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Home My WebLink About1000-79.-7-35 TOWN OF S UTH LD Rental Permit 0238 Owner Jonathan & Joy Ellinghaus Occupied as Single Family Dwelling Located at 930 Jacobs Lane Southold 79.-7-35 Maximum Permitted Occupancy 6 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. 3/11/2024 -);*, Code E r ent Offi - i This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD BUILDING DI 631 7+6i5r 1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CA! [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] TIRE SAFETY IN! j ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII [ ] CODE VIOLATION [ ] PRE C/O [ ]` REMARKS: 4�4� *,,,, 4z3gv,., Man T EC" %afaL Town Hall Annex Town of Southold 54375 Main Road PO Box 1179 c Rental Inspection Report Southold, NY 11971-1179 rh •, � , ► �,' Tel: 631-765-1802 a� . � � -no— SUM# � Date��M • ._... ..�. �..._...... gOwner .� Phone w Visible f AAddress �Hamlet �? . _._ µ..••��. .. .., .� ..•..__. ._...�. .w ..�_ .....�..� ....._�. ... ._..._..._ Ins ector ,Floor Level +�.anrti<� Sub 1 2 � 3 Smoke Detectors(not located in bedrooms) ! Carbon Monoxide Detect W � ors ... { Fire Fxtinguisher _ ........... -...... _._.. .... ... ...._ Exits Bedrooms 1 2 3 4 �... V d� 5 �.. 6 i ;K-4 Smoke Detectors Egress Occupant Count �. BuildingSystems...��.__. .�._u_u ... .. Condition of Property _ _.�,.. ....._� . .. .. .,. �.. _, _.,_....... .Operational......_,. __ .. ... . .... .. .. ...... . „Maintained & HeatingBuilding interior ._ ,.M ��....,. ._ ,... Hot water !Building exterior (Electrical Propel clean, maintained&safe.,,._-,__ Mechanical �,�.w,•w..�. �� .�.� M.. n. .mm�� .. . ....... .......e .Q ,w �•.... ....,� ....� �, Handra ils&guards installed &secure f.�Pool Safety...�.��w. ........ � ,u. �„ �m.... ..,. . _. . n'�S�.i�t�e !Date of CO issuance -Surface water alarm � a .... ..�.- ..,.. a , Door alarms Pool completely enclosed ._... ... Self closing/latching gates .Pool fence to cod.e requirements .._.�.�.n _......_..-__.........�.....�.-_. ....a _°, .m_. ....�_a. ..m... ,....�.. ._� ._.�...� ._. .,.m _ ... _ iCO's for all items present Prior Rental 10 Comments . _..m._... ...._. ..... _. .... .. .._._.. TOWN OF SOUTHOLD Rental Permit 0238 Owner Jonathan & Joy Ellinghaus Occupied as Single Family Dwelling Located at 930 Jacobs Lane Southold 79-7-35 Maximum Permitted Occupancy 6 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. 3/7/20224 Code Enfo emet Official This Notice must be posted by the main entrance at all times SOUTHOLD TOWN Town Hail Annex 54375 Main Road PO Box 1179 Southold 01 *, Rental Inspection NY 11971-1179 . g Tel: 631-765-1802 Fax 631-765-9502 SCTM # Date 2 7_� Owner J V Phone '9S_ 53 Address Zip Hamlet S U l Inspector Address visible from street? LEVELS SUB 1 2 3 Smoke Detectors (#- bedroom detectors excluded) V1111- Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) BEDROOMS 1 2 3 4 5' Smoke Detector Alarms (#) j Carbon Monoxide Alarms (#) (/ Egress (windows) (Y/N) BUILDING SYSTEMS CONDITION OF PROPERTY CY Heating system maintained/operational Building Interior is clean/maintained Hot water system maintained/operational Building Exterior is clean /maintained Electrical system maintained/operational Property is clean/safe/maintained Mechanical system maintained/operational Handrails&guards present POOLS Y/N POOL BARRIERS Y/N Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min. 48" high resent POOL GATES Y/N All openings in barrier less than 4" Self-closing, self-latching Max. 2" clearance @ bottom of barrier Latch on pool side of gate, meets height Barrier capable of being locked &child- requirements proof when unattended COMMENTS: TOWN OF SOUTOLD s Rental Permit Permit No. 0238 Owner Jonathan & Joy Ellinghaus Occupied as Single Family Dwelling Located at 930 Jacobs Lane Southold 79-7-35 Address S/B/L Maximum Permitted Occupancy 6 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. 11/25/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times SO 01 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 COM �.... BUILDING DEPARTMENT r^ TOWN OF SO OLD A U G r' 019 RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1.000 SECTION -? � 190 BLOCK OD LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) b ` b1 -J Telephone Number (s): . Property Owner Email Address: (3 '(1 Page 1 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 room. 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 Uni 0 LQ Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: Via Zj,e � uu 1"IP nd W m �.u� '�IMwYg� WotVWy1,02. 