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Home My WebLink About1000-117.-9-16.2 TOWN OF SOUTHOLD 1Rental Permit� Y 0104 Owner Jeremy & Jean Goell Occupied as Single Family Dwelling Located at 16640 Main Street New Suffolk 117-9-16.2 Maximum Permitted Occupancy 2 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, 7/12/2021 de E rc me l icial This Notice must be posted by the main entrance at all times p®r!,,ol TOWN OF SOUTHOLD BUILDING DEPT. a "f 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPINGf [ ] EI AL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REM S. v DATE [77/1014 INSPECTOR TOWN OF SO T OL Rental Permit } Permit No. 0104 Owner Jeremy & Jean Goell Occupied as Single Family Dwelling Located at 16640 Main St New Suffolk 117.-9-16.2 Address Village s/B/L Maximum Permitted Occupancy 2 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. 7/8/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town llall Annex, Telephone(631)765-1802 54375 Main,Road Fax(631)765-9502 PO. ox 1-179 239 Southold.,NY 11.971-0959 BUILDING DEPARTMENT TOWN OF SO HOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: � � i" -w�. IM a �► 00 12- Tax Map Number: 1000 SECTION SECTION B. OWNER INFORMATION: Property Owner Name: ,- GO-CJ Property Owner Legal Address: Property Owner Mailing Address: 5 Telephone Number(s): Daytime jtj 181, Evening Emergen r Property Owner Email Address:. Page 1 of 5 Town 1401 Armear. 41 Telephone(631)765-1802 54375 Main load Fax(631)765-9502 P.D.Box. 1179 _ .. Southold,NY 1.1971-0959 Oom BUILDING DEPARTMENT TOWN OF SO OLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: N/A' 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 Emergen ' EmailAddress: 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): Page 2 of 5 'i Ci so Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 /]a� BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: 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, 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 DwellingUnit Identifier: Yew Requested Maximum number of persons allowed to occupy Dwelling Unit: -. r Number of rooms in Rental Dwelling Unit: _. Use and Dimensions of each room In Rental Dwelling Unit- c to Page 3 of 5 ;i h J Town 1...1all Annex Telephone(631)765-1802 :4375 Malum Road Fax(631)765-9502 MO.Box 1��9 __ S routh..old,NY 11971 0959 COUNN BUILDING DEPARTMENT TOWN OF SOU"]HOLD 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 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) -T 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 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 SO HOLD 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 Nauru+ :, Property Owner's Signature: Sworn to before me this) day of ,, �...- ,•20 Official N Public Signatu dand Original Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2DaU Page 5 of 5 i Town Ifall Annex Telephone(631)765-1802 54375)Main Road Fax(631)765-9502 - - -P.O.Box :1179 � Sow.nllll dd,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO OLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit os rni�ii seal`:e aired r Architect or Erl ineer, licensed tome Inspectomus rovid ca 'valid current,.,+cerci at!on Rental Property SCTM Number: Rental Property Address: Owner/Name: Rental Dwelling Unit Identlfier` , Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq., Bedroom#2-90 sq., etc.) Property Description (Include all improvements indicated on survey) I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy servation Construction Code of New York State. F NAc7 Print Name and Title a 0, '' Origina ig ur 01, ip 4 Please place professional seal: ' . Uw 100 r I, 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 SO OLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seat re aired br Architect or En ineer licensed T ome inspector must ro d copv of valid current cern ication Rental Property SCTM Number: Rental Property Address: i L G 111 Owner/Name: ., — 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.) �r Property Description (Include all improvements indicated on survey) I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy olervation Construction Code of New York State. °M 4p ,,, 5p o n ywue � Y Print Name and Title M.; � O Origina Sigure° Please place professional seal: � 02 r M. aw '�.Vk4(h TOWN OF SOUTHOLD BUILDING DEPT. Nil, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. f [ ] FOUNDATION 2ND [ ]I INSULATION [ ] FRAMING /STRAPPING [ ],,,,,FINAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) l [ ] CODE VIOLATION [ ] CAULKING a DATE". INSPECTOR# 1 a I i 0 �z w. 1 CL 00 r co i 0IM C 0 1 0 v) 0— U) CD 2L IrD (D -n 0 :s ro i m 0 0- :3 1 CJ m v rr cl �i z 0 i4 )PI CID _jz CD IM 0 mO m 01 gfl _n (D C7 IM _71 < or O PrP ""1 ;0 M m LIO Z U) CJ Co _n -n O 0 L z OmI G) 6) m m 0 M 1p rr, -n 4 IOU AW C: cn IV, IOU In T7,_ CID w n n +� n m io m co v v a CID o o' ; 01 1 1.„.,., r w n V ',. �� " W' id � r uj GO ` s I 0 o T 1 m CO „ . mm:... — _ x w o r ° [ m m � m 3 a- 0 m w CCID U) — - � b 9 mo 11—H o w o ( CD e iM� d .. o cD cn r Xx k �r. ��f �_ 1 PO m ui , r y 1 ~o W, 1 � kfJ eb I r i I r r �pp e. � � e f a 1 0 o �O nr� n `7„1 e .w....... e m ... n r' N x 1i C3J 0 i 0 O 0 0 (D® o � ® CD EAo - � ® (3 T Q CD f r � 6 4 1 e J f l nm, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREAUSES THIS IS TO CERTIFY that the /X Pre C.O. #-X/ Land —...Z /7{}d Building(s) Date- December 12, 1986 F/ Use(s) 16740 New Suffolk Ave. (Main St. ) located at 750 Fourth Street New Suffolk Street Hamlet shown on County tax map as District 1000, Section 1 1'( , Block 09 Lot p/o 16 , doesknot)conform to the present Building Zone Code of the Town of Southold for the following reasons: The property has insufficient area. There are two (2) non-conforming dwellings on this lot, per 100-30 A ( 1 ) . The two (2) dwellings are * labeled on survey and are non-conformin for following ww„ reasons;_ On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming IT/Land /_X/Building(s) / /Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: A one-story wood frame dwelling and a ' ' one (1 ) two-story wood frame dwelling with access to Fourth, and Main Streets (New Suffolk) which are all Town maintained streets.. Theproperty is located in the "A" Residential-Agricultural Zone. The Certificate is issued to rJOSEFi (owner, x jt% x of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. **Building 1 has insufficient frontyard setback on both streets. Building 2 has QQ insufficient rearyard setback. ui.:dinc- rts"p'3.eecior FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31886 ate® 03/2 Q THIS IIE t the building ADDITIONS & ALTERATIONS Location of Property® 16640ww MAIN ST NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Mapo. 473889 ec io ,117 Block 9 Lot 16.2 Subdivision Filed Map No- t No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 22, 2002 pursuant to which Building e o. 29216-Z dated MARCH 13, 2003 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ADDITION & ALTERATIONS TO EXISTING is TWO STORY ADDITION, DECK AD .. ...... _,..... SINGLE FAMILY DWELLING AS APPLIED FOR & ASPER CONDITIONS OF ZBA #$5219 DATED 1/9/03. The certificate is issued to JEREMY & JEAN GOEL'L (OWN-ER) of the aforesaid building. SUFFOLKCOUNTY DEPART14ENT OF HEALTH APPROVALN/A ELECTRICAL CTRTIFI 1194852 06/03/04 WILLIAM CREMER PT.� �,"S CERTIFICATION DA 02/2�� .. ._... ._...... ..... ..�.. � .m.. A 1lo zir ed Signature Rev. 1/81