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HomeMy WebLinkAbout1000-88.-1-1.5 i TOWN OF SOUTHOLD Rental Permit - 1241 Owner 425 Jacobs Ln LLC Occupied as Single Family Dwelling Located at 425 Jacobs Lane Southold 88-1-1.5 Maximum Permitted Occupancy 10 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. 12/17/2024 ode car el-Official This Notice must be posted by the main entrance at all times j2 ( 2 � TOWN OF SOUTHOLD—BUILDING DEPARTMENT M/ Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959� L a4 Telephone (631) 765-1802 Fax(631) 765-9502 tt,s://www.sOtitl olds°owt°tip , �°ov RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two eons " J A �.� Section A. Property Information: Rental Property Address: 425 �acabs (-e�►'�e Sou y l -1 Tax Map Number: 1000 SECTION 0* 8 OD -1 LOCK 1 ' CC) -LOT 00 9- SECTION B. OWNER INFORMATION: 1�, P Property Owner Name: `� dwdb - s Lane- L 'C Nro IeKk l , � J g at wq Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) i �° A00a Kdench )-+s (� &09 W A:Pt _3 I • s, Telephone Number (s): Daytime �R �`LJ'5 TveLng Emergency Property Owner Email Address: ODS Ij 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): 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: 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 Uni Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: LR; 20 (� 1 a d3+� l X . 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 ❑ 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 -*, f k.K) 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. 1f2� �` ��1 e Ll�C Property Owner's Name: J � r� Property Owner's Signature: -`°�' Sworn to before me this day of , �'�. -�::� ..�=� '? , 20�5 4 n Official Notary Pu " Signature and Original Notary Stamp NOTARY PUBLIC STATEI NEW YORK REGISTRATION No.OILA6140445 QUALIFIED IN NEW YORK COUNTY COMMISSION EXPIRES JAN 30,2026 Page 4 of 4 so TOWN OF SOUTHOLD BUILDING DEFT. un 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL AL) [ ] CODE VIOLATION [ ] PRE C/O [ (F RENTAL RE RKS: 0 DATE � b � � � � INSPECTOR s_ _ TOWN OF SOUTHOLD PROPERTY REGC OWNER STREET VILLAGE DISTJ SUB LOT oh _� ACR. REMARKS s F TYPE OF BLD, PROP . CLA / LAND IMP- TOTAL DATE V, F 12. _p. . i%. � 3 , t F�. �I�-� � i3P-t`�7 _�i-— ,J�•�`� /�-l�+'- , i r� ;'�_ /c.' o _ s� 3e 3 s . - FRONTAGE ON WATER TILLABLE {° ?© FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND 1 BULKHEAD HOUSE/LOT TOTAL \ \ \ \\ �f T ,p> �l7 � 88-1-1.5 1/02 £. 88-1-1.5 BARN 9/02 s M. Bt -- — Foundation Bath 7 Dinette a • lr z 3 Ut Extension Basement Floors Kit. l� Y _`e.. � s �� SLAB Extension -. Interior Finish L.R- j .' Ext. Walls ;_� � / 0 Fire Place Heat D.R, 1 , / Woodstove BR. Dormer Porch U � Attic i Deck I y � = ���' �S ��(� Rooms 1st Floor Garage !L � Driveway Rooms 2nd Floor O.B. f t 3 -F x Pool— c I - ey g z Datc3TIFaCIIE IL.516,66M0600 T.*5712063795 iE,,%YIllWiGu5Yomar5eniiae@d&MraaefHleicom Certificate of occupancy Search TITLE #: SP50518-S DATE:6/24/2024 PREPARED FOR:SPANO ABSTRACT SERVICE CORP. (SPA) ORDER ID: 12536889 PREMISES: 425 JACOBS LANE, SOUTHOLD State: NY County: SUFFOLK Town: SOUTHOLD Unincorp: SOUTHOLD District: 1000 Section: 088.00 Block: 01.00 Lot: 001.005 A search of the Building Department records in reference to the above mentioned premises has revealed the following information: Certificate of Occupancy #Z28260 issued on 3/6/2002 under permit #27401 for a one family dwelling with covered front porch and