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HomeMy WebLinkAbout1000-17.-3-7 TOWN OF SOUTHOLD } AZ Rental Permit Jll 0975 Owner Oysterponds LLC Occupied as Single Family Dwelling Located at 20275 Route 25 Orient 17.-3-7 Maximum Permitted Occupancy 10 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. 8/7/2023 o � � c a Official This Notice must be posted by the main entrance at all times Town Hail Annex Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1179 nu Southold,NY 11971-0959 BUILDING DEPARTMENT TO OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section Aa Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -BLOCK -LOT SECTION B. OWNER INFORMATION: Property Owner Name: filep Property Owner Legal Address: Property Owner Mailing Address: .�� SfR� - t„ . '_� _.. A AA Telephone Number(s): Daytime b 3�� Evening_ Sri rYl e- Emergency Property Owner Email Address: 1 i so q LiSkow0 e.o` m e , Qty\ Pagel of S Town Hall Annex i Telephone(631)765-1802 54375 Main Road ��� � Fax(631)765-9502 P.O.Box 1179a Southold,NY 11971-0959 wa.P�.Amdra��x�� 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 Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: � m Name of Authorized Agent of dwelling unit, if any: 1 a Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): DaytimeEvening , 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 ,w Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 � r by"4"4y �r bA 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: 0 For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, B, Q;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." ""Is Rental Dwelling Unit Identifier: �� ° No 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: \, C iC �\ X � 7 Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 � V Southold,NY 11971-0959 "s �y 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 I am submitting a completed Town of Southold certification form from a licensed rchitect 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) 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 Town Hall Annex " Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Cool a;0 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: ( w ' ', M ' °' �;" �.. C 1 UtS / 'v/,,,( S fie. vol i � Property Owner's Signature: Sworn to f e me thiseday of + 20 0 clal N tary Pubdc Signature and Original Notary Stamp ISA l NM ISTER Re?,No FC 64c,State 02091 C cluaffed In SUffolk C+un comwMara fres Nc embar 11,2023 Page S of 5 Town Hall Annex ` V Telephone(631) - Tele 765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO FOLD 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 Ero&Aslonal seal re u!Ired bgr ALghltect or Engineer licensed'l�l�:me iris ect r mr st rov cis my o waa Md trent cerci dation Rental Property SCTM Number: WOO Rental Property Address Owner/Name: : iL 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.) Property Description (Include all Improvements indicated on survey) AN � �r. " � •c�'Di 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 w York State, the Fuel Gas Code of New York State, and the Energy Conservation C ' structio ode of New York State. "' L1 .., Print Name and Title ' OF o Ori- l Sign t e ca , Please place professional seal: .e� , 0570 orclO 1,� R oy TOWN TH LBUILDING EPS`. 631-765-1802 1:� . • ; + I I No S P E C T 14d 03h k- N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L [ ] CODE VIOLATION [ ] PRE C/ [ RENTAL REMA S,-,.,, 77 ........... ...... 010" 00,� UAt DATE gINSPECTOR SOUTHOLD PROPERTY RECORD OWNER iSTREET VILLAGE �DISTRICT j SUB. LOT c t N E ACREAGE e S W TYPE OF BUILDING _ I a sm- f .� VL FARM COMM. IND, CB. MISC. 'Rnl___- ( r„-ail , ,.:= -. ,.,• Al I�Y.TE �ZE;y'1A�'r�5 3 AGE BLJQLDING CONDITION NEW NORMAL BELOW ABOVE Farm _ aim rlie -'. , Swainpland U;,a t # House Pict I 1 t q t _ 4 } 1 _ e_ a 17.-3-7 6/t t 6 , x . NA. Bldg. Foundation Bath Extension 18asemer,i Floors Extensi � Ext, Walls Interior Finish Exten i n C : , ` e Fire Place Heat i Pore, Attic Porc;; ' Rooms 1st Flooi Breeew -.- Patio Rooms 2nd Floor I Garage Driveway 3 O. B. Y TovO , r� F ; Town of Southold 7/13/2023 53095 Main Rd V Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 44270 Date: 7/13/2023 THIS CERTIFIES that the structure(s)located at: 20275 Route 25, Orient SCTM#: 473889 Sec/Block/Lot: 17.-3-7 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- 442711 0 dated 7/13/2023 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 fraena sin le f n it dwellin withfront and sides eyed rcl es walk a fairs to unfinished Stora e attic anal ccessor�od fraacne earae»* The certificate is issued to Oysterponds LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ' A th' »i°,..fid Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPOR LOCATION: 20275 Route 25, Orient ....................NO............... . . ...... ................................. SUFF. CO. TAX MAP .: 17.