - -re Oa cis
FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WQDL D
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT 1 6
TOTAL ,
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COLOR
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M. Bldg. Foundation CB Bath Dinette
, '.. ' 9 FULL
CRAWL LExtension Basement Floors Kit.
LAB
---- ---------
Extension
Ext. Walls 8 Interior Finish f L-R.
Extension Fire Place Heat D.R.
Patio Woodstove BR.
Porch �� Dormer Fin. B.
Deck `, Attic
Bree�eway Rooms 1st Floor _—
Garage ` a Driveway Rooms 2nd Floor
0.B.
Pool �1r'?
J
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27762 Date: 06/20/0
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 145 OLD FIELD CT MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 120 Block 3 Lot 8.19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 23, 2000 pursuant to which
Building Permit No. 26906-Z dated NOVEMBER 6, 2000
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 WITH COVERED FRONT PORCH AND ATTACHED TWO CAR
GARAGE AS APPLIED FOR.
The certificate is issued to BRIAN & SUSAN DE RIDDER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-00-0222 06/04/0
ELECTRICAL CERTIFICATE NO. 1737 06/05/01
PLUMBERS CERTIFICATION DATED 06/15/01 WARREN KEANE
ut orized Signature
Rev. 1/81
N
FORM NO. 4
i
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-27762 Date: 06/20/01
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 145 OLD FIELD CT MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 120 Block 3 Lot 8.19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 23, 2000 pursuant to which
Building Permit No. 26906-Z dated NOVEMBER 6, 2000
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 WITH COVERED FRONT PORCH AND ATTACHED TWO CAR
GARAGE AS APPLIED FOR.
The certificate is issued to BRIAN & SUSAN DE RIDDER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-00-0222 06/04/01
ELECTRICAL CERTIFICATE NO. 1737 06/05/01
PLUMBERS CERTIFICATION DATED 06/15/01 WARREN KEANE
ut orized Signature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 26906 Z Date NOVEMBER 6, 2000
Permission is hereby granted to:
JOAN M CRON
PO BOX 953
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH ATTACHED TWO CAR
GARAGE & COVERED FRONT PORCH (CONFORM TO R40 SETBACKS AS PER PLANNING) .
at premises located at 145 OLD FIELD CT MATTITUCK
County Tax Map No. 473889 Section 120 Block 0003 Lot No. 008 . 019
pursuant to application dated OCTOBER 23 , 2000 and approved by the
Building Inspector.
Fee $ 732 . 20
Author' d Sign ure
ORIGINAL
Rev. 2/19/98
�o�0S11FFBI&COG Town of Southold '7/18/2018
�� P.O.Box 1179
o -
T 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39778 Dake: ' 7/18/2018
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 145 Old Field Ct,Mattituck
SCTM#: 473889 Sec/BIock/Lot: 120.-3-8.19
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/18/2009 pursuant to which Building Permit No. 39062 dated 7/28/2014
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:
accessornground swimming pool with fence to code as applied for.
The certificate is issued to Deridder,Brian&Deridder,Susan
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO., 39062 7/13/2018
PLUMBERS CERTIFICATION DATED
Authod Signatur
�oo TOWN OF SOUTHOLD
�SUFFOI�4
o BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
y • o�� SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 39062 Date: 7/28/2014
Permission is hereby granted to:
Deridder, Brian & Deridder, Susan
145 Old Field Ct
Mattituck, NY 11952
To: REPLACES EXPIRED B.P. # 34816
CONSTRUCTION OF AN INGROUND SWIMMING POOL IN THE REAR YARD, FENCED_TO
CODE.
At premises located at:
145 Old Field Ct,Mattituck
SCTM #473889
Sec/Block/Lot# 120.-3-8.19
Pursuant to application dated 7/28/2014 and approved by the Building Inspector.
To expire on 1/27/2016.
Fees:
PERMIT RENEWAL $125.00
Total:
$125.00
Building