HomeMy WebLinkAbout1000-61.-4-28 � - TOWN OF SOUTHOLD
Rental Permit
s
0170
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. B
Located at 475 Youngs Avenue Southold 61.4-28
Maximum Permitted Occupancy 2
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.
6/3/2024 ---y4w*�>�
Coke f cement o cil
This Notice must be posted by the main entrance at all times
All
TOWN OF SOUTHOLD
e Rental Permit
0171
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. C
Located at 475 Youngs Avenue Southold 61.4-28
Maximum Permitted Occupancy 3
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.
6/3/2024 1*4;>�
Code Ef ree t Official
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD
f Rental Permit
0172
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. D
Located at 475 Youngs Avenue Southold 61.4-28
Maximum Permitted Occupancy 2
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.
6/3/2024 ;;��
Code Et rce nt Off ici
This Notice must be posted by the main entrance at all times
f4f so
TOWN OF SOUTHOLD BUILDING DEPT.
ca 631.765.1802 61- �Z-v2e
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [�ENTAL
REMARKS: /-lot
�
-fA p ` c
DATE �- 30�'� INSPECTOR
TOWN OF SOUTHOLDRental Permit
0172
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. D
Located at 475 Youngs Avenue Southold 61-4-28
Maximum Permitted Occupancy 2
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.
9/23/2021
Code Enforcement Official
This Notice must be posted by the main entrance at all times
SOUTHOLD TOWN Town Hall Annex
54375 Main Road
Rental Inspection PO Box 1179 Southold,
NY 11971-1179
Tel: 631-765-1802
Fax 631-765-9502
L
SCTM # Date
Owner Phone
Address VO UA Ade Zip
Hamlet ( Inspector
Address visible from street?
LEVELS SUB 1
Smoke Detectors (#-bedroom detectors excluded)
Carbon Monoxide Detectors(#)
Fire Extinguishers (#)
Exits (#)
BEDROOMS 1 4 5`
Smoke Detector Alarms (#)
Carbon Monoxide Alarms (#)
Egress (windows) (Y/N) LIZ
BUILDING SYSTEMS / CONDITION OF PROPERTY
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 YAP POOL BARRIERS Y/N
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
COMMENTS:
g
TOWN OF SOUTHOLDRental Permit
Permit No. 0172
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. D
Located at 475 Youngs Avenue Southold 61-4-28
Village S/B/L
Maximum Permitted Occupancy 2
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.
9/3/2019 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 ° ��
gr
$ 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: 14"51�
Eil
Tax Map Number: 1000 SECTION -BLOCS
SECTION B.
OWNER INFORMATION:
Property Owner Name: A) ..
o. A-0
Property Owner Legal Address: �operty Owner Mailing.Address:
m
Telephone Number(s): DaytimeG3 �5 , ening_.; ^ Lrr- Emergency Sc., Lr&-
Property Owner Email Address: T
Page 1 of 5
4,
Town Hall Annex a Telephone(631)765-1802
54375 Main Road ar° Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SO OLD
Section C.
Authorized Agent Information:
4
Name of Authorized Agent of dwelling unit, if :anY
t
Address of Authorized Agent (no P.O. Boxes): ' N6' "
Mailing Address of Authorized Agent: h
Telephone Number(s)�: aytime � nin�g ���( 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 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
r
°yMY � u
Town Hall Annex ;r. Telephone(631)765-1802
54375 Main Road �3 ;y Fax(631)765-9502
P.O.Box I t79
Southold,NY 1 1971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
a
Mailing Address of Managing Agent: -:�A (DO i\n rA h
p yt.
me
S �'a
�mergenc� ,,,�
Telephone Numbers : Da 11A---'.--9 t Evenin
Email Address: A-�C-rv�-- -�o�Y\
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 Unit: �
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: :Emi&ll Se-C.,
Z)k nrlPage 3 of 5
Town Hall Annex -; 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 ADDENDUM
Rental Dwelling Unit Identifier: ('� ( S'l� III
Requested maximum number of persons allowed to occupy each dwelling unit "
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed o occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
, °
Rental Dwelling Unit Identifier: t7i II
Requested maximum number of persons allowed occupy e" h dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Town Hall Annex gip' Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
4W h
P.O.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.
m 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)
1 � � cerify 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
m r»
Town Hall Annex 711Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 r
Southold,NY 11971-0959 41�,
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: VV41 1
��
Property Owner's Signature:
Sworn to before me this day of SUI 20I
w
{official Not Public Signature an Original Notary Stamp
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2Wa
Page 5 of 5
-Bunch, Connie 10—
.................
From: njp@tchamptons.com
Sent: Friday, Augiust 30, 2019 1L53 AM
To: Bunch, Connie; connie.bunch@ southol d.town.nyus SEP 3 2019
Subject: Basement smoke/carbon: 475 Youngs ave
r nT Nr;T)T"'
Connie
Attached is image of hardwired smoke/carbon combo in basement of 475 Youngs ave Southold
Applicant: Charles Horton house llc
Most appreciated!
