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HomeMy WebLinkAbout1000-88.-6-13.4 TOWN OF SOUTHOLD
Rental Permit
Permit No. 0373
Owner Joshua Bronstein & Jason Canales
Occupied as Single Family Dwelling
Located at 225 Water Terrace Southold 88-6-13.4
Village S/13/1-
Maximum
/B/LMaximum Permitted Occupancy 8
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.
12/16/2020 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
S6
Town Hall Annex s °; ' Telephone(631)765-1802
54375 Main Road � , Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
UX,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
�RENTALVERMIT APPLICATION,
Rental Permit Fee$200(Application must be renewed every two Ea ,,_K.,- ,a �
D D
A 2020
Section A.
Property Information: BUILPITGDUT.
T(3 iTT"' Cv% „rt'77HOLD
Rental Proerty Address:
Te r
Tax Map Number: 1000 SECTION. Oo- -Bt-QCK_0 _ LOT -� V
SECTION B.
OWNER INFORMATION:
Owner Nae:
Property O m_
Property Owner Legal Address: Property Owner Mailing Address:
_:_�K
k
Telephone Number (s): Daytimeq// 73 Via 10 vening 173 Y' %mergency a L/
rb✓�5 �
5 O �®
Property Owner Email Address:_ ® - ,
` f ' 'Po Page 1 of 5
'Sov
Town Hall Annex �: �,z �`" 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: A)
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: A)IA
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 prop rties 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
U U
V- U ` r
�R -, irk
Town Hall Annexa, • Telephone(631)765-1802
54375 Main Road ������. Fax(631)765-9502
P.O.Box 1179 ,u, '�
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
. A) o.
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,.Q, 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: C kl— Q ?/ire^ c Ae--
Requested Maximum number of persons allowed to occupy Dwelling Un/_.
Number of,rooms in Rental Dwelling Unit:
Use and Dimensions,of each room in Rental Dwelling Unit-,-
/0/9
nit: _tc��� �
64
Page 3 of 5
•
" �
solm
Sel
Town Hall Annex , , Telephone(631)765-1802
54375 Main Road
Fax"(631)765-9502
P.O.Box 1179 °
Southold,NY 11971-0959rC® r tiyby
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
SECTION G.
INSPECTION:
J
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.
❑ lam 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)
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
Fa
Town Hall Annexr*, Telephone(631)765-1802
54375 Main Road ' ', 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. I 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:.
Property Owner's Signature:
4- I
Sworn to before e his �t day of R,I 20�
0fficiaL�Lotar.�c -t,�liG,$jg and.Qriginal Notary Stamp
= : DIANE F. KRAUSZ
Notary Public State of New York
ND2KR4929845
Date �P�l� �
Page 5 of 5
1 - . May 27, 2020
46rg so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 Q °
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Professional seal reaulred Lor Architecto,Ench-7-er, licensed Home lnsmdar must provide
copy of valid current certification
Rental Property SCTM Number:
Rental Property Address: 225 Water Terrace, Southold NY 11971
Owner/Name: Josh Bronstein
Rental Dwelling Unit Identifier: 'd,?-,S- QUA 7-.e rre-e
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.)
Property pDescripti n (Include all improvements indicated on survey)
S
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it
fully complies with all the provisions of the Code of the Town of Southold, the Residential Code
of New York State,the Building Code of New York State,the Plumbing Code of New York State,
the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New
York State.
Victor Cornelius III CEO Inspector
Print Name and Title ceo# 1216-0283 Original Signature
Please place professional seal:
�apF SOUIyO l/v<
# # TOWN -OF SOUTHOLD-BUILDING DEPT. ,
• b�
°`ycourrn,�' 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH-PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] NA440�
[ ] FIREPLACE.& CHIMNEY [ FIRE SAFETY INSPECTION,' -
FIRE
NSPECTION,„-FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL-(ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATE 10 INSPECTOR
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TOWN OF SOUTHOLD PROP
OWNER _ STREET 2_2 VILLAGE DIST- v SUB. LOT .7
i �"os�r.�.G.-�'�w•c +s�P:�n -` , r �, _ --'-- \ E _ zFt {F4L97-79
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�,✓ ACR. REMARKS
TYPE OF BLD. ,r
s Y� r► �Y'�S. �1 PROP. CLASS taO �tD I D L
lo
t , /c/mc/j jt] J' �3 Q "� � - v O �O/1 ►� t^� � 1U 2 uj e-l l r n,;
LAND IMP. TOTAL DATE �iaoJ 'FS- LiKizi n6p(pi _4,-,ah p
01 �� j ri►�t?, ac `« '�
F �� ab-L 13C71o"�a W��� �.nca�.�'t✓��✓o.-,-'�.n TC.�.-� `� �
y 54 a l ra t4nd SW
FRONTAGE ON WATER TILLABLE \`
FRONTAGE ON ROAD WOODLAND \
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
TOTAL
I
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.X.
CERTIFICATE OF OCCUPANCY
No: Z-26101 Date: 11/13/98
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 225 WATER TERRACE SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 6 Lot 13.4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 10, 1998 pursuant to which
Building Permit No. 24880-Z dated MAY 13, 1998
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, COVERED PORCH
AS APPLIED FOR & AS TO CONDITIONS OF THE PLANNING BOARD.
The certificate is issued to THEODORE & ANGELA LAOUDIS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RIO-98-0047 11/02/98 /
ELECTRICAL CERTIFICATE NO. 23073 11/11/98 (`
PLUMBERS CERTIFICATION DATED 09/18/98 G.A.H. PLUMBING & HEATING
Bu' ding fnspector
f
Rev. 1/81