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Home My WebLink About1000-25.-2-7.1 TOWN OF SOUTHOLD Rental Permit Permit No. 0377 Owner Eleanor Hughes Occupied as Single Family Dwelling Located at 905 Village Lane Orient 25.-2-7.1 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. 1/25/2021 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times 10 lq� Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 � �-� °`�� ^�`'�`t�`�� Fax(631)765-9502 Southold,NY 11971-0959V LR, -� ., , BUILDING DEPARTMENT ` ' TOWN OF SOUTHOLD � �' JUN ," 2019 RENTAL PERMIT APPLICATION T01VIN OF SOUii'dz)lfl:!� Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Ren4 Prlerty ,&-ldr ss: Tax Map Number: 1000 SECTION.- . .o✓5 _BLOCK r_� SECTION B. OWNER INFORMATION: Property Owner Name: f Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number(s): �5 Property Owner Email Address: Page 1 of 4 t� so Town.Hall Annex � ' ` Telephone(631)765-1802 54375 Main Road '' `� Fax(631)765-9502 P.O.Box 1179 , f southold,NY 11971-0959,L �� S � BUILDING DEPARTMENT TOWN OF $OUTHOLD RENTAL PERMIT APPLICATION INSTRUCTIONS Rental Permit Fee $200 (Application must be renewed every two years) The items listed below are required to be submitted with the completed application. "oor Plans: Detailed floor plans of each Rental Dwelling Unit, please show location of all smoke &carbon monoxide detectors Zcertificates of Occupancy and Pre-Certificates of Occupancy: Provide copies of Certificates of Occupancy or Pre-Certificates of Occupancy for each rental dwelling unit 0 ❑ Certification of Code Compliance(form enclosed):Applicant has the option of having a rental dwelling unit inspected by,the Town of Southold or by an architect, engineer or home inspector of their choosing. If the Applicant elects not to have the rental dwelling unit inspected by the Town,the Applicant must submit a Certification of Code Compliance completed by a NYS licensed architect or NYS licensed engineer, or a licensed home inspector who has a valid New York State Uniform Fire :z Prevention Building Code Certification. Rental Permit Fee: $200.00 (Please (Vote:The Building Department does not accept cash. Payment must be in the form of a Check, Credit Card or Money Order.) Town Hall Annex t Telephone(631)765-1802 54375 Main Road �, •'' Fax(631)765-9502 F.O.Box 1179 : bduthold,NY 11971-0959 BUILDING DEPARTNfENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier:A95 Requested maximum number of persons allows to occupy each dwelling it U-� Number of Rooms in Rental Dwelling Unit: � Use and Dimension of each room: r �! 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: 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) rtify under penalty of perjury;.the following: 1. I 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 thisyapplication 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: Sw rn before his day of - _ J t7 AJ�' _ , 20Lcj Official Notary Public S' nature and Original Notary Stamp ROBERT S.HUGHES NOTARY PUBLIC,STATE OF NEW YORK j NO.02HU5029422 1 Page 4 of 4 ^� QUALIFIED IN SUFFOLK COUNTY q Q COMMISSION EXPIRES JUNE 20,20,U SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: nx&;::� 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 Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: Alt A- C 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. I am requesting a fire safety inspection to be performed by a Code Enforcement Official \ from the Town of Southold. Page 3 of 4 Section C. Authorized 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 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 OUlho # # TOWN OF SOUTHOLD BUILDING DEPT. courm, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] INAL;44 [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS lobu 0 16A Ul 1 9-1\� 1, DATE INSPECTOR - ISSUES/REVISIONS 10'-3" 16-4 112" N N f() PATH LJ 1 1'-3" G-2 112" O N N i ENCLOSED PORC 1 KiTCti C l l BC ROOF:9 i0 o� B B AI AI (2) Nr\"d SVELUX SKYLIGHTS VS'01 l"d!TFi V�NFTIAIJ BI II1DS N [` A I i I 1to ( E; i l i i UP N 9'-5' CLOSJ— UHDFIrl r I�'-3 I/2" STAI''I I I CI-G m 1' 1/2" I I I 1 I I `LOt'F Fri DO'v"IPI SLOt,E CO X J lJ �J— TU5e • LIVIt1G R00%1 P'^.T"- m N CLG 0 SLOPE I SLOPF DO'A/i I I'-8 112" 7- 9'-2" II 1 I'-3 112" — — — — — — �- O A A G CL =B;''' A Ai AI AI AI -di 0 l'-4 112" THESE PLANS ARE AN INSTRUMENT OF SERVICE AND ARE THE PROPERTY OF THE �-� ARCHITECT.INFRINGEMENTS WILL BE PROSECUTED B 4'-7 1/2" 14'-I" 9'-I I" A I 2oi9 ALL RIGHTS RESERVED B SECOND FLOOR AI Robert I. Brown Architect, P.C. FIRST FLOOR t NY no@rlbrownarch tecoticom 631-477-9752 IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED ARCHITECT,TO ALTER ANY ITEM ON THIS DRAWING IN ANYWAY.ANY AUTHORIZED ALTERATION MUST BE NOTED,SEALED,AND DESCRIBED IN ACCORDANCE WITH THE LAW. (2)2_"x6" HEADER TCCO'D TO ,b�> -O' (2) HF--V1 VE,-UX SY�YiIGHT5 AZ k , AM. PAITE"S TOP 4 V5!O 1 \^;'ITI-I VEt ILTIP,,;' R 6.4'„, BOTTOt,t. (2) HFAV VELUX 5KYLIGf":TS VS 10 1 \A ITH VFIIETIAfi \\\ BIIf05. ■ �,. �-�{ EXI5TIfJG .` STUDY B`:DROOM UJ _ -- CLIENT/OWNER C n ° i HUGHES J _ 0 _ RESIDENCE 905 VILLAGE LANE ORIENT, NY I ■ PROJECT TITLE IT AS BUILT AS OF EX!STI°JG EXISTIIJG � -- ----- _ LIVING ROOM LJVIt G ROOt'l � AUGUST 2011PLUS SKYLIGHTS f - DRAWING TITLE FLOOR PLANS SECTIONS ELEVATIONS - SECTION— SECTION—e SECTION ELEVATION 1 30 MAY,2o19 SCALE I/4”=1'-0" 1 iL 1 B B DRAWING NO. ' TOWN OF SOUTHOLD PROPERTY RECORRES. SEAS. VL. FARM COMM. CB. MISC. Mkt. ValueJ OWNER STREET VILLAGE DIST.1 SUB. LOT FORMER OWNER ACR. TYPE OF BUILDING LAND IMP. TOTAL DATE REMARK!JLI�/i ��, AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable I Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brush/ono FRONTAGE ON ROAD � House Plot DEPTH —TB67LKHEAD | Total DOCK ' -- --'-----' . T~ - ■■■ee■ ■■■ ■■■MEN■■■■ L No IIIMMMEEMON ON a■■■ ■ens■■■■■■■■■■■■■■ ■ p41 - ONMI ::■::■■■■■ ■■■■■■■■■ MIMMEE ■■■" IN■EMM■■■ ■ ■■ ■ ■■■�Iiii�A ■t�■■■■■■■�■■■■■ IN ■■■■■■■ ■Y■■■■■■■■■■■■■■�■� . . Foundation® =• .. r Walls Rooms 2nd Floor' ® ---- Dormer Driveway ��I FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED PRE EXISTING CERTIFICATE OF OCCUPANCY No. Z- 31006 Date: 06/23/05 THIS CERTIFIES that the building DWELLING AND ACCESSORY Location of Property 905 VILLAGE LA ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 025 Block 0002 Lot 007.001 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- 31006 dated JUNE 23, 2005 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 AND ACCESSORY GARAGE. THIS CERTIFICATE OF OCCUPANCY UPDATES COZ9671 ISSUED 9/12/79. The certificate is issued to GEORGE J HOSSENLOPP & WF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. 00 Auth rized SignalFure Updated to include accessory garage as noted on Housing Code inspection report dated 9/11/79. Rev. 1/81 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. . .?`��.7.1. . . . . . . . . . Date . . . 'Ieptember. .1.2 . . . . . . . . . . . . . .119 .79 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property . . . 9.Q5 .Vi1149A .I,4me. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Orient House No. Street Hamlet County Tax Map No. 1000 Section . . .Q?--5. . . . . .Block . . .002. . . . . . . . .Lot . . . . .00.7. . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . Requirements for a ane fami1 dwellin , Lt r'or to conforms substantially to the Certifi4 0 . . . . . . .APP:I.?3 . . . . , 10.7. .pursuant tow�c cot . . . . . . . . . . . dated . . .Sentembsx.1 Z . . . . . . . . . . 