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Home My WebLink About1000-143.-4-4 TO WN OF SOUTHOLD Rental Permit a 0913 Owner Lynnett Keele Occupied as Single Family Dwelling Located at 200 E. Legion Avenue Mattituck 143.4-4 Maximum Permitted Occupancy 3 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. 5/22/2023 ode nfo e e t Official This Notice must be posted by the main entrance at all times ,gal DH lllpppp9oM ul'.n�A 41 Town Hall Annex ! Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959A 1v r BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two y rs) juN I 2020 Section A. Property Information: Rental Property Address: _ b�, - �ec -vi Ka,,H-i+6(-, N Tax Map Number: 1000 SECTION -BLOIC_ ! -LOT Q L4 L4 3 - SECTION B. OWNER INFORMATION: Property Owner Name: n Ike e, e, Property Owner Legal Address: Property Owner Mailing Address: . o 1 tp Telephone Number(s): Daytimeq I 19P44 vening yq5jmergency 15- . Property Owner Email Address: _ a01 2wrdloal (4cait' Poo [ +4 CIO c53"A; W, (01'6�ftyd � I Page 1 o Town Hall Annex �' � � Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 k Southold,NY 11971-0959 °'wL o BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. N� 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 r 4e,� Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 . Southold,NY 11971-0959 �'l` r, 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, 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: 4-� Chi) (Jen� Number of rooms in Rental Dwelling Unit: ,1 t Use and Dimensions of each room in Rental Dwelling Unit: Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road [ Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-09591 �, t BUILDING DEPARTMENT TOWN OF SO HOLD 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. 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) I °fie , , 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 Halt Annex Tele 631)765-1802 �p � Telephone 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 i`�� 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: Property Owner's Signature: �.... worn +: before me this L ay of u - 200 t Official Notary Public Signature and Original Notary Stamp DOREEN E BRUZGA Notary Public-State of New York No.01 BR4868033 Qualified in Suffolk County My Commission Expires Aug.18,2022 Page 5 of 5 CONSENT TO INSPECTION the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersigned(is) (are) the owner(s) cif"the premises it the Town of Southold, located at �. f"rl which is shown g and designated on the Suffol.C)unty Tax Map as District 10 Section v-aq Bloch� , ,Lot That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances,rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: � �`� �,.. "-°VSiglna � rt�urke) .. (Print Name) (Signature) (Print Name) �ve TOWN OF S06THOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND INSUIOWCAULKING FRAMING / STRAPPING AL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANTI IELECTRICAL—(ROUGH) ELECTRICAL X(FAL) RATION INSPECTOR" ,� � _. . jv TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ] INSULATION/CA ING [ ] FRAMING/STRAPPING [ ] AL &�-�ey r [ ] FIREPLACE & CHIMNEY I FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O A- I o DATE INSPECTOR Bilco:Doeoto stairs to Deck baser nt 75 ft to street 18.7 Screened Porch a DW < , 267sgftLn , N 01 Main living space z 1st floor house r 492 sq ft U l =3 N 4-1 N _...._.._ ' W N Sleep Loft +-� M n > m n Q Access to Loft— o pull dawn stairs Smoke � " Bedroom ,0 1 . Storage monoriae � � I closet arin 4-' Bathroom LU 7, LI 18.7' a x� � I r Main water line to city Water turnoff Valve for washing machine y ull Down Stair to access loft Smoke and Carhop t]o N monoxide U Furnace 2"d floor house M M gas 100sgft o o, ID Loft (D < Air Filter here—lift Basement cover to replace bedroom i s � N Water Heater outside rD electric shower turnoff valve -7/�� Q TOWN OF SOUTH LD PItOPERTY OWNER I STREFI" �� `� VILLAGE DISTRICT SKIS._— LOT AO . � 4 /''l 4 OW R l NE ACR EAGE R S W _ yr TYPE OF BUILDING A ¢ ,h YJ RESP SEAS. VL, r FARM , COMM. IND. CB. MISC. Est. Mkt. Value I _- LAND '� IMP. TOTAL DATE 1 REMARKS I «s_ Yrl a F fC,r= hl n g 1300 ? 0 I l AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD ' Tillable 1 I I BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland B rush largo I House Plot I Total I l a F a t 7 IN 14 a_ o M. Bldg. Foundation Bath yLk Extension , / c;0 Basement ':' Floors Extension Ext. Walls _ _ Interior Finish Extension i Fire Place Heat PorchRoof Type Porch Rooms 1st Floor Breezeway Patio Rooms 2nd Floor Garage Driveway ' Dormer t /9'r L 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-24789 Date DECEMBER 5 1996 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 200 EAST LEGION AVE. MATTITUCR N.Y. House No. Street Hamlet County Tax Map No. 1000 Section— 143 Block 4 Lot 4 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-24789 dated DECW4BZR 5 1996 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 SEASONAL DWELLING * The certificate is issued to JOSEPH & DIANE AIELLO {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. Bu' ding Inspector Rev. 1/S1 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 200 EAST LEGION AVENUE MATTITUCK, N.Y numbe"r &.street (municipality) SUBDIVISION_ _._.... ... ._.,....,. _....� _.. ._ NAME OF OWNER (s).... __..S _....... .. ...._......., NAP NO LOT(s) JOSEPH 6 DIANE AIELLO OCCUPANCX .,.,.. .... . ,..,..... __ _,.,. . ..m... . �ovner—Cenant ADMITTED BY: JOSEPHINORA ACCOMPANIED BY SAME ,F _...._.., ._� F`NIrv.WI,IJ. 1 A MAP NO 1000 14 37-4'—'4 _ ... .__. KEY AVAILABLY............ _ _._ ..,, ...._...._,. ...... .....& DIANE. AIELLO DATE: OCT w 25 1995 SOURCE OF REQUEST: JOSEPH � DIANE 1fPELOFGCONSTRUC" ..� .. w.�...s..— T TION._,....._1 S .mFRARl6 _._..__....... ..... TORIES I EXITS FOUNDATION CEMENT BLOCK CELLARn CRAWL SPACE. JARTIALµµ TOTAL ROOMS: IST FLR. 2 2ND FLR. LOFT 3RD FLR. BATHROOM (s) ONE TOILET ROOM (s) UTILITY ROOM._µ.,,,,..._. . .._......__ .. ...��... PORCH TYPE..... COVERED CtIQC►p� HECK, TYPE �......_.,,,..._.... PATIO BREEZEWAYFIREPLA. �A .... CE GARAGE DOMESTIC HOTWATER .µ...._......._ _ ... — YE G„5 w TYPE HEATER ,LILCO GAS AIRCONDITIONING TYPE HEAT LILCO GAS WARM AIR XX HOTWATER OTHER: ACCESSORY_STRUCTURES: GARAGE, TYPE ..m,., STORAGE, TYPE CONST. OF CONST., .............. .........�.....__.,_...... — SWIMMING POOL GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE LOCATION DESCRIPTION ..,,_,.._w,. ...._ ....., �.m.... TION ART SEC ._. .., ...__.......... ... .. ...._ ._..m_.w_... .._...�... BP 123298Z—CO Z-24788 (ADDSALT) REMARKS: INSPECTED BY � ��a s^ INSPECTION NOV . °�.....w.�.._ . .,, ISH — TIME START 11:00 AM END 11:45 AM FORM No. 4 TOWN of SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.X. CERTIFICATE OF OCCUPANCY No Z-24788 Date DECEMBER 5, 1996 THIS CERTIFIES that the building ALTERATION Location of Property200 S. LEGION AVE. - MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 143 Block 4 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FE U 16 1996 pursuant to which Building Permit No. 23298-Z dated MARCH 14p 1996 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 ALTER EXISTING "SEASONAL OCCUPANCY" DWELLING TO YEAR ROUND OCCUPANCY AS APPLIED FOR. The certificate is issued to JOSEPH & DIANE AIELLO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-291132 - DEC. 11, 1995 PLUMBERS CERTIFICATION DATED NOV. 19 1996-JOSEPH AIELLO B4t1ding Inspector Rev. 1/81 �� I%� /rmf �� ' /� �� /�� ! ,�'� �� ,// ��,/�, 1 ! �/ �,,i ��i�� J, �/�'� r i% � �� , r;i �� ;/ ��I �: �� ' �, '� ' °�� t viii � �� viii/ rf%�� %; �, r' �� , ��G <<�;i� �� / � i �� f 'l�� / /� i l�� '� � ,�, . �, � ; �� ° % �� /� I��e 1 ,, ,1��- �� % ��,� �0 ,�. � � � i 4 +^%yF SIV,' �% �1 / /// / / ;Q r/ /, /� �/ ,r r �/" � � �� /� %i �',,, �i� J�%�j%� ,;;� ��,I J�j�„/i�% !� %Gii� �i h �, /% � ;� �% �f/f�� 1,/,�f ��,,� lI /i � rj �� j/��, � j �: � ,, n�JJ �. 5 N *. I iai / nisi i 1 ;, ?.f r,, n I f ATTENTION:This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. 6