HomeMy WebLinkAbout1000-59.-6-12 of so
Rental Permit
1357
Owner: Noel Reyes-Gonzalez , Ana Garrison
Occupied as: Single Family Dwelling
Located at: 7715 Soundview Ave Southold 59.-6-12
Maximum Permitted Occupancy: 8
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: 07/25/2025 -)Ilew
Expiration: 07/25/2027 Code En"n64t Official
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 htt aL///v,,v\v.so tlioldtoa viiii . ov
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every two years)
E C E 0 V E
Section A. J U L 2 1 202
Property Information:
Building Department
Rental Property Address: Town of Southold
7715 Sou ndview Ave, Southold, NY 11971
Tax Map Number: 1000 SECTION 59 -BLOCK 6 -LOT 12 -
SECTION B.
OWNER INFORMATION:
Property Owner Name: Noel Reyes-Gonzalez
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
22 Colchester Rd, New Providence, NJ 07974 22 Colchester Rd, New Providence, NJ 07974
Telephone Number (s): Daytime646-709-5750 Evening Emergency
Property Owner Email Address: noelivan@gmail.com
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Page 1 of 4 3 ��
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: N/A
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: N/A
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: N/A
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: 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, C);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: Unit 1
Requested Maximum number of persons allowed to occupy Dwelling Unit: 8
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
Bedroom 1 -20'0"x14'0", Bedroom 2 - 15'0"x12'0", Bedroom 3 - 10'0"x12'0,,
Bedroom 4 - 1 1'0"x1 0'0", Kitchen - 15'0"x160", Great Room - 14'9',x32'0"
Family Room - 15'0"x10'0", Bonus Room -24'0"x13'0"
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
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)
New-,A)
COUNTY OF SMfOtK)
I Noel Reyes-Gonzalez 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: Noel Reyes-.Gonzalez
Property Owner's Signature:
Sworn to before me this day of 20 2
Official Notary Public ` hature and Original Notary Stamp
7Commission
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Page 4 of 4
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TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPE(C"" TION
[ ] FOUNDATION 1 ST/ 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 AL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS: --e4
DATE
INSPECTOR
Town Hall Annex ' Telephone(631)765-1802
54375 Main Road' s Fax(631)765-9502
P_D_ Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a licensed architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Professional seal re utired for Architect or Engineer, Licensed Home Inspector must
provide copy of valid current certification C
Rental Property SCTM Number: 73 i✓
Rental Property Address: 7 7 / 5'c�uN� V46 W Avg
Owner/Name:
Rental Dwelling Unit Identifier:
Number& Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 —100 sqft., Bedroom#2—90 sgft., etc.)
6 4) oe 1' :46 / — 2-90 -5611PE 4 16 •-- 8' IT T
Property Description (Include all improvements indicated on survey)
O ,. ?
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, the Fire Code of New York State, the Property Maintenance Code o New York State
and the Energy Conservation Construction Code of New York State.
OF
Print Name and Title C.a N� 0 al Signature LIZ
Please place Professional Seal: w. W
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TOWN OF SOUTHOLD PROPERTY RECORD
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Town of Southold 6/23/2022
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
...............
CERTIFICATE OF OCCUPANCY
No: 43179 Date: 6/23/2022
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 7715 Soundview Ave., Southold_,.,.__,,,
SCTM#: 473889 Sec/Block/Lot: 59.-6-12 .......................
..........
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/17/2021 pursuant to which Building Permit No. 46904 dated 9/30/2021
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:
sgment µ4 beeLrroms,,co ered ppiLch.Ac eetied
gm ea s mPL,e—d.Lo i,
The certificate is issued to 105 Soundview LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-21-1571 5/31/2022
ELECTRICAL CERTIFICATE NO. 46904 6/14/2022
PLUMBERS CERTIFICATION DATED 6/2/2022 lu bing& ating
u 0*6 Signature
jFfilt Town of Southold 6/23/2022
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTII+ICATE OF OCCUPANCY
No: 43180 Date: 6/23/2022
THIS CERTIFIES that the building 1N GROUND POOL
Location of Property: 7715 Soundview Ave., Southold M ww ,. _ . m....... -
SCTM#: 473889 Sec/Block/Lot: 59.-6-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/17/2021 pursuant to which Building Permit No. 46905 dated 9/30/2021
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:
accs :�i��,fir and srimmin �u! fenut°d to cacle s�a lied fray:
The certificate is issued to 105 Soundview LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46059 6/15/2022
PLUMBERS CERTIFICATION DATED
_w_._.................... ...
Aut .
S" atur
tilt Town of Southold 6/23/2022
P.O.Box 1179
53095 Main Rd
+ � Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43180
Date: ... 6/23/2022 ....
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 7715 Soundview Ave., Southold
SCTM#: 473889 Sec/Block/Lot: 59.-6-12
Subdivision: Filed Map No. Lot No.
conforms substantially to t the to a Application for Building Permit heretofore filed in this office dated
.. �.. _. 2021
9/17/2021 pursuant to which Building Permit No. _ 46905 dated 9/3 0
was issued,and conforms to alI of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
accq r u d s virni in (Lo f nced tq code as," plied Sos.
The certificate is issued to 105 Soundview LLC
- _...,......,.,.,.,_....w.a......__
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. �_........ ..�,_.....4605.9 6/15/2022_........ .....e..�.. ..w�. ....�.........................._w..wv_w.......
PLUMBERS CERTIFICATION DATED
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