HomeMy WebLinkAbout1000-106.-6-35 TOWN OF SOUTHOLD
Rental Permit
s�.
1088
Owner Kathleen Williams
Occupied as Single Family Dwelling
Located at 1745 Bayview Ave Mattituck 106.-6-35
Maximum Permitted Occupancy 8
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.
3/11/2024
Code ocet Official
This Notice must be posted by the main entrance at all times
I2� -q)Ck ot 12Co
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 ��i�
JI
BUILDING DEPARTMENT i uL 7 202
TO OF S O 'COLD
RENTAL PERMIT APPLICATIONj3Un,DjNGDEPT-
TOY
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Property Address:
Tax Map Number: 1000 SECTION ----BLOCK_bto� -LOT_2�S--"-
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
AT-( V I IffC16
.��_.
�l
Telephone Number(s): C aytlme ,- " ' Evenin& Emergency -
r
Property Owner Email Address: I
Pagel 0 5
Town Hall Annex N,� 1� s � ^t` Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
r
P.O.Box 1179
Southold,NY 11971-0959
I �
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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."
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:
2- 0
Page 3 of S
1�k'...C 1,1 Ito
rt 1�
Town Hall Annex Telephone(631)765-1802
54375 Main Road 1¢ Fax(631)765-9502
a
P.O.Box 1179
Southold,NY 11971-0959 tip'
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V011' Via` F
BUILDING DEPARTMENT
TOWN OF SO J'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 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.
I am requesting a fire safety inspection to be performed by a Code Enforcement Official
q g
from the Town of Southold
❑ 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)
I 1 certify under penalty of perjury,the following:
�� fY P Y p J rY� g:
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 -31
Southold,NY 11971-0959
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 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: l
Property Owner's Signature:
Sworn to before me thiJ day of
rvr
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.01 BU6185050
Qualified in Suffolk County
Commission Expires April 14,2
Page 5 of 5
TOWN OF SOUTHOLD BUILDING DE
631 ?65 1802 A* -
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL.BG.
[ ] FOUNDATION END [ ] INSULATION/CAUI
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSI
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PETS
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN,
[ ] CODE VIOLATION [ ] PRE C/O R
REMARKS:
DATE INSPECTOR
TOWN OF SOUTHOLD so
631 -765 1802 106--
INSPE'C ION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING / STRAPPING [ ] FINAL.
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (TII
[ ] CODE VIOLATION [ ] PRE C/O [ .e
REMARKS: /&IA4", a�4
J94WI
IL
hooe
g.
,too- ,
DATE .2S- 3INSPECTOR
/
Town Hall Annex
Town of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
ti Tel: 631-765-1802
SCTM# Date ...... _ w ..'........
;Owner /% %�I" -C
Phone
�. . .. ._m !" _Visible
Address / _ _ �: d/e.J s
Hamlet ....._. . . "+.........._ . , . .. . _ ..,,... .._..... . pector...�_. .. . ....w... ...
_ .,..
;Floor Level Quantities _
Sub 1 2 _ - _ ._3.. .....s
Smoke Detectors not located in bedrooms)
,I a.........
Carbon Monoxide Detectors
Fire Extinguishers.. ..... . .. ....w... . ,_.w _ .... .. .__ ...�...�., ..... �_ „��.,.
Exits
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Bedrooms 1 2 3 4 5 6
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Smoke Detectors
Egress
Occupant Count
Building Systems Maintained &Operational Condition of Proi)erty
Heating Building interior
Hot water _ Building exterior
Electrical p y aintained &safe
e,,... �.. . . _ .
Pro ert clean. m _ .,�e . .,
Mechanical g installed &secure
,- Handrails&guards install e
Pool Safet on Site
Surface water alarm 1-1 sac
Date.o ..CO su
_� .. .....ne_.a_.-... . .�....
Door alarms Pool completely enclosed
_._ ....... e.. _,e. e _ . �._ ._. .w
SeH( o i ng Iatc �i��, iIato k Pool fence to code requirements
CO's for all items present Prior Rental
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Comments:
fiAt
CA-
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Erstrwc vvl��n�W� ._�
._....w__wv Case No.
ndet RS FEDERAL CREDO
22 0' s*n rrmr
ry Fao+N 0
20 4y
"
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Open to Below tO rr 4
Mas¢et smw"
bath
?4 a
Bedroom
22 0'
28 0
...w.�.w.+.....+rr 200'
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„.....M,.d.,_.�.. 280
I Comments
LIVING AREA BREAKDOWN
Breakdown Subtotals
4VcaALC Size .....,�......�..._ .,..._,...w,.,.....
. Cod............. KY,,� ..._.._.�.............�.....,.�_��..m.."_�1120.00
� ,.��w.......Totals���n..... ���...,...�.�.�.,.�...�_�...,,...w...... ..�._...,�.
