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HomeMy WebLinkAbout1000-15.-5-30 g TOWN OF SOUTHOLD 4 g= Rental Permit 0389 Owner Anne & Gerard Bellesheim Jr Occupied as Single Family Dwelling Located at 2130 Plum Island Ln Orient 15.-5-30 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. 6/27/2023 Code Enforcement Official This Notice must be posted by the main entrance at all tim TOW IF U IHH LD BUIL IN PT. � UNt» 631-765-1802 1 INSPECTION FOUNDATION 1ST ROUGH PLBG. FOUNDATION 2ND INSULATION/CAULKING FRAMING 1 STRAPPING FINAL RESISTANTFIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE ELECTRICAL (ROUGH) ELECTRICAL (FINAL) C 1 O RENTAL J v DATE INSPECTOR - * ' TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLRG. [ FOUNDATION 2ND INSULATION/CAULKING [ FRAMING ®STRAPPING FINAL CHIMNEYFIREPLACE & [ I INSPECTION FIRE RESISTANTI IRE RESISTANT PENETRATION ELECTRICAL ) ELECTRICAL ( I [ CODE VIOLATION DATE INSPEvrOR tarrax / 3,6 TOWN OF THOLD BUILDING 1 . � ear INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLB,G. FOUNDATION 2ND INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANTI IRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION PRE C/O RENTAL R MARKS: DATE ._ .. w _ � U TOWN OF SOUTHOLD CO t Rental Permit Permit No. 0389 Owner Anne Bellesheim & Gerard Bellesheim Jr. Occupied as Single Family Dwelling Located at 2130 Plum Island Ln Orient 15-5-30 Village 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. 2/23/2021 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times p SOUT Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-09597E c� D QQ3 BUILDING DEPARTMENT gu-'Kv� -3 D TOWN OF SOUTHOLD OCT - 9 2020 RENTAL PERMIT APPLICATION i ff P, G PT Rental Permit Fee$200(Application must be renewed every two year1r Section A. Property Information: Rental Property Address: 213-0 ?I(AcvX t6lclrA two ©cker+j NY 1195-7 Tax Map Number: 1000 SECTION 61 C 0 -BLOCK-0m,00 -LOT O 3 0 - D®-D SECTION B. OWNER INFORMATION: Property Owner Name: Gemcck 6v,j AnRL �e�le Shea�e Property Owner Legal Address: Property Owner Mailing Address: <6O {1yArc tkcto r� AVf_ SO V�A( i n o(-\ AJ'e-, Scmcm�\e,, (0 y to S-%3 W Y 10 S'::3 --11LA-ck$3� Telephone Number(s): Daytime Evening Emergency Property Owner Email Address: -kV)& ,112She.1mS VU VOr) e'f e r).o(0�q���� Page 1&5 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: 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 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: 11 Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 � c®���, pp �tltd BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: A 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: �1r1 Requested Maximum number of persons allowed to occupy Dwelling it: 6 Z Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: tA �— j 5+ex Ud x�' �° ; bv nqQayn I S'i I 11 23'6 I 231%u x ZA; X6 11'1 , V-�'I1 SGAA-roorn 1 6° Page 3 of 5 Af 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 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. �y I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold V 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 ) wes s� 1 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 y Town Hall Annex Telephone(631)765-1802 54375 Main Road " Fax(631)765-9502 CA P.O.Box 1179 G Q O Southold,NY 11971-0959J BUILDING DEPARTMENT TOWN OF SOUTHOLID applicable laws and rules. I further acknowledge that 1 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: AAVI� '64 1 Property Owner's Signature: Sworn to before me this_W—day of Offici otary Public Signature and Original Notary Stamp - MARK PAUL KRAUS$ Notary Public,State of New York No.01 KROM719, Qualified iri Putnam County My Commission Expires Mardt9, Page 5 of 5 ®v SOdI� August 1, 2020 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 COUl 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 dome Inspector must provide copy of valid-current certification Rental PropertySCTM Number: 0 Ds , �� — D30 Doo Rental Property Address: 2130 Plum Island Lane., Orient NY Owner/Name: , Gerard Bellescheim Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom #2-90 sq., etc.) Bedroom #1 250sgft Bedroom #2 235sgft Bedroom #3 250sgft Property Description (Include all improvements indicated on survey) single 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 �V" Print Name and Title ceo# 1216-0283 Original Signature Please place'prc+'Pssional seal: f 2130 Plum Island Lane, Orient, NY 11957 Anne and Gerard Bellesheim 10 sq Master Bedroom 16'8"x 1010" 180 sq ft 0 sq Laundry 610"x 11'10" 81 sq ft Master Bathroom Hall Bathroo Kitchen 6'8"x 6'11" 6'1"x 6'1 ' 23'8"x-20' - 45 sq ft 41 sq ft - - Hall 388 sq ft 56sgft Bedroom 2 132"x 107" sq 140 sq ft 11 s Living Room q 1311 x23 6, 335 sq ft Front Porch 157 sq ft s sq ®Smoke Detector Bedroom 3/Office 132"x 9'9" ®Smoke&Carbon Monoxide Detector 12&sq ft OFront all 30 sq ft 2130 Plum Island Lane, Orient, NY 11957 Anne and Gerard Bellesheim A4< ;1618":x-,10'10 q; Laundry •6110"x 11'10" MastetBathroom "HallBattiroo' „k'6111' _ -Kitchen- 6 8 x6;11, •8;1 ` 23`8"x'•20' 388 sq"ft 56 s -f Bedroo 2 132-•x;1b 7, - .140 sq°,ft: •. - - • . �i' iri 9.Room: -'--L"v . ., - Front-Porch- 15' -sgft s Smoke - mo Defector ~:Bedroorri.3l�Office:. - _- Smoke&Carbon - - - - Monoxide Detector - a 30'sv - ,4. 