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Home My WebLink About1000-64.-5-27 T 'WN 'ou"" F SOUTHOLD 0 W W 40.� t Rental Permit 1096 Owner Robert Bynum Occupied as Single Family Dwelling Located at 1385 Old Shipyard Ln Southold 64.-5-27 Maximum Permitted Occupancy 4 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. 3/20/2024 Code forc j nt Official This Notice must be posted by the main entrance at all times � TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 1 1971A1 4 2 ?92 Telephone(631) 765-1802 Fax (631) 765-9502st „fr° t1dtc 3 RENTAL PERMIT APPLICATION re- Ar Q "I,pCQ Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: (3 s (L / Tax Map Number: 1000 SECTION -BLOCK -LOT Z - SECTION B. OWNER INFORMATION: Property Owner Name: laJ1r Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number(s): Daytime t hW 9Y9L/ Evening Emergency (p31 8-Dk ?9IL/ Property Owner Email Address: Page 1 of 4 q k Section C. Authorized 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): Dayt meC�d u fl"7 Evening Emergen-y'-! -r 7 Email Address: c < 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 I30S 014 gkLwv'79 1'14 . Town Hall Annex Telephone(631)765-1802 54375 Mnin Road Fax(631)765-9502 P.O.Box 1 179 " Southold,NY 1 1 97 1-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime�3 Evening Emergency Email Address: � ` SECTION F. PROPERTY DESCRIPTION: Number of Rental DwellingUnits onproperty: For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, B, Q;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: -W o vie Z .� Page 3 of 5 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: 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 thZla s adopted by the New York State Fire Prevention and Building Code Council. 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 F SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I a A try _, 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: Property Owner's Signature: Sworn to before me this ell day of 0 " I Notary Public Signature and Original Notary Sti mp JOSHUA L.WHALLEY NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 WH6440404 Qualified in Suffolk County My Commission Expires�� Page 4 of 4 TOWN OF SOUTHOLD BUILDING Iraf so cou 631 -765-1802 � 5 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INw [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit [ ] CODE VIOLATION [ ] PRE C/O [ REMARKS: ... S: Ok- 45 ol1 occ V DATE INSPECTOR Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Te1: 631-765-1802 SCTM# Date I .....m.. . .... ........ .,o, ...� Owner n t/ Phone Address Hamlet R.nd (yL. Visible ' �� In e �. .....,. �.. . � ..��...�� w.. .... ....... ... .. _.. .._.__...... _..� .sp ..... .ctor �........_.. �._m.. Floor Level Quantities ��..� .P.�. ,. Sub 1 2 3 Smoke Detectors(not located in bedrooms) 1 � `.... .....� .. ......aaa. Carbon Monoxide Detectors Fire Extinguishers Exits Be drooms 2.. 3 4 5 6 ...Y Smoke Detectors .m �. ... I Egress �/ 1.. i Occu ant Count Z t �...�.w. ...,.<,.. .....�««..,,,,...�,.�.�.. ...........o ..,.. .P„�,�, ,,.,,,._,.� ,..�,_,...a......,,N. .....,,,�, ....�.�,......µ .. .�.,,,�.,�� ®.,,,...»�.�..,,.... .,»,.. ...,, ., _...«.�. ...�.. .,.._.. ,., ..,...,....�.«,., ...,,,m.,,.„m ,. ......mot Building Systems Maintained &Operational Condition of property [Heating Building interior Hot water Building exterior Electrical � � �,.....� � � �.� .. Property clean, maintained � � � ��,�� .� &safe Mechanical p installed &secure 6�.. � o .�......... .u��_..,.� ..,�.� _��.Handrails&guards i.�..�. �.�... ..� ....�� , ........ ._.. .�_s �...... .. . .�...� ..a_. �.,A, .. �........ ., ,.. , .,,, ............. �..�..w a..�...e.. ._�.�..�,.. „F Pool Safety Pool on Site „� 1�. w,�. �. W ,,e,m,,..� .� ..,� ��w. . ...._ . . .., �w,.Ro.,�,� �..,.,., ,e ee ...... Surface water alarm Date of CO issuance ......., .... ,.��..�.. . .. .�..,,� ., .�... ..._.... ....,,,,,.,.., � ..a� � a��. „ m. .,� .. �., w„w,��R , Door alarms Pool completely enclosed .. g gates ;Pool fence to code requirements 1 Self closing/latching ...... .�..�.. �.�.��,�,. ., w _. .. ..�...� _........�.�... ... a�, �. .. .....�.... .M, � .�_,_.. all items resentPrior Rental j p CO s for.. l , ... m. . ...... .... � � . . _ ...._.. ....m_ Comments: ........... .............. . ..... . .......W., a.__ . ., .. . ...... ... ..... . �......... , . ...m.. . . ... �..,, . .0 ..�..,� .. UP E L Deck li 150" x 13' 6" DN Patio 6' 6" x 6' 0" REF OVEN Kitchen 15' 4" x 8' 3 as� Living Room 19' 4'3 x 9' 6" Dining Room 13' 0" x 10' 3 UP Lai UP-4- *7,UP Entry Foyer" Second Leve s 11 Bedroom °N Bedroom 12' 511x9' 6" 12' 5" x12' 5" ... TOWN OF SOUTHOLC PROPERTY R STREET VILLAGE DISTRICT SUB LOT FORME R OWNER.- " . I E ACREAGE C , S W TYPE OF BUILDING RES. S'EASc ,k.V., ,wro....�.. FARM c,. L. bMM IND CB � MISC. � Est Mkt Value LAND IMP. TOTAL DATE REMARKS ,.. ,, _ H, r AGE BUILDING CON DITION _..._..._...w n.... NEW NORMAL BELOW ABOVE Fi ONE Cal: N AVER �.W..�.. .__ ..._... ..... ........