HomeMy WebLinkAbout1000-52.-1-9 TOWN OF SOUTH OLD
Rental Permit
1258
Owner: Raymond Tamayo , Ellen Tamayo
Occupied as: Single Family Dwelling
Located at: 54505 CR 48 Greenport 52.-1-9
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: 02/11/2025 £
Expiration: 02/11/2027 Code Et , r a nedt04ciai
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
„1"
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY l )909
Telephone (631) 765-1802 Fax(631) 765-9502 htt,ps://www,so :t ol town" ,. taws
D 024
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION -BLOCK .-LOT---
SECTION B.
OWNER INFORMATION:
Z 41 CProperty Owner Name:
�r�c °" .CC U &,AjJ)W dVft'le I L C
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
Al
Telephone Number (s): Daytime ' �' Evening— ' Emergency
Property Owner Email Address: C S '
Page 1 of 4
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent (no P.O. Boxes): tx
Mailing Address of Authorized Agent:
4, r p
Telephone Number (s): Daytim Evening Emergen
Email Address: ..........................
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: n��
Address of Authorized Agent (no P.O. Boxes): 2
�� �� �, C �
Mailing Address of Authorized Agent: � 10-D
Telephone Number(s): Daytime Eenmg Emergency
Email Address: a.
SECTION E.
SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any; 4i 4 �
� � - -
Address of Managing Agent (no P.O. Boxes):
Mailing Address of Managing Agent: '° �1lLe- 11T7 0
51-k' �1a
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:
Requested Maximum number of persons allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit:
Use and Di ensions of each room in Rental Dwelling Unit:
.7- � 7
�- I e X 17
�v �o X 4
SECTION G. �I fo !�X /O
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 afire 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.
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 SUFFOL.K)
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, M Agent, or Site Manager.
Property Owner's Name: X anagin 1 �
Property Owner's Signature:
Sworn to before me t' 1 day of 11Vd V1(1�1 bell- , 20 2- 1
Official Notary Public Sonature and Original Notary Stamp r,TH G BANK,
Notary pubitc state oD26
New
040,01 BA64 7
Qu iNfied in*Say°t�8k
My(�;c,en4mission�".dKp" rolls
Page 4 of 4
t1F SpU m
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
IN S T 10 N
[ ] 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 (FI L)
[ ] CODE VIOLATION [ ] PRE C/O [ . RENTAL
DATE ���� S- INSPECTOR
FatTown Hall Annex
� Town of Southold 54375 Main Road
` Rental Inspection Report PO Box 1179
r � Southold, NY 11971-1179
Tel: 631-765-1802
SUM # So?- /_ DateSUM
Owner 6Q UGG! Phone
AddressS' (',C�, Visible
Hamlet &to Ld Inspector
Floor Level Quantities Sub 1 2 3
Smoke Detectors(not located in bedrooms
Carbon Monoxide Detectors
Fire Extinguishers
Exits%
Bedrooms 1 2 3 z 4 1 5 1 6
Smoke Detectors
Egress 10-1
Occupant Count �»
Building Systems Maintained&Operational Condition of Property
Heating Building interior
_
Hot water Building exterior
Electrical Property clean, maintained &safe
Mechanical Handrails&guards installed &secure
Pool Safety Pool on Site
Surface water alarm Date of CO issuance
Door alarms Pool completely enclosed
Self closing J latching gates Pool fence to code requirements
CO's for all items present Prior Rental
Comments:
l l'
/7/18
TOWN OF SOUTHOLD PROPERTY RECOF'�/
OWNER STREET VILLAGE —DI ST. SUB.�- LOT,
mfy�jt
1 1 -L-�FORMER OWNER N E ACR.
S W TYPE OF BUILDING
RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND Imp- TOTAL DATE REMARKS
v 4L
L I YA,
ACHE r;
B CqNDITIQJ� PJ-4—
PING
'A
NEW—
BE (ABQ-\/E
-7
FARM Acre Value Per Value
Acre
Tillable 1
Tillable 2
Tillable 3
Woodland
1 FRONTAGE ON WATER
Swampland
Brushkind FRONTAGE ON ROAD
House PISDEPTH
IBULKHEAD ,
!DOCK
Total
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52.4-9 12/09
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M. Bldg Foundation i Bath e I Dinett ;
Extension �_ I Basement 11 Floors K. Q
_ 1. a I
Extension al
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I
Fire Place eat p
r .I phi
3 {Type Roof i Rooms 1 st Floor ; ` BR.
Rooms 2nd Floors FIN. B I�
Porch Recreation Roorr� I
s
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Porch _ Dormer -
I i
diveway I
Breezeway ,-
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Garage F ,_ ,i g g� = TY
Patio I
1
Total ti
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COLOR
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WRAWL
$� Foundation Bath ;
Exension Basement Floors _ ; .
\ .
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Extension Ext. Walls Interior Finish L.R.
Fire Place \ Heat D.R.
Extension ���V = \� 3 2 0 I
Patio
:X Woodstove BR. _ 17—
Porch Dormer Fin. B.
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Deck Attic -
A a Rooms 1st Floor
Garage f Driveway Rooms 2nd Floor
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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- 26948 Date: 02/25/00
THIS CERTIFIES that the building DWELLING
Location of Property 54505 CR 48 GREENPORT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 052 Block 0001 Lot 009
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- 26948 dated FEBRUARY 25 2000
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 GARAGE UNDER HOUSE
The certificate is issued to RAYMOND T & ELLEN M. TAMAYO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-460868 7/31/98
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Authd#eized Sig attire
Rev. 1/81
Town of Southold Annex 9/13/2011
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35215 Date: 9/13/2011
THIS CERTIFIES that the building HISTORICAL
-- - ------------------- ... ...
Location of Property: 54505 CR 48 GREENPORT,
SCTM#: 473889 Sec/Block/Lot: 52.-1-9
..........
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Pen-nit heretofore filed in this officed dated
4/15/2010 pursuant to which Building Permit No. 35503 dated 4/23/2010
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:
MINOR INTERIOR ALTERATION TO AN EXISTING BEDROOM& LIVING ROOM AS APPLIFT) FOR.
The certificate is issued to Tamayo, Raymond&Tamayo,Ellen
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 35503 9/12/11
PLUMBERS CERTIFICATION DATED
" fOI/"41" ' Town of Southold 5/7/2015
P.O.Box 1179
53095 Main Rd
Southold,New.York 11971
CERTIFICATE OF OCCUPANCY
No: 37543 Date: 5/7/2015
THIS CERTIFIES that the building ALTERATION
Location of Property: 54505 CR 48,Greenport
SCTM#: 473889 Sec/Block/Lot: 52.4-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/10/2014 pursuant to which Building Permit No. 38637 dated 1/23/2014
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:
INTERIOR AIA ERA rIC.NS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Tamayo,Raymond&Tamayo,Ellen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38637 04-01-2015
PLUMBERS CERTIFICATION DATED 02-05-2015 Mattituck Plumbing
At ima i a mtur
a
` Town of Southold 12/30/2015
t P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE F OCCUPANCY
No: 38007 Date: 12/30/2015
THIS CERTIFIES that the building ACCESSORY GARAGE
Location of Property: 54505 CR 48,Greenport
SCTM#: 473889 Sec/Block/Lot: 52.-1-9
Subdivision: Filed Map No. Lot No.
------------------
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/23/2015 pursuant to which Building Permit No. 39717 dated 4/30/2015
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:
non-habitable accessM two car, ara e ilhApfini he t% ace above as a lied for.
The certificate is issued to Tamayo,Raymond&Tamayo,Ellen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39717 10/9/2015
PLUMBERS CERTIFICATION DATED
utlttr Sig__.,......
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