HomeMy WebLinkAbout1000-26.-1-6 . TOWN OF SOUTHOLD
Rental Permit
0930
Owner Lawrence Bernstein
Occupied as Single Family Dwelling
Located at 20 Vincent St Orient 26.-1-6
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.
6/12/2023
deE r Official
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 1179k$
Southold,NY 11971-0959rwmn
M
BUILDING DEPARTMENTe �
TOWN OF SOUTHOLD
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 a,10 -BLOCK -LOT—_14 -
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
--
01
Telephone Number (s): Daytim vening Emergency
Property Owner Email Address: "
Page 1 of 5
Town Hall Annex �. 'a'-�, Telephone(631)765-1802
54375 Main Road 6; Fax(631)765-9502
P.O. Box 1 179 �st a
Southold,NY 11971-0959
UNT
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
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, Q 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: in N
Requested Maximum number of persons aYlowed to occupy welling Unit:
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
Page 3 of 5
I Y10,
Town Hall Annex
"x Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
�` �. ma
P.O.Box 1 179
Southold,NY 11971-0959
o i`
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)
I = 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
0 s
Town Hall Annex ��, Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
CA
P.O.Box 1179
Southold,NY 11971-0959 0,
Coy
BUILDING DEPARTMENT
TOWN OF SO 'THOLD
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: _ ► I
Property Owner's Signature:
Sworn b fore meiPubilic,State
kgNew
of
(ficial Notary P bliOriginal Notary Stamp
JEN
Notaryrk
Ile °No,01K 2096
012ked In Suffolk Coun
Commission Expires Decmberl,202,1
Page 5 of 5
so
Telephone(631)765-1802
Town Hall Annex
54375 Main Road � b Fax(631)765-9502
��
P.O.Box 1179
Southold,NY 11971-0959 1 ;
dm„
BUILDING DEPARTMENT
TOWN OF SOUTHOM
RENTAL PERMIT APPLICATION ADDENDUM
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling
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:
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:
Orlo<
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION .
FOUNDATION 1ST [ ] ROUGH PLEIG.
FOUNDATION 2ND [ ] INSULATIOWCAULKING
FRAMING /STRAPPING FINAL
FIREPLACEI [ ] FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION FIRE RESISTANTPENETRATION
ELECTRICAL ) [ ] ELECTRICAL
CODE I L TI [ ] [ ] RENTAL
REMARK
.. �' .
May 06, 2023
Town Hall Annex hone 631)765-1802
�° �� Telephone
54375 Main Road � Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
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
Pro ssional seal required for Architect or Engineer, licensed Home In ector must pLoIrid'e
copy of valid current cerci catlon
Rental Property SCTM Number:
Rental Property Address: 20 Vincent S1. Orient 6
Owner/Name: `
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.)
Bp ppt ...
Bedroom #2 16 ft Bedroom #4. 160 sqft
Property Description (Include all improvements indicated on survey)
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
Print Name and Titie ceo# 1216-0283 Alginal gnat re
Please place professional seal:
�aC4
tr nn0 L 1-:V
AS NO
765-1802 a- - -- I FOLLOWING M TO 4 FOR E
INSPECTIONS: TH
_ - - t.FOUNDATION•TWO=EOUIRED
FOR POURED CONCRETE
2.ROUGH-'FRAMING E PLUMBING
.. - cSL ✓"` I;�, - -- _ ION
a.FINAL-T
CONSTRUCTION MUST _ -
_ BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
F Q50LII!Qr AXN7'7-.,r-SDE'OF FEW
'
YORK STATE, NOT RESPOF°BIBLE 0R
( DESIGN OR CONSTRUCTION ERRORS.
t_ COMPLY WITH ALL CODES OF
NEW YORK STATE&TOWN CODEf
AS REQUIRED AND CONDITIONS 0
q RR
;X �I�rS
OCCUPANCY OR
USE IS UNLAWFUL
Q _ WITHOUT CERTIRCA,
OF OCCUPANCY
1 .. .. :r.;Tr' PLUMBEPCETT,
I � LOCI)D ffs PREVENTION ON'LEAD COi Ertl
l r^17—t'o', Tv".''I COGS DERTIF;CATv OF U :;Y
t -SOLDER USED N 1/,'A,TE,
Gi f'I F`(I J S V1 11 Gt: SUPPL SYSTEM CA
8XCEED 21110 Q LEAD,.
fi WATERZ _
P�'H UAE TO i A`1n2:,u isd;F�''SIQi''R_GyUi`;��3 ..
