No preview available
HomeMy WebLinkAbout1000-7.-2-9 � TOWN OF SOUTHOLD Rental Permit 1248 Owner: Sarah Rose Occupied as: Single Family Dwelling Located at: 2133 Clay Point Rd Fishers Island 7.-2-9 Maximum Permitted Occupancy: 8 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. Issued: 01/09/2025 Expiration: 01/09/2027 c eE fo a entofficial This Notice must be posted by the main entrance at times S Town Hail Annex Telephone(631)765-1802 54375 Main Road Pax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 :-It,akv �' pu � . � r P �1 C E D BUILDING DEPARTMENT .II TOWN OF SOUTHOLD BLIILDINGOEPT. RENTAL PERMIT APPLICATION -rnrnrKr ~+ wT�nrn Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: -1133 CjA q P0tA4- Woad , Fich&TIsICInd, NY 6&39d Tax Map Number: 1000 SECTION 7 -BL CK Z -LOT 7 SECTION B. OWNER INFORMATION: A-n,l W >Ilmr-h _y O Rose', 7 �S Property Owner Name: + T VVa voC.et br- I- 5l- Property Owner Legal Address: Property Owner Mailing Address: 2►33 C ysa—j41- �o'n� R oa d--� Po Box *7& / psi us !.r a� i Obi� D 'Daytime Eve 8) - �'l 8�7-&1�q Telephone Number (s): Daytime Evening & N E g Y Property Owner Email Address: ago 'SarahwrDsermai 1@ �ma� l� ezm rd Page 1 of 5 n n� µ ' Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 d , Southold,NY 11971-0959 M 44)N � , BUILDING DEPARTMENT TOWN OF SOUMOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: Ills? t� Address of Authorized Agent(no P.O. Boxes):, _ _ Ave n Mailing Address of Authorized)Agent: �µ IS144d, AN ©le 3 q D Telephone Number(s):Daytime lb g Evenin Emergency Email Address: . I M t /SIB 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): . Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.D.Box 1179 Southold,NY 1 1971-0959w 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: 0A e- 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: 011 J� Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: /0 I,2-- Use and Dimensions of each room in Rental Dwelling Unit: ki4thCn 12 x13 dro6m 1 X / 12 X8' r 0 P"I /nx 1 r 1111� 1) # /4X ,� � 2- /2X8 /r• .l11 / &j vp L_ *,3 /3X/2, J /2X/D Page 3 of 5 Town Hall Annex "„ Telephone(631)76S-1802 54375 Main Road ��` Fax(631)765-9502 � P.O.Box 1 179 � Southold,NY 1 1 97 1-0959 �� BUILDING DEPARTMENT TOWN OF S01UTHOLD 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. ffir 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 F UFFOLK �n - 1�� � Jltnch W� osc.,Trusf�� I l�r'""~I - ''9CV-Fiusi- 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 Page 4 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 orb R° Southold,NY 11971-0959 �ue � k BUILDING DEPARTMENT TOWN OF St1►`i THOLD 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 as to any change to the information regarding Authorized Agent, Managing A ent,or Sit �ann ger0. , �� .f <<S! Ano W. A-4 n OB I Property Owner's Name: � � /S'A e yoca W'e Property Owner's Signature: S-A4 A k 14. kv A-C-- Swor to before me this ZS5 day of vt PQr.� 20Z, 401a'l Notary Public Signature'and �NotaryStam­p Victoria GDExpiresrs Notary P COMMONWEALTH OF M My CommissioMay 11,2 Page S of 5 TOWN O �SUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] INAL [ ] FIREPLACE.. & CHIMNEY FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL OK e- DATE INSPECTOR __ TOWN OF SOUTHOLD BUILDING DEPT. co 631-765-1802 �.arx • INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND Z] FIRE LATION/CAULKING [ ] FRAMING /STRAPPING L [ ] FIREPLACE & CHIMNEY SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN *RATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: I wW to PAvi*44 - Y) )!t& ll�klwoi/ ovel" ATE ?i INSPECTOR I -_ KITREN BATH 'FAMILY j - *no �GUEST - _ _... ENTRY LYING WI.0 _ a LAX3. ay °$ exit e { G F ENTRY LEVEL PLAN a JI MOB 7 BEDROOM #3 HALLWAY STORAGE �� A ORPl-cw-u.d ac wws.,nc .7HUR R SUMDE TE WASH flSHEft5 ISLAND.NY ' - OPEN -, •_ k NYRY di UPPER LEVEL PLANS t E v. 1 - t+ I s } FN 2034 UPPER LEVEL PLAN lei # 2811 3 r - _ =r COLOR i i TRIM 1 t3 7-2-4 3103 1st 2nd M. Bldg t Foundation -- Fin, B_ 1Bath 3 Dinette Basement Floors _ Kit extension Ext Walls ; Interior Finish LR Extension Fire Place C Heat - . — LBa Patio Woodstove Porch t 3 = y Dormer Deck _ g �� _ Dock Fam. Rm, A.C. Garage - - O.B_ _ ©j 2 i - 1 a .. d °; Pool - - 1 ! FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29555 Date: 07/02/03 THIS CERTIFIES that the building NEW DWELLING Location of Property: PVT RD OFF E END RD FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 7 Block 2 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 10 2001 pursuant to which Building Permit No. 27431-Z dated DUNE 25, 2001 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 SINGLE FAMILY DWELLING WITH COVERED ENTRY AS APPLIED FOR & AS PER ZBA #4218 & 4220 The certificate is issued to ARTHUR J & BERNADETTE WALSH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-00-0172M5 28 03 ELECTRICAL CERTIFICATE NO. PENDING 26, 5j 03 PLUMBERS CERTIFICATION DATED 06/19/03 THOMAS RAVING on d Si ture Rev. 1/81 V Ell //r/%�ir%%% // �"' II III I IIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIII I I Iv a uu'""'"'"I ""'"°`'' I�' °' y"y °� �"'"' r " / fi l�ll �I. , t r r err r rrrrrrr �E hd"II I(ui i ti fPf ni�`' f 1 �4 ,pry t t r ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. 2