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Home My WebLink About1000-25.-1-2 TURN OF SOUTHOLD E tlo* gill Rental Permit 1099 Owner Evan & Lynn Lewis Occupied as Single Family Dwelling Located at 795 Oyster Pond Lane Orient 25.-1-2 Maximum Permitted Occupancy 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. 3/21/2024 Code E(forcoent Officia This Notice must be posted by the main entrance at all times 4� . , TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971 0959 Telephone (631) 765-1802 Fax(631) 765-9502llttL)5:f�f/VWyV.S Lltl101dto m .11 gq i �• '-. RENTAL PERMIT APPLICATION Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Property Addr ss: Tax Map Number: 1000 SECTION �--BLOCK— 2-5 -LOT......-J ........ - Z SECTION B. OWNER INFORMATION: Property Owner Name: �---Vam (S Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 53 -P +- Ave- 1 .. N'<\o 5'9 o Telephone Number(s): Daytime 111,74135 Evening Emergency Property Owner Email Address: Vj"�f'wk J Page 1 of 4 Town HaII Annex 6 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 zKK Southold,NY 11971-0959 � tie BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: _ _....._. m...,. _ ._ Address of Authorized Agent(no P.O. Boxes):_, Mailing Address of Authorized Agent: Telephone Number(s): Daytime ening Emergency_,__ 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 Eve ng Emergency_,,,__.___ Email Address: _... .. ...__..._ _._,.._.. ....� . _. �� SECTION E. SITE MANAGER INFORMATION: (required for rental properties containin or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes):, ,,,, _ _ ......._ Page 2 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: 6 Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: Sao II 2 15 xll ° Srti-e - )J ofJA S TION 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. I 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 S1U,F,FIO.LK) i f-yah Lem � ,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: y LM Property Owner's Signature: Swo to befor e thi�-(d%y o A 2 Official Notary Public t ature and Original Notary Stamp DEBORA14 A.W OJCIK Notary Public,State of New York No.4990159 Qualified in Suffolk Count omission Expires Dec.30, f1,' Page 4 of 4 sol TOWN OF SOUTHOLD BUILDING DI 631 76r5r 1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PTBG. j ] FOUNDATION 2ND [ ] INSULATION/CAI. [ FRAMING / STRAPPING [ ] FINAL [ FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS [ FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit [ CODE VIOLATION [ ] PRE C/O [ 1 REMARKS: 4le j09/ IhAi�l w ins ,e4 ................... ................. L/L.7 � �LZIZ L•..a DATE INSPECTOR v TOWN OF SOUTHOLD BUILDING D 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAi [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN' [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O REMARKS: V lot/ IA DATE (let INSPECTOR (oil (yob TOWN OF SOUTHOLD BUILDING 755,1802 IN Pv.C - i 'll0N [ ] FOUNDATION 1ST [ ] ROUGH PL13G. FOUNDATION TND [ INSULATIO CA [ ] FRAMING STRAPPING [X� FIRE INA . 6A t ] FIREPLACE CHIMNEY [ SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O Ak 0 iot:;Aw �-- co T TE INSPECTOR � � , Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 t � Tel: 631-765-1802 , SCTMp#,�, ��,.,� ��o, ,�� ..... . ... �.. �... ... Date..ee�.. ...... �....1 � _. Owner lifit/ Phone .��mm . . s ? ss ..................... � Hamlet ;Ins Visible Address Visi �e.�... ml Inspector ...a .......... Floor Level Quantities Sub 1 2 3 ,m Smoke Detectors knot located in bedrooms) / l Carbon Monoxide Detectors y Fire Extinguishers Exits„ ... . ....... . ...._ . ... .. ...... . _.... ..... Bedrooms 1 2 3 4 5 6 Smoke Detectors �... ._. .. .�.. . ._.. . �, -..... �. L... Egress L�.. Occupant Count.... Building Systems Maintained &Operational I Condition of Property ' Heating [Building interior Hot , r a exterior .„.. .,... Electrical �Hro arty clean, maintained &safe Mechanical Handrails&guards installed &secure , n a Pool Safety Pool on Site . ..,.. ... ...... �...... �. �- Surface water alarm Date of CO issuance .. ......... a...,. ... gfence. enclosed Poo completely Door alarms e � latching gates Pool to code requirements .Self closing/ la. �..�. . ��.�_.. ...... _... ... .. � ,.�... _. ._..�.m.�, �......,,.��. .._ �.n. ... .� ...... �.� O all items present Prior entaN Cs for .w. . .... _,ro �. _........... .. t 4Commens IN... ..,... ..., 4 ...... .. _.. _..,.. . ..m........ ry.. ......... ........ .„ 795 Oyster Pond Lane Orient, NV rental floorplan I combo unit in basement I STEPS BATHROOM 1 DINING AREA E DR vA= 1 KITCHEN SCREENED PORCH 6 14 HROOM 2 LIVING ROOM B, OOM z 111 BED OMlot _ GARAGE } (9 nF Ile =carbon/smoke =carbon monoxide =smoke door Contact: Evan Lewis a 8 8, oz evaniewisa mail,com 9 7. 4 57 � �� I =window TOWN OF SOUTHOLD PROP CARD OWNER STREET �� VILLAGE SUB. LOT 1 E , FORMER OWNER Y g N E ACR. 75 - S W TYPE OF BUILDING Arc fi '- J ell REST 4 ' ° SEAS. VL. FARM COMM CB. MISC. Mkt. Value LAND ° IMP. TOTAL DATE REMARKS f L-51 8 T I D/2 7j G �� _)�� s _ a f�,5/.96�_.%E''C) _�' i}�1f, ACE c, BtDING CONDITI NEW NORMAL BELOW BOE FARM I Acre 1Value Per l 57 Tillabl f��1r7 ' 112�JzOf 4-1 - 9 = _ Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland j FRONTAGE ON ROAD - - . House Plot _ DEPTH ` BULKHEAD Total I DOCK I - . s � i 3 E LOR �� i M i s s ra 3 - 13 _ a II - t - _ -' 25. 1-2 2/2014 L_LLL�iL - � M. Bldg I _/3a.a - �o --/a o ,a.b a o ;�undation Bath / ( Dinette K. " Extension Basement Floors Extension t � �nterior Finish LR t Ext. Walls � 1 t��a+-L n Extension s IRre Place Heat f� DR. Type Roof ; Rooms 1st Floor B I Porch — I Rooms 2nd Floor; =iN. B i � 1 J s_ S0 �� Recreation Room Dormer orF, i3 c �� i , .. } Breezeway U o DrivewaY= 1 I I -------- Garage ul - Patio SQ�� Q 0. B, Total 3 { t 3 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE' SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No, ..32.92............... Date ..............S,apteimlaez.....30..........., 19.68- THIS CERTIFIES that the building located at QyAtex...P4$Ad.LaWO............................... Street Map No. ...................... Block No. ................,..... Lot No.Or183%t.,...maw...y oxk............. ....... M.....»...., conforms substantially to the Application for Building Permit heretofore filed in this office dated ...,..,,,,«,„,.«,«.«,..,.,,, !...« t.».,...»,..».....».. ., 19A@.. pursuant to 'Which Building Permit No. .3872 Z dated ................. I!.•••3i..................... 1A$•.., 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 ........ l®...famlly.. ............»,.,.,............... ............ .,.....»,...... The certificate is issued to .....Cvirt#..Nox)a1m)...«..... .,» .............. ....... ......».......»..........,. (own6r, lessee or tenant) of the aforesaid building, Health Dept. Approval, Jujy 23, 1968, Robert Villa Building Inspector mite Town of Southold 1/9/2019 P.O.Box 1179 53095 Main Rd Southold New York 11971 CERTIFICATE OF OCCUPANCY No: 11361 Date: 12/16/1982 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 795 Oyster Ponds Lane, Orient SCTM#: 473889 Sec/Block/Lot: 25.-1-2 Subdivision: • Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated _ .,. ......8/25/1981 pursuant to which Building Permit No. ............11345_ dated 8/25/1 981 was issued, and a conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: ilmmm art lfr Immd a,a JnJi Jg pgg rxtl! fenc:e., 1 d90 C 1 ?C'wc?rre t ,l�s c1 arlg tax p4 ,1a n� 1 rt i frm i 5 .1 .1 ,t . --1 _ of The certificate is issued to J _._Robert Reeves Jr &Mar one Reeves._.... ... ........._ ..._..... ... ... ..,. . , � .... of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. N 586146 9/17/1981 PLUMBERS CERTIFICATION DATED At.tlm(, t7 A Signature FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. .Z1169.7 . . . . . . . . . Date . . . . day . . . , . „ . . . . . . . . . . . . . . 1983. THIS CERTIFIES that the building . . . . .addition. . . , . . . „ . . ^ " Location of Property 7 useN .Oyster: •Pond .lane • Street 0rzant„ . Hamlet County Tax Map No. 1000 Section . 025. . . . . . .Block . . . .Y�. . . . . . . . .Lot . , 002 Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No, conforms substantially to the Application for Building Permit heretofore filed in this office dated May 24 . . , , , 19 82 pursuant to which Building Permit No. '1'1']�, Z . . . . . . . . . . . . . dated . . . .June .8. . . . . . . . . . . . . . . . . 19 82. ,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 . Robert C. Reeve Jr. , (owner,ldssee or tenant) of the aforesaid building. N/A Suffolk County Department of Health Approval . . . . . . . . . . . . „ . a . . . . . . . . . . . . . . . . . . . . . . . „ . . . UNDERWRITERS CERTIFICATE NO. . . . . . .5g6�46. 4 . . „ . . , . „ . . . . . . . " . . . . . . . . . . . . . . . � .ram: a . . . Building Inspector Rev. 1/81 .....................- Town of Southold Annex 4/29/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 ................. CERTIFICATE OF OCCUPANCY No: 36879 Date: 4/29/2014 ..................---------- ........... THIS CERTIFIES that the building GENERATOR ....... .......... ...... ........................................ Location of Property: 795 Oyster Ponds Ln,Orient, SCTM#: 473889 Sec/Block/Lot: 25.4-2 ..................... Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/8/2013 pursuant to which Building Permit No. 38430 dated 10/21/2013 .............. ----- 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: ACCESSORY GENERATOR AS APPLIED FOR The certificate is issued to Reeves Jr,Robert&Reeves,Marjorie ................. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ............ ELECTRICAL CERTIFICATE NO. 38430 04-23-2014 ........... ..................... PLUMBERS CERTIFICATION DATED ............ Authorized Signature V,A N LEWIS 453 Park Ave, Rye NY 10580 917.848.5702 evanlewisl Cgmain, .o �e - February 28, 2024 Southold Township Southold Town Hall Annex 54375 Main Road PO Box 1 179 Southold, NY 1 1 971-1 1 79 Ms. Horton, Please find enclosed check #462 for$300 related to the rental permit application and associated inspection for my property located at 795 Oyster Ponds Lane, Orient NY 1 1957. If you have any questions, please don't hesitate to contact me at: ev,anlewis-i grnr.ffL(- r n 917.848.5702 Sincerely, Evan Lewis