HomeMy WebLinkAbout1000-26.-2-25 T'OWN OF SOUTHOLD
Rental Permit
1020
Owner Lisa McDonald & Robert Aylward
Occupied as Single Family Dwelling
Located at 1390 Willow Terrace Ln Orient 26.-2-25
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.
J
11/3/2023
� e �e Official
This Notice must be posted by the main entrance at all times r� �r�
Town Hall Annex s, Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 p�
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD JUN 1 2021
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
1390 vO t tl ouv T'el wt- L Berle- U c aetr1+ i� I i q5
Tax Map Number: 1000 SECTION D-7-(P' 00 -BLOCK D2 00 -LOT 025 - oo
SECTION B.
OWNER INFORMATION:
Property Owner Name: L 56- MC
Property Owner Legal Address: Property Owner Mailing Address:
Ai)a a 1 A G
tv 0r� 10 .I
Telephone Number(s): Daytime Evening Emergency ,
Property Owner Email Address: 6L%
Page 1 of 5
Town Hall Annex Hca, Telephone(631)765-1802
54375 Main Road d Fax(631)765-9502
qr
P.O.Box 1 179
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Southold,NY 11971-0959
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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: }tit
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."
6qQ
Rental Dwelling Unit Identifier:
�.� flow " �� : ma y,
Requested Maximum number of persons allowed to occupy Dwelling U it: eO le-
Number
of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: - 'ee ",100v- DICLOS777 �
I-14-chert famll q Vbom 1(oufAct floor
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Page 3 of 5
d � mi
Telephone(631)765-1802
Town Hall Annex
54375 Main Road
g Fax(63 l)765-9502
P.O.Box 1179
Southold,NY 11971-0959
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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
❑ 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 U,56L AA —CXD(1i-)a� 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
Telephone(631)765-1802
Town Hall Annex
54375 Main Road ° Fax(631)765-9502
P.O.Box 1179 „ N"k
Southold,NY 11971-0959COUN
�
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: DISC. M C)oY--60
Property Owner's Signature: ��� KL 03 r\OJ
p Y
Sworn to before me this.10 day ofL)ne 202
Officia N ary Public Signat al d Orig al Notary Stamp
i
Nouty1'Wst° . stfro,,of aygw yo(k
Nt),4528 47'
OuWad in Suftk County
0DMMi ,0"E*res Nov.30,
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Page 5 of 5
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TOWN OF SOUTHOLD BUILDING D
n 631 -785-1802 ��--
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
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FRAMING / T PI G AL
[ ]
FIREPLACE &, CHIMNEY [ FIRE SAFETY INO,
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ]
ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI
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CODE VIOLATION [ ] PRT / [
■
REMARKS.DATE
'.'� '� INSPECTOR
OF50Ul9oZ.S�t��o
Q# TOWN OF SOUTHOLD BUILDING D
765-1802
s PECTIt� N
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAi
[ ]
FRAMING lSTRAPPING [ ] F AL�
[ ] FIREPLACE & CHIMNEY FIRE SAFETY IN'
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: l L1 �}pto t►b �'l� J.�1 L
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Wil ovv Terrace Lane,Orient,N-Y-
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Proposed Swanson Residence Second Floor Plan
Willow Terrace Lane,Orient N.Y.
Aug.15.1498 ' Prepared byDiavm Polio k '
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Horton, LisaMarie
From: Lisa McDonald <lmcdonaldnyc@gmail.com>
Sent: Tuesday, March 21, 2023 10:23 AM
To: Horton, LisaMarie
Subject: Storage room for 1390 Willow Terrace in Orient
Hi Lisa,
These are the pictures of my storage room. John said I needed a permit for this room.
Can you please tell me what form I need and how to get a electrician to inspect it?
nk yaall
Tha
Sincerely,
Lisa McDonald
917-628-8940
ATTENTION:This email came from an external source.Do not open attachments or click on links from unknown senders or
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FORM NO. 4
Towv oF` soUTS=
BUILDING D$PARMMT
office of the Building Inspector
Town Hall
Southold, H.Y.
CERTIFICATE OF OCCUPANCY
Dates 03107/00
NO3 E-26962
THIS CERTIFIES that the building NNW DM-LING
ORIENT
[ (HOOSE so.)acaticn a! Propertya _ 13+45 WILLOW TERRACE LA „,,,,,-....._,,._.. (�itII.ET)
-- - T
County Tax Kap No. 473889 Section 26� Block 2 Lot 25
Subdivision Filed Hap No. Lot No.
conforMO substantially to the Application for Building Permit heretofore
filed in this office dated REPT IGIS 199E3 pursuant to which
Building Permit No. 25512-L dAtsd F�„ 1�1ARY 2 1999
was issued, and conforms to all of the requireavento of the applicable
provisions of the law. The occupancy for which this certificate is issued
in oSiE FAMILY DWELLING WITH ATTAMED TWO CAR GARAGE & 1)ECX AS APPLIED FOR
The certificate ie i+ssumd to K - & sU HH SWMSON.�
(OWNER)
of the aforesaid building.
BITFFOLIC CaOURTY DEPARTHSNT OF H2ALTH APPROVAL Ilio-97-0189 02/10100
ELECTRICAL CSRTIJ!'ICATS NO.
H-516585 02/28/00
O1J2bI00 �. IiTUC P I'NO SCAT•.
PLUMBM CERTIFICATION DATED ... -1Tt1C
AuthoXi °d Sign re
RaV. 1/B1