'tiVc �Nr)aaktr (45" , X VW t 2C 1 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. -V/I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. Page 3 of 4 ❑ 1 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) 3I p , 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. Property Owner's Name: Property Owner's Signature: JF� Sworn to before me this day of � � „ 20J� �e:WbCI�p1 IC , wwa 4�"P Official Notary Public Signature � � @,S, � 4, and Original Notary Stamp �°��"�"��"'��"�� "�� "�� Page 4 of 4 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 CA P.O.Box 1179 Southold,NY 11971-0959 `" BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form to be completed by a NYS licensed architect, NYS licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit 1�"ro essr"oval seaa re aired car architect ar Irl ineer ar""ceased I�Norne ins actor mlxst rovide a copy of a valid New York Mate Ulai orl�rl Fare F"reverltion Buiidir bode erti ration. Rental Property SCTM Number: C Rental Property Address: Owner/Name: Rental Dwelling UnitI entifier: Number &Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.) Property Description (Include all improvements indicated on survey) I certify that I have done a physical inspection of the subject rental dwelling unit and find that the unit 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. Print Name and Title Original Signature Please place professional seal: TOWN OF: SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION IST [ ROUGH PLBG. FOUNDATIONINSULATIOWCAULKING FRAMING /STRAPPING [ �FINAI-04�4� FIREPLACE I [ FIRE SAFETY INSPECTION CONSTRUCTION,FIRE.RESISTANT FIR E`RESISTANT PEN ETRATION ELECTRICAL CODEVIOLATION PRE C/O REMARKS: Vw"Vk ( ow I1/ TOWN OF SOUTHOLD BUILDING DEPT'. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGHPL . [ ] FOUNDATION 2ND INSULATION/CAULKING [ ] FRAMING STRAPPING [ IFINAL [ `] FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION ] FIE RESISTANTCONSTRUCTIFIRE RESISTANT PENETRATION [ ] LCT I L ( H) [ ] ELECTRICAL (FINAL) [ ] VI LATI [ ] PRE C® REMAR S: km4m�,( c � kNAi%> ce,- ( ,�k rAl f I Lip DATE INSPECTOR k SM � � _. v r i haw F . � v w h k Cri 1 p �w a i L � .../� �r: .�,.✓sem ,�L p t .M I x R .� p I, 12 rno 04 n � d a. a � N p 0 e uw� an a ,Po w Z ZC m Q z D D q G) 0..i14 Qs m m N > r �- O Nl r r, f= c u c r C pp 1 M) k e� rJ r� 4"mfr. ri G s 'ax EP / and PJB p g A 11 00 n f'1 m 1 ul IA 0 4 .. z 7 8 T w 7O b I N ............��,.... i... ....,. , ,.., ..... .. .A,.... .. a...��.A _ u �mm., Tco N tm �r �I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. .Z9139 . . . . Date . . . . . . J�4Y. . . .31. . . . . . . . . . ., 19. 78 THIS CERTIFIES that the building located at cobs Lane , . , . . , . Street Map No. 5.599. . . . , . Block No. , . , . , . . . . .Lot No. , . . . . . . .28 conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . April . . 1 B . . . . . . .. 19.78 pursuant to which Building Permit No. . . . , 9681Z dated . . . .April . . .18 . . . . . . . .. 19. 78, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . with, Addition. . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . .iy .H� .clrt: . . . . . . . . . . . , . . . (owner, p� of the aforesaid building. Suffolk County Department of Health Approval T UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . 1 . �R. . . . . . . . . DOUSE NUMBER . . . . . .93p. . . . . Street . . . . . . . . . .Jacobs. Lane. . . . . . . . , Building Inspector i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 289£38 . . . . . Date . . .April . . . 20 . . . . . . . . . . . . .. 19. .7.3 THIS CERTIFIES that the building located at . VS. a.aaobalaae . . , , . . . . Street Map No. . 5599. . . . . Block No. . . . . . . . . . .Lot No, . . . . .2B . . . . . . . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated .March. . 25 . . . . . . . . . ,, 19.77. pursuant to which Building Permit No. . .91?_Az dated -Ma rch. . 25. . . . . . . . . . ., 19.7.7., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . FTMATE ONE 'i; MILY Did . ING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . .G� aen�ax' ..a (owner, 1 ) of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . 7-; 7�3 „ UNDERWRITERS CERTIFICATE No. . . . . Pen 419 HOUSE NUMBER . . .J�V`l. . . . . . . . Street . . . . . . . . Jacola Land . . . . . . . . . . . . .S.Outbnld,. now. Xorlk:. . . . Building Inspector I f � i t p n i Its h �. TZ sw r JR �^x nn.. d w e iz all � fg rs 1 r. r FO M f r 4 VIII IIIIIIIII IIII lill f 6v" %� J rrr; / / / / r ! f/ r / / / / r / 1 / 1 1 1, / / / ro / / / f � i r N / / / / / l / 1 / , / / J� 1 //////m//�Ur F �l APO l!!llllfi/iifAi//H/r , l//� %i///// /✓ rye%f11%i/11//ioyi//%0ll�hMINElll/%////%l//lllllfll/lh' e f f� / / r all td Ml / ///% ✓o�l � /� '�-„I /////%/j/� ,, ////i/ �ilii �, / ,,;,Dili/ �� //, ✓ // / ,, ,,,�// Di /// � 1 r / / r / f / / i r, r rr i r / r ro r r / l t. 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