HomeMy WebLinkAbout1000-115.-4-31 #; TOWN OF SOUTHOLD
Rental Permit
0662
Owner Scott & Michelle Fritscher
Occupied as Single Family Dwelling
Located at 5375 New Suffolk Ave Mattituck 115.4-31
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.
9/13/2024m&E `
rc n fficiall
This Notice must be posted by the main entrance at all times
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TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802 11 SS, -- li -'1�1
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE. C/O [ RENTAL
REM KS:
64� LW AA
DATE l INSPECTOR
Town Hall Annex � �, Telephone(631)765-1802
54375 Main Road ^` Fax(631)765-9502
P.O.Box 1179
J
Southold,NY l 1971-0959 � ��
y,
5 F P 2024
BUILDING DEPARTMENT
TOWN OF SOUTHOi►
Building Department
RENTAL PROPERTY CERTIFICATION own of Southold
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Professional,seal requiredcar Architect or Engineer, licensed Home lns ector must provide
co v of valid current certi lcatlon
Rental Property SCTM Number: Q - 0
Rental Property Address: ��-
Owner/Name:
Rental Dwelling Unit Identifier:
Number& Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom #1 -100 sq., Bedroom #2-90 sq., etc.)
Property Description (Include all improvements indicated on survey
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it
fully complies with all the provisions of the Code of the Town of Southold,the Residential Code
of New York State,the Building Code of New York State,the Plumbing Code of New York State,
the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New
York State,
ti
leg t °
P 'int Naq and Title � " � 0 Original Signature
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V
Please place professional seal:
xichar . M . Mato, Architect
TOWN OF SOUTHOLD
Building Department
54375 Main Road
Southold, New York 11971
September 11, 2024
RE: Fritscher
Tax Map# 1000-115-4-31
Rental Permit#0662
To whom it may concern,
This letter certifies that the above mentioned property information has not
changed.
Should you have any questions regarding the enclosed,please feel free to
contact me.
Sincerely,
Richard M. Mato,A.I.A.
P.P. Box 2284
Aquebogue, NY 11931
Tel: (631)523-5879
E-Mail: rmatoarchitect@gmail.com
T "WN OF SOUTHOLD
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Rental Permit
0662
Owner Scott & Michelle Fritscher
Occupied as Single Family Dwelling
Located at 5375 New Suffolk Ave. Mattituck 115.4-31
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.
6/9/2022
ode E �r e ficial
This Notice must be posted by the main entrance at all times
rzw
b
Town Hall Annex Telephone(631)765-1802
54375 Main Road a? Fax(631)765-9502
P.O.Box 1179 P
Southold,NY 11971-0959
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:
I I P l k._w 4.:ve ..�J,1 to n/L19 5,�,
Tax Map Number: 1000 SECTION d -BLOCK ? LOT _" f
SECTION B.
OWNER INFORMATION:
Property Owner Name: 111
Property Owner Legal Address: Property Owner Mailing Address:
a � m ..
Telephone Number (s): Daytim 4`- 12-14—'V"Evening i�- Emergency �&er1e
Property Owner Email Ad ress: /Vl
Page 1 of 5
Town Hall Annex t y°, Telephone(631)765-1802
54375 Main Road j` Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: �,, ___w,w, __...w .._..
Address of Authorized Agent (no P.O.
Mailing Address of Authorized Agent:,................mm........� _ ___ _._._..._
Telephone Number(s): Daytime,,µW, ......... 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):mww _ _MM
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 Hall Annex "3 Telephone(631)765-1802
54375 Main Road �� �� Fax(631)765-9502
P.O.Box 1 179
sl
Southold,NY 11971-0959 k ,ty
1"T
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION ADDENDUM
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 un
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:
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
d`
P.O.Box 1 179 All, 4
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:..,_,_-...
Telephone Number(s): Daytime Evening .....____Emergency_,,_,,,,_,
EmailAddress:...._ww__m.... ........ _..................................... ............. .......... _. .
