HomeMy WebLinkAbout1000-127.-6-8 Rental Permit
0851
Owner: Richard Collins , Jill Collins
Occupied as: Single Family Dwelling
Located at: 1810 N Oakwood Rd Laurel 127.-6-8
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.
Issued: 03/04/2025
Exp i ration: 03/04/2027 e E oe j
fl�iciai
This Notice must be posted by the main entrantoatallmes
so
!�!oA - � �
TOWN OF SOL,I"" HOLD BUILDING DE PT.
631-765-1802
INSPOECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INJSULATIOWCAULKING
[ ] FRAMING /STRAPPING [/] FIRE
INAL
[ ] FIREPLACE & CHIMNEY [ SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ } FIRE RESISTANT PEN ATION
[ } ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
lA 0140W 1/INSPECTORyk
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TOWN OF SOUTHOLD
4�"
95
Rental Permit
0851
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ap
Owner Richard & Jill Collins
Occupied as Single Family Dwelling
Located at 1810 N. Oakwood Rd. Laurel 127.-6-8
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.
4/10/2023 VAtw >��
Code Enforcuent Officia
This Notice must be posted by the main entrance at all times
Town Hall A nex „� �; Telephone(631)765-1802
� - 765-9502
5375 Mir
P.U.Box 117 Fax 631
( )
Southold.N' 11971
BUILDING DEPARTMENT
TOWN OF SOLF117HOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must.be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION 9 -BLOCK V (0 -LOT Q
SECTION B.
OWNER INFORMATION:
Property Owner Name: T( I (
Property Owner Legal Address: Property Owner Mailing Address:
�15 fi 1,SS I K SSe-( S+
Telephone Number (s): Daytime 42-q-M Z Evening 42-8-133 ZEmergency
Property Owner Email Address: , Ky P I T SL K 4�) &H 4 1 L. C,6
RKcL4ZZLP (LV H-OTH A L . Ldm
Page I of 5
C)0
U��
Town Hall Annex Telephone(631)765-1802
54375 Main RoadFax(631)765-9502
r�j CP
P.O.Box 1179
Southold,NY 11971-0959 F"
f.=
-01
BUILDING DEPARTMENT
TOWN OF SO OLD
Section C.
Authorized Agent Information: l
Name of Authorized Agent of dwelling unit, if any: J m m m `t �'Jh 6)1110S
Address of Authorized Agent (no P.O. Boxes): -issq SS
Mailing Address of Authorized Agent: 5;0( �( � �� � � �S �j l( 12
Telephone Number(s): Daytime���'�Z�' gs�Lng61u �-L% 4Eme gency _ _
Email Address: J K D I TSC1
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: U
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: Jam- mo V
1111
Address of Managing Agent (no P.O. Boxes):
Page 2 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 1 1971-0959Al
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: �� A bye,
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: Y d(od Y1'1 q IC)
13Zjf ql�o,, gedroc)m
Page 3 of 5
Nk
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179AI
Southold,NY 11971-0959
oul
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 ws 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)
11�S 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
;
A
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 '
Southold,NY 11971-0959 �
� -
BUILDING DEPARTMENT
TOWN OF SO OLD
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:
?,0
Fi-
Sworn to before me this 3 ay of 20L�
Official Notary Pu lic Signatgo a and Original Notary Stamp
DIANA SONG JACKSON
Notary Public-State of New York
NO.01JA6247825
Qualified in New York County
My Commission Expires Sep 6,2023
Page 5 of 5
TOWN OF SOUTHOLD BUILDING D
631 -765-1802
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING 1 STRAPPING [ ] FINAL
[ ]
FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL {FII
[ ] CODE VIOLATION [ ] PRE C/O [ I
REMARKS: AIA 3pt e at"k
f
DATE
INSPECTOR
Town Hall Annex
SOUTHOLD TOWN 54375 Main Road
PO Box 1179 Southold,
Rental Inspection NY 11971-1179
� - Tel: 631-765-1802
Fax 631-765-9502
SCTM # ��` Date a-7- 93
OwnerPhone
Address zip
City Inspector
LEVELS SUB 1 2 3
Smoke Detectors (#-bedroom detectors excluded)
Carbon Monoxide Detectors (#)
Fire Extinguishers (#)
Exits(#)
BEDROOMS 2 3 4 5
Smoke Detector Alarms (#)
Carbon Monoxide Alarms (#)
Egress (windows) (Y/N)
BUILDING SYSTEMS Y/N CONDITION OF PROPERTY YIN
pie hn s stem maintained/operational I Building Interior is clean/maintained
Hot water system maintained! perational _ Building Exterior is clean/maintained
Electrical system maintained/operational Property is clean/safe/maintained I
Mechanical system maintainedloperational Handrails & guards present
COMMENTS:
Rental Inspection Form 4/7!2021
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TOWN OF SOUTHOLD PROPERTX ,,RECC
OWNER
STREET VILLAGE 15T. SUB LOT
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FORMER I O kIEI ,„ m;N N E ACR.
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LAND IMP. TOTAL DATE REMARKS
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FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. 2.1.122f , . , , . . . . Date . . . Agptpmber. A$ . . . . . . . . . . . . . .. 19$2.
THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . , , . . , . . . . . . . . . . . . .
Location of Property . . . . . . . . . . . . . .Vont.h .ppkW9p0. ,QCT Ve, . . . . . . . . LA-tgrel. . .
House No. Street Hamlet
County Tax Map No. 1000 Section . .127. . . . . . .Block . .06. . . . . . . . . .Lot . . .00.8 . . . . . . . . . .
Subdivision . . .lrau re 1. FArl�. PAO, , . . . , . . . .Filed Map No. .21?. . . .Lot No. 1, .4 .i. of .2
conforms substantially to the Application for Building Permit heretofore filed in this office dated
. . . . . . . . . . . . . 19 U pursuant to which Building Permit No. .11.7.6.Q . ;. . . . . . . . . . . .
dated . . . JUB?. 3-Q . . . . . . . . . . . . . . . 19 R2 ,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 . . . . . . . . .
•. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . .dolzn. .4 . 8. , ' . . . . . . . . . . . . . _ . . . . . . .
(owner,l rpt
of the aforesaid building.
Suffolk County Department of Health Approval . .1,2-V;»1Qv. A/,2,xZ/ ?v. A,o b P... A! . V !1 ilk., P.E.
UNDERWRITERS CERTIFICATE NO. . . . . . . . . PBn0yng. . . . . . . . . . . . . . < . . . . . . . . . . . . . . . . .
{
Building Inspector
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-32520 Date: 06/08/07
THIS CERTIFIES that the building ADDITION
Location of Property: 1810 NORTH OAKWOOD DR LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473869 Section 127 Block 6 Lot 8
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 7, 2007 pursuant to which
Building Permit No_ 33136-Z dated JUNE 154 2007
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" DECK & OUTDOOR SHOWER ADDITION TO All EXISTING SINGLE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ESTATE OF ELEANOR BASTONE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
�th,�ried Signature
Rev. 1/81
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