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Home My WebLink About1000-143.-4-17 y. TOWN OF SOUTHOLD w Rental Permit NCO �p 7k 0404 Owner Andrew Oppenheimer & Nicole Dobranski Occupied as Single Family Dwelling (rear) Located at 495 Riley Ave Mattituck 143-4-17 Maximum Permitted Occupancy 2 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. 11/14/2022 cede orcewt fficial� This Notice must be posted by the main entrance at all times �� FE Town Hall Annex - Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 =t a BUILDING DEPARTMENT TOWN OF SOUTHOLD � I RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 10 /Vy 13 Tax Map Number: 1000 SECTION -jq3 -BLOC - -LOT__L7-_- SECTION B. OWNER INFORMATION: Property Owner Name: 0-0 Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): Daytime.'16 ��J Eveningg(C-q Emergency 'tell r ' Property Owner Email Address: Page 1 of 5 € t Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-09594 rip ` MIN BUILDING DEPARTMENT TOWN OF SO OLD 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 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 1179 Pt � r 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." Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: y Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: c�v/� )S `,4,y 10 1 � f P %z lv _ Page 3 of 5 �s Town Hall AnnexTelephone(631)765-1802 54375 Main Road — - Fax(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 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. VI 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) Qmt.. L elk- rr , 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 Cr 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 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 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: Property Owner's Signature: Sworn to be qre me this day of `} 20d Official Notary Public Signature and Origina1otary Stamp Q12 Pueuo `- =* 1+1�. 0511 #Itlt Page 5 of 5 TOWN OF SOUTHOLD BUILDING _ I 631 -765-1802 IN PECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATIOWCAI [ ] FRAMING 1 STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL {FII [ ] CODE VIOLATION [ ] PRT C/O [ REMARKS: 49 k� Po r& � DATE g i INSPECTOR g� FFO ,� SOUTHOLD TOWN Town Hall Annex 54375 Main Road PO Box 1179 Southold, Rental Inspection NY 11971-1179 Tel: 631-765-1802 s Fax 631-765-9502 SCTM # — Date } Owner Phone Address _ ,t(�.� ,L Zip City Inspector LEVELS SUB 1 2 3 Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) BEDROOMS 1 2 3 4 5 Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows), (Y/N) BUILDING SYSTEMS Y/N CONDITION OF PROPERTY Y/N Heating system maintained/operational Building Interior is clean/maintained Hot water system maintained/operational Building Exterior is clean /maintained Electricals stem maintained/operational Property is clean/safe/maintained Mechanical system maintained/operational Handrails & guards present COMMENTS: bel It rliq fill Rental Inspection Form 4/7/2021 us= all, 118 in 12 in � � 00 � 106 in 156 in 123 in , u m OWNER STREET VILLAGE DISTRICT SUB. LOT FORMER OWNER N E �..� .��..,_._ _ __- ,w_.... ,._....._.�.._ _.�.._. , .�. ._�....._ _.....�.�.�..�......,..__._..,._,,�...._....._...�_�. ._ ACREAGE S W TYPEOF BUILDING f u I� J+ J e a � RES D SEAS. VL. FARM ..Comm. IND. CB. MISC, Est. Mkt. Value ............._M_...... _ . ......,_..___ ... ...,.. .._. ,.._. .._. ,... _. M_. _ ...._ LAND IMP. TOTAL DATE REMARKS 17 40-1 ' 2 N U �7 !.. .. .. .. ,e, y �,^ n �^✓ � �l`�'�� AGEBUS ING C DI ,,,, FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable le 1 BULK H EAD ..,. __ _��. .......... . ._ _ _.., _,. _ _ . _ __ �_ _ _ __ .. ......_� ..,. ...,. ..�...._..... ... _ ..,,...,.. _ m, _ ..,.,, Tillable 2 DOCK _ ........ Tillable 3 _j.. WoodlandL, --k%f .�.' ',. , �d . lc,",,, Swampland Brushland House Plot 1 __ Tota I -7/ TOW14 OF a OWNER STREET VILLAGE DISTRICT 1 SUB. LOT FORMER OWNER N I E ACREAGE . .... . . _. . __... __. S W TYPE OF BUILDING RES SEAS VL FARM COMM. IND CB, MISC LAND IMP, TOTAL DATE j REMARK' AGE , � BUILDING CONDITION NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value , Tillable 1 Tillable 2 Tillable, 3 f Wcadland Swampland •. Brushland House Plot Toto i fl�„'sir � G /r P � M � a ,� � xA✓9/� � � �,� ”� �1�� rr � � �� Lin /�� /� ✓r��; '�n� r�'`�rc�/� i, �� _ _ / / 1 — _.. .,� ,�.......m . �� w.. ........... ... .. ..... if k I �1�� i 1 Jnw.wwWm�nzmdG i J, J, T a III 143-4-17 accessory 2104 �. M Dldg r . r e...... r� Foundation Bath Extension Basement '� �', 00 rs , � Y ... Extension � Ext. Walls _ � ,.'., Extension Fire Place eot f Porch Porch �Rooms 1 sto _ Breezeway! Patio Rooms 2nd Floor Garage Driveway O. B. r" /711 Il rr l� � JV "� _. . _ r v �ry r� u ` 143-4-17 2104 Y ` .... ...___ m. ...._...�._ _. �.._.,,... .. r �. JL M. r m . o Bldg Foundation "' cath ° U �rm Basement Floors Frr.0keOWL =xter�si�r► ��I Ext. Walls y1 rar � Interior Finish ` .xtensiorpw � """ Fire Place �� Heat f l4 '�� . Porch na Roof Type✓C Y1 t T� � Q Porch, � � Rooms 1st F�0 (2- 3 r��t /0 �c /Z patioRooms 2nd F " re�cuy "" r e Driveway Dormer n 0 . . 