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Home My WebLink About1000-143.-2-16 TOWN OF SOUTHOLD Rent _ l Permit zg£ � Permit No. 0124 Owner Toner Premises Trust Occupied as Single Family Dwelling Located at 875 Sigsbee Road Laurel 143-2-16 Address Village s/B/L Maximum Permitted Occupancy 3 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. 7/26/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times f l r ' Town Hall Annex Telephone(631)765m1 54375 Main Road � ;' Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT PERMITTOWN OF SOUTHULD RENTAL I Rental Permit Fee $200 Wplication must be renewed every tura years) Section Property Information: Rental Pro rty,address w Tai Map Number: 1 SECTION �r � BLOCK LOT SECTION B. OWNER INFORMATION: Property nor em "f Al S "S Property Owner LegalAddress: Property Owner MailingAddress: (Cannot be thea a as Rental Property Address) 4 41 d� Telephone Number Property Owner Email Address: Page I of .. �,. U Section C. Authorized Agent Information: Name of Authorized t of elfing unit, i � ) Address of Authorized Agent B, „ �... Flailing Address of,authorized A e t":' Telephone Number(s)e Email resse Section D. Managing Agent ® .. Name f Authorized Agent rell!9 ”' � it,if nye Address of Authorized Agent(r P.'b,,Boxes); Mailing Address f A t z edAgent: �... Telephone Number( EmailAddress: SECTION SITE E. ® (required forrerilial properties containing 8 or more rental units) Name of ManagingA errt,pf dwelling uni�; i " Address of Managing Agent(noIBoxes): Mailing ress of Manawhig Agent: Telephone Numberg � EmailAddress: d Page 2 of SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: For eachRental Dwelling Unitset forth the Rental Dwellingi identifier( r example, Unit 1, Unit 2, Unit 3 or Apt A, C}P the use of each in the Rental Dwellingit (for example, Kitchen, Bedroom1, Bedroom 2, LivingRoom) and the dimensions of each room. For properties with multiple Rental Dwelling Units s "Rental Permit Application x'00 Rental Dwelling Unit Identifier: Requested axi number of persons allowed to occupyDwelling I1� ~ Number of rooms inDwelling Unit: (>O ns Use i e si s of eachroom in RentalIliUnit- SECTION p Pursuant to the Town Code oft e Town of SoutholdChapter 707 (Rental Properties), a safety inspection by Code EnforcementOfficial isrequired. if the owner chooses not to havesaid inspection performed by the Town,a certification from a NYS licensedarchitect, licensed professional engineer or a home inspector s a valid t te Uniform Fire Prevention it i Coe Certification is required ting that the property whichis the subject of the rental permit application is in compliance i I the provisions of the code of the Town of Southold,the laws and sanitary and housingi County of Suffolk y the laws adopted by the New York State Fire Preventionand Buildinge u cil- I am requesting a fire safety inspection to be performed by a Ce Enforcement Official from e Town of Southold. Pae 3 of 4 I am submitting a completed u certification for licensed architect, licensed r ssi I engineer, or a licensede inspector a a valid New York to Uniform FirePrevention it ing code Certification, SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwellingunit. STATEYORK) COUNTY OF SUFFOLK) certify under penalty of perjury,the following: 1. l am the ownere property identified in "'Section A"of this application. 2. The ro °s legal address set forth in "'Section r of this application is my legal address and I understand the Town will use the addressservice rs t to all applicable laws and rules. I further acknowledge that l will notify the Town of Southold Building Department oany changes of address within j ( s of any changes Cert . . 1 havee received e f the Code of the Town of Southold and agreed to abide y the same. 4. I will notify the Town within five (5) business days s to any change to the information regarding Authorize a i Site Manager. 6 „i Property War's a . Property is Signature: Sworn to before me this day of20 r Official Notary,.Public Si r a OVgin I to to T IS i Notary Public, State Of NewY rl No. OITAoomooi uafffied In Suffolk GOLInty Page 4 of 4 Commission Expires 011/13120 �. T WNI OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIONi i i [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2N,D [ ] INSULATION [ ] FRAMING /STRAPPING [ ] pINAL { ] FIREPLACE & CHIMNEY jFIRE SAFETY I SECt' 'N" [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REM KS: �> ................ V A"S"E INSP T . f Ci 01 9 1 r Mt m� _ ......." .. .. . .� s w ..m CS _. 14 L L- Ql_ A_ T r S W IV . 1 c r.... 1. 1 .. 1 lb s ; Edi JN li 111)k . �: Y w LnS Rcr C r N I ' _ > CL 7 CL �a r-, 9�^•w. w T, n w N » I „ LIN1 CD 7 ti l ` _ I {i w 1 t.m.- r SS 1 0 �-i CA NJ .. ... .. �� ,M C k r E m I p CO p m m m Z Z w•a.LL. z4` m � . c � n m p 9 C1 rW. o rw co ryry'� l • i i Y ms''µ i a� to O t W _ ��. CD i A W CIA "N 3 O N w N �.. ,p 4 0 0 as a M " ✓ g- r� � � r ry a � �" .��_ I ,� -�?�q vi N �rS� e� � .t�� ax�J � �� °i,d l r� � h tiwo.-• � �Y i" J CC w -- 999 a � 1 � 9 R K �k x , S n• .Y @ � N �'M 0 � �"' �'�" �PJ ��p Ida 'Rte 6 I m CD CD " Ur O� TI O O r . d s • � �� ,� ...� ala a i a--of " q " N o (A V) 3 c , OG AL � r 0 4 q 1 " . a. " " I .. �. m�. r „ J ----—------------------------------------------ ------ ..... F04 Town of Southold 7/26/2019 53095 Main Rd Southold,New York 11971 PRE E STING CERTIFICATE OF OCCUPANCY No: 40549 Date: 7/25/2019 . .............................. THIS CERTIFIES that the structure(s)located at: 875 Sigsbee Rd., Laurel .................................... SCTM#: 473889 Sec/Block/Lot: 141-2-16 ----............ ............ Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40549 dated 7/25/2019 was issued and conforms to all the requriernents of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame a, family yell e I ggy�i porc h enclosed fi-ont h.* ly_ i t BP 2308 additions COZ-2004;BP 34519 "as built d a e aftered to ivin 94 an Lwl-3 1 y�_q, ddeckadditiog CQ The certificate is issued to Toner Premises Trust (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. A , I ri d S ignat -e BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 875 Sigsbee Rd.,Laurel SUFF.CO.TAX MAP NO.: 141-2-16 SUBDIVISION: NAME OF OWNER(S): Toner Premises Trust OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Toner Premises Trust DATE: 7/25/2019 ........... ........ ........... DWELLING: #STORIES: I #EXITS: 3 FOUNDATION: .... ................ cement block CELLAR: — partial CRAWL SPACE: BATHROOM(S):--" '"'I TOILET ROOM(S): ...................... UTILITY ROOM(S):..—,,- PORCH TYPE: front enclosed DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: ..............---.................... DOMESTIC HOTWATER: yes TYPE HEATER: gas AIR CONDITIONING: TYPE HEAT: gas WARM AIR: HOT WATER: baseboard #BEDROOMS: I #KITCHENS: I BASEMENT TYPE: unfinished OTHER: ........... ACCESSORY STRUCTURES:. GARAGE,TYPE OF CONST: —--------- STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: ......................... REMARKS: ........... .......... .................. INSPECTED BY: JOHNJ DATE OF INSPECTION: 7/18/2019 TIME START: 10:00am END: 10:42am ---------- FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33641 Date: 04/10/09 THIS CERTIFIES that the building ADDI-.TION/ALTERATION.m _ Location of Property: 875 SIGSBEE RD LAUREL (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 143 Block .2Lot 16................ .m ......... Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH13„ 2009 pursuant to which Building Permit No. 34519-Z dated MARCH 20, 2009 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ....................... 1S "AS BUILIED LIVING SPACE AND DECK ADDITION AS APP , T_"_GARAGEIT ALTERED TO LIVi FOR PER ZBA #6239, DATED3/5/9. The certificate is issued to TONER PREMISES TRUST .WWW. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTM@1T OF HEALTH APPROVAL N/A RI CTRICAL CERTIFICATE NO_ 4025974 04/01/09 PIAJMSHRS CERTIFICATION DATED N/A Authorized Signature Rev. 1/81