HomeMy WebLinkAbout1000-38.-6-15 a. TOWN F SOUTHOLD
T-4
Rental Permit
1049
Owner Mary L. Hess
Occupied as Single Family Dwelling
Located at 230 South Lane East Marion 38.-6-15
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.
1/12/2024
Code E orc went Offi iA
This Notice must be posted by the main entrance at all times
P" AQc 10 64 ,6q lx l q(zA
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
'ENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
9ei �6 1802 Fax(631) 765-9502 htlt s. b c° V���ic Imliny C
DEC, -.- 202
WIdi n�Pnrfmont RENTAL PERMIT APPLICATION
TOMI of E;QLA,,Ac�i
Rental Permit Fee $300(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION 3 -BLOCK -LOT -
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
400;80 I�OLWLLV.�,. R150.4-A---
Telephone Number(s): Daytime Evening Emergency
Property Owner Email Address: �-LA I iA r) e S S k(-fO ud , corn
Page 1 of 4
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: U �.
Address of Authorized Agent (no P.O. Boxes): E170 `r - Lew�c,4,
Mailing Address of Authorized Agent: 'A
Telephone Number (s): Daytime�� �qven i g Emergency � �3_ 2Q- n
Email Address:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any:
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:
Address of Managing Agent (no P.O. Boxes):
Mailing Address of Managing Agent:
Telephone Number (s): Daytime Evening Emergency
Email Address:
Page 2 of 4
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:
r
Use and Dimensions of each room in Rental Dwelling Unit:
"2° � w t
bL6�x y
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 lags 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
❑ 1 am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
Page 3 of 4
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
I is ge L!t5s 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
applicable laws and rules. I further acknowledge that I will notify the Town of Southold
Building Department of any changes of address within five (S) 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 s to any change to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name: MA"
Property Owner's Signature:
Sworn to before me this' 'D-day of NCv '.r 20-23
Official Notary ublic S nature and Original Notary Stamp
'BRITTANY CONRAD
t40tArY Ublic Sty rat k 9c v orkC
Reg.No 01 �
C)Lua dtMd in SAfJk COW'ItY
Page 4 of 4
TOWN OF SOUTHOLD BUILDING D
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631 -76S-1 802 M, 6
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE 'SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
[ ]' CODE VIOLATION [ ] PRE C/O [
REMARKS: gttxi gt=t b m r
DATE INSPECTOR
" ,. Town Hall Annex
Town of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
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Tel: 631-765-1802
_ Date
SCTM #
r Phone
Owner D' .
6
visible
Address
ee.
Hamlet
Inspector
Level Quantities —
Floor Sub 1 2
Smoke Detectors (not located in bedrooms)Carbon Monoxide Detectors
Fire Extinguishers
Exits
Bedro f 45 d
orns yy 3
n
Smoke Detectors
Egress
Occupant Count
Building Systems Maintained & Operational Condition of Property
Heating Building interior
Hot water Building exterior,
Property clean, maintained & safe
mtai
..... . ..___ , ,guards insta ..,.d
Mechanical Iked & secure
Handrails & gu _
Poo
Pool Safety Ion Site
Surface water alarm issuance
CO issua
Date o _
Door alarms Pool completely enclosed
Self closing/ latching gates Pool fence to code requirements
CO's for all items present Prior Rental _.
Comments:
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OWNER ;STREET ` „ ;VILLAGE LOT
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Breezeway Fire Place ..m Heat DR.
Garage r �� =Type Roof ;Rooms 1st Floor BR.
Patio Recreation Room€ Rooms 2nd Floor FIN, B
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Extension Fire Place Z Heat 3 D.R.
Patio Woodstove BR.
Porch �_; �.+� 0. v Dormer Fin. B.
Deck Attic
- Rooms 1st Floor
Breezeway
Garage ' I Driveway Rooms 2nd Floor
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POOL ,
Town of Southold 8/23/2023
"r 53095 Main Rd
�a Southold,New York 11971
PRE E X :ST NG
CERTIFICATE OF OCCUPANCY
No: 44476Date: 8/22/2023
_................ ...
THIS CERTIFIES that the structure(s) located at: 230 South Ln, East Marion
SCTM#: 473889 Sec/Block/Lot: 38.-6-15
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- 4447X6
dated 8/22/2023 was issued and conforms to all the requriements of the applicable provisions of the law..
