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Home My WebLink About1000-30.-2-31 fatFg TOWN OF SOUTHOLD Renter Permit UP 1097 Owner Daniel & Nancy Myers Occupied as Single Family Dwelling Located at 510 The Crescent East Marion 30.-2-31 Maximum Permitted Occupancy 10 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. 3/20/2024 Cod t nfo mint offic` This Notice must be posted by the main entrance at all times C MAR 2024 TOWN OF SOUTHOLD—BU1LD1NG DEPARTMENT F" fl]—' *'7* Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 1147 T�'�"0%` Telephone(631)765-1802 Fax(631) 765-9502 htt[,Ls://www.soutti)l(tLo Nrun 3 // q RENTAL PERMIT APPLICATION a l�+l Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address, 5_10 1_ NY W69 12 Tax Map Number: 1000 SECTION '30 --BLOCK -LOT SECTION B. OWNER INFORMATION: ell Property Owner Name: mver- " Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 601 M007MOA A .iz 'So'rnq (3�o Telephone Number(s): Daytime' Evening Emergency Property Owner Email Address: 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: 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:jo� 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." , i,�� Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: -8 -T—oTG ( Use and Dimensions of each rootm�in Rental Dwelling Unit:!5q�, r—lwor PIC,, C)r1 q ,✓ u 0,*1 OtI g O q(, )etX-)rt See 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. XI am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold E] 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) l 1'7c1 e 2) ?, certify 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. Property Owner's Name: . �) Property Owner's Signature: S� Sworn to before me s_day of_�r� , 20 2-`{ 21 Offlo rotary Public Signature and Original Notary Stamp u Page 4 of 4 TOWN OF SO THOLD BUILDING DI Coo �� 631 765r 1802 INSPEC ION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ j FOUNDATION 2ND [ INSULATION/CAt ] FRAMING / STRAPPING [ FINAL ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN' FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIB CODE VIOLATION [ ] PRE C/O [ I REMARKS: 0 5 0' INSPECTORDATE Town Hall Annex �V " Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 " Tel: 631-765-1802 ..... ry / ,.. .....�, Date Owner 5._ Phone ....._ _....... ........ ... . Address $/ � 77•-ec3eesG Visible ,....,w .... ...�.. Hamlet ........ . .. . ...... . _....... Ins ector � Al/Li .. _ ..._� � .. _... ., P Floor Level_Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) �1-1-1-- o....w�R..�.�._.......,� .. �_�a��.�.....,. �r_a _w ,�. ,�� Carbon Monoxide Detectors ,. ..................w . . ........W,.w�mmwm.�w .. ....w. ._.. .w... .. Fire Extinguishers Exits I.....�. w. ....... ....._. Bedrooms �,� 1 2 . . ._..6...m Smoke Detectors �.. �. _, .,. �. ✓. �. ° �. _ . a .. .� I Egress reOccupant Count m... ......,�...,.,_.._.1., .�...... .„ � .,.w ...�.. .�w�.. ..... Building Systems Maintained &Operational Condition of Property Heating Building IB uildi interior o,� a�..�,.. ...... ..... . .� .� �. ..,, �dBuildin exterior 1Hot water... ...�., �... ,, o exterior �m._ ...z Electrical Property clean, maintained & safe _. .,o a.. w. .....,,.��..,, . , ��,,.a ,..... w . .. .� ...,. ,.. g ere Mechanicalm Handrails &guards installed &sec Pool Safety Pool on Site ... ..........,,. �,� �. d „�.. . _. �. m,. . �,,,. ,,,�..... m Surface water alarm Date of CO issuance w........ .na ��..... ....... .. .R-n11.a ...,,,su -1 a-.,, _........... ..nor„alarms _. .. .. 'Poo ..l coa�m�p..let_ely enc.los.e.d g Self closing/ latchingtes lf tcoera .a...� _ .�..� � nts _< .... ,... ,.a present _� ......., ..f �C Prior Rental .. O s for all items. . .... ,_.. ... �. o..� � ..._..... . _. �..., .. ..... �� Comments ....... ... .,mm..... ...,._ _,...e. .�_ .. __ . ...m ..m ... ........................__ .. ,....rv...._o. .. ... _ ......I i 1 _...._ 0-2.0-M-0 � � I � �`Y RE ®� IMF SuMm. .m e }} s - ir PLUMBER CERTIFICATION 1.8 AO CaNTENT'I FORT 7r OF OCCUPANCY e~# t l # sg g QCCUPANCY OR .It USE,,IS UNLAWFUL WITHOUT CERTIFICATE �� - P a . jF OCCUPANCY �. = . - L g 'a 6v �- - bFIE FOR C CL t AU `W s C-" WALL-MEETor pm"sw ftS0,OR E 11MI ERRORS, .UP�LfiY+i7lrM T` �� wwr- � t t • . MWMIMI sm— W- l- _ t. I �T - fill- �f E i - � Aw- lit , a f r E E f x E a s _ as' _ -741 - :1. `- s' _ e ' TOWN OF SOUTHOLD PROPERTY RE( -413,c kzc�-�, STREET VILLAGE DIST. SUB. LOT 4 1, 60 -PIC e Al 10 FORMER OWNER N E ACR. Li S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM, CB. MICS, Mkt. Value LAND IMP. TOTAL DATE REMARKS - ----------- j -5 �77 D406 v--N r 2;:�Oce CD Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD i Meadowl0nd l DEPTH House Plot BULKHEAD Total TRIM COLOR _ - - — r Vf '- -` - F. .A I 3 30:2-31 2/3[2021 1 , a . — — — — -- — — Extension - 4 , a. r� t nsion - a � a fib_ Extension II Foundation BothED_ tta Porch _ Basement : Floors tP Porch E Ext. Walls Interior Finish t_R �. E a � Breezeway 1 Fire Place Heat ; DR Garage ? <� Type Roofv �s ist Floor r2 A - _ .._ _.> Patio =Recreation Room Rooms 2nd Floor ? FIN B O. B. Dormer Driveway Toto k r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20400 Date DRCEMBER 10 1991 THIS CERTIFIES that the building NEW DWELLING Location of Property 510 THE CRESCENT EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 30 Block 2 Lot 31 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV EMBER 16 1990 -----Pursuant to which Building Permit No. 19526-Z dated NOWT' ER 19 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 ONE FAMILY DWELLING WITH ATTACHM CARAGE & DECK As APPLIED FOR The certificate is issued to MICHAEL & SANDRA J. BERNARDO {owners} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAJ, 87'- -24 -NO" '. 1 1991. UNDERWRITERS CERTIFICATE NO. N-205877 - SEPT. 30 1991 PLUMBERS CERTIFICATION DATED OCT. 1 1991 - PEECONIC PLUMBING & HEAT. a Building Inspector Rev. 1/81