-3-7 SUBDIVISION: ....... NAME OF OWNER(S): Oysterponds LLC . ........ OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Oysterponds,LLC DATE: 7/13/2023 DWELLING: #STORIES: 2 #EXITS: 3 FOUNDATION: brick CELLAR: full CRAWL SPACE: ....................... ...... ........ BATHROOM(S): 3 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: front&side covered DECK TYPE: PATIO TYPE: ...... ... ... .. ................. ... ..... BREEZEWAY: FIREPLACE: 2 GARAGE: ................. DOMESTIC HOTWATER: yes TYPE HEATER: gas AIR CONDITIONING: TYPE HEAT: coal WARM AIR: HOT WATER: ..................... ........ ...... ........ #BEDROOMS: 5 #KITCHENS: I BASEMENT TYPE: coshed OTHER: ........... ................ . ..... .......... ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: .... .. -------- SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: ................ VIOLATIONS: ................... . ........ REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 7/11/2023 ............ TIME START: END: 6000� Town of Southold 7/13/2023 1P.O.Box 1179 01 53095 Main Rd Southold,New York 11971 CERT`"IFICATE OF OCCUPANCY No: 44269 Date: 7/13/2023 THIS CERTIFIES that the building ALTERATION Location of Property: 20275 Route 25,Orient SCTM#: 473889 Sec/Block/Lot: 17.-3-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/25/2012 pursuant to which Building Permit No. 49087 dated 4/3/2023 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: alterations including window replacement and central air condtioning,to existing single family dwelling as applied for. The certificate is issued to Oysterponds LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49087- 5/13/2023 PLUMBERS CERTIFICATION DATED f ignature Town of Southold 7/13/2023 � P.O.Box 1179 53095 Main Rd � Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44268 Date: 7/13/2023 THIS CERTIFIES that the building GENERATOR Location of Property: 20275 Route 25,Orient SCTM#: 473889 Sec/Block/Lot: 17.-3-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/29/2023 pursuant to which Building Permit No. 49078 dated 4/3/2023 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 bb gilt"acssor enrator a lied f`or. Maintain orover distance to shrubs and combusti les. The certificate is issued to Oysterponds LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 4907 5/30/2023 PLUMBERS CERTIFICATION DATED ............. ��o ��.._ .��lgnatur ' _.�..w.. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 4P! . . . . . . Date . . . . . . . . . . . . . .Z1gy. . . . .16. . . ., 19. 73 THIS CERTIFIES that the building located at . . . .N/.S .Rain .Road . . . . . . . . Street Map No. XX . . . . . . . . . Block No.XX. . . . . . . .Lot No. . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .AA4 . .Ilk . ., 1967. . pursuant to which Building Permit No. . .3569Z dated . . . . . . . . . . . . Aug. . .14 . ., 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 . . .Private. accessary,building. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . William .Schriever . . . .Owner. . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . N-R!. . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . .troreZleting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER. . .20275. . . .Street. . . . . .Main .Road . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13uilding lnspec:tor L FORM NO.2 %TOWN OF SOUTHOLD, BUILDING DEPARTMENT TOWN CLERK'S OFFICE " SOUTHOLD, N. Y. _ BUILDING PERMIT (THIS PERMIT MUST BE KEPT:ON;7HE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV 3569 Z Date ........... ......... .... . ..... 19. Permission is hereby granted to ...... .......................... .......°.... A .. ......... ...+....................x........ ........ to .,.490,. .. &QA ..MOM... w.x..........xx........«w..................aw+...............w..w 4............ ...........................f..................... ..............x........ ° at premises located at .... ...... .... .. ...... ....... .......... .. ... ,..... ,. .f ...... ..................................: ...... � .. , ... ......:.:......:....... .... ... .... . .... «.......... w....+.,.. ................................................... .... .. ....... ...... .. .......... ........ ..a.. .. 0 Pursuant to application dated` '............ and. 'oow-o ed lay the Building Inspector. Fee $... . ...w........ ........... wilding Inspector .=�. l r bi "J70" OF WY FIRST FLOOR EXISTING SECOND FLOOR EXISTING SCALE: 4'= 4 ' I I SCALE: ill= I ' v.� IL I F------------- NJ.MAZZAFERRO,P.E. PROFESSIONAL ENGINEER EXISTING FLOOR PLANS NY�957 A-1 - \ ] < � . � k��w THIRD F DOR E 15TING . 5CAL: - b CCCCTM4LE �P / \ ©MAZZa_P �r «a P" o f © © PROFESSIONAL . JA- EXISTING e_m_