HomeMy WebLinkAbout1000-70.-9-59 TOWN OF SOUTHOLD
czco Alm- Rental Permit
0519
Owner Emavri Realty Corp. / Richard Amthor
Occupied as Single Family Dwelling
Located at 940 Clearview Avenue Southold 70.-9-59
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.
8/10/2021LLI
Code Enforce Official
This Notice must be posted by the main entrance at all times
Town Hall Annex
G
a� z. SOUTHOLD TOWN 54375 Main Road
® - PO Box 1179 Southold,
vs Rental Inspection NY 11971-1179
• Tel: 631-765-1802
Fax 631-765-9502
SCTM'# n ,— ' S Date
Ownert\�L 0 ( Phone 5(G 64Y0 �?3
Address qQ L Cal V('PW Zip q
HamletSov 1 Inspector
Address visible from street?
LEVELS SUB 1 .3
Smoke Detectors (#-bedroom detectors excluded)
Carbon Monoxide Detectors (#)
Fire Extinguishers(#)
Exits (#)
BEDROOMS 1 ' 2 3 4 5
Smoke Detector Alarms (#)
Carbon Monoxide Alarms (#)
Egress(windows) (Y/N)
BUILDING SYSTEMS &N CONDITION OF PROPERTY N
Heating system maintained/operational Building Interior is clean/maintained
Hot water system maintained/operational Building Exterior is clean/maintained
Electrical system maintained/operational Property is clean/safe/maintained
Mechanical system maintained/operational Handrails&guards present
POOLS Y 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"
Self-closing, self-latching 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:
ra
l
�.
'ibwd Hall Annex $sem 'Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 = s: � fSonfhold,NY 11971-0959 � , !,`�C(:� LE5
-� JUN 2 2021
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
.17
RENTAL PERMIT APPLICATION?
Rental Permit Fee$200(Application must be renewed every two years)
Section A. .
Property Information:
Rental Property Address: f ( �-\J I t r
Tax Map-Number:1000 SECTION `t -BLOCK l -LOT=_�q-
SECTION B.
OWNER INFORMATION:
Property Owner Name:
r'
Property Owner Legal Address: Property Owner Mailing Address:
00,jZDYVTCVJ
119 -1 I 1 7 3-
��S -� � �
Telephone Number(s): daytime Evening ��q Emergency :tel G a
j ./
Property Owner Email Address: � �cl �"l tho � ® � /l l rt
Page 2 of S
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19
Town Hall Annex 1m ; art Telephone(631)765-1802
54375 Main Road `# r,$, c� Fax (631)765-9502
P.O.Box 1 179
Southold,[VY 11971-0959
rou
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: q000 c1,"- ( V d y
S1b b8o - s4(0 Esq -
Telephone Number (s): Daytime 5340k� Evening 2,021 Emergency
Email Address: 6a,+n'11 (\ MAJLe--5,C-k6 0 1 t 6 Cci
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: (6 trbom s
Use and Dimensions of each room in Rental Dwelling Unit:
Page 3 of 5 (�
I
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 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 t7a1
s adopted by the New York State Fire Prevention and Building Code Council.
m 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)
COUNTY OF SUFFOLK)
certify under penalty of perjury,the following:
1. l 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 Annex 'Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOU=OLD
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. f 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. i will notify the Town within five(5)business days as to any change to the information
regarding Authorized Agent, Mpnaging Agent,or Site Manager.
Q ,
Property Owner's Name:.
Property Owner's Signature:
Sworn to before me thisZ� day of 1 T I wvl 20'aQFNotary
HN GIORDANO
lic•State of New York
.01 G16364106d in Suffolk County
Officio Public Signature and Original Notary Stamp ion Expires Sep 5,2021
Page 5 of 5
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TOWN OF SOUTHOLD PROPERTY RECvmj—uAxD
Po� - 4., t
OWNER --
STREET VILLAGE DIST. SUB. LOT
'FORMER OWN ERjak'*-5 E ACR.
lev :
S W TYPE-OF BUILDING-
RES, SEAS. VL. FARM COMM. CB. MICS. Mkt. Value.
LAND IMP. TOTAL DATE REMARKS
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sk42*70,667)
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s 11 %,as bv iP5dfA er,
I 1C)1z73 )0q- g)p re-p &,Ces ?0-3 2.5 75
4z) psi �
AGE BUILDING CONDITION / ?k/O _175
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
House Plot BULKHEAD
Total DOCK
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.1 4 y'� ,•' ` _ 39:„, -a ,:.; «4'..u:,ro',„ig " '£«: t.t.. {.�.'3 p C
70.-9-59 11/10
M. Bldg.
Extension
Extension
u,
t Extension _0
t
Foundation Both Dinette
-Plm . ,JL h,"�f f S
c e Basement �� (� Floors Q A f K.
Porch lExt. Walls Interior Finish 5� LR.
Breezeway Fire Place Heat fit
Garage Type Roof Rooms 1 st Floor BR.
Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. Dormer Driveway
Total °
WORK NQ 4
;TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk% Office
Southold, N. Y.
Certificate Of Occupancy
No. . . . .?93' 3, . Date . . . . NoveF:4gr. . . .24. . . . . .. ., 19. .78
THIS CERTIFIES that the building located at . .940 ,q q-1M1 ew.Ave , , ,, , VMK=
Map No. . . .47.7Q. . . . Block No. . . . . . . . . . .Lot No. . . . . . . . .9. . . . . . . . . . . . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .June. . .. .28 . . . . . . . . .. 19. 10 pursuant to which Building Permit No. . . 9.$7$Z
dated .Su1y.. . . . 5. . . . . . . . . . . ., 19. 3Ek 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 Family Dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . . . . . . . .. . . . .John.Robert.Krie$. . . . .. .. . . . . . . . . . . .
{owner, Imme1moc1,soft
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . NOrember. 9, 197'8
UNDERWRITERS CERTIFICATE No. . . . . . . . . . . .N 1;1379. . . .. . . . . . . . . . . . . .. . .. . . .
HOUSE NUMBER . . . . . .9�P . . . . Street . . . . . . . . . . . Clearview. Ave
. . . . . .. . ... . . . . .. . . . . . .. . . . . . . .
outho
. . . . . . . . . . .. . ... .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..ld�. New.York. . . . . . . . .
. . . . ..���. . . . . . . . . . .
Building Inspector
County Tax Number
1000-70-9-59
JJ
,f Town of Southold Annex 9/18/2013
P.O.Box 1179
- 54375 Main Road
Southold,New York'11971
kilt
CERTIFICATE OF OCCUPANCY
No: 36507 Date: 9/18/2013
THIS CERTIFIES that the building AS BUILT DECK
Location of Property: 940 CLEARVIEW AVENUE SOUTHOLD,
SCTM#: 473889 Sec/Block/Lot: 70.-9-59
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this otHced dated
10/23/2009 pursuant to which Building Permit No. 37531 dated 9/21/2012
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"deck addition to an existing one family dwelling as a lied for.
The certificate is issued to EILEEN DUFFY&MARK FOSHION
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
01
Auth d S' ature