HomeMy WebLinkAbout1000-127.-9-18 N
O
C Cl)
O —
CU C
.--i O
C7) io
00
Q U
O X
Lj O
'V U
O C O
C— =370 C) C r
cn
C V C §
O c�
C6
W
C—) C Ca
E � cp N
c6 C w
cn :_ NINC cu
a'
�I cn -0 Q
C j M cu
O
^� s C 12
•N L
> m v
Cd � co
• o
O U o CD `n
U 0
$Ulm Cc
O cn N
aW _ 2 °:
Ln
O •sg 0
F� O O CD CU
CD O
O Z Ln
0
u o- O
cl) >NC-
- o
� z
C) O c ~
x Lncvo n
vs E O cn a� cV
O 0�. ca � CD
Z a�
CD E Ln
O o�C o N
_ O O
cc� ca _0 \ M
G - cc a) l O
?. Y a \
f6 +.+ 0 M
ca cu c) O
O
+ Q-p . . P
E
Cli o
U V C p .CL
0 0 c) �' w
so
!�!oA - � �
TOWN OF SOL,I"" HOLD BUILDING DE PT.
631-765-1802
INSPOECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INJSULATIOWCAULKING
[ ] FRAMING /STRAPPING [/] FIRE
INAL
[ ] FIREPLACE & CHIMNEY [ SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ } FIRE RESISTANT PEN ATION
[ } ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
lA 0140W 1/INSPECTORyk
TOWN OF SOUTHOLD
CIO,
ay
Rental Permit
0959
h K
Owner Thomas Short & ay Lazidis
Occupied as Single Family Dwelling
Located at 1250 White Eagle Dr Laurel 127.-9-18
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.
7/27/2023 `
:ode E care icial
This Notice must be posted by the main entrance at all times
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 '`#
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee $200 (Application must be renewed every two or g[E n V
JUL 20) 20,23
Section A.
Property Information: BUILDING DEPTo
Rental Property Address:
V
Tax Map Number: 1000 SECTION " -BLOCK -LOT -
SECTION B.
OWNER INFORMATION:
Property Owner Name: in Q
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number (s): Daytime Evening Emergency_
Property Owner Email Address: � ' Ove-
`"ori
Page 1 of 5 V � �)S
CZtCila5 /��
S .
Town Elan Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
m ,
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 , 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
.} �v sod
631 hone Tele
Town Hall Annex P ( )765-1802
54375 Main Road Fax (631)765-9502
P.O.Box 1 179
Southold,NY 1 1971-0959
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:
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier (for example,
Unit 1, Unit 2, Unit 3 or Apt A, B, Q 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: L4 _
Use and Dimensions of each room in Rental Dwelling Unit:.017
r
C4 e
Page 3 of 5
a il,
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Sox 1179
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.
Property Owner's Name:
Property Owner's Signatures
Sworn to before me thiV4") clay of 2 0
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.OIBU6185050
Qualified in Suffolk County
Commission Expires April 14,
Page 5 of 5
vJ�n( 6 Q4jjk4Cjr'-
*I TOWN
OF SOUTHOLD BUILDING D
631.765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CA
[ ] FRAMING / STRAPPING iNAL
[ ] FIREPLACE & CHIMNEY [ � FIRE SAFETY IN'
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F}
[ ] CODE VIOLATION [ ] PRE C/O [�
RE ARKS: 2
,I���� 1�r/�✓ �M^-
CrN
C
DATE INSPECTO
1
34 M
!,n +µown... .�.. a � ....�........�....� ,. .,.��„ �....... .. ....�. .."....m..._W
W
�P
S„a
a
2 CAR
6Aw SIM
.:..,.
. 1 ..... 791 ....:
IS q
d m
............. �l..i a ,Aw — I.....x..i.. X ....fin m
.............
A" �groq
a 9 oa 5 F
_.... F
FIRaT FLOOR FLAN - 1,55(9 SOFT.
6ARA6E FLOOR FLAN - '111 Sa.FT ��
77`7i,
Hom
44
...........
.....®.pr
....
"Ao 1114-4JI
ll�F�H RM
AN fox lo yw,
ul
BASEMENT
LU -wwcwa
OwAv
............
5/6%5EMENT PLAN
_ a
AS—BUILTS
DECK do
BONUS RM.