Have a great weekend
Best
N
Ps please let me know when ok to pick up my rental permit and the electrical inspection report from Sean
Ty!!!
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Nicholas J. Planamento
Licensed Associate Real Estate Broker
'T. "A
TOWN OF SOUTHOLD BUILDING
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
T
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
/
[ ] FIREPLACE & CHIMNEY [v] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
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FORM[ NO. 4
TOM OF SOUTHOLD
BUILDING DZPARTMUT
Office of the Building Inspector
Town Hal1
Southold, N.Y.
UMRTBD
CZRTIFICWM OF OCCUPANCY
No S-23580 Date 30, _1995
THIS CERTIFIES that the building MULTIPLE
Location of Propert 275 YOUNGS AVE. i 2.75 HSCOM0 ST. BC.1.
House No. street Hamlet
County Tax Map No. 1000 Section al Block 4 Lot 26
Subdivision filed Map No. Lot No,
conforms substantially to the Application for, Building Permit heretofore
filed in this office dated L 22 1B I0 rsuant to which
Building Permit No. 4702-9 dated APRIL 22 1870
was issued, and conforms to all of the rmpirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ALTERATION 2 rAmy nwz=W UNITS To 3 FAKELY
DVfl&LLrNG URI" As PER zC011M BOARD Of "PIMA #620 D&= 12/5/53, *
The certificate is issued to awryLX3 b. NRLLGRAr a ADRIBURE B. OLIVUR
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTHM OF HEALTH API"' W/k-
UNDRRNRITERS CERTIFICATE NO. NIA
PLUMBERS CERTIFICATION DATED IA
*TSIB UPDATES CO i-3671 DATXD a= 21, 1970.
riAin no c cr
Rev. 1/81
VOM
NO.
TOWN Of SOUT"OLO
BUILDING DEPARTMENT
TOWN CLERICOFFICE
SOUTHOLD, W. Y.
CERTIFICATE OF OCCUPANCY
No. 13871............... Dote ........................ . ...... l..........,
THIS CERTIFIES that the building located at .. fl .. r............ Street
Map No. ............ Block No. .XIL............... Lot No. . .......fat MOIL.... a ....................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.......................................... ,...., Q.., 19.QQ.. pursuant to which Building Permit No. ?1t7.02Z...
dated .........................kp ..... .., 19..7Q.,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 ........
......�1, •• ..�..�..3... ".'��A.�#F..bY..A4t>�il��i..�i�S�4.. ... ."�:.4�...�Ppe4, . )
The certificate is issued to ....y ru.....DAM31............
. . RSC° ................... ..
............................
(owner, I or t)
of the aforesaid bonding.
House 27 0 mit; $t East ..
475 Yours
. ...... .....Blding..�.. ... ,,
STATE OF NEW YORK:
:SS
COUNTY OF SUFFOLK:
PHYLLIS B. MALJARAF1 residing at !->00 Goose Creek Lane,
Southold, New York 11971, being duly sworn deposes and says:
DepoHent is one of the owners of the residence on the
corner of Youngs Avenue and Mechanic Street,, Southold, Nov
York, forwhich an up-dated certificate of occupancy is
being applied for.
Deponent further says that there are three (3)
apartments in the residence and that there is a smoke alarm
outside the bedrooms of each apa ent.
yll�is B. Mallgr
Sworn to before me this AUCE
Pu .stal Yom
day of March, 1995. ManDONALD
o,4879351
ou i" yu oI a gun
tary
lic
21-mallaff
Southold Tcr4m Board of APPOalff -4- December 3. 1963
IMSOL
VEDthat H. Brochard. ^/
R. joseph
feet r be in heit granted
permission to erect a le t ground signelaac� s
on the service station zty o p* j eph
idO
i e Roado Seat l«d, New York. This sign is to be located at
lea&t 5 feet from any Property line.
Vote ofthe 804adl :« Mr. G ig is®
d Mr. Hulse,
rumLiC MEARMOm Appeal go, 7%45 P.M.
application of Marjorie H. Baker, y Avenue, Southold-
blow york
old-b . for as varUmee inaccordance with the ZOniRg Ordinance'
a tltla Section 300, Subsection 1, and Article, 11, Section
Gion to increase the y of hex h k*
202, for POrmis families- a Of rty at sidea nueo
thxem sera old.* New V=ko bounded north by C. FMuller, east, Youngs
Avenue, South by mechanic Street, and went by Charles sr.
fte id $5.00.
chairmanThe opened the 120axing by reading aPPIic&tIQ`n 90V
a V pace, legal notice of hearing, &gfid&vJt attesting to I
tS
Publication In the official nawapbp= and ir-4 to the applicant.
