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HomeMy WebLinkAbout1000-106.-10-20 TOWN OF SOUTHOLD Rental Permit 1213 Owner Gregory & Cynthia Guthenberg Occupied as Single Family Dwelling Located at 410 Cedar Drvie Mattituck 106.40-20 Maximum Permitted Occupancy 6 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. 10/15/2024 Code > - eat Offici This Notice must be posted by the main entrance at all times Ito vy josys M� mTOWN OF SOU THOLD-111WILDING DEPARTMENT C t I D f Town Hall Annex 54375 Main Road P. O_ Box 1179 Southold,NY 11971-0959 Telephone(631)765-1802 Fax(631)765-9502 littpsWwww,southoldtownRy4ov RENTAL PERMIT r PPLI7e,.? e Rental Permit Fee$300(Application must be ID �a 01, SEP 2 I tip Section A. B �,� � °1°�? '" ,� °5t;t° 'll�'1 '�" Propel Infonrnation: Rental Property Address: 0 Ce Lc r 'D('r v f��t i �cr l� /V I V9 6Z Tax Map Number: 1000 SECTION -8LOCK -LOT_j�-- SECTION B. OWNER INFORMATION: Property Owner Name: r C i tJ. G o t r1 e n P r Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 014 I kW,01-f e- VrVe/l L) �e- -De(cAwo re E- 1 L _ 1. : . ,OF c� $'IGS2Y-G8�18 Telephone Number(s): Daytimes//v 5-2-V& E ening 5 Ptly? Emergency Sl6 3 3 0 •-y,1L ?-lO Property Owner Email Address: o f'h e A b e r cA Q o To r1 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. loxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Eveniniz 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: CTIO111 E. SITE tarER INFORMATION:(required for rental props containing 8 or more rental units) Name of Managing Age tl Ding unit, if any: „„ Address of Managing Agent(no P.O. es . tea, Mailing Address of MvIn ing Agent: Telephone 14 ber(s): Daytime Evening _E ency Ema" ddress: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: V f T 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: wo 6e d ct r Pn V e McNi f c , Requested Maximum number of persons allowed to occupy Dwelling Unit: 6 Number of rooms in Rental Dwelling Unit: 3 � ('�yr . bq+1, 5- cc Use and Dimensions of each room in Rental Dwelling Unit:0 /-/"J'1 Z , fc eti %aX 7, r." 13e ro 1 - 16 2 lC), q x /I, 9 /3a ZQ, 2 X t-, 9 A,+k 2. Zf. Z x SECTION G. INSPECMON: 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 STATE OF NEW YORK) COUNTY OF SUFFOLK) 11,4 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: ° a Property Owner's Signature: r Sworn to before me thisv-day of 20 2� TIFFANY J BEREZNY Notary Public-State of New York No.01BE6284112 AA QuaV'ifiatt in Suffolk county Official Notary P S Mature and r al Notary Stamp My cornmissoon Expires 06117/2025 Page 4 of 4 f SOGlpy��a TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 /o&- /c -,,20 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: 5M o fc,=_ CAAP-b0A Coo, h o 1 /l .. DATE INSPECTOR Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 ` Tel: 631-765-1802 SCTIVI i O e ..... ... _-...._.._„ .. ..mm��. . . .. . .._ ...�......Address . . ... .. .. ....�v.._. . ;V�....m_��..... .........�. .W......._. ��.._...........: !Owner Phone I ....�.,�.. . _.... .... .....�..a . w��� .�.C� -....... sible.,......�. .... Hamlet......._.. ... __._. � ' .... -__.� .. .W _..... Inspector.. w ._.._.. .. .. _ _..w..µ...„i Floor Le vel Quantities Sub 1 j 2 3 ....wok Detectors..W. � not located in bedrooms.... _.. ....... em Carbon Monoxide Detectors ........ t.....�. ..w...... . ,._._���. . ..�. ... .m..... __ ..... ,,,.. .n�,..�...r ( ) .... Fire Extinguishers _. ......_..._w._. . .. ...... ...... .. _. ._.... _.. .._. .. _:_._. ..... . ._.. . . ...... .:, Exits.. .. ._.�.�_..... ......�._... �m m_.w_._ ..b_.M_ .. _... Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress �. _ . ...._ Occupant Count BuildingSystems w..�.... ....__... .,. ,,..._. �. ........ . ......�.. ... �_ .... ...-. ........ ....�._..� ..... ,�__.. . .. ... . ._ ... .. .� .a� ..�;. Maintained &Operational Condition of Property Heating Building interior Hot water Building exterior ,.