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HomeMy WebLinkAbout1000-137.-4-4 TOWN OF SOUTHOLDAo� -V Rental Permit 5 Permit No. 0021 Owner Landers Family Trust Occupied as Single Family Dwelling Located at 5705 Stillwater Avenue Cutchogue 137-4-4 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. 3/29/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hell Annex - Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G 3oudwid,NY 119714)959 ; iJ do 1 1 a BURDI iG DEPARTN93PU [ TOWN OF SOUTHOLD Mi 7 2019 RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) T. Section A. Property Information: Rental Property Address: " Tax Ma.w......�._ ,_... N Number: 1000 SECTION BLOCK O LOT _. SECTION B. a ( t;�P�j f4j4je4o OWNER INFORMATION: Property Owner Name: __....� ... _: � . Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number(s): C)...0 ....W_... .�. .. Property Owner Email Address: (114 w .., Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any : 1,P.O. Bones X10 d r LvM NeJ J ©rf°(,k/, Address of Authorized Agent(no Mailing Address of Authorized Agent: ,_ ,. � � ..• - --. - ..-- -- mmmmm--m- ._.�.... w ��••••.•.... ............�.....,�......�.. Telephone Number(s) ....�. Email Address: I Section D. Managing Agent Information: f dwelling unit,if any: Name of Authorized Agent o g .�m�-�w... .�-_��-..•._-.�-�-...............-�°�_°�.. .�.�._��,� Address of Authorized Agent(no P.O. Boxes): _ �. ...� Mailing Address of Authorized Agent: Telephone Number(s): Email Address: m. ...�.� ... ...._ .. SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit,if any: �" . w.... ,. n... ..._ �. Address of Managing Agent(no P.O. oxen: ..........._. Mailing Address of Managing Agent: Telephone Number(s): Email Address: �...... _.. .... .... � ..� .�m� Page 2 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: ,q persons allowed to occupy bw�r Requested Maximum number of elling Uni " �L��1 ri�y IanwliGk Number of rooms in Rental Dwelling Unit: . Use and Dimensions of each room in Rental Dwelling Unit: .__........ �. 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 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 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. am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. Page 3 of 4 ❑ I am submitting a completed Town of Southold certification form from a licensed architect, a licensed professional engineer,or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building code Certification. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I .µ_ 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 W 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 Managet, oK Property Owner's Name: Property Owner's Signature: W Sworn to before me this21 day of f'C. 20�1 StOfcial NotaryP Signature and Original Notary p Page 4 of 4 �w1 / a '✓", 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 SOUMOLD RENTAL PERMIT APPLICATION ADDENDUM SAS- .9�4WX-(A y Rental Dwelling Unit Identifier: w Requested maximum number of persons allowed to occu each dwelling unit: ..,,._,,,_ Number of Rooms in Rental Dwelling Unit: BK1t Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit:.w �__. _....... -............... . --.- . Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: CONSENT TO INSPECTION C54", AQJ "e�� �a- �elo �"Vlg the undersigned, do(es)hereby state: Owner(s) Name(s) Southoldhlo at d undersigned s)(afire the owner(s) of the prertW. min the To �f �. . which is shown and designated on the Suffolk County Tax Map as District 1000, Section " �.. . Block _��� _�Lot Ati' That the undersigned(has)(have)filed,or cause to be filed, an application in the Southold TownBuilding Inspector's Office for the following:� � -------------------- . .. . That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property,including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application,including inspections to determine that said premises comply with all of the laws, ordinances,rulesand regulations of the Town of Southold. The undersigned,in consenting to such inspections,do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws,ordinances,rules or regulations of the Town of Southold. Dated .. ._ Name (Si r u ®..... . rint Name) CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 ;?tee Attached Document(Notary to cross out lines 1-6 below) ❑See Statement Below(Lines 1-6 to be completed only by document signer[s], not Notary) j .. __ - __. ...m.. . ... ",. ...r... .. ....:... .m._. _. Signature of Document Signer No. 1 Signature of Document Signer if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California Subscribed and sworn to (or affirmed) before me Countyof on this V day ofAp 0,. _ by Date Mon h Year (1) 1. A TI RC?CAi31t t (and(2) Lw t4i ) COMM. #2151713 z Namefs)of Signer(s) Notary Public. California Los Angeles County ° proved to me on the basis of satisfactory evidence to M Coma Px Ire iiia l p ' be the person(s)who appeared before me. Signature . Place Notary Seal and/or Stamp Above Signature of Notary Public yy ................. OPTIONAL �.. _. Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: ,,,,w_,,,,,_w_ a �n � Document Date: ���' _�ex, T _ Number of Pages: _ Signer(s)Other Than Named Above: 02017 National Notary Association Alt "+00 u�rqq�� w� TOWN OF O 1 r"+ moon U65-1802 .. 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Certificate Of Occupancy No. A7503 . Date . . . . . . . . . . . . . Xaro . . .25 . ., 19. .".. THIS CERTIFIES that the building located at . Atil rater. -Av . . . . . . . . . . Street Cove _Map No. r1o. W.o.$ . Block No. . . . . . . . . . .Lot No, conforms substantially to the Retalre*eUt o l built or, ficate oau dated before. .Apr, . .23. . ., 19. .'5? pursuant to which &0. ZR 3„ .y dated . . . . . . . . . . .Mar. . . .25. . ., 19-77., 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 . .pri tO .040. laxily.dwalling. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . The certificate is issued to D , ,3,, . XUxA t?i, j#y9A of the aforesaid building. (owner, lessee or tenant) Suffolk County Department of Health Approval pro". eximt .. UNDERWRITERS CERTIFICATE No. .pr 9xisting . . . . . . . . . . . . . . . . . . . . . . , HOUSE NUMBER . . . .5705 . . . . . Street . . . Stillwater. Ave. . . . . .cutchoom Building Inspector HOUSING CODE INSPECTION March 24 , 1977 45705 Stillwater Avenue R-1 Cutchogue, N.Y. Sub. Div. : Fleetwood Cove #1263; Lots 16 and 17 Tax Roll: Daniel B. Lyons and wife Upon receipt of an application for a Pre-existing Certificate of Occupancy, I made an inspection of this one-story wood framed structure. I picked up keys from the Four Sails Realty office in Cutchogue and began this inspection at approximately 10 :30 A.M. The dwelling consists of two bedrooms, a bathroom, living room, and a kitchen that opens to an( enclosed porch used as a dining and sitting room. Building's foundation is cement block with a crawl space. Section of porch on Sound side of building is constructed on wooden posts. The source of heat for the building is a gas-fired, free standing room heater located in living room vented to exterior. The following violations of the Housing Code, Chapter 52 , Town of Southold, New York were found: Front entry - no means of controlling light in room on entry, Art cle V, Section 52-56 B (2) . Kitchen - gas cooking range, no shut off valve at unit, Article V, Section 52-52 B (2) . Heater - insufficient clearance to side wall combustible mammal, no protection. The unit stands on wood flooring, no protection provided, Article V, Section 52-53 F. Front entry - concrete stoop, settling, cracking and de- formation occuring, Article III, Section 52-30 B. P ;� Foundation - crawl space area, flooded water approximately 3 ' to 5' ep. Window on west side broken pane of glass, Article III, Section 52-31 A. Electric water pump - located on exterior east side of building. Protective enclosure deteriorating and in need of repair, Article V, Section 52-50 A. Inspection completed at approximately 11:00 A.M. Keys were returned to Four Sails Realty.. Res ectful y submitted, 4 wa lindermann Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ..32 ............. Date ...........;.... u9vt..m.............. ., THIS CERTIFIES that the building located at ........................... Street Map No. F.1ee.tw,qq.d Block No. .........I............ Lot No. . tcl>lo�u®�...Nipw York........ Cove conforms substantially to the Application for Building Permit heretofore filed in this office dated .................MAY.. . .............................. ., pursuant to which Building Permit No. 39©4„Z dated ....... y... a.!................................ 196R..., 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 ........ ...........Pxivate..one—fa Aly..dwel].inq:.. ................u.... .,.,..... ,..,..... ........, ,.,...... ............., The certificate is issued to ....... ........... (own r, lessee or tenant) of the aforesaid building. ........................... Building..Inspector..�...............,.,.... FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3904 Z Date ......................... . .28.......... ., 19.6a.. Permission is hereby granted to: Mcftnad .................. WtU .....,., .......................,.. to ......... ct premises located at .... . . 00A...CeO:- .......... .................................... . U11i►a . . .............. ho ..... .,,..,...........,... pursuant to application dated ... .........2A........... 19..66., and approved by the Building inspector. Fee $5t}Q.............. Building lnspector FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . 2.1135.7. . . . . . . . Date „ " December '16 19 82 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . , „ . , . . , . , . . . . . . , . . . , , . „ . Location of Property5.7.0.5 . Cutchogue w House No. Street Hamlet County Tax Map No. 1000 Section . . .13 7. . . . . .Block . . 4. . . . . . . . . . . .Lot . . ` . . . . . . . . . , . » , Subdivision Fleetwood.Qoge. . . . . . . . . . . . . .Filed Map No.1263 . . . .Lot No. 16 —. .17. . conforms substantially to the Application for Building Permit heretofore filed in this office dated March. .31 . . . . . . . . . I9 .7.