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Home My WebLink About1000-88.-3-9 g TOWN OF SOUTHOLD Rental Permit 0145 Owner Samash 812 LLC Occupied as Single Family Dwelling Located at 700 Gin Lane Southold 88.-3-9 Maximum 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. 2 2 2 � 6/ 9/ 0 3 Code Enkkement O is This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD BUILDING D1 831 785r 18 2 '` INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE &. CHIMNEY [ ] FIRE SAFETY IN% [ ] FIRE RESISTANT CONSTRUCTION [ ] EIRE RESISTANT PEI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII [ ] CODE VIOLATION [ ] PRE CIO [ eF DATEr - INSPECTOR - o"toe �� wnt' � TOWN OF SOUTHOLD BUILDING D1 631 -:765-1802 -- INSPEC l0rw [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INE [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL [ ] CODE VIOLATION [ ] PRT C/O [ (FI REMARKS: 1 wl. 14� a' S4 INSPECTOR ,DATE 11 lxz A/ "T-owrj HH11 Annex �NSQ -4375 Main Road UTHQLD]S�K 5 `11-79 SouthOld, F'O Box 7� Rental 1 §pgctic n NY 11971 -1179 Tel 631 -765-1802 Fax 631-7(>^.9502. Date SICITM # Phone Owner Zip Address n s.p e cto r m City y SUB 2....... LEVELS tecto�s .......... -oor-f-� detectors excludedr, ....................... ......... E-,,37(b(;jTM" onoxide Detectors ir -,xtiriguis,hers (7t) 1:X—i't, 5 2 3 BEDROOMS rincke [)Oector Alari-Tis C,',arbon iVoncmde A�arrns (#) Egress (vvmdows /t l 7 X, -'Y m I OF PROPER I BUH MG SYSTEMS j,ONDI'TiON 1:1, ild,ng ¢E `o> s )�ai n& RuOdmq naintaine .Li�(-)t \N�3r.er sy t e n,i r d./ Property is c,,,ean safe rinaintained 8, guarcJs present Mec,hanical systemn NA M N--F,-.), ............ .... ....... La, TOWN OF SOUTHOL Rental Permit Permit No. 0145 Owner Samash 812 LLC Occupied as Single Family Dwelling Located at 700 Gin Lane Southold 88-3-9 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. 8/8/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times a Town Hall Annex 14 Telephone(631)765-1802 54375 Main Road Fax(631')765-9502 coo P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application most be renewed every two years) Section A. Property Information: Rental Property Address. Y Tax Map Number: 1000 SECTION _ BLOCK� LOT SECTION S. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address (Cannot be the same as Rental Property Address) Lir L° Telephone Number(s): tin vl Property Owner Email Address: �` e )&L,,� [°'' Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: '& '" err": N e'1 1 1 ._ Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s). � � i Email Address: i �V0 1 VIS,. ,.b i, v 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: 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 roorn. 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'' �. L " �" 221- Use and Dimensions of eachroom in Rental Dwelling Unit: F 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. Page 3 of 4 ❑ I 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. M. Property Owner's Name.: Property Owner's Signature: Sworn to before me this day of26 Noftq PUMIG, ftlm of low Yo fi�� .� o. t� Official Notary g Public Signature and Original Notary Stamp in Suffolk County . t o Page 4 of 4 44 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959All � BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: 100 111 I Requested maximum number of persons allowed to occupy each dwelling unit Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: ri i 4 I B X 115 wrr* -1.<-1 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 SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINALAn 'f r [ ] FIREPLACE & CHIMNEY [VJ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL(ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING DATE INSPECTOR a :r• T2• x�� ms.µ, rnx�a :vrsxlro rtmaa w � r w 1�r�++ , r+7LL'7�u+L[t'hRt'tl Lf twf 7.L,tr ch.j I Bedroom#'i M M �1 a ^ r ww • DINING �.L• rte• � nw gwr .Sw.WACLL aa" ,arr. y•a; ,.at. a� rSj � . r I w RC+�i�ri.^RY`Pr e« r+�.ramr.7fLw`i tw � s "["g at LIVING �+� � � Leo � ; • w U. 'p gAkN 4 vvix way: �" �., • a^gym• ,� 7=«* fair a , r" t } X17.3 E Cf�•� 1 N E 1 .51• l S^^,sp• Knell L+1"�71 N N` � roor4 8edtoo.m #3 a Ic+secKu 37.14' N 1 1 t cc I �� .. �+u ate. ;a, G•; � �lfri N ' N � s � N � �* �� .• ��tiaN �� N N 1 WT I N I N N B-psimin #2 N N t N N QPEII 2.3a*3 kb=f► 1 glgm L'•e! r 4 N N N N E N E r+sa�l•a *�1•a rtir70e�5 2ND FLOOR PLA( SCALE: 114" - V.0" ARM4 J m e ,y ryj ea'GUna" tlYeNauW. MN IRp. a �l ". Pit tl y y n r _ , G �Y{t 5 9 � �q1 V X Y MF' JM.ntl xMF'IM ry, � "". . � N N. � Ips a �R'HIM,P iii tl a WN mi; B•- �C� I 1 tl, q y e -.—-—--^——————— r MIMI I r c a q r u tl 8 S' X ✓ tl X P g}¢ fl r! � Y eu m e4 � N euXr�,v I H 1 I 1 tl NI i 1 , 2nd Floor Bed 3 Bed 4 9 l eeI y, N a g j N� II I 1011 1011 115 cfm 97 cfm .... :� 76 ....> 30x6 TG 6i1 % 30x6 TG 8 � Bath 3 711 Hall 711 7 30x24, 1 RA g° 1811 10 , 40 c+. 4 � tl 14 1 10 a , 16 � � 8 �, 30x6 811 8„ TG AH 611 f 611 'r„ 711\ 88M Tp 7B'u a 43 cfm ..... 8.�� yl... [.1 11 11, 89 CfM y Bath 2 1011 1011 , 1 79 cfm 79 cfm p 11 pp < < Bed 2 n i I 9 Job#:700 Gin Lane Scale 1 71 PerfoInned byAnthony A adlo,PEfor. Home Energy Solutions, Inc. PaW2 187 E Mah St RIgt&jtOUnvasd2J18 700 Gm Lane Huntington,W 11743 1aaoeRSU1M8 i Southold,W Phone-631-673-0664 Fax-631-547$446 2(118.lar0912.4248 vmwhome-ene olutrons.com dlama -�GlntaewoGrntn-JSDRUP rgys g y3@gmalcom i ;ova " ° f 1st Floor m M Bath Master '' '73 cf67 t t 7 ra'r � n 4r� .h 7 c fin 7„r Landry 0x6 { 1'0 10 11,021 c; 104 cfrn 101, U 0 104c mi l l ” a � i ( '104 cfm 104 ch 1 9 i { u . n LFaniUy 4 I I I I n Job#:700 Gin Lane Home Energy Solons, Inc. scale:1 71 Perfo'7'ed byAnthonyAmadio,PE for. Pagel 187 E Man St R U 2018 700 Gin LaneNY Huntrrglon, 11'x'43 1a®OSRSU18218 Southold,NY 2A 1a4248 Phone-631-673-0664 Fax:f 31�47�446 _�GinraeVmGmin-JS®RUP www.home energysoUions.com gciamay3@gmaR.com f I I --i � m Z ' r 1 " 0 c o O °o C: U) o n D m O ro o` co m f o -* a w 73 B ,.� m ice_ � -o � � �• ro n w. y. D — m O rC (..... ..... Z. ..,.w_ ..... off Uri " D ro O OU r_ O O.. . .. ...,,. Z Z %1 O (} � m ?� D DCAI m < m m ou OZ „. ,w m m O '} m %Aj to �NSOF X10 w� < l w ' � 'mow � �� ...� � �"&mw,�� .. .,,•,•„� cu 4 w� i •U '9 m I'T'1 C) O o cT a r i 0 I 1# 00 �7, l 4� i ) ICD IU) QJ w Irk O O n + N ';,ti •< � -�. (D to r .....d d-.-. — q ..... ..... p 7-7 _d v I en + o 0 Inp .... a ,. a rt �• � r .... _..,. , � CD1 C ............ ..... ... rt V y 9. dm, .s Town of Southold 9/12/2018 r' 'kid P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39827 Date: 8/7/2018 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 700 Gin Ln, Southold SCTM#: 473889 Sec/Block/Lot: 88.-3-9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/20/2017 pursuant to which Building Permit No. 42272 dated 1/2/2018 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: prime f 4p �ly dwelling with,rurivaistabasement, owri licrl and rearµl)orches and attckaeasl cap ara ITs. ,Iaµlali for. 9/12/2018 Corrected for Certificate of Qqq Mnumber only. The certificate is issued to Wells,Arthur&Rose of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-17-0216 8/2/2018 ELECTRICAL CERTIFICATE NO. 42272 _........,.� _...._7/23/2018 PLUMBERS CERTIFICATION DATED 7/17/2018 Wil in:Schs b �. D1 -iz,d Signature ........- -.... Town of Southold 7/15/2019 � g P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40497 Date: 7/15/2019 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 700 Gin Ln, Southold SCTM#: 473889 Sec/Block/Lot: 88.-3-9 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/17/2019 pursuant to which Building Permit No. 43679 dated 4/25/2019 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: accessory in-Mind syiannt:.p pt�ol as ap��licd fc:`, The certificate is issued to Samash 812 LLC i of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43679 6/26/2019 PLUMBERS CERTIFICATION DATED ut oriz aattat°c_. .. m.... i i