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HomeMy WebLinkAbout1000-15.-7-13 3£� TOWN OF SOUTHOLD { Rental Permit 0858 Owner Hilary Christian Occupied as Single Family Dwelling Located at 255 Three Waters Ln. Orient 15.-7-13 Maximum Permitted Occupancy 8 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. 4/10/2023 Code En ore ent Of ici-I This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1502 54375 Main Rogd F"(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 ' BUILDING DEPARTMENT MAR 2 2023 TOWN OF SOUTHOLDwM RENTAL PERMIT APPLICATION 71'1,,N qr,0 n P Rental Permit Fee $200(Application must be renewed every two years) c�+ JCCiti w 1�V11 MAs Property Information: Rental Property Address: 10 Tax Map Number: 1000 SECTION �_BLOCK .� -LOT t3 - SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): Daytimegt " Evening, �"' Emergency ' Property Owner Email Address: 1 " ` t 1o' ` Page 1 of 5 r k r so Town Hall Annex k^' Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 � ' BUILDING DEPARTMENT TOWN OF SOUTHOLD 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: A, 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: r 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 y t 41 �! rN� Town Hall Annex Telephone(631)765-1802 54371 Main Road [aux (631)765-9502 P.O.Box 1179 Southold,NY 11971-09.59 ` CD 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 6 (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 it Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: �A *r L Q 0tm-111 x 1-1,S, _ _ g ., 2,01 1� 1 M W 1 M Page 3 of 5 �N Town Hall Annex Telephone(631)765-1802 Fax(63 I)765-9.502 54375 Main Road P.D.Box 1179 Southold,NY 11971-0959vlm � �� 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 Iws and sanitary and housing regulations of the County of Suffolk and the by the laws adopted byNew 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 ❑ lam submitting a completed Town of Southold certification form from zi.Mcensed 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) f 1 certify under penalty of perjury,the following: 1. l 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 X21 a � o Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box l 179 Southold,NY 11971-0959 ,. n ° 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. i have read and received a copy of Chapter 707 of the"Code of the Town of Southold and agreed to abidq by the same. 4, i 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: Property Owner's Signature: Sworn to before me this day of M G1�C.�f 1 , 20_2-5 ' 140tpm- 0-� C�711A:d� A '0 Official Notary P is Signature and iginal Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01OW6308900 CUALIFIED IN SUFFOLK COUNTY r COMMISSION EXPI'R'ES JUNE 30, T' Page 5 of 5 TOWN OF SOUTHOLD BUILDING I 631 -765-1802 INSPEC ION j ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING j ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN% [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit [ ] CODE VIOLATION j ] PRE CIO [ ioKF REMARKS: Ok., 4e, .3 DATE INSPECTOR „v, „�i,,, ., <,. %% //:.nlll ri/�l�i/H�/I%%I ru//iiii.-it/'//`/'� !/✓G ,jr�ri�Bl'/6i%/!r r,�'%/9/i� r/�r,l�r/„J;: ! r.:; eoi 1 ,,,,,, r/r„/;//'Ir JJ rr ,'s �;�� y,,,°,r,,, „�i %/„!%i��j;/r,,r//�1�/ii/,�/��>�,////���'//%/�r�/r., /I �f( ✓"'�� //1//// Of 1� r ' i � fir; r ✓/ r r "Fm ; ” fi I x � r � r l r J i f w 1 ” a .w I At i M� �s I s i � waw r //fir//ii����/�o%/�i%�oi��/,� ........... / v�o,w r u ,,07, FrI, ........... 11t: i p ...... i�"",e I��s� �� P��( Jy � [[ I r �l Y y! wq ww .................; a'7 wwr�r�w.Wni . ww x 41 v, mammm.wwww.w mo mui Ma.." b I I f I III f ` f ; jl I II r / wrwweuuw.riuw no,na�rnr '. g Y ���wnr�,m.mm..o-wmm ar«rww.m..rr "Al Nry .wm wo�ww�ww,www„w�„,w Www �w� A,) TOWN OF SOUTHOLD PROPERTY F XRD OWNERAjSTREET VILLAGE SUB, (�COi --1 A JL" F-OPMER OWNER = N E ACREAGE v 0 S 1W TYPE OF BUILDING RES. SEAS. VL IFARM Comm, IND, CB. misc. Est. Mkt. Value LAND jmp- TOTAL DATE REMARKS �vl L .001 --T L -JAF9 P 40� x- L L NEW NORMAL BELOW BOVE ; FRONTAGE ONWATER Form Acre ,p 1 Oa+cm e Value FRONTAGE ON ROAD BULKHEAD -�7 Tillable I Tillable 2 DOCK Tillable 3 4V Woodland Swampland Brushlandk—.- House Plot Total t o. OG z. COLOR - a 1 F _ TRIM 15.-7-13 09/2016 1 M. Bldg_ , : z °-Z' -7i Foundation Bath Dinett - Basement 1 is AWL Floors �y Kit. � Stenson �g �s { SLA© Extension ` ' Ext. Walls 2r ,�; Interior Finish L.R. �f Extension Fire Place ('t\ Heat D.R. - Patio Woodstove BR. I. q _ A. Porch Dormer Fin. B. Attic �°' - I Deck _.'_ I Breezeway Rooms 1st Floor i Gara a �a Driveway — Rooms 2nd Floor I O.B- Pool Spaf O 1 Ac x'77 n 1 0i O ,t U1,60 F E 15.-7-13 6111` ti M. Bldg. 4 oundotion Both Extension Basement Floors Extension Ext. Walls =, Mt for Finish Extension Fire Place ' eot Porch Roos` Type Porch Rooms i st Floor Breezeway = Patio Rooms 2nd Floor Garage - _ - ; Driveway Dormer , . B. m FORM NO.4 TOWN OF SOUTHOLD BU11MING DEPARTMENT TOWN CLERK'S OFFICE ... SOUTHOLD, N. Y. ,h; CERTIFICATE OF OCCUPANCY No. Z-1318................ Date .....................M=u.......6.............1 19.62.. THIS CERTIFIES that the building located at •••••••••••••••••••• Street A�Cap t..byThe •Seglock No, ..�9.0Aj% .—.... Lot No. . .............Q . . Z11 .,�... ,. ,..........,.......... . P conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........................•,••••Alt ust.....7..........., 19,.i 3L. pursuant to which Building Permit No. .. i3. 1Q•. dated .......................AU9U8t,....7......... 19.6j.., 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 .......... .......... .:kxj%tQ.. .......................................................... ....................... . This certificate is issued to ...WALItex...V...U0.................awrier...,,....,.......................,...... ..a,....,,.. (owner, lessee or tenant) of the aforesold building. H«D.approval Iar.27¢ 162 by R.Villa Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office `" g Southold, N. Y. Certificate Of Occupancy No. 24283 . . . . . Date . . . . . . . . . . . . . July. . . .9. . . . .. 19. ?4 THIS CERTIFIES that the building located at re tern • * Street 1 Map No. Orient• by ck No. . . . . .1. . . . .Lot No. 43 . . . . . .Orient. . . .N.Y.. . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . .Aye, . .29. 19.69. pursuant to which Building Permit No. 4440Z . dated . . . . . . . . . . . ..&'n . '29' 19.69, 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 •Private- vriv family -dtw'wwr12ing, . . . . . . . . . . . . . . . . .. The certificate is issued to . •Weedhei ow.Prepertf *w Inc . . . . . . . . . . . 'OWXST owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R•m . . . . . . . . . . . . . . . . . . . . . . . . . . Rense # 255 Building Inspector Omit Town of Southold Annex 7/30/2014 Ap N X, P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37048 Date: 7/30/2014 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 255 Three Waters Ln, Orient, SCTM#: 473889 Sec/Block/Lot: 15-7-13 Subdivision: Filed Map No. Lot No. . ..... ..... conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/27/2014 pursuant to which Building Permit No. 38667 dated 2/10/2014 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: 2ND STORY DORMER ADDITION TO A SINGLE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Graziano,James (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38667 07-08-2014 PLUMBERS CERTIFICATION DATED 07-24-2014 William Gremler All AI )-)d /n�t d S' , ure �gU1F#1t�p� �y Town of Southold 11/9/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42509 Date: 11/9/2021 THIS CERTIFIES that the building INGROUND POOL Location of Property: 255 Three Waters Ln,Orient SCTM#: 473889 Sec/Block/Lot: 15.-7-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/19/2018 pursuant to which Building Permit No. 43067 dated 9/25/2018 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: sccestry g�aanc win.nuin cool fbne to ccdde as applied for., The certificate is issued to Graziano,James of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43067 11/21/2018 PLUMBERS CERTIFICATION DATED A� ..._. . gnature