The URL can be used to link to this page

Home My WebLink About1000-74.-1-15 TOWN OF SOUTHOLD Rental Permit 0864 Owner Laura Bonelli Occupied as Single Family Dwelling Located at 875 Henrys Lane Peconic 74-1-15 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. 4/19/2023 This Notice must be posted by the main entrance at all times C de Enrrc e t ff i cd a I ff o�� Telephone(631)765-1802 Town Hall Annex 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 D ) BUILDING DEPARTMENT TOWN OF SOUTHOLD A U G 18 2021 LDj! RENTAL PERMIT APPLICATION BTIT, INTG DEITYL Rental Permit Fee$200 (Application must be renewed every two Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION 0-14 -BLOCK 01. 00 -LOT-0 15 - 00 SECTION B. OWNER INFORMATION: Property Owner Name: Laucc& I l Property Owner Legal Address: Property Owner Mailing Address: U — --) �. Telephone Number(s): DaytimeSW-IJ -Yi3lbing_ Emergency. Property Owner Email Address: L a uc ' Page 1 of S U Town Hall Annex ; Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1 179 tS Southold,NY 1 1971-0959 'Y Ou BUILDING DEPARTMENT TOWN OF SOFT OLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: �(1Cy- 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 Ult Number of rooms in Rental Dwelling Unit. Li Use and Dimensions of each room in Rental Dwelling Unit: Page 3 of 5 Town Hall Annex Telephone(631)765-18.02 ` Fax(631)765-9502 54375 Main Road Y.O.Box l 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) I Louc1, t on \ , 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 Ar Town Hall Annex Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 �Ytcn, 40 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 s Owner' Signature: p Sworn to before me this B—day of i 20,91 Official Notary Public Signature and Original Notary Stamp 4 � Page 5 of 5 TOWN DF SOUTHOLD BUILDING D *couxn�° 765.1802 IN PECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCA [ ] FRAMING / STRAPPING [ ] INAL�1 [ ] FIREPLACE & CHIMNEY [ FIRES FETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O REMARKS: how �trViYrtc�- � �►;' t uC 'n :Ziwc� °a` `ltr epi a� DATE _ INSPECTOR DJ � pe.urn� � 14 - 1 - i s # # TOWN OF SOUTHOLD BUILDING D 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CA [ ] FRAMING / STRAPPING [ ] FANAL [ ] FIREPLACE & CHIMNEY [ Vf FIRE SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE GO REMARKS: (V/ ks DATE 3 � baa` INSPECTOR a � SCTM-9- °' r > Www ay I _mm M TOWN OF SOUTHOLD PROPERTY REC< �I a`I � OWNER STREET VILLAGE DIST, SUB. LOT ACR, -� REMARKS _.....,x_... TYPE OF B PROP CLASS '�a,�.M��. � 'C �,,,v.4m✓'g.R.,w,F"N'°�,e 'G Iay.O�`.wJ�"' �Fm 'Aa.,,, x � LAND IMP, TOTAL DATE ------------- FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL w TOWN OF SOUTHOLD y OWNER _ STREET DIST. SUB. - LOT a� 1 tf i __. ��.... _ �.�if —] � ,�s-ti v is � _ FORMER OWNER, N E ACR. r S W TYPE OF BUILDING RESP SEAS, VL. FARM COMM. CB, MISC, Mkt. Value LAND ;� MP, TOTAL i DATE REMARKS f n"4 3 _,. ... a ._...._,. ._. d AGE BUGLING �ONDTIOp �. �._ � ....._... r ✓ z- �- NEW NK) MALS 9 BEI. )W ABOVE' t _ "f ,. , ��.,...�`.. ..�.,.! _ . FARM Acre '114 � Value Per ......,_,�.._a ILA _ Tillable 1t ? `7 �".. m' /(J'/c� a t `L / Tillable, N ;i I Cay �/� / . " ✓ s C1 V ' "d s ly �__..... _ ATE FRONTAGE ON W Brushland , � �" �. �� '._ FRONTAGE ON AD RO �� ._.. n„ .._n. _,__.n., v I House Plot DEPTH 7q _...�.� .._M BULKHEAD__ ... .._ _.m.....__ 3), � _ I Total--f, --� ` ' __jDOCK 1 — �. Gd 2i - mm i m �m ^ LO �- 7 P ."' .. ...... j „,.., _ a � '.... .._.... ,. ��_. f 1 s w ^ I� I M �r log ll 1901 y ,m Zv,q Mv_,'..._....._.^.�.... .,,,_,, 0..........�_,_., 74-1-15 2/04 ..,, ._ .,w .. ._ µ.w..... ..w ...,_ .. ......, ._.1 .._..... _... _ .._^._. . ... ._�.._ .. M. Bldg,_ ro ��b ._.. F ondation... /� °�...,.A Q_ Dinette .� - �. � . ��~ �, a�. ,. , ,� . �� Floors ,� h� �K.�n. ..M .......__.., ... _.w Extension r,� G� '1 ., ,� ^ - c� ment Extension Su .xt, Wallsr r Interior Finish ..._. ....._ .. _ LR. _. mm...... . � 5 Heat DR. n f atensio ^ �s VFire Place _. y. M. R. p a e Roof Rooms 1st Floor iB Porch ecreation Room, lRooms 2nd Floor l FIN. B. _._....Ma.__ _ _._. .._...M._ _._._ _ _ _._. __ ...�..._.__.._m_...... ... ...... I .....,,.. .__. . ........ ..._.......__. _., __. __. ._... Drsxser P.�....G h ......... _ __.. _..__..._._.. _ _ _.... ,._._.,... ,..rv..._.. . ........ s z �areaaeay °� 'fDriveway r Garage Patio _ __.. ..... .... ...... __...__.........�.__,.._.._.._.......w. .._.........._M O. B. Total J ' f 1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z .3616 . . . . . Date . . . . . . . . . . . .Oct. , . 28. . . . . ., 1969 . THIS CERTIFIES that the building located at . t a. Ro . . . . . . . . . . . . Street Map No.Pec... -Homes Block No. . . . . . . . . . .Lot No. 8 . . . . . .F*Conle• • • •1101.. . • • • . • . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . .April. .1f,, 19-69. pursuant to which Building Permit No. . . .4288z dated . . . . . . . . . . . . . • . . . 1 3. ., 19.09., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . Private -one •family•dwellln$ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . .Inge •Clausen• • • •owne-r --builder • • . . . _ • • . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Oct. 28,. .1.969. . .by. R-, .Villa. . . . . NOTE: window variance approved by Housing Fid. . . . , 00 , 00 . , � . . . . . . . . . . . . . . . . . . House 875 FORM No. 4 TOWN OF SOUTHOLD fl Yhai BUILDING DEPARTMENT ,y '�Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Tr3.879. . . . . . Date . . . . . . . . . . ;-Uly- . .22 . . . . .. 19.70. THIS CERTIFIES that the building located at Henry,Lene. . . . . . . . . . . . . . . Street Map No. Pee 1,- Hm#gBlock No. . . . . . . . . . .Lot No.8. . . . . . .Peconic. . .N.Y�* . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . .Dee. . . .8. . . . . .. 190.9 . pursuant to which Building Permit No. 45. %Z. . dated . . . . - . . . . .Dec. . . 1.6 . . ., 19-69•, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . -Private• one -family dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to Inge.Clausen,. .builder to •Mrs Eileen•OuU*tt • •o .r (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Oct:• 2B - 1969 by •R: Villa • . • HOTEs Window variance approved by10 umBoard,�o eals Building Inspector House # 875 FORM NO.z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NOV 4599 Z Date ...........................RR*f....... .,,..., 19.... '� Permission is hereby granted to: I................AAA .0 ur- ................................. ........ ..310-.l.... 41*..PA ................... .................461 .........%*'U. .................... ,...,. to ............. ou•1w 11 ............................................... at premises located at .......... .... .Zat,.4....P*0 0 ....................................... .................................................... O ........P0411 4.......1t'V*x.*. .............................. pursuant to application dated ...............................p ........16....... .. 19...0, and approved by the Building Inspector. Fee $....� - ........ .�. ., .......... Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .Z408a.............. Date ...........................Dma........ 19...7 . THIS CERTIFIES that the building located at .....HeuryAs...L&............. .................... Street Mop No)P.Q.'4*..HX4..... Block No. ...................... Lot No. ...8....I.........POPPIAIP.......NXIt............... conforms substantially to the Application for Building Permit heretofore filed in this office doted ............................................A 4. ....12...., 19-7.0., pursuant to which Building Permit No. A49.8Z... doted ...................................A,14..••.••14., 19...7.0.,was issued, and conforms to a I I of the requirements of the applicable provisions of the low. The occupancy for which this certificate is issued is ........ .........P.r.j.Va-tA0---ga3!ajP.................................... .............-'-.......... ....................... The certificate is issued to ..Ztj"n....N.--QUllette..........Q=am.............................................. (owner, lessee or tenant) of the aforesaid building. House # 875 ...............( Building i*n*�cior 4 FOP14 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20327 ]late NOVEMBER 7, 1991 THIS CERTIFIES that the building ACCESSORY Location of Property 875 HENRY'S LANE PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 74 Block 1 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 144 1982 pursuant to which Building Permit No. 11976-Z dated- OCTOBER 20.t 1982 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 STORAGE BUILDING The certificate is issued to JOHN & LAURA HELF (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO, N/A PLUMBERS CERTIFICATION DATED IA _ ui ding Inspector Rev. 1/81 x FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20326 Date NOVEMBER 7, 1991 THIS CERTIFIES that the building ADDITION Location of Property 875 HENRY'S LANE PEMNIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 74 -Block-- 1 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application, for Building Permit heretofore filed in this office dated OCTOBER 141-1982 pursuant to which Building Permit No. 11975-Z dated OCTOBER 204 1982 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 FULL CELLAR ADDITION WITHIN FOUNDATION OF EXISTING DWELLING The certificate is issued to JOHN & LAURA HELF (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL VA i7NDERWRITERS CERTIFICATE, NO. N/A PLUMBERS CERTIFICATION DATED N/A Buil ding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.X. CERTIFICATE OF OCCUPANCY No Z-20363 Date NOVEMBER 204 1991 THIS CERTIFIES that the buildin ADDITION Location of Property 875 HENRYS LANE PECONIC, N-Y House No. Street Hamlet County Tax Map No. 1000 Section. 74 Block 1 Lot 15 Subdivision Filed Map No. lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER lei, 1985 'Pursuant to which Building Permit No. 143295- dated OCTOBER 259 1985 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 ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to JOHN & LAURA HELF (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-025609 - NOVEMBER 15, 1993. PLUMBERS CERTIFICATION DATED NOV. 6, 1991 - JOHN HELP I B ilding 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-28866 Date: 09/12/02 THIS CERTIFIES that the building ADDITION Location of Property: 875 HENRY'S LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 74 Block 1 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 5, 2002 pursuant to which Building Permit No. 28626-Z dated AUGUST 5, 2002 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 FIREPLACE ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN M & LAURA C HELF, SR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Aut8orfAd Signat e 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-29434 Date: 05/14/03 THIS CERTIFIES that the building ADDITION.