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Home My WebLink About1000-145.-4-17 Rental Permit 1299 Owner: Christopher Ariens Occupied as: Single Family Dwelling Located at: 455 Macdonald Rd Laurel 145.4-17 Maximum Permitted Occupancy: 6 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. Issued: 05/02/2025 Expiration: 05/02/2027 Code Enfo ern4 Official This Notice must be posted by the main entrance at all times US TOWN OF SOUTHOLD—BUILDING DEPARTME A P R 02 " r Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 " PutIdlnq apart of Telephone (631) 765-1802 Fax (631) 765-9502 I1tWS://NVNVW S0Utho1dto � �� y o v� of�outl ld V)se 14 3vp- RENTAL PERMIT APPLICATION Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: &A Gz.C- L Tax Map Number: 1000 SECTION (ys -BLOCK °Y -LOT -,7 - SECTION B. OWNER INFORMATION: Property Owner Name: li j►r91- -0- ) � Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 1 / d Telephone Number (s): Daytime Rvening Emergency Property Owner Email Address: e,%S 1'1V-S (P C&_'VX 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, 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: Use and Dimensions of each room in Rental Dwelling Unit: x fS" V �l �;e 3 12, x= C,�a- 12 x7 rlf Z -2>9 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 �, 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: Property Owner's Signature: Sworn to before me this 11 day of {', , 20 2 1 /�r� --V�s L LXt-\- Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.0 1 BU6185050 Qualified In Suffolk County Commission Expires April 14,2 Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. ^gum 631-765-1802 1N So' P E%Ck T 10 N [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN ) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: e--—P- k--kn— si clv DATE -as INSPECTOR TOR Town Hall Annex Town of Southold 54375 Main Road c* