HomeMy WebLinkAbout1000-63.1-1-39 TOWN OF SOUTHOLD
Brutal Permit
1138
Owner Muggs Brothers LLC
Occupied as Single Family Dwelling (Unit 18D)
Located at 2555 Youngs Avenue Southold 63.1-1-39
Maximum Permitted Occupancy 4
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.
5/28/2024
Code EAf c ment off `
This Notice must be posted by the main entrance at all times
a
WiN't
I*OW11 OF SOUTH OLD )C UILDtNG D1±;PA TI" E,1" T
� . Box 1179 Southold NY 11971-0959
. Town. Hall Annex 5375 lain load P. O
Telephone (631) 765-1802 Fax (631) 765-9502 t�://w . otit,hol town�nii ly ,
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RENTAL PERMIT APPLICATION le C0 f
6
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Pro arty Addr ss:
� � 17-71
4'� &I tIC
Tax Map Number: 1000 SECTION �, .duo ( -BLOCK OI-V) -LOT v J0
SECTION B.
OWNER INFORMATION:
Property Owner Name: "'' °
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as yRental Property Address)
Telephone Number (s): Daytime - d Evening Emergency
q83.5'
Property Owner Email Address: �)-
Page 1 of 4
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: 1
Address of Authorized Agent (no P.O. Boxes); �., ""
Mailing Address of Authorized Agent: �a hyt-
Telephone Number (s): Daytime 311103, Evening Emergency (o3-573
Email Address: tzlway
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, 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 allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: V' s J"�
l i o ! rr,c 13't" 0 1" r�«
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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.
Page 3 of 4
v
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
)
COUNTY OF SUFFOLK)
w
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: V
n
Property Owner's Signature:
Sworn to before me this 15 day of It 20
NOTARY PUaUC,STATE OF NEWYORK
� Na,01
WOW fCOUMY
Official otary Public Signature and Original Notary Stamp " `
w p7`*
Page 4 of 4
DEPT.rowm OF SOUTHOLD BUILDING
INSPEC ION
ON 1ST [ ] ROUGH PL13G.
ON 2ND [ ] INSULATION/CAULKING
' STRAPPING [ ] FINAL
E & CHIMNEY [ ] FIRE SAFETY INSPECTION
'ANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
AL (ROUGH) [ ] ELECTRICAL (FINAL)
—ATION [ ] PRE C/O [ Ar6NTAL
C'?Cic•�
INSPECTOR
Town Hall Annex
Town Of Southold 54375 Main Road
�, Rental Inspection Report PO Box 1179
� � Southold, NY 11971-1179
Tel: 631-765-1802
SCTM#
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Owner � oo � Phone
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Address e
Inspector
Hamlet . �..�,........�...� .min_..._ .�.... .....,,��„ ��. .......,... �...., .. '�._._.._ma��_.. �w m. ...._m.....
.....Floor Level Quantities��...... .............:...........�a�........._�,_..._...�........„ ..,�........,............................,,,. ,.,.,...,,......Sub,,....... _....,..,......_1..�.......� 2,. ...::.:L�,�......�,...3�...,..........
..,. ., .�
Smoke Detectors (not located in bedrooms)
Carbon Monoxide Detectors . _.„.a .. .,. .,m _.. .. ,. _ . �„�.... .��
Fire Extinguishers
Exits
Bedrooms 2 3 4 5 6
Smoke Detectors .,,...,a _.,� ®. .. .._. 1 �...�. ..., _... ..
m �..� . .....�m.,..E ..,., ....... .
gr ess
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Occupant Count
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Building Property Systems Maintained&Operational Condition of ..,
Heating Building interior
Hot water Building exterior
ELe,e... �. .............�.� ..,.,�.o..�_.... .� �,.... ve� ,..,�. 9. ......�._... � ...�.��..n
ectrical Property clean, maintained &safe
Mechanical �. ..... . �®.... .._. Handrails & �.�,.���.mm...�.,.._........�.�.,.,,.�..�,__.. ...�..�.�.�,...� . ���_, ..�,,
�......... guards installed &secure
Pool Safety Pool on Site
Surface water alarm Date of CO issuance
. .v.. e., .. , b .. ..... _. ..... .....s M.,.n.. . _ ,......,,.
