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Home My WebLink AboutZ-44600 & 44601 Town of Southold 9/25/2023 ,� gUFFOIXc<�, �Gy- 53095 Main Rd H z s Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 44600 Date: 9/25/2023 THIS CERTIFIES that the structure(s)located at: 2150 Park Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 123.-8-9 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- 44600 dated 9/25/2023 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame single family dwelling;with rear concrete patio.* (front road side house) The certificate is issued to JSK Park Ave LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. 1 Aut or ed i ature BUILDING DEPARTMENT TOWN OF SOUTHOLD i HOUSING CODE INSPECTION REPORT LOCATION: 2150 Park Ave,Mattituck SUFF.CO.TAX MAP NO.: 123.-8-9 SUBDIVISION: NAME OF OWNER(S): JSK Park Ave LLC OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: JSK Park Ave LLC DATE: 9/25/2023 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: 1/4 CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: rear concrete BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: AIR CONDITIONING: TYPE HEAT: oil WARM AIR: forced hot air HOT WATER: #BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 9/18/2017 TIME START: END: Town of Southold 9/26/2023 a y� 53095 Main Rd co z Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 44601 Date: 9/25/2023 THIS CERTIFIES that the structure(s) located at: 2150 Park Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 123.-8-9 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- 44601 dated 9/25/2023 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame single family dwelling with brick patio.* (rear water side house) The certificate is issued to JSK Park Ave LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ! ut ori a Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 2150 Park Ave,Mattituck SUFF.CO.TAX MAP NO.: 123.-8-9 SUBDIVISION: NAME OF OWNER(S): JSK Park Ave LLC OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: JSK Park Ave LLC DATE: 9/25/2023 DWELLING: #STORIES: 1 #EXITS: 4 FOUNDATION: cement block CELLAR: 1/4 CRAWL SPACE: BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: brick BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: electric AIR CONDITIONING: TYPE HEAT: oil WARM AIR: forced hot air HOT WATER: #BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 9/18/2017 TIME START: END: Q s Raw c� TOWN OF SOUTHOLD.BUILDING DEPT.- 765-1802 INSPECTION .- I FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION . [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: peont� 0.) uoi.1 A OA -KW' rp e4i�g� Lm� MA�.,2�U DATE 0 INSPECTOR �� ,5�� Ilg✓j'1� �� - —- of socoutmv, ar • �� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: (Pwv 6 -0 Pvvv nA lw✓a--,� .-9/ jindN6 . C&06--of L I -N C. &wt to i s i �, 44ve, on �— ✓ 64eAv kjS MmAg, San o IVZ, DATE. =I 0ld INSPECTOR L OUTDOOR SHOWER CL TUB CL BEDROOM 3 BEDROOM 2 FULL BATH BEDROOM 1 11'-0" X 13'-3" 7'-7" X 8'-2" 6'-3"X7'-7" 11'-0" X 9'-10" BILCO CL CL DOOR > .. HALLWAY MIM ��: `$�as�R -''Sa� _Ty.�$ii`;'�." '�h�`�v`�F'+ 'F`.