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Home My WebLink About1000-55.-2-13 TOWN OF SOUTHOLD 211 Rental Permit its 0146 Owner Cynthia Dgheim & Christina Dgheim Occupied as Single Family Dwelling Located at 4200 Youngs Avenue Southold 55.-2-13 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. r 3/23/2023 pie Enf c rite fficial This Notice must be posted by the main entrance at all times ISO « 6v /® \ . x - - ƒ» ��¥ \§ 631=7654802 INSULATION/CAULKINGINSPECTION , FOUNDATION 2ND [ ] FRAMING / RESISTANTFIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION FIRE CONSTRUCTIONPENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL j [ � CODE VIOLATION [ ] PRE C/ � . � . § \ INSPEC,7TOR 765-1802 r '�mLJOSPECTION [ ] - TOWN OF SOUTHOLD BUILDING DEPT. FOUNDATION 1STROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING ] [ ] I I [ FI "IN PECTI FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION [ ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) CODE VIOLATION [ ] PRE C/O REMARKS: `AIA ovi 6tvil om✓ PAY , Y VVJ �OV6fAA, tA4 ralC4 pjf, �jp" Keejvl�4 withtomA INSPECTORDATE Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �+7I, " y 'ly"lYllWid'Y' R Southold,NY 11971-0959 BUILDING DEPARTMENT " TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION �� u Rental Permit Fee $200 (Application must be renewed every tw er rs BUtLDIN -rvi F OF Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION S -BLOCK- 2 SECTION B. OWNER INFORMATION: Property Owner Name: _..._. . Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytime 3gL/ ?13 (-Evening„ Emergency Property Owner Email Address:.. R c- 4 rn C -� L- (fQ Page 1 of 5 rti' aN b� �NtirRm�9� �2' Town Hall Annex Telephone(631)765-1802 H�d /l i 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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_.,,.,_._...d wM.._.,..Evening Emergency M ,_ 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 Emergency,, .�._..._.___ 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):_M , Page 2 of 5 Town Hall Annex �d�� » jr Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 r �r P.O.Box 1179 qql Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO AHOLD Mailing Address of Managing Agent: _.... ..... __.. ..... . ._. ...................._. ..w-.__-_w Telephone Number(s): Daytime Evening Emergency. _..... Email Address: ._..�...... �. _.µ.. � �w_...._ 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 Uni Number of rooms in Rental Dwelling Unit:.. _..._. Use and Dimensions of each room in Rental Dwelling Unit: �r bfZ�� '- ci • -7 r Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road G Fax(631)765-9502 P.O.Box 1 179v � Southold,NY 1197 1-0959 n . ....... �D�� ' Cpl[ ( p 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 ❑ 1 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) \ 1 j la h-ei , 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 „ e � �a� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179IG3 " Southold,NY 11971-0959 p q 0 BUILDING DEPARTMENT TOMN OF SOU OLD 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 Name: Property Owner's Signature: Sworn to before me this day of 20_a'0),, Official N t ry Public Signator and Original Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNT5� .k COMMISSION EXPIRES,TUNE 30, Page 5 of 5 i T� --T)j G U �11 'I lbev (L y Gm E o 7 s 1 CIA r rp GG� - d� E- 0 2 N °`l ti Ile ry V M S-4L �� I �x T FDLj� TOWN OF SOUT OL Rental Permit Permit No. 0146 v� Owner Robert Kraus & Ors Occupied as Single Family Dwelling Located at 4200 Youngs Ave Southold 55-2-13 Address Village S/13/1- Maximum /B/LMaximum 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. 