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Home My WebLink About1000-31.-17-11 TOWN OF SOUTHOLD iZ co 4W Rental Permit 1075 Owner Raymond Lombardo Occupied as Single Family Dwelling Located at 295 Rabbit Lane East Marion 31.-17-11 Maximum Permitted Occupancy 6 Is in compliance with ail 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. 2/20/2024 _ Code fore est Offici This Notice must be posted by the main entrance at all times vi F l F E 13 2 2024 TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southol4,,�. Telephone (631) 765-1802 Fax(631) 765-9502 late ://wNvw.s0utholdtqw,nn .ggy 10(4,5110 RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: r �' --BLOCK -LOT Tax Map Number: 1000 SECTION SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Lie— Telephone Number (s): Daytim;!'�) E iing Emergency Property Owner Email Address: " Page 1 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: lc� Use and Dimensions of each room in Rental Dwelling Unit: 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. V/1,01"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) 1L&*J0;kertify 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: Property Owner's Signature: mv A A Sworn to before me this day of `i_ 20 JpLUAN L JANESKK Commission#50045286 Official Notary Public Signature and Original Notary Stamp Nota Puabiic, State of New Jersey Y Commission Expires September 06„ 2026 Page 4 of 4 Town Hall Annex Telephone(631)765-1802 54375 Main Road c P. O. Box 1179 n Southold, NY 11971-0959 Ze BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: 296 jU'L— Requested maximum number of persons allowed tQ occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: TOWN OF SOUTHOLD BUILDING DI 631 -765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAl [ ] FRAMING / STRAPPING [ ] FINAL [ j FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (TII [ ] CODE VIOLATION [ j PRE C/O [ REMARKS: ��Lup-Q-, � f0( Town Hall Annex Town Of Southold54375 Main Road PO Box 1179 Rental Inspection Report `4 _ Southold, NY 11971-1179 ! ► �x, Tel: 631-765-1802 SCTM# ✓�/ Date 'Owner Phone . __.. ..w... ._. .. 'Address X.'atl Visible ..w...._ Hamlet _ .. ... . .._ . .., _. .. ....Mw _....,w..w„._�..._ ... , .... _. . .. .. _.. Inspector ,floor Level Quantities, Sub 1 _. �w .....a � ��ww� a�e......� ..ro .�� ......... ��..u�.� .��........ .w. 2 3 Smoke Detectorsnot located in bedrooms} mm, W.a � .w�&. _.w .� .... ... _ _...�. .. Carbon Monoxide Detectors ...,._w._._ .... .._.. o... rs Fire Extinguishers _. .. .m..., .. Exits Bedrooms l 2 3 4 6 Smoke Detectors �. �t ,�..... .. .. _ m.� .. ., e Egress Occupant Count .,.. � .. .._... Building Systems Maintained &Operational e e Condition of Property m e,e...... . .�� Heatinm... .. g ;Building interior b �...............,, ... , . _ . _ Hot water Building exterior I 1 _ E nical .�_.. , .. _. Property clean, maintained &safe Electrical 1 Wecha (Handrails&guards installed&secure Surface water alarm Date of CO issuance ... v ..... v�. _.. ��wae .� .a� Door alarms Pool completely closed Self closing/latching gates Pool fence to cod requirements CO's for all items present Prior Rental a _ ..._ _p �....._ ........._ . lComments: ..... f .......... ... 1 I / �Y a .w.___. AL j 1 ♦ n r ♦ f r w � d I d 11 r 4 _ _ _ wc)�� E a -I All r Ag_. fNk z- ... 4 E TOWN OF SOUTH LD PROPERTY RECORD CARD OWNER !STREET VILLAGE DIST.; SUB. LOT r �FO WER OWNER N_ E ACR. g s a TYPE OF BW UILDIN G o RES_ SEAS_ VL� FARM COIvhM. CB. MICS. Mkt. Volu� LAND IMP. TOTAL DATE REMARKS \ F= 4-11 No �t T r� _ F e t AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Vclue Ac re Tillable FRONTAGE ON WATER r - Woodland FRONTAGE ON ROAD Meadowland ' DEPTH House Plot BULKHEAD Total DOCK = r r E TRIM , , > � r = y x� s . Ec 31-17-11 3/03 F _e Extension_ g s � Extension Extensions X �R� Foundation Bath Dinette = — Basement 'Floors Porch r - .2 (� Ext. Walls interior Finish LR. Breezeway :,Fire Place z 'Heat �,,� DR. Garage : ��„ v,,, Type Roof Rooms tst Floor BR. Patio Recreation Room: 2nd Floor IN. B Q. B. ;Dormer Dri ewoy l , Tota FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29676 Date. 08 29 03 THIS CERTIFIES that the building NEW DWELLING Location of Property: 295 RABBIT LA -_, �._ EAST MARION (HOUSE N(S. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 17 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 26 2001 pursuant to which Building Permit No. 28,033, Z dated JANUARY 23201 2 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 SINGLE FAMILY DWELLING WITH ATTACHED DECK AS APPLIED FOR. The certificate is issued to BETTER LIVING HOMES INC. _ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-99-0218 0 ,�2a3 ELECTRICAL CERTIFICATE NO. 1101780, PLUMBERS CERTIFICATION DATED OCa 2' 03 JOHN FINGER , a orized Si ature. .._ _ Rev. 1/81 Suffolk Security Systems _. Suffolk Security Systems Incorporated 50300 Main Road PO Box 1355 • Southold NY 11971-0937 Telephone(6:31) 765-5262 • info@suffolksecurity.com i-e of, InsTallation certificat Name System Ra mond Lombardo Location Address 295 Rabbit Lane City,state&Zip Code 11939 East Mardon, NY An alarm system was installed at the above location. As of the date noted below,a U.L.Listed Central Station monitors it. Conditions Monitored X Burglary Propane or Natural Gas X Fire Fire Sprinkler and/or Tamper Carbon Monoxide Other X Low Temperature (42°F) (specify) Spot Water Detection Monitoring Options Digital (phone line) X Test Transmission transmission Daily X Internet transmission X Weekly 3G/4G/CDMA or LTE Monthly transmission System Installed by �w_w Suffolk Security Systems Incorporated 50300 Main Road PO Box 1355 Southold, New York 11971 (631) 765-5262 �'i ned �,. �� Title Office Mana r Date 1/26/2024