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HomeMy WebLinkAbout1000-76.-2-22 TOWN OF SOUTHOLD Rental Permit XF 0278 Owner Caroline Fish Occupied as Single Family Dwelling Located at 5125 Main Bayview Rd Southold 76.-2-22 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. 6/3/2024 Cod Ergr rat Official This Notice must be posted by the main entrance at all times TOWN OF SOUTH LD BUILDING DEPT. 631-765-1802 INSiwr.CTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ F AL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: IDS. TOWN OF SOUTHOLD Rental Permit 0278 t�= Owner Caroline Fish Occupied as Single Family Dwelling Located at 5125 Main Bayview Rd Southold 76-2-22 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. 5/12/2022 Code Enforc Official This Notice must be posted by the main entrance at all times Town Hall Annex SOUTHOLDTOWN 54375 Main Road Rental Inspection PO Box 1179 Southold, ZL_ r NY 11971-1179 Tel: 631-765-1802 Fax 631-765-9502 WIN j�/j.- G���/1��///' ,/�,ii ilick Ulf j �ff�//�,�/��l i /�J✓�,�o/y %J/,�/ v\� C� o ��,l1►il�l�i;fi ;Ur,f:yflD//// //�rfl/ iiia,,/;W' LEVELS Smoke Detectors (# bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers(#) Exits (#) %// BEDROOMS i,,1%% ✓% r!2f„�lal � ; 31r, ,, ' „ , ;, 1 !'S, ,., Smoke Detector Alarms Carbon Monoxide,Alarms (#) Egress(Windows) (YIN) 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 POOL BARRIERS o” Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is aurin. 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 proofwhen `unattended COMMENTS: �osuFFoc,�co TOWN OF SOUTHOLD C* z Rental Permit a6 Permit No. 0278 Owner Caroline Fish Occupied as Single Family Dwelling Located at 5125 Main Bayview Rd Southold 76-2-22 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. 1/22/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times VS Town Hall Annex - Telephone(63,1),765-1802 54375 Main Road 41 Fax(631)765:9502 P.O.Box 1179 Y U i Southold,NY 11971-0959 NOY 20 2019 BUILDING DEPARTMENT -- _y_,,_,._ TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Re tal Property Address: N,5� Ma4, &MVfeW Tax Map Number: 1000 SECTION lip -BLOCK Z -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: r ,�-- Telephone Number(s): Daytimerr ,, Evening Emergency Property Owner Email Address: D�linQ,(O W19�1•� �✓V� 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 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION INSTRUCTIONS Rental Permit Fee $200 (Application must be renewed every two years), The.item� listed below are required to be submitted with the completed application. jFloor Plans: Floor plans of each Rental Dwolling Unit, please show location of all smoke&carbon monoxide detectors. la Certificates of occupancy and Pre-Certificates of occupancy: Certificates of occupancy or Pre-Certificates of Occupancy for each rental dwelling unit. M Certification of Code Compliance(form enclosed): Must be submitted by a license architect or engineer or license home inspector if an inspection by Town of :I Southold Inspgctor is declined. __ I V Rental Permit Fee: $200:90 I it o�t�pF SUplyQl ti d Town Hall Annex Telephone(631)765-1802 54375 Main Road 41 41 Fax(631)765-9502 P.O.Box 1179 • Q Southold,NY 11971-0959 Q Y rOUN�`(,Na BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: a ' 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 SOQTy�Id Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 1 197 1-0959 O UM`I 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 Unit: Unit: 11 Number of rooms in Rental Dwelling Unit: `tom 4- r9- !9OL. S o� Use and Dimensions of each room in Rental Dwelling Unit: kl hgo Vr Z 13eLQ.roow, 12 l S�'�>•edkn©� IV ng� Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-09594 ' 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 ❑ 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 Caro Vdf �, Y1 �yL , certify under penalty ofperjury,the following: Torn(the owner of the property identified in "Section A"of this application. 