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HomeMy WebLinkAbout1000-62.-1-24.7 (Holyaoke Bldg #5) TOWN OF SOUTHOLD Y Rental Permit 0606 Owner Colonial Village Tenants Corp. Occupied as Single Family Dwelling Located at 55075 Route 25 Southold 62-1-24.7 Maximum Permitted Occupancy 2 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. 3/17/2022 rode Enforcement Official This Notice must be posted by the main entrance at all times Town Hall Hall Annex Telephone(631)765-1802 ��� r" 54375 Main Road ��` Fax(631)765-9502 P.O.Box 1179 ? Southold,NY 11971-0959 "' BUILDING DEPARTMENT TOWN OF SOUTHOILD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) JV Section A. _w Property Information: Rental Property Address: s,5*5075 Route 25 Co/onl'a/ V,'I1a. e 116/ oa�c ff5# J7ovfho/a'�l 7/ Tax Map Number: 1000 SECTION _0 6 2, 00 -BLOCK 01 . 00 -LOT"" 24 , 7 SECTION B. OWNER INFORMATION: Property Owner Name: &a/?e Ba-rlt e Property Owner Legal Address: Property Owner Mailing Address: 02 i'rrn e f S t " na a 2og9 Telephone Number (s): Daytime 693/-76!o .. Evening j&Z4 _ Emergency Property Owner Email Address: d/ a ne bh an��nade�hatinQi/ C��YV✓ (y IOD(o�jS Page1&S 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 HOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Dl ;me Burke Address of Authorized Agent (no P.O. Boxes):. 7 d 2- ne7` 1-e rl—N y Mailing Address of Authorized Agent: S4 2 da .3 7 (P (P 2— 0 Telephone Number(s): Daytime Evening Emergency Email Address: dl . a e b Alm trade- cd hotm Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: d 4ng Burke Address of Authorized Agent(no P.O. Boxes): k ralrXQ- 9-S 0 W yuN Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): as OWI1pi✓ Page 2 of 5 Town Hall Annex k" Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959cou " " u BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: 11pwr" 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." Ir" INS Rental Dwelling Unit Identifier: an4 5 1 / 0/Y da k 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: Ile 2 ' L,'v' morn). Pln'rj - 716 // x toilet Page 3 of 5 Town Hall Annex ° Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959w �� a�. BUILDING DEPARTMENT TOWN OF SO HOLD 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 ❑ 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 D lQ/'I e ur 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 a Yi �, Tele Town Hall Annex hone 631 P ( )765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 � � Southold,NY 11971-0959; BUILDING DEPARTMENT TOWN OF 3O ..SOLD 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: D 1 Q/2e Property Owner's Signature: jSweforeme this/6 day of , 202 2_ Official Nota P lic Signature and Original Notary Stamp ro-recV awn Johnson NOTARY �'-w.Notary Public,State of New York . PU3L1, --N.O1J06349053 P : fl"sic .in Suffolk County "", �"` � ssaxrta�iw��oas Gxpirn� 1.0/1.1/Z0?-`� Page 5 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 r Southold,NY 11971-0959 nil ; BUILDING DEPARTMENT TOWN OF SO .ITHOLD 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 required for Architect or Engineer,licensed Home inspector must provide cony of valid current cern cation Rental Property SCTM Number: N Rental Property Address: Owner/Name: 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.) 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. Print Name and Title Original Signature Please place professional seal: Town Hall Annex Telephone(631)765-1802 54375 Main Road G Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: / Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: v our OWN OF SOUTHOLD BUILDING, 765-1802INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ] SUL TI NSC ULII G I l I /STRAPPING [ FI AL to j ' [ ] FIREPLACE CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL.-(ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE l°� Ted /1 C�oSeT �iViyCy RooNf ,, 10 d4©5 0� y , 'f Lj,4 It6LIOAXt �//? '0-5 n ,r { SVC, 3o"u<ac�nu Ue ,r Lc Flans udo.� A!Y',rnKAr-.o.y 4� 91- P. IU TT F7encc 6-r w' I.i}'to �'rTru L'1 �... .. - �3 h .� s rw. e�,._A,E s r,•,,y —— 71, r--UA,.A( PIAV - V 3 .