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HomeMy WebLinkAbout1000-107.-1-20 @ _ TOWN OF SOUTHOLD Rental Permit g 0876 Owner Lena Koropey Occupied as Single Family Dwelling Located at 300 Knollwood Lane Mattituck 107.4-20 Maximum Permitted Occupancy 6 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. 4/21/2023 Code Error(e+ent Offici This Notice must be posted by the main entrance at all times Q) dim ay�✓ i 00e�one 7b"JTown Hall Annex -11402 �% l � . 631 54375 Main Road Fax�� r �, � )765-9502 P.O.Box 1179 , y'ljrllrf �� Southold,NY 11971-0959 rl BUILDING DEPARTMENTMAR 2 2 2023 TOWN OF SOUMO D RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Add ess: SOO Tax Map Number:1000 SECTION_ -BLOCK -LOT Z0 -� SECTION B. OWNER INFORMATION: z' Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 3DU Feral/ G.700Q L4-'Lem rl I S ( wv(B� 0 ? 76 Telephone Number(s): Daytime Evening Emergency Property Owner Email Address: C- (f— Page 1 of 5 Town Hall Annex „, � G`P Telephone(631)765-1802 % 631 54375 Main Road Fax((�% � � )765-9502 P.O.Box 1179k Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOXffHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any:­ 1v01'G Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s):Daytime Evening Emergency Email Address: Section D. Managing Agent Information: NONL Name of Authorized Agent of dwelling unit,if any: 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: 0 Address of Managing Agent(no P.O.Boxes): Page 2 of 5 Town Hall Annex ;� l � �� ��'` Telephone(631)765-1802 54.375 Main Road f Fax(631)765-9502 P.O.Box 1179 Y 11 71 9 Southold,N 9 -095 ,� /l' ✓ BUILDING DEPARTMENT TOWN OF SO '' HOLD Mailing Address of Managing Agent: Telephone Number(s):Daytime Evening Emergency Email Address: 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, 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." ." -T �1 Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: (0 Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: 6 C 6 �' 70 2 /� l t l + �," - '-�- - -S t i P, 101 .. NDN A 10 ^ /I " �w� CI-z/ '�i"Y')I1� I T-C AYL-e—A (--,7 -0 &T(-q Page 3 of 5 Town Hall Annex '�j° �% p ,�jj � Telephone(631)765-1802 54375 Main Road Fax(63 l)765-9502 P.O.Box 1179 Southold,NY 119714959 � '���%perp BUILDING DEPARTMENT TOViN OF SOLYMOLD 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. ❑ 1 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) I C61C-101--61C-101-- Ileox0e!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 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road , �� Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �///%�� ,N coo „ 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 247 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: G��� �b2 aP� Property Owner's Signature: Sworn t efore me thisc��day of � 20 a3 Official Notary Public Signature and Original Notary try Stamp ' NOTARY owy Public, 4 lam fork No.0101..62 PUBW Q�n�a.�W is SuffolkW O y Page 5 of 5 i i� � �a eP ) Town Hall Annex �� ��� , Telephone(631 765-1802 54375 Main Road Cyt Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 6� �ID�I "� o •,M 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 Professional,seat required tgr Architect or i n irleer licensed Home lays ector must provide copy ot valid current cerci ication Rental Property SCTM Number: r � © s� � � ""'"" � c7 �� Rental Property Address: �'` L-A- " C � ��Z` m � Owner/Name: -11�A 0 (L-o P 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 iodic d on surve Lk 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 EnV yy..Conservatio tion Code of New York State. ` .4 cNAte► A� 0A Print Name and Titleiria e (l Please place professional seal: .�, ' SOT�'✓1 vir o-,, U E BEDROOM 'Z- 117 117 pp BEDROOM �j /GB'✓� PRIMARY BEDROOM 11'8'x 199' 10'7'x 10'3' Sp/C HALL (J�Lv✓1 >r 92'x 5711' c 8AJH NECK I F 6- 24'3"x 270` 1 DINING AREA 1710"x 16'11" LIVING ROOM 1711'x 11'9' f 3 q -- FOYER 4 vm 98'x T7' LQ EAT—IN KITCHEN 21'0•x 99" f FLOOR 2 k to BASEMENT 27'0"x 427" O x L NiAANg t 0794 GROSS INTERNAL AREA IF FLOOR 1:731 sq.R,FLOOR 2: 1199 sq.k EXCLUDED AREAS:,DECK:625 sq.ft PATIO:1310 sq.It TOTAL:1930 sq.k MEASUREMENTS ARE CALCULATED BY CUBICASA TECHNOLOGY,DEEMED HIGHLY RELIABLE BUT NOT GUARANTEED. i } TOWN OF SOUTHOLD, PROPERTY RE(. � c OWNER _ STREET - VILLAGE i DIST.I SUB. LOT s OR1vtER OWNED J' N E ACR y _ _ _ k�, , � S a _ W TYPE OF BUILDING Z I fl z r ll, 7 = f RE SEAS. I YL. FARM COMM. CB= MIS' Mkt Value LAND IMP- TOTAL DATE REMARKS f- PIP E y. _ a a 1 � m: s / li �/ FARM _ Acre Value Per Value Acre ci f Tillable 1 — � - - _ T -k - Tillable 2e>> - it ab Till le 3 Woodland ' FRONTAGE ON WATER Swampland Brushland ' FRONTAGE ON ROAD House Plot ..r € DEPTH �F BULKHEAD DOCK Tota - = ` E s OLOR z gir, TRIM _ ; - - \ \ zj I t - . 