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HomeMy WebLinkAbout1000-50.-4-10 F0`/r .� TOWN OF SOUTHOLD Rental Permit 0489 Owner Conte Susan Trust Occupied as Single Family Dwelling Located at 2450 Lighthouse Rd. Southold 50.4-10 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. 6/29/2021 Code Enforcement Official This Notice must be posted by the main entrance at all times o`OSUFFO�XCOG Town Hall Annex ,�•� y.► SOUTHOLD TOWN 54375 Main Road o =`t PO Box 1179 Southold, C/3 Rental Inspection NY 11971-1179 n^r Oy • �� y Tel: 631-765-1802 Fax 631-765-9502 -~ once &san Trus SCTM# ' ' 1, 0 Date Owner Phone /6 —376 3� Address Zip` Hamlet Inspector 6 � Address visible from street? � LEVELS , SUB;: :: , 1 2- 3 Smoke Detectors (#-bedroom detectors excluded) �, 1 Carbon Monoxide Detectors (#) Al I Fire Extinguishers.(#) Exits(#) . 3. BEDROOMS A. r ;:.2 3. -. 5 .. Smoke Detector Alarms (#) I Carbon Monoxide Alarms (#) Egress (windows) (Y/N) BUILDING SYSTEMS Y/N CONDITION OF PROPERTY Y/N Heating system maintained/operational y Building Interior is clean /maintained Hot water system maintained/operational Building Exterior,is clean/maintainedY Electrical:system maintained/operational y Property is clean/safe/maintained Mechanical-system.maintained/operational `I' Handrails&guards present POOLS YIN POOL BARRIERS Y/N Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min.48" high resent POOL GATES Y/N All openings in barrier less than 4" Y Self-closing, self-latching y Max. 2"clearance @.bottom of barrier Latch on pool side of gate, meets height Barrier capable of being locked &child- requirements proof when unattended COMMENTS: Town Hall Annex 3 ¢ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 ' fi UbfT`f� /s'11' BUILDING DEPARTMENT TOWN OF SOUTHOLD ....; . RENTAL PERMIT APPLICATION `Y MAY 1 7 2021 Rental Permit Fee $200(Application must be renewed every two years) _ y I 1.. S Section A. Property Information: Rental Property Address: 1r Tax Map Number: 1000 SECTION SD -BLOCK -LOT-4-- SECTION R. OWNER INFORMATION: I Property Owner Name: Yh'vert, ycu'h Property Owner Legal Address: Property Owner Mailing Address: Ml$ N VYC-u MkA(je,, M n Se fir, k1G 2SYo NIj,SPY i Jen , M rxh �s� rL y fl©3'4 Telephone Number(s): DaytimLS)0g65_t)-1q Evening 11VV_/ Emergency Property Owner Email Address: kPA ff-01( < Go h) Page 1 of 5 soij- ti. c� •t� Town Hall Annex } Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 CP P.O.Box 1179 , C Southold,NY 11971-0959 �" � BUILDING DEPARTMENT `OWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: 1v 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: f Name of Authorized Agent of dwelling unit, if any:1�!)L I 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: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 11' h Town Hull Annex .Y� Telephone(631)765-1802 54375 Main Road ; it Fax (631)765-9502 P.O. Box 1 179 stz Southold.NY 11971-0959 C�1j1 � i t BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: WA A 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, 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: 5 Use and Dimensions of each room in Rental Dwelling Unit:zj wla6 PM - 17 �� l BEDNem Z C1 X 16 ako'M Page 3 of 5 Town Hail Annex 4 Telephone(631)765-1802 54375 Main Road t Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 `rQ.. ` �4-e `�, 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 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLAMATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) C,y},i 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 Town Hall Annexe Telephone(631)765-1802 5437.5 Main Road Fax(631)765-9502 P.O.Box 1179 r�y Southold,NY 11971-0959 ' ' %W, ` Y 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 Owner's Signature: .. -,� a—)� j Swor to before me this Vclay of 114t1y , 202/ Offi�al N t ry Public Signature and Original (Notary Stamp RAFFAELLA E A MARCIARI Notary Public-State of New York N0.01MA4795921 Qualified in Nassau County My commission Expires Jul 31,2022 Page 5 of 5 qz" j o-or- k 4�.►�. ��►► q7t► 146 Y2 � 15 GI�c�SE1"' 'DeaL So l h S(cf e, m"O e, o f door 3 � ' i le7 fi k � bt Cot �&ck R e 3661 20eA;;1,4ftW 5R��°� � I es9� 7.1 24 bO sa4w� iY.M1 i f y�;�� y �f•yy ffii �� awe Yt:i. � I8 F 110,D, �733 a� roti -To f 1AUh 7 ­ 'CARD',, TOWN, OF,,',SO TUT HOL STREET'`---Z, : ,,VILLADE '.SUR.,. ^LOT G. N, A I ILI Lo larl FORMER OWNER N 'ACR. S 4 i 04L TYPE OF'B,U,ILDING W_ FARM Comm.; U6 RES. EAS. VL. MICS.: �;') Mki. V�I­ is LAND IMP_ TOTAL DATE _1.:.,REM ARKS . �4 01 3 6, .0 J_ V 4,�7 x/7/ ri 4, Z 7 4 eR,00 AGE BUILDING CONDITION NEW NORMAL i B EL*&V ABOVE, FARM AcreValue Per Vtlue Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE`ON-ROAD i Meadowland. �DEPTH-". House Plot 1 5,ULK-HEA P, Total I DOCK�� ........... • .,; est y� wi r'z* 'S ! rj'ot S E t fJi � ♦ 9 r "��,. r V rt N d i + t..