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HomeMy WebLinkAbout1000-52.-2-35 o .N 00 c 0 f° O O . U OC13 " o r� 0) X 41 M O W N 0 U) s N =3 O O_, c U cn w o ca CD U co c CU Loi cu-E L6 -0c )AOMIlik m � �- c -� . ., c o a, co 3 O O7 Y 3 � EZ � 0) m U CD Wcu fu r.rr Q O > v L � " t�j V 0 LL c o w 0 0 VIP ow 'aa� � Q cu LL O"Mmo4-a Avwk Cd CD 3: L E •J Q o z ca a) y++ ^, Y IIIA W -0 � � N nooO N E L N E C— OE Cd O N n .N (B F wrrw •X O m > co Q -0 a� E O o Co cB co = >, ^� O N rcu i - E N .CL +-+ 0 0 m L' 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road t Fax(631)765 950 r{ P.O.Box 1179 u r v Southold,NY 11971-0959 r BUILDING DEPARTMENT fi TOWN OF SOUTHOLD RENTAL PERMIT APPLlCATIQN na Rental Permit Fee$200`(Application must be renewed every two years) Section A. Property Information: Rental Property Address: It 5 S Tax Map Number:1000 SECTION -7 3 S S q -BLOC �� -i* ►T `": - 56 7S SECTION B. O"liy'"NER INFORMATION: Property Owner Name: V—et�-� -e Lr k B Property Owner Legal Address: Property Owner Mailing Address: " 'a', , .Q. � 4-ekAp Telephone Number(s :Daytime I� � vening� Emergency Property Owner Email Address: A Vcple 4 22-c 2)h e Page 1&S Town HO AnWx � � Telephone(631)765-1802 54375 Maier Road Fax(631)765-9502 n�M M�- P.O.Box 1179 Soud"d,NY 11971-0959 ri BUH DING DEPARTMENT TCAW OF SOITMOLD Section C. Authorized Agent In ation: Name of Authorized Agent of dwelling unit,if any: Address of Authorized Agent(no P.O.Boxes): Mailing Address of Authorized Agent: Telephone Number(s):Daytime Evening_ Emergency. Email Address: Section D. Managing AgentInformation: Name of Authorized Agent of dwelling unit,if any: Address of Authorized Agent(no P.O. es): Mailing Address of Authorized Agent: "telephone Number(s):Daytime 3&5_ 15h Evening_ np°u_, -Emergency , ��� � Email Address: `e ' SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing$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 1 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �s Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF ISOUTHOLD 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,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: S Q �1 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: Page 3 of 5 Town Hall Annex ,` Telephone(631)765-1802 54375 Main Roads Fax(631)765-9502 F.U.Box 1179 u ✓r Southold.NY 11971-0959 40 BUILDING DEPARTMENT TOWN OF SO : OLD 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 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 ", Van&Kk tk, Tertifyunder penalty of perjury,the following: 1. I am the owner of the property identified in "Section A"of this application. I 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 1179 Southold.NY 11871-0959 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: V4 Property Owner's Signature: �► q Sworn to be +ire- k day of M'�� cla otairy Public Signature and Original Notary Stamp DEZELLE A,TRELLIS "Otary Public.State of New York Now 01TR6222706 Qualified in Queens County Cornmission moires June 1,2 )D.. Page 5 of 5 so TOWN OF SOUTHOLD BUILDING I 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] INAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INc [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Elft [ ] CODE VIOLATION [ ] PRE CIO [ ] F IDoc� ............-Vte&k 1 v m0iFs��j TOWN OF SOUTHOL "rouxn�� 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ] FRAMING / STRAPPING [ �INAL4tk [ ] FIREPLACE & CHIMNEY ] FIRE SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] CAULKING REMARKS: oz& A- sl� 4C Pfe," AAh el 16),F a r DATE � INSPECTOR Town Hall AnnexTelephone(631)765-1802 54375 Main Road �f Fax(631)765-9502 P.O.Box 1179 " Southold,NY 11971-0959 , � ., % BUILDING DEPARTMENT TOWN F SOUMOLD 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 l�ro essional seal re wired or�4rchitect or Bn ineer licensed dome lr�s actor must rovid+ co a I valid current cert/ cation Rental Property SCTM Number: i 0OC7 — 2- ' o 3 2— Rental Rental Property Address: "G so UT2r&0(-f--) 'v i ��� Owner/Name: Rental Dwelling Unit Identifier: I _. Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq.,Bedroom#2-90 sq., etc.) Property Description (include all improvements indicated�on survey) �01-1?cz : �' = t 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 outhold,the Residential Code of New York State,the Building Code of New York State,the Plu bing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conserv t n str ction Code of New York State. Print Name and Title 0 ginal Sign tur ,47 �0 .4 �2, Please place professional seal: , 021 b J �µ cn N W � O-' Z 00�� CD �. ERE u 71 i �� � � °'�_...„gym..._ o-O�,�. Al C� oN7� �i7 y 0 1 cn c�b .50 C o N o T O hV r N � E— OD a v rn c., e C/), cn T'iv R m r ................................. 0 _ .._...... OPfkN 2017 FRAM(N.UFllBVML RA FLOOR FINS NU flEW11016 ARE PROTECTED TRUER FfIR1YL COPfPopII UJt.ALL PUNS NAU CdS ARE IFEE SOLE PROPE1RIlf OF FRUWI N UEllf1UAIQ RA 1HE RSHf TO FAUD ORI,Y Ok(SfRIR31RlE FROM THESE PU-S S UC(1W IXCWSNELY 10 THE BUYER m ...... . moullm _.�.. ._..............W ...._.... ..� � T. d Cn i-- q �� ..... .. ._,,,....,..._..__.........................-.....,a - ...._ n o 0 4� l" J J a U A w m ULL s �' 6 O tic N \ u a u. � ZEr lo 0 0Ul 0 ' . C2 . j w � L j 3 ...... ._._.... __,., . ..._.. LL > usL Mrd w d 10, t� m V) Z cn J © Z a Q p CD Q L 10 I � �,. Q 0 "' uj � e w cwt cry v r vo LL a� or ai 6 1 a f Lu w ID — Z & s u I — � ,� '" °�," 6 6 6 O '� P 7 6 C7 _ W O o3 00 x x x lD N CDD N a 1 (D o' o' o b 9Y � o � 0 s 0 k s. G, I H.kw..._. _.w_...._.........._ __. .._._........... gg 0 -o -n o 9 n :t n <' m ^' c o :3v 3 a n n (D 3 0 0 n _, w....._� ........ __.. ..........„� �� _w . _.._.... _ ............... _.._ _ ...._. .._. ..... ..... _.. On CD N O En h 3 T T 00 00 ......,�, ......_., _,,,,, .. ..,_........_. ..�........,.__.. ._._., ._._..._. ..�.. xJ ~ O 1 0- i Town of Southold 2/7/2024 53095 Main Rd m1. Southold,New York 11971 PRE EXISTING CERTIFICATE GF OCCUPANCY No: 44941 Date: 2/7/2024 THIS CERTIFIES that the structure(s) located at: 1150 Ruch Ln., Greenport SCTM#: 473889 See/Block/Lot: 52.-2-35 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 44941 dated 2/7/2024 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: +,00d f gnj!gm jl lc fam...)yw q lr--g,* The certificate is issued to Vanderbeek R& B Irr Trust (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ....._..... ...�. 0 ht �i .ed Si "." .W.. ..__. �. . .... _...... gnature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REP LOCATION: 1150 Ruch Ln.,Greenport ' ­­­......... ..... .......... SUFF. CO.TAX MAP NO.: 52.-2-35 SUBDIVISION: NAME OF OWNER(S): Vandeel,�,R& OCCUPANCY: ADMITTED BY: —­—­­­­­­­ DATE: 2/7/2024 SOURCE OF REQUEST: Vanderbeek R&B Irr Trust DWELLING: #STORIES: I #EXITS: 3 FOUNDATION': ................. cement block CELLAR: 2/3 CRAWL SPACE: 1/3 ............. .. ..... ........ ..... .i. ............. UTILITY ROOM(S): BATHROOM(S): TOILET ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: ....... ....... ........ ..................... ' BREEZEWAY: FIREPLACE: GARAGE: -------------- DOMESTIC HOiWAT TYPE HEATER: AIR CONDITIONING: TYPE HEAT: forced hot air WARM HOT WATER #BEDROOMS:'­­ ­... — 3"'' #KITCHENS: I BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL- GUEST,TYPE OF CONST: OTHER: VIOLATIONS: ............. .. ...... REMARKS: .......... INSPECTED BY: JOHNJ DATE OF INSPECTION: 9/11/2019 TIME START: END: 1SFIlI, Town of Southold 2/7/2024 lr '» P.O. Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE O� " OCCUPANCY No: 44940 Date: 2/7/2024 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 1150 Ruch Ln, Greenport SCTM#: 473889 Sec/Block/Lot: 52.-2-35 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/24/2022 pursuant to which Building Permit No. 50291 dated 2/2/2024 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: "as built"acceS,sory deck_withm,staircaseuas-ap�pliedm„for. The certificate is issued to Vanderbeek R& B Irr Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED r Auth.ri .ae S tgnatur M. rn Et Town of Southold 2/7/2024 fi 7. P.O.Box 1179 53095 Main Rd ", ' " ,cy Southold,New York 11971 CERTIFICAr.FE OF OCCUPANCY No: 44939 Date: 2/7/2024 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1150 Ruch Ln, Greenport SCTM#: 473889 Sec/Block/Lot: 52.-2-35 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ........... 1/24/2022 pursuant to which Budding Permit No. 47507 dated 2/28/2022 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: , s !21 it " ad it, n/w It rgtiot S,it cluc�µrn oy c1 c�,r Msl lc ye at _HV ,�c r;tr�lg.. Ir t�tM r p,_c llrwtt as.. l?1a1P�l for. ... The certificate is issued to Vanderbeek R&B Irr Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47507 4/5/2022 PLUMBERS CERTIFICATION DATED 2/5/2024 I:er Giglio ...._... ... :.. . . .."�.ut caws.,..._ :..: .__......�..�.�_._.._.. Signature