HomeMy WebLinkAbout1000-31.-6-5.2 TOWN OF SOUTHOLD
Ak Rental Permit
0937
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Owner Kathleen Corrigan
Occupied as Single Family Dwelling
Located at 930 Cedar Ln East Marion 31.-6-5.2
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.
6/23/2023
Code Enfor a ent Offici
This Notice must be posted by the main entrance at all times
i
Town Hall Annex Telephone(631)765-1802
54375 Main Road . ' Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address: �3
o C —r � �
La n e La - � ry /V `l
Tax Map Number: 1000 SECTION -.3M -BLO-CK.3 r -LOT
SECTION B.
OWNER INFORMATION: Carr
Property Owner Name: �I 1-cety � ov✓4 V ,,�1 r
Property Owner Legal Address: Property Owner Mailing Address:
Zg0d Or 5� J'� 0, 8.0.54
o e-0 n f-0 L i`/4 rr 9Q r
M'//V 31V2
z�od a YI613g- -50-3
Telephone Number(s): Daytime 9_2&wpening Emergency
Property Owner Email Address: kol ►�&VODEELVtl 0 ow maj >7/1
Page 1 of S
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 3
Southold,NY 11971-09594 Or,ci}
. vu = t3'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
\\ Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: ho/h as LI n I-a
Address of Authorized Agent (no P.O. Boxes): 22-6) 0 MC' f
C'(./�-c k o rJ-el
Mailing Address of Authorized Agent:
510'3) -d3Z
Telephone Number(IIs): Daytime Evening Emergency
1-n
Email Address: dwk4 5 ji rt e V' �_�.�i MOL n , Ldp`^
V 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:
ra I IN 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):-
Page 2 of 5
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179 Gr
Southold,NY 1 1 971-0959
enuff V
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: r 4a
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
Diim�ensions of each room in Rental Dwelling Unit::
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1\ I k4 Pi`y 1 - .-ree,•►� 1 3 'l7 /TS ' M�N &kh &f X 7
0i1?�2,/Jp I2IXI2- W'rt
Page 3 of 5
Town Hall Annexe Telephone(631)765-1802
54375 Main Road c� Fax(631)765-9502
P.O.Box 1179 �.
Southold,NY 11971-0959
C®UNT'tw�
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
❑ 1 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 W49,4 (06-v-&. D0certify 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
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Town Hall Annex t Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 -6
Southold,NY 11971-0959
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. f
Property Owner's Name:; ClN C (a� ° I G l i
Property Owner's Signature:
Sworn to before me this LFI"day of 20E!Z3
Official Notary Public Si nature and Original Notary Stamp
THOMAS J.UHLINGER
Notary Public,State.of.Now Yo*
idc,,g71JH4T93098"
clugifiad in Suffolk County -7
Cor6mission Expires Feb.28,a®`--<
Page 5 of 5
OF SOUlholo
/ * * TOWN OF SOUTHOLD BUILDING DEPT.
coufm 631-765-1802
INSPECTION
[ ] 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 (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ �NTAL
REMARKS: S55v�,o� �� /�- -)� fit,
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DATE
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DATE � � INSPECTOR
Town Hall Annex
� = . SOUTHOL_D TOWN 54375 Main Road
PO Box 1179 Southold,
Rental Inspection NY 11971-1179
Teli 631-765-1802
Fax 631-765-9502
SCTM # Date 3—�
Owner Phone
Address Zip
City Inspector
LEVELS SUB 1 2 3
Smoke Detectors (#-bedroom detectors excluded)
Carbon Monoxide Detectors (#) /
Fire Extinguishers (#)
Exits (#)
BEDROOMS 1 2 3 4 5
Smoke Detector Alarms
Carbon Monoxide Alarms (#)
Egress (windows) (Y/N)
BUILDING SYSTEMS Y/N CONDITION OF PROPERTY Y/N
Heating system maintained/operational // Building Interior is clean /maintained
Hot water system maintained/operational ✓ - Building Exterior is clean/maintained
Electricals stem maintained/operational ✓ Property is clean/safe/maintained
Mechanical system maintained/operational Handrails & guards present
COMMENTS: a S — So
S 5 2.114 a
of
Rental Inspection Form 4/7/2021
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FORM NO.4
TOWN OF SOUTHOLD ✓
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. . . . Z�1,6876. . . . . . Date . . M.1 y. 1988 . . . . . . . . . . . . . . .
THIS CERTIFIES that the building . . .ONE„FAMILY, DWELLING .. .. , , , , , , , , , , , , , , , ,
b
0 Cedar Lane East Marion .Y,.
Location of Property .�. .H. . . . . . . . .
House No. Street Hamlet
County Tax Map No. 1000 Section .4 3 . . . . . . .Block . .Q§ . . . . . . . . . . .Lot . 5 :2. . . . . . . . . . . .
:- Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
} conforms substantially to the Application for Building Permit heretofore filed in this office dated
.' e
. April 16,: . .19 8 7 pursuant to which Building Permit No. t 5 9 3 5 . Z. . . . . . . . . . . . .
Apr , 1
dated . . . . il. . . . . . .25. . . . . .987. . . . . . . . . . . was issued, and conforms to all of the requirements
•5 ,
of the applicable provisions of the law.The occupancy for which this certificate is issued is . . . . . . . . .
ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR
i . . . . . . . . . . . .
Tile certificate is issued to . . . . . . , , EUGENE CORRIGAN . , . . . .
.;� (owner Ye�Fs�3eKr�ic��ckC X%X
of the aforesaid building.
Suffolk County Department of Health Approval . . . . .8 6-S o- 13.1. , ,Ap r,i 1 , 12,,, . 19 8 8 , , , , ,
UNDERWRITERS CERTIFICATE NO. . . . . N008 l0A , March, 2,5 a , 1988
I PLUMBERS CERTIFICATION DATED• April 5, 1988 — K & K Plumbing & Heating
1
. Building Inspector
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Rev.1/81
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Suffolk Security Systems
Suffolk Security Systems Incorporated
50300 Main Road • PO Box 1355 -b Southold NY 11971-0937
Telephone(631) 765-5262 • info@suffolksecurity.com
Certificate of Installation
Name
System Kathleen Corrigan
Location Address
930 Cedar Lane
City,State&Zip Code
East Marion, NY 11939
An alarm system was installed at the above location.
As of the date noted below,a U.L.Listed Central Station monitors it.
Conditions Monitored
✓ Burglary Propane or Natural Gas
Fire Fire Sprinkler and/or Tamper
Carbon Monoxide ✓ Other
Low Temperature (42°F) (specify)Heat Sensors
✓ Spot Water Detection
Monitoring Options
Digital (phone line) Test Transmission
transmission Daily
✓ Internet transmission Weekly
✓ 3G/4G/CDMA or LTE Monthly
transmission
System Installed by
Suffolk Security Systems Incorporated
50300 Main Road
PO Box 1355
Southold, New York 11971
(631) 765-5262
Signed QLa,,,, �'a�amere Titie Office Manager Date 4/11/2023 __
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