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Home My WebLink About1000-127.-9-18 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