__ ... Electrical 1 Property clean, maintained & safe Mechanical Handrails &guards installed &secure Pool Safety Pool on Site .._ . ...�_�. ..... ��...,m. ,_...._....__. .. ... ........... Surface water alarm .. .w ..... .... Date of CO issuance f . .m. Door alarmscompletely enclosed Self closing/latching gates �_..w� ........... .. . .��. �- � Pool fence to code requirements _..... CO s for all item s ins present � � Prior Rental � . x Comments: 3 _ .0 s I s v_ _ a I c: 1171 IM t H, 3 f t Cs,a �i, A* Z3 � t 106.10-20 11/20/2017 c =3 I t Bath h Dinette= M. Bld g. Z 3RY ) 0 I Foundation ` OV0,0:7 IT Extension 3 I asement _ ; Floors K. J Opq Extension Ext. Wall Interior Finish LR. s on�l ( r PlanS � 3 Place Heat r� S DR. Type Roof �"�ram'o c Rooms 1stF oor BR. � Porch 1 Recreation Roo Rooms 2nd Floor FIN. B, Porc QYl o�0�� Dormer ' I way S LA�� 5 pC i Q Q Driveway I -Re KIO = -0 S q0 a. B. - a Total I 0 Z673 r 7 TOWN OF SOUTHOLD PROPERTY R -a � OWNER STREET _' [�t��_, VILLAGE �DISTJ SUB. LOT c _ z _... f FORMER WNER '�� *c,o� N E ACR* t S W TYPE OF BUILDING iC _. P r RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value `, i' LAND IMP, TOTAL DATE REMARKS �//' /.i: ' It f. AGE BUILDING CONDITION NEW I NORMAL BELOW ABOVE FARM Acre f Value Per Value q Acre 71,r=��3irrrS rn 4 _` / ' J, �Ca E',pLt U Tillable 1 /i lam' 3 r Tillable 2 h Tillable 3 Y s _ t v r !. . Woodland 'L—% Swam Land FRONTAGE ON WATER $ , t 9 Brushland FRONTAGE ON ROAD r House Plot i DEPTH = BULKHEAD Total I IDOCK FORM NO. 4' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .....Z-1842........ Date .............................fty".'.....1'4-......... 19.W T,,,,,,��HIS CERTIFIES that the building located at .......(;.�dar...DriApra.................................... Street MQRyy'IV"or �F" Block No. Lot No. .... ... ........Matt ;LtjA0k ...... .�. as..., conforms substantially to the Application for Building Permit heretofore filed in this office dated .....................................4AXXIY....-22.......1 19",..4. pursuant to which Building Permit No, P,12;k� dated ........................... .Uljr....22.......... 19..,.63, 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 ........ ..Trivate..,c�aa .. 'atilt �.y...cwe.�..ling..................„.....,, The certificate is issued to .......t,.,.SpenCep,+,....But;t,garwprth...................... (owner, lessee or tenant) of the aforesaid building. K.D.Approval Dec. 12g 1963 by . V' lit Building Inspector Town of Southold 2/2/2018 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39489 Date: 2/2/2018 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 410 Cedar Dr., Mattituck SCTM#: 473889 Sec/Block/Lot: 106.40-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/9/2017 pursuant to which Building Permit No. 41688 dated 5/31/2017 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: &DAM I IONS AND AL"I I ATIC NS INCI I7I 1 _....."AS BUILT"....._.._ f, ' ;_T 1 AN 1 :I TLNG O01' I IMIL I I VJ 11_ Ca�,W T 1:1 BA DECISION#7094 DATED 09-"2L-2017 The certificate is issued to Chalone,Anthony&Chelsea of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41688 09-27-2017 PLUMBERS CERTIFICATION DATED 10-23-2017 M, 'tuck Plumbing ..�_...� ...._.. thM 9 „ed Signature SONT R..E I— E­ERS k LEADERS Is 1--D 11-1 FA— z A ----------------- 0i F- tj i <z z F, 0 of(1) p o Lu <LU <c)z ------------ ----- ---------- T -------------- ------------------ ------ ------------------------- ----------- ----------------- REAR ELEVATION FRONT ELEVATION RIGHT ELEVATION SCALE:1/4"=T-O" SCALE:114"=l'-O" SCALE:114"=V-0" Him ED— ---------- R A E A Al- SE jZ� RED—I nr -3, KEY —SE.IRE,ISs S, N,—1, Rc El. "T P—d-IP L E g—,U-3-R­-2A E.R-11­11 ..cvs p'nC4 e v: a � P ' F w i - 'Cia, O G Z oofm , t_ s< _ ,1.._,` E 0 e > o<w z R a Qo0 c x. Y' BUJ F r S M - _ zE -_# YF o- v' _ $.. 9 i� rEr eti �c�A�E E" t srssa,. a itE"-J( 1 F_ G. n ffS c Re 3 �j j.. SECTION-A _ E SCALE:1/4"=1'-0° G r R R.c _ i Y N E F w_ NGE ER!RC TAS 4 l OR SEE C O C 3 xc ae ,__,L �� ��. 4