& ALTERATION Location of Property: 875 HENRY'S LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 74 Block 1 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 26, 2002 pursuant to which Building Permit No. 28624-Z dated AUGUST 5, 2002 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 ADDITION & ALTERATION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN M & LAURA C. HELF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1104690 04/18/03 PLUMBERS CERTIFICATION DATED N/A 1 A orized 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-33630 Date: 04/01/09 THIS CERTIFIES that the building ADDITIONS Location of Property: 875 HENRY'S LA PECONIC (HOUSE NO.) (STREET) (HAMLET) county Tax Map No. 473889 Section 74 Block 1 Lot 15 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 25, 2009 pursuant to which Building Permit No. 34530-Z dated MARCH 25, 2009 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 SUNROOM AND DECK ADDITIONS, WITH ABOVE GROUND SWIMMING POOL & FENCE TO CODE, TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN M SR & LAURA C HELF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1077725 09111/02 PLUMBERS CERTIFICATION DATED N/A _4.�;tho 'zed Signature Rev. 1/81 N l s ��,�� pz� - �- �- �;. _� _ _ � ;i - \_ `�` �� \��\ �_ "`�_ _ � �� R: ��_ ��\�� \ \ \ \ \ \ \ \\ \ \ o \ \ \ \ \ \ \ WWII \\\\\ \ \ \ \\ \\\ \ \ \\\ \\\ .\. \ w� v_ R e g �1 \\moo ��` `�� \\\�� ` -� � e 1 Me- i6 Orr,. J \ �. RRK'I a .� - ° ._ � R PROJECT SCOPE: � _ LESALI MILT RECREATION ROOM AT VASEMENT " ` f ZE A6- a .� - � I N s R .... zar. M '920 �S INSULATION 8 FENESTRATION REGNJIREMENT5 6 g� 6 ft- 7 � COMPONENTPRDP09m 023:eN tooE PR[9GRIPTIVE VA1UN a VULt CITATIONM3070 ptTePl.Ccl M w � - p4�effi - tMw1WLIWNN �4ttA{h1�i== R IS �ro m�:uElWllw wRIDITwP.IOA !�F - - LeR nKr :i n m- r.00eo.aaaeort.nmR eroo.rsuarc..ep i Mr.. wa. ,. � e eaier�raaeHnwieo�.nurnx eae.wwow.m.aan , pro.o.i.wa+aa.. a. MEWS- ma - v •U) i ,. .w.orewraw...a ."" > ' e2+ Oa,+. is r s W " OUR NNW —tt IN .. RK I 1 I- ws+F. ...:.+.•rte s.trcwfle All. BONELLI € - - - r IF8➢€ta . ,.a t i AS-BUILT PECONIqNY .�a...ssan waw-wrmw-wee _ f 11110 A-10 00 I 1. 3�:s* _ �� l � s^.T"^'• #W1u W33174 4 0P3 w.yr is 5 V 2— DEC 9 2022 o UXEI TOWN OF SOUT e OL g t Y"` _� f¥.tea+-�- ��T�� - -•_ -. _� -_ _ _ ILL 11 It� 3Y' txTy - - T POW y �` �f # Fho a 477-04QQ $tfi R r 4 i jt n { a' i ------------ ti i ti a I ' �— `. •` � f's - - .a.-�G Ts:.-- 4:-...�.r-t f... �aFf5T40�p s m��_�_ �•f<�• _-��2 �. - _ _ �� /fib r r � ✓ I SLI?��aGQ B? eL n r 7zSr - 't8 KIT q ' -_-_ 09 VJrN9cw2#a I f t; _ SUN ZC u ■h YF /r4n ED (v 7' b tf ® DECK, 4. .t T 1 l� {}QA2o� 3y.a s� N 11 T j {'�S�� Tf7r- -�r�_?"� j �' ..-�.•- �r .____ �{ [QUI F f �}-yvzoyc SGa Sf,�i E 1T_ Zi SLeDEC ..—sr`—.. 3t' ?a�s+.NER YM 'I } hPVKox K I � _i8VE4FT � j yp TTt�' h I TREU-+sL f� � if c ' 16+� � � SfELc �.-hsE Ya x' I ♦ "'$YufKRGiV.Znuu{ �'ow.tx N-Y. tam D�ctc t�A APR--1 24 e- - - STDG.DEPT. f _ I - �- i}Er.lcepa QfD!Nl "N