HomeMy WebLinkAbout1000-70.-7-9 Tu"IN OF SOUTHOLD
Rental Permit
�g
0257
Owner Anthony Portillo
Occupied as Single Family Dwelling
Located at 48920 Route 25 Southold 70.-7-9
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.
--1 ---1 ')P4
3/6/2024 oz4x 44,
Code Enforfemo Official
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD BUILDING N
6 -765-1802
31
�U
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PTBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAt
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
[ ] CODE VIOLATION [ ] PRE C/OREMARKS: [ I
T"
To
DATE
INSPECTOR
Town Hall Annex
Town of Southold 54375 Main Road
{ = a Rental Inspection Report PO Box 1179
r= Southold, NY 11971-1179
► �a Tel: 631-765-1802
Date
.�
Owner w _._. __,,,_a_�, Phone
u..
4Address �fs f�0 ll�/lA•l�l� _.. ... . ....... 1m 1
4 Visible
Hamlet Inspector
` . s..
iFloor Level Quant�tles Sub 1 � 1 a...
2
SmokeDetectors;(not located in bedrooms
r _...... .._
� W .. ..._W'... ,. .....,... ���.._ .a�,...�� , �... ....,o.. ..� �.. �. �.
Carbon Monoxide Detectors _._ .. .,,..._
� � I
Fire.Extin Extinguishers
1
Exits
Bedrooms _ .. .
B . .... L i
Smoke Detectors
Egress
_.. .. , �.�.
g .4_. .
Occupant Count .,.
Building Systems Maintained & Operational Condition of Property
Heating IBuilding interior
Hot
water
r,
Building exterior
1-1-11-1.-.M-. .. . ..
Electrical Property clean, m
aintamed &safe
Mechanical -Handrails&guards installed &secure
Pool Safety i Pool on Site
Surface water alarm Date of CO issuance
Door alarmsPool completely enclosed
�...w. ��.��...,�. ..�a.,a�.�..,.�...... �ta.._�.... .... .o, �..N... .�.�_ _ .�_.
Self closing/latching gates Pool fence to code requirements
:O
fC0'sfor all items present Prior Rental�. mm�.�- ..._..... ... w..,.... ,.,
;Comments
..
4 't--- T 0 N U bUU HU Us `W& 0 #v%F Oft Aw' s ETR " " Lr%
Permit
0257
Owner Anthony Portillo
Occupied as Single Family Dwelling
Located at 48920 Route 25 Southold 70-7-9
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.
2/2/2022
Code>=nforc V nt Official
This Notice must be posted by the main entrance at all times
Town Hall Annex
SOUTHOLD TOWN
54375 Main Road
PO Box 1179 Southold,
Rental Inspection
�,i all NY 11971-1179
Tel: 631-765-1802
Fax 631-765-9502
° Z
SCT
�0 . �— ? -- Date /13
Owners Phone
Address - �� " i
°
Hamlet Inspector °
Address visible from street?
LEVELS S, 1 2 3
Smoke Detectors (#-bedroom detectors excluded)
Carbon Monoxide Detectors (#)
Fire Extinguishers(#)
Exits (#)
BEDROOMS
' 4 5
Smoke Detector Alarms (#) * f
Carbon Monoxide Alarms (#)
Egress (windows) (Y/N)
BUILDING SYSTEMSYCONDITION OF PROPERTY Y
Heating system maintained/operational Building Interior is clean/maintained .
Hot water system maintained/operational Building Exterior is clean/maintained
Electrical system maintained/operational V1 Property is clean/safe/maintained
Mechanical system maintained/operational Handrails&guards present
POOLS " Y ,,, POOL BARRIERS /
Pool present Pool is completely enclosed
Pool surface alarm and/or door alarm Barrier is a min.48" high
resent
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
® I tu AA PeJ Q UTa� I
.e
' r°
TOWN OF SOUTHOLD
Rental Permit
`x Permit No. 0257
Owner Anthony Portillo
Occupied as Single Family Dwelling
Located at 48920 Rt 25 Southold 70-7-9
Address 5/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.
12/23/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
1
Town Hall Annex ,� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 `t dap
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
NOV 20f9
RENTAL PERMIT APPLICATION
Rental e i ee (Application us renewed every two years) . d`
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION -BLOC SLOT q -
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
tei
.mm
Telephone Number (s): Daytime ( `' Ila' '%ening l a " )�mergency y��l�
Property Owner Email Address: (-
Page 1 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 1"
com
.�:
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 allowed to occupy Dwelling U °t:
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: - '` ( _ �Page 3 of 5
4
Town Hall Annex Telephone(631)765-1802
54375 Main Road f Fax(631)765-9502
�{ may„
P.O.Box 1179 �� sS,
Southold,NY 11971-0959
,z r,'M
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.
;W 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 H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
)
COUNTY OF SUFFOLK)
` � .A 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 `'� Telephone(631)765-1802
54375 Main Road x Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 `
COW
BUILDING DEPARTMENT
TOWN OF SOFT. OLD
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: N*a r 6
Property Owner's Signature:
Sworn to before me this_day of 020—
Official
20Official Notary Public Signature and Original Notary Stamp
Page 5 of 5
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1 ,,
FORM NO.
TOWN OF L
BUILDING
Town Clerk's Office
Southold, N.Y.
Certificate
No. . . . 6 , I . . . . Date . . .A . .St. 9. . . . . . . . . . . . . . . . . . 19 .7
THIS CERTIFIESthat the build' . . . . . . . . . . . . . . . . .. . . . . . . . ., . . . . ,
Location o e . 4. 20. . . . . . . . . 9 h//,V/ fSouthold
Houm No. . : . . . . . . . .
