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HomeMy WebLinkAbout1000-70.-4-16 a TOWN OF S UTHO D t Rental Permit a 0897 ly Owner Matthew F. Stanton Occupied as Single Family Dwelling Located at 2725 Wells Avenue Southold 70.4-16 Maximum Permitted Occupancy 7 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. 5/5/2023 Code o c ment Offic` This Notice must be posted by the main entrance at all times 15- a fe e,4f 1 W3 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 s BUILDING DEPARTMENT TOVIN +Out'" SOUMOLD RENTAL,PERMIT IT APPL,ICA"TION �,� kn a Rental Permit Fee$200(Application must be renewe re tw crap 2023 Section A. . Property Information: Rental Property Address: -' , "` -��.... ,� � ►J Y «�X11 Tax Map Number: 1000 SECTION� B O -LOTI ,''3 QQ0c� � o no 4 IIo SECTION B. OWNER INFORMATION: Property Owner Name:. lei v, `,P�J-TV r`1 Property Owner Legal Address: Property Owner Mailing Address: Cos 0611601 Telephone Number(s):Daytime q 114 -" -V4vening Erhergen "i -3 8 6 0 Property Owner Email Address: '&r A-N To iJ .+ : . O Page 1 of 5 n Town Hall Annex - Telephone(631)7654802 54375 Main Road Fax(631)765-.9502 P.O.Box 1179 Southold,NY 11971-0959 u� BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling.unit, if any: I�" 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) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 VAN " Town Hall Annex Telephone(631)765-1802 54375 M4 in Road Fax(631)765-9502 P.O.Box 1179. 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, Unit13 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: L�0 & vp iT 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: L.�,✓t�a�- i�c,,�t� 1�. 2 i�r�»t�� 1�' n l� !�-.,�+�►� to'k ��� 0� 4 �F 11 A*'s W-h 0-0m-N m"t j C1D�mo►�t 1 lS a r x 11. 2 1.��+ � lt?� L n 3 Mn�+- P'M-A-eosm 'I t 2' &VS5T P�hfir�•9A'I '1�(o"x IZ'4 �i a;T $an-' oo*'1 &r r Page 3 of 5 Town ball Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1197I-0959 C 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. l 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 a! s�' �"� certify under penalty of perjury,the followi.ng:. 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 rely legal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 A So ,n Town Nall Annex Telephone(631)765-1602 54375 Main Road Fax(631)765-9502 P.O.Box 1179. Southold,NY 11971-0959 XX 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. 1 I 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: Property Owner's Signature: " , Sworn to before me thk; day of '/,>1-120.,-)3 Loll, Official Notary Public Signature and Original Notary Stamp CONNIE D. BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14, 2 04 Page 5 of 5 TOWN OF SOUTHOLD BUILDING DI 631 -765-1802 IN PEC 10N [ ] FOUNDATION 1ST [ ] ROUGH PLBG, [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL I l FIREPLACE & CHIMNEY [ ] FIRE SAFETY WE. [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit [ ] CODE VIOLATION [ ] PRE C/O [ eF REMARKS: /�Jl 0 1'e- 1. 11 1-11 1 '-7 r n DATE = 5- , INSPECTOR Town Hall Annex d SOUTHOL® ®WN 54375 Main Road PO Box 1179 Southold, Rental I�1��tion NY 11971-1179 it 9 iµ Tel: 631-765-1802 Fax 631-765-9502 SCTM # _� - - �� Date a ,� Owner T. Phone Address Zip w.....�.._..�.. :. �. , , s � City Inspector LEVELS SUB 1 2 3 Smoke Detectors (# - bedroom detectors excluded) Carbon Monoxide Detectors Fire Extinguishers (#) Exits BEDROOMS 1 2 3 4 Smoke Detector Alarms (#) _....w .. __.w_. _w... ..._w._ _.........M..._ _ .. _..._.. _..__w_. _._ w...._ _,.. ..._. .ww.._ Carbon Monoxide Alarms Egress (windows) (Y/N) BUILDING SYSTEMS Y/N CONDITION OF PROPERTY Y/N Heath s stem main Interior is clean /maintained �: ...� M�n. at i o n a I Building Hot waters sten°a maintained/aperational Building Exterior is clean/maintained "� Property is clean / safe/maintained Electricalr maintained/oi �µational p y -- -� �- Mechanical s steno maintai¢ied/o 'erational Handrails & guards present COMMENTS; Rental Inspection Form 4/7/2021 , 0 lot, - — so UN M -�m sir _ _ - - PJAIII - - - - ° _ - - - -- - _ - _ v ETI � a _ 441 At i 16 £ .. g E CIA Lj g - _ - - E z - -- - - _ s f t tz CT& _ Ar _ a z TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST_ SUB. LOT I AGR. REMARKS TYPE OF BLD. PROP. GLASS LAND IMP- TOTAL DATE I FRONTAGE ON WATER TILLABLE i FRONTAGE ON ROAD WOODLAND I DEPTH MEADOWLAND 3 �T _- BULKHEAD HOUSE/LOT TOTAL U - Li . s COLOR t o Wk 's F TRIM s 70,41-16 1/12 6 I Foundation Bath Dinette M Id _ 3 C - ,a _.... FULL '.- - -. ,--Extension - Basement p-AL Floors Kit. °T'. � -- SLAB - -- - _-- -- Extension Ext. Walls i Interior Finish , _ L.R. r Extension Fire Place Heat — - D.R. Patio Woodstove BR- Dormer Deckx z ;2-2, Attic s a tet. �.�- � _` Rooms 1st Floor a Driveway Rooms 2nd Floor Garage O.B. Pool i a Ea Z ^4R COLOR Xi T IM t 1-4 { T 1 _ m_ f s � e 44-4- _ M. Bldg. = - �' i Extension e - Extension Extension _ 1 Foundation jBath Dinette Porch -�� B Floors I<. E Basement ' E Porch - v 'Ext. Valls = Interior Finish - � � LR Breezeway ` I !Fire Piece 'Heat DR. Garage _ Type Roof Rooms 1 sf Floor BR. r T-- - . =,---Recreation Room Rooms 2nd Floor FIN. B 0. B. � `Dormer � � � Driveway E i Total I I I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY N a Date ..... 4 ,THIS CERTIFIES that the building located at ....... ......... 3Street Map No. 4.,.ij......... Block No. .......7=.......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated _0.............19.�]., pursuant to which Building Permit No, dated •.......—..195-7, 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 ....--- O.W Q'. ................................................... R This certificate is issued to ... ....)-I 'n (owner, lesse or an of the aforesaid building. ...................%. ....... Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPAR'T'MENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20443 Date JANUARY,3j, 1992 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 2725 WELLS ROAD SOUTIOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 4 Lot 1G subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEM13ER 19 1930 __pursuant to which Building Permit No. 19559-Z dated DECEMBER 10 1990 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 GARAGE & DECK ADDITIONS & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS KELLY & NANCY IANNICELLI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N-217284 - DECEMBER 1.8 1991 PLUMBERS CERTIFICATION DATED NOV. 15 1,991 - HARDY PLUMBING & HEAT. taa.lding Inspector Rev. 1/81 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy 210688 September 1611 No. . . . . . . . ,. . . . . . , . » » Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . THIS CERTIFIES that the building . . . . . . . . » . . . . . . . . . . . . . . . . . . • . • . . • » • . , • » » . . . . . . . . 2725 Wella Avenue, Southold, New York Location of Property . . . . . . . . . . . . . . . . . . . . . . » , . » , . . . . . . . . . . . . . . » » « , . . .Hmrrfei House IVa 070 S#r. .ei v 016 County Tax Map No. 1000 Section . . . . . . . . . . . .Block . . . . . . . . . . . . . . .Lot . . . . « » . . . . . . . • . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application' for Building Permit heretofore filed in this office dated September 4 81 11363 Z . . . . . . . . . . . . . . 19 . . pursuant to which Building Permit No. . . . , , . , » . . . . . . . . . . . . . September 9 81 dated . . . . . . . . . . . . . . . . . . . » . . . . . . . . 19 . . . ,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 . . . . . . . » . Addition of Deck to Dwelling William Worth The certificate is issued to , . . . . . w u . . . . . . . . . . . » . . . . ¢ ; ac�ct; ............. ............... Town of Southold Annex 7/15/2011 54375 Main Road Southold,New York 11971 .............. CERTIFICATE OF OCCUPANCY No: 35069 Date: 7/15/2011 THIS CERTIFIES that the building DECK ............ Location of Property: 2725 Wells Avenue, Southold, SCTM#: 473889 Sec/Block/Lot: 70.4-16 .............. Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore Med in this officed dated 9/27/2010 pursuant to which Building Permit No. 35920 dated 10/5/2010 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: deck addition Lo an cy.isti _qgg fAj elj� for. dWe 5_4ppfip� The certificate is issued to Stanton,Matthew ........ _. ..... (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED - - -—------------- ------- - U Si ure ... ....... ....... ....... ...