The URL can be used to link to this page

Home My WebLink About1000-115.-16-13 T OWN OF SOUTHOLD Rental Permit 1234 Owner NoFo Haven LLC Occupied as Single Family Dwelling Located at 1365 Donna Drive Mattituck 115.-16-13 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. 11/20/2024 Cod Erg r t offiml This Notice must be posted by the main entrance at all times . ,. Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 1 97 1-0959 410111 BUILDING DEPARTMENTp� TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 1 3 6, (-N cw ,, e t-u C k Nam( I I Z Tax Map Number: 1000 SECTION -BLOCK -LOT S CTA-f A- /000 SECTION B. OWNER INFORMATION: Property Owner Name: 1DO.Vicl Property Owner Legal Address: Property Owner Mailing Address: 63 i 63 t 631 Telephone Number (s): Daytime 77q-009_3 Evening sI L/-60ri�3 Emergency S1 S- 2n . i Property Owner Email Address: Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Cou BUILDING DEPARTMENT TOWN OF SOUTHOLD 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: / 14- Address of Managing Agent (no P.O. Boxes): Page 2 of 5 �Z Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. Box 1 179 Southold,NY 1 1971-0959 ✓ cou BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: / L 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: ON 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: l Page 3 of 5 5T` Flom G` ��pe r �� `'e ►J4 J�'��9 n��°ad �c! �� lJ r qr r.tr c>,, /—!�/`G 4 — �l r x l C!`-/ /qC�l.��/✓�-'1 �"'1 717 rr sott4 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 toc P.O.Box 1 179 Southold,NY 1 1971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 la s 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) 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 Page 4 of 5 sou' , Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �" Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO HOLD 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: �Aw*j Property Owner's Signature: Sworn to before me this)Xday of �t 1 20 2-3 Official Nota P a blic Signature d Original Notary Stamp p TRACEY I.. %NY1511. NOTARY PUBLIC„Trg a`OF NEW YORK N0.01 DW6306900 QUALIFIED IN Si,TFOLK COUNTY COMMISSION EXPI�iES-JUNE,30,2a&(P Page 5 of 5 l kwtvje�- 1 4 TOWN OF SOUTHOLD B IL.DING DEFT. 631-765-1802 l�. (v- 13 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING oe [ ] FRAMING /STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: CU DATE 0 1�A w ANSPECTOR TOWN OF SOUTHOLD PROPERTY RECORD OWNER STREET _ VILLAGE DIST. SUB. LOT E _ _ t FORMEROWNER N E ACR S W TYPE OF BUILDING RES. ;1 SEA VL. FARM i COMM. CB. MISC. Mkt, Value LAND IMP. TOTAL DATE REMARKS Vn r 9 fr r f o j f { wj _ e s NEW NORMAL BELOW ABOVE FARM _ Acre Value PerjaIue Acre Tillable: 1 a a _—e Tillable 2 Tillable 3 L - e f 4 Woodland i �6t � — Swampland 3 ,_ i /7y � �~ f` Brushland _ FRONTAGE ON ROAD House Plot DEPTH l BULKHEAD Total 'DOCK �A -- -, COLOR44 e f AVM � TRIM m l . t f .. - l 0 l M. Bldg a e n ion '' -Fou dat p Bath Dinette - n Floors Extension -_ a Basement Extension a Ext. Walls _ Interior FinishLR r Extension Fire Place Heat DR i •-3 I 6 a BR 1 s 'Type Roof I Rooms 1st Floor Recreation Roo n _ Porch Rooms 2 d Floo Fib g B•. a _ Dormer rme r - — - - - o Breezewa Driveway y Go rage f Patio O. B. J Total _ - __ FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . . Z 13 6 3 7 . . . . . . . Date . . . . . . .July . .16. . . . . . . .. 