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Home My WebLink About1000-123.-3-20 r?'A?Z-0 _ IONAVIN OF SOUTHOLD z Rental Permit 0924 Owner 1645 Bungalow LLC Occupied as Single Family Dwelling Located at 1645 Bungalow Lane Mattituck 123.-3-20 Maximum Permitted Occupancy 6 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. 6/7/2023 Official e a e r� � c This Notice must be posted by the main entrance at all times Town Hall Annex 'k- Telephone(631)765-1802 54375 Main Road � H, Fax(631)765-9502 P.O.Box 1179 � � � Southold,NY 11971-0959 co Ll �ti;a1� BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: ganoolow Lene, Y` 6l -'k*vct 1-J l� ys�Z Tax Map Number: 1000 SECTION 12-3 -BLOCK 3 -LOT 2 0 SECTION B. OWNER INFORMATION: Property Owner Name: 6 �SJ Qun �� L L Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Da me ° Evening 54'me_ Emergency Property Owner Email Address: ��_ (A4 es/O QtrtjI a O-rrn Page 1 of 5 r ° w Town Hall Annex Telephone(631)765-1802 54375 Main Road . Fax(631)765-9502 C P.O.Box 1179 Southold,NY 11971-0959 ire" � Y BUILDING DEPARTMENT TOWN OF SO GOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: -T')da tZ 0+-k .�.,- Address of Authorized Agent (no P.O. Boxes): 9� Pcf'^k 0C2c,11 fCcl. rnun��ss�� ✓v v �l o�� Mailing Address of Authorized Agent:.,_ ._ SaM► e' Telephone Number(s): Daytime J/6-3/6-2979 Evening sQm?- Emergency s�6-3�z-15 y0 Email Address: 6� �o �n 4'o j ), j,e, 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 Annexe" ht Telephone(631)765-1802 54375 Main Road �`h Fax (631)765-9502 P.O.Box 1 179 Southold,NY 1 1971-0959UN D �` .> BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: w m -rtwwwww ._ Telephone Number(s): Daytime Evening Emergency_,_..-..-o 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." 11I �a Rental Dwelling Unit Identifier: U ¢Mv m, Requested Maximum number of persons allowed to occupy Dwelling U Number of rooms in Rental Dwelling Unit: .. s N Use and Dimensions of each room in Rental Dwelling Unit: gedroOm I - 4 _4f;wm Z - 11 'x iD'z'' �Pc�r 3 ID's"x 9 Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road NJ Fax(631)765-9502 P.O.Box 1 179UC AY 4"� 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. P4 1 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) ulryw L L G 16Y �� V� I dell flzl�� J'A momur certify under penalty of perjury,the following: Ci A 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 Annexe Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 ( ) P.O.Box 1179 Southold,NY 11971-0959 "6 101i t ,e ff`I UN BUILDING DEPARTMENT TOWN OF SO HOLD 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: y� du� ( L L C Property Owner's Signature: 11.71 C d vA Swor "pre hi day of 1"Y.+ , 20 > Of iciaSignature and Original Notary Stamp NILUA L Pt-rLA fit U Nitary Public, st,%te of riew York 01 P0613'097 QuO ic,J in Nassau County rertil.rsd in New York County Commrcssion Expires Dec. 19,20 Page 5 of 5 E�I!j-TING WINDOW SCHEDULE Yj BATH ADD VIER E)asiiNG ST ED 0 DEOC AR r-*� WNDOW SCHEDULE v�- L WY T UVEG ROOM Lii z I 40 Z 0 W -J X GZZE z le i - 0 0 w XH CK _j Z ALSAlt z-------------- Ld f7S�! U) 'o 11 0 fl 0 (o M= BEDROOM ti PoRa mr-",-"I 14 LI-LLIM BEDROOM imas c t PROPOSED FlRs-r FLOOR PLAN PROPOSED FLOOR PLAN �T EXISTING WINDOW REDUCE DOME UMILL-W r ' - �- WINDOW SCHEDULE -_ s - 9'� �._._ae�.-rte • � = L' V WY r, t aw � F EO n GARAGE ` uurioarl Room CCc,r 0 W �Z 1 � � ZLd Y z U EDF Lo s 3 Li CRAWL SPACE TO E v FULL CEILAR ] s 4 = Charles M.Thomas ' a r c h I t e c t �s 2 t roemm�r�a[nrow(ngto-in �1 PROPOSED BASEMENT PLAN -- PROPOSED BASEMENT � PLAN ani � OWNER D- LOT STREET VILLAGE N ACREAGE 1 TYPE OF BUILDING COMM IND VL. FARM CB AND AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Form Acre Value Per Acre Value Tillable I | Ti|fab|m 2 / ---- - ----- - i - - - --- --' - | TUlobhe 8 | ________ ^�L=� y-�� 6 - � - --- Swornpland Bnus6|on6�=~ | - --- ( - ------ - -- ' -- - -- -- House Plot ( | � _ . / f � r e� - 17 I - { 10/1812022 3/20/2020 � � .N - } AA- 3 I ;N Foundation Both Basement i lours - - n E Its Interior Finish _ xt Wa Fire Place Feat Pu rcAttic fiC —Rree ___k. < i Patio Roorns 'nd Four € , E t s 0, B- 5 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. .Z12415. . . . . .. . . Date . . . . . . . . .April. 