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 Unit:�. .
Number of rooms in Rental Dwelling Unit: ggMe
Use and Dimensions of each room in Rental Dwelling Unit: w�,_ w
Page 3 of 5
,off iiCe i
Town Hall Annex Telephone(631)765-1802
54375 Main Road �`} Fax(631)765-9502
P.O.Box 1 179
Southold,NY t 1971-0959 V41rr.
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
C� 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)
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 qq' Telephone(631)765-1802
54375 Main Road k Fax(631)765-9502
P.O.Box 1179 x
duo-
Southold,NY 11971-0959
T .,i
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: 5co, {µ� L�?P�' ww.._.........
_....
Property Owner's Signatures _..... �
Sworn to ore me thise4 day of , 20a�
Official Notary Public Signature and Originalrat« ?Stamp
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Page 5 of 5
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T� UT TD BUILD14G DI
631 -765-1802
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
C l FOUNDATION 2ND [ ] INSULATIOWCAL
] FRAMING f STRAPPING [ FINAL
Z ] FIREPLACE & CHIMNEY [ FIRE SAFETY INS
FIRE RESISTANT CONSTRUCTION [ FIRE RESISTANT PE
l
ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
[ ] CODE VIOLATION [ � PRT C � � 1
DATE � � INSPECTOR
` hone(631 765-1802
Town Hall Annex b` r': Telephone )
54375 Main Road k? Fax(631)765-9502
P.O.Box 1179
Southold,NY 1 1971-0959rc
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
F'ro essional seal re iced or architect or n inset ticened ltorrme In etor mast rovide
CoPV of valid current certi ication
Rental PropertySCTM Number: r
Rental Property Address: ' ew � �
Owner/Name: ,
Rental Dwelling Unit Identifier: �. w
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 —100 sq., Bedroom#2-90 sq., etc.)
�014
Property Description (Include all improvements indicated on survey)
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it
fully complies with all the provisions of the Code of the Town of Southold,the Residential Code
of New York State,the Building Code of New York State,the Plumbing Code of New York State,
the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New
York State.
,rpt W
Pr t i1e " ` � Original Signature
Pleas ace`pr slynal ea
61,x 014 18 6
OF °M'
-711 G 113
TOWN OF SOUTHOLD PROPERTY IMAJKLO %. KU
OWNER 'STREET PILLAGE GrE DIST.
SUB. LOT
�
FORMER OWNER N E ACR
S W 1 TYPE OF BUILDING
RES ' SEAS. VL. FAW COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
fif
S� UA
f Ank
7�,
2
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
1 House Plot BULKHEAD
Tota` DOCK
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COLOR TRIM
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F
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a
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M. Bldgst
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Extension -- --
Extension
Extension
Foundation Bath Dinette
4
Porch - Basement Floors _ '� K K,
t
Porch > Walls Interior Finish - LR.
Breezeway Fire Place Heat
Garage Type Roof —-- Rooms 1st Floor BR.
Patio Recreation Room '. Rooms 2nd Floor FIN. B ,
0. S. Dormer Driveway
Total ��
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. Z.:!-23.76....... Date ......................... .......... .. 19.66..
THIS CERTIFIES that the building located at -ff/6....New.-S folk.4vo.-W/.-Wt.,Rdtreet
Map No. ...XXX........... Block No.XXX............... Lot No. ...X.7M.........Natti..Wokp...N.Yo............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.................................September.....29., 19.-60, pursuant to which Building Permit No. ��$�•.,`�,.•
dated .................................$;ept.-29...... 19:65..,, 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 ........
Er.ivate..4fte..;&Ml y..d-V$11isig................................................... ... ..................................
The certificate is issued to .-Ger-tr .dffi.-Bold Jin.......... e!..............,... .. ..........................•..
(owner, lessee or tenant)
of the aforesaid building.
H.D. Approval March 22t 1966 by R. vile.
..............
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