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HomeMy WebLinkAbout1000-15.-2-5 TOWN OF SOUTHOLD co Rental Permit Permit No. 0334 Owner Robert & Monica Wyse Occupied as Single Family Dwelling Located at 1830 Greenway East Orient 15-2-5 Village S/13/1- Maximum /B/LMaximum 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. 9/2/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times r S0� Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 O Southold,NY 11971-0959 O BUILDING DEPARTMENT TOWN OF SOUTHOLD '• � '- ' 4�AA 1 3 �b�0 RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -BLOCK -LOT S - SECTION B. OWNER INFORMATIO Property Owner Name: ��✓' Property Owner Legal Address:* Property Owner Mailing Address: �30`7 h"j Sfkpt ft !�.L h9U)p skozV Apt kL Neu) yeak i 110 4 yr,P, rl roe pp Telephone Number(s): Daytimeq[I �� Evening9il-SST 20/Emergency •-�3q-,VD l Property Owner Email Address: (fr)im . 4 Page 1 of S b� , so 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 Section C. r Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: L'Ri'-' kc, i jr Address of Authorized Agent no P.O. Boxes):No I I a e- ion• g ( ) FAV a7►'r'�I•� �t�L L.s I-� � � 3 . `nl Mailing Address of Authorized Agent: U 1;-ek kCt.NL LAA WC -53 M, AL0 Telephone Number(s): Daytime 0° 719-6 ZZ Evening 174- ZLEmergency 4 1 711-0 �L. I 6 G iI� Email Address: Ri�Yka1 l'�i� i V6 kor Ct2l0 Section D. Managing Agent Information: k6if-d Name of Authorized Agent of dwelling unit,if any: iioi Address of Authorized Agent(no P.O. Boxes):U 'O k R.LkSfafz 1'0• sa Mailing Address of Authorized Agent:kP9�lr- 2&L e_ �nl 5��3 •/u�r� 1� J Telephone Number(s): Daytime&"3k-&&I-© 2 Evening 1d &- mergency 631-7W-NO- Email Address: e-iji',il e�1�,J � (� �h�6 n4 rr 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 Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 1 1 971-0959 C®UtVT� BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:1Zcri �lo�� �� � �� Awe I • �����. l���� I� Telephone Number(s): Daytime Evenin !1 h 2 Emergency �3VA110KtZ. Email Address: rd�t�� (A)oo C ,6,yA- 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." f Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: LP,J,eyo z0as -f wo As Used nd Dimensions of each room in Rental Dwelling Unit: Page 3 of 5 ' M Town Hall Annex Telephone(631)765-1802 54375 Main Road ` n` Fax(631)765-9502 3`t P.O.Box 1 179 y Southold,NY 11971-0959 l Cou 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 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) ' 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 SO Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Y BUILDING DEPARTMENT TOWN OF SOUTHOLD applicable laws and rules. I further acknowledge that I will notify the Town of Southold Building Department of any changes of address within five (5) days of any changes thereto. 3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and agreed to abide by the same. 4. 1 will notify the Town within five (5) business days as to any change to the information regarding Authorized Agent,AManaging Agent, or Site Manager. Property Owner's Name: VVIRza Wei Property Owner's Signature: Sworn to befor a thi day f 2� I uLnte ew Yorkffounty Official Notary Public Signature and Origins ry Stamp 49[M: 0 Page 5 of 5 OFsoUTyo� /y. o 6r-zftKA*lcw4 Oji - # # 'TOWN OF SOUTIHOLD-BUILDING DEPT. `��ournr ' 765-1802 = INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND , [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] NAL X&A-AatLl"', [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: Aft 4vwt! ! Diefw 41- c q) Fv dz pv!�-V" t DATE 7/16V20 INSPECTOR ire Cal is gs 4AV I x AV5 ol ,:_�_i�_i=:� 1 W 1,._"_.�'-S WZ14Y f' g-r i j.- edt.�i/+c+ •�s � � ¢ �. y ddd 'N r 3 - F ffFF y I r - � - 1 � -7/a7fDO) 3 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET J VILLAGE DIST) SUB. LOT b -f? MEN OWN N E ACR. vJd 9, no S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKSL/ Ek, /�/ � S' � 1 /SO � r V" �� „ • 0 Q� X44 Q /./i �f ✓r , n� c��l l l rile Lehr 1�4�a "/ O U S//6" 7-1` (, T t o ! s o 7300 -L 3 Ayt)ySC 5220 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre i Tillable 1 f Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD—�� House Plot j DEPTH `� `�' .✓ ... BULKHEAD Total DOCK i _ a "'x ,- "' •R.fit`' } s:,,e„ ■ ■■■■- rig ■■■ �:�■ ■■■/V■� EMMME■fir■ -� _rv�:, ._, . ` ■ ■ .■�-■�■■■i�!�■■c cam■■ ■■■r■■■■_■■■I1"MRIMM■■■i■I ■e■■■■■■■■■■ ■■■■■■ ■■■■■■■■I�■■■■■■■■■■■ ■■■ - ■■■■■■■■■■■■■ ■■■■■■ ■■■i■ ■■■■■■■■■■■■■■■■■■ • lnterioirFinish Hect Rooms lst Floor' Rooms 2nd Floa���= •��• � Dormer riveway _ • ti FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z637.1 . . . . . Date . . . . . . . . . . . .ftr¢h . . . 18 . . ., 19.75. THIS CERTIFIES that the building located at . .Greanvay. Bast . . . . . . . . . . Street Map No. GrJ Xar*flock No. . . . . . . . . . .Lot No, 26. . . . . . . ftiont . .1L*X* . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . .Marah. . 1 g ., 19.94 pursuant to which Building Permit No. 71212. . dated . . . . . . . . March . .2J. . . ., 19. 74, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .Private .oas. .family.dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . .Virginia.& Daisy . .dill . . . . 0Cners. . . . . . . . . . . . . . . . - I (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval _ Mar. 1.0.1$'15. . by-Rs. 1111a . . . UNDERWRITERS CERTIFICATE No. .1I204WI. . . . . Jan. . 21 . • 19' 5• • • . • • • • • • . . . HOUSE NUMBER . 1:630. . . . . Street . . .Greaway. Bast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bufldinginspector