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Home My WebLink About1000-117.-6-1 TOWN OF SOUTHOLD Rental Permit 0224 Owner 300 Fanning Road LLC Occupied as Single Family Dwelling Located at 300 Fanning Road New Suffolk 117-6-1 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. ii"OAR-�- f'V 11/9/2021 ft -M Code Enford �t Official This Notice must be posted by the main entrance at all times Town Hall Annex SOUTHOLD TOWN 54375 Main Road " PC Box 1179 Southold, Rental IllSpeCtlOtl NY 11971-1179 ti Tel: 631-765-1802 Fax 631-765-9502 axzM" W" SCTM` Date;. Owner' ZSY C� 7 �l Hamlet;, 'Soo��O Address,ulslble from streets l �"' LEVELS SUB` � ,� ', �. ,,,, 2 ,, �3, Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits mooll- BEDROOMS 5` Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows) (Y/N) BUILDING SYSTEMS CONDITION OF PROPERTY IN 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 POOLSY/N POOL BARRIERS Y/N resent Pool present Pool is completely enclosed Pool surface alarm and/or door alarm ,Barrier is a min. 48" high POOL GATES Y/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 —Lic c, rI ,V Town Hall Annex NOV 0 Z121 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 I!ii$IUIIIL..L:�'p�c;; <.!fpT Southold,NY 11971-0959 TOWN OF SOU BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit f Pro esslonase al required for Architect or Engineer,licensed Home Inspector must provide l ctivil: co o �rfrlr_ I,rrr �al certe r �i ., ......... .__. Rental Property SCTIVI Number: _...� ... _ .., � Rental Property Address: _ fir _ -� Owner%Name: ....... .—®fir �` -_ Rental Dwelling Unit Identifier: e Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq., Bedroom#2-90 sq., etc.) ........_ ............................1-111-111-11 --- -._..._- ......... ..... Property Description (include all improvements indicated on survey) .....n ........... — _ . . ...... _, - .... ._.... ..... I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. Print Name and Title a L A-- Original Signature Please place professional seal: OF TOWN OF SO T OL Rental Permit - �Ar Permit No. 0224 Owner 300 Fanning Road LLC Occupied as Single Family Dwelling Located at 300 Fanning Rd New Suffolk 117-6-1 Address S/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. 11/19/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times r Nov 1 5 -�h R11 Town Hail Annex �, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOILD RENTAL PERMIT APPLICATIONp Rental Permit Fee$200(Application must be renewed every two years) , Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION k �-BLOCK, --LOT>- SECTION . OWNER INFORMATION: Property Owner Name: P. �cx� kms. ,4- C rk 0ys_< Property Owner Legal Address: Property Owner Mailing Address: 0 .� Telephone Number(s): Daytime9 98\ Evening Emergency 9 k�k �Alc) Property Owner Email Address: _moo is,. < � �_ Page 1 of 5 J\ qq 1 Town Hall Annext , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 7 Southold,NY 11971-0959 � w Y`4 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 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: Requested Maximum number of persons allowe LLto occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit Page 3 of 5 Town Hall Annex ��a1 Telephone(631)765-1802 54375 Main Road 9 Fax(631)765-9502 P.O.Box 1179 All- Southold, 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. I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION . DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I /J Co� As Ts � F 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 "y Telephone(631)765-1802 54375 Main Road �� Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 rIT 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: Y)U- �2n Property Owner's Signature: Sworn to before me this 1`day of��ew h < , 20kR Official N alc ignature and Original Notary Stamp =Public TT KUSHNER tate of New York6366666ssau Countypires Nov 6,2021 Page 5 of 5 VlWL �t TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPEC TION ] FOUNDATION 1STROUGH PL13G. ] -FOUNDATION2ND INSU T'I I UPC L Ih1 FRAMING /STRAPPING C ]�NALf :�t FIREPLACE I Y - FIRE F' TY INSPECTION [ FIRE'RESISTANT CONSTRUCTION • ] FIRE RESISTANT PENETRATION ELECTRICAL ( ) [ ] ELECTRICAL (FI `L) CODE VIOLATION [ ] PRE C/O I� Zo 6 �e to v CN j Qa 04 LM w1w. .21 4 014 mi IN 14 ,we 50 , . x Ln CE 1 7-1 cr or X w t M Ln 70 —m—.- _. 00 ,., r Ln m m G O k" m d IC -{ �h. D D m < !� m '"' D � Ln e m i c� N I D m o � W � __. In 1r k 01 m � µ I ti. k N f ry r m , CA µ CD W m .n , CD _..-,.---,m..,.,.,m.....___�...... ......... ....._._ ❑ x x pp x CD CD o ❑ , p ¢❑ y �o l"5%„ :3 "a„ i I - h� lµ, I 1 4' 0 Z� n m t n x c O ro rn c ❑ o p ro O ❑ 1 _ WtlVVllrsSl nw�. :w+awnxu ...rm ..w- - T � j I n O �. I , J t I .� ...... ..... �:v ... L9, I s, O 0 S 1 I 1 � r 6 I n o f.. ". FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z. -6.8 51 . . . Date . . . , , . . . . . .• �n i�l 1 3 19��? THIS CERTIFIES that the building located at AUC Street Map No. . . . . . . . . . . . . Block No. . . . . . . . . . .Lot No. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . , . . . . .�0 G. . .f. . . . . .. 19 7>" pursuant to which Building Permit No.9.1.6.0Z_ dated . . . . . . . . . A U 6. - A k. . ., 19:1.15-1 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 . . A. . . .y •1.vA.i The certificate is issued to . .j J,1 V.N. . .6% . . .Ih,a�,�. . . .�h/��.I: �. (N: r I S H L �'�. (owner, ; of the aforesaid building. Suffolk County Department of Health Approval N . .1.9`. ( .97 6. . . R,F. UNDERWRITERS CERTIFICATE No. . . . . .LTJ . . .9.6.3.r 44 6 . . . . . . . HOUSE NUMBER . . . . . .:30.0. . . Street . .F-1 t, tit�.tilt r_rm. R . . . . . . . . . . . . . . . . . !�.e.w . . .0 t=ro 1-1�. . . . Building Inspector