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HomeMy WebLinkAbout1000-86.-2-1.2 TOWN OF SOUTHOLD Rental Permit 0801 Owner John Fischetti & Deborah Deaver Occupied as Single Family Dwelling Located at 2615 Wells Road Peconic 86.-2-1.2 Maximum Permitted Occupancy 10 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. 1/11/2023 Code Errfo ceree_4 Official This Notice must be posted by the main entrance at all times A00 Town Hall Annex X Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 p Southold,NY 11971-0959 BUILDING DEPARTMENT OC 2022 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: ,� C 2-,6 1,5- 1-.S Re;,1-e d e,C 4ni I., Tax Map Number: 1000 SECTION V -FLOCK _ LOT - 2-- SECTION B. OWNER INFORMATION: Property Owner Name: bq C Ar Property Owner Legal Address: Property Owner Mailing Address: 66lt� l 23 Telephone Number (s): Daytime Evening . Emergency--: " Property Owner Email Address: e' C �tl Page 1 of 5 lit. k'j- Town Hall Annex Telephone(631)765-1802 54375 Main Road m Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Sc\\419n C. Authorized Agent Information: w Name of Aukt prized Agent of dwelling unit, if any: " Address of Auth('razed Agent (no P.O. Boxes): Mailing Address of A64horized Agent: ikk Telephone Number(s): I�aygime Evening Emergency a„ Email Address: w� k� Section D. `v Managing Agent Information: Name of Authorized Agent of dwelling unit, if w ley: 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 0 ore rental units) Name of Managing Agent of dwelling unit, if any: 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 Southold,NY 11971-0959Co . BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. h "bESCRIPTION: Number of Rental 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, 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 Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: 'r .,J <., - , 4tP tit - " Page 3 of 5 � S Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 `oum 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. ❑ 1 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 � 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 e P.O.Box 1179 6 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO HOLD 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: J}�'� Property Owner's Signature: ' -,r A-- 1 Sworn to before me this day of 1 �, 20 2-2— jG . Official Notary P is Signature and O i inal Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2-Qp Page 5 of 5 Town Hall Annexa Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 Aoc P.O.Box 1179Slz y Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF ISOUTHOLD 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 Pro essional seal re r lredi►r Architect or Eng linger, licensed Home InVector must provide copy L>t valid current cerci cation Rental Property SCTM Number: C/7 3 ? 'F Rental Property Address: ,� 6,1 l-S LL4-1 56 Owner/Name: J-0 � ^J 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.) 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. Print Name and Title Original Signature Please place professional seal: son TOWN OF SOUTHOLD BUILDING I X3'1 - 65-1802? INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY j ] FIRE SAFETY INc. [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit [ ] CODE VIOLATION [ ] PRE C/O [ REMARKS: 0 , Ln DATE ! ' INSPECTOR so * ' TOWN OF SOUTHOLD BUILDING D1 631 -765-1802C INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION/CAL I 1 FRAMING / STRAPPING [ ] FINAL [ j FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN% [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit [ ] CODE VIOLATION [ ] PRE C/O [ REMARKS: l?