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HomeMy WebLinkAbout1000-9.-9-25.2 TURN OF SOUTHOLD
e
Rental Permit
0214
Owner A & H Braun Realty Trust
Occupied as Single Family Dwelling
Located at Equestrian Avenue Fishers Island 9-9-25.2
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.
7/25/2022
Code EnforcTment Offic I
This Notice must be posted by the main entrance at all times
alf SO
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION
FOUNDATION 1ST ROUGH PL13G.
FRAMINGFOUNDATION 2ND INSULATIOWCAULKING
INSPECTION100FIREPLACE & CHIMNEY vr'FIRE SAFETY
FIRE RESISTANTI IRE RESISTANT PENETRATION
ELECTRICALI
CODE VIOLATION PRE C/O RENTAL
go,
lv;
DATE
� E 4
. iINSPECTOR
Pakf so 7- 7— �-�
*)TOWN OF SOUTHOLD BUILDING DEPT.
7651802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] 5MAL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION ( ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
00
DATE 04ZZ INSPECTOR
TOWN OF SOUTHOLD
co Rental Permit
Permit No. 0214
Owner A & H Braun Realty Trust
Occupied as Single Family Dwelling
Located at Equestrian Avenue Fishers Island 9-9-25.2
Village S/13/1-
Maximum
/B/LMaximum 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.
11/4/2019 Mike Verity
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
Town HailAnnex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION_
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address.
W 103- -'EGv eg--Ar;a n Aye., 'T�s6 rs �s�car� �Q N 6 G-3770—6103
Tax Map Number: 1000 SECTION lI 3 $q -BLOCK -LOT 7 -_ZS 2—
SECTION
SECTION R.
OWNER INFORMATION:
Property Owner Name: 61j��n. A Kecd�
Property Owner Legal Address: Property Owner Mailing Address:
25[1 ��¢c,� �1. 2�1( • �2rr�,r 5� .
(c-jGNl-1201 _ C ,--L GOfd-I1-120
Telephone Number(s): Daytime fOb yt°i Even in 50.-]'=-7V,,Emergency3 2-SfoG'zo�Z
Property Owner Email Address: 5W • �f1cN M
Page 1 of 5
d
sor�T
Town Hall Annex , Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
Tu
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 Evening Emergency
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
oxes):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):
Page 2 of 5
S.k
Town Hall Annex Telephone(631)765-1502
54375 Main Road ; CA Fax(631)765-9502
P.O.Box 1 179 Gam,
Southold,NY 11971-0959
Comm f
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: I �- _nym t no-s@
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example,
Unit 1, Unit 2, Unit 3 or Apt A, B, Q 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 Unit;
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
Page 3 of 5
i
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.D.Box 1179
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 of the County of Suffolk and
by the laws adopted by the New York State Fire Prevention and Building Code Council.
VII 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)
I ✓1 �/ .� 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 �4 Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 t ,
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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:
Swor before me this day of L,/ . 20 j OFFICIAL SEAL
R08FRANK GOMEZ
NOTNOTARYPUB PUBLIC-STATE OF ILLINOIS ,
MY COMMISSION`XPIRES.01/27/21
Officia Notary Public Sig ure and Original Notary Stamp
Page 5 of 5
SOUTh��
# # TOWN OF SOUTHOLD BUILDING DEPT.
`ycourm,��'' 765-1602
INSPECTION
_
[ ] FOUNDATION 1ST [ ] ROUGH PL-BG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FI AL
[ ] FIREPLACE & CHIMNEY : [ kf FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION ` [ ] FIRE RESISTANT PENETRATION
[ ]_ ELECTRICAL (ROUGH). [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: `
Citi► ...� �•O ��� +�.
DATE �* /� / INSPECTOR `
V SOUlyolo
# * TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ IRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
�o .
DATE Ora INSPECTOR
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TOWN OF SOUTHOLD PROPERTY _(;ARD
OWNER STREET
VILLAGE PISTJ SUB. LOT
No&ewA, 1-ia-len 3(aun
FO ER OWNE�,, N3 vp E/,
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4
S W- TYPE OF BUILDING
P 6"; F"� "? ,v/
V -61-4 16
SEAS. VL. FARM comm. CB. MICS. Mkt. Value
LAND j IMP. TOTAL DATE REMARKSF -7
_ !_ 7;o 7_
-7920
,q
-9 , B
4-12 6 27
Jp— 7�
7 S, /p w C-"
tj
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Vclue
Acre
Tillable FRONTAGE ON WATER
Woodland I FRONTAGE ON ROAD
Meadowland i j DEPTH
House Plot BULKHEAD
Total I DOCK
COLOR l`}�rj�r.� �r to TRIM
• - - � I ( I i i � ! I I i I I I I I i � -
44C,.D
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Extension'
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Foundationi 1 Bath I � Dinette - -
f' rch P i I Basement I �„ rs`] Floors !
K.
Porch" ' r J Ext. Walls r ;Interior Finish S o LR.
/7� ! �Ja S�����4
Breezeway > '� Fire Place Heat ; DR.
Rooms 1st Floor i BR.
.Type Roof i f
Patio .` ��^e I 3 i Recreation Room` Rooms 2nd Floor ; i FIN. B
0. B. i 1 f Dormer Driveway j 1
i Total
Illi ,
FORS NO. 4
TOWN OF SOUTHOLD
BU11 DING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z72.89. . . . . Date . . . . . . . . . . . . . .©etober. . . .
13 19.7.6 .
,
THIS CERTIFIES that the building located at . L/0"'. Equestrian .Ave. . . . . Street
Map No. . ?x. . . . . . . . Block No. . .M . . . . .Lot No. . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . .June ,28, . ., 19.75 pursuant to which Building Permit No. .8155Z .
dated . . . . . . . . . . . . . '.I 4Y. . ?9, 19. 75, 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 one family .dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . Xr. & .Mrs, .Andrew. Braun. . . . .CwMers . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval 54 :-.1.70. by, q �n�.tb. . . . . . . . . .
UNDERWRITERS CERTIFICATE No.X2542.& . . .Ykay. . 24 . . 197.6. . . . . . . . . . . . . . . . .
HOUSE NUMBER . . none. . . . . . . Street . . .Aque s.tr ian. Ave. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspec7
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