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Home My WebLink About1000-61.-4-19.1 0 0 0 CD ni r' k r-r c c 70 fD k � 3 (D _ Q (D N o = Q N o N N T- =r CD v �� N Q W ., 11C O � W ::r m O CL CD C— w <. O o � o x �-- 0- � 3� N z CD O� o c ^ m s CDL CU l 1 3 m o O .moo c1�■ _ 3 m fD cr CD CD rD fl' z o 3 " o O � CD0 0 rF a N r+ r r-. mn a * CL r-� A Ask CD N = v SL, co o 0CD r+ `° m CD =r rt 0PLO m v � � m n °' `= o h * CD cn a � Q n Oy cuOD En C E 0 =3 v CL f � rM m 01 -0 o c -� m c a 0 cam- an O m m `O -0 w Cly '- o J o c N v � v, US. 0 qTd � 'va "Town Hall Annex Telephone(631)765-1802 �°p `° r 54375 Main Roads Fax(631)765-9502 P.O.Box 1179 0 Southold,NY 11971-0959 Cel l o C BUILDING DEPARTMENT TOWN OF SOUMOLD OC 0 2021 DD RENTAL PERMIT APPLICATIONBUILDING TOWN OF DEPT DTHOLD Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: h dj�45 Tax Map Number: 1000 SECTION -BLOCK -LOT � 1 SECTION B. OWNER INFORMATION: Property Owner Name: ori M ti,o S TS C 7� t�/0 0►A �r-�c�� lDIJ r� Property Owner Legal Address: Property Owner Mailing Address: R&j K 'ReJ 31 �( Telephone Number(s): Daytime 410 Eg54 2_'Evening410 0-S'b6gZ_Emergency410 b5i3 664 Z Property Owner Email Address: Page 1&S Town Hail Annex ,�� "�°� Telephone(631)765-1802 54375 Main Road ��s � Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 � 1% BUILDING DEPARTMENT TOWN OF SO1': THOLD 0 '/k Mailing Address of Managing Agent: 6 K-w Telephone Number(s): Daytime G�J-Y))_/7/7Evening 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, 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 Uni Number of rooms in Rental Dwelling Unit: [' Use and Dimensions of each room in Rental Dwelling Unit: 1 `rl�Dt Cc.C. �_P Page 3 of 5 9 s s Town Hall Annex 1 Telephone(631)765-1802 a i Fax(631)765-9502 54375 Main Road P.O.Box 1179 'TJ Southold,NY 11971-0959 �, A BUILDING DEPARTMENT TOWN OF SO ` HOLM 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 M� I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engine. 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. I 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 rAf So TOWN -OF SOUTHOLD BUILDINO DEPT. 765-1802 INSPECTION- ' [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATIOWCAULI ING [ ] FRAMING / STRAPPING [ FINAL h baff-#t73% [ ] FIREPLACE &-CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] `FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: ula _lp V Wwm�v_ LeL . A vum Wn '... -N Iy C Cevd VAI IN T� µ o DATE INSPECTOR Oct 09, 2021 Town Hall Annex �� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 UN 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 p'ro ssional'seal required Lor Architect or En lneer licensed Home lns ector must Provide copy of valid current certi cation Rental Property SCTM Number: " Rental Property Address: 53930 Southold NY 11971 Owner/Name: CAST - Cathy Demeroto 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 &1 144, saf Bedroom #3 210 s9f Bedroom #5 144 sgft Bedroom #2 144 s ft Bedroom #4 144 sqf 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 Signature Please place professional seal: s Ueld JOOIJ bullsIX3 .LL-Zl �,9"Xl ploglnoS 1_S` O ioaroad �....e y v xuv ' oxww 4• HOUSE FIRS7, FLOOR PLAN .B-rVL .9-EL ul h 4 � v.,awM;n WMM n r p�.vavxx..xw.wWWmmmxnmmmmmmmmw!ry �� 1 9�a�0 V :p Dew xel ............. ... , bio-majpjoylnoGj—®oryj;lp— HOUSE S E C O D FLOOR PL N Ll[l LLb Lf9 Rl MLI AN'LLDdUvelg'6 xoeod naw ti, m,w r. �•+ i-svo :luelp L96LL AN'Na.. au w., —,p,,nple9L,IP-p@ SNN6 9ZVI EZC LE9 L66 L L Z66Z 169LL9SYAp ke-I Co Z- AN'Pe6S K9 T yoogS umW 1soM l99 sloalluoae q/e olpnls fill 8�stw�t�►•-f' ✓ MM Cd^uGgvrr ----------- y 4 rrvt Y" Aix R2b k.'urvd efx• " ,w P M6�k T Fp�q N1"R.YG"6 Rw P$ tW Wk qN {If 5 h� p J Ir !rh� .._ II4� '� IPo Jk. Jwt. ,� f. _. a e „�.dia. .............. � VIP( � I ::. u r d � tV:,R,«:mow%m�kwrr. II m n P '01 ,_"...�, Y virv,p�7ak 4 �� y�p'-M � �+��k� .