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Home My WebLink About1000-87.-2-19 1�sa�raj't TOWN OF SOUTHOLD co Rental Permit Permit No. 0433 Owner Chao (Kelly) Occupied as Single Family Dwelling Located at 50 Tepee Trail Southold 87.-2-19 Village Maximum Permitted Occupancy 10 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. 5/4/2021 a Code Enforcement Official This Notice must be posted by the main entrance at all times Town Hall Annex Tclephone(631)765-1802 54375 Main Road ` Fax(631)765-9502 P.O.Box 1179 s ` in k Southold,NY 1 197 1-0959 16 } BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: D iee. Tax Map Number: 1000 SECTION -BLOCK :.LOT QSECTION B. B. OWNER INFORMATION: I Property Owner Name: !V a-AAa&) C'6a Property Owner Legal Address: Property Owner Mailing Address: �t rte 'hat �%�-✓�� Telephone Number(s): Daytime Q17 c10-2(^tn Eveninggl':Z� Emergency Property Owner Email Address: r.IT2ocx 7,��F�' Pagel of S 1Jf' 7, 004 Town Hall Annex ' Telephone(631)765-180.2 54375 Main Road ' t; fax(63 l)765-9502 P.O.Box 1 179 Southold,NY 11971-0059 t� BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent information: Name of Authorized Agent of dwelling unit, if any: 0 rx-, Address of Authorized Agent (no P.O. Boxes):_ 1�3 76 P C. -L7 r') P-V61TC 0,-• Yt K/ 35 Mailing Address of Authorized Agent:��0 .. _ __ or Telephone Number(s): Daytime_ 24''611-0 Evening '3)S-032?Erner•gency Email Address: -T—L) -to.-&v/ ^A-Ala 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 Emergency Email Address: SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing 9 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 \oF sooa�� . Town Hall Annex 1 i' 'Telephone(631)765-1902 54375 Main Road aw (� Pax (631)765-9502 1'.U.Dox 1 179 f Southold.NY 1 197 1-0959 i�. BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Enrierger:cy_ Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on prope-ky: For each Rental Dwelling Unit set forth the Rental (for example, Unit 1, Unit 2, Unit 3 or Apt A, B,C);the use of each room in the Reotal 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: __ Number of rooms In Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: ,► r �`_9ccgac. - Bet"an an��17 �� ° �� 1 Jr. ?-loam ��, I fir. 6 j Ct. „} (q u�I Li 7 Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road 'f� tax(631)765-9502 t t P.O.Box It 79 Southold.NY 11971-09,159 BUILDING DEPARTMENT TOV;N 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 Vie Tonin, a Certification from a licensed architect, a licensed professional engineer or a home insp edor;rho has a valid New York State Uniform Fire Prevention Building.Erode 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 aced sanitary and housing regulations of the County of Suffolk and by the laws adopted~' by the New York Stale 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 ❑ I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature roust be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) I `��l C -ka o 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 50(/p/yo Town Hall Annex "Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.U.Box 1179 Southold.NY 11971-0959 ' leOUNTt.4ti ,. BUILDING DEPARTMENT TONVN OF SOUMOLD applicable laws and rules. I further acknowledge that 1 will notify the Town of Southold Building Department of any changes of address within five (5) days of any changes thereto. 1 1 have read and received a copy of Chapter 207 of the Cade of the Town of Southold and agreed to abide by the same. 4. 1 will notify the Town within five (s;: s:1.-�sness da;yzh c:� ,+ �d ci.an ,- ro':'.h e 1n f'o;FfIation regarding Authorized Agent, !`Managing Agent,o Property Owner's Name: Property Owner's Signature: _ Sworn to before me this-2f-day of °la 202-I J.ll LINGER Notary Public,state of New York Official Notary Public Signa re and Original Notary Stamp No.oin Suffolk Co Qualified in SufiFolk County Conwnission Expires Feb.26,20 23 Page 5 of 5 Town Hall Annex SOUTHOLD TOWN 54375 Main Road j C7 ' Rental Inspection PO Box 1179 Southold, ��`� nx, NY 11971-1179 •t G . • 'r Tel: 631-765-1802 Fax 631-765-9502 SCTM # g `r, — J Date �{ Owner �A Ao Phone g J 1_0 3 Address 'S'o t L_ Zip I (q 7 Cityscae_c't7A tv Inspector -T-Looc, LEVELS SUB 1 - 2 3 Smoke Detectors(#-bedroom detectors excluded) J 2 _7 Carbon Monoxide Detectors (#) ;2-1 Fire Extinguishers(#) Exits(#) J BEDROOMS 1 2 3 4 5 Smoke Detector Alarms(#) 1 Carbon Monoxide Alarms(#) Egress(windows) (Y/N) L Y BUILDING SYSTEMS Y/N CONDITION OF PROPERTY Y/N Heating system maintained/operational Building Interior is clean/maintained Hot waters stem maintained/operational Building Exterior is clean/maintained Electricals stem maintained/operational Property is clean/safe/maintained Mechanical system maintained/operational Handrails&guards present COMMENTS: C9 OF– PQ0 L O A k�S -V CD G o Co MAP– ( n,�.) 