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Home My WebLink About1000-106.-10-4 OWN OF SOUTHOLD W W Rental Permit 0768 Owner 1200 W Mill Rd LLC Occupied as Single Family Dwelling Located at 1200 Mill Road Mattituck 106-10-4 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. 11/7/2022 ode E or ewe � i This Notice must be posted by the main entrance at all times Telephone(631)765-1802 Town Hall Annex 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL.PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) i a Section A. b � Property Information: �` MAY 2 6 202 Rental Property Address: 1200 W. Mill Road Mattitucl< NY 11952 Tax Map Number: 1000 SECTION 106 -BLOCK 10 -LOT 4 SECTION B. OWNER INFORMATION: Property Owner Name: 1200 W. Mill Rd., LLC Property Owner Legal Address: Property Owner Mailing Address: 6245 Cox Lane 6245 Cox Lane Cutcho ue, NY 11935 Cutcho ue NAY 11935 Telephone Number(s): Daytime631-445-7879Evening Emergency Property Owner Email Address: cheryl@corazziniasphalt.com 2.0� I�G tole Pagel 0 5 Town Hall Annex R" Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 , , Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOU . . OLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: McCarthy Management, Inc. Address of Authorized Agent (no P.O. Boxes): 46520 County Road 48, Southold, NY 11971 Mailing Address of Authorized Agent: SAME Telephone Number(s): Daytime 631-765-581!ivening Emergency Email Address: tmccarthy.tmccarthy@gmail.com Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: NA 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: NA Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex hone(631)765-1802 �� Telephone 54375 Main Road Fax 765-9502 N� �� ) P.O.Box 1 179 Southold,NY 11971-0959 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: One 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 Uni . 8 Number of rooms in Rental Dwelling Unit: 10 Use and Dimensions of each room in Rental Dwelling Unit: 4 bedrooms, 2 1/2 bathrooms, EIK, living &family room. Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road jw1b'f Fax(631)765-9502 P.O.Box 1179 , 5 Southold,NY 11971-0959m aka COU 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 afire 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) 1 Richard Corazzini 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 ix Fax(631)765-9502 P.O.Box 1179 ,� � j Southold,NY 11971-0959 ' ;��+, 7 BUILDING DEPARTMENT TOWN OF SO1 TT". OLD 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: Richard t; zini Z, Property Owner's Signature: ' AKAA4, Sworn to before this day f&-1--- 2a Official Notary Public Si re and Origlna otary Stamp THOMAS J.McCARTHY Notary Public, State of New York Suffolk County- No. 5004790 Commission Expires November 23,202� Page 5 of 5 i 1 st Floor , 4 16' 71 i Patio Bedroom u T 9' 9$ i 71 Foyer 15, V t Bath Kitchen m Bath 16 16 i Bedroom 18, e � E a � ° Living room �� ° ro 14 14 a a. au e n , 0 k R r` �i "k w� 2 0 bill o i M , � p� 1 � �. 1OCt;W, MNII Po d; a Ruck„ Y 192 4 r w 'SC � ' 1000 106,10 ,,4 #� r dd Piot To Scale gcAt 2ndF"I'o 6 r Sbat*n,' F Y ,ww � r 4 1 a �. J-- 1,ON, F e _ 21, 10, ;l . � .: A Ic 2nd Foy s a ° 4 y g � � 4 4dj- at �, w, r V ., SCIb . .. ..a.. �� a I � ALF _ e E Nct T Scale w m. - V b, aseMert 16' 7' 9 7. 'L9' m � r 7' i t i I v 1 < ( V y __6 16, ' o � L 16' x 1 q b F ' 18' s f ' 14' �.