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Home My WebLink About1000-143.-3-24 TOWN OF SO T OLD Af Rental Permit Permit No. 0210 Owner Nicholas & Maureen Deegan Occupied as Single Family Dwelling Located at 795 Marlene Lane Laurel 143-3-24 Address Village S/13/1- Maximum /B/LMaximum Permitted Occupancy 4 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. 10/29/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hail Annex Telephone(631)765-1802 54375 Main Road 4 Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 0 C1 . 2019 BUILDING DEPARTMENT TOWN OF SO OLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Pro erty Address: N-1NAL-VTT-bf Tax Map Number: 1000 SECTION -BLOCK -LOT SECTION B. OWNER INFORMATION: Property Owner Name: , Property Owner Legal Address: Property Owner Mailing Address: a 3- W Telephone Number (s): Daytime Evening Emergency awn 70 Property Owner Email Address: Page 1 of 5 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 SO " HOLD Mailing Address of Managing Agent: —7710( Telephone Number(s): Daytime Evening Emergencym „_„ f Email Address: /PI 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, Q;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.” W Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit:_m m Use and Dimensions of each room in Rental Dwelling Unit: _13 Page 3 of 5 i II f, Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(63 l)765-9502 P.O.Box 1179 Southold,NY 11971-0959 , 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 laws adopted by the New York State Fire Prevention and Building Code Council. I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) 1 , 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 Town Hall Annexf�; Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 u Southold,NY 11971-0959 'gym ytiM BUILDING DEPARTMENT TONM OF SO OLD 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: i Property Owner's Signature:...jl�l e Sworn to before me this�O day of 201 . . Official Not ry P ' lic Signature and Original Notary Stamp Lith.�1p8 Zed Page 5 of 5 f r tiv �d I Town Hall Annex Telephone(631)765-1802 54375 Main Road t`` Fax(631)755-9502 P.O.Box 1179 Southold,NY 11971 0959 � i h . BUILDING DEPARTMENT OCT 2 4 201.9 TOWN OF SOUTHOLD RENTAL PROPER"T"Y'CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit E oo ` ssionoi seal re aired or rchttect ar Fn sneer iicensed borne ins actor mastLgvide f;qpy—of valid cgrrent cern catiog Rental Property SCTIVI Number: w� D Rental Property Address: e_ Owner/Name: . Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedrock 1-100 sq., Bedroom# 90 sq., etc.) 'j Property Description (include all improvements Indicated on urve ) r µ w I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation onstr ction Code of New York State. �. Print Inal Si Hato Please n (� . HAVi ., _ 0 t�'9; ceZ' a� rz Town Hall Annex Telephone(631)765-1802 54375 Main Road �' Fax(631)765-9502 P.O.Box 1179 ` Southold,NY 11971-0959 i � Wi�� r w, BUILDING DEPARTMENT TOUN OF SO OLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit #ro ssional seal re ui ed or Architect or Engiheer, licensed Home Inspector must �cqa o Ivalid current ceokation Rental Property SCTM Number: ^ �� Rental Property Address: ie� °je Owner/Name: _ILLcAtV Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Redroo #1 -100 sq., Redro�m 0 sq., etc.) , Property Description (Include all improvements indicated on urvey) - - cc I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation onstr ction Code of New York State. m L Print Orglnal Signatu Please p ol e 16 al TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION' ' [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ l FINAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING INSPECTORRE A?IK No I A A All DATE 10 14L76" }Z2S�)/G(i1:TN�A�.)Il.Gl.7..�.d� edroi,JI i SS.lYiJO SV'd JIiiVMIiJ4 Hi1VW H14V7 3fd3"IY tJW S6L ft.k i s � I vn N r � w,. F- �s, O V /f O 7- 11 X d LIJ �� 7tT1(>h M3t�[>IJCI.(d,LJ.�i'IN s „//� � �rvt,xossro�a rzx�vnnx:>s aaww r, INV 13N`{'I2CVW S6L 7 NVIWJ x 0I3 `A, U .� ' i j a c Now �r r 0 LLIU ................ ........... � 7 Aero h 0 Ip T r '7 j W Ln Cr m o a 3 0. I CL M APCD 9a � � a Q O �, — m � CD zi r r D m Z Q r N Z w 1 LI CID (� Q m Z � D Q i co \ m m b C� W m r- n v p "� � "i. r O O `r v "' Z Z D 7o m m m R„ N ao O L Z Z m 0 Ln .�^mG i i a _ 1 c CID 9L) n � N Q -rt C) oo a G� °° Ll :. 49 I o I � �I o 0 Q G)Y(D ° ❑ 9 W O i� ; y� w 00 u p4 hh w rn a O cD o o p CD a o ❑ �. {k O O N m •+ O ;..� 1 i o m p O 3 rr o S O rt --" �p .._. ..... L wr I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28345 Date: 04 1 021 THIS CERTIFIES that the buildingDWELLING Location of Property 795 MARLENE LA MATT/LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 143 Block 0003 Lot 024 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 28345 dated APRIL 19, 2002 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 ATTACHED ONE CAR GARAGE The certificate is issued to ROBERT & VIRGINIA DIESENBERG�__ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. u or' ed Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSELIG CODE 3NSPECT—ION 'RUPCI&'T LOCATION: 795.,,,,, MARS ENE LA_ 23ATT LAUREL SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): ROBERT & VIRGINIA DIESENBERG OCCUPANCY hGSaP__FAMILY ROBERT & VIRGINIA DIESENBERG S '. ADMITTED BY: NICHOLAS DEEGAN ACCOMPANIED BY: SAME KEy AVAILABLE: SUFF. CO- TAX MAP NO-: 14:3.-3-24 SOURCE OF REQUEST: VIRGINIA DIESENBERG — 2/8 02 DATE: 04/19/02 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 3 FOUNDATION: EA C �FNT�BLOCK_ CElJ.AR. PART. CRAWL SPACE: TOTAL ROOMS: IST FLR.: 4 2ND FLR.: 0 3RD FLR.: 0 BATBROOM(S): 1.0 TOILET ROOM(S): 1.0 UTILITY ROOK(S): PORCH TYPE: FRONT ENCL01E3 DECK TYPE PATIO TYPE: _ BREEZEWAY: FIREPLACE: ONE GARAGE: 1 CAR DOKESTIC BOTWATER: YES TYPE BEATER: KEYSPAN GAS AIRCONDITIONING: TYPE BEAT: KEYPAN GAS WARM AIR: XX BOTWATSR: .._ OTS: (CENTRAL FLOOR HEATER) ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: NONE STORAGE. TYPE CONST.: _ .. SN33MING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION _ DESCRIPTION ,.. �RT, SEC .....�,.. . q �I j INSPECTED BY: _ww DATE ON INSPECTION: 03/04/02 GAR J- FISH TIME START: 9:45 AAS END: 10:15 AM