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Home My WebLink About1000-87.-3-10.1 TOWN OF SOUTHOLD o Z& Rental Permit �j 0731 Owner Robert Holzer Occupied as Single Family Dwelling (second floor is storage only) Located at 3385 Minnehaha Blvd Southold 87-3-10.1 Maximum Permitted Occupancy 3 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. 8/24/2022 %A de E orc m nt fficial This Notice must be posted by the main entrance at all times I Town Hall Annex 1�i Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Or • `,�4 S E r �,VnU JUL 1 5 2022 Lam` BUILDING DEPARTMENT T. TOWN OF SOUTHOLD BUILDINGtN 'I"OWfV OF SOUTNOLD 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 7 -BLOCK -LOT D -� SECTION B. OWNER INFORMATION: J) rr Property Owner Name: - ��J /V_' Zn=,'��Lf Property Owner Legal Address: Property Owner Mailing Address: nlg�i1 , r=C.,-�i - e- - &12- - - Telepahone Number(s): Daytime,c_� 6/2 . Evening Emergency, ge3 Z- Property Owner Email Address: e__'�Oknc 'fell eyGrte' Page 1 of 5 WS0 1 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 coumv ' 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: Use and Dimensions of each room in Rental Dwelling Unit: i vQ cow r l 3LA.tq is a-��LJ VI x I� P F�. ` % x /.3 Page 3 of 5 j s° Town Hall Annex ` Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179ISS Southold,NY 11971-0959 ` elf, 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. X1.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 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. „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 so 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: PC6,tk Property Owner's Signature: Sworn to before me this r day of 20 aa, Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01BU6185050 Qualified in Suffolk County Commission Expires April 14,2 Page 5 of 5 OF soUTyO 77 # # TOWN OF SOUTHOLD BUILDING DEPT. cou631-765-1602 �'�. ��.,� 10. 1 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] PKAL [ ] FIREPLACE & CHIMNEY [ IRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: Y\ UVB, �J p v S d(A4 DATE Y INSPECTOR 6'-0 184' 28'-512• 34' II -51/4' A9 606BSGD O� 2852 A7 I A6 24218 Tag MemWr Al (3)2x8 SPF 92 A2 (3)1 1/Y x 5112'LVL(E=1.8) 1 I A3 (3 1 l..x 5112'LVL(E=1.8) ®I .,{la ——— A4 (3)1 1/Y x 51/2'LVL(E-1.8) GAS F6iEPl/d;E V0815 VB30 1�•' A5 (3)1 1/2"x 9 114'LVL(E=1.8)per module FIREPLACE AND HEARTH I R'S A6 (2)2x8 SPF 92 PER MEPLACF MANUAC R'S — INSTALLATION INSTRUCTION A7 (2)2x6 SPF 02 ® BATH WIC A8 (1)2(6 SPF#2 1 NOOK LIVING ROOM >® A9 (3)11/2"x 5 112'LVL(E=1.8) i �9p #2 A10 (2)2x8 Is #2 All (1)2x10 SPF#2 per module Al2 �i A7313 is A74 �V 25M � A15 y 268 A16 A77 AI 11 l I 'il 0. n A19 2668 Y A20 ON ® 13'-1 1/2' vii T_ 2 FIIIca V03 O LBATH zee #1 m SITE INSTALLED SLOPED' o RAILING O 36'ABOVE TREADS BEDROOM#1 EN DINING ROOM FOYER; oom Room Req'd Reqd Prov'd Prov24B R.'wN 2D1261ocw Name AMa LI ht Vent Li ht Vent U—SBr#1 223 17.8 8.9 22.8 12 Al 2/210M1R1ED O 2852 MUUED A} dWS�ELIGIfTS A6 2857M�D Diring 156 123 6.2 228 �12 Nook 161 11.3 5.6 46.5 Br 94 0.0 0.0 19'-712' 29'-4'- - _ 43'-9' ❑Nr1g 245 19.6 9.8 22.8 tra _I t7a' I I� s-t D• ( e'-oj' 1sa • STATE MODULAR LABEL ■ NTA LABEL I 25'-0'J 4X-9"JDATA PLATE 6 DORMER CA. 6'DORMER C& 6'DORMER CIL �✓), /.AM CpQ TO THE BEST OF MY KNOWLEDGE,BELIEF,AND PROFESSIONAL I I i11' JUDGEMENT,THESE PIANS AND SPECIFICATIONS COMPLY WIT THE C ENERGY CONSERVATION CONSTRUCTION CODE OF NEW YORK(ECCCNY). COMPLIANCE SHALL BE DEMONSTRATED TO THE LOCAL BUILDING OFFICIAL BY NY MECH CHECK(ECCCNY CHAPTER 1)AND GENERAL �•u.