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HomeMy WebLinkAbout1000-66.-2-9 TOWN OF SOUTHOLD Rental Permit 0685 Owner Christopher Stack & Judi Christiano Occupied as Single Family Dwelling Located at 705 Orchard Rd Southold 66.-2-9 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 arrangin the bi-annu s ion. _ 7/1/2022 Co nfor en Official This Notice must be posted by the main entrance at all time OF.SOUTyo Town Hall Annex , Telephone(631)765-1802 54375 Main Road Vs Fax(631)765-9502 P.O.Box 1179 ! Southold,NY 11971-0959 O • ��� 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. � 1 sy �"fi►dI U �� I� 1 � Tax Map Number: 1000 SECTION _ BLOCK ( LOT _- " �'C (d 4► �j �S f3 (p e Z L c; r SECTION B. OWNER INFORMATION: 11 I _ i Property Owner Name: k St6S 1 C�\( (� Property Owner Legal Address: Property Owner Mailing Address: 6-16-LISj- S3�-s Vit-► Z�Vwe�rg�enc Telephone Number(s): Daytime Evenin y Property Owner Email Address: �U�1 t C���S�IP1�d Q C�l�"f �CC.•CCNY1 Gh<<s• � kC�C6►�-�•01� " ,^ J CP '6b Page 1 of 5 �( �y pf SOUr�ol�, � o Town Hall Annex 4 i Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 • O Southold,NY 11971-0959 O Y U� BUILDING DEPARTMENT ID) E TOWN OF SOUTHOLD MAY 3 12022 81J�Ow�OFgOU���® RENTAL PERMIT APPLICATION INSTRUCTIONS Rental Permit Fee $200 (Application must be renewed every two years) The items listed below are required to be submitted with the completed application. V/ Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of all smoke & carbon monoxide detectors. Certificates of Occupancy and Pre-Certificates of Occupancy: Certificates of Occup .ncy or Pre-Certificates of Occupancy for each rental dwelling unit. Certification of Code Compliance(form enclosed): Must be submitted by a license architect or engineer or license home inspector if an inspection by Town of Southold Inspector is declined. �ntal Permit Fee: $200.00 Sou 01 Town Hall Annex i Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 G� • Southold,NY 1 1 971-0959 Ql ,{f ou 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 Unit: Number of rooms in Rental Dwelling Unit: ,0— -S 9 Use and Dimensions of each room in Rental Dwelling Unit: L�v!�4 Pt may® sse'uj �uuw4oarn 16XI.7 ej _ I ^�Z �ZLaJi vt- 2 q 1C4 Z Page 3 of 5 K I i3Ls1l� 1 �'�3 7�b �Soyv'pr, Town Hall Annex Telephone(631)765-1802 54375 Main Road ac Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Q o,iiIM '�`h fi BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: A_ - �1h., 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 Y oF SO!/T�o� Town Hall Annex l�L Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 o • Southold,NY 11971-0959 10UII� 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 fro the Town of Southold I am the 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) /� �j I Cha s �� /9 ® Jerti Cl penal of eri r ,the following: p Y p J Y 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 SOUTyoI. Town Hall Annex Telephone(631)765-1802 54375 Main Road C Fax(631)765-9502 P.O.Box 1179 �O Southold,NY 11971-0959 l�Co ��AR U , 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. 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, Ma na ing Agent, or Site Manager. Property Owner's Name: G , Property Owner's Signature: Sworn to before me this (P day of 20 22-- '(1- -gg a)j�4� Officialo ary Public Signat and Original Notary Stamp TP.ArF-,r, 'lWYER NOTARY PG,;_,,, , ;; )F NE11Vy0 TRACEY L. DWYER NO 01!:1 .:;q00 NOTARY PUBLIC,STATE OF NEW YORK QUALIF1,FD,;, • .COUNTY NO.01 DW6306900 COMMISSION EXt-114 6.;UNE 30,2,,Q9,01 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2L229,— Page 0,2L229, .Page 5 of 5 �aOF SOUTyoJ -- - -- # TOWN OF SOUTHOLD BUILDING DEPT. ourm, 631-765-1802 *,— 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 (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMAR S: ✓ C � i yo✓ U4M CM J DATE 1 INSPECTOR 0 S6 Town Hall Annex 4 Telephone(631)765-1802 54375 Main Road cn Fax(631)765-9502 P.O.Box 1179 G Q Southold,NY 11971-0959 �Q1 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 Professional seal required for Architect or Enaineer, licensed Home Inspector must provide copy,of valid,current certification n p Rental Property SCTM Number: U16 C19 Rental Property dr ss: 4 �6LC! /� Owner/Name. f7 L �T � (� Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.) � y 2 Pro erty Descripti Include all improvements indicated on survey) /!Q - B 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 C str tion Code of New Yo k State. 1JA%L, Print Name and Title gin Signature A Please place professional seal: N�' 031286 O� 9T�OF NE�-1 i �16 SO!/p, ,moo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 fi Southold,NY 11971-0959 CQu ,�, BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: . Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: 4- r . loot ? O `�' 115N }� ri �c�b� �a�s -IT- CI k,_0 r� TCS 01 ' ` T' 0 N R C� TR ; . 5 EET r VILLAGE d . : OLDT: SUB . '? 'g.,r°�? (,,,tai �Lµ�:d; t Q �.