HomeMy WebLinkAbout1000-61.-4-19.1 TOWN OF SOUTHOLD
Rental Permit
0572
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Owner CAST Inc.
Occupied as Single Family Dwelling
Located at 53930 Route 25 Southold 61.4-19.1
Maximum Permitted Occupancy 10
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.
1/4/2024
ode for e t official
This Notice must be posted by the main entrance at all times
R W
10
631 -7654802
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CA
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI
[ ] CODE VIOLATION [ ] PRE C/O [�
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440
DATE INSPECTO
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Sept 23, 2023
J
Town Hall Annex ��` °�� Telephone(631)765-1802
54375 Main Road °k � Fax(631)765-9502
P.O.Box 1179 "1� �
Southold,NY 11971-0959
UN
BUILDING DEPARTMENT D E C 5 202
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
Pro essional seal re uired for Architect or Enaineer licensed Home Inspector mast Provide
copy of valid current certi nation
Rental Property SCTM Number: i
Rental Property Address: 53930 Main Rd,, Southold
Owner/Name: CA5T - Cathy bemeroto
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 #3 210 s f Bedroom #5 144 sqft
Bedroom #2 144 s ft Bedroom #4 144 sqf
Property Description (Include all improvements indicated on survey)
--singte-�ly 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
Print Name and Title ceo# 1216-0283 VOnal Signatur
Please place professional seal:
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"Town Hall Annex Telephone(631)765-1802
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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
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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:
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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,