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HomeMy WebLinkAbout1000-126.-10-17 TOWN OF SOUTHOLD Rental Permit 0751 Owner Ellen Wagner Occupied as Single Family Dwelling Located at 6825 Peconic Bay B1v Laurel 126-10-17 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. 10/13/2022 Code fo eme fficial This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road r. Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 N y A BUILDING DEPARTMENT TOWN OF SOUTHOLD u �/ RENTAL PERMIT APPLICATION SEP 1 4 2022 Rental Permit Fee$200(Application must be renewed every two years) BUILDING]DEPT. TO"I aP SC UTHOLD Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION ZG -BLOCK. d -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (0(6� Telephone Number(s): Dayti4 Evening Emergence Property Owner Email Address: # �D �c to aha l Page 1 of 5 Town Hall Annex ; �t. Telephone(631)765-1842 54375 Main Road x Fax(631)765-9502 P.O.Box 1179 , Southold,NY 11971-0959 ejou BUILDING DEPARTMENT TOWN OF SOLYMOLD Section C. Authorized 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 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 gyp •�i '� ,a'r Town Hall Annex � S, Telephone(631)765-1802 54375 Main Road ; ' Fax(631)765-9502 P.O.Box 1 179 °' r Southold,NY 11971-0959 C � 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, r 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: Requested Maxim number of persons allowed to occupy Dwelling Unit: to Number of rooms in Re tal Dwelling Unit: Use and Dimensions of each Qom in Rental Dwelling Unit; 05).to_ = I©7-X k, I ymra)C� cC MOM (�� 1t) V:5-jr duV�. ��'� Page 3�f 5 soy '' 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 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. VI 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. 1 am the own f 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 z Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 v , c, Southold,NY 11971-0959 ��� I BUILDING DEPARTMENT TOWN OF 501=0LD 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. I 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. PS u Property Owner's Name: Property Owner's Signature: Sworn to before me this dday of 2���. 601GAA Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01BU6185060 Qualified in Suffolk County Commission Expires April 14,2a Page 5 of 5 SN4'' .. Town Hall Annex Telephone(631)765-1802 54375 Main Road ¢D Fax(631)765-9502 P.O.Box 1179 ' Southold,NY 11971-0959 a /�}' ,•' BUILDING DEPARTMENT TOWN OF SOXJTHOM RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: �. Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occ y each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: I o�apF SOUIyO 092,� TOWN OF SOUTH LD BUILDING DEPT. courm��`` '631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: DATE INSPECTOR i J s LSC C�L�f f� A� � f S / X11 TOWN OF SOUTHOLD PROPERTY 10,00 - 12-6 - lo - I Y RE! 9 17 (aO "'�W OWNER STREETUB. 7T VILLAG DIST. S Ppe 6 1 val La, o-f e, ACR. REMARKS es,j TYPE OF BLD. Apr ScSPROP. lz I Sin LAND IMP. TOTAL DATE ba�')A- tDp -5-10 - ............... 6,00 �4700 I az57--z'o FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL 77— .......... Z77, 7' cy OWN lgqllf R SOO T RECO -1 E'I--` STRE t. df, `SU66 ,, LOT -A fX", FOR WNE .:° pytt*A N E ACREAGE. j 16 A'al V, ID E . g, ,e � I 6f WjIA W,f BUILDING TYPE OF B FA RM ' SEAS: VL. COMM IND. CB. misc. IMP. TOTAL DATE REMARKS 'VArk v- AWA�q 14 0. I J 77 1.2 0411 I& 0 P/W- ........... E. ag' 'tog 7 -f*Dr&— To, J ND Lt N . E­W1NORMAL.:` BELOW ABOVE, Farm Acre Value Per Acre Value` YO J fh4 ce��Yw 1. i-2 3/4-q .......... T i ilo,OeL, 2- 7ill6ble, 3, 41 ;Woodland :Swampland' - . Fri 457. : u hi'"d, s� an House P To Total Lnr ........... ............ ?. �t #, .,a24 COLOR .�. -.. - A fin won *#I �!i � M11 � �"����1M ■� , TRIM f 11t " •r* ANN a ^` k 126-10-17 3/03 1st 2nd M. Bldg. ` ' Foundation PC Fin. B. Bath Dinette =� �.�. �j,C�, _.... X '-n `Fl1lL COMBO /// 1 Extension Basement PARTIAL Floors /�/ T��p Kit -- SLAB Extension `` Ext. Walls interior Finish L.R xtension3�J Z ©rt7 Fire Place Heat * D.R. 6 7,1Ct2 - �� Patio � ' Woodstove BR. 3 Porch-N/ X 2t , Dormer Baths /r fl Liz'•�- _— _ _ —_ _ _._. to 2 j ?Ot1ar ' Dock Fam. Rm. A.C. — ------ -..,. "s Yes spo?' a.o o Garage OB o100 /9 2 5. E i 3 o I t, i 3 : 1 lad. Bldg. + $� -° ' f�.e Foundation Bath ,► _ -- - - — ----- ---- a Extension Basement Floors r r Extension Ext. Walls Interior Finish Extension ! Fire Noce f Heat Porc Attic jv <j Porch Rooms 1st Floor Aq.aPatio Rooms 2nd Floor Garage , Driveway a ^ i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31198 Date: 08/18/05 THIS_ CERTIFIES that the building DWELLING Location of Property 6825 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 0010 Lot 017 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 31198 dated AUGUST 18, 2005 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 ONE FAMILY DWELLING* The certificate is issued' to WILLIAM A CAGGIANO (OWNER) . of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Authorized Signature i Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 6825 GREAT PECONIC BAY BLVD LAUREL SUBDIVLSION: MAP NO.: LOT (S) NAME OF OWNER (S): WILLIAM A CAGGIANO OCCUPANCY: SINGLE FAMILY DWELLING WILLIAM A CAGGIANO ADMITPED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAY MAP NO.: 126.-10-17 SOURCE OF REQUEST- GARY OLSEN, ATTY - 8/12/05 DATE: 08/18/05 DWELLING: TYPE OF CONSTRUCTION. WOOD FRAME # STORIES: 2.0 # EXITS: 2 FOUNDATION: CEMENT BLOCK LIKL.Au: FULL CRAML SPACE: TOTAL ROOMS: IST FLR.: 5 2ND FLR.: 3 3RD FLR.: 0 BATHROOM(S): 2.0 TOILET ROOM(S): 1.0 UTILITY ROOK(S)- PORCH TYPE: ENCLOSED DECK TYPE: PATIO TYPE: BREEZRNAY: FIREPLACE: ONE GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: GAS AIRCONDITIONING: TYPE HEAT: GAS WARM AIR: YES HOTWATER: YES* OTBBR: *SEPARATE HOT WATER HEATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. I I I � I I I I � I I I � I � REMARKS: BP#5472-COZ4411(ACCY)BP#28099Z-COZ29424(ALT ACCY)BP#280992-COZ29424 (ALTS) BP #31442-Z-CAZ-31197 (DECK) INSPRCTED BY: DATE ON INSPECTION: 06/18/05 GEORGE GILLEN TIME START: 10:20 AM END: 10:50 AM 1 i FORK NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 7444.1.1 . . . . . . Date . . . . . . . . . . . . .Oct . . .7. . . . . . ., 19.71. THIS CERTIFIES that the building located at . .POAQU10. .Ia4y. Jlvd. . . . . . . Street Map No. xx . . . . . . . . Block No. . . . .xx. . . .Lot No. . .xx . . .Lame l. . .Pi.Y.. . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . Aug. . .23. . . . ., 19. .7.1. pursuant to which Building Permit No. 5472Z . . dated . . . . . . . . . . .Aug . . 23, . . ., 19. .7.1, 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, -accessory -building (Storege). . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .John.a:. Antoinetto •Plage• • • . • mars. . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.-L11 o. . . . . . . . . . . . . . . . . . . . . . . . . . . . . House ; 6825 �. }f.. . . . . . . . . . . . . . �. . . . . . . . . . Building Inspector FORM NO. 4 TOWN OF SOUTHOLD 2 l BUILDING DEPARTMENT v Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29614 Date: 07/31/03 J THIS CERTIFIES that the building ALTERATION Location of Property: 6825 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 126 Block 10 Lot 17 j Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 19, 2003 pursuant to which Building Permit No. 29398-Z dated MAY 19, 2003 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 INSTALLATION OF ELECTRIC TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to WILLIAM A & MARGERY A CAGGIANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1146301 07/17/03 PLUMBERS CERTIFICATION DATED N/A 2�_ tho zed Signature Rev. 1/81 1 FORM NO. 4 TOWN OF SOUTHOLD r BUILDING DEPARTMENT Office of the Building Inspector �+ Town Hall Southold, N.X. CERTIFICATE OF OCCUPANCY No: Z-31197 Date: 10/11/05 THIS CERTIFIES that the building ADDITION Location of Property: 6825 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 126 Block 10 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 8„ 2005 pursuant to which Building Permit No. 31442-Z dated SEPTEMBER 12, 2005 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" DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM A CAGGIANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Auth rized Signature Rev. 1/81 ' 1 I