Loading...
HomeMy WebLinkAbout1000-107.-2-2.6 gg TOWN OF SOUTHOLD } Rental Permit t 0859 Owner Sophia Gutherz Occupied as Single Family Dwelling Located at 4230 Grand Avenue Mattituck 107.-2-2.6 Maximum Permitted Occupancy 7 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. 4/13/2023 Cod nfo ce ent Official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 " Southold,NY 11971-09.5901 cou " BUILDING DEPARTMENT D TOWN OF SO HOS MAR 1 PERMIT APPLICATION RENTAL P` Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property©Address: � N Tax Map Number: 1000ECTION -BLOCK SECTION SECTION B. OWNER INFORMATION: Property Owner Name: Lkf 1/c ie ce Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): Daytime r,, vening Emergency Property Owner Email Address: 4'1 &�L `1 Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Ir c Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 enur BUILDING DEPARTMENT TOWN OF SO THOS'. D Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: V Number of Ren$el 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: +" . Use and Dimensions of each room in Rental Dwelling Unit: ('CL'+CX / 1� f 14koccl Page 3 of 5 S .. Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 cou 1971-09592 a BUILDING DEPARTMENT TOWN OF SOU THOLD 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 thy'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 bu the New York State Fire Prevention and Building Code Council. P-111 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 I , 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 of si . Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box It 79 Southold,NY 11971-0959 c 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 thelown within five(5) business days as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name:_S_m+) Property Owner's Signature:.�;Z At,�A/t,�4 .11�/7"J�A )�4-�,-,�(� F- -W- th Sworn to before me this I7 day of ' , 20 Official Nota c Signature and 1 Inal Notary Stamp Off"N E ���'i'x OUPLIFF�L- -1K COUNTY JU 3 b, Page 5 of 5 h TOWN OF SOUTHOLD BUILDING DEPT. mu 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ kTIRENTAL REMARKS: o in e X- 4OIi 4 a,w Chi A& gt),/,J,rux LL 6 / 0 vac a o & T��YId e,4 'on 6661 t DATA � � ��'" � INSPECTOR � } | � / - GLASSED IN PORCH DINING ROOM ! § KITCHEN . q ! STUDY/GUEST BEDROOM Li COAT CLOSET LIVING ROOM / | HALF BATH ` _\ ( � � | � � � � � � \. � � �� i � | � � ( SCREENED IN PORCH � ( � IFIRST FLOOR ,SCALE: 1 /4 5'-11 9` 9*-3, � | ; : / d \ : | � _ 2'-5i i � j � | � � . ! | lo, 2 17' V)m LJ BEDROOM BEDROOM BEDROOM V) ) 17AA&T FLOOR }SCALE. 1 /4 = V - 0 " Customer Name : Sophia Gutherz City-CS-Sub : 88db2345 Installation Address : Gutherz MacAddress : 1382CAOC139EBE Zone#A SiXT-M Status Sensor Type Device Type Response Typc Description I Description 2 Loop 4/Services Connected Toga Serial WMac Supervised I Takeover Temperature Monitor First Floor 3 undefined 0642162 RF Module Supervised 2 Takeover Smoke Fire No First Floor I undefined 0642162 RF Module Detector Verification Supervised 3 Takeover Temperature Monitor Second Floor 3 undefined 0642321 RF Module Supervised 4 Takeover Smoke Fire No Second Floor I undefined 0642321 RF Module Detector Verification Supervised 5 Takeover Temperature Monitor Basement 3 undefined 0642354 RF Module Supervised 6 Takeover Smoke Fire No Basement