Da _. .._. ._.
oor alarms Pool completely enclosed
Self closing
/latching....,.ates. _m iiPool fence ....., n o a ..
e requirements
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CO `..... . ... .,,. p or ., .............. .
ri Renta
I�.......�s for all items present
....�.. �P .._....,..,. .. ........,._.�,�.,.._.._ .� .._,.,..., .,..,� .....................
Comments..,�..,.... ...,....�,..�j...�._,.,.,..._...p.�.......................................��.�.._... .�.,...�........._ ..�........_.......m_....._..w.._..�,_....�....�_..�...,.....�.....�........,,�.�,........._...........m.�...........�....._
._� ..._.....�.._.... .�...... ... .W�.,. .� �. ...��._.._.,. ,.,..�, ...,., ..�....._..__...�.. ... .....__. ,. .. __ ..... .... ....... .. .....
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TOWN. F SOUTHOLD PROPERTY RECORD
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LIMING ROOM 17'0"xli'4"
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William D. Moore
Attorney at Law
51020 Main Road
Southold,New York 11971
Tel: (631) 765-4663
Fax: (631) 765- 4643
Betsy Perkins Paralegal
Kylee DeFrese
May 15, 2024
Town of Southold
Building Department
Re: Deed transfer for 2555 Youngs Avenue, Unit 18D, Southold
To Whom It May Concern:
Please be advised that the attached deed was recorded with the Suffolk County Cler's office
on May 8, 2024, in Liber 13427 page 815. It has not yet been returned by the Clerk's office.
Kindly make this part of the application for the rental permit.
Thank you.
Ve tWWore
1/� W illia
WDM/kd
Encls.
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. . . .1.40. .1. . . . . . . . . Date . . . . Novemb. . . . . .1. . . . . . . . . . . . . . .. 19 .85
THIS CERTIFIES that the building . , MULTIPLE , DWELLING . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property 2555 YOUNGS AVENUE SOUTHOLD
House No. Street l lamlei
County Tax Map No. 1000 Section 0 6 3 „ Block . . . .M. . . . . . . .Lot . . .?S, &. . .9. . . . . .
Subdivision . . FDIJNAE VILLAGE Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
Sept : 2 7 . . . . . . . . . 19 . pursuant to which Building Permit No. 1 3 516 Z
dated . , . , , Nov . . 2 19 84. , 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 . . . . . . . .
Building .#)A ,Apt 1 -D Unit in multiple dwelling
The certificate is issued to . . . . . L I Z D A REALTY LTD .
(owner,I �r�t��antJ
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . #N717893 . . . .
Plumbers Certificate 10/9/85
n . , . . . . . . , .
Building Inspector . .
Rev. 1/81
NY 025-Executor's Deed—Individual or Corporation(Single Sheet)(NYBTU 8005)
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE,made the day of April,in the year 2024
BETWEEN
WILLIAM T.CONWAY,residing at 530 South Harbor Road,Southold NY 11971
as executor (executrix )of the last will and testament of,CHRISTINE O.CONWAY AKA CHRISTINE
OLSTAD CONWAY,late of SUFFOLK County,deceased,
party of the first part,and
MUGGS BROTHERS LLC,a domestic limited liability company doig business at 530 South Harbor Road,Southold
NY 11971
party of the second part,
WITNESSETH,that the party of the first part,by virtue of the power and authority given in and by said last will and
testament,and in consideration of NONE($0.00) dollars,paid by the party of the second part,does hereby grant and
release unto the party of the second part,the heirs or successors and assigns of the party of the second part forever.
ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected,situate,lying and
being in the
PLEASE SEE ATTACHED SCHEDULE A,DESCRIPTION OF PREMISES
BEING AND INTENDED TO BE the same premises descdribed in a deed made by Rachel O.Valentine to Christine
Conway and recorded July 27,2001 in Liber 12132 at page 540.
Said premises known as:2555 Youngs Avenue,Unit 18D,Southold,NY 11971
TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and roads abutting
the above described premises to the center lines thereof;TOGETHER with the appurtenances,and also all the estate
which the said decedent had at the time of decedent's death in said premises,and also the estate therein,which the party
of the first part has or has power to convey or dispose of,whether individually,or by virtue of said wiil or otherwise;TO
HAVE AND TO HOLD the premises herein granted unto the party of the second part,the heirs or suco ssors and
assigns of the party of the second part forever.
