HomeMy WebLinkAbout1000-51.-6-11 Rental Permit
1309
Owner: Lisa Markey
Occupied as: Single Family Dwelling
Located at: 610 Richmond Rd Southold 51.-6-11
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.
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Issued: 05/14/2025
Expiration: 05/14/2027 Code fors ent official
This Notice must be posted by the main entrance at all times
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V"41, TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 1'1 71-0 ►5
Tlelalonef ) 765=1802 Fax(631) 765-9502 ltt s://www.sotflldtownZov
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RENTAL PERMIT APPLICATION
e,n al Permit Fee$300(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
,. 2 C-" v-,�...ok>
Tax Map Number: 1000 SECTION 6—/ -BLOCK
SECTION B.
OWNER INFORMATION:
Property Owner Name: L
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
Telephone Number (s): Daytime -3zu vening Emergency
Property Owner Email Address: k,i
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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):
Mailing Address of Authorized Agent:
Telephone Number (s): Daytime Evening 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): 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):
Mailing Address of Managing Agent:
Telephone Number (s): Daytime Evening Emergency
Email Address:
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, 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 Dimensions of each room in Rental Dwelling Unit: w
eop
10
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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.
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.
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),��
l 5 R tivl P�' ut-F `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: /--L
Property Owner's Signature:
Sworn to before me this_day of ►' / . 200 y
0-'�" ram-- 8un
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,Mate of New York
No.0i BU6185060
Qualified in Suffolk County
Commission Expires April 14,2�
Page 4 of 4
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TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION
[ ] 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 (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS: Q(L -PO,2-,
TOWN OF SOUTHOL D BUILDING DFPI""".
631-765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] 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 [ kifEENTAL
REMARKS: c o r "'
-42 S4 7/
4 i Cie-
IAS�11te-
DATE INSPECTOR
Town Hall Annex
". Town Of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
RCn ZL-
Southold, NY 11971-1179
�o Tel: 631-765-1802
SCTM # — Date .. .... ...o? .
�wner..". .....m.... .Ma ... .. ••__,..�Ar Phone
O ..
Address �"r � Visible
qq
.. I inspector
'Hamlet 1 2
Lecter
Sub
Floor Level Quantities 3
Smoke Detectors knot located in bedrooms) --Carbon Monoxide Detectors
.., . .._.a.. .........
Fire Extinguishers °
Exits .
_. ._..w.. .m.. . _... 4._ ... 5 6
Bedrooms 1 w ....�, 3 �.._._ _... ... .... .
Smoke Detectors
Egress
Occupant Count
Building Systems Maintained &Operational I Condition µof Property
Heating Building interior
Hot water I... Building exte ri or
Electrical Property clean, maintained &safe
_ _ �
Mechanical installed & secure
�......... �. _..... e,v..... . . .
Handrails&guards __... ..,. ., ..w ...
Pool Safety Pool on Site ..�.,
Surface water alarm
Date of CO issuance
,Door alarms (Pool completely ode osed �
Self closing/hatching gates Pool fence torequirements
_.
CO s for -.�. .. .
' items present j Prior Rental
Comments.
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51.-6-11 1/28/2019
M. Bldg. i = F undation ;Bath a.1
Extension Basement � Floors
� Ext. Walls ; Interior Finish
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Extension = Fire Place Wk35 Heat Cc
Porch Roof Type
Porch s Rooms 1 st Floor
Elreegewc� f��V L4 d of ' Patio Rooms 2nd Floor
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Driveway Dormer
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TOtt'N OF SOUTIIOLD
OFFICI; OF BUILDING I\Sl'L;CT `Ic
TOtt N IIALL
SOUTIIOLD, NEW Y OI',K
CERTIFICATE OF OCCUPANCY
NONCONFORMING PREMISES No. ,Z12219
January 25, 1984
TIiIS IS TO CERTIFY that the
/X/ Land
Building(s)
Use(s)
located at 610 Richmond Road Southold
Street Hamlet
shown on County tax map as District 1000, Section 051 , Block 06
Lot 01 1 , does;noOconform to the present Building Zone Code of the
Town of Southold for the following reasons;
the property has insufficient area.
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming /X/Land /u/Building(s)
/ /Use(s) existed on the effective date the present Building Zone Code of the
Town of Southold, and may be continued pursuant to and subject to the appli-
cable provisions of said Code.
IT IS FURTHER CERTIFIED that, based upon information presented to
the Building Inspector's Office, the occupancy and use for which this Certifi-
cate is issued is as follows: a private one-family dwelling, with
accessory burner and accessory shed located in the rearyard.
The Certificate is issued to MARION D. RICHARDS (ESTATE)
(owner, 1e3se%—_ 1nr-ten3nt•)
of the aforesaid building.
Suffolk County Department of Health Approval no record
UINDEPL%VRITERS CERTIFICATE NO. no record
NOTICE IS HEREBY GIVEN that the owner of the above premises HAS
NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec-
tor to determine if the premises comply with all applicable codes and ordin-
ances, other than the Building Zone Code, and therefore, no such inspection
has been conducted. This Certificate, therefore, does not, and is not intended
to certify that the premises comply with all other applicable codes and regula-
tions.
lttildi,i^ inspector
Foe Town of Southold 3/30/2017
P.O.Box 1179
53095 Main Rd
' ° gyp Southold,New York 11971
CERT"`MCAT OF OCCUPANCY
No: 38874 Date: 3/23/2017
THIS CERTIFIES that the building RESIDENTIAL ALTERATION
Location of Property: 610 Richmond Rd, Southold
SCTM#: 473889 See/Block/Lot: 51.-6-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/15/2016 pursuant to which Building Permit No. 40933 dated 8/24/2016
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:
'ALTERATIONS TO AN EX STING ONE ILy_QWELI,ING AS APPLIED FOR
The certificate is issued to Richter,Dagmar
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40933 03-07-2017
PLUMBERS CERTIFICATION DATED 12-13-2016 hogue Plumbing
ia `-ec Signature
Town of Southold Annex 11/25/2013
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36620 Date: 11/25/2013
THIS CERTIFIES that the building RESIDENTIAL ADDITION
Location of Property: 610 RICHMOND ROAD SOUTHOLD,
SCTM#: 473889 Sec/Block/Lot: 51.-6-11
Subdivision: Filed Map No. Lot No.
................. ........ ...... ...............conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/25/2010 pursuant to which Budding Permit No. 37808 dated 2/14/2013
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:
4CIPL(ign a d Iterati r Wo and dqcLjqAq cxis Ling o
m—A —nq.� -gl
—_M..including one 0_ -a_ _.I_ tinj)y4w ling s h4ftcwr.
The certificate is issued to MARIE L.CARRIG
...........
(OWNER)
of the aforesaid building.
SUt FOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. N 344792 3/8/95
...... ....... ..........
PLUMBERS CERTIFICATION DATED
....... ... .... ..............
Auth z Si turc
Town of Southold 8/5/2019
P.O.Box 1179
53095 Main Rd
,40 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40589 Date: 8/5/2019
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 610 Richmond Rd., Southold
SCTM#: 473889 Sec/Block/Lot: 51.-6-11
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/21/2018 pursuant to which Building Permit No. 42416 dated 2/27/2018
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:
is.-n a nd,wirnn in o fenced to code as a Lied for.
The certificate is issued to Markey,Lisa
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42416 4/19/2018
PLUMBERS CERTIFICATION DATED
ut o Signature
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