5. . . . . . . . . . . . . . .. 19 8.4 THIS CERTIFIES that the building!$7 7.W. . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . , . . . . Location of Property 1645 Bungalow Lane Mattituck Wause IUo. Street Hamlet County Tax Map No. 1000 Section . . .12 3. . . . . .Block . . . 3 . . . . . . . . . .Lot . . . , 920 Subdivision . . . .X. . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. X . . . .Lot No. ? . . . . . . Requirements for a private one-family dwelling built prior to conforms substantially to the Applieeticxrfor-BtdMirtg-Permit--heretofore• ' in-drir-af'f wlda ed Aril p Certificate of Occupancy . . p a 2.3 . . . . . . . , 19 . .�.pursuant to which Bold rmiwt No. . . . . . . . . . . . . . . dated . . . . . April 5. . . . . . . . . . . . . . . 19 . 84 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, private one,-family dwelling and accessory one-car garage. The certificate is issued to . . . . . . . . . . . . . . . .HAROLD H. & JOAN F. WHELAN . . . . (owner,ksseeartbnarrt�l of the aforesaid building. Suffolk County Department of Health Approval . . . .nQ. XeQQrO. . . . . . . . . . . w . . . . . . . . . . . . . . .. UNDERWRITERS CERTIFICATE NO. . . . . . . . . . RQ .rcc=(d. . . . . . . . . . . . . . . . . . . . . . . . . . .. . SEE ATTACHED HOUSING CODE INSPECTION REPORT. Building Inspector Rev.1/81 BUILDIP-2 DEPAa':�-177NT TO-Jill GF SOUTEOLD, N. Y. HOUSING CODE INS-ECTTON REPORT Location 1645 Bungalow Lane Mattituck T.LW, 00 9 Fr C.t (Vit nic Lpal..tyj Subdivision M-Dp NO. Lot(s)_ Name of Nner(s) Harold H. & Joan F. Whelan Occupancy R-1 owner C:iFy--p 7e tvner--,erant) Admitted by: Mr. Whelan Accompanied by: same Key available Suffolk Co. Tax No.__123-3 .2.0a Source of request Harold H. Whelan ___Dcte 3/23/84 MFE'LLI'M, Typo of construc".,'Lon #ztories, 1— Fou-ndvt,'Lon block —Celiar_a�rtja]Crawl- sp-,.ce—rest— To,'-L,l room,-,, 1st. F1 5 2nd. F1 3rd. F! Bath.room(s)_ Toilet room(s)— Pr-rch, ty-p-� Deck, type Patio, type Bre,2ze-,•iayqarage__ Utility r,Dom___ Tvr', 11C.'It oil firedWarmAir central Ho'Lvi✓ter--- Fir,:placr(--)I---,—Nc. Exit-zs 2 --AL,conditionira.— Domers'i c he twat er T-,Ij)�, hoate'r ___5,as 0 t,h Cr--- STPUCTTJ',qES- Garoge, type const. wood, one-lcarStorage, type const.—.-- 1-j-'imminG P001 Guest, type const. 0 thsr w od fence, west side yard VIOT,ATIONS: Housing Coc7. 7, Chapter 52 L-,r at i on Desc-rivtion ArT,. I See to -,-dq. need som6re3Dairs -TIII 5230-fit --A- �a kitchen, 7_was stove--no shut off Remarks: Inzpectad by: Dale of 1nsp.__.aj_3q.ZaA_. Curtis W. 'Horton Time start 3:01 end 3:30 ........................ ............... ........................ Town of Southold Annex 4/2512012 P.O.Box 1179 54375 Main Road Southold,New York 11971 .. ....................................... CERTIFICATE OF OCCUPANCY No: 35560 Date: 4/25/2012 ............ THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1645 Bungalow Lane, Mattituck, —1-1-11 11 ..'........... ........... SCTM#: 473889 Sec/Block/Lot: 121-3-20 ................... I ——............. ............ Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/1/1900 pursuant to which Building Permit No. 15855 dated 4/4/1987 .......... .. .... 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: renovation and adOtLtiop. udjM4pck to an exis!� Ilin'. This417 . i 2"3/89. L The certificate is issued to Joan Whelan (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL .. . ......... ELECTRICAL CERTIFICATE NO. N-019532 6/28/88 ............. PLUMBERS CERTIFICATION DATED 11/10/88 Henry G. Lange, Jr. u-ioriz/Sig t-11,ture 6W Town of Southold 2/12/2023 P.O.Box 1179 53095 Main Rd ° Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43834 Date: 2/12/2023 ...... THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1645 Bungalow Ln, Mattituck SCTM#: 473889 Sec/Block/Lot: 123.-3-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/3/2021 pursuant to which Building Permit No. 45978 dated 3/25/2021 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: alterations nd additions hicludi go v!°ed ntry aj d finashedw, g4pn ent; to g,:si in sin le-family dwelli11g, p„pl ed for. The certificate is issued to 1645 Bungalow LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45978 1/20/2023 PLUMBERS CERTIFICATION DATED James Orlowski (➢ 0/2022 th iz gnature