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HomeMy WebLinkAbout1000-78.-2-14 IF t K TU4`WWWN OF SOUTHOLD } Rental Permit 1184 Owner Ben & Jessica Krejcie Occupied as Single Family Dwelling Located at 3715 Main Bayview Rd Southold 78.-2-14 Maximum Permitted Occupancy 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. 8/19/2024 .40 Code rrfjnent Offc' This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD—BUILDING DEPART:C4 " AUG . Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Building De a Telephone 631 765-1802 Fax 631 765-9502 lal � ticltoli° xrn of me°I P ) ) P outhold 2Lf RENTAL PERMIT APPLICATION 3D r - /off/ 5" Rental Permit Fee $300(Application must be renewed every two years) 114 Sys Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION 1 U -BLOCK -LOT -� SECTION B. OWNER INFORMATION: Property Owner Name: d�seSS C A C.\ Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number(s): Daytima� (OW)LIBq—o'70 vening i0 O)qbtA-b74I Emergency Property Owner Email Address: �C e G \e 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: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: . d \`WJ00" 15' A" x •71 r 6rI SECTION G. jb hvo a 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. am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 1 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) 1 �' % "►ei 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: CL.�. ' w '�- ,GS 5 C. q VfG ` ��)0 Property Owner's Signature: Sworn to before me this3eday of _, 29 Official Notary Public Signatu e and Original Notary Stam sot 0B , OA;! t Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [�/RENTAL RIEMAIKS. I� -� Af2 son oc- DATE INSPECTOR " Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SUM # Date �•/g 2 ���... a.. . ...w.. Owner �CrG GI C� Phone �... . ._. _ .. .�..... .. .. ... �...... ...... iAddress .�,....., !u �...! � !L _ _�u.. . .. ... Visible Hamlet Inspector ........ . . .. .... .... .. ... ........... ...... .... ...........�...... . ... �............ � Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) , Carbon Mo noxide Detectors Fire Extinguishers Exits �.. �. . o. _.. .�. .... __v m . .... ........ ....�.. ._.. �.�. .... _ ... �. �mm..� .......�. �... .w_ � � _.._.. .�..... ._.._� ..._..._ �..,��._ . . �.. .... � ..�wu.�..�.... .� 6 Bedrooms 1 2 3 4 5 Smoke Detectors Egress .. .upant Count . ..... '-..w... . .... w...... _ { ��... Building Systems Maintained&Operational 4Condition of Property Heating Building interior Hot water Building exterior ...._. �. .. . .... .. �......__. ��� . ....a_ a....� ,. ..e�w. �._ m....�. a.w...... . ...._�. . ..� �...�.�. . . m rty clean, maintained &safe al �Prope ,.,Electric„ ......., ..._ _�..�.�.....�.�. ..__...�_mm.,e,e,.., ..._ ....�. ...,�..�. _.,,..�....-..w. .._...� ..� .. _ �. e®. ...m...... ... .....�.� Mechanical (Handrails&guards installed &secure .. Pool Safety Pool on Site alarm Date CO issuance ossuanc Surface water r......__ �..._..... .�.._ ._._.�. ... . ...... . ...�...w�.�.... . �._ .m.... _..... . ..w._�a .. Door alarms Pool completely enclosed . .._. . Self closing/latching gates Pool fence to coderequirements O s for all items resent Prior ............. ..... ........... C IIII j Rental Comments p ._F TOWN OF SOUTHOLD PROPERTY RE C11 _ A OWNER „ STREET VILLAGE DIST: SUB. LOT F FORMER OWNER a �� � � ` � N - E 5 � �ri"" _•`� � -� = r �)mod 10 S W TYPE OF BUILDING 1 C� RES. ;'; i SEAS. VL ;FARM �COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS s L 3 ox, 7 ,r r AGE BUILDING CONDITION -7 ion la NEW NORMAL BELOW ABOVE g= -7 FARM I Acre Value Per Value r I Ace >, Tillable 1 b Tillable 2 Tillable 3 Woodland _ �T Swampland I FRONTAGE ON WA R - - - t Brushland FRONTAGE ON ROAD House Plot DEPTH i LIBULKHEAD ` £DOCK Total - i I •may Y F �- mz i s—— s SCTM # E-1 YO N OF SOUTH OLD PROPERTY RECORD CARD OWNER STREET � ' } _wh VILLAGE DIST SUB. LOT a 8 ACR. REMARKS g RK S TYPE OF BLD, PROP. GLA _ € i��. _ ` . `� _�- , S _@ ;�, (`<r ., t c" t '', .ate:.. LAND IMP. TOTAL DATE i i ` I t ,. FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL wY I 11 .< o - � � -- _ jr <:. s zz = I „ £ AYEi r s 4f . — — _.. s a _ r WON 6 A f I € T V I JiT - - LL s f _ b r S 7 € F � ` ` r Foundation r Bath �/ QinettL = f Extension # � �oserrert > Floors .1�1+�/ K' Extension ' � 6� lnf� / LR. _ act. Walls Interior Finish Fensio-� f i Fire Place � Heat ��5 �QR. pe Roof Rooms 1 st Floor BR. - << FIN. B. 2ecreat�on Room Rooms 2nd Floor: Porch [Dormer _B s Driveway f 3 �� Town of Southold , �,� l� d 9/29/2021^ __.�_w...�. ' 53095 Main Rd Southold,New York 11971 --------- PRE EXISTING CERTIFICATE OF OCCUPANCY No: 42378 M mmmmYY Date: 9/29/2021 THIS CERTIFIES that the structure(s)located at: 3715 Main Bayview Rd, Southold SCTM#: 473889 Sec/Block/Lot: 78.-2-14 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 NUNMER Z- 42378 dated 9/29/2021 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: Aggd f a r e sin ale f rail dwelli with 7 a 8 azad "/ 22 c ver orc&1 , The certificate is issued to JRMJ Properties LLC ._...._.. .... ...-.....__.............._ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ..._ ..M. e *PLEASE SEE ATTACHED INSPECTION REPORT. _.__Q ith ri ed Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HO'V'SIN+G CODE INSPECTION RK RT LOCATION: 3715 Main Bayview Rd,Southold SUFF.CO.TAX MAP NO. 78. �,--_------ ....��� .�....m.....SUBDIVISION:....... w.._,,.. ._........_.w..._._,..........,�__�w.___.ww._....._.._.�..__....._. S : JRMJ Properties �....... NAME OF OWNER �.._��... O LLC .... .._... M..__..._ �_......._ ......��.. OCCUPANCY: _._...._ ,_w.,..M....�,_.W..,....__ _...... ,_,�.��..,..._..._�M... .,,,._._ ._....a ..... ADMITTED BY: ...... .�.ww._... _.__.�.�.._...._......... .._..M.....w..�_...�..._._...�.�ww......_.,.,__w�..._..�_.�._. _...._. ......_........µ SOURCE OF REQUEST• Simon,w._ e rt....._......_ _.............. ....�.._,.: .w.,,,,.._..........._.w —v_......__... ....._._DATE w.....m_.M.....__9/ .. .,�...._.w.29/202...1...... .......... _ o : 9/ DWELLING: �_._..�...._w.m_... ......�w,�.__....._ _...v.�._ .__ww,..�...._w.., ....._,... #STORIES: 1 #EXITS: 2 A BTHROOM(S): �.� CELLAR: CRAWL SPACE: _. _wi._......,.�,..... .N„_.._. .._.. TOILET RO UTILITY ROOMOS _.. , PORCH TYPE: 7 BREEZEWAY: DOMESTIC HOTW A w._�T DECK TYPE: .,�.... ..�......w.w_.......__....w.-.-PATIO TYPE: 8& x22 ER: FIN TYPE HEATER: ��� oil AIR CONDITIONING: ��� GARAGE: TYPE HEAT: �oiI µ WARIVI AIR: forced hot air _ HOT W ATER: _......... -—- OTHER: _w ........._ __ww_....... _.m..............._w,ww........w.._.�....._„ #BEDROOMS: 3 wA w #KITCHENS: BASEMENT TYPE: OTHER: CCESSORY STRUCTI.'9'RES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMINGPOOL: .._... ...........�.. �..�.�_._.�.....,_ _ ._.�..............._ GUEST,TYPE OF CONST: OTHER: ............... w...._........- - w_M.......w w ,,,.� VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 9/14/2021 TIME START: END: 4 Town of Sout.._.__.M.M..�.. ._.__..www_�.._.. .... .....wwww_ _._ _._......�.., .. ._...�_ __._....... � ....._. tt "f hold 9/19/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: �- 42361 Date: 9/19/2021 THIS CERTIFIES that the building ADDITION/ALTERATION ,_.. _ _....�.a_. w.._... ... ........... Location of Property: 37I5 Main Bayview Rd., Southold SCTM#: 473889 Sec/Block/Lot: 78.-2-14 µ_ _.�...._ ......w...__ Filed Map No. ........... Subdivision: ....._........�.................. ...-....................Lot No..��.�........._�..�,......_.......... conforms substantially to the Application for Building Permit heretofore this office dated filed 'in mmm6/7/2009 pursuant to which Building Permit No. 45782 dated 2/5/2021 . was issued law. The occupancy and conforms to all of the requirements of the applicable provisions of the ~ ....0 w. pancy for which this certificate is issued is: d�liticn a�� tter,�ti�ans tea ara eist�n singe " zily�vtln�as ppl�,q�C l�ar_ r�1 _ f�f�71�., at;cd.�/ /2007.. The certificate is issued to JRMJ Properties LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ............. ELECTRICAL CERTIFICATE NO. 45782 5/24/2021 ._ ............. _.._.. ..... wa__ PLUMBERS CERTIFICATION DATED 7/19/2021 .e blo nski 1 , lips _. IF - { E in 1 ` s ail to l y Cal t g �£ fylln ,1 ftH@x. a llylull i�G ° U4t� t L Rio 4in . Rio N to Iop I l , 4` i m jlYl�ll.Jld _ 1' , y ROBERT SDNON RESIDENCE 3o�s MAINRAYVIEW SOUTHOLD,NY SCALE 4:-l DATE:9118106 pB XN WINGATE PAGE 460 BOOTH ROAD SOUTHOLD,NY 11971 631.70.2743 3 OF 3