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HomeMy WebLinkAbout1000-13.-3-11.3 of so TOWN OF S UTH LD Rental Permit Ulf 0174 Owner: Venetia Hands , Christine Novak Occupied as: Single Family Dwelling Located at: 255 S View Dr Orient 11-3-11.3 Maximum Permitted Occupancy: 6 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. Issued: 01/24/2025 "Q�fxm4f Expiration: 01/24/2027 c e E t r ement Official This Notice must be posted by the main entra at all times a-14 V iwJ b TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL NE KS: _ A NJ DATE .l _ _ INSP"Et T"ON s _ TOWN OF SOUTHOLD Rental Permit 0174 Owner Venetia Hands & Christine Novak Occupied as Single Family Dwelling Located at 255 South View Dr Orient 13.-3-11.3 Maximum Permitted Occupancy 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. 1/25/2023n Code Enforceo4nt Official This Notice must be posted by the main entrance at all times SOUTHOLD TOWN 4375 Main Road M PO Box 1179 Southold, Rental Inspection NY 11971-1179 �► � t° Tel: 631-765-1802 Fax 631-765-9502 :m Vie.n 57C µ.soVa- �� kms. i n Date �' �, ,t, ,,; ., " Owner,;;;,��l � ,' 1�,� Phone c — Soo "� - / s- ;ia.,a ,v r�/L//;%d„lei/�G91G,/%1c� iro,//�„ �l iA�, ✓, i.in� A //i! itd;,�%i�Jl!!/iiil//ir/, ^/��I�i7;��idJiLlrfHli��lraU/i✓,iu,.,y„�, ���„ii��%i%iii// LEVELS Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) BEDROOMS ' Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows) (YIN) BUILDING SYSTEMS CONDITION OF PROPERTY N 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 present POOLS N POOL BARRIERS X11 Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min.48” high resent POOL GATES 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 proof when unattended COMMENTS: TOWN OF SOUTHOLDRental Permit Permit No. 0174 Owner Venetia Hands & Christine Novak Occupied as Single Family Dwelling Located at 255 South View Dr. Orient 13-3-11.3 Village 5/B/L Maximum Permitted Occupancy 6 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. 9/5/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex ' Telephone(631)765-1802 54375 Main Road Fax(631)765-95£02 P.O.Box 1179LP F7 Southold,NY 11971-0959 :s _ J U 1 8 2T BUILDING DEPARTMENT TOWN OF SO OLD D =�_ RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: , `} -% I+ ii I r ! 9 tom. r Tax Map Number: 1000 SECTION ) g'LOCK - LOT SECTION B. OWNER INFORMATION: Property Owner Name: C #P-`�'tf;� VA W Property Owner Legal Address: Property Owner Mailing Address: t�. Y - t l�� Telephone Number (s): I _ ° ' µ" ( 11\ Property Owner Email Address: vt L®gin i vt �3 Page i of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: o Address of Authorized Agent(no P.O. Boxes): PO 5 Mailing Address of Authorized Agent: 1101 Telephone Number (s): 13 .� Email Address: VA 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): 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): Mailing Address of Managing Agent: Telephone Number(s): Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 0AAZ 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: U Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental DwellingUnit: � Use and Dimensions of each room in Rental Dwelling Unit: o! 27 Y, 2-2a - - 1 IL 5 . 1 6 I SECTION G. ` j I I 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 0 1 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 MUSTbe the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) &, a &-b-5 J 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 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-_ q,, -r--qn� i ..10-J Property Owner's Signature:A-,�� „ -&, Sworn before me thi day of 2 Official Notary Pub Ignatu Ire and Original Notary Stamp 1301\1NIE1.DOROSKI Page 4 of 4 Notary Public,State Of Nm York IVa. 01 D06(1 ',�3�8 S u f f i:flk III is Expi�asjtfly S TOWN OF w ; 765-1802 INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ FINALW,,64j'�fw;f, [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING om DATE 5 TO YYdWd I VM, ;118111 1S,N;;IM"J I'm,INTI U'- N1 %�, It'.'!SFl.'i O s r y /y 4 r x to a i i D1I� mT7����ON. r "llff�fUliGf µ G? Q { Du T _ RA .... ... �. I w pj ........... .... 