AND the party of the first part covenants that the patty of the first part has not done or suffered anything whereby the
said premises have been incumbered in any way whatever,except as aforesaid.
AND the party of the first part,in compliance with Section 13 of the Lien Law,covenants that the party of the first part
will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to
be applied first for the purpose of paying the cost of the improvement and will apply tlrz same first to the lwayment of the
cost of the improvement before using any part of the total of the same for any other purpose.The word"party"shall be
construed as if it read"parties"whenever the sense of this indenture so requires.
IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first above written.
IN PRESENCE OF:
t ��'�. WI1.1.1AM�T -5WAy S I,' (':c.DTOIt.�_.���_...
USEACKNOWLEDGMENTFORMBELOWWITHINNEWYORKSTATEONLY USEACKNOWLEDGMENTFORMBELOWWITHINNEWYORKSTATEONLY.
State of New York,County of SUFFOLK}ss.: State of New York,County of }ss.:
On the day of April in the year 2024 On the day of in the year
before m , the undersigned„ personally appeared WILLIAM T. before me, the undersigned, personally appeared personally
CONWAY , personally known to me or proved to me on the basis known`to me or proved to me on the basis of satisfactory evidence
of satisfactory evidence to be the individual(s) whose name(s) is to be tht; individual(s) whose name(s) is (are) subscribed to the
(are) subscribed to the within instrument and acknowledged to me within instrument and acknowledged to me that he/she/they
that he/she/they executed the same in his/her/their capacity(ies),and executed the same in his/her/their capacity(ies), and that by
that by his/her/their signature(s) on the instrument, the his/her/their signature(s) on the instrument,the individual(s),or the
individual(s), or the person upon behalf of which the individual(s) person upon behalf of which the individual(s) acted, executed the
acted, xecuted the instrument. instrument.
KYLEE S DEFRESE
note public NOTARY PUBLIC-STATE OF NEW Y RK
No.01 DE6420156
Qualified in Suffolk County
My Commission Expires 08.02.20 S
ACKNOWLEDGMENTFORM FORUSEOUTSIDENEWYORK STATEONLY.'
ACKNOWLEDGMENTFORM FOR USEWITHINNEWYORK STATEONLY. (Out of State or Foreign General Acknowledgment Certificate)
(New York Subscribing Witness Acknowledgment Certificate] STATE OF _ } ss.:
State of New York,County of } ss.: (Conrp(ete 1Yenue with State Coanlry, a°atvirrcc�or ?'tenter"lur0ita
On the day of in the year On the day of in the year
before me,the undersigned,personally appeared before me,the undersigned,personally appeared
the subscribing witness to the foregoing instrument, with whom I personally known to me or proved to me on the basis of satisfactory
am personally acquainted, who, being by me duly sworn, did evidence to be the individual(s) whose name(s) is (are) subscribed
depose and say that he/she/they reside(s) in to the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their capacity(ies), that by his/her/
(if the place ofresidence is in a city, include the street and street number, if their signature(s) on the instrument, the individual(s), or the person
any, thereqj);that he/she/they know(s)to be the individual described upon behalf of which the individual(s) acted, executed the
in and who executed the foregoing instrument;that said subscribing instrument.
witness was present and saw said
execute the same;and that said witness at the same time subscribed
his/her/their name(s)as a witness thereto.
EXECUTOR'S DEED
INDIVIDUAL OR CORPORATION
TITLE NO. DISTRICT 1000
SECTION 63.1
WILLIAM T.CONWAY as Executor of the Estate of Christine O.Conway BLOCK I
AKA Christine Olstad Conway LOT 39
COUNTY OR TOWN SUFFOLK COUNTY TOWN OF SOUTHOLD
TO
MUGGS BROTHERS LLC
RECORDEDATREQUESTOF
Fidelity National Title Insurance Company
RETURNBYMAIL TO
William D.Moore,Esq,
FIDELITY NATIONAL TITLE 51020 Main Road
INSURANCE COMPANY Southold,NY 11971
NOOK oRAM 1928
G�-y-Fidelity "
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