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Home My WebLink About1000-78.-8-1 TOWNOF SOUTHOLD Ail �FL Rental Permit E, 1023 Owner Howar & Ruth Eilenberg Occupied as Single Family Dwelling Located at 800 Goose Creek Ln. Southold 78.-8-1 Maximum Permitted Occupancy 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. 11/13/2023 Code; n care ent o ial This Notice must be posted by the main entrance at all times os (Nc( v Telephone(631)765-1802 Town Hall Annex �u ', Fax(631)765-9502 54375 Main Road P.O.Box 1179 c:. Southold,NY 11971-0959 ' t 9 �. BUILDING DEPARTMENT E 1 3 20 23 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION TOWN Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: - z e s Tax Map Number. 1000 SECTION -BLOCK- __-LOT�_- SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytime_ Evening Emergency Property Owner Email Address: Page 1 of 5 pl j f i y Telephone(631)765-1802 Town Nall Annex a 54375 Main Road Fax(631)765-9502 � m P.O.Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOL Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: � ��., �, "k,, Telephone Number(s): Daytlme=i 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 Evening Emergency 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: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 a r A .M1i�, Town Hall Annex a' Telephone(631)765-1802 54375 Main Road Fax Fax(631)765-9502 P.O.Box 1179 � Southold,NY 11971-0959 ° � � 19 G 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: Use and Dimensions of each room in Rental Dwelling Unit: 7 x �I � r x Page 3 of 5 A Town Hall Annex fia Telephone(631)76.5-1802 Fax(631)765-9502 54375 Main Road P.O.Box 1 179 -s� ; Southold,NY 11971-0959 r , O BUILDING DEPARTMENT TOWN OF SOUTHO D 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, 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 Dime dons of each room in Rental Dwelling Unit: z 17 ` Page 3 of 5 gym . � fA°m"' Town Hall Annex Telephone(631)765-1802 i Fax(631)765-9502 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959 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. ❑ 1 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) 1 , 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 Annexe t t �� Telephone(631)765-1802 54375 Main Road „ yr Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF 13OUTHOLD 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, naging Agent, or Site Manager. Property Owner's Name: 0 k1✓ 4 6�j) jC Property Owner's Signature: NOTARY t q�F C, CJhIi 4 w r 1 ,STAT 'O NEW YORK NOTARY PV �'"1TF t-n ;RK on No.02KROOI0042 Registrauc• .,.r)0'"l: t.'42 � �In New i County Qualified i NOIA'YorK Co:-.,ty June 22 cornrnlssion.E $-JUne22,2(,'V Sworn to before me this Zf day of u 5? 20.2 NoTAnY , -. TATE OF NEWYOW i h, ')KR0010042 p 0 ^nun + Comr.,r ' O clal Notary Public Signature and Original Notary Stamp At,IX a-/' 14s1 4,e ,.. ,, gge s,0 2/sSTATE OF NEW Y� 7 7;;_ Q t tM %, E 1 22 2 , so r m 631 -765-1802 f9-4'. [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND I ] INSUEATION/CAl I ] FRAMING / STRAPPING [ j FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII [ ] CODE VIOLATION [ ] PRE C/O [ 'l r �� 1. . DATE �?'( - 3 INSPECTOR Town Hall Annex IN; Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 N0 Date SCTM # w a� Owner � ` b Phone Address Visible HamletIector nsp Floor Level Quantities Sub 1 2 3 m Smoke Detectors(not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms 1 2,,. 