( Wl * ........... ex, DATE INSPECTOR r V� U f'" Town Hall Annex 54375 Main Road SOUTHOLD TOWN VA � PO Box 1179 Southold, Rental lu§q tion NY 11971-1179 vNv Tel: 631-765-1802 Fax 631-765-9502 SCTM # Date Owner Phone Address Zip city Inspector LEVELS SUB 1 2 3 Smoke Detectors (# - bedroom detectors excluded) Carbon Monoxide Detectors {#) Fire Extinguishers (#) Exits (#) BEDROOMS 2 3 4 5 Smoke Detector Alarms (#) qe Carbon Monoxide Alarms {#) Egress(windows) (Y/N) sommonammonsom BUILDING SYSTEMS Y/N CONDITION OF PROPERTY Y/N Heati 2g s stem maintained/operational...- Building interior is clean/maintained Hot waters item maintained/operationaii Building Exterior is clean/maintained Electrical system maintained/operational Property is clean /safe/maintained Mechanical sstem maintained/o erat'ionW Handrails & guards present COMMENTS:. Rental Inspection Form 4/712421 ————---------- ­Jv v w w 0 W'z w cf)cf)l Z NO W!Li 1JI11111 u Ckd 17 lilt ------------ - Lq O4 W z HA z 4W 47 U-1 41 4ALL & ------------ �u t ON—. H A - ----- tiag"w_'g- fluh H PROJECTNO 1407 •W" TS 4W16 ---------- v SCALE' ---- ------------------ - --------- SHEET­E: Z_ SECOND SEC1'OND FLOOR PLAN FLOOR SCALE-114"m a" PLAN SHEET No: BIDDING 8, PERMIT SET 8 F—1 LU W ' o 0 LU z co V)j Z LLJ' ------------ ---- ------------ ------ -----—--------------------------—----- t LLJ > OZ 06 LLJ!IL co 13. O EF4,S F-lw D W;= W Aw -7j p W co --A 0: vl ol- &ARA6E CL N H 1407 El TS 87, !37-- gro,16 SCALE SHEET PRE: FIRST FLOOR FIRST FLOOR PLAN 4 1A 1. PLAN SCALE IM-1-- (fo ol o/c BIDDING & PERMIT SET TOWN OF S UTH LD PROPERTY REQ -1 OWNER I STREET =VILLAGE DIST. -SUIS. LOT c : ,VI C FORMER OWNER__ N E ACR. Is W - TYPE OF BUILDING r i F RES. SEAS. VL_ FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 73 6 e 13 Li f It CL .^ fk t 0 E � i a ? Tillable FRONTAGE ON WATER Woodland T ! FRONTAGE ON ROAD - Meadowla-nd i DEPTH House Plot BULKHEAD I Total I TRIM f .. , . _ s 3 l 3 g! . i [[ 5 _ S ? P � S _ VOW N. , a i . t f� ;=c tea• as <.-.` �, _ ' - i_ _ f � _ -_. e. n ; r 86.-2-1.2 10/03/2017 00.-L-1.L U3/LU/LU1/ (Y{a 471 - - I- Li ExtensionZJI - - - — — - - i � 1 t lc,o ; . '. Foundation Both r£ 1 t ' = Basement s F IOars ° £. Porch Ext, Walls Interior Finish + ` a _.- Fire Place _ 'i :ear Garage —` - Type Roof cams I st Floor . _ i e Recreation Raom Roams 2nd Floor I `[ Tv Dormer jDrivewoy i , £ C F yy 3 FORM NO.4 TOWN OF SOUTHOIrD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z1a.q28. , . . . . . . . . Date . . . . . . . . .;Tune 17,» . , » . . . . . . . . . ., 19 31 THIS CERTIFIES that the building . . . . . . . . » . . . . . . . . . . . . . . . . . . » . . . . . . . . . . » . . . » . . . . . Location of Property24.1 . W�'Y14. Road,. . . . . . PecQx��c , Ne,, Yorkw House Alo. Street Ham%r County Tax Map No. 1000 Section . .Q8 F. . . . . . .Block . . . . .?. . . . . . , . .Lot J./Q. 1...Q02. . » . . Minor #169 1 Subdivision . , Geo. Wella Est•. . . . . . . . . . .Filed Map No. . . . . . . . -Lot No. . . . . . . . . . . .­ conforms conforms substantially to the Application for Building Permit heretofore filed in this office dated N o v e,mb er. ,20, . . , . . , 19 7,�pursuant to which Building Permit No. . . . . 10.4 94. »Z . . . . . . . . dated . . °v:'m:? r 2 6 . . . , . . . . 1 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 . . . . . . . . . . . . . . . .rrivate One-family. Dwelling. . . . , . . . . . . . » . . . . . . . . . _ _ _ _ » . . . . . » . The certificate is issued to . . . . .H e F?r:Y. Pmt a r e e , . ,( . . . .ouvrrer,.t. µ » . . . . . . .".. of the aforesaid building. 6/1'1/t31 Suffolk County Department of Health Approval „ . . . . . . , y`'' `1. :'. �;° .!�' . ti.'i 1 Z a p• .�' UNDERWRITERS CERTIFICATE NO. . . . . .iv 5 1w14E113. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev.1/81 w ' FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy NoA l2965. . . . . . . . . . Date . . . . . . . . . . . . . November, 1.0. . . . .. 19 83 THIS CERTIFIES that the building ACCESSORY . , . . . . . . . . . . . _ . . . Location of Property . 2 1 5. wEbRa RD.. . . . . . . . . . . PECONIC N.Y.« , . «House o. eet Hamlet County Tax Map No. 1000 Section . . . Q$6. . . . .Block . . . Q . . . . . , . . ,Lot . . . . . . .1..2 . .: . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. , . . . . . . .Lot No. .. . . . . . . . . « . . conforms substantially to the Application for Building Permit heretofore filed in'this office dated . • . .AERN?5. . . . . . . . . , 19$3.pursuant to which Building Permit No. . :�.2'1��.Z . . « . , .. . , , , . dated . . . . .�pril..�5 . . . . . . . . . . . . . 1983. ,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 . . . . . . . . .. for an accessory building The certificate is issued to . . , HENRY PIERCE,. . . lessee or«l;r;nw » « µ ` « " • • • « , . » . of the aforesaid building. Suffolk County Department of Health Approval . , . N/A , . , , , ,; , , , ,, , , , « , , . , . . . , . . . UNDERWRITERS CERTIFICATE NO. . . . . N8871.38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � . . . . . . . . . . . , : . Building Inspector Rev.1/81 �9 FOAM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . x.1.7720 . . . w Datd . . .JANUARY 30 , 1989 THIS CERTIFIES that the building . . . SATELLITE ANTENNA Location of Property 2615 WELLS ROAD PECONIC House No, Street Hamlet County Tax Map No. 1000 Section . .018 6 Block . . . . . . . . . . . .Lot . . .l.:?, . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . „ . , . .Filed Map No. . . . . . . . .Lot No. . . . . . . , . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated N 0 V . 2.4., 19 8 6 pursuant to which Building Permit No. . . 155.2.4.Z. . . . . . . . . , . dated . NOV... .28.,' .1.986. , . . 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 . . . . . . . , , SATELLITE ANTENNA (GROUND MOUNTED) . TIle certificate is issued toHENRY & JENNIE PIERCE . . of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . » N./.A . . . , . . . . . . , . . PLUMBERS CERTIFICATION DATED: N/A 'r*7. . . . . . . . . . . . . . . . . « .. Building Inspector Rev.1/81 b u Town of Southold 11/19/2017 P.O.Box 1179 53095 Main Rd ¢ $ 4 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36353 Date: 11/20/2017 THIS CERTIFIES that the building ADDTFI0 /A1;r • KrION Location of Property: 2615 Wells Rd.,Peconic SCTM#: 473889 Sec/Block/Lot: 86.-2-1.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated p g 94 dated 5/12/2016 4/29/2016 pursuant to which Building Permit No. 406 mm YW �,�..mwwwww 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: literati an and addition.5 includin cay_ ..t ont porch;and rear decks,.to an exi tione 4jni1!d 11in as applla p per1 .A,#58541,dated 5/21/2015. The certificate is issued to Fischetti,John&Deaver,Deborah of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-15-0025 9/7/2017 ELECTRICAL CERTIFICATE NO. 40694 5/30/2017 PLUMBERS CERTIFICATION DATED 5/18/2017 rge Be y, Jr. ut 'zed Signature r �f r / � l �f I i 1 i i F � da / rrrrfv�r� 1 ® 0 r r I � ji ri 4 a f Ir% /"// �,, � �� ���� ,,� , , 4 �, �: �, ii%i �r 1 iii �� �y„�, ,� ,, 1' ,; ,, no �� �, � �'t �! s�;a �;' �' � i” r/�� /r/��� �. �� ^�������/ �fa����y � � ��� ���.� 2 ��1����� �����«y- 2 d»\\°/��2�« �`/����y \\/\ «�/��� ` ©��'���L . / ^,\^ �����^ ��/� ��\ ® ~����\\\��\ « �© » < , ©< y < \��: \ \ \ ��: : ? ; < �» } : < : )�/. f �� �r �� � §��\ � ���\ � \�(��\ \\ � \ � ��� ��� ., �/ ^ � ��� � � �� � \\ \ . y \� y� „f �« ? . �\ �»m�} �? ? j�«�\ <�,��\ ?/���\ ��� �®%^ �y\. ƒ � � . . : \ d® © �` « �