THE CUAUMMI is therePresent who w Speak
ftx this application?
LZrMATS p. SWCO, M., 1 think the application Should
be
sed 00 S tion 1007, subsection (a) Ictk ers the Board
in i discretion to e d inV use:
building. l think there is no question that the two family
Use
is n non-comforming and could tiaue& Also the proximity
of the 00h&ck building, Telephone COuqmnybuilding and other
business hnildingG in the areashoul^ era Into i r ti
ou-
Tag e _ in there anYOUt elua Present who '
*peakah" to
application"
1S $ 1 aSomof my nelgkgms are here and
Id be willing to speak in t0VOK,
`Rt leaft 15 01` s. Baker's neighbors red InJhVOt
o a applicatioli.
ScuthOld TOM board of Appeals -S- Decvmber S, 1961
*IM Cf1AMRMANj is there anyone pcesent who wishes to speak
&9ft1nst this a li,catto:i
(Where was no xesponse.)
TIM CHAIMMs This is certainly an unusual Case. We haVa,
granted two family uses In smmral other cases and have lost one
Of them is a higher tau=t. Howmer, the point you make in this
case of extenalon of a non-conforming use is a conclusive one In
this case.
TME CHAIRM Ut Is there anything further
(There was no response.)
After sti ti and i t " tete Board finds that the
applicant pre tly s a large home with; two family dwilins
units. This isa fottiag asa established prior to Zoning.
Sb* now wishes to ftpand the use to thrGe, twoUiGs. Under Axticle
X, Section 1007 (a) the1&Wful wsa of a building existing on the
effectivedate of the or y be continued, although such
use
d00s AQt Contom With the pran i, Of the ftdiraawe and
such use may be OXtended throughout the building Umfully acquired
Prior to said da
The 200xd finds that strict appliaatir�a of the ordinance
will Puodttre PrkertIcal difficulties os unMGC0M4&ry har4shIpI
the
hardshfp created is unique and Would not be shared by all
prtpertLes alike in the immediate vicinity of this property
din the ) and thO varSAncos obeenm the
Writ of the Ordivance and will not change the s Iter of the,
district.
On motion of Mr. Dill pie, seconded by Mr.iiulse, it Wes
PBSOLM t1tat rJo*ie ti. r, Youngs Avenue, Southold,
W granted permission to inetwase, the occupancy of her
house to' three ftmillef- This 0xPWIston shell be cmfined to the
-
in rior of the present dwelling.
Vote of the Boardt Aye*:- Mr. Gill pie, Mr. Grigon1s,
and Mr. Intl e.
' �tttTown of Southold 10/25/2016
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 38613 Date: 10/25/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 475 Youngs Ave, Southold
SCTM #: 473889 Sec/Block/Lot: 61.4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/21/2016 pursuant to which Building Permit No. 41009 dated 9/21/2016
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:
1Clb l 1IaC,TI ,C11 M 1 A IAI ( PAN :1C llml' , .
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41009 10-13-2016
PLUMBERS CERTIFICATION DATED
Authorized� .
Signature
Town of Southold
5/25/2018
; P.O.Box 1179
53095 Main Rd
,t Southold,New York 11971
CERTIFICATE F OCCUPANCY
No: 39665 Date: 5/25/2018
THIS CERTIFIES that the building FOUNDATION
Location of Property: 475 Youngs Ave., Southold
SCTM #: 473889 Sec/Block/Lot: G1.-4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/17/2018 pursuant to which Building Permit No. 42694 dated 5117/2018
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:
{, urel ,tic iccasti, ts ,arr°y 1 �icli�tg � e lc�
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
tl Wv"-st Ignatt:µa
Town of Southold 6/7/2018
P.O.Box 1179
53095 Main Rd
` le Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39664 Date: 5/25/2018
THIS CERTIFIES that the building ALTERATION
Location of Property: 475 Youngs Ave., Southold
SCTM #: 473889 Seclfflock/Lot: 61,4-28
Subdivision: Filed Map No. /sot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/17/2018 pursuant to which Building Permit No. 42693 dated 5/17/2018
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:
r Lim a rL gJ.E :�� Pia , 1--ij1�✓d wrellip as�P)1i1 ' 1or:::.
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
tA l?ri, d Signature_ _ _
Town of Southold 8/31/2019
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40667 Date: 9/3/2019
THIS CERTIFIES that the building OTHER
Location of Property: 475 Youngs Ave., Southold
SCTM#: 473889 Sec/Block/Lot: 61.4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/13/2019 pursuant to which Building Permit No. 44093 dated 8/23/2019
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:
as built"central air conditiolvi� as�p Ali .
