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Home My WebLink About1000-6.-5-10 TOWN OF SOUTHOLD V Rental Permit AL 0017 Its Owner Linda Duryea Occupied as Single Family Dwelling Located at Mansion House Dr Fishers Island 6-5-10 Maximum Permitted Occupancy 12 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. 3/31/20232 1 r !-� — Code Enfor ment ofd ial This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD BUILDINO ,DEPT. 631-765-1802 INSPECTION FRAMING [ ] FM AL FIREPLACE & CHIMNEY FIRE SAFETY'INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION I PRE C/O [vi-lRo"ENTAL Dec DATE D 3 — INSPECTOR � TOWN F SOUTHOLD PermitRental g Permit No. 0017 Owner Linda Duryea Occupied as Single Family Dwelling Located at Mansion House Drive Fishers Island 6-5-10 Address Village S/B/L Maximum Permitted Occupancy 12 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. 3/25/2019 Mike Verity Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 „ IIID r V n. Southold,NY 11971-0959 nDi1 �D�IIN�� `''✓l�y��l iii�a ,F �i , BUILDING DEPARTMENT TOWN OF SOUTHOILD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every t rs) MAR 6 2019 Section A. Property Information: T. Rental Property Address: .. p y q Jy p r r Tax Ma Number: 1000 SECTION �C�LOg LOT � Map � SECTION B. OWNERINFORMATION: Property Owner Name Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number s Property Owner Email Address: 2ec��5�5 Page 1 of 4 Section C. Authorized 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): Email Address: 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): 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: ..m" IA- Address of Managing Agent (no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number(s): 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, 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: I Use and Dimensions of each room in Rental Dwelling Unit: m 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 NYS licensed architect, a NYS 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. am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. v t z" �... h a J /� . _� � Page of ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect, a licensed professional engineer, or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building code Certification. 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: Property Owners Signature: f M sworn to before me th s, da of � � (� , 2 , ... _r LINDA M CP��"��4� AN otary Public �.t r r,i a 4,vvYork Official Notary Public 46-r nd'Original Notary Stamp No. Qualified in Nassau County Commission Expires June 9, 20a Page 4 of 4 Town Hall Annex °r°ij Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179rr tyro, ��1i�� " Southold,NY 11971-0959 i�� Vp��»»rr�l' BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier I ,_ ��Vi'µ ��" � ��. Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: � r and Dimension of each room: � .m. v . Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: TOWN Of MIIII D BUILDING 7165.1 802 � Yu��94 INSI' ECT'10 4, VIII°° II IIIIII) IllllIlllllllullllIII l °I ,IIIIIIIII III IIIIIIIIII IIIIIIIIIIIII IIIc III IIII IIID°° IIID IIID ,IlllIlllllll 11111 III Illlll) 111HIMSUIllIIIIIIII IIIIIIIIIIIIIII IllF]lll IIII,IIII VIII IIII ;s, (IIII° (IIII IIIIIII IIIIIIIIIIIII IIII IIIA�Il llll llllllllllAGIIE &, C111 FIR111E, IIIIIII I11,,,,,,,,lllllllllr11111% Illl:::,;llll llll111 l RESVIII 7llrxlmllll claims,riiiuclIIIiIIIIIIII IIIY IIIIIIIIIIIIIIIII IIIIIIIIIII 1° JIIESII 'F IIITIF F)llllw �i WNW llllll III IIIIIIIIIIIII IIIIIIII Ell III ,IIIIII IIIIIIIIIIIII III °° IIII � � I""11111""IIIIM°° 1 (IIIIIIIIIIIII IIIIIIIII IIID 11 AT1110114 CAUL111<111HING Doli .. ::.. INSPECTOR n..i - I C'4 I M JO 0OM6 U r , ca 9 Ln I,J I 1 1 W Ali It r I � , + a a = a a I r _.,v.. 2 .5 X a ii g � r w a 41 1 � - I r W d ._ ,� g x,m^ v 77 w 6 _� ........... r ��" { W e— p �— �u �� `� a Q x ill r Idl U " s� " z 0 C g@ --tn _ nm y .. .� ;'•..w.. � ��II �.. �r...Po � K Irl vY N LU r.1 oe C� o G) t7 rn ............. .......... ................. ........... 0 IT p 0 "i > 1-7 n Xt -4' 1� Pt Z �, � iCmi��rIE 7 55,7 TI'E I 4 .4 1" 1 GI w F� wk TP ------I . ............ ............ . ....-—------- O 0 0 u' VVV INA- c:: Z z 20 z > ... ....... ri. r7 #t r 4frmaiiaa „H d faa �u u� r �l waw ,,.., �..d�, wane away j�wai��n/ ,....... .... .:a�. ,. x,w o �n w.,,� —.ti�,< 9 ... moaw� .............. .. t E. R. c t � I r t � ..... _a'i 1 .,,,.. CSR t 1 m I i��_j a CD ,k2 co S rw•k Q- _ 5 s, ............. ...... I, ..... ....., rr ........... �R FYI r f 1 r IJ o �,.. _ .. . �. 