I
TOPENINGt €
1MULLS s . , MBR UMN
LNG AREA �$ ' 1
L-®-_----j . n - � RESIDENCE
;•,_< _
1250 NHffE E01 LN
5H'DRYWAl1 LAUREL, NY 11948
ARCHITECT
qac LULLM
90X 316
PA
GARAGE 'W 11944
631-4n 8644
Al
OWNERS
SECTION & +11 r1«m
�32746
2131
®—�
ACCESS �OOR
TO Arnq
CE0.1NG GRILLE
HIGH HAT ———
' 2 O ' • { O i
# s-
Fi
1 I HIGH KAT I
CAB 1 y
ZSITTING AREA
114
ISE NOT AS `—— yGtE Mrs
z El ; BONUS RM PLAN
do SECTION
1 I STEP UP
ITS
MBR-400 SF R ®� 1a A-2
ceiling height: 8 to 10 0 LNG — MBATH f C� P LIN
m ne 1 � Av4" 3'-"
7
BED I
" wnaaXwu ws
n"'�..."° •• ww Y BED ROOM 4/OFFICE '"'
0
t TRAY CEILING 4 �
@ an F SEE DETAIL
K�sr�
A § Nr«......., rr �..�....... __ _ --------------
------
____ ________..._ Y........�... f --
e�'
r u 0
BEO�
p
'°� �'xwxwrwarA..
M 2�or..,, I Bm-rr
Orm TO
4,7
V'l
R' up
N W S8
u B� '
'M Z
WW _N
ly
DBL,21.x6"_d
� —i a.amw rrsarrcn��
y
SE( T HEADER® tL 1
. .._......................._.... LA�...�"...�..._ la• PERIMETER
OND FLOOR PN - 1,51OJ50F D
(TYPICAL) `""--51UD WALL Q 9
w €a
..�.........�.�. ............TRA'� DETAIL
..„.,...,... In 4
. .
I
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER I STRE VI-SAGE DIST, SUB. F€
FORMES OWNER: >°°_ N E ACR.
L u 4 -o- S
$ W TYPE OF BUILDING � s
;A — °
RES. EAS. 1 VL. FARM COMM. CB. MICS. Mkt. Value
3
LAND ` IMP. ! TOTAL DATE REMARKS
_ n
r
E
�a
I � _
I �
I f r
I
l E
I
Tillable _ [ FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland s DEPTH
House Plot BULKHEAD
Total i
I
l
u
,� 7
N
I +�
D rra M JV d
LL
.»... ... ._ 3 sad
Foundation Bath
Extension ^,� Basement Floors
Extension TS Fxt. Walls a� Interior Finish ;,
Extension Fire Place Heat > v a
e ..
o.
K�„. �.._...__..,,,__�v.. ,�_.W,....�.M_.' �.,..._._�.w_.�� _._.._.� .. ,.,.......�.. _....._.. .....�,.
PorchPool Attic
w
Pat__._._.__ ....._,._..._. ..,�........____�,..
Deck `r.' ' 1O Rooms 1st Floor _�:a1
Driveway Rooms 2nd Floor i >
�.
Gara
ge
diA, r I 37C ,
J
..w
D
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30956 Date: 06Z01/'05
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 1250 WHITE EAGLE DR LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 127 Block 9 Lot 18
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 7, 2004 pursuant to which
Building Permit No_ 30498-Z dated JULY 20, 2004
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 SINGLE FAMILY DWELLING WITH ATTACHED THREE CAR GARAGE & COVERED FRONT
PORCH AS APPLIED FOR.
The certificate is issued to CHRISTOPHER J ERIC ON
(OWNER)
of the aforesaid buildings
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-000-0096 05/27/05
ELECTRICAL CERTIFICATE NO. 844 05/16/05
PLUMBERS CERTIFICATION DATED 05/25/05 PIPE DOWN PLUMBING
uthorized Signature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34594 Date: 10/06/1{}
THIS CERTIFIES that the building DECK ADDITION
Location of Property: 1250 WHITE EAGLE DR LAUREL
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 127 Block 9 Lot 18
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER e, 2010 pursuant to which
Building Permit No. 35912-Z dated OCTOBER 1, 2010
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 "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to DONALD & ROSEANN GAVIN, JR,
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HFALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/+
fA[tho ized ignature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34688 Date: 11/19/10
THIS CERTIFIES that the building ALTERATION
Location of Property: 1250 WHITE EAGLE DR LAUREL
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 127 Block 9 Lot 18
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 21, 2010 pursuant to which
Building Permit No. 35966-Z dated OCTOBER 25, 2010
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 "AS BUILT" SITTING ROOM AS APPLIED FOR PER NEW YORK STATE VARIENCE
PETITION #2010-0483.
The certificate is issued to DONALD F & ROSEANN GAVIN, JR
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 35966 11/O1/10
PLUD93M CERTIFICATION DATED N/A
Authorized Signature
Rev. 1/81
Town of Southold Annex 8/27/2013
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36465 Date: 8/27/2013
THIS CERTIFIES that the building M GROUND POOL
Location of Property: 1250 White Eagle Drive, Laurel,
SCTM#: 473889 Sec/Block/Lot: 127.-9-18 Q
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/5/2011 pursuant to which Building Permit No. 38256 dated 8/15/2013
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:
accessory iaRx oud swimming lfc to codes ali for.
The certificate is issued to Thomas Short&Kay Lazidis
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38256 8/22/13
PLUMBERS CERTIFICATION DATED
VAuoSi aturo