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44093 8/26/2019
PLUMBERS CERTIFICATION DATED
�ulluoi•i�c�� , .° ��'o
Town of Southold
8/29/2020
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
�r
CER'riFiCATE OF OCCUPANCY
No: 41399 Date: 8/29/2020
THIS CERTIFIES that the building ALTERATION
Location of Property: 475 Youngs Ave., Southold
SCTM#: 473889 See/Block/Lot: 61.4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/9/2019 pursuant to which Building Permit No. 44299 dated 10/16/2019
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:
roof repairs ,-p qqe tee ex.isliz:� relliri as a lied for.
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Aut ori- xta .w
TOWN OF SOUTHOLDRental Permit
v
0171
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. C
Located at 475 Youngs Avenue Southold 61-4-28
Maximum Permitted Occupancy 3
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
9/ 321/ 0
Code Enfo nt Official
This Notice must be posted by the main entrance at all times
SOUTHOLD TOWN Town Hall Annex
" 54375 Main Road
PO Box 1179 Southold,
Rental Inspection NY 11971-1179
;;� Tel: 631-765-1802
3 r
� Fax 631-765-9502
SCTM # -- �,. Date o �
Owner GS.-
Phone '
Address 7 VVUAP Zip
Hamlet 5 11 0 ( Inspector
Address visible from street?
LEVELS SUB 1
Smoke Detectors (#-bedroom detectors excluded) , ..
Carbon Monoxide Detectors (#)
Fire Extinguishers(#)
Exits (#)
BEDROOMS 1 m 4 5
Smoke Detector Alarms(#)
Carbon Monoxide Alarms (#)
Egress (windows) (Y/N)
BUILDING SYSTEMS 1 CONDITION OF PROPERTY
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 d�
Y POOL BARRIERS Y/N
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
COMMENTS:
W "' "To NLL'
TO N U O%jU HU U
�q &.5 Rental Permit
Permit No. 0171
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. C
Located at 475 Youngs Avenue Southold 61-4-28
Village S/13/1-
Maximum
/B/LMaximum Permitted Occupancy 3
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.
9/3/2019 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 01vH�t
BUILDING DEPARTMENT
TOWN OF SOUT OLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
- LOT � )
BLOI^4
Tax Map Number. 1000 SECTION __LA �,
SECTION B.
OWNER INFORMATION:
Property Owner Name: A - mm
._
Property Owner Legal Address: operty Owner Mailing Address:
w
r
Emergency.
Telephone Number(s): Daytime g
-
Property
Owner Email Address:
Page l of 5 ;, ��
� r
Town Hall Annex ;. Telephone(631)765-1802
54375 Main Road �y Pax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
r
�p k,
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); w
Mailing Address of Authorized Agent:
Telephone Number(s): DaytimeLM ve i�ng ,t Emergency
Email Address:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: — o'
Address of Authorized Agent(no P.O. Boxes):__,___
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
Town Hail Annex Telephone(631)765-1802
54375 Main Roads 9 Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959 r
A
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
t
Mailing Address of Managing Agent: '
p ( g..
934
Telephone Number
s)�: Dayt� me � � E nin -5 �mergency '1_
Email Address: w. AVI,
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 Unit:
Number of rooms in Rental Dwelling Unit: w°
rill
Use and Dimensions of each room in Rental Dwelling Unit: n
Page 3 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road �� Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 w 04
ou
BUILDING DEPARTMENT
TOWN OF SO HOLD
RENTAL PERMIT APPLICATION ADDENDUM
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to,occupy each dwelling unit100
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
2ka
en
Rental Dwelling Unit Identifier: �\ <<�,
Requested maximum number of persons allowed o occupy each
dwelling unit: IIIII
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier: Or, irc- e,
Requested maximum number of persons allowed occupy e" h dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
„w ,
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 r
Southold,NY 11971-0959 � "v,
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.
<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)
1 Au, M � 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
dd;J
Town Hall Annex Telephone(631)765-1802
54375 Main Road Y �, Fax(631)765-9502
P.O.Box 1179
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: 5 _
Property Owner's Signature:
Sworn to before me this, —day of 3U 20
O ficialNot�y Public Signature ani riginal Notary Stamp
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2bg,�)�
Page 5 of 5
Bunch, Connie
From: njp@tchamptons.com
Sent: Friday, August 30, 2019 11:53 AM
To: Bunch, Connie; connie.bunch@southold.town.ny.us SEP3 2019
Subject: Basement smoke/carbon: 475 Youngs ave
nrJ'x
Comic
Attached is image of hardwired smoke/carbon combo in basement of 475 Youngs ave Southold
Applicant: Charles Horton house Ile
Most appreciated!
Have a great weekend
Best
N
Ps please let me know when ok to pick up my rental permit and the electrical inspection report from Sean
Ty!!!
OT,
..........
wr
Nicholas J. Planamento
Licensed Associate Real Estate Broker
TOWN OF SOUTHOLD BUILDING DEPT.
