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HomeMy WebLinkAbout1000-125.-4-12 T TOWN OF SOUTHOLD Rental Permit � ► "� af� 0708 Owner Sean & Erin Brodarick Occupied as Single Family Dwelling Located at 2880 Delmar Drive Laurel 125-4-12 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. 7/22/2022 qu �A 0 k� C de fo a en Official This Notice must be posted by the main entrance at all times a A_ Town Hall Annex �W� 1�3 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 I C(7 I L`r`; ' r Southold,NY 11971-0959 t u ' �,��{ ':��W i �• I�f! JUL 1 0 2019 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: Q S 90 D EMAP, 0izyvr- LAuREL /v `I Tax Map Number: 1000 SECTION -BLOCK SECTION B. OWNER INFORMATION: Property Owner Name: S E R A/ M B RCS 0R I dY Property Owner Legal Address: Property Owner Mailing Address: AM 0 e)rnar d r ioe- Laurel l�f alio Nlm4r dr.'ve 119W8 1�.�rel fly I I Telephone Number(s): Daytime 63j-33)-qV 9 Evening Emergency Property Owner Email Address: Jroj o_r;c- m,.:l I. co Pagel of S AL Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971"-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. ❑ 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 occupancy 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. ❑ Rental Permit Fee: $200.00 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: /V . ly r 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: Name of Authorized Agent of dwelling unit, if any: 1 VO/U E 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: IVC)A)J _ Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex Telephone(631)76.5-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 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: E 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: n, o n e Requested Maximum number of persons allowed to occupy Dwelling U it: Number of rooms in Rental Dwelling Unit: X Use and Dimensions of each room in Rental Dwelling Unit: A0.slee' Ige� : W-9" X 1 p' v AoJer AA x g' S Qed room 1 In" a„X 1l, v Guest 6 eJ rav v� x �/�8" ✓ ►l"Uel) // yi4q (00M : a 3' S� x - Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 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. I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 1 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. 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 Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 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: AJ /LA o n da R T Cl' Property s Owner' Signature: p Sworn to before me thisgt day of _, 20/'/ �fiyy�J�i Official Notary Public Signature and Original Notary Stamp SABRINA M BORN Notary No101York 1306317038 Qualified in Suffolk County Commission Expires Dec.22,20,� Page 5 of 5 z4az> DAN, ✓' Or �Avv v( �o�apF SOUTyO� # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION . [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] INAL g64.y [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION . [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING R MARKS: � (o cv i ' oc,c,,v L"'oom © ( llr�l &46nty pil..ff Al oA ,wvv O' DATE INSPECTOR " .,,r.rv„'.*;Yr .�""�1•;?%:errZ:v';r r?� , �:• - ..�:�.F4.n ;.'�+f.;�p4?`�. .- .!�.F.•moi:��,{-•V'�"��•,'$j.Yr i+'s'E..�T E',�;-''�i°'ti��•:•'• i,T.- .^n _ ,Tr- ��a'�. '"'.'••.,- .:�f??��li.�� ..,Y�,'\�, ;'lt..r..!1ryy,.� , d r p ) j•. • � P.c.SM P � • Iq il El IA o BE.L? Q - ' RE.NU. 4 0 1-g TOWN OF SOUTHOLD PROPERTY RECORD CARD S>00% 'LOT %,r06.cxe 1 C\4, STREET I VILLAGE DIST. SUB.,-, -MAU FORMER OWNER E ACR. err,(/1L 6tyg I 5 W TYPE OF BUILDING I 'Ila 61 RES. SEASAC . VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARK S/,ZIY12 c. L/ 1 76 7121 ZIL11 "q lelv Id,w 13)o AL .5i 9Oa ; , , . , 5g. iv -w Pv D%v, / ,c 7:"/7 A/y Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowknid DEPTH House Plot I BULKHEAD 70tal = `: ■■■■■■■■■■■■ ■ ■■■■■■■■IMEMM MEN ■■■■■ . o OMEN■■■■■■■■■■■■■■■■■■ r `t ■M■■■■■■EN■■■E■■■■■ ■N■■■■ h ■■■EN■■■E■■■■■■■■■■■ ■■■■■■ IN KNENMENNE ■ ■�iMonsi■■■®■■■sN■E■E ■E ■ ■■■■■■■■■aM■■■iiEMEEM AMEN�■ . ■■■■■■■■■■■■■■SEE■■■■■■■■� C.........■E■■M■■■E■■■■■■■■Rooms I st Floor . Foundation . .. . Recreation Room Rooms 2nd Floor Dormer �rSOFFnc�co:Y, Town of Southold 7/22/2022 O G P.O.Box 1179 " N 53095 Main Rd Southold,New York 11971 Cpl -A CERTIFICATE OF OCCUPANCY No: 43279 Date: 7/22/2022 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 2880 Delmar Dr, Laurel SCTM#: 473889 Sec/Block/Lot: 125.-4-12 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/27/2020 pursuant to which Building Permit No. 44818 dated 5/28/2020 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" central air conditioning and oil burner as applied for. The certificate is issued to Brodarick, Sean&Erin of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44818 1/25/2021 PLUMBERS CERTIFICATION DATED s A thori e Signature FARM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. X. Certificate Of Occupancy No. *7' 6. . . . . . Date . . . . . . ... . . . . . . . . . . . . . . . . . . 19. � THIS CERTIFIES that the building located at .P/4'.31 .1mst kve . . . . . . . Street Map No-40P. W AxAlock No. . . . . . . . . . .Lot No. 38 . . .14%we .. . A#Y.« . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . . .AUS . .11 19.75. pursuant to which Building Permit No. . 149A dated . . . . . . . .Aft . .15. . . . . . ., 19.75., 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 . . 'K�'�e. �. •�3! dt�l���. 1��. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . F4MVIOV. W101ag. O.Q.fte. . . . .QwAO a. . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No. l�a '07 . . . . . :�.!�. . . . . . . . . . . . . . . . HOUSE NUMBER . . . . .^880 . . . . Street . . .PO.w Dl**de . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector �.��..�� �,i'°�, ti "'!� .�+---- . , � - ,.; . . + �. ., ��; :, .�'� �� ,�� �i �f�' ���� � •^� ., y, �1,.' :.��i'�41,�.r1 .+�`,�. �1 �. /.�� ��'; A� �' 1 t �.r -. -�`'� � � •; ,+ !�� 1 � / ��o+`�OSUFFUI Town of Southold 7/22/2022 '} P.O.Box 1179 + 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43279 Date: 7/22/2022 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 2880 Delmar Dr,Laurel SCTM#: 473889 See/Block/Lot: 125.4-12 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/27/2020 pursuant to which Building Permit No. 44818 dated 5/28/2020 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"central air conditioning and oil burner as applied for. The certificate is issued to Brodarick,Sean&Erin of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44818 1/25/2021 PLUMBERS CERTIFICATION DATED A thori e Signature