HomeMy WebLinkAbout1000-50.-2-3 fg� fat N TOWN OF SOUTHOLD
Rental Permit
- 1123
Owner Katharine Bicknell
Occupied as Single Family Dwelling
Located at 105 Soundview Ave Ext Southold 50.-2-3
Maximum Permitted Occupancy 8
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.
5/10/2024
Code i(nfoJefnent offs ' I
This Notice must be posted by the main entrance at all times
� �� ��
TOWN OF SOUTHOLD—BUILDING DEPARTMENT I,
A P ,� ,
„r Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 1197 1-0959
Tel
ephone (631) 765-1802 Fax (631) 765-9502 lit! ww.sontlio)citowr2.! OY
A(6V
RENTAL PERMIT APPLICATION !l4 C-'�_/b7 ?5_7
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
'500 tkve.
Tax Map Number: 1000 SECTION -BLOCK
SECTION B.
OWNER INFORMATION:
Property Owner Name: V l�
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
Telephone Number (s): Daytime3+�4AJ-3N9{o Evening3t44--SI- mergency Sq--F-40q 1-3LM
Property Owner Email Address: —�ticlwtell f.��
Page 1 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:
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: L
a ' y C
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 acid 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
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
)
COUNTY OF SUFFOLK)
I y 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: rr1
Property Owner's Signature: 1C
Sworn to before me thisc y of ft i-I
tyl
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.01 BU6185050
Qualified In Suffolk County C,
Commission Expires April 14,2_04 �5
Page 4 of 4
TOWN OF SOUTHOLD BUILDING DI
631 765► 18 2 TO
INSPEC ION
FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAt
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN;
[ ] FIRE RESISTANT CONSTRUCTION [ ] TIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
C ] CODE VIOLATION [ ] PRE C/O [ qI
REMARKS: eovo" c4 L,
"rk -- parc•44t'l�
43"
v- 1
DATE `'I'� INSPECTOR
µ Town Hall Annex
Town Of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
rZ Southold, NY 11971-1179
77Tel: 631-765-1802
_CT # �..�. . ...... ............ ....... ....._. Date ,....._.
� o� .3
Owner Phone
Address �`Jour'd VI
isible
Hamlet ,.... __...._.. . .. .._... ....... ..... .....Inspector
Floor Level Quantities 1 2 3
Sub
....... .. . . .. m... �. ._.. ......... .� ...� .. m�_.� �..�_. � � u . ... .�
Smoke Detectors(not located in bedrooms).
Carbon Monoxide Detectors
Fire Extinguishers
Exits
Bedrooms 6
_..m _.1 �. .. .�.... 3 4 . .,.. w..m... 5_� ,,,,,1._.. �....
Smoke Detectors !
Egress
Occupant Count .. _" . . ._ .:: ...w, . .., . ._. .
Building Systems Maintained & Operational Condition of Property
.Heating_ . .,_..... e._...m.�..�... .......... . rv..v,.�
Building interior
Hot water Budding exterior
...�... . m .. . .. ..... . ....._..__.., a, ...... .....�.. ... . . ��...�w... _ ._ . . e n_ Property e maintained & safe
Electrical p Y clan�ea , ain
m „ n e.,. . .. m e,e
Mechanical Handrails&guards installed & secure
Pool Safety �Pool on Site
Da CO .a .
f Surface water alarm to of O issuance
w..1-1 _ . . ......� . �.�.., _... ..
Door alarms Pool completely enclosed �....
Self closing/ latching gates Pool fence to
code requirements
Prior..
C for all itemspresent
...._. ... ...w. ....... .......��... _ ., ... .., . ... . Rental
O'sr
]Comments
:^NERAr.Nt7f r„.
1. Comtrnctor in to check and verify u11 dimaroinco before proceeding wit,work.
2. M111 work is to be etrietly 11,, con eldanee w th npplieetle c ordiner en, and Fe.-elly
t
accepted etandb,dx,
3• All material Se to be new, and the SnA tal lati on
is to be done in a nuat ru,8 wor®an-
` like manner.
