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Home My WebLink About1000-24.-2-1 TOWN OF SOUTHOLD Rental Permit 1032 Owner Orient Realty LLC Occupied as Single Family Dwelling Located at 675 Skippers Lane Orient 24.-24 Maximum Permitted Occupancy 5 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. 11/29/2023 X X�%. j odefo c rn t Off cia This Notice must be posted by the main entrance at all times jo/ t3 �23 h�3 Town Hall Annex fi Telephone(631)765-1802 54375 Main Road � P.O.Box 1179 , " i U� Southold,NY 11971-0959 4' BUILDING DEPARTMENT TOWN OF SOUTHOLD adding 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: (a If �4E_ OtRt T Tax Map Number: 1000 SECTION 2'� -BLOCK Z -LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: � ee L a per'( t�Zo Telephone Number(s): Daytime ii Evening Emergency �S Property Owner Email Address: Page 1 of 5 14) Town Hall Annex Telephone(631)765-1802 �)� ' ' �`` 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 wro app BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Aut ' +gid t of dwelling unit,if any: �� Address of rd" e t(no P.O. Boxes): OV� +j �'1 Mailing Address of A ent: ..,, Telephone Number(s): Daytime Evening Emergency_ Email Address: Section D. Managing Ag t Information: Name of Authorized ent of dwelling unit, if any: Address of Authorized Ag t(no P.O. Boxes):— Mailing Address of Authorize gent: Telephone Number(s): Daytime Evening_Emergency Email Address:SECTION E. E. SITE MANAGER INFORM\ON: ired for rental properties containing 8 or more rental units) Name of Managing Agent of ifany:Address of Managing Agent ( s):_.- Page 2 of 5 Town Hall Annex ��: Telephone(631)765-1802 lINS 54375 Main Road Fax(631)765-9502 �� P.O.Box 1179 Southold,NY 11971-0959 /rr% S, M, BUILDING DEPARTMENT TOWN OF SOUMOLD 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 Dimensions of each room in Rental Dwelling Unit: MUDrt (2'-4r�r�N I.r(1fCtkt-Ht� �j,pr-(orr�c l5r-�rT.V {�OOtI'1 �Q�-,$rrc Cg=t0� L t Page 3 of 5 � Telephone(631)765-1802 Town Hall Annex 54375 Main Road P� Fax(631)765-9502 r k� P.O.Box 1179 Southold,NY 11971 0959 BUILDING DEPARTMENT TOWN OF SOUIMOLD 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) 1 V ,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 ✓ rr Town Hall Annex Telephone(631)765-1802 54375 Main Road 9 Fax(631)765-9502 P.O.Box 1179 w° Cc- Southold, 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: \\1 1%0i n Property Owner's Signature: Swor4n to to before me this Liday of 20-z 9 Official Notary Public Signatu a and Ori otary Stamp PIYUSH B.SONI Notary Public,State of New York No.01 SO6038647 Qualified in Kings County Commission Expires March 20,2026 Page 5 of 5 631 -765-1802 � • 1 ,NSPEC ION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION/CAL [ FRAMING / STRAPPING [ ] FINAL [ FIREPLACE & CHIMNEY [ FIRE SAFETY INS [ FIRE RESISTANT CONSTRUCTION [ FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FI [ ] CODE VIOLATION ( ] PRE C/O [ 1 REM m ell Town Hall Annex h Telephone(631)765-1802 54375 Main Road + Fax(631)765-9502 P.O.Box 1179 „f Southold,NY 11971-0959ow a , BUILDING DEPARTMENT TOWN OF SOM'OOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect,licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit iro essional seal re aired car Arcliteet or Fn inset iiensed borne ins actor rnustpLov�d„'e 1:ogLoLvolid current certi ication Rental Property SCTM Number:04 WPACA& •'� Rental Property Address: Owner/Name: Rental Dwelling Unit Identifier: Number&Square footage of-each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq., Bedroom#2-90 sq., etc.) t" * eeoRwt #3 t 10 Property Description (Include all improvements indicated on survey) I-tpT -tv B . I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation nstruction C de York State. 2 Print Name and Title Orig ill Signet 0 NO Please place professional seal: ` � Ilea C fIlk m m r' 11r Town of Southold 9/21/2017 53095 Main Rd ca e Southold,New York 11971 PRE EXISTING CERTIFICATE F OCCUPANCY No: 39228 Date: 9/21/2017 THIS CERTIFIES that the structure(s)located at: 675 Sldppers Ln, Orient SCTM#: 473889 Sec/Block/Lot: 24.-2-1 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z 39228 dated 9/21/2017 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame�p►q ficlue n with covered ow°clues a:rd ac sc�a q c- fr�acn� e.* The certificate is issued to Vannostrand,Barbara&Hughes,Jean ..............__..._ _...._...............m__wv_._._. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. • �....._ _, .. ,.( I ,..,Signature._...............__..._�_...... .. BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION RLPORT LOCATION: 675 Skippers Ln,Orient ......._------w-w-_._. - SUFF.CO.TAX MAP NO.: 24.-2-1 SUBDIVISION: _...._............ .... NAME OF OWNER(S): Vannostrand,Barbara&Hughes, _..................�...... .._ ....._....�_ _. ughes'Jeaa ......ww.. ........--- ....�.�...................._...w.� Jean _.......... �_�_..__... ,��..�._w�w_. OCCUPANCY: ADMITTED BY: .........................,,,,,,,.w_.._.M.mm ._......w-w_v_._._�_..w_.....w.....v.................._. .._.. ... l.www....�.�_ DATE: SOURCE OF REQUEST: Vannostrand,Barbara /2017 -.................... ._w. _.................................. _.. _- _. 9/2,,,,,,,ww._.w. DWELLING: #STORIES: 1.5 #EXITS: 2 FOUNDATION......................, concr.....mmmmmmm.w � _ ete%oncretcrete block CELLAR: x CRAWL SPACE: x . ........... ...... -._..............�..www_ BATHROOMS) . 2 TOILET ROOM(S)'�.,MX, ..�,W..W...w__._... ............_ UTILITY ROOM(S): porches_...�._ ............ PORCH TYPE: covered DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: yes....._....... ., _._,M_...w-wwwwwww__. ......—_.......-. _www.._.._. _,, ... GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: electric AIR CONDITIONINmmmmm TYPE HEAT: gas WARM AIR: floor fum not workin g HOT WATER: #KITCHENS: 1 BA . SEMENT TYPE: unfinished OTHER: ACCESSORY STR'UCT "S: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: _ ......�.............._ _. ..M _... ,.................._ �_ _--_..... w._....... SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: __w..._w.�........_....._.. INSPECTED BY: JOHN) DATE OF INSPECTION: 9/19/2017 r TIME START: 2:45pm END: 3:25pm 0* '00' Town of Southold 8/31/2023 P.O.Box 1179 53095 Main Rd �` Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44512 Date: 8/31/2023 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 675 Skippers Ln.,Orient SCTM#: 473889 Sec/Block/Lot: 24.-2-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/30/2020 pursuant to which Building Permit No. 45453 dated 11/16/2020 was issued,ued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: additions and alterations includica cta rered rclaes d ant se g flour cte ,to e istin.W_&si i l _ "ami „dw Il ,g,. s V21iie fear; The certificate is issued to Orient Realty LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45453 8/17/2023 PLUMBERS CERTIFICATION DATED 1/11/2022 "I-1 i Bing& ting Inc RENOVATION OF: CREWDSON RESIDENCE 675 SKIPPERS LANE ORIENT,NY 11957 REYRODE CHIRIGOS ARCHITECTS . _ ... t ±0MT23ROST STNFLOOR N —,NEWYOKIM10 p¢5 T21236—1212YS02 EVAN AKSELRAD NJAYSTAN Er'J YORK.,NEWYORK±M±3 �'c> x - i9iT6�tit3di It DOS/HPC 10.1&2020 31 o- �a 3 k r. E i� BASEMENT FLOOR I PLAN A-100.0 RENQVAP.ON OF: CREWDSON RESIDENCE 675 SKIPPERS LANE ORIENT,NY 11957 RE{RODE CHINGOS ARCHITECTS IDEAST23RDST.,B n.00R NMYORK,NE YORKI®10 T2123871 F2122 2� 1 EVANAKSELRAO ,_ 16 JAY 8TflEET,FIa E9 888 W9J1 YOflK 1N13 T OOR,tHPC 10.76.2040 `CD Q Y rt V 'TA t__\.,_��`"- -.vim. .•_ �—•c i u � y e FIRST FLOOR _uu PLAN 11- I 01 .00 RENOVATION OF: CREWDSON RESIDENCE 675 SKIPPERS LANE ORIENT,NY 11957 REXflODE CHIRMS ARCHITECTS 10EAST23i0ST,BTHFLOOF NEW Y.W NEW YDBK 1rb10 T 21238]'19.,10 F 2122802]8-0 c<.a EYAN AKSELflAD e Y STREET,F NEW NEW YORK,RK, PW Wl YORK 10013 T91]8890030i —'.. —E.— 2. I ti-mss S- �;�JK � 4 j a •.' _.`._ - COB ti.C 10 16.2020 N xi K SECOND FLOOR & GARAGE PLANS r L _ A-10 2.00 RENOVATION OF: CREWDSON RESIDENCE 675 SKIPPERS LANE ORIENT,NY 11457 REXRODE OHIRIOOS ARCHITECTS 10WK.NEW OK—�AXIOR { YO238p] FIN2PW— EVAN AKSELRAO NEWYORRK. EYSK NFla NW YORK 1 W43 T9fT 8&4 W301 V z} 'I I :6T`v FOR DATE DO . _ GOBfHFR; ?a 15.2020 y Al I _ - a BASEMENT REFLECTED CEILING PLAN H-1 50.00 L'RA 3=R: RENObATICN OF: -- CREWDSON RESIDENCE 675 SKIPPERS LANE ORIENT,NY 11457 REXRODE CHINGOS ARCHITECTS _ 1 N EA5 RK NST.,BTHFLOOfl NEW YORK,NEW YORK iD310 1 T 2123B119W F 2t22802T96 EVAN AKSELRAD _ 1-STREET,R3 NE YORK,NttiYYORK10013 T 917800301 �` A r _o-o DOB/HPC 10 16 2020 WI/- e ( ter'' I �! �, t J✓ I Y t H ( II, _ - \ 7 i v z E 3 � 0 t::�;c 4U FIR FLOOR R FLECTL CFH PLAN ----------- -- ---- LN- RENUVATION OF: CREWDSON RESIDENCE 675 SKIPPERS LANE ORIENT,NY 11957 HERRODE CHINOS ARCHITECTS 10EAST28 DS..6THFMR NEW YORK NEW YORK 10010 T 212SS]7 F2122602 EVANAKSELRAD G E1 I 16J YSTREET.F I NEW YORK.NEW YORK l— s T 91768 MWI I a — �.=,,t; 'AT- t. Doa/ppc 10,16,2020 tu lo G s?{{ i e 3 3 s t #x ;l t ------------------------------ vcxie 3 -______! ^- � ! SECOND FLOOR 3 I " GARAGE REFLECTED CEDING PIANS ft A-152.00 t