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Home My WebLink About1000-75.-4-4 TOWN OF SOUTHOLD a€ Rental Permit 1202 Owner William & Dana Lehnert Occupied as Single Family Dwelling Located at 795 S Harbor Rd Southold 75-4-4 Maximum Permitted Occupancy 3 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. 9/17/2024 Code E .for ant ofci 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 11971-0959 Telephone (631) 765-1802 Fax(631) 765-9502 htas://%Aww.south(ll to n t m � .`.. RENTAL PERMIT APPLICATION . "G E Rental Permit Fee $300 (Application must be renewed every two years) q _�-a� �� _ Section A. Property Information: Rental Property Address: 74S p� h i Tax Map Number: 1000 SECTION 117M y q -BLOCK 7 -LOT SECTION B. OWNER INFORMATION: Property Owner Name: %� �(' M � ' Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 106 &WL Q �-e Telephone Number(s): Daytime G Evening Emergency '6 /,� VA Property Owner Email Address w L I_ M 0 y� c/ Cam Page 1 of 4 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): Daytime Evening 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): Daytim Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containin more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Mailing Address of Managing Ag Telephone Number(s) ytime Evening Emergency Email Addres .. Page 2 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, 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: -�—I V O)Q, I 1 Use and Dimensions of each room in Rental Dwelling Unit: / i/ k17 �o irk )d /U it 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 a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 0 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) (J 1 �10 (V,, Le—kn�A7, 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,LorSite Mana er. Property Owner's Name: Property Owner's Signature: Sworn to before me this X day of 20-0&1- Official Notary P blic Signature and iginal Notary Stamp :w �'r. IIRUP'4A L. COOMA N i , NOTARY" PUSLIC-STAT6 OF NEW YO11 ,0,1C0630318 ! 141 I44d in Suffolk County Page 4 of 4 My Commission Expires `t7-Z; of sore° TOWN OF SOUTHOLD BUILDING DEPT. eI,1 631-765-1802 lNtiECTIONAgrakL r [ ] 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 e �sAge gs,00 .0c s DATE 1IMSPECTOR N y Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 � ...... �.._. S �............ ....w.....SUM # ��— �/ Date �..-._ ; .. mm..��. ,.� ........ .........! Owner , Phone ... _..... .. Address 6J f . H4 Visible ,m.._. _ a ........ _. �HamHamlet �__. - __._ ............ Ins ecto let _.. _. p ..._...r. ............. .. .... �� _......... ..... ..... . �.... .... ... ..... . ., . . _.-.......... ... Floor Level Quantities 3 ......a�.�._.._ _.. .��. �� ....��.. . ��....�� sties Sub ... ..... . ..� Smoke Detectors (not located in bedrooms) 1 �. .m� w a,..._.. ..... ........_ _...�_.._ . ... .� --_--- ,---------,--- _ ... � .....al.... ...... .w ... a......._a............�..._ ors t...�.--,Fire,-a E tingu shed Detectors � _ � �.,�.. .. ..... ...... ...., Exits, _.,,.- ..... ....... � _ � �... .._. � . ,......, Bedrooms 1 2 �. .... .. . _. 3 4 5 6 Smoke Detectors � .... .�.... ...., �.�; Egress .�,. Occupant Count � ...�...�.. ....�.,.�_.... ... ..a....... .�...... . �� ....�.. _ .... ... .w._..._... ..� Building Systems Maintained &Operational Condition of Property Heating Building interior ..a. . . _ ��m. ... . _. ..........a . .. ,, _....._. -...... .. ...... ... . Hot water Building exterior Electrical Property clean, maintained &safe Mechanical Handrails&guards installed & secure .�.� �. Date on Site �"S'or9 facefwater alarmw_ ... ... ._.��Pool o .m...�. a........ ...,b..m.m_,.w_ ._.._.. ......_..�� ..� ��.._aa� f CO issuance Door alarms Pool completely enclosed Self closing latching gates Pool fence to code requirements • CO s for . .