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Home My WebLink About1000-143.-2-12 TO N OF SOUTHOLD fr Rental Permit 0650 Owner Mattsigs LLC Occupied as Single Family Dwelling Located at 615 Sigsbee Road Laurel 143-2-12 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. 5/17/2022 3e End re iial This Notice must be posted by the main entrance at all times p Town Hall Annex �'�% �,';�vi �„ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 1 1971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD �� e RENTAL PERMIT APPLICATION„ Rental Permit Fee $200 (Application must be renewed every two years) �3 2 Section A. Property Information: Rental Property Address: (( ... . ._... ......._..mm.._ . ,_.. �1 rp Tax Map Number: 1000 SECTION -BLOCK.....03-0.! ...._._....-LOT. .D/... .._ .................... SECTION B. OWNER INFORMATION,.,,,----, Property Owner Name: � p ��//+,. ,w...�.�..._�..... ... �" � .............._._....�._..��-..�..._.�._�_�.,_.. �.�...,� Property Owner Legal Ad, ress: Property Owner Mailing Address: 0 .../. Telephone Number(s): Daytime_...___ Evenin ...__,_„ ...... Emergency tv Property Owner Email Address: )i)^ 1 ° ; IT...m.. .___... ... .... , . Page 1 of 5 Town Hall Annex e //�/� /�i�iji 1 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. Box ]179 Southold,NY 1 1971-0959 '; t11 . BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ._...._.._......W . _ ..._... . . ..._... ._..�..... Address of Authorized Agent no P.O. Boxes Mailing Address of Authorized Agent: _ Telephone Number (s): Daytime,... �.�...� ,,,,___ Eve 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: .._..._.._.m....._.............. ..w ._ ........_......... ......._... ....wvw.._._....._...... . Telephone Number(s): Daytimeµ µ _ Evening_ _ Emergenc.yµw_._ EmailAddress: _ ...... ..� _.__._ _._w__............. .. .,...... ._ ..... SECTION E. SITE MANAGER INFORMATION: (required for rental propertie containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes)4_.. .. M.M..M...M._._.._.w...,... _.a,M ..�_.___...__...,w_._wv._...............�....._ _. ....._. Page 2 of 5 Town Hall Annex ,% '�ri�' ''�� Telephone(631)765-1802 54375 Main Road 7�' ;;��a� Fax (631)765-9502 11,0. Box 1 179 SouLhold,NY 11971-0959 ,,; BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number (s): Daytime.. .�.._...... Even ing.........._............... _�_........... Emergency ....�.�.,. ...�....�_�__,.�._.�_..... Email Address: ........... SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property _...._.�...� ......�.�.....�..�...a............. �............_. �w. _.. mm ....__...._....._�_....��... 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: w ._.m___ ..._.._. . U w and Dimensions of each room in Rental Dwelling Unit m f" "� �e Q tg Page 3 of 5 4 �/1f r' Town Hall Annex ��i��1�� i�/ Telephone(631)765-1802 54375 Main Road %i� � �'� Fax(631)765-9502 P.O. Box 1 179 Southold,NY 1 1971-0959 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. pf I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ lam 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) 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 l /r / 2 f � Town Hall Annex � ��/ Telephone(631)765-1802 54375 Main Road i,,�� ✓l;//!% Fax(631)765-9502 P.O.Box 1 179 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. n p y °' Pro ert Owner's Name /'r/�'.��.� __...._.. .. � �..w..m_.._....__,_.....�..._. _. .�..�......w..... Property Owner's Signature: Sworn to before me this 4 day of 20._Z1) Official otary Public Signature and Original Notary Stamp LII M.M 1 OT�►ffrtfsl CSIfU.S Now .I Ouwslifind in f1 uu C":r MMis sion,E) Ire Ra bra�tSrV 2 . Page 5 of 5 of soHa * ,TOWN OF SOUTHOLD BUILDING DEPT. - < �� a` I -Ak, 3INSPECTION , 'A FOUNDATIONISTCROUGHPLI3G. , INSULATION/CAULKING FRAMING /STRAPPINGAL 4wkllrFIRE FIREPLACE & CHIMNEY INSPECTION CONSTRUCTIONFIRE RESISTANT IRESISTANT ELECTRICAL ( ELECTRICAL CODE VIOLATION PRE C/O RENTAL INSPECTOR rc— i os. w&. `Sgbee, PA . �° 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] F AL [ ] FIREPLACE CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: c/. �� o DATE �� INSPECTOR i ......._._. o .... . a ... a G 0 y � - ............. .......... _. _ . .. _ _ ...... .. .. ... SCTM # TOWN OF SOUTHOLD PROPERTY RECORD Ct OWNER STREET VILLAGE DIST SUB, LU 1 ve ACR. REMARKS TYPE OF BLD. PROP. CLASS z LAND IMP, TOTAL DATE - - 3 I d E _ FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL ,l C) `SOWN OF SOUTHOLD PROPERTY RECORD —OWNER, STREET VILLAGE DIST.` SUB. LOT � f FORMER OWNER N 4 - E I ACR. . S - RC1 � _ _ � BUILDING t � a W TYPE OF BU Df G - - I RES. J�1 SEAS. VL. = FARM COMM. CB. MISC, Mkt. Value LAND IMP. TOTAL DATE REMARKS _ y ..... % { - I \' - l -- = �- `-} �.. AGE BUILDING CONDITION `J�-`z. /1 V� t P; 1770 NEW NORMAL BELOW ABOVE3 r T T p a 1 _ t �`t ' s '1 gam_ FARM Acre Value Per ( Value ! Acre �.