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HomeMy WebLinkAbout1000-123.-10-3 TOWN OF SOUTHOLD NCO Rental Permit Al 1179 Owner Kean & Bridget Driscoll Occupied as Single Family Dwelling Located at 905 Willis Creek Drive Mattituck 121-10-3 Maximum Permitted Occupancy 9 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. 7/31/2024 Cod En rc rn t Official This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 7 EQV E RENTAL PERMIT APPLICATION F E B 1 6 2024 Rental Permit Fee $300(Application must be renewed every two Section A. Property Information: Rental Property Address: q5� q0j W-�IL5 G-��Lb r-L­vc Tax Map Number: 1000 SECTION -BLOCK 10 -LOT-3--- SECTION B. OWNER INFORMATION: C�D Property Owner Name: DrIdA4, 0A Keafj r i.3 Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 15'q A vl Gar�'0w No A"[1 b Bad 'sm Da, Telephone Number(s): Daytime Aa Vening 9- 2- 03 33 Emergency_ Property Owner Email Address: Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: L _ ba"i el LL&A& S Address of Authorized Agent (no P.O. Boxes): LA )l q 3 5 Mailing Address of Authorized Agent: �j 1 Telephone Number(s): Daytime l'7'�� Avlening _So-hie, Emergency Email Address: Rj 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: (�AAA AC 07q .00 Telephone Number (s): Daytime YW 1 r� Z ,,,, � vening .. 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): 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, 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." 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: I / a3 fa" ° to w ��1� /l �� � 1 p� X i i3t �CcA �" '" N. b wm w,.mw 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. V/ I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the,Town of Southold Ci- I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 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: 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: 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 ❑ 1 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 SUFFOLK) I \A(Ietl�rl"Scvtl 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 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 s to any change to the information regarding Authorized Agent, Managing Agent,or Site Manager. Property Owner's Name: h ridatL, Property Owner's Signature: Sworn to before me this_day of Official Notary Public Signature and Original Notary Stamp CHANORAKAN7 PATEL NOTARY PUBLIC OF NE';�JERSEY MY CO";MiSMN EXPIRES JAN,17-2026 ID 4 2339173 Page 4 of 4 Barr ��'� ���1� ortek Dr. TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 4,3� - 10 - 5 INSPECTION [ ] •FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] F L [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: `l ' DATE � . INSPECTOR _�. ooar '1 d> W TOWN OF SOUTH OLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU TION/CAULKING [ ] FRAMING /STRAPPING [ ] F AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REI'�,�1RKS: � A'L( to DATE INSPECTOR a_ A. COLOR ONE s { 4 s ` TRIM 77_ F = f s = 121-10-3 3/13-� [ 1 s M. Idg, E Foundation P.c Bath � Dinette 2. 