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HomeMy WebLinkAbout1000-117.-3-4.1 TOWN OF SOUTHOLD _4 Rental Permit 0139 Owner Given JB III 2012 Irr Trt Occupied as Single Family Dwelling Located at 199 Old Harbor Road New Suffolk 117.-3-4.1 Maximum Permitted Occupancy 10 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. 4/30/2024 Code n rc ent Official This Notice must be posted by the main entrance at all times * , TOWN 0T SOUTH OLD BUILDING � 631 -765-1802 //J-wgsw INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII [ ] CODE VIOLATION [ ] PRE C/O [ REMARKS: 944tX� DATE ,2�-4- 11NSPECTOR ,M y Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 Y S, CUM # ? Date �oa2 Owner Phone A......... ..... .oo M�� w..,... . �..V �....../ �.. ...........awa... ..... ddress �/d /7R2�p Visible Hamlet S pp Inspector .,...t .. ....... ....._ � .. ..... ....W . ..... ...... �..._ _..... ....... ..... .. ... _.... .. .... Floor Level qu....w_.....a.,� . ............ �... ._............... . ... -...... Quantities Sub 1 2 3 bedrooms)d located in b(not lo Detecto rs ors caero / -�.. ...�...� ...,....,..,�... .�. . . . R ....�. ... �._ .. � .� ..........� _. Carbon Monoxide Detectors . .° p Fire Extinguishers Exits .e„ ... .., .r,,.a...... �...m, ... ... Bedrooms 1 2 . ... .., 3✓..... 5 ... . 6 Smoke Detectors g .._ �.._�.. � E ress � � .� Occupant Count eZ 1 �.... .... ..._.. . ............� _.. �a.w.... .wm,rc. _.. BuildingSystems Maintained &Operational _[Condition of Property ..,.m.......�. ,Y ,,...�..� ,. .,. P eraq... . ......... . .... ��non ,.,w..,. a �operm�, �..e,. .R .. ..- ..,.. .. . ......._ Heating Building interior m Building exterior Hot water � .. _.Property clean, maintained ntained &safe ..... ..� A .._........... Handrails ..� g &secure Mechanical ... Handrails& uards installed .�.... . Pool Safety Pool on Sitew..... - � .u.. . w.....v, .... ..,.w......�...._ .. _a....a...... .. . �n.R �� P, �..... Surface water alarm Date of CO issuance ff Pool Door alarmss�.latchin� � ..ates..d.. ... . ,.., �.�.n fencelto dode requirementso .,.. ,,......, .�... .... . _ .........,� Self closing/ g g _�m.�.. .__..._...... . ,_. . C ..., ............ . ins present O's for all ate esent PriorRental .� .�.._ omments ®.., . _ .. .. .. ....... . .... .._........,.. .... . ....._.........-...... ..... .............. ..... ......... . ....._............. f _. .,.,,.. ...�........... ..._...,..,.. .._.....,.,. ,...._....,...... .,...,. ., ,....,.e„,,., ....,, .. ..... ......,...... , I ..,.,.,._. .... ..................... ..,_ ......... .... ..... .,,...�.,,,,,., .. „_.., r� .. ,...... ..... ....n, ,...._.... .._,,..,,..., ..... ............. .. ._ ,. ..., ..,...._.,.. .... .w.........,.. ....,_.,.._. _ . ........ ..,,.......... ...... ,,,....., ..,,.� TOWN OF SOUTHOLD r Rental Permat 0139 Owner JB Given 1112012 Irr Trt Occupied as Single Family Dwelling Located at 199 Old Harbor Road New Suffolk 117-3-4.1 Maximum Permitted Occupancy 10 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. 7/29/2021 Code Eforc t Official This Notice must be posted by the main entrance at all times -U5K4W-)- l WO Town of Southold July,9, 2021 Building Department Renewal of Rental Permit Last Name:Given Tax Map Number: 1000-117.- - .1 Permit Number:0139 Expiration Date:8/5/2021 To Whom It May Concern: We wish to renew our rental permit as referenced above and state that there have been no changes to the property/structure since the last inspection and issuance of the current permit. Sincerely, James B. Given Trustee 199 Old Harbor Road New Suffolk, NY 11956 Town Hall Annex SOUTHOLD TOWN 54375 Main Road PO Box 1179 Southold, tRental Inspection NY 11971-1179 r o w Tel: 631-765-1802 rFax 631-765-9502 SCTM # —.3 _Li C Date 7 Ownerj b i`lr�1�1 Phone Address ( }����OiI' �� Zl,p 1 Hamlet N'e lA/ S v f �o Inspector Address visible from street? LEV11 E11 LS 3 Smoke Detectors (#-bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits ('#) BEDROOMS 1 2 3 4 5 Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress(windows) (YIN) BUILDING SYSTEMS OY CONDITION OF PROPERTY Heating system maintained/operational Building Interior is clean/maintained Hot water system maintained/operational Building Exterior is clean/maintained Electrical system maintained/operational Property is clean/safe/maintained Mechanical system maintained/operational Handrails&guards pr nt POOLS Yl- POOL BARRIERS Y/N Pool present (Pool is completely enclosed Pool surface alarm and/or door alarm „ Barrier is a min.48 high resent POOL GATES Y/N All openings in barrier less than 4" Self-closing, self-latching Max. 2"clearance @ bottom of barrier Latch on pool side of gate, meets height Barrier capable of being locked &child- requirements 1proof when unattended COMMENTS: f TOWN OF SOUTHOLD ��o Gym M- Rental Permit Permit No. 0139 Owner_ JB Given 1112012 Irr Trt Occupied as Single Family Dwelling Located at 199 Old Harbor Rd New Suffolk 117-3-4.1 Address Village S/13/1- Maximum /B/LMaximum Permitted Occupancy 10 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. 8/5/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex 'N `� Telephone(631)765-1802 54375 Main Road ,.`r � Fax(631)765-9502 P.O.Box 1179'=y" Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN'OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application mustbe renewed every two years) Section A. Property Information: Rental Property Ad ress: , qq o r I 2 f Tax Map Number: 1000 SECTION I I BLOCK 3 LOT T` I SECTION B. OWNER INFORMATION: Property Owner Name: � CVV���j '�> . 6 t uen ( t-" Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) �i q,, Telephone Number(s): Property Owner Email Address: 61�`2�1 (J Wl Page 1 of 4 e , 01 �f Town Hall Annex f °dig Telephone(631)765-1802 54375 Main Road $� Fax(631)765-9502 P.O.Box 1179 -O Southold,NY 11971-0959 �� y BUILDING DEPARTMENT TOWN OF SOUTHOLD DENTAL PERMIT APPLICATION INSTRUCTIONS Rental Permit Fee $200(Application must be renewed every two years) The items listed below are required to be submitted with the completed application. Floor Plans:Detailed floor plans of each Rental Dwelling Unit,please show location of all smoke&carbon monoxide detectors Certificates of Occupancy and Pre-Certificates of Occupancy: Provide copies of Certificates of Occupancy or Pre-Certificates of Occupancy for each rental dwelling unit Certification of Code Compliance(form enclosed):Applicant has the option of having a rental dwelling unit inspected by the Town of Southold or by an architect, engineer or home inspector of their choosing. If the Applicant elects not to have the rental dwelling unit inspected by the Town,the Applicant must submit a Certification of Code Compliance completed by a NYS licensed architect or NYS licensed engineer or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building Code Certification. Rental Permit Fee:$200.00 (Please Note:The Building Department does not accept cash. Payment must be in the form of a Check,Credit Card or Money Order.) Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)7659502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOU MOLD Section C. Authorized 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 Emergency Email Address: == Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit,if any: tV) Address of Authorized Agent(no P.O. Boxes),;L Mailing Address of Authorized Agent:, Telephone Number(s):Daytime. _Evening Emergence 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: OL Address of Managing Agent(no P.CS. Boxes)t. . Page 2 of 5 Town Hail Annex Telephone(631)765-1$02 54.375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: � - .c dam"V, Telephone Number(s): Daytime,�3 - "A�kvening -13 A ergency 17. �6 Email Address: c Lj h Co 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: ✓ Cedaw Requested Maximum number of persons allowed to occupy Dwell!n Unit: . 