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HomeMy WebLinkAbout1000-54.-6-6 TOWN OF SOUTHOLD a Rental Permit 0163 Owner Richard Rabatin Occupied as Single Family Dwelling Located at 790 Hickory Road Southold 54.-6-6 Maximum Permitted Occupancy 5 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. 9/28/2023 irm C nforcement Official This Notice must be posted by the main entrance at all times so TOWN N 8T OLD BUILDING DEPT. 631-765-1802 014� NECT10 mrim [ ] 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 VIOLATI N [ ] PRE C/O RENTAL DATE . INSPECTOR �� �c so TOWN OFt0eTHoZDJI1L.�►1N "" " 631-765-1602 IL a INv5PE T Io'mmb' N [ ] 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 jj<vRENTAL REMARKS,: lit C44-4 ;c4,- 40/ DATE INSPECTOR f4f so TOWN OF SOUTHOLD BUILDING DEPT. 621-765-1802 163, 1 Or"Im S P E(AD" T 10 N [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] 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 ,�,(` RENTAL C- 1,ecicr A 41'q 2z j -17 �u DATE INSPECTOR ,"D 81� Richard P. Rabatin 155 Norwood Ave. Port Jefferson Sta. 3 102 NY 11776-2553 Building Department Town of Southold Town Hall Annex 54375 Main Rd. PO Box 1179 Southold, NY 11971-0959 June 26, 2023 Re. Rental Permit Renewal fee: Home Dwelling at 790 Hickory Rd. Southold, NY 11971 Dear Sir or Madam: Enclosed, please find a check for$200 (two-hundred dollars)for the permit renewal fee. Please contact me to schedule an appointment with a Southold Town inspector for an inspection of the premises—also, if I can be of any help with any additional information. Thank you. Sincerely, Richard P. Rabatin 631-377-1821 rabatin2009@juno.com _1_ TOWN OF SOUTHOLD Rental Permit 0163 Owner Richard Rabatin Occupied as Single Family Dwelling Located at 790 Hickory Road Southold 54-6-6 Maximum Permitted Occupancy 5 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. 8/21/2021 Code Enforcement Official This Notice must be posted by the main entrance at all times k : � "'%' SOUTHOLD TOWN Town Hall Annex 54375 Main Road PO Box 1179 Southold, `exp Rental IIISpeCtlOfl NY 11971-1179 !, Tel: 631-765-1802 Fax 631-765-9502 Cate" «� ; I , 63 t' S(6 o s A" �Uthe" 14 tr i r s I�Ible�fr 'at�66t" ,iii i LEVELS Smoke Detectors (#-bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) BEDROOMS Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows) (Y/N) BUILDING SYSTEMS YIN CONDITION OF PROPERTY YIN 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 systern maintained/operational Handrails&guards present 11111. MEMO= (POOLS X/N POOL BARRIERS I Pool present Pool is completely enclosed Pool surface alarm and/or door alarm fLI Barrier is a min.48" high resent POOL GATESI 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 �x COMMENTS. y I ��4 "1 a 0 i 1,.` MAY 2 0 2021 Richard P. Rabatin 155 Norwood Ave. f i "Vr''. Port Jefferson Sta. NY 11776-2553 Building Department Town of Southold Town Hall Annex 54375 Main Rd. PO Box 1179 Southold, NY 11971-0959 May 16 ,2021 Re. Rental Permit Renewal fee: Home Dwelling at 790 Hickory Rd. Southold, NY 11971 Dear Sir or Madam: Enclosed, please find a check for$200 (two-hundred dollars) for the permit renewal fee. Please contact me to schedule an appointment with a Southold Town inspector for an inspection of the premises—also, if I can be of any help with any additional information. Thank you. Sincerely, Richard P. Rabatin 631-377-1821 rabatin2009@juno.com r. r0 000 0 r w 0 O r.+ (D CD O \ CLiu N O CA N r.