The occupancy for which this certificate is issued is:
v as :f nitta .mt glc f alt, Iy 1?vc 11 r r ywa @„fnr l ttcs grI-Ji�si-n! cr1t M rmme c la 1. ea° x ). rrmc l s c
pcar�laerlm�b�ce,��a�y„�n�cao�mm�,J�ne#ctcar tct �° ge,��°
The certificate is issued to Thorp JT Irry Trt ................. ...
(OWNER.)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
uti c�ra. digtat �tx
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 230 South Ln,East Marion
SUFF.CO.TAX MAP NO.: 3.�.w.,
8.-6-1;5 SUBDMSION:
NAME OF OWNER(S): Thorp JT Irr,�Trt
OCCUPANCY: _
_...........
_...w...._................�....._............, _...._..__...._w_._._._._......, ...w_�_�_......__�ww. .,,
ADMITTED BY:
SOURCE OF REQUEST: Thorp
J TrtDATE: 8/2
w....._._._...,._.��wwa,�.�.,..._.............__._._ 2/2023
........ ..__ � ... ,...�..,,..�...................�._m,....... __.......�....�...._mm.,,w�...................... �_.._..�.�.�.�.�.�.�.� ..�w._._. . �..m...
DWELLING:
#STORIES: 1 #EXITS: 2
FOUNDATION: cement
CRAWL SPACE:
ROOM(S)
BATHROOM(S): TOILET ROOM(S): CELLAR: full „
ILITY :
PORCH TYPE: covered&enclosed DECK TYPE: PATIO TYPE:
BREEZEWAY: wood connector FIREPLACE: yes GARAGE: 18 x 24 w/breezeway..
conn..................._...,,,..m,_ ..
DOMESTIC HOTWATER: yes TYPE HEATER: off boiler AIR CONDITIONING•
TYPE BEAT: oil W ......... _.._......._. .......__....._..www_......_ _ w_......._,...w w._._._.....
ARM AIR: HOT WATER: radiator
_................... �_. ...w�._._._.. _�_ _.... _w__...._www .._...,,................._._...........................
#BEDROOMS: 4 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER: �`�"....�"...._..,..._._w........ ._,_
ACCUS.0 STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
a
REMARKS:
INSPECTED BY: J:OHNJ DATE OF INSPECTION: 8/10/2023
TIME START: 11:02am END: 11:25am
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.Z1184.8 . w . . . . . . . , Date . . . . . AueiU8. . . . . . . . . . . . . . .. 1983.
THIS CERTIFIES that the building . .400ti4P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property 3 0 . . . . , . . . . , . South Lane. East Marion
hlra s Nva: . Sweet » * raalet
County Tax Map No. 1000 Section .0 3 8. .. . . . . .Block . .0 6. . . . . . . . . . .Lot . . . . P.1.5 . . . . . . . . .
Subdivision . X. . . . . . . . . . . . . . . . • . . . • . . . . . . .Filed Map No. .X. . . . . .Lot No. . X . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
A u u s t 3 , . , , , . , , , 19q?.pursuant to which Building Permit No. , 1 19 0 6. Z. , , , , . , , , , ,
dated . . , September. 1.5 , , , , . , , , , _ 19 .8?,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 . . . . , . . . .
an addition to, existing, dwelling: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . . .JANET T... T H O R.P , . . . . . . . . 11 . . . . . . . . . . . . . . . . . .
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . N/A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . .M •$A 8 R 5. . . . . . . . . . . . . . . . . . . . • . . • . .
, , Building Inspector
Rev.1/61
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20823 Date JUNE 23 1992
THIS CERTIFIES that the building 1T10N AL TION
Location of Property, 230 SOUTH LANE EAST :SON N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 38 Block 6 Lot 15
Subdivision Filed Map No. Lot No.�,
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 27, 1991 ____pursuant to which
Building Permit No. 20308-Z dated DECEMBER 3 1991
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 ADDITIONS & MT TIONS TO MISTING ONE FAMILY MEN
AS APPLIED FOR.
The certificate is issued to JANET T. THORP
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A
UNDERWRITERS CERTIFICATE NO. N-235867 - MAY 194 1992
PLUMBERS CERTIFICATION DATED JUNE 24- 1992 - FRANCIS A. THORP
Building Inspector
Rev. 1/81