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Home My WebLink About1000-6.-4-5 TOWN OF SOUTHOLD Rental Permit - 0557 Owner Alfred Ferguson & Ann Posey Occupied as Single Family Dwelling Located at Central Avenue Fishers Island 6.4-5 Maximum Permitted Occupancy 8 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. 10/27/2023 Code Enfo ement o� � This Notice must be posted by the main entrance at all times M TOWN OF SOUTHOLD BUILDING 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLSG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (TIl [ ] CODE VIOLATION [ ] PRE / l ' REMARKS: it zox� INSPECTOR TOWN OF SOUTHOLD _ PC 'l R Rental Permit 0557 Owner Alfred Ferguson & Ann Posey Occupied as Single Family Dwelling Located at Central Avenue Fishers Island 6-4-5 Maximum Permitted Occupancy 8 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. 11/8/2021 Code Enfor" gent Offi :i This Notice must be posted by the main entrance at all times k Telephone 631 765-1802 Town Hall Annex t; P ( ) 54375 Main Road g Fax(631)765-9502 P.O.Box 1179 4n Southold,NY 11971-0959 eo 1 ; BUILDING DEPARTMENT TOWN OF SOUTHOL D 1 RENTAL PERMIT'APPLICATION ""Pov d j r, Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000SECTION -RLO -LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: �rl Lek.)ls LA Telephone Number(s): Daytime Evening Emergency Property Owner Email Address: ' L 6 Page 1&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 SO OLI) 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. ❑ Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of all smoke&carbon monoxide detectors. ❑ 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. 0 Rental Permit Fee: $200.00 B Town Hall Annex v' Telephone(631)765-1802 54375 Main Road �� Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOXYMOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): k"e Mailing Address of Authorized Agent: Sp` Telephone Numbers : Daytime `d5- Ev p yt' ening � Emergency Email Address: C- isle rP�l C�w� 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 elveningEmergen Email Address: w SECTION E. SITE MANAGER INFORMATION: (required for rental Propertl s containing more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road E' Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOTMHOLD Mailing Address of Managing Agent: Telephone Number(s): DaytimeEveni Emergency 7 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: 1 Number of rooms in Rental Dwelling Unit: • 1W)frw•5 2. T��Vl-,Icy�.� I Use and Dimensions of each room in Rental Dwelling Unit: Page 3 of 5 Town Hall Annex r� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 � Southold,NY 11971-0959 BUILDING DEPARTMENT TOW' OF SOUMOLD 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. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) �,,"�. I bn -:�C, � � 6, ti �, 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 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 SOUMOLD 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: lS Property Owner's Signature: Sworn to before-me this'Jay ofL2071 :��' � V" .jq-22 Officia ota a lic Signature and Original Notary Stamp Page 5 of 5 u v u u v v v 30 o r O O O v M mm D C C a M 0 m Z z < cn a z v v w j z Ro -1 Z " Z .-. m IV in z c z = v O � zIA = c < IA 0 y co zm a N no r--1r, r+ i Mi Cc C v u u u v u 0 0 f= �_ M :0 Z m A h) Cl m r m Z Cl) O to M M m a c cC. n m V) r r 0 cn D D v O r 0 -n -o Z a z m cn 0 z 0 M AA-\ eters e Nil w � � i�� 1 04, 1L w, 'll x t 4, 'll x 1 , � Lin Sirnoke sffw,)I(e 40 BR r Y� II r , Al 15 X "$6 m-r e 1000-6-4-5 3527 Central Ave.FINY Ferguson Sri 0 sa� qk n mw -- 'Make µ L, oke oke m:ok : . Combo in the basement 7 " TOWN OF SOUTHOLD PVtERTY %.jWR OWNER STREET VILLAGE I DISTRICT SUB. LOT } s I FORMER OWNER = i N � - E ACREAGE a r (� w 71- S u C Lt c.4\ ! TYPE OF BUILDING I RES. ; SEAS. VL. FARM COMM, IND. CB, MISC, Est. Mkt. Value LAND IMP. 9 TOTAL DATE REMARKS i vq 9 a � It J ' r NEW NORMAL BELOW ABOVE [,.,-,FRONTAGE NTAGE N WA Farm Acre Value Per Acre Value !'FRONTAGE ON ROAD 1 Tillable 1 BULKHEAD' Tillable 2 j DOCK - Tillable 3 3 � Woodland i I Swampland Brushland House Plot OC}t` Toto l E r-- ...... �} tl.T"% rp c rn i 00 �y r I o o f i l P^.:V.. e...r✓' i .�, �,�J m p ,' � r//� "� 1®E;qqy � 1 v 1 r r l " a w r' Ot )f� b s h ( X rj O I f a lI � CD C7 r a y err � F Y r p w uo f 0 7 � 2 � 7D � � �n cz e O O O C) y i t'ti r -n O O O 0 N CD ? .. 19 u ffi Rn 1 r D i � n ;avv v� Ww f f M 11 t i m. y. y FORM NO. 4 TOWN OF SOUTHOLD ' BUILDING DEPART14ENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22839 Date JANUARY 18 1994. THIS CERTIFIES that the building NEW DWELLING Location of P.rope ty House CENTRAL AVE. FISHERS IS N. '. Street Hamlet county Tax Map No. 1000 Section 6 Block 4 Lot 5 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated. AUGUST 24e, 1992 ___pursuant to which Building Permit No. 20981-Z dated SEPTEMBER 254 1992 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 ONE 'FAMILY DWELLING 'WITH ATTACHED DECKS AS APPLIED FOR The certificate is issued to ALFRED & ANN FERGUSON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-83-0°AN. 10 199+ UNDERWRITERS CERTIFICATE NO. N-292825-10 W 93 & N-292822-10 '18'93 PLUMBERS CERTIFICATION DATED OCT. 16 1993-Mario Zan hetti Jr. 4 01?"��, Bu" Fnd Inas e' tar Rev. 1/81 1 mystic Iste ..............J inc. �..�.� Po FellvSw. ptUP�� .2 pot.,Ilk y�- P.O. BOX 475 • fisheizs isLdno, ny 06390 • teL; 631-788-7882 " fAX: 800-516-3601 • www.mysticiSLCPEALty.com