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Home My WebLink About1000-144.-3-12 x TOWN OF SOUTHOLD N Rental Permit Ar- �t 1219 Owner 2135 Marlene Ln LLC Occupied as Single Family Dwelling Located at 2135 Marlene Lane Laurel 144.-3-12 Maximum Permitted Occupancy 8 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. 10/28/2024 Cod n rc nt Official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road " Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD BUIWI1461DEPT 70WN O= OUT OLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Lit �� f(9SZ Tax Map Number: 1000 SECTION 106V -BLOCK l i -LOT �Z SECTION B. OWNER INFORMATION: I �-�� Z-LC Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: -z-13< lwU"e lA"t- I( Ii .(V_ .4,(( Telephone Number(s): Daytime ✓Evening Emergency ( t�7 3 Property Owner Email Address: 4/-5 S117 Le, t `�l tom � > " Page 1 of 5 VS Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971 0959 ' BUILDING DEPARTMENT TOWN OF SOU OLD Section C. Authorized Agent Information: kt Name of Authorized Agent of dwelling unit,if any: _ C �' �" Address of Authorized Agent(no P.O. Boxes):kj- Mailing Address of Authorized Agent: Ik.. tC, `({„, ..,�'"` _441 U S 64•<Z,7- cw Emergency__::-- Telephone Number(s): Daytimes_ Evening geney — Email Address: „��`S S I �qV °`\ 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 S 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 Town Hall Annex "� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 eou Plb'tz c ur , BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: �1� IDS � Telephone Number(s): Daytime Evenin Emergency Email Address: S I I i 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. l Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: LL Page 3 of 5 � rqt s Town Hall Annex a�; Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box It 79 Southold,NY 1 1 97 1-0959 o v y�� BUILDING DEPARTMENT TOWN OF SOLYMOLD 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. CY 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) t 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 Page 4 of 5 Town Hall Annex "( Telephone(631)765-1802 54375 Main Road h �` Fax(631)765-9502 P.O.Box 1 179 a' Southold,NY 11971-0959 r BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. I 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: ��,,. �'„ L e-10 �� Property Owner's Signature: Sworn to before me this day of n�1 r . 20 Official Notary Public Signature and Original Notary Stamp CONNIE D. BUNCH Notary Public,State of New York No.01 BU6185050 lualified in Suffolk County Conirnission Exoires April 14, 2-0a-y Page 5 of 5 A��m� TOWN OF St i►UTHOLO! 61ILDING DEPT., 631-765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ v FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARK.- M �V, --O:x O� ................ DATE INSPECTO "` .........o.��.�......�. „, i CoN►�0 f r ��i r iemwum G SWrv,,,,uXw„Mmm+wi.ua�na„mumw�mul'wuawmwM1w�wrmromo mwuwdmmmu„.i„�.tarwrvwuo,�Mvww�uwmmMummmso,oNwvrvw�m mwmm muo„wrnmawtl A„.W;mewavenY�f!4Mu,,,. .. mawwwl2�Wm mWW.rouaYlON,m,,,m N¢u'ammr,N,mwo mmni.M��.m'�rvMa'aa'2MNprv. m�Mpm N+mua.waw.�'whuiM:NMMvw�Rm s Q = { \vim\\ v w ;NM MV 41, \ , � TOWN OF SOUTHOLD PROPERTY � Lp►Kv Prr - QWA11R STREET ; = VILLAGE DIST.1 SUB. LOT' e v R N E ACR.'4 ' el S _ W l TYPE OF BUILDING' Y RES SEAS. 'VL. FARM 1COMM, CB. MISC. Mkt. Value o LAND IMP. TOTAL i DATE REMARKS Cs=� :/ � C-` � �r 7 �' i �C = '� �'O� A � �' ° T ,L. � f'f IC d !d✓k �d ��1'�J�.f��:�7�1! W F - - _ = — f AGE BUILDING CONDITION 0' 1 . �4 •� NEW NORMAL BELOW ABOVE = y FAQ _ Acre Value Per Value y Ac re Tillable l s1 Tillable 2 l l \ I Tillable 3 Woodland l Swampland FRONTAGE ON WATER' FRONTAGE ON:,ROAD Brushlo-Ad I �. DEPTH House Plot Total = ip- y o� —c g E TRIM 144.