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HomeMy WebLinkAbout1000-99.-3-17.1 t aTOWN OF SOU` HOLD Rental Permit Permit No. 0192 Owner Candace Corlett Occupied as Single Family Dwelling Located at 55 Harborview Ave Mattituck 99-3-17.1 Address Village s/B/L 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. 10/9/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted bythe main entrance at all times Town Hall Annex Telephom(631)76.5--1802 54375 Main Road Fax(631)765-9.502 Scjuthold,NY 1 19 7 i-0959 BUILDING ��F�A���x FixJ I OF' SOUITHOLD TOWN RENTAL PERMIT APPLICATION j�61- grmit Fee $200 (Application must be renewed eery two years) Section A. Property Information: Rental Proaerty�Adress: .. . ._ _. _. Tax Map Number: 1000 SECTION .f BLOCl�.._� ..�..._... LOT_..,_..._ 1_.7�_.�, . ....._ SECTION B. OWNERINFORMATION: Pro eut` C+r ner Name _.� ,.. � C'� �� Property Owner Legal ,Address: Property Owner Mailing Address: (Cannot be the same as Dental Property,Address) 7, Telephone Number a = ._ ____..._ Property Owner Ernad Address �'!e� :'�.�(G-Al O::..�L .w . ) .. ,l 1 0... � Page I of 4 Section . AuthorizedInformation: Name of Authorized Agent of dwelling unit, if an Address of Authorized Agent (no P.C. Boxes): Mailing Address of Authorized Agent TelephoneNumber (s): __ ..____._w ..... _a._.._...._._.....__ ........M_. __._...... ....__v __ ..__......_ ..__..._____.. ..._ �.......,... Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if an Address of Authorized Agent (no P.O. Boxes):_ Mailing Address of Authorized Agent: Telephone Number (s): Email Address.SECTION .. .. _..._ . .._,.w..... :;.._.. .._.. . __. _._... _._.. __ . ........ 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): Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units onproperty� For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier (for example, ^. Unit 1, Unit 3, Unit 3or Apt A, B, [);the use of each room in the Rental Dwelling Unit (for example, Kitchen, Bedroom l, Bedroom 2, Living Room) and the dimensions ofeach nmorn. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: ______ � ' Requested Maximum number ofpersons allowd to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: Use andDimensions f each roorn in Rental D ||ingUnit' 7- .rJA 4 1- ^� ��,�� � _� �� �� ^� � 1.3 � � "� SECTION G. INSPECrION: Pursuant to the Town Code of the Town of Southold Chapter ZO7 (Rental Propert|eI\, a safety inspection by Code Enforcement Official is requ'ired. If the owner chooses not to have said inspection performed by the Town, a certification from a NYS licensed architect, a NYS 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 isin compliance with all of the provisions of the code ofthe 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. [] | on1 requesting a fire safety inspection tobeperformed bya Code Enforcement Official from the Town of Southold. Page 3of4 O I am submitting a completed Town of Southold certification form from a licensed architect, a licensed professional engineer, oralicensed home inspector who has avalid New York State Uniform Fire Prevention Building code Certification. SECTION H. ' DECLARATION: Signature must&e notarized and MUST be the owner mf the dwelling unit. ' STATE OFNEVVYQRK) COUNTY OF SUFFOLK) i7, certify under penalty Df perjury, th86 I owing: l 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 understandthe Town will use the address for service pursuant to all applicable laws and rules. l further acknowledge that | will notify the Town ofSouthold 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 tm 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: �iayof --�4_ "~ .'ONN|EO.BUNOH SwoSworn ^~ ~^'~'^ '''~ ~ !,�otaryPuNic state of Now York No.O1SU61@5050 Qualitiod in Suffolk County Com / iva|mn���nsm��h 1�'�C[�{} Offcia| Notary PubUcSignature and (}h 'na| N0tary5tarnp � --- Page 4of4 H*w�w Aw, iq TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 I a No S P OE Cm 0;` T I (m)" a rw4m [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNTION 2ND [/]IFIRE SULATION FRAMING./STRAPPING [ NALFIREPLACE & CHIMNEY [ SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING EM Sm cl 0C�� 1 r —bowl ,. F DATE, C PROPERTY RECORD CARD OWNER STREET VILLAGE DISTRICT SUB. LOT r FORMER OWNER N - ACREAGE 5 a © W TYPE OF BUILDING d-t P- ie Ck -IA RES.,�9� SEAS. VL. I FARM f COMM. IND. i CB. MISC. LAND IMP, TOTAL DATE REMARKS r4 ' od � _' _." o1d ��> ;�� E!e%rf _fo Ley ✓e!� — _ - -- �� 13,2 lam 700 817 A t- a AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable I I Tillable 2 Tillable 3 Wcod land Swampland Brushland House Plot, 1 — `V k� /g F M is �y/Foundation _ ;j - 4 Basement Floors Extension �- Ext. Wails Interior Finish Fire Place Heat Extension �. t s o N 1�6 x..c: = ti �J = /p Porch Attic ?: Porch Rooms 1st Fioo; _- Rooms c Patio - —_ F 2nd Floor = - lae ��r•a•�^•ems Garage Driveway i 0. B, - _ - 4J, a _ e i Amewvm0-6 �;� e_ ,�-�• _ ,ems- ��_� f R r a t ' N F 1 2F.