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HomeMy WebLinkAbout1000-137.-4-5.1 TOWN OF SOUTHOLD Rental Permit 0635 Owner Rosemary Knise & Frank DiGregorio Occupied as Single Family Dwelling Located at 5765 Stillwater Ave. Cutchogue 137-4-5.1 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. l 5/6/2022 de En f rce e t O icial This Notice must be posted by the main entrance at all times �p� SOU"i'o Town Hall Annex !, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 • r Southold,NY 11971-0959 O y �yC4Um��� BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every tw arm D ( L 7 6 ��p022D Section A. MAR Property Information: az ,�IT Rental Property Address: ��`1�5� S�, Ilwo•'ref /4ye- Cui -Aoc� j' Tax Map Number: 1000 SECTION 137 -BLOCK -LOT 0O J-- SECTION -SECTION B. OWNER INFORMATION: Property Owner Name: 17o©oma/-$I 1q• 1s'e— 4— 1 C"--,-7) Property Owner Legal Address: Property Owner Mailing Address: afi [ >JGJt,- /+,] (I3S� cc..lue-' ize.( -0 .) h—Lto� ofry I( qs5- rj:� !l q -11 T Telephone Number (s): Daytime G V 017-4 A Evening Emergency 903 406 uj1 Property Owner Email Address: )9 PT I g 6 0 42 A C o,,v1 ��Ob Page 1 of 5 �p�,Sauxy Town Hall Annex +, Telephone(631)76.5-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ty � zM. 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: Uu, -� Requested Maximum number of persons allowed to occupy Dwelling Unit: 3 z Number of rooms in Rental Dwelling Unit: 7 Use and Dimensions of each room in Rental Qwelling Unit: ed,.dOm /-/3'y/3 A4 c Y m 0 rt1 ,�I�IIU e�UiM �� �� !! [ '?S /r , �//d/✓!�i C®d'/►l ! �n ` ;5�>7 —Y��j 5v��navr� �3 �� � X /5 Page 3 of 5 rqfo y � off, Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 . Southold,NY 11971-0959 Q 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: VV Sworn to before me this day of I'1'1 20 02 — Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,Stat®of N®W Y@rK No.01 BUM 8606® Qualified in Suffolk 0@01Y Commission Expires Ap01141 _ Page 5 of 5 Town Hall Annex . Telephone(631)765-1802 54375 Main Road : Fax(631)765-9502 P.O.Box 1179 • Southold;NY 11971-0959 Ql 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. 0 lam 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) 'Orr ccA &r-eck0-r 10 „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 Telephone(631)765-1802 54375 Main Road CA Fax(631)765-9502 P.O.Box 1179 s Southold,NY 11971-09.59 Q � coo BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: L Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: li?eItrew 1 1 - 13'X 13� �����r,, �- G `9 v a 0-t 1,rocs M — `7 r/o 'r X 7 I r' 1 W i rna r•car,M — 1 0� X ,111 �y Y lt' SAN Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: OFSOUTyp o # f TOWN OF SOUTHOLD BUILDINGDEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O RENTAL REM KS: �k 1J CJ DATE �� 7070L INSPECTOR r A , � L ' a a 9-1 p - - � Z7 - - - - � 3 I � I TOWN OF SOUTHOL® PROPERTY RECORD /.0? ;'i,,.,,"• " ..: YF. . [[�� .+#.c^="rte.. , { OWNERSTREET -�`i`_+? :M"; VILLAGE . DIST. SUB, LOT •.. , r ; ;z";d..�l'�e' .�� ��1- r,��.�''4 �4� 11°%�. •o g�.. t.." 1*" { " ✓� � C.r„`� �.,,.•r}* 7��. ��:.Y FORMER OWNER i N E ACR. rn r ( TYPE OF UILDING RES:=', ;SEAS. i VL+ FARM COMM CB. _ MICS. Mkt. Valu` I -- _........... .__ ——- LAND IMP. TOTAL DATE REMARKS Z/ zl - }y r ?'�ti..• _,�4+1^'7 �} �.� ? ,°s' `��' !��?.r" r• it> gy,Y:.`.'' ! •°� �i r'a8.,�3;.;ri i'>.% •.`a v. C z"eT`r'P:•' ^a e t:.:=.._ !�l C.3 k ww� .r'^, 'd- c+, 3; £ fCom,' ju • <, „�; ,°.�._� r} .f` i ,�•. " n?='_a_ ,•"� , i f �t'+ i~�`;;•�' �f�FF"`� �l'��/ �7.J1�+'�— C'�G✓1S'� �CP U`/f F�t^g, � �:�2•�'c`1 1`r�^ > C. > ����,i:�'.r= c'P. L—.^' i t •^ ..,� •:r I � ;.ate .t'f �, apt'..'.' �,+°+.x•,:w: 'f��z`(�8� ..�. P•'�...`.+ �'d`�rs!i' '`•�- �r/°",,'�'�'°°''3 f p al�c'�..,� ,..a >-�.�-;I';:5 I it:a:"b' ' "�(.3 CS:.,m. •. ••}•�'«_� rw4 .. ,.i A'La d;�C<;." � �-i A t '••°'ib"x i i+. I��I� t e''..�-......�^ fl (,,.� Y A^"R ¢ =t1 ,� "T � i="�`^r"{ t# i�°� jC ( _.a�°�.,. `.Ld � �.2IY:^•,vt». �a tzil(L�iC• Sp^��..:•_ - G/ ,� .t i r 4r'✓"v fii.fizm , ) f ul , 34 v t Tillable T FRONTAGE ON WATER Woodland ( ! ,FRONTAGE ON ROAD Meadowlond DEPTHfi ( BULKHEAD House Plot I i Total i j '�� �� ►X000-- LI- 5.! COLOR / �� � Iv t-1 UIO 0%1 r^r� TRIM � t M. Bldg. '. � - \ i --__— - � , � ��• - - -- � - '-� ---�-------�- Extension 1 2 3- Extension eau I I Extension —I Foundation . Both i Dinette Porch Basement t .1 Floors K. Porch- , ' Et. Walls Interior Finish LR. Breezewqbt[ +r- 1 2 �, ,r Fire Place Heot N �. DR. Garage J ? Z 'Type Roof Rooms 1st Floor I BR. Patio �b Recreation Room Rooms 2nd Floor ; FIN. B 0. B. c.