HomeMy WebLinkAbout1000-54.-5-39 TOWN OF SOUTHOLD
z4. Rental Permit
1003
Owner Edwin L. & Sherry A. Thirlby
Occupied as Single Family Dwelling
Located at -11185 Soundview Ave Southold 54.-5-39
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.
10/17/2023
e En rce a fficial
This Notice must be posted by the main entrance at all times
V sO�ry�f
Town Hall Annex 9��i Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �.
Southold,NY 11971-0959
-17
J �
BUILDING DEPARTMENT SEP 6 2023
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATIONO�Y-xt, r , •
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
\\\95 5eVwY\&J\eX0 +nue- c.6&4_4A \00
Tax Map Number: 1000 SECTION H -BLOCK S -LOT 5 - 3q
SECTION B.
OWNER INFORMATION:
Property Owner Name: SAW\ L• �►- \2� \
Property Owner Legal Address: Property Owner Mailing Address:
I kgs SCruY1�V�P�u� � �S �CSl1JY��l�SS1� �'�J
Telephone Number(s): Daytime _i I Evening Ch-l-, Emergency Ck 1- 45_3-58\\
Property Owner Email Address: A-ea ADO dray�CSJ�S US-�1e'�1 Ll91fY1
--r11 VA\4 V ra\ • Cevil
Page 1 of 5
pF:SO(Ip�a`
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G ,
Southold,NY 11971-0959 D
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: D 41InOc'
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: G top1Z9:Z
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: '19 tvj4
Address of Managing Agent (no P.O. Boxes):.
Page 2 of 5
Town Hall Annex __ (Telephone(631)765-1802
54375 Main Road
P.O.Box 1179
Southold,NY 11971-0959 � �. i
SEP 6 2023 `
BUILDING DEPARTMENT ]BUIIDDTNG DEpr.
TOWN OF SOUTHOLD TOWN'
Mailing Address of Managing Agent: 0 VV ne,Ir
Telephone Number(s): Daytime q'/7-,/3-3-3S//Evening SSE Emergency SSE-
Email Address: 2'�(/�—/�D�
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: 'r
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: LV73M s L� , —J —3q
Requested Maximum number of persons allowed to occupy Dwelling Uni • . —1
Number of rooms in Rental Dwelling Unit: 0�
Use and Dimensions of each room in Rental Dwelling Unit: � bon �+ X
III` X 2 i -b knk , -71X I ' &Apm2 q 'X -�
/V L r FkA I be
MW) A-�z /X 5ki,An, Y)a-
. D i X l Com? \Y1 or �J i X
Page 3 of 5
Q
Town Hall Annex Telephone(631)765-1802
1�t
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G •.' Q
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.
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)
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
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.
41�-
Property Owner's Name:
Property Owner's Signature: L
Sworn to before me this Aday of 'l� :2023
Official Notary Public Signature and Original Notary Stamp
DIANE DISALVO
NOTARY PUBLIC-STATE OF NEW YORK
No. 01D1475593
Qualified In Suffolk County
My Commission Expires April 30, 20240
Page 5 of 5
OE50(/T
1�l
* # TOWN OF SOUTHOLD BUILDING DEPT.
couto��'' 631-765-1802 �11 , �� 2,1
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] F AL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL AL)
[ ] CODE VIOLATION [ ] PRE C/O [ (F RENTAL
REMARKS:
O
DATE O l INSPECTOR
_ TOWN OF SOUTHOLD PROPERTY Rs �RID �
OWNER STREET VILLAGE DIST.' SUB. LOT
_ 1
FORMER OWNER ' N ,,� E AC R.
