HomeMy WebLinkAbout1000-80.-1-25 TOWN OF SOUTHOLD
t4l9
Rental Permit
0983
Owner Jonathan & Chloe Huang
Occupied as Single Family Dwelling
Located at 1160 Paradise Shore Rd Southold 80-1-25
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.
41�-
8/30/2023 ALF
odeEfifo4cen, Official
This Notice must be posted by the main entrance at all times
Town Hall Annex " 1 Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 „
Southold,NY 11971-0959loU
t �
BUILDING DEPARTMENT "s
TOWN OF SOUTHOI D
M A"( 8 r 2
RENTAL PERMIT APPLICATION
Rental Permit Fee $2.00(Application n7ust;be renewed every two yeos)
Section A.
Property Information:
Rental Property Address:
1160 Paradise Shores Road, Southold, NY
Tax Map Number: 1000 SECTION 080.00 -BLOCK 01.00 -LOT 025 000
SECTION B.
OWNER INFORMATION:
Property Owner Name: Chloe Huang
Property Owner Legal Address: Property Owner Mailing Address:
7 Oakwood Drive West 7 Oakwood Drive West_
Lloyd Harbor. NY 11743 _LJ
631-896-0519
Telephone Number (s): Daytime 631-896-0519 Evening Emergency 631-896-0519
Property Owner Email Address: chloerubel@ mail.com
Page 1 of 5
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Town Hall Annex t , � Telephone(631)765-1802
54375 Main Road � � Fax(631)765-9502
P.O.Box It 791 u;
Southold,NY 11971-0959
RPS"
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: 1
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
Requested Maximum number of persons allowed to occupy Dwelling Unit: 6
Number of rooms in Rental Dwelling Unit: 7
Use and Dimensions of each room in Rental Dwelling Unit:
Kitchen/Living Room - 15'x19'& 10'x8' Full Bathroom-9'x5' Halt Bathroom-5'x4'
Laundry Room - 8'x8'
Bedroom 1 - 9'x12' Bedroom 2 - 9'x12' Bedroom 3 - 91x9'
Page 3 of 5
k
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959 �
eou
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
W 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)
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
r � Ze,
Town Hall Annex �� , Telephone(631)765-1802
54375 Main Road q rax(631)765-9502
P.O.Box It 79
Southold,NY 11971-0959 "r
k
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: Chloe Huan
Property Owner's Signature:
Sworn to before me this��day of__bAaV 20?-3
Official Notary Public Sign re and Original Notary Stamp
ROSALIE A. BRANCACCIO
Notary Public, State of New York
No. 01 BR6396872
Qualified in Queens County
Commission Expires August 261,26 Z3
Page 5 of 5
Town I lail Annex �, Telephone(031)765-1802
54375 Main Road Pax(63 1)765-9502
P.O.Box 1 179
Sowhold,NY 11971.0959
i fail&t V
BUILDING DEPARTMENT
TOWN OF SOU'THOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by o license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Pro ssiongl seat reguulre far rT a t j t(qr C"nglpr" !. rc r rl l rra Pns ect f r rrq jrp crvirfc
copy of I valid current certtfct icsrr
Rental Property SCTM Number: 1000-080,00-01.00-025.000
Rental Property Address: 1160 qhores ,Sq,. khold,
Owner/Name: Chloe Huanq
. __.._ _u._—__ .. .._._ .. _.. ._ ._ ._—_....,...._..... .. ___w�
Rental Dwelling Unit Identifier:
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom #1 —100 sq., Bedroom a2-90 sq., etc.)
Bedroom #1 - 108 S.F,..__
Bedroom #2 - 108 SF
Bedroom#3-81 SF
Property Description (Include all improvements indicated on survey)
One story residence with a ravel driveway+and wood decks at front and rear. —
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.
Print Name and Title
r". zl
0 as cot
Please place professional seal:
s10 _ aAT
TOWN OF SOUTHOLD BUILDING CREPT.
���` 631-765.1802
114m S P E C T 10 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 (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ]4ENTAL
TOWN OF SOUT'HOLD BUILDING DEPT.
631-765-1802
T T 10 N
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN TRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS:
DATE
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UVINGAINING ROOM
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FIRST FLOOR PLAN
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TOWN OF S T1 �
OWNER STREET VILLAGE DIST; SUB. LOT
FORMER OWNER N E ACR
TYPE OF BUILD
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RES. ` SEAS VL. ; FARM COMM. CB, MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
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AGE1 BUILDING CONDITION
NEW NORMAL BELOW ABOVE �(G .5 1 bq
FARRM Acre Value Per Value
Ac re
Tillobie FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
House Plot BULKHEAD
Total DOCK
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Floors
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Pore- a Ext. Walls interior FinishLR.
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Breezm_._y _. e ire Place Heat DR.