-Hamlet
County Tax Map No. 1 ion . . . .M . . . . lock . . ..?. . . . . . . . ..Lot . . . . . . . . . . . .. .. . .
Subdivision , . . . . . . . . . . . . . . . . .. . . . . . . . . .Filed Map No. . . . . .. . .Lot No. . . . . . . . . .. . . .
Requirements for a one family dwelling builtfor to
conforms substantially to the
Certificate of Ocoupancy
1 .7. .pursuant to whit No. . . . . . . . . . . . . . . . . . . . . .
dated . ,August, . . . . 1 . . . . . . . . . „ . . . 1 was issued,and conforms to an of the requirements
of the applicable provisions of the law.The occupancy for which this certificate is issued is . . . . . . .. .
. . . . . . . . . . . .e.F. . 1y. Dwelling. . . oce . . . . . � . . . . . . . . . . . . . . . . . . . . . . . .
Th
rry
e certificateto . , . . . . . . . .. . . . Lillian A L ori . . . . . . . . . . . . ..
oft the aforesaid building.
Suffolk County Departmento a pro . . . . . . . . . .. . . . . . N/ . . . .. . .. . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE . . . . . . . . . . . . . . . . . . . . . . . . IR. .. . . . . . . . . . . . . . . . . .. .
Building Inspector
Raw 4/79
FORM NO.4
TOWN OF SOUTHOLD
BUILDING
tce of the BuildingInspector
Town Hall
Southold,N.Y.
Certificate
No. .. . .. :.155 . . .. Date . . . ....December 23 .... .. ... . .... 19.. 6
THIS CERTIFIES thatthe building . ® Addition to exist ing dwell in
Location r 4892.0 ® ®ai ®Road Southold, N.Y.
H® . t ,t . ®. . .
. . . ...
County Tax Map
�lei
. 1000 Section . ..070. ..... 1 . .. . ?.. .. . . . .. t .. ...009.. ... . ..
Subdivision.. . . .... . . . . .. . . . . . . .. ... . . . . . .Filed Map No. . . ......Lot No. . . . . ... ... . . .
conforms substantially to the Application for Building Permitheretofore fed in office dated
November µ . . . .. .. .. . 85 ursuantt is Permit . J .4 n6Z . ,
ate . . .December ®11 .. ... . .. .. .. 19 . ? issued,and conforms to aft oft the requirements
oft the applicable provisionsoft the law.The occupancyfor which this certificate Is issued is ... ... ...
Addition tao existing one® ` ®
familydwelling.
. .®®®`® ®`Y ® ® ® ® ® ® ® ®
SHL
The certificate is issued t . . . XX.... .. .. . . . .. . . . . .
. ® + ars
of
the aforesaid '1 i .
Suffolk nt Department of HealthApproval . . . , . . . .�.N .A„ . . . . .. . .... .
CERTIFICATELfNDERwRrrERS . . . . . . . .. . ... . . . N763045. . . . . . . . . . . .. .. . . .. .. .... .
Plumbers Certification dated August 2 , 1986
, . . . . . .. .
.� il i cr
Rev.
FORK
.
BUILDINGTOWN OF SOUTHOLD
office Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE
: 2-26273 : 09/22/97
THIS CERTIFIES that the building ITIONS
Location of Property: 45.920 MAIN SOUTHOLD
("mm NO.)
(STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 7 Lot 9
Subdivision it Lot
conforms substantiallyo the Application for BuildingPermit
filed in thisi SEPTEMBER-221_1997 pursuant to which
Building Pei . 24452-Z 30 1997
was issued, and conforms to all of the requirementsf the applicable
provisions the law. The occupancy for which s
in POUNDATION UNDER EXISTINGONE rAMILY DWELLING & TWO 'NEW CHIMNEYS
AS APPLIED FOR.
The certificate is issued to SHIRLEY c DARLING
(OWNER)
of the aforesaid building.
ELECTRICALSUFFOLK couNTY DEPARTMENT OF HEALTH APPROVAL NA
T . B-062824 I./'14/59
PLUMBERSTI I TI T /
Building 'In ector
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-29401
Date: 04 '29 f-3
THIS CERTIFIES that the building ACCESSORY_
Location of Property: 48920 MAIN RD SOUTHOLD
(HOUSE NO (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 7 Lot 9
Subdivision ..-, Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 15 2001 pursuant to which
Building Permit No. 27923-Z dated NOVEMBER, 20, 2001
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 CCE SOR'Y G• GE AS APPLIED FOR PER ZSA X5'015 DATLO+ 10 25/01,
The certificate is issued to SHIRLEY G DARLING
of the aforesaid building. (OWNER)
SUFFOLK COUNTy DEpARTMEW OFEogALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1037982 d) f08/ '
PLUMBERS CERTIFICATION DATED N/A
..
Aut prized Signature
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-33929Date: 09/01/09
.�,.. ...
IS CERTIFIES that building ling AL""�""ERATIONS FIRE 1?EPAI'
Location of 48924 MAIN RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473.889 Section 70 Block. 7 Lot 9
Subdivision Piled p No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 3, 2009 pursuant to which
Building Permit No. 34594-Z dated APRIL 9 2009
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 ALTERATIONS AND 'FIRE 'REPAIRS TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to SHIRLEY G DARLING
(OWNER)
of the aforesaid building.
sUFMLIK COUNTY DEPARTMENT OF HEALTH APPROVALN/A
MLgCTRIrsr• CERTIFICATE NO- 09-3290 06/04/09
PLUMBERS CERTIFICATION DATED --. .N/A
_. "L.hrz,.d ,ttare
Rev. 1/81