4 5 _ 6 Smoke Detectors ✓ �' Egress Occupant Count Building Systems Maintained & Operational Condition of Property Heating Building interior Hot water Building exterior _ Electrical Property clean, maintained &safe Mechanical Handrails &guards installed &secure Pool Safety `Pool on Site Surface water alarm Date of CO issuance Door a 11 larms Pool completely enclosed Self closing/ latching gates Pool fence to code requirements CO's for all items present Prior Rental Comments: TOWN OF SOUTHOLD PROPERTY ECk.. 1%0A-%1M8W T— — OWNER STREET VILLAGE DIST SUBLOT 4 er) 5 f,C'7--Tp-fl�ryj E ACR. FORMER OVVPER N S W TYPE OF BUILDING RES. .1 SEAS �VL. �FARM COMM. CB. MISC. Mkt. Value 1 LAND IMP, TOTAL DATE REMARKS 77------ AGE BUILDING CONDITION 'C /V NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable I Tillable 2 Tillable 3 Woodland !FRONTAGE ON WATER Swampland Brushland FRONTAGE ON ROAD House Plot i DEPTH BULKHEAD DOCK Total o 71, T E 1 TTi COLOR r i , , _ I s 0 1 i TRIM - I S\\ 12 STt -ter 1 i I . � 3 i i B1 x 3 2 = 8� J SO 'Foundation . Bath ' ; Dinette Extension (� Basement - Floors K• R Interior Finish i LR. Extension U Ext. Walls Fire Place '` - Heat ( DR. Extension ; i -Type Roof Rooms lst Floor I BR. 1 n X 11 _�2� g ZI ZS fl� Recreation Roorr Rooms 2nd Floor ! FIN B Porch iDormer _ 1 i Breezeway Driveway Garage i _ Patio i O. B. Total f, - J FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 8-23457 Date JANUARY 19 1995 THIS CERTIFIES that the building NNW DWELLING Location of Propert 800 GOOSS CRJW LANE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 8 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARM 2 1994Pursuant to which Building Permit No. 21949-L dated MARCH 21 1994 wag issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FA11ILY DWELLING WITH PORCH & ATTACHED QhRAGS AS APPLIED FOR. The certificate is issued to 1"IN & LESLIE TEMME (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-90-17-JAN. 18 1995 ELECTRICAL INSPECTION CERT. #5550 - DEC. 30 1994 PLUMBERS CERTIFICATION DATED SEPT. 9 1994 - CHRVALLRY & WALLACE PLUM. ildirb Ins aior 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-26773 Date: 11./ 04/99 THIS CERTIFIES that the building ADDITION Location of Property: Boo GOOSE CREEK LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 _ Block 8 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 221f 1999 pursuant to which Building Permit No. 25931-Z dated AUGUST 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HOWARD S RUTH EILENBERG (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A s Building Inspect Rev. 1/61 GENERAL NOTES. 1.CORSTIMITON LOCAL PWtS POOR TO STA4T. THESE PLANS ENERGY SUMMARY e4�t Y C L L is AJ C 44 COAtPL.Y WSBF N.Y. I gWy isTEcx AND VERY ALL ODNINTIDINS AT TIE SWT COAIPONANT AREA{SO.tT.) U RILING PRIOR TO STARTING OF WORK AD IW SFLWL FAMILIARIZE MELF GTH 76 .054 242 THE INTENT OF MSE ET AND Ma WAMWTN THE SW � c– � �7.'