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HomeMy WebLinkAbout1000-144.-3-3 TOWN OF SOUTHOLD re u 1Rental Permit m m 0447 Owner Hugh & Christine Gilgoff Occupied as Single Family Dwelling Located at 1155 Marlene Ln Mattituck 144.-3-3 Maximum Permitted Occupancy 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. 7/13/2023 M^. ) 4codeforc(t fit o' � � A,� � This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD BUILDING I 631-765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fll [ ] CODE VIOLATION [ ] PRE CIO [ REMARKS: t2e?rj� -,41) gZy�7 g lj( / 40 f DATE INSPECTOR Town Hall Annex 3 SOUTH L® TOWN 54375 Main Road PO Box 1179 Southold, ental nspec,t l NY 11971-1179 Tel 631-765-1802 _ Fax 631-765-9502 E `4 SCTM # _ 2_ Date 30— Phone Owner Zip Address JV,55 Inspector city ft 2 SUB 3 LEVELS. .. I Smoke Detectors (#- bedroom detectors excluded) — I Carbon Monoxide Detectors A t Fire Extinguishers Exits (#) Milo! BEDROOMS l 2 300!0 5 l Smoke Detector Alarms (#) l { Carbon Monoxide Alarms ( , Egress (windows) (Y/N) - �, i ;BUILDING SYSTEMS Y/N ;CONDITION OF PROPERTY Y/N Heating system maintained,' -erational Building Interior is clean i maintained .Building Exterior is clean /maintained `Hot water syem ma�ntamedlo�#rational - Property is clean/ safe / maintained lElectrica{ s-,stem maintained/oPetional !Handrails & guards present } Mechanical ss�em maintainea/operational - - i I l Rental Inspector Form a/7/2o21 TOWN OF SOUTHOLD co Rental Permit Permit No. 0447 Owner Hugh & Christine Gilgoff Occupied as Single Family Dwelling Located at 1155 Marlene Lane Mattituck 144-3-3 Village 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. 6/3/2021 O 'cial This Notice must be posted by the main entrance at all times *Cece en Town Hall Annex {� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ,'� yk BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION- Renta I PPLICATIONRental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: F ental Property Address. Ltt rit NL- jt/,Cr' tuy 0SOL-1 l Tax Map Number: 1000 SECTION ! -BLOCK _ -LOT__3 - SECTION B. OWNER INFORMATION: (-ProProperty Owner Name: AL/1,.. of(- Property perty Owner Legal Address: Property Owner Mailing Address: J ��� ? 1. SS l 14 S �I 5-qq 31 9f7 5't-1 9 9,17 q? Zz.4) Telephone Number(s): Daytime . Evening Emergency. Property Owner Email Address: Page 1 of S V SQ(/ ,` Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ���,` f� ' Southold,NY 11971-0959' jjArN a 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: OarclalkJ r Sa� d�d Address of Authorized Agent(no P.O. Boxes): J Mc 1 i'1 gond Mailing Address of Authorized Agent:C5`3'10�aij, rhC�Id f 9 o Up�31�l�s �� Telephone Number(s): Daytime Evening Emergency Email Address:, 9 I ' �.�r !" 19 ' V �/ � Zei/ (11cf COTVI_� 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 dl. SO Town Hall Annex, Telephone(631)765-1802 54375 Main Road 1st Fax (631)765-9502 P.O.Box 1179il Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 0 Mailing Address of Managing Agent: r?lys�" -! l 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: Requested Maximum number of persons allowed to occupy Dwelling Un t: _ Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: Page 3 of 5 1.