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Home My WebLink About1000-139.-2-5 £_ TOWN OF SOUTHOLD z^ Rental Pe6rit s. Pe o. � e g � rrn�`t N 0453 Owner ) garahi Ali R�, , Trt. Occupied as Single Family Dwelli.� -(6ad Side aka 2605 Wickham Ave.) Located at 2655 Wickham Avg-,- Mattituck 139-2-5 Village Maximum Permitted Occupancy 3 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 inspecto 6/7/2021 This Notice must be posted by the main entrance at all times ode En e er icial IO61WWWN OF SOUTHOLD Rental Permit AY Permit No. 0454 Owner Agarabi Ali Revoc. Trt. Occupied as Single Family Dwelling (Water Side) Located at 2655 Wickham Ave. Mattituck 139-2-5 Village 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. 6/7/2021 Code Enforcement Official This Notice must be posted by the main entrance at all times L/ V Town Hall Annex �( Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY l 1971-0959 BUILDING DEPARTMENT �' � TOWN OF BOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION BLOCK„ .LOT 00"5 000 SECTION B. OWNER INFORMATION: Property Owner Name: A ui A 64eLA j& I Property Owner Legal Address: Property Owner Mailing Address: SiG Grp' µ313V Telephone Number(s): Daytime Evening Emergeny Property Owner Email Address: n Of k b oa— S 5 .e owl Pagel of 5 Town Nall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 1 97 1-0959 BUILDING DEPARTMENT TOWN OF SO HOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: S�YL1 C 1 Address of Authorized Agent(no P.O. Bones): Mailing Address of Authorized Agent: i" d• 101 1 -( Aj,,'t 1575�— g Telephone s : Evenin Emer en+ Email Address: vrA F0rk l>&�j e,; 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: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Sam, , Town Hall Annex Telephone(631)765-I802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY l 1971-0959 " NV" BUILDING DEPARTMENT TOWN OF SOUrHOLD Mailing Address of Managing Agent: 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: V N 1-r 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: V I 1,X «,;,1, '! t1 at'X I Z.51 oseva ;10` al t 660fzorm Z - 1'1, I �Jl: may►+ IVX IIt 2�6oyu - .2j1X 2$ 1r1�� 5tot46£- bIXZZ1 Page 3 of 5 11 � Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box H 79 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOITMOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: a Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: ,,. '" Number of Rooms in Rental Dwelling Unit: occu Requested maximum number of persons allowed to yach dwelling unit: g Use and Dimension of each room: � Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to pcc y each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: aso Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959r BUILDING DEPARTMENT TOWN OF SO HOLD 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. Is/ I am requesting a fire safety inspection to be performed by a Code Enforcement Official m 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) 5 1�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 qf So Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 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. I 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:, Property Owner's Signature: 1 Sworn to before me this Z!day ofµ i _ , 204 Official Notary Public Signature and Original Notary Stamp Lori T McBride ;NOTARY PUBLIC,STATE OF NEW YORK Registration No.OIMC6368447 Qualified in Suffolk County Commission Expires December 11.2021 Page 5 of 5 t !� a -OXY.is fi 0 - . C cow OIZA Mot 6L Al WOW Ott pr Wey� y � I � mn , ,P o fog so , h f TOWN OF SO , THOLD BUILDING D a � 765-1802 t'y(,— 400- 7 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLERG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] INAL C) [ ] FIREPLACE & CHIMNEY [ FIRE SAFE Y NSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: QYV '�V DATE INSPEC T""ORYN 0 *Arwi 4vv,- 41*9-kA-- lwf TOWN OF SOL ' "`HOLD BUILDING DING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] INAL� [ ] FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: d — F*V 4- 3 QA - "41S e LATE INSPECTOR 7/Q3/ IS TOWN OF S UTH LD PROPERTY RECORD CARD l� - OWNER STREET �* VILLAGE DIST. SUB. LOT FORMER OER N F E / /c G- i ACR"A� 1 .