�.. .all items present rv.. .. NNtln Prior Rental j �.omments:... .... .... .. ....... .. .... ..... .µ . ... _. .. . .. . . _ ... I . - . . - « �» � \ - , ;- ! . . - . . , °S oil oil , � - !! y , - .. ., R ; , , =� EXISTING FIRST FLOOR PLAN LE/\ERT RE51UE\CE 79/ SOUƒ/ HARBOR RU 50UTMOLD, NY 1 e TOWN OF SOUTHOLD PROPERTY RECORD .�. - OWNER STREET VILLAGE DIST. SUB. LOT t _ _ �: . A = ; - RMERt OWNER N E ACR. S W TYPE OF BUILDING E RES. . SEAS. !VL. iFARM COMM. CB. MISC. Mkt. Value LAND IMP, TOTAL DATE REMARKS _ ,1 . I y .mot Z . i - i AGE BUILDING CONDITION NEW NORMAL s BELOW ABOVE FARM Acre Value Per ( Value Acre Tillable 1 Tillable 2 Tillable 3 Woodland f i Swampland FRONTAGE ON WATER Brushlond t i FRONTAGE ON ROAD House Plot 1 DEPTH ' BULKHEAD Total I DOCK i i F -; COLOR 7 r I : TRIM x 3 f 3 l I 75.-4-4 3/26/2019 ' i M. Bldg, 1 F -� ;Foundation � ja Bath / Dinette Extension I = 'Basement Floors K Extension ! �Ext. Walls Vliy�� T��interior Finish ; 'LR. y 1/ � _ Extension lFire Place £Heat G I L) 'r 1- I DR. i Type Roof Rooms 1 st Floor ;BR. i Porch ;Recreation Room Rooms 2nd Floors FIN. B Porch I 'Dormer s � I Breezeway t driveway Garage Patio I � j I 0. B. i Total e i Town of Southold 2/21/2018 n 53095 Main Rd b Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 39497 Date: 2/21/2018 THIS CERTIFIES that the structure(s)located at: 795 S Harbor Rd., Southold SCTM#: 473889 Sec/Block/Lot: 75.4-4 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 39497 dated 2/21/2018 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: 1 'CJOD I R E ONE rAMILY DWELLING. I.I tecl 2/2I/2 18 to r ove eltric vic�l,atic�n. The certificate is issued to Kramkowski, Jean ......__.._.... (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 75-4-4 PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. �.. . . ....... u_ .. a.. Signature ..�...... ..._...� BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 795 S Harbor Rd., Southold .. . .. ..................... .. . ..w.. ..SUBw__.. _�... ..... SUFF.CO.TAX MAP NO.: 75.-4-4 DNISION: .. .. NAME OF OWNER(S): KramwskiJean ko ...........�.�..._..............._ OCCUPANCY: ADMITTEDBY: Jean Lehr m Kra�WkW.WW owski ---_._._ �......ww�w_._�w_.__............._.....__mmm__�w�w_�w....._. ..�........ww_ _ SOURCE OF REQUEST: Kramkowski,Jean _..........w_ww ..__.. DATE: 2/2 201 Q 1/2018 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: Cement Block CELLAR: no CRAWL SPACE: Yes ........................................,....____ BATHROOM(S): 1 .TOIL ..... _. _. _..� ET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: Pavers BREEZEWAY: _.....M.M._........_.._..__ _. .w._ _...w_._...�....,,,,, .�,�_ �wwww...._......... FIREPLACE: 0 GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER:_._._.. oil AIR CONDITIONIN G: TYPE HEAT: oil WARM'AIR: w IT HOT WATER: baseboard _.... .................... #BEDROOMS: 2 — ._#KITCHENS ....__........._ .....__..__.B— 1 ASEMENT TYPE: none OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 1/2/2018 TIME START: END: w s E P 1 2024 Department eSCUth Old Moved from here At detector in rear hallway r 124 i ,a/ / / / I / f / i / l / i o i i / I t / diot's to S E F 1 6 211,1 In rear µto DIN DES. hallway TOWN '11F Moved irk �om�ib r�udra uviNy�l,. from err y 4 t di d r, wc u u I I � 1 ; JOHN DE REEDER LICENSED ASSOCIATE REAL ESTATE BROKER DOUGLAS ELLIMAN REAL ESTATE MORE THAN FOUR DECADES OF EXPERT REAL ESTATE SERVICE ON LONG ISLAND'S BEAUTIFUL NORTH FORK DIRECT:631.298.6161 OFFICE:631.298.8000 FAX:631.298.8133 11700 MAIN RD, PO BOX 1410,MATTITUCK,NY 11952 CLICK HERE NYS HOUSING DISCRIMINATION DISCLOSURE NOTICE,&FORM CLICK HERE NYS TENANTS'RIGHTS TO REASONABLE ACCOMMODATIONS FOR PERSONS WITH DISABILITIES 2