�- ,Z�;Dormer Driveway Total i y�FR(,f Town of Southold Annex 9/10/2014 54375 Main Road • Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 37139 Date: 9/10/2014 THIS CERTIFIES that the structure(s)located at: 5765 Stillwater Ave,Cutchogue SCTM#: 473889 Sec/Block/Lot: 137.4-5.1 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 37139 dated 9/10/2014 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame one family dwelling.* Note:BP 7796 shed COZ6472:BP 10247 additions, including one car garage COZ10090•BP 11316 addition COZ10824: BP 13855 enclose porch&deck addition COZ13882. The certificate is issued to Burrows,Matilda (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Aut ' ed-SXpaturi BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 5765 Stillwater Ave,Cutchogue SUIT.CO.TAX MAP NO.: 137.4-5.1 SUBDIVISION: NAME OF OWNER(S): Burrows,Matilda OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Burrows,Matilda DATE: 9/10/2014 DWELLING: #STORIES: 1 #EXITS: 3 FOUNDATION: Concrete Block CELLAR: 60% CRAWL SPACE: 40% BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: front covered DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: No GARAGE: DOMESTIC HOTWATER: Yes TYPE HEATER: Off Boiler AIR CONDITIONING: TYPE HEAT: Oil WARM AIR: HOT WATER: X #BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: Unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: A GARYF DATE OF INSPECTION: 9/9/2014 �� TIME START: 10:30am END: 10:50am FORM Nd. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. b415i . . . . . Date . . . . . . . . . . . . . Feb 4 . . . . .. 19.71. THIS CERTIFIES that the building located at . .S./.S .St:J11water• Kve. • . . Street Map No. Fjeetwood• %W* NO. . . . . . . . . . .Lot No. .1 .5. a.Pt. .14. . Gutchegue. . . .Yi..Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . .Jtug . . 2.1— ., 19 70. pursuant to which Building Permit No. . . .49.16L dated . . . . . . . . . . xug. . 2.1 . . . ,, 19.70., 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 . . . . pTjvdto •ons family- dwel-ling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . .ria,tilda. 13urrcaws. . . . . . Oarnes . . . . I . . . . . . . . . . . I . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . . . . .N.R•.• • • • • • • • • • • • • • • • • • • • • • • • • House 5765 6tillwater . . Building Inspector FORM NO.2 TOWN OF SOUTHOLD BUILDING DEPARTMENT; TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 4916Z Date ............1................ .................. .��� Permission is hereby granted to: .....................................................1.......................... ..........................................................••.......••.•........• to ►............ . ........ 1-. ...........................J:';...Xi.' ..1..I..'.?7..&..........0-M&............... ............................... :. :.t. :.��':............•.......O W.:...kAtR. ..! ::...................... ......................... r at premises located at ..................... ................... ............... ............ .. ....................................... ..................................................................................................... ......r .................................................. •..........................•...•.....•....................................•...............•.•.........N.........................•............•...•..........r.• 1 pursuant to applicdtion dated ................................. ..l......... .er-., 19.740 and approved by the Building Inspector. j Fee $.. ........... ...... t K Bud?lr;ttnspector 1 1js roatc Na s TOWN OF SOUTHOLD BUILDING DEPARTMENT Torn Clerk's Office Southold, N. Y. Certificate Of Occupancy No.26472 . . . . . . Date . . . . . . . . . } . . . . . 1 Ka�t. . . .20. . ., THIS CERTIFIES that the building located at 8#►S.11 ►ter• •Pegnas • Street "• Map No. VleatwoodFM* No. . ... . . . . . . .Lot No.I.Y. . . . . . #oho s . .R, .. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .April. . 4 ., 19. 9.5 pursuant to which Bu*ing Permit No. .77-96Z. dated . . . . . . . . .AprU . . . . 4. ., 19. 