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Home My WebLink About1000-56.-3-4 f $4 ttot}_ TOWNOF S UTHOLD Rental Permit 0639 Owner Mary Matyas Occupied as Single Family Dwelling Located at 170 Laurel Avenue Southold Maximum Permitted Occupancy 56-3-4 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 5/11/2022 ode is o e Official 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 ri Southold,NY 11971-0959 4000 �y d BUILDING DEPARTMENT OR TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Rent C/ 71 Tax Ma p Number: 1000 SECTION ___ BLOCiC -LOT . s� SECTION B. OWNER INFORMATION: Property Owner Name: � Property Owner Legal Address: Property Owner Mailing Address: M, (ya ( ct�, 71 Telephone Number (s): Daytime" f Evening_�Emergency Property Owner Email Address: 2 ,c Pagel of S Town Hall Annex i" , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. /A- 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 Southold,NY 11971-0959 y, UNI it gyp,. BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: 1Iq 7 LI Telephone Number(s): Daytlm9 Evening_y 4 _ Emergency Email Address: �r( 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 Un Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit:A 15 . �. _aA Page 3 of 5 P Town Hall Annex Telephone(631)765-1802 54375 Main Road �^ ;. Fax(631)765-9502 k P.O.Box 1179 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. 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) 1 j , 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 p` �`� Telephone(631)765-1802 54375 Main Road x Fax(631)765-9502 P.O.Box It 79 ° 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: MAIrm . Property Owner's Signature: ° � " ,, Z� Sw rn to before me this ay of ffi ial Notary Public Signature and Original Notary Stamp THOMAS S.VITALS Nobly Public,State of New"Murk ftistration No.01V16276776 Oualkied In Suffolk Count " Commission Expires . Page 5 of 5 F t Rk 7 TOWN OF SOUTHOLD BUILDING, DEPT. �u 6311-765-11802 ;ttrl, INSPECTION [ ] FOUNDATION1ST [ ] ROUGH PI-Elb- FOUNDATION 2ND INSULATIOWCAULKING C ] FRAMING / STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ FIE RESISTANT CONSTRUCTION [ ] FIRE [[ ]] RESISTANX(FAL) ATION ELECTRICAL (ROUGH) ELECTRICAL VIOLATION I E C/ L REMARKS: ffi(1 cane, hk DATE l 411w� .. .. . . . . . . , . . . .. - ! � .. . . , + : H � �~ � T ? . . . i • ] . � • ! � � � \ � � \. � , � \ yx —I,/ � . !� ^».^ , ■ . � .. .�y> . . , «0 o 0 0 0 0 ) __ —_ l « . - ! ! _ I .Ind Fbw1a wok& . . . . . 4 ) swumm xv@ . . .. > ,. g, , - ) r-t�y.�§ . ! u. . . 4 \ . n mr r . _ . . .. �� ?_ . . , �, rrvlk | : ! � �. . • ! . . F !� . . . ! . . k _Mr �, 17 0 vA Nt-L t TOWN OF SOT OLD PROPERTY REC I�� m OWNER ��°.,� � ,. _- _I STREET VILLAGE DIST. JvrS. LOT FORMER OWNER � N E ACR. ?1 ! (y AS11 S TYPE OF BUILDING _ t ARES. SEAS. VL, FARM COMM. 2CB. MICS. Mkt. Value 3 � , LAND IMP. TOTAL DATE REMARKS _ a CIO1 w , M 1 f I F g �'- 4 E L--4J �`�� ' V�. Y 'J �+.�� .f+"'s s:�•d��''_ � � +a '� - � �F(tT T t��-� -a �' !�I Vi�.?F {4 1* c j - { r� / . AGE BUILDING CONDITION Lj NEW NORMAL BELOW ABOVE FARM Acre Value Per j Value Acre TillableFRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH _ House Plot BULKHEAD n Total � � DOCK n ' "M r t r Al TRIM _F \ _ _ £ S € (( ki e t_ _ _ y eY m g rr� v 56-3-4 1108 56.-3-4 Rearview 1108 - � _ , , M. Bldg. e £ r _ _ xte-si on. _ Exten . scan . t t 3 Extension Foundation CBath i , _it2 ` i v. .