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Home My WebLink About1000-31.-7-1 TOWN OF SOUTHOLD Rental Permit 0618 .g . Owner Jeffrey Rogers Occupied as Two Family Dwelling (Unit A) Located at 8200 Route 25 East Marion 31.-7-1 Maximum Permitted Occupancy 4 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. 4/12/2022 ode r e nt Official This Notice must be posted by the main entrance at all times ` Telephone(631)765-1802 Town Hall Annex ��1 ,e Fax(631)765-9502 54375 Main Road i �Ak ice" r P.O.Box 1179 �r, �a��iK ," N , Southold,NY 11971-0959 APR __ 2022 BUILDING DEPARTMENT 0 � � c° a a p-� TOWN OF SOUTHOLD 'n."OVM OF SOufi-jOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -BLOCK( _ SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 4S6 Telephone Number(s): Daytime Evening Emergency_ ,_ ..,,__.- Property Owner Email Address: aao f2e,6 101-39D Page 1 of 5 rs` Town Hall Annex ' " Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 �k �� P.O.Box 1179 �fIRG Southold,NY 11971-0959 �✓� � ��fuu i`� BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: 1�r Name of Authorized Agent of dwelling unit, if any: !µ`! ._ .w. .,_.,. .._w_. Address of Authorized Agent no P.O. Boxes : ..... Mailing Address of Authorized Agent:._,._._. ,.__. .....,.,... __ ,,,, ,._.._. ....._....a._ Telephone Number(s): Daytimer......W µ _w Evening d� Emergency„___ EmailAddress: ......... ...- ........_. ...._wwww. .. ........._. __._..� ._.__._ ..www_�._w.ww.. ._ �. . w.. �. Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Mailing Address of Authorized Agent: Telephone Number (s): Daytime Evening Emergency EmailAddress: _._ ._.,..._......_...... .............w......... ..... ..._ _ _ ..... _. .w. _._. ._,. .__w. .... .. ._...� �. 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):,_,_.-.,,,—..—, .............._.�ww...... .. .�._.. Page 2 of 5 t '�P, wwf 1 a�� '✓ ,, Town Hall Annexy � Telephone(631)765-1802 54375 Main Road „ Fax(631)765-9502 �o P.O.Box 1179 , �oD)is�ai t , Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: r4/N Telephone Number(s): Daytime...... _.............— Evening_.,,,__,,............ Emergency__,,,___,,,,,_,,_,.,,.,, EmailAddress: _ . .._µ m,.. _.M...._w.,_.... w..__.._. ._ ..._. .., _...... __.. w..... ._. .._._..._ .. ... . ._ 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 Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: _ _._... ...,s X M T' )(- (3,J-' ... . .�.J. �_... .._..... ....._N�.x .�� _.......w_......_,. ..��.�_!�._._�.�..�._...1�............_ .�.µ... Page 3 of 5 f Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 � a BUILDING DEPARTMENT TOWN OF SOU'THOLD 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 1 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) 1 � ..._. , 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 Town Hall AnnexTelephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 .T" Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO HOLD 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. I 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: _.__ ._ Property Owner's Signature: Sworn to before me this ON day of 20a,. Official Notary Pub is Signature and Original Notary Stamp KAITLIN ELIZABETH MACOMBER NOTARY PUBLIC-STATE OF NEW YORK No.01 MA6424002 Qualified in Suffolk County My Commission Expires 10-25-2025 Page 5 of 5 F 'SOUTHOLD BUILDING 1) 765-1 802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PTBG. [ ] FOUNDATION 2ND [ ] INSULATION/CA [ ] FRAMING / STRAPPING [ ] FINAL v4vw [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PN [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O 5 0- 07 i c t f G iv t e�src 0 i � N __ _..... .170. .. - ed om :1 a • �= �` _ :. wingi_ s=ue � G - �, X219'► A3'0'► +1'8 •x`10'r .2'0^► X2'2'► 13'5' _.. _.. _ 14'0' 0 0 r2'0'► s a1'8'► �s' �. e e� C1 l STJ q---ETa LOT ICTs P, 4 ff..._ .gam •' a` .;}y a � s. FOR ER 01V1;NfR a EA� ! - — b Le Am _ _ yEh, TYPE L D REQ_ 5S _, FARM LAND IMP TOTIAL F R E M AIR KS 17 a a v e -- �._ - e W ; a Y t� i�(,Acre ��e Pow , � sil Tr1[o -- �_ t �� Ti" obl 3 - dic- w Drus land House Plot s A s to I HIM PF _ , f i NA, _ Foundation r _ Both e = s -:- Basement r FI C s E ao t � Exttins.1en Ext.t Wa Its Interior� fn oe Finislti Extensiiot Fire Place i Heat Pore, i Attic i - cuc, a 7 P - - ' Patio - z �, F Ro orae Driveway s44 ND 502it> FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Z 496 November 7 60 No, Date .... 19. .. 4 THIS CERTIFIES that the building located ai ................ -..........Main StreOt.. East MOVion.—_-....... .......... Street Map No. . ... Block No--...............Lot No-- ........ ...... conforms substantially to the Application for Building Permit heretofore filed in this office june 3 60 z 1099 dated ..............................................1, 19......., pursuant to which Building Permit No. ......................I. dated ............. Ju no...4................. 