1 = 1 C.a Extension d _ _ FULL j Basement CRAWL Floors Kit. p g gy g SLAB Extensions Y / Ext. Walls Interior Finish L.R. - u Yo/ Extension Fire Place _ Heat D.R. Patio m. Woodstove BR- Porch Dormer Fin.B. Attic Rooms 1st Floor Garag _l }' L1 -2 Driveway Rooms 2nd Floor is k c.r - s } TOWN OF SOUTHOLD PROPERTY RECORD CARD T VILLAGE DIST. SUB. LOT 1v _ t _ FORMER OWNER .€_.,, . _ t l lc° N E ACR. S W TYPE OF BUILDING _ RES, SEAS, VL- FARM COMW "a LAND IMP. TOTAL DATE REMARKS 77 cw a z- {.sp�z� r = - g `max L.` FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH I MEADOWLAND I I BULKHEAD HOUSE/LOT ( TOTAL F v ql � l�SCTM # I ¢ P TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET =` VILLAGE DIST SUB LOT ACR. REMARKS _ fir - L a e TYPE OF BLD. _ PROP. CLASS, ws LAND IMP. TOTAL DATE �- C o {51 z� FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL - i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP ART MENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATB OF OCCUPANCY No Z-23657 Date MAY 17 1995 THIS CERTIFIES that the huilding D LLI� Location of Property 905 WILLIS C ' ' R DRIVE �TTI !� NSfii !C House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 10 Lot 3 Subdivision Filed Map No. Lot No.� conforms substantially to the Application for Building Permit heretofore filed in this office dated DRCZKM 13 1993 pursuant to which Building Permit No. 21855-Z dated DECEMBER 29 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 OPEN PORCHES & GARAGE IN CELLAR AS APPLIED FOR. The certificate is issued to PATRICK J. SCOLLARD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-SO-70-MRRCH 31 1995 UNDERWRITERS CERTIFICATE NO. N-344266 - MARCH 2 1995 PLUMBERS CERTIFICATION DATED SEPT. 26 1994-CUTCHOGUE EAST PLUMB.&HEAT. . ku ding Inspector Rev. 1/81 Town of Southold 11/15/2017 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39336 Date: 11/15/2017 THIS CERTIFIES that the budding RESIDENTIAL ALTERATION Location of Property: 905 Willis Creek Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 123.-10-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/4/2017 pursuant to which Building Permit No. 41625 dated 5/10/2017 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: SCREENED PORCH CONVERTING TO LIVING SPACE ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Driscoll,Kean of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41625 11-06-2017 PLUMBERS CERTIFICATION DATED 11-14-2017 rad Pi h _.r. ignatur r Town of Southold 6/27/2018 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39737 Date: m 6/27/2018 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 905 Willis Creek Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 123,10-3 . wwwma. Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/13/2017 pursuant to which Building Permit No. — 42228 dated 12/11/2017 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: AtCSS(!R l RO SWl1MlTG 1'OO FENCED,l CODB A APPLIED FOR The certificate is issued to Driscoll,Kean&Bridget of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL , ELECTRICAL CERTIFICATE NO. 42228 06-19-2018 PLUMBERS CERTIFICATION DATED nhoSiS;raature ._...w.