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Home My WebLink About1000-62.-1-14.1 T WN OF OUTHOLD Rental Permit 1037 Owner South Hldg Props LLC Occupied as Residential Unit 41 Located at 55465 Route 25 Southold 62.-1-14.1 Maximum Permitted Occupancy 3 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. 12/13/2023 r e Official This Notice must be posted by the main entrance at all times c� ecar TOWN OF SOUTHOLD Rental Permit 1038 Owner South Hldg Props LLC Occupied as Residential Unit #2 Located at 55465 Route 25 Southold 62.-1-14.1 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. 12/13/2023 % % - End c e ficial This Notice must be posted by the main entrance at all times OV 8 2 2` "O ` TOWN OF SOUTHOLD–BUILDING DEPARTMENT i Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 1197 P�)59, Telephone (631) 765-1802 Fax(631) 765-9502 L-it �w >ctloldtorca RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION W -BLOCK„_._o SECTION B. OWNER INFORMATION: Property Owner Name: , Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) L PIP I Telephone Number (s): Daytime ' Evening Emergency _W Property Owner Email Address: M j :?— Soo f —9 42> QeC JOS!)(o eco it-�-�.� t2eC to&t0 L/ Page 1 of 4 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: www. Telephone Number (s): Daytime ._.______ Evening _ Emergency Email Address: Section D. Managing Agent Information: fjo 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. N T A CL. 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): Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency, Email Address: Page 2 of 4 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, 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." � ,j s , CC - sr R� Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Use and Dimensions of each room in Rental Dwelling Unit: 9 « A l 0,57 SECTIO 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 C 1 I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) I rtify 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 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 s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager.. e-g Le-e- Property Owner's Name: " Property Owner's Signature:_ wW Sworn to before me this'5 day of + _ 20�3 4ilotary blic Signature and O final Notary Stamp RACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO,01 DW6306900 QUALIFIED IN SLIP='FOLK COUNTY I NTY COMMSESION E PfRES JUNE M,262�0 Page 4 of 4 TOWN OF SOUTHOLD BUILDING I 631 -765-1802 INSPECTION C ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAl [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY C ] FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIl [ ] CODE VIOLATION [ ] PRE / [ I REMARKS: Acr -- I D3-7 to n TE INSPECTOR ¢ V �",,.,, + �....,, m e, TOWN OFSOUTHOLD, BY, 1LRRG I 765-1802 IN PEImw IONj [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND { ] INSULATION/C� [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IIti [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT P [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F ]`CODE VIOLATION [ ] PRE C/O '111n .. . REMARKS: w. .w•", { DATE INSPECTOR L"A, I TrVt ........ ------ ......................... ------------------------- COD EXISn UNFINISHEO CEUAR NOT PAW OF LLJ pIRECTVENT EITMERMARTMENT 0 WILER U LLJ BURNER N 4 ae�a�K� E(E � Nay LL I • _ yrs warore�pBar cawa, or Vie`»r° lasts a ir. Kt; � ro ro , $ IL . azer; a �1 � EG6"tA4OMBY �n li «ENE CyNM111 E a € A� Ki'IJINkp4!XMw9»YwW V5GAtlM4FXadN'B°hB EIRV, raRACN^«r+IIaeTBRtNrm�na:+e me N� roa::. ��I; �ro 3 $ 3� -� eo cKIT OHr rcBRas re;,'nkn +nwa p a rezrc� f - �' Nwrxr.narrotrat "'""" �5 �,� Z � M.� t n a NA1'MAtN�&•a�'CIa4"»7R6kKfi N•.. �j +a! 1''d✓, +� srsE:Pti;w�w�PcwrruWevt � ��Ess R4rovw asrmn s _ _ .5., awl acc" uj uj UP74 ProwarPPswaa� aw _w. axme rA wa Q yk'AwWSpk7WLwMW�$M NE`;Au wR"1+B:h RpM cw'RaweaAaPr�«Aa�n"aswarwr ,�,�. i Q q„ ..� pININGRM T. vaacNi ... §M4 `*xM YwY E705TPaB�ALO a`dIW!SM k M z'W., n """7d'M&N�PPW"EkN'P$RNtaPo.W'BXW,4.dUTP o »••••••••,••• 4wdIWtlL'W%•MGN N N dRftp 7R7MRA+l ..«. Bk'T"'A8MM48wr4 W O e7 w-rf at ESP LMNGRM STA c Illi ....,..,..», ............. ,....,.........,........ / .?.'. YP, ��rvm , ..........,,..........e...................... 1~y11 1 �z iFBE ..... _ ._._... ............._ _ ..._ w_..__ ....... SERVICES �D BASEMENTPLAN SCALE:1/4'=1'•0• M� Delo for p� C4#bww Mon §d veledor L1 c �uf k tef w r U Gene d Wes O EwsrNBWaus nR s w I.b°uaarwwaw»mwu wnt6a:i M'a 4 tl uN B+a ® NEW wivas at PK 2& IF C.R,'9aA,T9�3t5°�tNP Rbwmkalmro�4wri _ R�ltl kA Of N'ys C______] WALLS TO BE REMOVED f T p ^/ uj Fland VV flama ,..•. aae zo^4 � LV 3,18 ^: ..... w Q NEW CV m rrdnew a m»rmw�waa^ua *aa� 1 usa"r+Y mY01* c6' b. �, w�xwrmrN aexaoaaa"^.wm aMueNnea .1"00 Lu 0.0 Q cxw+mnrr +» d+'mramroewrtia��'aLL� .,... a0 ww lu aar Lo NEb .a. THE - 70 .,...,...... .� "a 01 UEVICE3: E NALL INO " BEDROOM .. ' ' 3E THE p.. New wood arwt�.:^' a ' NORNUNo _ lit NINO In CtaE I k, ap.T .. .,....,..,..,..w,"" n �..4. ................�.,�,,......,......,. w....... 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NMWAua hNdNB lLR K 1 FCC tlIR SCALE:114•=1'-0' :PLACE FARE SLPA9AIION � C wausroeEREMaVED 'BI7E'56NUNITS sRSF¢nc daaa,paawmeNSDm ” Car �+ MODEL. WEE ToAudo°�Nwa'dp tt,o war«u 7-j +DWARF,ETC. I LOORS, Au isr1 I.j RFIREFIRE &CetL6 NG q,ACE 6EMRaT1oN wau n d " tl 24*KNEE WALL T-W x a-0• 5.0'LINE CLOS 2 U FAN LUN ri 102 sq ft. "` �. Nq " Ilk u " Y ara 24"N:N!EE WAkL 2P KNEE WALL, T-T x 3'-0' AREA w- 0 22'-»" BEDROOM#1; AREA UNDER 7'-O"=16% �y AREA OVER 7'-0"=64% awlaSCALE:1/4"=V-0" BEDROOM#2; AREA UNDER 7'-0"= 42% AREA OVER 7'-O"= 58 ALL WORK SHALL CONFORM TO; 2020 NYS RESIDENTIAL CODE KEY APPENDIX J SEC TION AJ301.4 -ALTERATIONS -LEVEL 1 ..L:„,1I AREA BETWEN 51-7' SECTION SECTIONAJ301.55 -—ALTERATIONS TE TIONS—LEVEL 2 ® AREA AT T MIN. 12��g OWNER S; RE k VILLAGE TOWN OF SOUTHOLD PROPERT CARD DIST SUB. LOT FORMER OWNER N - E ACR. i S W TYPE OF BUILDING s � RES. SEAS. !VL. f FARM !COMM. CB, MISC, Mkt. Value LAND IMP, F TOTAL DATE REMARKS I AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE I FARM Acre Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 I Woodland Swampland FRONTAGE ON WATER i Brushland i - FRONTAGE ON ROAD - -_ t E . House Plot I DEPTH i BULKHEAD 3 I Total 3 DOCK q I jz1 l� `OWN OF SOUTHOLD PROPERTY RECO OWNER STREET 2 1 VILLAGE DIST.' SUB. LOT � r F-ORMER OWNER ACR. n- -�� S W TYPE OF BUILDING RES. �� SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 2 v f _ AGE BUILDING CONDITION NEW NORMAL BELOW A 0,B E FARM ; Acre Value Per i Value Acrei - ' 4_ F Tillable 1 Tillable 2 Tillable 34 to ZZ - I f > Woodland E4 f,r Swampland FRONTAGE ON WATER - Brushlond - FRONTAGE ON ROAD House Plot _ I DEPTH ; BULKHEAD Total = DOCK i COLOR l All ot s m i l l e I 3 TRIM t � l -12 li _ L g E ' l D• M. Bldg ine Faundation Botte Extension Basement Floors Extension _ . - '' - Ext. Walls Interior Finish LR. a x a - �pe , Fire Place '� . Heat DR, Extension = �;_ ., _ .