% 4[ri YY�rv� +. Y If YbVq KKYkN a y "w.,`MU I ,. 4�am`v 1 w°'...,vNime I ,�::.....�.a� ww�f"'� � mv:�rw•n«w�m�;�"� e ��ra�ww. .. Ircrrsco-� ,mar.« 1 r r Plan 1st Floor Plan ?n,, ,n �,,,,,,,,,,,,,�,�,,,,e tl F.muI F,�,m,� is � � Y� I f P fVeryr f I n,tlC $ yemlmw P N'RtchU 8 Rfn SRuai t Tj Y a e �' '�A GI11crr ra waRr . ....... ~m w kz m k E ww Condon Engineering,P. , Parsonage ly..,dC 9�MD1w.mtr- S-1 1755 5ig.9ee Road MaWl-k,New York 11952 •`c uvhn(m,IV Y 6Pa�Yrv:Cr.26-MD (631)298-1986 Rap-Brlck ro..004*b, K Om-o j..............2 x 1 r-,l 0................. 3 x54WSL Sopp.n RpS.09.m — Cohms Fro 6 .rr RvTd Foo, *, a. F_zron N, 3 x 5 PSL.SUPPM or F, in (3)1 75 x 7.25 LVL e1w S 0 111 M.7 2,5t�L L—dry FII.W 5 25 11 25 (3 5 w S—Led9r,,B-oft „ E AI KAM” AdpOrx E.Ming r Rc,p,or Bri.k ��h,,Balls 16"OC 51W WIMAN Staggered Ro tc rM IMI (2)PH. 6 �A N�p ............. A /'Mm r p R—.-,Wall S si,Wr 2 x 6 s to Existing B-Irr 14aA—.Adaq..l.S.pp.1t of 5 5 1 P-t Ah— BEDROOM 0 1–XL qfq%%41Ww Window 11...Ir Brick Fov Jau5 7 sr CP gar" Opa"i.g --o,27 . ..................... ........... Repair Brick Fou,v< PORCH .......... Cellar Plan 1 st Roor Plan .............. (3)1 314-X 7.25'M, 5t6"O Bars 25 ........... (a�j 0 fe A36 Fht:/ Plate ('�)j.ril,r Bea Detail- � � � I O I " o :"-n C "',� Cc, FD7 6c" ;mu ........... in . .......... tit on ......... .-.- CQ kA cc -n -n X 10 CA INC I IN NIn ....... /I ch G-) 0 Fu I wi � V ��F � � b�"�. µ.. 4 v G rt�-µow � ,�... Im� ,mow ry ppg PM CD 17 rr, Csw G7) all _.. ...".. . o m / 6 w d' (D �^ " ," ,r li 1 t r �d CD Ll lr KIT-- :3 .._ _..� ra m ., ( ° 4 o cul o 1 71-4 LA �. ._.._ �3 9 y O U0 (D O O r N 0 r V ; a 6 IT p k f Town of Southold 9/28/2015 53095 Main Rd Southold,New York 11971 47 F EK EXISTING CEWfIFICATE OF OCCUPANCY No: 37799 Date: 9/28/2015 THIS CERTIFIES that the structure(s)located at: 53930 Route 25, Southold SCTM#: 473889 See/Block/Lot: 61.-4-19.1 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- 37799 dated 9/28/2015 was issued and conforms to all the requriements of the applicable provisions of the law. .............................................................................. The occupancy for which this certificate is issued is: good f'rame,one 1'amLit dwelling with small front covered porch,rch�, 1 gas fir lace 1 fireplace blocked offi, ,gad�ucc e,�sor,y Mod frame 1 1/2 car Para, The certificate is issued to United Methodist Church (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Au. ed l;tttt' BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 53930 Route 25,Southold SUFF.CO.TAX MAP NO : 61.-4-19.1 SUBDIVISION: NAME OF OWNER(S): United ...... (S) ted Methodist Church OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: United Methodist Church DATE: 9/28/2015 DWELLING: #STORIES: 2 #EXITS: 2 FOUNDATION: Brack CELLAR: 1/2 CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: ___ BREEZEWAY: R X TYPE FIREPLACE: 2 GARAGE: DOMESTIC HOTW R: Off Boiler AIR CONDITIONING: TYPE HEAT: WARM AIR: HOT WATER: X #BEDROOMSk: E3 #KITCHENS: 1 BASEMENT TYPE: Unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: Wood Frame 1 1/2 Car STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: Roof shingles in need of replacement on accessory garage. REMARKS: INSPECTED BY: jARYF DATE OF INSPECTION: 6/22/2015 TIME START: END: 01ir Town of Southold 9/28/2015 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 37798 Date: 9/28/2015 THIS CERTIFIES that the structure(s)located at: 53930 Route 25, Southold SCTM#: 473889 Sec/Block/Lot: 61.4-19.1 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- 37798 dated 9/28/2015 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 church.