HomeMy WebLinkAbout1000-80.-1-10.1 A 4 _ TOWN OF SOUTHOLD
Rental Permit
0199
Owner Jonathan & Marcella Sanders
Occupied as Single Family Dwelling
Located at 2350 Paradise Shores Rd Southold 80.4-10.1
Maximum Permitted Occupancy 3
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.
5/22/2024
Code E �c ent Officia
This Notice must be posted by the main entrance at all times
4 300
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
�_G10� ai
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 litws,� art plc t 1�w
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION _ --BLOCK—
SECTION B.
OWNER INFORMATION:
Property Owner Name: A,JVIA e
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
0 �. N F •
6%-
Telephone Number(s): Daytime Evening2Si-2SS( Emergency
Property Owner Email Address: Ms
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:
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, Q 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 allowed to occupy Dwelling Unit: 4
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
•
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.
V0001'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.
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)
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:
Sworn to before me this 1 day of . 20 2-4
Dawn Johnson
0 al Notary Publi Signature and Original Notary Stamp ono Notary ublic,StateofNewYork
)01J0049053
Q.A,Ilcd 1n Suffolk County
<i AoiPvwi y+ Commission Expires fG/fl./201..4
Page 4 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)
I 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:
Sworn to before me this I day of
„p zw�weluPaar; q�i'A .�O`�1lTMG"6&W"
r ra ar i,aiPaicar D:^uwlp0p¢y 't ater aaf New York
Offic al Nota Pu lic Signature and Original Notary Stamp 11a0.63J 053
T�20--,
Page 4 of 4
f4f so
TOWN OF SOUTHOLD BUILDING U
" y � 631 765-1802 so --/-
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION END [ ] INSULATION/CAt
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
[ ] CODE VIOLATION [ ] PRE C/O [ el
REMARKS: 0 6
INSPECTORDATE
Town Hall Annex
Town of Southold 54375 Main Road
o Rental Inspection Report PO Box 1179
`r' ` 'f Southold, NY 11971-1179
Tel: 631-765-1802
4!k,
Date
JOwner S Phone
Address "' Visible
..... n ._... w .�m..._.. _. ..
a,.�.,.. _._ _w.... l ins
.. �.
Hamlet � � _. _... .. ..__ ...pect°r .�...
_.....
Floor Level Quantities 1 Sub 1 2 3
,. . ........
Smoke Detectors(not located in bedrooms)
Carbon Monoxide Detectors�
...o.... .. ...,. .�.. U.
..�... .. .... _ _.
Fire Extinguishers
....._..._......... m.m
Exits
Bedrooms 3
4 5 l 6
Smoke Detectors
Egress _ �... .
Occupa
nt Count
Building . .Operational .... . lt
tion of Proper
.....,.. ....Systems Maintained & O ti l oncl
... �
Heating Building interior
Hot water Building exterior
Electrical Property clean, maintained &safe
_..
�Mechanical Handrails&guards installed & secure _ P
Pool Safety Pool on Site
Surface water alarm ., _. w ,....,..o f
Date f CO issuance
IDoor alarms Pool completely enclosed
Self clostn / latchm ates Pool fence to code requirements
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merits
CO's for all items present j rior Rental `
..__
Comments �S -tj
'7
TOWN OF SOUTHOLD PROP R D C A R D
!STREET VILLAGE SUB, LOT V'
FORMER OWNER E ACR.
S
W TYPE OF BUILDING
RES. SEAS, VL. FARM' comm. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM I Acre Value Per Value
Acre
Tillable I FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meaclowland DEPTH
House PIqt BULKHEAD
Total I DOCK
4a
COLOR.. ' IRlrl
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M. Bldg= -
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Extension F I i
Extension
=Foundation - Both Dinette
Porch - ;Basement 'Floors K.
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Pr Ext. Walls 'interior Finish LR. '
r,
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i
Breezeway Tire Place ! !Heat DR.
1 Garage Type Roof Rooms 1st Floor BR.
Patio 'Recreation Room Rooms 2nd Floor FIN. B
i O. B. Dormer ;Driveway
Total
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LIVINE Rs�H ou'rowk
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23 S-0 4'1�
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f;e,1/ Town of Southold 8/9/2018
53095 Main Rd
Southold,New York 11971
---------
PRE EXISTING
CERTIFICATE F OCCUPANCY
No: 39885 Date: 8/9/2018�
� � es Rd, Southold
THIS CERTIFIES that the structure(s)s located at: 2350 Paradise,Shor _ � �..M _...
SCTM#: 473889 Sec/Block/Lot: 80.-1-10.1
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 39885
dated 8/9/2018 was issued and conforms to all the requrieenents of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood Lamqgne tgmil dwell with and ac gem e
l^ ote:13P 42 � 'l al ti as C,O�-39834.On reds deck d •not . oildira .�;rarr�i.
The certificate is issued to Sciscente,Rose Ann
..�.___._........_____.,_.__.... _ (OWNER)
of the aforesaid building. r
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
... ._ _ the_' Signature _......_..... ..__.
BUII.DING DEPAKIVENT
TOWN OF SO OLD
HOUSING CODE INSPECTI N III+ RT
LOCATION: 2350 Paradise Shores Rd,Southold
._................_w. w .. ..........�w_w_. _.
SUFF.CO.TAX MAP NO.: 80.4-10.1 SUBDIVISION:
NAME OF OWNER(S): Sciscente,Rose Ann
OCCUPANCY:
ADMITTED BY: Rose Sciscente
SOURCE OF REQUEST:n Sciscen ..._.........._ �...._. --...._. _..._._ _._.._.w_.........
te,Rose Ann
.w...........w..........._..................__..�.._-..�,.-...._._. ........._..........�.�......._..........�.�................,,,,,,_,_.w,.. .ww.._..._..Hww�______ DATE: 8/9/2018 �......_.__...
DWELLING:
#STORIES: 1 #EXTTS: 2
FOUNDATION--'-'-- cement block CELLAR: partial CRAWL SPACE:.,,_,,_,___
BATHR _..w-..w__.w.._.._...._m_._. ...__._._�.__._ UTILITY ROOM(S):
g
POR 0 Yp�S):� � 1 TOILET ROOM(S):
DECK TYPE: on gradePATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE: _
,,....w.w_..........-._.��w_...... �......_..._..w_...
DOMESTIC HOTWATER• TYPE HEATER: AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: forced hot air HOT WATER:
#BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST:
�.......
.........�...,,.._w_.......�.._.._... w..... _.._..........� _ � ._
SWEVIMING POOL: GUEST,TYPE OF CONST:
.
OTHER: _.............
VIOLATIONS:
REMARKS. _..w ._.__w___.............._... _.......v ..........._. w_ _ .___.......... _ _............... ..__ ..........
........
INSPECTED BY: JOHN7 DATE OF INSPECTION: 6/27/2018
TIME START: 12:14pm END: 12:35pm
�l t � Town of Southold 8/9/2018
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39834 Date: 8/9/2018
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 2350 Paradise Shores Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 80.4-10.1
.
Subdivision: _.......... FRed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/10/2018 pursuant to which Building Permit No. 42861 _ dated 7/13/2018
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:
'"� uilt'"a�I tivans„ llin windows doors aadelectric an'as lit"out shower stall to an eaistin one
fad d eliln, hied�for..
The certificate is issued to Sciscente,Rose Ann
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42861 7/19/2018
PLUMBERS CERTIFICATION DATED
t ignat re -