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Home My WebLink About1000-64.-5-26 P£ SOUTHOLD WWffi Rental Permit 0109 Owner Kirk Lloyd Occupied as Single Family Dwelling Located at 1325 Shipyard Lane Southold 64.-5-26 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. 7/10/2019 John Jarski Code Enforcement Official This Notice must be posted by the main entrance at all times Town Hall Annexe Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 ijjr, P.O.Box 1179OP � f Southold,NY 11971-0959 oil BUILDING DEPARTMENT TOMN OF SOUTHOLD RENTAL PERMIT APLICATIO Rental Permit Fee $200 (Application must be renewed every two years) Section A. q Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -BLOCK � -LOT SECTION B. OWNER INFORMATION: Property Owner Name: b b t ene Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): Daytime Evening Emergency_-- Property Owner Email Address: *45f Page 1 of 5 . 0<1 Town Hall Annex �, ��'� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 ]P.O.Box 1179 Southold,NY 11971-0959 '�� BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized i unit, if ( ( d Address of Authorizednt (no P.O. Boxes):., e- Mailing Address of Authorized Agent: SO SIP �� a w„Y NY-P-5 Sou 1 ,� � 4 1 ; le Telephone Number (s): Daytime__,,,,__�....._ v ing .........,.... rgen y Email Address: ( X1.5 V I` �1 ... t T o r , Section D. Managing Agent Information: Name of Authorized Ili i , i : Address of Authorized : Mailingr riz :. __..____.. ....__. ...._.................. .......... .._�.. _ _ __... ............... Telephone Number : Daytime Evening_ rgnry.. _ Email : SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing r more rental units) Name of Managing Agent of dwellingit, if y: Address of Managing Agent (no P.O. Boxes):_ Pae 4Fi"r �ti Col Town Hall Annex ` °. Telephone(631)765-1802 54375 Main Road t'l ��, Fax (631)765-9502 P.O.Box 1 179 Southold,NY 1 1 971-0959 � ,y,c BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: �IT Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: V _.. 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." 101/ Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: ,, Number of rooms in Rental Dwelling Unit: ® m Use and Dimensions of each room in Rental Dwelling Unit: �� 1Z 0e t L Page 3 of 5 1 I q y9 Town Hall Annex l` Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 r�U w BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 flaws adopted by the New York State Fire Prevention and Building Code Council. M1 I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION . DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit STATE OF NEW YORK) COUNTY OF SUFFOLK) 1402.9- —A......................_ ._...... _ _, 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 Page 4 of 5 J y oA" , Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold NY 11971-0959 � ,a� I j( " BUILDING DEPARTMENT TOWN OF SOUTHOLD applicable laws and rules. I further acknowledge that I will notify the Town of Southold Building Department of any changes of address within five ( ) days of any changes thereto. . 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and reed to abide by the same. . 1 will notify the Town within five (5) business days as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. cProperty Owner's e: ... Property Owner's Signature: .... Sworn to before me this IL day of w °°�� -.,,.,........ 20ift h m � Off' al Nota „� h �_....__ ......._.... �. ry Public Sigi and Original Notary Stamp JEW ICA ROO NOTARY PUBLIC,State of Now y(xk No. 0 1 R06236,923 Quallfted in Kngs county Cam*,Won Expires7 Page 5 of P �P &so TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ' [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] I AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION r [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ j CAULKING X,,� 06�AAA W 1 INSPECTO DATE sm all, Comments., AREA CALCULATIONS SUMMARY WING AREA BREAKDOWN Code DOSCHPtion--.- Siza Not Unals Smakdoffli subMiras.... GLAI First Floor 1302.00 1302.00 Fisat Floor GLA.2 Second Floor 518.00 518.00 14.0 x 50.01 700.00 14.0 x 43.0 602.00 Second Floor 14.0 x 20.0 280.00 14.0 x 17.0 238.00 TOTAL LIVABLE (rounded) 1820 4 Calculations Total(rounded) 1820 ............ O E : 3 ou— z o cl- CL z 5ma rn Z ! Mm0 ......... . ......... mu rj 0 oz on col 2: c 4 Irl > o 00< ......... 0 M'D 10) ro In < Vb -n -n 0-00 10 z 2, z j! 0> ----------------- co -fit FU tI 0 tz GZI ......... lq� fw ......, < CO t (D 1W 4 g d4 .d (D (D L, (A (A O 70, � I y Y 1 i l � kl w 1 h I "off I I I I I �. ...M w. -M -n .-x� ° c m m � o N ^F O � F I T W � O O O CID I rt (� O O O p N p N (n to O —I 3 I to N "* N K { 0 o G sL 0 14� �~� , .• I I kill i , . i . � j I r FORM NO. 8 'DOWN OF BOY{'PpFOLD BUILDING MPMTKWT Gffice of the Buildiag Inspector Tota Ha11 Scurhold, M.Y. CBRTIFI'CATB OF OCCWANCY No: 2-32971 Date: F 3I '�17 C12III IN q chat the Indlding M DWELLING, mMU R uxcatium of Psopert'Y: 1326 ow S91PYIMD RD SOUTK= p1'OUR N ,? 4;TRU Y ,i E '1 ComtV Tax*V No. x''36' ,9 .Sea ion 64 91ock 5 Lot 26 fir68iviaioa Filed Map Yo, Lot No. cvnfotzns substantially to the plication for Building FL>rM t heretofore filed is this office dated MAY 1 _ to wbd h Building Mermit Mo. i2 d�1 dated vas issued, aAd conforms to all of the requirements of the applicable provisions of the law. The occupancy for which th" cerCiffeate is issued is � F"AMMY DWRL G COVBR FRCi'i' �t�OF TRC FL1 VOR The certificate in imaued to B O F LIV TRUST' of the aforesaid building. BOR'FOI.]C LVm=°MWARTKIMT 419 MUM APPROVAIN R10-o3-0-123 0s 22 07 l_A7• ICMB NO. 30294594, 6, 9 OU CmTIrxmTi ICfi DATW 2 6CUTCHWUB EAST PLI11111M tired $igmture Rev. 1/al G b d DLL ON i3vNIS9v Pill M NdL 6 °G EM 'S 9nV FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32571 Date: 08/31/07 THIS CERTIFIES that the building NEW DWELLING (MODULAR) Location of Property: 1325 OLD SHIPYARD RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 64 Block 5 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15, 2006 pursuant to which Building Permit No. 32004-Z dated �...... MAY 15, 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 ONE FAMILY DWELLING WITH COVEREDm FRONT STOOP_ ANDREAR DECK AS APPLIED FOR. (MODULAR) _ The certificate is issued to MARY EKKERS BARROWS REV LIV TRUST (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-03-0123 08/22/07 ELECTRICAL CERTIFICATE NO. 3029494 06/29/07 PLUMBERS CERTIFICATION DATED 06/26/07CUTCHOGUE EAST PLUMBING Aut' ri ed Signature Rev. 1/81 st° Town of Southold 7/9/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40487 Date: 7/9/2019 THIS CERTIFIES that the building DECK Location of Property: 1325 Old Shipyard Ln., Southold SCTM#: 473889 Sec/Block/Lot: 64.-5-26 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/24/2019 pursuant to which Building Permit No. 43836 dated 6/7/2019 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: DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING ASAPPLIED FOR The certificate is issued to Lloyd,Kirk&Aimee of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ......... ...... .._ __ .. 1 .. til r° Signature