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Home My WebLink About1000-3.-2-10 Rental a rm it 0972 Owner: Harry Hurlburt , Sandra Hurlburt Occupied as: Single Family Dwelling Located at: 13274 East Main Rd Fishers Island 1-2-10 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 i-annu . spection. Issued: 05/28/2025 Expiration: 05/28/2027 oes f� t official This Notice must be posted by the main entraUeaall ti qv so , TOWN OFKOUITHOLD BUILDING DEPT. � w 631-765-1602 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION/CAULKING [ ] FRAMING /STRAPPING [ ] INAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: �.. I Uuxllo DATE < 111 SPELT 1►R $� µ. TOWN OF SOUTHOLD 7, Rental Permit 0972 Owner Harry Hurlburt, Jr. Occupied as Single Family Dwelling Located at 13274 East Main Rd. Fishers Island 3.-2-10 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. 8/3/2023 ode This faac.,,m ntOfficial This Notice must be posted by the main entrance at all times SOUP 49 Town Hall Annex ff Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road P.O.Box 1179 { , Southold,NY 11971-0959 �C BUILDING DEPARTMENT r; TOWN OF SO OLD Lj RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 13 2.71 IfAS`l- ►MI\r t-) Ztl ,,�''?�i-1 ��S LANi`>,NY (A3�� Tax Map Number: 1000 SECTION _ -BLOCK -LOT ) - I� SECTION B. OWNER INFORMATION: Property Owner Name: Ht;)jZ��( • 1-1�SZ 3v�Z 1 3Z Property Owner Legal Address: Property Owner Mailing Address: 2y y it�'�1Niz�� ay + �za�►,J 'zt� LAt�ISi>> 1_ ,'17 , lo f_A >v51)Al-Eto `�/� 1�►441A ts-i$a-z�11, t � 7 ts_l,fio-.ayyl, Telephone Number(s): Daytime Evening EmergencyZ Property Owner Email Address: ,,) h\ T ° �• c�' Page 1 of S Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 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: I 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: r Page 3 of 5 U Town Hall Annex - °, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959aB U , BUILDING DEPARTMENT TOWN OF SO OLD Section C. Authorized Agent information: Name of Authorized Agent of dwelling unit,if any: �' '"� r 1 D 1�r AIT o'Z Address of Authorized Agent(no P.O. Boxes): '31 S� CCA-1 lk8 L 6±k- r t SN ER S IS Mailing Address of Authorized Agent: 5'1M Z �i3�UE (&11-1 =1 � rsl,o$�S-�1 %toy— Telephone Number(s): Daytime Evening Emergency Email Address: '�`� `i rr ► s IQ r�g(' . c 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: Address of Managing Agent(no P.O. Boxes): r' Page 2 of 5 Town Hall Annex Telephone(631)765-1802 IL 54375 Main Road _ a' 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. 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 ISA t9-Y 6 441Ji"SP� a R,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 Town Hall Annex Telephone(631)765-1802 - Fax(631)765-9502 54375 Main Road a- P.O.Box 1179 Southold,NY 11971-0959Al `\ Ul BUILDING DEPARTMENT TOWN OF SOU OLD 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: 4fA-W Y t•f-IvVt*-. � R Property Owner's Signature: Sworn to before me this ay of 20.q Official Notary Public S' nature and Original Notary Stamp OOMMQNW AI TH OF PI NNSYL.'ANIA NOTARIAL SEAL Sura,)B.Hughes.Notary Punlic WF.;%:a,n T�vp..Montgomery County My Commission Expires May 30,2021 MEtsBER 5=yjSNi_SANjAAS LAnvN OF NOTARIES Page 5 of 5 14f s TOWN OUTHOLD BUILDING DEPT. 631-765-1802 � 'Z-190 mPowobE G" T 10121" ON [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INULATIOWCAULING [ ] FRAMING /STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL F AL) [ ] CODE VIOLA I [ ] PRE C/O RENTAL 'c.. -001 � ivi DATE '�� INSPECTORY i a I f i _T s 1 7` Ee i f F v ( i a saa= 1 f TOWN F SOUTHOLD PR01 - -)RD CARD __. OWNER. .. . . ._...��.._ �_ STREET .. _.._.w ......._ . _ww..... ....._ .., „ VILLAGE l DISTRICT SUB LOT FOrw�,7,,A,E'R OWNER N E ACREAGE TYPE OF BUILDING S i °� ; SEAS. _.__� ...� _...�__....._...__.4 __...� RES VL. FARM COMM. IND, CB MISC. LAND IMP TOTAL DATE REMARKS u es C DIT 0 W NEW NORMAL BELOW ? ABOVE Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Wcodland Swampland Brushland House Plot { _... _........... _ ............... ...... ._ ........ ..._...._ Total a � t r , COLOR TRIM 3-2-10 3/04 1st 2nd M...Bldg, �.. _ . ._ w.... .._. .._ .. , . ..