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Home My WebLink About1000-113.-7-10 TOWN OF SOUTHOLD Rental Permit 0927 Owner Lisa Israel & James Gross Occupied as Sitigle Family Dwelling Located at 2415 Cox Neck Road Mattituck 111-7-10 Maximum Permitted Occupancy 8 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. 6/8/2023 Code of � ment off c This Notice must be posted by the main entrance at all times Nrr<. w Town Hail Annex Telephone(631)765-1802 54375 Main Road � ,� Fax(631)765-9502 r P.O.Box 1179r r } Southold,NY 11971-0959 UN �r BUILDING DEPARTMENTID TO" OF SOUTHOLD MAR RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 2415 Cox Neck Ind, Mattituck NY 1195 l2 2 Tax Map Number: 1000 SECTION 1 ✓ -BLOCK SECTION B. OWNER INFORMATION: Property Owner Name: Use Israel Property Owner Legal Address: Property Owner Mailing Address: 2415 Cox deck Rd 2415 Cox Deck Rd t Mattltuck NY 11952 11952 Telephone Number(s): Daytime 845-304-9330 Evening Emergency_ Property Owner Email Address: fiisaj llgross@clo:.:d.com Page 1 of 5 Town Nall Annex ; Telephone(631)765-1802 54375 Main Road ; '-' Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 d � T BUILDING DEPARTMENT TOWN OF SOU O` Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: Address of Authorized Agent(no P.O. Boxes): SILIL Mailing Address of Authorized Agent: , �_... Telephone Number(s): Daytime--1-Z,, .:!�!O- Evening, _ Emergency Email Address: i ` » 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. Page 2 of 5 Town Hal!Annex Via` ' Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 M ' Southold,NY 11971-0959 � Mr, BUILDING DEPARTMENT TOWN OF SO HOLD Mailing Address of Managing Agent: _ _ _ _,.,�_._ ..,. �_...__ .... .._.. Telephone Number(s): Daytime Evening Emergency__ Email Address: SECTION E. 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; Number of rooms in Rental Dwelling Unit: �Z Use and Dimensions of each room in Rental Dwelling Unit: � � rslla Z2.� 4 ` 12 . ` .fix 11'ky!` ZaTo.., Z ...! `k��b�� Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ^^ " Southold,NY 11971-0959 Plout 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 Fre 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 ❑ 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 bra� iti CM 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 r Town Hall Annex ; Telephone(631)765-1802 54375 Main Road �� i Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 c LL r fi BUILDING DEPARTMENT TOWN OF SOUTHOLD applicable laws and rules. I further acknowledge that 1 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: ,' 5 ��r0 SS Property Owner's Signature: _.._ Sf Sworn to before me this day of , 2o23 Official Notary blic Signature an rlginal Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01^WF306900 OUA.LIFIED IN SUFTOLK COUNTY COMMISSION EXPIRES JUNE 30,ZQ)J!p Page 5 of 5 jCtf S0 � TOWN OF SOUTHOLD BUILDING DEPT. cou -1802 -~ INSPECTION [ ] FOUNDATION i ST [ ] ROUGH PLSG. INSPECTIONFRAMING /STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL FI N [ ] CODE VIOLATION [ ] PRE C/O [ ,,`f ENTAL REMARKSM-1�� e ..m. TOWN OF Sa lNiPIE"10N I FOUNDATION 1ST ROUGH PLBG.' FOUNDATION 2ND INSULATION/CAULKING FRAMING I STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION RESISTANTFIRE IRESISTANT ELECTRICAL (ROUGH) ELECTRICAL (FINAL) VIOLATIONCODE DATE INSPECTOR � ' Town Hall Annex SOUTHOL D TOWN 54375 Main Road PO Box 1179 Southold, /f/m fu Rental 1g§ @Ct10n NY 11971-1179 Tel: 631-765-1802 Fax 631-765-9502 SCTM # _._..