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HomeMy WebLinkAbout1000-104.-7-1.3 TOWN OF S UTH L Rental Permit = 1094 g = g R Owner Patrick Sweeney Occupied as Single Family Dwelling Located at 150 Mason Drive Cutchogue 104.-7-1.3 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. 3/18/2024 ode c e t Official This Notice must be posted by the main entrance at all times i 71 TOWN OF SOUTHOLD-BUILDING DEPARTMENT F . Gti6 14all Annex 54375 Main load P. t . lox l 179 Southold NY 11 . ..„ To�nrra Southold,� 1'4�959 Telephon,1 (631) 765-1802 Fax (631) 765-9502 s�tti,�_:' ��.�.�).�.ut;ihtrlrj;�,��lr� F.fiw� een /&P RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section IA. Property Information: Rental Property Address: LA--f-' Li � Tax Map Number: 1000 SECTION ©� -BLOCK ' -LOT - i I SECTION B. OWNED INFORMATION: Property Owner Name: ?oA T rLl Property' wner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) !-h L-L- W1'4 C- n—VD 11 0 !o 91 F Telephone Number (s): Daytime l Evening Emergency Property;Owner Email Address: � Page 1 of 4 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: 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: Aj Address of Managing Agent (no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening Emergency Email Address: Page 2 of 4 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: 6'v Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: � �„` �—('`' ��--�In Use and Dimensions of each room in Rental Dwelling Unit: l Fc—,-x ,�� 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 from the Town of Southold I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. C STATE OE 4 ) COUNTY O E 4#: 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 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 s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: "° `' Property Owner's Signature: Sworn to before me fi sZ day of � ` �, 20 M Official Notary Public Signature and Original Notary Stamp LISA PAZMANDI u Notary Public C.nnecticut My mission Expires May 31, 2024 Mir w :'ro- n �.s�"no-1M^ �nTo Page 4 of 4 Town Hall Annex �ffaq tj� ✓ Telephone (631)765-1802 54375 Main Road '` ; Fax (631)765-9502 P. O. Box 11791' Yr `���� h�;fii Southold, NY 11971-0959 , � BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seal required for Architect or Engineer, Licensed Home Inspector must rovide copy of valid current certification Rental Property SCTM Number: i o v o — j 4 Rental Property Address: 1 �D �`��� �` a u L� Owner/Name: �� /��►�-� Z-1 C �'�Z� Rental Dwelling Unit Identifier: Number& Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 — 100 sgft., Bedroom#2—90 sgft., etc.) - — Z'� 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, the Fire Code of New York State, the Property Mai f New York State and the Energy Conservation Construction Code of New York S19 � 1 w Print Name and Title Orig a ign We, Please place Professional Seal: ! TOWN OF SOUTHOLD BU DING D1 631 -765 18 2 1q, P.-T. 1, INSP,EC ION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIf 000, [ ] CODE VIOLATION [ ] PRE C/ [ I REMARKS: .......... PrA VOY%K fl s _ J O m CD CD a WV x a a� i- J 3 di ... _ _. OW il v7 Ul F� 0 cm �_. �� x� �� � 03-515-1956 SWEETEY OF U s z o M B U � � � � swoec Cgmail.com , r 'r & . _.. p Vow m I P a - l µ y f ' V PAC n r^ C a O t m M f: 3 _ f F 9r� _ � r - r - CD ul cn _ tacc s #€ CLn a _ TOWN OF SOUTHOLD PROPERTY , 71,311s, � NER � � STREET f TILLAGE DISTRICT SUB. = LOT OW FORMER OWNER 1 E l ACREAGE i I � d ._j, �- TYPE OF BUILDING 7�lNqZ: Ad RES. ? SAS. VL. FARM ' COMM. iND. CB. I MISC. LAND '` IMP. ' TOTAL DATE REMARKS G 2660 I _ _ C U U , AGE BUILDING CONDITION FORMAL BLOW ABOVE Q, a Farm Acre Value Per Acre ,Volue m 3 tallw ? - E 0 9 7 0to E G Tilla �, bl 3 -- q Wcodland g : _ - Jai Swamp land�5 , Sa _ F BQ goo 3 IV- 6rushla House Plot Total • f a — e_ q � G- �1 � g ti Y a L t -,- .--71 [ - = Aji 104.-7-1.3 3/05 J� -- j w. ',� Bath - ��. Foundation Extension �� � = � -� i.: er er�t _ � Floors Y 0 c xtens� _ % ®E Ext. Walls � i Interior Finish, f,°Extension 7 Fire Place - Heatt` �� e Z � I � Porch Attic ! Porch Rooms 1st Floor -T '# _ ree x ! 1 .� Patio Rooms 2nd Floor oo Gor6ge Driveway - - - c i 7 6; - �- T �� :�� � � � ��'. /(., t� v i3r',l4 `ice •? 