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Home My WebLink About1000-51.-6-3.10 _g - TOWN OF SOUTHOLD Rental Permit 1205 Owner Kahya LLC Occupied as Single Family Dwelling Located at 50 Leon Road Southold 51.-6-3.10 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. 9/30/2024 Code Entircoent Official This Notice must be posted by the main entrance at all times OcV q120121j. r( c-*k I o g Y 46 4 9a TOWN OF SOUT'HOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631)765-9502 http /wNvvK.sor�thold owi!D , c-y RE ION Rental Permit Fee$300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -BLOCK -tOT SECTION S. OWNER INFORMATION. /, // Property Owner Name: 14455['i1 1 CK Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Emergency;. � Telephone Number(s): Daytime 4� ..,n... .,. Property Owner Email Address: ' * Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: All, 4 ` Address of Authorized Agent(no P.O. Boxes): i Mailing Address of Authorized Agent: 2 Telepho� umber(s):Daytime S� E nin 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): ? ni'e Evening-Emergency_ Email Addr " 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(�.):ANyt ..im e..�,.. ,Evening Emergency_ Emai.Addfr 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, C);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 Dweting Unit: .2 Number of rooms in Rental Dwelling Unit, Use and Dimensions of each room in Rental Dwelling Unit: t 3 It IV 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. 0 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold g 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3of4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. ape �1�1 STATE O COUNTY OF L C) l LL— 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 W 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. i 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 Owners Name: L1' Property Owner's Signature: ' 1�---- �i L-1 C Sworn to befor e this day of f 11 Official Not Public gnature and Original Notary Stamp ALE H letar Pub Stare Of: Colora o dotar ID 201 41�07.1 4 MV errwmissi n Expires o2 15 J Page 4 of 4 qf soU TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSOP"ECTION [ ] 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 (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ 4'-R/ENTAL Town Hall Annex " Telephone(631),,765-1,802 54375 Main Road = Fax(631)765-9502 DD P. O. Box 1179 � Southold, NY 11971-0959Lr ,... BUILDING DEPARTMENT TOWN OF SOUTHOLD RU17,DINGf RENTAL PROPERTY CERTIFICATION TOWN, T F OUT G'f� 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 mast provide copy of valid current certification Rental Property SCTM Number: Rental Property Address: Owner/Name: `At�. A L-G C M LIU e Sl!s 0 C,L-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.) 2 - i + �. OCe IA-lP Property Description (Include all improvements indicated on survey) 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 C e of New York State,the Fuel Gas Code of New York State, the Fire Code of New York State,the Prope y IUI tenanc Code of New York State and the Energy Conservation Construction Code of New Yor Sta Print Name and Title � '` 'o O in Signature Please place Professiona, l: ` a N CP 560 X/o va PAS 3,3 1 �__ -�__� �»_ e _� �,- - - �� '�� SCTM # TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST LOT ACR. REMARKS a_ r TYPE OF BLD. PROP CLASS LAND IMP, TOTAL DATE Z�5Do FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL 1 _ TOWN OF SOUTHOLD PROPERTY RECORD OWNER q 'CN STREET VILLAGE DIST.= SUB. LOT prjax ,��,` REQ - FORMER ON N E 1 ACR. TYPE OF BUILDING __ _ RES.,2Zb SEAS. jVL. FARM �COMM. CB. MISC. Mkt. Value _ LAND IMP. TOTAL DATE REMARKS , t I I o% ,' Via, z� E i I AGE BUILDING CONDITION �� _ - J , ' , 4, JG;. x NEW NORMAL 1 BELOW ABOVE - FARM Acre I Value Per Value Acre c, — Tillable 1 Tillable 2 Tillable 3 Woodland Swampland 1 [ FRONTAGE ON WATER � Brushland FRONTAGE ON ROAD House PlotDEPTH BULKHEAD Total ��e�,,,; ��..� =., � DOCK i � � I F i COLORi I f TRIM - - � x t 1 £ s I 3 1 s £ 3 S I Ij§ x z 33 3 [ 'Foundation Bath Dinette M. Bldg ou 7 ZX 3 `� _ � a Extension 1 Basement L Floors -- I Extension !Ext. Walls Interior Finish a .