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HomeMy WebLinkAbout1000-98.-4-28.1 TIOWN OF SOUTHOLD 3 � Rental Permit 1062 Owner Adam Bremner & Tamara Hubinsky Occupied as Single Family Dwelling Located at 1350 Robinson Lane Peconic 98.4-28.1 Maximum Permitted Occupancy 10 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. 2/5/2024 >11OV141 Code Entorce font official This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD–BUILDING DEPARTMENT w � Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0 " Telephone (631) 765-1802 Fax (631) 765-9502 TO . RENTAL PERMIT APPLICATION f"e ^ re- C' bLPLfaQ Rental Permit Fee $300 (Application must be renewed every two years) +3p0°- Section A. Property Information: Rental Property Address: 1350 Robinson Lane 4: Tax Map Number: 1000 SECTION 98 -BLOCK4 -LOT 28 _ 1 SECTION B. OWNER INFORMATION: Property Owner Name: Tamara Hubinsky &Adam Bremner Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 440 W 23rd Street, Apt D, NY NY 10011 440 W 23rd Street, Apt D, NY NY 10011 Telephone Number (s): Daytime 646-249-9071 Evening _ Emergency 646-249-9071 & 917-294-1246 Property Owner Email Address: t.hubinsky@gmaii.com Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 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: Unit 1 Requested Maximum number of persons allowed to occupy Dwelling Unit: 10 Number of rooms in Rental Dwelling Unit: 6 Use and Dimensions of each room in Rental Dwelling Unit: Kitchen 18'x20'; Living Room 17'x18'; Den 18'x18'; Master Bedroom 16'x18'; Bedroom 1 16'x1; '; Bedroom 2 16'x16' 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. 10 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. 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) 1 Tamara Hubinsky 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 (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 s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: Tamara Hubinska ` ' Property Owner's Signature: Sworn to before me this ay of ZTA a 20 c) 1 I Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01BU6185050 Qualified In Suffolk County Page 4 of 4 Commission Expires April 14,Z,; I gr - qf so TOWN OF S h 6311 -765-11802 94,5�- M INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN: [ ] FIRE RESISTANT CONSTRUCTION [ FIRE RESISTANT PE ] ELECTRICAL (ROUGH) [ ] ELECTRICAL {FII [ a CODE VIOLATION [ ] PRE C/O [ REMARKS: Dic �-1 4 Town Hall Annex Town Of Southold 54375 Main Road ' Rental Inspection Report PO Box 1179 d �y Southold, NY 11971-1179 Tel: 631-765-1802 CDate STM# d .... ww � �. ... . . .�_ _..._ ......_...._..w ........ _ Phone __.._. ..w....... 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Door alarms Pool completely enclosed Self closing/latching gates Pool fence to code requirements Prior Rental CO's for all items present C �. Comments studio a/b architects --wmara Hubzns.y a Adam r [ . r i� t =j _ 1 - i _ f ort 3 s ( l I HubinskyBremner � i s_ Residence e Electrical Layout } 3 E.---01 - studio a/b architects } I z i Hu s bin ky&Adam Bremner I wR } _s I j � 3 , I r3 € 4 �m z s } 9 I <a# — I E `s 0 _ - _ _ = 17, d ( r , Hubinskyfgremner r Residence f First Floor Plan r ° 3 - EXISTING � oI BEDROOM i W �r [ 13 ZI� I i I W zf i `C) ( EXISTING g co i BATHIm I CS _ e i i j I lu 2 {{ E X I S T I N G E X I S T I N G G A R AGE I PLAY ROOM v ; € ' 1 € iHR. RATED EXISTING BEDROOM 5/15" i ] 5� "TYPE X SHEETROCK I L— . 