attached two car garage. Certificate of Occupancy #Z29649 issued on 8/19/2003 under permit #28117 for a horse barn. Certificate of Occupancy #35021 issued on 6/24/2011 under permit #35746 for run in shed addition to an existing barn. Certificate of Occupancy #37245 issued on 10/31/2014 under permit #37691 for a deck addition and existing unfinished room altered to bedroom for a bed and breakfast. Certificate of Occupancy #39342 issued on 11/16/2017 under permit #41708 for roof mounted solar panels to an existing one family dwelling. Certificate of Occupancy #40047 issued on 11/14/2018 under permit #41676 for stoop addition and alterations. Certificate of Occupancy #42083 issued on 6/15/2021 under permit #45048 for an accessory inground swimming pool fenced to code. IMPORTANT NOTICE ABOUT SEARCH INFORMATION HEREIN DATATRACE INFORMATION SERVICES,LLC DISCLAIMS ANY AND ALL LIABILITY TO ANY PERSON OR ENTITY FOR THE PROPER PERFORMANCE OF SERVICES REFLECTING THE CONDITION OF TITLE TO REAL PROPERTY.THIS SEARCH WAS COMPILED FROM PUBLIC RECORDS MADE AVAILABLE FROM VARIOUS COUNTYAND MUNICIPAL OFFICES,AGENCIES AND DEPARTMENTS. THE SERVICES ARE PROVIDED"AS IS"WITHOUT WARRANTY OF ANY KIND,EITHER EXPRESS OR IMPLIED,INCLUDING WITHOUT LIMITATION ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FORA PARTICULAR PURPOSE,OR WARRANTIES BASED ON COURSE OF DEAL,ING OR USAGE IN TRADE OR ERRORS OR OMISSIONS RESULTING FROM NEGLIGENCE,MIS- INDEXING,MIS-POSTING OR ITEMS THAT ARE AFTER THE EFFECTIVE DATE OF THE SEARCH.THIS IS NOTAN INSURED SERVICE THIS DISCLAIMER SUPERSEDES ALL PRIOR AND CONTEMPORANEOUS UNDERSTANDINGS.THE SERVICES ARE EXCLUSIVELY FOR DATATRACE CLIENT AND NOT FOR THE BENEFIT OF ANY THIRD PARTIES ,offt lInrV tbAt the c :L 'mar. - U* wbicmL Mad n ' 400 aA!twd" •� the ftT" xt'9 'lour- as , myw fw ' tff I *VP=jam ' lawu �� to lonvad tot or Nam SLAMUMOL C042zm=�+- ILVOOMM = MAIM' Q f „ vol' OF -GOB= u= ce the suiWizemo TOAM sail N k Ir wA" VA"Ivisim - so. a t i ,OV " fjU& in datedwas jwsm�a, d VW%f=m tQ all ^of the 114UirGwwwG ' . b " .Vio u 'o a �1�: z ismued yi is Vo- ,Lo ="i z:e5d V � qq$ Imm of Sootbo4d Asa" $ "M , Wo Road CERTIFICATE 'OF OCCUPANCY "I to; 3 .OlIl D / /2011 ft%wW. 425 JACOBS LA'so i l low.. FAed Map No. f t N . conform:substanUi4 to flw n for Bufldmg P=dt her was issuodand cwfomnslo All ofthe he aWjjcabk provisioosd.; w. Tbeoccupancy for whiob fttismtfifica certi` e is inued to lob :iUiomToth,Vicki (OWNER) ELECrRSCAL CERTMCATE NO. �. . M Rex 1179 54375 Miim Rood 'loto CERTIFICATE F 37 . 10131,12014 1 Locadon,of ftvputy.- 425,,Sacdbs L,SmffiA S "vi " No. Lot No. 12/4/2,012 PwmwUA to WN&Bummaga No. 37691 12/1 l b vAdch tbiscettificft is issued 1 . dwk addition andexistingumfuished romwittered1 d ggrgkfast1 ,E (OWNER) 'T soduldd 11/1 1 rjo.BOX 1179 r 5 SOU601d,New York 1197 . 39342 Dabnll1F ' a g 'SOLAR PANEL Lecadme orrr*. 425,jacobs Lt,mold No. lot No. conftm substanbAy to lbe for BWldij39F=mnft bCV0lQfbrC o , emu" c • ,ble pr i �of - TbrICCOVaneYfOr whiobdus,cert, ficate mtfflcate b Issued to Nappa,AnIhony&Barak aflheaftts6dbu MUMBERS CERTMCXTION DATED S .M not 1 1 S3p"Mids Rd SouthoW New Vm*10771 CE T CATS OF OCCUPANCY SCTM f: 473989 SoM31 &)Lvt: SubdbAsivor am map No. Lot No. '/2/2017 parsmat to wM&Bafidivg rervat No. 41,676 126/ 17 was issued,and coeorms loallof the Jaw, Theoccupwacyfor vAlich ois=Wficateis S199PAMMONAND,�� fteverfificste is issued to spa,Arthon �&; rrr ,tithe, SUFFOLK COUNTY DEPARTMENT OF REALTRAPPRMAL rLUAUW,' ICATTON DATED " SipmUme e ff I k� 'T e'. bald 11/79 � o Il�Il CERT CAA F OCCUPANCY X,al 42083 Date: Il IMS . *,at ufl gg GROUNDPOOL 'SCTM#.