HomeMy WebLinkAbout1000-52.-5-5 TOWN 0 SOUTHOLD
Rental Permit
0511
Owner 1875 Bayview Avenue Property LLC
Occupied as Single Family Dwelling
Located at 1875 Bayview Ave. Greenport 52.-5-5
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.
6/12/2023
je Er�f�r( ent �cial
This Notice must be posted by the main entrance at all times
1
11o
631 -765-1802
INSPECTION
ON 1ST [ ] ROUGH PL13G.
DN 2ND [ ] INSULATION/CAULKING
STRAPPING [ ] FINAL
& CHIMNEY [ ] FIRE SAFETY INSPECTION
ANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
NL (ROUGH) [ ] ELECTRICAL (T4'
-ATION [ ] PRT CO ( RENTAL
TOWN OF SOUTHOLD Y O /7//<3 X
OWNER STREET VILLAGE DISTRICT SUB, I LCAT
-DP!'f 1 E OVA NaR- E ACREAGE
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= b TYPE OF BUILDING
RES, VL. FARM COMM_ IND. CB. ` misc.
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L, ND ,"3P_ I TOTAL DATE REMARKS
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE '^
Form Acre Vclue Per Acre Value
Tillable 1
Tillable 2)
Tillable S
WcodiondI
Swampland
Rrusrland 1
House viol
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Extension u Basement
,LRAIV I . Floors 'Kit
Extension l Ext Walls Interior Finish L R
Extension l Fire Place Neat D R
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Patio l Woodstove BR
Porch Dormer Fin B t
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Breezeway ' Rooms 1st Floor
Garage Driveway Rooms 2nd Floor
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Parch Rooms l st F100
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Garage, g3 Driveway ®_
May 20, 2023
Town Hall Annex Telephone(631)765-1802
54375 Main Road r % Fax(631)765-9502
P.O.Box 1179 "k
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
i"" o essi anai seal re Tired ar Architect or n ineer licensed borne ins actor ml t r wide
copy of valid current certification
Rental Property SCTM Number:
Rental Property Address: 1875BavviewAve• SoUt fold 1 971
Owner/Name: lsou Sat nders
Rental Dwelling Unit Identifier:
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 #1 105 S ft Bedroom #3 105 sqft
Bedroom #2 105 sqft Lott.
Property Description (Include all improvements indicated on survey)
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 40014gunaSignature
Please place professional seal:
TOWN OF SOUTHOLD
�O
C* Rental Permit
0511
Owner 1875 Bayview Avenue Property LLC
Occupied as Single Family Dwelling
Located at 1875 Bayview Ave. Greenport 52.-5-5
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.
7/28/2021
de Enf c e fficial
This Notice must be posted by the main entrance at all times
s
oF sociryol.�
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 G.�' •
Southold,NY 11971-0959
BJdILDING 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:
Tax Map Number: 1000 SECTION - -BLOCK -LOT S -
SECTION B.
OWNER INFORMATION:
Property Owner Name: ( 5-T9 AV VI r"-AV pADr'a4z.11 tu_
Property Owner Legal Address: Property Owner Mailing Address:
5 SMO J f6GYi Wf, I L U
0
5'/41 370_.-
Telephone Number(s): Daytime Etre— F�
Property Owner Email Address: IIPo,J�
Page 1 of 5
as
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G. CS.-
Southold,
Southold,NY 11971-0959 'O
l�enUM`I,�r�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION INSTRUCTIONS
Rental Permit Fee $200 (Application must be renewed every two years)
The items listed below are required.to be submitted with the completed ,
application.
fa Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of
all smoke &carbon monoxide detectors.
` j Certificates of Occupancy and Pre-Certificates of Occupancy: Certificates of
occupancy or Pre-Certificates of Occupancy for each rental dwelling unit.
❑ Certification of Code Compliance (form enclosed): Must be submitted by a
license architect or engineer or license home inspector if an inspection by Town of
Southold Inspector is declined.
Rental Permit Fee: $200.00
,pF SO(/TO-
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G
Southold,NY 11971-0959 `Q �o
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
`Section C.
Amt orized Agent Information:
Name of Autho Agent of dwelling unit, if any:
Address of Authooged Agent (n . Boxes):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address:
'cc ' D.
