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HomeMy WebLinkAbout1000-64.-5-30 TOWN OF SOUTHOLD Rental Permit Permit No. 0072 Owner 1605 OSYL LLC Occupied as Single Family Dwelling Located at 1605 Old Shipyard La. Southold 64-5-30 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. 5/30/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times sof So Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT 1`' TOWN OF SOUTHOLD �s RENTAL PERMIT APPLICATION 'P' 2 2019 Rental Permit Fee$200(Application must be renewed every two years), Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION `' BLOCK, PUT..__-12-3k--) SECTION B. OWNER INFORMATION: Property Owner Name.-, 1 L 1,C-- Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) t6—41 C, rl� 4�A S rLP-j Telephone Number(s):� 1e 1 G czl,—Scy<S e Property Owner Email Address: I®S d) a 2 +M F? AA-�IQ - C C;JM Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: Address of A`uthoriied Agent(no P.O. Boxes): _ Mailing Address of Authorized Agent: Telephone Number(s): Email Address- Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit,if any: ® S Address of Authorized Agent(no P.O. Boxes):�� c Gt r✓�S �ye kwk4jll \J Mailing Address of Authorized Agent: Telephone Number(s): _- Email Address pS elp C�2 J`P��c� ��aCO'�] SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: �., e �M 2J�?'8~ Aaw-, . " 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 toQoccupy bwelling Unit: 1�d3� Number of rooms in Rental Dwelling Unit: J Ta 06�� Use and Dimensions of a ch 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. Page 3 of 4 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 SOUTHOLD 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. 1� Property Owner's Name:_ --j-0S V_ yyl-_ Property Owner's Signature:- �,�,t' Sworn to before me this day of _��' : 20 l� Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County 0' — Commission Expires Aoril 14.2, U Page 5 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 CDUo t 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. ❑ 1 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. 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 addre'ss'for service;pursuent.to all Page 4 of 5 � s F Q�y�OE SO�ryo ' Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road 2 Fax(631)765-9502 P.O.Box 1179 - Southold,NY 11971-0959 H'( BUILDING DEPARTMENT '\�, TOWN OF SOTTIHOLD )-11 ' MAY 2 8 2019 ' RENTAL PROPERTY CERTIFICATION I �,A=i A0�1I Form to be completed by a NYS licensed architect,NYS licensed engineer or7icenseome Inspector Separate form is required for each individual Rental Dwelling Unit ' Professional seal required for Architect or Engineer,licensed Home Inspector must provide a copy of o valid Neme-YokkSt8b,iJAII rP exenfibfi MUM et9,Loge:CerflfVairon. Rental Property SCTM Number:: (C�!;77- 3 C Rental Property Address.. 0 s141 Ygg Int MIC OV ` I" ' Owner/Name: .C? o'-_ L. ' G..-- / l _ b F4 CoAeAi Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq.,Bedroom#2-90 sq.,etc.) 0 RCC 12oa , - 13"9:QR-4aq *V5- 179. ESE Property Description(Include all improvements indicated on survey) wo pill I certify that I have done a physical inspection of the subject rental dwelling unit and find that the unit 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 an t law opted by the New York State Fire Prevention and Building Code Council. M�t2�Sc�{w9�Tz . ,�,ec��lr�c Print Name and Title T7 Original Signature p J j3 Please pir r W 1--i SD MUD ROOM O ww BATH #4 a LIVING ROOM >'' ENTRY BREAKFAST NOOK w a z HALL #2 Q p SMOKE&CO a T' - - - - - - - - - - - - DETECTOR 0 b HALL #1 SD 0 O CRI,m o 01, 9. OFFICE o �2 KITCHEN DINING ROOM To 2 ' PANTRY 6n d+ v .