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Home My WebLink About1000-59.-5-21 TOWN OF SOUTHOLD Rental ' to Permit 0682 Owner Faught Lynn Living Trust Occupied as Single Family Dwelling Located at 425 Lake Drive Southold 59-5-21 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. 6/28/2022 Code r)c re)t Official This Notice must be posted by the main entrance at all times Vike o� . Town Hall Annex , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ® �Ar Southold,NY 11971-0959 WON BUILDING BUILDING DEPARTMENT TOWN OF SOUTHOLD . v ' RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: ; Rental Property Address: MAY 23 2019 HSL15 T . - ",To Tax Map Number: 1000 SECTION cS�' BLOCK 5 LOT SECTION B. OWNER INFORMATION: Property Owner Name: L.s,nn Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Wr�3{n�ti.a►�r.i D� �oOoq Telephone Number(s): o`l.o&-- 67-Z — G L(.2 �Cir to Property Owner Email Address:—1 `,r%8: ow. kt&jC1 a. Page 1 of 4 �0 6� SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: Oftf 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 Uni �o Number of rooms in Rental Dwelling Unit: 7 Use and Dimensions of each room in Rental Dwelling Unit: Koos lay-a ', L-6ylr,o► P—O r%,- to -,�o". 10 (o . c� doC rr% g x� d- 6o.�1'h�oorr 5�5 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. 1 am requesting a.fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. 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. SlIffE 6F NEW YeR Wark,, Ws-irCe--* de" Co1"n.6� I Lynch En certify under penalty sof 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 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, or Site Manager. Property Owner's Name: L M Fa Property Owner's Signature: 0\ Sworn to before me this 14day of Oda V 020�� LX Official Notary Public Signature and Original Notary Stamp Page 4 of 4 p�S� SOUTh°� * # TOWN OF SOUTHOLM BUILDING DEPT. cou765-1802 o"L h-;KLa�cD(',fANSPECTION [ ] FOUNDATION 1ST [: ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING - w [ ] FRAMING /STRAPPING [ ] F AL a Q,,+c-Q "V� [ ] FIREPLACE & CHIMNEY -[ FIRE SAFETY-INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: c DATE 5 �� I Zz INSPECTOR - v a0F so f # TOWN OF SOUTHOLD BUILDING DEPT. courm, ' 765-1802 INSPECTION . ' [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] INALow FET -� [ ] FIREPLACE & CHIMNEY [ FIRES Y INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR IM5 c ..ke, n 0 to xcoiC P�c?,aA � of q 0.S I t naS 1 6 K� c�se„ 0 '`to 5 NLJP, otoor 10 Y- 9-0 , �eo�rocm�'3 � 3 x 5 i ��n i�q tbom 'a�-l0 i`oarx I S x 8 Nei Ele��c w ofe�- V TOWN OF SOUTHOLD.:;. PROPRRTY Rte. _ OWNER ; LTr• 51. STREET 25 -:VILLAGE DIST. SUB. LOT F �R OW N E ACR. � h. . T. r I' e� ,ZILI-d— w . S , :, . TYPE OF BUILDING � e'f e %, G1 '€% _ _� - : ./✓Y�cel RES. VLi' ' FARM CONI CB. MISC. Mkt. Value >LAND . 'IMP. TOTAL DATE REMARKS r.Z3 v`a. �-�* vim.. ,' ,� - Z,� ` ^, �r :;� i 77 lia 314 _ - tit'.• �. - •�Y - -� O, IS E -3 B. 1 DING ONDS ;!,`' G zi NEW RMAL BELOW FARM -Acre Value Per Vale' r Acre r -Z7 :jam' :.Tillable Y .. - ,.i''% . :.Tillable • 2 :.Tillable 3 Woodland Swampland FRONTAGE ON WATER . Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD '.'" ° °•`� DOCK Tota SOMEONE E■■■■■■■■■■■OM■■M■■ ■M■ME MMEMEOMMM■■MOMMME■■ MENEM ■■■lI■M■■■■MWOMMEMO. ■■■■■® .. _ R sement • . Y v • , I f zr^ o�OgQFf01 �, Town of Southold 6/28/2022 53095 Main Rd y x Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 43192 Date: 6/28/2022 THIS CERTIFIES that the structure(s)located at: 425 Lake Dr, Southold SCTM#: 473889 Sec/Block/Lot: 59.-5-21 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- 43192 dated 6/28/2022 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame single family dwelling and accessory shed.* I The certificate is issued to Faught Lynn Living Trust (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ho ' e Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 425 Lake Dr,Southold SUFF.CO.TAX MAP NO.: 59.-5-21 SUBDIVISION: NAME OF OWNER(S): Faught Lynn Living Trust OCCUPANCY: ADMITTED\BY: SOURCE OF REQUEST: Faught Lynn Living Trust DATE: 6/28/2022 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: Cement Block CELLAR: CRAWL SPACE: X BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: yes .TYPE HEATER: Electric AIR CONDITIONING: TYPE HEAT: Electric BB WARM AIR: HOT WATER: #BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: wood frame shed SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 5/19/2022 TIME START: END: t � FORM NO. 4 - TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, CERTIFICATE OF OCCUPANCY No. Z,18.7.5............... Date .........................uly..........21......... 19..20. THIS CERTIFIES that the building located at 8/6.....ifrke---rive.................................. Street Map No. Block No. . .. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................dune, .29....... ., 19...7,0 pursuant to which Building Permit No. 1+8.292... dated .........................� .....�9............. 19....7.0 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 ........ ...............acee•ssory...(staro•Ce.)... ............................................................................ The certificate is issued to ...4„� �gm n,.,j�n m l�O•• :••:ti•1Z'6............OLwr .>rs............................ (owner, lessee or tenant) of the aforesaid building. House # 1+05 Bilding • uInspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z5567. . . . . . Date . . . . . . . . . . .Qett0W.As . . . ., 19.73. THIS CERTIFIES that the building located at . . 0.WT9. . . . . . . . . . . . . . Street Map No. #2537 . . . . . Block No. .XX . . . . . .Lot No.225#226t 2,21. . . . . . .Southold. . . conforms substantially to the Application for Building Permit heretofore filed in this office /dated . . .jWT. .l?!. . . . . . . . . ., 19. .71 pursuant to which Building Permit No. . dated . . .Jul..20i. . . . . . . . . . .. 19. . 1, 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. pont. family.. AveUf n g. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . 3=1 min .Aeniaml= . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . .N.R.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. Af oR r. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . .k0.. . . . . . . Street . . . . 14*0. Pxt'V . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . .r'� . . . . . . . . . . Building Inspector FORM NO. 2 TOWN OF SOUTHOLD ; BUILDING DEPARTM9114T" TOWN CLERK`S OPOIC£ SOUTHOLD, N. Y. BUILDING PERMIT {THIS PERMIT MUST BE KEPT ON THE PREMISS UNTIL PULL COMPLETION OF THE WORK AUTHORIZED} N'? 5417 Z Date .........................Aa y.......20......... 19-74. Permission is hereby granted to: ............. 2a� ....................... .................. .. . r�?" .. . . ................. ..........I......... ....... %..........I...... to ...Build...+z .. &tt94w.-.4164W. . .......... ............................. ............................................................ ...................... .......... .............................................................. atpremises located .................................... .......................................I.................. ......................................... ....... .��. ....................... ....................................................... pursuant to application dated .............................July I•`'•.-••••. 19. l..., and approved by the Building Inspector. Fee $• a04............. s _ �•'�Building�Ins ector