-3-12 11/11 _- F � F Foundation " a Dinette Bath Ak Bldg Basement �� `a = I F r- � � �K loors � F� g IExt. Walls Interior Finish LR. s i .. e H R F � f � ,tea a Sig i ;Fire Place eat ^ D Type Roof Rooms 1st Floor _ B . e > 0 s 1 _ - _ .` ;Rooms 2nd Flocr FIN. B = C' Recreation Room Porch r �Dorme�� i Driveway i Breezeway _ y -x Garage E � x �7 = e � Patio � s- a , 0 66 a Total - 7/0 v. l 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- 26986 Date: 03/14/00 THIS CERTIFIES that the building DWELLING Location of Property 2135 MARLENE LA MATT/LAUREL (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 144 Block 0003 Lot 012 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to AP'RIL 9 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 26986 dated MARCH 14 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 ATTACHED ONE CAR GARAGE The certificate is issued to RAYMOND FLANAGAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. r ut rized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD zxkm LOCATION: SUBDIVISION: MAP NO-1 LOT (S) NAME OF OWNER (S) : OCCUPANCY: ADMITTED BY: Tnna mwuu ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAR MAP NO.; SOURCE OF REQUEST: DATE: 4313,4/40 DWRLLI_NG•_ TYPE OF CONSTRUCTION: STORIES: _j.0 # EXITS: CELLAR „ " CRAWL SPACE: 1/4 FOUNDATION: 7TOTAL ROOMS 0 BATHROOM{S : _ 2.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) : : PLATE PORCH TYPE: DECK TYPE, _......W w PATIO TYPE BREEZEWAY: FIREPLACE: GARAGE: R DOMESTIC HOTWATER: _ TYPE HEATER: LTPA GAS AIRCONDITIONING: YRR TYPE HEAT: LIPA G8S— WARM AIR: _,U........._ HOTWATER: OTHER: ....."" GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: �www SWIMMING POOL: GUEST, TYPE CONST.: OTHER: ------� VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE to a i It � { d q � q N � : y w { r REMARKS: INSPECTED BY: _w DATE ON INSPECTION: 03/13/00 F +H TIME START: j 0 i .4 AM END.- 10:4 0 AM Town of Southold Annex 9/19/2011 t 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35224 Date: 9/19/2011 THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: 2135 Marlene Ln, Mattituck, SCTM#: 473889 Sec/Block/Lot: 144.-3-12 Subdivision: Filed Map No. Lot No. ....................conforms substantially to the Application for Building Permit heretofore filed in this officed dated 2/7/2011 pursuant to which Building Permit No. 36168 dated 2/7/2011 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: 22'X 24'addit jqAAjMk._fqtpj1y dwelling, The certificate is issued to Singleton,Joseph&Singleton,Mary (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 36168 9/16/11 PLUMBERS CERTIFICATION DATED tlt rized ignat re Town of Southold P.O. Box 1179 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 45691 Date: 10/26/2024 THIS CERTIFIES that the building SINGLE FAMILY DWELLING-ADDITION AND A.I.x°I"'1:;I ATION Location of Property: 2135 Marlene Ln Laurel NY 11948 Sec/Block/Lot: 144.-3-12 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 05/09/2024 Pursuant to which Building Permit No. 50890 and dated: 07/01/2024 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: "as built" finished basement with one bedroom, one bathroom and playroom, to existing single family dwelling as applied for. The certificate is issued to: 2135 Marlene Ln LLC Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 50890 09/11/2024 _.w.. 7/2024 PLUMBERS CERTIFICATION: Chris Sinu�eton..09 1...w................................................................ ._� ...ww...........................w uth r' .ed w.ignature