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HomeMy WebLinkAbout1000-59.-11-2 o .cQ 00 c = O o .o ca is � 2 w N •�- cm .o to L C) v�i cU U c th �, o U Oft co c co cu US 1--� E--I co o Oco H r—� CO ;-� rn U o 0 ca low L r� U 44 L fL0 0 V O L.L s! c CU N Q n3 0 E E LAW '� _� c � ru g- Y aiL M N O OLL L T Q O `r v C- cn E O a p z ai I�I�iwrw� 'O •--• O Lim N OV -0 a) E E c- n0 o_ a) z 11--11 o O � .X o N o 'o `—u cu Qa' -0 O o 00 o u (� (6 N 39; N c o N a oO U TOWN OF SOUTHOLD BUILDING DEPT. vim, 631-765-1802 I IN S r" L C T I CA" N [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL �� so �. Town Hall Annex ` Town of Southold 54375 Main Road r, Rental Inspection Report PO Box 1179 zm Southold, NY 11971-1179 0* �o Tel: 631-765-1802 oe SCTM # 6 '" .-�� Date ► �"- OwnerOv ............. Phone Address Visible le Hamlet Inspector _ �"±� _.. e ..... ................. ... . _.._ ..... .. ..... . ...e ,_ _ _, _ _. ._ .. a, Floor Level Quantities Sub 1 2 3 Carbon Detectors not located in bedrooms Mono ) Detectors Fire Extinguishers Exits ........ . ... .. . Bedrooms 2 3 4 5 6 Smoke Detectors Egress _ a _ ........ ...... ....... ... Occupant Count ;Building Systems Maintained &Operational Condition of Property Heating LBuilding interior Hot water Building exterior Electrical Property clean, maintained &safe Mechanical i Handrails&guards installed &secure Pool Safety Pool on Site Surface water alarm Date of CO issuance .. ........ Door alarms Pool completely enclosed Self closing/ latching gates Pool fence to code requirements CO's for all items present Prior Rental Comments: r r i Mp a fv T r �yyyyww��u W v f � rury• � z C w fir" f u ulLi 1 Cri r' r� 41 �� tA r -' r Lim a...... �... W UJ a ) �a 1 F � > LU Y I��� fL1i175 a ii ilk"•,m d e S ¢ r W o 1 z h..,, L I � t Ln r r �l f r t L{f17 IL _m E1 _W f7 { �■■ rr 0, J 1 1 u_LL C Ln o ° w L Lo Mry I .. _ T T 1 4) 6 6 E � �- v : in O 0 ` i X 0 LL CD W LL ° i d am CCU. rJ i w �i �1 i�` to � d,�U ,K I ` TOWN OF SOUTHOLD Mal Permit 0798 Owner Joshua & Wendy Smith Occupied as Single Family Dwelling Located at 155 Glover St Southold 59.41-2 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 inspec' n. 1/10/2023 This Notice must be posted by the main entrance at all times 'r7 enTfficial Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 lJN T 9 2092 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: d Tax Map Number: 1000 SECTION _ -BLOCK _-LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: �xI ' ' Telephone Number (s): Daytime Evening Emergency Property Owner Email Address: s o ` 0' ✓�� Page 1 of 5 r Telephone 631 765-1802 Town Hall Annex Fax(631)765-9502 54375 Main Road " bc m P.O.Box 1179 4e ^� Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOU OLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: !"r .. Address of Authorized Agent (no P.O. Boxes):. Mailing Address of Authorized Agent: (0`5 319 (OOq Telephone Number (s): Daytime Evening Emergency_,_„_.„_ Email Address: k c �� 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: `haw` C��IyyV4— Address of Managing Agent (no P.O. Boxes): Page 2 of 5 a Town Hall Annex �' Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1 179 A Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: i ,"' Cjc "` .`'-� p� �' 64',�,*17 3,ig—((iLt& Telephone Number (s): Daytime Evening ^ Emergency Email Address: "e,kxtt,n w d 0 olo, Pe 11 1 i*ya i-111 11 � SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 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 Un` Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: Page 3 of 5 Town Hall Annex `P� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �y Southold,NY 11971-0959 a ou 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. (V/l 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) "-{ I kJ 01 ��^'� 1 U , 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 Abp Telephone(631)765-1802 54375 Main Roadr Fax(631)765-9502 P.O.Box 1179 q� � Southold,NY 11971-095942. 