- � L z � 3' �� 0(.� I Tillable 1 Tillable 2 ' �� I'J('rtt Tillable 3 - 3 Woodland Swampland FRONTAGE ON WATER e : FRONTAGE ON ROAD 0/1 AA - Brushland V c � oil House Plot DEPTH - BULKHEAD 2 Total ' DOCK - - a a sr , a I 1Ins T I I I rRlnn E _ _ 3 �.., � r i 0e s - _ - 143.-2-12 3/1212020 c - tv1. Bldg f �> to Feunc!ation o n �� _ Both Dinette Extension r 'Basement ° Floors _ I . Extension }Ext. allI I` Interior Finish LR, tj s Extension =I -Fire Place _ ; Heat DR. Type Rooft Rooms 1st Floo BR. i gr a 3 Styr ,�( Recreation Fro-om - Rooms 2nd Floc - F!N. G. i --- t Dormer BreezeWay :Driveway t.: Garage Patio i 1 3 0. B. _ I I _s ---------- Tota! - C?C?a -3 a a j 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- 31830 Date: 09/21/06 THIS CERTIFIES that the building DWELLING Location of Property 615 SIGSBEE RD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 143 Block 0002 Lot 012 Subdivision Filed Map No. Lot Na. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL_9, 1952 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 31830 dated SEPTEMBER 21 2006 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 WITH ACCESSORY WOOD FRAME ACBE*. The certificate is issued to HERBERT A GUNTHER & ORS. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF $EALTH APPROVAL www. NZ„A ELECTRICAL CERTIFICATE NO. ww NA PLUMBERS CERTIFICATION DATED �NIA *PLEASE SEE ATTACHED INSPECTION REPORT. Au orized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD jgkt S'jgg C DE' INSPECTION' REPORT LOCATION: 615 SIGSBEE RD LAUREL SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): HERBERT A GUNTHER &_.2P,9. _- ---- OCCUPANCY: SINGLE FAMILY DWELLING HERBERT A GUNTHER & ORS. ADMITTED BY: HEATHER GUNTHER ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TALC MAP NO.: 143 -2-1.2._ ._ SOURCE OF REQUEST: HEATHER GUNTHER 8 2 506 DATE: 09/21/06 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME $ STORIES: 1.0 $ EXITS: 2 FOUNDATION: CEMENT BLOCK CELLAR: PART CRANL SPACE: TOTAL ROOMS: IST PLR.: 5 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S) : 0.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: NONE GARAGE: 1 CAR DOMESTIC HOTHATER: YES TYPE HEATER: AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: YES HOTNATER: YES 011M; SEPARATE HOT WATER HEATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: .1-1/2 CAR-WOOD FRAME STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST-: ......, OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION' ___J_ww C)ESCRIPTION .ART SSC.. q N D I g I I M I p I I d � b b REMARKS: _ _ .....................w....... INSPECTED BY: ON INSPECTION: 08/29/06 GEORGE GILL T17SE START: END: til t� " Town of Southold 12/6/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40898 Date: 12/6/2019 THIS CERTIFIES that the building ALTERATION Location of Property: 615 Sigsbee Rd,Laurel SCTM#: 473889 Sec/Block/Lot: 143.-2-12 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/28/2018 pursuant to which Building Permit No. 43148 _ dated 10/18/2018 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: _ DITIONS AND ALTERATIONS INCLUDING ENTRY DECD ANT)Ol.�w�'QOO9,HOW 1�R T�':�,. AD EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Farley,Lance of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43148 11-11-2019 PLUMBERS CERTIFICATION DATED 10-15-2019 a Bugdin it ori- >d ignature . .......... ........... ........... ,plt14 Town of Southold 12/9/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 .......... ........ ............ CEI TWICATE OF OCCUPANCY No: 40907 Date: 12/9/2019 THIS CERTIFIES that the building ACCESSORY ALTERATION Location of Property: 615 Sigsbee Rd,Laurel SCTM#: 473889 Sec/Block/Lot: 141-2-12 ............ Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/15/2019 pursuant to which Building Permit No. 44323 dated 10/22/2019 --................— ............. 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: ALTERATIONS TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR The certificate is issued to Farley,Lance ............................. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44323 11-08-2019 PLUMBERS CERTIFICATION DATED Ynature r f /�f 'o . Photo 43-1 Photo 43-2 44) Basement full bath J 1 114 m Photo 44-2 Photo 44-1 Y r 1 l f err n r �rww1 �an� i6 f, F Photo 28-5 29) `/All smoke and CO alarms are present where expected. M l > n Photo 29-1 Photo 29-2 k IT Photo 29-3 a Photo 42-5 42) Extra pics , 17 ta Y, MIMI �i 7a r� y 2 Photo 42-1 Photo 42=2 k m , i� iii/ MWIMMMtiwwCeu, On r i JO it Photo 42-3 Photo 42-4