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Home My WebLink About1000-79.-6-3.8 w TOWN OF SOUTHOLD 'F Rental Permit 0981 wyo D4' Owner Bransbourg Gilles Rev Trt Occupied as Single Family Dwelling Located at 2160 N Bayview Rd Ext. Southold 79.-6-3.8 Maximum Permitted Occupancy 4 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. 8/22/2023 ","V/Y'l Code E#rc i�nent Official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-18M 54375 Main Road Fax(631)765-1502 P.O.Box 1179 Southold,NY 11971-0959 a r BUILDING DEPARTMENT . £ TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Z ISO Na ,02 7-H /J&j L� 4,1 A&f4 4D _ Tax Map Number: 1000 SECTION -BLOCK -LOT SECTION B. OWNER INFORMATION: Property Owner Name: c�•� 'l' ��'4�Sg��'t Property Owner Legal Address: Property Owner Mailing Address: to ov Nit 111/� Telephone Number (s): Daytime4/3y?-`ZZ Evening 4- 1 Emergency- 0/04 mergency -_°/D6 69b �Jr Property Owner Email Address: ,�7'6E{1• /S�fr.✓ff�o��tG �(rtLrt,Z.co�-► 10 -�`J Page 1&5 rifsolo-, . Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box It 79 - Southold,NY 1 1971-0959 BUILDING DEPARTMENT TOWN OF SOLTTHOLD 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: 5 Use and Dimensions of each room in Rental Dwelling Unit: a d Page 3 of 5 town HaII,Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 NC P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF 9O SOLD 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. JK I 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) I l LL 5 62-AWS " 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 Annex Telephone(631)765-18M 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO 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. 1 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; -CSS �� ill It Property Owner's Signature: Sworn to before me this d y of 20��j L 2�i r Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14, 2L)71+ Page 5 of 5 Store Finc You're shopping Delivering to Riverhead v 11901 until 10 pm ventless dryer 1M. -4 OOPENAll Departments Home Decor,Furniture&Kitchenware DIY Projects&Ideas Project G� VEE TLESS DRIYE 1 R@SUItS Brand:Electrolux Get It Fast ^ —� Department ^ < Appliances < Washers&Dryers �N1�111fuIIN�IIIIIUI�IIIUUIIIU�NHIUUII�� < Dryers Electric Dryers $94800Save$251.00(21%) Brand ^ Get up to S50'n nebale-K=a 1'90'. (68) PNC SERIAL `20. \ �� `= \\ .11 A-11-10m. .. . ,��\ t Mom z s / \ :/ �y: 2-2./ ; 4 60 4/1 NNW M � ,r _ / r".R. mimp � � o d em IJ 4 TtE 07 a,. . .o. �o....... .. .... 41° dar „ui�� Solloll w6 mir iol wiil�i�mum $ 'TOWN OF SOUTHOLD BUILDING DEPT. .� 631-765-1802 �9 G INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ q--'RENTAL �C®rl s elr moll be, y26,e'v1&Ae- e .ff � TE -. INSPECTOR rt4f So TOWN OF SOUTHOLD BUILDING DEPT. 631-7651802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL DATE s-e�,�3INSPECTOR so TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 � q-& - 3, E- lNbPE%;TI N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [-T-R-ENTAL } p s� �'/oaW- DATE / 3INSPECTOR Town Hall Annex SOUTHOLD TOWN 54375 Main Road ¢- PO Box 1179 Southold, R � Insecta NY 11971-1179 f z� Tel: 631-765-1802 Fax 631-765-9502 q67-a 3 SCTM # !� _ Date Owner / Phone Zip I Address City Inspectornommmmm , 3 LEVELS SUB 1 2 Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) ` Fire Extinguishers #) Exits (#) BEDROOMS a 2 3 4 5 Smoke Detector Alarms (#) I I 1 1 Carboy� Monox de A,arms �; I Egress (windows) (Y/N) i I =operational Y/N )CONDITION OF PROPERTY I Y/N Building Interior is clean/maintained - =Building Exterior is clean /maintained Hot waters stem maintained/operational - z (Electricals item maintained/ era :o^a3 t Property is clean / safe/ maintained Mechanical system maintained#operational Handrails &guards present I COMMENTS: i ow 49 00 11 440 Aov 1/41-17 I f - 1 Rental Inspection Form 4/7/2021 TOWN OF SOUTHOLD PROPERTY RECORD CA 1 ) 1�,POoq:;` OWNER STREET LO (jg VILLAGE DIST T ........... ................ —h en - q-7 ACR REMARKS -I TYPE OF BLD. r PROP. CLASS re, LAND IMP TOTAL DATE .............. ...... 'sw-7777 3 ...yd .......-L-LL—. .............. ......................... ........ .. ........... ------- FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND o BULKHEAD HOUSE/LOT wYWWY WmW TOTAL l TOWN OF SOUTHOLD PROPERTY RECORD CARD _ ._ ...rn .. ._m,._m ._ ........, .w .. STREET DIST SUB. LOT OWNER .v 7 Y _ FORMER OWNER ',r k; MAnA$ -. E ACR. ` / r� r' S W 4 TYPE OF BUILDING & SEAS VL. FARM COMM. CB. MICS. Mkt. Value w LAND IMP. TOTAL DATE , REMARKS M '141 _. ., fI o i ' x AV o f f y md" �,✓ Am l f"�r° /+. ,„,�� l '� ,��' F mJ� , ACE � BI)ILDING CONDITI � I N l � tl ry FRONTAGE.. � �. � .. .�,._......,�:,.. ON WATER t a90� fl�fl Woodland FRONTAGE ON ROAD Meadowland 4.....,..... _ ._ DEPTH_ . . ..... ., �_....,. _� .w__.�. .._..� .... . W .w._. _mow...° .. ¢ �P _..w.. .. _ m.. __.,..__........_...... �_.....__...�..... w...w_....�_ }louse Plot � BULKHEAD 7 Totol`— � � DOCK N � �'�' � 11 y „r COLOR31 RI CCC ..,p .. ._ �._... ._ d � I I,I�� IIIA i It ._ V yy rF ,..6'1, �ryw. .�"..�_�...�...�_..J,..��.,�..,_ ..�.. ..r,w..,..,... .. .......,._. w. a. 9.-6-3.8 2/0� M. Bldg 4_ p p � M ,.,:,�....... .. ............ ........... q p {r I �...�, Wly,y .„.,,..„....,.�, ...4w. � .,. i r kM( -a' 1��,ma Extension Extennsion �y . - - ` - T.m. F Extensionv._m_ ,,... _ _.. .. _ .... i` m .....�.m.,e. Fo..un.....d,,..a«.t..,.i»o,.. .nff iloors Dinette Porch Basement - 0 7 . ,_,..... ..».,,...,..a..,,.,._....,....,�,.,, Porch Ext, Walls � ar , �� y; "R InteriorFinish LR _. D.. Breezeway Fire Place Heat R. Garage __. _...m. ... .M . .. .... Type Roof Room ,. _....,w_ _. ., s 1st Floor Recreation Rooms 2nd Floor � FIN. B crRoom _.. _ w.....__ .__. _._...., r Dormer Driveway .. ._..... . _ .ww.. ., .. w... m _ __.. ... Total .....��. off^ l FROM CWEO)0EC 28 2007 O:OB/ST. O:OS/Mo.7515101024 p 3 Nov 26 07 03:20p Lance E. Larsen 321-6:31-0235 p.4 FORK NO. 4 TOWN OF SO"JTHOLD BUILDING DEPARTMEhT Office of the Building Insmector Town_ Hall Scuthold, N.Y. CBRTIFICATE OF oCCUPANCY No: Z-32586 Date: 09 0/07 THIS CERTIFIES that the building NEW DWELLING Location of Property: 2160 RTH BASE► RD E OL•D (HOUSE No.) (STREET) (E ET; County TaX MaP No. 473889 Section 79 • Block 6 Lot 3.8 Subdivision Filed Nap 1Qo_ Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 23, 2007 pursuant to which Building Permit No. 33 datedJULY 23, 2007 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 r Y DWELL I I TH P T1 C1t AS DL FOR. The certificate is issued"to &OWARD & oLLt� mAmu of rhe aforesaid bsilding. (OWNER) SUFFOLK COUNTrURPARTKMrOF HEALTH APPROVAL 14-SO-122 08 30/07 KEr6C 3:CAL j 8 NO- 3040062 07/23/07 CERTIFICATION DATED 07 24/07 ED REMAND Au oL`°?red Signature Rev. 1/81 'f Town of Southold 4/29/2022 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43019 Date: 4/29/2022 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 2160 N Bayview Road Ext., Southold SCTM#: 473889 Sec/Block/Lot: 79.-6-3.8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/10/2021 pursuant to which Building Permit No. 46018 dated 4/1/2021 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 in mound swimming 1 fenced to code plied for The certificate is issued to Bransbourg Gilles Rev Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46018 3/9/2022 PLUMBERS CERTIFICATION DATED Autho Si t r� i /�/i✓/f/rrfrr��,y // ��r�l(�� J� l��i ( �` s";,,r /ir r /ii/�i/�/!//Jr if/l✓l0//�/1 f 1 0 r ,'✓f!�i'1f�`/,�'/'%!i/��/%/�/�i//o/'/////l�fj/�ro�� l�/��/i�rf r'� i r