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Home My WebLink About1000-61.-3-5 a TOWN OF SOUTHOLD � a Rental Permit - 0246 Owner Robert Somerville Occupied as Single Family Dwelling -lst Floor Apartment Located at 415 Oaklawn Ave. Southold 61.-3-5 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. 12/9/2019 John Jarski Code Enforcement Official This Notice must be posted by the main entrance at all times eel TOWN OF SOUTHOLD Rental Permit �f 0247 Owner Robert Somerville Occupied as Single Family Dwelling -2nd Floor Apartment Located at 415 Oaklawn Ave. Southold 61.-3-5 Maximum Permitted Occupancy 5 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. 12/9/2019 John Jarski Code Enforcement Official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Cy Southold,NY 11971-0959 zLeeT BUILDING DEPARTMENT TOWN OF SOUTHOLD RECTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Pge,t Ad r ss: Tax Map Number: 1000 SECTION -BLOCi T) -LOT �- SECTION B. OWNER INFORMATION: Property Owner Name: p y Property Owner Legal Address:: A Property Owner Mailing Address: ,. N Telephone Number (s): Daytime Evening Emergency 1-7 Property Owner Email Address:, Page 1 of S 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 Agent of dwelling unit, if any: Agent (no P.O. Boxes): _ J Address o Authorized Age MailinAddress of Atlthoriz d ATt:g Telephone Number(s): Daytime_-,._ Evening_Emergency ------ Email Address: 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): Dayti a Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties cora ping 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): _m �.... Page 2 of 5 Town Hall Annex F Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 N BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property, For each Rental Dwelling Unit set forth the Renta we 'ng 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." Rental Dwelling Unit Identifier: Requested Maximum number of person lowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit Use and Dimensions of each room in Rental Dwe Ing n Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P_O.Box 1 179 Southold,NY 11971-0959 ,w Y 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 ❑ 1 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) 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 Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 N, 7� n" Copy 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 (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: Property Owner's Signature: Sworn, to before me th'isL' day ofd. y 20f k , )il,�jtA- Official NotZW Public Signature 4jOriginal Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY' COMMISSION EXPIRES J NE.,90, Page 5 of 5 �� O�-`� �,�� ° per"` 4 �V a 1v/L�1 Nve', 5 OVA&TOWN OF SOUTHOLD BUILDING DEPT. 1 2 765m INSPECTION 8 FOUNDATION [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION/CAULKING FRAMING/STRAPPING [ l FINAL CHIMNEY FIRE [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O t fibs/ �`a 100v OV01 0,247 INSPECTORDATE T I TOWN OF SOUTHOLD PROPERTY RECORow OWNER STREET VILLAGE DIST.' SUB. LOT E j FORMER OWNER"'-11 E n S W TYPE OF BUILDING j SEAS, VL FARM ; COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS z P _ AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE F/,RM Acre Value Per Value I Acre E Tillcbie ( FRONTAGE ON WATER Woodland FRONTAGE ON ROAD i Meodowl-and DEPTH House Plot j ' BULKHEAD r Total DOCK �� I s gr o Y x w " a f , _ a _ I I TRIM 9-170 M. Bldg. I Extension i I IT e r e , Extension x Extension Foundation ath Dinette Porch - - Basement Floors K. Porch �s Ext. Walls Interior Finish LR. Breezeway 6 Fire Place Heat DR. Garage r TYPe Roof Rooms 1st Floor BR. Patio j lRecreation Room j Rooms 2nd Floor FIN. B r - �O. B. 3Dormer 'Driveway -� Tota I FORM NO. 4 w. TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 33167 Date: (}7/22/08 THIS CERTIFIES that the building DWELLING AND ACCESSORIES Location of Property 415 OAKLAWN AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 061 Block 0003 Lot 005 Subdivision Filed Map No. Lot No. TWO conforms substantially to the Requirements for a RM FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 33167 dated JULY 22, 2008 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 TWO FAMILY DWELLING WITH COVERED FRONT PORCH, ACCESSORY TWO CAR GARAGE AND ACCESSORY SHED.* The certificate is issued to WILLIAM S ZEBROSKI, J '. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO- 3064456 garage XWN PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. o "zed Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 415 OARLAWN AVE SOUTHOLD SUBDIVISION: MAP NO.: IAT (S) NAME OF Old (S): WILLIAM S ZEBROSKIa.. LTR .... .__..� OCCUPANCY: TWO FAMILY WILLIAM S ZEBROSRI„a 7R ADMIT ED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 61.-3-5 SOURCE OF REQUEST: ABIGAIL WICKHAM ATTY ___ DATE: 07/22/08 DWELLING: TYPE OF COMSTRUCPION. WOOD FRAME STORIES: 2.0 # EXITS: 4 FOUNDATION: —BRICK CELLAR: 3 4 CRAWL SPACE: TOTAL ROOMS: IST FLR.: 5 2ND FLR.: 5 3RD FLR.: 0 BATBROOK(S): 2.0 TOILET ROOK(S) 0.0 UTILITY ROOM(S): PORCH TYPE: FRONT COVERED_—— DECK TYPE: PATIO TYPE: CONCRETE BREEZEWAY: F]RSpLACR: GARAGE: DOMESTIC ATE : YES IT w TYPE HEATER: OFF BOILER AIBCONDI3TONING: TYPE HEAT: OIL MARK AIR: HOTHATER: X OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME STORAGE, TYPE CONST.: WOOD FRAME SHED POOL: GUEST, TYPE COAST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION VI u 1 b REMARKS: INSPwL'a'rzn_. ...