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HomeMy WebLinkAbout1000-51.-4-14 TOWN OF SOUTHOLD Rental Permit 1 1078 Owner M & D Merrick Prpts LLC Occupied as Single Family Dwelling Located at 20845 Soundview Ave Southold 51.4-14 Maximum Permitted Occupancy 6 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. 2/28/2024 Code E:forc ent official This Notice must be posted by the main entrance at all times Town Hall Annex ,` Telephone(631)765-1802 54375 Main Road Fax(63'1)765-9502 P.O.Box 1179 Southold,NY 11973-0959 � � �� 2 12 (1.2 A +20o -71 c* BUILDING DEPARTMENT TOWN OF SOUTHOLD a0-10-9 1 d RENTAL PERMIT APPLICATION C't C -�k 10 6-7;LO Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: - - -. Tax Map Number: 1000 SECTION �"'�`""" """ -BI�.O -LOT A 5- 1 SECTION B. OWNER INFORMATION: .. Property ©caner Name: ����... .�'►?��Z..�m._..,.. . ..___...... Property Owner Legal Address: Property Owner Mailing Address: Id1T C it>1.�r"'- &-L S Telephone Numbers . Da time. o G..6.. �S evening ,...... .. a�. , Emergency, _ Property Owner Email Address;ym .m�m„ C"' 1 FE8 16 2024, Page 1 of 5 i!d l q o� Town Hall Annex Telephone(631)765-1802 54375 Main Road "% Fax(631)765-9502 �mug N P.O.Box 1179 �b Southold,NY 11971-0959` BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: v Name of Authorized Agent of dwelling unit, if any:ww„ Address of Authorized Agent (no P.O. Boxes' ,. � Mailing Address of Authorized Agent; _w...,. .. .._ . ,..... m ,µ. , Telephone Numb) r(s). Daytim Eveni� n..,., ng �.. „mm,�,.�._..... Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit if any: Y' Address of Authorized Agent(no P.O. 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 prof 1 9� I 0 l{ ^o Grp Town Hall Annex Telephone(631)765-1802 54375 Main Road %" Fax (631)765-9502 P.O.Box 1 179 Southold,NY 11971-09-59 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime,, W......ro ...... Evening,-, roan Emergency, Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: , M 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: Requested Maximum number of persons alloweto occupy 9welling Unit: w�? 7 Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: ---_-,, �.._.... , .,.m .„. \� l Cl 1 i Page 3 of 5 Town Hail Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 Y_O.Box 1 179 d � Southold,NY 11971-0959 , 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. ❑ I 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 !ti m v -1 C1 G certify under penalty of perjury,the following: .9�n� ..,. . 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 .rte fir Town Hall Annex Telephone hone(631)765-1802 ,��: t; Tele 54.375 Main Road Fax(631)765-9502 P.O.Box 1179 4' Southold,NY 11971-0959 �^ BUILDING DEPARTMENT TOWN OF SO T'rHOLD applicable laws and rules. I further acknowledge that I will notifythe 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: � "''11 ._ ....... \Z . ... ._.. ._.....__ ...00. ............... .�_ . .,. Property Owner's Signature: Sworn to before me this 21day of 20�,G Offical Notary Publi Signature and Original........ .. Official �� Notary Stamp ALLEN t4otary Pu io Stow A of YIJ "York No.Ott 55 oWifted In Nassau Cou CornmlWon Expires Page 5 of 5 TOWN OF O 631 -765-1802 .5/— INSPECTION ION 1ST [ ] ROUGH PLBG. ION 2ND [ ] INSULATION/CAULKING J STRAPPING [ ] FINAL E & CHIMNEY [ ] FIRE SAFETY INSPECTION TANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION AL (ROUGH) [ ] ELECTRICAL (FI" L LATION [ ] PRE C/O RENTAL roINSPECTOR s Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(63 1)765-9502 P.O.Box 1179 " Southold,NY 11971-0959 �UNT BUILDING DEPARTMENT TOWN OF SOU OLD RENTAL PROPERTY CERTIFICATION Form Is to be completed by o license architect,licensed engineer or licensed home inspector ; eporote,form Is required for each Individual,Rented Dwelling Unit F"ra essianal seal re aired err Architect car n freer licensed hlorne dns actor rnaet rovide y o v lld current eerti kation Rental Property SCTM Number: Rental Property Address: Owner/Name: Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (Le. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.) 13602cV.41 t4 0. '3 Property Description (Include all improvements indicated on survey) 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 Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. ` r ✓ � "w�mJ Print Name and Title fl Origina i atur� r b g R x Please place professional s�, � r J SCTM # TOWN OF SOUTOLD PROP f�I �I CARD OWNER STREETVILLAGE DIST SUB. LOT E p j ktvve _ _ c ACR. REMARKS TYPE OF BLD. F _ PROP.CLASS LAND IMP. TOTAL DATE pfd � �4 111 FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL TOWN OF SOUTHOLD PROPERTY RECORD CARD -7- STREET I VILLAGE DIST, I COUNTY TAX MAP NO. 0 LAND IMP. TOTAL DATE REMARKS: -A 0-- )h / 'I , LY-7 j 14-jr E = f I s I I �om �_. y Qk- -- 1.-3-14 1/2014 6� s 51.-4-14 1/2014 51.-4-14 1/2014 ; M. Bldg Foundation _ BathAt, Extension Basement Floors _ r 3 1 ExtensionExt. Walls i Interior Finish ` Extension ' - i Fire Place Heart IP a : � L � '!? ' , DS Porch Attic t �.. _ ` Z.a Porch Rooms 1st Floor Breezeway. Patio Rooms 2nd Floor GW e '-k Driveway Town of Southold Annex 7/11/2013 fi 54375 Main Road Southold,New York 11971 PRE EXIS"T"ING CERTIFICATE OF OCCUPANCY No: 36393 Date: 7/11/2013 THIS CERTIFIES that the structure(s)located at: 20845 Soundview Ave, Southold SCTM#: 473889 See/Block/Lot: 51.4-14 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- 36393 dated 7/11/2013 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: woad,frame Lme faLnLly dwel xt ., ith acce;.or N(.YVL,:_.5 '.1390 addition CO 109 P B 559 c itirrtl,CQ 46 1 P m3 ) 1 cicctri ryc+.,QQ 36325 The certificate is issued to Soundview Ave LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ut n " 1 tat ........ BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 20845 Soundview Ave, Southold SUFF.CO.TAX MAP NO.: 51.4-14 SUBDIVISION: ........... .... _..._... _ _._.......... _ .. NAME OF OWNER(S): Soundview Ave LLC OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST. Soundview Ave LLC DATE: 7/11/2013 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: 1/3 CRAWL SPACE: 2/3 BATHROOM(S): 2 TOILET ROOM(S): u.. UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: . es TYPE HEAT._...._•.... el ... c AIR... O. ....0002 - y HEATER: electric CONDITIONING: TYPE HEAT: oil -. WARM AIR: X HOT WATER: #BEDROOMS:... . ._ ..._.. ..._._ #KITCHENS ........__.. . .. ...._-...- -. _...... ... ... 3 : 1 BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: A11YF DATE OF INSPECTION: 7/11/2013 TIME START: END: Town of Southold Annex 7/l/2013 hkt P.O.Box 1179 54375 Main Road Southold, New York 11971 ........................... ............. CERTIFICATE OF OCCUPANCY No: 36325Date: 7/l/2013 THIS CERTIFIES that the building ELECTRICAL ........... Location of Property: 20845 Soundview Ave, Southold, SCTM#: 473889 Sec/Block/Lot: 51_-4-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 6/25/2013 pursuant to which Building Permit No. 38131 dated 6/25/2013 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: ELECTRICAL.SURY-El PANEL The certificate is issued to Soundview Ave LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38131 06-24-13 PLUMBERS CERTIFICATION DATED Authorized Signature FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLZRX'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY NO; Date .... ...... ............._:4u THIS CERTIFIES that the building located at ............ ... Street Map -No. XX. ................ Block No. ..=.................Lot No. ......Southd conforms Substantially to the Application for Building Permit heretofore filed in this office dated ...................... 19.49. pursuant to which Building Permit No. 'AP2 0 dated . ......... ............W�....... .... ........ 19..!g, 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 .......I LVAt-0--QX1 -I awl ly..4'V4!UUV. ..................... ..... ........ .......__...._._ This certificate is issued to AX.1chUr.. ............ .... ............................ .... ... ..... (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N91390 , Z Date .,.......».............. . '.....,.1......»......... 19.6.1. Permission is hereby granted to: Donald Fredexic—A.IAC.....Ar.ti ur......Udla d...J•r...... i t3iklj p� [I s . �, @ J.O to .•Bu ld• •An—sdd.ltion..on...an.. x3.si.3.at . .ds�rc�I. . n . ........................... ...............».. ,..... at premises located atwAy.....Siound.—Viev•.ve.........»..........».. ,......,.a....,..,...»........,...»..,....,»,.......... .»..,..,..».»..............».o..,......R.....,....y....,....»..ur` O'l�tYlttJ�.t�..g� ...�e'.`iro, ..a....,........u....,.„....„..,»�»........,...,,....»a..»..,, pursuant to application dated .............................Wpv-ember.•..5.........i` �...., and approved by the Building Inspector NOTE: Additional property has been purchased to vtiden the original ,lot to cain].7l with side lines. Fee $...5 pp. ......... Buil�ing Inspector FORM ASO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Cleric's Office Southold, N. Y. Certificate Of Occupancy No. Tik, t . . . Date . . . ;I=* . . .99 19. 12 THIS CERTIFIES that the building located at N/S Bound V:Lew Amg Street Map No. = . Block No. .= . . . Lot No.x= . fiOUtho3..., NEy• conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV* '1., 19 71 pursuant to which Building Permit No. 55992. dated . . . . .NoV . . .1. 19.71 , 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 -Pr3:vate• -one' Tamily 'dW611ing The certificate is issued to .A:N.U.jand & W-ife. .owners • . • • • • . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No. N.Ro. . . . . . . . . . . HOUSE NUMBER. 20845 Street Bound View Ave Bmldmg Inspector FORK NO z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. w BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 5599 z Dote ........................S"I ......�..., 19....R� Permission is hereby granted to: .................s 0 .......................................... to ......................................................... .............................................................................................I..................................................n........ at premises located at ........... . ............................................................................. .................................................................sou old....0*10. .....................,...................................... pursuant to application dated ............................No*.......... ............. 19..11., and approved by the Building Inspector. .Fee s....14.0.......... .... .� .�.. .. ...... ..... wilding.Inspectoar 34X00• 94YE(Y � I, i �i BFDR�OpNO� L � - ('J� ! 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