No preview available
HomeMy WebLinkAbout1000-78.-2-12.1 gs TOWN OF SOUTHOLD VIPa Rental Permit g 1171 g� Owner Southold Rlty. Inc. Occupied as Single Family Dwelling Located at 3145 Main Bayview Rd. Southold 78.-2-12.1 Maximum Permitted Occupancy 7 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. 4 7/17/2024 tde rc e r�i This Notice must be posted by the main entrance at all times " TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-950271. : 1 + th�alt.orvnn °a RENTAL PERMIT APPLICATION Dr\ � „ Rental Permit Fee $300 (Application must be renewed every tw6y ars)JUN 2 12024 BUMDING DEFT. TOWN ..F SOM01 Section A. Property Information: Rental Property Address: � I `-(S /L4 /3 c--,) IQ�( , S o 04-4q& CCL /(--7' C 14 Z C Tax Map Number: 1000 SECTION _ -7 g • UO -BLOCK Oa, 00 -LOT 0 I a - 00 i SECTION B. OWNER INFORMATION: Property Owner Name: S t cA 9 e --y Ln G Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) jL/uo p(al. Cc v��-�y 2k Sy,tL C- tyci ScM.e 4�5 tc �� &u)fc,�S c,�f6 SJC7 S l6 -ssl -aK46 Telephone Number(s): Daytime Evening Su'"e Emergency Sc_--q e- Property Owner Email Address:_S00+-JL7& icA r ec, 300 ed � -=w �y C., j0-)-)3L Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: /41(J0 o 1J- G0 ^* y, Qa Address of Authorized Agent (no P.O. Boxes): W e-S 4 1 u-y Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening S c— Emergency S C-,L-x� Email Address: SOu ct �` e `` t 4-/@ Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: N I� 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: Number of rooms in Rental Dwelling Unit: 6 Use and Dimensions of each room in Rental Dwelling Unit: IV 1 r5 np `1`/`'f S - ,/�et�./'l7G.vvi a 7� 5 r-f ►J +CA G� ( -7 G �'f C� B d- -5 l t : 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 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) I M IGhctf-( AA W " '-1 ., 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(Cl k4.e-( Property Owner's Signature: i Sworn to before me this /0/4 day of ✓-U�e , 20�� Q Notary Pub9 c • 61Ato oY Now York No, 01 TS6'349943 Official Notary Public Signature and Original Notary Stamp aQualified c in Queens o i car oty Page 4 of 4 14V So' l� TOWN OF : OUTHOL BUILDING DEPT. 631-765-1802 It , — N PECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] F AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O ( RENTAL F REMARKS: Ael DATE INSPECoTOR DocuSign Envelope ID:8C3427D2-2C5C-4B78-B14B-9001F4A7CAAE 11_ s Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P. D. Box 1179 Southold, NY 11971-0959 - IN BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seal re ui ed for Architect or Engineer, Licensed Hoene Inspector Lnust rovide copy of valid current certification Rental Property SCTM Number: 1000 Section 078.00 -Block 02.00 -Lot 012-001 Rental Property Address: 3145 Main Bayview Rd, Southold NY 11971 Owner/Name: Southold Realty Inc. Unit 1 Rental Dwelling Unit Identifier: Number& Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 —100 sqft., Bedroom#2—90 sgft, etc.) Living R Bedroom 2: 73.5 s ft Kitchen: 176.25 9ft Bedroom 3: 118 s ft Bedroom 1: 97.5 saft Bedroom4: 175.5 s ft Property Description (Include all improvements indicated on survey) Two-Story One Family Dwellin with rear/side deck 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, the Fire Code of New York State, the Property Maintenance Code of New York State and the Energy Conservation Construction Code of New York State. DocuSignedby: 7oseph villani , Home Inspector es 86136229WO_ Print Name and Title Original Signature Please place Professional Seal: Sle m- c" . e .. \Adsa � AFFER; fit s e e N�- �-LANIOSE E pun q �,. '' AW First Ston�,,� Floor Plan N 18'-51' 11'-9" I CV 4 Kitchen Living Room N 5'-7" O BathroomCD co ®' L .... [Mechanical 'ea � Room N Lewd Door: CO/Smoke Detector: O Smoke Detector: T Second Sty Floor Plea N � —"` 18'-2" 11.