�.. 7 s j - ,:, a Air s� > W s - .n Y L W LE if s - - _ z , 3 <£ r � » - s tt E� A s s� — aw m rF� if OF Elwo a LE GTE C L 6 YOL JT € oar € C' tCAL i PLAN PROGRESS PRINTS - - NOT . ?" UCT(d?N DATE r' � --------------- _ ��� � � ��� f �i #_ �f E •gam' � - =+ :zrrh.ws� ¢ ,.w -m�` --�?�=-._e - �=- � A #-- ` uj f ) t �s ,f - iiii!Iii a _ ® cc 1 co _ e ui tcl gig Y , t w E4, f-: t f a I e - 1_ Im f :S � Te+ _ -tea JUF n - ] eIT _ N iV a - , SASEME O PLAN a Uzi— PROGRESS Shot h'0. PRO S PRINTS ,— — NOT FOR C UCTIOW ®. _ ` FLOORPLAN SKETCH Borrower DRISCOLL,KEAN ............. FiIe No. 78.66. Pro rty A ess:905 WILLIS CREEK DRIVE Case-ISLO CiM MATTITUCK 5tale:NY Zia,11912 I.endev CIT17-ENS BANK,N.A. xp. Dining living Bedroom Bedroom Bedroom C. Bedroom t Kitchen Closet Foyetz--- Bedroom closet Bath closet bath Den Bath Secord Floor First Floor [A,.1510itj (Boaz 14i841 I W MO Floor x tAv.192S'26 fl, stzondrma iUx let x 265 W V1 x 91t x 1.GOw 101V 176 0 3.6R I In% 1.043® 36W L B.72ft. 321eft. 0A0 135.14 , 13 3S 2184 v 31*x IAD- 11K, Moro L 028ft% I z4ft% 0.48. 0.14W 13 3,64 x lux 1.00. 359t, 332441 37ft x 0.14. 1440 Ifix N x 1.00- 9 T I fa 2.83ft 1 211. 035- U.4 20,x 1A00- 12 Mrs 2fix 2-631t% 0.36= 241 MAN 2ftx 0,36- 2 fe E3 r,,x 1.00. 12 W A 21i ZMA a 0.35. 2 ftl L 7.784 11 66ftx 035- 16 Q"I 20R x. 66#x 1.00. MR, 700 K--Am x 036. 1617 M, —1v 3-61tx 24ft,x 04 ft, 4ftx 140 r flew 31 4. 086", 11 n 1. 46.5W 9Rx 31nx 1.00- 279 A, ISR x 45ft x 1.00- 15.75 '44�A ---------at—x .......... PO BOX 972 SMITHTOWN,NY 11767 PHONE:631 64-6600 FAX:631-864-6601 2-4 i i _ " - T C R R A T C L n s -`"-""` 535 ALBANY STREET BOSTON MA.02118 P 817.451.1555 t F 617.01.1555 IPY rvo a 1 ♦, � Fife rt� I O w 1 c cn 1 3 1 1 4 t aenswu; PATS 1 — x � � f raaawwNonn.E EXISTI NG 1 st s FLOOR PLAN 1 ' - u DATE DPAWNU NUM&Ei_. 1„05R015 i A-001 :A e'=1•� I � # ELMS N!N FWANT STN10T B00TON M9,02110 p 91i•96l.SNlN - p B1T.963.l0B0 p}( E E L OPEN TO BELOW z s CAROUNES BEDROOM W { s L GUEST BEDROOM ®� W J s LL HALLWAY � £ f l E JACK&LUKES BEDROOM AIDAN'S UEij, CLOSET � , BEDROOM € BATH ;i = - NEY�BN7N; DATE € i EXISTING PLAN ' SECOND FLR �� �oRFWIFTlNUMBEN �4 owww 1 N� A-102 5 u H1 01 NpGE OVA E / NOTES: py 1. ELEVATIO XIST A` C EXIST F.F TA Ua .W"""•"" ..� qa L 11i a ew u p \ 2. AREA OF 3, FLOOD ZO FLOOD IN ZONE A , ZONE V LOT ZONE X ZONE X 0 ar " aN ,. vc- dS lit A XZI Ai r x�C7 p� 4di /✓// /// a aaa 4wa ot 10 o` � SURVEY OF LOT 17 MAP OF HARBOR VIEW AT MATTITUCK FILE No. 8377 FILED AUGUST 21, 1987 S/TUATF,D AT h" MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-123-10-03 SCALE i"-30' H r � MARCH 31 20035y a lY3 V G 11-A Yµ4Clt ':S I�rAIY<;N 9.2U0 Fk.�'Y9P(P N'M5 OU7 NYV:A F.