- 4,73989 �r - - , Sabdivigow Ffied Map NO. confo=s s6ftuddlyto the Apolication for BuddiAg Pamt heretoforein was imed,;end tomMoMe mquirmerftof is le; o`dw law. neoccupmoyfor *bi&*, 3's,certffic4e is issuedis: SWIV l ogo , a li 7 k L, )q O_ ` veaMficate is inued to Napp Amy&Smmh ,oftheafaresaid building. EL=TWAL(MRTMWATE NM 45"49 CMIWWATWN DAM 'TOWC Of 19001h+ a "9M6=4 P.O.Box 11719 ' 5 Main,R4 CERTIFICATE OFOCCUPANCY No.- 453.18-9 19 /.2024 MRS CERTIFIES that the b IH,VAC Locadon as a p , 42, acc bs Lat,'Southol SCTM,*- 4USB [? Filed Map Na. Last NI Q. confomis sLibstantidfly to ht� tte ti r l ,uil l Pwrdit heretofore Wed indits(affice dated ?f r2�024 pursuant!to, � " aaT ing,PernAl No. s i 10:' 8/2 l/2024 was iissued,,aud,na formns ito;gall,of t'he;requiirememts"ofthe;4,pp cable provisions"af the law.. 'Tbe"w au,pancy Cor Whiidn this,caeaatfficaate.is issued is: ""as built"cmuraa'l air rvatiatigatin aas;a pl ae 'for. 'The,cerfificate is i ed to Nappa, nthony, Sarah of the aaif6Tcs6J lbuiiltdiing. E N , CURIWICATENa5:1'1;05 9L2072024 PIATIMERS CERTMCATION DATED hod, ,Ignata�r I W, :N 425 ACOBS LANE, SOUTHO N _ I euluRl EAT IN o --` 70FFIC7E�/STUDY]LIVING KITCHEN coROOM � " ° MUD 20'x 15' ROOMi DESK DEN DINING FOYER ROOM S -UP- 10'x 10 11'x 14' [CAR - a { i Plor:3 ShoWn ote for PtesefflOtloh pur oWS only ot%d dte not pdrt of any legoll documeot of title: `�Vb,-v,\ They subject to etrots. omssi ion `i s, MCcUtdcies and should not be used o d sole and davrdte V e E teferetfce: Interested mes shmd make their o i�incfuities using independent"sources. FIRST FLOOR _ 1 526 J I 1 W, - ACOBS LANE, SOUTHOLD, NY N 42-5 BR2 B-2 BR4 14'i 1 1, M. i HUM, BR3 84 Plans shown drd,fbf pimsetildtion Pu"seS only once ore not part of ony legol docurhent ot title; 1'hey subjed to eflors, omissions, inuccurociest and should not be uscid ds tj sole find occufate mfereoce-interested parties should tr4ke their own inquiries using indndepe ent sciurces< SEC-ONE) FLOOR 1760 S, 4 25- JAG LANE, SOUTHOLD, NY AIL dL WINE 0- UNFINISHED LIBRARY LAUNDRY NCL Plons shown ore fort presetootion purposes only rind ote not port of any legol docurnent or title. They su6iect to errors,orhissions, inoCcutdcies'and should not be used cis 0 sole tend occutcitc- tencii.intetested porties should moke ih inqg berid l ou eh srcm LOWER LEVEL 1360 r SF ofe eir own uiries usin Inde Ws 425 jACOBS LANE, SOUTHOL , NY E coop r-I r- r-I r- L JI L JI TRACTOR AND TOOL SHED 1 L e.Iz r BARN 17xu•s• BARN AU i7a Iv LM SL II STaL SMI SiALI B`sL HAY LOFT BARD = 1370 SF Flans shown ot€for presentation u=To S onty and ate not part of Ony legal docurh@flt bt tifle: SHE @ _ 576 SF They subject t etrors,ontisstons indc urocie4 and shouldn a ds a sb6 dttd "accurate � LOFT �I = q �A� rencue lnt rested rties should tri e theft own inquiries using jrde nd nt sources. I 0 W, 425 jAC BS LANE, SOUTHOLD, NY E v T, Hoof BARN a ' c. .. ' y POOL Aw ..,qq.� � .�. v f . � �.. v v # . RIDING RING \ \ j \\: \\ t ..; ... .. . .� .�.rya. i Mons sk,dWn dM fof pWsentot'son bUtpoM only and dre not part of dny legdl document or tine; They subject to e#ors,onnissions, ihoccutocies and should not 6e used ds to sole dnd dccUrdte �1TE PL�� teference. Interested porties should make their oWtr inquiries Using independent sources: