HomeMy WebLinkAbout1000-22.-4-18 TOWN OF SOUTHOLD
Rental Permit
,a 0677
Owner Eric & Rachael Rosenblum
Occupied as Single Family Dwelling
Located at 1870 Stars Road East Marion 22-4-18
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.
6/21/2022in
e Enf c m t fficial
This Notice must be posted by the main entrance at all times
°rte
Town Hall Annex 1� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 0
Southold,NY 11971-0959 �� � D
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NOV 0 1 2021
BUILDING DEPARTMENT
TOWN OF SOUTHOLD BUILDING DEPT.
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two ) EC
E � V E
NOV,O12021 x
Section A. BUILDING DEPT
Property Information: TOWN OF SOUTHOLD
Rental Property Address:
1870 STARS ROAD,EAST MARION NY 11939
Tax Map Number: 1000 SECTION 22 -BLOCK 04 -LOT 18 _ 000
SECTION B.
OWNER INFORMATION:
Property Owner Name: ERIC ROSENBLUM
Property Owner Legal Address: Property Owner Mailing Address:
899 LINCOLN PLACE 899 LINCOLN PLACE
BROOKLYN NY BROOKLYN NY
11213 11213
Telephone Number(s): Daytime 847.204.4379 Evening Emergency
Property Owner Email Address: ERICMROSENBLUM@GMAIL.COM
Pagel of S
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Town Hall Annex Telephone(631)765-1802
54375 Main Road . Fax(631)765-9502
CA
P.O.Box 1179 G
Southold,NY 11971-0959 CO „�a )
UNT(,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: JASON MICHAEL FAY
Address of Authorized Agent(no P.O. Boxes): 177 NORTH 10TH STREET SUITE F
Mailing Address of Authorized Agent:
BROOKLYN NY 11211
Telephone Number(s): Daytime 347.463.3168 Evening Emergency
Email Address: JASON@READESTREETSTUDIO.COM
Section D.
Managing 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 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
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sou
Town Hall AnnexTelephone(631)765-1802
54375 Main Road ron Fax(631)765-9502
P.O.Box 1 179 G �O
Southold,NY 11971-0959
Comm
A�,t
BUILDING.DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address: 1
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: UNIT 1-SINGLE FAMILY HOME
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: UNIT 1-SINGLE FAMILY HOME
Requested Maximum number of persons allowed to occupy Dwelling Uni : 8 �I Q• ��
Number of rooms in Rental Dwelling Unit: 7 d
Use and Dimensions of each room,in Rental Dwelling Unit: FOYER 8'2"x5'11"-
DINING/LIVING ROOM 16'1"+22'8"x 20'0"+11'6"(SEE PLANS)-KITCHEN 11'5"x10'9"
FAMILY ROOM 13'8"x17'5"-PRIMARY BEDROOM 11'4"+12'5"x 16'0"(SEE PLANS)-
BEDROOM 110'0"x 11'0"-BEDROOM 210'0"x 12'8"
Page 3 of 5
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Town Hall Annex Telephone(631)765-1802
54375 Main Road co Fax(631)765-9502
P.O.Box 1179 G
Southold,NY 11971-0959 OUS� {�
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.
❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
IX 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
ERIC ROSENBLUM , 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
I
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Town Hall Annex Telephone(631)765-1802
54375 Main Road �'4` p 't : Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 /7 ,
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, Managing Agent, or Site Manager.
Property Owner's Name: �— �-!�L
Property Owner's Signature:
- SS r
Sworn to before me this�4day/_of -z — 20,---�
Offi a-1 Notary Public Signa re nd Original Notary Stamp JOAN D GRIFFIN
Notary Public State Of New York
No. O1 GR4929343 �
Qualified In Kings County
Commission Expires Mav 2, 20
r�
Page 5 of 5
Building Department Application
AUTHORIZATION
(Where the Applicant is not the Owner)
j� ERIC ROSENBLUM residing at 1870 STARS ROAD,EAST MARION NY
(Print property owner's name) (Mailing Address)
do hereby authorize JASON MICHAEL FAY
(Agent)
to apply on my behalf to the
Southold Building Department.
