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HomeMy WebLinkAbout1000-122.-10-2 E_ TOWN OF SOUTHOLD IS, ' E Rental Permit 0889 Owner Joseph & Darla Doorhy Occupied as Single Family Dwelling Located at 1125 Ole Jule Lane Mattituck 122.40-2 Maximum Permitted Occupancy 2 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. 4/28/2023 cycle E Official This Notice must be posted by the main entrance at all times d Town Hall Annex Telephone(631)765-1802 6� � Tele 54375 Main Road '� Fax(631)765-9502 P.O.Box 1179 ^ Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHO RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) SeCt1i vn nn aa.u . Property Information: Rental Property Address: Tax Map Number: 1000 SECTION _.-BLOCK -LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: _ Property Owner Mailing Address: OL. �rr .� �-e ✓ " Telephone Number (s): Daytime vening Emergency Property Owner Email Address: G_ I (j AA �,© 4, APS Page 1 of 5 rif SO 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 s0 HOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: - F, Telephone Number(s): Daytime___ Evening Emergency Email Address: -� Section D. Managing Agent Information: 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: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Fuad Fax (631)765-9502 P.O.Box 11794 Southold,IVY 11971-0959 ° rouo BUILDING DEPARTMENT TOWN OF SOU OLD 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, 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." r 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 ach room in Rental Dwelling Unit: S I�h 13U � �13 ✓p° j iC .r r c F 7 O�dre r ®J j Page 3 of 5 so 4t "relcphone(631)765-1802 Gown Hall Annex : Fax(63 I)765-9.502 54375 Main Road 't P.O.Box i 179 Southold,NY 11971-0959 r� BUILDING DEPARTMENT TOWN OF SOUTHOLD SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 2017" (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. 64 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold i7] 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 t ��P� r� ��� certify under penalty of perjury, the following: Z. 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 a � s Town Hail Annex Telephone(631)765-1802 54375 Main]toad ,. Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 " BUILDING DEPARTMENT TOWN OF SO SOLD applicable laws and rules. l 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: JCS jJ Property Owner's Signature: K fi� Sworn to before me this day of_ _. 2o23 Official Notary lic Signaturea d C►riginal Notary Stamp TRACEY L 1)WYER NOTARY PUBLIC,STATE OF NEW YORK NO.010W6306900 OUAL1FIFD IN SUFFOLK COUNTY CO1W114i11SSION EXPIRES juNe 30„2AYo Page 5 of 5 S ��� w ` Telephone(631)765-1802 Town Hall Annex 54375 Main Road J, Fax(631)765-9582 c{ P.O.Box 1179 Southold,NY 11971-0959 �� f 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©welling Unit proLessional seal re aired or Architect or Engineer,lic er ensed None Ins actor rrlust rovide cop yof valid current certi atign Rental Property SCTM Number: Rental Property Address: Zl de- owner/Name: _ . ? �.r. ..... �. _�.... Rental Dwelling Unit Identifier: ••- Number &Square footage of each bedroom as depicted in the attached floor pian: (i.e. Bedroom#1 -100 sq., Bedroom #2-90 sq., etc.) '�`�" .,....„„_.,... . ti4',iC%"'....CY,Sw'"tl/' ...,..., ,,..� c'*"""...:"9""`^ ...,........,....„_',...:..r,.....``..�.."�„��...0... 4ia;a.',":�,�'�'a".',,,.� ..,m'� y.»......,..,...®.%m'u�d'l'r,„,...a'—.°�....,,...�0.�,.,o.. ............_.......,.,.,,,,,.. Property Description (include all improvements indicated on survey) 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 Energy Conservation Construction Code of New York State. f Print Name and Title Cr al mature Please place professional seal: TOWN OF SOUTHOLD BUILDING D1 e 831 -785-1802 I V),. , --- I c INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INS TATIOWCAL [ ] FRAMING I STRAPPING [ KFIREE AT FIREPLACE & CHIMNEY [ SAFETY INc [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C [ F JAZO Saar V i XTR TYR Sp A W k $Hold per ok, KW TOW Sod CT— la rA-LE pa"n cr Ilk 5W aff—HRCJCN- e QP yj202 RIDGE M ow EAMLX 10, YF7,gia Ivo CLG HT ,g" AL AS MR.Re ,VFt4Ttooxm Am, , �' F e � dn 77 /, / TW3062 TN30,52 ag r rll//iii/ it i Ll / (")'1n3r"4"X'd1 °d"M i i//i/r' VA r r r r �i /✓ v r 5( TOWN OF SOUTHOLD PROPERTY REO " 4 � , t WN, EJR- v STREET VILLAGE DIST SUB LOT 3 0 ie Li AORe REMARKS TYPE OF BLD. 11 At-1lA=Aooexl fnPROP. CLASS _ s t LAND IMP- TOTAL DATE063 a_ r 03'�16/ pw- bulb #_V s �. _ �� - ,. p14 31 os� t rf ZZo o z f� - - - 5 V/ FRONTAGE ON WATER TILLABLE _ FRONTAGE ON ROAD WOODLAND � DEPTH MEADOWLANDI BULKHEAD HOUSE/LOT I TOTAL 05COLOR _ Ji I I . I , s t , ' f l I TRIM 122:10-2 03/13/2017 l i I _ Pc i Dinette - Foundation CB �d� Bath M. Bldg. € FULL _ - CRAW M - 1 Floors Kit Extension Basement S,$ - l ' Interior Finish R i Ext. Walls IA �� l � - Heat D.R. Fire Place - E Woodstove t Q� Dormer Porch � i Attic l k - � a Rooms 1st Floor o Rooms 2nd Floor