HomeMy WebLinkAbout1000-115.-14-14 TOWN OF SUTHD
Rental Permit
0610
Owner Michael & Lynn Ruder
Occupied as Single Family Dwelling
Located at 2275 Deep Hole Drive Mattituck 115.44-14
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.
3/30/2022
ode ref nt Official
This Notice must be posted by the main entrance at all times
Town Hall Annex Telephone(631)765-1802
54375 Main Road �`; �� br Fax(631)765-9502
P.O.Box 1179 s
Southold,NY 11971-0959 "' v
BUILDING DEPARTMENT
TOWN OF SOUTHOILD -e )
RENTAL PERMIT APPLICATION �
Rental Permit Fee $200 (Application must be renewed every two years)
p�M3
Section A.
'MAR 202
BLD
Property Information: TOWN F O Dt:�loL
Rental Property Address:
tg
Map � -LOT.,A—Tai Ma Number. 1000 SECTION � L�OL ,, �, � _. .1.
SECTION B.
OWNER INFORMATION:
Property Owner Name:, , _, _ �. .... �
Property Owner Legal Address: Property Owner Mailing Address:
2- 2 ... ... ,.'D 2 u�✓'f e 7._,�.
63
Telephone Number (s): Daytime_,._,_,____ Evening_„- Emergency,,
Property Owner Email Address: _..... � ��'� µ�rvd,�.M
Page 1 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 SOHOLD
Section C.
Authorized Agent Information: (�
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent (no P.O. Boxes): _M
Mailing Address of Authorized Agent:
Telephone Number (s): Daytime_ Evening Emergency—.,' ,
Email Address:
Section D. �1
Managing Agent Information: I
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 containing 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
Of
Town Hall Annex Telephone(631)765-1802
54375 Main Road % Fax (631)765-9502
1'.0.Box 1 179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: _.......
Telephone Number (s): Daytime,. Evening____.,,..............m,,__._.,. Emergenc
Email Address:
SECTION F.
PROPERTY CITI
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." ��"r wn— — Z �
1
N g
Rental Dwelling Unit Identifier: , I
Requested Maximum number of persons allowed to occupy Dwelling Unit: „a
Q.„� _.. _.m..... .._... ., ... ... ...
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
��- 2
Page 3 of 5
Town Hall Annex r Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
'k
P.O.Box 1 179
Southold,NY 11971-0959
/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.
i 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)
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
r
e;
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box It 79
r
Southold,NY 11971-0959 °
BUILDING DEPARTMENT
TOWN of so OLD
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, Ma aging Agent, or Site Manager.
Property Owner's Name: tJ G i
Property Owner's Signature: ......
Sworn to before me this zt day of �--ec,, , 20�
Official Notary Public Signature and Original Notary Stamp
KRISTIAN A Rf'INIBACHS
Notary f'uhlic-Stab of New York
NO, 01 RE641 5967
QW1116(ld Sri ktrfldtk Cdunty
MY Cuma6sltltt E*11ltos Mar 29,2025
Page 5 of 5
tILAJ� .
T WN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION I ST ROUGH PLEIG.
FOUNDATION 2ND INSULATIOWCAULKING
FRAMING/STRAPPING ��N,AL 6v�t
FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION
ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
CODE VIOLATION PRE C/O
FLOORPLAN SKETCH
BWO'YWf:RUDER � .�... FileN ,: TF11121605AZ
Erto Case No.:428366
f-id L b�atNgCk _ t I NY 1 1962
HERS FEDERAiI.CREDIT UNION
(artdt TEACHERS _ _. .. ............ . _ ._...__.._.. _....._....w.....w. _._w......................_
71
CO
Al
e�h�"P9
pqg,� KITCHEN DINING
O6"CA "4 X 8�a4
LIVING GARAGE «
&A C14
Ii
24.0'
15.0' 14,0'
Comments:
AREA CALCULATIONS SUMMARY LIVING AREA BR KDOWN
Code Description Stze NetTotat5 BreakdovmSubtotals
GLAl First Floor 903.00 903.00 First Floor
GLA2 9eeoad Floor 615.00 615.00 15.0 . 25,0 375.00
GAA Gerage 291.00 294.00 22.0 as 24,0 528.00
Second Floor
6.0 s 31.0 186.00
11.0 w 39.0 11 00
i
I
I
I
I,
TOTAL LIVABLE (rounded) 1518 4 Calculations Total(rounded) 1518
_.. ...v,_...,...... .. w.,,......,.�.........M „_a_ ...w ....m ..._..
500 WEST MAIN STREET,STE 107,BABYLON,NY 11702(888)317-6957 FAX(631)422-4605
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TOWN OF SOUTHOLD PROPERTY RE
OWIN �4TRE T -
L�eCE DIST,_ SUB. LOT -
4
FORMER OWNER ;' N Ir ACR.
41Is
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W OF BUILDING3
RES, - SEAS. VL. FARM c COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
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AGE BUILDING CONDITION
fS.4 .m. ,' ,
NEW I NORMAL ' BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland
I FRONTAGE ON ROAD s _.
Meadowland DEPTH
House Plot BULKHEAD
Total DOCK
-753
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115,14-14 12/2013
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Extension L�,.,
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EensirY' ���5
Extension
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-5PO Q} o n otion '' Bath i \ Dinette
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osempnt _ Floors i 4 ' K. I
Porch t a aInteriorFinish -'�
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Breeay ,` iFire Place iHeat � �
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Garage
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_ = A Rooms l st Floor R. ,
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Patio 'Recreation Room ;Rooms 2nd Floor -"� `{
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Total
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERIC'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. Z...240!............. pate ..,................Apr#........ I.......... 1 .. ..,
THIS CERTIFIES that the building located at ..j)j*/.`.*j,•Jj/.j6 p Street
MapNo. .... .,..,..,.... Block No. ...... . ......,.. Lot No. .,...... . ttitnakj.....N440. ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
19.66., pursuant to which Building Permit No. ...297.6..Z
dated ...........................» ........ 19..66., 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 ........
'rvats' e' l.ly.. r7. : h ...........................................................
The certificate is issued to ........,, , Aa,6.,&,.Oen.. �, ." d ..I ...
...... ... ..............a.........,.,..
owner, essee or tenant)
Of the aforesaid building.
H,p.approval F�Sb 99 1966 by R. Villa
Rctorll� �.... ...