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HomeMy WebLinkAbout1000-143.-4-17 (2) of so OWN OF SOUTH OLD Rental Permit 1336 Owner: Andrew Oppenheimer , Nicole Dobranski Occupied as: Single Family Dwelling (FRONT HOUSE) Located at: 495 Riley Ave Mattituck 143.4-17 Maximum Permitted Occupancy: 4 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. Issued: 06/24/2025 Expiration: 06/24/2027 4de 00rcerne'rit cWficial This Notice must be posted by the main entrance at all times u 15 JUN 9 2025 TOWN OF SOUTHOLD—BUILDING DEPARTMEN bo T ' Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971 VT Sot hold Telephone (631) 765-1802 Fax (631) 765-9502 ha / +'w I,soutlio Idiow "y 0�' ewb' s f;tonf RENTAL PERMIT APPLICATION Y"'eo 110 a(o A Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -/q3 ,00 -BLOCK a,. OQ SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) S avv"-z Telephone Number( ): Daytime 51( _Eveningss;gy-1 Emergency 5 k• ' - 35- Property Owner Email Address: 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, 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: Sc= © S I c) (-c A, Z. S 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. )d I am requesting afire 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) 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: Property Owner's Signature: Sworn to before me this day of 4_ _, 201,� Official Notary ublic Signature and Original Notary Stamp MELANIE JO SEAMAN Notary Public, State of New York No. 01 SE6038684 Page 4 of 4 Qualified in Nassau County Commission Expt es March 20, 20a�O q OUP, * TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 /�-3_�-/7 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 [ 4- R' ENTAL REMARKS: 4012- F�-rO DATE �-lam a �� INSPECTOR � - Town Hall Annex Town Of Southold 54375 Main Road zi �k Rental Inspection Report PO Box 1179 r r Southold, NY 11971-1179 �a Te1: 631-765-1802 w � SCTM# - — Date Owner 0 Phone Address — ao,5 Visible Hamlet Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) I Carbon Monoxide Detectors / Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress Occupant Count pZ Building Systems Maintained&Operational Condition of Property Heating Building interior Hot water Building exterior Electrical Property clean, maintained &safe Mechanical I Handrails&guards installed &secure Pool Safety Pool on Site Surface water alarm Date of CO issuance Door alarms Pool completely enclosed Self closing/latching gates I Pool fence to code requirements CO's for all items present I Prior Rental Comments: r 10 0 NOW log e�3C� i TOWN OF SOUTHOLD PROPERTY K JWKD - - OWNER STREET .�= VILLAGE DISTRICT - SUB. LOT FORMER OWNER 1 N E ACREAGE cf S W r TYPE OF BUILDING RES. SEAS. VL. FARM COMM. IND. CB. MISC. Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS 41 04- r7 - 4 4. AGE I f BU1_L I G CONDIT�O - 1 t s - r FRONTAGE ON WATER - Form Acre Value Per Acre Value FRONTAGE ON ROAD ll � ae Tillable 1 BULKHEAD Tillable 2 _ DOCK Tillable 3 � Woodland e , i Swampland d Brushland House Plot s - I Tota I e ee -71a1 ao�� tom t .-y-t s OWNER STREET VILLAGE DISTRICT SUB. LOT FORMER OWNER N E ACREAGE _ I S - - - W _ TYPE OF BUILDING RES. ; SEAS. VL. FARM COMMs IND, CB, MISC. ' I LAND IMP. TOTAL DATE REMARK l I i i e AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Form Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable, 3 Wccdland Swampland Brushland House Plot Toto l 1 Wr'l aINIS — T — — Q ZMA �. - _ __L i"—� e Q 143-4-17 2104 t, W Bldg, ,_ Foundation Bath .r 1 ixtensi Basement La r Floors tensi �'� ; �� Ext. Walls VO, Interior Finish 's :�xtenss` i Fire Place Heat ; .y_. _ _ Ur Porch Roof Type �z q Ph Rooms = om 1st FI are Patio Rooms 2nd Fr . ....Vy,zDriveway Dormer I i\ � y r d d a a j i I s ` s i i _.� ...,y_. „rye I 143-4-17 accessory 2/04 _ LLL ? M. Bldg I Foundation f Bath E �� v Extension . i Basement '. Floors } Extension Ext. Walls � �` � Extension Fire Place idea s ttr Porch A r , Porch aoms 1 st F oo. 3 R Breezeway, 1 Patio Rooms 2nd Floor _ Garage Driveway I 0. B. _ _ — — f 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-22349 Date MAY 21 1993 THIS CERTIFIES that the building TWO ONE FAMILY DWELLINGS *Location of Property 495 RILEY AVENUE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 143 Block 4 Lot 17 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-22349 dated MAY 21 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 TWO ONE FAMILY DWELLINGS FRONT & REAR YARDS The certificate is issued to ESTATE OF MARY SULLIVAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED N A *PLEASE SEE ATTACHED INSPECTION REPORT. ld` g Inspector Rev. 1/81 FRONT HOUSE BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 495 RILEY AVE.nr ber & street_ MATTITUCK, N.Y. ­..._...7� �t SUBDIVISION MAP NO. LOT (s) NAME OF OWNER (s) ESTATE OF MARY SULLIVAN p OCCUPANCY A-1 RES. OWNER �����Cype� � owner-tenant) �� ADMITTED BY: .. BERNICE (BOOK KILLER REAL ESTATE) ACCOMPANIED BY: SAME KEY AVAILABLE SUFF. CO. TAX MAP NO. 143-4-17 SOURCE OF REQUEST:,. ABIGAIL WICKHAY ATTY „ DATE:PEB. 12, l993� DWELLING: TYPE OF CONSTRUCTION WOOD FRAME # STORIES ONE # E%ITS_ 2 FOUNDATION_ CEMENT BLOCK FOUND CELLAR FULL _ CRAWL SPACE TOTAL ROOMS: 1ST FLR. 4 2ND FLR. 3RD FLR. BATHROOM (s)-- ONE TOILET ROOM (s) . .,- UTILITY ROOM PORCH TYPE WRAP AROUND ENCLOSEMECK, TYPE PATIO, TYPE BREEZEWAY_ --� FIREPLACE NO w - GARAGE CAR PORT --� DOMESTIC HOTWATER YES TYPE HEATER LILCO GAS AIRCONDITIONING -� TYPE HEAT OIL WARM AIR II HOTWATER OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.- STORAGE, TYPE CONST. SWIM ING POOLuM - „-�-�, GUEST, TYPE CONST. ---� OTHER.,____ --� VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE DESCRIPTION �-- ART. N SEC. REMARKS: -� - 4/13/93 & 5/19/93 INSPECTED BY: DATE ON INSPECTION TIME START END REAR JIDUSE. BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 495 RILEY AVENUE MATTITUCK, NEW YORK '--(n'-amber 6 streetT �Ia:►un#.t2p t - SUBDIVISION MAP NO. LOT (s) NAME OF OWNER (s) _ ESTATE OF MARY SULLIVAN m--._ .,..�. .. OCCUPANCY A-1 RES. OWNER ADMITTED BY: , BERNICE (BOOKKILLER REAL EST) , ACCOMPANIED BY: SAME KEY AVAILABLE_ SUFF. CO. TAX MAP NO. 143-4-17 SOURCE OF REQUEST:_ ABIGAIL WICKHAM _ DATE: FEB. 12,1993— w,_._,.. DWELLING: TYPE OF CONSTRUCTION WOOD FRAME STORIES ONE # EXITS 2 FOUNDATION CEMENT BLOCK �- CELLAR SMALL AREA CRAWL SPACE XX FOR UTILITIES- TOTAL ROOMS: 1ST FLR. 4 2ND FLR.