%'"�` -�+F�:4X"R i��-+ ��ili°°r.�r`�� S�o°m`.3��:F=:',r:#7xR'-�. �-�J� ;.Fi%`f,�.\I"4:y=\lon:.i;F.'��_'.''s.�`�"r�7 _ STOOP II II II I DINING ROOM I KITCHEN CL LIVING ROOM 11'-11" X 13-7" I 11'-11" X 9'-01, 11'-11" X 17-10" I � I - I f" CL y�. STOOP EXISTING NORTH WEST COTTAGE Date: 05/02/2023 0 2 4 JSK PARK AVE, LLC r=�� 2150 Park Avenue SCALE 1/4" = l'-0" Mattituck, New York BIL O CONC. DOOR OUTDOOR STOOP SHOWER ELECTRIC METER WWI I A FULL BATH CL 4'-11X7'-10' TUB CL BEDROOM 2 FULL BATH KITCHEN - CL 7'-0"X7'-2" 13'-2" X 9'-10" 9-5 X 12-1 BEDROOM 1 I I CL 14'-5" X 10'-10" II CL Q SUN ROOM 9'-3"X 22'-10" I amr Ir7 LIVING ROOM DINING ROOM FOYER - BEDROOM 4 71 1-7 Ll 2l'-3" X 13'-0" 12'-0" X 13'-0" 10'-6" X 15'-4" 13'-3" X 11'-8" II CL o � o ns .. CONC. CONC. STOOP STOOP EXISTING SOUTH NEST COTTAGE Date: 05/02/2023 0 2 4 JSK PARK AVE, LLC H=r=l 2150 Park Avenue SCALE 3/16" = 1'-0" Mattituck, New York J� v � Pico�( E QPJF `I��O•"�' �OG00 E \��PFSF90 OOs s 9fi��i� Fpgf. ��n ,9� yJl q Z 9� O� GQ Pt 0 cL^� 9O� / O^ Oi 7h 901„ OGS V 0 0 O a51 0�� 0� ,. 9 G 0. fir'' O 7 �2 N O 0 0 co G„ o c^0 S co -0 EO co Ce; sNE� 2'W N� 0 �z 0� SSE St�`�P�� cow O 37 0JPD�� G . g 0� o e sNEO co a £�✓ �Co� PO • Z� �6 96 PReF, rp DATE: JULY 31, 2017 PpO JOB NO:2017-331 00•� 5gw CERTIFIED TO: iC, THE N. SUE MUELLER ET. AL. NEW Survey for: o YORK TRUST FIDELITY NATIONAL TITLE INSURANCE THE N. SUE MUELLER PP" 'moo COMPANY ET. AL. NEW YORK TRUST w I At cr Z Mattituck Town of Southold QoRM Suffolk County, New York �p S.C.T.M.: 1000-123.00-08.00-009.000 a y9e� 40 0 40 SCALE:1 40' DAVID H. ^FOX, L.S. P.C. N.Y.S.L.S. #50234 FOX LAND SURVEYING P �oao G 64 SUNSET AVENUE NOTES: f •` WESTHAMPTON BEACH, N.Y. 11978 (631) 288-0022 1. AREA = 29,691 S.F. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY 2. ■ = MONUMENT FOUND, ® = STAKE FOUND. IS A VIOLATION OFSECTION 7209 OF THE NEW YORK STATE 3. REFERENCE DEED L. 12025 CP. 827 EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS `vw BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY OO ANDLENDING INSTITUTION LISTED HEREON , AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. DWG: 2017-331 S.C.T.M.# DISTRICT 1000 SECTION 123 BLOCK 8 LOT 9 & 10 e U.P./ S � 111 a P W.V. +e� �_ \ '41Z_. 10"OA '8 4� 10 0A1( 41 3� =p e +e +ee m / 1151 SOti \2O OAK \ S ° \e1 JEtDEa 10'LOCUS 20 0A;y +9 621 -�if ° 1 STY FRAME':. DWELLING ? \ �+\ +ye� •'FFL=21.7' "'::. \ '✓' h'q \4, "O\ ,...:x/2200:_::::::. OAK FRAME'..;M \ ?c\ CONC. DWELLING: \ Jr, PATIO ll.P. EXISTING LOT COVERAGE O� FFL=21.6':" AREA LANDWARD OF CREST OF BANK:27869 S.F.or 0.64 ACRES #2150. DWELLING(NORTH):10815.F. SHED.76 S.F. DWELLING(SOLITH):1684 S.F. I TOTAL:2841 S.F.or 102% oyF PATIO ASPHALTI^ DRIVEWAY e3 g? \I4"OAK EXISTING LOT COVERAGE �No� �m \\+e9 \ °�N +e°zz•OAK AREA LANDWARD OF CREST OF BANK:27495 S.F.orH63ACRES OAK OWELLING(NORTH):1081 S.F. o� \ 4 °o'OAK �'a'} 11 AN SHED:76 S.F. ° e 1 \ DWELLING(SOUTH):1684 S.F. TOTAL:2841 S.F.or 10.3% 1�6' OAK 1 \N 1.$"W.� \:.� \ 14'OAK +e1) SEED„ \ °e1 I�OAK�A'''''';; 6.OOAAK6.OAK \ ED 20.0 / e & '.' T Y / +1q 10"0. t. �AK // +e0 ib 19 S.C.T.M.