[ 4 ,t 00 E O O Lf) "Os r N � v � w3 a 1ST. FLOOR FLAN U u (T' O ROOM NAME AREA ENTRY 117.5 sq ft. N OFFICE 206.8 sq ft. d MUD ROOM 63.1 sq ft. U BATH #4 43.3 sq ft. LIVING ROOM 255.3 sq ft. BREAKFAST NOOK 127.9 sq ft. KITCHEN 202.2 sq ft. '-CEREDgR 14 PANTRY 39.7 sq ft. 0IN DINING ROOM 208.4 sq ft. 4 Q 1 tv Dom, ; HALL #1 24.9 sq ft. N SCALE:. JOB#: N� 5/28/2019 HALL #2 60.2 sq ft. ��� ?2339 0 SHEETNUMBER: - A- 1 'i a O O w w W z �----------------- � ao o BATH #2 LAUNDRY BEDROOM # 1 ________________� �a-+ Q O LOFT TDETECTOR ® T l ALL SD SMOKE&CO DETECTOR SD / S o S m �N' o m v B #3 `� v O m epi � +± o /-1 as a, c� o O w Ua° BEDROOM # 2 v BATH #1 O BEDROOM # 3 ° 5 LnU N cu � v � W o a W w O 2ND, FLOOR PLAN W ROOM NAME AREA SCALE: 114" = 1'-0" BEDROOM # 1 304.3 sq ft. H BEDROOM #1 - CLOSET 57.7 sq ft. BEDROOM # 2 179.8 sq ft. U BEDROOM #2 - CLOSET 14.4 sq ft. U � BEDROOM # 3 180.3 sq ft. BEDROOM #3 - CLOSET 14.4 sq ft. _ BATH #1173.3 s ft. ���ARC q X- scy ti% BATH #3 61.4 sq ft. BATH #2 54.4 sq ft. 'N DRAWN: "I �k SCALE: .1oB#: LAUNDRY 59.3 s ft. '�� O� q T 22339 Q- 5/28/2019 LOFT 184.2 sq ft. F N E\�N SHEET NUMBER: HALL 84.5 sq ft. A-2 ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ • SLAB ®� C AWL PARTIAL .. fS J Jl� ' � / � IG Wy ¢ �•y.,�aq� ��x � I I I i i ' I � I I a=;,• I I l - -i M. Bldg, i , _ n\ Foundation j �^" ^`'P B`th ( �� Extension j!a x .ti Basement Y-f Floors ! Extension Ext. Walls c.uc) '� ` v, Interior Finish 0 1 Extension I � _ ( Fire Place �,� } Heat 1 _ � - - Y f _ I y^ ! ! Porch ( Roof Type _ y I Porch I Rooms 1st Floor ! Breezeway i Patio ! Rooms 2nd Floor ` I Garage f -, 1 CDriveway I + Dormer I��1 j— y, f� fi7� i O. B. L ��o� fFOI,�COG� Town of Southold 12/5/2017 0 P.O.Bog 1179 o • 53095 Main Rd 4A' �ao�' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39384 Date: 12/5/2017 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 1605 Old Shipyard Ln., Southold SCTM#: 473889 Sec/Block/Lot: 64.-5-30 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/4/2008 pursuant to which Building Permit No. 42112 dated 11/3/2017 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: one fanuly dwelling(modular)with wood frame entry as applied for per ZBA 46234, dated 1/22/2009. The certificate is issued to Prahlow,Theodore of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-07-0063 10/25/2017 ELECTRICAL CERTIFICATE NO. 17-47455 11/27/2017 PLUMBERS CERTIFICATION DATED 11/14/2017 NS Mee nical ut o ed Signature o v SURVEY OF PROPERTY LOT NUAI©ERS P.EFER TO '5V DIVI5ION MAP OF FOUNDER5 AT SOUTHOLD FS REF# RIO-07-006E5TATE5' FILED IN THE SUFFOLK COUNTY CLERKS OFFICE ON 3�a TOWN OF SOUTHOLD'Cl MAY ,J 1927 A5 FILE NO 634 SUFFOLK COUNTY, N.Y. IEPTIC LOC.ATION51000-64-05-30 SCALE. 1=20' sn AUGUST 29, 2006 �' 2t e m MAY 11, 2007(HEALTH DEPT. INFO.) sr2 27 24' / MAY 15, 2007(TEST HOLE) a'::°m, SEPTEMBER 18, 2007(ELEVA AGNS) LPI 34' 43' FEB. 19, 2008(FOUNDATION) LP2 26 99 t JUNE 13, 2008(ELE✓A77ONS) LP3 31 36 LP4 36 4( V'�vr \�� SEPTEMBER 27, 2017(FINAL) LP5 34' 36 +� a*y� SEPTIC 5Y5TEM °1 dor ASi 150 9GALLON GYLIlDRIOAL SPPTIC TNR 'z' `. - ®'•�—- '�q_ 20� C/ 4 .HNC POOLS 61 x S DEEP M Y SND OO.1aR Y MIH ADOVE OUD WATER p•„Q�' '6 ,• , ,''_`OT o STO C C _ .�p1,• �,r*o rye` �o 3Z 'iP TE5T HOLE DATA McDONALD GEOSCIENCE Z C-"y �iyyY� Os/f</2g0 a 0 fag' �°b ,, � { `p S ' G M1XED SAND 8 LOAN OL �O ��_ Or,'p BROWN SILT ML -L7• 3, � ,L•,�c•��' oy r�� �' mak. f” c9 PALE BROWN RNE TO MEDIUM SAND SP A .10) WATER IN PALE BROWN FAT TO MEDIUM SAND SP F G pr <CT�0 f4' ol OHS ARE REFERENCED TO NG.VD / N.� <Oj.'p Qar h•7- ZOIES FROM FIRM 36103G016M EGTIVE DATE-SEPTEMXR 25.9009 1- '� r�', / N.Y.S. LIG. NO 49616 sFto ><RnT1oH oR AcomaN To nus sutvEr Is n viOLATION OF PECONIG SURVEYORS. PG r ° 720-Kr TW NP_V'TOKK STATE EOWATION LAW EXCPrT AS '� (631) 765-5020 FAX 1631) 765-1797 .TION 7909-S000IVI5ION 2 ALL COtTFICATIOM MWON F PO. DOX 1109 .10 POR TH15 MAP Aro C4nE5 Trt XEOP OILY IF SAID MAP AREA=7,700 SO FT. R RTHE�IMESY.D SEAL of THE SLRVEYOR VMO5E 1230 TRAVELER 5TREE SOUTHOLD, KY 11971 06-209