�....._ BY: DATE ON INSPECTION: 03/21/08 GARY J FIS'` TIME START: 10:15 AM END: 10:45 AM Town Hall Annex °tl Telephone(631)765-1802 54375 Main Road x Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 �C) BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Pgert d Tax Map Number: 1000 SECTION SECTION B. OWNER INFORMATION: Property Owner Name: CA Property Owner Legal Address: Property Owner Mailing Address: . , Telephone Number(s): Daytime Evening __ Emergency 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 'ror u��91 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. " Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: t _ U. Address of Authorized Agent (no P.O. Boxes): J Mailing Address of Authoriz d ATnL- ow'� Telephone Number(s): Daytime Evening, Emergency Email Address: \C� v9 G�-"' 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): Dayti a Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties con ning 8 or more rental units) Name of Managing Agent of dwelling unit, if any:, Address of Managing Agent (no P.O. Boxes): w Page 2 of 5 Town Hall Annexe Telephone(631)765-1802 54375 Main Roadyi Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 � r BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:. , � , Telephone Number(s): Daytime \\�Evening Emergency Email Address: Q�o 2 �� ` ° Uri— SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property, For each Rental Dwelling Unit set forth the RentaoehStidentifier(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: *d vc& Requested Maximum number of person lowed to Zup y Dwelling Unit:, Number of rooms in Rental Dwelling Unit ^ " Use and Dimensions of each room in Rental Dwe 'Ing n . Page 3 of 5 r. Town Hall Annex , Telephone(631)765-1802 54375 Main Road i Fax(631)765-9502 P.O.Box 1 179 1 Southold,NY 11971-0959 "Ou 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 ❑ 1 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) I ~` 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 Annex w Telephone(631)765-1802 54375 Main Road Fax(63 1)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 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 (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: ` Property Owner's Signature: NV rl Sworn to before me this day of 3 y /1", d, (�) Official NotQ Public Signature Original Notary Stamp TRACEY L. DYE NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COW40ISSION EXPIRES JUNE 30,P-O Page 5 of 5 �� ' 1`F�G�z �� . � � �°� �,w�S \S��o �� -�lS c��z�� V DIP ! BUILDINGTOWN OF SOUTHOLD 765-1802 FOUNDATIONINSPECTION [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATIOWCAULKING FRAMING/STRAPPING [ ] FINAL 5 (0), FIREPLACE [' FIRE SAFETY INSPECTION [ ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O ell, A la otov Cj O 07 W DATE -"_ INSPECTOR _ — °c o ° m e N D d u ' W D p�, r ' P o G) m o a m 0 a S C) �.3 m i !d V) � G i (D vo D E- m � G) r CD m zl Z y m m r � O O �. -n m 7- n z z s m m Gt (f) 0I GY�� Z Z m m 1 fl m..b ' P Ln r m P °J r— LO LT z o0 1 M I , v� I ti c i � p j I r ` � ! 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- 33167 Date: 07/22/08 THIS CERTIFIES that the building DWELLING AND ACCESSORIES Location of Property 415 OAKLAWN AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 061 Block 0003 Lot 005 subdivision Filed Map No. Lot No. TWO conforms substantially to the Requirements for a M FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 33167 dated JULY 22, 2008 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 TWO FAMILY DWELLING WITH COVERED FRONT PORCH, ACCESSORY TWO CAR GARAGE AND ACCESSORY SHED.* The certificate is issued to WILLIAM S ZEBROSKI,, JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3064456 garage PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. o. .zed signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT IJOCATION: 415 OARLAWN AVE SOUTHOLD SUBDIVISION MAP NO.: IAT (S) NAME OF OWNER (S): WILLIAM S_ZEBROSKI. JR OCCUPANCY: TWO FAMILY WILLIAM S ZEBROSaRIwwJR ADMITTED BY: ACCOMPANIED BY.- KEY Y:KEY AVA lJU3 .R: SUFF. CO. TAX MAP NO.: 61.-3-5 SOURCE OF REQUEST: ABIGAIL WICKHAM ATTYmmmm DATE: 07/22/08 DWELLING: TYPE OF OK)AiSTRUCPIOF: WOOD FRAME # STORIES: 2.0 # EXITS: 4 FOUNDATION: BRICK _ CELLAR: 3/4 CRAWL SPACE: TOTAL ROOMS: IST FLR.: 5 2ND FLR.: 5 3RD FLR.: 0 BATHROOM(S): 2.0 TOILET ROCK(S) 0.0 UTILITY ROOK(S) PORCH TYPE: FRONT COVERED DECK TYPE: PATIO TYPE: CONCRETE BRS6ZBWAY: FIRETLACE: GARAGE: DOMESTIC sTE : YES TYPE HEATER: OFF BOILER AIRCD�IDITIONIPC': TYPE HEAT: OIL WARM AIR: EKY1 : X OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME STORAGE, TYPE CONST.: WOOD FRAME SHED SWINNING POOL: GUEST, TYPE COQ.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION ......... _ DESCRIPTION ART. r �I u V � 6 A q L C C REMARKS: INSPECTED BY: DATE ON INSPECTION: 03/21/08 GARY J FIS TIlf START: 10:15 AM END: 10:45 AM