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HomeMy WebLinkAbout1000-75.-8-2 g TOWN OF SOUTHOLD a ca Rental Permit 0763 Owner Susan Creecy &.Ors. Occupied as Seasonal Single Family Dwelling Located at 3720 S. Harbor Road Southold 75.-8-2 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. 10/26/2022 This Notice must be posted by the main entrance at all times ode E or em nt fficial �t ®f soU �µ d `tZ % Town Hall Annex t}, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 -Z;zZzl :x: BUILDING DEPARTMENT TOWN OF SOUTHOLD Zi'o RENTAL PERMIT APPLICATION JUL 3 1 2019 Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -q73ftl -BLOCK -7 _-LOT—S - �- SECTION B. OWNER INFORMATION: Property Owner Name: /�larcji 'T� s Property Owner Legal Address: Property Owner Mailing Address: -1 - ` "Lr-k cv C ra ri'ce �- _4�;+ 5—.2-z c/ Telephone umber (s): Daytime 5 6 5"' y 3 vening 0 ' ,a b, Emergency 556?3 79-4--a2(Vd`'U Property Owner Email Address: = Gt xI'g ivy Page 1 of S '9 So Town Hall Annex Telephone(631)765-1802 54375 Main Road } Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �� 'f c4 C®UNTI BUILDING DEPARTMENT ' TOWN OF SOUTHOLD { i 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. C� 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 fpF S®(/�.. Town Hall Annex rf Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �ti mac' Southold,NY 11971-0959 U 'A'�qi{� 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): 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: VO� Address of Authorized Agent(no P.O. Boxes): :74 1 4'"1 �'fi. . S+e- Q,uJa 'j Mailing Address of Authorized Agent: Telephone Number(s): DaytimeW-9-/4- evening _ Emergency Email Address: 0-keh4 06kUQ— 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'of5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 i 4 Southold,NY 1 1971-0959 ��C DUlm ,�z 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: f 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 U it:. Number of rooms in Rental Dwelling Unit: c� Use and Dimensions of each room in Rental Dwelling Unit: Lay Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road c� Fax(631)765-9502 P.O.Box 1179 - G Southold,NY 11971-0959 UN'Ns���f r- 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. ©Zam 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) T-OW9 COUNTY OF SUFFOLK) S960 � pL�q����'vV"-GST I c :SCvn �eec.i,� N� . certify under penalty of perjury,the following: 1. 1 am the owner of the�0tdp ty identified inF'Section A" of this application. 2. The property owner's legal address"set fo'rth.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 _5 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 UNT't,��1�sj 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: c cart c-u fru-Ai e ee1Kc-r&r-e,4lA&r-ck -rhkslf- Property Owner's Signature: Sworn to before me thia2 day of 20 V3 - Official Notary Public Signature and Original Notary.Stamp L ASSIE GODDARDtarial Seal-Iowamission#773 l3sion Expires 11 0� Page 5 of 5 pF SOU # # TOWN OF SOUTHOLD BUILDING DEPT. ��`yinu►m ''� 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING' [ ] FRAMING/STRAPPING [/] FIRE INAL 16,4 FIREPLACE & CHIMNEY [ SAFETY INSPECTION [ ] 'FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) i [ ] CODE VIOLATION [ ] PRE C/O REMARKS: OW �1 (226bat vwy� Cm/h NIA �/✓ vt c ''`- �r L) V4 DATE /oheLwio INSPECTOR r Pd. Thr �_ •tai ���°�, Ll 4 4 ii gal����� TOWN OF SOUTHOLD PROPERTY RECORD OWNER STREET VILLAGE DIST. SUB. LOT FORMER OWNER N E I / ,, "2� ACR, if 1. /r/7 -1- '1 , 1'--- -.' 2,,S--07-6 -1 14M 6f S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE R f A/lR1 S a r, pLr/L r) -k) 2 0 C".) Pik, A h -,L 16 '0 �60 PW Q 1�0 Q Id 10141,11(l 0, AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tifiable I Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD C) Total DOCK P'.: _ ,� � _ `fix• ''���Yr COLOR =� ��.�- - ' �--• tee' Vn TRIM � 1 f o, , w-'r".`:aS,,^„,.- - �;.C' '. .;7A:,rr�„c. s; nx„rY.�,•1 '•'„',.-r� _.:s`'i= '1 1 I 1 m!..:;yy-;::•:x:,�+�."t�.�e•:�ir�' ��- �; "_y'�"5..:'ty^,"��'�;�ki4�..z:�`.__ :�.�r„c,�a'J�;:..,•_• _�r.r:.��'�,�_. 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Porch Recreation Roo �f Rooms 2nd Floor FIN. B. Porch Dormer Breezeway Driveway Garage Patio 0. B. j Total G g6FFOlAt Town of Southold 10/26/2022 j Gy 53095 Main Rd H x Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 43532 Date: 10/26/2022 THIS CERTIFIES that the structure(s)located at: 3720 S Harbor Rd, Southold SCTM#: 473889 Sec/Block/Lot: 75.-8-2 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 43532 dated 10/26/2022 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame seasonal single family dwelling with screenedop rch. The certificate is issued to Creecy, Susan&Ors. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. A thori ignature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 3720 S Harbor Rd,Southold SUFF.CO.TAX MAP NO.: 75.-8-2 SUBDIVISION: NAME OF OWNER(S): Creepy,Susan&Ors. OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: March Margaret M Liv Trt DATE: 10/26/2022 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: posts CELLAR: CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S): PORCH TYPE: screened DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: X GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: gas AIR CONDITIONING: TYPE HEAT: WARM AIR: HOT WATER: #BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 10/20/2020 TIME START: 10:06am END: 10:25am a�o�gHfFOL$CpG.� Town of Southold 6/22/2022 P.O.Box 1179 0 y 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 47875 Dates 6%22/2022 THIS CERTIFIES that the building ELECTRICAL Location of Property: 3720 S Harbor Rd, Southold SCTM#: 473889 See/Block/Lot: 75.-8-2 Subdivision: Filed Map No.. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/9/2022 pursuant to which Building Permit No. 47943 dated 6/9/2022 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: electric for ceiling fans. mini-split system removed) The certificate is issued to Creecy,Susan&Ors. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47943 6/16/2022 PLUMBERS CERTIFICATION DATED Authorized Signature guFFet,��o Town of Southold 10/20/2016 P.O.Box 1179 o - 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38606 Date: 10/20/2016 THIS CERTIFIES that the building ELECTRICAL Location of Property: 3720 S Harbor Rd, Southold SCTM#: 473889 Sec/Block/Lot: 75.-8-2 Subdivision: I Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/4/2016 pursuant to which Building Permit No. 41055 dated 10/4/2016 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: RE-WIRE ELECTRIC IN COTTAGE The certificate is issued to March Margaret M Liv Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41056 10-11-2016 PLUMBERS CERTIFICATION DATED Authorized Signature I 4 Fat* Town of Southold 9/8/2016 0 P.O.Boz 1179 o 53095 Main Rd y.,y01 �ao� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38501 Date: ' 9/8/2016 THIS CERTIFIES that the building ELECTRICAL Location of Property: 3720 S Harbor Rd, Southold SCTM#: 473889 Sec/Block/Lot: 75.-8-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/11/2016 pursuant to which Building Permit No. 40899 dated 8/11/2016 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: 100 AMP OVERHEAD ELECTRIC SERVICE UPGRADE The certificate is issued to March Margaret M Liv Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40899 09-01-2016 PLUMBERS CERTIFICATION DATED Authorized Signature