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HomeMy WebLinkAbout1000-79.-5-14.5 EaFGLk�a TOWN OF SOUTHOLD U� �o Rental Permit 0504 Owner Michael Koke Occupied as Single Family Dwelling Located at 595 Reydon Drive Southold 79-5-14.5 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 inspection. 7/19/2021 ode nt Official This Notice must be posted by the main entrance at all times f rc SDUjy��, Town Hall Annex J��[ l�Q Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 0 Southold,NY 11971-0959 BUILDING DEPARTMENT D TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION JUL — 2 2021 V Rental Permit Fee$200 (Application must be renewed every two years) BUILDING I3E,PT. TOWN 0 XjTFTYTv0LD Section A. Property Information: Rental Property Address: 595 Re%,�i2oo Nave SoL7-atoL-D, d l 9 D Tax Map Number: 1000 SECTION 077 -BLOCK - 05 - -LOT SECTION R. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: ton a.t,- V-0 P. o . 10-1 S- (931—yJ�F (.31 Gal - Ya`{ ?3u3 Telephone Number(s): Daytime '73-3 Evening 87�- SZI Emergency Property Owner Email Address: /7111 E' G04-s-1-&- e c-cntem Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 coU������4 ' BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized 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 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 8 or more rental units) Name of Managing Agent of dwelling unit, if any: ZZ Address of Managing Agent (no P.O. Boxes): . Page 2 of 5 s Town Hall Annex Telephone(631)765-1802 54375 Main Road cn Fax(631)765-9502 P.O.Box 1 179 ® O Southold,NY 11971-0959 10 U BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Hing s 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, C);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: 595- RE O bOUE --S0VF1i0 1197f Requested Maximum number of persons allowed to occupy Dwelling Unit:I c Number of rooms in Rental Dwelling Unit: EiGHT- PASIiARLe�- �►s, Use and Dimensions of each room in Rental Dwelling Unit: k1TCFfE0—i l' 3 g x 14'434 �,r7►m" f�m,-- 19"0"K-/4-43/4 'ILIyiorr RH.-19'10`x 12' 2!4 DI►Ji06r 17.11 "� 12i2-3%"4 Seumm ! - jF�'I l �sc 12'-113V' B�gpom 2 - 19�7/> �x 10`-0 Z$ Page 3 of 5 E: �f O'SOUryol - � o Town Hall Annex Telephone(631)765-1802 54375 Main Road 7 Fax(631)765-9502 P.O.Box 1 179 G �o Southold,NY 11971-0959O1�COU '�a,.�1 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. ❑ 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 must be notarized and MUST be the owner of the dwelling unit STATE OF NEW YORK) 1 COUNTY OF SUFFOLK) I Mt L,ItwCA 1�l-t „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 i ® SDUj• Town Hall AnnexL J [ Telephone(631)765-1802 54375 Main Road " Fax(631)765-9502 P.O.Box 1179 4 Southold,NY 11971-0959 Q 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. 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:.- Property ame:.Property Owner's Signature: p VV Sworn to before me this day of 20 01.1 Official Notar Public Signature and Original Nota amp BARBARA H.TANDY Notary Publlo.Stats Of Now York No. OITA6080001 . Quallfled In Suffolk County Commission Expires 01/13/20 23 Page 5 of 5 Al Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 197 1-0959 Q BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to o py each dwelling unit:_ Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to oc py each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occZdwellingt: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: { OF SOUTyo o # # TOWN OF SOUTHOLD BUILDING DEPT. i o 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAUL'KING , [ ] FRAMING/STRAPPING [ ] FINALTIGSC y [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] °FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: Q (/rN (poi ✓, ' i DATE Iq 'y0 INSPECTOR Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 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 reguired-forArchitect or Engineer, licensed Horne lnspectormusf.provide copy of valid current-certification Rental PropertySCTM Number: 1000 079 14 > � Rental Property Address: 59S _"00PRIF- &ov w>,X, 14,!A. 112'71 Owner/Name: Rental Dwelling Unit Identifier: 6-95 &W.DQJ Ze1Je /_S0U`n0tr) �(7/ 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 Description (Include all improvements indicated on survey) `rWo STDP-U .Sr log