8/8/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times �a Town Hall Annex '� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959w�� BUILDING DEPARTMENT TOWN OF SO HOLD RENTAL PERMIT APPLICATION Mental Permit Fee $200(Application must be renewed every-tiye u s e 0 2019 Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION BLOCK 00 LOT (] v SECTION B. OWNER INFORMATION: Property Owner Name: r y ' Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Lh � moi` C'1- o , i Telephone Number (s): Property Owner Email Address: ISI 'Q A r 5 C�0 Page 1 of 4 ,;� 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: lo" Telephone Number (s): ILI Email Address: Section D. Managing Agent Information: Name of Authorized Age6t,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 WOO MATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling Ulftit",if any: Address of Managing Agent (no P.O. Boxes):__ ................. Mailing Address of Managing Agent: ........... Telephone Number(s):, Email Address: ..... Page 2 of 4 bi I 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. Co ff,nr-AC STATE OF K) a u� COUNTY OF S LK) certify der 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 Signatu Swo,n-to before meth is R�' clay of 20 Off' al Notary Public Sig ature ann Original NptaryStam c fie. L aO 2 ( !( 2Z, Page 4of4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: o 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." 0 Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Sin 107 Number of rooms in Rental Dwelling Unit: W Use and Dimensions of each room in Rental Dwelling Unit: Vim. z 00Q1U,-)v 6 S J" , & AL& 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 11971-0959UK icy BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Rro sslonad seal re Fred ror rwhltect or i=r+ t eer llcer ed 1► 1 *+*s a or my roVide My valid current certification Rental Property SCTM Number: l � Rental Property Address: 0c, Owner/Name: Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: a sq., etc.) I e. Bedroom#1 -100 sq., Bedroom#2-90 W Z. I�� S �'° '.� "� � 2/ss, Property Description (incl de all �'mprovements,indicated o survey 1 y \\ 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 Conservation Construction Code of New YzkState. O Print Name and Title 0783 Ori ina Si Cab 17,110— g nature g Please place professional seal: / %///� rr x It At s � �,i AMMIN �� fpm y� a✓e SU,,�� fd, SSS A 2- � 3 �wTOWN OF SOUTHOLD BUILDING DEPT. cou 765-18012 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] F AL 4alqw�4 [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: J b°Gf�I ��a A (tS Y v, r /01)Y�C/ IK .15�001 A5 rn rx „ M M r „ V eµ ro a A w. o C,c � m a Z � m a Z �w ^ *hk N �. i a 03 q o m roCD r CD � T hj co m k pp T m m O V rte- 4 rTi ;v vO AO 7C f M Z Z D m > r , O O n Z ' Z1 W mu .,.. v _ 70 � C7 rn yyy � nl f, w .m C N, 1 i Gl I { i 6 O ti o _° ® 00 0 0 x x x O u N s ;y- 3 77 CD CD t1- w ! rL I ry pp Vii; 1 i; I' rr w k f v I ... ......... ro ro � 4 CD , T— CL ro �oj O D -: o ❑ fl _ ,u 3 ° ° m in O cn IN f J1 d � « F � 7 E r FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z10731 . Date . . . . . October ,14. . 19$?. THIS CERTIFIES that the,building . . . , . . . . . . . , . . .. Location of Property . .42Q0, ,YgpP.94 , 43F9AV0. , , , , , . ,,5QVtjXQ1d,. AQV. X,ork. . , . . House No.. ,Street Hamlet County Tax Map No. 1000 Section . 55 . . . . . . . ,Block . . ?, . . , . . . . , . . .Lot . . . . . .13. . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . .. . .Lot No. . . . . . . . . . . . . . lie uir ments ior. a .Pr1vaje.,Rne—Fam J� 1U2f BM1t Prig to conforms subst ntial�y to the— }�pl� WQJa ,. ar— ui ut}EerQU e e ari. z� �c� Cert c.LIe Q upancy Z10731 Apr': .], .23. . . . . . . . . . . 