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Home My WebLink About1000-18.-5-10 TOWN OF SOUT OL Rental Permit Vk 0-1 Permit No. 0132 Owner 22950 Main Rd LLC Occupied as Single Family Dwelling Located at 22950 Rt 25 Orient 18-5-10 Address Village S/13/1- Maximum /B/LMaximum Permitted Occupancy 7 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. 7/30/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times P Town Hall Annex Telephone.(631)765-1802 54375 Main Road � � '° Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-09591 JUN 1 2 2019 f3U.11,D'ING D PA TMENT TOS 1OU " . :"" .. RE INITIAL PI RM IT A PPLICATION, TOWN OlFSOU AUr Rental Permit Fee$200(Application must be renewed every two years) Sextion A. Rental Proper �� Y 9 . -LOT G,o 1'"a Map 1000 SECTION,— a -!LGA SECTION Bm OWNER Il iff1IRI "If I G N: Property Owner Name:.,. Property Owner L6gaI-Address:;,,; �P.ro,perty Owner-.Mailing Address: " eo /LA go 1 l� Telephone Number(s): Daytime E e ing mergency r Property Owner Email Address: =3 1V Pagel of 5 ` 1 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 1 1 971-0959 BUILDING DBPART'MENT TOWN OF " OLD' Section C Authodied Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: P( 1 Ofl-IAPU T Telephone Number(s): Daytime venin m r e Email Address: , Section If ManagingAgent Illnfolmrtmtiol°tm Name of Authorized Agent of dwelling unit, if any: Address of Authdr'ized Agent (no`P:O'LBoxes),: � Mailing Address of Authorized Agent:. Telephone Dumber(s): Daytime Evening_ Emergent- Email mergentE ail Address:y SEC , . SITEL V C w ER.IIVFORf P1 ,, :,(required for rental properties,,containing 8.or more rental units.) !. Name of Managing Agent ofdwellin-g unit,,if ars ` e Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road "i Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 BIJILDII,G DEPARTMENT °4 "n "F�011:]'THQIG� ; Mailing Address of Managing Agent:, Telephone Number(s): Daytime Evenirpg DnE:!ugen y , Email Address: . 1 SECTION P. P RO P"ERTY DESCRI 'TION: Number of Rental Dwelling Un � nits 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 roorrho_. For properties with multiple Rental Dwelling Units use,'Rent j PermitApp,lipqbon 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: to -6 ,1- t O -6t G 4041 OVS 1916 OPP? E' �, < u Page 3 of 5 f;, Town Nall Annex Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1179 � �A„ Southold,NY 11971-0959 BUILDING G D PARTMENT TW 6P S'01"OL SECTION G. Pursuant to th-e Town Code'of the Town of Southold Chapter 207 (Rental Properties,);;.-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°Certifi•cat°ion:is:requi�ed stat;ng_that:the property-which is thesubject 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!Co unty of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. VI.am requesting a fire safety inspection to be performed by a Code Enforcement Official r' from the Town of Southold - jjA Il:.::1 1 am.suli.imutriing-li c it pl6,t d 7'd rl of ou—thold ce"itification formjrorn a licernsed , architect or a licensed professionalengi jeer„ a , . d SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK} „ Vt certify enaltperjury,the folfowing s ��. � v under p Y'of � g�° 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 •1 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 RoadFax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OFS01"OLD ap plicable laws an(J ru.ullles. i iuq.her ar;km"Ttiowllledge that i will notifthue 'lr'own off'sou th(-Jkl B '[)epP rrm,rrsent olf array r haiing(n�.of'address within five (�"):days of any�,i�a�ir� as u.iullafuin s k thereto. . " 3, ll'ha wi read Grid,:ecbii ed a cojjy of Chapter 2017 o tho Code Of the'Town of,Soutlh of and �ag,teehd�to abide tam1*'m_ 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;.,..,.- Prop I ertV anagerProperty OVVner'S-Name: 44-79, Property Owner's Signature: . m Sworn to befog is day of Of loial y Public Signature and Original Notary Stamp , ANGEL R MACEIRA-II " Notary Public -State of New York NQ.,OIMA625468.6 , Qualified'In Suffolk Ccuht' Lw y Commission Expirns Page 5 of 5 765-1802 INSPECTION i [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION j ] FRAMING /STRAPPING [ ] INALkeib� [ ] FIREPLACE & CHIMNEY EV FIRE SAFETY INSPECTION [. ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING J �Cvv i i DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. c�r�r 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. I [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINA &TY AmW— j ] FIREPLACE & CHIMNEY iv� FIRE INSPECTION' [ ] FI RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] LECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING � r DATE INSPECTOR l G nrc' I „V.."Y Z D ��y� m t P , R i r rvry ag. O D n " cn O M 0 m �� m O C7 m .... Z 1 En 0 en v D rn �r '� O 77— Z m Q co r C MD v Z D Q m V Orn m z 33 DI' m I I �wh m G µ v a yy I Cn co �l i O O D m 0 tt OI N d 47 o hm� ''foo ir Q "EM �r y an W „t � Z w u x x co rn Uro. e. D c) � 10 m w Z Z m " m ov Pal 4 OM W �F w " M j � � 1 I .r ' � I 1 nA. i ED Vl rn D. a gill .......... n r � w „„ 00 f e� k N r Aen Y � � �,,.. �f �m..... .. N -f, CD (A � f m y o, N � I r 4 y F P f r m co O o (D •� ,* o o n (7) $ s i CL �, f 1 mu _mn jar "� I� u ,� � Ws I 4 Q � 6 w CID m JI f u �a FORM NiO. 4 `OWN OF SOUTHOLD I . BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. 4. . ,2633 . . Date . . . . . . .. . . .s 11ZUAry . . . . . ., 19. 