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HomeMy WebLinkAbout1000-77.-3-2 az TOWN OF SOUTHOLD Rental Permit 2 }i 1185 Owner Joan M Stroh Protection Trust Occupied as Single Family Dwelling Located at 1050 Pine Avenue Southold 77.-3-2 Maximum Permitted Occupancy 6 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. 8/28/2024 V414t;11�& Cod of art€ al This Notice must be posted by the main entrance at all times � w A y24 TOWN OF SOUTHOLD—BUILDING DEPAIt,TMEN'I. � Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 litt s://wvwwrww,,s(°)utlwoldtownn my, to I o V'C 167l0(00 RENTAL PERMIT APPLICATION 6? oer / r,...-i Ez) Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 1050 Pine Avenue, Southold, NY 11971 Tax Map Number: 1000 SECTION ,77 -BLOCK-. 3 -LOT 2 SECTION B. OWNER INFORMATION: Property Owner Name: Joan M Stroh Protection Trust Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 76 Parkwood Road 76 Parkwood Road West Islip, New York 11795 West Islip, New York 11795 Telephone Number (s): Daytime631-553-0077 Eveniri631-553-0077Emergency631-553-0077 Property Owner Email Address: peter@strohengineering.com Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Peter Stroh Address of Authorized Agent(no P.O. Boxes):217 West Islip Road, West Islip, NY 11795 Mailing Address of Authorized Agent: 217 West Islip Road, West Islip, NY 11795 Telephone Number(s): Daytime 631-553-0077Evening531-553-00ff&rgency631-553-0077 Email Address: peter@strohengineering.com 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: 1 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: Whole House Requested Maximum number of persons allowed to occupy Dwelling Unit: 6 Number of rooms in Rental Dwelling Unit: 7 Use and Dimensions of each room in Rental Dwelling Unit: Living/Dining (22' x 12') Kitchen (7' x 8'), Bath 1 (7' x 5'), Laundry (12' x 8'), Bedroom 1 (11' x 11') Bedroom 2 (11' x 14'), Bedroom 3 (11' x 14'), Bath 2 (5' x 6') 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 9 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) I William A. Stroh, Trustee , 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: William A. Stroh, Trustee Property Owner's Signature: Sworn to before me this 5 day of J u As— 20Z Official Notary Public Signat�eand Original Notary Stamp DONNA GIAMPIETRO NOTAM OUSUC, State at New Yb* NO 24.4956265 w SCoftwisskouftk VkVS Augusta . Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. � 631-765-1802 �-3,eP- 7 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 [ q-"RENTAL REMARKS: loc S®n OCG DATE - INSPECTOR Town Hall Annexe µ � Telephone(631)765-1802 54375 Main Road �r try", Fax(631)765-9502 P. O. Box 1179 Southold, NY 11971-0959 frt 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 required for Architect or Engineer, Licensed Home Inspector must provide copy of valid current certification Rental Property SCTM Number: 473889 77.-3-2 Rental Property Address 1050 Pine Avenue, Southold, NY 11971 Owner/Name; Joan M Stroh Protection Trust Rental Dwelling Unit Identifier: Whole House Number&Square footage of each bedroom as depicted in the attached floor plan" (i.e. Bedroom#1 —100 sqft., Bedroom#2—90 sgft., etc.) Bedroom#1 - 125 sgft, Bedroom#2-140 sgft, Bedroom#3- 135 sgft Property Description (Include all improvements indicated on survey) 2 story frame house(open Living/Dining area,galley kitchen, 3 bedrooms, 2 full bathrooms, laundry room and covered porch) 1 1/2 story frame detaftched garage(unfinished) 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 Yta erty Main nand Code of New York State and the Energy Conservation Constru State. Peter J. Stroh, P.E. NYS 072184 Mrs Print Name and Title Sri na ignature Please place Professional Seal: . w f TOWN OF SOUTHOLD PROPERTY RECORD OWNER—r-- ' STREET VILLAGE DISTRICT SUB. LOT FORMER OWNER-! fQ—' /-" IN E ACREAGE ! is W TYPE OF BUILDING Est. Mkt. Value B. misc. RES. SEAS. VL FARM COMM.MM. INE LAND lmp. TOTAL DATE I REMARKS h, 'z L C/ iz UILDI� ,C�AGE B LDING CONQITJON NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Form Acre Value Per Acre Value I FRONTAGE ON ROAD A Tillable 1 ItKHfj"4 1-7 s 7 Tillable 2 Tillable X Woodland Swampland Brushland 9 3 House Plot Total �s a 3 _ r _e f � ©` y = E = _ 77:3-2 01/2015 WAR— M. - - - - SPIP E Bldg- Foundation <f Both Extension � 2 Basement � �� Floors _ Ftensta �� x 22 � � �, Ext, Walls interior Finish�� tic _ Iv Fite Fire Place Sion �j �,r 3 Heat Porch I Root Type t _ - Porch � Rooms 1st Floor Breezeway Patio Rooms 2nd Floor ? Garage Driveway Dormer O. B. �.