PE T
765-1802
S C ON
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING
[ ] FINAL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[
]. ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
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FORK NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTIQNT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATUD
CKRTIF1CJ= OF OCCUPANCY
Ko 5- 3SBO Date Kuwa 10, 1995
THis CERTIFIES that the building T -
Location of Property 475 AVE. a ,775 C ST. N.Y.
House No. Street Hamlet
County Tax May No. 1000 Section 61 Bloch 4 'Lot 1 '
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for, Building Permit heretofore
filed in this office dated AML 23, 1970 psrsuant to which
Building Permit No. 4702-2 dated APRIL 11 1970
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 ALTZRMON To =M= 4 FAMILY DWREMM UNITS TO 3 Y
MMELIN0, UNITSPZR SONING BOARD OF APPRAIA 1620 DR= 13/5 63 *
The certificate is issued to PffiLLIS S. MRIZAMAY a ADRIZOM E. CMXVNR
(owners)
of the aforesaid building.
SUPFOLK COUNTY DEPARTMMIT OF HEALTH APP N/A
UNDZRWRITZRS CBRTIFICATZ NO. */A
PLUMBERS CERTIFICATION DATED N A
*THIS MMATES 00 3871 DhTXD JULY 21, 1970.
c
i szs ctor
Rev. 1/81
ram NO. l
TOWN OF OLD
BUILDING DEPARTM T
'TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. 8,71............... Date ........................ . Al........... 19.. . .
THIS CERTIFIES that the building located at »..;. IIiR ..ti............ Street
MapNo. �.............. Block No. AM............... Lot No. . .......amtb ..... ..e....................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
...........I......................I.......ftril....IN-, 19.10.. pursuant to which Building Permit No. 47027A...
dated......................... .., 19..170.,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 ........
The certificate is issued to .... ...........0=0Z...........................I........................
(owner, lessee or tenant)
of the oforesaid building.
How* 275 M00 trio St East ..
47 " Yaw ............. .,
.........................
iuildip.. ..tv�r
MA ..
T-W
STATE OF NEW YORK:
:SS
COUNTY OF SUFFOLK:
PHYLLIS B. KALLGRAF, residing at 500 Goose Creed Lane,
Southold, New York 111971, being duly sworn deposes and says:
ponentt, is one of the owners of the residence on the
corner of Youngs Avenue and Mechanic Street, Southold, New
York, for which an up-dated Certificate of Occ'upa'ncy is
being applied for.
Deponent further says that there are three (3)
apartments in the residence and that there is a smoke alarm
t
outside the bedrooms of each aP a en .
hyll s H. Haller
Sworn to before me this
ALICE Q MOODONAL
? Nom(Public, t to 4f Aittuw Yto
day of March, 1995. ft 4679361
7 _ 04ARti in tuffgfk Cbwnt
wt Ca mmtiia ian apires Doc,8,9
"tary Public
21-mallaff
Southold Town Board of APPORIN -4- vecember S. 1963
RESOL
Dthat H. Sr rd. a c . `ore. Wheeler be 93ranted
permUsion to erect a pole type ground sign 21 feet in height
an the servicer statiOn Prq;4rtY Of 'g. J00OPh
Wheel"'
northsi
middle, de
Road, southold, Thie sign is to be located at
le"t S feet from arty pz9PeXtY line-
Vote of the Boards A s:- Mr. GLUIspie, Mr. oxfgcnis.
and Mr. MISS.
e e �
VjMjC MARIM: Appeal No. 620 - 7 s 45 V.?L
Upou application of "arjocieM. Baker, youngS Avenue. Southold.
blow ycwk, for a varlimce in accordance with the Zoning Ordinance,
Article 111, Section 300, Sdbeectim 1, and Article 11, Section
242, for permission to increase the occupancy of hex how"O
than families. a of pr rty. west side Y+oungs Avenue.
Southold, New Yank, bOUUddd amth by C. F. Muller. east 96
Avenue, south by Mechanic Sts t, and west by Charles T r:
Fee paid b 5,00.
The Chairman o d the ho&ring by reading application
a variance, legal notice of hearing, affidavit attesting to ItS
publice,tion in the ofglcisl newspaper and notice to the applicant.
THE C a is there anyone Pc*seat who wishes to Speak
Lor this application?
F. E M. 1think the application Should
be
sed tion 1007, Subsection (a) uhich OIMPOwOrs thawBoard
in its discretion to extend a 4 use thr out
building. 1 think there is 00 questionUlat the two family use
t�"
is n non f in4 could continued' Also e p
of the whack buLlding, Tslapbone Company building and other
business buildings in the ase* shouldbe taken into congidsro&tion.
VkjE CHAIR Ys a anyone else pre sent who k s to
a ak for this application
MRS. WJLXWIU BA10 t: Somaof arty neighbMs are here and
would be willing to speak in r.