10 Number of rooms in Rental Dwelling Unit: _CIO ✓lanm ' IQ Use and Dimensions of each room in Rental-Dwelling Unit l�f` l ' � Il `'�c I� ' 1 15� 1• '1 � Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(6.31)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUMOLD 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. ZI m 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) l `raar'a I-,kah 1 ,.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 1 understand the Town will use the address for service pursuant to all Page 4 of 5 Town(tall Annex Telephone(631)765-1802 34375 Main Road Fax(631)765-9502 P.O.Box 1179L Southold, 179- Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUMCKM applicable laws and rules. I further acknowledge that I will notifythe Town of Southold Building Department of any changes of address within five(5)days of any changes thereto. 1 I 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. I will notify the Town within five(5)business days as to Any change to-the information regarding Authorized Agent; Managing Agent,or Site Mana$er. Property Owners Name::- Propeli ty Owners Signature- Sworn to before me this da f Official Notary Public Sig ature.and Qriginal Notary Stamp MELANIE V BROWN Notary Public,State of New York No.01 BR4908712 Qualified in Suffolk countyAo I Commission Expires October 19,..... Page 5 of 5 CONSENT TO INSPECTION e' Z & %vtV1 V4 I�"` —e,' , the undersigned, do(es) hereby state: Owner(s) ame(s) That the undersigned (is) ( rthe owners of e pre ses in t e To n of Southold, located at q I 6� D� which is shown and designated on the Suffolk County Tax Map a istrl'ct 1 00, Section ,Block , Lot That the undersigned (has) (have) filed, or cause to be file, an agplicatipin the Southold Town Building Inspector's Office for the following: K That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: qk/V(Signa re)/� , W-V S l� (Print Name) (Signature) (Print Name) 'AhpF SORoo,& UOMJ SJ��Dlk ll-+.— -5-- q • I l UIy * # TOWN OF SOUTHOLD BUILDING DEPT. Quo,��'' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] INAL eAPuw;4 [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: NA A AN LA lro f J 0- DATE INSPECTOR Y", TOWN OF SOUTH L fi Di OWNER STREET V1xLI.AGE` �SlJ6: LOT � = Dw 1 Im I ven) VVY tvl�ijl�k �rfVP S , -BUILDING Vi73T ,TYPES OFx ` s,,;; r-. ; •M , RES SEAS. I VL. FARM COMM. 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I � �­��" � �!� :j . � ' ' I I :'�I, " � �,%; : I ��, l , � 1, ,,,, -,� �:`*,��, I .i I I � Q, !� -1111' � �,,�,,�'�, -i � ­,,��,��,,� ,��, , �". e�*� ,111""i"., , "�,"�""",. 7­ . � . i I , - ,J�� : �I -,�� ,11 "I�* , i 0 M I T 010 into ,V I is!i -""�,��,����""","����,,'��i 7' 1 � 1 �� � ; � I �! !� � � : ,� . � � r � , I � ,� �� � ;�d � �- -- ., �-,- ' I .I � �, � �� , � :��'.� i�! � : � �:� ��­,��,� �; . ­� "� . FORK NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ...$..390.......... Date ...........................&1 t...9.7........eeo _ THIS CERTIFIES that the building located at. ,..Reid..r•. �..i?�d•.11 b4iC. ....... Map No. ..mm............... Block No. ..... ............Lot No=.......W6W..04tQ ....l41A.................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............................A ue1r,...21....... 1955$....,pursuant to which Building Permit No. IA1.2.................. dated ...............r........... t...%,........ 1959....,was issued,and conforms to all of the requirements of the applicable 1prropvii]siio/n�ss ofthelow, The occupancy for which this certificate is issued is.............. ......................... X17JG9M9:..T11w1i..6•V1 .. ��}t Atl ..........................................................................I...... This certificate is issued to 1PXGd...l3 V9t 9x..........(...iq mm)................................................I................ (owner, lessee or tenant) of the aforesaid building. . ..................................... CC 1 JS t . 5