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Home My WebLink About1000-117.-10-11 TOWN OF SOUTHOLD Rental Permit 0291 Owner 1470 Jackson St LLC (VOID HOUSE DEMOLISHED) Occupied as Single Family Dwelling Located at 1470 Jackson Street New Suffolk 117.40-11 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. 2/11/2020 John Jarski Code Enforcement Official This Notice must be posted by the main entrance at all times Town Hall Annex v Telephone(631)765-1802 54375 Main Road q Fax(631)765-9502 d P.O.Box 1179 Southold,NY 11971-0959 �� " y BUILDING DEPARTMENT TOWN OF SOUTHOLD JAN 1 4 2020 RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION �04 -BLOCK 1)0 -LOT �- rr� SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: -AN '11061*17 L Telephone Number(s): Daytime Evening Emerg In Z_ Property Owner Email Address: a t4e,le v eqlhzilayA Page 1 of 5 9 ,_.,w Town Hall Annexk Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 u� Southold,NY 1 197 1-0959 w ,a BUILDING DEPARTMENT TOWN OF SOUTHOLD 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: orl\c Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: 4` Telephone Number(s): DaytimeS 4 Evening Emergency Email Address: s � � u ' CJ. SECTION E. SITE MANAG ER 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): Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 bc P.O.Box 1179s " Southold,NY 1 1971-0959 UN BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 law 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 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I �3 6) CC Wll '� '' ��ertify 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 Page 4 of 5 V, Town Hall Annex °A, Telephone(631)765-1802 54375 Main Road 'f Fax(631)765-9502 P.O.Box 1 179 Southold,NY 1 1971-0959 �r BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: 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: -DW i 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:Oa, ; + r� / � A Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO "HOLD 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 (S) business days as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: �CC Property Owner's Signature: Sw to before me this ay ofZ)ec 20 I V Of vial Nota fc Signature and Original Notary Stamp BETSY A. PERKINS Notary Public, State of New York No. 01 PE6130636 Qualified in Suffolk Coun Commission Expires July 18, Page 5 of 5 i i " TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 rr INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] I N A L ?A o" 'o4� [ ] FIREPLACE CHIMNEY { FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O I MARKS: t DATA: INSPECTOR IN ri Deck 30' 0"x 5'6" Master Den Bedroom I 14' 0"x 10' 6" — aaAU, r Deck FP 38'0"x 8' 0" C�, DN Living/ REF Dining Room 16' 8"x 13'0" Kitchen 11'6"x10' 0" Deck 38' 0"x10' 0" DN ON N_ 1470 Jackson Street— New Suffolk, NY 11956 , First Floor All dimensions are approximate.This plan is for marketing purposes only. i - - - - - - - - - - - - - - `7 ' x J# Family Room Bedroom� ./ 21'0"x 16' 0" ,�� N' Covered Patio Gas UP use F] Bedroom Bedroom L Bedroom3 9' 10"x9' 9" 9' 10" x9' 3" 9' 10"x9' 3" N 1470 Jackson Street— New Suffolk, NY 11956 Grourid Floor All dimensions are approximate.This plan is for marketing purposes only, TOWN OF SOUTHOLD PROPERTY REC(arixo OWNER ISTREEf VILLAGE DIST.# SUB. LOT FORMER OWNER, i N F ACR. . bA - rat . .vlo `v, 5 -.. S = W TYPE OF BUILDING n , $ _ _ = I . ._ � =,ate _ :�. . — _ R E S VL, SEAS. FARM COMM. CB, MICS. Mkt. Value t e. LAND IMP. TOTAL DATE REMARKS - - � � , - } 3 s - J I AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE ffi FARM Acre Value Per Value Acre Tillable I FRONTAGE ON WATER f� Woodland FRONTAGE ON ROAD Meadowland DEPTH: - t 4, House Plot I = BULKHEAD Total DOCK ; y )LaR TRIM �. r - ® 4 , a t 2k PAt MMI �L WE 117.-10-11 2110 M. Bldg. 3 l 42A _ ice.. Extension =} ° ° `��... E ; Extension � ° Extension l F , 'Foundation !Both Q incite . F Porch 'Basement - Eloors I I ' Parch _ ✓' '` i i _ - r _ xt Walls fn`�r'ar Finish =LR. i I Breezeway l [Fire Place �f leaf � ( CR. Geroge Type Roof Rooms 1st Floor BR. PC io �Recreation Room .Rooms 2nd Floor FIN. B 0, B. Dormer .Driveway _. u Tcto l 1 t FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Date .................»......Appteb ber»...??.3, 1 68 THIS CERTIFIES that the building located at ....SIS.....Jackison..►fit.......................... .». Map No. .....XX............ Block No. ...XX............. Lot No. ......3t9 .......WOTr1..Bk1XTO ....XsY.......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........Doe,, .......�.1......... 19.6.7.. pursuant to which Building Permit No. .....324% dated ....,.....»....«.<...No.......2.0.............. 19-67., 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 one familxdWell-Ong............ ..............................: .. The certificate is issued-to JQb=.:.4 .Clad,re-Mam. Ug.......... .�11d�X'�.,....,,.... .... ..................... (owner,'lessee or .tenant) of the aforesaid building. RX.Approval Sept 16 1968 by Rs Villa Building Inspector It Town of Southold 11/20/2019 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 40877 Date: 11/20/2019 THIS CERTIFIES that the structure(s)located at: 1470 Jackson St.,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-10-11 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 NUMBER Z- 40877 dated 11/20/2019 was issued and conforms to all the requiiements of the applicable provisions of the law. The occupancy for which this certificate is issued is: pece.soa wood frame barat. The certificate is issued to Manning Crdt Shelter Trt (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. .........ture nutb ?' .. _ ....,_.... LOCATION; (number&street) (Municipality) SUBDIVISION: MAP-NO.: LOT(S): NAME OF O'WNER(S)': O-CCUPANCY: (type) ADMITTED BY: ACCOMPANIED BY: _ KEY AVAILABLE: SURRF CO.TAR MAP' O. 000. SOURCE OF U'EST: -DATE: "/ TYPE OF CONSTRUCTION:_w i 9 STORKS: 4 EXITS: FOUNDATION: 60,��,,,IUVXENt 'CRAWL SPACE: #OF BEDROOMS: IST FLR: "AND FLR: 3RD FLR: . BATHROOM(Sji_ TOILET ROOM(S): UTILITY ROOM: . PORCH.TYPE: DE-CK,TYPE:.. . PATIO;TYPE: BREEZEWAY:' FIREPLACE: QARAGE: DOMESTIC HOTWATPR: //0_ TYPP HEATER: A•IRCON•DITIONING:, TYPE HEAT: AV _ _ WARMAIR.: HOTWATER: 9 OF KITCHEN act" _._ FINISHED BASEMENT:, YES NO OTHER: CC"SSORY STRUCTURE GARAGE;TYPE OF CONST.: STORAGE,TYPE CONST.: SWIMMING POOL: GUEST,'TYPE CONST: OTHER: VIOLATIONS: CHAPTER.144&'N.Y,STAT&UNIFORM VIR.E PREVPNTION&BUI,LDING CODE LOCATION DESCRIPTION ARTa C. REMARKS; INSPECTED BY:TAVI � '± DATE OF INSPECTION: TIME START;,Vqo AN __ END: