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HomeMy WebLinkAbout1000-79.-4-17.5 TOWN OF SOUTHOLD �i 43 Rental Permit 0848 w� Owner Terence & Margaret Kelleher Occupied as Single Family Dwelling Located at 1075 Clipper Drive Southold 79.4-17.5 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. 4/4/2023 µ C� e ` for.ee pit fficial This Notice must be posted by the main entrance at all times so 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 RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION ' -BLOCK �� -LOT �' - - SECTION B. OWNER INFORMATION: Property Owner Name: � � l Property Owner Legal Address: Property Owner Mailing Address: a t— 976 � Telephone Number (s): Daytime Everting Emergency __ Property Owner Email Address: �� �" A 6V iq &C, Page 1 of 5 Soltp- Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 . , =t BUILDING DEPARTMENT TOWN OF SO . HOLD 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: 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) i Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 �--�' A S Per- nLtfD omu sJd 691 2,j O Z2.1 e D ►� l� Town Hail Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 1 1 971-0959 cou. 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: �� 4 � 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: °` 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: S� S v L �- Page 3 of 5 of s Town Halt Annex ? Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 11 cour~m 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. `6 I am requesting a fire safety inspection to be performed by a Code Enforcement Official ((�� from the Town of Southold 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) %J, 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 P.O.Box 1 l79 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. Property Owner's Name - f Property Owner's Signature* _' £ ,T&te,-202-; Official tl—,z i i�- Pf Sworn to be re me this�day of Official Notary Public Signature and Original Notary Stamp Notary Public-s York . 1 3 2026 my c Page 5 of 5 ho��UF SOUIy� l ' * � TOWN OF SOtlTHOLD BUILDING Di 631 .765.1802 INSPEC 10N ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATIOWCAI ] FRAMING / STRAPPING [ ] AL ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN: ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII ] CODE VIOLATION [ ] PRE C/O [� ZERKS: 4 &,�(/ OJX� �Kl� DATE y�7 O INSPECTOR 4 ' 71 _._..� . so mommi OWNS w=(rmj i wwmsrnwwwwWww�wvmrmmm�wwww ow www.uw ru wauwwn rmuwww�ww�w uuwgrvwxwrwrwwrw�M: re - 5ECOND fLOOK, PLANm „ , NISI Iao,� IONA 7R 91 M M �i2oce ✓® � � pOSTMSs IMAfJ1C7' 0.0.4 .� ...�..mm��..�,.�.,,...,...�..,�......�..�. tl DOWNTO low l OEM*WIZ v"m " wsae�n 400 SMM Hrrrnnam �� Wall FIRST FLC7OR PLAN . k cimm ,N b cr�e� own nersnep ansa mxr "vs asix Agyx 19 9.7 " r r fL�3A44N6A89�d8}lOAd,C�d'E #'%" u " /r ns pill,/ w, :„i ✓ "„/ /i ,,, /, ,,,, / l�r,,,,a ��//r ,oil%�i /� ,,,,;,, "" ," /i, �m.,n�« / ,;�; ///,v, r r ,, r ,/� r // ///r, c -� ww���a�.a.•��„ �sw�, ,�,«,G 711171 r r ,r /ii...../ r � //>� ,,, r✓i. //,,,i ,,,,...,/ / -rr ,. /... rrr, .✓./ / ., /„ / / ,.. �./ r ✓ ,.. / ,....../ /.. ,/ ,,,,. _.,. // .../ oil�", // l/ ✓ // rrrr /i .,r�r,„ / r / // r ,,. / .../, / ../., �. / / /., ,,,. ,,: / ".r / %/..../ %iii// ,., / ,..✓ /./.. / ,.. ,. r« o�/ / r ✓/ r„r r «,. / rrr, r, ii/ / / r /r/ � // / / / r ,_%/ r � �„ r / ✓/iii/ / r � / / � � / /// r // f /i � /,/ii i�„ r ri/ /,;.,,oiiai,,, i,,, U rrr�i%✓alio/�� r,/ re _ ,A �v ­TOWN OF SOUTHOLD PROPERT STREET V_LLA__ , .. .__�... 45T. SUB. :: LOT µ FORMER OWNER�.� �.. � ....�., ,.,rv.�.. _..,..M�... a N E ACR, s S W TYPE OF BUILDING o RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS Lft n i ,, y op ����"' m � �`oS� •`.•fir �.. "�" m� m � Maur i e �;,i`� ».......� ....���^w1.... �u.nm� � � .�"' ....., ryq {y ��.,.n ,��µ���.�....���,.,, ._��..'�� ar"..... ur,,..��✓i.,a,.v...i_� �'`.m.�, �, ��iu � �,� � �u�!.,,.: � a4� � r, �,,, o° ni�^ '..'`P A.✓T r31 fl ,,,,`� �p ,r° n Jr` Y � N v i W � ,5 .,... „. '� h,.».....• WP w���u m #,�,a .�gip" „_3M ��'�"���Md4�1�� 4.�.,,.� J / l f ar ,....... _.._......, �rvm ..... ..._, ........X..., ,. ...... .. ......Mr,...:. •...,,...,.,,,'�p ° .X RSTGw ..,�u�._ ....... ......-wn.�;�.. v �I w .„,,. .................... ......,,...,.,,,,.,.t ! t�„e L.. , /44 /µ ,� ....,,.... "� ....gym Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot 1' BULKHEAD , �,�'� ✓,. r z: � i ........... Total Poll, /5 x' II ")W s:- V 1 r, r t � �... i r!s,�,�.r:fl✓Ni fw„�.�e�.��N�;ct i;, w�ODl�k24�1�//�/1�9f�fi`D����l'�i��?w/i/,rw r ,,�„ .,.�.�. 79.-417.5 03/28/2018 M. Bldg, —_ P,. ,,..�...� ... �.,_, .. ��. Foundation . ;Bath 97, y/rte Extension �� r.:' Basement Floors u Exten � � � �.��,.. �. ._................ .:..»._...... ... '._,.w.....��„' '.!_...._ .:_.,....� gym" ._.....,...,.._,. ..,,.,,,....,.,..,... t o ion ��� � �� � r��: Fx�t. Walls � � � Interior. Finish , xten5wo Fire Place Heat � j' 0 �, — ��� � , r"r"" 7 $"+� ":" ....,.,....._.�....__.................._........:........, ., ..,.:...».,,,,�,....,.. 9 1 c >, Prr` h to, . T �s} ar', Pool Attic Deck �� "� g '� �) � Rooms 1st Floor �. Patio Br �wa - Driveway Rooms 2nd Floor �d� W ,, w Garage fir` � mag �' t,'���`� �% t�� j 77 r r vrc.•i .v... TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26608 Date: 08/03/99 THIS CERTIFIES that the building NEW DWELLING Location of Prpperty: 1075 CLIPPER DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 4 Lot 17.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 24, 1998 pursuant to which Building Permit No. 25338-Z dated NOVEMBER 18, 1998 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 FAMILY DWELLING WITH COVERED FRONT ENTRY, REAR DECK AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to ESTHER PILLES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-98-0132 06/23/99 ELECTRICAL CERTIFICATE NO. N 492371 06/24/99 PLUMBERS CERTIFICATION DATED 05/28/99 PECONIC PLUMBING & HEAT. Building spector 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-28557 Date: 06/28/02 THIS CERTIFIES that the building ADDITION Location of Property: 1075 CLIPPER DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 4 Lot 17.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 18, 2001 pursuant to which Building Permit No. 27613-Z dated AUGUST 20, 2001 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 SUNROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ESTHER PILLES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N580024 01/02/02 PLUMBERS CERTIFICATION DATED N/A 11 Z46thqofized Signature Rev. 1/81 Town of Southold 11/16/2018 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40055 Date: 11/16/2018 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1075 Clipper Dr, Southold SCTM#: 473889 Sec/Block/Lot: 79.4-17.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/2/2017 pursuant to which Building Permit No. 42029 dated 10/5/2017 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: ACCESSORY IN-GROUND SWLAIMING POOL FENCED TO CODE.AS APPLIED FOR. The certificate is issued to Kelleher,Terence&Margaret of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42029 08-01-2018 PLUMBERS CERTIFICATION DATED nut mature Town of Southold 10/16/2018 P.O.Box 1179 ca 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39972 Date: 10/16/2018 THIS CERTIFIES that the building ELECTRICAL Location of Property: 1075 Clipper Dr, Southold SCTM#: 473889 Sec/Block/Lot: 79.-4-17.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/1/2018 pursuant to which Building Permit No. 43107 dated 10/9/2018 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 accessory shed. The certificate is issued to Kelleher,Terence&Margaret of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Authorized Signature Town of Southold 4/4/2023 P.O.Boz 1179 53095 Main Rd �g r Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43981 Date: 4/4/2023 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1075 Clipper Dr, Southold SCTM#: 473889 Sec/Block/Lot: 79.4-17.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/3/2021 pursuant to which Building Permit No. 45961 dated 3/19/2021 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: additions and alterations including"as built"finished basement,to existing single family dwelling as applied for= The certificate is issued to Kelleher,Terence&Margaret of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-21-2396 5/4/2022 ELECTRICAL CERTIFICATE NO. 45961 10/14/2021 PLUMBERS CERTIFICATION DATED A or ' atro ylV�y \\ \\\ \\ \\ IMEIN All LAI IF \ Q M \�\\ \� g \ \ \o\\\ \ \\ f IS \\ \\\\ RE ZX ; 1 7z. _ 1075 Clipper Drive 1` Southold,New York 11971 kit— � 6 6.5257 cell 646.808.4601 tkelleheresq@gmail.com f 1� F . a . s vim.