100 1 .._ _.... 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-22349 Date MAY 21, 1993 THIS CERTIFIES that the building TWO ONE FAMILY DWELLINGS Location of Property 495 RILEY AVENUE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 143 Block 4 Lot 17 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 -22349 dated MAY 21, "993 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 TWO ONE FAMILY DWELLINGS FRONT & REAR YARDS The certificate is issued to ESTATE OF MARY SULLIVAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. idV g Inspector Rev. 1/81 FRONT HOUSE BUILDING DEPARTMENT N TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 49.5 RILEY AVE, MATTITUCK, N.Y. ruler S street municipality SUBDIVISION MAP NO. LOT (s) NAME OF OWNER (s) ESTATE OF MARY SULLIVAN OCCUPANCY A-1 RES_ OWNER (type-) (owner-tenant) ADMITTED BY: BERNICE (BOOKMILLER REAL ESTATE) ACCOMPANIED BY: SAME KEY AVAILABLE SUFF. CO. TAX MAP NO. 143-4-17 SOURCE OF REQUEST: ABIGAIL WICKHAM4 ATTY DATE:FEB. 12, 1993 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME # STORIES ONE # E%ITS 2 FOUNDATION CEMENT BLOCK FOUND - CELLAR FULL. CRAWL SPACE TOTAL ROOMS: IST FLR. 4 2ND FLR. 3RD FLR. BATHROOM (s) TOILET ROOM (s) UTILITY ROOM PORCH TYPE WRAYrAROUND ENCLOSElbECK, TYPE PATIO, TYP BREEZEWAY FIREPLACE NO GARAGE-71 PORT DOMESTIC ROTWTE S TYPE HEATER LILCO GAS AIRCONDITIONING TYPE BEAT L gg WARM AIR II HOTWATER OTHER: ACCESSORY STRUC S: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST_ SWIMMING POOL GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION S BUILDING CODE LOCATION DESCRIPTION ART. SEC. z E v i [ If i i i REMARKS: INSPECTED BY: DATE ON INSPECTION 4/13/93 6 5/19/93 TIME START END REAR JIOUSE." BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 495 RILEY AVENUE MATTITUCK, NEW YORK x� er b street nielglfty SUBDIVISION MAP NO. LOT (s) NAME OF OWNER (s) ESTATE OF MARY SULLIVAN OCCUPANCY A—] RES. OWNER (type (owner—tenant} ADMITTED BY: BERNICE (BOOKMILLER REAL EST) . ACCOMPANIED BY: SAME KEY AVAILABLE SUFF. CO. TAX MAP NO. 143-4-17 SOURCE OF REQUEST: ABIGAIL WIC 4 DATE: FEB. 12, 1993 DWELLING: TYPE OF CONSTfUCTION WOOD FRAME # STORIES ONE $ EXITS 2 FOUNDATION CEMENT BLOCK CELLAR SMALL AREA CRAWL SPACE XX TOTAL ROOMS: IST FLR. 4 2ND FLR. — — 3RD FLR. S- BATHROOM (s) ONE TOILET ROOM (s) UTILITY ROOM PORCH TYPE DECK, TAPE � � � PATIO, TYPE BREEZEWAY FIREPLACE �£ s GARAGE DOMESTIC HOTWATER YES TYPE HEATER ELECTRIC AIRCONDITIONING TYPE HEAT LILCO CENTRAL AIR WARM AIR II HOTWATER OTHER: ACCESSORY STRUCTURES- GARAGE, TYPE OF CONST, STORAGE, TYPE CONST. SWIMMING POOL GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE LOCATION DESCRIPTION ART: SEC. e � y s I I i i s REMARKS: INSPECTED BY: a DATE ON INSPECTION 4/13/93 6 5/19/93 G Y FISH TIME START END FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28350 Date: 04/19/02 THIS CERTIFIES that the building ALTERATION Location of Property: 495 RILEY AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 143 Block 4 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 14, 2002 pursuant to which Building Permit No. 28173-Z dated MARCH 14, 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ELLEN & VINCENT MCLAUGHLIN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A At=ori zed S` nature Rev. 1/81 Town of Southold 3/14/2021 P.O.Box 1179 53095 Main Rd * + Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41887 Date: 3/14/2021 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 495 Riley Ave, Mattituck SCTM#: 473889 Sec/Block/Lot: 143.4-17 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/23/2020 pursuant to which Building Permit No. 45596 dated 12/22/2020 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: "as built"'2as furnace and central air cpnditionin in existing single f ApALy dwelling as a filed for. rntDwelling) The certificate is issued to Cacioppo Living Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45596 2/24/2021 PLUMBERS CERTIFICATION DATED t -gnature 1 Town of Southold 3/14/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CER'T'IFICATE OF OCCUPANCY No: 41888 Date: 3/14/2021 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 495 Riley Ave, Mattituck SCTM#: 473889 Sec/Block/Lot: 143.4-17 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/23/2020 pursuant to which Building Permit No. 45595 dated 12/22/2020 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: "as built"windows water heater and was ce in an eistin oze f ly dellin as a lied for Tellin The certificate is issued to Cacioppo Living Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45595 2/24/2021 PLUMBERS CERTIFICATION DATED U Signature J 1�1 Ift� ��0 l 1 r l 1 i i 1 i / i 1 � l i 1 1 / i (� l / o 1 l J � ,. .....,........1,111 l �� / 1 i r i l i � r i � 1 r / / t .. ......... ......... SO i i i / i / i rrrr / rt r iflGlll / . � / / ilii J l r f ill ,, �1 G 0 i + �j1155, FF� ��