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HomeMy WebLinkAbout1000-137.-2-14 TOWN OF SOUTHOLD Rental Permit y 1161 Owner Denis & Suzana Lipovac Occupied as Single Family Dwelling Located at 5220 Stillwater Ave, Cutchogue 137.-2-14 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. 7/2/2024 ..... al This Notice must be posted by the main entrance at all times Code � otoent o TOWN OF SOLi"I`ITOLD--BUILDING DEPARTMENT Town hlall ;nnex 54375 MainRoadP. 0, Box 1179Southold, NY 11V4,09 . Telephone (631) 765-1802 Fax (631) 765-9502 I I I ° W e UflN'fl�ItoWTIn� Y 2 2 P' 2 , RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: ZZo ��-v 1lurrut� 4vz C-4�C�Vo tn2 Tax Map Number: 1000 SECTION / -_7�-BLOCK 0170,�P- -LOT�q 0/ -� SECTION B. OWNER INFORMATION: Property Owner Name: _.�) -A,S 0.#jd Suzctua Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 3 z- X>_ Ts 1 r Telephone Number (s): Daytime 9" 7 b&-7 4of EveningT17 "Z.7y°1 Emergency 1712 Property Owner Email Address: s u zg+•aq L o vac- �J hat( . Co " Page 1 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: ......... UY7 4 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: Pitt /51omoom l l X/O �... .rX 9 L 9 SECTION G. , X'4 01� 1, u ` A / S-X/2 INSPECTION: e-o2ool t 1,9 X f 1 � 6A Tr! 3 c�Coo�-1 j o X to k 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. l� 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. STATE OF NEW YORK) COUNTY OF 1 51424,00 i✓z` '�J� , 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: �izRN� >l�1 0VA� Property Owner's Signature ro=befor e this day of I L� 20 THOMAS R.MAZZOLA Official Notary Public Signature and Original Notary Stamp Notary Public,tioo,01MState f 507727New k Registration No.01 MA5077278 Qualified in Queens County Commission Expires May 5,20& Page 4of4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF:: YeeO...._. , certify under penalty of perjury,the following; 1. I 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: ✓�i _ Z,; fQG Property Owner's Signature: worn to be e me this day of 202� THOMAS R.MAZZOLA Of i ` Notary Public Signature and Ori anal Notar Stam NntaryPubiic,StateofNeorlc g y p Registration No.OIMA50772-78 Qualified in Queens County, Commission Expires May S,20& Page 4 of 4 so TOWN OF SOUTHOLD BUILDING D 631 -765-1802 15 ,,Mao ION [ ] FOUNDATION 1ST / REBAR [ ] ROUGH PLBG. [ ] FOUNDATION END [ ] INSULATION/CA! [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O [ )CW000(4 Ale, So to GG c�!.n Gt EPEE INSPECTOR of SO TOWN OF SO THOLD BUILDING DI - -1 � 6►31 L6►5 02 3 8 / 7 o? I VIM C ION [ ] FOUNDATION 1 ST / REBAR [ ] ROUGH PLLG. [ ] FOUNDATION 2ND [ ] INSULATION/CAl [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (TII [ ] CODE VIOLATION [ ] PRE C/OREMARKS: [ a/j &099 all qr - we Vt*0 (4jio" iqa 5�A e,.5 V. .51 le-m �� -5 `lh Town Hall Annex Town Of Southold54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 � f Tel: 631-765-1802 SCT M _ .....""""_ .._M .... ....... .._ . ... _ Datew...........". _ .".. ".".... Phone .Address..��.�.......�, ..... r...... ..�.,_.._,..u. .._."_�_ ..... �..,�.. _"_�..�...,_.__.�, Visible Hamlet Inspector Floor Level Quantities Sub 1 2 3 ,..w°.Smoke Detectors not located .. w��,,,... .. „". ,�.". " ..,�w���.��.....�. , , ��,� . ,,,,. ( in bedrooms) Carbon Monoxide Detectors f Fire Extinguishers e Extingui shers Exits Bedrooms _ """".... . . �.... _ ...." ....., .w. 1� 2 3 4 5 6 Smoke Detectors ✓ " Egress +' �.._ww.. ..... . ...� �• Occupant Count,,,�..,._..,��....................,,,.�.�.,..__,"�.�.�"......� ...�.a �� ..�". ._�,� .,.,"�,, ,�,,_�.,.. ..._ .�...��",_�,�......�..._ ...� „ .,,�.� BuildingSystems....._. ._�. ,..,�,.� ..._._._...........".�...."""._"".�.......� .."_.._.._..."",,�"..�.�� ...� .............�..� _, ... ,_M .M V Maintained&Operational Condition of Property . .,,, ._... w. ""_...... . ,,.. . . _........ .. _. ,.,". . Heating Building interior Hot water Building a" ._......o�.�a ""..""".�. (ding exterior mm Electrical Property clean, maintained &safe .�..�... _...... ........w„� _ .... a.,,. w.. ."��.... �..,.� .,.. .,.,r "R r . ra guards installed &secure Mechanical Handrails& ._,,,,.,.,.�_...����,_,_..,.. �,..._,,.�....,.,.�"���,,,.....�.,�.�.�...�..,,.�„��,_�. _........_�...,�, Pool Safety _. �,..� . .M.,,....,..�..,"...�., ,. Sit e S Pool on a ... � ...""" , .. .... � .. ...... _ ... ...._..... .... .. . . ....Sit Surface water alarm Date of CO issuance Door alarms � �„�n�w...,�.,�m �� _ _ ."�,��.�. ....W� �� . �.,,,�.,,... Pool completely enclosed ....�.���� ..,"�.....". Self closing/latching g gates Pool fence to code requirements CO's for all items present Prior Rental ". ... w w .. . r..u.. w .......... .,_"... ... .. Comme .�""..._,.�_�_,.... ._.�...�.._..�_._.��,.. �,.M�._,.�."." .. ,.... .. . . ..,. . .._ntsts:........�.. . � it...,. �,..,...,� .....� _..,,.._._.,.�_. 5 _........"...m, "........ ...................................".....,,.......................,...... ..... ..w.."""""".... .._. TOWN OF SOUTHOLD PROPERTY RECORD CARD �{ OWNER STREET VILLAGE B, LOT e . FORMER OWNER ACR. fQ -K t' Yo v a X�l S W I TYPE OF BUILDING A y RES. - 1 - SEAS. VL. FARM COMM. CB. MICS, Mkt. Value LAND IMP. TOTAL DATE REMARKS 4d, "I Z ,Lill At fi Prot__et_ 7 4 nk4'11) 41-� 7 C) I J 1,CA 4�1 It= AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE J L FARM Acre Value Per Value Ac re Tillable 4......... Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total DOCK 0 ,1 _ - TRIM _ 01a a s = E _ j 137.-2-14 11/07 TO -Extension' , t Extension71 - 77 Foundation Bath ;Dinette Q Porch Basement _ - Floors K. - „ 'Ext. Walls Interior Finish LR. ` < B - ,DR_ Fire Place _- Heat Garage 1TPe Roof =Rooms 1st Floor BR !Recreation Room Rooms 2nd Floor ` FIN.. B 0, B� 2Drivewoy Total 1 t kk E y. � o 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- 33792 Date: 06/25 09 THIS CERTIFIES that the building DWELLING Location of Property 5220 STILLWATER AVE CUTCHOGUE www _.._ . �. ,,......... (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 137 Block 0002 Lot 014 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- 33792 dated JUNE 2.5t 2009 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.* THIS CERT. OF OCC. REMOVES VIOLATIONS NOTED ON C/O Z 4 7 64....DATED 8 ONLY. / 9 7 2 SEE UNDERW RITERS CERTIFICATE 7915, 10/11/07. 2. .. ..�_�.._...... ..... _�_w.._._._.�.,.,�www........�. The certificate is issued to DAVID W & JENNIFER OLSEN ...__... _.......................v.r............_......_....�OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. #7 91 5, 1 0/1 1 /0 7 N?CX PLUMBERS CERTIFICATION DATED N/A Q , H �X�N �9CDiN"KX AuMorized S' #nature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. i Certificate Of Occupancy No.Zlt7b4 . Date A.Ug 29 , 19 72 THIS CERTIFIES that the building located at . Stillwater Avg Street Map No. 7CX Block No. . .= . . . . .Lot No. XX . . . .CUtehogUa requirements for one fa dwel in ode conforms substantially to the t prior to Ce�3.ficate o Occupancy . . .Apt. 23 . . . . ., 19 57. pursuant to which i . Z1+764 dated . Aug. . . . .29 . • , 19. 79., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . private one. tamily.dwelli.ng . . . . . . . . . . . . . The certificate is issued to . .Anna .KovArSkl • • • • • • •Owner• • • • • • • • • (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval prey iSting. . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . .pre--eX4st;LAg . . . • , , , . , , HOUSE NUMBER. 522© . . . .Street . . . 6tillwater. Ave . . . . . . . Exception to Housing coder I Liiht s Itch & fixture living room, 2. 