* NOTE: BP 39868 restrogm and ramp Additions to church COQ-37797. The certificate is issued to United Methodist Church (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. th ria signs tura BUILDING DEPARTMENT TOWN OF SOUTHOLD MOUSING CODE.INSPECTION REPORT LOCATION: 53930 Route 25,Southold SUFF.CO.TAX MAP NO.: 61.4-19.1 SUBDIVISION: NAME OF OWNER(S): United Methodist Church OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: United Methodist Church DATE: 9/28/2015 DWELLING: #STORIES: 1 #EXITS: 4 FOUNDATION: Brick CELLAR: Full CRAWL SPACE: BATHROOMS : 3 UTILITY ROOM(S):Boiler in basement ( ) TOILET ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZE : . FIREPLACE: GARAGE: DO TIC'HOTWA ER. Oil TYPE HEATER: Off Boiler AIR CONDITIONING: TYHEAT: O WARM AIR: HOT WATER: Steam ' EDROOMS: #KITCHENS: l BASEMENT TYPE: Finished THER: AC+ ESSORY S UCT'URS: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: Side entrance to church in need of repair,interior and exterior. REMARKS: INSPECTED BY: YF DATE OF INSPECTION: 6/22/2015 TIME START: _ END: t ' f Town of Southold 9/5/2020 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41293 Date: 9/5/2020 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 53930 Route 25, Southold SCTM#: 473889 Sec/Block/Lot: 61.4-19.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/19/2019 pursuant to which Building Permit No. 43682 dated 4/25/2019 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: "as built"alterations to an existing one famil, dwellin as a lied for. Corrected 9/5/2020 to say"as built""alterations instead of sin e famil dwellin The certificate is issued to Olivanne LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 20-60707 3/4/2020 PLUMBERS CERTIFICATION DATED 7/l/2020 IN K Scanlan _............ Sa nature tlao y e FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ........ ..563.... Date ...............I..............."��. ..�5...... 19........ THIS CERTIFIES that the, building located at .......... Street MapNo. ............ ....... Block No. .......***.......... Lot No. ..........................***................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................. ?!,Z.Y.................. .1 195.x. ., pursuant to which Building Permit No. ...,.....753... ... dated...........................WY ............ 19..X,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 ................. .......................... .... .......! . ...:, .. .. a... . ...................................................I..........I.......... This certificate is issued to 0Utb0Ld.. th0 h.Ch=x24...amox.................... ................... (owner, lessee or tenant) of the aforesaid building. .. ...................Building Inspector'........ .,.,....,. .. FFt�tat' Town of Southold 5/4/2018 P.O.Box 1179 , 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39629 Date: 5/4/2018 THIS CERTIFIES that the building COMMERCIAL Location of Property: 53930 Route 25, Southold SCTM#: 473889 Sec/Block/Lot: 61.11-19.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/22/2016 pursuant to which Building Permit No. 40502 dated 3/2/2016 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: lteratlo¢ts for an ORera Hoose in an cxisting,comercial building as applied for. The certificate is issued to Olivanne LLC k. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40502 3/9/2017 PLUMBERS CERTIFICATION DATED W ...... At to e Signature StO ke Town of Southold W 5/4/2018 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE IFICA'T"E OF OCCUPANCY No: 39630 Date: 5/4/2018 THIS CERTIFIES that the building BASEMENT ALTE RATION Location of Property: 53930 Route 25, Southold SCTM#: 473889 Sec/Block/Lot: 61.4-19.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/13/2017 pursuant to which Building Permit No. 41975 dated 9/15/2017 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: construct interior alterations in basement of existina commercial.buildin era House as a lied for.. The certificate is issued to Olivanne LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41975 12/5/2017 PLUMBERS CERTIFICATION DATED 6/3/2017 �Willi m ;reamer Jr. it 0 ho " ignature,