HomeMy WebLinkAbout1000-127.-9-2 _Dike TOWN OF SOUTHOLD
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Rental Permit
�g OO
0324
Owner James & Susan Gelman
Occupied as Single Family Dwelling
Located at 110 Eagle Nest Court Laurel 127-9-2
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.
7/30/2024
Code Enforcement Official
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. -
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI AL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS:74e Ct4 �74VZ-'�-
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DATA: 11DSPECTDR
Of fat Town Hall Annex
Town of Southold 54375 Main Road
" Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
Tel: 631-765-1802
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SCTM # _. :�f�� _ .. . Date
..
Phone
Address %" S Visible _...........
_.
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Hamlet Inspector
,_ ...._. .,.. �.,_ m....._ m.......� _m .. „e _...., , e,..
® m _ .. ®_ _w_ . , _ _„ e, �... _. . ..__,
Floor Level Quantities Sub 1 2 3
Smoke Detectors(not located in bedrooms) ! �/
Carbon Monoxide Detectors `
Fire Extinguishers
Exits
.. .................. ....
Bedrooms 1 2 3 4 5 6
Smoke Detectors
Egress 1/
.. ............... _ _. „e„e. .....
Occupant Count , �o em
Building Systems Maintained &Operational i Condition of Property
Heating Building interior
Hot water Building exterior
Electrical Property clean, maintained &safe
_. _ .. _............ .... _ m __. w _ ,e .
Mechanical Handrails&guards installed &secure
Pool Safety Pool on Site
....... ..... - _
Surface water alarm Date of CO issuance o�00
Door alarms Pool completely enclosed
Self closing/latching gates Pool fence to code requirements
n w
... ...........
CO's for all items present Prior Rental e,
.... , .. . .�...m...._ _ ........ . .. _.._..........._ ,..,e e..e .......
Comments:
TOWN OF SOUTHOLD
ZXN
Rental Permit
0324
Owner James & Susan Gelman
Occupied as Single Family Dwelling
Located at 110 Eagle Nest Court Laurel 127.-9-2
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.
7/15/2022
Code nf!� ent Official
This Notice must be posted by the main entrance at all times
SOUTHOLD TOWN Town Hall Annex
54375 Main Road
o PO Box 1179 Southold,
Rental Inspection NY 11971-1179
Tel: 631-765-1802
Fax 631-765-9502
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TOWN OF SOUTHOLD
CAP Rental Permit
Permit No. 0324 -
Owner
324 -Owner James & Susan Gelman
Occupied. as Single Family Dwelling
Located at 110 Eagle Nest Court Laurel 127-9-2
Village S/B/L
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.
8/2/2020 John- Jarski
Date of Issue Code Enforcement Officer
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 1179 Awe
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOI.D
RENTAL PERMIT APPLICATION_
Rental Permit Fee$200(Application must be renewed every tw
JUL 1 2 2019
Section A. BIJULDHITG,
Property Information:
Rental Property Address.
T-- I
Tax Map Number: 1000 SECTION , -l3tQCK =LOT,
SECTION B.
OWNER INFORMATION:
Property Owner Name:-
Property Owner Legal Address: Property Owner Mailing Address:
az��k) AD
NY
j
;
Telephone Number(s): Daytime Evening_ EmergentV
Property Owner Email Address:
Ki-
Pagel ofS
so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
SOU
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION INSTRUCTIONS
-Rental Permit Fee $200 (Application must be renewed every two years)
The items listed.b'elo%eare required to be submitted with the completed. `F
application. f
❑ Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of
all smoke &carbon monoxide detectors.
❑ Certificates of occupancy and Pre-Certificates of Occupancy: Certificates of
occupancy or Pre-Certificates of Occupancy for each rental dwelling unit.
❑ Certification of Code Compliance(form enclosed): Must be submitted by a
license architect or engineer or,license home inspector if an inspection by Town of
Southold lnspector is declined.
$
❑ Rental Permit'Fee: 200.00
°F
I
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:
�q}
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Evening Emergency
EE
Email Address:.,_—__
Section D.
i-
Managing Agent Information:
h'y
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent(no P.O. Boxes): 3e,
Mailing Address of Authorized Agent:; s
Telephone Number(s): Daytime 1 Evening Emergency _ .E
Email Address:
yj3
SECTION E.
SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any:
•S
Address of Managing Agent (no P.O. Boxes):
_ 3
s
t'
Page 2 of 5
t
F
f" u
Town Hall Annex , Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 '
Southold,NY 1 1 971-0959
' �dUtd 1"
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytime- Evening Emergen>y" .
