HomeMy WebLinkAbout1000-70.-9-10 Rental Permit
1344
Owner: D&G 3930 LLC
Occupied as: Single Family Dwelling
Located at: 3930 Oaklawn Ave Southold 70.-9-10
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: 06/30/2025
Expiration: 06/30/2027 c° forcern nt cial
This Notice must be posted by the main entrance at all times
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TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. 4. Box 1179 Southold, NY 1 1971-09 v1d1n Oe
merit
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Telephone(631) 765-1802 Fax (631)765-9502 https,. vwNy.southoldtowRIZ c
RENTAL PERMIT APPLICATION
Rental Permit Fee$300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address: (l V
SZ 5 '
Tax Map Number: 1000 SECTION_j L9 -BLOCK -LOT o
SECTION B.
OWNER INFORMATION: j
Property Owner Name: `✓ "�
Property Owner Legal Address: Property Owner Mailing Adddrelsv�
(Cannot be the same as Rental Property Address)
w Y a � � w
Telephone Number(s): Daytime_d _ Evening Emergency
Pro a rtYOwner Email Address: oC
..�
Page 1 of
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:.,
/►a,
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for ex ple,
Unit 1, Unit 2, Unit 3 or Apt A, B, C);the use of each room in the Rental Dwelling Unit
(for example, Kitchen, Bedroom 1, Bedroom 2, Living Ream) and the dimensions of each
room.
For properties with multiple Rental Dwelling Units use"Rental Permit Application
Addendum." -
Rental Dwelling Unit identifier: W1► o
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:
a oo rA
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
o I am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
Page 3 of 4
SECTION H.
i DECLARATION: Signature must be notarized and MUST be
DECLA the owner of the dwelling unit.
STATE OF
NEW YORK)
COUNTY CIF SUFFOLK)
)
1
1 certify under penalty of perjury,the following:
1. 1 ern the owner of the property identified in"Section A"of this application.
2. TI a property owner's legal address set forth in"Section 6"of this application is my legal
address and l 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: 6 6 0
P�operty Owner's Signature:
Sworn t0 b e�me this�day of �2��
Michael F Henry
Official Notary Public Signature and Orii • ota Stamp s Public" 60 of Now York
8 ry o.g1FlEC�fl g
tatiified in Queens County
Commission ,tuner 14 0.2
Y
Page 4 of 4
,(1F Soy
TOWN OF SOUTHOLD BUILDING DEPT.
" coo, 631-765-1802 10
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 (FIN L)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS:
a oN- f ✓� � � D� dU
r
ELATE 114SPECTOR
M Town Hall Annex
° Town of Southold 54375 Main Road
�y Rental Inspection Report PO Box 1179
F
Southold, NY 11971-1179
" Tel: 631-765-1802
SUM# Date
Owner Da Phone
Address ''M;0 Visible
Hamlet Inspector
Floor Level Quantities Sub 1 2 3
Smoke Detectors(not located in bedrooms)
Carbon Monoxide Detectors /
Fire Extinguishers 1
Exits IL
Bedrooms 1 2 3 4 5 6
Smoke Detectors
Egress
Occupant Count
Building Systems Maintained&Operational Condition of Property
Heating Building interior
Hot water Building exterior
Electrical Property clean, maintained&safe
Mechanical Handrails&guards installed &secure
Pool Safety Pool on Site
Surface water alarm Date of CO issuance
Door alarms Pool completely enclosed
Self closing/latching gates Pool fence to code requirements
CO's for all items present Prior Rental
Comments:
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a
BEDROOM
21'2" x 257" {
IF
PRIMARY BEDROOM
157 x 12'4'
i €
DECK
72 8'x 25'5"
BATH
BATH 1711'x 47Pi
.4'2'x 4'8"
HALL
1'1(Y'x `4` 1 —
BEDROOM �
16'8'x 12'3"
BATH
4'11"x 77
BEDROOM KITCHEN GARAGE
STUDY OM
10'7"x 11'3" 1$'3'x 25'7" 175'x 25'r
ROOM
8�P'x 9'2' 7 x-
HALLA
Y+ 11'3"x W2' •
OININGAREA "
SUNRONol LIVING ROOM � 12'4'x 11'S"
11'4'x 13'5' 22'B'x 1374'
TOWN OF SOUTHOLD ARo E TY RE 'CORDl0 5 I$ �
WEE STREET VILLAGE DISTRICT ——SU�B- LOT
&n 11(42613 Iff-�f
ACREAGE
FORMER OWN, N
Z2 ER,
11 17 17
S
TYPE OF BUILDING
RES. SEAS. VL. FARM comm. I IND� CB. MISC. Est. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
0 r)
66 f
L4
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER
Form Acre Value Per Acre Value FRONTAGE ON ROAD
Tillable I BULKHEAD
-Tillable 2 m ; DOCK
Tillable 3
Woodland
Swampland
Brushland
House Plot
Total
e
- -
Will -
gm
tnlll
rg �► � II .� ;�i ;fib
70.-4-10 03/15/2017
a �
_
M. Bldg. Foundation Both
Extension sement Floors X.oo, E
t
En Cxt. Wallinterior Finish T
Extension �� k —I 0 z�I L Fire Place Heat
-----
Ga 1,4�
7j
S � Porch.. Roof Type
PO
Porch- Rcoms 1 st Floor
?� Patio Rooms 2nd Floor r
Garage = .13�C �C.�U _ �j i , �� Driveway ; Dormer
4. B.
15
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TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORMING PREMISES
THIS IS TO CERTIFY that the
/X/ Land Pre C.O. #- Z14148
/X/ Building(s) Date- Jan. 13,1986
F/ Use(s)
located at 3930 Oaklawn Ave. Ext. Southold
Street Hamlet
shown on County tax map as District 1000, Section 070 Block 09
Lot 010 doesfnot)conform to the present Building Zone Code of the
Town of Southold for the following reasons:
Insufficient total area. Insufficient front yard set-back.
Non-Conforming accessory shed in side yard.
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming /X/Land /X/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: Property contains a one story, one family,
wood framed dwelling; two accessory sheds and accessory green-
house. Property also contains hedges and stockade fence. Pro erty
situated in the A-Residential-Agricultural Zone with access to both
Oaklawn Ave. Ext. & Custer Ave.
The Certificate is issued to 'I fi JEAN
(owner, 21ermvawxzxbec&ie4
of the aforesaid building. '
Suffolk County Department of Health Approval N/R
UNDERWRITERS CERTIFICATE NO. N/R
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.
liuiidin, inspector
8
Town of Southold 8/2R017
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTCATE OF OCCUPANCY
No: 39096 Date: 8/=017
THIS CERTIFIES that the burg ADDITION/ALTERATION
Location of Property: 3930 Oaklawn Ave,Southold
SCTM#: 473889 Sec/B1ock/Lot: 70,-9-10
Subdivision: Piled Map No. Lot No,
,=forms substantially to the Application for Building Permit heretofore Hied in this office dated
4/1 8120 1 6 pursuant to which Building Permit NO. 40658 dated 4/29/2016
was issued,and conforms to all of the requirunmts of the applicable provisions of the law. The occupancy for
wbich this certificate is issued is:
The cerl is issued to DeNicola,Joseph
?f the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
eLECTRICAL CERTIFICATE.TE NO. 40658 07-05-2017
PLUMBERS CERTIFICATION DATED 05-08-2017 P
a
x°
VOXX NO. s
TOWN OF SOUTHOLD
Bunxim; DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 17W..».. , Date ... ... . .. ...+��...
THIS CERTIFIES that the building looted at A"- Street
Map No. , C.. ^. .. .. . Block No. . . atZ.....Lot NO- . .zs ,.8oatkold •M.Y..... .....
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ... . . . ..%Tuft. .'6. . .. .. 19.?y pursuant to which Building Permit No. .7986a-
dated . .. . . . . . .JUMS. .6_,. .. ., 19.75., was issued, and conforms to all of the require-
meats of the applicable provisions of the law.The occupancy for which this certificate is
issued is ...Prftxto.asoovs,sar7.. .stomp .budding . . .. .............. .... .... .
The certificate is issued to , .Xcbert.Ls_Alkinion. . . .QWMX... ..,.µ•. .......
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .N..R•• . ., «. .. ..•..•.• .... ... .
UNDERWRITERS CERTIFICATE No. pondins. . .... ..
HOUSE NUMBER . . . 3930..... Street . :0sk1& ., wt•.i;at.............. . ......
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