+J * � t 'ems Kf. z : � L C j Nnre Any L'2y G F- g,„-rQy c cx o• — n tsn� it g t ;S lls id �- F a.rzIr-f os' a _ cs ow F��- ��. _m- ..a� �'•` _`_x� � �- _-__ .�s ue-�e✓4 �- _ -'t-L-L_-€B� t � � a _ - PC'h�ro ie�t477-0400 944 r s z - s-< 74777 �'�h (�B�,c �, �� /�► ►��r'i�x c� sec 3 L 17.1 r g �� �G �14 � f,Z 6-1,r A49 86a V ) ,c Ol Ar-r7-7 77,C a X 5S 0 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. .z1051.4 . . . . . . . . . Date . . . . . .June.4. ... . . . . . . . . . . . . . . . .. 19 . . s1 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property $15 Harborview Avenue, Mattituek, New York Noc a No, trier H*a* a%t County Tax Map No. 1000 Section . . 99. . . . . . . .Block . . . . . . . . . . 3. . . .Lot . . . . . .1.6 .&. .1.T . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . re i em.e t #��r one;f8m ly g�1rling built prior to conforms substantially to the Ap ��i!-ter i3i3c1iftr t.he l�ti tlecl irr this r ftf d- _ . , April , 19 .57pursuant to which S l' of—Occuparicy„ Z 1 051 k dated . . . . . . . June . . . . . . 19 .$1,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 . . . . . . . . . . . . . . . . . Prlya.te . One-Family. Axelling. . . . . . . . . . . . . . . „ . m . . . . . . . . . . . . . . . . The certificate is issued to . , , Auden 6filma„ BiBealox (owner,` . e-&rat„ 0-- of the aforesaid building. Suffolk County Department of Health Approval . . . . N!R . . . . . . „ . . . , . . „ . „ . . . . . . . . . „ . . . . . . UNDERWRITERS CERTIFICATE NO. . M . . NlTR . . . . . . . . . . . . . . Ks-p��tl'ctor R.v 417s BUILDINIG DEPARTrIENT Tovall OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 815 Harborview Avenue, Mattituck, N.Y. nu ber street t unicipality Subdivision Map, No. Lot(s)_� Name of Ovm er(s) Auden Wilma Bigelow Occupancy R-1 Owner type owner-tenant) Admitted by- Mrs. Bigelow Accompanied by: Mrs. Bigelow Key available Suffolk Co. Tax No. • 9973-16 & 17 Source of request William Wickham DateJune 1 , 1981 D.'=LI NG: Type of construction Wood ;,tories 1 Foundation Cement Block Cellar Fuld Crawl space Total rooms, lst. F1 5 2nd. Fl 3rd. F1 Bathroc,m(s) 1 Toilet room(s) Porch, type Deck, type Patio, type Breezeway Garage Utility room Type Heat Oil Fired Warm Air Hotwater Fireplace(s) 1 No. Exits.____ ___________..Airconditioning Domestic hotwater Yes e heater Tankless Other ACCESSORY STRUCTURES: NONE .Garage, type const. Storage, type const. Swimming pool Guest, type const._ Other VIOLATIONS: Housing Code, Chapter 52 Location Description - Art. Sec. Kitchen Gas Stove no shut off w_ w-Sm � t JSJ4r fit: t -44-44). — r D Remarks: _ Inspected by _ �� Date of Insp. 6/3/81 Start3:15 end 3:30 Curtis W. Horton Time FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15304 . . . . . . . Date . .Feb; 251 1987 . . . . . . . . . . . . . . . . THIS CERTIFIES that the building „ „ADDITION rt „ w „ . . . . . » . Location of Property $!5„HAR$ORVIEW AVE- MATTITUCK F ' House No, Streetlrnlet County Tax Map No. 1000 Section '099. . .Block .3. . . . . . . . . . —Lot . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . , . . . . . . , conforms substantially to the Application for Building Permit heretofore filed in this office dated VO_ . H ' . M7. . . . . pursuant to which Building Permit No. . .15705Z. _ . . . dated . .Feb; 25, 1987. . . . . . . . . . . . . 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 . . . . . . . . . . . . .PW> .1.nnTTTON.T0. EN15TW. OF. WILY. . . . . . . . . » . . . . . . . . . . . . . . . The certificate is issued to . CANDACE CORLETT. (owner, SS�EYXWX of the aforesaid building. Suffolk County Department of Health Approval . . . . . N/A. . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . N/A. . . . . . . . . . . , , , . . . . . . . . . . . . PLUMBERS CERTIFICATION DATED: N/A Building 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--17727 _ Date JANUARY 31 1989 THIS CERTIFIES that the building ADDITION Location of Property 8151 J°IARBORVTIIM AVLl?. _ TTITUCK NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section- 099 --Block 3 Lot_, 17.1_ Subdivisionµ *„ ---Filed Map No. Lot No.---- conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 1, 1987 pursuant to which Building Permit No. 15852-Z dated� MAPRIL_ _3 -1987 _ . 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 SECOND STORY ADDITION AS APPLIED FOR The certificate is issued Lo CANDANCE CORLETT (owner) . of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N�A UNDERWRITERS CERTIFICATE No. N830901-swr 8 1967 �. PLUMBERS CERTIFICATION DATED 't "'I .M S 1q 6- !'TZR CORLETT Building Inspector Rev. 1/B1 rlf �j �A y � J i i litz"t %r u Rio li uu 4, n Im% rr III Ok �, % Ais r / r �„fit�Ly / s �(•. luuuugl i' III 1, e / r II