AREA �ULA I _ SUMMARY
e k7 a�r Net T
20.00 1120.0 First Floor
GLA1 First Floor 28.0 x 40.0 1120.00
1104.00 1104.00
GLA2 Second Floor Second Floor
-0B0.00 480.00
GAR Garage 20.0 x 29.0 980,00
6.0 x 40.0 240,00
12.0 x 16.0 192.00
12.0 x 16.0 192.00
U
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TOTAL LIVABLE (rounded) Total(rounded) 222
2224....., 5 Calculations
5100 FAX(631)422-4605 OR V1S1T OUR WEBSITE„@ LASHOMEVALUEGOM
631 422
.............. _ _.. pNa . 1762tY8 .......
. P.., Wq _.
X L(Lq p _j 45!jAY\ E-S vy..._. _ _.._......_w.... ....ww_.._ w...M.w _ _ ...._. ry 1s5z
. �.w. . ..m cai�MATTITUCK
era . .... ...... . ...
Lc rettr�a r�.Ac���ERS FEDERAL�,�afu..._ ..... .. ..........
`22 fY
rurnly
U6hl4c-In �...
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MntWr
Bxnthx
169
0¢dr�am
2201
2s a
20 rr
C'waaVr„ram W1nuFaxan
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s e
...kar��rdn'~rG
G.isr'my dsrlWwkw Npf.2�8MJu4 200'
..........._..................��.........,,.,.......,...,...._.................,................,.,...............,...........�..............
��_........._...........,.....,,...._........,.,......�....�.w..............,.........
..,.,.........�.�......._....,,�.....��,
Comments:.. _.. ..._._ wm.
....�.w__ww__w...._..._�—_w_...__w....�....w.w...._.w�__.._�—..._.. LIVING AREA BREAKDOWNIVI
AREA CALCULATIONS SUMMARY LBreakdown Subtotals
Code Description Size Net Totals _ �,...._�.......�.w........—.--
_ ....�..__,...._... ...,.,..._.�......�.,.,.�................�........11.20.00 � 1120.00� First Floor ... -....,..W�,......m
GLA1 µN.—Trst Floor
GLA2 Second Floor
1104.00 1104.00 28.0 x 40.0 1120.00
GAR Garage 480.00 480.00 Second Floor
20.0 x 24.0 480,00
6.0 x 40.0 240.00
12.0 x 16.0 192.00
12.0 x: 16.0 192.00
TOTAL LIVABLE (rounded) 2224 5 Calculations222
_ Total(rounded} 4
............ _.,_.,._...w ., . ........,.
�� (631)422-5100 FAX(631)422-4605 OR VISIT OUR WEBSITE @ LASHOMEVALUE.0
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17837 Date MARCH 13 1989
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 1745 BA`.fVIEW AVEN T"fITUCK
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 06 Lot 35
Subdivision MAP OF SHORE ACRES Filed Map No. 41 Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated. JUNE 8,g 1988pursuant to which
Building Permit No. 17120e dated JUNE 17 1988
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 WITH ATTACHED GARAGE & DECKS.
The certificate is issued to CHARLES & VALERIE ALLEN
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-68 FEB. 22p 1989
UNDERWRITERS CERTIFICATE NO. PENDING SLIP 3 10 89
PLUMBERS CERTIFICATION DATED DAVID LEE FULTON 3 10 89
r
uil.d.a.ng Inspector
Rev. 1/81
111`Fa't "Z* Town of Southold 3/2/2024
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 45028 Date: 3/2/2024
THIS CERTIFIES that the building HOT TUB
Location of Property: 1745 Bayview Ave, Mattituck
SCTM#: 473889 Sec/Block/Lot: 106.-6-35
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/27/2023 pursuant to which Building Permit No. 50153 dated 12/21/20 11 23
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:
ffas hu It"...h„ot,tub as pp.a.i. .�mml...:f�.r.
The certificate is issued to Williams, Kathleen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 50153 1/22/2024
PLUMBERS CERTIFICATION DATED `
. utl on M
11
atur . .
1xt
Ftttl' t Town of Southold 3/2/2024
, - P.O. Box 1179
53095 Main Rd
01 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 45027 Date: 3/2/2024
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Properly: 1745 Bayview Ave, Mattituck
SCTM#: 473889 Sec/Block/Lot: 106.-6-35
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/27/2023 pursuant to which Building Permit No. 50153 dated 12/2 11 1/11 202 11 3
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" alterations to exi�,t,in Wn1 l ..:t4111,1�l m�lu��Ili_►: �5. p1�� , or:.
The certificate is issued to Williams, Kathleen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 50153 1/22/2024
PLUMBERS CERTIFICATION DATED 2/19/2024 Pa k Kae %,
Authorized S ' i ature