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 MON—CONFORMING MULTIPLE RESID)WCE: .......... .............. James and Joan A. nagfts" owners This certificate is issued to ......... ...... (owner, lessee or tenant) of the aforesaid building. Building Inspecor FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N91099 Z Date ....... D..... ..................• 1960.... Permission is hereby granted to: ...............941n.-Road.................. ....... t...1101= to ..... ........... ................ ............ at premises located at ............... ad Read...... ......... ............... ........................ a&t.-.44aon. ....... ....... ................ ..... ........... ....................... ........ .............. ............................. pursuant to application dated ...... J)".....3.•............,...1 ,.., -and approved by, the Building Inspector Fee ....... 1A Building Inspector -------------- .............................._,. _........_.._.._w.ww .M_.......................ww_.._w telt Town of Southold 1/6/2022 53095 Main Rd Southold,New York 11971 PRE EXIS"T"ING CEIL.TII4ICATE OF OCCUPANCY No: 42660 Date: 1/6/2022 THIS CERTIFIES that the structure(s)located at: 8200 Route 25,East Marion SCTM#: 473889 Sec/Block/Lot: 31.-7-1 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- 42660 dated 1/6/2022 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 sin le famii dwetlin witEt c oared e at; va lc ala a,nfinished_ttic and reason Roca. The certificate is issued to Rogers,Jeffrey&Rogers,Alan of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. tit Mari a Signature...... .-..�........................... BUILDING DEPARTMENT TOWN OF SOUT TOLD HOUSING CODE INSPECTION REPORT LOCATION: 8200 Route 25,East Marion .....31SION:._ .,._,.....,,,,m-,M,M,M,M,M,M,M,M,,,------------------w.-__-.._._.._._w.._....._.... .........._.......__...... SUFF.CO.TAX MAP NO.: � -7-1 SUBDIVI -......_..__._._._._.-._..__ �_�_ �.............._� .-......... .. w,,.,._......._ ........... _ww NAME OF OWNER(S): Rogers,Jeffrey&Rogers,Alan OCCUPANCY: _. ...ay.. ...v.._.ww-www----w-w._., ........ ..��....�,,,,,,,.. .___..___.... n.�w wwwwwww.....w.............. _..... w _ _,w_..w- __............._ ......... ....._,_. _.._.._..........._.M.M.M.M......................................................W...................._...__..__ ADMITTED BY: SOURCE OF REQUEST: Rogers,Jeffrey DATE: 1/6/2022 DWELLING: #STORIES: 2 #EXITS: 3 FOUNDATION:: stone CELLAR: partial CRAWL SPACE: BATHROOM(S): _ ww._w.I µ TOILET ROOM(S): 1 UTILITY ROOM(S): . '............w w.............. PORCH TYPE: covered entry DECK TYPE: PATIO TYPE: masonry _..._.... ............................................_._._._._.........._ BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HO..............................w _.... _........�_. _.,._ _....._.........._..........._........... TWATER: yes TYPE HEATER: off boiler AIR CONDITIONING: ............. ............................._...... ............ A _. TYPE HEAT: oil WARM AIR: HOT WATER: baseboard #BEDROOMS.�... �...w......5................ - #KITCHENS: 1. BASEMENT TYPE: unfinished ._ ...._.._ .__....-..._. OTHER: __.......__....�.............. ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: .�._..�.-..�....................._._...........� GUEST,TYPE OF CONST: OTHER: .. ..... _._.....�.. _....-�...._._..... .. �� _, VIOLATIONS: .........................................................-. _ .,,,,,,,,,,....._...........................................w_........____.._........................ ........................................_.......__. __._.,,,,,,,,,, ..._a..._...................... _._._w................................................... ......................... REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 12/16/2021 TIME START: 2:07pm END: 2:35pm FORK NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. . Z 33 6 Date . ... . . ..Decdabot. . 17.. .. . . ., 19. b6 THIS CERTIFIES that the building located at Asia.Road.. ..... . ..... .. . . . Street Map No. . .. .. .. . . .. . Block No. . .. .. .. .. ...Lot No. t Marion, or . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated ... AWAX—A... ... .. .... 19.JW pursuant to which Building Permit No. 3422.Z . dated . ..ARr.i.l.. l. ... ... . .. .. 19..67 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 ... .1?rATa w."9.4W*9 . .( ... * . .b"141m) .. .. .. ... . .. .. .. .... .. . . .. . . . The certificate is issued to . . . . !S.lk s+ .. ..... .... .......... .... ... . ..... . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . .. . .. . . . .. . . . . ........ .. . . . ..... .. .. .. . .. .. Building Inspector j µ . .. .». . . FORM Pio. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z621+0. . . Date . . „ . . . . . , . Dec # . . . . . , . . ., 19. 