$ pursuant to which Building Permit No. 97622 dated . . .Maxch. 3.1 . . . . . . . . . . . . . . . 19 78 ,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 . . . . . . .. add. onto. a. .1 .family. dWejjjAg. . . . . . . . . . . . . . . . . . . . » » . , . . . . , . . . , . , . . . . . . . . The certificate is issued to . . .Bernard. 1)P'MPSey (owner,' ;, �. of the aforesaid building. ll Suffolk County Department of Health Approval . . . . . . VA. . . . . . . . . . . . . „ , , , . . . . . . . » UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . .N. .4.9 3 6 7.9. , , , , . . . . . . . . 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 113 6 6. . . . . . . . . . Date . . . . . .Dec ember 16 , 19 8 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . Location of Property . . . 57.05 .Sh.illwater.Ave, .Cgt"n bogus Nouse No. Street Hamlet County Tax Map No. 1000 Section .1.37. . . . . . .Block . . . .4 . . . . . . . . . .Lot 4 jSubdivision . . .Fleetwood. Cove. . . . . . . . . . . .Filed Map No. ].,ZU. , .Lot No. . . 167.17. , . . conforms substantially to the Application for Building Permit heretofore filed in this office dated June. la . . . . . . . 19 B.0 pursuant to which Building Permit No. 10 7 3 5A dated . . .June . 16. . . . . . . . . . . . . . . . 19 80. ,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 . . . . . . . . . . . . to .construct .ona .car. .gazage .addA-I;iQn .4 .a1:�e27., 2nd floor to living space in exisiting dwelling. . . ' ' ' ' ' The certificate is issued to . .Bernaxd. R.. .I)eMP.sey. . , (owner, of the aforesaid building. Suffolk County Department of Health Approval . . N/A. . . . . . . . . . . . . . . . . . . . . . „ . , . . . . UNDERWRITERS CERTIFICATE NO .N .4936.7.9. . . . . . . . . 'Building Inspector Rev 7/81 �. �� _ 4u'`_ FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . 1.5.4 2 4. . . . . . . . . Date . . . . . . November 25 66 . , THIS CERTIFIES that the building . . . Pool Location of Property5705 Stillwater Ave. Cutchogue Hoase No.Street . . Ham/et County Tax Map No. 1000 Section . . . . .13.7 . . .Block . . . .0 4 . . . . . , , , ,Lot Subdivision . . . . . . . . . . . . . . . . .. . . . . . . . , . . . . . .Filed Map No, , . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated +AU.g: . 16 . . . . . . . . . 1.8 $A pursuant to which Building Permit No, , , „ . A5 0 9 2 dated , ,Oct . .. „ . , . , . . . .. . i9 84, ,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 . . . . . Inground swimming pool and fence to code. The certificate is issued to . . . , , . , , BERNARD R. DEMPSEY of the aforesaid building. Suffolk County Department of Health Approval . . , . „ . . . N/A. , • , , _ . , . . . . _ . , UNDERWRITERS CERTIFICATE NO. . . . . . . , . . , „ , , . , N670.4.67 , , , • , , , , • • Building Inspector Rev.1/81 ,fFt� ,.. Town of Southold Annex 9/13/2012 P.O.Box 1179 � 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35951 Date: 9/13/2012 THIS CERTIFIES that the building ALTERATION Location of Property: 5705 Stillwater Ave, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 137.4-4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 4/13/2011 pursuant to which Building Permit No. 36338 dated 4/20/2011 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: fence for existing Wimming pool as applied for. The certificate is issued to Gerowski,Douglas&Michele (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED rized ignlure ........................ Town of Southold 10/25/2018 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39993 Date: 10/25/2018 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 5705 Stillwater Ave, Cutchogue ................................ SCTM#: 473889 Sec/Block/Lot: 137.4-4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/19/2017 pursuant to which Building Permit No. 42008 dated 9/28/2017 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: alterations and additje ,.41dadip -g ,g.covered porch and(leek, to an-existin2 .1 a1 dwpfti as,Applied,for per ZBA. #7072, dated 8/17/2017. The certificate is issued to Landers Family Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42008 10/18/2018 PLUMBERS CERTIFICATION DATED 3/28/2018 1 d Piccucl . ........... tor'le, Signature TOWN OF SOUTHD PROPERTY RECD� aDd I - OL VILLAGE DISTRICT SUB. OWNER ' STREET 17- LOT 17- 0 L ve FORMER OWNER N E ACREAGE S 1W TYPE OF BUILDING Ix, tilt N RES. EASVL. FARM COMM. IND. CB. misc. e Est. Mkt. Valu, LAND I IMP. TOTAL DATE REMARKS f: Lou 'I-W Z k f 2- 7� 03-1ja 0 0 Y- --X J fc I -NIL Bv1LQJNGC NTA-G C:rCLqRMAL FRO E ON WATER ABOVE 7 Per ore I Ped AcM tIV41ue FRONTAGE ON ROAD jQ0Farrn C 7 HEAD --2 Tillable I BULK jgj n L Tillable DOCK Tillable' 3 Woodland J Swampland 7A Al Brushland, ry L+ HoL=*VP TqZ I � !oco - 134. - 4-�-I- z IN 14 �r s a t v. a-- d Lk 137.-4-4 04/06/2018 s M. Bldg _ _g -Foundation _ Both Extension a5 39 Q Basement Floors Extension Ext. Walls Interior Finish EN Fire Place meat- __ ._ -.,Xpp dot ' Roof Type �S— _. 5Porch Rooms 1st Floor ` iRooms 2nd Floor � } - W. - _ — arae Driveway Dormer (57 5 - 1