OCTOBER 21,2021
(Owner's Signature) (Date)
ERIC ROSENBLUM
(Print Owner's Name)
Of SOGIyo -
# TOWN OF SOUTHOLD BUILDING DEPT.
G _
765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
i I ] FRAMING/STRAPPING [ FINAL T.P 4
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: nk#M V/ g' St',K 6&'O/l
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DATE INSPECTOR
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 91-
Southold,
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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
Processional seal required for Architect or Engineer,licensed Home Inspector must provide
copy of valid current certification
Rental Property SCTM Number: 1000-22-04-18
Rental Property Address: 1870 STARS ROAD,EAST MARION NY 11939
Owner/Name: ERICROSENBULM
Rental Dwelling Unit Identifier: UNIT 1-SINGLE FAMILY HOME
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1-100 sq.,Bedroom#2-90 sq., etc.)
PRIMARY BEDROOM-190 SQFT
BEDROOM 1-110 SQFT
BEDROOM 2-127 SQFT
Pr perty Descripti(n (Include all improvem is indicated on survey)
UPDATED KITCHEATHROOMS
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.
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Print Name and fitle Original Signature
0 ARCh/T
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Please place professional seal:
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TOWN OF SOUTHOLD PROPERTYAtECORD CARD
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123 Sq.Ft.
DININGAIVING ROOM
z9 FAMILY ROOM 400 Sq.Ft.
238 Sq.Ft.
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BEDROOM 2 190 Sq.Ft,
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10'-0' Co 12'-5' RENTAL PLAN
1870 STARS ROAD
* EAST MARION,NY
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BEDROOM 2 190 Sq.Ft.
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127 Sq.Ft. FIRST FLOOR
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�► EAST MARION,NY
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 7401. . . . . . Date . . . . . . . . . . . . . Doo. . . .3. . . . . .. 1976 .
THIS CERTIFIES that the building located at Stars. Road. . . . . . . . . . . . . . . . Street
Map NoSound .Crast 1 E&1c o. . . . . . . . . . .Lot No. . .13 . . . .Hast .Marion. . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . . . . . !00'4. . 27 HR. . pursuant to which Building Permit No. .6205Z .
dated . . . . . . . . . . .90. . .30. . . ., 19??. ., 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 . .FrtV to .oxte. Xa ,17.dY.*13J 3H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . .80Art.. 0.0moe4or.* lothol. .Sohmader. . . .%more. . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval AQ!. . .29. . x.976. r4-t.V1114t. . .
UNDERWRITERS CERTIFICATE No. .312679.46 A. . 1.976. . . . . . . . . . . . .
HOUSE NUMBER . . . .1870 . . . . . Street . . . . $tars -Road • • • • $. •Xrrion• . • • • . • .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
¢r S Ff0[
ADO cGy Town of Southold 6/22/2022
a P.O.Box 1179
0
y 53095 Main Rd
y��l �S� Southold,New York 11971
1�
CERTIFICATE OF OCCUPANCY
No: 43177 Date: 6/22/2022
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 1870 Stars Rd.,East Marion
SCTM#: 473889 Sec/Block/Lot: 22.4-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/18/2018 pursuant to which Building Permit No. 47825 dated , 5/18/2022
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:
alteration(sliding glass door)and"as built" interior kitchen and bath alterations,central air conditioing system and
rear deck to existing single family dwelling as applied for.
The certificate is issued to Rosenblum,Eric
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47825 6/8/2022
PLUMBERS CERTIFICATION DATED 6/17/2022 Er'c osenbl I
ut o ze Signature
o��pF SO!/lyOlo
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 Ol
IriQ
OUM` ,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
December 28, 2021
,�ev�� 1✓i IBJ��
Eric Rosenblum
899 Lincoln Place r� A-P
Brooklyn, New York 11213
RE: Rental Permit application for 1870 Stars Road, East Marion.
This property has an expired Building Permit#42612 issued 4/27/2018 for a
sliding glass door. Upon review of your rental application the Building Inspector
noticed central air conditioning and renovation of kitchen and bathrooms was
also constructed without a Building Permit. Once the Building Permit has been
renewed we can amend it to add the additional work.
These items are-needed for the Building Permit:
1. $125.00 renewal fee.
2. Specs for the air conditioning or a picture of the.sticker on the unit:
3. Architectural.plans for the kitchen and--bathroom renovations.
4.. Electrical inspection form.
Additional fees may be required.
If you have further questions please contact me by email
cohnie.bunch(a)town.southold.ny.us.
Best Regards,
Southold Town Building Dept.
Connie Bunch