Managing A nformation:
Name of Authorized Agent of dw unit, if any:
Address of Authorized Agent(no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Evening Emergen
Email Address:
SECTI
SITE MANAGER ATION:(required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, 1
Address of Managing Agent (no P.O. Boxes):.
Page 2 of 5
ya*o o yp,
Town Hall Annex l Telephone(631)76.5-1802
54375 Main Road �} Fax(631)765-9502
Y.O.Box 1179
y0
Southold,NY 1 1 971-0959 s
I�COu ,,.r•{i.
zra:o�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
1
1tt� ddress of Managing Agent:
Telephone Number(s): Daytime ening Emergency
Email Address:
SECTION F.
PROPERTY DESCRIPTION: f
Numb-6r of Rental Dwelling Units on property: r
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: CP
Number of rooms in Rental Dwelling Unit: C
Use and Dimensions of each room in Rental Dwelling Unit:
zy,-* I = 10 -br/)c t 2 I �t1'
art#,2, = 10 161
10, S '
Page 3 of 5
1 Ff oU yo ?
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 •
Southold,NY 11971-0959 Q y J
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)
)
COU TY OF SUL-
1.
I ` � �Mertify under penalty of perjury,the following:
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
f
LZv m M1
�.�pF SOUr�o�
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 D
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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.
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: � 1- 5—
�� llteul
Property Owner's Signature: c ✓��-l' �'�
Sworn to before me this day of , 20r
Official Notary Public Signature and Original Notary Stamp
Page 5 of 5
of SOUTyo V
1 o r
# TOWN OF S UTHOLD BUILDIN DEPT. .
�`y�omme 765-1802
INSPECTION - .,[ "] FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING/STRAPPING [ ] NAL
[ ]'°FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION- [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
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D•rlvOimYQO�\
F04 Town of Southold 6/29/2021
G� 53095 Main Rd
Southold,New York 11971
o �
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 42133 Date: 6/29/2021
THIS CERTIFIES that the structure(s) located at: 1875 Bayview Ave., Greenport
SCTM#: 473889 Sec/Block/Lot: 52.-5-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built.prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 42133
dated 6/29/2021 was issued and conforms to all the"requne-in6ts of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame seasonal sinale family dwelling with glass enclosed porch and accessory wood frame two cararg a.eg_.*
The certificate is issued to Gaston Family LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
ut ri e Signature
�gufF04" Town of Southold 6/29/2021
ay 53095 Main Rd
C2 z Southold,New York 11971
PIKE EXISTING
CERTIFICATE OF OCCUPANCY
No: 42133 Date: 6/29/2021
THIS CERTIFIES that the structure(s)located at: 1875 Bayview Ave.,Greenport
SCTM M 473 889 Sec/Block/Lot: 52.-5-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 42133
dated 6/29/2021 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame seasonal single family dwelling with glass enclosed porch and accessory wood frame two car garage_*
The certificate is issued to Gaston Family LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT,OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT. a
u e Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1875 Bayview Ave.,Greenport
SUFF.CO.TAX MAP NO.: 52.-5-5 SUBDIVISION:
NAME OF OWNER(S): Gaston Family LLC
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Gaston Family LLC DATE: 6/29/2021
DWELLING:
#STORIES: 1 #EXITS: 2
FOUNDATION: cement block piers CELLAR: CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: glass enclosed DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER: yes TYPE HEATER: electric AIR CONDITIONING:
TYPE HEAT: none WARM AIR: HOT WATER:
#BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE:
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: wood frame 2 car STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/25/2021
TIME START: 3:27pm END: 4:00pm
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: 2-26800 Date: 11/24/99
THIS CERTIFIES that the building ADDITION
Location of Property: 1875 BAYVIEW AVE GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 52 Block 5 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 13, 1997 pursuant to which
Building Permit No. 24247-Z dated JULY 16, 1997
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 & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED
FOR AND AS PER ZEA #4575.
The certificate is issued to J.FRANK GASTON
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-444794 02/04/98
PLUMBERS CERTIFICATION DATED N/A
-1-4-4-W
/,/"i,-l.dfi-ng Inspector
Rev. 1/81