S W I TYPE OF BUILDING
Z 0
RES. SEAS.- - VL FARM COMM. CB. MICS. Mkt. Value
LAND ( IMR. TOTAL DATE REMARKS
Z 1 4> tr 1/`// to Lo e►` • ,' ` sa.s, �i�/ —
is i% a.✓ c c R,, ` sLV '"~ •+:7 �a?w +sem "a. +. L`,. "'.°1 !., /F s)+ W M'�
------------
�/ ✓`Ff
.. " #�,,,, x y,'i tom" T` / w&� .✓ ;; a.°�' :,air,.e° ,`I$Y$F..i tT"t_, ". "l�. }- _��y�F
�. ..-1 C
t "..E '> S-70o 2- �f� � `4f' ' *�?;r' 13 f 3 1 `1 Z. r�s�r t��c.� �� k4z) �dV�oc�a ---
/ 16 1. � _ � fl r4
ec
Cad 5
AGE i BUILDING CONDITION
,? _mac a 3> 2,3,04-1 .
NEW NORMAL BELOW ABOVE .5 `
FARM Acre Value Per I Value
Acre
Tillable ; FRONTAGE ON..W.AIER �� �*�� - J � �� � % � -
Woodland FRONTAGE ON ROAD
Meadowland i DEPTH
House Plot
Total ,,; �' DOCK I
(Doo —t
x r
r
� � t
M. Bldg t 6" - 'IC Foundation Ce Bath Dinette
FULL w
*Extension . E pyBasement s ABL Floors Kit.
E tensions tAA IS Ext. Walls Interior Finish L.R.
Extension Fire Place Heat D R.
Patio Woodstove BR.
Porch X w � Dormer Fin. B.
�:=ate -�
tax2Z. m �2c - - ----
Deck 2 ( a t5� Attic
Breezeway \44 Rooms 1st Floor
Garage Driveway Rooms 2nd Floor
i
OB
Pool
s
-39
t .y� COLOR TRIM
146-
I i _
I t
I !
- --
- I
'. z�
M. Bldg.
LAII
Extension ,F Z.
Extension
Extension
i
Foundation $ath ! l
_ • i Dinette
PorL ' _ BasementFloors K.—
Porchi x ' , Ext. WallsFinish
I LR,
Breezeway j !Fire Place p Heat DR.
Garage
—. S — ( Type Roof _ Rooms 1st Floor BR.
Patio Recreation Room iRooms 2nd Floor ` FIS. B
Dormer Driveway
Total - - --
N q .>
FORM NO. 4
1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
Nox 501+9. . . . . . . . Date . . . . . . . . . . .Isar. . 27 . . . . . . . ., 19 73 .
THIS CERTIFIES that the building located at NQS. Sound. :View. t%ve. . . . . . Street
Map No. . . yx. . . . . . . Block No. . . . . Zx. . .Lot No. . xz. . . Southold• • N.Y.. . • . • • • • -
regui. ements for o_ne .f 1 d�rel"ng,& Hou�ng_'code
conforms substantially to the Xpg=
Built before Certificate of Occupancy
dated . . . . . . . . . .AV r3.1 .23 • •, 19.57. pursuant to which N o.Z. •50491
dated . . . . . . . . . March . . . . 27, 19. 73, 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 .prAVate. .QUO. Xamily. .dw-elliag. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to .Ronald.Loaunsbarry. . . . . . . Owner. • • • • • • • • • • • • • • • • • • • • •
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval Pre-.- AxistiLg. . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. .prg•.existirig. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IiOUSE: NUMBER. . 1.1.'185. . . . .Street. . . . Sound. View. Ave . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exception- to -housing- codes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 . no central heat — summer occupancy only 513a
2. Open pump pit & cravl space 302a
Building Inspector
r
y _
HOUSING CODE INSPECTION
March 27 , 1973
11185 Soundview Avenue
Southold, N.Y.
Tax Roll: Ronald P. Loonsberry
Unoccupied
Upon request of the Southold Town Building
Department, I made inspection of this one story
framed dwelling and found the following violation
of Local Law 41, Housing Code of the Town of
Southold. I picked up the keys from G. Nickles
at the office of Dickinson Realty, Southold, N.Y.
I admitted myself to front entrance and began
inspection at approximately 9:30 a.m.
The building is unheated and shall be used
for occupancy from May to October - Section 513a.