� LR. I =Fire Place Heat DR Extension g sILI ,Type Roof Rooms lst Floor BR. Porch (Recreation Room Rooms 2nd Floor. ' F-IN. B Porch jDormer i F Breezeway ;Driveway F/ I� Garage ✓F 9 _ 1 Patio a _ -e� x £ Total 3 ;b ° 1 � � OPERATING AGREEMENT OF KAHYA LLC This Operating Agreement is entered into by Amy Wessell, as the sole manager and sole member of Kahya LLC, a Colorado limited liability company (the "Company"). ARTICLE I. FORMATION On April 10, 2019, Amy Wessell caused the organization of the Company by filing the Articles of Organization with the Colorado Secretary of State. ARTICLE H. PURPOSES AND POWERS 2.1 Pu pokes. The purpose of the Company is to own the real property located at 8849 Lakeside Drive, Boulder, CO, and 50 Leon Rd, Southold NY, 11971, and to undertake activities related thereto, and to pursue any other lawful purpose for which a limited liability company may be organized under Colorado law. 2.2 Powers. The Company shall have all of the powers of a limited liability company set forth in the Colorado Limited Liability Company Act, as amended(the "Colorado Act"). 2.3 0 The Company shall continue until it is dissolved, liquidated and terminated pursuant to Article IX. ARTICLE M. OFFICES 3.1 Prin i x l Qffce. The principal office of the Company shall initially be at 8480 E. Orchard Road Suite 5000,Greenwood Village,CO 80111,but the Manager,in her discretion,may cause the Company to keep and maintain offices wherever the business of the Company may require. 3.2 Rejistered Aggnt andffi The Company shall continuously maintain in the State of Colorado a registered office and a registered agent whose business office is identical with the registered office. The initial registered office is 8480 E Orchard Road, Suite 5000, Greenwood Village, CO 80111, and the initial registered agent at that address is Scott Gelman, both as specified in the Articles of Organization. The Company may change its registered office, its registered agent, or both, upon filing a statement with the Colorado Secretary of State. 1 FORK( NO. 4 TOWN OF SOUTHOLD BuiLDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 33263 Date: R2 10 O-8 TEAS CjmTjFM that the building DWSLL:£ ,TC3, Y ., Location of Property So LBON��RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) comity Tax Mp No. 473089 Section 051 Block 0006 Lot 003.010 subdivision �.... Filed Map No_ Lot NO. conformst to the Reqmirewomtz for a ONE FAMILY MELLING built prior to ,APRI 9 19 7 pursuant to which CREtTIFICATE OF OCCUPANCY DER Z- 33263 dated EMBED?Off was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is .. igmxed is O _.O CAR G .* .._.L3$„ FAMILY r�r.r.rntG....ANa ACCESSORY TSi..- The certificate is issued to EDITH SAWICKI �_._. ..__..... (OWNER) of the aforesaid building. SUFFOLK COMM DRPART"BW OF 'HEALTH APPROVAL N/A BT3Ut"TRIC L CERTIFICATE' 1D_ N/A PLUMBERS IFICATIQN DATED N/A *PLEASE SHE ATTACKED INSPECTION REPORT. 6 thorized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTTON 'REPORT LOCATION: __ 50 LEQ RD _.,. SO Fw°'H!LD SUBDIVISION: MAP NO_: LOP (S) NAME OF OWNER (S): EDITH SAWICKIµµµ OCCUPANCY: ONE FAMILY ,DWELLING EDITH SAWICKI w...� AIIIITPBD BY- DONNA S YPHER..._.....,,__......_..�..,,,.. .. A AN'TRD BY „ BEY AVAILABLE: SUFF_ CO. TAB MAP NO.: 51 6 SOURCE OF REQUEST: J KEVIN MCLAUGHLIN DATE: 09 1.0, DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME �.._... # STORIES: 1.0 # EXITS: 2 ..__ CEMENT L .. „� _....,. taw CRAWL SPACE: FOUNDATION: CEMEAIT BLOCK CELLAR: FULL........... TOTAL ROOMS: 1ST FLR_: ._...5 2ND FLR.: .....0 3RD FLR.: . O BA (S): 1.0 TOILET ROOM(S): 0.0 UTILITY ROOMS) PORCH TYPE: DECK TYPE: PATIO TYPE: FIRBPIACS: NO GARAGE: NO _ ...........,,, DO119MC HOTTER: YES TYPE HEATER: OIL AIRCON01TI0NING: NO WARM AIR Y HOTWEITER: YES TYPE HEAT HOT...WATER.... ES_..... ..... ....... ......... ....... OTHER: HOT WATER HEATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST_: TWO CAR WOOD FRAME YPE STORAGE, T CONST.: _ww.rc SWrAPIENG POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE TDESCRI PIr[ N G � I Ili V V G � I Ili C � U Y REMARKS: ..... INSPECTED BY:.... _�....„ . �....:�...,.ww...._...., _.�. µ__.. ._....., ....... � .�..... DAT �E ON PEC'rlON 0 09 GEORGE GILLEN TIIM START: WID: fat Town of Southold 3/5/2022 P.O.B"1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42599 Date: .12/1112021 THIS CERTIFIES that the building ADDinoN/ALTsA*noN_.._,_,,._,_,-----,---.--- Location of Property; 50 Loon Rd,Southold M889 ScvMocWjcj.- 51.�3-10 ............. Subdi0siow. Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore ow in this office dated 8/13/2021 pursuant to which Building Permit No. 46942 dated 9/1712021 was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this ceKificate,is issued is: §u LVANAdd k _10.9ALo e WM�pr The certificate is issued to Ajax 201 8-F REO LLC of the aforesaid building, bu FOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTMCATE NO. 46842 PLUMBERS CERTIFICATION DATED III &12/ 1 SiS hrre gnature