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Home My WebLink About1000-63.2-1-32 of so TOWN F SOUTHOL Rental e rm it 1359 Owner: Pamela Abele Occupied as: Apartment (Unit 11E) Located at: 2555 Youngs Ave Unit HE Southold 63.2-1-32 Maximum Permitted Occupancy: 4 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: 07/30/2025 Expiration: 07/30/2027 eon nfo ent offiaat This Notice must be posted by the main entrance at all times W TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O, Box 1179 Southold,NY ALOE D W E Telephone(631) 765-1802 Fax(631) 765-9502 litt1/www. outholdtown o Bullding department RENTAL PERMIT APPLICATION Town of Southold Rental Permit Fee$300(Application must be renewed every two years) Section A. Property Information: Rental Property Addreatzl , ��" z Tax Map Numb 1000 SECTION_ �d --BLOCK SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) "477��"' VA Telephone Number(s): Daytime 4- 71- a— Evening � 1 mergency Property Owner Email Address: +1 Page 1 of 4 gP.c�/`��ct6ereC �rnai 1. tO/7 tl e Section C. Authorized Agent Information: v Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Cd yk 6I Mailing Address of Authorized Agent: l/o Zoe �aa Telephone Number(s): Daytime &Evening -- . mergency Email Address: <L,-, 4 gig' Mx �%'r' 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 w 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, 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: 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: � /z - 37 X Id �� r - //' ��rX'(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. "' lit 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) 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: E" Property Owner's Signature: .. +h Sworn to before me this a day of `TLA ,201.5 Official NotaT ublic Signature Original Notary Stamp TRACEY L. Gy' YME NOTARY PUBLIC,STATE OF NEW YORK NO.01 OW6306900 f-NlL!.LIFIED IN SUFFMK COUNTY COWASSION EXPIRES JUNE 30,ZQtp Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. COO 631-765-1802 �L I N E%AC;T 10 IN [ ] 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 (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: ....... DATE .� INSPECTOR % FFOL Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 ip Tel: 631-765-1802 SCTM# '— — Date Owner �j Phone Address ,r ,, L 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: I v 3 ice- - TOWN OF SOUTH OLD PROPE I T REGC)RD CARD STREET VILLAGE DIST.1 SUB. LOT F FORER OWNER �' 3�,f1r�,v1C'E? N E ACR, --_ — F 41 kis er r �{ j{ � ', ja — Y ICl✓v !3 t S W TYPE OF BUILDING t RES. SEAS. VL. FARM COMM. LAND IMP. TOTAL DATE REMARKS I,ram C_.. - 1 ' e , E f- r` rt I a � n- I I FRONTAGE ON WATER rTILLABLE FRONTAGE ON ROAD WOODLAND f 1 DEPTH MEADOWLAND I t BULKHEAD HOUSE/LOT ' TOTAL v � I t i �D r O 0 F _ C ! P zEA I �' -- -- - M. Bldg_ Foundation S Extension Basement Extension Ext. Walls — . — < Extension Fire Place Patio c Porch Dormer Deck _ s = � v Breezeway Garage Driveway — - - — G.B-a - = T Pool e FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. Z*16 109w * w Date „August. 3 1 , 19,87. . THIS CERTIFIES that the building . . MUL I LE D LLING . . . . . . . . . . . . Location of Property . . , ? ? YOUNGS AVENUE SOUTHOLD . w . * House*No. . . . . . Stieei M Hem/ei County Tax Map No. 1000 Section . . ,063. . . . . .Block . . .00 1. . . . . . . . .Lot , 2w8 .& ?9 . . . . Subdivision . . FOUNDERS VILLAGE . , , , , , .Filed Map No. .Lot No. . . . . , . , , . . conforms substantially to the Application for Building Permit heretofore filed in this office dated • Dec .. . . . . . .�.'. . 19$4 pursuant to which Building Permit No. . , 13 fi 5 4 Z . w . dated ,Jan;, 2 , 19 8 5. , . . . . 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 . . . . . . . BUILDING # 1 1Unit E in Multiple Dwelling . . . The certificate is issued to L IZDA REALTY, LTD.--FOUNDERS VILLAGE . .fowner, . ]610EF.oil%X. . . . µ . . . . . . . * . w . of the aforesaid building. Suffolk County Department of Health Approval . . , ,S-5 4w wA 19 t 7 w * w µ UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . .ending . w . M .. . . PLUMBERS CERTIFICATION DATED: MICHAEL DUFF, INC . July 13, 1987 Building Inspector 4 . . . Rev.1/81 ` or N06 A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 13654 Z Date ,aC. �Ql. ......al............... 19A Permission is hereby granted to: ......� f�k....w�� `e,qj.p/. ,..... ...k ,. .. .........�d-14— 1........ to t ..... ' ,,�.... yy F. .Y�....' ... y..,.;-�p M..ik.x.�.MpriYak4www� . " . ....N� k.A�a i14 �WfA.. -AV16�WNMM....M AUMw.4;.Y.......... at premises located at .44e):,�...........'&iC.r"". �r. k . '.w............ .�( .... ...1 :.�. ....... «..........rt....aF.......1`.......................Y..........................................x....a.......................................................*............ County Tax Map No. 1000 Section .0-0/9......... Block ...0/........... Lot No. _ pursuant to application dated .1)z-C.........,1 Q....................... .. and approved by the Building Inspector. Fee $.. �". J. t Sul t IrO Inspector Rev. 6/30/80 �q. lSpa j PAT. d ij C i U r _ —< i S.,•',2,AA [ ��1 �iiri �i id? aU P�`i <,Xem -bi. PIK,G'YSc 4� � 96+i rsn*vu vas• - � ( - may, f 4Y�-� ` N � F[ Hr- F g ] t a m _ F a tj ✓Ev �fiv z t �. c� _ t : ` � e i _< —61 t ''-_�a� i�� k^`'l_d�a+, _ � � .�.1...�—�k._ii✓��.. �F!' G � ✓``�%v� *'S-Z4�$3Y s — : � t