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Home My WebLink About1000-80.-1-10.1 TOWN OF SOUTHOLD Rental Permit Permit No. 0199 Owner Sharon Gorman Occupied as Single Family Dwelling Located at 2350 Paradise Shore Rd Southold 80-1-10.1 Address Village S/B/L Maximum 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. 10/24/2019 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 a: BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL. PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two ye rs S E 4:, 1 19 Section A: Property Information: Rental Property Address: Y-- 56 5" Tax ... �. Map Number: 10.00 SECTION-1- SECTION ECTION .. -SECTION B. OWNER INFORMATION: Property Owner Name: _ Property Owner Legal Address: Pr6perty Owner Mailing Address: Cn ile mm � ell ,. Evening Emer enr � w Telephone Number (s): Daytimemm_ g 1" .. . Property Owner Email Address:.mIT Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 1]971-0959 - OU BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any m f: 20 tj Address of Authorized Agent(no P.O. Boxes):" 7 � ��"" i r _ I Mailing Address of Authorized Agent: � � .. - Telephone Number (s): Daytime i Evening._ Emergency, fu Email Address: "A Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O.. Boxes)',- Mailing oxes);Mailing Address of Authorized Agent: : Telephone Number(s): Daytime„ Evening_...._Emergency r Email Address:. ___. ._. SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) I Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes):_ ...... .......... Page 2 of 5 Town Hall Annex n Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 Ulm BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:m Telephone Number(s): Daytime. ,.Evening_. .:Emergeq ;_. 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 Petrii.it Application Addendum." q 4 Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy D d welling Unit., Of Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unif ml Rxxoi � i rL EA sof 5 d..�.., r w �•r a � .�_ .. Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(63l)76.5-9502 P_O.Box 1 179 0 S Southold,NY 11971-0959 ' 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 ofthe County of.Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. AI am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ lam submitting a completed Town of Southold certification form from a licensed " architect or a licensed professional engineer. P' A. c SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. P STATE OF NEW YORK) COUNTY OF SUFFOLK) I Ls w A J m �� m"�'°iry��t� certify under penalty of perjury,the following: 1. I 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 €. I Page 4 of 5 l r a 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-DEPARTMENT TOWN OF SOUTHOLD applicable laws and rules. I further acknowledge that 1 will notify the Town of Southold Building Department of any changes of address within five (5) days of any changes B F thereto. i 9 3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Sduthold'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 Manager. Property'bwner's Name' Property Owners Signature: y :2t Swor4tobefore me thi �da ofO ficPublic Signator.. lnd Original Notary Stamp TRACEY 1— Eli INC),0 N 1DW6306 900 UALF11H1)IN SII C 00\171 C0jMMIjSSII011q EXPIRES JWIE 30,2Q-Ala., Page S of 5 2 ' C sovmo - t — ID. TOWN OF SOUTHOLD BUILDING n 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL . [ ] FOUNDATION 2ND [ ] INSULATIOWCAU NG [ ] FRAMING /STRAPPING [ ] INAL04,.,4 ;71- [ ] FIREPLACE CHIMNEY [ ] FI E SAFETY INSPECTION ] -'FIRE RESISTANT 1CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) : [ ] ELECTRICAL (FINAL) C ] CODE VIOLATION [ ] PRE C/O REMARKSM �.... . _, _. .� ® � �.......,_.. _ ------- o c o o o m Aj o ° Y Z rz FD o a m Ln M � " t � �,. 0 a� < — p. Y O Z (gin m O 6 � (D m Cy m uuu r f O C m n z771 _ m D G) Gl °a is r j m m , O _ N { rye ,. CO i O J i ,� ................ 0 m m 0 x x 71" ..........- n CO JC)) 'ND C) CD (D (D QJ :3 n (n. !� L. E: 0 .......... 40,1 V .... ....... -71 (D o ( a { pa (D (D ........ 0 (D ...... ....... rt, .......... 0 0 CD 0 0 a CD CD < cn Ln 0* (n t C) -n n. -1, . . ........... .. ........... . ... ............ ........ .............. ............ Fat �. Town of Southold 8/9/2018 53095 Main Rd Southold,New York 11971 : rrM°„ *0 PRE EXISTING CERTIFICATE OF OCCUPANCY ANCY No: 39885 Date: 8/9/2018 THIS CERTIFIES that the structure(s)located at: 2350 Paradise Shores Rd, Southold SCTM#: 473889 Sec/Block/Lot: 80.-1-10.1 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 39885 dated 8/9/2018 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame one family dwelling�wand,ac essM good ltame feara *' Note BP 428 1 alterations COZ-39831. gado dock does not reM�Lq a buildingppermit. The certificate is issued to Sciscente,Rose Ann (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ih to "rct Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING Cv.ODE+,INSPECTION REPORT LOCATION: 2350 Paradise Shores Rd,Southold .._... _ __........._. _.. ............. _.. SUFF.CO.TAX MAP NO.: 80.-1-10.1 SUBDIVISION: NAME OF OWNER(S): Sciscente,Rose Ann OCCUPANCY: ADMTTTED BY: Rose Ann S ciscente SOURCE OF REQUEST: Sciscente Rose Ann DATE: 8/9/2018 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: partial CRAWL SPACE: BATHROOM(S): l TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: on grade PATIO TYPE: BREEZEWAY:......... FIREPLACE: GARAGE: DOMESTIC HOTWATER: TYPE HEATER: AIR CONDITIONING: TYPE HEAT: oil WARM AIR: forced hot air HOT WATER: It BEDROOMS: 2 #KITCHENS: I BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: .. _ _......_ .._.......... OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/27/2018 TIME START: 12:14pm END: 12:35pm tFGt Town of Southold 8/9/2018 ' P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39834 Date: 8/9/2018 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 2350 Paradise Shores Rd, Southold SCTM#: 473889 Sec/Block/Lot: 80.-1-10.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/10/2018 pursuant to which Building Permit No. 42861 dated - 7/13/2018 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: "as built"alterations. i tcia d g-W:n-1dol=vs,doors andelectric and an"as built' outdoor shower stall to an exisjm g one; fang l dig , _plied for. The certificate is issued to Sciscente,Rose Ann of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42861 7/19/2018 PLUMBERS CERTIFICATION DATED t d iature