+ 4 � �J fD O �10 CD 57, 3 D CLQ O � = N - C x v CD 0 �. o N N X O NX. S U) Q 3• o O Z 0. = 0 o c � Q- CD C 3 �• C:r0 3 `� l< CD m CD fD w Z o o O o s rDp Q@D O O < U) �- * UQ fD o O CD V J =3 O N m 0 n o �' CD CD 0 M f7 < �, CD w C °+ = = CD c CD fD Q Q CU W Cf) Q CL c C) m 3 o o c CU Cn m � ! `� 01 r ID M CD x CO o �+ O =3 cn W o L Town Hall Annex ��y� Telephone(631)765-1802 54375 Main Road " Fax(631)765-9502 P.O.Box 1179 t° �1,� Southold,NY 11971-0954 BUILDING DEPARTMENT TOWN OF SOUTHOLD R RENTAL PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two yeLs) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION 5.4 _M -BLOCK _6 _-LOT 6 SECTION B. OWNER INFORMATION: Property Owner Name: :. t ::,„w�, a � . .� I.L �...._ Property Owner Legal Address: Property Owner Mailing Address: f SS 1r IZL/tr,'0[> A )F -5..7"..7_.. Telephone Number(s): Daytime _ Evening Emer enr �-E Property Owner Email Address: � � �.=� � (." 'w )V nE � ►V1 _ ,,, Pagel of 5 Town Hall Annexa` Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 `� � BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. " Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ➢ wwN_' � wwwwwwwwwwww µ Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime ­ Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: .....i C k� Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergen y— ....... 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: w .ww ry aE Address of Managing Agent (no P.O. Boxes):M �„n y � n Page 2 of 5 06 �NJ, Town Hall Annex Telephone(631)765-1802 _54375 Main Road � P.O.Box 1 179 Fax(631)765-9502 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO HOLD Mailing Address of Managing Agent: r:> i b.;Jrt-3,-]`-1 -Lk:11 Telephone Number(s): Daytime Evenin ��� Emergency SA Email Address: t '--4 2 © c -Xd .., � 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: � ' q poccupy Dwelling Unit: Requested Maximum number of persons allowed to JJJ� I Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: -5 .a.. i r ° `d- ii 4�2a ° e�. L_ 1 r a '2 " � �� fI "', " i Fay d aC as Page 3 of 01` Town Hall AnnexTelephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 orFi 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. ❑ 1 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) IF�f� w�w � � � � w , 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 lM Mta ww Town Hall Annex -, Telephone(631)765-1802 54375 Main Road r t a�, Fax(631)765-9502 P.O.Box It 79 + m Southold,NY 11971-0959 uP d BUILDING DEPARTMENT TOWN OF 3O 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:.— fit„ ,� r � i ,t Property Owner's Signature: Sworn to before me thiO4 day of,�U.t/e . 20-0 r Official Notary Pu�-ic Signature"a Original Notary Stamp NANOY ORAbL Y 110 Y'Pi»BUC,State of New"fork No,4908224 u titled in Sutt()pp,µ(,a1rR I Ca nn tssicrs Expires s C ta( r Page 5 of 5 TOWN F SOUTHOLD BUILDING . 765-1802 INSPECTIONr [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] INAL4 `-� oftW [ ] FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING RE7 .. IM,_ j g!v rw k t5) "rl v 4vi 1� c'o CAI "r-6 � I DATE INSPECTOR d I ter' N t p I� mm ti SII �iw� i e o 1 " y y I � ® ... I 9 _ v Cot o En .I o y m d r N O ^ (1 En 70 �a d '� „ ��� D �, m yZ p ""'4"'41-til Aalittilex i 1 g� i I 5-1802 11.0. cox 11n7� . _, v i -.- �" adatilr;1.u 11'71 C�B�a�< _ Ln �� i ,'4 O ro �� D D — C" w r B1 I L C illi T P 'Ti�1 eN" 2 J Fo _ AH I 1O < C T o m r D m R it OH, rn, ._ w.�.. _..... ... _ wn —n < � c: < 0' �H..� m � O C Orn „ �,.r d. N m n f1 2 I z .