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HomeMy WebLinkAbout1000-111.-3-2 4 a TOWN OF SOUTHOLD Rental Permit #- 1198 Owner Martinez-Fonts Jr. Rev. Trt. Occupied as Single Family Dwelling Located at 115 W. Cove Road Cutchogue 111.-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. 9/16/2024 Code E- orcr Official 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) 765-9502 Iiijps.f/yNww ;a tl oi ll� APPLICATION RENTAL PERMIT R Rental Permit Fee $300(Application must be renewed ever t o Ye TOVN1)jr Section A. 9-�' �9H Property Information: �e_c_W 1u-6sb� Rental Property Address: C� I Tax Map Number: 1000 SECTION 7 ,7(fF2 , .-BLOCK 84 -LOT -- - y SECTION B. OWNER INFORMATION: gLr-Z)AlfO Property Owner Name: &4�( '`E� Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Z{lfe Sg7L(� —/�97 Telephone Number (s): Daytime Evening Emergency, Property Owner Email Address: AZ. 1JAI'/'7(7A1,6-z,0---6Al%T <"HA f1- " 6e M Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: A11A 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: /(0 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: A IIA 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: lr r7"" G 4 AVW D eAJ Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: d ? Use and Dimensions of each room in Rental Dwelling Unit: !I f2C l0r dL3 - !O 1 &J-AJ - 1 7 �<� ��(6 1,f 2) 4 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 0 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 -4fib �'i gify 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 247 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: A)Ja /t4~AJ6,7�—��Aff T,,9-7L Property Owners Signature: Sworn to before me this 3 day of t 20 24 icial Notary Public Signature and Original Notary Stamp JULIANdNE CAROt.NNE FEDELE Notary NSubk.State of New York 140o OI EOD1 050N Quad in Suffolk County y Commission Expires Nov I I,2027 Page 4 of 4 SO TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 ///- 3 -INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL 4—f--K�-so t�, � DATE INSPECTOR Town Hall Annex Town of Southold 54375 Main Road a Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SCTM # f � �.. ~_.m.... . . .. . .�.. .. Dateo-.. Owner Phone ...�., _�........�_. . ~. . ...Address Visible ....._w m .._...... .....m. .._. �_wW,.�,._. .. . �,, ....µ .� a�...._._ . M .......,.� ..� ...µ.. ...��__ Ins Hamlet 'Inspector ; p ....,_w .ry ... w......_.,..... .......... _.., ....... ... . ...M.. ..._.. ..,... ...,..nsp .............& Floor Level Quantities Sub 1 .w... . . .3... Smoke.. Detectors� (.no o wl d !. bedrooms)n bedr Carbon Monoxide _. Fire Extinguishers Exits w_ Bedrooms 1 / 2 /' 1 3 4 5 6 Smoke Detectors Egress Occupant Count Building Systems Maintained &Operational Condition o Property of Property Heating :Building interior !Hot water Building exterior .. . ......~m ....... ........_. . ..__. .. ........... .._ _ ..~, ._. _ �...... ._.o-.. _ . .._ .._ . ... ._. ....... , Electrical Property clean, maintained &safe Mechanical Handrails&guards installed &secure Pool Safety Pool on Site !Surface water alarm k Date of CO issuance enclosed SDelf closing al arms , ....... �_...�... W. w .....�. ....m _. �!.. ._�..... . ._..,Pool completelyo code .. � . ,,.. ....... ..�.. , � .. �. .~.w... , . . / latching gates Pool fence t requirements ' for present �CO s fo �....��._.._ ...��all items pre �.. . � ...,�..t RentaI... _.._. w�._..... .�...,. w_.� .,_ .. ._._.~ .. .�....~ .__....w� ..�. Comments: ~ � �4 At, 21 G" � Igo © /� A) f U Ci,f TOWN OF SOUTHOLD PROPERTY RECORD jo - OWNER STREET - V LACE DISTRICT SUB. ' { LOT FORMER OWNER N �E ACREAGE �� Z- Via)" �► _ `is W TYPE OF BUILDING i RES. aG SEAS. VL. FARM COMM. I IND. CB. MISC. Est. Mkt. Value LAND IMP, TOTAL DATE i REMARKS -� ffr(/ �jJ ^ '4 �� �� �J��� al S;(a� /{ /y I 10 �. G ea r t. ,3 t,9 �_ " - f `cJ ,. � i 7�� '� o-[r-u l� / !�Py'?7 1t Y4` �G �)cx �i)9 r •);�� - • 9, �j, AGE BUILDING CONDITION C,c NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre ; Value Per Acre Value FRONTAGE ON ROAD - _ Tillable 1 Tillable 2 Tillable 3 I �� Woodland Swampland I I Brushla& House Plot Zi o Total _ i l t � _ - t , a k _ 111.-3-2 4l11 s M. Bldg. Foundation Both Extension ,Q - 3 6 rJ Basement _ Floorst x Extensio3 y C Ext. Walls Interior Finish Extension Fire Place Heat _. Porch Roof Type Porch Rooms 1 st Floor Breezeway Patio Rooms 2nd Floor Garage 3 ° Driveway Dormer Q. B. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY Ne�.GGNF-GR I'HNI&44+E ik,HSE& No. Z11641 4/28/83 THIS IS TO CERTIFY that the Land /_/ Building(s) /X / Use(a) located at 115 West Cove Road Cutchogue Street Hamlet shown on County tax map as District 1000, Section 11 1 , Block 03 Lot 002 , does(neticonform to the present Building Zone Code of the Town of Southold for the following reasons: a one-family dwelling use is permitted in this 'A' Zoned District. The addition of 1962 has a Certificate of Occupancy.* On the basis of information presented to the Building Inspector's Office, it has been determined that the above aeqconforming %/Land /_/Building(s) /g/Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: a one-family dwelling. The Certificate is issued to ELAINE BERNHARD (owner, }e ssee-er tenant) of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NU. " NIA NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. *B.F. 1884Z--C.O. Z1610 ,N-,.13ui1 ing Inspector FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ,,..Z...�' 'Q.,....... Date ,......................Jun® 17 ................. ..,. THIS CERTIFIES that the building located at ,�E�da?11�1N,I��lin;�T�..���.� 5�.1����E?���...... Street MapNo. ........**. ....... Block No. .....**...... .. Lot No. ..: *................................. , ......»....,.........,...., conforms substantially to the Application for Building Permit heretofore filed in this office dated ................. .SeP a�ex..17.•.•.. .. 19-6.2. pursuant to which Building Permit No. .....,�.J§1$4 dated .................. ,ej3rLer(kby',..j7,,,,... 19,,,62, 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 ........ PRIVATE OM FAMIToY MINTG The certificate is issued to ....IMed.M.'r... ............................................................... (owner, lessee or tenant) of the aforesaid building. j .» . ...»..... ,..... ,may. .�w*. Building Inspector FORM No.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . . .Z-µI7035 June 27 1988 . . . . Date . . . . , . , . . . . . '. . . . . . . . . . . . . . . . . . . THIS CERTIFIES that the building .. , , AD I T I O N . y » , Location of Property .1.1.5 West Cove Road O u t c h o g u e , N.Y. House o. . . Street, . . . . . . . . . . . . . . . . . . . Hamlet County Tax Map No. 1000 Section . . .! 1?. . , . . .Block . . . .03. . . . . . . . .Lot . . .0? Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. , . . . . . . conforms substantially to the Application for Building Perniit heretofore filed in this office dated June 17 , 1 9 8 7 pursuant to which Building Pennit No. , 6 l 4 4 Z dated Jru n e 2 9 ,y 1 9 8 7 . 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 . . . . , . . , . DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to . . . . . . . , . ALFONSE MAR TINEZ-FONTS , JR. (owner,%„ a�� � � . . . . . . . . . . µ . . , . . . , . , , of the aforesaid building. Suffolk County Department of Health Approval . . . . . , . . �Aµ , . , . , , , „ , , „ . , , , , UNDERWRITERS CERTIFICATE NO. , . ® . . , . . . , , . PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81