- S W ,� TYPE OF BA DING Wi&'•..tGtt¢< M RES. ,o SEAS. i VL. FARM COMM. CB. MICS_ Mkt. Value LAND IMP. TOTAL DATE REMARKS s. i o d `Y" -70 - -� 1 AGE BUILDING CONDITION /o v ` ;� •t -,r i'- Q+� Gfj r� r _ r t7 J = NEW 1 NORMAL, BELOW ABOVE FARM Acre � Value Per Value Acre Tillable FRONTAGE ON -o r r 6, Woodland FRONTAGE ON ROAD 1 ? - s i A Meadowland ( DEPTH �- House Plot � - , BULKHEAD Total DOCK •..ice � � _ a i COLOR P TRIM FE - I o i -I I I I I I I -1� A-T p,I�vl F amLO M. Bldg. Extension �.Z 1( U = �I`6✓`'0 Ij " ��' ` l `,��J � tom• m y _ _ ,� _ I I Extension I Extension ' �Fbundotion G Path L- [ inette Porch r -• t` ' 2 s' ?u ; ent r� f 1 loors ' t,uGb� 51lItN6 I Walls , ntenor Finish •= SLR. Porch I` ! Breezeway �z a iFire Ploce DR. . . .. Garage IiWe Roof looms 1st Floor BR. a_ Patio �Recreo'no Room Rooms 2nd Floor I IFIN. B W O. B. �orrn€r riveway i Taal �' m COLOR TRIM i 8� £ i • M. Bldg. Z ZLfI Extension ?C 1 b _ �d• i i i .. Extension E, / 1 Extension 3 i - � e Foundation G th Dinette Porch YL /! i Basement Floors K. Porch C I Ext. Walls Interior Finish Breezeway l /1Fire Place Heat R. Garage Type Roof Rooms 1st Floor Patio Recreation Room f Rooms 2nd Floor FIN. B O. B. Dormer Driveway Total 7 l , TOWN OF SOUTHOLD PROPERTY RECORD CARD 6 WNN ER � � BEET `.# VILLAGE DIST. SUB_ LOT � RMEIWNER N E ACR. S W TYPE OF BUILDING RES. SEAS. VL FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS t f - s f AGE F BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value- Per Value a Acre Tillable FRONTAGE ON WATER Woodland ' FRONTAGE ON ROAD Meadow[and i DEPTH mm House Plot BULKHEAD • i Total I � DOCK _ „ - I Town of Southold 6/6/2021 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 42064 Date: 6/6/2021 THIS CERTIFIES that the structure(s)located at: 2655 Wickham Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 139.2-5 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 42064 dated 6/6/2021 was issued and conforms to all the requrrements of the applicable provisions of the law. The occupancy for which this certificate is issued is: w o frame cane Tamil d vellin with finished loft enclosed,porch and w od rear ent .* The certificate is issued to Agarabi Ali Revoc Trt (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED'INSPECTION REPORT. _._. Au ! o . c `ignature w__ww. ... _........... BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 2655 Wickham Ave,Mattituck SUFF.CO.TAX MAP NO.: 139,2-5 SUBDMSION: NAME OF OWNER(S): Agarabi Ali Revoc Trt __�_.�w�w_._._... �_.........................._.....-...... -�._..�..�..-..�. ... ... ............__................._._.... _. _....www....._... .._�_.....__......_... wa._. �........... ------ OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Agarabi Ali Revoc Trt � �� DATE: 6/6/2021 � �� DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: full CRAWL SPACE: ........... ..............._._......._m_ .........................................._ . BATHROOM(S): _......... __.wwwww.....I WTOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: enclosed DECK TYPE: rear entry mmm m mPATIO TYPE: .............�.................................... ...........v_....._....... _ � �.._.........._.. M BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOT WATER: yes TYPE HEATER: _ off furnace AIR CONDITIONING� � � TYPE HEAT: oil WARM AIR: HOT WATER: baseboard #BEDROOMS............. ......._...... _. _.M.M.M_.m_m..w ......._......_..� 2 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: C S-.O Y 9 It TURFS: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 11/7/2019 TIME START: 10:08am END: 10:30am �1�Ot Town of Southold 6/6/2021 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 42065 Date: 6/6/2021 THIS CERTIFIES that the structure(s)located at: 2655 Wickham Ave,Mattituck SCTM#: 473889 Sec/Block/Lot: 139.-2-5 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- w42065 dated 6/6/2021 was issued and conforms to all the requrrements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood ftmc oc�e fami�w� tl n with second floor covered., -!' The certificate is issued to Agarabi Ali Revoc Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED `PLEASE SEE ATTACHED INSPECTION REPORT. ................_w_._................__w........._ riz igna tore BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 2655 Wickham Ave,Mattituck SUFF.CO.TAX MAP NO.: �139.-2-5 ........................ _..........._,,w......_ SUBDIVISION: .............�......._�.......__._.._�... �. ...... _ ....____...,.,,. NAME OF OWNER(S): Agarabi Ali Revoc Trt OCCUPANCY: _.__ ..._. a.... ........ ._... _.w _.._ ..... ,w_-_---------- „..-_,.-------------- _... .............. .._. ADMITTED BY: SOURCE OF REQUEST: Agarabi�Ali Revoc Trt...., ..www_. _w._.__.. .. ..w.._ . ..�.... �� _..�. ....... DATE: 6/6/2021......,.� ......_.._, 021 DWELLING: #STORIES: 2 #EXITS: 3 FOUNDATION: cement block CELLAR: full CRAWL SPACE: BATHROOM(S): 2 _.. _ _..w_........ __. _.__....... ..... TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: 2nd fl.covered porch DECK TYPE: PATIO TYPE: ------- ..� .._................. ._......�........ ._� _H._............._w� ��..�, BREEZEWAY: FIREPLACE: 2 GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: gas AIR CONDITIONING: TYPE HEAT: gas WARM AIR: HOT WATER: baseboard #BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 11/7/2019 TIME START: 10:35am END: 11:30am FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF110E SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z. PAT Date . . . . . . . . . . . . . .A U94 .9., 19.67. TIES CERTIFIES that the building located at V/S. Vie . AVO . . . . . . . . . . Street Map No. . . . Block No. .X= . . . . . . .Lot No. ZM . . .Matt:tt�MV ,j-1-u:�'V. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . .�gty . . . . . , 19.6..7.. pursuant to which Building Permit No. .31qjz. dated . . . . . . . . . . . 411ty. . . . . . ., 1967. ., 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 . tm3.y;� .;bq 1 . . . . . . . . . . . . � ' The certificate is issued to • . . . . . . . . • » . . w (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of' Health Approval . . . . . ...-1 ¢. . . . , . . . . . . . . . . . . . Building Inspect?� .......... ........ f F04., Town of Southold 2/28/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 .............. ........... CERTIFICATE OF OCCUPANCY No: 41857 Date: 2/28/2021 THIS CERTIFIES that the building DECK Location of Property: 2655 Wickham Ave, Mattituck .................. SCTM#: 473889 See/Block/Lot: 139.-2-5 ............ Subdivision: Filed Map No. Lot No. . ... ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/22/2020 pursuant to which Building Permit No. 45495 dated 11/24/2020 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 built"second floor deck addition tpL@Ln exisfin dWellin ql-v AM -Plt Moor K addition t qt fon The certificate is issued to Agarabi Ali Revoc Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 911 ed Sigiature %V Alt Town of Southold 2/28/2021 "- P.O.Box 1179 53095 Main Rd 9" �� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41855 Date: 2/28/2021 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 2655 Wickham Ave,Mattituck SCTM#: 473889 See/Block/Lot: 139.-2-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/22/2019 pursuant to which Building Permit No. 44345 dated 10/28/2019 „ 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 built"water heater aid rail two gam cppr�esin a lic .for. The certificate is issued to Agarabi Ali Revoc Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 10/18/2019 l:ol Mechanical Grp. gn re Fat Town of Southold 2/28/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 ............. -—----- CERTIFICATE OF OCCUPANCY No: 41856 Date: 2/28/2021 ................ THIS CERTIFIES that the building AS BUILT ALTERATION -—----- — Location of Property: 2655 Wickham Ave, Mattituck ........... SCTM#: 473889 Sec/Block/Lot: 139,2-5 Subdivision: Filed Map No. Lot No. ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/21/2019 pursuant to which Building Permit No. 44347 dated 10/29/2019 ................ ....... 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 built"oil to water an ,q,.gqV-qr-5'91"..h(—)tMat d windows a a plied for. The certificate is issued to Agarabi Ali Revoc Trt ............. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ..................... ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 10/17/2019 Res- i n. .......... ........ h rized Signature