� .o....o.o.o........o.....a................. ... .... ... .................... ........ ....�.w�_�..o..... n o Master Bath .. Bedroom 4 + , Q0 0 Hall T b- Bath Hallway OWasher/ Dryer - 81 T 1• uu W Bedroom 3 Cn � ( p Bedroom Bedroom 1 T T 8'- " Q 7'-2" 9'-11 II Legend: Door: CO/Smoke Detector: 0 Smoke Detector: SCTM # s TOWN OF SOUTHOLD PROPERTY RECORD OWNER STREET VILLAGE DIST, SUB_ LOT ACR. REMARKS $- TYPE OF BLD. PROP. CLASS } it LAND IMP. TOTAL DATE i i FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL F SOU THOLD PROPERTY RECORD CARD OWNER , STREET VILLAGE DIST, SUB. , LOT . - a rz a o F N FORMER OWNER - N E y lam: i LIT , R ,. _ AOR. $ W TYPE OF BUILDING RES. SEAS. °VL. FARM !COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS r � - r -715 r c `7 I 1t �N I?T [f F= f � w � NEW 1 ' - F� FARM . Acre Value Per Value Acre Tillable 1 i , �. Tillable 2 I - Tillable 3irk Woodland --_ '_ Swampland FRONTAGE ON WATER FRONTAGE ON ROAD Brushland - f House Plot DEPTH ' CNAVII 1 r r a Total -e re Ad & MAY 12 2022 iLOR T-4-� y t - 'Idyl 2T 41- [ i x � O,ION - P 78:2-12.1 1/26/2022 t [€ - -------- -- s� 3 f Foundation C-- Both Dinette melon — Basement :�i_! . a�.� Floors G f,�� K. i En rt Extension , Ext. Walls T ��' ;. Interior Finish r~ LR. I A6 I Extension Fire Place Heat »` DR. 1 Type Roof - Vic.—�-�i Rooms 1st Floor BR. Porch SXIv � Recreation Room Rooms 2nd Floor! FIN. B. P / �j K. 1 - •� I t r L4I '. .c 2l0= 31�� , Z _ Dormer d s (�►4. Br lO� Driveway Garage InAL of o Total __ � " FORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold,N.Y. Certgicat@ Of Occupancy No. ..... . .... . . . Date . . AA1!yp xy .. .. . �. . . a.. ... .. . THIS CERTIFIES that the building .. . .4ne..f am i l y. dwe l l ip g. .. . . ....... . .. Location of Property 3145 HAIN. BAYVIEW ROAD *S01T"I11�1"t D w� w • ,. .. ... ... . � County Tax Map No. 1000 Section ..9 7 8. ......Block . ..Q?. . . .. . .. ..Lot .. ..D.1? .. . . . .. . Su"Vision m/o. WE S T C REEK- EST.. . . .. ...Filed Map No. 3 84 S... .Lot No. 3 . ...... . .. conforms substantially to the Application for Building Permit heretofore filed in this office dated .J u 2 y, .P.'. .1?8; ... . . - ..pursuant to which Building Permit No. 14 5 3 2 Z ....... . . . . dated February 7,. . .19 .6. . . 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..fami l.y.dwell ink, , including,deck: . .._. . , . ... .. ... .. . .. . .. . ... .. The certificate is issued to . . .$ENNSTfi, SCHiILl;4 of the aforesaid building. Suffolk County Department of Health Approval ... ..$,�.:$0—.1. 7. ...... . ... .... .... . . . ..... UNDERWRITERS CERTIFICATE NO. .... .... ....W.7.$Q 3 53. .i )/zQ I$G.. ....... . . ... ... . PLUMBERS CERTIFICATION DATED: Sept. 26, 1986 r ....... . .. .. . . ..«.. ..... . . . . .... . �^ � �II1SpeCtOF a Rw.1/S1 Town of Southold 3/20/2022 P.O.Box 1179 53095 Main Rd ^' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42934 Date: 3/20/2022 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 3145 Main Bayview Rd.,Southold SCTM#: 473889 _. Sec/Block/Lot: 78.2-12.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/29/2018 pursuant to which Building Permit No. 46612 dated 7/23/2021 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: � � `r L and ccav wra arouni"M and aggond floor d d din ��: s � .. . r ... .. The certificate is issued to Minasi,Michael&Lori of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICAT NO. 46612 1/4/2022 PLUMBERS CERTIFICATION DATED 3/15/2022 ltelw i"" r d.,. ignat a