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Home My WebLink About1000-61.-1-16 of so OWN F SOUTHOLD Rental Permit 1261 Owner: Jewell on Main LLC Occupied as: Second Floor Apartment Located at: 53795 Route 25 Southold 61.4-16 Maximum Permitted Occupancy: 2 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: 02/24/2025 Expiration: 02/24/2027 ode E fo em ntOfficial This Notice must be posted by the main entrance a tim E TOWN OF SOUTHOLD—BUILDING DEPARTMENT , . Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone( 3'1)765-1 02 Fax (631) 765-9502 �tttM,.I wAyA.soutlioldto,�Aian gov RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 53795 (second floor#53801) Main Road aka State Route 25, Southold NY 11971 Tax Map Number: 1000 SECTION 61 -BLOCK 1 -LOT 16 SECTION B. OWNER INFORMATION: Property Owner Name: Jewell on Main, LLC c/o Nicholas J. Planamento, Member Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 7160 Horton's Lane Southold NY 11971 same Telephone Number(s): Daytime 631-948-0143 Evening same Emergency same Property Owner Email Address: NJP@TCHamptons.com Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: One (1), second floor apartment over commercial storefront 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: second floor(2nd) apartment Requested Maximum number of persons allowed to occupy Dwelling Unit: Four(4) Number of rooms in Rental Dwelling Unit: Four Rooms PLUS Full Bathroom Use and Dimensions of each room in Rental Dwelling Unit: See attached floor plan 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. E)( I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ I 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 Nicholas J. Planamento, Member 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, Managing Agent, or Site Manager. Property Owner's Name: K 61 C, ok e ur Property Owner's Signature: OF Sworn to before me thAT'd'ay of 20_1� f ` Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01BU6185050 Qualified In Suffolk County CommfSslon Expires Apr"14,449 4 of 4 x "ZZ4—' m Town Hall Annex y� �� " Telephone(631)765-1802 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 � BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Second (2nd) Floor Apartment Requested maximum number of persons allowed to occupy each dwelling unit: our Number of Rooms in Rental Dwelling Unit: Four 4 rooms plus f hroom Use and Dimension of each room:. see attached floor plan Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: of$01) bt TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 6 (,- I - (P 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 (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [,-�RENTAL ■11aE RKS �mv Olt DATE i IFISPECTORyt TOWN OF SOUTHOLD PROPERTY RECORD OWNER-t. STREET VILLAGE DIST SUB. LOT ",""C. . ........ ......... .............. FORMER 'OWNER N E ACR.. W TYPE OF BUILDING Mkt, Value RES. SEAS. VL. FARM COMM CB. MISC, C.. .................. ................... .. ........ ...........— LAND IMP, TOTAL DATE REMARKS ............ f . ............. ............ I........... AGE BUILDING CONDITION ............. NEW NORMAL BELOW ABOVE 2- —T .. ...................... -,A-,c',r e Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 Woodland ............... Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH (BULKHEAD ... .........DOCK Toto I ................ P ig, r COLOR TRIM. . ... _ m. ......mm 1, I I 4. I � 61 1 16 3/16/2021 - �_ ..M.. M. Bldg. Foundation ath ,. ....._.��.. Dinette' Basement F oors �..�" . .".._ .... ..M ww � K� .v --- �� Extension Interior Finish LR. Extension V Ext. Walls I r Extension Heat DR. . .,,.._... YPe Roof _.. Rooms Ist Floor BR ..,_.... Porch _ FIN B Recreation Reo �Rooms 2nd Flooal..._. . _ . W.._...._ _..... _M. ..,_ Porch Driveway ,. _.. .... ..,.._, BreezewayY " .vewa. . � r Garage Patio u.� ... .........,....O. B, Total 5URVEY OF PROPERTY 51TUATE: 5OUTHOLD N TOM 50MOLD 15UIFOLK COUNTY, NY w 1SURVEYED 04-21-2022 ^ -RE-GERT 06-28-2022 SUFFOLK COUNTY TAX a S 1000-61 CTAMFMDTO, JewcU on Mein LLC lu i* =Sant 1.1,C COY eeai t6aa '.. R-kcRAmmca,NA.,L4A0AATIMA .00 ro h� m tl ONO s ot Ile' .a mod. NOTES: 1 p PIPE FOUND AREA=4,154 5F or 0.10 Acres JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.IM NO.50M GRAPHIC SCALE l"= 20' RIVERMIAD,N.Y.11901 631-369-M REF.C.,111 R 295 awY•D- s g. a — - -7 = }} 7f8 �F �, 10 i - -z s i i _ _ 0 - CL p1Ll! SECOND FLOOR PLAN �1 - -- - Town of Southold 2/28/2025 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 45994 Date: 2/24/2025 THIS CERTIFIES that the structure(s) located at: 53795 Route 25, Southold SCTM#: 473889 Sec/Block/Lot: 61.-1-16 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- 45994 dated 2/24/2025 was issued and conforms to all the requrrements of the applicable provisions of the law. The occupancy for which this certificate is issued is: C,ommercial ,(retail business firstfLqgr)_ jttjLjgcqnd floc_r.r .drttl, p t , nt_ N _ T+�uaent. rrtltrrl ,rangy kaec rcicl�P�l��tchgrl (a thro—,Qjr .J Na1ri►� rc r11 Se exhib1m�;?� . �� ;_l.and F... rJ9_ r tL1 c.At: ? t.)c L4 P 4 11c Y.. : 3 aMMissugd 1 Ll—! 1 The certificate is issued to Jewell on Main LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. i ignature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 53795 Route 25, Southold .......... .. . .............-"", ..................... SUFF.CO.TAX MAP NO.: 61.-1-16 SUBDIVISION: .. ......................... --------------------.... .. ............ NAME OF OWNER(S): Jewell on Main LLC .......... OCCUPANCY: ........ ADMITTED BY: Nicholas Planamento ---- ............ —---------------- ... . .................. ... .. ... ... ... 2/24/2025 SOURCEOFRE6U—ES JewellonMainLLC DATE: . ... ........ ........... DWELLING: #STORIES: 2 #EXITS: 3 FOUNDATION:....... .... cement block CELLAR: 3/4 CRAWL SPACE: ... ............. ......... ......... BATHROOM(S): I TOILET ROOM(S): 1 nu UTILITY ROOMS): rear mud room PORCH TYPE: DECK TYPE: PATIO TYPE: ........ .............. ........ .............BREEZEWAY: FIREPLACE: GARAGE: .......... ........DOMESTIC HOTWATER: yes TYPE HEATER: natural gas AIR CONDITIONING: .............. -11-11-1111.1- TYPE HEAT: gas WARM AIR: forced hot air HOT WATER: #BEDROOMS:.... ........... ....... #KITCHENS I BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL- GUEST,TYPE OF CONST: OTHER: ----------- VIOLATIONS: .......... ........... ................. REMARKS: .......... ........... . ..... ................. .......... INSPECTED BY: JOHNJ DATE OF INSPECTION: 12/19/2024 TIME START: 2:30pm END: 4:00pm ........... .....--1---