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HomeMy WebLinkAbout1000-66.-2-43 c TOWN OF SOUTHOLD Co Rental Permit Permit No. 0434 Owner Scott Hale & Stephen Bjorneboe Occupied as Single Family Dwelling Located at 595 Rogers Road Southold 66-2-43 Village Maximum Permitted Occupancy 6 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 inspe 'on. 5/6/2021 ode E for en Official This Notice must be posted by the main entrance at all times pf- SOU-Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax.(631)765-9502 P.O.Box 1179 , • O Southold,NY 11971-0959 7C BUILDING DEPARTMENT TOWN OF SOUTHOLD MJF, 3 29� RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every-two years):., Section A. Property Information: Rental Prope ddr�s: d rs u 4 ! Tax Map Number: 1000 SECTION w -BLOCK. f� -LOT 1-3 SECTION B. OWNER INFORMATION: Property Owner Name: G6 Property Owner Legal Address: Property Owner Mailing Address: s�r�a l e ga AN L5oullial4i Alf H771 b,�s 3JO 122-6610 310 yu4W Telephone Number(s); Daytime Evening Emergency Property Owner Email Address: L5 billy -Irn ze Page 1 of 5 .�i i sl, 4 r �S Town Hall Annex Telephone(631)765-1802 54375 Main Road °' k Fax (631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 ;Y .v BUILDING DEPARTMENT TOWN OF SOUTHO LD Mailing Address of Managing Agent: 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: _ Number of rooms in Rental Dwelling Unit; 1 Use and Dimensions of each room in Rental Dwelling Unlit: SL[Jq -90D n 4Ir-c,oPn ,Oln f��m (TT) x 1 2 � K�kh�,� 9- n'� �oom ro 2- 17'(x " 16 o) 4?d r-0 0M 1 ?J I' /Y\ G- J q 'J -T ' f v J Page 3 5 SUUT'y0.. Town Hall Annex Telephone(631)765-1802 54375 Main Road • Fax(631)765-9502' P.O.Box 1179 Southold,NY 11971-0959 d Y COUNTY 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. ❑ 1 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) I G��c9k certify under penalty of perjury,the following: 1. I 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 pjf. pF SOUryol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(63 1)765-9502 P.O.Box 1179 G • O 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: GA4 /t 4// Property Owner's Signature: Sworn t e re me this&rday of .20 Of cia Notar lic Signature.and Original Notary Stamp .a., DAUVE A.TURNER �'•""" Notary Public-california Z o Los Angeles county Commission#2288678 ` �•"• MY Comm.Expires May 16,2023 Page 5 of 5 ri Feb 27, 2021 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �O Southold,NY 11971-0959 _ J ( sI t) • ' fy , L.) BUILDING DEPARTMENT `� MAR TOWN OF SOUTHOLD - 3 2021 RENTAL PROPERTY CERTIFICATION ;�; F:;:>>: . rv_ .sem 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 rea,uired for Architect or Engineer, licensed dome Inspector mast provide copy of valid current certification Rental Property SCTM Number: (�((�• ��'�?J' Rental Property Address: 595 Rogers Rd., Southold NY 11971 Owner/Name: Scott Hale Rental Dwelling Unit•Idehtifier: Number & Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom #2-90 sq., etc.) Bedroom #1 225 SWI Bedroom#3 100 Bedroom #2 130 sgft Bedroom #4 100 Property Description (Include all improvements indicated on survey) single family home 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 0 ginal Signature Please place professional seal: o�aOF 50Glyo 1 * # TOWN OF SOUTHOLD BUILDING, DEPT. Couto, 765-1802 1 NSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ J FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE'& CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ :] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: In A DATE INSPECTOR ___________________ 19 20 21 22 --. --------------________ ._____-____-_____ �_____ _ ___ ________; U _. ___ ------ T __iP W WF11W FawAn BATH NEW TOILET 2S \ 1 1 NEW 9N1 NEW PA N]'fJ ROff W11FER5 1f OG I I EAG NNEEW FLOOR n1LLE IIAW , E4 O __ , iii--- ' � , ____________ _' r gnud;;;; :I - „� 2, , ---- NEW CROWN To � ' �1"/ ' O\ -ENSRNG CROWN E2 i i1i. __� I� • WAKE NEW RAISED ' 'A'i0 NELNN • NEW OIJNI i0 /D MT BODE MiN ZX I I EG MATCH'A' NEW DOW AND ' DOOR TAPEAS AND f 0.YW000 _-___i � 01ENE I �____________ 2 S Om FOR 01ANIOE� O ' 1 . 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SOUTHOLD, NEW YORK Pax a,Ls7&W12alvla - TOWN OF SOUTHOL® PROPERTY REl R� ,y /� STREET ----- V►LLAGE_ DIST.j SUB.---E � } !� i.�J ° J? ` �`Y ....r° 6 ... ..,.3 F r;:,, ,I *�...J c � FORMER:OWNER �- eohq N E ACR TYPE OF BUILDING r RES. Is"' S. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS IDf GC. ova C w. s AJ A -- L 7 t ter° { 4106-L ) 7-- -,jof ion, h -oa)e 604�) i I AGE BUILDING CONDITION — NEW NORMAL BELOW ABOVE FARM Acre Value Per Value v ---- _ Acre Tillable FRONTAGE ON WATER Woodland I FRONTAGE ON ROAD , ,w v _ — Meadowland i DEPTH House Plot BULKHEAD i Total, DOCK ( ` Jam" ',; ®• ■■ ■ ■ ■■■ kI�IRi1P'iiiln �Q11r1'lU .. ■ MEN ■■■■■■ ■■■I ON ONNo ■■ ■■ Mimi NMI@ I No IN ON ■ "■ ' ■■■■■■■ ■ ■■ ■■■■■■■■■■■■ ■ ■■■ ■ • No own ■■■■ ■■■■ ■ ■ ■■ ■■■■■■i -■ ■■■■ ■' ■■ ■■■■■ i1 ■■■■ ■■■■ ■ Foundation C• ® III • Basement •• •• iExt. Walls ! nte • IY • Garage Patio ' -• s '•• Rooms 2ndFloor— 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- 31583 Date: 05/26/06 THIS CERTIFIES that the building DWELLING AND ACCESSORY Location of Property 595 ROGERS RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 066 Block 0002 Lot 043 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- 31583 dated MAY 26, 2006 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 FIRST AND SECOND FLOOR COVERED PORCH AND ACCESSORY GARAGE.* The certificate is issued to RICHARD & LINDA KOHUT (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. Aklhorizedignature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 595 ROGERS RD SOUTHOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : RICHARD & LINDA KOHUT OCCUPANCY: SINGLE FAMILY DWELLING RICHARD & LINDA KOHUT ADMITTED BY: JOAN HAMILTON ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAB MAP NO.: 66.-2-43 SOURCE OF REQUEST: WILLIAM PRICE, ATTY DATE: 05/26/06 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 2 FOUNDATION: CONCRETE BLOCK CELL AR: FULL CRAWL SPACE: TOTAL ROOMS: IST FLR.. 4 2ND FLR.: 3 3RD FLR.: 0 HATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): PORCH TYPE: COVERED FRONT - 2 STORIES DECK TYPE: PATIO TYPE: BREEZEMAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: OIL TYPE HEATER: OIL AIRCONDITIONING: TYPE HEAT: WARM AIR: HOTMATER OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: WOOD FRAME STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION ART. SEC. I I I I I I I f I I f I 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I REMARKS: BP 11134 ADD TO PATIO COZ10694; BP 32038 HEAT/AC REPAIRS COZ31579 INSPECTED BY: DATE ON INSPECTION: 05116106 MICHAEL J VERITY TIME START: 9:45AM END: 10:35AM FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Nall Southold, N.Y. Certificate Of Occupancy 210694 No. . . . . . . . . . . . . . . . . Date . . . . . . September. 22 . . . . . . . . . . ., 1�1. . THIS CERTIFIES that the,building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property . . .595, ,Rogers Road Southold} New York House No. Street Hamlet County Tax Map No. 1000 Section . . . . .Q65. . . .Block . . . . . .Q?. . . . . . .Lot . . . . .R . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . .. . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated May 1 81 1ii34 Z . . . . . . . . . . . . . . . 19 . . . pursuant to which Building Permit No. . . . . . . . . . . . . . dated . . .May. . . . . . . . . . . . . . . . . . . . 19 . . .,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 . . . . . . . . . Addition to Existing Patio and Roof The certificate is issued to . . . Mary June Kohut '(a wner�fC3�.s8. .bC 7�4dtL1JX of the aforesaid building. Suffolk County Department of Health Approval . . . . , , ,N/R UNDERWRITERS CERTIFICATE NO. . . . . , 1!1531318 Building Inspector Rev 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34542 Date: 09/03/10 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 595 ROGERS RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 66 Block 2 Lot 43 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 7, 2007 pursuant to which Building Permit No. 32780-Z dated MARCH 7, 2007 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 ALTERATIONS AND SUNROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL P & ERIN C WARLAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 335991 11/21/07 PLUMBERS CERTIFICATION DATED 07/28/10 JAMES WILLIAMS A thor' ed ignature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31579 Date: 05/26/06 THIS CERTIFIES that the building ALTERATIONS Location of Property: 595 ROGERS RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 66 Block 2 Lot 43 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 24, 2006 pursuant to which Building Permit No. 32038-Z dated MAY 24, 2006 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" HEATING AND AIR CONDITIONING UNITS, MINOR REPAIRS AND OUTDOOR SHOWER TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RICHARD & LINDA KOHUT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2099070 05/23/06 PLUMBERS CERTIFICATION DATED 05/26/06 RICHARD KOHUT or Authorized Signature Rev. 1/81 Town of Southold 11/24/2020 P.O.Box 1179 a - o 53095 Main Rd f✓.1j �;S} Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41628 Date: 11/24/2020 THIS CERTIFIES that the building RESIDENTIAL REPAIRS Location of Property: 595 Rogers Rd, Southold SCTM#: 473889 Sec/Block/Lot: 66.-2-43 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/18/2020 pursuant to which Building Permit No. 45141 dated 8/26/2020 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: roof repair due to storm damage as applied for. The certificate is issued to Hale,Scott&Bjotneboe,Stephen of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED th0 ' ed i ature