HomeMy WebLinkAbout1000-13.-3-11.3 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
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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
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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
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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
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