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Home My WebLink About1000-68.-3-6 o .� = c O 0 u (� L r� 5 0- W tl r M M 0) o 00 v) = N e o U U � O w c 0 (a Co U O ca a c Loi cc bA � m r 1 c L .,� co c o v —_, U) E ♦+ Q co c ca c LA v O Q r .. .... 1J o o a um F- >- �, v L 0 a zCD vm (D ZMy o li o �' a) E MM "" D c v o 0- = z N U N ca cn .x rn o low cu Q CD -0 a� E � o cn CU r' �P�40,, � cu U (, N O /q 0 p \ t, U U " c.� U a� k TONff OF SC7rUTHOLD-]BUILDING DEPARTMENT ' Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold; NY 11971-09 1. , Telephone (631) 765-1802 Fax (631) 765-9502 Iittp ://www� ,�.thoJ�1t° n w c , D 7 RENTAL PERMIT APPLICATION r't C.'+ I p-1 81( Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 0 o t-T M AP-St LAKe S nvr�toL.o Tax Map Number: 1000 SECTION (93 -BLOCK 3 -LOT t7 - SECTION B. OWNER INFORMATION: Property Owner Name: JE'6 C) L L C Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 5- WemDpyef� �Z-V• 1 S EADD VEEZ EZD. c' ( (3 N`I l t 73 oafs Telephone Number (s): Daytime Evening_Emergency Property Owner Email Address: ja(A-te I e yj e q f��1 •Ca m Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Fp-�MtK -rArylA-yp Lei/A Address of Authorized Agent (no P.O. Boxes): �J3`J S-E rJ&0 f► V£• 1812.00KL�4 1\1 Mailing Address of Authorized Agent: l ' '(T ( - 1 -1 - : I -9 sa Telephone Number (s): Daytime Evening Emergency Email Address: VL c u1e ll r:e5 �evt'�"I t h C O M 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: I 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: iD Use and Dimensions of each room in Rental Dwelling Unit: $trn"6, ARM t20 JJ %2t-7�4 �►-{,' ��4" Q�-�► V. Dim. t - ?.h�� (5�8" t�tT. 2t 4%c RKO& ► #2 W-fl;-to!tt a owett W-Ln'x 2l=2v 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. I am requesting afire 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) I -k, L,e 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. a� Property Owner's Name: Property Owner's Signature: --'" JA Sworn to before me this day of , 207(q �� r^wll k-,StpW aaf Naw)(rj* Official Notary Public Si n tu4i ? ,+ 7h�f— Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: _D6c� �/ �►C!i v 4410 co o kovsz Pt �tf, DATE -o? INSPECTOR Town Hall Annex �� may„ Telephone (631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1179 �� Southold, NY 11971-0959 nl BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seal re Mired for Architect or En ineer Licensed Home Ins actor mu provide cogy of valid current certification Rental Property SCTM Number: Woo by — 3 — Rental Property Address: LAPF= 0 c1OL-.Q 4wnerlf4arne; Rental Dwelling Unit Identifier: i Number& Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 —100 sqft., Bedroom#2—90 sgft., etc.) m rA- # t • A30 ch Livalof a Property Description (Include all improvements indicated on survey) — I SM I ACO O I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Sou t0enti'al Code of New York State, the Building Code of New York State,the Plumbing Coo Statb�the fl Fuel-Gas- o c►f New York State,the Fire Code of New York State,the Property o kNew York State and th r nergy Cons rvation Construction Code of New Yor nM;� Print Name and Title i at Please place Professional-Sean ., , trc 26"x:3VS` LE"x:3^ ?6"x3a I"NEE L'A1S' CASE. CASE. CASE. u,er, rnnr��uriim�w.nlrrxrrr„r",✓Nww w"„arrruuvr�r,Wwturrrun�!�' �;a"rrzrf fr 4if� �°.... ,�r "�"" — Is SlTTVNG. RII BEC:➢RG`bC.)Yv1 �. '7t7'36:t.fr'f. _ L3(7 so,-�I. f r VI 4Gj� 10 dnN4jYP 1p J vli uw, IN CAD LIVING 8, DINING ROOM wM�M f ac saE.r�-. aww unv RA114400i' r m 14l I CII IERV ....... JYRk'YC54YPf°w� Ar 6.G� 1 • OHM 'Yekl .,,..dr' q e f r a F3E.Y.`.YRC1C„M 92 ENCLOSED F'6>RCH t r'1'rerrryrrrGrp26"'.ro�,�mirroiwCire'we �rw('v 'Giwlurv�iul N,;ofi,tl 1010 SALT MARSH LANE SCTM# 1000-68.-3-6 FLOOR PLAN 1/4" = V-0" 5.9.24 `1 y wR M1 O n n µ� r SZ i t Qei cz 4zss JJ ' r a «= UA CO r °p w w w z z g �, m O O � u o ' H Ile IL w Q _ _z z Y wR ," ', O O a J U O y 0 _ LL.. U`LLI �.. .. . ... w..... W6 '� w.... _...,.,.._. _.. _ O L { u Ij rq 1 Q ice ,� o J G� p I w ci, rl m c Q v Z W O p> . LLI _ Ar _ _ � ._ .._ m__ w... .� . gym..... � .....,...�.._....w _.. . .....n __.._... ..._ _.. ._ ... .' _._._ _. ..._, I NJ .............»... ..,. ..�,., 9 ........ p _.n ..... _ .. Ll CV �» Ln o E L •L �+ +. 