-. n_n 3 5 � f (-i.rarf t - RL AFlrT�eo.JS 6 TW N 1. Y�.I # -Lr7 <.r € ' ' f 1�.. FPTs,Do uRCC SY,wRJ Wr'rN s �-� ; '� rray.• l Er,< �,.� 3 '- % .to otW V Y tzr1VQ.X(l' � Ju APT M - t L1rrr>aYe3C' i3 1.i 32'('t:.4' A%`"P yr " - a � s� ] ' "' €�� _.. .. asw - „ •ar � o.Pocee Ft`T' .%/ 6J� t !!ro^r � -. - i of. GULJ.Jr nL IJi[!.?(xc tiocTN at9 •V•rf � jY D^ <�=-� _. , U ---r- - -- ---- ----- - / TRIM COLOR 4—� 77 M. Bldg. Extension Extension Extension Foundation Both Dinette Porch 9 Basement Floors Porch ; Ext. Walls Interior Finish 1 LR. Breezeway Fire Place Heat DR. /6 TY ]:R o Garage pe Roof Rooms Floor BR. Recreation Room! Rooms 2nd Floor FIN. B 0. B. Dormer Driveway Total JI-------------------- TOWN OF SOUTHOLD PROPERTY RZZCOR[q/10/1<� fry OWNER ISTREP VILLAGE DIST. LOT ov 4)A FORMER OWNER N E ACR. S S TYPE OF BUILDING Mkt. .ES. SEAS. 1 VL. FARM COMM. MICS. Mkt. Value LAND I IMP. TOTAL DATE REMARKS Ai- 'illable FRONTAGE ON WATER Voodiand FRONTAGE ON ROAD /�eadowlcnd DEPTH louse Plot j BULKHEAD otal COLOR a TRIM € € 0 g } r _ �i M. Bldg F n i t a dat'on Both �' Dinette Extension v cement Floors :- K. Extension Ex-t, Walls � Interior Finish LR_ Extension Fire Place > Heat DR. I ype Roof 'Rooms 7st Floor BR_ Porch - reation Room! Rooms 2nd Floor IN. B- , Porch ? Dormer Breezeway Driveway Garage Patio O, B. Tota I n �o . e TOWN OF SOUTHOLD , 3� � e OWNER STREET 7 DIST.� SIS B LO T FOR-AvAER W P, i ' ASR - $ ' TYPE OF BUILDING RFS. SEAS. VL. FARM . CB, M!CS, Mkt. Valu k LAND IMP- TSTA! DATE REMARKS i 20 Y F = a� _ PF e r. { J r Z APSE BUILDING CONDITION _ NEW NCRt0AL BELOW ABOVE Acre Value Per Vclue Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot - BULKHEAD 4 Tota l DOCK g COLOR TRIM - E i - \ �_� - 1QI 3 € 3 3 e t s x l M. Bldg r.< a { - Extension � l Extension ' ! Extension I i } i Foundation _ Bath Dinette Porch Basement -_ 1Floors �. Porch ;Ext, Wa[Is _ interior Finish LR. Breezeway Fire Place i HeatDR r . ' Garage Type Roof Rooms 3st Floor FSR. Patio Recreation Room{� Rooms 2nd Floor FIN. B e 0. B. Dormer Dri=;ewar Total s x � - - / --o' -- ~ �- - --- -------- --' ------ ----- -- - ' - - � T _ L YCARD - - as OWNER STREET VILLAGE DIJ i E_ SUB_ LOT a I FORMER OWNER N E ACR, s ; 0. z 1 SW TYPE OF BUILDING > RES, SEAS. ` VL. FARM COMM. CB. MICS, Mkt. Value LAND IMP. TOTAL DATE REMARKS t w - 6 i 1 I l I � i 9 } AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Ac re Tillable ! FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total DOCK > [ ---« -r-~---�� -- ------ -~----------,-����-�----- ~�-' - - - - - ' - TOWN OF SOUTHOLD ,CARD OWNER STREETVILLAGE DIST.' _ SUB. LOT _ .: " — a F, OBER OWNER N A _ s R '. s S ' W TYPE OF BUILDING s� RES, i SEAS. VL. I FARM COMM. CB. MICS. Mkt. Value LAND IMF. TOTAL DATE REMARKS 3 3 , 3 AGE BUILDING CONDITION - I NEW NORMAL BELOW ABOVE FARM Acre Value Per Value i Ac re Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD , Meadowland DEPTH £- House Plot _ BULKHEAD Total DOC K s s 3 x . . E x e 3 p� IRS s IWE d, UY, 17 6 a q s e f M. Bldg I Extension Extension - - I Extension Foundation Bath Dinette Porch , F Basement Floors K. _ _ I Porch ;Ext. Walls Interior Finish LR. Breezeway Fire Place Heat DR, IR Garage ,. ye Roof ooms 1st Floor BR Patio 'Recreation Room Rooms 2nd Floor FIN. B 0. B. `Dormer ! Driveway Tota I | -- - - ----~- -`'--'- -- ^ TOWN OF SOUTHOLD PROPERTY � / �-_�/ /~�~ | i i COLOR TRIM t _ t M Blda. _ i Extension Extension l ' € E Extension ;Foundation I Bath Dinette . Porch Basement ;Floors Porch 'Ext. Walls Interior Finish Breezeway - a Fire Place _ €Heat FDR, Garage - ! 