� 0� e FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of. the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20393 Date DECEMBER 4 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1050 PINE AVENUE SOUTHO'LD YORK House No. Street Hamlet County Tax Map No. 1000 Section 77 Block 3 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-20393 dated DECEMBER 4 1991 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 FAMILY DWELLING WITH ACCESSORY ONE CAR WOOD FRAME GARAGE The certificate is issued to ERNEST CHRISTENSEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED _ N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspector Rev. 1/81 BUILDI"G DEPkRT.,L 'NT TO'.,iIi OF SOUTHOLD, N. Y. HOUSI',G CODE INSPECTION REPORT Location 1050 PINE AVENUE SOUTHOLD YORK knumeer ( street) Municipa ity) Subdivision Mau No. Lot(s) Name of Owner(s) ERNEST CHRISTENSEN Occupancy A-1 SCOTT RUSSELL, CONTRACT VENDEE ltYPe) owner-tenant Admitted by: SCOTT RUSSELL Accompanied by: SAME Key available_ Suffolk Co. Tax No. 7-3-2 Source of request SCOTT A. RUSSELL Date NOV. 22, 1991 DWELLING: „ Type of construction WOOD FRAME `stories ONE Foundation CEMENT BLOCK Cellar FULL Crawl space Total rooms, lst. Fl 3 2nd. F1 3rd. F1 Bathroom(s) 1 FULL BATH Toilet rooms) Porch, type Deck, type Patio, type_ Breezeway Garage Utility room Type Heat OIL Warm Air Hotwater xx Fireplace(s) No. Exits 2 Airconditioninb Domestic hotwater YES Type heater OFF BOILER Other ACCESSORY STRUCTURE'S: Garage, type const. 1 CARD ;Storage, type const. S%-ti,rming pool Guest, type const. Other I3L KIy'j„„ CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE Ln ati on De criDt.on Art. Sec. Remarks: Inspected by. ezee Date of Insp. DEC. 2, 1991 FI.H Time start 10'OO end 10:15 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26722 Date: 10/05/99 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property: 1050 PINE AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 section 77 Block 3 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH lO, 9995 pursuant to which Building Permit No. 22675-Z dated APRIL 14 1995 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 COVERED PORCH ADDITION AND ALTERATIONS TO AN ECISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN N & JOAN M STROH TRUSTEES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H 058289 12/31/97 PLUMBERS CERTIFICATION DATED 10/04/99 JOHN STROH r u din Ins e for Rev. 1/81 t1Ffat,� � Town of Southold 12/15/2015 ' P.O.Box 1179 53095 Main Rd ` Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37966 Date: 12/15/2015 THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: 1050 Pine Ave, Southold _...........................................M_� __-.........___. �..... �. SCTM#: 473889 Sec/Block/Lot: 77.-3-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/15/2014 pursuant to which Building Permit No. 39163 dated 9/9/2014 . Y 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: addition with.stoor. to an exi ting one fhmily..AwgUjza_g 9-plid forfon The certificate is issued to Stroh Irrev Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39163 12/8/2015 - s Plumbingc� ring PLUMBERS CERTIFICATIO DATED11/23/2015 _m......J.Z.ee' ...___..nn _ ..............�_. _. Auto ed Stgr►a e CLOSET CLOSET I REAR ENTRY/ LAUNDRY ROOM WASHER DRYER DINI(1NG02 SF)AREA KITCHEN O go CYO kD BATHROOM lfl O IZ HALLWAY CLOSET OPEN COVERED PORCH ToO >ABOVE CLOSET CLOSET LIVING AREA BEDROOM #1 (133 SF) (125 SF) CLOSET FIRST FLOOR 1050 PINE AVENUE SOUTHHOLD, NY 0 2•_10. BATHROOM BEDROOM #3 (135 SF) 'sm M OPEN UNFINISHED TO SPACE BELOW SM BALCONY BEDROOM f2 (140 SF E90999M SECOND FLOOR 1050 PINE AVENUE SOUTHHOLD, NY