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HomeMy WebLinkAbout1000-111.-11-19 TOWN OF SOUTHOLD ti Rental Permit 0073 Owner Edwin Blesch Jr. Occupied as Single Family Dwelling Located at 22495 Rte. 25 Orient 18.4-14 Maximum Permitted Occupancy 4 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. 6/11/2021t� K]4;L g Code Enorcnt Official This Notice must be posted by the main entrance at all times TOWN OF SO THOL -z Rental Permit Permit No. 0078 Owner 3295 Haywaters LLC Occupied as Single Family Dwelling Located at 3295 Haywaters Rd Cutchogue 111-11-19 Address Village S/13/1- 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. 6/4/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex p 7, Telephone(631)765-1802 54375 Main Road k Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 b BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 I 11, 00 _BLOCK I I I)o �LGT . 0 Q� SECTION B. OWNER INFORMATION: Property Owner Name: �� 5 L— L C- Pfd er 11.11 dWner Legal Address: p Property Owner Mailing Address: Can not be the same y Address) e as Renta��� to � Li 52 Qj 121 -7 Zl �leph �umber(s)• Property Owner Email Address: �p q Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: r , Address of Authorized Agent (no P.O. Boxes): �.rv� � rr �� Mailing Address of Authorized Agent: Telephone Number (s): -(; ILA � � '� Email Address: i (e: 0 r 110 C Q r 0&A 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): 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 Unit4' Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: L 'v me, D ' w 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 ❑ 1 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) 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: p Y Sworn to before me this day 'el 20A , 20A µ Official Notary Public Signature and Original Notary Stamp O iE NOTARYpUSUC_STATE OF NEW YOl Page 4 of 4 No,OIPJ6265772 )f FOLK coUNVQUALIFIED COM 1 1IN 1 S VORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. . .7....13,90.......... Date .............................. �A-y.. .3........... 196P----- THIS CERTIFIES that the building located at -Road}.................... Street No. . ., a:r. ....... Lot No. .?.l.Qs'........Cuit4ej-.jog-2e conforms substantially to-the Application for Building Permit heretofore filed in this 'o'ffice-dated ...............,te-!Dt.....2b...... 1963!. . pursuant to which Building Permit No. Z1.56-7: dated .............................:Sept.....P-6.-, 196...., 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 .......... -Pri-Vate•,.one••fancily--dwelling. ................. ...... ........r ....,.,r ....,.. This certificate is issued to ...thom'a&--D;i lel-—Son' .............©'m » ................... r...... .„,,...r...r,r. (owner, lessee or tenant) of the .aforesaid building.' 4 °'4 '•VHF+d'."9� 5 � r. . �:`..�✓�•.( .. ,.tl ..,.. .. .. 1,N Building°I�nspectorq • ,u P I � I}� n� Po :� q FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23795 Date JULY 25, 1995 THIS CERTIFIES that the building___ ADDITION Location of 'Property 3295 HAYWATERS ROAD CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 11 Lot 19 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 27, 1994 pursuant to which Building Permit No. 22553-Z dated JANUARY 11, 1995 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 2ND STORY ADDITION WITH GARAGE UNDER & REAR PORCH TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. T The certificate is issued to CORNELIUS M. & CAROL A. MCSihM (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - JULY 24, 1995 PLUMBERS CERTIFICATION DATED JULY 25 1995- BERTSAND PLUMBING & HEATING 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-23977 Date OCTOBER 23, 1995 THIS CERTIFIES that the building ADDITIONS Location of Property 3295 HAYWATERS ROAD CUTCHOGUE NY House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 11 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 23, 1975 pursuant to which Building Permit No. 8096-Z dated JULY 23, 1975 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 ADDITIONS TO AN EXITING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to CORNELIUS & CAROL MCSHANE - (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building InspectoA,+O 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-23978 Date OCTOBER 23, 1995 THIS CERTIFIES that the building ADDITION Location of Property 3295 HAYWATERS ROAD -CUTCHOGUE NY House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 11 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 24, 1992 pursuant to which Building Permit No. 20860-Z dated July 29 1992 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 AN ADDITION TO EXISTING DECKS TO A ONE FAMILY DWELLING AS APPLIED FOR. �- The certificate is issued to CORNELIUS & CAROL MCSHANE owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A A/1 .. Building Inspecto ;d Rev. 1/81 Town of Southold 7/23/2018 Ww P.O.Box 1179 ' 53095 Main Rd � Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39784 Date: 7/23/2018 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 3295 Haywaters Rd., Cutchogue SCTM#: 473889 Sec/Block/Lot: 111.-11-19 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/16/2018 pursuant to which Building Permit No. 42495 dated 3/27/2018 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 1N-GROUND S r MMIN'G POOL FEN IT-1_0 CC DE, APPLIED FOR The certificate is issued to Muscolino,Jordan&Martin,Andrew of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42495 05-25-2018 PLUMBERS CERTIFICATION DATED d Signature A.. ^� r ,6 ° r w co ° ° 0 a o t2: Qj a " " a q+-A+ +RCD w r ills Is ' Y w, � �. Q t � a � ' �mmswoo mmlriixox fofoifF�q+1, „/r �ii ic. auaur'�MtlwW r X Z Ll '1 m� m QQIM w �� Ia<rm 1.1 Ab NS D ,q Z p r+ �;13 N J N ct,ikm T Cu FI 2 r IM YY, ay .2P tri /i rr?rr.. l mx e m s F �' - vidu�ferura��mmrc� =OpIM m �8m "wm ND o x� c IMco Cis D 40 0 414 IIII��I�� it wpAm vtl sow l BUILDINGTOWN OF SOUTHOLD Nmil7 -18 2 11111111111111""CTION INSPE. [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING R7;:KS: n A OK/ eoo'�- OWvQ AqVm A A plwuvwt/ f, DATE INSPECTOR 1 li II N. f 0i) cr a crI im-n Ss M :5 0- M 12. 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