4 THIS CERTIFIES that the building located at Naha. Roan do G--Cita-rd, _ , . Street Map No. x t. Block No. 17P. . . . . . . Lot No. 3Rc. . . .T1aSt Marion. . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . Y .29 , 1973 . pursuant to which Building Permit No.65827, . . . dated ley. . . 21. , 19 73 ., 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 PX-tv4te ,tV.0 XAM117 $veillr4 : . wit .addition . . . . . . . . . . . . . . . . . . . The certificate is issued to J=es. Rt?tera . . . . . . .Qv3zgr of the aforesaid building. (owner, lessee or tenant) Suffolk County Department of Health Approval Atilt. UNDERWRITERS CERTIFICATE No. penU nK . , . . . . . . . HOUSE NUMBER 8200 Street �14in Rortd: �5. . . 01.d *t}ra r*d* , li . . . . . . . . . . . . . . . . . . . . . .. Building Inspecto Iroxx Na 4 TOWN OF SO OLD BUILDING DEPARTJMT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy z7s 341 y No. . . , . . . . . . . . r Date . . THIS Cll�TIFIES that the build located at . . . . . . . No. x Map . . . . . . . . . . . . Block No. . . . . . . _ .Mt No. . . . . . . . . . . . . . » . . . . . ; . . . . . . . . . . . . . conforms saantia l to the A�ppl' for Building Permit heretofore fie in tis o dated . . . . h^( . .�.�. , . . . . ., 19.v�,�-Tursuant to which Building Permit No. . . . . . .. . dated . . . . , . , . , , , . , 19. rt . r, was issued, and conforms to all of the require- ments of appli ble p of a cupan f *"Vj!jate is issued is . . . . . . . . . . . w . . . , . . . The certificate is issued G . (owner, lessee or tenant}m . » ` ' . r . , of the aforesaid building. �r Suffolk County Department of Health A . . . . . . . . . . . . . . w . . r . . . . r » . . UNDERWRITERS WI6 TE No. . . . . . ' m HOUSE NUMBER . . w . . . . . . . . . . Street , . . . . » . . , . . . . . » . . . . . . . . . . . . . . . . . . . . . . . . » rt . rt r . . x •« . w . . .. . . w . . . . . . ., . . w . + . x • r ♦ w/.yy. . . . . . . . . r .+ . . . . . . Building Inspector FORM NO,4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . , Z 15 3.8.6 . . . . . . Date . March„ !8?. .1987. , , . . „ » . « . , . . . THIS CERTIFIES that the building Add t o, ac c e s s o r y Location of Property . . . 8 2 0 0Main Road East Marion House 11% . . . . «Hamlet County Tax Map No. 1000 Section . . 3.l. . . . . . . .Block . . . .7. . . . . . . . . . .Lot . . . . . 1 . . , . . „ , , . , . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . .. . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . April ]B , ]9 7 7 pursuant to which Building Permit No. 9 1 9 2 Z. . . . . . . . . . . . . . . dated . April. t 8 r, .1.977 . . . . . . . . . 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 . . . . ., .. . . . . . . . . Add . ro. .acCe.s,sQry. .garage. for .ptor age. . . . . . . . . . . . . . . . . » . , . . . . . . . . . . . . . The certificate is issued to . . . , _JAMES 6 JOAN ROGyEyyRy�S yy�� a .o- . • s „ • a of the aforesaid building. IF Suffolk County Department of Health Approval . . . . . . „ . „ , .N(A, . . . . « . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . « . « . , , . . , N/A PLUMBERS CERTIFICATION DATED: N/A 7�64 ding Inspector Hey.1/81 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. , . Z 1537.9M * Date „March 18 , 1987 THIS CERTIFIES that the building . . A d d i t i on w . . . , . . . . . . . . Location of Property $? 0 Main Road µ „ . East Mario n House;Vo. . . . . . . . . . . . . . . . , i; . . . . . . . . . . . . .Ham%t County Tax Map No. 1000 Section . .3 1 . . . . . . . .BIock . . .7 . . . . . . . . . .Lot . .1. , . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed In this office dated , . . , . .Qct; l 2 .1.9 8 3 pursuant to which Building Permit No. . . 1?A8 1 Z . dated . .Oct .Q 12 , 1983 • • . • • • • 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 . . . . . . . . . Constrict addition. Ao. existin dwelling : The certificate is issued to „ . .JAMES & JOAN Ro GE R S . . . .�owner,f Tt1 . . . . . . . , , . , « . , , . , . . . » of the aforesaid building. Suffolk County Department of Health Approval . . . . . . N,/A. . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . RZ 9 5 3.6.2 , PLUMBERS CERTIFICATION DATED: N/A '. .1 . . . . . . . . . . . . . . . . wilding Inspector Rev.4/81 a FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No—Z-22057 Date DECEMBER 23, 1992 THIS CERTIFIES that the building ACCESSORY Location of Property 8200 MAIN ROAD EAST MION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 31 Block 7 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12 1987 rsuant to which Building Permit No. 15"767-Z dated CH 1b 1987 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 ACCESSORY SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to %J ES & JOAN ROGERS {owners} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N' A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N LA a Uilding Inspector Rev. 1/81