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Home My WebLink About1000-64.-5-22 v o .� N c 00 0 EL N CD 0 w c c 4 o Q o IC U cn N w o air ca U00-0 c co ca -� r� m 0 E CISO ca c L N y � CA U !n U) cc WO N �� O O (n Q t � ) O LO � r y �-- 4-JI— � O Q. CU Z d� O E "� �- V v = 2 o o �-- acu _ c cu .N ,L- V1 •X D) U) o t� > O Q o cu E a � o N r� cu Co �= N +.+ a) cin o N W o ca N / t-- CLE 4-J 0 J pg iy�`f,�,✓' ¢�j g p' `�y��i�Q��,Cl 74�� .+".+' ✓S,�y� �� 1��,c"'` � 1 ;y�r„, �i.'Id ,"'e 0s� �I�... TOWN OF SO U'TH 1►1LD BUILDING DEPT. 631-765-1802 �- N SPEC'1” I O N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F,NAL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL b RE1 A I , DATE INSPECTOR "r" a i 9 t K yti � Efol � TOWN OF SOUTHOLD Rental Permit Permit No. 0382 Owner Charles & Isabel Barkley Occupied as Single Family Dwelling Located at 1055 Old Shipyard Lane Southold 64-5-22 Village Maximum 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. 1/30/2021 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times t� so Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 r7 N T, BUILDING DEPARTMENT DEQ 4 2020 TOWN OF SOUTHO11,D RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -BL0,CK- -LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: OLVa' 10,55 OU, Sk" �O 5 5 S��' PALn ivqooct Ln J h 01,6- Pr PM Telephone Number (s): Daytime(�LAA)M D6FA Evening (3�)3jqiS-1%mergentV (qtj) 2q; .3qe1 Property Owner Email Address: N� k QM oil 00 n� p� QQ,o, � -a0b o 0 Pagel of 'Xlof.so(/pa Town Hall Annex p Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 coulmi BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: )l Q°' _ __- Address of Authorized Agent (no P.O. Boxes):' -- Mailing Address of Authorized Agent: 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 oxes):Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency 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 Address of Managing Agent (no P.O. Boxes): Page 2 of 5 F_SOUryo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 G Southold,NY 11971-0959 Yo BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: ni Com., 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 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: t _C� 1 CA1�11 Number of rooms in Rental Dwelling Unit: � __ _ _ � °^��.� �yv� Use and Dimensions of each room in Rental Dwelling Unit:; kvt, = .mi6 ®m tied 4brl6mtL3 �eAvuom 1 yo 0_r - - 5 - io 562p, 9, 10-Ircli 13'X ` Wr Wo -fbf Car Page 3 of 5 4konz'(�. Ib $ ��ed-+o COOK aj J' ►�� , pv SOUT�ol o ' Town Hall Annex .A; _§ .{'+ Telephone(631)765-1802 54375 Main Road q ;. Fax(631)765-9502 P.O.Box 1 179 s Southold,NY 11971-0959Qd Y e0uml a 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) 5 C twbar k W ,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 So Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G Southold,NY 11971-0959 Q r 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: t7 TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 D W6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2 Sworn to before me this�f day of '(� 20 _C) 14 AV Official Notbty Public Signature Original Notary Stamp Page 5 of 5 if S®(/TNov 14, 2020 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Q r�c®UM'1,� BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Professional seal required for Architect,or Engineer,licensed Home Inspector must provide copy of valid current certification - Rental Property SCTM Number: "1 — 1 0� o, Rental Property Address: 1055 Old Shipyard Lane., Southold NY Owner/Name: Isabel Barkley Rental Dwelling Unit Identifier: Number'&Square fo6tage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom #2-90 sq., etc.) Bedroom #1 140 soft Bedroom #2 160 sqft Property Description (Include all improvements indicated on survey) single family home 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 Construction Code of New York State. Victor Cornelius III CEO Inspector alp& Print Name and_Ti#leceo# 1216-0283 Ori inal Signature Please plcP�r��fessi�rSal seal: - thPYiO14V 56�o[e # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 K INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [. ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] F NAL [ ] FIREPLACE & CHIMNEY FIRESAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION' [ ] ELECTRICAL (ROUGH) [ ] -ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: 6velD DATE / y INSPECTOR" - F',RS'FLOOR Isabel 1.Barkley&Charles C.Barkley 1055 Old Shipyard Ln Southold NY 11971 Legend: Garage Door A Fire/Carbon Monoxide detector garage B Fire/Carbon Monoxide detector C Fire/Carbon Monoxide detector D Fire/Carbon Monoxide detector ' Daor Locations Basement n represented by portion of d footprint highlighted in red bold. stairway to r 6 bedroom yry; , bedroom family room basemenr C A ■ hallway ,,ng room Isabel 1.Barkley&Charles C.Barkley loss Old Shipyard Ln Southold NY 11971 - Legend: Garage Door Fire/Carbon Monoxide detector garage Fire/Carbon Monoxide detector Fire/Carbon Monoxide detector _ D Fire/Carbon Monoxide detector ' Door Locations Basement is represented by portion of footprint highlighted in red bold. bedroom bedroom family room C hk , J hallway living room i p� d. SO�iii i ifiva rrLli dry •,� � fine, w r q�. i i ha�fumt,i rai xd PPCN a�i �. ^.hur miti y.. BASEMENT Isabel J.Barkley&Charles C.Barkley 1055 Old Shipyard Ln Southold ply 11971 Legend: A Fire/Carbon Monoxide detector B Fire/Carbon Monoxide detector C Fire/Carbon Monoxide detector D Fire/Carbon Monoxide detector ' Door Locations Basement is represented by portion of footprint highlighted in red bold. astrwaT m storage - basemen[ -Hr door TOWN OF SOUTHOLD PROPERTY RECnRD OWNER STREET V d VILLAGE DISTRICT SUB, LOT er FORME OWNER N E ACREAGE �- S W TYPE OF BUILDING RES. Zvy SEAS. VL. FARM COMM. I IND. I CB. MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS - 6 6 -- - _3 �. 1..� t ccs AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER a Form Acre Value Per Acre Value FRONTAGE ON ROAD - , Tillable 1 BULKHEAD Tillable 2 DOCK Tillable. 3 Woodland Swampland Brushland House Plot Tota V, I I � _..._. i rt Y --f........_ r i I i i 11 M. Bldg. Foundation Bath Extension ` i Basement Floors Extension _ D Ext Walls Interior Finish _ ---- /.L{.-- -` - --- �3 ►2 G �i --... - - --- - --'- -- + Y 0 V-1Z _..i. ---............---- Extension t,� ,�� , Fire Place Heat Porch Roof Type } ' __—........_ _._................... — _ _ _. __.._.—._.-_....-............ ....... xc�_— _.. - . ----.._ Porch Rooms lst Floor --.._. - - ---------... -. ._ .. _ __ _...... _....-- -- ---....-._............---........................._._..__....._.-_......... - Breezeway Patio Rooms 2nd Floor - -- -.... _-- -- . ...... —_........ ---- _�—. _ GarageS f - 3 1. Driveway Dormer _ .....................__................- f- -4- - -- -..__...._..._.. _- -...... — O. B. TOV.. ..)F SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN IIALL SOUTHOLD, NEW YOPM CERTIFICATE OF OCCUPANCY NONCONFORMING PRE;iIISES TIIIS IS TO CERTIFY that the / X/ Land Pre C.O. #- Z-16121 /_/ Building(s) Date- September 2, 1987 / / Uses) located at 1055 Old Shipyard Lane Southold, New York Street Hamlet shown on County tax map as District 1000, Section 064 , Block 05 Lot 22 , does!.not)conform to the present Building Zone Code of the Town of Southold for the following reasons: Insufficient total area; side yard set back; On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /_X/Land /_/Building(s) / /Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office. the occupancy and use for which this Certifi- cate is issued is as follows: Property contains 1 story, one family wood framed dwelling with attached garage; open porch; all situated in the 'A' Residential Agricultural zone with access to Old Shipyard Lane The Certificate is issued to RICHAMH..:ORGASS, EXEC. ESTATE OF ELIZABETH M. ORGASS (owner, 11§ ddCM3�tiOXX o: the aforesaid building. Suffolk County Department of Ilealth Approval N/A UNDERR-RITEftS CERTIFICATE NO. N/A NOTICE IS IIEREBY GIVEN that the owner of the above premises ILLS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Buildinn "Lone Code, and therefore, no such inspection has been conducted. This Certificate. therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. �? :nip cctor