� _w...M...._...ww _.,_..._..�__.. ww..._...._.._._ .,.,.. ..,.Foundation ce FI n. B. Bath Dinette .,,M...»,w .,.,.,,..wv..._.,., ._. ..„,,..„.......... ........._,,... , ............... .. ..... ,..,..... .. .... . . . . ,,... ,..,.... ...._. ,,,.„ ..... .. ,.. FULL COMBO Extension Ffe dd CRAWL PA9TIAL Floors Kit,Bment SLAB Extension_ .__..._...,�, ... . 1 l t om "7 a . Walls Interior Finish L R. 1 s Extension � ? � Fire Place Heat ..... . ...... _ D.R Patin Woodstove BR. Porch Dormer Baths Deck .. Dock Fam. Rm, A.C. .. ^^. .. ... , . Garage „�� p V, P fzr �- 1 i Z J— .,,..,M.,........... .,,,,,..�,..,..... Pool e a i 111 1 ... .....F,.,,...... . .„,...,... ..4 f J .. . . _ ... j r Tf i 1II J _ 1 _. .. 1.... .......... .... !._.: r � M Bldg ;o o G o Foundation 3 Bath _.... .... _. _. ....._ Extension Basement 5- L Floors T m Extension .__.._............... .. ... � Finish Ext. Walls F Interior ..��.�. www.. .. ,.._._�__ _ ...., _.. � .. .....,' .,.. .... ..�. . ...... .�,. -__.._M... ..ww.w . Extension Fire Place Heat ... Porch Attic G 3 l = z 7 Porch Rooms 1st Floor way Portia Rooms 2nd Floor BreezeGarage r Driveway O. B. r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 44427. . . . . . Date . . . . . . . . . . . .Oct . . . . 1.2 . . . . ., 19.71. THIS CERTIFIES that the building located at . . N./S.prienta1.xvo . . . . . . Street Map No. F..1,.Est. . . Block No. . .19 . . . . . .Lot No.3.Fishers •Is.l.&nd• • • • .N.Y. . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . .Oct . . . . ..6 . ., 19. .69 pursuant to which Building Permit No. . �497Z. dated . . . . . . . . . . . Oct. . . .8. . ., 19. .69, 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 Private -one -family- dwell-ing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . Harry- .0; •llurlburt-& Wife ' ' pwners7 - ' ' ' ' ' . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . .Fending. . . . . . . . . . . . . . . . . . . . . . . . . l r . .. . . . . . . . . . . . . . . Building e �r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30546 Date: 11/12/04 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: OFF EAST END RD FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 3 Block 2 Lot 10 Subdivision Filed Map No_ Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 18, 2002 pursuant to which Building Permit No. 28789-Z dated SEPTEMBER 30, 2002 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 ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5159. The certificate is issued to HARRY O & SANDRA L. HUIRLBURT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1156207 88/06/04 PLUMBERS CERTIFICATION DATED N/A ut` riz Signature Rev. 1/81 n — Fishers island — :Aication # 5159 Side = Rem yard IS s; if io'r Hurlburt Residence — Fishers Island — Mplicat on # 5159 x Hurlburt residence — Fishers Island — ation # 5159 Nest Side — Side Yard Here is the info for the application: James Reid Mystic Isle Realty 1318 Central Avenue Fishers Island, NY 06390 NY Real Estate License#30RE0987718 Office: 631 788 7882. After Hours/Mobile: 860 885 9880 Emaili � Verity, Mike From: Chip Hurlburt <chip.hurlburt@gmail.com> Sent: Monday, February 20, 2023 11:18 AM To: Verity, Mike Subject: Scheduling return visit - Rental permit application (Fishers Island) Mr. Verity I wanted to follow-up to request/schedule a return inspection visit for a rental permit a fico J _, der to get the permit issued. Our property is Tax Map: 47381 We made application for a Southold rental permit in October 2019. There was an inspection in early December 2019. We don't live on Fishers Island so Jim Reid accompanied the inspection. We were told the inspector needed to return for a follow-up in early 2020. I don't believe the follow-up visit happened before COVID hit and I don't believe the permit was ever issued. We would like to seek to have the rental permit issued ' be the person who o could accompany the inspector on our behalf. Can you let me know if a follow-up visit is required and if so, if we can schedule the return visit as soon as practical? Thank you in advance. Sincerely, Harry Hurlburt 917-363-7143 ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. i