VAwIA4 b0e L-L1J 01 ATTACHFZ) T� &lip- Nape 41,0 OIJAM I certify that I have done a physical inspection of the subject rental dwel ing unit and find that it fully complies with all the provisions of the Code of the Town of Southol ,the Residential Code of New York State,the Building Code of New York State,the Plumbing C de of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Const uction Code of New York State. Print Name and Title Original Signatur Please place professional seal: W. d �a Michael yoke,. Nigel Robert Williamson Architect 9 Rydon Drive. . out_hold, N . Y 11971 P.O. Box 1758 Southold N.Y. 1971 Phone 631 .834.9740 S.C. NI. 1000-079-05-14.5 - - tu - o s2i NOT 4.0 {32 CAL.) s�Jcv h !I COL,✓�' oma' up. O P LTE tZs.(52 - O CE vAR4L200 A (� 0 pAu 0 1 OF 3 . i Michael Koke ig�Robert !/i/illiam on Architect P.O. Box 1758 Southold N Y 11971 Phone 63� .834 74 9 ydon Drive, h d, N. Y 11971 -- e 0 M. 1000-079-05-14. r 8i R i-7 ►.1 � W S of 2 SREv1t •AST Ito SOQ.�T. ( (50 l TCH P-i l F I IG2 sa:Fr. 0 � 1� a'M t Ly R.o©M - 273 SQ. F"T: 4] Ll PW uz s ! GTL�,QAG,E r PA.O rp-Y �E�. u L 1�/) til Gr (�00►�, D 1 o 1 Ki c, . Room N 232 Sc, Fr 200 sQ. FT. GOu -ZED POZC H FOYER . rz 1 R.5T FL-Fa PL _n,�t D2OF3 Michael yoke � i Nigel Robert Williamson Architect 5.95 R ydon Drive, SouthoI , N. Y 11971 P.O. Box 1758 Southold N.Y. 11971 Phone 631 .834.9740 Ni 1000-079-05-14.5 - t BATH r z BA.rH y s v iL W GL, ATTIC . sti/co so1� BEva;oor� I � _ -N 312- 56L. Fr. 0 !q 7 SGL- F-r. 5EC/O?AD FLOOP, PLA" D3 OF 3 % fx W T® F . SCUT � '�': /a 7 CAR OWNER - STREET, ~ V.ILLAGE,, 'DISTRICT SUB. LOT -_ - T^ i`'�� v�..t.. �' �}� .. ep°"'� �,i' � " 6°"K. �^'`` .;r'-a . �- �¢,,a�..,.. � ..�• .,s r +?3���P� "�r _-- -------...__— _—__ r � f- FORMER OWNER j N E ACREAGE S , J 1N• �,;.''' TYPE OF BUILDING •` .��.:i�t �� .,c;'? a= Ya`��::.i.�.�.:�;,���^�'. r-z�r� .. r� .a.-?moi,:,:=:�4'.'��t i �:.' - ��=���� . " . -- G t g RES, - .. SEAS. VL. FARM COMM. — IRD.. CB- , MISC. Est. Mkt. Value i LAND IMP. TOTAL DATE, REMARKS ° "-j#. �� 'A r:.._.✓rf'.i f �r � r &� ftA .' ts '- r /no u AGE UILDINGCONDRI, - 34—o --' r Nom; 12,4 -L494 NEW lal RMAL BELOW ABOVE FRONTAGE ON' ATER r Farm Acre Value Per Acre Valug f' . FR°0 N R, AD ----_ .._. ....... --- --- - r I 1 :rrs .t. 4 • *,n t t J t jk V Tillable 1 �� U KH Tillable 2 DOCK ......_..._...._.._............. — ...__.._...__.,_......-- —--- -- - Tillable. 3 Woodland Swampland Brushland House Plot Total- ' .......... ...... t OCT _77 _T .............. T .......... ........... 76 -A F" ............ A, Bot( i`"" n F �dfio _lp 'Extension I T, Iffd—s.�6.m en-t' Floors ­ ........... . . . ....... " Extension h Ext'. alls pt6Hor!,Fl s . .......... ........... .................................................... .......... Extension F i re:,,P.Io: c,6 i Heat . IM -.4 ................. ............ .......... ...... ' R T� Pdrch f e: Y]p .......... ............... ...................... ......................... .................... ................. Porch 1 I ns 1st Floor l .2nd,-F oor, !'Roo m"Sc Breezeway �p Q filo: ................. Garage DrKqWay a-Dor�mer, ............ 0. B.: .............. FORM NO.4 TOWN OF SOUTHOL.D BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. .z 6 706 ch 1 S , 1 987 Date . . . .Ma. . .r. . . . . . . . . . . . . . . . . . . . . . . . THIS CERTIFIES that the building ,fl n e. f am i 1 y d w e 11 i n g . Location of Property595 Reydon Drive Southold House No. Street . .11amlet County Tax Map No. 1000 Section 9 7 9 . . . . . . . .Block . . . . . . . . . . . . .Lot . . ....5 . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated June l 0 , 19 8 7 pursuant to which Building Permit No. , ,I.6 1 2.1.Z. dated , JU n e 2 3 , . .1.9.8 7 . . . . . . . . . . . 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, attached 2 car garage , covered porch . The certificate is issued to . , , SUSAN LEE PHELAN & M. LEE PHELAN . . . . . . . . . . . . . . . . . . . . . of the aforesaid building. Suffolk County Department of Health Approval . . 8.6.—SO—.2.07 .M a r c h 14 : 1 9 88 . UNDERWRITERS CERTIFICATE N0. . . . . . . . . . . . .Pendi . . . . .ng. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBERS CERTIFICATION DATED: PECONIC PLUMBING & HEATING 3/ 15/88 . cz . . . . . . . . . . . . . . . . . . B . ding Inspector Rev.vat