HomeMy WebLinkAbout1000-80.-1-9 TOWN OF SOUTHOLD
Rental Permit .
0735
Owner Tully C & P Joint Revoc. Trust
Occupied as Single Family Dwelling
Located at 2544 Paradise Shore Rd Southold g� _
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.
8/31/2022
ode E or e e Official
This Notice must be posted by the main entrance at all times
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Town Hall Annex A 5�, Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 4cjc��
Southold,NY 11971-0959
_EGA
BUILDING DEPARTMENT
TOWN OF SSOUTHOLD AUG -0 0 2022
RENTAL PERMIT APPLICATION BUILDNG DEPT
TOWN OF SOUTHOLD
Rental Permit Fee$200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Ad, ress:
Ain5 g c,� Ad�� ,torr 1 c1�
Tax Map Number: 1000 SECTIONS -BLOCK f
SD4- 91
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Iry 1/y _0In s���L z l�i�us -
Property Owner Legal Address: Property Owner Mailing Address:
-761 /Lyy-wal�m ,GA & I)y-- A) /6 Al
/c g
Telephone Number(s): Daytime Evening Emergency
Property Owner Email Address: Oo /ll 5k -7—&/&_(2 6 zZ 14/ 1
o Page 1 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road 41 Fax(631)765-9502
&0
P.O.Box 1179
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 Renial 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, 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."
Rental Dwelling Unit Identifier: VV
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:
/�4 Ae d Ila g 5-
/ 9 )( /0 1
f
Page 3 of 5
®� so
Town Hall Annex Telephone(631)765-1802
54375 Main Road CAM Fax(631)765-9502
P.O.Box 1 179 Q
Southold,NY 11971-0959 Q y
c®urm,�� '
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.
l�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)
.5 // f 1 , 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
SOU��o,
Town Hall Annex l��B® fl®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
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.
flOPrProperty Owner's Name: lt S`(A ---
Property
operty Owner's Signature:
Sworn to before me this q-Ada y of 200Q
4 P L 4Rt.t/1 Ci
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 14,2-0a
Page 5 of 5
hO�apF 50UTyOlo /�` ` ��♦7Pi `-I K/ � ��. C;�CR�
# TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS LATION/CAULKING
[ ] FRAMING /STRAPPING [ ] NAL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN ATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O ] RENTAL
REMARKS:
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40 year dimensional shingle by tarnko or approvedequal,architect to select color,
over 1511 building fell on%"ads plywood sheathing over roof mf ers(refer to
framing plans Far sizcc&spacing).Provide 36"strip of water!ioe guard m
botmra intersection of roof&fascia
ORldae Vents:
Shingle style ridge vent,muchmg style&color ofroofshingle.Installed in strict
a I accordance with msnufacturcrs spec',.Locations ss indic tred.
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2'xa•A¢ _ 2x�e¢ (Collar Ties:
Install 2'k 4"collar Lies 48"o.c.,Locations as indi:ated
0Sofft.&Fascia Boards:
Provide vinyl soffits with cunt
uinuous alum or vinyl vent svnp.Fastin boards to be
_ either clear pine painted while or N2 pine wmppedin alum.Sim of fascia boards
rc 1 9.1 _h Cot000stu:
I + ,4 to be Ill.B"with a I'k?"accent board Cor gables. t� '
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@x ^+\ uI o I provide tyvek house wrap by Dupont over W edxplywood on 2"x 4"wood studs
16"o.e.with R- 13 batting insulation&14"gwb(Interior face)tape&spackle(3)' WEST 5140IP.a Pe l VE e
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plywood sub Dearing with(1)layer of Y," an top.lap all stems.Refer ,r9 r2ga7
floor plain far Floor finishes Align all Door elevations. - FIIE5T Ft,00l2 p1e6N�p�U1l.OING`.6�fioN) T``-r n..ut+°•
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33012 Date: 04/30/08
THIS CERTIFIES that the building RECONSTRUCTION
Location of Property: 2544 PARADISE SHORES RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 80 Block 1 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 21, 2007 pursuant to which
Building Permit No. 32826-Z dated MARCH 22, 2007
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 RECONSTRUCT ONE FAMILY DWELLING INCLUDING ALTERATIONS, SCREENED PORCH
AND OUTDOOR SHOWER STALL AS APPLIED FOR.
The certificate is issued to CALLISTA TULLY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DSPART146RP OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H 074359 02/11/02
PLUMBERS CERTIFICATION DATED 04/23/08 H2M LABS INC
Authorized Signature
Rev. 1/81