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Home My WebLink About1000-78.-7-5.6 TOWN OF SOUTHOLD Er Rental P rmit Permit-No 0348 Owner FrXeric. & Be ce Blanchard Occupied as Sing Familywelliu Located at 5 ain Bayview Rd Southold 78-7-5.6 Village S/B/L Vil i Max Permitted Oc pup ncy �� 6 Is in compliance with all of rovisions of the c e of the Town of S othold, the laws and sanitary and housing regulations of the County of Suffolk and by the adopted by t e New York St Fire Prevention and Building Code Council. Expiration is two (2) years from date of is The op at or is rep sible for arranging for the bi-annual inspection. 10/13/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be meted by the main entrance at all times Town Hall Annex �� p,"f Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 au�� p Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL.PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) APR 9 rp ' Section A. mow.w Property Information: Rental Property Address: RA. Tax Map Number: 1000 SECTION _-BLOCS SECTION B. OWNER INFORMATION: Property Owner Name:" ` � "� � � 'qV kVa;A) Property Owner Legal Address: Property Owner Mailing Address: ' AA V Telephone Number(s): Daytime /7 S/ Evening Emergency 117 35 o l 5 Property Owner Email Address: f ck W efzS Pagel of 5 Il Fd'f.� 4 p� Town Hall Annex Telephone(631)765-1802 54375 Main Road ems. Fax(631)765-9502 P.O.Box 1179 A�' Southold,NY 11971-0959 a� � p BUILDING DEPARTMENT TOWN OF SO HOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: G f A.0pt, 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: P ' Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex �- Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 x 1179 Mr � Sot'� „ P.O.Bo � Southold,NY 1 1971-0959 � .t b r, r 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: 1 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, diving Room) and the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: IV Requested Maximum number of persons allowed to occupy Dwelling Un" : Number of rooms in Rental Dwelling Unit: " 1 Use and Dimensions of each room in Rental Dwelling Unit: ;�1�eot2oc" Page 3 of 5 Town Hall Annex J Telephone(631)765-1902 �„ 11 Fax(631)765-9502 54375 Main Road nah ZW �N P.O.Box 1179 ,�� Southold,NY 11971-0959 d+ BUILDING DEPARTMENT TOWN OF SO"iIwJTHOLD 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 1 1 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) I P�fLiC l4oWCVkakJ , 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 Page 4 of 5 a ":b Telephone(631)765-1802 Town Hall Annex 54375 Main Road Fax(631)765-9502 i 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: ' µ. ' l Property Owner's Signature: Sworn to before me this day of ,,,,,, , 20 2.d AA, Official chary Public Signature and Original Notary Stamp DANI L RILA NOT y"+')Bjjr-STATE OF NEW y0 RK C(3MMIZON EXPIRES W/16120 Page 5of5 5��eo� mw p—tSevz (�, TOWN Off` SOOT OLD BUILDING DEPT. � # 765- 802 4, - 1 - S- w INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL 9 w4k , �*� P-6 [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: �- S .0 CA DATA INSPECTOR " June 13, 2020 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 a �� u Southold,NY 11971-0959COU BUILDING DEPARTMENT J N 3 0 2020 � TOWN OF SOU T f, OLD RENTAL PROPERTY CERTIFICATION a Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit pro essional seat reguired for Architect or Engineer licensed Home Inspector must provide pogy of valid current certi nation Rental Property SCTM Number: 1060, O-1 .076o •(OS006 Rental Property Address: 5503 Main Ba view Rd. Southold NY 11971 Owner/Name: Rodulfo David Cif uentes Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.) 1 V r 9rl . i Property Description (Include all improvements indicated on survey) I certify that I have done a physical inspection of the subject rental dwelling unit'and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. Victor Cornelius III CEO Inspector Olt'- Print Name and Title ceo# 1216-0283 O glnal SI re Please place professional seal: s - --------- STATE OF NEW YORK -0: Be it known that r Victor Cornelius has successfully completed the requirements of a Basic Code Enforcement Training Program i` established by the Minimum Standards for Code Enforcement Personnel (19 NVCRR Part 1208) in j � the State of New York as a: w � CODE ENFORCEMENT OFFICIAL I 14EWYOWSUM ■ : -; John R.Addario,PE,Director Division of Building Standards and Codes Certification No.1216-0283 Jai t :oecember 13;20tfs i maintainthis crtifi such person must satisfy annual in-service training requirements an advanced m serwce training requirements. r 1 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET A SUB LOT f � Q VILLAGE DIST g ti x _ _ - * c ACR. REMARKS 44 p —y1c( TYPE OF BLD_ (` }} r PROP L_A , LAND IMP. TOTAL DATE F• Y `� f �� J/� 1 !•fir' I " r'r"£ t; —f�,�ZIO'f' r m --- � � �� .a r; 1 FRONTAGE ON WATER TILLABLE j-T 2 �� 7 FRONTAGE ON ROAD WOODLAND ° DEPTH a - MEADOWLAND a BULKHEAD HOUSE/LOT �� I TOTAL vyyv v�� ivy `v y\�y COLOR a \�� wit-Y+''— \ yo u � r Al TRIM E 78:7-5,6 1/2014 1st 2nd M, Bldg I �r <� 'I' �� Foundation`ce Fin. B. Bath Dinette Extension L� x I(� = ' 'I (�6i Basement PeTsinr5 LAB i Floors Kit, Extension Ext. Walls Interior Finish L.R. Fire Place Heat `�� .� DA, Extension yU j Patio Woodstove BR. Porch Dormer Baths�, Dock - � -� Deck \ -} ;,. Fam. Rm. U Garage -- - I Pool [ 1 ........... Town of Southold Annex 2/4/2013 P.O.Box 1179 54375 Main Road Southold,New York 11971 ....... .......................... ....... CERTIFICATE OF OCCUPANCY No: 36054 Date: 11/26/2012 .................... .......... THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 5503 MAIN BAYVIEW RD SOUTHOLD, SCTM#: 473889 Sec/Block/Lot: 78.-7-5.6 . .......................... ........... Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/21/2011 pursuant to which Building Permit No. 36164 dated 2/3/2011 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: one family dwelling,wit h coveLed front entry.rear deck and second floor balcon asa�plie for, Corrected 2/4/2011 for, hoLisfTMMber only. The certificate is issued to JP MODULAR HOMES INC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RI0-07-0114 925/12 .......... ELECTRICAL CERTIFICATE NO. 36164 7/24/12 PLUMBERS CERTIFICATION DATED 10/3/12 to Ph ing&Heating LLC A o ed Si ature t ritlt Town of Southold 7/25/2018 P.O.Box 1179 53095 Main Rd q " Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39798 Date: 7/25/2018 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 5503 Main Bayview Rd., Southold ... SCTM#: 473889 Sec/Block/Lot: 78.-7-5.6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated _ _..._._..._.._ - 5/2 5/16/20y18 pursuant to which Building 5/23/2018 ding Permit No. 42714 dated 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: EXTERIOR_STAIRWAY GV 1 ll l.. - .D71t [0 1 1,a 1." ! r CN lA /1I1 ' l 4El�LINi A .-AI'PU'El. FOR The certificate is issued to Blanchard,Frederic&Beatrice of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED _..._............ .__.............. ._._._.- th d Signature fl- i D✓i=K 1 _ �3 ft ! i FA € TWGr-'�+ Fl+b!'.(IIAPLRri r'2ba�0 +t 3I IIS L �rW!=wCotiAd�2 PN!l 3itol15 �r i � ��. Alm! Ii�A �9} �- _li �1 i r Jri1/ x� J n��; �:lei c>• k y � � : rlri ! � � Pt cra x. fir! ' MIJ to 3 r holeLVL to i�a" to Lva r44� LL ¢'Ts 1'<!ro Tid 3D4rt, F �.i '+. p CGlecr 'Q4 -�- ; TJlro1P$ cJ®ramaa. N t6 � �' 1 I D 3�i o., 5 D11 � " a--s }�t�� TT f4.'Zxte'Lil � I o " S 2 ki,�p'!a><wiro s s z T '41 p — 4 ty Of NEW, D r(2#4 TOP G BOTTOM 44-0, 42'-o' y Evi, 8'&' g'u' B'o" �b- Tf - #4 218 R O 9 Z > € q z EACH FACE 3 iza y ,..1 -4,. vj '.17 o ao° ° —CONCRRANCE FOR Zz 0 o R _0 (2)#4 LL3 :n ec TOP OF NTHu�c ,�a�:r..��.x- =su.:s ` TOP OF PILE n EL.5.0' —'A 81 PILE @o'OC(10 TON) ` - `_ PILE GRADE BEAM A-A ml AT FOUNDATION WALL � SCALE: 1j2'=1'-0" ( I o Z-9 #4 @8"OC TOP tT _ BOTTOM EACH WAY $_, # 8"PILE(15TON) L71 2 ° _ ) A A e = PIERS SCALE:112'=1'-0" 10 ea GRAVEL w p N, SAC{F€LL E w Zql z d. w m x6 - 3 ) .� Z o @12' °o I VERTICLEw w HORIZONTAL o'-ff a 2"aia.DRAIN g 1.0" DRAWN BY:IF o- t' p , #5 @12"EACH WAY May m,2011 SCALE:1/4"=1.-0, TOP OF P LE EL.2.0' ,- —8"PILE @4'OC(15 TON) SHEET NO: FOUNDATION PLAN RETAINING WALL SCALE: iJ4"=1'0 SCALE:1j2"=1'-o" �1