� of y:-'p FORMER' —--- OWNER .. , . .... ACR. �1 TYPE W OF BUILDING RESi ,S,EAS:. VL. - FARM __... COMM,. CB- MIS i Mkt: Value LAND IMP. TOTAL DATE REMAR<S r e iA <3" r, Is AGE BUILDING CONDITION. , NEW. . .. NORMAL BELOW ABOVE. , ; ., , 2. Z_� � } : Acre:: Vcitue Per FARNL v ualue� Acre.' ' :Tillable::' `.-Tillable 3-` --- . ---- Woodland. FRONTAGEON WATER .�- : bru"shlcind', ;<• . Y., FRONTAGE;ON ROAD, DEPTH BULKHEAD TotoDOCK , • , . _ y�� .f, "p ��,t f���k����f i.�„r'"+1G z 1' ■�■■■'IIl�■Ir�!!�■�!��_■_■_©�_■_■■ J M. A. Foundation Basement • Walls Int6ric�r Rose ° ' Fire Place ! Type Roof NO Rooms ! Dormer _� Driveway S � 1��e s, f r • = JL' in Wo l! r 1- 0 t • i t JC i 11P' L � •a d� 4 Y.�. t, ! w ! '_ «:`!t r p; •7..:... ,:l' i 3� Sw{ �, N.': r� }e,. .1':.e5�. p�.' ��� Y � �' ��, ,'�, ?': i '��_ �s L Ir�"y', f 6 { w e.J i ��� rl � ��r#���Tj�,•t} � `' + _ 'a _•.� f „4vw�Y� ��� ^4� � a 4�: � "� � ���d�'tla rrt �'y' }_E"^�A ��,.f Xi �" _. k _�+ _i � Xv x s� fk, t,.� } � a�' r .,,,,k �S �s{i.�,�t , � j ����n: ti ,� ,� r_i 3� � • pi a :t T?"'. 'e. A 4• V� 77 Sx. i xta4 t M c f /k y' ���,�'�('�/� A�' /Av low UP } ..■ FIs n1 a �-Sf ,d � i �z_ t FORM NO. 4 TOWN OF SOUTHOLD � BUILDING DEPARTMENT NO Ip/W �-0 TOWN CLERKS OFFICE 'SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ....... Date ..........................4J?4 ..§............... 19.... THIS CERTIFIES that the building located at. ` b,??° ..u .y...$ �? !�� .. !�. *.. St Map No.4e PC 19A.)YAtck Nd. ....***.............Lot No. . +..'+'.. !R>Ir.. '..,........................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................$A.P.t1g?0qA-AQ........ 19... 8 pursuant to which Building Permit No. .......A439........... dated ....................RGPtemb*3,'..10..... 19.55...,was issued, and conforms to all of.the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is.............. ..................................................P.R V.AM..Q1MO('Art' my.D1 "INOA............................................ This certificate is issued to ...:james .okeyt owned (owner, lessee or tenant) of the aforesaid building. ....................Buildin9.. Insp.ector......................... l Noward M0 Tarry* FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Zi..1.959............. Date ...................AGIRIM....... .?......... 19.64.. THIS CERTIFIES that the building located at 941..X rektard..At.................................... Street pp����idon fat Map'tVtF.'............:......... Block No. ........�,�1.......... Lot No. .17.,0..........w.aLL'ghslld.t...�.1•................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................ .........Mareh.....19... .. 19.6..4... pursuant to which Building Permit No. 2.314..2. dated ................................Mar.eh.....1.9.., 19.61.+.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...F.rd-VatO...01*.•X.aM11..y...dweJ1JL:g.............................................................................................. The certificate is issued to .JaMS-RIJOkey................ .......Qmer............................................... (owner, lessee or tenant) of the aforesaid building. . .... �.. .....`. .:........:. ........... Building Inspector FORK NO. 2 TOWN.OF.-SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'$ OFFICE SOUTHOLD, N. Y. 'BUILDING >P KRMIT (THIS PERMIT MUST BE KEPT bN THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NOV 2314 Z Date ...........:.............. , 19-64-- Permission qtr....... . ......... Permission is hereby granted to; A. ROUIY-4460-4,140.....J 6S..Nj4Qk4yr....•...... j ...... ..........i : ttr, ......................................... I ...................f................................................,..........: to ......... :1 .. 'hiel ....................... .................... .. ...............................•...................................................................................:................................,...... ...... at premises locateda ... .....1.0t.•l ........... .,................ ....... ....................�.1•S.—Ttegave•Road-1....IStho ..................................................................... ........................................a..........................f.....5........................................................................................... pursuant to application dated ................. .............Matah..... s ........ 19..64., and approved by the Building Inspector, Fee $.......;5............... C.�.,,t .......... . . ................... . _ .... ��Building inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 2-24269 Date APRIL 8, 1996 THIS CERTIFIES that the building ADDITION Location of Property 705 ORCHARD ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 66 Block 2 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 30, 1992 pursuant to which Building Permit No. 20513-Z dated MARCH 30, 1992 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 ADDITION TO 19XISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MAUREEN C. OSTERMANN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-233837 - APRIL 29, 1992 PLUMBERS CERTIFICATION DATED N/A Building Inspect r Rev. 1/81