• r' COMPLIANCE WITH ECCCNY CHAPTER S.SECTIONS 502 THROUGH 505 'OF'JSI`� 1L THE PLANS AND SPECIFICATIONS OF THIS PERMIT SET `�j ARE DERIVED FROM AND CONSISTENr NTH INE PLANS �( AND SPECIFICATIONS ASSOCIATED NTH APPROVAL M009-03-021 AND ITS CONDITIONAL APPROVAL LETTER, DOTH ON FILE NTH THE DIVISION Integrity Building Systems, Inc. DEALER:FUTURE SURROUNDINGS DATE: 2/9/04 1 REV:6/11/04 4 C171304 FIRST FLOOR CUSTOMER:HOLZER DRAWN BY: CS/GS CAPE PLAN I Al Fror `6P O-7 -7 `i� / �-vo c �v� S �� 1-Fe�� _. � �� Z � W LS 2 �� J �� s S - 5,�.� o, • TOW 'SOUTH QLQ POO P. R'fY RECORD CARS OWNER lCi oc) ;',' E .. 4 � STREET f VILLAGE — 'DISTRICT :SUB. LOT FORMER,OWNER N ACREAGE Lei- F /vc;.r `ia Yl6� w/' S W HYPE OF BUILDING RES. SEAS. VL.. FARM COMM. IND. ,CB. MISC. Est. Mkt. Value - .s LAND IMP. TOTAL DATE REMARKS -^ `kms ___ AGE BUILDING CONDITION NEW - NORMAL BELOW ABOVE FRONTAGE ON WATER - i -Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable ] BULKHEAD - — Tillable 2 --- DOCK �- Tillable. 3 -- --- _._. ---.......... ...- ---- Woodland ------- _ . Swampland -` -------------------. '. Brush land -- House Plot - Tota I --- • • :':;.� �-.`�::�.'.�`:'..`;.:'.- ...,. ., ... ,.. ''fit.. �•-C"F"'Y've-ve. ,sr.:'R wxa ,Fes'-,• `�� `�� T0WN ' OF SOUTH LD P , Q MOPE OWNER �D CARD: ---- STREET VILLAGE iTRICT SUB. LOT, - FORME 1� R OWNER N 1 :;# .' " , .� <' -i of zer �,', i% $ f E �:':.... ACREAGE l WS' �.� TYPE OF BUILDING :. RES. ' .' SEAS. VL FARM- Comm IND. ._. CB. MISC. Est. Mkt. Value . I : I LAND IMP.,_, TOTAL DATE REMARKS 1_:_1 Gt 7 P 'd 7l iC.f NAte :: f tl_LPf�� a»e { c a"3 % t r# Fj y67 ` £ I'i'i i�'�t� i�C.�i •ir2.� F } � _.�f�p i t�xl��:r. • . AGE BUILDING C DITION C_6 �} Q" NORMAL B L , FRONTAGE ON WATER Farm, Acrer - Value Per Acre lue FRONTAGE ON ROAD 2 'Ti lll^able 1 — -r BULKHEAD Tillable 2. - _ - - = -- DOCK f� , \'E : Tillable. � - : ..Woodland . ---- — -- - Brushland:.. ' -- House'Plot - " �.... ' r i " . a i ..n e _ °, r ° 21 M, Bldf < 'ar.r - •,.>„a,_ ":�.. ,. 'tt ---•—__.r._.--; .✓ �:`�'°moi, at I , i _ _,Kl m i , i' �a : ' > I Both Faun bion , Extension _ t se _....____-- _ ment Floors 'A c Extension : 1 ; E f' a Ext Walls ,i nt—er_ior Finis-h Extension HeatFire Place . i. ._., �.......:._...._._ _.r�<<.��.. f Roof Type n, � Porch '< -- Porch 4 Rooms 9 st Floor ✓ Breezeway } R -- _ _._�..._. ._........_............_.._.._...-_-... - -- ' i Patio 2nd Floor , ----- ....- _ - _._-_.....__-.._-_._..._____._._-._--_ Garage . ........... ' Rooms Driveway Do,rme,? I_ ».-,...-...,a„„.,�...................n.. ....a'�..✓✓.J""-.<.,..<..,.<.m.,.,......,.-.........,..„,,.,.,...,.,.,....,..a..,.._..c.._...-..„..,.<.w.,-,u...-.-,......,,,.,,,.w".[i...,.,:.�x:`w:......�-:,.ti-.a...�.,”-...i_.:......:.�a.......,..,,...�-.<....-.�fr_..�,..::Y...,....,.':=-,.:,:...n,....„.. „ w.J �- - -� i .. .'�'.. 1 `'�\ '7^� fes`•-'�. f�.t � r _ I f ' t i I - ' FF$ � ' k I e 1 i i t ' - 1 : -- --�-- - = - -- f- o ----i- - 87.-3-10.1 3/06., .......... i L ; , ! N1 BIc7 „g', undation —i - --_ ---- _ --_ ova,, Both Extension — �I Basem ___.._..----__....._......:_----------- ent - Floors Extension ._........__..------- _ I Ext. Wo l is ! Interior ---- - I nterior Finish Extension Fire Placeye� S Heat : Porch Roof Type f f ' Porch � Rooms t st Floor � d Breezeway __ ___._.—:.___ _ --------- _...._ _....____ at1Q _ Rooms 2nd Floor _ ........._.........._�i . Drivewa ._......._... Y Dormer I - --- - -wa7 .fL°7 -few FORM NO. 4 30-7 -7--7 — TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31335 Date: 12/15/05 THIS CERTIFIES that the building NEW DWELLING Location of Property: 3385 MINNEHAHA BLVD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 87 Block 3 Lot 10.