1957.pursuant to whi ttl 1 M+t . . . . . . I . . . . . . . . . . . . . . dated . . . .O.ct. . .o.be. . r. .1.4 . . . . . . _ . . . I981 . ,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 Private One—Family Dwelling with Accessory Structure (3Car Garage) The certificate is issued to . . . Ju0ith .R'Ab.in . . . „ . . . . . . . . . . . . . . . . . . (owner,kwW of the aforesaid building. Suffolk County Department of Health Approval . . , N/R . . . . . . . . . . . . . . . . . . „ UNDERWRITERS CERTIFICATE NO. . . . /R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . « . . , . , . . . i r Buiiding Itlspector i Rev. 1/81 p I' t h �l BUILDING DFI-AF.THENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 4200 Youngs Avenue Southold, New York numbcci^ 6'cstree't T miunIcTFE - it--YT-Subdivision P1ap No. Lot(s)- Name of Own er(s) Judith Rubin Occupancy R-1 Unoccupied typ e (owner- ant Admitted by: Self Accompanied by: Self p y Shan Realty Key available Suffolk Co. Tax No. 55-2®13 Source of request Gary Flanner Olsen Date 9/23/81 DV=LING: Type of construction Wood Framed #;stories 2 Foundation Poured Cement _Cellar Partial Crawl space Rest Total rooms' lst. F1 5 2nd. F1 4 pd.° 1 Bathrocm(s) 2 Toilet room(s)"' Porch, type Side-Roof oWekT- ype--- Glassed i� P�4.-io, type Breezeway Garage Utility room Type Heat Oil Fired alarm Air ~-Faatf - steam Fireplaces) No. Faits III Airconditioning gmcstic hotwater Yes Type heater Gas her (Wood Burner in living room ACCESSORY S'T RUC T L E-9: Garage, type const. Wood-3Car Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Loca'vion Description. Art. Sec. Kitchen Gas Stove no shut off V 52-52-E6 Bath, down No Ventilation 52-26-B-4 Front of Duelling Broken window sash III 52-30-C Side All need repairing III 52w30-A .m... ....... Stairs Down Open side to stairway Ii 52-27-B Wood Burne- To close to combustible material IV 52-.41-A 3 Car Garage Needs major repairs — III 52-30-A Remarks: Inspected by: � "' J Date of Insp. 10/14/81 FORM NO.4 M TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . . - -Z— 15295. . . . . . . . Date . . . . . . . . . . . . . . . February 24 ' . . . . „ , . . . . . ., 19 . .87 THIS CERTIFIES that the building . , . I n g r o u n d Pool & fence Location of Property420th Young Avenue Southold, , .outhold, New York . House 5tre�t Ham%r County Tax Map No. 1000 Section . . .5 . . . . . . . .Block . . . . . . . . . . . . . . .Lot . . . . 13. . . . . ... . Subdivision . . . . . . . . . . . „ . „ . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated .u 1 .y ». » . , „ » » , » » . . , . , , 1%9 . 8 p12546 z ursuant to which Building Permit No. s Augut 6 , dated , . . , . . . . 19 . . .3 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 . . INGROUND SWIMMING POOL & FENCE The certificate is issued to . . , „ . R 0 B E. . & ELIZABETH KRAUS , towner,1X&aj§Kffi&N41 of the aforesaid building. Suffolk County Department of Health Approval . . , , . „ N/A» UNDERWRITERS CERTIFICATE NO. . . . . . . . . . „ „ , . , . N6 1 5 3 . 7. . » . . . . . . . . . . , , . Building Inspector Rev.1/87 I; (r ffI' U' FORM x0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 24205. . . . . . Date . . . . . . . . . . . . . . 19. 71. THIS CERTIFIES that the building located at . . E/S• Younga .Ave• . • . • . . • . Street Map No. .xx. . . . . . . . . Block No. . .x3c. . . . . .Lot No. . x=_ b uthold. . X P'x... . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . July- . . .21. ., 19.70, pursuant to which Building Permit No. . .1+86.9z dated . . . . . . . . . . .July. . . .23• •, 19.70., 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 .garage. .(Acoeeasory. bldg). . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to John. Beg vle . . . . . . .Ownex . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..R.. . . . . . . . . . . . . . . . . . . House ,# 4200 Building p] ect i I 1 r t fs l