© / �\ �/> Town Hall Annex , Telephone(631)765-1802 54375 Main Road ll Fax(631)765-9502 P0.Box 1179 G i Southold,NY 11971-0959 � ���. i 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 engineeathame�insQMhhLas a v, -lid ;:e;uv Y�c�rl<State lJ_nLiforrrnIr� ft Qng it i� §§41—M. ; vile' Cie t-i&fteatlangis3r quired 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 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) I L � , 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 �J, a'F ; 1^ ` A Telephone(631)765-1802 54375 Main Road ' Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 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: 1 CA G1 uC Property Owners Signature: Sworn to before me this 2' day of M,00 20 A Official Notary Public Signatures Original otary Stamp PIYUSH B.SONI Notary Public,State of New York No.01 S06038647 Gualiried in Kings County Commission Expires March 20,2022 Page 5 of 5 Town Hall Annex Telephone(631j 765-1802 54375 Main Road ',. Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 i� BUILDING DEPARTMENT TOWN OF SOUTHOLD MAIR 2 6 202 y 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 Professional seatreguired for Architect-or Engineer, licensed Home Inspector must provide copy of valid current certification /1 '�J 14-- 3-3 Rental Property SCTM Number: V�� % l U2 (� Rental Property Address: 1155 Marlene Ln. tttuck,N 952 Owner/Name: Hunh Gilgoff Rental Dwelling Unit Identifier: 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 - 100 sq ft, Bedroom#2-90 sq ft, Bedroom#3-176 sq ft Property Description (include all improvements indicated on survey) Single family home 3 bedroom 2 bathroom full basement d tach d garage.deck on rear of ho ua ._ I 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. ober- - U)eWe ge Print Name and Iltle Original Signature Please place professional seal: 50UlyOlo * # TOWN OF SOUTHOLD BUILDING DEPT. courm a 765-1602 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ' INSULATIOWCAULKINC [ ] FRAMING /STRAPPING [ ] FINAL �" po�-� [ ]' FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE-RESISTANT CONSTRUCTION [ ` ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ : ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS:. o T;6-- GIA, 0 vi�lw I DATE '1�0 INSPECTOR - x r ,a....-. s:b:?=tit •,',.:e:„ F� ..,y-.- ?-max;��-r •-��- €--5. R-s."� ,�.:' sf�:'€.-: a.j7`�t,, _��fyvz-�€�-r[[S¢ ,•.: � -ggf.;-. s-rt�- f.�- .3.-... iir-e .,,_ ,`.i.. � 3+=;t.t{ z X, # }yam, �E"�'.-y E :� '.: -.:� £ ^"�.- __� -._..z �t�_.i�' s�• -.:..-._{�.-�::� _-.,§'3.I:".. -_ - �. zt ._�� t?5.�, .f.+a -az;by .t,rn� "{:.��� ,ki.J:J�...- S _:3r-,-,:'� 3 '- :' ,. ..� '}, •::� $.r:e.. 3 ,. 6. '$. F .: ri,.A.., f_3� � .... s: � R..i ...,{ k'.:. � C '" ,y3i" .r. C s .F . ��;.?-E3. �? -ts�:2-.3 S' •i-., - ( a - s=."��... 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ATN ITTR 9nOWCR z M FASTENED TO IP Dlh LAYOVER VA= 90NOTUEE MINIMUM SG- �P - 2'X I O BEAM •� 90.4• TO OCLPW GRAOC co � LAYOVER VAILPY�/ NEW PENCE 1 GATE '� E)(15TNG.BE{D,R,OOM - MATPRIAL TO BE DETCRMINEp u L'IGNTTO MATLnr�//r p gggggg y/, ' a !pyi � L•• UU3TING!UOGG' R _ a� t WPOOD eeBl11WING C WALLESTOVED E - -I cMiMNEY UC 33 1: _ CXI"iTII IG F�� I /ti � I� TILE nCARTN ARCA K ' TO RCMAnI l r 1571NG RR LtnSTIHG F!DGG ¢ V TO R1:MAW TO RTMA41 � _ o� EXISTiNG LIVING ROOM EXISTING BEDROOM � a 8 O f IL ^.4 07 ti y .�,•� C L •'• I LAYOVER VALLEY F!DGC C STIN •'� r+{ IIS I CNI OFAL 9DAC'✓i51GNA� Li.16 1 O.C.— 1 � I •--•`.�M� 2 2'%6'GP.DZR –•— •..'._ _`—IPCPIAA°CA9TCOTLGUFNI r • O m FIRST FLOOR PLAN -7/t RM aS TOWN, OF, SOUTHOLD -OR OPERTY R I-C-A - OWNER STREET':. VILLAGE DIST. 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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- 29082 Date: 11/15/02 THIS CERTIFIES that the building DWELLING & ACCESSORY Location of Property 1155 MARLENE LA LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 144 Block 0003 Lot 003 Subdivision Filed Map No. Lot NO. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 29082 dated NOVEMBER 15, 2002 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 REAR WOOD DECK AND ACCESSORY 1 1/2 CAR GARAGE.