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HomeMy WebLinkAbout1000-63.-3-27.2 a TOWN OF SOUTHOLD
t Rental Permit
0719
Ar
Owner Second-Half Productions Ltd.
Occupied as Single Family Dwelling
Located at 400 Boisseau Avenue Southold 63.-3-27.2
Maximum Permitted Occupancy 4
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.
10/28/2024
o r licial
-
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] F AL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANX(FIAL)
ATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICALCODE VIOLATION [ ] PRE C/O [ AL
REMARKS.
DATE NSPECT X
TOWN OF SOUTHOLD
F
Rental Permit
0719
Q
Owner Second-Half Productions Ltd.
Occupied as Single Family Dwelling
Located at 400 Boisseau Avenue Southold 63-3-27.2
Maximum Permitted Occupancy 4
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.
8/4/2022 j
r
o a fficial
This Notice must be posted by the main entrance at all times Enfo e e
"V sonUTy 4
Town Hall Annex Telephone(631)765-1802
54375 Main Road cn Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0I9 �V��.�
Via°-f-?.rzc��T
jD
JUL 2 2022
l BUILDING DEPARTMENT
BUILDING DEPT. TOWN OF SOUTHOLD
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION -BLOCK. 3 -LOT 2"7 _ Z
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number(s): Daytimeo -�B -joEvening f3/!?B MEmergency 63/-7W-147
Property Owner Email Address: �%T�L/�H//yl�i✓��Dl �v»a
Page 1 of 5
U
Town Hall Annex t, 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:
Address of Authorized Agent (no P.O. Boxes): 33 4,-wl17o,2ky{ E W�� ��'`1/47fJ—
Mailing Address of Authorized Agent:
Telephone Number(s): DaytimeAN R3 f3o Eveninglj/Y&'j"f* Emergency G3/' 75`7—//R7
Email Address: �-!�✓�I�i�G� All 017)
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
Q T
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax (631)765-9502
11.0.Box 1 179 G i Q
Southold,NY 11971-0959
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: Ode
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: %r •
Requested Maximum number of persons allowed to occupy Dwelling Unit: ' o
Number of rooms in Rental Dwelling Unit: P
Use and Dimensions of each room in Rental Dwelling Unit: e- 04t?�
...,?y
k t'OA g��• -9 `l dL�� is
/f''�/�-� L��.%c xean a5°�x 1t'G`0 r�in,wy �um9�k/L�!`,��'�t.��kly��i� / ►�.»�-,Y�S�h�z1`�dnn
J&IIW7191,
Page 3 of 5
f, apF so�ryo
Town Hall Annex l�~tO f� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 COU4� j
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
V/ 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 Gfh2/�� �d+v✓ 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 flUT A. }
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: SG=ozL( r G� gy 7o,* 4 � r
Property Owner's Signature: _
Sworn to before me this 7S day of 202-2—
Official
0?ZOfficial Notary Public Signature and Original Notary Stamp
CHERYLL K.DUHARTpZ'b6 ludysaaldx3 uolss'WWOO
Notary Public,state of Klesp,York /lunob>Ilobns ul pagenQ
No.01 DUS185390 06£9919f1t3 w'oN
Qualified in Suffolk County �jol,09N JO 9181S'ollGnd k81ON
Commission Expires April 14,204 1WHf14')i11'083HD
Page 5 of 5
so �ao
f # TOW OF SOUTHOLD BUILDING DEPT.
cou631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANX(FIAL)ATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICALCODE VIOLATION [ ] PRE C/O [ AL
REMA S:
DATE INSPECTOR
Town Hall Annex 4 Telephone(631)765-1802
54375 Main Road Fax-(631)765-9502
P.O.Box-1179 G �'
Southold,NY 11971-0959
Call
BUILDING
,
i1
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
Rental PropertySCTM Number: 1000-63-03-27.2
Rental Property Address: 400 Boisseau Avenue
Owner/Name: Chris Thompson CIO Second Half Productions
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.)
Bedroom #1 - 222 sqft; Bedroom #2 - 80 sqft;Bedroom #3 - 96 Sqft
Property Description (Include all improvements indicated on survey)
Two story frame, single family dwelling with cellar and front porch. Dry garage with
gravel driveway.
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.
Steven Affelt,Architect <,gED ARCS,
Print Name and Title �O� N B. q� ij� )riginal SI nature
CO a ��
yF
Please place professional seal:
037611
OF NES.
STEVE AFFELT
ARCHITECT
�acv�
O BATHROOM
CI. r — 0 era
jp
SYMBOL LEGEND �I
L__j
u oxw SOISSEAUAVE N
2 SECOND FLOOR PLAN _!"�_ m ® tea.
adDINS PLAN REVIEW HD7E
03
KITCA♦$1 Q . 0
01
0 n
O O ® I LIVING RootsQL
) BOISSEAU AVE
HOUSE RELOCATION
DINING ROOM
FIRST AND SECOND
11 FLOOR PLANS
&_11R FLOOR PLAN
-���.� Tool A-101.00
0
STEVE AFFELT
ARCHITECT
--------- - ---------- ---- ---
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BOISSEAUAVE N
——---——— --------------- —
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FOUNDATIONS CONSTRUCTION PLAN
SYMBOL LEGEND --BOISSEAU AVE
HOUSE RELOCATION
o—cr——
NEW FOUNDATION
P N
LA
FOUNDATION WALL DETAIL
SYMBOL LEGEND STEVE AFFELT
ARCHITECT
m e
165 SQPr
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IB
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BOISSEAU AVE N
,EXISTING GARAGE PLAN(DRY STRUCTURE)
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BWLDINB PLAN WAEW NOf6
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BOISSEAU AVE
HOUSE RELOCATION
ATTIC&GARAGE
PLANS
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STEVE AFFELT
ARCHITECT
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IL---____________________________ BOISSEAU AVE
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,NORTH-SOUTH SECTION 2 EXISTING FRONT ELEVATION
1 94LD(N5 PLAN fgVIHN NOTE
W7
BOISSEAU AVE
I HOUSE RELOCATION
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BUILDING
ELEVATIONS
8 SECTION
TEXISTING FRONT ELEVATION •� I2-200.00
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},o�gOFFOtKIp Town of Southold 3/20/2022
v P.O.Box 1179
Is _ 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42933 Date: 3/20/2022
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 400 Boisseau Ave., Southold
SCTM#: 473889 Sec/Block/Lot: 63.-3-27.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/16/2018 pursuant to which Building Permit No. 44966 dated 7/9/2020
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:
relocated single-family dwelling with new foundation'(unconditioned finished basement), covered front porch and
side deck as applied for.
The certificate is issued to Second-Half Productions Ltd
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-18-0031 3/9/2022
ELECTRICAL CERTIFICATE NO. 21-75283 6/16/2021
PLUMBERS CERTIFICATION DATED
0 T u o ' d Signature