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Home My WebLink About1000-55.-2-6 Rental Permit 1312 Owner: Alison Bloomer Occupied as: Single Family Dwelling Located at: 4600 Old North Rd Southold 55.-2-6 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. Issued: 05/15/2025 Expiration: 05/15/2027 coa of ementO icS This Notice must be posted by the main entrance at all times F rygq p Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 r Yr P.O.Box 1179 Southold,NY 11971-0959 r o. BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: —P-0J SO -�o A'60 -L:)�k Tax Map Number: 1000 SECTION q5 -BLOCK a -LOT -� SECTION B. OWNER INFORMATION: i Property Owner Name: � � Owner Legal Address: Property Owner Mailing Address: Property Ow g ��► 4two No Y-� Rom -6 -3 13 Telephone Number (s): Daytime Evening_ Emergency Property Owner Email Address: CAI 4e�6 �2w C' N�a�1 GDI/V1 Pagel of 5 Town Hall Annex Telephone(631)765-1802 t ' Fax(631)765-9502 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959 ^ BUILDING DEPARTMENT TOWN OF SOUTHOLD 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):. Page 2 of 5 / a � Y Town Hall Annex ' r' Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box It 79 ' Southold,NY 1 1971-0959 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: 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." r 6e Rental Dwelling Unit Identifier: �wm, Requested Maximum number of persons allowed occu �welring Uni Number of rooms in Rental Dwelling Unit: z 5 Use and Dimensions of each room in Rental Dwell! nit: VC,A-60 : Y ZD iV�tale . coM = x Ig �ec�rGGm1: 12-� L—SleAVtza) Z : (Zxl 3�ejv-oo,-n :? =ioxll Page 3 of 5 Town Hall Annex Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road � P.O.Box 1179 Southold,NY 11971-0959 ,' BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) 1 I .� .. = .-- certify under penalty of perjury,the following: 1. I 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 d , Telephone(631)765-1802 Town Hall Annex 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Agent, or Site Manager. Property Owner's Name: Property Owner's Signature: 2day Sworn to before me this of Mort . 20 da Official Not Public Signatur nd Original Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2-";t, Page 5 of 5 lqf so 4600 01.0 uwy.-,- N, �1� TOWN OF SOUTHOLD BUILDING DEPT. ou 631-765-1802 � _Z-(e INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN TRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL (1�,, DATE I NSP CT sour -lw n IV044, N4 sw�6 / TOWN OF SC1IJ"I"HOL D BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] INAI-Rewvl r ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O t REMARKS: &vtto4 4f,�- rh DATE l INSPECTOR SPECTO P„nNo tta�� a ,w W Li- uj w r 14) ❑ d I— m tu lu CL uj X We f M s ' �� i NJ( _. W.�_._. 131 rr7 7 u.jui d h [ m, W �i a. u LL U6 w , �i w a f ro f r GO Ln O q1 O Q t�� d w cn a� _ G a � V �i vi t r �l,Jed, _d N��'��.,, } �� t f"' N m r LL CN 0 0 rz 11Z4 FT 0 CL 0 c u 41 ID Ell: E (D C"l 1-3r c c r- rn .2 .2 ro, m Ln c C: c N w cu (D a) x x uj uj Lij (D FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-27168 Date JOKE 30 2000 THIS CERTIFIES that the building ADDITION Location of 'Property 4600 OLD FORTH ROAD SOUTH House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 2 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 26C 2000 pursuant to which Building Permit No. 26586-Z dated JUNE 160 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR HAS BUILT"_ The certificate is issued to GREGORY C. CAHILL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED NIA Building I Spector Rev. 1/81 AJ0 h1i TOWN OF SOUTHOLD BUILDING DEPARTNMM Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.z7367. . . . . . . Date . . . . . . . . . . . . . Xd!. . 1 C. . . . . 197.6 . THIS CERTIFIES that the building located at BIB.tl •1 . . . . . Street Map No. . .XX . . . . . . . BAck No. . . . . . . .Lot No. . =. . . 84M 1._.. . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . 19 60. pursuant to which Building Permit No. "7Z.. . dated . . . . . . . . . . . .�r. . .1 . . . .. 19.b0., 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 P;3.r!a r. . . VOMIT. 4"3-.Iftg.xJ..th. a00 0017.building.&. tonoint The certificate is issued to . AWY .141-. JJ319'PAtrJL0k. . . . .VA*r. . . . . . . .. .. . . . . .. . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Pr*-. OXi fig• . . • • • • . • • • • • . . UNDERWRITERS CERTIFICATE No. PXOT.OXIO C. . . . . . . . . . . . . . . . . • • . . . . . HOUSE NUMBER . .46W. . . . . . . Street . . .9� .ftrrt . ld. . . . . . . . Building HOUSING CODE INSPECTION November 8, 1976 4600 Old North Country Road R-1 Southold, N.Y. Tax Roll: Betty L. Fitzpatrick occupied: Owner Upon receipt of an application for an updated Certificate of Occupancy, I made an inspection of this one-story, framed dwelling which was constructed under Building Permit #997Z, dated March 16, 1960, to which subsequent Certificate of Oc- cupancy #2705 was issued to Robert and Judith Williams on July 14, 1960. I picked up the key from Edward J. Boyd V, Attorney, in Southold, admitted myself to the dwelling, and began this inspection at approximately 12:50 P.M. The building consists of a kitchen with a dining area, a living room with a heatilator fireplace, a_tMjl_bathr4QMj, and Heat is furnished to all rooms from an oil- fired, hot water heater located in cellar of building's cement block foundation. The following violations of the Housing Code, Chapter 52, Town of Southold, New York, were found: Kitchen - entry at rear of building to dining area, no meads of controlling light on entering, Article V, Section 52-56 B (2) . Cellar - open electrical box on the first floor joist mated over the furnace, Article V, Section 52-56 A (1) . Open yard area contains the following structures: a paddock-type fence along the front yard property line, and a greenhouse located in the rear yard area. Buildings and grounds in good condition. Inspection com- pleted at approximately 1:10 P.M. Key was returned to Mr. Boyd's office. Re ctfull s4m itted,,wkard i dermann Building Inspector EH:med k A FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCC"ANCY No Z--23498 Date FEBRUARY 15, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 4600 OLD NORTH 'ROAD SOUTH!OLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 2 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 1 1975 ___pursuant to which Building Permit No. 8052-Z dated DULY 7 1975 was issued, and conforms to alb of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY METAL STORAGE SHED The certificate is issued to GREGORY & ANNE L. CAHILL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. 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