19 85. THIS CERTIFIES that the building . . . . ss"?': . . . t? .Pool.. S. & Fence ). . . , . . , , , , . Location of Property �A . . . . . . . . . . . . . . . . . . . Donna Bra e µ . . w Matttuck House No, Street ' . µ Hamlet County Tax Map No. 1000 Section . . . .1 5. . . . .Block . . . 16 . . . . . . . .Lot . . , 4.13 Subdivision .Dee3? ,Hole ,Creek, Est; , , , , , _Filed Map No. , 4256, ,Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . R ?4 w . 19 8 3.pursuant to which Building Permit No. . . , , , 12 2 4 6 Z dated . , . , April 14 . , + 19 . 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 . . . . . . . . . ------rt-- Swimming Pool & Fence ------- . . . . . . . . . „ . . . . . . . . . . . .SACKS . . . . . . The Certificate is issued to . . . . . . . . . . . . . . t GREGdRY . . . . . . . . . . . . . . of the aforesaid building. Suffolk County Department of Health Approval . . . » . . .N/A . . , . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . .N6.05137w . . w , . , , , yt « µ . . . Building Inspector Rev.1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 46339. . . . . . . Date . . . . . . . . . . . .Feb. . . .26. . . . . . .. 19.7 j. Matt. nl t THIS CERTIFIES that the building located at .5/13. .F,,• •ti 1 • lJoa.d• I-)• • • • • Street Map No. ?X . . . . . . . . . Block No. .:xz . . . . . .Lot No. .xxx . .Matt ituck . .R.- conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . . . . .Oct .2R 1V?+. . . pursuant to which Building Permit No. 7h337. i dated . . . . . .2Yk.IRQa . . 1 3 . . ., 19 7?+ ., 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 Bu.sine s.s .bu.i ldi.ng . .r. .storaga. A. shop. e.tca . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to CPLthia. Aaminsk7. . . . . um4m . . . . . . . . . . . • . • . • . . • • , • . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.it., . . w . . . . . . . . . . • . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No.2121+/.7 5. • hY.J.+. Xuba oki. . . . . . . . . . . . . . . . . HOUSE NUMBER . . .$p . . . . . . . . Street . F.. .M111.lizad. . . . . . . . . . . . . • . . . . . . . . • . Building Inspector i " FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . F13637 Date . . . . . . . . . . . . . .July . .16. . . . . . . ., 1985 THIS CERTIFIES that the building . . . . P:K . . nc.r .Pool. ( & ,Fence ). . . . . . . . . . Location of Property . . . . . . . . . . . . ,. . . . . , , , , Donna Drive . . . . . . . . . . .Matituck House No. Street w rt Hamlet County Tax Map No. 1000 Section . . . .115. . . . .Block . . . 16 . . . . . . . . .Lot . . . o i 3. . . . . . . . . . Subdivision.Deep Hole ,Creek Est; , , .Filed Map No. . 4256. .Lot No. 61 . . conforms substantially to the Application for Building Permit heretofore filed in this office dated March 24 , 19 8 3.pursuant to which Building Permit No. . . . . . . 2 4 6 Z. . . . . . . dated . . , April 14 . . . . 19 .