HomeMy WebLinkAbout1000-64.-2-50 Of DIA TOWN OF SOUTHOLD
Rental Permit
�a
0432
Owner Lauren Frasca & Michael Kleiman
Occupied as Single Family Dwelling
Located at 230 Old Shipyard Ln Southold 64.-2-50
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.
5/15/2023
Code Enforc nt Official)qilzot
This Notice must be posted by the main entrance at all times
qF so
TOWN OF SOUTHOLD BUILDING •
" /-",?`631-765-1802
may"
INSPECTION
FOUNDATION 1ST ROUGH PL13G.
FOUNDATION 2ND INSULATIOWCAULKING
FRAMING / STRAPPING FIN AL
FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION
ELECTRICAL (ROUGH) ELECTRICAL I
CODE VIOLATION PRE C/O RENTAL
::. .
Vw �« uta
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DATE INSPECTOR
Town Hall Annex
SOUTHOLD TOWN 54375 Main Road
PO Box 1179 Southold,
m ill iil
Rental Inspection. NY 11971-1179
raw Tel: 631-785-1802
Fax 631-765-9502
rSCTM # - — Date
Owner Phone
Address ,3CJ w . _ _ Zip
city Inspector
LEVELS SUB 1 2 3
Smoke Detectors (#-bedroom detectors excluded)
Carbon Monoxide Detectors --
Fire Extinguishers (#) / --
Exits (#)
BEDROOMS 1 2 3 4
Smoke Detector Alarms (#)
Carbon Monoxide Alarms (#)
Egress (windows) (Y/N) �
BUILDING SYSTEMS Y/N CONDITION OF PROPERTY YEN
H,at m maintainer/opera'tionaN Building Interior is clean/maintained
Hot water steno maintairo-e'i/fw)perational Building Exterior is clean/maintained
ational Property Pro ert is clean /safe/maintained
Electricals stem maintained/o st
Mechanical s stent maintained/o stational Handrails & guards present
Rental Inspection Form 4/7/2021
Q TOWN OF SOUTHOLD
Rental Permit
Permit No. 0432
Owner Lauren Frasca & Michael Kleiman
Occupied as Single Family Dwelling
Located at 230 Old Shipyard Lane Southold 64-2-50
Village
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.
5/4/2021
e E orem n O ficial
This Notice must be posted by the main entrance at all times
Town Hall Hall Annex P
hone(631)765-1802
t• ) Tele
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959Q��, * y�'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200 (Application must be renewed every two sJ; -• • ; `, ,
JUN 2 4 2019
Section A.
Property Information: �, �, ��k ,7778
Re tal Prope` Address: Q _,p 1 O
� o a�'1 )j ,o d l 3
Tax Map Number: 1000 SECTION BLOCK LOT_ 50
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Lai,)r�,n 1'03 ►`'—^'I ow
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
sL� Ali-P,
Telephone Number (s): � 'T� 2 CX.I�-1' 1�� J`l� �b53
Property Owner Email Address: LnT�w Cp—@ Q G�-� ` • �.0�'1
Page 1 of 4
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any:. /y _.
. T
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:_
Telephone Number (s).:
Email Address ^ 1 _
P
Sectio"n'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.. 3
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
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..
Number of rooms in Rental Dwelling Unit.
Use and Dimensions of each room in Rental Dwelling Unit; , , iyn���`1.0 KI .�
S6 BagLmS- 9S3 _NL"
�P
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 th%R�rr of Southold.
owto
fty v fA Jo 9%2, WduqymMtA
as tIsea'— )M 4
Page 3 of 4
❑ 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)
; certify under penalty of perjury,the following:
L 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 this application is my legal
address:artcl i understand the Town will use the address fbr 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; orSite Manager.
Property Owner's Name:; Is
-_-
Property Owner's Signature _
Swo to before me this tq��day of. .�l!`�
__. DwuWo
Offi ial of ry ublic Signature(gnOriginal Notary Stamp Notwy Stele of New York
No.01DE6381154
QudCW in Westftster County
Conssion Expires September 24,2Q.9
Page 4 of 4
Leo oI�P
Of SOUI�'o�
* # TOWN OF SOUTHOLD BUILDING DEPT.
coum, 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] INAL �,�iLN�Il
4""w[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: t G o►✓�
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DATE INSPECTOR
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TOWN OF SOUTHOLD PROPERTY RECOF
OWNER STREET T VILLAGE DISTRICT SUB. LOT
�:ORMER OWNER M �Lfj
k N Ef ACREAGE
�n p o E"' "
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S W TYPE OF BUILDING
..„ s i Y cr +f d7 t.C._.