Garage e C7.B. �, Pool , _� _ . - 4 rte' s� z s� 3 4 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23922 Date SEPTEMBER 28 1995 THIS CERTIFIES that the building -_ NEW DWELLING Location of Property 1125 OLS JULE LANE �MATTITQCR NY House No. Street Hamlet County Tax Map No. 1000 Section 122 Block 10 Lot 2 Subdivision Filed Map No. Lot No. - conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 27, 1994 ,pursuant to which Building Permit No. 22555--Z dated JANUARY 121, 1995 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 ONE FAMILY DWELLING FIRST FLOOR ONLY WITH ATTACHED GARAGE AND SECOND STORY STORAGE AREA AS APPLIED FOR. The certificate is issued to JOSEM & YJUU A DOORHY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RIO-94:-0113 SEPT. 28r_ 1995 ELECTRICAL INSPECTION SVC. 8390 SEPTEMBER 13 1995 PLUMBERS CERTIFICATION DATED SEPTEMBER 27f,, 1995 DENIS NANKERVIS 14 uilding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27891 Date: 08 24 0l THIS CERTIFIES that the building ACCESSORY Location of Property: 1125 OLE JULE LA MATTITUCE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 10 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15, 2000 pursuant to which Building Permit No. 25504-Z dated MAY 16 2000 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JOSEPH M & DARLA A DOORHY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _NJA ELECTRICAL CERTIFICATE NO. H 071432 51S O1 PLUMBERS CERTIFICATION DATEDN/A C t ri d Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27891 Date: 08 24L0'1 THIS CERTIFIES that the building ACCESSORY Location of Property: 1125 OLE JULE LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 10 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15 2000 pursuant to which Building Permit No. 26504-Z dated MAY 16 2000 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JOSEPH M & DARLA A DOORHY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H 071432 051 01 PLUMBERS CERTIFICATION DATED w N A s ti C t ri d Signature Rev. 1/81 F014r, Town of Southold 10/25/2016 P.O.Box 1179 . 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38614 Date: 10/25/2016 THIS CERTIFIES that the building ACCESSORY WW ��__ww__......._.w_..........._ww. _........... __m_ w..-..... Location of Property: 1125 Ole Jule Ln.,Mattituck SCTM#: 473889 Sec/Block/Lot: 122.-10-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated • WWYYYYY µHµMµµ dated 8/9/2016 8/2/2016 pursuant to which Building Permit No. 4893 0893 „m YYY- 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: ACC: tl "�`SI� IJ ASw..�1?LIEL.. 0 The certificate is issued to Doorhy,Joseph of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED u 0 w_ Signature xra " Town of Southold 1/30/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41794 Date: 1/30/2021 THIS CERTIFIES that the building HOT TUB Location of Property: 1125 Ole Jule Ln,Mattituck SCTM#: 473889 Sec/Block/Lot: 122.-10-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/11/2020 pursuant to which Building Permit No. 45630 dated 1/4/2021 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 aAy hqtj9h_as appljW for. The certificate is issued to Doorhy,Joseph&Darla of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45630 1/19/2021 PLUMBERS CERTIFICATION DATED _. ... .....w_.....w............. .. _...... ...... __w._...._.. A rSignature .w._.. �gflllt , Town of Southold 3/2/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41867 Date: 3/2/2021 THIS CERTIFIES that the building GENERATOR Location of Property: 1125 Ole Jule Ln,Mattituck SCTM#: 473889 Sec/Block/Lot: 122.-10-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/11/2020 pursuant to which Building Permit No. 45631 dated 1/4/2021 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: Accessos _g aerator as a lied for The certificate is issued to Doorhy,Joseph&Darla of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45631 01-19-2021 PLUMBERS CERTIFICATION DATED ,.__w. ..._w_.._ Authorized Signature w._....._�.._._ Ut� tk, Town of Southold 5/26/2022 P.O.Boz 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43105 Date: 5/26/2022 THIS CERTIFIES that the building ACCESSORY Location of Property: 1125 Ole Jule Ln,Mattituck SCTM#: 473889 Sec/Block/Lot: 122.40-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/19/2021 pursuant to which Building Permit No. 46391 dated 6/9/2021 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: Lion-habitable a s zry it a g is ildrr►g ry ttlmrtr l s l e rr at and half= ath a. Ftp ie—f The certificate is issued to Doorhy,Joseph&Darla of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL 46391 5/16/2022 ELECTRICAL CERTIFICATE NO. R-21-0857 2/1/2022 PLUMBERS CERTIFICATION DATED 5/16/2022 Mat. k Plumb' g u ori Signature o M )(WI Ott s d3s 0 ii,e) wa ot 3ONZI Ivan Ilvo– PIE. IWA ouvd Voz ro Bit 3,VIWI Abo -ISnOH lS ove e pyo. NMI MY .9B got AJ, .-H"WDd BoOM U " hfJAO 40o -7 94 r _� 0 J nj i ^ r( Nt Q) gown wnu- tj '00,og I IN3K3AVddo 003— An '00,og 3?Od 4#1 Ain '4 Ni lz 3LV?A ongn 4 4