* The certificate is issued to LISA LEENON HOLOBIGIAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMBTPP OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PL04BERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. r ` //Aut rize Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 1155 MARLENE LA LAUREL SUBDIVISION: NAP NO-: LOT (S) NAME OF OWNER (S): LISA LEENON HOLOBIGIAN OCCUPANCY: SINGLE FAMILY LISA LEENON HOLOBIGIAN ADMITTED BY: PAUL HOLOBIGIAN ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO_: 144.-3-3 SOURCE OF REQUEST: RONALD A POLLIO, ATTY DATE: 11/15/02 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2 FOUNDATION: CONCRETE BLOCK CELTAR: FULL CRAWL SPACE: TOTAL ROOMS. 1ST FIR.. 4 2ND M.: 0 3RD M.: 0 BATHROOM(S): 1.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: REAR WOOD PATIO TYPE: BREEZEWAY: FIREPLACE: NO GARAGE: DOMESTIC HOTWATER: YES TYPE BEATER: KEYSPAN GAS AIRCONDITIONING: TYPE IIEAT. KEYS. GAS WARN AIR: X HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 1 1/2 CAR WOOD FRAME STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS. BP5336 GARAGE COZ4555; BP16499 PATIO COZ16753. RE-INSPECTED 11/14/02. INSPECTED BY: DATE ON INSPECTION: 11/08/02 GARY J ISI TIME START: 10:OOAM END: 10:20A4t FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z 16753. . . . . . . . . . Date .March 30, , 1988 . . . . . . . . . . . . . THIS CERTIFIES that the building . . Ad d i t.i on. . . . . Location of Property , 1155MARLENE. LANE. MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section l 4 4. . . . . . . .Block . . .3. . . . . . . . . . .Lot . . .3. . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated 19 8 7 pursuant to which Building Permit No. . �64 9 9 Z . dated . . . 0.c t : 5 , 19 8 7 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 . . . . . . . . . ,} gplacing a cement patio to an attached wooddeck. , , . , , . . . . . . The certificate is issued to . ,LYNN _P. LENNON iowner.�"i*rXtwt . . . . of the aforesaid building. Suffolk County Department of Health Approval . . . . . . N/A. . . , UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . .N/A. . . PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rov. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y_ CERTIFICATE OF OCCUP2%1.TCY No: Z*-30454 Date: 09/21/04 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 1155 MARLENE LA LAUREL (HOUSE NO.) (STREET) (IUAMLET) County Tax Map No. 473889 Section 144 Block 3 Lot 3 Subdivision Filed Map No_ Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 1, 2003 pursuant to which Building Permit No_ 30173-Z dated MARCH 18, 2004 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 ADDITIONS & ALTERATIONS TO EXISTING SINGLE FEMILY DWELLING AS APPLIED t FOR. The certificate is issued to EVE S. SERER (OWNER) of the aforesaid building_ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 2005690 08/16/04 PLUMBERS CERTIFICATION DATED 06/28/04 HELLER PLUMBING "'Z- )"—, Au iz Sig ture Rev. 1/81 I I FORK NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy NoAlt555 . . . . . . Date . . . . . . . . . .l�eb . . . . . . . . . . . ., 19r. THIS CERTIFIES that the building located atKAVUAQ .Dr. . . . . . . . . . . . . . . . . Street Map No.�. . . . . . . . . . . Block No.. . . . . . . . . . .Lot No. . . . . . .� tit=k . ... . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . a1W . T . ., 19.71.- pursuant to which Building Permit No. dated . . . . . . . . . . . . .JVAR. . 7 ., 1971. ., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .Private. garap.(. Acceasory..Lldg). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .: .La an. . . . .owner _ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .N A& . . . . . . . . . . . . . . . . . . . . ... . . . . . . . House 1155 Building Inspector