�- 14' 6 t a M a � r 20' o !, a t r r 4 1210 pll -PJIU)P�F,,t7f 01y 1 CI . Mill,Flo d, 11a1.ituck; Y 119 2 1dolD-106-10-4 6 a LF..';Not Td,Scaler �� f" 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLEG. [ ] FOUNDATION 2ND [ ] INSULATION/CAl [ ] FRAMING / ST P ING [/] FIRE NAL ... .FI E 'T C C I NEY [ SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Ful [ ] CODE VIOLATION [ ] PEE C/O [ ] N REMARKS: obml (MIAW "E �' ' ''�"''' INSPECTOR ct 7i 'LO'�- •�' SCTM # TOWN OF SOUTHOLD PROPERTY REC G�f"Z5��qQ-Q_ OWNER STREET VILLAGE DIST, Sues. LOT ACR. REMARK TYPE OF BLD. z PROP. CjtS� a v � OIL LAND IMP. TOTAL DATE FRONTAGE ON WATER HOUSE/LOT i i BULKHEAD I _ TOTAL f t - OWNER STREET . VILLAGE DISTRICT SUB. LOT FORMER OWNER N E — A _ EAGE ;� _ w g$ j,:. .v S 1 I TYPE OF BUILDING RES. SEAS. VL. I FARM COMM. 1 IND CB, MISC. Est. Mkt. Value " LAND IMP_ TOTAL DATE REMARKS t _ 4q J _ e r �v AGE ? BUILDING CONDITION Q NEW NORMAL BEL01V ABOVE FRONTAGE 0' TER Form Acre Value Per Acre Value FRONTAGE ON ROAD F Tillable 1 ,` BULKHEAD - Tillable 2 1 ! ; DOCK Tillable 3 �1 � - - ' 9 I Woodland i e- Swampland rushlo _ House Riot _. e A -4- Total Total y, e � a Lm F G i a - - - - - e M. Bldg. RAW—K� Foundation Jath Extension ( ' �� Basement �' Floors Extension , Ext. Walls J Interior Finish Fire Place Extension Heat Porch € oof Type � 3 fi � � � Ph� R1st `�=� Porch �_�on�s Floor Bey Patio �. f t` Rooms 2nd Floor Gog C Driveway �s Dormer Q. B. jvt - -IL 5 t s � ltl Town of Southold 11/5/2022 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 43569 Date: 11/5/2022 THIS CERTIFIES that the structure(s)located at: 1200 Mill Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 106.40-4 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- 43569 dated 11/5/2022 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: v orad:._ ar e is le nil elf e Ctng with slate rpat,ca, clnl nished basement and two acce anLm�(, -a The certificate is issued to 1200 W Mill Rd LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. i At )r" e Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 1200 Mill Rd,Mattituck SUFF.CO.TAX MAP NO.: 106.-10-4 __....�................. . ._................ .W.._w......_....�.m.._._�...., .._.mw...�w..._... SUBDMSION: NAME OF OWNER(S): 1200 W Mill Rd LLC -----.�................_.. � �� ........... OCCUPANCY: _.......... .................. .............. ........... �.... _-.._-w_.... .._.W----- .................... ADMITTED BY: en............................................ . .._.._..........._.__._ _w.�__................_... ...................... SOURCE OF REQUEST- Shulha,Ir e DATE- 11/5/2022 _.ww,._ w_ w �w......... .. w_---------- ............. D;WE�L'LING- #�STORI'ES: 1 #EXITS: _ 2 ---- FOUNDATION: cement block CELLAR: partial CRAWL SPACE: BAATRHROO (S): 1.5 TOILET TYPEPPATIO S) m. ._......_..1 ._.. ILITY ROOM(S): CH TYPE: TYPE: slate I3REEEWAIC: .µ�_v_._._. _�..FIREPLACE: ._____w._................� GARAGE: w DOMESTIC HOTWATER. x TYPE HEATER: off boi. _T,....___....�w_........ filer coil AIR CONDITIONING: "H'Y'PE HEAT: oil WARM AIR: HOT WATER: radiator and baseboard BEDROOMS: 2 #KITCHENS: 1 B #� ASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: 2 wood frame STORAGE,TYPE OF CONST: SWIMMING POOL: �_._µ..._. GUEST,TYPE OF CONST: Q "THER;__m_...�....................... _. _ w__..........�...... ,.w_._._._..._....._. �_.w.�_�.�_� ............... VIOLATIONS: p, w.............. ......... ....... ...._,.m_ ._... __�_._ .. ..... ...,_ .w_w . .............. .__ �_ww...... ,...�.. u d N p V c � _.M..M...,...w........................................www._---------.._�.�_.........._.�.�.�-,_ ,.__ �......�.........._............... ,�.�_....w.�.�.�...�._�..__.�. - REMARKS- _....._......... .....w....... ...