`c 'A.y" y ,� k r aC Sr '" .x" Y+ • p d'ti v °wt WY,i' ®e mom MON �® ■ ' F� NONE 0 W , zx4 a: `� �snit ,r!* Sr♦ 5F�2`{#'. + �s l \ t�" set t�� WE "10 ■■� t �Fvr�^' 7 ,Si• a,� 1 �Y�[zr��e�`. ;�r,.� tr rd Pt��.', l,��a�SQ��. ��kA t�'' �S+�, "t�.k^.ii. R 11/07 ME M. b ��, er � S lls t�.J t ?!-t •, j r r}��/.� h F y�f y e�c..t i J J 1. ys S'xa � E- 1i�.°k <k r r\'x3+ yC,�-� i! J�C ,"� Sa a1 a�'p.�s�� i�''4�•t;'7"'"h`"� S =`' �■ �� �- Bid 9 •• Extension Extension ®�®®■�■ Extension • dation :• _ Porch Porch Walls r • Breezeway _ Place. , -• •° •- ^• o ••• •e• • •• i 0• - - e FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z .2551+2. . . . Date . . . . . . . . . .. .... . .oc.tober 19. Soundview Ave THIS CERTIFIES that the building located at X./S Street Map No. . .V.,v„K. . . .. . Block No. . . .X=. . . . .Lot No. .,g . . . . . .s Lt ea i� # � . .. . . . conforms substantially to the Application for Building Permit heretofore filed in this -office dated . . . . . . . . Ap1*11. . . . 19-66 pursuant to which Building Permit No. .30.78. 3 dated . . . . . . . .May. . . . ..9. . . . . .. 19.66., was issued, and conforms to all of the require- ments of the applicable provisions of the'law. The -occupancy for which this certificate is issued is . .PVJ.V,6A0. .aCaGgsory. -Bldg- .tool -shad. storage. . . . .. .. .. .. . . .. . . . The certificate is issued to Milip. &-NalSaVat•Saba js.••• • • ••Wawa.••• • • •• • • . (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval . . . . . ..14. .,R* .. . . . . . . . . . . .. . . . . .. . . . . . Building Inspector FOR51 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No 483® Date Sept 26 , 19 72 THIS CERTIFIES that the building located at 1 ighthQuse Rd 3,,V m Street Map No. Block No. Xx. Lot No. XX . .S014tho .d N.Y., conforms substantially to the Application for Building Permit heretofore filed in this office dated Get i . ., 1971, pursuant to which Building Permit No. 556CZ dated Oct !I 3 ., 19 71 , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private one.f4mily. dwelLtr1g . . . . . . . . . . . . . . . . . . . . . The certificate is issued to Philip S$.bAla mer. . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Vab . 2�. 1.9.72 by Rd V�J:L& UNDERWRITERS CERTIFICATE No . MM HOUSI. NUMBER 21'50 Stret:t Lighthouse Rd 15465 Somd View Ave Building Inspr�toi d�gUFFO� Town of Southold Annex 8/30/2012 a P.O.Box 1179 54375 Main Road o ® Southold, New York 11971 �Y CERTIFICATE OF OCCUPANCY No: 35926 Date: 8/30/2012 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 2450 LIGHT HOUSE RD SOUTHOLD, SCTM#: 473889 Sec/Block/Lot: 50.-4-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 3/29/2007 pursuant to which Building Permit No. 32868 dated 3/30/2007 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: accessory in ground swimming pool with fence to code as applied for. The certificate is issued to George&Pamela Tietjen,III (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL, CERTIFICATE NO. 32868 8/27/12 PLUMBERS CERTIFICATION DATED Aut rued Signature Town of Southold 2/14/2019 LN_ P.O.Box 1179 53095 Main Rd ? Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40212 Date: 2/14/2019 THIS CERTIFIES that the building DECK Location of Property: 2450 Lighthouse Rd., Southold SCTM#: 473889 Sec/Block/Lot: 50.-4-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/1/2018 pursuant to which Building Permit No. 42672 dated 5/11/2018 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: deck addition to an existing one family dwelling as applied for. The certificate is issued to Conte,Steven&Dorren&Ano. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42672 2/5/2019 PLUMBERS CERTIFICATION DATED ut r ed Signature OLSEN SL OLSEN, L.L.P. ATTORNEYS AT LAW GARY FLANNER OLSEN DAVID WORTHINGTON OLSEN ATTORNEY AT LAW ATTORNEY AT LAW 32495 MAIN ROAD • P.O. BOX 706 • CUTCHOGUE, NEW YORK 11935-0706 PHONE 631-734-7666 .FAX 631-734-7712. olsenlaw@olsenllp.com April 7, 2021 Re: Tietjen to Conte Our File 10880 Dear Steven: Enclosed please find a copy of the Certificates of Occupancy and survey in re the above matter as per your request. Very truly yours, AVID ORTHING N OL DWO:lmk Enclosure Steven Conte 256 Nassau Ave. Manhasset,NY 11030