1.1111-
0—c a e.4cm
M1
C�2
S-C-C-G-n�
157 � °, R� �
,w
� � I
TOWN OF SOUTHOLD PROPERTY REC F
OWNER STREET VILLAGE DIST.' SUB. LOT
>_
FORMER OWNER NE ACR
s-
C4e—A
VA
- SW TYPE OF BUILDING
RFS ;s $ SEAS. VL FARM COMM. CB. MISC. Mkt. Value
I I
LAND IMP, TOTAL DATE REMARKS
= F
kJ
r
e
r
-
�► c� YBaY
}
AGE BUILDING CONDITION "
NEW NORMAL BELOW ABOVE
- _ t
FARM Acre Value Per Value
Acre V��� �� 2'].7 9 ID
Tillable I } � s
Tillable 2 ,
Ti_lable 3
I
Woodland I
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD
House Plot DEPTH
e BULKHEAD
Total �DOCK
I
-MW
LO R
3
.s
o
�_
s
26.4-6 11/14/2018 I
C
M, Bldg. Foundation
Both
i n ette
Extension _ Basement Floors
K
Extension .� sr s Ext. Walls `_ Interior Finish
LR. 0 ^
I Fire Place a ��
a �
Extension Fire � C� � Df'
Type Roof Rooms 1st Floor -_ 8R.
t i
- any - ms 2nd Fig FIN. B
rs Recreation Room
s
3
Dormer
—
_ ;
Stn XZ - 3C� �" Driveway
Garage
� t O ik
i
g
y n 0
to
Total
o
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........... ........
*FGL* Town of Southold 10/6/2017
53095 Main Rd
Southold,New York 11971
.......... .........
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 39270 Date: 10/6/2017
..............
THIS CERTIFIES that the structure(s)located at: 20 Vincent St,Orient
SCTM#: 473889 Sec/Block/Lot: 26.-1-6
Subdivision: Filed Map No. Lot No.
..........
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 39270
dated 10/6/2017 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for whi6h this certificate is issued is:
AQqd frame qngja, 1"fin,.with accesg)r )am.!
-y
1_
XotSa. 1111278 addition/alteration to dwSlIbi 6; 1'._1.. 835 addition to dwells" ffi��1620 B 118 1
Z_QQLL6__R_ �_ -Q—
acr p9rc _ cclitton& gnpj1Wqaj xistjpgp9r:ch,�QQZ-25800.
The certificate is issued to Gesell,William&Joann
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
utho Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE'INSPECTION REPORT
LOCATION: 20 Vincent St, Orient
SUFF.CO.TAX MAP NO.: 26.-1-6 .... _.._..........w_........SUBDIVISION: _......._.Hw_.. ._...
w_11,William&,..wo _ w_._ _., ..........................._u....�ww_w�_�.............M. �'.�.�.�.�.�.�. .._.�.........._��_m_�
Joann
..,µ_ ww.........._._... _........M.
NAME OF OWNER(S): Gese....m..m... ... .. �.
OCCUPANCY:
_ .._..._..�w��wwww____..._..._.ww�w_w.......��.ww..............._....�._�.._........,,,_w_..._..........w_.. ...._.,.................__..wkw
ADMITTED BY:
SOURCE OF REQUEST: Gesell,William�.......w.........�..........w�..._............ww.__...._._....._..�.._wwwwww�.._._.. ..,. .,.�...__�..�..m_,._.,....
DATE: 10/6/2017
OWED
#STORIES: 2 #EXITS: 3
FOUNDATION:..............._.. .wwww.H...w.
...._._..
.................................m,. .........P...........__..
BATHROOM(S): 2 TOILET ROOM(S): UT _w...
cement block CELLAR: partial CRAWL SPACE:
... .......... .........,..w, ,w.._....�.._....._...� _ ....ILTTY ROOM(S):
_. .. ., _._.,_.. ..... .........
PORCH TYPE: DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: yes GARAGE:
DOMESTIC HOTWATER: ..x TYPE HEATER:.............. ... ��.�....._.,gas.w_�� AIR CONDITIONING: __........ .