'Type Roof I Rooms 1st Floor BP.. Patio Recreafion Room Rooms end Floor ' FIN. B 0. B. Dormer 'Driveway Toto I ' T SOUTH PROPERTY CARD OWNER STREET . y VILLAGE s DIST,' SUB. LOT _FORMER OWNER N = E I A z W G S TYPE OF BUIL I � .. RES. : SEAS. VL, FARM COMM. CB, MICS. Mkt, Value LAND IMP, TOTAL DATE REMARKS 3 J 15 ji F , 3 v � S � — s AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value m Ac re Tillable FRONTAGE ON WATER Woodland I FRONTAGE ON ROAD 1 Meadowland DEPTH House Plot BULKHEAD TU ., DOCK O CO L TRIM M T - t I f i r i = f ] M. Bldg- Extension mm Extension j 3 r Extension I ;Foundation {Bath Dinette Porch 'Basement Floors K. Porch Ext. Walls I Interior Finish YLR, Breezeway :Fire Place Heat DR. Garage d _Type R s oof - Rooms 1 st Floor BR. i . . Patio 4 1 !Recreation Room Rooms 2nd Floor FIN, B 1 O. B. Dormer g7 ,Driveway — Tota i D t CARD TOWN OF SOUTHOLD PROPERI,914j � OWNER TET i— ;z: VILLAGE SUB. LOT /* FORMER OWNER N EAC R. 0-6 S W TYPE OF BUILDING n !4� RES VL,SEAS. FARM COMM. CB. MICS. Mkt. Value !z- LAND ]MR. TOTAL DATE REMARKS AGE x BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per I Vclue Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot l BULKHEAD Total DOCK ! COLOR f TRIM ' � I 6 - M. Bldg � I _ _a I � Extension } I Extension I { ; Extension =Foundation 16oth1 Dinette i Porch ;Basement - ?Floors I Porch I Ext. Walls lInterior Finish 1 LR. 1 Breezeway ;Fire Place :Heat DR. Garage Type Roof lRooms 1st Floor BR. i Patio `Recreation Room iRooms 2nd Floor FIN. B O. B. Dormer,, Driveway ; Total I t COLOR _ TR'=.1v1 e i e i F e _ I a M. Bldg '- Extension 1 Extension ? i i Extension Founclotion =Both D_3G _-__+,4 , Porch i Basement 1 Floors , PorchExh. Wallsl Interior Finish Breezeway Fire PlaceHeatDR. Gar ,g ,TVpe Root j R Ji,:_ is' t 0r ` R. rs 3 Patio BCreation RO�„� Rooms 4,1 d Fi0or F1N. B -F—A- Mu O. B. D firer Total { f a n a s 1 COLOR TRIM x _ e 3 f , F � s g l � e ! 1 l 3 M: Bldg - — m { Extension 3 I Extension — i Extension Foundation Bath - t Porch Basement _ Floors l<. Porch - Ext. Walls -� 'Interior Finish LR _ _ Breezeway Fire Place J9I Heat DR, Garage ,ape Ro Roosr,s 1st Floor BR. _ — Patio Recreation Room: Rooms 2nd Floor ` FIN. B 0, B. Dormer Driveway Total SUPERVISOR'S OFFICE TOWN CLERK'S OFFICE Ib South Street Main Street Greenport, N. Y. BUILDING DEPARTMENT Southold, N. Y. Tel. Greenport 7-0550 Tel. Southold 5-3783 TO'W "'N OF SOUTHOLD SUFFOLK COUNTY, N. Y. BUILDING I'NSPECTOR'S OFFICE CERTIFICATE OF OCCUPANCY Apt house # 8 (W'a. Holyeak* House) No. Date 19"49– THIS CERTIFIES that the building located at 1Street, -- Map No. , Block No. x= Lot No. -in the Town of Southold, conforms substantially to the approved plans and specifications heretofore filed in this office with Application for Building Permit dated 19- pursuant to which Building Permit No. _, dated 19(x, 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 This certificate is issued to joulls"11 141 owner, lessee or tenant) of the aforesaid building. RoDeApproval Aug21 , 1969 by Re Villa* ( No additional fee required) G° hiding ns r (The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the completion of the construction in compliance with the Multiple Residence Law and with other laws, ordinances or regulations affecting the premises, and in conformity with the approved plans and specifications.) FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTt4ENT Office of the Building Inspector Town Hall Southold,N.Y., , P� Certificate Of Oc:8 upancy Z10611 81 No. . . . . . . . . . . . . . . . . . Date . . . ff,« . 'Iu.Zy, .1.►. , , . . , . . . . . . , . . . . 19 . . . P THIS CERTIFIES that the building . . . . « . . . . . , . . . . . » « . . . . . . . . . . . . . . . . . . » . . . . » . . . 485 Boisseau Ave. , O� Southol.d, New York Location of Property . . « . . . . . ; . . . . . . . . . . . , » . . . . . Mouse fti�o. � »fr�'et� �H,rrr,ie t. County Tax Map No. 1000 Section . . . » .abs 4a ra. . . . . . .Block ��. . . . .t. . . . . . . . .Lot . « . . . .Pia. . . . 0 a . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed l p No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . January. . . . . . . . .1. . . . . . . 19 . .8�ursuant to which Building Permit No. . . . 11020. .. . . . . . . . . . » . 81 dated . , January 21 M « . » « « 19 . . . ,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 „ . . . . . . . „ Private One-Family Dwelling redThe certificate is issued to . , , . .. . . . . i c lc F. Rich towner,l bT6°r1 , of the aforesaid building. Suffolk County Department of Health Approval . .�I /.`.1 ! , �. . . . . -0 . .p,', , . . i11. , P.E. 456 UNDERWRITERS CERTIFICATE NO. . . . . . . 2, . . . . . . . . . . « . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector B Rev.1/81 re g R , if