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Home My WebLink About1000-62.-1-24.7 (Yonges #3) of so TOWNOF SOUTHOLD Rental Permit lot R �. � 1305 Owner: Colonial Vill Tenants Crp (Brett & Carol Kehl) Occupied as: Apartment ( Yonges #3) Located at: 55075 Route 25 Southold 62.-1-24.7 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: 05/05/2025 - - Expiration: 05/05/2027 c e En(o�lcernent 06cid This Notice must be posted by the main entrance at all times TOWN OF SOUTH OLD—BUILDING DEPARTMENT V"e Z, Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone 631 765-1802 Fax 631 765-9502 l tt js://N ( ,Ms uthol�.to ° t 1Y " E U E " RENTAL PERMIT APPLICATION ullUnn De"° qnt Towa of SoutiWd Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: eO`dA1113`- .550, S, > SOH L4) Tax Map Number: 1000 SECTION 6 -BLOCK -LOT a4 . SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 6-�l-L(,334D,�4 1,31- 433-`toS� Telephone Number (s): Daytime- i.4 ) Evening Emergency Property Owner Email Address: �� Page 1 of 4 fir, 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: Yo^� � Urlj % W-3 Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: ( fir' Use and Dimensions of each room in Rental Dwelling Unit: 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. ;5- 1 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 3of4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) Q, , 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: ZMIT Property Owner's Signature: / . f�a Sworn to before me thi day of 20 a5 f-11--P &--121 C Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01BU6185050 Qualified In Suffolk County �„ Commission Expires April 14,2_ Page 4 of 4 "» Telephone(631)765-1802 Town Hall Annexrr �� 54375 Main Road P.O. Box 1179l Southold, NY 11971-0959 � Y BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: uj wt Requested maximum number of persons allowed to occupy each dwelling unit:� Number of Rooms in Rental Dwelling Unit: I -glz " Use and Dimension of each room: 599 PLA- 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: TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1602 IL4-7 INSPOEOCTION [ ] 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 (FIN ) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: DATE INSPECTOR SUPERVISOR'S OFFICE TOWN CLERK'S OFFICE Ib South Street BUILDING DEPARTMENT Main Street Greenport, N. Y. Southold, N. Y. Tel. Greenport 7-055o Tel.Southold 5.3783 TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. CERTIFICATE OF OCCUPANCY BUILDING If 2 No. Date CkIt 11 19-0— (AM'a Way) THIS CERTIFIES that the building located at ffT R.Q.w NIS NA111 AMC Street, Map No. 3= , Block No. an , Lot No.= 8 t 141 Y* in the Town of Southold, conforms substantially to the approved plans and specifications heretofore filed in this office with Application for Building Permit dated 19-0 pursuant to which Building Permit No. Malle 163, dated #1111 MA 19-62, was issued, and conforms to all of the require. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is as This certificate is issued to ftederlak Pa Rich && Colonial Village (owner, lessee or tenant) of the aforesaid building. H.D*Approval Sept. 281 1965 by Re Villa Building Inspector (The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the Completion of the construction in compliance with the Multiple Residence Law and with other laws, ordinances,or regulations affecting the promises, and in conformity with the approved plans and specifications.I f OAS Ole s Y. VVI TA _ f r soya°v pp� . �� i c 'E'er' \ 6 t� F _6 �xx� '` \ Al ue- S� KEHL DESIGN ASSOCIATES lac A41 AN281 a oomm a iaea9n.non:�mn9 2668 m PO.kx1675 phone:(631(4ii-4086 o Na BATHROOM Souhad Now M 11971 Rklk ka5* 0r*eJ0 I � €CL. 7 0 Kee LLC € LLC 3i WNERSHIP & U CUMEN BEDROOM These drawings and specifications including the Si ideas, design and arrangements represented Washer - therein, are the property of KEHL DESIGN - R Dryer i CL 1 ASSOCIATES, LLC. No part thereof shalt be m ry I ! copied, disclosed to others or used in connection o _-_ with any work or project other than far which CL. `� 3068 they hove been prepared without written consent. �SMd K£ PROJECT: i SMOKe KEHL �`- RESIDENCE E_ STF.N ELECT RANGE LltltriF4 COLONIAL VILLAGE 55075 MAIN ROAD KITCHEN YONGES_UNIT#3 SOUTHOLD, NEW YORK 0 REF. EXISTING 3068 FLOOR PLAN OF ONE BEDROOM UNIT FLOOR PLAN SCALE:1t4"=1'-0"