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HomeMy WebLinkAbout1000-110.-8-12 TOWN OF SOUTHOLD CA Rental Permit Permit No. 0385 Owner Hadley Wiggins & Daniele Marin Occupied as Single Family Dwelling Located at 405 Oak Road New Suffolk 110-8-12 Village 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. 2/16/2021 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times s { �pF1so Town Hall Annex . Telephone(631)765-1802 54375 Main Road Fax(63 1)765-9502 P.O.Box 1179 • �0, s Southold,NY 11971-0959 BUILDING DEPARTMENT JAN ® 3 z02® TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: qo5 D a lck"oaj New Svc l JL N " Tax Map Number: 1000 SECTION 1 I a ___;-BLOCK SECTION B. OWNER INFORMATION: Property Owner Name: '64 LE U�i Q U1 V-,S - !�q,Vi-/a— Property 1Property Owner Legal Address: Property Owner Mailing Address: Pb Box Go'6 New -7TGT F37 Telephone Number(s): Daytime 'GGS -evening Emergency 21 u 1-j2° 1-4-&15 Property Owner Email Address: kod 14 !L � C )r-) ffl0f)v> G mu,f C6 M Page 1&5 F'SQ� Town Hall Annex .>` Telephone(631)765-1802 54375 Main Road „N I Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ;i�%� x�.•.�a'�` BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Namof Authorized Agent of dwelling unit,If any: Address o Authorized Agent(no P.O. Boxes): Mailing Addre of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Secti D. Manag g Agent Information: Name of Aut orized 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 SITE MAN GER INFORMATION:(required for rental properties containing 8 or more rental units) Name of Mana ' g Agent of dwelling unit, if any: Address of Managin Agent(no P.O. Boxes):. / Page 2 of 5 Town Hall Annex i, Telephone(631)765-1802 54375 Main Road Fax(631)765-9.502 CO- INC P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing ddress of Managing Agent: Telephone umber(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: Una 00, Requested Maximum number of persons allowed tuQccupy Dwelling Number of rooms in Rental Dwelling Unit: pp Use and Dimensions of each room in Rental Dwelling Unit: I��clr;e/1 I o �c la 9-OQVIA11 � x ) IlC) 20 (b. V-4A-2 I X , la P�(2-4 35 IU�x 101 Page 3 of 5 1. Town Hall Annex 1 t Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 s! •ti` Southold,NY 11971-0959 C _4Um,: 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;bf 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. am requesting a fire safety inspection to`be performed by a Code Enforcement Official / `from the Town of Southold 1 ❑ 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) �LAA-v�, , 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 SOUT�p!. Town Hall Annex J~' ® Telephone(631)765-1802 54375 Main Road ,; } F Fax(631)765-9502 P.O.Box 1179 - .' Southold,IVY 11971-0959 Cp�,j�y;t BUILDING DEPARTMENT TOWN OF SOUMOLD 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: 4cA j � Y W I u I In S e HarrV Property Owner's Signature: � wt�1 UVLf�tJ i�w` r Sworn to before me this lay- ay of 20 L�O Official N Public Signature anA briginal Notary Stamp yER NOTARY PUBLLIIC,STATE @F NEW y91jX NO.01 DW63063oo QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30, o Page 5 of 5 © �o owe 5VR4 I Imo- o�NpF SOUTy� TOWN OF SOUTHOLDS BUILDING DEPT. - couto, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAUL'KING [ ] FRAMING /STRAPPING [ FINAL FIREPLACE & CHIMNEY [V] FIRE SAFETY INSPECTION [ ] -FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [= ] - ELECTRICAL-(ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: - - A / lll� (+_v A�� JA� cw cvSA o Lboc� �= DATE o INSPECTOR _ "Octr ,i -ilea iii 17 cyl is 1 U q �I 71 1 S " r a i�Te�'=ylti•��• ' 1 , 2 3�� ',L a ,, 11 1 _A7-- 7-7 -71 CW V-O0VV"- -Liza �r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28509 Date: 06/12/02 THIS CERTIFIES that the building DWELLING & ACCESSORIES Location of Property 405 OAK RD NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 110 Block 0008 Lot 012 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 28509 dated JUNE 12, 2002 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 FRONT ENCLOSED PORCH AND REAR DECK WITH ACCESSORY ONE CAR GARAGE AND SHED. * The certificate is issued to JOSEPH & JOSEPHINE FALLER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. ,,4 �' /"�Z' //4th ize ignature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 405 OAK RD NEW SUFFOLK SUBDIVISION: KAP NO_: LOT (S) NAME OF OWNER (S): JOSEPH & JOSEPHINE FALLER OCCUPANCY: MARY ANN FEAVEL JOSEPH & JOSEPHINE FALLER ADMITTED BY: SAME ACCOMPANIED BY. KEY AVAILABLE: SUPF_ CO. TAX MAP NO.: 110.-8-12 SOURCE OF REQUEST: ABIGAIL WICKHAM, ATTY DATE: 06/12/02 DWELLING: TYPE OF CONSTRUCTION: WOODR FRAME # STORIES: 2.0 # EXITS: 3 FOUNDATION: CONCRETE BLOCK CELLAR: 3/4 CRAWL SPACE: 1/4 TOTAL ROOMS: IST FLR_: 4 2ND FLR.: 3 3RD FLR.: 0 BATBROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S)- PORCH TYPE: FRONT ENCLOSED DECK. TYPE: WOOD REAR PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: KEYSPAN AIRCONDITIONING: TYPE HEAT: OIL WARN AIR: BOTWATER: X OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST_: ONE CAR WOOD FRAME STORAGE, TYPE CONST.: WOOD FRAME SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. I R]DV&R.KS: BP#28455 DECK CO#Z-28507 INSPECTED BY: DATE ON INSPECTION: 06/12/02 GARY J F H TIND3 START: 10:00AM END: 10:20AM