HomeMy WebLinkAbout1000-59.-6-2 � € TOWN OF SOUTHOLD
Rental Permit
F 0831
Owner BUSHKER II LLC
Occupied as Single Family Dwelling
Located at 7005 Soundview Ave. Southold 59.-6-2
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.
3/13/2023
ii c� rOfficial
This Notice must be posted by the main entrance at all times
e le�cine 631 �
Town Hall Annex
�
T631)765-".a-",I
54375 Main Road Fax 0
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT4D
TOWN OF SOUTHOL ►
RENTAL PERMIT APPLICATION
Rental Permit Fee$200 (Application must be renewed every two years)
RD, IE2 '1 2023w
Section A. (n
Property Information: SUIWIN(i0EPT "I I'll Drt:�O/
FS o
Re�n'1�1�Property Address: NOL
Tax Map Number: 1000 SECTION _-BLOCK C 1> -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name: j5'h�C-� - U-C. Lftutf-�')
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number(s): Daytime `�Vf— 417- Evening SrO� Emergency 303'"93 1 -632-s
Property Owner Email Address: . -L-C • CDM
Page 1 of 5
� m
�r o�
Town Hall Annex Telephone(631)765-1802
54375 Main Road „K Fax(631)765-9502
P.O.Box 1179 k sr
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SO HOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: 'Jill T)on\J ,...
Address of Authorized Agent (no P.O. Boxes): 12-4 t .e Sl-v��/ AJIj
1
Mailing Address of Authorized Agent:—L�d�
Telephone Number(s): Daytime G, i 35� Emergency �CK�f
CQ 11 - (031- a-i--$---
Email Address: i i k� , A U,"kj&y' Z
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: I r'
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime � " Evening Emergency
Email Address: �-� n Q f CVM (-QV)A
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
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:
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,
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: !!5A6:P � -
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:
D Zl )4 214 1
5� t f x 22-'x /3,5', 4 ", °. .16,,6
4 71 le
214,4 tL OD2 ; t�o�-lE o�FL�E��UE�S?2Kf 12�x 24.3
Page 3 of 5
Town Hall Annex , Telephone(631)765-1802
V
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.
❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
I/ I 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)
tl AN6!S COMITY )
I + GOODW 11*-J , 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 ro � Fax(631)765-9502
P.O.Box 1179
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. �` 1
Property Owner's Name: mil i
Property Owner's Signature:
f
Sworn to before me this I� of �e va , 201!5
z/F
Official Notary Public Signature and Original Notary Stamp
ADEFOLAHAN O. OYEFESO
NOTARY PUBLIC-STATE OF NEW YORK
No.010YO327590
Ouslified in Kings County
My Commission Expires 07-13-2029
Page 5 of 5
-qm� sm-e4� D�/O- clvw
TOWN OF SOUTHOLD BUILDING 'Y
631 -76S4 802
INSPECTION
[ ] FOUNDATION IST j ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ FIRE RESISTANT PE
I l ELECTRICAL (ROUGH) [ ELECTRICAL (FI
[ ] CODE VIOLATION [ PRT C/O
REMARKSM
DATE o w
�G ,
Town Hall Annex p ", Telephone(631)765-1802
�a
54375 Main Road i Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959,n ��
UN i
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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 required Lor Architect or Engineer,licensed Home Inspector must provide
copy of valid current certhication
Rental Property SCTM Number: e e
Rental Property Address: °, 0 :E` _ L
Owner/Name: L '
Rental Dwelling Unit Identifier: lL
Number &Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom #1 -100 sq., Bedroom#2-90 sq., etc.)
200
Property Description (Include all improvements indicated on survey)
.;
U! A)8 PA66 - d (o`x 12 00e2
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.
ppgl D �
,
H/ ry�"" 4
UL
Print Name and Title i^i lnal Sign tra ��" ,� `
Please place professional seal:
TOWN OF SOUTHOLD PROPERTY RECOMI � � �
I OWNER SLE VILLAGE SUB= LOT
3 e
'. ` � ' 17 f, j IN I E ACR.
FORMER O
S TYPE OF BUILDING
RES SEAS VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
I
r
3
�V
e
i
i ,
z
1 3
E
AGE BUILDING CONDITION
NEW NORMAL I BELOW ABOVE
FARM Acre Value Per Value
Acre l
Tillable _ FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
House Plot _ BULKHEAD
tc DOCK
i
-
-
LOR
,
-H44- !
�o-
F
}
a
3
E
a
59.-6-2 2/10
I M. Bldg -
Extension _
3
,
Extension
7
s
Extension i
F
Foundation = Both
ye ;Dinette ,
Porch = I B Floors '<
Basement � �° i
Porch Ext. Walls i Interior Finish LR.
s >
!Fire Place Neat DR
Go rage { -Type Roof Rooms !st Floor BR.
