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HomeMy WebLinkAbout1000-78.-9-50 so A TOWN OF SOUTHOLD Rental Permit 1475 Owner: Matthew Raices , Samantha Gould Occupied as: Single Family Dwelling Located at: 605 Highwood Rd Southold 78.-9-50 Maximum Permitted Occupancy: 7 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: 05/18/2026 we�el Expiration: 05/17/2028 cod - W0 official This Notice must be posted by the main entrance at all times ,41�� TOWN OF SOUTHOLD—BUILDING DEPARTMENT T„__._. TT-11 A..,�,.__ CA'f'7C 11 d...� T)�...7 Tl !1 Tl--_ 11'7!1 C' ...,aL...1.7 AT%T 11/1^/1 /%/1Cf1 1 V Wll 11[L11 C1L111GA J`t-1/J 1v1C1.111 AVQU.r. V. lUllA 1 1 /7 0 UL11Vl11� 1V 1 1 17/1-V7J7 Telephone (631) 765-1802 Fax(631) 765-9502 hap "lNv%v"r sopt�l�g1d1o�v�nr� RENTAL PERMIT APPLICATION Rental Permit Fee 5300(Aoolication must be renewed every two vearsJ Section A. A{"Rni. Property Information: Rental Property Address: 605 Hi hwood Rd Southold NY 11971. Tax Map Number: 1000 SECTION 078- BLOCK 09w- LOT 050 SECTION B. OWNER INFORMATION: Property Owner Name: Matthew Raices Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 70 Washington Street Apt 11D Brooklyn, NY 70 Washin on Street Apt 11D 11201 Brooklyn, NY 11201 Telephone Number (s): Daytime 516 448-7868 Evening 516 48-7868, Emergency 516 448-7868, Property Owner Email Address: Mattraices@gmaii.com Paee 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: One Rental Dwelling Unit (Single Family Home 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: N/A Requested Maximum number of persons allowed to occupy Dwelling Unit: 8 Number of rooms in Rental Dwelling Unit:4 Bedrooms 2 Bathrooms Living Room Dining Room Family Room Kitchen. Use and Dimensions of each room in Rental Dwelling Unit: Bedroom 1: 11'6" x 13'0" Bedroom 2: 9'-6" x 9'-8" Bedroom 3: 9'-8" x 12'-0" Bedroom 4: 9'-0" x 10'-0" Bathroom 1: 9'-0" x 5'-10" Bathroom 2: 10'-0" x 8'-0" Living Room: 16'-6" x 13'-0" Dining Room: 13'-0"x 13'-0" Family Room: 22'-6" x 12'-0", Kitchen: 13'-0" x 10'-4". 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 `X I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) 1 Matthew Raices certify under penalty of perjury,the following: 1. 1 am the owner of the propertv 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. Propertv Owner's Name: Matthew Raices 5. Property Owner's Signature: Sworn to before me thisZOO-day of , 202 Official Notary Public ig ature and Original Notary Stamp Michael Allen Plump Notary Public, State of New York Reg. No. 01 PL6324871 Qualified in Kings County Commission Expires May 18, 2027 Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 N Si" P E�T IV""k N [ ] 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: - �►'l DC�� DATE - 9 60 INSPECTOR laii Annex Telephone(631) 765-1802 54375 Main Road W r' Fax(631)765-9502 P. O. Box 1179 Zft ::r 'i'lu71-0959 BUILDING DEPARTMENT TOWN OF SOUTHO! ^ RENTAL PROPERTY CERTIFICA T iuR 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 uwired for Architect or Engineer, Licensed Horne Inspector must provide copy of valid current certification Rental Property SCTM Number: 000 " 0 $- 0 0 O 9. 00 tI S P'410P Rental Property Address: 0S (C Wad10 10?-D )f J 7 J Owner/Name: Mot-thew I Rental Dwelling Unit Identifier: M h h .S Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sgft., Bedroom#2-90 sgft., etc.) �e rr Z - l oo + 13e�rovM > 3 - I Z.0 l yf Property Description (Include all improvements indicated on survey) I certify that I have done a physical inspection of the subject rental dwelling unit and find that it full 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 of New York State n� a of New York State. and the Energy Conservation Con .... _r P Print Name and Title ' `��" � � �v4 Original Signature 9 9 r Please olace Profession all: ��"5SV ^_g TOWN OF SOUTHOLD PROPERTY RECORD 6X6 i STREET VILLAGE DIST.' SUB. LOT . f /�orr►UnFI,. I i FORMER OWNER N E ACR. $ W TYPE OF BUILDING I i RES. ; SEAS. VL. FARM COMM. CB. MICS. Mkt. Value I LAND IMP. TOTAL DATE REMARKS id r _ f �t Jcy4 t`;.- AGE BUILDING CONDITION �} J1 fU NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD 3 Meadowland DEPTH House Plot BULKHEAD j i Total DOCK i SGTM # L02-5) 25 - 1 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DI SUB LOT _ ..... ACR. REMARKS TYPE OF BLD_ 'dV4'G1 � a?f_nv�'��CiC `�,...—J r }.�`j ter 1t� r t[!i '.�: ✓ PROP_GLASS �NAt 1 LAND IMP_ TOTAL DATE , t a Ie t FRONTAGE ON WATER HOUSE/LOT I 1 - BULKHEAD _ e TC]TAL COLOR TRIM AN 9 0 - f _ I � z ; 4 a 4 € F 3 � a 3 € 1 ` t 3 F � x { M. Bldg Extension 1 f Extension Extension I 'Foundation 'Both Z Dinette Porch - `Basement % /�° Floors K. ' - ` `.Ext. Walls — £Interior Finish LR. Breezeway i 'Fire Place E Heat � U ;',-; f% DR. Garage _ =Type Roof Rooms 1st Floor R. Recreation Room ' 'Rooms 2nd Floor IFIN. B O. B. i - "d 'Dormer Driveway ' Total <. i f r " FORM NO.4 • 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT ° Office of the Building Inspector Town Hall Southold, N.Y. , Certificate Of Occupancy r No. . Z 1�2 510 . . . . . . . . Date . . . . . .June. .5. . . . .. . . . . . . . . . . . . .. 19 84 THIS CERTIFIES that the building --new, dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 605 H qh" ? ' Road ..Southold Hate No: . . . • , . . ° • Street . . . .Hamlet County Tax Map No. 1000 Section . . . 97.8 . . . . .Block . .p9. . . . . . . . . . .Lot . , .050 . . w . . Subdivision . . .Highwopd .4t. RAYViAN . . . . ,Filed Map No. .5: . .Lot No. . 8 . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated k Sep embP,r 15 , „ , 19 .83pursuant to which Building Permit No. . . I.ZQ P. Z . . , a , . dated . . . . •September .2 6, . , , , , . , , 19 ,83 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 .. . . . . .. . " . . . . . . . . . . .�L. P.riyate ,one-familX, dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . r The certificate is issued to . ,THEODORE ,S. KUDLINSKI, JR. & THERESA M.: . KUDLINSKI M + r�wner,1 -mmmi! of the aforesaid building. Suffolk County Department of Health Approval . . 1 -59-15 9,, 5/11/8 4, Rob t. A Villa, P.L UNDERWRITERS CERTIFICATE NO. . . . . . . . . .N. A4046.1 . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . Building Inspector Rev.1/81 e FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17676 Date 3ANUARY 12 1989 THIS CERTIFIES that the buildxag ADDITION Location of Property 605 HIGHWOOD RD. SOUTHOLD YORE. House No. Street Hamlet County Tax Map No. 1000 Section 078 Block 09 Lot . 50 Subdivision HIGHWOOD - BAYVIEW Filed Map No. 5547 Lot No. 8 conforms substantially to the Application for Building Permit heretofore filed in this office dated. NOVEMBER 18 19BS ___pursuant to which Building Permit No. 17634-Z dated NOVEMBER 25 1988 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued isOPEN DECK ADDITION TO EXIST ONE FAMILY DWELLING ZBA APRD #3758 The certificate is issued to THEODORE & THERESA KUDLINSKS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED N/A a Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29216 Date: 01/27 03 THIS CERTIFIES that the building ADDITION Location of Property: 605 HIGHWOOD RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 78 Block 9 Lot 50 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 4 2002 pursuant to which Building Permit No. 29020-Z dated DECEMBER 18 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 "AS BUILT" FRONT DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GAR TT A & BARBARA A STRANG (OWNER) of the aforesaid building. SIIFFOLK COUNTY DEPART14HUT OF HEALTH APPROVAL NIA _. ELECTRICAL CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED ww NZA ___ Authorized Signatur Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30933 Date: 0S/26 05 THIS CERTIFIES that the building ACCESSORY Location of Property: 605 HIGHWOOD RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 9 Lot 50 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 14 2003 pursuant to which Building Permit No. 29302-Z dated APRIL 16 2003 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 "AS BUILT" ACCESSORY GAZEBO AS .APPLIED FOR. CONSTRUCTION CERTIFIED BY GARRETT A STRANG ARCHITECT. The certificate is issued to GARRETT A & BARBARA A STRANG (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. __, N A PI M ERS CERTIFICATION DATED NIA Authorized��qnature Rev. 1/81 *tow F� >- gg F _ t: F 3 1dA5q VXY 34 � g FEE ri 3 22 T �--- F U K r � > go _a 9 } z r um IQ AS - -a 74 - ,. a° r 4 x 4 t v _ - o So SO NOW W ISO, .. . .