I undefined 0642354 RF Module Detector Verification Supervised 7 Takeover RF Temperature Monitor Master 3 undefined 0642304 Module Bedroom Supervised 8 Takeover Smoke Fire No Master I undefined 0642304 RF Module Detector Vorification Bedroom Supervised 9 Takeover Temperature Monitor Bedroom 3 undefined 0642318 RF Module Supervised 10 Takeover Smoke Fire No Bedroom I undefined 0642318 RF Module Detector Verification Supervised 'It Takeover RF Temperature Monitor North Bedroom 3 undefined 0642054 Module Supervised 12 Takeover Smoke Fire No RF North Bedroom 1 undefined 0642054 Module Detector Verification Supervised 13 Takeover Carbon Carbon RF Basement I undefined 0231669 Module Mono.Det. Monoxide Supervised TOWN OFSOUTHOLD PROPERTY RECORD CARD 41- OWNER VILLAGE DIST. W13. LOT i A _A C , k I FOR,MtR OWNtR-M fj ftyl:&V E AOR iyo f S TYPE OF BUILDING a7 v 1k , FARM RES. SEAS. VL. 'COMM, CB. MISC. Mkt. Value ] LAND IMP, TOTAL DATE REMARKS 621 c e,�j 217 4� w NJEW FA� lk&mh L +0c, �La, e�_YLM TAW-i -III- 1 1, ,tiot"; �C L L I i TA05re— Woodland I Swampland FRONTAGE 07RCwATER A 7 f HJ - Brushland FRONTAGE ON ROAD 0A V DEPTH House Plot IBULKHEAD 072 f i 77- z Totol 'DOCK —RECORD CARD TOWN OUHPROPERTY � OWNER e - STREET f VILLAGE i DIST SUB. LOT- _ FORMER OWNER N _ ACR .. b 5 c C_ 5 W TYPE OF BUILDING c 4i - - - ti R9 � SEAS. !VL FARM COMM. CB. MISC. Mkt. Value LAND 1MP� TOTAL DATE REMARKS s� s AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FA Acre Value Per Value l Acre I Tillable 1 Tillable 2 Tillable 3 Woodland 5titrampland FRONTAGE ON WATER ushland N FRONTAGE OROAD N House Plot �T . - �� DEPTH ;BULKHEAD DOCK Total = M f e y ` COLOR TRIM _ t f $' f ] 1 U 71 gg ate : , - — _ r ` 1 g I _ S = y if - _ - M_ e - Bath Dinette I a Extension G ;• r K. � en ( laors Extensior� t�� X --' "� Ext. Walls �l Interior Finish LR_ Extension,- _ i� !! Heat DR. `= Place l Type Roof Roams 1st Floor _ � SBR. - - 15 Porch ' t 3 'Recreation Room_ Rooms 2nd Floor FIN. B , Porch t _. I ' ` r g riveway C-cra - e I F, Patio 41 0. O. B� Total ftx�O —101. to I IT All 1 q std _ 107.-2-2.6 10/10 1 311 Foundation Bath Dinette - t — Off 2~ 5 ,3 Extension 2.4 _ ( Basement s e I Floors Kit E m _ — - — -- Extension Ext. Walls Interior Finish L.R- Ex.1ns w >,� b Fire Place ,P Heat D R 1 � j7 — `7 X ?2 = Woodstove BR. Porch Dormer Fin B y it{C J i - rway ��.. �. A�. S X ' l? ` Rooms 1st Floor L � Garage Driveway Rooms 2nd Floor , ' 4 r� Pool 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- 32712 Date: 11/92/07 THIS CERTIFIES that the building 'DWELLING Location of Property _ 4230 GRAND AVE MATTITC3CK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 107 Block 0002 Lot 002.0062 Subdivision Filed Map No. _— Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING w built prior to APRIL 9, 1957. pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 32712 dated NOVEMBER 2- 12007 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 ACCESSORY 5 CAR GARAGE & ACCESSORY GUEST COTTAGE* The certificate is issued to MARGARET E CRUISE (OWNER) of the aforesaid building. SUFFOLK COU31TY DMEPAARTMEW OF HEALTH APPROVAL _..N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. t Authorized signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 4230 GRAND AVE .,� MATTITUCK SUBDIVISION: RAP ND.: IAT (S) NAME OF OWNER (S): MARGARET E CRUISE OCCUPANCY: SINGLE FAMILY DWELLING MARGARET E CRUISE .