(At least 15 of Mrs- bakerag nei. rs appeared in ver
of %he applicatiOlf-
Southold Tom Board of Appeals -S- December S, 1961
TIM C 3 Is there anyone Pcesent who wishes to speak
against this a lication 1
(There was no .response.)
TME CHAIRMUz This is crtainly an unu0ual Cage. we haVe
granted twofamilY uses LA Several Other comes and have lost one
of thea in a higher court. However, the point You awake in this
case of extenslon of a nonce-a0nf*=1n`9 use is a conclusive one its
this case.
TIC CHA1RM S: Is there anything further
(These wam no rospmse.)
After investigation and inOVOction the Board finds that the
applimnt Presently has a large home with ily 11 9
041tS. This a non-conform1mg noe +es 1 hed priorto f
onr
S,be Dow wLshOs nd the use r g.
X' t ti 1007 l"a�h s wful a a buildings. r t l
eff tiv+e of r ycontinued, ting e
uch
e 6 t conform
on with k�: d
Of d
such U80 MY be extended throughout the building lawfully acquired
prior to said date.
The Soard finds that strict application oftheordinance
will u 1 Ufficultleg Or unnecessaryhip= the
hardGhip created d would, red by all
P"POCtles alike in vicinity of WS Vzoperty,
dIn thesam l bad the Variances observe the
spirit of the OW41inance and will not ch&ngo the character of the
dlstxLct.
On Motion of Xr. 0111 Pie. seconded by M r.bulse, it Weis
RESOLVED t1t4t r.) is U. Baker, o A ue, Southold,
Now Yorko be granted permission to increase the occupancy of her
house to throefamilies. This exPanbiOn Shall be con f ined to the
interior of the present dwelj ,
Vote of the boaxdo Ayes-- Mr. GLIUSPLO, Mr. Grigonis,
and Mr. nul e.
..........
Town of Southold 10/25/2016
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERWICATE OF OCCUPANCY
No: 38613 Date: 10/25/2016
..... ..........
THIS CERTIFIES that the building ELECTRICAL -------
Location of Property: 475 Youngs Ave. Southold
SCTM #: 473889 Sec/Block[Lot: 61.4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/21/2016 pursuant to which Building Permit No. 41009 dated 9/21/2016
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:
1-10()LA—.!"I!,I-I-'C—TRC F,,M -TFRSA —0-MATY-P3, L�UXIUA
,,,- JN
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41009 10-13-2016
PLERSCERTIFICATION DATED
4,7LI
Authorized Signature
5/25/2018
Town Town of Southold
P.O.Box 1179
53095 Main Rd
" Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39665 Date: 5/25/2018
THIS CERTIFIES that the building FOUNDATION
Location of Property: 475 Youngs Ave., Southold
SCTM #: 47188q Sec/ c aot: 61.4-28
Subdivision: Filed Map No. Lot No®
conforms substantially to the Application for Building Permit heretofore fded in this office dated
5/17/2018 pursuant to which Building Permit No. 42694 dated 5/17/2018
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:
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Town of Southold 6/7/2018
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 39664 Date: 5/25/2018
THIS CERTIFIES that the building ALTERATION
Location of Property: 475 Youngs Ave., Southold
SCTM#: 473889 See/Block/Lot: 61.-4-28
Subdivision:
it Map No. of No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/17/2018 pursuant to which Building Permit No. 42693 dated 5/17/2018
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:
r an existijig-flirce
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
•
A Ih ri, ed Signature
1f�t Town of Southold 8/31/2019
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
^i �yw
CERTIFICATE. IFICATE OF OCCUPANCY
No: 40667 Date: 9/3/2019
THIS CERTIFIES that the building OTHER
Location of Property: 475 Youngs Ave., Southold
SCTM#: 473889 Sec/Block/Lot: 61.4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/13/2019 pursuant to which Building Permit No. 44093 dated 8/23/2019
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:
'"as built"central air conditioning as applied for.
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44093 8/26/2019
µ— � ....,....
PLUMBERS CERTIFICATION DATED
utllorizecK :tttt :ze
,�fJ �Cy'FFMf� `
Town of Southold 8/29/2020
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
*X rrs
CERTIFICATE OF OCCUPANCY
No: 41399 Date: 8/29/2020
THIS CERTIFIES that the building ALTERATION
Location of Property: 475 Youngs Ave., Southold
SCTM#: 473889 Sec/Block/Lot: 61.4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/9/2019 pursuant to which Building Permit No. 44299 dated 10/16/2019
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:
root arairs_(in- lace to e .istirrg dwelling as applied for..
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
m g
tit oris �tnz-e
..
T ' WN OF SOUTHOLD
I- Aft
Rental Permit
0170
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. B
Located at 475 Youngs Avenue Southold 61-4-28
Maximum Permitted Occupancy 2
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.
