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Home My WebLink About1000-63.1-1-45 TOWN OF SOUTHOLD Rental Permit Permit No. 0193 Owner Betty Rugg Occupied as Single Family Dwelling Located at 2555 Youngs Ave 19E Southold 63.1-1-45 Address Village S/13/1- Maximum /B/LMaximum Permitted Occupancy 4 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. 10/9/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 d IJJL DING J)EPARTMENT ., "1'"N CSF S6Vt110 ,D, JUL' 3 1 2019 RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two.yrears) Section A. Property Information: Rental Property Address t -LOTTax Map Number: 1000 SECTION w SECTION B. OWNER INFORMATION: Property Owner Name:, P Y Property OwnerLegaFAddress:.,,,, Property Owner Mailing-Address: X11 Telephone Number (s): Daytime 111. ' `5'z 5.1,,>E Fvenin Il:weir�eurocY_ Property Owner Email Address: Chon Page 1 of 5 i Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631,)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 �P TOWN OF SQUTH01M Mailing Address of Managing Agent: �p �° : : 16'0"un J�:nl�al°,�e4r.�xg1 . ... .- — t��_ ehonn N�.�rnlsnr D ima R Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: I 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_,"R-e.ntal.Perx-oit,Application Addendum." r Rental Dwelling Unit Identifier: - Requested Maximum number of persons allowed to occupy Dwelling U " Number of rooms in Rental Dwelling Unit; Use and Dimensions of each room in Rental Dwelling Unit; ` 5 Page 3 of 5 i Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 Y.O.Box 1 179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO THO SECTION G. INSPECTION:,,; Pursuant toll a'Town Code ofthe Town:ofSouthold-Chapter 207 (R:enta;l 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-requited stating that the property;whi.ch 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,Couhty,of Suffolkand by the laws adopted by the New York State Fire Prevention and Building Code Council. I am requesting a fire safety inspection to be performed by a Code Enforcement Official` from the Town of Southold r . ❑ I am submitting a completed Town of Southold certification form from a,licensed-. r 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) I - certify under penalty of perjury,the following: 1. 1 am the owner of the property identified in "Section A" of this application. q 2. The property owner's legal address set forth in "Section B":A:f 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 1 179 Southold,NY 11971-0959 k BUILDING DEPARTMENT TOWN OF 8OUTIjQLD applicable laws and rules. I further acknowledge that I will notify the Town of Southold BuildingDepartment of any changes:of address within five (5) days,of.any,changes; thereto. 3e I,have read and received a copy of.Chapter 207_.of-the.Code-of the Town of Southold and reedlo abide y� e Larne. 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 Manager. Property Ovrrnet''s=Dame: I Property Owner's Signature: e Sworn to before me this day of '� , 20 � . � „ Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH ?�otenv Public,State of New York No.01 BU6185050 )a afifled in Suffolk County 4 Page 5 of 5 i' a oe TO N OF L = 765-11802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAUL NG [ ] FRAMING /STRAPPING [ I AL C ] FIREPLACE & CHIMNEY : [ INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) ( ] CODE VIOLATION [ ] PRE C/O (20m V ATE INSPECTOR 3 O Q ~ f- j Q W a J W So c J _ o 0 F,7�/j O Z S N *- O Z � > 74 0)0 J � Ool Eno BE m=5 .. v � 0 v s m O r 0 IC ui WO 0! r 20 CO ow cr ii S n Q fa V a i O r J s � b e 1 I LU J � 0 �,a ILA O (A D Z ,P zm lb% n I fal I Ann cx Nm I eiell gim!ie 631 7 -1 ME-. So idiok,NY 11971-09f 9 a BUILDING C � I� "! UfH � S ` o n 0 m m ou g T l � o O ) y p O c co O z > T D < w o 3 m �D O O O z 3 m D ) m w M m 0 O -� n Q4 co r W I 2 „ O pp O I' I r m0O ....�., O �iu ,.µ µ v� F u Z ty 3 f Y y i o w F I EZ i Yl 1 o r y I . I � � r � � n p� i I A r N I I i I 6 P I i hu i mea�rP'nPro t p +®u rW f f ja r � '. . 4 I , WALK SIN-CL f, BATH ..._ . BATH R � Cl. LIVING ROOM a� PATIO ' 1! 19'0' x12' 0„ �r3�r�rr��aaww maw "- G D N azoHsnos 3o IvAos - 'E , o t 0 llflEl MASTER BFDROOM BEDROOM �� 6 �� i KITCF�EN u Gnti �T1a� »�p� > 1 0' x120" 11'x}'"x10 �INING ROOM 6Lir xog'0-a +0Q 6-S;9L,(1£9)xEd � '4"' x10 0'" . O� PLOd UWW SL£VS I d IIEH 9� � q. Z�8i-4 (i£9)auogdaja,L � xaau W f � ref—; uruwwru,irr.w�¢�xiw�aruwrva�rowa �mwruomi¢imm,�;.. � � " � � ,.. 77 a, FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No.Z) 4»027 Date . . .November 22. » . . . . . . . . , . , . 19 $.5 THIS CERTIFIES that the building — MULTIPLE DWELLING Location of Property 2555 YOUNGS aAVENUE SOUTHOLD House No. Street » Hamler County Tax Map No. 1000 Section . 0.6.3 , , , , . . „Block . . . ,0 01 . . . , . . , ,Lot . . 2 8 & 2 9 . . . . . . Subdivision . F OYU N D E R S VILLAGE . . . . , , ,Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated 19$�. pursuant to which Building Permit No. .1.3516.Z . dated . . .N. . ... . .2 , :Y 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 . . . . . . . . . Building it19 Apt 19-E Unit in multiple dwelling The certificate is issued to of the aforesaid building. Suffolk County Department of Health Approval .�. ` ° UNDERWRITERS CERTIFICATE NO. . . . . . . #N.7.1.7 9 p 0, , PLUMBERS CERTIFICATE 10/9/85 X va'e- Building Inspector Rev.1/81