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Home My WebLink About1000-63.2-1-45 so TOWN OF SOUTHOLD Rental Permit 1433 Owner: Tast J Irrev Trt Occupied as: Single Family Dwelling (Unit 14C) Located at: 2555 Youngs Ave Unit 14C Southold 63.2-1-45 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: 03/30/2026 Expiration: 03/30/2028 a n �� ..meat official This Notice must be posted by the main entrant a all times v TOWN OF SOUTHOLD—BUILDING DEPARTMENT O . ,,.,. Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 &iltp� �L % s titl oldtowni,i Yoga RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) .� _ %—" Section A. CK Property Information: ?o,,,yC�•,'fast COX Re�taI '�o�ert'y,+ ddress:Ave-,V— C oq OY r, 7 Tax Map Number: 1000 SECTION 3�-BLOCK � 2 -LOT SECTION B. OWNER INFORMATION: Property Owner Name: 1"1('T41rWz6t1�(e ( S Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) ro Telephone Number (s): Daytime Eventing Emergency Property Owner Email Address: p Y Page 1 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 U . use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: P7 J�C Requested Maximum number o ersons alto to occupy Dwelling it: Number of rooms in Rental Dwelling Unit: Use&andLimensions of each room in Rental Dwelling Unit: -vpn cryv7 - ► 3 d a -C/ 1�1�11 2 _ I .�OI l C� �d r� �11� `r O�lda 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 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) ) C NTY OF SUFFOLK) 1 ,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: �L—W Property Owner's Signature: Sworn to before me the -*day of " .. _ , 20-&� Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 hU8185050 page 4 of 4 Qualified in Suffolk County Commission Expires April 14, ,- Dw% TOWN 1= S UTH LD BUILDING DEPT. 631-765-1802 ' ' womohL � c�I AP%ik OL M INSlift T wim [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION Ile [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL RE DKS: ..... DATE ` " "" y INSPECTOR ---------- 3 'PATIO RED ROOM 11-0/10- AT LIVING ROOM FOYER O O� RED ROOM KI C" � 7-0/1 - 3-4/9- 0 BATH 1 .00 �� ns A &# 1n 2555 Y��s Av6 aNr'r lac, IQOG- 2- - {- TOWN OF SOUTHOLD PROPERTY OWNER ` ly STREET 4�czz VILLAGE DIST_ SUB- LOTrvst- _ ACK REM A KS �- -a TYPE OF BLD_ Natalie Vol 10 � k ► � �`�� PROP.�- CLASS LAND IMP, TOTAL DATE #. 3 - - GAS -S � 4 - _ G z I FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL 9/ Mis a ' TOWN OF SOUTHOLD PROPERTY RECORD CARD =3 -z U STREET VILLAGE DIST. SUB. LOT 1eGt*"?Or- '` taVS 0r, FORMER OWNER:zo" y Eclv„orA5 N E ACR. ,0,ro $ w S W TYPE OF BUILDING RES. ,4 ( SEAS. VL. FARM COMM. LAND IMP. TOTAL DATE REMARKS - 2 ff I4 Cc) 5 ' "0 ~L t VCR 8 : _ — W i 1 rn T vio rH 7 7- = 1p �I. = F s Z� v o o - lase ` jq rN 4v vs127 FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND - BULKHEAD HOUSE/LOT TOTAL rr�cao-t�3. �-r' -►� � PATIO COLOR MATBEDROOM - LIVING ROOM 17'0-x11'4" 22'6"x 13'0.. CL 1� N Foundation DINING CL r M. Bldg, Extension Basement --- BATH Ext. Walls � ' -� Extension BATH Extension Fire Place LC Patio r _ CL Porch Dormer CL FOYER Deck Iff Breezeway€ P MiTCH�EN BED OO Garage Driveway 11"0 x10"S Pool a 1Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Halt Southold,N.Y. Certificate Of Occupancy No. Z l 5 8 . . . . . . . . . . Date „June 5 , 1987 µ µ µ m tl THIS CERTIFIES that the building .MULTIPLE DWELLING . + « ` . µ µ Location of Property 555 YOUNGS AVENUE SOUTHOLD Hoast%Uo. ' ' Stneet Hamlet County Tax Map No. 1000 Section . 0.6 3 . . . . . ..Block , 0 0 1 Lot 2 8 & 29 Subdivision ,FOUNDERS VILLAGE ,Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated , Dec ; pursuant to which Building Permit No. . .M�4.? . . . . . . . , . . . . dated . .Jan.. . . . . . ., . .1,9. . . . . . . . . . . . . . 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 # 14 Unit C in Multiple Dwelling. The certificate is issued to L IZDA REALTY, LTD. ' of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . , A-5 4. . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . 7 9 8 4 0 8. . . . . . . . . . . PLUMBERS CERTIFICATION DATED: March 30, 1987--Michael Duff w Building Inspector Rev.1181