The URL can be used to link to this page

Home My WebLink About1000-9.-7-8.4 T "Q'WN OF SOUTHOLD Rental Permit Permit No. 0054 Owner Peter Coolidge Occupied as Single Family Dwelling Located at Midlothian Avenue Fishers Island 9.-7-8.4 Village Maximum Permitted Occupancy 14 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. 5/24/2021 Code Enforc ment official This Notice must be posted by the main entrance at all times ` TOWN OF SOUT'HOILD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND- [ ] IULTIN/ ULI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE CHIMNEY [j;oef FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION- [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) i [ ] CODE VIOLATION [ ] PRE / , f • aw INSPECTOR e � l� TOWN OF SOUTHOLD 'J" a$ az 1 Rental Permit Permit No. 0054 Owner Peter Coolidge Occupied as Single Family Dwelling Located at Midlothian Avenue Fishers Island 9-7-8.4 Address Village S/13/1- Maximum /B/LMaximum Permitted Occupancy 14 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. 5/15/2019 Mike Verity Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times 7 h 1"1 Town Hall Annex Telephone(631)765-1802 54375 Main Road �� Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 R BUILDING DEPARTMENT nD L TOWN OF SOUTHOLD e p RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) T. �r Section A. Property Information: Rental Property Address: Vtrqn,�e fi v'e A V '�;�e r /mA Tax Map Number: 1000 SECTION BLOCK LOT 60 SECTION B. OWNER INFORMATION: Property Owner Name: 4.0 00 Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) . � � � �. e . r w� . o Telephone Number (s): W, Property Owner Email Address: a 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:._ 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 C1 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 � 1,20 �,..' . rtify 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. 1 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 Owners Signature: � Swor n to before me this day of� �° 20 co9+ M � " I 14. ,.4 G" , ,�,A � �`"� fir" C+� �o 21 Official Notary Public Signature and Original Notary Stam ,% p � m ." , .� 489 Ro 19 Page 4 of 4 ` a,. 1% 04 +'e�e'ae��k6�hd. ifu No 765-1802 INS 'PE,CTION w11 � 1111 I ION 1 ST ROUGH PI-111131G. I!!!!!BAM[NG / STI!!!lAPl!!!)11%G !1 L FIRIE RIIESISTAN r CONS1 FIRE RESISTANT ELECTIll° L It ELECTRICAL (I!!!!!` GODEV1101111 ATION CAU1111 K1111MG "way �J 765-1802 arms is c INSPEC','r, ioN I FOUNDATION IST 11ROUG1111°I P1111 R. IIS IIU "ri IIID IIII NU IIl R, II1 „ FRAMING °"'IIII' IIII� IIIIIII II II IlFlllF III IIII! IIII III,: & CHIMNEY IRIS°"111°°Y IN „ III III III° Illii,,, F " IN'T cams"nRUCT1011M FIII III E FIESISTAIM"°IIII"" IIIA „ IIII IIII m °"'rill""' III lli IIROUGIIH) E SII II L (III C01111DE V11110LAT11110NSII IIII II E. ! "'111111 "111111 v. a 1 p. d' 5 r II O � a a v o 3 L)TE ,A ...._... r fi dE 7H j R b fob S o 4� C7 � z o -lu c ) » . m i C) 7 z � 2¥ J; Ef \!y $ ! I la \ ® ) � { |/ � »», / C /z ._ . . .. i i CR 7 � k RE � i 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- 31246 Date: 06/22/06 THIS CERTIFIES that the building DWELLING Location of Property MIDLOTHIAN AVEFISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 009 Block 0007 Lot 008.001 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING builtprior to APRIL P L 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 31246 dated JUNE 22, 2006 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 ONE FAMILY SEASONAL DWELLING WITH OPEN PORCH AND BLUESTONE PATIO.* The certificate is issued to ALBERT H GORDON WNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. ,,.. �.�. t ,, zed ignature- Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION:: ?,_IR;L2pTjil 17 AVE _ FISHERS ISLAND D SUBDIVISION: NAP NO. LOT (S) NAME OF OWNER (S) : ALMRT H —-- OCCUPANCY: SEASOHAL_RFSIT�MNTIAL ALBERT.H GORDON ADMITTED BY: OPEN .--- ACCOMPANIED By. KEY AVAILABLE: — SUFF. CO- TAX NAP NO.: 9-7-8.1 SOURCE OF REQUEST: CHERYL NEWTON, AIA DATE: 06/22/06 DWELLING: TYPE OF CONSTRUCTION.