HomeMy WebLinkAbout1000-126.-10-21 � FF SOUTHOLD
V; -
Rental Per ■
Permit No. 0066
Owner Kathleen Collins
Occupied as Single Family Dwelling
Located at 6495 Gt Pec Bay Blvd Laurel 126-10-21
Address Village S/13/1-
Maximum
/B/LMaximum 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.
5/22/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
soy
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)76579502
P.O.Box 1179
Southold,NY 11971-0959
B ELD -G DEPARTMENT
TOWN OF SOUTHOLD
RENTAL kIlMIT APPLI ATIO I
_Rental Permit_.Fee,$2QO (Application must be gene red every t ar
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MAY - 6
2019
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Section A. ITOWN OF,So
Property Information:
Rental Property Address:
,i..a Map iwuirndeur: ,' . SEICIU)N � � .
BI O�"miC
OWNER INFORMATION:
Property Owner Name:
�
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Property Owner Legal Address: Property Owner Malling Address:
(Cannot.be.te same as_Rental Property.A . res )` P
Telephone Number er (s); ,?, 0y)
Property Owner Email Address:..+�
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Section C.
Authorized Agent Information:
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Name of Authorized Agent of dwelling unit, if any: _
Address of Authorized Agent (no P.O. Boxes): O9 NY
Mailing Address of Authorized Agent:
Te e lbs)
� 'I„Add...
Ema rens,_,,, ! t,&'/
m M6
Sectioq-&, J
information:
Name of Authorized Agent of dwelling unit, if any:
,
Address of Authorized Agent`(no P.O.Boxes):
. A.
Mailing Address�of Authorized:Agent: J ”
Telephone Number(s):
Email Address:,__
SEC71ON E.
SITE MA14AGER INFORMATION: (required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any
Address of Mainaging Agent (no P.O. 'Boxes):
Mailing Address of Managing Agent:
Telephone Number(s):
Email Address:
Page 2 of 4
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-32332 Date: 45/02'/0"77
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 6495 GREAT PECONIC BAY BLVD LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 126 Block 10 Lot 21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 3, 2006 pursuant to which
Building Permit No_ 31708-Z dated JANUARY 5, 2006
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 SINGLE FAMILY DWELLING WITH FRONT & SIDE PORCHES & REAR SCREENED
PORCH AS AJPLIED
FOR ..... - _ ......
The certificate is issued to RICHARD & KATHLEEN COLLINSmmmmm
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-05-0214 0.4/03/07
ELECTRICAL CERTIFICATE NO. 7558 04/24/07
PLUMBERS CERTIFICATION DATED 04,/30707 MATTITUCK PLUMBING & HEAT
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Authorized Signature
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-32331 Date: 05/02"Z_0
THIS CERTIFIES that the building ACCESSORY
Location of Property: 6495 GREAT PECONIC BAY BLVD LAUREL.
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 126 Block 10 Lot 21
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 3,,2006 pursuant to which
1� JANUARY 5, 2006
Building Permit No. 0'1"708 dated JANUARmITIT_
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 ACCESSORY GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to RICHARD & KATHLEEN COLLINS ..........
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 7558 04/24,/07
PLUMBERS CERTIFICATION DATED N/A
Authorized Signature
Rev. 1/81
.............
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SOUTHOLD BUILDING DEPT.
765-1802
jINSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] INALIfM�,�
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[ ] FIREPLACE & CHIMNEY [vf FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
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REMARKS:
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DATEj INSPECTORIP
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SURVEY OF PROPERTY
SITUATE: LAUREL N
TOWN: SOUTHOLD W E
SUFFOLK COUNTY, NY
SURVEYED 09-29-2005 ^'"
AMENDED II-09-2005 r S
FOUNDATION,GARAGE LOCATION 1-51-2006 0
SUFFOLK COUNTY TAX• '' ��^
1000-126-10-21
f SUFFOLK COUNTY DEPT.OF HEALTH ✓''�
SERVICES REF.A RIO-05-0214
CERTUTIMTO:
Kaffilow Co11huM..
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y 09 NOW York G
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NOTES: `
MONUMENT FOUND ..
1
AREA=50p0O S.F.or 1.14-1 Acres
TIE DISTANCE FROM SUFFOLK COUNTY TAX MAP JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC 5GALE 1"- 40' RIVERHEAD,N.Y.11901
369-8288 Fax 369-8287 REF ACompagerveitmA05\05-31 Lpro
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