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G fD O ® 'CD {� pa n 1 ,,,,.... .._. .....,..: �,.... �_ .._m..,�..m_,._ @ -r C:S ® _....... w 'C9 a C3 m a h .. 1 o' ZJ---- � -- _ a j �p M �L r � � y P .�.� µenuwnru,�mwn w�rMwrirxww•—w.wwWwrww�+.�.�. -..... < Vtl J ri uu �...w� non xunr�o yn mwiwn mmm�w.w�rc�aww.www�w—. 1 w TOWN OF SOUMOLD U TIMING DEPAIMM Two 'II4 0006 sauffield. m T. Certificate Occupancy MM CER7WM that the buildiAg locoWd at Map om jBj,-OVft2.S110ock No. . .04a-Ae-LutNo, conforms substantlaUy to the Application it Imetotare faid III V*Office te& . u n . . w.. . ,.. „ � . . �'' i which Building, � , w� a. P_ Fob ssu�4 and conforms to AU of the mquire- applicablyprovisions of the law,The oca wor ,ice certificate .. , . . . .W , A. .,, W , a , mwarom�mAW. , .W „. m The cerdfirateImued to Ift9sx9a. . of the afbmaid WOW& (owner, kmoe or tenant) S ea of Health Approval . —Aug. .. . . m n . . .m 1 . HOUSE . —South Niox , iveu . a . ea .� w � . �� w ., � � Building hm ec m FORM NO. BUILDINGTOWN OF SOUTHOLD 7 Office of the BuildingInspector Towyn Dail Southold,N.Y. Certificate Of Occupancy . . . . . . DaW . . . . . . m . "'lHS CERTIFIES that the�ftfldmgA .ad.d..ition Location of Property. 255 w � . w. .S o wuu t to v t.e r m D r-i v e ., .. . . . .,a . . . P u. j e n.t'w C uunty,Tax Map No. 100O Sccti t�. u , —Block , �3 , . . . . , , .l.ot Sub ivision.. ... ...Fi.led Map.No ....Lot No. ... . .. . w . conforms substantially to the .Application, for Building, Permit fieretofore filed in this office dated 19 §�D pursuant to which Building Perinit No. l Il� l � oa. , . , . . . duntcml . . ,.. w m mu „ Wf , 1 . was issued,and conforms iro all of the requirements of this al-)plicable provisions of the law.71te occupancy:for wi°aactu this certificatels issued is to ..,m. . . . . ... .. . ...._ . .pwu . wn . . . mm 1lug certificate is issued tuum w Il .�C J. A .LITS LE, I! & I)N=;u 4 A LIfs ll tl l l L ER mit the aforesaid building. Suuffolk oun.ty Department of l-lc ltll Approval w w ru o t re.also i p.e,d. . . . . . . a , . . . . . UNDERWRITERS CERTIFICATE NO. . . . -14 , not �w��ul��.�,.� . . . Building inspector ®v®1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspectom7 Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Z-27625 Date. 1,octian of 'T.rope tyt255 OUT" "'VIS DR ORTEXT _........... — (HOUSE NCD.) (STREET) (HAMLET) Coimty 'Tax Map No- LLIIEU Section 13 Blw—k _........ ...... Subdivisicm Filed Map No. -- Lot NO. s-sonfoims substantial.11V to the Appl.icatio n Eo- 13�n:d,.Iding Permit 'lj,eretoE re filed in this E-Lc dated LTOW�OBER 12,," 1999 has."!A nun nttla to whi c-h. Rui.I.Aing Permit No- 26226-Z ciaLed CENnE,'R 27 1999 was issued, amd co:gafoucmo to all,, of the requirements of the apr.LAi.ca1)1e provi.ssiucsu:ua of the law. °k'"]I:'se occupancy for vrb.3.ch this u::ertt: :ii..f:.-Ic .tt e is 1.sasu.ed _,.Yt FOTO �..... $nal"lDqCe ONE FAMILY DWELLING nAPPLIED, ..,®.. _ .. ._ 'nie cuu i T.is ate is issued to ua°E101D Ddu HANDS _ .. ......... . (OWNER) SUFFOLKof the aforesaid building. DEPARTMNT OT* EEALTH Rqv .. -- ELECTRICAL CERTIFICATE03 0I � rte"A ].e Esq IFI ION ffD]Vr 1p Y'' D� D ()BERT 2UIL I'TE WW au1 T,or zed .i nature Rev. 1./81. wd , . 1/10/2018 Town of Southold P.O.Box 1179 �r 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY Date: 1/10/2018 No: 39443 ,,.. ... THIS CERTIFIES that the building ADDITION/ALTERATION w Location of Property: 255 S View Dr.,Orient SCTM#: 473889 Sec/BlocklLot: 11-3-11.3 Filed Map No. Lot No Subdivision. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/26/2016 pursuant to which Building Permit No. 40958 dated 9/2/2016 was m issued,and conforms to all of the requirements of the applicable provisions o , a f the law. The occupancy for which this certificate isC issued is: pg q ry y g ry p p 1,., "1 ; 1 w 1TMV1 1IM„ 11, i Hands Veneta&Novak,Christine The certificate is issued to i 6 of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 40958 01-02-2 ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED � Signature 1 m1 p