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HomeMy WebLinkAbout1000-140.-2-1 TOWN OF SOUTHOLD Rental Permit 1481 Owner: Schowalter Holdings LLC Occupied as: Single Family Dwelling Located at: 645 Hamilton Ave Mattituck 140.-2-1 Maximum Permitted Occupancy: 5 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: 05/19/2026 Expiration: 05/18/2028 This Notice must be posted by the main entrance at all times 1 - ¢ ;�?'� 5 y��, TOWN OF SOUTHOLD—BUILDING DEPARTMENT G" Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold,NY 11971-095 'T.W:,nl 'of Southold Telephone(631) 765-1802 Fax(631)765-9502 I::rpa, RENTAL PERMIT APPLICATION Rental Permit Fee$300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION ) _-BLOCK SECTION B. OWNER INFORMATION: Property Owner Name: c �r1 Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) I Icri 1 Telephone Number(s): Daytime 8- ening Rg Emergency MoL Property Owner Email Address: G 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.Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evenine 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 Emerge Email Address: SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing a or mo\realunits) 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): Daytime Evening Emergency Email Address: Page 2 of 4 1 " 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 eta h t in Rental Dwelling Unit: " I • � lt-V IS 11 �xq� 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. ❑ lam requesting a fire safety Inspection to be performed by a Code Enforcement Official /r( m 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 SUF+�FOLK) I � n nno SMiga'WC 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 m thi ay of NOTARY PUBLIC,STATE OF NEWYORK E!asImfion No,05FR628MI Official ry Pub �Sriature a4d Original in k County 10 Vyul on September us, ,"". ro Page 4of4 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSrr.%�,-TION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIFA [ ] CODE VIOLATION [ ] PRE C/O [ ENTAL REMARKS: ._ ww e 07 DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 �o -�-� 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 [ ENTAL REMARKS: 4& sAovA/ /�S � /s kow-s vy, e (DATE ��a �? _ _ INSPECTOR mow. , � Town Hall Annex' Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SCTM # — o;— Date Ste-(p Owner Phone Address Visible Hamlet zm=L Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors 1 Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress Occupant Count f Building Systems Maintained&Operational Condition of Property Heating Building interior Hot water Building exterior Electrical Property clean, maintained &safe Mechanical 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 IPool fence to code requirements CO's for all items present , I ;/;,,,,;!,,a # %% ; tt . Comments: r Clip, .,, Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 1 Southold,NY 11971-095® ; 'Noftoor IV' BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit PE21MIogAl M1 regulMd for AMIhiftect gE r r Rental Property SCTM Number Rental Property Address: 64S ff ,L�."r49111 `II' A 7-11C9". 1J99Z Owner/Name: Rental Dwelling Unit Identifier. Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 —100 sgft., Bedroom#2—90 sgft.,etc.) LL I� z Property Description (Include all improvements indicated on survey) I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State, the Building Code of New York State, the Plumbing Code of New York State,the Fuel Gas Code of New York State,the Fire Code of New York State,the Property Maintenance a of New rk.State and the Energy Conservation Construction Corte ew York State. S'Td�i✓ Z 7 t ' NEB' . _. J► P N Print Name and Title 144W, i SignatureAt Please place Professional Seal: r• td 6744 7/Q3/ 13 l TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET 4L,Lf VILLAGE it DIST SUB. LOT ,r r � y1 r x ORMER OWNER N E ACR., S W TYPE OF BUILDING � RES: I SEAS. VL. €FARM COMM. CB. MISC. Mkt. Value�® I LAND IMP, TOTAL DATE REMARKS 00, oe F t <s 3 3 e AGE BUILDING CONDITION � . NEW NORMAL BELOW ABOVE G ' t Ca, l� © fix# r t FARM Acre Value Per Value Acre , Tillable 1 Tillable 2 Tillable 3 Woodland F Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD = f s House Plot DEPTH i -BULKHEAD Totcl -y 'DOCK s A IA. a'IA. COLOR , t ' : TRIM i EL ; r 1 ? ff . I I s I I I 9. 1 . 3 IFoundation r Bath � Dinette M. Bid _ � s Extension ; 3-�SJ; � Basement � Floors K. �, Extension !Ext. Walls �`� Interior Finish roc�-L" �� '' LR. : ;Fire Place Heat iA �,,f DR. i Extension t� Type Roof Rooms 1st Floor BR. Porch /S !Recreation Room I Rooms 2nd Floor, FIN. B 1 Porch Dormer I Breezeway t I Driveway Garage i r O. B. i ? Total FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. �►1 iti8 ............ Dote ................... x� .....25................ 19.6�.. THIS CERTIFIES that the building located at .� r.. { •I•.. •w � �... � ............ Street Map No. .aar. en-9t9lock No. ....... =....... Lot No. ...........I tt:-j-tU0k............................... conforms substantially to the Application for Building Permit heretofore filed in this office dated x........., 19.1$. pursuant to which Building Permit No. ..Z.9,2.. dated .........................NOVATa aar....•9.., 19.62.., 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 ........ ...........PrIlrate-one..xMily.. .:f.xa . .................----...........----................................. .. The certificate is issued to ...12.wazd...Ablt4'... ............. ....,0Wp + +.................. .............„...... fawner, Gasses or tenant) of the aforesaid building. X.D.approval April 11,1963 Building*lnspectc�r �„ p fi 1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 8-23215 Date SEPTEMBER 14f 1994 THIS CERTIFIES that the building ADDITION Location of Property 645 BAMILTON AVE.a 855 MARYS RD. MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 140 Block 2 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNS 16, 1994 pursuant to which Building Permit No. 22246-8 dated AUGUST 10 1994 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR a AS PER ZBA #4252. The certificate is issued to DENNIS a ANN BANNON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N A 'VJ Building Inspector Rev. 1/81 tiT 645 Hamilton Ave .xt WIF► W 11952-Fka Fk ar ew wrawwwaw rrw Room shm approximate Muftorn $ B a 1a A tas tri Home 4cr . ' x 9 t . 17 .satrs'. 4747ra'► � ■rrwearrwwr�w to 9- Storage rip tsar N CITr. .+V TV/S%ia yr oom UYkag Room o Bedrom#1 o ,µ IT .31etsrIc► .a�zuts'► �_.ze�re'. 1W 4' 1a 8' 8 8' 646 HamkonAve MatObxk,NY 11 -2nd seer g 0" 910 W" 11'10 7116' �3'11716'► �Ztl6'► 4C7B"►Now* �4'99118'► __ ._.. .. E Yr o OtY'OoCY!rrw 02 � c o AL TV J f, • 1J4'► � � w 0` 1S 0' r 31C A Bedrrrdm M3 O �S'4'► �63 Wrb. 1fi0` 15'O" Ior 645 Hamlfton Ave 15 5Ire- 1r i MY tt852•easement crawl Space Craw4 Space 1301 rrr m � m 1733W TO to N N 6R I ® SD t+ aa�gN L "4 A2^L 140 ti 230 1R' 102` _ , _ r , tp e - MAO , /i _ MAP 0 AR ..- ..- , of THE ww Tom , s E e wY€ amsa- Vad OUA mt Wow am,to PAW- _ t Inu OPW 4Y . ,