7 THIS CERTIFIES that the building located at .6/6. . . .all.Rpad. . . . .. . . . . , , . Street Map No. . . . . . . . . Block No. . . .? . . . . . .Lot No. .=. . . . .Orient,- -N,X%. .. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . .. . ..;Uly- . . .2.5. . - ., 1966. pursuant to which Building Permit No. . 3. 170 .2 dated . .. . . .. . . .July. . . .25• • ., 1.9.66, 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 Private, -one -famiI7-dwo1-1-Ing. . . . . . . . . . . . . . . . . . . . . . . „ . . . . . . . . . . .. . . . . . The certificate is issued to . ... Ward.Tabor. ... . .. . .4Wn6V..... ..,« x• .. .. . .. . . . . (owner, lessee or tenant) of the aforesaid building. ,Suffolk County Department of Health Approval . . .� �'f. . . "` Building Inspector FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . . .Z14467. . . . , . Date . , , . . . . . . . .June 3 . , , . , , . , , . „ 1986. THIS CERTIFIES that the building . . . . .accessory shed , . , . . . „ Location of Property „ . 22950„ , . . . „ . . , . , , Main Rd . Orient House 1Vo. street . let County Tax Map No. 1000 Section . i,8 . . . .Block . . . . . . . . .5. . . . .Lot . .1. . . . . „ . . Subdivision . . . . . . . . . ,X. . . . . . . . . . . . . . . . .Filed Map No. . . .X. . . .Lot No. . . . .X, . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated A p r i l 3 1 19 .8 5 pursuant to which Building Permit No. „ , 1 3 8 3 5 2 . M . . . . dated . . . . A p r i L 3 19 8 5 ,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. shed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . » . . , . . . . . . . . . . . . . . „ , . . . . The certificate is issued to . . . . . . . . . . . . . ARTHUR A . S P A N GE L . . . , , (owner J9 eli H&"Xtx of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . , „ . . -N/A . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . ., . N/A. . . . . . . . , Building Inspector Rev.1/67 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Bali Southold,N.Y. ( (af).._ Certificate Of Occupancy No. Z1229-6 . . . . . . . . . Date . . . .FLBRUARY 24 . . . . . . . . . . . . . . . I9�4. THIS CERTIFIES that the building A1. I?ITI,ON, , , , , , , , , , , , , , , ,, ,„ , , , , , , , y . , ,„ . . . . . . , . . Location of Property 2 29 5 R .IK}1 S N. I�QA V. . . . . . .. . . . ORIENT House No. treert Hamlet County Tax Map No. 1000 Section . .9 8 . . . . . .Block „ . . . . . . . . . .Lot . . . . .1.0 . . . . . . . . . . Subdivision . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .Filed Map No. . . , . . . . .Lot No. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated .��,4bU".x . , 1.4, . . . . . , 1984 . pursuant to which Building Permit No. . . .1.2$58, . . , . . , . . . . . dated .FJaj3.RV41R.Y .�4. . . . . . . . . . . . . . 1984 . ,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 . . F.QB.A .I)F OQK. .AAA.Z> SUN. TO AR ,E iISTlNG. .ONE FAMILY DWELLING The certificate is issued to .W4lRA . i3OR s�, WIFE towner,lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N . . . . . . . . . . . . . . . . . . . . . . . . . .. , « , . . , . . . . . . i UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . 4 Building Inspector Bl w.1/Si FORM NO. •1 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30275 Date= 07/01/04 THIS CERTIFIES that the building ACCESSORY Y- ORIENT Location of propert • 22950 MAIN RD ..... ....... (HOUSE NO.) (STREET) (ILA24LET) County Tax Map No_ 473889 Section 18 Block 5 Lot 10 Subdivision Filed Map No_ Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 2002 pursuant to which Building Permit No_ 2 8 �f �_ dat .....-JULY 17, 2002 .,.,, Ywas 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 GARAGE AS APPLIED FOR PER ZEA # 5132 DATED 6 20/02. The certificate is issued to JOSE & IVONNE RERNANDEZ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL, N/A ------------- ELECTRICAL CERTIFICATE NO_ 1098883 12/13/02 PLUMBERS CERTIFICATION DATED N/A w _w m.Ar ,,,,,, u lio 1 , Rev- _. 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-33149 Date: 07/14/08 TRIS CERTIFIES that the building ACCESSORY Location of Property- 22950 MAIN RD ORIENT.......� .... .... (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 18 Block 5 Lot 10 Subdivision Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in 200 4 this office dated JANUARY 2 , 8 pursuant to which • Building Permit No. 33659-Z dated JANUARY 29, 2008 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ED FOR. �- � POOL WITH FENCE, TO CODE AS APPLIED is ACCESSORY, IN GROUND SWIMMING _� The certificate 1s issued to JOSE & IVONNE HERNANDEZ� (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL W N/A _ ELECTRICAL CERTIFICATE NO. 3066098 05/p7_ Yd' pl,#UMBERS CERTIFICATION DATED ,Yorized Signature Rev. 1/81 Town of Southold Annex 10/26/2012 P.O.Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36022 Date: 10/24/2012 THIS CERTIFIES that the building ALTERATION Location of Property: 22950 Route 25, Orient, SCTM#: 473889 Sec/Block/Lot: 18.-5-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 9/9/2011 pursuant to which Building Permit No. _- u, 3.6700 ^ dated 9/21/2011m 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: exigingAttap trL ara e conv�:rt 1, 01%r! ztt .: p c in an existill.one fanfil d re!'ing as applied for. The certificate is issued to Hernandez,Jose (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 36700 10/21/12 PLUMBERS CERTIFICATION DATED riz. c. Sita r