19 7,q ,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 . . . . . . . . . . . . . . . . . . . . . . . . . onQ. F.Mily. Nelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . .JoSppb.C... .&.Alice. J.. Kra. inski . . . . . . . . . . . . . . . . . . . (owner, jt) of the aforesaid building. Suffolk County Department of Health Approval . . . . . .N/R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . .N/R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • • Building Inspector Rev 4/79 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location FOS- `Ati� Znumber & street) (Municipality) Subdivision Map No. Lot(s) Name of Owner(s) �Y- �` ��i c ✓ �k�i bi.y5.rc Occupancy type owner Admitted by: Accompanied by: _51FC.T Key available l` `v � Suffolk Co. Tax No. -aZS-a�z7 Source of requester (r Ljgc� c i� Date &-Zo -79 DWELLING: Type of construction ffJpUy frt.4 #stories Foundation ,f& �lo,L;� . Cellar % Crawl spaceLLi�,2r - Total rooms, 1st -'"oz. 2nd. Fl Z w ig 3rd. Fl --- Bathroom(s) X,J= Toilet room(s) Porch, type12 Deck, type -- Patio, type --- Breezeway Garage Utility room Type Heat:5 t /e 'farm Aires• Hotwater Fireplace(s) No. Exits JXh_ Airconditioni g Domestic hotwater A-" �'/ . Type heater i art Other ACCESSORY STRUCTURES: Garage, type const.ffdZ f/l4 F Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. � f '- '-s•U/ S-2-Z 6 - � Remarks: Inspected by:Ar bate of Insp. Time star ir 3a PP.end�'So /? �4 Town of Southold Annex y0f�[ 11/2/2012 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36031 Date: 11/2/2012 THIS CERTIFIES that the building ALTERATION Location of Property: 905 Village Ln,Orient, SCTM#: 473889 See/Block/Lot: 25.-2-7.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this ofliced dated 9/16/2011 pursuant to which Building Permit No. 36738 dated 10/6/2011 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 rear facing skylights in an existing_dwelling as applied for. The certificate is issued to Hughes,Eleanor (OWNER) -------- ---_.----- of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A.Aorized Signa ure SURVEY OF PROPERTY SITUATE: ORIENT TOWN: SOUTNOLD SUFFOLK COUNTY, NY SURVEYED 07-I5-2005 � SUFFOLK COUNTY TAX # r Lq 1000-25-2-7.1 �t� \\ `\ eh' �/n� No W r � r C�tT�I®'l�ID: ' .26� Chr�tion 1 oF: E Ileanor HE Hughes '�,L�I2 0�0,,,� � � AIS ]Fidelity National Title Company �q of New York##62016 iV\ 23 y \ G c <q ea9� \ �, \ 868 o 9e \ b qro \/ No \\ \2'`\ c o ��s 6.',o®'r \ C or \ �' 8� d` \ m 27.9 ` \ \\ `��- e• 2 SSR Z\ \ �O \` \ Rr dor, 0 O� \\ SEo'\\\ o OLS \ u \ \ h4 \0 C ��,30 ` 0 o �a� qr / ghgrN� ®�'� �� . ^^� �l � ON mor eq9 tij �° Z0�0 �• 'LhauthoNzed alteroNon or otldltfon to o survey ° mop teoring a Iwensed land svrveycrb seal is a vlolotlo F secticn'12G9 svb-dlNslon 2 0!Ne - _� __-. � New Ycrk State Education Law' �¢ al of Fh •Cniy copses rom Na origqNtis s�+vey NOTES: �� ., U orkad with an orl9lnol of the lantl surveyorb ,�?�'. _ stamped 9eol shall be ccnsldered[c be valitl We MONUMENT FOUND ,i} Su y aaple; .Y- �, 'Gertlilaatlons kdicated hereon sl F that Nls l'Ft ,py � rvey was prepared in acccrtlance with the ex- p PIPE FOUND === ��9V slog Godo cf Practice for Lard Sur Z adopted 4 y 'd by the New York 5tote Assoclat. of Professional "\ � Lcntl Surieyors Said rerLifiaatlons shall run only AS - t �,.' to the person For wMm the simrey b p�epad jd- ��•� and on h's beholF Lo the title company, I I 1�-,�I _ � , Lal agency and lerdrg Insnmucn Ilstea�recn and A r In� " eo the ossig ees of mo lending -tl eerunco- Y. y rF� ' NOr�ora rot transferable!a additicrol InstlWLbns AREA = 5,146 S.F. or 0.12 ACRE JOHNCm E LERS LAND SURVEYOR ti. `.v 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 GRAPHIG SGALE I"= 20- _ -� RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 REF.—\\Hp server\d\PROS\05-235.pro