� _ m ween nt _ _ _ °Floors Porch & £� Walls <.r ;, lntersor Finish P B eezeway 'Fire Place He& � s a� - s 1s;- Floor ype Roof r �. Patio 'Recreation Room= Booms 2nd Floor , ;^4, - 0. B. I Dormer Drivewcy c Total S 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-23581 Date MARCH 30, 1995 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 170 LAUREL AVENUE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 3 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9f_ 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-23581 dated MARCH 30 1995 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 * The certificate is issued to RODERICK W. FOSTER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - !ARCH 20p" ,1995 PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. r 74, Buildin Insp or Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 170 LAUREL AVENUE SOUTHOLD, NEW YORK number 6 street municipality SUBDIVISION MAP NO. ---� LOT(s) NAME OF OWNER (s) RODERICK FOSTER OCCUPANCY SINGLE FAMILY stype)_ owner-tenant ADMITTED BY: CATHERINE FOSTER ACCOMPANIED BY: SAME KEY AVAILABLE SUFF.CO. TAR MAP NO. 10 - SOURCE OF REQUEST: RODERICK FOSTER DATE: NOV. 3, 1994 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME # STORIES 1-1/2 # E%ITS 4 FOUNDATION CEMENT BLOCK CELLAR PART CRAWL SPACE - w TOTAL ROOMS: IST FLR. 3 2ND FLR. 2 3RD FLR. BATHROOM (s) 1 TOILET ROOM (s) 1 UTILITY ROOM LARGE REAR PORCH TYPE REAR COVERED SCREENED DECK, TYPE PATIO BREEZEWAY NNE FIREPLACE ND I GARAGE 1 CAR DOMESTIC HOTWATER YES TYPE HEATER OFF BOILER AIRCONDITIONING TYPE BEAT OIL WARM AIR HOTWATER YES OTHER: LARGE PANTRY - 2ND FLOOR FOYER NOTE: WOOD STOVE HAS BEEN REMOVED. 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. W REMARKS: BP #22630-Z - CO Z-23581 (ACCY SHED)---�� IKS'?ECTED BY DATE OF INSPECTION NOVEMBER 9, 1994 TIME START _ END FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218567 Date NOVEMBER 16 1989 THIS CERTIFIES that the building ADDITION Location of Property 170 LAUREL AVE. SOUTHOLD House No. Street Hamlet County Tax Map No. 1400 Section 56 Block 03 hot 04 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 3, 1989 pursuant to which, Building Permit No. 178892 dated MARCH $ 1989 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING. The certificate is issued to RODRICK FOSTER (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H084708 AUGUST 3 1989 PLUMBERS CERTIFICATION DATED N/A B .lding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT NO F."C"Aos. Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23561 Date MARCH 30, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 170 LAUREL AVENUE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 3 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 3 1995 ____pursuant to which Building Permit No. 22630-Z dated MARCS 161 1995 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 ACCESSORY STORAGE SHED IN REAR YARD "AS BUILT" & FENCE ENCLOSURE AS APPLIED FOR. The certificate is issued to RODERICK W. FOSTER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspec Rev. 1/81 lltlt Town of Southold 12/30/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40984 Date: 12/50/2019 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 170 Laurel Ave., Southold SCTM#: 473889 Sec/Block/Lot: 56.-3-4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/9/2019 pursuant to which Building Permit No. 44505 dated 12/9/2019 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: A�: I ITI `_ AI" 1 "PIONS IC 'CLI DIN S R .M TO, I E;' I I::: 11 "DWELL1N x EVER ZBA DECISION#5695 DA`F OL--2.-2005 AS APPLIED FOR The certificate is issued to Tison,Don&Giardi,Diane of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 31330 03-20-2006 PLUMBERS CERTIFICATION DATED 12-16-2019 Dt n Tis _................ __ w. .._r ............. ._.... . _.. gnatur