$ ,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 . . . . . . . . . . . . -------- Swimming Pool & Fence ----- . . . . . . . . .ACKS . . . . . . The certificate is issued to . . . . . . . . . . . . . „ ' ► . ' PY 1 . . . « . . . • . . . . • . . . . . ar+wne, of the aforesaid building. Suffolk County Department of Health Approval . . , , . . .N/A _ . . . , . « • • • . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . „ . , ,N 6 0 513 7. 4 . . . . . . . . . . . . . . . . . . . . Y, z— B . . . Building Inspector Rev.1181 FORM K0. 4 TOWN OF SOUTHOLD' BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z"03 Date . . . . . . . . . . . . . ... U y. . . .31 . . ., 19.` V. . . . . . . . . . THIS CERTIFIES that the building located at . '. . . . • .. . . . . . . . . • . • Street Not Map NoDaep Rol#. Oblock No. . . . . . . . . . .Lot No. . . . . . Id-tt't+'U4jL . .N'Y* . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . .0ea . .21? . . ., 197)+ . pursuant to which Building Permit No. .7673Z. dated . . . . . . . . . . . . . . V9c. . .39, 19. 14, 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 . Primto . ope .family. dwe3- . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .Sp Oflw000. ftrk- HOZO t O. . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. by R Suffolk County Department of Health Approval ' . �. .� .. . . . . . . . villa UNDERWRITERS CERTIFICATE No. .19183 . . . . A,jptVIX II, . 1.975 . . . . . . • . . . . HOUSE NUMBER . . . . 1365. . . . . Street . . A * . . . . . . . . . . . . . . . . . . • . • . . . . . . . Building Inspector ------------ EXIST EXIST C BATH, � .., HAL �L BATH EXISTING o , BEDROOM #1 ��J g EXISTING EXISTING O� CLOSET CLOSET .._._.� EXIST LIN ,In EXISTING EXISTING BEDROOM #2 BEDROOM #3 EXIST CLOS EX S `II U SECOND FLOOR SCALE: 1"=1'-0" .__....ww �...._�.._.. .. ....._._.�.._�.._.�.�._ ,�___...__....�_..._.�.._... NO CHANGES PROPOSED �r�CrvSio�S � EXISTING EXISTING SLIDING o WINDOW WINDOW PATIO DOOR EXISTING SLIDING PATIO DOOR I NEW 2-2x 10 HEADER j NEW 2x 6 CEILING , S- DW I REF JOISTS @ 16"O.C. ( \ FLUSH WITH EXIST! }` ENLA GED 4� BATH EXISTING 0 Y 6'-7" Q Ci I KITCHEN J O EXISTING I I REMODELED I j m DINING EXISTING l FAMILY ROOM 1 ISLAND @} AREA BAY WINDOW I I EXISTING I EXIST Z I ; VAULTED I I ry°} PANTRY CD p CEILING - I i x— ALIGN NEW ±26'-32' GIRDER L GTH EXISTING WALLS EXISTING WALL WITH TO BE REMOVED SKYLIGTHS EXISTING r�----e -- HSS _ -- -- -- -- TUBI DN e 3t.,x NEW W12x 53 LOW WEL HSS 32"x 321"x 4'SQUARE HOLLOW STEEL GIRDER.SEE 7'„x TUBE STEEL COLUMN WITH WELDED DETAIL THIS SHEET. PEA 3� x 10'x`2"THICK STEEL TOP PLATE EXISTING WALLS PRC - WELDED TO STEEL GIRDER ABOVE 8 EXISTING_ TO BE REMOVED p O BOIL w< ° 7''"x 10"x� THICK STEEL BOTTOM STAIR 0 O i. PLATE WELDED TO CENTERED HSS COLUMN LL_ aD tO o I PROVIDE 4-1"DIA.x 12"DEEP GRADE SS x BOLTS DRILLED AND EPDXIED INTO EXISTING @ EXt: EXISTING FOUNDATION WALL BELOW LIVING Z� FIRE ExisrlNG AREA 030 FOYER w UP EXIST CLOS EXISTING �' _ —��------------------ ————— — -----� NG— EXISTING BOX WINDOW DOOR V' t l EXISTING c A2 2 4i/f LI t�j COVERED t 111 PORCH &0 Se-5or. s9/f n r Ys "+-e �t st c J y (m[✓er �A` �c �p ✓�l-�//� rJvfeg,-aid Jwl t�/��o�er IRST FLOOR PLAN EXISTING F EX 1'-0" ALL DIMENSIONS SHOWN ARE SHOULD SCALE: 1''_ / Ex 131=VERIFIED WITH EXISTING CONDITIONS ON SITE. �.�./" JC •in1.-...__"-___....-.-...av nlerPGnAA�r�Cc �,� I l` /