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HomeMy WebLinkAbout1000-53.-6-18 Rental Permit 1351 Owner: James Clous , Nancy Clous Occupied as: Single Family Dwelling Located at: 3805 Bay Shore Rd Greenport 53.-6-18 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: 07/16/2025 ko,57z- Expiration: 07/16/2027 CACEnfUcement of This Notice must be posted by the main entrance at all times @, 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 lilt l,.//wr A utliolcitownn . ov �. RENTAL PERMIT APPLICATION RentalPermit ' �-ermit Fee $300 (Application must be renewed every ear 1di"no "sotX00ta M �. lowo of Section A. Property Information: Rental Property Address: I '10 o-4- eeo,�y-f `I' 119`f Tax Map Number: 1000 SECTION S-3 -BLOCK & -LOT (a - SECTION B. OWNER INFORMATION: Property Owner Name: `J 0W?S t N A in 6CAS Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) S n�a a u r-t Telephone Number(s): Daytime Sib 3& y'r0°Evening S76 3ke)yr0e ergencyy( 38Q`f80g Property Owner Email Address: AM S , 0L. CIO(AS Cey" Page 1 of 4 Section C. Authorized Agent Information: IVIA 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: Ar/t+ 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: ►1l t 1 Requested Maximum number of persons all wd . o to ccupy Dwelling Unit: u SQ — S roan s + 2 to A4t s Number of rooms in Rental Dwelling Unit A-*ratR 2 CO21neos Use and Dimensions of each room in Renta x 2q odcvh 1 (s�y°k12A ( d'f+r Z Is'q",r,8'y� IWFM 3 2'bHK 11�S�� !`A ; 1-� Il'y x Iy�O"� gD�rm �iliNK Ws��l 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 ❑ 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. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) i c S A. 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 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: Property Owner's Signature: Sworn to before me this day of , 20 � W � 4 Official Notary Public Signature and Original Notary Stamp / i✓At, * � t 5% " 8/ Ow `SA10 y Page 4 of 4 4 z tf SO TOWN OF SOUTHOLD BUILDING DEPT. .�` 631-765-1802 53- & -- /gr 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 (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL DATE �5 ....... ..,. INSPECTOR Town Hall Annex Town of Southold 54375 Main Road .a Rental Inspection Report PO Box 1179 Zer �A Southold, NY 11971-1179 Tel: 631-765-1802 o0 SCTM# Date Owner p Phone Address Visible Hamlet Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits 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: TOWN OF SOUTHOLD PROPERTY RECOR ' CV1� R 3 STREET VILLAGE DISTJ SUB. LOT �� _ a i Q t. , ORMER 0WAEFff s )K 1vk,,;:i, N - _ E AC R. a S W TYPE OF BUILDING RES. r: SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP_ TOTAL DATE REMARKS f� - s g AGE BUILDING CONDITION - t - NEW NORMAL BELOW ABOVE 1 - FARM Acre Value Per Value Acre i - Tillable 1 Tillable 2 Tillable 3 Woodland I FRONTAGE ON WATER Swampland = - Brushland FRONTAGE ON ROAD House Plot DEPTH ' .BULKHEAD Total _ DOCK I r � r _ COLOR 1 F If I TRIM 1 I I I e f i - - I T = s 53:6-18 12/2013 j -- — �- _ s 1 ,� Foundation ? �� Bath i Dinette M. Bldg. I Floors a - I<ntExtension Baseme 14470 , ' Extension [/6 lrU) Ext. Wallsd Sy�� Interior Finish ; LR. i Extension ` i Fire Place Heat I a _� Type Roof Rooms 1st Floor BR- Porch 'Recreation Roo Rooms 2nd Floo ` FIN. 13.1 Porch Dormer ; Breezeway =Driveway Garage Patio 3 v Total SG s -07 ok�. a 0 3/a� J 6 ? 6ot FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28512 Date: 06 12 02 THIS CERTIFIES that the building DWELLING AND ACCESSORY Location of Property 3805 BAY SHORE RD GREE:NPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 053 Block 0006 Lot 018 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9 , 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 28512 dated JUNE 12, 2002 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 WITH SLATE PATIO AND ACCESSORY TWO CAR GARAGE. * The certificate is issued to ANNA MARCHHART (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPO Authorized Si ature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 3805 BAY SHORE RD GREENPORT SUBDIVISION: MAP NO.: LOT (S) NAME OF OVUM (S): ANNA MARCHHART OCCUPANCY: SINGLE FAMILY ANNA MARCHHART ADMITTED BY: PAUL HEFFERNAN _ ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 53.-6-1,8 SOURCE OF REQUEST: PAUL J HEFFERNAN DATE: 06 12 02 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2 FOUNDATION: CONCRETE BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOMS: 1ST FLR.: 6 2ND FLR_: 0 3RD FLR.: 0 BATHROOM(S): 2.0 TOILET ROCK(S): 0.0 UTILITY ROOM(S): PORCH TYPE: ENTRY WAY DECK TYPE: PATIO TYPE: SLATE BREEZEWAY: FIREPLACE: '1 GARAGE: DOMESTIC HOTfLATER: X TYPE HEATER: OIL AIRCONDITIONING: CENTRAL TYPE BEAT! OIL MARK AIR: X BOTNATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: TWO CAR WOOD * STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: * exterior tiolet room and bathroomw_ with arh o kitchert) family VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC,. N p � N Il up W p� k N � I REMARKS- B #9423 ADD 02AA-19033 INSPECTED BY. DATE ON INSPECTION: 06 04 02 HN M BOUFIS TIME START: 9:50AM EeID: 10:25AM 04 LOCATION: 50 (number& t) (municipality) SUBDIVISION: MAP NO.: LOT($): NAME OF OWNER(S): OCCUPANCY ✓d+ (, e) (owner-tenant) ADMITTED BY: AL ,IK,4,&/A OMPANIED BY: KEY AVAILABLE: SUFF.CO.TAX MAP NO.'I 00- " SOURCE OF REQUEST: DATE: - " DWELLING: TYPE OF CON'STRCCYON": 4; ., STO' " S: EXITS: FOUNDATION: CELLAR: CRAWL SPACE; TOTAL ROOMS: I T FLR: ND FLR: RD FLR BATHROOM(S): TOILET ROOM(S): UTILITY ROOM PORCH TYPE: DECK, E: PATIO,TYPE: BREEZEWAY: FIREPLACE: GARAGE: _ DOMESTIC HOTW'ATER:_) , _ TYPE HEATER: / CONDITIONING: TYPE'HEAT: WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST.: I. STORAGE,TYPE CONST.: SWIM G POOL: GUEST,TYPE CONT: OTF VIOLATIONS: CHAPTER 45&N.Y.STATE UNIFORM FIRE PREVENTION&BUILDING CODE LOCATIO DES PTION ART. SEC. REMARKS: INSPECTED B` DATE ON INSPECTION: TIME ST END ART: i : 1 _ � - -- FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19033 Date MAY 8 1990 THIS CERTIFIES that the building ADDITION Location of Property 38GS a k a 701 BAY SHORE RD. GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 53 Block 6 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 22 1977 ------Pursuant to which Building Permit No. 9423-Z dated AUGUST 22 1977 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS PER AMENDED PLANS DATE 9 19 77. The certificate is issued to PATRICK ZINNA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N-407558-OCTOR 25 1989 PLUMBERS CERTIFICATION DATED N A uil ing Inspector Rev. 1/81 ylf4� Town of Southold 1/5/2023 P.O.Box 1179 53095 Main Rd " Southold,New York-11971 , ' CERTIFICATE OF OCCUPANCY No: 43740 Date: 1/5/2023 THIS CERTIFIES that the building ACCESSORY ALTERATION Location of Property: 3805 Bay Shore Rd.,Greenport SCTM#: 473889 Sec/Block/Lot: 53.-b-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore . filed in this office dated 3/21/2022 pursuant to which Building Permit No. 47721 dated 4/21/2022 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: windows and doors re pIg kind to existing a cessgr ra, e as applied for. The certificate is issued to Clous,James&Nancy of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED _.._. u or*rature .._ -------- fait Town of Southold 6/27/2022 �"- P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43188 Date: 6/27/2022 THIS CERTIFIES that the building ELECTRICAL Location of Property: 3805 Bay Shore Rd.,Greenport SCTM#: 473889 Sec/Block/Lot: 53.-6-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/8/2021 pursuant to which Building Permit No. 46385� dated 6/8/2021 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: 300 amp underground eigg is service; 6 g e The certificate is issued to Clous,James of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46385 6/15/2022 PLUMBERS CERTIFICATION DATED SAuthori Signature i E sR-AL L <E : UM t - -- I TI-Ifil I i emr�ai� i t _ 1 ®aas =I ; w ¢•mi I` Z ;¢z i xc�a i' O O =x r °a' �t ;m z Ir: i 1 EXISTING FIR5T FLOOR PLAN 1,419 5.F.HA61TA5LE 5PAGE;1,414 5_F.GRO55 AREA x'�'VD LU o _ 1 Q w � 3t �-� � 6-orose ............ Ij I fl ......... od 64-111 3, Q r7-9 o, Old Sy �' f rr Al Lj %p' �^'►t`r y �� r t _ � d � Y " cay 1 �1 rf�Q�o 0 CJI e M _µ. i co ac CD �� y . \y a> . . \� � � � «. / �z � i � i \ { �/�/ ���� . �\�\ , �z � \�Z � ���; �` �`\ « \. ��\ Z 2 < � < �\ } ., �^~�\ / \\ . ©� / ice. \ ` + A < » / � I �/ , � � � � `