1 BUILDING DEPARTMENT TOWN OF SOUTDOLD 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: loswft Property Owner's Signature: Sworn to before me this day of 20��'_ Official Notary P is Signature and Original Notary Stamp ALLISON L.S"R5Oiq Notary Public,State of fJstiv 'c No.01 ST6239226 Qualified in Page 5 of 5 TOWN OF SOUTHOLD BUILDING I 631 -765-1802 765-1802 o INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PL 13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL {F [ ] CODE VIOLATION [ ] PRE C/O [ I REMARKS: I40 �Co VA 5w V�A tweoo\., o DATE Y INSPECTOR r"` 1 �� � "��-�- o� r �� � -,- �� � �� � - ;� �� �� �� � � �. a �� .; -` � 3 -- � � � Nov 12, 2022 Town Hall AnnexTelephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 r.., � 0 11 1 e IF .m m' w a rom �. h`Wdi 4 ri BUILDING DEPARTMENT NUV TOWN OF SOUTHOLDr RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Froesslor of seal required or Architect or Engineer licensed Home,insipector must roviafe copy of valid current cert!ication Rental Property SCTM Number: 5q- Rental Property Address: 155 Glover St., Southold N " Owner/Name: Joshua Smith Rental Dwelling Unit Identifier: Number & Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.) Bedroom #1 120 s ft Bedroom #2 240 sqft Property Description (Include all improvements indicated on survey) I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold, the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. Victor Cornelius III CEO Inspector Del, Print Name and Title ceo# 1216-0283 Original Signatur Please place professional seal: SCTM # _ oto /:3� _ TOWN OF SOUTHOLD PROPEF BARD OWNER STREET VILLAGE DIST. SUB. LOT s- r slu ACR. REMARK � e 4 o - TYPE OF BLD PROP. CLASS LAND IMP. TOTAL DATE s _ . FRONTAGE ON WATER HOUSE/LOT I BULKHEAD TOTAL TOWN OF SOU H LD PROPER /4 CARD STREET _ " VILLAGE DIST.` SUB. LOT FORMER OWNER if �eovc N _ E ' ACR. S W Y TYPE OF BUILDING _ RES, _ SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP_ TOTAL DATE REMARKS 4 - -} 7 r fk t CC z ? t LI g s E s y: - — = Woodland Swampland ' FRONTAGE ON WATER Brushland ' FRONTAGE ON ROAD House Plat DEPTH BULKHEAD Totol_ ..� DOCK _ - COLOR _- __ i z TRIM - ; - i ., - - l i � r E 3 -- — x — _ I l �S I i 59.-11A, 11/2014 _ - - 3 -t 59,11-2 12/11 m M. Bldg. Foundation Bath / ; Dinette Extension Basement ' Floors K. Extension `- Ext. Walls £` F i Interior Finish I 4 LR. — — Extension Fire Place t Heat ,) DR. Type Roof Rooms lst Floor _ BR. Porch 'Recreation Room Rooms 2nd Floor' FIN. B ;Dormer l i Breezeway Driveway _ } Garage 0. B. :5 I Total i D ��w� �� °, : � ; : \\ \ / , \\ « � \ � �/ } ~? !/ §,� \� ';;�%ƒ ��:�/ ` � [ ^ £ ������ �\ �/�\ / � . ����<�j� \���\ , j> �����/ ��\�\ «% 2 j, , .. �y< »7 <«�,: «�i�����»«�\ ) }� �~ �//% �l\�\ ; : i m j , , �/���� �����\ © �%/����� �\���/ � �y\\��( \ \\ \�< \ � � �m�» ` ®!\ ���� �� � « \�< ��7777 �2� { // \\� i`\ \ ° \ � » d, � . : � � � �/ . . , . / � FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .1. Date . . . . . . . . . . . . .ttober 14. , 19.67. THIS CERTIFIES that the building located at tI}UV87.$t. At.TVAk0r. tai. . . Street Map No. *;C. , . . . . . Block No. . . . . . . . . . .Lot No. =. . th0,144. ,N*T*. . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . 1=4_ .2. . , 1%7. . pursuant to which Building Permit No.3%).' . dated . . . . . . . . . . .J A0. I ??. . . . ., 19.F7., 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 Px'XW3.0. -Me. fAcOl;Lt'. .dwe A.ling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to Joseph. Sahal3.e.. . .t .4+tJXe. . . . . . . r . I . . . . . I . • • • . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of. Health Approval .PrA* .4. . .3 967. . .b7. -R•.Villa. . . . Building Inspector W W Y FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No �-20940 Date AUGUST 12 1992 THIS CERTIFIES that the building ADDITION Location of Property 155 CLOVER STREET SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 11 Lot Z Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated ALLY 9 1992 pursuant to which Building Permit No. 20830-Z dated JULY 14 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is i issued is DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to ROBERT J. & BETTY DEROSKI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED NLA *Mm.Q'i' '�d'ec' il.ding nspector Rev. 1/81