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Home My WebLink About1000-88.-5-31 TOWN OF SOUTHOLD 7-4 Rental rm 0034 Owner Maribeth Beckner Occupied as Single Family Dwelling Located at 375 Rambler Road Southold 88.-5-31 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. 4/7/2023 Code 3f rcerrent Official This Notice must be posted by the main entrance at all times rTOWN OF SOUTHOLDS � 631-765-1802FIREPLACEINSPECTION I FOUNDATION IST ROUGH PL13G. FOUNDATION 2ND INSULATION/bAULKING FRAMING /STRAPPING FINAL - PENETRATIONFIRE RESISTANT CONSTRUCTION [ FIRE RESISTANT ELECTRICAL (ROUGH) [ ELECTRICA -(FINAL) CODE VIOLATION [ PRE C/O RENTAL Ot AoAoIT DATE zINSPECTOR , r TOWN-�F SOUTHOLD BUILDING DEPT. ao yyINSPECTION FOUNDATIONuNoll 631-765-1802 FOUNDATION 2ND � INSULATIOWCAULKING FRAMING / STRAPPING, FINAL FIREPLACEIMNEY FIRE SAFETYINSPECTION FIRE RESISTANTI IRE RESISTANT PENETRATION ELECTRICAL CODE VIOLATIONl / V�F RENTAL ,17 co o ✓ ,P�� C/o m Z� INSPECTOR ,r i i I l / ............ ....... . � 1 WMIllp �� ,� I JN r i l N� 1 / I i if i j � I I / i J, i- J, Z iii .� , !� . �l/////,, r/lf J r , � i r „ .,rr hi�„�✓,,r,,f,,��ra �f� r ; z,u'�r)r ,ems �rg9�Yl�i�n�/Jll�lralP/l/la� �lfvl/!/6>?%%�PrU% rnoiH,�Yrp � ri/a' m�r�;r� � r f��woPu you � o/rno,� w, G r' "+hp� TESD` SILENCE 4 �// ///�// /�f � �� i� ,� ,/ ` , ��o�i/��iii,�� %i%��j, Ali% ; �///// ,/, �,�� %i�%��/ is , /�<, , r , ,ice � r, � i �iii � �V" ��' i 9 �.o. j r' V �I fl�l i IIIIIIIIIIIII IIIIIIII IIIIIIII I i� �. '/ 1 1 1 /�,�" r �. %i 6 o , g" v, i, 8 Town Hall Annex , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 5 I'� Southold,NY 11971-0959 Coma �� . BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Pro ertY Address: Tax Map Number: 1000 SECTION -BLOCK 5 --LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytlm I V Evenin 4fn nc 6 f~fGlb Property Owner Email Address: Page 1 of 5 �'l Town Hall Annex , Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road P.O.Box 1179 �, SS ,r Southold,NY 11971-0959 x BUILDING DEPARTMENT TOWN OF SOUT HOLD 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 Evening 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 Emergency Email Address: SECTION E. p SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) °� 1 A Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 %ry Town Hall AnnexTelephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 � Southold,NY 11971-0959 Co BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: fA 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: UOk. mnk Requested Maximum number of persons allowed to occupy,Dwelling Unit: 1pC `- Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit:( ,` . M w�- N Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959w�� Ul �, BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. I am requesting a fire 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. 1VJV STATE OF NfW YO" i�ar'io1� ) COUNTY OF S1-JfF=) I 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 V p$ry@ a Town Hall Annex °AI Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 COON , , BUILDING DEPARTMENT TOWN OF SO OLD 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: Property Owner's Signature: G�G Sworn.to befdre me thin I� day of Official Notary Public Sin Lure and Original Notary Stamp on ob how `)MCLAL SEAL s-rare OF QST V�IRG L Foran of Fe+*ar�^ssl CrWh union Ptd Bax 2139 +' M E9wrrw w 4d. Page 5 of 5 T ' WN OF SOUTHOLDPermitRental Permit No. 0034 Owner Maribeth Beckner Occupied as Single Family Dwelling Located at 375 Rambler Road Southold 88-5-31 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 inpecti 4/21/2021 de arc t o ScaI This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 ,3 INSPECTION [ ] FOU DATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [?] FIRE INALFIREPLACE:& C I NEY [ SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION, [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL(ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: mmi Koovivw( ov"I" (A)v\v- Nk lw I , - —d DATE 31 10102-el INSPECTOR TOWN OF SOUTHOLD l gas Rental Permit i�k Ip As Permit No. 0034 Owner Maribeth Beckner Occupied as Single Family Dwelling Located at 375 Rambler Road Southold 88-5-31 Address Village S/13/1- Maximum /B/LMaximum 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. 