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Home My WebLink About1000-70.-1-1 4, TOWN OF SOUTHOLD Rental Permit r 0932 Owner Howard Robinson & Maria Masliah Occupied as Single Family Dwelling Located at 51295 Route 25 Southold 70.4-1 Maximum Permitted Occupancy 6 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. 6/14/2023 Code rc ent Official This Notice must be posted by the main entrance at all times �v►S� -h MY Town Hall Annexa '��; Telephone(631)765-1802 54375 Main Road , )765-9502 Fax(631 76 P.O.Box 1179 Southold,NY 11971-0959 ro JUN - 2 2023 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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—70 -BLOCK -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: ►0 ca ► ,,,a,,� a LSA�n Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytime631 r.7n3kaV Evening Emergency, 5"lb Property Owner Email Address: . Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road fi Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959x" BUILDING DEPARTMENT TOWN OF SO HOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent- Telephone gentTelephone Number (s): Da eEven in Emer ene Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Box Mailing Address of Authorized A Telephone Number(s): irne Evening Emergency_,___ Email Address: SECTION E. SITE MANAGER INFORMATION::(required for ai properties containing 8 or more rental units) Name of Managing Agent of dwellin , if Address of Managing Agent P.O. Boxes):_,_--,.-,-----.. Page 2 of 5 Town Hall Annex Telephone(631)765-1802 k 54375 Main Road C Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 C ash BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:�....._ _ w. .�..... .__. .„�. Telephone Number(s): Daytime.,__., Eveni _..___. __..,., Emergency_ Email 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.” mowwoam"°""ww,�i� Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Oil Number of rooms in Rental Dwelling Unit: Cl Use and Dimensions of each room in Rental Dwelling Unit: e µ c« Page 3 of 5 ry Town Hall Annex A ' Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 �^ � Southold,NY 11971-0959 + ' 9^ m Pv6,, 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. VPi 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) N r 1 Cl. 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 rr ryn w ry� co� " Town Hall Annex" Telephone(631)765-1802 54375 Main Roads Fax(631)765-9502 P.O.Box 1179 C �` Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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, Mara ing Agent, or Site Man ger. Property Owners Name. LA �W Property Owner's Signature: Sworn to before me this a day of U _ 20,3 Official Notary Pub ° Signature and Or ;l ai Notary Stamp TRACIE Y i.... 0VVY_..R N0'T;R1(F LQ?,V..�kC;,STT"'FE 0F N5-W YORK C,'o 9"..m',r10 1 T,,"r CI r CW Page 5 of 5 So 51 1,1 l� . 631-765-1802 .+ -- � INSPECTION FOUNDATION 1ST ROUGH PLBG. FOUNDATION 2ND INSULATION/CAULKING FRAMING /STRAPPINGLAL FIREPLACE & CHIMNEYL FIRE SAFETY INSPECTION CONSTRUCTIONFIRE RESISTANT IRESISTANT ELECTRICAL (ROUGH) ELECTRICAL (FI L) CODE VIOLATION PRE C/O [7RENTAL o w w ........... ................----............. ........................... DATE �_ INSPECTOR OWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 .. C INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI ) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL r 1J __ . S .. TOWN OF SOUTMM PROPERTY R h-7 _F STREET VILLAGE DIST_; SUB. a ar FORM R NN E ACR. _ a S W 1 TYPE OF BUILDING r RESP SEAS. VL. FARO COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS e 3 s E B , t t E t AGE BUILDING CONDITION C,0�340 I -F , , NEW NORMAL BELOW ABOVE _ FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER '- Woodland FRONTAGE ON ROAD _ ..ems A Meadowland DEPTH g House Plot BULKHEAD Total DOCK a R "TRIM € - I I z r z , F (_ _ - �� E — _� a I M Bldg. _ Ex-tension - i Extension E Extension [Foundation Bath Dir Porch , -Basement e n� s _ . Basea-r�e t 'Floors K. PorchExt. Wails =Interior Finish I¢ LR. Breezeway Fire Piave Heat iDR. Garage _ CY�e Roof .is Ist .. R. . I a� _ A - Recreation Room ,Rooms 2nd Floor N. B Q. B. Drivew 'Yorne. [oral TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PRE\RISES THIS IS TO CERTIFY that the Land Pre C.0. #- Z'1 9 8 /X/ Building(s) Date-November Tl 1985 C:/ Use(s) located at ;) Mair. Road Southold Street Hamlet shown on County tax map as District 1000, Section ?0 , Block I , Lot I , does(not)conform to the present Building Zone Code of the Town of Southold for the following reasons: Insufficient total area. Insufficient front yard setback. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /X/Land /X/Building(s) /_/Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: Property contains a two-story, one- tuated in the"A"Residential-Agricultural Zone w/access to Main Rd., a state maintained highway. The Certificate is issued to MARY H. CONKLIN (owner, of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises !1AS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes-and regula- tions. Wilding .nspzertor FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33406 Date: 11/21/08 THIS CERTIFIES that the building ACCESSORY Location of Property: 51295 MAIN RD ..... SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 1 Lot 1 Subdivision Filed map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 31, 2008 pursuant to which Building Permit No_ 34264-Z dated OCTOBER 31, 2008 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 ONE CAR GARAGE WITH STORAGE (NONHABITABLE) AS APPLIED FOR. The certificate is issued to RONALD RROSSI �..w.,._.... .. . (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 121647 08/2306 PLUMBERS CERTIFICATION DATED N/A ..... _ .__... .. .-.-Sig-.- __�-_.___. horized Signature Rev. 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-32254 Date: 03/19/07 THIS CERTIFIES that the building ALTERATION Location of Property: 51295 MAIN RD SOUTHO_LD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 1 Lot 1 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 15 2000 pursuant to which Building Permit No. 27009-Z dated JANUARY 10 2001 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 COVERED PORCH ADDITION AND ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RONALD R ROSSI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL � N/A ELECTRICAL CERTIFICATE NO. 101051 01/29/02 PLUMBERS CERTIFICATION DATED 03/26/02 HARDY PLUMBING & HEATING r A thorized ignature Rev. 1/81 .. FF g011, 1:.� V Dj r, a'a^C.H. o' 111 IN. •,�, _.._.._... 310'*"' ,IYs ..... p I✓`p-F,�"r�„�.mm .:�, .. _.p,,. .- S'C7"'C,P-I rITI r' 1 1G) .ruin%uev �, •t "J , ..,,.....�..,.,:.. .,.._ ... ....,. �10 I rIWI ! . H i REF FYW�N. :.. 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