#1000-123-8-11.3 1.4'W LAND N/F OF +y2/ 10-OAK , °AN P. CNC PARK AVENUE LLC ° 9 \ +e° 0 6'OAK 20*OAK I `IS �fi ` 10 6AK s l 6'OAK I 14.OAK 18'OAK 9 d tb ° 0 � IB"OPH fi"OA t Na 6.OAK N (D 11 10 OAK 0"OAK © DWELLINGS �G 6 OAK2 �,6`°"` W/PUBLIC WATER 1.7• I 14"OAK 6'OAK \ ~ 150 8'OAK Q SHED' 0 \\\,6,OAK 6.0. 12'OAK 6 W 1� OAK 2.7• 18 ."" lJ \\14"OAK 2."OAK S.C.T.M.#1000-123-8-8.3 LAND N/F OF N'6 U.P. 9 � TIMOTHY MURRAYASPHALT DWELLINGS \ DRIVEWAY W/PUBLIC WATER 29•E 150' ob a \ 12\"OAK 0 0" n 14'OAK MON.MON. 9 19 (D Q10'TURK 10-OAK 14'0A1( \ t1e 12'OAK a °�9 18'OS'OAK / I l:d 6"OA ., IQ K 6"OAK IV a •d K J� SHOWER a+leo / 0'OAK \ _. ..T��..:. FENCE IffE ELEV. 18.2 .::. Pd 0. SM BROWN SILTY SAND 5.0' PALE BROWN �Z v..... '...:::i:.:::'i:: .. _. FINE :..,.:..)::. SP SAND 224' 37' Z 312' 17.3' PALET:RIDS �i —_] SP BROWN 10 Ppt\O ZONE X FINE 28 - 5 SAND +ys —78, 23• 112 29. 1I • +ee P APRIL 15, 2022 �T. iC.P\1 McDONALD GEOSCIENCE 1+•C.P) f i X18-'8 Of a� SOP 0f N 9�2i' FLOOD ZONE B09NDNN i +61 /o /��/ /S Sg�x•90�,fp'O y5 Wpt0 FEMA MAP#36103CO482H / AREA:59,791.66 SOFT. or 1.37 ACRES ELEVARNAVD88 ON DATUM: 2 q2 W ZONE VE(EL 8) UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLARON OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY51D503apLON�MNW MAPOr SEARING £LAND SURVEYOR'S CONSIDERED TO HE A VALID ONLYNTOTHE PERSONFOR WHOM THESURVEY E UA 15 PREPARED AND ON NSBEHALF TO 774E TITLE COMPANY, AGENCY AND LENDING E COPY GUARANTEES INDICATED R EON SHALL RUN INSTITUTION / TE ONES a LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDING INS7ITU770N, GUARANTEES ARE NOT TRANSFERABLE MNW EQUALS TIDAL WERMMO ROUNDARY THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE AS OEIERNINED BY NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS EN-CONSULTANTS 11-09-22 - AND/OR SUBSURFACE 57RUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY ENDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF:DESCRIBED PROPERTY of NE1y CERTIFIED To: JSK PARK AVE, LLC; 0�11V h �V MAP OF' ,SPS SN M. Woy YO.p o of Y E FILED: hy2 c�G� ry �I� SITUATED AT:MATTITUCK F c L1 0 7owN oF:SOUTHOLD n '" KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK ysF 050882 JQ- Professional Land Surveying and Design 5 FIELD P.O. Box 153 A uebo ue, New York 11931 THE WATER SUPPLY, WELLS, OSAND CESSPOOL 4 g LOCATIONS SHOWN ARE FROM FFIELD OBSERVATIONS FILE#222-113 SCALE:1 —30' DATE-AUG. 30, 2022 N.Y.S. LISC NO. 050882 PHONE(631)298-1588 FAX(631)298-1588 AND OR DATA OBTAINED FROM OTHERS OWN OF SOUTHOLD PROPERTY R 4 OWNERSTREET VILLAGE DIS-1 "OT . FORMER OWNER N E ACREAGE ve. I S W TYPE OF BUILDING LQ C Q ov lfbrs'� RES.,;� /,r)� SEAS. VL. FARM Comm. IND. CB. I misc. ........... LAND IMP. TOTAL DATE 1 REMARKS ................................ .......... 1>0 Lov 77 '2o 4 is ....... AGE BUILDING CONDITION 14uro)o*Ors- 40 khpolts- �yje- ..................I-- I NEW NORMAL BELOW ABOVE Farm Acre i Value Per Acre Value zld-f* ="t2 6 . ............ —--—------------ -------------- Tillable I 94,� <A, �._—_------------------ ------------ Tillable 2 ........... Tillable 3 .. .............. Woodland .. . ........................ .......... --------- .......... .......................................................... Swampland ............--........... ................................ ...... ............ ........... ...... Brushland .................. ................... ................... ........ ----------------....................................................................................... House Plot ------------------------------ Total 3 nk t _ TOWN OF S TOLD PROPERTY RECORD box � _ OWNER STREET VILLAGE DISTRICT rSUB. LOT FORMER OWNER N E ACREAGE S W TYPE OF BUILDING RES. SEAS. VL, FARM COMM. IND. CB. MISC, LAND I IMP. TOTAL DATE REMARKS ...._........_. —_............._...._ _- 1 R X e' •F AGE BUILDING CONDITION - NEW NORMAL BELOW ABOVE Form Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 -- -- - --- — - -- Wcodland ! Swampland ....... Brushland House Plot V __. .......... . .- ........................ i ._-................................. ......_............._........... _ - - . .......... _ - —----------- 'Total ----Total f t R u • .Y fff4 n c �' a*'� CJS.+ L.+-y t..- r i A��d � a r f i 123.-8-9 10/18/2022 I r r p � BathM. BldFoundation ' Extension Basement +� Floors Extension Ext. Walls Interior Finish - ...—_ _-......... _- . . _... -- ------ — - ---- Extension I I Fire Place I Heat 1 Porch I Attic j Porch Rooms 1 st Floor -- .........................----- --......................_.--..._........_.._.. -- _- ..__...._............--..._................................_._.._......._.....__............. . _ ....__..._...._ ----.. _ Breezeway Patio Rooms 2nd Floor _._. .............__-_.......................__.....__... ......... ...__.----'_-- _---- -- ___._-- ._...___........-_-.._. _ ....... Garage Driveway O. B. i t I t ....._... ..............- - -. M. Bld - �r Foundation � � ' Bath 1 g Extension Basement Floors -------- ---------._ ension Fact Walls ExtInterior Finish -- I - --- --...-..._-------- --.w_......_�.... - ------.. - ' —. Extension Fire Place i Heat /� ------ .---_-_- - ---- - —_ _.... ---- - ._........... . ....._ _. - --- ..._......... . .._ ----- Porch ! Attic __........._.- __ ....... ......._._..... _ Parch Rooms 1st Floor _ _ --- ----.-------___._._................._____ __.___.___:.._..........._. ...._ ... — __ -_-_..___ Breezeway Patio Rooms 2nd Floor ............. ... ._ .._ -_ . ..... . ..... - -----__.. - - .._ ............ — Garage i Driveway 1 ---- s ' �,61L•JV�'� �l�/ LOCATION: �� Q/ A 4Al(dz� (number & street) (municipality) SUBDIVISION; _ MAP NO.: LOT(S): NAME OF OWNER(S)': O'CCUPANC'Y: W01% (type) (owner-tenant)- ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUPT. 'CO. TAX MAP'NO. 1000- SOURCE OF REQUEST: DATE: �', l l.. LOLL DWELLING TYPE OF CONSTRUCTION: W W, �V*Otl # STORIES: # EXITS: FOUNDATION: .0 �/�.DG��1r_ EASEII�IENT: CRAWL SPACE: # OF BEDROOMS: 1ST FLR:`_�� 2ND FLR: 3RD FLA: . BATHRO'OM(S): 0 ke/ TOILET AOOM(S): UTILITY ROOM: . PORCH-TYPE: D'E'CK, TYPE: PATIO,•TYPE:=G,Acre BREEZEWAY:' FIREPLACE: QARAGE: DOMESTIC HOTWATER: TYPE HEATER: �. A:IRCONDITIONING: TYPE HEAT: WARM AIR: HOTWATER: ,,nn # OF KITCHENS-' �L h. f'D d -----� �� Qui t FINISHED BASEMENT:- YES NO OTHER: ACCESSORY STRUCTURES ' GARAGE; TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING P'O'OL: GUEST,'TYPE CONST: OTHER: 1 VIOLATIONS CHAPTER 144 &N.Y, STATE:UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCPJPTION ART. SEC. .,(- FAOLWIor PIA V .P REMARKS: INSPECTED BY�o�jr� � DATE OF INSPECTION: &#•Mbh �0 TIME START: l Y, END: 5 �. LOCATION; -L (number & street) (municipality) SUBDIVISION: _ MAP-NO.: LOT(S): .. NAME OF OWNERS ': OCCUPANCY: W (type) (owner-tenant)- ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUPT. CO. TAX MAP'NO. 1000- SOURCE OF REQUEST: DATE: S 'l/Ir+.�dt.L L_?i.0 l� DWELLING TYPE OF CONSTRUCTION: W(A(Y �✓.�k1�'�/ 9 STO-=S: Ow _# EXITS: FOUNDATION: &ov tA8VMENT*: i, CRAWL SPACE: _ 4 OF BEDROOMS: IST LR:' 3FLR: 3RD PLIC: v `( BATHRO'OM(Sj: TOILET AOOM(S): UTILITY ROO''M: y PORCH.TYPE: DECK, TYPE: nn PATIO;TYPE: 1�� C` BREEZEWAY: FIREPLACE: QARAGE: DOMESTIC HOTWATER: TYPE HEATER: �C/XIRCONDITIONING: _ TYPE HEAT. DIV WARM AIR �[I � . . HOTWATER: 4 OF KITCHENS:Onjzoe.. No'rOAI,e 14t. L FINISHED BASEMENT:- YES NO OTHER: ACCESSORY STRUCTURES GARAGE; TYPE OF CONST.: STORAGE, TYPE CONST.: 1AA1 SWIMMING P'O-OL: _ GUEST,'TYPE CONST: OTHER: 4L Obi N o� rgrwN �� VIOLATIONS:. CHAPTER 144 &N.Y, STATE:UNIFORM FARE PREVENTION & BUI,LDING CODE - LOCATION DESC PTION ART. SEC. IVAD S Al omog D �- - ♦ ,l t - - - MARKS: 111WIM=trKy=. �Fx IfyX I I r) ''II . INSPECTED BY: JA� V% �I J DATE OF INSPECTION: ,/ TIME START: �� END: J TOWN OF SOUTHOLD—BUILDING DEPARTMENT og�o as Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtownny.gov .APPLICATION FOR PRE-EXISTING CERTIFICATE OF OCCUPANCY OWNER(S)OF PROPERTY: - Name: JSK PARK AVENUE LLC Date: 05/04/2023 Physical Address: 2150 PARK AVE,MATTITUCK,NY 11952(SOUTHWEST COTTAGE) SCTM#1000-123.-8-9 Phone#: 917-520-9967 Email: SKIM_YTD97@HOTMAIL.COM JSIREFMAN@SIREFMANVENTURES.COM _ Mailing Address: 150 HICKS STREET#4A, BROOKLYN, NY 11201 CONTACT.PERSON: " Name: FINNEGAN LAW, P.C., MARTIN D. FINNEGAN, ESQ. Mailing Address: PO BOX 1452, 13250 MAIN ROAD, MATTITUCK, NY 11952 Phone#:.631-315-6070 Email: MFINNEGAN@NORTHFORK.LAW To apply for a Pre C.O.for an existing building(prior to April 9, 1957) provide the following: • Accurate Survey • Floor Plan • $100 Fee CONSENT TO INSPECTION That the undersigned does hereby give consent to the Building Inspector of the Town of Southold to enter upon the above described property,including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, or ' s, rules and regulations of the Town of Southold. SI�'Zdz3 Owner's Signature Date PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) a46 A,-d I, residing at the above address,do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date I oo �� log �a Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) SARAH KIM, SOLE MEMBER OF Y� JSK PARK AVENUE LLC residing at 159 WEST 24TH STREET, APT. 713, (Print property owner's name) (Mailing Address) NEW YORK, NY 10011 do hereby authorize MARTIN D. FINNEGAN (Agent) to apply on my behalf to the Southold Building Department. (fdwner's Signature) (Date) JSK PARK AVENUE LLC BY: SARAH KIM, SOLE MEMBER (Print Owner's Name)