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: l
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." f
' Rental Dwelling Unit Identifier:
Requested Maximum number of persons allowed to occupy Dwelling Uni
Number of rooms in Rental Dwelling Unit: ':-
Use and Dimensions of each room in Rental Dwelling Unit:; S(22 /l �
Page 3 of 5
r�
t
e r
Town Hall Annex Telephone(631)765-1802
54375 Main Road At= Fax(631)765-9502
Y.O.Box 1 179 ,
Southold,NY 11971-0959 `
Cvu18 l�s
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 "Sectio`n B"`of this application is my legal
address and I understand the Town will use the address for service pursuant to all
j
Page 4 of 5
so
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
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.
F
4. 1 will notify the Town within five (5) business days as to any change to the information
4
regarding Authorized Agent, Managing Agent, or Site Manager. i '
Property Owner's Name: - - _
Property Owner's Signature: VK14L-It-;(�3
Sworn to before me this day of , 20J9
kuj
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.01 BU6185M
Qualified in Suffolk County
Commission Expires Auric 14,26�
Page 5 of 5
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# TOWN OF SOUTHOLD BUILDING DEPT.
�ycourm, 765-1802
INSPECTION _
[ ] FOUNDATION 1ST [ ] ROUGH PLEG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [XFIRE
INAL FIREPLACE & CHIMNEY SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (R GH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLAT N [ ] CAULKING
REM RKS:
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
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OWNER STREET VILLAGE DIST.1 SUB. LO Z • °— �
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FORMER OWNER N E ACR.
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RES. SEAS. VL. FARM COMM. CB. MICS, Mkt. Value
LAND IMP. TOTAL DATE REMARKS
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Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
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House Plot BULKHEAD c $;
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Total
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Foundation
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Fire Place
Driveway
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22979 Date MAY 3, 1994
THIS CERTIFIES that the building NEW DWELLING
Location of Property 110 EAGLE NEST COURT LAUREL, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 127 Block 9 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 26, 1987 pursuant to which
Building Permit No. 21871-Z dated JANUARY 26, 1987
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 GARAGE & WOOD DECK
The certificate is issued to JANET BRUNO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 86-SO-213-APRIL 1, 1994
UNDERWRITERS CERTIFICATE NO. H-040489 - APRIL 21, 1994
PLUMBERS CERTIFICATION DATED DEC. 2, 1991-BERTSAND FLUMB.&HEATING INC.
Buil ing Inspector
Rev. 1/81r
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34037 Date: 10/27/09
THIS CERTIFIES that the building INGROUND SWIMMING POOL
Location of Property: 110 EAGLE NEST CT LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 127 Block 9 Lot 2
Subdivision Filed Map No_ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 1, 2008 pursuant to which
Building Permit No. 33805-Z dated APRIL 8, 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 ACCESSORY IN GROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to JAMES & SUSNA GELMAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH .APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 125107C 10/14/09
PLUMBERS CERTIFICATION DATED N/A
//t,h rizedA ign ture
Rev. 1/81
S� Town of Southold
o�A o 7/28/2020
P.O.Box 1179
a -
CA 53095 Main Rd
�aUN-� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41294 Date: 7/28/2020
THIS CERTIFIES that the building HOT TUB
Location of Property: 110 Eagle Nest Ct,Laurel
SCTM#: 473889 Sec/Block/Lot: 127.-9-2
Subdivision: bled Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/31/2019 pursuant to which Building Permit No. 44903 dated 6/23/2020
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:
hot tub as applied for.
The certificate is issued to Gelman,James&Susan
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44903 7/24/2020
PLUMBERS CERTIFICATION DATED
tho ' rature
Dwyer, Tracey
From: Gelman, James <jgelman@mcguirewoods.com>
Sent: Friday, July 31, 2020 2:36 PM
To: Dwyer, Tracey
Subject: 110 Eagle Nest Court, Laurel
Final e-mail. Hopefully, you received three e-mails.
o �
AUG - 3 2020
BUlLP1NG DEPT•
TC'
7HOLD
i
D.
AUG - 3 2020
DMT%1NG DEPT-
'T
-''HOLD
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James Gelman D i
McGuireWoods LLP
1251 Avenue of the Americas AUG - 3 2020
20th Floor
New York,NY 10020-1104 BUILDING DEPT.
212.548.7023 (Direct Line) TC --HOLD
212.548.2174 (Direct FAX)
igelman@mcguirewoods.com
http://www.mcguirewoods.com
Please note our new address.
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