4A � � � -_� Room Sketcher SummerHome1 2. Floor 3 Bilco doors cover exterior basement exit and stairs. Unfinished Basement 725 sq ft � W ter Smoke and CO detector He Fu nac 'Unfinished Basement 326 sq-ft I 1 -71OPO) 8 TOWN OF SOUTHOLD PROPERTY v %,AKD O STREET j 3 VILLAGE DISTRICT SUB. LOT .r !a � sah ��� _��..� ;z ✓ ----- -- --- i N FORMER OWNER M:1 ( • i tO ! i N E - ACREAGE A/- Ito II' ,t c f { ur K c►bG✓� • �4jIc S W TYPE OF BU ING RES. Jap ( SEAS. VL. FARM COMM. I IND. ( C MISC. Est. Mkt. Value - --- ------------ LAND IMP. TOTAL DATE REMARK!, l/1 ,; 1Ga 146,X .�.�6 'Td a va a► d ----------- 15` 44 . X" AL4re, L 9 _ z4o d _ l0© d 1111 73 /a jio l 2 o SA 1 t ta► TcL F�^ /1121- 0 �GE •9�3� --- —6V11LD�%G NDIT N od ! C6 a Ind - .- EW NORMAL E FRONTAGE ON WA ER 2 — — - --Lo10 - - -- - a S oS 6 7 lace, 8P# - !4 Farm Acre Value Per Acre Value FRONTAGE ON ROAD I? �' te'a.trpn, Tillable 1 - -- -- - - — _ BULKHEAD 2fjj p6_3(,17 Tillable 2 DOCK Tillable 3 -- ------- ---- 'I�\' '�� -� 0IL%; Woodland Swampland Brushland House Plot Total. b ,, „ r u: s. . , 15.-5-30 9/11 - 0- •--. ate. M. Bldg. L Foundation P Bath / Extension I Basement Floors o -- 9 eo t��I \ c Ext. Walls to Interior Finish Extension _ Ext sloes Fire Place / Heat - I Porch Roof Type 1_. ` Porch Rooms 1 st Floor aim Breezeway Patio Rooms 2nd Floor = — Garage ! X — �.S Driveway Dormer I -- ---- _ _ ---_ - ---1 --- --- - - - -- - 100, e�s. Zoe (.CS) o\ . FORM X0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office �ns Southold, N. Y. Certificate Of Occupancy No. 47260 . . . . . . Date . . . . ®1?ter:ber 29 THIS CERTIFIES that the building located at A/.S. Plum. 1,31and .]A,.. . . . . Street Orient By th* Seas Orient, N* v• Map No. i1t. . . . . . Block No. . .X. . . . . . .Lot No, . .98. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . Feb. 2lt . . . . . . . . . . . ., 19.76 pursuant to which Building Permit No. .838.4Z . dated —Fel?. 24. . . . . . . . . . . . .. 19. 76, 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 Fri ,nate. .One. .4az.: J,y. .dw.e,7,jjni;. . . . . . . . . . . . . . . . . . . .'. . . . . . . . . . . . . . . . . . . . The certificate is issued to .J lurXe.0, Fxamvs. I+ bunt . . . . . ... . . . . . . . . . . . . . . . . . . . . . (owner, X&JAMUMA) of the aforesaid building. Suffolk County Department of Health Approval Sent, 291 1976 (Robert Villa) UNDERWRITERS CERTIFICATE No. .? 29709 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER a13o. . . . . . . . . Street Plum Island, Lan® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33003 Date: 04/28/08 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property: 2130 PLUM ISLAND LA ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 15 Block 5 Lot 30 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 8, 2008 pursuant to which Building Permit No. 33675-Z dated FEBRUARY 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 INGROUND SWIMMING POOL IN THE REQUIRED REAR YARD WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JAN KIRWAN & JENETTE HOLLOWAY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A RTCYRICAL CERTIFICATE NO. 2001223 05/11/04 PLUMBERS CERTIFICATION DATED N/A u ori d Signature Rev. 1/81 .7•lb. + SUIfQjk�o Town of Southold 8/18/2016 G� P.O.Box 1179 _ -Ir 53495 Main Rd y ° Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38457 Date: 8/1812016 — THIS CERTIFIES that the building RESIDENTIAL ALTERATION Location of Property: 2130 Plum Island Lane,Orient _ SCTM#: 473889 Sec/Block/Lot: 15_-5-30 Subdivision: _ Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/4/2008 pursuant to which Bulling Permit No. 36173 dated _ 2/11/2011 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: ADDCIONS AND ' ONT PORCH AND ENTRYWAERATIONS INCLUDING �A SPACE, PACEECOV AND REAR LANDING,O AN FMSTING ONE SPAERED FF R FAMILY DWELLING AS APPLIED FOR The certificate is issued to .tan Kirwin&Jenette Holloway of the aforesaid building- SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL — ELECTRICAL CERTIFICATE NO_ _ 4024533 06-11-2009 PLIUNMERS CERTIFICATION DATED 07-18-2016 Jpe Whitecavage Author ed Signatur