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 5, 2004 pursuant to which Building Permit No. 30777-Z dated NOVEMBER 15, 2004 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 SINGLE FAMILY DWELLING WITH COVERED FRONT PORCH & UNFINISHED SECOND FLOOR AS APPLIED FOR. The certificate is issued to ROBERT C & PAMELA HOLZER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL R10-04-0094 11/03/05 ELECTRICAL CERTIFICATE NO. 2045519 05/26/05 PLUNIDERS CERTIFICATION DATED 05/16/05 CUTCHOGUE EAST PLUMB&HEAT Authorized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 30777 Z Date NOVEMBER 15, 2004 Permission is hereby granted to: ROBERT C HOLZER SOUTHWOODS DANBURY,CT 06810 for DEMOLITION & RECONSTRUCTION OF A NEW SINGLE FAMILY DWELLING (MODULAR) WITH COVERED FRONT PORCH & UNFINISHED SECOND FLOOR AS APPLIED FOR at premises located at 3385 MINNEHAHA BLVD SOUTHOLD County Tax Map No. 473889 Section 087 Block 0003 Lot No. 010 . 001 pursuant to application dated OCTOBER 5, 2004 and approved by the Building Inspector to expire on MAY 15, 2006 . Fee $ 1, 337. 30 J Authorized Signature ORIGINAL Rev. 5/8/02 sufrogawg�'G Uff 6ftfte C �' 't oun y of� Of [k On. the Date Written Below LETTERS TESTAMENTARY were granted by the Surrogate's Court of Suffolk County, New York as follows: File:#: 2021.,-5492 Name of Decedent: Robert C Holzer Date of Death: 10-10-2021 .AKA Robert Charles Holzer Domicile: County of Suffolk Type of Letters Issued: LETTERS TESTAMENTARY Fiduciary Appointed: Ernest Handau Limitations: NONE THESE. LETTERS, granted pursuant to a decree entered by the court, authorize and'empower the above-named fiduciary or fiduciaries to perform all acts requisite to the proper ad"ministration and disposition of the estate/trust of the Decedent in accordance with the decree and the laws of:NeW York State, subject to the limitations and restrictions, if any, as set forth above. Dated: March 23, 2022 IN TESTIMONY WHEREOF, the seal of the Suffolk County Surrogate's Court has,been affixed. WITNESS, Hon Theresa Whelan, Judge of the SuffoJk County Surrogate's Court Doreen A. Quinn, Chief Clerk These Letters are Not Valid Without the Raised Seal of the Suffolk County Surrogate's Court Certificate# 240619 Surrogate's Court of the State of New York Suffolk County t=ile#: 2021=5492 Certificate of Appointment of Executor IT IS HEREBY CERTIFIED that Letters for.-the Estate .of the Decedent named below have been granted by this Court, and such Letters are unrevoked, are valid and, are in full force as of this date. Name of Decedent: Robert C Holzer aka �Robert.Charles Holzer Date of Death: October 10,X2021 Domicile: County of Suffolk Fiduciary Appointed: Ernest Handau Letters Issued: LETTERS TESTAMENTARY:. Letters Issued On: March 23, 2022; - Limitations: NONE THESE LETTERS, granted;pursUeiit to a'decree-e-ntered.by>the.court; authorize and empower the above-named fiduciary or fiduciaries to perform all acts requisite to the proper administration and.disposition of the estate/trust of the Decedeot=in'.:accordan.ce.with the decree and the laws of New York State, subject to the limitations and restrictions, if'any `as'set forth above. s - and such Letters are.unrevoked and in full force as of this date. Dated: March 23, 2022 IN TESTIMONY WHEREOF,the,seal of the.Suffolk Riverhead, New York County Surrogate's Court has been affixed. WITNESS, Honorable Theresa Whelan,Judge of-the Suffolk County Surrogate's Court. k Doreen A. Quinn, Chief Clerk Suffolk County Surrogate's Court This Certificate is Not Valid Without the Raised Seal of the Suffolk County Surrogate's Court