6 1 E WALLS k CEILINGS RAANICAL `s _ I ROOM 9 s i 13 L ---=� EXISTING D a va ENTRY/ LAUNDRY ` i € , � I 3 IF PLAN i 3 I � I � Ncr ro SCALE � OIL TAfdKOIL TANK � I TOWN OSOUTHOLD PROPER -711/11w CARD' F To OWNER 1STREETf V).LLAGE DIST. SUB. LOT jf-�71 c�r FOB R OWNER IN E ACR. _dG aV, W TYPE OF ILDING r f, Air` RES !SEAS- VL. jFARPvk �-C)MM� CB, MISC. Mkt. Value LAND I lmpTOTAL DATE REMARKS AGE -_ } BUIED( CONDITION -th - NE, NORMAL BELOW ABOVE Value Per FARM elA Acree Tillable _ 1 q v Tillable 2 Tillable 3 -4 Woodland Swampland FRONTAGE ON WATER Brushland 'FRONTAGE ON ROAD House Plot DEPTH !BULKHEAD ,f 4-1 'DOCK Toto I OI=OR `�� TRIM o, E E ,mom y I t UF 77 P Extemon E a — , , Il 98.-4-28.1 10/2014 main house ` � - � a � _ m i Y 1 E . i s Extension g Foundation ° , �, doth Dinette rho _ easement Ioors K. r Interior Finish LR, Walls ,€ 'Fire Place eat Breezeway - _ e i arae � I ; Type Roof oms 1st Floor BR. e , Patio LK Recreation Room Rooms 2nd Floor FIN, B E s 7-1 0. .� �' Dormer 1Driveway r i � l' qa ;QL©R _ r� :J1 I _RIM - a G tr , — l 98.4-28.1 4/07 s - 98.-4-28.1 Rear View 4107 l -_ i M. Bldg o .r dation - oth,~ $ i Dinette R _ 01,19-A 41 Extension i i �- B�ment a Floors . _ _t s - Ext. Walls, !Interior Finish SLR. a_ Extension /a ..__ � . �a. = moire Place !Heat � s'd €DFZ. Extension ` - ' ?ye Roof 'Rooms 1st Floor BR. a {,x t•`l ' f, �4reatian Room 'Rooms 2nd Floor' 1FIN Porch I, r�� 'e Porch _ f g 4>brmer Breezeway driveway l i Garage - u__ N j vC r Total U L Z,p-_- vX� t I = x r`' TOWN OF SOUTHOLD PROPERTY RECORD CARD A OWNER °STREET VILLAGE DIST.i SUB. -LOT FORMER OWNER N E ACR. S w TYPE OF BUILDING RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Ac re Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD 7 -J� MeadowlandDEPTH House Plot I BULKHEAD Total DOCK IFOR31 NO. 4 TOWN OF SOUT"OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ................Z-2140 Dote .........................Aprll..22............ 19...6" THIS CERTIFIES that the building located atRobtlWon-Latmi—on...PVJV&t&-'RC*4. Street MapNoBar8ow.. Block No. Lot No .......j ..............................»................. conforms substantially to the Application for Building Permit heretofore filed in this office doted ...................................... 19,64., pursuant to which Building Permit No. .2515Z.. doted ............................QCt0bA3:...115K..., 19...84., 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 ........ .............................Omt—ftmily..dwelling...... ...---......... ................................................... Thecertificate is issued to ....... ...... ............ ......... .................... .. ...... (owner, lessee or tenant) of the aforesaid building Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23075 Date JUNE 30 1994 THIS CERTIFIES that the building ADDITION Location of Property 1350 ROBINSON LANE PECONIC, NY House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 4 Lot 28.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated. APRIL 27 1994 _____.pursuant to which Building Permit No. 22069_Z dated MAY 19 1994 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 A DECK ADDITION TO A ONE FAMILY DWELLING "AS BUILT" AS APPLIED FOR. The certificate is issued to DONALD & JUDITH DSMAREST (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building I spector Rev. 1/S1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31417 Date: 01/26106 THIS CERTIFIES that the building ADDITIONS Location of Property: 1350 ROBINSON LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 98 Block 4 Lot 28.