9/23/2021
}
Code Enf event official
This Notice must be posted by the main entrance at all times
Town Hall Annex
SOUTHOLD TOWN
r - 54375 Main Road
Rental Inspection PO Box 1179 Southold,
ruiv
NY 11971-1179
Tel: 631-765-1802
Fax 631-765-9502
SCTM # Date S- 410 -
Owner G b T Phone 00 -dl
Address ( 7 9 UA P I Z'p
Hamlet S Inspector
Address visible from street?
LEVELS SUB _ 1
Smoke Detectors(#-bedroom detectors excluded)
Carbon Monoxide Detectors(#)
Fire Extinguishers (#)
Exits O
BEDROOMS / 4 5
Smoke Detector Alarms (#)
Carbon Monoxide Alarms(#)
Egress(windows) (Y/NI)
BUILDING SYSTEMS / CONDITION OF PROPERTY
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 POOL BARRIERS Y/N
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
COMMENTS:
3
g_ _a
W F T H U- L DN Rental Permit�
Permit No. 0170
Owner Charles Horton House LLC
Occupied as Three Family Dwelling - Apt. B
Located at 475 Youngs Avenue Southold 61-4-28
Village s/B/L
Maximum Permitted Occupancy 2
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.
9/3/2019 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 1179AA �
r
"oF
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:
..
60
Tax Map Number: 1000 SECTION
-BLOCK -LOT ,
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Address: �operty Owner Mailing Address:
p y Owner Legal g
Lac) JAC, ..
S '
Telephone Number(s): DaytimeG 9 ECveni �.f Emer envy r1
qk
Property Owner Email Address:
cj!
Page 1 of 5 ��
Town Hall Annex Telephone(631)765-1802
54375 Main Road 0 ` Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SO OLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: �.
Address of Authorized Agent (no P.O. Boxes): —Q "
Mailing Address of Authorized Agent: _µµwww ._
Telephone Number(s): Daytime % V`eningIT �w .A1v( 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 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
All
Town Hall Annex `J� ��; Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box I t79
Southold,NY 11971-0959 f
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: p
Telephone Number(s): Da Ime 94 , Evenlrl ' OEmergeney
Email Address: -
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: cica
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 Unit:i'
Number of rooms in Rental Dwelling Unit: ``��1A �
Use and Dimensions of each room in Rental Dwelling Unit: + '
I
Page 3 of 5
� P
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
J
P.O.Box 1179c �
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.
V, I 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)L\ ,
N,
Nrix L,,� ", cer ify 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
Pv f
V4
Town Hall Annex i Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 s I
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: , VAI), Vx xt.m ���
p Y
Property Owner's Signature:
Sworn to before me this. M y of � Vii' , 20 l C`
4Artr-QU Z ",i- U17 lke-A
r4
Oficial Not Public Signature an Original Notary Stamp
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2b�a
Page 5 of 5
TOWN OF SOUTHOLD BUILDING IG G T.
.1802
COO 765
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
r
[ ] FOUNDATION 2ND ( ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINALxe, k pzoy#�
[ ] FIREPLACE & CHIMNEY [ /] FIRE SAFETY INSPECTION'.
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP NT
Office of the Building Ins for
Town Hall
Southold, N.Y.
CERTIFICA79 OF OCCUPANCY
No E-23580 Date HARM 30, 1999
THIS CERTIFIES that the buildi MULTIPLE
Location of Property 4'7"5 YOUWS AVS. A 278 MECHANIC ST., X.T.
House No. Street Hamlet
County Tax Map No. 1000 Section 61 Block 4 Lot ZB
Subdivision riled Map No. Lot No.
conforms substantially to the Application for, Building Permit heretofore
filed in this office dated L 22 1970 ursuant to which
Building Permit No.
q 4'702-S dated APRIL 22 1970
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
Lesued is ALTZRATION 20 EXPAND 2 VAMY VOMMJJM UNITS TO 3 YAMILY
DWELLINGA8 PER ZORM BOAMD Or APPRUA 6620 DA'T'ED 12/5/63 *
The certificate is issued to PHYLLIS B. MMXXGRhr a ADRIENNE B.
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTKENT OF HEALTH APP S/A
UNDRRMITUS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED E/
*THIS UPUNT28 00 -3671 DATED, JMZ 21, 1970.
KiLdinq no or
Rev. 1/81
VOM NO. l
TOWN OF SOUTHOLD
BUILDING D "iL11T T
T CLERKS OFFICII
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. 2387.1............... Dote ........... ........... . ......At........... 19..x. ..
THIS CERTIFIES that the building located at ........... street
MopNo. ............ Block No. . ....... ..... Lot No. .. ....... ....................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
...............I............I............. ....in.., 19.9o.. pursuant to which Building Permit No. 47A??a...
dated..........................LpirU.......... ...., 19-7Q.,was issued,and conforms to all of the requirernerrts
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
The certificate is issued to .... or ....................................,,„„........
