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Home My WebLink About1000-64.-5-15 N O C) N •-- C N 00 O � O N C Ca- w O o 0 (1) -� U c� cu O c sLu U c c cu c t' °' cu W L ro CU aj O q co c > - c 03, COo a E a� CU LL ,� Q o cn QJ U o >` O a, 0 cu Z a) V) N o E a) a) a, 6z a) = N N o o.L CU o > I\ O <n a) N � C � O E N O _ � o 00 �X � �`~ NO O N \ G ca cc � a . 0000 O ca O cu Q o O N E >. 0 Q � c) U U U) U N .x 0 0 `� w �.. PC 1 cv, TOWN OF SOUTHOLD-BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,N. 119" ,_ 959 Telephone 631 765-1802 Fax 631 765-9502 h -sw//ww� .south(Lldtg,,ri r 4 oar P ) ) 1- - __. .� RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 1115' 011 14, rz,�aKj �_Cuyb�_ SdUA1,101d. � V Tax Map Number: 1000 SECTION ,/pD 0 -BLOCK 6 L/ � -LOT SECTION B. OWNER INFORMATION: R , Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 71,30ol le j Ph C" v Telephone Number(s): Daytime — Evening/—Emergency,/ oZ5 Property Owner Email Address: 6J ,COD Page 1 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: N Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: �e ro 0 t45 ! 3 6gj Ira Use and Dimensions of each room in Rental Dwelling Unit: e � � ► 'gyp°IrT t� � � � X m „ 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 ❑ 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 o,+-wfc '"IcCR-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. Property Owner's Name: K Cala I ee CCECO Property Owner's Signature. " Sworn to before me this L day of , 20 Official No a y Public Signat r and Original Notary Stamp TP'OEY L. DWYER NOTARY PUL-LUC,STATE OF NEW YORK NO.01 DW630690 ^'J 0l`nlF'r,IN t*:I,I""FOLK C' «,I'^, 7Y COMWlC' `Ot4�hPi ;S JUNE ,,:& 2to Page 4 of 4 OnZ TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 6aq- 5/S INS"' PECTION [ ] 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 7RENTAL AL) CODE VIOLATION [ ] PRE C/O [ REMARKS: Ok— 'TOR ce ,,Xe-t4 F�aae wA-zn open.. DATE INSPECTOR " . Town Hall Annex Town Of Southold 54375 Main Road �a Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 µ 0 SUM# 5= Date 3 —� Owner ( Phone Address o Visible Hamlet 14 fW Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) f Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress Occupant Count Building Systems Maintained&Operational Condition of Property Heating Building interior Hot water Building exterior Electrical Property clean, maintained&safe Mechanical Handrails&guards installed&secure Pool Safety Pool on Site Surface water alarm Date of CO issuance Door alarms Pool completely enclosed Self closing/latching gates Pool fence to code requirements CO's for all items present Prior Rental Comments: 25-V 2 CAR GARAGE tY $ATH F AML Y L.aAIU 10.01 RFDRCK)## DiB4G C� 6O SED LIVING BA1H 14_0' TOWN OF SOUTHOLD PROPERTY RE( 9j�Zi/lg D OWNER STREET VILLAGE DISTRICT SUB LOT 9. o^n• f F p y, ryh j<k N ACREAGE I 1 0,A. '..d N c P 4 ms � f , ..TYPEOF BUILDING � � � f R a EA a. v FARM COMM, IIJD. CB MISC. LAND 7 DT�,A.L DATE REMARKS a.. m en " o _ C tl tl FN VLO�L��x P>�C'7 N �r eP BELOW :r ,ABOVE Fcarrn Acre Voluuee Per Acre beskie .3"uPUcaVrPIe 7"Illcrha{r� L THIcO:aVae 3 We<s<9Prrnd SwornpIand 43r<xsR�Pa. � �. 1--buse P o �,Wrcr1 dm F t o .......M w_ .. . ...._ .... _..w ._....... Foundation Bath Bldg, M. Ex tension k 4— Basement Floors Extension ion 1 = Interior Finlsh Extension Fire Place Heat li Porch Attic Porch Rooms 1st Floor 1 Patio BreezcwoyP Rooms 2nd Floor Garage /M C' h Driveway �,1 i D .. _.. _..._.... _ _ ...__.. ...w_ _ www _...._.._,_._...._._ M_..........._........ . ..._..wwww._...__ F p Town of Southold 4/8/2025 53095 Main Rd n� Southold,New York 11971 ft E EXISTING CERTIFICATE OF OCCUPANCY No: 46094 /8/2025 Date: 4_.... .. ..w_..... _............_ THIS CERTIFIES that the structure(s)located at: 425 Old Shipyard Ln, Southold SCTM#: 473889 See/Block/Lot: 64.-5-15 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to p 94 APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 460 tl dated 4/8/2025 was issued and conforms to all the requrrements of the applicable provisions of the law. The occupancy for which this certificate is issued is: Wood fi��tic�� gl�.�mCl1y elA91t . itb 24!14 The certificate is issued to McCready, Kathleen (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ..._...... ..ry_ .... _.w._ ...... �............. ... Aut )ri B-Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 425 Old Shipyard Ln, Southold .... ...... - - —------- SUFF. CO.TAX MAP NO.: 64.-5-15 --- SUBDIVISION: "" ------------ .. ...... NAME OF OWNER(S): McCready,Kathleen OCCUPANCY: ..................... .............. ADMITTED BY: ....... ........... . . ........... SOURCE OF REQU'ES'T":""-,McCready. ... ............ ,'Kath'l'een" DATE: 4/8 202.5 ... ........ .. .... DWELLING: #STORIES: I #EXITS: 2 FOUNDATION': Blo ck CELLAR: x CRAWL SPACE: BATHROOM(S): TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: Enclosed FIREPLACE: GARAGE: attached.. DOMESTIC HOf ATER: TYPEHEATER: Boiler w/expansion tan AIR CONDITIONING: TYPE HEAT: FHA W.ARM AIR: HOT WATER: Oil #BEDROOMS 3 #KITCHENS: 1 BASEMENT TYPE: Partially finished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: .......... SWIMMING POOL: GUEST,TYPE OF CONST: .......... OTHER: .......... VIOLATIONS: .......... ........ REMARKS: .......... ............. INSPECTED BY: NANCYl DATE OF INSPECTION: 3/7/2025 TIME START: END: .......... ....... ef so Town of Southold P.O. Box 1179 53095 Main Rd Z Southold, New York 11971 .............. ........ ...... CERTIFICATE OF OCCUPANCY No: 46092 Date: 04/08/2025 THIS CERTIFIES that the building ELECTRICAL- RESIDENTIAL Location of Property: 425 Old 11971 Sec/Block/Lot: 64.-5-15 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 03/14/2025 Pursuant to which Building Permit No. 51744 and dated: 03/14/2025 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" 200 amp electrical service. The certificate is issued to: Kathleen McCrea.dy Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 51744 04/01/2025 PLUMBERS CERTIFICATION: ...... ................ Authorized Signature M NO. 4 TOWN OF SOUTHOLD B u 1NO DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z7; 57. . . . . , Date . . . . . . . .. 19.77. THIS CERTIFIES that the building located at . .Old .Shipyard la. . . . . . . . Street Ma No. Founders Bat* Lot No. . . . . . . . , . .Lot No. .100, Southold N.,Y.. . . . . . . p . . . . . . . . . . . .. . conforms substantially to the Application for Building Permit heretofore filed in this office dated July. 13, 19. 7b pursuant to which Building Permit No. .$7a0Z. dated . . . . . . . . . .q!gY . .1 4 . . ., 19 7b ., was issued, and conforms to all of the require- ments of the applicable provisions of the law.The occupancy for which this certificate is issued is The certificate is issued to .401P*t. A .41;r 4.j4pr C1s. . . . . ere. . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R.. . . . . . . . . . . . . . . . • . . • . • • . UNDERWRITERS CERTIFICATE No. .M7090. . . . .AUS . . 55. . .1976. . . . . . . . . . . . . . . . HOUSE NUMBER . . . . .425. . . . . Street . . Q14. WVYaFd.11-0, . . . . . . .Southold. . . . . . . . . , ' Building Inspector p