4/10/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex ' Telephone(631)765-1802 54375 Main Roadr � Fax(631)765-9502 P.O.Box 1179 �� Southold,NY 11971-0959 " U ri ro BUILDING DEPARTMENT TOWN OF S0XJTH011,D RENTAL PERMIT APPLICATION FE .3 ;;,01 Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: ry. V Tax Map Number: 1000 SETION _ BLOCK ^LOT SECTION B. OWNER INFORMATION: Property Owner Name � Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) m , Telephone Number(s): Property Owner Email Address: Page 1 of 4 Section C. Authorized Agent Information: �)11A 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): Email Address: Section D. Managing Agent Information: ffA 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): 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): Mailing Address of Managing Agent: Telephone Number(s): Email Address: 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: Requested Maximum number of persons allowed to occupy Dwelling U► i ,w y Number of rooms in Rental Dwelling Unit: use and Dimensions of each room in Rental Dwelling Unit 't x 41 Ce) &Aqx)rn i oxia - bebtun W ryxicon beas�men� - \-avndry . �-Lxvno cp 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. !�( I 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 iff COUNTY OF SU4600: 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: v Property Owner's Signature: 16AL SEAL Ift Sworn to before me this day of �-/ " NOTARY PUBLIC Rebecca Echawd h rG,bur ,WV 2 .Notary Stam � � �r I � O wcial Notary Public Signature and Original N ry p Page 4 of 4 TOWN OF SOUTHOLD BUILDING DE,PTI. 7 65 -1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] INAL&'k paott [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING w000 DATE INSPECTOR , SKETCHIAREA TABLE ADDENDUM s=;P--ro „MSz,Pa 178��Fi�wmdaGnY B Y 0 „97t ,.-.,� ptrcu�f'gnp ,NIA ,..�...�..,..».. .�....__m...,.� _ .._ o ,:... M r'ad;„s00ar�'SFm.rrY er AP,l4ns*n.,'�. YSr�£rMA. AQ Address clop Maard.� �i,02Q r Am�n�or Wun � �. • � ptl Box 63 ViAarR4Wtr1',.1�Y � i."��r�reM,r!�taa�Set_ —.� _......� ,,,..�,........,......,..,_...�w.address.�....�....._...w_.�_�.._....,....,.,,�—.. .,� ..�.._..._...,. .�.u.—,�,......�: Large Shed Garden d Shed 18.0' y Enclosed-Unheated 12:0' Porch 48.0' Half Full Eat o BathIn ClosetI filen (p Bedroom WF Bath Kitche Dining Area �� . v Halfway . o B morn Living Room ED 1 Car Garage o U-) ' Covered f=ront Porch __ �. ...... .... ,.;;I 0' 12.0' Subject Dwelling Comments. WN Code -rRrEA C ALCULATION$�5U 9�RY 010 µti Ll1Yll k f3ftF fCC1C? r 1440.00 1 1440.00 cst Floor I PJP r..Ad.ed Yor.h 180.00 I 9 12.0 It 16.0 b 19?.QO' Covered V=at Patch 135.00 315,00 2 26.0 s 4B.0 E 1248.00 RABR i Car 0azaga 240.00 240,00 ; 4 e r j � A I TOTAL LIVABLE (rounded) 1440 ➢ 2 Areas Total(rounded) 1440 . a SKETCH/AREA TABLE ADDENDUM j FkNO 11y6671pa ,a3cxkrl}la9d 3W15 gcrua[wdwa9 �"�� - #�SILRi�e�,a do 1 � 1, p AlIrin.. Large Shed Garden fn I . f� �Ao, 1 Co lea LA m , L (;V()r � I Subject,Dwelling I �pH,H,ah15:��i, 1n.M cc3 w lql le&,, -Z ._._ --------- , AREA CALCUTATiONS rr Y . I cad oo MAI .440.W i 14aoMP 'FYrbt Floor ..m. r jp/p Sraalenod Porch ]HO Otl 12.0 at 16.0 198.00 t i Covered want Pocch. 135.00 31S.o0 I .26.0 x 40.0 N 1208•00 t OAR 1 caw Garage 240.00 M-00 I' 4 r I I l 0 a pp VV I 2Ar0a80t8t,(rQ1jRjd'cd) 1440 C a . ..__, E (rounded) � id40. ._...._._ ".._..�.�."..�.. m ... . TOTAL LIVABE.�. .... .. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 2679. . . . Date . . . .. .. .... .... . . x . . . . . ., 1967. THIS CERTIFIES that the building located at Z/a.plam,bler•F4• •......•. .. . Street worry Watorat Map No. . .. .. . . ... .. Block No. . .......... .Lot No. .21. . . . foUth Id. . . . . .. . . . . . .. . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . ....., . .. .• . .. . ., 19. pursuant to which Building Permit No. -3230- Z dated . .. .. .. ... . P . . . . . ., I9. ., 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 - -FrdVarta. . .0119-family- dwell I. , . , . . . . . . . . . .. . ... .. .. . . . .. ... . . .. . . . The certificate is issued to o . . . . .,... .. . . ..4'mer ..... . .. . .. . . .. . .. .», (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health ,Approval ra. . 11. 29.67. .• • .. . m • . .. . Building Ins;k6r F / J O�NER asTO" OF SOUTHOLD PROPERTY RECORD CARD STREET 7�, VILLAGE DIST. SUB. LOT Jr _ aek ` , . - �. 4ER OWNER N _ � �AL I .�� ✓ I � r ,. .� W TYPE OF BUILDING SEAS. VL, FARM COMM. CB. MICS. Mkt. Value LAND IMP. e< TOTAL DATE REMARKS 00, { CrrJ00 p fir , I ll m AGE I BUILDING CONDITION NEW L NORMAL BELOW ABOVE FARM Acre Va(Le' Pyr Value Acre Tillable FRONTAGE ON WATER, Woodland FRONTAGE ON ROAD Meadowland DEPTH ' House Plot BULKHEAD Total,,_- s„ DOCK a z i 1 COLOR _ TRIM 3 - - . II ..r } - a 7 [ 1 i M. Bldg d v Extension Extension _ I Extension - Foundation Bath _ Dinette Porch �iB sement t Floors K - s Porch t k z 5A. Walls interior Finish : ?R.: Breezeway ; Fire Place -` Feat CSR Garage Pe Roof . Roams 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. B Dormer Driveway Total t; 0