�- - 3RD FLR. - - BATHROOM (s) OHB TOILET ROOM (s) UTILITY ROOM PORCH TYPE DECK, TYPE PATIO, TYPE BREEZEWAY FIREPLACE GARAGE DOMESTIC HOTWATER YES TYPE NEATER _ELECTRIC AIRCONDITIONING TYPE HEAT LILCO CENTRAL AIR WARM AIR X% UOTWATER OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. _- STORAGE, TYPE CONST. .— w .--, SkHMING POOL , GUEST, TYPE CONST. OTHER: _-- VIOLATIONS: CHAPTER 45 N.Y_ STATE UNIFORM FIRE PREVENTION BUILDING CODE LOCATION - DESCRIPTION mm� - ART: SEC. w_ REMARKS: INSPECTED BY: - DATE ON INSPECTION 4/13/93 6 5/19/93 Y ISH TZ: START END 6' �� �r c , +ow° 4% Z eRM 6„�^x, «ter. SURVEY OF PROPERTY ° SITUATED AT KAY MATTITUCK P/o zorQ rcrasE >� TOWN OF SOUTHOLD � -��--•-- ' �� "�„\ SUFFOLK COUNTY, NEW YORK ' S.C. TAX No. 1000-143-04-17 SCALE 1"=20' MARCH 31, 1993 p , «, ciCA AREA = 15,005.97 sq. ff. 0.3445 ac. A� P/O LOT @ CERTIFIED TO.- FIDELITY NATIONAL TITLE INSURANCE COMPANY OF PENNSYLVANIA iz FLEET REAL ESTATE FUNDING Corp. 4*1 PETER F. McLAUGHLIN ,f ec 1 NOTE: , ,F LOT NUMBERS REFER TO MAP OF a woFr ` T"w. « A PROPXRTY OF C.o. H., 1RrL T. &D r. PJMY ,y « FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON NOJEMIRER 27. 192a AS FILE No. lee OAW 6 > 1 STORY `�". FRAME HOUSE A ; « L4 d •pNM+gdrY;r r.oYL N. 405 a - ci� �. C n�� — , '• . '� Nam 24%OZL 475.00' AFr,wO F .NON S 70'31'00" W 75.00, \ RILEY AVENUE FFovim N mome=FIRM IWE woo" MM 1F4 W.d aIW'i9 ACNM9C9 +.MWG'4MeMFiC49 ��Mc ApFM4NM0k Joseph A. Ingegno M1FN1AFA11bM OVID Land Surveyor Twu°F,"9URVIN MWNff IIIINAINCI of ^.. YELL NOF e[c9N®Dlm To K A YAm ... .....«,.......�.....„... .....m.^,......., ..__..,.. ....'... .. ..,«„ Ar4 q �«�b 10.[A ID lAl[COPY. TWo Suneo — SubCiviuow — Sit.Pfone — Con.Fruoffon LoyoN yy,Ey PHONE (519)727-2090 Fax (51(1)722-5093 $ n-:Fni Mraow M I= Mk OFFICES LOGTED AT UVUNC ADDRESS On.Union Square P.O. Box 1931 °"'� /a�I15 AHM OF NIGHT OF WAYS Aquebopue,Nw York 11931 Myot"od,Now York 11001 Its , Town of Southold 3/14/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41887 Date: 3/14/2021 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 495 Riley Ave, Mattituck SCTM#: 473889 Sec/Block/Lot: 143.4-17 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/23/2020 pursuant to which Building Permit No. 45596 dated 12/22/2020 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: "asebuilt" e-p .furnace and central air conditioning in eaxistin s n l .Lqn l dwellipg,..as a ��c� q��(�o t�l� gllin The certificate is issued to Cacioppo Living Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45596 2/24/2021 PLUMBERS CERTIFICATION DATED .„_. ......... ....... th riz ...�. ;natter..... .. .......�...... e Town of Southold 3/14/2021 P.O.Box 1179 53095 Main Rd « Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41888 Date: 3/14/2021 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 495 Riley Ave, Mattituck SCTM#: 473889 Sec/Block/Lot: 143.4-17 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/23/2020 pursuant to which Building Permit No. 45595 dated 12/22/2020 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 bl al " radow_ t heater and x e;..,T r ace in an qZjt sae f i jjgg. p N or. ear llirW The certificate is issued to Cacioppo Living Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45595 2/24/2021 PLUMBERS CERTIFICATION DATED