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Home My WebLink About1000-62.-1-24.7 (Yonges Bldg #6) of s 41"OkWUN' OF SOUTHOL Rental Permit 1329 Owner: Colonial Vill Tenants Crp (Nancy Fischer) Occupied as: Yonges Bldg Apt. #6 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: 06/10/2025 Expiration: 06/10/2027 code nforc ent Official This Notice must be posted by the main entrance at all times 9- � TOWN OF SOUTHOLD—BUILDING DEPARTMENT " Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 l it,, s://Nvww.sotitl)oldtowiir,iv.,aov RENTAL PERMIT APPLICATION JUN _ 20 Rental Permit Fee 300(Application must he renewed"every two years, ull to Oep �� 0��1 O .;L15Tow"Of Southold 119 Section A. Property Information: Rental Property Address: t? r / 51075 ,a S t ��o �� ' 7 (. d an ! V. 11.)e Tax Map Number: 1000 SECTION 2' -BLOCK I -LOT 2- - SECTION B. OWNER INFORMATION: Property Owner Name: ICY k vl C A G Y_'r Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 32Fs Telephone Number(s): Daytime 631 9�S-�p�3 Evening , 2 Emergency Property Owner Email Address: C. t, eve p Page 1 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: I V01 I$xQ CJq *4 if x331Y x1j 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 0 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) I &ri C.4 ., ` 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: N ev n c;uf L5 Gr Property s Owner' Sig nature: P Sworn to before me M94" day of , 20A- Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 t ua0fled In Suffolk County Commission Expires April 14,2L� Page 4 of 4 G��awr V/Ufa TOWN OF SOUTHOLD SUILUI G DEPT. 631-? 5-1 c � #�v 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 REMARKS: 6� SUPERVISOR'S OFFICE TOWN CLERK'S OFFICE Ib South Street Main Street Greenport, N. Y. BUILDING DEPARTMENT Southold, N. Y. Tel. Greenport 7-M.W T.I. Southold 5-3763 TOWN OF SOUL HOLD SUFFOLK COUNTY, N. Y. CERTIFICATE OF OCCUPANCY BUMING 0 2 No. 1168 Date act 11 (Ann's Way) THIS CERTIFIES that the building located at Street, Map No. , Block No. Z= . Lot No.M S0U,:th21djX, in the Town of Southold, conforms substantially to the approved plans and specifications heretofore filed in this office with Application for Building Permit dated &Z A 119-0 pursuant to which Building Permit No. , 163, dated .. .. ..am a 19-(6, 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 .. This certificate is issued to ftedleirtak 2, Rich &Zs CoIgnial Village (owner, lessee or tenen+) ,of the aforesaid building. H.D.Approval Septa 28t 1965 by R. Villa Bsrtlding Inspector (The Cwrdificafe 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 premises, and in conformity with the approved plans and specifications.) 1 m r John Yonges House COLONIAL VILLAGE ,I ---- ONE- BEPROOAI nI Alttlt1.111 ., Louve,%ed Uoon to 25 6t. Gantlen AAea CortdZtione)L , BATH Lin en n— F CL# BEDROOM 12 z II- 1 /2 0 OTCHENETTE �{! - ApaRtmentd Sepahated ' By Doubte 1114 ittated ,s Ctod et I I z LIVING 6 0114ING AREA 3- 314 16 z 12 M AM PictuRe W.tnclotu Covehed Watklua(/ to PaAk-Ing AAea