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-22712 Date NOVEMBER 9 1993 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of .Property 150 MASON DRIVE CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 7 Lot 1.3 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22712 dated NO ER 9 1993 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 The certificate is issued to JANE SWEENEY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NZA UNDERWRITERS CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED N A *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTIIOLD HOUSING CODE INSPECTION REPORT LOCATION: 150 MASON DRIVE CUTCBOGUE NEW YORK nu�n�Cr�,^'r b street �••��•municl,lxs�Lity SUBDIVISION �._ MAP NO.. ... LOT (s) NAME OF OWNER (s) JANE SWEENEY OCCUPANCY A-1 RES. OWNER ADMITTED BY: JANE SWEENEY _. ACCOMPANIED BY: SA KEY AVAILABLE SUFF. CO- TAX MAP NO- 1000-104-7-1.3Wmm - SOULZZ OF REQUEST: JANE SWEENEY qqq� DATE: JULY 6, 1993 mm � DWELLING: TYPE OF CONSTRUCTION WOOD FRAM[: � I STORIES ONE � $ EXITS�2 FOUNDATION CEMENT BLOCK CELLAR CRAWL SPACE TOTAL ROOMS: 1ST FLR- '4 — 2ND FLR. 3RD FLR. BATHROOM (s) ONE FULL BATH TOILET ROOM (s) UTILITY ROOM PORCH TYPE COVERED PORCH ENCLOSI?kCK, TYPE MTw_ PATIO, TYPE ONE GARAGE I CAR YES FIREPLACE BREEZEWAY DOMESTIC HOTWATER YES. TYPE HEATER ELECTRIC AIRCONDITIONING TYPE HEAT OIL WARM AIR HOTWATER OTHER: 'XT= Rom_ ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. WOOD FRAME SWIMING POOL _ , GUEST, TYPE CONST.____,,,,,_ OTHER: — VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION S BUILDING CODE LOCATION �ww. ._•.._ DESCRIPTION ��„_•, ART. SEC. REMARKS: BP i1031Z-COZ-2753; BP 117248-Z-COZ-19405, BP120587Z-COZ-22710, BP 121562Z-COZ-22711 INSPECTED BY: - _ _ DATE ON INSPECTION_AUGUST 9, 1993 GaI" Fi,sW� TIME START 10:10 AMEND 10:35 FORM XO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ..........Z.,.7.5.3. Date .... ... .........................July..2.1........, 19.6()- THIS CERTIFIES that the building located at 1YUS01L.DriVQo,-Xy1liCh0.QIt0............. Street Map No. .2347-6.....Block No. ......**,*......Lot No. ... .... .27. .ac...26. ......... ................................Wa...... conforms substantially to the Application for Building Permit heretofore filed in this office dated April 11 6A••• pursuant to which Building Permit No. ...... ... .................................. .. 19..... dated ......° rig Il , 1919., was issued, and conforms to all of the requirements of the app'sicable provisions of the law. The occupancy for which this certificate is issued is ..,. .fit O 41MY• 8U)MN••RESIDE•NCE ................ This certificate is issued to ot ( v aer, lessee or tenant) of the aforesaid building. . .. ;.:.,.,.. :.....� �..... ...................... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N® 1031 - Z Date ....................... ......»... 19. .. Permission is hereby granted to: f.dgley &..Hor•' or*.....A/C....; jx..T aer............... to ....1kild- ... ......,............................................. atpremises located at ....Has,Qn..) "" ,"II", .............u....,,».....»...»,.................................,..o-,,...»................... pursuant,to application dated ..»..................«..,.....April.......4......:•.•.i ..••, and approved by the "Building Inspector Fee $ �lO..»».....».... A Building»»Inspector..... ..» FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19405 Date OCT. 2 1990 THIS CERTIFIES that the building ADDITION & DECKS Location of Property 150 MASON DRIVE CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 07 Lot 1.3 Subdivision Filed. Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated�JULY 22 1988 ursuant to which Building Permit No. 17248Z dated JULY 22 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 ADDITION AND DECKS. The certificate is issued to JANE & GEORGE SWEENEY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVA14 N A UNDERWRITERS CERTIFICATE NO. N12.5492 APRIL 24 1990 PLUMBERS CERTIFICATION DATED_ RICHARD MAC NISH MARCH H 1990 Building Inspector Rev. 1/81 y FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22711 Date NOVEMBER 9 1993 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 150 MASON 'DRIVE CUTCHOGUE NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 7 Lot 1.3 Subdivision Filed Map No. Lot No.� conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 13 1993 ______pursuant to which Building Permit No. 21562-Z dated JULY 28 1993 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 DECK ADDITION & FINISH 2ND FLOOR AS APPLIED FOR "AS BUILT" The certificate is issued to JANE SWEENEY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N-291225 - OCTOBER It 1993 PLUMBERS CERTIFICATION DATED N A ild .ng Inspector Rev. 1/S1 tl " FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22710 Date NOVEMBER 9 1993 THIS CERTIFIES that the building ACCESSORY" Location of Property 150 MASON DRIVE CUTCHOGUE W YORK House No. Street Hamlet County Tax Map No. 1000 Section 104 lock 7 Lot 1.3 Subdivision Filed Map No. Lot No.� conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 23-1 1992 pursuant to which Building Permit No. 20587-Z elated. APRIL 28 1993 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 STORAGE SHED The certificate is issued to JAKE SWEENEY {owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A X� uilding Inspector Rev. 1/81