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Home My WebLink About1000-31.-8-12.11 TOWN OF SOUTHOLD co Rental Permit a� 0694 Owner Diane Mulvaney Occupied as Single Family Dwelling Located at 225 Marion Lane East Marion 31-8-12.11 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. 7/11/2022 U A ' ode n r nt Official This Notice must be posted by the main entrance at all times V S= h0 lit` Town Hall Annex {, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 I Southold,NY 11971-0959 ,E 000 ,t�".!Z.•Te.'r:t�?"" � I... i d..."=4�'.:_''4.-,.:�':. vat r.:'.:.. BUILDING DEPARTMENT TOWN OF SOUTHOLD FEB 2 3 2021 RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: kcc.vl -c— � �d�ti(&rr o� Tax Map Number: 1000 SECTION 1 -BLOCK lS -LOT SECTION B. OWNER INFORMATION: Property owner Name: Pu I Property Owner Legal Address: Property Owner Mailing Address: d-��5 C _y-7-7 — e� X31 99S Telephone Number(s): Daytimes -79-37 Evening �Q 02— Emergency �� Z Property Owner Email Address: C M U �V-A n �'_�o f Av ) • C'�k 0 Page 1 of 5 14f so Town Hall Annex %r{ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 uim ��f BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: q4-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 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 Evenin Emergency l 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: I Address of Managing Agent (no P.O. Boxes): Page 2 of 5 f ,moo ��, Town Hall Annex "45> ? Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 GAO 4 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: I A— x,31, K3� 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, 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: ?7 Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: !`�i� (,i►t.lJ Ininti IrUOM� �. �aoM, dull 13Nl�aO-Yhj (iILFA�eoM co ro i)m s s co,u 4— Page 3 of 5 fifs� tf SQ�r�® Town Hall Annexe Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G YQ Southold,NY�11971-0959plp 11 � 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. _1V1 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) 1 OUNTY 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 1 �pF SOUT�� Town Hall Annex 4 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 t �•�1;�*�>��.,�tY 1'e� i� 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. . � til �h Property Owner's Name:. OLA t., 1"�l.{ I�CIA Property Owner's Signature: 6W 44/ Sworn to before me thisZ2 day of G0PVX44 , 202( Official Notary Public Signature and Original Notary Stamp SAMANTHA M.NUCCIO Notary No. i lN State ofiN7wYO* f]ualified In Suffolk County Commission Expires November 30,20? Page 5 of 5 s 0 qk A$4 b rV TOWN OF SOUTHOLD BUILDING DEPT. co 765-1802 3t INSPECTION FOUNDATION 1ST ROUGH PLBG. FOUNDATION 2ND INSULATIOWCAULKING FRAMING /STRAPPING [X[�AL 4vw pe,� 'FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION PRE C/O REMARKS: AA DATE * INSPECTOR . ou �O,*pF SOUlyo6 # # TOWN OF SOUTHOLD BUILDING DEPT. �yco 765-1802 22 ' Aavim L m-e— � ... INSPECTION I�"""_" I" [ ] FOUNDATION-1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] INAL [ ] FIREPL""ACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: AvA qo�A ewe 4A DATE INSPECTOR b) LA�ill ft,06 %if,n1 G i . ac ' X10 0 (L I �S--rai r� 1 d fp p GO - OCAP 4 Sb . C MOWN OF SOUTHOLD PROPER� %�`� I �� ,RD STREET VILLAGE DIST. SUB. LOT c o "hlanevN+givn t t,�sr !`�r�r C-I ra-- S +� DORMER OWNERS &n P-,Ian� N E ACR. U7 U P1/ 7�. D /lk'Iq 0F;CA f 400 . � 7C) � a1-4 13 v)6)J LS i S W TYPE OF BUILDING G�c� Q1un�„ry Q� o - D SC F:EVi C CtTo •/ OA i / V J.D -7-t RES.al SEAS. VL. FARM COMM. CB. MICS. Mkt. Value X a,l _ LAND IMP. TOTAL DATE REMARKS / //,3 /7? // ;c 3/7 oL0 �> doo. 8S /1G /0 1 � a n� tl W � J I icz e eKl;z"rmu YJ 24jpt v 5v c.> N/ eR 12Co � 9200 t 1 t. 21�� 1 2�a �i.. eQ\eA-LAfi 4 Nb c kA,v. Ae 2,00 CPZ Q0 oc t l 5 200 - /9 }.S 'jd lU -,lam r � _ 3 '9 �k, - 3�''�~� 'r5 c o�s f T1�o s�F- ,_ G s~f 4�r ea`$c �L► c f� Lcn -}O /flat ✓ q37 --- ° 6100 7 40 3i1 /01 oddIt:�,� �_��► os (3P 31 9 I m” pool Eps,-, y o t c, _Tillobie FRONTAGE ON WATER A�L IyCJS� �(,� � �� Ld� ��,�, Woodland FRONTAGE ON ROAD L 1 ZSgZ 67b It (2'(P.S jL)j Meadowland DEPTH House Plot Total reo/Ace-s# y3079 • ' W MOEN I ONE 11 NINE No .�EMI..■NINE MME ONE ■■..■ ■■■■■■■■■■■■!D■M ■■■N ■N■ - ■■ii■■NIl,.■■I■ E�■■ ■■■. .■■ .■ ■■■■■��■mli.ii■■■■■■■ ■■■N sill "Room M MEN on� ■■■■■■viii■■��®■r■f■...■■■■■... ■■EM■■■IME Ez ■■■■■■■■■■■■ Ext. Walls Interior Finish Fire Place . Y ,Rooms Ist FI Rooms 2nd Floor f Y i - � ■■■■■■■■■■■ ■■ NOON . .- ,, = ;t ■■■■■■■■■■■ ■■ ■■■N ■N■■E■■■■■■ ONE ■NONE ENO M .r ■■■OM E■E■■O■■O■MININ■■NE■ ■ENE■■■s■EomE■■■MEN■■NE■ ■ENEEN■O■■■Nil■!�■■■■■ E■■■■ -,.,. ■ENE■NEN®EENEEE■E■■NEN■MOENEEE OO■■ENO■■■■■■■■■■■■■■■■EE■ _- -_ - ■■EN ■ EMEMIMEMMEMMMMONE ■■■■NE ■E■ENEE■E■E■ENE ■■EN ■ E ■■ ■E■ NE ■■E■NEN ■ NO■OIN ■ ■E■■■E■E■■■■■■■■■E■ ■ENNEN MEN!■■■■■■■■■■■■EE■■■ IHS :. ' .. LR J • ••• • BR •• Dormer s! Y Dock Fam. Rm. ' • D ,