17% was issued, and conforms to all of the requtm ments of the applicable provisions of the law. The occupancy fbr which this certificate Is issued is PrSvat* •aecossery•(s#torago)• building. . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .Ms�tildar •Eura�ows• • • • •Nnor . . . . . . . . . . . . . . . . . . . . . . . . (owner;.lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Rift i. . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. .N aR e. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . HOUSE NUMBER . . .4I 5. . . . . . Street . . .gequash• Ave. . . . . . . . .. . . . . . . . . . . . . . . . . 5765 Sti111*tpr Ave . . . . . • . . . . . . . . . .. . . . . . . . . • . • . . . . • . . .. . . . . . . . . . . . •.. . Y• • . o o e . .. . • • . • . . . . .• . • • . C . . . . :. . . . . . . . . . . . . . . . . . j . Building Inspector t r FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. . . L'1,0090. . . . . . . . Date . . . . 21 . . . . . . . . . . . . . . . . 19 80 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 5�5 11'leetwaod. Rd.X5765 Stillwater Ave. Cu.tchopue..N.Y. House No. Street Hamlet County Tax Map No. 1000 Section . . 1.37. . . . . .Block . . . 04. . . . . . . . .Lot . . . . .g05. . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . 4 , , . , . . , , , 19 T9 pursuant to which Building Permit No. 104TZ . . . . . . . . . . . . . dated . . . . . . . .June. �: . . . . . . . . . . . . . 197`x. ,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 . . . . . . . . . . Living xloom, Porch and One Car Garape. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . . . . . . . . . . Mat i 1 da Burrows (owner,�e�si�oi� i�J of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . #. . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . X .493-303. . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �. . . . . . . . . . . . . . . Building Inspector Rev 4179 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. 10.8.44. . . . . . . . . . Date . PP,c.eM)P .1�. . . . . . . . . . . . . . . .. 19 -81 THIS CERTIFIES that the,building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Prop erty5.7b5. . . . . . . . . . . . 53.tiI 1.w.4ter. .Ave.rutq . . . . . . . . . . .Gtjt..C.4Q&P0. House No. Street Hamlet County Tax Map No 1000 Section 03.7 . . . . . . . .Block . PA . . . . . . . . . . .Lot . 0 A 5:9P.1. . . . . . . Subdivision . k Z 41 woad , Cov,� . . , , . , . . ,Filed Map No. I263: . .Lot No. 1 . &, ,n�Pt. ,of 14 conforms substantially to the Application for Building Permit heretofore filed in this office dated . . .Auj—1 u4 t. 5. . . . . . . . . , 19 . 8.1pursuant to which Building Permit No. . .1 1 16 .Z. . . . . . . . . . . dated . . .A V U.0 a t. 6. . . . . . . . . . . . . . . . 19 81. ,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 . . . . . . . . . . . . . . . .aI;. 0rl.(at;..0n .tP. .al .9110.-�aPIA,IY. ANgII Ail9 bedr.oam). . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . .1)vrr.QWS. . . . . . . . (owner,lesseeor ant9 of the aforesaid building. J Suffolk County Department of Health Approval . . . . . . .14/A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . .V5A516.7. . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . 4,4,1 L �. . . . . . f. . . . . .�!� . . . . . . . . . . . . Building Inspector Rev 1/81 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Na. . . , Z13882 . . . . . . Date . . . . . . . September 26 . . . . . . . . . 1985. THIS CERTIFIES that the building . . . , , porch enclosure. .& .dec k.addition: . Location of Property 5 7 6 5 . . Stillwater Ave . , , . , . . . . C u t c h o g u e Rause No. Streei Ham%t County'Fax Map No. 1000 Section . . . . . . . 13?. .Block . . . . . . .4 . . . . . . .Lot . . . . 5.:1 . . . . . . . . . Subdivision , e e t w o o d Cove . . , , . . .Filed Map No. 2.63.LotNo. . . . . 14. .& . 15. conforms substantially to the Application for Building Permit heretofore filed in this office dated April ,1. . . . . . . . . . . . , 105.pursuant to which Building Permit No. . . . , .13 8.5.5 Z . . . . . dated . , A p r i 1, ,1 1 . . , . 198 . ,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 . . . . . . . . . Enclose porch and construct deck addition . The certificate is issued to . . . . . . . . . , M A T I 4 BURROWS . . . . of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . I . . . . . . . A. . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . . . N/A. . . . . . Y", �C,c?-c� c. ,.,. Bui ding Inspector Rev.1/81