(owner, lessee or
of the aforesaid building.
Souse 27f Machanio St East
475 YatIA90 06
STATE OF NEW YORK:
:SS
COUNTY OF SUFFOLK:
PHYLLIS S. KALLGRAF, residing at 501 Goose Crook Laner
Southold, New York, 11971, being duly swore: deposes and says:
t�eponent is one of the owners of the residence on the
corner of Youngs Avenue and Ma panic Street, Southold, New
York, for which an up-dated Certificate of occupancy is
being applied for.
Deponent further says that there are three (3)
apartments in the residence and that there is a smoke alarm
outside the bedrooms of each a ent,
hy7lis B. .Mallgr
Sworn to before me this
SCE C,MacDONALD.
9 "Wfy Pu a bra,; fray York
day of March, 1995. , E
7 oua1WF8� .
z,,ff,11 'o,n
L'6 - asmtirrom� r � 909�
btary N is
21-mallaff
Southold Town Board of APP04291 -4- December 5. 1963
SOLVEDthat H. Brochard, a/c A. Joseph Nbeeler be granted
perm"Ision to erect a POIA type ground sign 21 feet in height
on the servicestation property of U, Joseph eel.er, north side
Middle Road, Southold, gew yack. This sign is to be located t
lesat 5 feet from any property line.
Vote of the Soards h s:- GLUisples Mr, axlejonis,
and . Hiner,
p,ZLYC HEARMG, Appeal no, 630 - 7:45 p.P4 (F..S.T. ).
Upon application of Marjorie H. makex,, Youngs Avenue, Southold.
mew Work, fora variance to 4cc0VdftnCe with theZoning or ce.
*xtic a 111, section 300, eubgsctLon 1, and AsUcle 11, Section
202, for permissionde ths OccuPftncy of hex house"
families. a of property, west Aside Youngs Avenueo
sou olds, New Yoxko bounded north by C. F. Muller, east by Youngs
Avenue, South by S , andwentby Charles Turner.
Fee d $5.00.
The Chairman Od the hearing by reading a I t for
a variance,, legal notice of hearing, affidavit attosting to i
publicationts
in the Official nOwsPaPtr and noticeto the SPP" nt.
THE CUAIMM, I& ther* onyaw present who wishes to speak
g" this application?
LZFMTS F. EDSON, M. Y think the application
based should be
on section 1007, S t (a) ubid, eopwasrs the soaz4
An its discretion to extend g use througUout
bui1ding. l think there is no question that the two family use
In n<3w non-conforming and could be continued. Also the Proximity
of the Uohack Wilding, Telephone coupany building and Other
business buildings in the azea shoul4l into cOnsid8ra
THE C Ys there anyone *Joe present who wiahes to
speak for this applications,
MRS. MIUMIS BAXW& Some of uly neighboas are here and
would be willing to Speak in ftv0v-
(At least 15 of s. ankeres nes. re appeared in fbVOt
o a applic t .
Southold Town Board Of AppOala .-3- December S. 1963
TIM Ck s Is there anyone Pcesent, who wishes to speak
agalast this a 1 tt r
(There was no xe nae.)
TVE CHAIMANx This is certainly an unusual case. We have
granted two family a in several Other Cases and have lost one
Of thOm Lt a higher court. Hiowever, the point you make in this
Case of extension of a use jA a conclusive one Ln
thie case.
TLC CHAIRMAN: is there anything further?
(There was no response.)
er, investigation and inspection the Board finds that. the
applicant pre tly has a large how, with ily dwIlLng
Units. Thin is anon:-Conforming Use es l d, prior to Zoning.
She mm Wishes c the use to throes. Under Article
X, Section 1007 (a) the lawful e of a building eKAstLnqe
effective ti Of Oc y be continmd# although such
e 4066 not conform with the of the 0x4jWaK.0 and
such U00 Maybe
. n d throughout e g fully atwu ed
prior to said
The Board finds that strict applivat1cm of the Ordinance
will Produce Practical dlfflcul,tjos OW Urmomagazyhip; the
hardship created Is unique and would not be shared by all
prApertles aljkg in the Imedlate vicinity of this property
d In the same use district, and the vaziance does observe the
spirit of the Or4inanced will nor change the character of the
district.
On "Otl(M Of Mr. Gill , GOCXM404 by "r.1jUlso# it Wag
RESOLVED that j is s3. Baker, youngg Avenue, Southold,
blew York, be granted V*rmisgion to increase the occupancy of her
house tO threefamilies. This 4xpaxision shall be conflne4 to the
Intexior of thepreaent dwelling,
Vote of the Saudi r- mr., Gill p . Mr. arigonia,
d Mr. Ltulsswwe.