107.-1-20 11/2014 c M. Bld9� _ ^` Foundation Bath Dinette, - Extensi=on � �; � Basement )�_c. t�.�. ; Floors K Extension Ext Walls Interior Finish �, t LR. Extension Fire Place Heat a DP- Type Roof _ Rooms 1 s FloorBR. - - �- �' � � � � � cr I Re eation ROOM Rooms 2nd Floor FIN B. Por Dormer I r f Driveway E �. s Gar, Zj asp 1 Total € f 01 �b TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATI; OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the C-0-#Z13523 fx-/ Land Date June 14 , 1985 / / Building(s) /_/ Use(s) located at 300 KNOLLWOOD LANE MATTITUCK Street Hamlet shown on County tax map as District 1000, Section 107 Block 1 Lot 20 does not conform to the present Building Zone Code of the Town of Southold for the following reasons: On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /-XI Land /_/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: One story-one family, wood frame dwelling witn accessory she in the rear yard in the A-Residential A ricul- tural zone with access to Knollwood Lane a town maintained road. The Certificate is issued to CHESTER & FRANCES BLASKO. (owner, ' %ztAsa&7aQx of the aforesaid building. Suffolk County Department of Health Approval—_ N/A UNDERWRITERS CERTIFICATE NO. N/A Attached inspection report Building Inspector BUILDING DEPARTT•ENT TOWN OF SOUTHOLD, N. Y. HOUSI`:G CODE INSPECTION REPORT Location j0O 0ANE MATTITUCK number & street Tlunicipality Subdivision Map No. Lot(s) Name of Owner(s) CHESTER & FRANCES BLASKO Occupancy T , (type) owner t; Admitted by: pliner Accompanied by: Owner Key available ' Suffolk Co. Tax No. 107-1-20 Source of request Date 6/13/8 DWELLING: Type of construction WOOD FRAME stories 1 Foundation BLOCK Cellar FULL Crawl space -- Total rooms, 1st. Fl 6 2nd. Fl _ZZ_3rd. F1 - Bathroom(s) 1 Toilet room(s) -- Porch, type FRONT Deck, type -- Patio, type -- Breezeway NQNF arage NO11E Utility room 1 Type Heat OTL farm Air xx Hotwater Fireplace(s),l � ---_No. E,cits 2 Airconditioning ONE Domestic hotwater xx Type heater OIL Other ACCESSORY STRUCTURES: Garage, type const. NONE Storage, type const. 6'X8' METAL SHED Swimming pool NONE Guest, type const. NONE Other VIOLATIONS: Housing Code, Chapter 45 N.Y. Stat 'i c�rsn Fire Prevention Location Description � Art. 1 Ser. NEEDS OKE ALARM OUTSIDE BEDROOMS Remarks: Inspected by: W Date of Insp. 6/12/85 ` WALT CORWIN Time start 1 0:O s end 1 o::10 m FORM NO. 4 r TOWN OF SOUTHOLD r` BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19428 Date OCTOBER 141 1990 THIS CERTIFIES that the building AITERATION Location of Property 300 KNOLLWOOD LANE MATTIT'UCK YORK House No. Street Hamlet County Tax Map No. 1000 Section 107 Block I Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 4 1988 ___pursuant to which Building Permit No. 17504-Z dated 0 6 1.988 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 ENCLOSE EXISTING PORCH AS APPLIED FOR. The certificate is issued to JAMES & LO R INR. KILKENNY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-016087 - MAY 24 1990 PLUMBERS CERTIFICATION DATER N A i 7-- r Bul, ding Inspector Rev. 1/81 Town of Southold Annex 5/12/2014 P.O.Box 1179 54375 Main Road 'I1► Southold,New York 11971 CERTIFICATE OF OCCUPANCY PANCY No: 36914 Date: 5/12/2014 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 300 Knollwood Ln,Mattituck, SCTM#: 473889 Sec/Block/Lot: 107.-1-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated P � dated 4/30/2014 pursuant to which Building Permit No. 38836 4/21/2014 ..... ........._ _.....__www www. ..�. 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: °ABUJLT-DECK ADDITION TO IIX STING SINGLE FAMILY.D, WE1, 11 Ka-A.-S �?"P! IED h"0 R The certificate is issued to Kilkenny,James _........e, ......, (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A inatu� 1 Town of Southold 3/13/2020 P.O.Box 1179 4 . 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41142 Date: 3/13/2020 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 300 Knollwood Ln,Mattituck SCTM#: 473889 See/Block/Lot: 107.-1-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/18/2018- pursuant to which Building Permit No. 43171 dated , 10/26/2018 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: ACCESSORY W-GROUND SWMMjXQ PO0l FENC"Pl)"r0 00131 AS APPLIF I-LOR. i The certificate is'issued to Richards,Adam&Cantarella.Claudia G of the aforesaid building. l SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43171 02-25-2020 PLUMBERS CERTIFICATION DATED Signature .w.w.._.�-