8N 0 p p V i� A .,...... ,.,,,,..».. ,,,,...».............. �.....,,,»,. ..».»,., E J 1- O Q. vce p L x p m I 0 d \.. -- o o.. i � •.9 in •w •� V� � N p m o W W W �i�,ll" n. CL 0 F— �G 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- 31662 Date: 07Li0 THIS CERTIFIES that the building DWELLING Location of Property 1010 SALT MARSH LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 068 Block 0003 Lot 006 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 31662 dated JULY 10, 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 ONE FAMILY DWELLING WITH .ACCESSORY GARAGE AND ACCESSORY UNHEATED GUEST COTTA E* The certificate is issued to MICAEL & ARLINE YOUNG (OWNER) of the aforesaid building. SUFFOLK L90UNTY DEPART CST OF HEALTH APPROVAL NZA ELSCPRICAL CERTIFICATE NO. N/A „ PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. -A#or. zed Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT ............ IOCATIOR: 1010 SALT MARSH LA PECIONIC SUBDIVISION: MAP NO.: LOT (S) BANE OF OWNER (S) &_ARLINF Y,0Uj!E1jA4__._ OCCUPANCY: SrNGLP FAMILY DWELLING MICHAEL ARL[NF YOUNGMA14 ADMITTED BY: MR. YOUNGMAN ACCOMPANIED BY. SAME KEY AVAILABLE: SUFF. Co_ TAX MAP NO.. 68.-3-6 SOURCE OF REQUEST: OLSEN & OLSEN,-_LL-P 611 DATE: DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME—— # STORIES: 1.0 # EXITS: 2 FOUNDATION.• CEMENT BLOCK CELLAR: _ CRAWL SPACE. XX TOTAL ROOKS: 1ST FLR. 3 2ND FLR.: 0 3RD FLR-: 0 BAlnlROOM(S) 0 TOILET ROOM(S); 0.0 UTILITY ROOM(S): PORCH TYPE: ENCLOSED.(UNHEAJER)_.,.. DECK TYPE: PATIO TYPE: ............ BREEZEWAY: FIREPLACE: ONE GARAGE: DOl�STIC s TYPE BEATER: ELECTRIC AIRCONDITIONING- E PROPANE � w AIR: FLOOR HEATER IOTIATIR: OTHER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.. ONE CAR WOOD_FRAME STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST-: UNHEATED GUEST COTTAGE OTHER- VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION II REWD&RKS: BP#18099Z-COZ-19323(ADD)BP#27917Z-COZ26673(ACCY GARAGE AS PER COND, of ZW5129 ted 4/ (0/02--Elec.Cert #2103594 dated 6/29/ 339SIPEDCTED BY: y DATE ON INSPECTION- .0 GARY PI TIME START: 9:30 AM END: 10:00 AM tt fw FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19323 Date AUGUST 28 1990 THIS CERTIFIES that the building ADDITION Location of Propertlr 1010 SALT MARSH LANE PECONIC, NEW YORL House No. Street Hamlet County Tax Map No. 1000 Section 68 Block 3 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Ma 3 1989 _____pursuant to which Building Permit No. 18099 Z dated MAY 5, 1989 was issued, and conforms to all of the requirements of the applicable provisions of the law. Th=::N:%TDZNCE r which this certificate is issued is A"0L11T10 TO AS APPLIED FOR. alltl �d�Q-C. The certificate is issued to & ARLINE YOUNGMAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N- 108435 w DECEMBER 27 1989 PLUMBERS CERTIFICATION DATED N A Building Inspector Rev. 1/81 v u FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28673 Date: 08 12 02 THIS CERTIFIES that the building ACCESSORY Location of Property: . 1010 SALT MARSH LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 68 Block 3 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUKE 1 2001 pursuant to which Building Permit No. 27917-Z dated NO"C,JEMBER 19 2001 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 ONE CAR GARAGE AS APPLIED FOR. ZBA #5129 DATED 4 18 02. The certificate is issued to MICHAEL YOUNGMAN & WF: (OWNER) of the aforesaid building. Su"OLK COUNTY DEPARTMMU OF HEALTH APPROVAL N A BLSCTRICAL CSRTIFICAT$ NO. N/A PLUMBERS CERTIFICATION DATArVIN toil 60, 91 " ut rized .ignature Rev. 1/81 SURVEY OF PROPERTY AT PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK 1000-68-03-06 SCALE: 1"=30' FEB 14, '2002 LON�+' IS�ND SOUND N 6 •i r r, ttl m TI 2 r`1 ' A J; ri rr+ b Um 2 w.r h N r6d b 40 70 rn A0 0 p 67 1�- 33' RIGgT OF MAY �F qtE 0F �.* h ND a9r51E7 AREA=30,023 S.F. a � r „ A +au rCvrarrpa';pw awv aM0.6ppwpM'Ma Mq'W rrara s'!.wsaiC M5 w�p'aap, aua�.wa fi ,?P ✓lr,a °�# .f kkA,r�u,;3P) 765-1797 YM+ 7AA'P xd A' &P'- pna+Mao wr r4.' AWE P.P"C"W.k.w �❑ TIE ��E yt eresr as ¢� awa�prr•aeaarwratnm *Aa r' azrrmMa'xx 4 pCY " t Atb ur a mM�A a MWA r aad%1w lw n�rr yu aAwar. aea R w„ a'car .a �nP ram. srwcrr,w cawa��r mru�wweamwxa• �'m¢aaa.a�« 9 g"Cr'E ,p"