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Home My WebLink About1000-96.-1-7 TOWN OF SOUTHOLD f Rental Permit 0794 Owner Matthew Ketcham Occupied as Single Family Dwelling Located at 21125 CR 48 Cutchogue 96.4-7 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. 12/20/2022 Coof rpt nt Official This Notice must be posted by the main entrance at all times f' Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179Q Southold,NY 11971-0959 aZ0jI0r , p jW1 -jAaa oma-ma BUILDING DEPARTMENT ( "� TOWN OF SOUTHOLD ENTAL. PERMIT APPUCATION C RAO Rental Permit Fee$200(Application must be renewed every two years) Section A. AIG 3 0 2021 Property Information: ,DJ-NT DEW. Rental Property Address: TOWN n N F SOS T HOI 21125 County Road 48 Cutchogue NY 11935 Tax Map Number: 1000 SECTION 96 -BLOCK 1 -LOT 7 - SECTION B. OWNER INFORMATION: Property Owner Name: Matthew Ketcham Property Owner Legal Address: Property Owner Mailing Address: 21125 County Road 48 21125 County Road 48 Cutcho ue NY 11935 Cutchogue NY 11935 Telephone Number(s): Daytime 631-495-7061 Evening Emergency • matt econic,� ldo sters•com Property Owner Email Address: C� ...._. Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179A �� ? 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: 1 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: Unit 1 Requested Maximum number of persons allowed to occupy Dwelling Unit: . 3:; Number of rooms in Rental Dwelling Unit: 7 Use and Dimensions of each room in Rental Dwelling Unit: Insulated porch/laundry(200"x 83"), Living room (125"x 208"),Dining room(120"x 127"),Kitchen(102"x 110'))first bedroom (100"x 140"),second bedroom 101"x 113" ,bathroom 68"x 100" Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road 'x Fax(631)765-9502 P.O.Box 1179 � a , Southold,NY 11971-0959 „' y `4 BUILDING DEPARTMENT TOWN OF SOS ""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 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. Igl 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) 1 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 S Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUMOLD 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:4A ` Property Owners Signature: Sworn to before me this 2�y of 20 Z l Official Notary Public Signatur and O Inal Notary Stamp MWIn I JANINU7_7_I �Antt— "m York JANWIZZI a t d ,"ate ofNewyork � i;. .. � � county 4! 1 6265 Comrmis6ion txpiies Dec 26, 20 OSuffolk C,`outt� Commi 6s,SRO Expires (� Page 5 of 5 s pill # * TOWN OF SOUTHOLD BUILDING D 765-1802 I NSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CA [ ] FRAMING / STRAPPING [ ] F L [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE INSPECTOR o n✓ r � f P @ r .. r f � E � a I t I li f % "amwuuir 'u arae ew:wwemm-�✓n iii � vu r" Rnrm is .-ory mm "i rti. JF I Mme n nn✓a m now. no m no a�I;. � �1 (r(kI p {% o ». r � j I min��✓� ��fi��r�„, w V ��o TOWN OF SOUTHOLD PROPERTY RECORD Z-1 OWNER 1 VILLAGE DISTJ SUB. LOT V-1 I FORMER OWNERN E 1 ACR -3 e� S W TYPE OF BUILDING j RES. SEAS. VL. FARM COMM, CB. .MICSMkt. Value -x�77-- LAND 1 M P. TOTAL I DATE REMARKS fA -77 p-4-74 IDN 2. -3 L ( " I L7 or, K,-", - -,-� 042K C) vn CL�, AGE BUILDING CONDITION iRc-e J CA I NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland Wood FRONTAGE ON ROAD Meadowland DEPTH House Plot 1 BULKHEAD Total If DOCK V t = _ E - y f _ . - COLOR VTRIM o -41 Irl [ [ t [ E t r - [ r f � 1 g� Extension e Extension Foundation j Bath Dinette rs rh �� Basement Floors [C. y Porch Ext. Walls r, `Interior Finish t LR _ _ Breezeway Fire Place X Heat J17R- Garage T�pe .Garagee Road Rooms 1st Floor DR. ac Patio Recreotion Room` Rooms 2nd Floor B a. B. 50 `Dormer a Driveway Tota( r t TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the Pre- C.O.# 212973 /X/ Land Date Nov.9,1984 % Building(s) - /_�/ Use(s) located at 21125 County Rd. 48 Cutchogue Street Hamlet shown on County tax map as District 1000, Section 096 , Block 01 Lot 007 , does(not)conform to the present Building Zone Code of the Town of Southold for the following reasons: Insufficient Total Area On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /11 Land 5W Building(s) / /Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: A one and one half sto ; one familX wood framed dwelling. Situated in an A-Residential-Agricultural Zone with access to Cty.Rd.#48 a County Maintained Rd. The Certificate is issued to DELAWARE BROWN & WIFE (owner, of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. V ►cam• Building Inspector a FORM NO. 4 TOWN OF SOUTIHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall :, �t Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32427 Date: 06 25 „07 THIS CERTIFIES that the building ADDITIONS _.____ Location of Property: 21125 CR 48 CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 96 Block 1 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated _ JUNE 5 2007 pursuant to which Building Permit No. 33124-Z dated JUNE 11 2007 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 BUILT” ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID & BARBARA VERITY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _....._ N A ELECTRICAL CERTIFICATE NO. 2040093 01/13/05 PLUMBERS CERTIFICATION DATED ..-........._ N/A r .....w Au.°orized Signature Rev. 1/81 Town of Southold 12/20/2022 P.O.Box 1179. 53095 Main Rd Southold,New York 11971 CERTIFICAI`E OF OCCUPANCY No: 43701 Date: 12/20/2022 THIS CERTIFIES that the building DECK Location of Property: 21125 CR 48,Cutchogue SCTM#: 473889 Sec/Block/Lot: 96.-1-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/1/2022 pursuant to which Building Permit No. 48405 dated 10/14/2022 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: "a bail V'deck-4A it r tcapj,n as ap litti for er7 A#7 O dated 81'1 / 22. The certificate is issued to Ketcham,Matthew of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Author". .w._. giant re