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Garage
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Patio Recreation Room Roon-is 2nd Floor FIN. B
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Total '=
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. A5109 . . . . . Date . . . . . . . . . . . . .Flay. . . . 2.9. . . . . ,, 19.73.
THIS CERTIFIES that the building located at . Paradise - Share S. Road. . . Street
Map No. . . XX . . . . . . . Block No. ? . . . . . . .Lot No. . . ? . . Southold .t.I.
t
conforms substantially to the evade,.
CartifIcate P Y
before- April .23. . ., 19.57. pursuant to which N —141 7. —
dated . . . . . . . . . .May. . . .29. . . ., 19. 73, 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• one -family. dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . itichard lfe. . , . .Owners . . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval Pra-.exists R9 . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. . . .rre-AxOstir.
HOUSE: NUMBER. . .116-0 . . , . .Street. . , s ,load. „ . , . . . . . .
t�xeeptiorls • tc- -00de.3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 No light a`ritch at point of entry ( SIS) 529b / I
2. No shutoff valve at kitchen range 50£b /
3. No show,.r cl' tul in bathrcon 505b
I+* bttertor— ia/S no founciatlaL or skirt 302& 6C4Wkiilcling Inspector
HOUSING CODE INSPECTION
May 29, 1973
#1160 Paradise Shores Road
Southold, N.Y.
Tax Roll : Richard C. Clark and wife
Seasonal
Upon request of the Southold Town Building Department,
I made inspection of this one story framed dwelling and
found the following violations of Local Law #1, Housing Code
Town of Southold. I was admitted to south entrance to
screened enclosed porch by Mrs. Clark and began inspection
at approximately 9:30 a.m.
Large room containing livina room and kitchen: No switch
at south entrance to control ligHt in room - Section 529b.
Kitchen: Range, gas, no shutoff valve at unit - Section
508b.
Half Bath: No shower or tub inside dwelling - Section
505b.
Exterior: Building on posts with crawl space; section on
west e under kitchen and bath area not skirted -
Section 302a, and Section 604b.
Inspection completed at approximately 10 :00 a.m.
pectfully bmitted,,
Edward Hin ermann
Building Inspector
EH:tle
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT'
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. ,gab ?. . . . . Date . _. . . , , . . .July . . . 16 . . . . ., 19.75.
THIS CERTIFIES that the building located atE/S. Yexad.ise. ,Shores .1oadStreet
Map No. xxx. . . . . . . . Block No. . xxx. . . . .Lot No. .xxx - -Southold - -V-1 . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . - . . . . - . . .J-1+--1 16, 19 7.5 • pursuant to which Building Permit No. BoAQr. .
dated . . . . . . - .July. . . . 16. . . . ., 19 r?5., 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 . . .PrI-vate c�1 .ssory stoxa e- building: . . . . . . . . . , . . . , .
The certificate is issued to . Uchar-d . . Phyllis •Clark • - • • owners • • • • • • • - . . • • . • •
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . • . . . . • • . r w
UNDERWRITERS CERTIFICATE No. . A+13+. . . . . . . . . . . < . . • • . . • • • . • . • . ,. M .
HOUSE NUMBER . . . 1.7.64. . . . . . Street . . . . .Paraditse• Shores• -Road. . . . . . . . . . . . .
Building Ins r
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-21011 Date SEPTEMBER 11, 1992
THIS CERTIFIES that the building ADDITION
Location of Property, 1160 PARADISE SHORE ROAD SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 80 Block 1. Lot 25
Subdivision Filed Map No. Lot No.�
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 2314 1.987_ ______.pursuant to which
Building Permit No. 16490-Z dared SEPTEMBER 30 1987
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 DECK ADDITION TO EXISTING ONE .FAMILY DWELLING AS APPLIED FOR
The certificate is issued to JOHN & ETHEL McKENNA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL, NLA_.
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED NIA
Uuild I spoo or
Rev. 1/81
j M
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-21012 Date SEPTEMBER 11 1992
THIS CERTIFIES that the building ADDITION & ALwT TION
Location of Property 1160 PARAI7'ISE SHO�tES ROAD SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 80 Block I—Lot 2
Subdivision Filed Map No. Lot No.�
conforms substantially to the Application for Building Permit heretofore
filed in this office dated—MARCH 11 1991 pursuant to which
Building Permit No. 19715-Z dated MARCH 15 1991
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 D'ITION ALTERATIONS & DECK. ADDITION TO CONVERT AN EXISTING
SEASONAL DWELLING TO YEAR ROUND ONE FAMILY DWELLING..
The certificate is issued to JOHN & ETHEL McKENNA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A
UNDERWRITERS CERTIFICATE NO. N-208903 - OCTOBER 21 1991
PLUMBERS CERTIFICATION DATED SEPT_ 1.8 1991 - MIKE JACOBI PLUMB & HEAT
�.
Bui ng Inspect6r
Rev. 1/81
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