�............... _.............m_._.....,...w _u.,_ _.........,.. a C P INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/27/2022 y ...................._.�..�.�.�.� _.w......_�.�..__.�_._ .� .................x TIME START: END: h K OFoloot Town of Southold 11/5/2022 P.O.Box 1179 53095 Main Rd A Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43568 Date: 11/5/2022 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 1200 Mill Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 106.-10-4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/25/2022 pursuant to which Building Permit No. 48389 dated 10/11/2022 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: "as lauilt"'altgratic n to kitchen and t r a la tl rooms a Pl gd;_Lor. The certificate is issued to 1200 W Mill Rd LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 22-85150/48389 9/27/22/10/20/22 PLUMBERS CERTIFICATION DATED _ 9/23/2022W yW^ i Plumbic ri- d lgn tune FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. n Certificate Of Occupancy No. M.. . . . . . Date . . . . . . . . . . . .baa 28 . . . . ., 19. THIS CERTIFIES that the building located at .Gox .ftok.Road . . . . . . . . . . . Street Map No. PF. . . . . . . Block No. . . . . . .Lot No. ? - - • .M 4t uck N.Y•. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .1 19 71 . pursuant to which Building Permit No. Om- . dated Se ?t . . 11 1973 , 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 Prigate one family . . . . . . . . . . . .. . . . . .. .. . . . . . . » . The certificate is issued to Mrs. Thgdg. . .4. . . . . . . ¢r . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R. UNDERWRITERS CERTIFICATE No. N13�225. . . . . .J� . • . . •. .10 �� . . . . . . . . • . . • . HOUSE NUMBER .$204 - , , , . Street . .W,- M3.11- Raad . . . . . .. . . .. . . . . . . . . . . . . . . Building Inspe for McCARTHY MANAGEMENT, INC. • 46520 COUNTY ROAD 48 SOUTHOLD, NY 11971 qq &............... ..w....�� .... 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WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via........._...... _.. ..ww._..........._�w_ww. flee following items: 5 ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order V.V _ ._ __ w_....�_._._ _.._ ..._ �._......... ._....._ww.,..... liall! in .......... _._. _ __ .._.__.. _.. ..fj_. ..._�cd ..,,_ .w.. .._._...................ww.. .__....... __wwwww .......... ww_t _._._.......... .ww_ w ............._..............__w .__......._.......m ..ww........ _ ...... .............._.... �w�www_._._ _, ..__._._......... ....M.w�w�ww._ . .. ........_ ...vv. ..._..._....�_._..M...m.... _ _�....... _.. ...._____...._......._.w.w ._._www_��_ . ._...w._..........M.M_..w_.__�__w ... .......__www_ __ .w_............... .�._..... . �,�...�... ..ww..._. � ...�.m...__ ..._�.�.� �.. ............. ..:m��.�. _.. ..._._....mm_.w.w_._______.�......_..........w ........�_ THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit .m........._........ ..,copies for approval ❑ For your use ❑ Approved as noted ❑ Submit .. ................�.�., ,,copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints y ❑ For review and comment _.............. ...m...... ._.............__._................................... ..... ❑ FOR BIDS DUE _......�........__�.�... _..............................�.�..�._��_�. w.........ww...........__. ❑ PRINTS RETURNED AFTER LOAN TO US ...w ... .. RIMA.... ____........... .. �....... ....... _. REMARKS _._. i ... W' M11 202 COPY TO .................. ....... _.. SIGNED° .. If enclosures are not as noted,kindly notify us at once.