The URL can be used to link to this page

Home My WebLink About1000-78.-3-18 TOWN OF WV SOUTHOLD Mgt Rental Permit =a_ 0948 Owner Richard Hokanson Occupied as Single Family Dwelling Located at 740 Nokomis Rd Southold 78.-3-18 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. 7/10/2023 de Enon)-Official This Notice must be posted by the main entrance at all times ° �� Telephone(631)765-1802 Town Hall Annex Fax(631)765-9502 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD ID�- UI1.UMbUE ). . RENTAL PERMIT APPLICATION OWNOFS lrM()I'_� Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property)Address: ✓ N,/ q -7/ Tax Map Number: 1000 SECTION -BLOCK -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address:. �A YU Telephone Number(s): Daytime Even ingl Emergency_.._. Property Owner Email Address: N-- P T o,,� -) �\)e' cT (2o a - 14 Page 1 of S Town Hall Annex �� Telephone(631)765-1802 �i Fax(631)765-9502 54375 Main Road r� P.O.Box 1179 �" r 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. 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: �� /� �S a -✓ ke Property Owners Signature: - ----_— Sworn to before me this- day of 20 ... ..... ...._ ��- Official Notary Public Signature and Original Notary Stamp CONNIE D. BUNCH Notary Public,State of New York No.OIBU6185050 Qualified in Suffolk County \\ commission f�xpiro�April 14, 204 Page 5 of 5 M rp, Telephone(631)765-1802 Town Hall Annex ` Fax(631)765-9502 54375 Main Road ge Jy P.O. Box 1 179 Southold,NY 1 1971-0959tk "V i` cou BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: - 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, 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: __/ � t.M �' 1L _ , ._ wmM .._.... w ._ Page 3 of 5 Telephone(631)765-1802 Town Hall Annex �N Fax(631)765-9502 54375 Main Roadly P.O.Box 1 179 Southold,NY 11971-0959 m- Coua , 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. p-"'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) 11/c&elfy 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 TOWN OF SOUTHOL D BUILDING DEPT. 631.765-1802 tz� 3 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ XFIRE TIOWCAULKING [ ] FRAMING /STRAPPING [ [ ] FIREPLACE & CHIMNEY [ FETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETR ON [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL E,M A R KS.- ' b DATE " ► k4 INSPECTO A at sar Q�OM cj TOWN OF SOUTHOLD BUILDINGDEPT. 631-765-1802 imSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [/] FIIRE NAL FIREPLACE & CHIMNEY [ SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL 2tvv e ej e I€ TOWN F SOUTHOLD PROPERTY RMPso OWNER I STREET VILLAGE DISTRICT SUB, LOT �'_`- , t I RM R OWNER N �' E m ACREAGE 6 P , ,: S W TYPE OF BUILDING a RES. SEAS. VL, FARM COMM. IND, CB. MISC. 'IEst. Mkt. Value LAND I IMP. TOTAL ? DATE REMARKS I 6 - s AGE BUILDING CONDITION - � NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 BULKHEAD m. Tillable 2 _ SOCK Tillable 3 s ` _ - 7 1 _ - Woodland Go (' r Swampland CIE) 14 `I.S 4'% Brushland House Plot I } Total :.. t 4 i ; € € f x I - FTI € M. Bfd V Foundation _ 3 Bath I Extension ; Basement = Floors i Extension Fact. Walls Interior Finish Extension Fire Place— f Heat -� EI Porch Roof Type �I Porch 'I Rooms 1 st Floor Patio Rooms 2nd Floor Breezeway I Garage _ j Driveway y Dormer I } O. B. I f r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERWS OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY Date ..., ...... ; iAk THIS CERTIFIES that the building located-at WAkoMiS.14,*..00Ut1XQ1A....... Street Map No. _....***. ...... .Block No. .*+a*.............!,ot 1`110. ............ ***....... conforms substantially to the Application for Building Permit heretofore filed in this office dated "October 1-$-___, 1#q.... pursuant to which Building Permit No. .�_239 dated .... .......1 19A ., was issued, and conforms to all of the require- menta of the applicable provisions of the law. The occupancy for which this certificate is issuedis ...... ............MUM..00- .........,,.......,.. ....,.......,,.......... ..o, This certificate is issued to ........ *Ot...0 -K....,_ I— „µ.........I,"__........ . — -1 (owner, lessee or tenant) of the aforesaid building. Building inspector Town of Southold Annex 8/13/2013 P.O. Box 1179 54375 Main Road ° + Southold,New York 11971 CERTIF"ICA"TE OF OCCUPANCY No: 36445 Date: 8/13/2013 THIS CERTIFIES that the building WINDOWS Location of Property: 740 Nokomis Rd, Southold, SCTM#: 473889 Sec/Block/Lot: 78.-3-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/7/2013 pursuant to which Building Permit No. 38096 dated 6/13/2013 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 window reolucent as aapled liar.. The certificate is issued to Hokanson, Richard (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED t rizel tgnature