_w, .......... ... ...,,, ,... r . e FRONTAGE ON R6AD Acre Value Farm Acre i Value Per .._ ... Tilloble 1 D�KHEPD f Tillable 2 Tillable 3 Woodland . ..."" "( Swampland Brushland House Plot Toto I fH: l I' V e rala. C fl(Ag. !c,xtk..ru:�or.;9'�i Iat.:.rttrrco-:xvd' r � vi.:.rrr Extension Ext. ArlcHs Extension F"re Noce Porch' � ,.rra r yp:e Porch orr'co 11rt Hraa:ufl" rrm ,re Breezeway Pa Nc Rooms 2nd Floor Goroge DI[iveway, D rr-rier" O. B. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-24940 Date MARCH 19. 1997 THIS CERTIFIES that the building ONE FAMILY DOLLING Location of Property 1395 OLD SHIPYARD LANE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 64 Block 5 Lot 27 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 90 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER 2-2 940 dated MARCH 19, 1997 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 ONE FAMILY DWELLING * The certificate is issued to VIRGINIA GORIER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. t Buikiring insp&6tor Rev. 1/81 BUILDING DEPARTMrNT TOWN OF SOUTHOLD HOUSING COOK. INSPECTION REPORT LOCATION: 1„ n5+�beD AHsPr ANE _.. . SOUTHOLD, N-- _. ..,,.,, .._. 5 O D SHI .... RD _._ _ �._m�,_... � ,vy _ ....w_ .. munacl.Pa4Wt ... w.._ SUBDIVISION MAP NO LOT(s) NAME OF OWNER µ_(s), .,., RGI VIRGINIA GOHigR GLE FAMILY _..._. .....� .�owner-tenant ............ ..._..m,_,._. OCCUPANCY SI N��_ ,-,.....,. w._ .,.. ...,. ., ADMITTED BY: SAME REYAVAIT,ADI.( µNPAUL BARER-. w _...._,.m.,. "(1T�".,CO. TAXMAP ACCOMPANIED NOF 000 1 -6 SOURCE OF REQUEST: PAUL A. CAMINITI, ATTY DATE: MARCH.S,w_,1,99„7,µ,WWII . _ ....... ....... ........... _., _............... _........ DWELLING 'T._.._..ww.0 PE ._,. I F.RiTS 2Y OF'.I CONSTRUCTION.,... W00D FRAME,., STORIES j_j.......... ......._. _....,�.........._,.„_�_._._ FOUNDATION BLOCK CELLAR PARTIAL CRAWL SPACE TOTAL ROOMS: IST FLR. 4 2ND FLR. 2 3RD FLR. 1 TOILET ROOM (s UTILITY ROOM BATHROOM (s) PORCH TYPE �.__.. ..._.w._.. __,� DECK,..T........... ., YPg WOOD PATIO — BREEZEWAY FIREPLACE _ ....._. _, m..... GARAFIREPLACELILCO GAS TYPE HEATER YN_._... ��..._... DOMESTIC HOTWATER ILCO GAS ATACONDITIONING TYPE. HEAT LILCO GAS WARM AIR %% HOTWATEA .......w... ._,.,u. OTHER: ACCESSORY STRUCTURES: GARAGE TYPE „,....._ TYPE OF CONST....._...�..,........._..._._.w___....._._.....W....w._..... STORAGE, TYPE CONST-...............SHED ....�_.W..........._._.....,._.......... SWIMMING POOH. GUEST, TYPE. CONST. OTHER: VIOLATIONS: CIIAPTER 45 N.Y_ STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION µ_ .,.-.... ._ART... SEC REMARKS: BP 02,3985-Z-COZ-24938.__...(deck.). .00...,wZ-24939.....(Acgy..S�M.4.R)_...ww_... ........._,....,, ...._.......... .._..... ....... _, INSPECTED BY �.. DATE OF INSPECTION MARCH 7,,1997, REINSPECTED.. 3/13/9 Michael Verity TIME. START 10:30 END 11:00 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. •Z5563" " ' Date . . . . . . . .00 tober. .18 q. . . . . . .. 19.?3. THIS CERTIFIES that the building located at .0ld• •Shipyard. pane. . . . . . . Street Map No. . Potutders. Block No. .7X . . . . . .Lot No. . .21.jf114 . . . . Southold. . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . October. 1gf ., 19. ?2 pursuant to which Building Permit No. 6247Z. . .Ncm;,. .17 , 19. .7Z 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- -(.accessory) •storage-building . . . . . . . . . . . . . . . . . The certificate is issued to . . . .Al. (3ohier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . q!R*. . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No.N'.R' . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . 1385. . . . . . Street . . . . . .Old. Shipyard. IoAae. . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . . 9outboU. . . . . . . . . . . . . . . . . . . . . . . Building Inspelr FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY B No -24938 Date ABM 1. 19 1997 THIS CERTIFIES that the building ADDITION Location of Property 1395 OLD SHIPYARD LANE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section— 64 Block 5 Lot 27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 7f 1997 ursuant to which Building Permit No. 23985-$ dated MARCH 13 1997 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING "AS BUILT" The certificate is issued to VI'RGINIA GORIER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A r lding I speotor Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. j CERTIFICATE OF OCCUPANCY No Z-24939 Dais MARCH 19t 1997 THIS CERTIFIES that the building ACCESSORY Location of Property 1395 OLD SF[IPY LANE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section-64 Block 5 Lot 27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 7 1997 ___pursuant to which Building Permit No. 23985-Z dated MARCH 13 1997 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 SHED "AS BUILT" AS APPLIED FOR. The certificate is issued to VIRGINIA GOHISR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A r i-u ring I'nspe or Rev. 1/81