Patio
'Recreation Room! i Rooms 2nd Floor
FIN. B
O. B. =Dormer ;Driveway
Total
I
3
1
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.X.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 30180 Date: 05 07„04
THIS CERTIFIES that the building DWELLING
Location of Property 7005 SO 'VIEW AVE, SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 47388,9 Section 059 Block 0006 Lot 002
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a 014E FAMILY DWELLING
built prior to APRIL X957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 301so dated MAY 7 ; 004
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 FAKIL ' DWELLING WITH LAs3SIONE PATIO AND ATTACHED ONE CAR
GARAGE.*
The certificate is issued to HARRY S OLIVER JR & WF
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
SLSCTRICAL CERTIFICATE NO. - _ NIA .
PLUMBERS CERTIFICATION HATED N/A
*PLEASE SEE ATTACKED INSPECTION .POR
.r��r 2V24
OAC
............... ''I'll Aa
Authorized Si r
t.ure
Rev. 1/81
BUILDINO DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPSC"7"ION RLwPORT
LOCATION; 7005 SOTINOTEW AVE SOUTHOLD
MAP go.s WT (S)
MAXE or Owm (8): HARRY S OLIVER JR & WF
OCWpAga, S
j!!GLE yAX-jLy HARRY 6 OLIVER JR & WF--
AM12"M BY HENRY OLInR ACCOKPAXIIED BY; —SME
M AVXIT-Kw-*- mwr. CO. TAY MAP NO.: 59._6.2
SOURCR OF WXWRST, WILLIAM H PRICE JR -�RATTY DATXs 05-0-Woll
DWELLING:
TYPE OF aUSTRUCTION, WOOD�FRME 1-2 V =ITS' 2
FOt*QATIOK& CON RETS B&2CK CM61AR. PART CRAWL SPACE:
TOTAL ROOKS IST FLR. 2ND FIA.: 0 3RD FLR.z 0
BATELOCK(S) 2.0 TO ROOM(8) Vr=Tr Room($): MUD
PATIO Typol FLAG NE
DORM TYPE: DRCZ TYPE: DOCK
BR$RZoM'y, FIREPLMX- 1___ GARAGE: _1 —
DONZ M C BOTMATER: X TYPE RRATARs LP GAS AnCONDITIONING
TYPE EO=t OIL Li wx AIRS X— ROTWATZR-.
OTMM, 2 _LIAO
A ST0RAGE`LAgWW NEW ARE UOIRV'E'-KIT
-MR -qT
Aq�L]�LSL(LRY
GARAW, TYPB'OF CCBWr- STORWA, TYPE CONST.
SWINKING POOL: GUYST, TYPE CCN=.:
OTEMR:
VIOLATIONS, CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILD1140 CODE
LOCATION A DESCRIPTION
RJUGLU". SP412423D I CO Z.124IL6
_ ,,�
By.
nMPRCTZD BY DATE 09 IBSPNCrIOK: 04,/14
114, 14
it BOUPIS TXKR STAITc 9;45AM EM: 1042$A14
FOAM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. A!2466 . . .. . .. . . Dat . . . . . . .. . . . . . . . .. 1984.
THIS CERTIFIES that the building , . Add i tioI .
n. . . . . . I . ... . . . . . . . . . . . .. . . . . . . . . . .
Location of Property . .7. Q . ;3.qup0vieV. Mv: , . . . . . . . . . . . . . . . .Southold. . . . . . .
House Nva. Sheet Ham%t
County Tax Map No. 1000 Section . . 1 1.7. . . . . .Block . . . . . . . . . . .. . .Lot , . . 6. . . . . . . . .. . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .Filed Map No. . . .. . . . .Lot No. . . . . . .. . . . . .
conforms substantially to the Application for Building Permit heretofore Bled In this office dated
March, 2.5. _ , , , , 1943.pursuant to wMch Building Permit No. 12 4 2 3 2. . . . . . . . . . . . . .
dated . . . . .. . . . , . . . . . . . . 19$3. ,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 one. two, batD,. .gr}e. ,st;ory addition . . . . . . .. . . . . . . . .
The certificate is issued to . . . . . . . . . . . . .... . . .. . ...
arrr,
of the aforesaid building.
Suffolk County Department of Health Approval . ,N/A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . .f 63,7.9Q7. . . . . . . . . . . . . .. . . . . . . . ., ,
a. . . . . . . . . . . . . . . . . . . .