The rooms consist of one bedroom, living room,
kitchen and bathroom. with an enclosed porch on
north side of building. A partial cellar is under
the porch with the balance of foundation being
crawl space. The' water pump location is on east
side of building; this is an open pit (no enclosure)
and extends under the kitchen section of house
violating Section 302a. An electric hot water heater
is located in the kitchen.
Completed inspection at approximately 10:00 a.m.
and returned keys to the Dickinson Agency.
Re` pectfully submitted,
Edward Hindermann
Building Inspector
EH:tle
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate , Of Occupancy
No. . .?1263 . . . . . . . . Date . . . . . .Ju.l�Y. .25. . . . . . . . . . . . . . . . . .. 1984.
THIS CERTIFIES that the building . . .Deck .a d d i t a.o n. . . . . . . . . . . . . . . . . . , . .
Location of Property . . , 1 1 1 q5 .Soundyiew,Ave . , , . _ .Southold .
House No. Street .Ham/et
County Tax Map No. 1000 Section .0 5 4. . . . . . . .Block . .9 5. . . . . . . . . . .Lot . .0 3 9. . . . . . . . . . . .
Subdiirision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
J u q y, ,2 0, , , , , , , 19$4 pursuant to which Building Permit No. . 13.2.92Z. . . . . . . . . . . . .
dated . July. 23. . . . . . . . . . . . . . . . . . . 198.4 . ,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 . . . . . . . . .
, , ,De,c,l� ,�aa,�,tion ,tQ existing, dwelling supper, deck). . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . .1:Y,n n e P a Z me r .
.
towner,% . . . . . . . . . . . . . . . . . . . .
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . N/A. . , . . . , . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . 4/A
. . . . . . .
Building Inspector
Rev.1/at
s - 9
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
N07.1,2638 . . . . . . . . . . Date . . . . . . . . . .July. 25 . . . . . . . . . . . . . .. 1984.
THIS CERTIFIES that the building . . . . . . , necka d d i ,i on, , , , , , , , , ,t
Location of Property . . . 11185 Soundview Ave . Southold . .
House No. Street �Hamlec
County Tax Map No. 1000 Section5 4. . . . Block . .Q 5. . . . . . . . . . .Lot . . .939. _ . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
J u l.y,„2 0. . . . . . , , , 1981 .pursuant to which Building Permit No. . 13?A 1 2, , , , , , , , , , , , ,
dated . . . J u 1 Y. 2,0 , , , , , , , , , , , , , , , , 198.1. . ,was issued,and conforms to ail of the requirements
of the applicable provisions of the law.The occupancy for which this certificate is issued is . . . . . . . . .
.dop.k) . . . . . . . . . . . . . . . . . . . .
The certificate is issued to „Lynnq , Falmer, , , , „ . .
(owner,%{XrAVxot X x
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . Nail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . Nf A . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
Rev.1/81
4
V,. ...-•-•ice.—may .
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20870 Date July 20, 1992
THIS CERTIFIES that the building ADDITION'
Location of Property, 11185 SOUNDVIEW AVE. SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 54 Block 5 Lot 39
Subdivision Filed .Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated _ JUNE 1.9, 1992 pursuant to which
Building Permit Np. 20749-Z dated JUNE 19, 1992
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 INSTALL HEATING SYSTEM, CHINMEY & DECK ADDITION TO AN EXISTING
ONE FAMILY DWELLING AS APPLIED. FOR.
The certificate is issued to EDWIN L. & SHERRY H. THIRLBY
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-029784 - JULY.10, 1992
PLUMBERS CERTIFICATION DATED N/A
Bui ng nspectar
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33503 Date: 01/23/09
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: 11185 SOUNDVIEW AVE SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 54 Block 5 Lot 39
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 18, 2007 pursuant to which
Building Permit No. 32653-Z dated JANUARY 18, 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 ALTERATIONS AND ADDITIONS, INCLUDING SCREENED PORCH ADDITION, TO AN
EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to EDWIN L THIRLBY & SHERRY A HALWEIL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 4021636 01/16/09
PLUMBERS CERTIFICATION DATED 12/30/08 CUTCHOGUE EAST PLUMBING
04
Authorized Signature
Rev. 1/81
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