—I ']aYGv NC k FmWun.9Nd! b iJ Y dffJ ItY{f n<1: i _'1'i..SA.:i41rW" 'pW,M L. 1 a091 I➢IY I.IY L t'Sf� AREA 46 083 sq ft (To n¢uI 1.058 oc. cERTIPIRD TO: ( ARE ,`'„"+^q KEAN D. DRISCOLL qp NAaE AREA y4,, '�: 3 BRIDGET E. DRISCOLL " r3 0E� a, ��q� 'Vjeep'I CONTOURFIRST ERICAN TITLE MOR GAGE CORPORATION CE COMPANY y, WA&F Nat.E. n6 DATUM "� y� 1 ELEVATI13lJ ARE RF FCREIJCED TO WAYU 15 11K �.,.:... ...:•"" nl ,. gAY+,144t Cd k'ioup,RT:AR@%wF'SW dM0.THUS! arA� h 3 a.xlharswkw,A�raarKwu�a�oNEs ARE latawvWN MsavS±00 � r: 2.AREA O DISTURBANCE 1 2,750 sq. fl. A �y' 4 'k �Yd�,.,h� F'3,FLOOD 7—INFDRIOATIO4 TAKEN FROIA A', 4 w FL[100 INSURANCE FATE MAP N 96 Y411L04H2 H 1r➢ a UA I10011 IDL—ONI,DVTU w p rvNr rn Lr�'IWL r ANU—1 vT.ueu.,m An ➢(­1 AL nD y 0 a xm N na.04AUUE rLWO,A-5 L F 1%ANNUAL FL(➢P> N` I mCR 4 p NAY 4YF V 1AE fVT I LYI6 YYU'li U 1, AR!A V.1 n YV:I- o„p .r,M r4N,d, N Ou 1.'R NVD AiYN f IE 1H, LN FV'�"G FYdIYN 0 N U 14"4PdC4„FYNOIS *M Q16j � 0 ✓a � yb5 WA,:r"„h 9.1'➢Vi.M'. N1dkYYY I:YI.YY dBAIIYLI➢Y4Y pd;-lIWP40k idOL 112R YJdWUNL f:.VUt VLt 114YPY YY➢MIV 1 Kbr ,r'u &'XfFPl11TG f07 T"fP6dNAd a^ OVER Y Oro UPLAND ALr,..EA Q"42,M57 ,ER ft DESCRIPTION i zraa A .ur s .,.+1. x ls. AREA oX { VA uN „e�� vY9"d� 07 M1LY15i FRONT PORCH II !m4 Vrrrra p k NWIS REAR PORCH (;,,�� � 4hN� roTAL EXISTING ., .....z use sq.Ir a sx LOT `,:.1 S Aa.0 "S V p .,.. .:.:.:.:.:.m.:. 1 .�., wN, 'd qq� yy ar v a r t rApo + AM a X°/A'" "+'A"N N, d w mb 6✓p Asia, r k it crczbr"d,.,+ tu ' H.- xn ....rry ,ay,'N1aN c„ p zr a A° N.° h ma a A,�r 4�, �d ✓'� c.rw°(~1yN ^;a �„:v -aA,�Y o M `� A"A,"°'�r�"„a�u V: 8�✓,�Y ""'Nr aC'S:: �auw �„ a .nA•� A, r ,a;N,d x ,gip+ aN gal: ' a A 4C� "2YJ I A � L � , e,,24CifFK w Vol x, WILLIS HOLE DEEP A. �n4 I Nathan Taft-�in III N Land Surveyor TI ,nnr On. [npe J' .,�1. n,Jr LS a Jnvmuir m. 'T ruin S wYa—:S.tlNwio an.n ukPa firm. C str,.iaar I.mYaaP nIY YP .a}YH a ,�--'"N'°r. F,Fa➢wr:g¢wskyr2a-ztPnu re.a,gr:arpzd-r72r THE fASrt—..or FI¢Mr8 or wAY lJFpiG&:S'ddN:A(tidD ar MnIItPlfi NIURFS!5 nMq/U11 CdlgA:hftM15 G4 RE:UN[I�U If"CPn UA? PO.#nu Ifi Nx,NOT AMA'iu'N�'W AfiE f10'Y OIA9NVmE%F). Jnle�maiwRr6,Mnwr ttork 119L'I lnmr.�IwrR°Ncw VF"ix I143aY 4 now . L P kkP*&"*er Naga w .e G _ j�4y affOLK COUNTY DEPART�I1WT Or HEALTH SOMM �I� O� FOR APPROVAL OR CONRfCT10N �,iMO'��7� C� G(-O m DATE H&R HIMM. Q 9 VA 24 MIS APPROVED L 0 LI:7tl1" 60001 C1 11 V Lea* y r� S 1 , py � w Ask E AFOLK COUNTY CCxfRT' �17 OF T��YANiE3 ,A sa .k4 SURVEY OF ! LOT 17 MAP OF "HARBOR . VIEW AT MA TTITUCK" ,, y FILED AUGUST ?1, 1967 FILE NO. a377 A T MA T TI TUCK TOWN OF SOUTHOLD ; � :� �'� SUFFOLK COUNTY N. Y. 1000 - 129 - 10 - 03 Scale 1" = 40' '� rp 04 Feb. 16, 1990 ,, Ju/y 9, 1990(topo & set stks.) " e:6 o-,C Doc. 20, WWroviae) eRT3" To Mr$ 1884(fouidation A�RL TITLE INSURANCE Jan.24, 1995 (final "" a Q` RIVERW"AD A aAW �U' NO of lTAtE ^' MA J. GORDON ©` poste G caq fo .r / VOTII ll. GORDON AREA = 1.0472acree iw 0000rd*Wo With 00^*xiol1Mk N T 3, k NO. 49e 18 }�. Aar awWrrlrur ar a dzo �L:OAII k! a��W��" IM�I' " � ELEVATIONS ARE'REFERENCED aarA aar U W Tank 4'a TO N.G. Y O:. O/zT/'9i I7 O" 8OX AWARlM ROAD SOLIT/IOLL) N,Y. 11871