7._- ` The property owner's legal address set forth in "Section B" of this application is my legal ad& ss and I understand the Town will use the address for service pursuant to all r r - Page 4 of 5 ���o�sauryo Town Hall Annex , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ` a� Southold,NY 11971-0959 COUNI't+ ` 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: av-b Unit �iSk Property Owner's Signature: Savoro bef e m this 6d f . 20�1) ALAN L SOLMAN Official Notary Pub c Sig ature and Original Notary Stamp NOTARY PUBLIC STATE OF,NEW YORK No 01SO6385139 Qualified in New York County _ My commission Exply,ef12.24-2022- Page 5 of 5 - of so # # OWN 'OF SOUTHOLD BUILDING DEPT. `ycourm,��' 765-1602 INSPECTION [ ] FOUNDATION 1 ST [ ] -ROUGH PL13G. [ ] "FOUNDATION 2ND = [ ] lNSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] NAL� �� AW4� '�'� .. [ ] FIREPLACE& CHIMNEY [ , FIRE SAFETY-INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: -� - 1,> 0)(Iri 10) _5�)( uslov✓ OC(1006ACZ, DATE INSPECTOR FLOOR PLAN: 5125 Main Bayview Road, Southold NY 56' CAVILV c� (p x9 33' s� Ib o3% TOWN OF SOUTHOLD PROPERTY I 1911'6 RECOF � � _ - ---. OWNER J STREET �/ 2 5 VILLAGE DISTRICT SUB. LOT d $`a F( RME� NER � N E ACREAGE 6:7�r1 P ! Ors S W TYPE OF BUILDING -RES. Z/t SEAS. VL FARM COMM. I IND. I CB. I MISC. ( Est. Mkt. Value i LAND IMP. TOTAL DATE REMARKS Ll o '� o y t� o -L l� 3/- r� �o�s f�pisan -V O o 0 r _ 4f / to Eel 2(0 F-fir`' - z=- 2o-r� AGE BUILDING CONDITION NEW NORMAL BELOW j ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD ° Tilloble 1 BlA.1CkiEAD,,�y�FJ Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot r - Tota l f 4-71"londki, - - _ --- - --Ag AAAA 76-2-22 10/00 - X33 75 M. Bldg. 5 Foundation �C Ecth Z — Extension �8-X � -- ---- X 14 = Z."j•7 j Basement ! I Floors -• -1 ---- --- -- Extension ! j Ext. Walls (Interior Finish Extension - _- , Fire Place - '� f Heat 12 X t4 = 12S ' A Z Porch Roof Type LR A Porch ' Rooms 1st Floor - Breezeway Patio Rooms 2nd Floor Garage ! Z Driveway Dormer o. B. CAC FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27656 Date: 05109M4 THIS CSRTIFMS that the building NEW DWELLING Location of Property: 5125 MAIN BAYVIEY RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 76 Block 2 Lot 22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 24, 2D00 pursuant to which Building permit No. 26445-Z dated APRIL 10, 2000 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE AND COVERED ,FRONT PORCH AS APPLIED FOR. The certificate is issued to MICHAEL PISACANO (OWNER) of the aforesaid building. SUFFOLK COUNTY D$PARTmENT OF HSALTR APPROVAL R10-99-0233 04/12/01 ELECTRYCAL CER TIFIC= NO. 003079 01/12/01 PL•tJHIBERS CERTIFICATION DATED 05/09/O1 LAWRENCE J. -LISO c ho zed Signature Rev. 1/81 I Tovm of Southold Amex X0/2013 P.O.leoa 979 5075 Main Road Southold,Now York 3011 CERT CA TE OF OCCUPA N Pio: 36232 Yuri: 511t)l2D13 TMS COMM that the building AS BUILT DECK Locationon"pettYc 5123 KeinBayviewRd,Scasthald, SCY'tvT M. 473889 SecBkMLIM: • 76.-2-22 Subdivisbm +iii ad Mp No. t o. �— cuafozmssnbstoliallytod0Applicationfor DddMgFaMtk fora flied9utbis 0C A dated 3J2 M13 pmaAd to wbich Bwldkg Permit No. 37922 aw 4/8013 was issued,and conforms to all of the tuphmeuts oftbe appli-bkprovisiOns Of the law. MOCOV&try for Y&M Ws certificate is issued is: ,,As BiJIL.T"DECK ADD1T10N AS AM—=POIZ The Cel fg(cate is issued to lbuig,IOhn {BwNfiR) of thoafoTesald building, sUEBoLK COY NTN DEpARTmEn OF HEAaI.TH APPROVAL -- UMCTRICAL CERTMCATE N0. YLiTM[BM CEATMCATION DATE