Building Inspector
Rare.1/81
q
SUNROOM BREAKFAST NOOK
BR 1 25.6'x9.0' 9.69.0,
25.6'x26.1' 235.1 SF 80.6 SF
198.0 SIF
77
I
!WHEN
Ox17.1'
LR 140.6 SF
25.6'x16.8'
d 434 SF
swu
Ii
sm/co LIJII GARAGE
10.1'x19.8,
224.8 SF
BR 2 Ie
22.0'x13.5'
307.2 SIF
HARD WIRED SMOKE AND CARBON
MONOXIDE DETECTOR COMBO wrni
BATTERY BACK-UP
THE GOODWIN RESIDENCE (BUSHKER 11 LLC) 1 ST�/FLOOR PLAN
7005 SOUNNEW AVE, SOMOLD SCALE:3,1116= l'-O'
El I I
\\RRiCK PATPHI
CRAWL SPACE GW13 M3
'V
2" RAT SLAB ADDED
R-19 INSULATION IN CEILING
LIP
sm/co
Fw_l
FiSHED HEATED
#
El HNISHED HEATED HOME OF.RCE06T BIR3
RECREATION RM.
1
23.0'x23.4' 255.0 SF i
1454.0 SF,
NATURAL LIGHT&VENTILATION
FLOOR LEL_ 255 SF
SF REQ.SF PROV,
QE K
UGHTING:min 8%
I I CEILING:R—lq BATF INSULATION 2E=FLOOR AREA 204 SF'208 SF
INTI'1111 WALLS:To R&W PILLS:R-20�.31 VENTILATION:min 4%
" LL*'" �URJGJ�2 11
WALLS
C
W
URIOR ALLS TO GRADE 2"MR.RN1 OF FLOOR AREA 10.4 SF 119.6 SF
WALLS AND CEUNG ARE INSULATED
E-- --T---------W —————
_W13 CW13
A21 ATIS p27 A21 ISO
SOUTERRAIN PLAN 2ND FLOOR PLAN
SCALE: 3/16 = l'—O" SCALE: 3/16 = 1' O"
x,
0 HARD WIRED SMOKE AND CARBON
MONOXIDE DETECTOR COMBO WITH 71
BATTERY BACK—UP
THE GOODWIN RESIDENCE (BUSHKER 11 LLC)
7005 SOUNDM AVE, SOUTHOLD
ElEl
W"PATH
CRAWL SPACE
`` 2'RAT SLAB ADDEDPAM-
R-19 INSULATION IN CEILING j
1
a—
UP
sm/co 1 s
4. b sHmC
AN6HED HEATED HOME k BR 13
RECREAl10N RSI. '1
1255,0 SF i
23.0'x23S 1
,454.0 SF,
NATURAL ucHr&vENnTnnoN
ETOOR AREA 255 SF
i
i [ SF-REO:SF PROV
�; .®.......... I � 11GHRNG:min Bx
= COLN:R-19 RATT O�YAAININ I ' OF FLOOR AREA 20ASF
0.8 IF
INIEAIOR YWLS:3'R—IIAX PLUS:R-20.3 I i
VOMTKK-min 4
t- EXTERIOR 00 TO GRADE:2'RIM.R-1 i
❑ OF BOOR AREA 109.6 SF
t. _
9B AND CE]LW ARE MUTED
Wit# i i2. ?T 1W
SOUTERRAIN PLAN 2ND FLOOR PLAN
SCALE: 3/16 = 1'-0" SCALE: 3/16 = 1'-0'
su 00 HARD WIRED SMOKE AND CARBON
MONOXIDE DETECTOR COMBO WITH
BATTERY BACK—UP
THE GOODWIN RESIDENCE (BUSHKER II LLC)
7005 SOUNDMEN AVE, SOUTHOLD
SUNROOM BREAKFAST NOOK
BR 1 25.69.0' 9.0,x9,o,
25.626.1' 235.1 SF 80.6 SF
198.0 SF r SHOWER L
FOYER
5.6'x
KITCHEN I II
ol
9 X171'
LR 140.6 SF
S 25.616.8'
434 SF
sm/co
LIP
ii
sm/co
sm/co
GARAGE
10.1'x19.8'
224.8 SF
BIR 2 U
22.0'x13.5'
307.2 SF jj
,Xl_
HARD WIRED SMOKE AND CARBON
S'/C' MONOXIDE DETECTOR COMBO WITH
BATTERY BACK—UP t at
THE GOODWIN RESIDENCE (BUSHKER 11 LLC) I ST,"FLOOR PLAN
7005 SOUNDVIEW AVE, SOUTHOLD SCALE: 3/16 = l'—o"