__.._............_.. CRUISE P BY: ADMITTED BY: MICHAEL C _ .._. ..... .,.,.,.. EKY AVAILAHI.B: BUFF. CO. TAX MAP NO.: 107.-2-2.6 SOURCE OF RROURST. MICHAEL CURISE ,...I0L26 07 DATE: 11/02/0 DWELLING: TYPE OF CONSTRICTION: WOOD FRAME # STORMS: 2.0 # EXITS: 3 TICK: CEMENT BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOKS: IST FLR.- 4 2ND FLR.: 3 3RD FLR.: ,, 0 BAT (S): 2.0 TOILET ROOM(S): 1.0 Vrr= ROM(9): PORCH TYPE: ROOFED SCBE DECE TYPE: PATIO TYPE: m CEMENT._ IT.... BREEZEWAY: _. P3 ONE GARAGE: .._,__. .. ...._........,..w..............._ DOMESTIC TRIC: YES TYPE _ OIL ASIC M : YES TYPE HEAT: OIL H/AIR MARK AIR: NO 80TVATER: YES OTHER: CELLAR ENTRANCES E]iCL WRAP AROUND PORCH HOT WATER ACCESSORY STRUCTURES: GARAGE, TYPE OF MUST_: 5 „CAR WOOD FRAME _..._ .. ...,.,.. STORAGE, TYPE CONSP.: W_.. L��",em,.,_ P..._„ ,«8T SWIMMX 1G POOL: GUEST, TYPE CONST.: *WOOD FRAME UNHEATED OTHBB: LIVING ._1TCBA"C' SL�EPING_LOfT . D STOVE�CT RR...�. 6�.,_..,'.......� VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION­L......wwwww_ ._... .DESCRI'PTI'ON _. ._... � .......... . ...,SEC..... _........,,,, A VJOUU M 8 d Q N : BP 24592—Z CO Z26601 ALTERATION INSPECTED BY: ..........................:...... DATE ON INSPECTION: 11/01/0 GEORGE GILLEN TIME START: .,_ __ END: ..................ww.,a......... BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION; 4230 GRAND AVE MATTITUCK SUBDIVISION: MAP NO.: LOT (S) MUM OF OMIER (S): MARGARET E CRUISE OCCUPANCY: SINGLE FAMILY DWLIANG MARGARET 9 CRUISE ALlMITTM BY: MICHAEL CRUISE AC"OKPAMMM BY: KEY AVAILABLE: SUFF. CO. 7AX MAP NO.: 107-2-2.6 SOURCE OF RNQURST: MICHAEL CURISE__IR/?,� _ DATE 11/02/07 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORI'MS: 2.0 # EXITS: 3 .......... FOUNDATION: CEMENT BLOCK CXEJ".- FULL CRAML SPACE: TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: -3 3RD FLR.: -0 HATHROOK(s): 2.0 TOILET ROON(S)-. 1.0 mmiaw ROOMS) POR(21 TYPE: ROOFED SCREENED DECK TYPE: PATIO TYPE: CEMENT 8011SKUKAY: FIREPLACE: . 9NE--- GARAGE: DOMESTIC EMYMTHR.- YES TYPE WtATRR. OIL AIRCONDITTONrING: YES TYPE BEAT: 011, R MUM AIB: NO BOIWiTIR: YES OTHER: CELLAR_ENTRANCR,ENCL WRAP,,AR(X;ND PORCH OT WATER HEATER, ACCESSORY STRUCTURES: GARAGE, TYPE OF COMST.: 5 CAR WOOD FRAME STORAGE, TYPE COMM.; WOOD FRAME LE _100 Hd SWn§CDW POOL: GUS4P, TYPE CONST.: *WOOD FRAME UNHEATED OTHER: LIVING-loom TC LULF991)—BuRN-ST9YE,-2u—TD0OR SHMM ---—------------------ VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE DESCRIPTION., ............ R134ARU: BP #24592-Z CO Z26601 (ALTERATION ADDITIONd INSPECTED BY: ImspE=cK. 11/01/0 GEORGE GILLEN T'nlE S17JM: FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26601 Date: 07/28/99 THIS CERTIFIES that the building ALTERATION & ADDITION Location of Property: 4230 GRAND AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 107 Block 2 Lot 2.6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 3 1997 pursuant to which Building Permit No. 24592-Z dated 3'AANUARY 12, 1998 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 COVERED PORCH ADDITION AND SECOND STORY ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARGARET E CRUISE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 07/20/99 PLUMBERS CERTIFICATION DATED 06/25/94 DAVID M. ANTONICK LC Building In actor Rev. 1/81