3 2i wA54,-� -3Aeta, rOOL 6WS OV-, 140u,sE P2.S4a.' -, Rental Inspection Form 4/7/2021 zwr x.r BEDROOM 1717 x 14'4' PATIO YARD 16'x Y 11'x12' ----- ----- 11S1LK11WBr I OPEN AREA I _— OPEN AREA _ •• __ - 17'x14' F7A—T - YARD BEDROOM DINING ROOM 101'CIEN b 10'11'x 14'4' 10'17 x 14'4' 1Cx 14Y' WALKWAY DW I r$ CLOSET -7 ao5ei '_'T "r. T.3 FAMILY ROOM ENTRANCE --- .•. 1T6'x 24' 23'x B4' CHS 8' 77 ♦ CH:9' POOL ' LIVING ROOM 1T 1218 BEDROOM I16,110, SCREEN 19'x 12'11'x 12'6' PORCH CH:18' - • 14'x 16'10" - " rx30 GARAGE ~ I 24'x 24' MOND FLOOR m YARD LAUNDRY _ 1Tx6' - -_ aa•ET MASTER CLOSET BEDROOM 17'2'x16' BATH - - 11'x 9'5' CL09ET _ c1m x r r SUNAREA mix HOT 1BxB' 8 14 L7 \ mTUB ..m" 38'5'x 23'3' WALK WAY • CH 78 • - — _—__.__—_.—_—._ A= YARD SHED • • r C FIRST FLOOR 345"x 16' FIRST FLOOR INT: 1950 ft2 SHED INT: 84 ft2 FIRST FLOOR OUT: 630 ft2 POOL: 552 ft2 SECOND FLOOR INT: 1500 ft2 TOTAL INT: 5810 ft2 BASEMENT BASEMENT INT: 1700 ft2 TOTAL OUT: 1 182 ft2 GARAGE INT: 576 ft2 TOTAL: 6992 ft2 Scale in feet.Indicative only Dimensions are approximate.All information contained herein is gathered from sources we believe to be reliable.However,we cannot guarantee its accuracy and interested persons should rely on their own enquiries. 50 Teepee Trail, Southold corcorran TOWN OF SOUTHOLD PROPERTY RECO -4h OWNER 2l STREET VILLAGE DIST. SUB LOT FORMER OWNER WASC,— C.-OfM" N E ACR. + S WTYPE OF BUILDING RES. SEAS. VL. �` FARM COMM. CB. MICS. Mkt. Value LAND IMP. I TOTAL DATE REMARKS v 7c- 0 7j � >z� -- 0 b l G' D a S D Q O ` - I'i° 'fo gym'•e r h rre✓ irz. - ✓t G -Lq L400 co 5b)11 �1a9/19- /y� r q CZ) AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM ! Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland i DEPTH House Plot BULKHEAD Total DOCK •i E " Y •'fes' T.. _. . Y _ ` ■ ■■■■■■■■■■ SEEM ■■e ! FINE ■a■■=�■a■■�■■■■■■■ _ ■■■■�■■■■■■■� ■■■■■■■■■■ ■■■�]I■C�EJ■■■■■� ■■■ MEN MEN MMM . y - i■■i■M SEEMS■■■■MEMO ■■ low . ��i■ ■■■■■ter■■i■■■■■■■■■■�■■■■ ■■N!D■!■�■■■■■■■■■■ ONE Qwu Interior Finish .. ,. . .. `.. -- t` I ` R- Recreation Rooms 2nd Floor400 _■� T 'f Town of Southold 11/3/2019 P.O.Box 1179 53095 Main Rd OT ' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40830 Date: 11/4/2019 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 50 Tepee Trail, Southold SCTM#: 473889 Sec/Block/Lot: 87.-2-19 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/2/2018 pursuant to which Building Permit No. 42864 dated 7/16/2018 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 unfinished basement, covered front porch,rear screened porch, side pergola covered patio and attached garage as applied for. The certificate is issued to Kelly,Paul of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-16-0036 7/22/2019 ELECTRICAL CERTIFICATE NO. 42864 8/20/2019 PLUMBERS CERTIFICATION DATED 10/30/19 B Piecuch 00 o ' ignature ..-- �o�p ��oG Town of Southold 11/15/2019 o P.O.Box 1179 y 53095 Main Rd � oloo� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40859 Date: 11/15/2019 THIS CERTIMS that the building GENERATOR Location of Property: 50 Tepee Trail, Southold SCTM#: 473889 Sec/Block/Lot: 87.-2-19 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/28/2019 pursuant to which Building Permit No. 44346 dated 10/29/2019 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: ACCESSORY GENERATOR AS APPLIED FORa4, The certificate is issued to Kelly,Paul of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44346 11-04-2019 PLUMBERS CERTIFICATION DATED Authorized Signature Town of Southold 9/27/2020 P.O.Box 1179 53095 Main Rd oy 4:84V4Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41480 Date: 9/27/2020 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 50 Tepee Trail, Southold SCTM#: 473889 Sec/Block/Lot: 87.72-19 \ Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/29/2019 pursuant to which Building Permit No. 43714 dated 5/7/2019 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: accessorin-ground swimming pool fenced to code as applied for. The certificate is issued to Kelly,Paul of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43714 9/5/2019 PLUMBERS CERTIFICATION DATED ktq0 d Signature ;r gUEfO opo opG Town of Southold 10/3/2020 y,!, P.O.Box 1179 o 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41494 Date: 10/3/2020 THIS CERTIFIES that the building HOT TUB Location of Property: 50 Tepee Trail, Southold SCTM#: 473889 Sec/Block/Lot: 87.-2-19 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/16/2020 pursuant to which Building Permit No. 44623 dated 1/27/2020 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: accessory hot tab as applied for. The certificate is issued to Kelly,Paul of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44623 6/11/2020 PLUMBERS CERTIFICATION DATED A ho e Signature Thomas Winger 13370 Oregon Road, PO Box 1025 Cutchogue, NY 11935 February 4, 2021 To whom it may concern: I am the authorized agent for the landlord for property located at 50 Teepee Trail,Southold, NY and have been requested to forward the enclosed permit application and required fee of$200.00. Please let me know if there is anything else I may assist with. Thank you, Regards, Tom Uhlinger F E 0 ® 8 2021 rY.,'1",n