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HomeMy WebLinkAbout1000-128.-2-20 r= TOWNOF SOUTHOLD 3 Rental Permit � 0356 Owner Minton TG Family Trt. Occupied as Single Family Dwelling Located at 5194 Peconic Bay Blv Laurel 128-2-20 Maximum Permitted Occupancy 4 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 10/18/2022 d E �r�c �ri) This Notice must be posted by the main entrance at all times f4ptlit�PLOBU(IALtING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1STROUGH PLBG. ] FOUNDATION 2ND INSULATION/CAULKING FRAMING1 STRAPPING [ ] FIREPLACE & CHIMNEY [ ) I I I [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN ATION ELECTRICALI FI CODE I [ RENTAL _ J�JA o - DATE 0 INSPECTOR TOWN OF SOUTHOLD Rental Permit Permit No. 0356 Owner Minton TG Family Trt. Occupied as Single Family Dwelling Located at 5194 Peconic Bay Blvd. Laurel 128-2-20 Village S/B/L Maximum Permitted Occupancy 4 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 10/24/2020 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.l3ox 1179 Southold,NY 11971-0959 7-7 BUILDING DEPARTMENT TOWN OF SOUTHOLD SEP 9 2019 R LiL,PERMIT APPUIC.ATIQN y Rental Permit fee$200(Application must be renewed every two years) T`OVIN OF 9 C ZOOJ Section A. Property Information: Rental PropertyAddr�-�- /-QU.�(f /V r .5 t,-9V-_ t-�Ute 1 Tax Map Number: 1000 SECTION /07Cf -BEQiytf_ -LOT SECTION B. OWNER INFORMATION: Property Owner Name:- ��� / —7rrleLry c 7r -fr Property Owner Legal Address: Property Owner Mailing Address: 8ws ,34-7031 s. s�tg3 $a ! Telephone Number(s): Daytime _. p Evening-_ _Emergence 5. Property Owner Email Address: i a° �• �'a � - too Page 1 of 5 �l y� Town Hall Annex Telephone(631)763-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1170 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. 'a Authorized Agent information: Name of Authorized Agent of dwelling unit If any.-, -- -• • - Address of Authorized Agent(no P.O.Boxes):- S WexP Y`e.. P� Mailing Address of Authorized Agent: Telephone Number(s):Daytime 2l2•� • �gEenin 941;-Emerrgen�q 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 Emergenq 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 Ei Town Hall Annex Telephone(631)765-1802 54.175 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY It 971-0959 BUILDING DEPARTMENT TORT OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s):Daytime Evening Emergenqt 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(far example, Unit 1, Unit 2,Unit 3 or Apt A, B,Q the use of each room in the Rental Dwelling Unit (for example,Kitchen,Bedroom 1, Bedroom 2, Luing Room)and the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: C o �` Requested Maximum number of persons allowed to occupy Dwelling Un' Number of rooms in Rental Dwelling Unit:—J Use and Dimensions of each room in Rental Dwelling Unit:- Page nit: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 �pUot BUILDING DEPARTMENT TOWN OF SOIITHOLD 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 Buliding Code Council. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official N from the Town of Southold I am submitting a completed Town of Southold certification farm 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 / �io3 (�• D'Y! `�;Certify under penalty of perjury,the following: 1. 1 am the owner ofthe property identified in"Section A"of this application. F . ry 2. The property owner's legal address set forth In "Section B"of this application is my legal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 Town Hall Annex Telephone(631)765-1802 54373 Main Road Fax(631)765-95M P.O.Box 1179 Southold,NY 11971.0959 - 9 BUILDING DEPARTMENT TOWN OF SOU MOLD 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:_ —1h 0 M A IT ri Property Owner's Signature: 4. - A. - K...�.^ . Sworn to before me this,„day of S.p,04e&b&,-20/9' MATTHEW J SULLIVAN Notary Public,State of New York Qualified in Dutchess county No.01SU6221145 Official Notary ublic Signature and Original Notary Stamp MY commission Expires 05-03-20-01 3 Page 5 of 5 i SO,°" TOWNF 4 SVSD # # OUTHOLD BUILDING DEPT. S °`ycnuun,N�' 765-1802 INSPECTION . [ ] FOUNDATION IST [ ] ROUGH PL13G. w [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] Ft9ALp 0pou � V [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: (c)Gtil/' DATE INSPECTOR soar o� o . # # TOWN OF SOUTHOLM BUILDING DEPT. coum, 765-1802 INSPECTION . [ ] FOUNDATION 1ST [ ] ROUGH PL13G. R [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ INAL -[ "] FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION ' FIRE RESISTANT-CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REM KS: nn vmti �S 414, + "Vv/ t4 ep 1 DATE INSPECTOR luf F(r)l DN ------------- --------� � � Us I I BAT44 I 5 0 BEDROOM #2 I x x I 14' x 13' LN I x -100 5.F.) I U d $ I I I I I GL GL I I L——————————————— I P I J i I I a I I u a a 6 I I U II SECOND FLOOR PLAN SCALE. Y"-1'-0" 4 I I t L------------------� Dewn By � RIIM D.t. 1 7/e/Iq D.—gN.OP 9 2 1 3}IPPT9 l\ CL D F U G v O O O RANGE F WzWzWza " o BATH OF7 x a LIVING ROOM d < BEDROOM *1 16° x 17• U °m 11m x 12" (316 KITCHEN _ a oso S.F..) UP REF Q° x 12' GL (131 S.F. 05D/co O SD _ SD - —• CLO w a � ' o U o PORCH w UNCONDITIONED 3 SEASON U ' z P-4 FIRST FLOOR PLAN a SCALE- Y4"-I'-0" i D.-By r� 7/OI/19 3 DmwlagM ��OP SHEETS � �V r r——————————————————————————1 F f ---------J w UP I a� BASEMENT I MEGH. UNFINISHED I I I _ I I L---------------- - ' I ------------------- I I pO U i I I , I I w o I SASE1"TENT PIAN 01 I I I I i I I Dm-Br --------- DWe I Dm.[.SNa ,F 3 , 55 yyt f�5 OF SHEMS 1 c TOWN OF SOUTHOLD PROPERTY RECOR� 7/a5j 13 J- Cc OWNER STREET VILLAGE DISTRICT LOT M61AN thii-Aivi FORIOER OWNER N E ACREAGE -A 13 W TYPE OF BUILDING De -i, dfl 4a lb 7 RES. 2- 6 SEAS. j VL. FARM comm. IND. CB. I misc. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS 30 o C) Soo Z4 to C, 0 C-1 3 6 J 7 122-1� 73Z D. P-olz 2-V--D AGE BUILDING CONDITION 13b0l0l-L (Q"a3 6D Man/ rol-n6l) le-vnfov- Zss, �- NEW NORMAL BELOW ABOVE ' FRONTAGE ON WATER Form Acre Value Per Acre Value FRONTAGE ON ROAD Y, Tillable I BULKHEAD Tillable 2 DOCK Tillable 3 49 D Woodland Swampland Brushland 1-P House Plot Total 1J. .i �1. .. L I ve L' I Lai r3 M. Bldg. .-B X © L�� � b Foundation C Bath Extension X45 � 3 �/ = l �z � � j Basement 0 Floors Extension Ext. Walls C �/ Interior Finish 1� Extension ; Fire Place IV61 Heat Porch! /� / Roof Type F ---------�--� -��".._�--- � x, 3 f! Porch Rooms l st Floor ---- Breezeway ! Patio Rooms 2nd Floor I — Garage Driveway Dormer 0. B. i r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No_ ..`�a.. .�1�......... Date ............................Play..19................1958... THIS CERTIFIES that the building located at8/8..P?econ;j.io..Ba ..Blvd................... Street Map No. - 0 111 . ... ...., U%a- .... conforms s stanti y to the Application for Builds Permit heretofore filed in this office dated ...... . ................19.57.., pursuant o which Building Permit No ...Z..17............. f dated .... ..............03IMP.....1 ...19 0/..., w issued, and conforms to all of the requirements of the app icable provisions of the law. The oc pancy for which this certificate is issued is ............ ......................... ........................T'ar '........DC kf P4LLTNG..................................................................... This certificate is issued to ....F...Dodlald.•Hart........(..o4Tnter.).............................................. (owner, lessee or tenant) of the aforesaid building. 1 i ri Building Inspector i S � FORM NO, 2 TOWN OF SOUTHOLD BUILDING DIEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLATS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Na. .. ,.. t.............. Date .....................j1hi�w.1,19,"'x.............19......... Permission is hereby granted to: ................................................. . glw... ............................................. to ;-press-'eta ...&M. "" ar .. ... ► � � �a,•• .••tn1 ................................................ t premises located at .Btaev vd- ...................................................... .... ........ ..... ............................. . , s $: ................................I......................... ................. .............I............. ....................................................................... .................... ................................... pursuant to application dated .•.•••..•.••. •••••• •••• •••• ......•••19..x.. and approved by the r Building Inspector, �. Fee $...5*.QQ.............0aid ®� C Building Inspect0 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerks Office Southold, N. Y. Certificate Of Occupancy No. .Z7 . . . . . Date . . . . . . . . . . . . . . Aug. . .3o. . . . .. 19. ,7,7. THIS CERTIFIES that the building located at P.eoonic .Bay. .B1Yd. . . . . . . . Street Map No. xx . . . . . . . . . Block No. .xx. . . . . . .Lot No. . xx. . . .L8ur,a1 . . 1.- •, . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . .Nov. . .22. . . ., 19.76. pursuant to which Building Permit No. •8978Z dated . . . . . . . . . . . .lox .22. . . ., 1976. ., 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. .one. Waily.dwelling. . .with Addition. . A.alto ration. . . . The certificate is issued to .Charle s. Minton. . . . .Owner. . . . . . . . . . . . . . . .. . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .4!R! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. pending. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . 190 . . . . . . . Street . . Great -Re conie. Bay.Blvd.. . Brutal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building for ��g�FfO(�COGy Town of Southold 10/24/2020 0 P.O.Box 1179 53095 Main Rd oy�01 �a0� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41557 Date: 10/24/2020 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 5194 Great Peconic Bay Blvd, Laurel SCTM#: 473889 See/Block/Lot: 128.-2-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/9/2020 pursuant to which Building Permit No. 45274 dated 10/2/2020 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"unconditioned three season room addition to an existing two bedroom one family dwelling as applied for per ZBA#7388, dated 7/16/2020. The certificate is issued to Minton TG Family Trt. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45274 10/21/2020 PLUMBERS CERTIFICATION DATED Au o ' e Signature