� S ALL PERMITS SHN.t BE OBTABFD,WHERE RE0UI7ED,PRIOR DOOR WALL 21 17 .5 24 TO SFARIX ANT'WRK -13 4.Alt XRX SN U 00NFM TO N.Y.STATE BUILOID CODE ANP ALL TURES WNDOW 434 .3O -70 20%OF WADSAND REMILATIORS i WORN OF ALL TRA S.MUTWOR SHALL W�UfWNTfiE THTRAMFOR ONE(T) CTOWN AND VLLAGE EILING 1152 045 6 YEAR TRW TIE DATE OF FINALW�ETIOI. ETUNG 1175 .645 6 A ALL DOM SPALL BE REINNED FROM BW SHE IN AN 0R0ERLY WTNER SKYLIGHT" 25 .30 -7" AND ON A R€OLAAR 6A,4S AND I ALLY DSD OF. TOTAL 164 7.ALL YiTERNIL USED IS TO BE INSSPIM AND CONFORM WIN INNUFACTIM &OCJORTCTOR V L WINIAIN N FOR ALL BONDS. t,�, rao� ANIS AS REDUIRED 81 LAW AND/OR T)i SH.SiAt $.TALK Comxlm 6 10 {DAT, GUENT TO mma UVADE TO A0Ut1)NT AmAmALL A WADEDWADEDDit€10CONNSOBACTTON i BE RESMRED TO ORI'IAAL OaIDUION. 0EM LOAM AIS' x ' (.�� FLOOR:4D pat.INE I=FIRST FLOOR T,; i1°' ti}* tr-C JJ 30 pat.LIVE LOA!MID FT.ODR 10 W.W.DEAD LOAD _ ROOF:39 Npj,DEAD m UVE LOAD _ L'3 i-7I,-1 iAt BUM r DFFIECTI6V:FLOOR LESS LES THAN T1'/24 PA 1 � AN ROOF'LESS TNLMI T SPAN � "' {t}t-N4iFij4Y ame 7I SOIL FRIESSUM-2000 W. CARPENTRY: (y E IF 15 �)YKBA fg Lt t.MESS NOTED ALL LUADER TO BE WUG-FW MR AN ALLOW LE BEINGt f � IT tr -STRESS-STRESSOF 1200 PSI AND BOW TOAD,IIF I,20O,0D0* ALL LAM BEANS €1 N NWic ALims E t ::5 '.3g"fl; At+", T,"-.�,;moi m , �� 22 ALL WIDOO IN CONTACT WON CONCRETE IS TO BE WIXY&NUIED MA � 't>f PRESSURE TREATED, 01 4-t -r 3.lAA6S 00#RAlSE NOTED P(ffi.DE: HEM lBM _____ a DDUBU WADER JOISTS NO MINERS AT ALL FLOOR OPENINGS. 3V _ir_ _ d DOUBLE 2:B NEW ABOVE ALL ODOR AND WIDOW OPEMNM �qM 3'-T' A'-t a DOUBLE JDRTS UNDER ALL PARALLEL PARTRDNB. S"r S t OM ERM FUM JDLSTS TWICE PER SPAN. r X r a am C#STRUCTLON 314'ETTERKIR PLYi AS UhDETWAYNRHT. tm ": �li: OPTM 31C TO BE PLACED AS ROL RON"NW SBWED}- �� 8-5 T.E RIM WALL 510THII IT TO BE ItY C-0 ExtM PLYMM wim AVE IBL3M WILLS ANO C CQA TO BE WD WITH T1'2 4 ALL ISMAt BOW WITH UM CONS RENFORM.TAPE FLOAT 16 R.D. � 1e-K IDcmLL� AND SAW SEW ON SPAG4E(THS NSA%WAY FOR PARA. m+e r is-3 CONCRETE: r ,I_5 III 9RF0RT ��:P. S-7 10'-C 1.SLAB SNAIL BE PSI{28 NY.Y STROWN) _ ppyfW C0N(Aa3E ON 4'SMD OR MWEL FRI.SLAB TO BE POURED ON _ - Tye Too'Sell 6 119PO YEII�DOTwm nr:,ti>s2.W-- TbfaYaS TO NORTH NO W 2.FIDOTINGS TO REST ON UNDISTURBED SOIL.AND BE=PSI(28 OAYIFAOER AIM 2 mrt rs wr t[t t IV_lr 3. SIAMI BE 2000 PSI CONCAENE A 4.PLACE T12'OA SILL PLATE ANCFIOR BOLTS AT B-G O.C. 27'-a• PLAT PLAN TAKEN FROM SURVEY DOW. SCALE 1"=30' 1.R-111LNSLAAll0N IN ALL E)"OR OnS. [� [g� �' `. 2 I BY I WE R}2AINSLRATIDN U s°NiALL NITRIC,FLODRS A ALL RAFTERS AOUII,'NT LS IS ti 1� tr--- F APPROVAL TO ST$WP t 3. VLM SBA TO BE RYtcED AGNNST INSIDE INaLNAWN 10 71# `SPACE XW 2 0 1994 £ _ A S. 6 .T. 4.FX MOR OF FDUNOKM)TO SEND WIN A PEBiOLIIW BASED VAPOR - PYL SWAM IMM IN CONTACT WADI THE GROUND. S.INSUA,VED DOUBLE OLM*WAS FOR ALL DUMOR MASS WRH A BtlXa,1}EPL 1 WK U AM OF Z BNIF HR 4 FT. TOWON#SOUTNOLD C OWARNO AT ALL W DOOMDDDRS.AND WHOM Joe"w-MR&MRS K. TEMME t mmmLf W, 91- ` ftF w MOW FLAN LO WT ON: scALE DATE 11/071'43 rn"mAOTOR: sot;at7L�ER stt�Y FIRST FLOOR&W,OT PLAN 1 OF 4 —W of OWNt! r-tr x I a' X[ 47 ��'� -/ftif ilEIl Y11f ❑ ,y�1 'sa' ®i sr � 3=. .. �.� mime -_ .. tr-f r-n aar+trse ! a.i� y A.aa-awe ... J_' ma ewes atarn>r mbarz lomwa sC.,a!Ilrr 31, s>m aAe h1 ase l r s r a s- � 2mr f-,r rr-m f-,r x f tt f saw r-lr J 1I_r y.-ate XY85 m UiIC - tz UNEXCAVATED r,aawo otxrAn[a!e w � a m ,m >w 7 f rm1 L UNIXCAYATED r Ir-r Y Paha tl1Mr9Aa YYY fwkllot Raa - a+ nir-C �v7' CDv2�dYxgC� t41-4ern FOUNDOW MM SECOM srm Prate a! N--MR&MRS K.TEMME lOrAMW. S1YLf..ear-1Y wiE:nPt%s ceNrwceax .�svuffa s,� Otk S,SfORS'!rDuruanDv 2 of a i �J e