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HomeMy WebLinkAbout1000-117.-2-6 a TOWN OF SOUTHOLD 1�kt Rental Permit 0517 Owner Jill Culbert & Brian Green Occupied as Single Family Dwelling Located at 5330 New Suffolk Rd New Suffolk 117.-2-6 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. 9/30/2023 This Notice must be posted by the main entrance at all times cl e Entl ent cial June 24, 2023 Town Hall Annex Telephone(631)765-1802 54375 Main Roadi Fax(631)765-9502 P.O.Box 1179e� Po 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 Piro essional seal required Lor Architect or Engineer licensed Home Inspector must rovide copy of valid current cerci ication Rental Property SCTM Number: Rental Property Address: 5330 New Suffolk Rd. New Suffolk NY 11956 Owner/Name: Brian Green 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 #3 110 s f Bedroom #2 130 s ft 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 Original Sign ur Please place professional seal: July 18, 2023 Southold Building Department Re: Existing Rental Permit Renewal Application (5330 New Suffolk Rd. New Suffolk, NY) Hello, I've enclosed my renewal application for our existing rental permit including an updated property certification form dated June 24, 2023. Our original inspection form is also included for reference. I spoke with your office a week ago about timing the renewal date on the permit after the summer rental season.Your office seemed amenable and requested a brief letter explaining the request. I appreciate the consideration. Perhaps end of September if that works for your office. Its more convenient to time the inspections in the shoulder or off season versus middle of Summer. Thank you, appreciate it. Best, Brian Green 415-756-1075 bjgreensf@yahoo.com TOWN OF SOUTHOLD o`pv` Rental Permit 0517 Owner Jill Culbert & Brian Green Occupied as Single Family Dwelling Located at 5330 New Suffolk Rd. New Suffolk 117.-2-6 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. 8/6/2021 ode nfo ce e t Official This Notice must be posted by the main entrance at all times .r �pF SOUFyo Town Hall Annex ,gam Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT JUN TOWN OF SOUTHOLD 5 2021 �.. RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 5330 A)Pw 5"76(o\\-\ Tax Map Number: 1000 SECTION -BLOCK -LOT - f:©'T► 'Q? ; -1'13qq`� ��'] —2—,6' C' .� cic,.1;,-i ,-na:\� SECTION R. OWNER INFORMATION: Property Owner Name: cjc' o JIV &At bz r'-�— Property Owner Legal Address: Property Owner Mailing Address: Qq� 0ucz,\v0k'.\ Telephone Number (s): Daytime Evening -K� Emergency '� �k� Property Owner Email Address: kA J0 o d-aw+ 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 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: A- 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: J Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex 49 Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1 179 G, • Q Southold,NY 11971-0959 -< c®u1� BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: tiN I' /J— Telephone Number (s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1.. C S� Ale –AO-N � 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: C',nCl. b�.�i �v*►+ Use and Dimensions of each room in Rental Dwelling Unit: ��� - 10� S� 1 'L:�.w� (�e�ov�, - ��� Ste, 0����, �►or�� - � S� , Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road CP Fax(631)765-9502 P.O.Box 1 179 ' Southold,NY 11971-0959 <`�C4UNT�,��� 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 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) N-Z' -,4 , 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 S A® Town Hall Annex Telephone(631)765-1802 54375 Main Road v/ Fax(631)765-9502 P.O.Box 1179 O 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: ' ,r;u� 09�%ce Property Owner's Signature: r Commonwealth of Pennsylvania-Notar;S 1i Sworn to before me thisday of � 2J TERESAPARRIS,NotaryPvwic .4aMontn County Expires My Commission Expires April 16,2Q22 Commission Number 1282793 Official NVt ry Public Signature and Original Notary Stamp Page 5 of 5 Si June 05, 2021 50f Town Hall Annex l 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 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 erofessional seat'required for Architect or Engineer, licensed Ho'me inspector must provide copy of valid current certification Rental Property SCTM Number: Rental Property Address: 5330 New Suffolk Rd., New Suffolk NY 11956 Owner/Name: . Brian Green Rental Dwelling Unit Identifier: A 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 #1 144 sgft Bedroom #3 110 sqf Bedroom #2 130 sgft 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 7 Print Name and Titlecoo# 1216-0283 Originll ignat re Please place professional seal:' �Of SOUTH �I ova - o� o # # .TOWN OF SOUTHOLD BUILDING DEPT. ��`y�ou►m '� 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]. ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAU KING [ ] FRAMING/STRAPPING [ ] FINA �� / [ j FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: CQ1% 1 DATE INSPECTOR Y . Main File No.70609402 Pae#28 Building Sketch Borrower/Client JILL CULBERT Property Address 5330 New Suffolk Road citf New Suffolk County SUFFOLK State NY Zi Code 11956 Lender WELLS FARGO BANK,N.A. 28 OSE to a rbasement 34' 0 U rn Bedroom Bedroomo Full Laundry 8.5' x1u� Bath v CL Living jDen !"Full CIO , Kitchen L�® a'Patio Bath Closet N 8.5' 13.5' 21' Cath/ `o Patio o, Dining 0Front Porch Bedroom in 14.5' 13' First Floor [1744 Sq ft] TOTAL sketch by a is mode,Inc. Area Calculations Summary Calculation Details First Floor 1744 Sq ft 12.5 x 8.5= 106.25 13 x 9 = 117 14.5x9.5= 137.75 24.5 x 28 = 686 34 x 20.5 = 697 Total Living Area(Rounded): 1744 Sq ft Form SKT.B[dSkl—'WInTOTAL"appraisal software by a la mode,inc.—1-800-ALAMODE Main File No.70609402 Pae#29 Building Sketch Borrower/Client JILL CULBERT Property Address 5330 New Suffolk Road City New Suffolk County SUFFOLK State NY Zip Code 11956 Lender WELLS FARGO BANK,N.A. o Basement [589 Sq ft] 31' MTX srs¢e by a L...de,— Area Calculations Summary Basement 589 Sq It 31 x 19=589 Farm SKT.BIdSkI—'WinTOTAL"appraisal software by a la mode,inc.—1-800-ALAMODE T" - ' R - VILLAGE . DISTRICT :SUB, LOT t _._ _ FORMER OWNER` ACREAGE 'ak 1`'` .f 't !✓ Cert I � � '.rl tt9a3 ; $t.' �,'cr° 6Sr n.}q !• a Y t. Y>1° a �iS x / 'J4 a •; ? ; .. S W' ... , , TYPE'OF;BU:ILDIN6 ! 'tmnr', 1`�/:�`:�? 1. �< ��° ) t : r a¢ � . S�. �R ES - 0 1 SEAS. VL, FARM . 1-:�:Omm;;;.: :' IND. CB-' 1vC1SC. 'Est. !vl(<t. Value ; I. . I LAND j IMP. TOTAL DATE . REMARKS `�a' - ��_.. .- ---- -- --- r. ,tom:. a'" i''tee.✓ r r, rc...�, •f g1 ,�� .°T '�r , 1 fG f7'. ls: °<''r a. /h I./ 't' `'«,. .`•� F'�,?G�,� 0 0 - - - r u �: Ai! BI�ILD(NG.CONDIlI N ... " AGEf f '7i t ►` i' a ,', .,` 31r? t . ' a 8f t NEW ORMALELO,W .B VE FRONTAGE'ON WATER' �., re .. V I P e lu FRONTA ROAD 0 CD `BULKHEAD Tillable 2 1 DOCK Tillable 3 _ - -� . ^ . KK r.. Woodland / / j J( ` dy' -C-C7 �� w F 3(,,? . g Swampland no .z rl — ---- Brushaanrlm,g vv HouseL 13&e- Tota � 4 &e: Total _ < < , - -' - Ga V i : .0 i, , I d, 1 e , : tt , I I : 77 ' r f...:.......) 1 -. ..... ............... ...... _.._... .........,....._. ._._._--_ II — __ .. _ _ I . M. B,ldj. i ` �•� F'oundotionBoth , , i , i , _X-e ion •' tol�_ Boseraent Floors. �.: ; j` I.._. _ Fxtens,�n { ° Ext. Wools " ; Interior Finish. , a i ; _ . Extension ? Fire ?Pince Heat. w B. s 4 .., - , -,....... . ' Po , r.. R p t Floor, Porch cc its .'1'.: , ; Breezeway P.®tio I'�ooms 2nd Floor- --.._.-._.. --...._......................................._. -. — _...._--' - — .._......_....._ - - - - Goaage J�r3veway ormer ner _ 71 a 4 4l., �r•��e,,>�. ;;,,. "i- C'.�,�.- ..f,,^ °�." ,��� ,°�° ��� t✓��.�-$ "��' �t' �t�? to�tais;�y�'w�.,�• �"$e1��a�� � 74 r ' Town of Southold Annex 4/7/2012 54375 Main Road Southold,New York 11971 1 * . P PRE EXISTING CERTIFICATE OF OCCUPANCY No: 35519 Date: 4/7/2012 THIS CERTIFIES that the structure(s)located at: 5330 New Suffolk Rd,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-2-6 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- 35519 dated 4/7/2012 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 one family dwelling with wood porch and unfinished full basement. NOTE:BP 4535 addition to dwelling COZ-3841;BP 6017 accessory shed COZ-4902;BP 7750 addition to dwelling COZ-6679;BP 26249 alteration to dwelling COZ-26936. The certificate is issued to Thompson, Christine --- (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL'CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. r A horized Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 5330 New Suffolk Rd,New Suffolk SUFF.CO.TAX MAP NO.: 117-2-6 