- WOOD FRME m„W mW # STORIES: 3.0 # EXITS. 8 FOUNDATION: STONE CELLAR: _ CRAWL SPACE. 100% TOTAL ROOMS. IST FLR.: a 2ND FLR.: 11 3RD FLR.: 3 BATHROOM(S): 7.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S): PORCH TYPE: OPEN DECK TYPE; BREEZEWAY: FIREPLACE. 1 PATIO TYPE: 'RLUE2TON� GARAGE: NONE DOMESTIC HOTWATER: YES TYPE BEATER: ELECT C --:LR--T- AIRCONDITION19G: NO TYPE BEAX-. NONE WARM AIR: .--- HOTWATER: OTHER ............. ACCESSORY STRUCTURES: GARAGE. TYPE OF CONST. IT STORAGE, TYPE CONST. SWIMMING POOL: GUEST, TYPE CONST. calmm. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE AjRT. SEC. P-EltARKS: BP 3759 SHED COZ3628 BP 31518 KITCHEN ALT COZ31244 /I INSPECTED BYc DATE ON INSPECTION: 08 16 OS ROBERT E 1, .....—------ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31245 Date: 10/28/05 THIS CERTIFIES that the building ACCESSORY Location of Property: MIDLOTHIAN AVE FISHERS ISLAND (HOUSE NO.) (STREET) (STREET) (HAMLET) County Tax Map No. 473889 Section 9 Block 7 Lot 8.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 18, 2005 pursuant to which Building Permit No. 31535-Z dated OCTOBER 18, 2005 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to ALBERT H GORDON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL. N/A ELECTRICAL CERTIFICATE NO_ 2069175 09 15. 05 PLUMBERS CERTIFICATION DATED N/A M or ..Zed ``ia nature 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-31244 Date: 10/28/05 THIS CERTIFIES that the building ALTERATION Location of Property: MIDLOTHIAN AVE FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 9 Block 7 Lot 8.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 18, 2005 pursuant to which Building Permit No. 31518-Z dated OCTOBER 18, 2005 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 —KITCHEN ALTERATION IN AN EXISTING SEASONAL ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ALBERT H GORDON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 30357G 01/31/94 PLUMBERS CERTIFICATION DATED 08/31/05 GLENN G / .. .........ELLO .. .. - .... :ho, zed nature 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-33311 Date: 10/01/08 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: ............. MIDLOTHIAN AVE FISHERS ISLAND (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 9 mmm„m Block 7 Lot 8 .1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 22, 2005 pursuant to which Building Permit No. 31473-Z dated SEPTEMBER 26, 2005 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 ADDITIONS AND ALTERATIONS TO IkN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.. The certificate is issued to ALBERT H GORDON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 300458.0. 04/25/08 PLUMBERS CERTIFICATION DATED 08/26/08 RAVING PLUMBING ..... fiat ri,,e Signature Rev. 1/81 fit NOLD � OWNER s STREET VILLAGE, DIST? SUB. LOT a nv FORR OWNER N E ACR / 7 _ /I NI(r I i"ilk•' �f f S P W m TYPE OF BUILDING Orl RES SEAS, VL, FARM COMM. CB. MISC. Mkt. Value LAND IMP, TOTAL DATE REMARKS la a = r - e> Is ;p 2 � - Q - B-to ' _ _ ? S Jar _ E r Q A E i �F�� BU I ING GONDJT PN ` ;-�pIa /s N EW NQA Ia W FARM Acre ; Value R value f _. Tillabjg Tillable ' 3 Woodland Swampland i FRONTAGE ON WATER - Brushland � I - FRONTAGE ON ROAD - - House Plot ? Z �� 5�0 �� DEPTH IBULKHEAD Total ' DOCK a r n 3 a t Lip el OM v COLORs Big TRIM f� ` � 4 t --7-8.1 3/08 9•-7w .1 4/07 - I 4107 t I INN Ai M 70 t Foundation P° cs 1st 2nd 1 Extension - a OTHER Bath17 - - Dinette Basement FULL LL n419 Extension e PARTIAL Floors Kit- Finished B. Extension j;_v I � e E COLODI 1 MA a 9` TRIM — i i E- r I ( € 1 t i �A � I� t — � E s � g e � e � I _ � I 3 M. Bldg. n o t Bath � z dation Extension B seri Floors e K. Extension a - --- �_- = Ea� - ' Interior Finish LR, Extension ' ' v. F = Place i . Heat Type Roof `� Rooms Ist Floor' BR. -- Porch -- �ara Recreation Rcjo Rooms end Fto.- FINS B Porch iner _ Breeze r ,Diiveway aray - -- — F- r Patio C, B. i Total - i i — i t