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Home My WebLink About1000-62.-1-12 Rental Permit g� Permit No. 0243 Owner Robeo Realty LLC Occupied as Single Family Dwelling Located at 55335 Route 25 Southold 62-1-12 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. 12/5/2019 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)765-9502 P.O.Box 1179 Southold,NY 11971-0959 "6 elm BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rentr , rt�ddr Tax Map Number: 1000 SECTION -BLOtl< —LOT J SECTION B. OWNER INFORMATION: Property Owner Name:.--- Property Owner Legal Address: Property Owner Mailing Address: So\ Telephone Number (s): Daytime Evening. Emergency Property Owner Email Address, Page 1 of S Town Hall Annexe', Telephone(631)765-1802 54375 Main Road ^R Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 1 97 1-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit if an �CJ`�� Address of Authorized Agent (no P.O. Boxes): X Mailing Address of Authorized Agent: S G1< Telephone Number(s): Daytime. Evening Emer en1Y Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.OXBoxes - Mailing Address of Authorized Agen Telephone Number (s): Daytime .Evening "Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental pro sties 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 Town Hall Annex C r" Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY l]971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent, __� Telephone Number(s): Daytime Evening_ Emergency. Email Address:J�— �4\ ` o 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, 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: �� S Requested Maximum number of persons allowed to occupy Dwelling Un" Number of rooms in Rental Dwelling Unit: is Use and Dimensions of ea ch room in Rental Dwelling Unit: Page 3 of 5 �P r Town Hall Annex `rr Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 a w Southold,NY 1 1971-0959 4 ("Outs Rk � 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 0 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 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 v4, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971 0959 y� 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: t Property Owner's Signature: Sworn to before me this day of .0ch ("- , 201q Official Not f� Public Signature and Uiginal Notary Stamp TRAU Y L. DWYER NOTARY PUBLIC,S TAT E OF NEW YORE: NO.01 DW6306n00 QUALIFIED IN Slit FO1.1Is COUNT COMMISSION EXPIR S JONE 30, Page 5 of 5 TOWN OF SOUTHOLD I L.. u° 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND INS LATI C U I G [ ] FRAMING /STRAPPING [ ] I L C ] FIREPLACE & CHIMNEY ' [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT-CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ( ] ELECTRICAL (ROUGH) [ } ELECTRICAL (FINAL) [ ] CODE VILATI [ ] PRE C/ REMARK lJ I h l6n�&w e M �fTn9rtra iPW ��aP i � i �x�4WFr4!rAu✓ 'SgL,i WLwF'g^k*kr m� ,r 4, f{f� Vrnnl?� 2W 2 N 1U1 Lt44P 11 _i T I r,.r R 4isW 1a q'pyM cmf5 jk• °i'th n� �� c �'ra+:, � .0 v a „`" !4J x�a dn!wR'✓}GrJ{p • y 11rJ'Eft }Wnw:LASG S ,pgs�, a{ v7�is�lyd�791(d+,w l{ � - Iuru.%.N.Putt fl"2 L"flK�fi a,r„r i s � eJw t�r,sdCzu�.u{[!',°�pFdr:r• 'Y(9-1x fl� w4ca b'•r-n —� .__. Y a^md Wwc w'a4 xr uti u�x raso na U rYTr NCL.Tbd,trvn.m5 cOMN Ny lopi �� '� }g,J•AMfbMY la Hatur UefW,"i�Et yHvEre t7 t;,' � �iVgW�'(U PinVaw aa�cl ytib� r�r r<Wfl6�+''_ I I ; a �..... {+on.nl(e✓a.:err tt.rrwtW. idtf W�cv B,1 iE7rr! � T ., C w h En IU{+ art b.T we VZ . � py r�Est rNon crcr{y.tuWr ELLF(kJi P 1 Nb E qa"q+a^ 5.k WP Mtn & W e�ua�p�xrr�. L 1 a I,� � I� ,uciar.Puwr';rv.�pe�c+raWsr.�aNa: C E u n m(q nhR s w� —.f�—�, 'wxl 7.,ia9 aia�cc.Weu'sj ccrJ'PaY,Nr nn tv{`fEfi GEI,IbR PI,G\f�f uaEu��^,�.