�........�._,.._.._ �I ,� _.�� ._.�.�.� Date Owner __M Phone Address /�� o� _ Zip City Inspector LEVELS SUB 2 3 1 Smoke Detectors (#-bedroomdetectors excluded) Carbon Monoxide Detectors Fire Extinguishers (#) Exits (#) BEDROOMS 1 2 3 Smoke Detector Alarms .. _m. Carbon Monoxide Alarms (#) _..___ _... .._. r .- •• ---• -- _ .. _ Eadress (windows) (Y/N) BUILDING SYSTEMS TY `AWN Y/N CONDITION OF PROPS Building Interior is clean / maintained p ti al - Building Eclean l/salean fe/maintained d F-ieatin .� stera� maintained/operation Hot waters sterA maintalnei/oer oval a Electncal s6eari maintal� �d o tionai _ Property is �. ._____ ;rationai � Handrails & guards present Mechanical system maintain d/ COMMENTS 4 d1 n-S--. ...,.--------_ � _� ��_-----_._. Rental Inspection Form 4/7/2021 S i t p t i i t' r a S _ g i t y 3 j _ x f i v , s , _ affix ' i ,ate-� �>✓ _� �_ 17 al gw+oA.�, --- i" " s 1_ 'Ell 3 _ 1' .a � a > AA 4 gee . ) 1 - t1 c35 P = a�Yrttf S�i1L../Ec�1�Artca� ./�°I�e� I 7�1 3 l [ 3 x _ i q 1; z V12 � a 1 I #3 1 a q 1 anc+xaMi of M .3 5 Mpu€ v I a u6.imatau - �6 1 tiW AV�Ite a <t '^. l 03�� I>51 K9(.Y91L GAX IeHj0R1aii0 fiffi4a.;RDAKC#6'1ECTffi1Aii�,CCL Eld Town of Southold 6/3/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42051 Date: 6/3/2021 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 2415 Cox Neck Rd.,Mattituck SCTM#: 473889 Sec/Block/Lot: 113.-7-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/3/2020 pursuant to which Building Permit No. 45599 dated 12/23/2020 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: n x e farrai w flingv t afin sl e sem rlt ont,.fiver c entry.rear covered orch and attached two car alla )lied fr, 4 Bedro m The certificate is issued to 153 Herricks LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-20-1743 5/10/2021 ELECTRICAL CERTIFICATE NO. 45599 4/22/2021 PLUMBERS CERTIFICATION DATED 5/20/2021 rian Kon' Signature Town of Southold 6/11/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CER'T'IFICATE OF OCCUPANCY No: 42079 Date: 6/11/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 2415 Cox Neck Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 111-7-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/14/2021 pursuant to which Building Permit No. 45755 dated 1/28/2021 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: ces r .i oun swinimin e ced to code a a died for. The certificate is issued to 153 Herricks LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45755 4/22/2021 PLUMBERS CERTIFICATION DATED _... tho '° cd'Signature..._w.. � 1 TOWN OF SOUTHOLD PROPERTY RECCE 3� t OWNS _ STREET VILLAGE - DIST. e E FORMER OWNER N E ACR. 41 S W ; TYPE OF BUILDING RES ' SFAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP, TOTAL DATE REMARKS a _ e a f t 3 i T _ AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE r t — FARM Acre Value Per Value v Acre Ji Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH ,s 3 House Plot I BULKHEAD LKHEAD Total DOCK E i - COLOR TRIM _ s ------------ E a ; p E ? E y ` � f � � E � E E '- M B;dq. - # 3 F Extension – E �. i Lf' Extension Extension Foundation jBath Dinette ; Porch E _ . � � t t Basement K. x = Floors Porch Ext. Walls `. 3lnterior Finish 1 LR. afeezeway i } Fire Placej Heat , DR. _ — 3 Garage t `' ; j Type Roof j - Rooms 2st Flccr BR. 9 Patio Recreation Room !Rooms 2nd Floor i fl. B. =Dormer ;Driveway Total # i I