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Home My WebLink About1000-22.-3-1 g� TOWN OF SOUTHOLD s, Rental Permit 0792 Owner Berry P 2021 QPRT Occupied as Single Family Dwelling Located at 2840 Stars Road East Marion 22.-3-1 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. 12/20/2022 ode r1orc) ffica This Notice must be posted by the main entrance at all times Ped PLC ( o Town Hall Annex „w elep,one(631)765-1802 54375 Main Road Fax(631)765-9502 Southold, ss NY 11971-0959 % P.O.Box 1179 , f, fp r t BUILDING DEPARTMENT T�"" TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: v 9 Tax Map Number: 1000 SECTION -BLOCK -LOT I SECTION B. OWNER INFORMATION: Property Owner Name: 'P0.J to, Property Owner Legal Address: Property Owner Mailing Address: 29`l6 S i�ead , ' rd,"e - Telephone Number (s): Daytime q0-3,`L ZA)SEvening Emergency Property Owner Email Address: 'v,1\,j, OWN Pagel of 5 nor Town Hall Annexa Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 " PZ� Southold,NY 11971-0959 ` BUILDING DEPARTMENT TOWN OF SO HOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: /l zA- Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: VI ,a 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: n Ck Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Saw- Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1 179 Pr- Southold,NY 11971-0959 . OU01 Ptd 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, 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: I I Use and Dimensions of each room in Rental Dwelling Unit: I• V c c Vc�dM 1 11x. 1 Page 3 of 5 Town Hatt Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 �� 18� Southold,NY t 1971-0959e, 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) rL4 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)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 l79 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 Signature: �-- Sworn to before me this��day of 20_ _, — Official No y Public Signat r and Original Notary Stamp N0'1'AR'1Y&'L;E31...IG,ST,'CTE 0 F NE-." YORK COUW4S'SiCki EXf-1RES,JWqE 30,12P-4.(4 Page 5 of 5 �y g■ •� w , A i f4f so TOWN OF SOUTHOLD BUILDING D ou 631 -765-1802 � INSPEC ION, ] FOUNDATION 1ST [ ] ROUGH PL13G. ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII [ ] CODE VIOLATION [ ] PRE C/O [ vrl REMARKS: A 010.44 �q4- Akw 4 In 9;2 J, -jo I�Vi h 00 f7 As 4x'1( s a 4y�Zz 4m )d p ae k7514"ll elosl" se'l DATE 1- 50- 49INSPECTOR SOUTHOLD TOWN Town Hall Annex 54375 Main Road PO Box 1179 Southold, Rental Inspection- NY 11971-1179 � mr Tel: 631-765-1802 ' � c Fax 631-765-9502 ° SCTM # o?oZ - 3 Date Owner Phone Address o'ZJf 940 �_IeS Zip city Inspector LEVELS SUB 1 2 3 Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) BEDROOMS 1 2 3 4 5 Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows) (Y/N) BUILDING SYSTEMS Y/N CONDITION OF PROPERTY YIN He11 atinsystem maintainedlo stational Building Interior is clean/maintained Hot waters stem maintained/operational Building Exterior is clean/maintained Electricals stem maintained/operational I Property is clean /safe/maintained Mechanicals stem maintained/operational Handrails &guards present COMMS TS: I So LW � Rental Inspection Form 4/7/2021 ; w.. TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNS STREET VILLAGE DIST. JVD. st ACR REMARKS 1� ` N,-,e. V-.a TYPE OF BLD ° rev lyjF PROP. CLASS ac C 17U LAND IMP_ TOTAL DATE ' r \` e 1� _ � £'3 - fat {' -. �Dc � i P ' 6 016a 3 � l - WC_ i i s ,3 s i I i FRONTAGE ON WATER TILLABLE ---- I FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL i F •- Om -. t � L v TRIM r vvz v --J---- k . y - E s t I . r — -- — - - � . 22.-3-1 10/07 _ F r - =a a� noon -a A -_ - - - - - Extension - - a, t� T ea 3 a Foundation a Bath D r 1 ette Porch �� 'Basement 'Floors K. y a 4 Ext. Walls 'Interior Finish LR. r + t Fire Place - 'Heat DR, Garage Type Roof —m - — Rooms 1st Fico BR. Patio � _ Recreation Room ooms 2nd F oor .: FIN B D !Driveway Dormer Total m �=3 �. � . �s_,� .Y � :�• �\�� ;- �� _a�_� a ONe FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31648 Date: 07/07 06 THIS CERTIFIES that the building NEW DWELLING Location of Property: 2840 STARS RD EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 22 Block 3 Lot 1 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 30 2005 pursuant to which Building Permit No. 31700-Z dated DECEMBER 302005 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 GARAGE, GREENHOUSE & BALCONY AS APPLIED FOR. � - The certificate is issued to SHAWN P TULLY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-01-0037 06 30 06 ELECTRICAL CERTIFICATE NO. 54304C _w 05 300 PLUMBERS CERTIFICATION DATED 00�06 BURTS RELIABLE 4 C /ithcr/,ze4dgnature 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-31649 Date: 07 07/06 THIS CERTIFIES that the building ACCESSORY q....... Location of Property: 2840 STARS RD - _ EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 22 Block 3 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 30 2005 pursuant to which Building Permit No. 31701-Z dated DECEMBER 30, 2005 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to SHAWN P TULLY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BIALTH APPROVAL N/A _ww_.... ELECTRICAL CERTIFICATE NO. 015761 m� 03/11/02 PLUMBERS CERTIFICATION DATED N/A Aut' oo�rize 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-34142 Date_ 12/18/09 THIS CERTIFIES that the building AS-BUILT DORMER Location of Property: ,2840 STARS RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 22 Block 3 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 1, 2009 pursuant to which BER 1, 2009 Building Permit No- 35188-Z dated DECEMBER.................--- 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" DORMER ADDITION TO ANEXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to SHAWNP TULLY ................_.........._ _. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUP03ERS CERTIFICATION DATED N/A At ize Sign ure Rev. 1/81 E E 1 CERTIFICATION OF NAILINGREOU Ri'- EOD. 4_'1 .•t.�-s`dx�t -------- -- _- - --= AYP?a'EDASNOTED ALL t%'SMUCTIGti SHALL �..EET'fHE AEQUTAEMo'dTS OFII iE OFNEWYMSTAT t ac{-j,}F„xk>N5�44E':LUiS v�N� _ - p.Si-"'3 GeR CUfs;cl:uSOvSRWCM ��s - tis t� •- - Nr - �+�- "�� '�i#f�C}1 TULLY REi�t+ 11 G�294C ITARS RD F,MbRiow E t q,=t,�,,I�vvQ�Pd, E rr rw USE IS UNLAWEUL WITHOUT CERTIFICATE OF GGGLIPANCY pisT 7 61