TYPE HEAT: WARM AIR: x HOT WATER:
#BEDI2ClOMS.M. _._._. KITCHENS...�..,..... ......__�w__, ...__......w_..........................._ _..�w,.�..,.._. w.�...w......... ..�....
1 BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES,
GARAGE,TYPE OF CONST: _........................................................_...................._. ..w... STORAGE,TYPE OF CONST: w.... _.....�.....�.�.�.�......wood frame barn�M. ..�.�.�.�.�.�.�..m....v..
SWIMMING POOL: GUEST,TYPE OF CONST:
.............m........,..,.. ________.................. _.....................
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 10/5/2017
TIME START: 2:45pm END: 3;20pm
Town of Southold 10/31/2019
P.O.Box 1179
53095 Main Rd
414%. Southold,New York 11971
AL *k 400
CERTIFICATE OF OCCUPANCY
No: 40823 Date: 10/31/2019
THIS CERTIFIES that the building RESIDENTIAL ALTERATION
�.. ......_. ...� .......... .._......._........................... ...... ...
................w .w.... w� ......
Location of Property: 20 Vincent St,Orient
..... .......................... _�......._.www._._.......w_.. ��w�...__
SCTM#: 473889 Sec/Block/Lot: 26.-1-6
Subdivision: Filed Map No. _M.............._..TM.......Y... Lot No.N-...M.......___w._,.._..._.�.__..
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/19/2017 pursuant to which Building Permit No. 42271 dated 12/28/2017
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for_.. ... ..._w..
which this certificate is issued is:
TN�TI 1 ')R P hi 1.. 01 S TO—.. N EX I Il l i t 1 1 T AS..MR1,IEI O
The certificate is issued to Shayne,Jeffrey&Karen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
�........_....,�......
ELECTRICAL CERTIFICATE NO. 4227.1w... ............�_ ........_..1.0-25_20..1 9.�._..�...
PLUMBERS CERTIFICATION DATED
10-09-2019 ... �.._...w........__...�Joe tit vage ..w�...........�.._....__._..._
" FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. —Z-16286 . . . . , Date . , , October 14, »1987 . . . , . . , , , „ ..
THIS CERTIFIES that the building . , ADDITION TO EXISTING ONE FAMILY DWELLING
20 Vincent Street & Willow Street Orient New York
Location of Property . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . ..% . .
House IVa. Street Hamlet
County Tax Map No. 1000 Section . . .026 . . . . . .Block . . . . . .Lot . . ,06, , . _ . . , , . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . , . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
March 30, 1987 pursuant to which Building Permit No. , 5835 Z
dated , » . »April 1, 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 . . . . . . . . .
ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to , , , «WILLIAM & JOANN GESELL
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(owner,*WKXKYAX1MX
of the aforesaid building.
Suffolk County Department of Health Approval . . . . N/A . . . . .
UNDERWRITERS CERTIFICATE NO. . . . , . w . . , „ , N8„3„51 14 „ „ « „ „ « «
PLUMBERS CERTIFICATION DATED: October 6, 1987
Building„Inspector.
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25800 Date: 06/29/98
THIS CERTIFIES that the building ADDITION
Location of Property: 20 VINCENT ST ORIENT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 26 Block 1 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 24, 1998 pursuant to which
Building Permit No. 24813-Z dated APRIL 3, 1998
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 SCREEN PORCH ADDITION & ENCLOSE AN EXISTING OPEN PORCH ON AN EXISTING
ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to WILLIAM H & JOANN T. GESELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A _. ....�
ELECTRICAL CERTIFICATE NO. H060070 06/02/98
PLUMBERS CERTIFICATION DATED N/A
Building Inspe or
Rev. 1/81
R
Town of Southold 10/31/2019
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40804 Date: 10/31/2019
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 20 Vincent St.,Orient
SCTM#: 473889 Sec/Block/Lot: 26.4-6
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/15/2017 pursuant to which-Building Permit No. 42251 dated 12/20/2017
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:
ACCESSORYIN-GROUND SWlMMjN QC.4.f ENf"1:�1 TO CODE AS APPLI p FOR
The certificate is issued to Shayne,Jeffrey&Karen
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 4225110-15-2019
PLUMBERS CERTIFICATION DATED
t
ho d Signature _..... .....