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Home My WebLink About1000-126.-2-10.1 TOWNOF SOUTHOLD Rental Permit - 1028 Owner Ellen Siliris Occupied as Single Family Dwelling Located at 495 Albo Dr Laurel 126-2-10.1 Maximum Permitted Occupancy 6 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. 11/17/2023 Code Enforce )nt Official This Notice must be posted by the main entrance at all times 1�� so V1 C)C,-k uv-, J03 Town Hall Annex , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 -5-7 Southold, Southold,NY 11971-0959 1'OUM't, 3�FD BUILDING DEPARTMENT � U �..�- TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION 1 , Rental Permit Fee $200 (Application must be renewed every two ylib Section A. Property Information: Rental Propert Add e s° �� . , 7 7 Tax Map Number: 1000 SECTION 1 GLP166 -BLOCK O-Z" DO -LOT to ,001 SECTION B. OWNER INFORMATION: Property Owner Name: gv'e11 Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): D�jctime g EveninEmergency Property Owner Email Address. - ? 'SIS (}1Q. Cn e� `� 4�) 'h3_09 ac!_1064 Pagel of S r +a y Telephone(631)765-1802 Town Hall Annex 54375 Main Road �;u1 Fax (631)765-9502 P.O. Box 1179 Southold,NY 11971-0959 u 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: (a Number of rooms in Rental Dwelling Unit: _ Cfw\ Use and Dimensions of each room in Rental Dwelling Unit: ,`D X &al Page 3 of 5 Telephone(631)765-1802 Town Hall Annex 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 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 ❑ 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) r 1 I L-J f �r 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 00 Town Hall Annex V Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 , Co . as 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 1�day of Offi4aotaryjPfic Signature a�rlginal Stamp TRACETRACEY L. DWYER OT Ry PUBLIC,STATE OF I A�:`1 I Y(,)r4 NO01I)W6 069W QUALIFIED IN SUPFOLK CVArry oOMWS ION Xl 15S j(jNr," ¢, Page 5 of 5 TOWN OF SOUTHOLD BUILDING D 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN [ ] CODE VIOLATION [ ] PRE C/O [ 41 REMARKS: ke4�om cl&kv4vk 4v bk9,4w�, , W 9CA&Ce, tv pI 0 k, DATE 0 - 3 - ,:v2,3 vo w Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 CTM# Date .......... ... .... . .Owner .Phone .�. / S �....... .. _. ....w....... _..... ..... Address Visible �....... Visible Hamlet �it/ Inspector .... �... .. _. .... _ .w...... _ ,., . _ ._... w...... . ... .. ... _....... Floor Level Quantities W.. . _........ ..,.� �w w.......'. S�.b.�... .. . 1 .. .. . ... _.�_ _.�... 3... . Smoke Detectorsnot located in bedrooms t �am�� m... .�..�.�.... .�'...... _._._ !........ . Carbon Monoxide Detectors �� w Fire Extinguishers Exits.. . .�._. .w_ ... _. ....�, .rv. ..e... ...... .._w. ... . ..._,a.....�....... ..._.w. . .. ........ __.......�. ..... c. ...w_... .. �..� �� Bedrooms . ,a . �. l e. _ .... . ...,.�.4 �.� . .. a 5.�.. f 6 ._... k Smoke Detectors Egress ✓" ' �. . .�... .rv.. ;........... �. p ount �" a . . . ...... . .. ......., . ..a..... Occu ant C ....._.....a . ,.... „., �..w.. ��....._ Building Systems Maintained &Operational CCondition of Property Heating Building interior ..... .a .g [J ..� .. m, ......, _. Buildin exterior,_ Hot water ®,..... �. .... .. .. M.. i ElectricalProperty clean, maintained &safe .._... .__... ....-._ ®_. .. _ . ... ...�.. ... ..� .� ,o,... Mechanicalguards installed &secure.,_._..w.... � . . ...,.. ....... . _.......... �a ......... Handrails& .. ...�_. ..... .......... ..� ....,.... .�.�...,�......_� ..., Pool Safety [�Poal on Site _ _.. .. Surface water alarm Date of CO issuance _ . �.re _...... w.,.._„ .,a.. .....w.... Door alarmsj Pool completely enclosed Self closing/latching gates Pool fence to code requirements ryry [CO's for all items present Prior Rental ..� Comments 1 ., _. _ _. .... ... .... .... ......... _.... ......_ ...... _. _,. v119-ob � )-loot LAN 3CL> s 3 OY, � TOWN OF SOUTHOLD PROPERTY RECORD ' OWNER VILLAGE 1 DIST. SUB. LOT J F60AER bWNER N E I ACR. S W TYPE OF BUILDING RES `A � SEAS. VL. FARM COMM. CB. MICS. Mkt, Value LAND IMP. TOTAL DATE REMARKS za, A, -Z- A- t7P AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per VCIUe Ac re Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total DOCK COLOR T777 � . - LJ J1 I T _ s , - - - b ` IRE }T M. Bldg. I i Extension ------- Extension ��-- � - - — —Extension i E Extension Foundation (Bath Dinette Porch Basement #` !Floors _ m Porch 'Ext. Walls - - ;Interior Finish �' LR _ Breezeway Fire Place HeatDR, Garage Type Roof 'Rooms 1st Floor I BR. Recreation Room; iRoorns 2nd Floor FIN B O. B. Dormer Driveway Total till t i I ,r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-23829 Date AUGUST 23 1995 THIS CERTIFIES that the building DWELLING Location of Property 495 ALBO DRIVE LAURELF NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 126 Block 2 Lot 10.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 10, 1976 pursuant to which Building Permit No. 8958-Z dated NOVEMBER 10 1976 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 ONE FAMILY DWELLING WITH ATTACHED BREEZEWAY AND GARAGE The certificate is issued to BARBARA SHEEHAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL APRIL 8g 1977- R. Villa UNDERWRITERS CERTIFICATE NO. N-332428 - APRIL 11 1977 PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES CO Z-7617 DATED APRIL 25, 1977« ° it .nab' ,. speotor Rev. 1/81 x TOWN OF SOUTtiOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, •YN �. � � � , �x�xl" a',�dx e'�m �N��, �'" .w"g �'" a ��^,G°i ^'� w�r��$ °..rt ��'"'�<��tr'.�`�' �ag"'E�e< �'u,. .�""'m,�'" "F>•�. s ,k �, No. . . . g. .i 53 5.8 . . 1at arc h. It q, 196 I. . . . . . . . . . . .. TIUS CERTIFIES that the building , , Above Ground Pool b fence„ 495 Albo Drive Laurel , New York Location of Property . . . . . . . . . . . . . . . . . . . . . . . „ . . . . . . . . . . . . . . . . . . . . . . . . . , . . » . . . House No. Street Hamlet County Tax Map No. 1000 Section . . . .1. .6 . . . . .Block . . . ..? . . . , . . . . .Lot . . . .1. . .1. . .. . . Sutdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No, , , „ . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated MaRCH 12 , 1987 15762Z . . . . . . . . . . . . . . . . . . . . . . pursuant to which Building Permit No. . . . . . . . . . . . . . . . . . . . . . March 16 , 1987 dated 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 . . . . . . . . . ABOVE GROUND POOL 6 FENCE & DECK . PATRICK A The certificate is issued to A . b FLORENCE HUGHES Downer,leTsWMArT1XXX ” of the aforesaid building. Suffolk County Department of health Approval . . . . . . . . N .A. . . . . . . . . . . . . . . . . . . . . . a . , . . . .. UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . 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