� egad , ; ' y O r U �. r � � t� G ' G) IM m uoi H � L -, o; N rn w �A o A ��r u, CID �H Z w r v„. i i I x i I itis� 1 --1 '� O -o � Gl O_ W O ❑ N 3' ;r � a 7 (D fn v) mCID f r lrn N o i ) n CD -* CD ° O O O �� .r O q o n o W < _- ❑ m 1' ❑ N T I j .,......... „,, . , TI Tl u. O O S i DIif . �i If .� °,' w T :g'O'dd�°�1... m "* a l � x6 9d9k Z06 a r ZOS I-S”9L a ¢a' ro l - - � r pp r "yI�H- Z I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27502 Date: THIS CERTIFIES that the building NEW DWELLING Location of Property: 790 HICKORY RD SOUTHOLD ' (HOUSE NO.) (STREET) (HAMLET)Lo County Tax Map No. 473889 Section 54 Block 6 t 6 Subdivision Filed Map No Lot No. conforms substantially to the Application for Building Permit heretofore filed in this Office dated NOVEMBER 29, 1999 pursuant to which Building Permit No. 26259-Z dated JANUARY 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 DWELLINGAS APPLIED FOR, The certificate is issued to THERESA 'BAKER. (OWNER) of the aforesaid building. SUFFOLK COL'Q= DEPARTMENT OF HIRALTH APPROVAL R10-99-0129 12/14,/00 ELECTRICAL CEI2TIFICATB NO. 4054"5 12/'1.8/{7q PLUMBERS CERTIFICATION DATED 0 1B 00 $EI8A1D PI,UMS. IEr" T227a Authorized S` natureRev. 1/81 Richard P. Rabatin 155 Norwood Ave. Port Jefferson Sta. NY 11776-2553 Building Department Town of Southold Town Hall Annex 54375 Main Rd. PO Box 1179 Southold, NY 11971, 0959 June 23, 2019 Re. Rental Permit Application Forms: Home Dwelling at 790 Hickory Rd.Southold, NY 11971 Dear Sir or Madam: Enclosed please find: 1)A chek for$200.00 for the Permit Application Fee; 2)the five pages of Rental Permit forms (1 notarized)for a home unit at 790 Hickory Rd. in the Village of Southold, NY 11971, 3)the original CO in the name of seller Theresa Baker the original owner from whom I1the house, and;4) the floor plan with dimensions and location of fire and CO2 alarms. In speaking with a Building Department representative I would like to opt to have a Southold Town Inspector inspect and certify the inspection as checked off on the instruction page.To my knowledge there are no violations of the town code as of the last inspection re. smoke detectors and the CO2 alarm.As per the instructions they are visible on the floor plans. If I can answer any questions please contact me at 631-377-1821 or rabatin2009@juno.com. If not inconvenient for the town representative phone contact is faster. Thank you. Sincerely, Richard P. Rab atin 631-377-1821 F k !U N 2 9 2019 1 Richard P. Rabatin 155 Norwood Ave. Port Jefferson Sta. U ( 019 NY 11776-2553 Building Department ,. . Town of Southold Town Hall Annex 54375 Main Rd. PO Box 1179 Southold, NY 11971, 0959 August 2, 2019 Re. Rental Permit Application Forms: Home Dwelling at 790 Hickory Rd. Southold, NY 11971 Dear Sir or Madam: Most recently in the interim from June 23 when I sent in all the paper work re. my rent permit application until now, some new information has come to my attention.There are now 7 people living in the dwelling-- possibly 8. 1 will be asking the tenant for the additional people to vacate the premises. On page 3 of the Permit Request under the section, Maximum Numberof Person Requested, the number shall remain at 4. The inspection of the premises is scheduled for August 19, 2019 with the Town of Southold Inspector. If I can answer any questions please contact me at 631-377-1821 or rabatin2009@juno.com. If not inconvenient for the town representative phone contact is faster. Thank you. Sincerely to Richard P. Rabatin 631-377-1821 cc:Tenant 1