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HomeMy WebLinkAbout1000-54.-4-7 T�� AKO- " - om' OF � Rental Permit �a 0556 z Owner Dotmedia LLC Occupied as Single Family Dwelling Located at 525 N. Sea Drive Southold 54-4-7 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. 11/3/2021 S. ]A � ode E o ce n Official This Notice must be posted by the main entrance at all times �I R" P � �r" "° a �`'c' I Town Hall Annex Telephone(631)765-1802 54375 Main Road 1 ax(53 .65- :02 P.O.Box 1 179 J , � Southold,NY 11971-0959 J il�. BUILDING 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: DC 'VC Tax Map Number: 1000 SECTION -BLOCK Y .LOT SECTION B. OWNER INFORMATION: Property Owner Name: Pa U—L Property Owner Legal Address: Property Owner Mailing Address: m; 'a'AAr IVY _757,571SE Telephone Number (s): Daytime" q Evening Emergency Property Owner Email Address: :6 � G ( tic;. k �_ C a� Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road ' Fax(631)765-9502 P.O.Box 1179 01 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelli unit, if any: Address of Authorized Agent (no P.O. oxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime _EveningEmergency 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 contai 'n 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 r i 4 Town Hall Annex x Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 TM k 0 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: 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, Q 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: Use and Dimensions of each room in Rental Dwelling Unit: �d , Page 3 of 5 Niki �o� Sol/"7, Town Hall Annex bTelephone(631)765-1802 54375 Main Road o � Fax(631)765-9502 Y.O.Box 1 179 Southold,NY 11971-0959 Cr M 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. 0-11, 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) COUNTY OF SUFFOLK) I n w ") 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 q SooTown Hall Annex ^� � Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179m Southold,NY 11971-0959 COM, *r ,N 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: 0A Property Owner's Signature: Sworn to before me thi g day of 2 , , Official Notary Public Signature and Original Notary Stamp CO NIE 0.BUNCH Notary Public,State of New York No.01 BU6185050 ualified in Suffolk County Cornaiis ion Exairps.Antis 14 2.0-u Page 5 of 5 �- N Ste- Dr. s L6, TOWN OF SOUTHOLD BUILDING DEPT. � rwa , 765-1802, INSPECTION III V III°; "l"°III I 1 S-111' IIN I 111:10UG111°°I IIP III ,BG11, FOUNDATION III[) III V III,,,,,, -1.1 14 114° IIIA "III'"' 114111 III., 1111111 NI. IN TIMIREIP111 ACIIIH & CH1111ANIEY1IRIIIIRIIE SAFETY III III Ilf 11 111 IIIA III°:°IIIj°:jII[;;1; IV° II[III IIsTAN I` COINs niuc°'1014 1N II°wl@SIE 13ES11S"'MIT PlEI IN,-r-mKIII-1 IIS IIS I III,,,,,,IIS ""r II III III,,,,,, (11ROUG1°°III) III.. „III Ili 11i--::::c"'r 114°uIII,,,,,, (PINAll,,,,, C011DIE V1110111,,,, fCAU111 114III REMARK DATE INSPECTOR .... P 1S—U YXJ.���I/%/ (5)CXW155 3.5muii 1. 1 (2)2x8 DFe2 HDR Nr "' m r U c o t� Af� �.. m E. b; no i 3 0 (2)2X8 DFN2 HDR C V 50 yy Rm a 10'-0„ ©0 n o 1m 00 n m "d M t7 -a PO pc� Q 71 r z x x G� lz nr � . 0 -- �(f,y CX755-FWH9161tAL-CX155 3 "+---(2'.2XODP92 R- CN 61 1/2 w ^ , ' w m m. X= 'mow_ 4W 0 W ---- .,- 0------------ \'\. a --,("c 2X8 DP# DR- � TfP.4P�FR£D AN281 AN281 CW14Lmx CX155-P H31611AR-CX15 p z m - c�nm 4z z o 2D Aatln n o ` OZr'On z �Z r ay p2 t-'`zp 'S^ Z �m� 1"zo a 8 >S x9 0 q no n m z -2.k Oap O --- a o� Ea oao O D o m o >D o Z m O C C Z F� ��X O D y Z N A Q __ p O - - �` o pz of To© Sz Nim G -� n ny 1p o r om- Q°z vZ� ° O z n Z wap CN Cn C,7.0 S. 2 m A m Cl1 04 E:l n Z -1 5,6 'p0zz Q p 1>� mr. ZA Z 3 � QZ r:a 1 F m X Y, S f l Q r r r r i i r o. o O h CX155-FWH31611AL-CX155 3,5mull --------- tz zxaoF# a "wK lei, '1 �nall, n �:10 ` ;a n a 0 m — o V F A ° x,\10 -(2 2X8 DFN DR 'AN281 CWIq Z x m CX155- H31611AR{X15 3.5muW �0 SOyX Z Apz HOZ Z SR �c Ouzo �0c z H� on rz o e± A p C m O 0> b0 tt y O �O z m -------- z sn m �F ;0 a iZ n iZ ?p �O r� -4 I FORM No. a TOWN OF SOUT14OLD BUILDING DEPARTMENT Town Cleric's Office Southold, N. Y. Certificate Of Occupancy No. 45M 9 . . . . . . Date . . . . . . . . . . . . . !.14Y. . . .6. . . . .. 19. 73 THIS CERTIFIES that the building located at N./Q,Igarth. Sea.P7 . . . . . . . Street Map No. XXX. . . . . . . . Block No. .� . . . . .Lot No. . XX. . . .Sou.t.aold N.X. conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .Apr I. . .5 ., 1961. . pursuant to which Building Permit No. 1.37N. . dated . . . . . . . . . . ..fpr:l. . .5 . ., 19. 61., 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- J... .Jazv. a �Iife• . • . • .owne.r.s . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Sf-,Qt. . .bY. n .V;04. . . . UNDERWRITIERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER. . •525. . . . . . .Street. . . N.Orth. Bea. larIve. . . . . . . . . . . . . . . . . . . . . . . . . . . . [3ui[di�l�ti [ns[7r�tor tt Town of Southold 2/25/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 ,-. V o CERTIFICATE OF OCCUPANCY No: 41841 Date: 2/25/2021 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 525 N Sea Dr., Southold SCTM##: 473889 Sec/Block/Lot: 54.4-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/27/2017 pursuant to which Building Permit No. 43980 dated 7/17/2019 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: Iterations and additions including two sunroom additiozas 1. rtlludiragl, decl and outdaor lao�vea stalla an, istin sip leery dwelling as applied for, The certificate is issued to Dotmedia LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43980 5/30/17&7/19/17 PLUMBERS CERTIFICATION DATED 12/15/2020 Urt n odd 0"D aid U leo et Signature