SUBDIVISION: NAME OF OWNER(S): Thompson,Christine OCCUPANCY: ADMITTED BY: Christine Thompson SOURCE OF REQUEST: Thompson, Christine i DATE: 4/7/2012 DWELLING: TYPE OF CONSTRUCTION: #STORIES: I #EXITS: 4 FOUNDATION: cement block CELLAR: cellar ent. CRAWL SPACE: partial TOTAL ROOMS: IST FLR.: 2ND FLR.: 3RD FLR.: BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: oil AIR CONDITIONING: TYPE HEAT: HW Base. WARM AIR: HOT WATER: x #BEDROOMS: 3 9 KITCHENS: I BASEMENT TYPE: full unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: 'STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS; INSPECTED BY: 1 DATE OF INSPECTION: 3/29/2012 TIME START: END: FORM NO. 4 N 0 (D 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT 40 )C/,D � _Q TOWN CLERK'S OFFICE (ir SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No Z 3841............... Date ........................June ...10. .. 19. 70. .... THIS CERTIFIES that the building located at .....DIeW..Suffolk..Lane.......................... Street Map No .......A......... Block No. ........M........ Lot No. ..... NwffN.Y. .....................:�....................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................................lQc.t....... .31........... 19.. .69 pursuant to which Building Permit No.45.35L..... dated .......................Ciet.........34............ 19.19., 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 ........ ............ lv ktf� ..4 ? .. am31.�:..dT,re 7 z1g........ ..... ..................................................................... The certificate is issued to .....r:r.% ..tar.i e..Ze11,1.Rk. ......ON=i ................................................ (owner, lessee or tenant) of the aforesaid building House # 5330 ............. ......�....r......................... Building inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. .?rw2. . . . . Date . . . . . . . . . . . . Navestber. . 1:3.., 19-72 THIS CERTIFIES that the building located at . NOV. Aute U.ROM. . . . . . . Street Map No. . . ,X. . . . . . . . Block No. . .3C . . . . . .Lot No. X . . .)Few•guf.f 62k• • •N*Y-4 . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . .J114. . . .1719.71. pursuant to which Building Permit No. . .6pa 7Z dated° . . . . . . . . . . . .Jay. . �.7 ., 197.. ., 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 -accessory •(storage)• building. . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .Marie•T.O. Bentek. . . . . . .Owm . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . . R..*Ro. . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . .N*R. . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER. . .5330. . . . . .Street. . . . . . . .Rex ftfioik•Road. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. .Z6,679. . . . . Date . . . . . . . . . . . . .Sop-t . . . �. . . . ., 19.75. (gth St) THIS CERTIFIES that the building located at . .'WIS.NOR .fttX0 . A g, . treet Map No. x=. . . . . . . . Block No. x. . . . . .Lot No, .� . . . •;ta£ g� . .23. . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .Maxi. . .1.1. . ., 19. 75 pursuant to which Building Permit No. . 7.'.5oz.• dated . . . . . . . . . . . . Har. . .11 . ., 18.75., 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 ?r .y.00 ,opA� {'�-'ly, ! vr1.14w3.thtd4tcA (APpxovd.b 13d, appeals) The certificate is issued to . . Rob®rt .001detse . . . . .l�0ner. . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval +. !► . . . ... . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . X242026 . . . . Aug. . 25. . .J.975. . . . . . . . . . . . . . HOUSE NUMBER . 5a,30. . . . . . . Street . . Xex .ftftolk. xane. .(5th At). . . . . . . . . Z.�;�J .�,_. . . . . . . . . . . Building Inspecto i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26936 Date: 02/17/00 THIS CERTIFIES that the building ALTERATION Location of Property: 5330 NEW SUFFOLK RD NEW SUFFOLK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 2 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 6, 2000 pursuant to which Building Permit No. 26249-Z dated JANUARY 6, 2000 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID C & CHRISTINE M. THOMPSON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A _ ELECTRICAL CERTIFICATE NO. N-408267 01/10/97 PLUMBERS CERTIFICATION DATED 02/04/00 WATERWORKS PLUMBING&HEAT. r r Authorized Signatu e Rev. 1/81