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Home My WebLink About1000-69.-3-21 y'aa'/fix rM" ;r, 4 TOWN OF SOUTHOLD Rental Permit 0349 Owner Charles & Isabel Barkley Occupied as Single Family Dwelling Located at 235 Apple Court Southold 69.-3-21 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. 7/26/2023 o • for rn rrt ff�c�al This Notice must be posted by the main entrance at all times x! C4t S001A Town Hall Annex Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road P.O.Box 1179ft Southold,NY 11971-0959 =r _ �mirm BUILDING DEPARTMENT JUL2 2-02-; TOWN OF SOUTHO RENTAL PERMIT APPLICATIONBURILDILING PToyN �_ Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address; � 1� \T-4 1 Q Tax Map Number: 1000 SECTION -1 -BLOCK -_ � -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: ho v les an<� Property Owner Legal Address: Property Owner Mailing Address: tc� le COV 4 kAX650 YYla'�n 12 C) ism -31a- Telephone Number (s): Daytime Evening Emergency_ Property Owner Email Address: - Q• } Y� IM011 �' (r�i V►� Page 1&S Town Hall Annex Telephone(631)765-1802 54375 Main Roadti Fax(631)765-9502 tV P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOHO Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: -n1 a' Address of Authorized Agent (no P.O. Boxes):. r1a Mailing Address of Authorized Agent: _ Y\`a' Telephone Number(s): Daytime . � Evening Emergency Email Address: Section D. Managing Agent Information: OLA)Ye V" Name of Authorized Agent of dwelling unit, if any: '^� Address of Authorized Agent(no P.O. Boxes): r 0, Mailing Address of Authorized Agent: Y1k 0-' Telephone Number (s): Daytime h1cr Evening Emergency_ Email Address: r<t� 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): n1a. Page 2 of 5 Town Hall Annex Telephone(631)765-1802 631 Fax 765-9502 54375 Main Road ( � P.O.Box 1 179 Southold,NY 11971-0959 N Cou BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: n1c..' 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: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: 14VI ,Krr1° KitJrNen '- 1q`-O x 14'-'4 `-O `-n 1 6e (j R � n Page 3 of 5 sot Town Hall Annex - Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Al IR BUILDING DEPARTMENT TOWN OF SOTHOLD 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. ❑ 1 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) �J.. I SGha &� , 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 AnnexTelephone(631)765-1802 54375 Main Road `_ Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 � BUILDING DEPARTMENT TOWN OF s0 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: - - Q Property Owner's Signature: Sworn to before me this day of 20?5 �Notary Offici nature-and Notary Stamp KYLES S DFFRESE tsioWky pUSLIC-STATF-or- 01 G4 66 E Yt�R t� Qualified in Suffolk CountY MY Commission Expires f18-02-2026 Page 5 of 5 140:r 4p�� c+l 4�7 19, TOWN OF SOUTHOLD BUILDING D 631-765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAl [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] TIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL CTRICAL {F1 [ ] C I LATION [ ] P / [ REMARK ow o COD PLC V,4 Q�l 49� ;if........... qct July 01 , 2023 SO y. Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 IN P.O.Box 1179 Southold,NY 11971-0959 a. 111M <. 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 Ero essional seal required for Architect or Engineer, licensed Home InIp ctor mast arovide copy of valid caret cer#itcotio Rental Property SCTM Number: Rental Property Address: 235 Apple fit., Southold NY 11071 Owner/Name: Isabel Barkley 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.) R r mann 01 22Q Soft Bedroom #3 220 5gft Bedroom #2 180 eft Property Description (Include all improvements indicated on survey) sirlle eerily home 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 Title ceo# 1216-0283 Original Signatur Please place professkonal seal: 04- Y 'k tij 9w TP ,�o"off /o'-o" P N w or�7�K '�a►I.� e �k N o � 2 , NQ T7\ N 4Aft g coCD M �N .„ ,..., ..,...... a t TOWN OF SOUTHOLD o�Q RD CARD OWNER STREET ViLLAUL DIST, SUB LOTIs ,a �( I ACR REMARKS rd TYPE OF BLD. ......�._. .� .._..� _ �,.,µ„�,�. . �,,.,.,, .. '.� � ��, � � I i 1� d ��"�. .,_.,.,.��.._. m....� _.. u ✓ F�,.,�... _.w,.�,a�` l k"�'p o'N � x' J`�� "��_„��..�; .rtym�.e � rPROP. CLASS LAND IMP, TOTAL DATE g t < A d J ...............m..,,...,,.,.,..._......�.,,,.<....,.,,_..,..,�,,.a....w,...,.., „„,,,.,,..„......, ._„_,,.�,...,,..,,,, ............_...... ._._.,,. ..,,W»._,..,...,.... .._,....�. rl -_p yl .w... ,. _ ...L..,.,.._...,.., ......,,,,,...�. ,........_....._ Y I i �...J_,� ...,.,.,._,...._...._.... / y FRONTAGE ON WATER TILLABLE .._. ,.. . _,., _..._w.., .._.. .. _... _ _.. . ..._ .. ...... .. .... ._ . _.....,._... . _ ..._.,.,_..,........ FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOU SE/LOT __,M.__ . . .... ...... . .... ....._. , . ..... . . TOTAL II .� � V ,1 r. u> 1 a y 69.-3-21 3/5/2020 .'. Mnq . Bids "A Foundation., . . .__. _ ...._._.. __... .....__ Bath Dinette Extension Basement "° ^ Floors Kit, st ne ,Extension . _____-..®_ ,�..._..m. .__........ _..,._ ...W_.__ �,�. .,.,,.. µ.........w..w . ....,._� . ....�_ __...._...._.. _ ..._ ......, ., _.....w... ..�..... ...... ... .._...__.___�..., . Ext Walls Interior Finish L,R, Extension Fire Place j Heat D,R. � r' .�Patio� ..__ ,Woo... __...,._.... ..�.. ... ..�.._._ _® .�. _,, .,,,,,._ . . dstove BR Porch Dormer Fin B Deck Attic I Breezeway Rooms 1st Floor Garage Driveway Rooms 2nd Floor __.. ....... 0.B Pool I v.. 4� 7