2 bedrooms Bwid►ng Inspector 3. Cellar 4, some rubbish in yard to be cleaned up > k HOUSING CODE INSPECTION August 28, 1972 5220 Stillwater Avenue Cutchogue, New York Tax Roll: Anna Konarski Unoccupied Upon request of the Southold Town Building Department I made inspection of this one story framed dwelling and found the following violations of Local Law #1, Housing Code of the Town of Southold; I picked up the keys at the office of William Wickham, attorney, Mattituck, N.Y. , and let myself in through the front door, beginning inspection at approximately 10:35 A.M. Living Room - No light switch on entry for controlling a light - Section 529b; no lighting fixtures - Section 529a. Bedroom .. southeast - no light fixture - Section 529a. Bedroom - northeast - no light fixture - Section 529a. Cellar - No light switch available at bottom of outside stairway (only means of access to cellar) - Section 529b. Open junction box not secured, laying on girder - east side of cellar - Section 528a. Rear yard accumulations of refuse against rear of building. I completed this inspection at approximately 10 :55 A.M. R ectfully su itted, 4 ward Hin e mann Inspector EH:tle " FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPA14CY No Z-22082 Date JANUARY 6 1992 THIS CERTIFIES that the building ACCESSORY Location of Property 5220 STILLWATER AVENUE CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 137 Block Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ' CH 3t 1992 _____pursuant to which Building Permit No. 20459-Z dated :FEB'RUARY 28 1992 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' 61 x 6' STORAGE SHED The certificate is issued to THOMAS P. GRALTON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N A. /,egildfng Inspector Rev. 1/81 FORM NO. 4 ne TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22080 Date JANUARY 5 193 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 5220 S`.�IL�,WATER AVENUE CUTC'HOGt1E N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 137 Block 2 Lot 14 Subdivision • Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRU ' Y 28 1992____,-----Pursuant to which Building Permit No. 20459-Z dated MARCH 3 1992 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 & ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS P. GRALTON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE 90. H-032690 - DEC. 30 1992 PLUMBERS CERTIFICATION DATED JANUARY 4 1992 - T.P. GRALTON i , /'44� Bu Iding 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-32899 Date: t 22 08 THIS CERTIFIES that the building ADDITION Location of Property: 5220 STILLWATER AVE C'UTC140GUE (HOUSE NO.) (STREET) (SET) County Tax Map No. 473889 Section 137 Block 2 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 18 2007 pursuant to which Building Permit No. 33307-Z dated AUGUST l0 2007 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" DECK ADDITION AND ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID W & JENNIFER OLSEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTM T" OF HEALTH APPROVAL N A ELECTRICAL CERTIFICATE NO. 7 915 PLUMBERS CERTIFICATION DATED N A r thorized Signature Rev. 1/81 .............. Town of Southold Annex 7/14/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37018 Date: 7/14/2014 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 5220 Stillwater Ave,Cutchogue, 1111-1-.................. ...... SCTM#: 473889 Sec/Block/Lot: 137.-2-14 .................... Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 2/5/2013 pursuant to which Building Permit No. 37794 dated 2/8/2 0 1 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: jtSta% UND SWINiMINC, POOLJE�NQL _#0607 AS APPLIED FOR The certificate is issued to Lipovac,Denis&Lipovac,Suzana (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37794 05-07-2013 .............. -------- PLUMBERS CERTIFICATION DATED Auth * Si ature 4 � 7 GO rt ym 4 v � k j, m E YSL, gg Ll t } a y-� 4 t: - e 1j 4� a f I za. m € I 1