1 J � „e FORM NiO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. UQU. .......... Date .... ...... .............. ? .... 2............, 19.61. THIS CERTIFIES that the building located at • m&:Lon...House• IV, ---........_ Street Map No. XX. Block No. XX.............Lot No. n...Shei.�,,.�sI nd confnrms substantially to the Application for Building; Permit heretofore filed in this office dated ....................NovMter..11., 19.48 pursuant to which Building Permit No. A..3C.1.1. dated a ......... ..........AN0Y.%Ab1$-r. ........ 19...60, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .......Pr.ivate..,one—family.. dw.011ing.................... ..... ....... .............,...................... .. .... This certificate is issued to .W.a.a.;.aIIlj)ury.ea...&Alre......... .... .........fw.m.vi ... .... ... ...., (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No. Z-23453 Date JANUARY 19, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property MANSION HOUSE DRIVE FISHERS ISLAND NY House No. Street Hamlet County Tax Map No. 1000 Section 6 Block 5 Lot 10 Filed Map NoLot No . conforms . .� ..„ conforms substantially to the Application for Building Permit heretofore filed in this office dated- DECEMER 9, 1993 pursuant to which Building Permit No. 21971-Z dated MARCH 29, 1994 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued i8 AN ACCESSORY SHED IN THE REAR YARD AS APPLIED FOR. The certificate is issued to WILLIAM DURYEA ..�. mom_ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ildin9 P In actor 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-33614 Date: 03/24/09 THIS CERTIFIES that the building NEW DWELLING R FISHERS ISLAND Location of Property. MANSION HOUSE DW.-www (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 6 Block 5 Lot 10 Subdivision Filed Map No- Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 2004 pursuant to which Building Permit No. 30508-Z dated JULY 23, 2004 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 COVERED FRONT PORCH AND REAR DECK AS APPLIED FOR. The certificate is issued to JAMES M DURYEA TRUST (OWNER)................_._.-m........._... of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-03-0134 03/13/09 ELECTRICAL CERTIFICATE NO. 2022721 09/29/06 PLUMBERS CERTIFICATION DATED 02/03/09 GLENN GELLO thoed -nature Rev. 1/81 i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33614 Date: 03/24/09 THIS CERTIFIES that the building NEWDWELLING Location of Property: _ _MANSION HOUSE DR FISHERS ISLAND Count Tax Ma No_ 473889 Section 6 Block 5 Lot (HOUSE NO. ) (STREET) (HAMLET) County p 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY' 20, 2004 pursuant to which Building Permit No. 30508-Z dated JULY 23, 2004 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 COVERED FRONT PORCH AND REAR DECK AS APPLIED FOR. The certificate is issued to JAMES M DURYEA TRUST (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-03-0134 0:3/13,/05 ELECTRICAL CERTIFICATE NO. 2022721 09/29/06 PLUMBERS CERTIFICATION DATED 02/03/09 GLENN GELLO 44 r �,tft,hori ed Signature Rev. 1/81 i Y I rte, A TOWN OF SOUTHOLD PROPERTY mjz,;.wKw OWNER STREET VILLAGE DISTRICT SUB. LOT FORMER OWNER N 1 ACREAGE 4- S w TYPE OF BUILDING RRES. SEAS. I VL, I FARM comm. IND. CB. misc. Est. Mkt. Value c, LAND lmp. TOTAL DATE REMARKS f fz� cf, 4% --sa,ib�,gi '4- U A' AL— f A Z, AGEBLALDING CON D T1,04 z-\ - ARQVii-7 ,FPOKITAGE 0 N WAT NOFRhAAL BELOW Val FRONTAGE ON ROAD ---------- Tillzble— ; BULKHEAD ' Tillable 2 DOCK Tillable 3 Woodland CC Swampland —7,k G— Brushland 14 7j,-,x -7tflle House Plot Total _ N d � ti � COLOR _ i= X_ s. � TRIM ME a � I 6.-5-10 3/06 - I 1 st 2nd M Bidg_ - s= z a Foundation Fin. B. Bath Dinette COMB Extension i _ PART' -- Basement � �� Floors Kit, xens�on c Ext. Walls Interior Finish LR. Extension _ � Fire Place Heat d t µ D R� _ � � C , Patio Woodstove BR Porch u' �, Dormer ( Baths Deck �, D � ock ' Fam, Rm. n A.C. - - Garage O.Bi Pool ` - m } a \ a LA M. Bldg` d Foundation � OtH � \ �� '. Extension ksement -{ ,- __ � Extension Est. Walls _ (r# >io F-In sh C _! Extension 141re Place � Heat arch -pb, Roof type_- 7 i Ei � Porch: ; Rooms 1st Floor Breezeway Rooms 2nd Floor E GarageD. i e I Dormer 0. X B. t - - - k —Q s' s `� y P - \\