G. t �p7CJ c• lna t¢ilati on of ntanderd product:: is to he a
f ate' '�-`.`.aim'.d;p �
3 LS€i A y -.. 'nflnul'uc turerc. ice trncti one, a per
No variation from plum n
- a�ba Litute ei 1 pc nl_owed u_nl pproved t
8ED2�N DF' -�...�. �.-.._ .. _ `. - .'N, chi tact before n•ork coon' c_• r he
t LIUIr'r•G F II a -- _r-. �, j_. 5�_ p, con tr�c for iu to protect tree,eplm and ao
entie d no
a' a
A �( a 3 GSM GEee n :arcl ele,encc rrnm dmm�X;e. a the,
T Si� -SW7 LrG An LF.,6 PmI7h fG Tu G G �5 - DFTxS .'JWD. € a
P - •`thd�sff4� ,' a 7. oiian curnLatio:,, son.-actor i, to leave nits rrnn
_
a Glenn en` cbrin, and 1-ilaf nr:is t be -brco+,
_ -
_ •fr
6EPRM• I a 7, DIN(hr4�M, __, _ '� `.:- f� �4#tiE. lrf:'t:t,R::1 r.I'=lra'ICY•
IV
-ai �EDLM.+r3 _
'=tom I}fA if I.
1 a s�
rlu 8@7P.t1 c I Len coat 2 floe urothnne varnLsh, 'en c
l `. CLi ll sic lna li^nla(F+r ti uts rlx4
e n t� e)
�+ ng th oudhoot and IXtnrior Boll^ of bedrooms
coot - t
`vl 1` � I i �If q)6.�r• }A �- I to Ge lz6 ThG Fluna ,l Dint Crudr A Redwood.
p and cybir.et,.ar4: to be Medium' # 'E- LenxS CY 1. c ni Ln all a bi'J end. ed be Medium? s '3:e [ 3PrAi,-+f€i-Y;, ST ¢' t srl d F r
22 33 o¢tn hiCh )on, Hanol
to Dior l� tMl01.#SiTS 31 i = t .` v77#i t.. _ -elected !. s rt,t tec c.
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iti 7'4 Las` ,� '�`-b x6•or - 4. f�. J:corer rc.,.u,d tool ntor-gm rnon, fi:,inheo
p §+s -_ , " - I , se # „i #' t:.tiIC a bei Lef Eaunft nixher- me+,be omx Ltrd, eni soils Girt
OWOMCATW
+e (lp Ncaeelo dL kitchen and M'P GiNVAY- bathroom o+nteru,_iM17 WTES AND n Ln d v 11s.
` ' L i''�. - [€ -n-- �.x-.., ,� - - P x =.-o•I �` YIC L ITE 4S IYCLUQeQ lY CoWp ACT
ii€r� lilt Model 3028, by orie
c —ey ant all neermenry `
,. `. 2 I<it _ s4 nr z -s Narveet^ tz4R.z3!•
I
- ..�� unb cup strainer 4,31.
W-w NON3 o i-Lure-. by U--tee S
# rsEiRT`a��r.7 `--`�# � �•LrA. ppp �; £ � _ap aI a ? - - t` €ts, Pl v-c • •� rthi3e;
E ( } � - •\r :i4r �# St�F �• � �--`-�- ��ttr.'�e:� �, i r t� - pre.. �:��.�sr��t r��a i•hechUsa 1,
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Lee eDl his€tali r .ire - € t
ly
! 3EPZM DEcK �� € nv€ r €ui Len =1Y
- ,. .` ari ee artsl
of I-€pecrit .
LIUIh7, ..ocM GEGK - --�. met.cr
BEDPtrf•D1UC ` 4_ 7. 0o-6e1. , ri ed het water h star, EQ_ $
eto a tonic. d Held water
Clgraezhauat ion in kitchen; al
-•- "�%`-`� - . best lwnp zh usL fan in each Lois helgomfi t:ure (Sih;ht
e I � ;7
1. Niidoor lidin
d gloat, doors.
§ " ? o 2. 111 hardware; all lighting fixtures: all kl tenon an iLi
' 11�f1_U F 7T£ FROM PIN(12*p8 =p= feookt nP, wall Dunn, diehweoher, rel'rirerntorl,
TO p
i =="r�E P561•'(tf4f,D LATEF- 3 -"pr tic.,r«-iirr asg� 11. bathroom
# - curter tat arm' -hse act: _ Ile chore tuba tc cig.
B•FN.rceTsaForriLAVATaroorF:^ nrttaTIB53
RTYIF7L•.5•¢Y h.
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3
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sue, '4a 7 ; ve,
WISED MAY ,I;n.�tiJl!E f�(IL�SETT 30 7z
TOWN OF S UTH LD PROPERTY t= -kRD
0� E - -.
STREET � �_ � VILLAGE DIST, SUB. LOT...
f
I r�
FORMER OW1E E C N
. 7
U
; W
TYPE OF BUILDING
S
z
tES. SEAS.
I VL. FARM COMM. CB. MICS. Mkt. Value
v� �
4 �
LAND IMP. 1 TOTAL DATE REMARKS
-
_
9/ 711
r
a.
I ; I
g
bun
i
f ;
/G j f
e
a -
AGE BUILDING CONDITION
NEW t NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER m
s _ s
-
Noodland i FRONTAGE ON ROAD i v
I
vAeadowland DEPTH
- 3 - f_ BULKHEAD
-louse Plot � f
DOCK
Total !
As
TOWN OF SOUTHOLD PROPEwry kR
1tE , , , . STREET VILLAGE DIST SUB LOT
w
�r
FORMER OWNER N E _ f ACR.
_ 7So
$ W TYPE OF BUILDING
3 �
}
ZES. a ' SEAS. 1 VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
{
m z
z
z -1 6a �, u- � l ��_ - w �,
f
L �l
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
j Acre
fillabie
FRONTAGE ON WATER d �>
l � -
Noodland I FRONTAGE ON ROAD
vAeadowl.and DEPTH !
-louse Plot 1 BULKHEAD
E �
Toto I DOCK
3
y
COLOR �i' TRIMWWII
-
� '
1
� E
r
t
f
- _
x ,
F
� s
to 7f goad, S--w/o
M. Bldg
3
Extension
t i �
Extension
Extension
T—
i Foundation ='Both I „ I Dinette 1
Porch Basement Floors K.
3
Porch F lExt. Walls ,_ Interior Finish LR. -
Breezeway Fire Place �,. Heat DR.
I � l
Garage I Type Roof Rooms 1 st Floor R.
I
J 'Recreation Room= Rooms 2nd Floor FIN. B
O. B. !Dormer £Driveway
Total-
7 ! J
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. . a-.S =7 1/ Date . ... . . . . . Y. . . . . . . . . . .. 19.73.
THIS CERTIFIES that the building located at .N,/S . . S*tMd. Yiew- fttentifteet
Map No. .?4cyt . . . . . . . Block No. . .3.=, . . . .Lot No. . . . Southold , .N,.Y. ,
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . Oct_ . . . .31 . . ., 19.72. pursuant to which Building Permit No. ()21.2Z. .
dated . . . . . . . . Oct. . .t . . . . . ., 19.72., 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 . . Private one. family.dwalling. & ;acey .patio-dook . . . . . . . . . . . . . . . .
The certificate is issued to .Paul Xieywa &. Stgraay.Abercrombie . . . . . .Owners . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval July. . . .20. . .t9?3. . .by. Re. .Vi114 . ..
UNDERWRITERS CERTIFICATE No. . . . .� - i��. ���. . . �
HOUSE NUMBER. 1`05. . . . . . . .Street. . . . Soundvi-ew•Ave -Zxtention . . . . . . . , . . • . . . . . .
s
i
Building Inspector
, saa:r�
gtFa�X Town of Southold 8/21/2018
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39853 Date: 8/21/2018
THIS CERTIFIES that the building .ALTERATION
Location of Property: 105 Soundview Ave Ext, Southold
SCTM#: 473889 Sec/Block/Lot: 50.-2-3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore Sled in this office dated
5/7/2018 pursuant to which Building Permit No. 42677 dated 5/14/2018
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:
INTERIOR ALTERATIONS TO„AN EXISTING ONE FAMILY DWELLING„AS APPLIED FOR
The certificate is issued to Bicknell,Katharine
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42677 08-20-2018
PLUMBERS CERTIFICATION DATED
....w... .. _,_ _.ors°ed Signature. . .. __.m.....�._........-____....