RES. SEAS. VL. FARM COMM. IND. CB. MISC.
LAND W.P. TOTAL DATE REMARKSQ
6a
Lr 1176 GC_� 'Qr �
B e ��q��' 91&/1-L� l z 1 f lffirt 'D�St �5 .
NEW NORMAL BELOW ABOV
Form Acre Value Per Acre TValue
Tillable 1 i
Tillable 2
Tillable 3
Woodland
Swampland
B rushland
House Plot
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FORM ANO. 4
TOW OF SOUTHOLD
BUILDING. DEPARTMENT
Town Clerk's Office
Southold, N. Y. .
Certificate Of Occiupahcy
Date
THIS-QjWIFIES,that the building located..at
. . . . . . .Street
Map 1Vo w�a Olock-No. Lot;No. h i 6Yo
t ,d d
§-.subsf�tntiallly.
conif orm :to the
Wild-bi�Xroz�
Go If :.-eato ow andy
:da'ted' . 19.55 7. pursuant.to which:.. N G.
dated -4`9. . . . .. 19-73:, was.issued, and -conforms -to all.-of.the require-
: merits of the applicable:provisions of the law. The occupancy for which this certificate is
issiied is P.Vinvate out'. _Lazi4r
The.certificate is:issued'to.. k. M a. . . .
-ap.1106110,v AM01
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval PT-V �-XIAt-q;49.
. . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE-No.. ... .P ZP,7.,PX-1-stli�4g. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER. 2.30. . . . . . . .Street. ships ad .2.a;. . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . .
... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BUildhIg Inspector
..............
29 June 1973
PRE-EXISTTNG C'..O: ..AND. HOUSING. .CODE INSPECTION
Eugene. 1Schoegor: -arid :-rife.
230 0I'd Shipyard; ane
Nevi York.-
Lot:.:474
.-Lot..:474 . ;Map; .#834. - 'Founders Landing
The:;:,off:.ice.:asked:-.me...to :make,..this, inspection,::.: I picked
u the keys fxo George `Smith &..<Sorx's,:..office Mrs . Scho- ner
:.>
was th. re so adm tted ne ante the hqus0 .--about' 2 00
::-second°..floor is:-.two:lafge:..Bed-ooms.-with 7 '
On thea ,5'"
;.. .
cep 1�ngs with large wioseient
isthree r sers< x�o: rail .-on.
oppn�. side', :.biut:)i"d rail
;... .
wa r olkad
There is`:a; ;detached garage -with :ro.of over-.at-ached patio.
The..hoose; ;garage: and yards- appear. .in very_.good`:ahape.
I:completedthe inspection about 2 :15 pe.m. -and returned:
the. key-. .
Respectfully submitted,
George H. Fisher.
Building Inspector -
i
P.O.BOX.11`•9
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36524 Date: 9/25/2013
THIS CERTIFIES that the building ALTERATION
Location of Property: 230 Old Shipyard Rd, Southold,
SCTM#: 473889 Sec/Block/Lot: 64.-2-50
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore fled in this oficed dated
9/11/2013 pursuant to which Building Permit No. 38334 dated 9/18/2013
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:
"As built"alterations to an existing single family dwelling as applied for.
The certificate is issued to Conklin,Michael&Conklin,Patrice
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE.NO.
PLUMBERS CERTIFICATION DATED 9/13/13 William Gremler
--A1#eaignatke
- ----------------
Town of Southold Annex 9/25/2013
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36524 Date: 9/25/2013
THIS CERTIFIES that the building ALTERATION
Location of Property: 230 Old Shipyard Rd, Southold,
SCTM#: 473889 Sec/Block/Lot: 64.-2-50
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
9/11/2013 pursuant to which Building Permit No. 38334 dated 9/18/2013
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:
"As built"alterations to an existing single family dwelling as applied for
The certificate is issued to Conklin,Michael&Conklin,Patrice
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED 9/13/13 William Gremler
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