�. s a ❑ ❑ ra Fri GO rD _ o- I� 3 ❑ ❑ � 1'7l i m �k w O G I ? s t IN � ❑ w C c i ro m I m I 0 co < m r O C 0 �u � µ n o r � o o D 0 m m O O Z Z f ,.e o; r J L x— 4 Y f e 1 II r III wuur ❑ N I � O Z O7 G� `'v F I k X �0 1 �. d oG;a J 1 V�i�� Cl) m � o e 3 s :3 za T, vl v fi 0 0 O Lo ,. ff m . _ --- P„�._._.. " M 44 a,m �d I __ ....... r -n m 00 —n x Q o n * an f1 O r _. ,.,.. 0 � f i j 1 � 00 w r � _ t.Ir O .,, r... .... - �......�. R , .,,,... ................. ....... .._-- ,,. T.,..._�--- _._- it N �mm ..... _ .m �.. m... CD „ ,. .. u { i TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YOPK CERTIFICATE OF OCCUPANCY NONCONFORAIING PREMISES THIS IS TO CERTIFY that the /X/ Land Pre C.O. #- Z13962 Building(s) Date- Oct. 2u5,1985 I�I Use(s) located at 55415 _ Main Rd. Southold --.� Street ..,. ._�m..........._.....�. .-....Hamlet - shown on County tax map as District 1000, Section 062 , Block 01 Lot 012 , doe<not)conform to the present Building Zone Code of the Town of Southold for the following reasons: Insufficient total area. Insufficient side & rear yard set-backs on accessory garage. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /X/Land /_/Building(s) /_/Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: Property contains a two story, one family, wood framed dwelling situated in the B-1 Zone with $Wo car garage with - access to Main Rd. (Rt 25) a state maintained road. The Certificate is issued to THOMPSON, ELIZABETH (owner, 1easG�en=1eEaaQ of the aforesaid building. p pp . Suffolk County Department of Health Approval - � N/A UNDERAVR.ITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes-and regula- tions. ;Mii ng inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No -17910 Date ,MARCH 30 1989 THIS CERTIFIES that the building ADDITION Location of Property 55415 MAIN ROAD S'OUTHO'LDD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 62 Block 1 Lot 12 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23 1988 --___pursuant to which Building Permit No. 17075-E dated JUNE 8 1988 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 ALTERATION TO EXISTING ONE FAMILY DWELLING FOR A RESIDENTIAL RENTAL APARTMENT ON SECOND FLOOR AS APPROVED BY ZBA 38 6. The certificate is issued to JERRY GAMBONE K KESTOTTS ZAPKUS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N UNDERWRITERS CERTIFICATE NO.—N-051524 - DECMMER 22 1988 PLUMBERS CERTIFICATION DATED 3 lb 89-INOATIONS PLQLuIBING & I"1'NG BE-1-ding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19863 Date APRIL 22, 1991 THIS CERTIFIES that the building' ,ADC11CION Location of Property 554.15 MAIN ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section fit Block 1 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUL'Y 24 1990 _____pursuant to which g 0, 10 Building Permit No. 19281,-Z date 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 HANDICAP RAMP ADDITION TO EXISTING STRUCTURE AS APPLIED FOR. The certif igate is 1 ds ed Nto SERRY QWBONI & KESTUTTS ZAPKUS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL, NIA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N A r 7--BU—A lding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.X. CERTIFICATE OF OCCUPANCY No Z-19867 Date APRIL 26 1991 THIS CERTIFIES that the building ±L"T9RA.TION Location of Property 55415 MAIN ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 62 Block 1 tot- 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 25 1991 ___pursuant to which Building Permit No. 19815-Z dated APRIL 26 1991 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 PROFESSIONAL OFFICEa RETAIL BUSINESS ON FIRST FLOOR OF STRUCTURE AS APPROVED BY PLANNING BOARD & ZBA #3896 The certificate is issued to GERALD GAMBONE & KESTUTIS ZAPKUS (owners) of the aforesaid building_ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A. UNDERWRITERS CERTIFICATE NO. N-051524 - DECEMBER 22 1988 PLUMBERS CERTIFICATION DATED N LA 9L ................ Building Inspector Rev. 1/81