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 9L__2006 pursuant to which Building Permit No. 31722--Z dated JANUARY 11, 2006 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 AND SCREENED PORCH ADDITIONS INCLUDING OUTDOOR SHOWER_„ TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. CONSTRUCTION CERTIFIED BY JAMES J. DEERKOSKI P.E. The certificate is issued to MICHAEL P & MARY M HEAGERTY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ERALTS APPROVAL N A ELECTRICAL CERTIFICATE NO. NA PIAMBERS CERTIFICATION DATED 01Z26 06 MATTITUCK PLUMBING Auth rued S", nature Rev. 1/81 ......... ......... Town of Southold Annex 4/1/2011 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 34881 Date: 4/1/2011 ..........- ....... ... THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1350 Robinson Lane,Peconic,NY 11958, SCTM#: 473889 See/Block/Lot: 98.4-28.1 .................. Subdivision: Filed Map No. Lot No. ........... .................. . ........ conforms substantially to the Application for Building Permit heretofore filed in this officed dated 11/5/2009 pursuant to which Building Permit No. 3 5171--- I dated .11,11,1111,1 1-/23./.200 911- 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: 4. oundswinimi4gpnol with kagg to--code 44P-pL1eA,Loi[I. The certificate is issued to Bremner, Adam& flubinsky,Tamara ............... (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ............. ELECTRICAL CERTIFICATE NO. 12112 1/12/10 ............ PLUMBERS CERTIFICATION DATED A igna re eFtttf Town of Southold Annex 7/29/2011 " 54375 Main Road Southold, New York 11971 .rw "tl.lnna CERTIFICATE OF OCCUPANCY No: 35093 Date: 7/29/2011 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1350 Robinson Lane, Peconic, SCTM#: 473889 Sec/Block/Lot: 98.-4-28.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 3/3/2010 pursuant to which Building Permit No. 35392 dated 3/15/2010 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: alterations to basement ant_ cr Led r and deck addition tai p e isitijo ._a rnil�w ll'i.tg Wad- la ligd i rr., The certificate is issued to Bremner,Adam&Hubinsky,Tamara .............. (OWN ER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-10-0032 7/26/10 ELECTRICAL CERTIFICATE NO. 35392 7/2/10 PLUMBERS CERTIFICATION DATED 6/6/11 Per' ion Plumbing&Heating A 1 ign re 1111QtfCAa. Town of Southold 2/4/2024 Al ��'��� P.O. Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICAT.E O� ` OCCUPANCY No: 44920 Date 111111111111--2/4/2 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1350 Robinson Ln, Peconic SCTM#: 473889 Sec/Block/Lot: 98.-4-28.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2013 p g . ... 0 dated .._....10/29..... „ _..... 10/17/2013 pursuant to which Building Permit No. 3846 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 411c alb; t t� ►is,Mitw, lu ,tlr 1°g� l tc _gAi�Iira _ iftge talp ly_ el1Nr m z alr Ytc for The certificate is issued to Bremner,Adam&Hubinsky, Tamara of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _... 4......... ELECTRICAL CERTIFICATE NO. 38460 7/7/2014 PLUMBERS CERTIFICATION DATED Attledt .re ctipt Town of Southold 2/4/2024 P.O.Box 1179 53095 Main Rd ' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44921 Date: ... 2.....4/2024�..,ry .... .... THIS CERTIFIES that the building POOL HOUSE/CABANA .....,. Location of Property: 1350 Robinson Ln, Peconic SCTM#: 473889 Sec/Block/Lot: 98.4-28.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/17/2013 pursuant to which Building Permit No. 38460 dated 10/29/11 2013 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: accqs, eMr .10 s1 Q1J po0j.1L(Lq,g half bath an ,jjggq a1 a5_ pplied oi,. The certificate is issued to Bremner,Adam&Hubinsky, Tamara of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-10-14-0001 3/23/2016 ELECTRICAL CERTIFICATE NO. 38460 .... ..... 9/29/2014_ ... PLUMBERS CERTIFICATION DATED 4/28/2015 Geor e Be Jr.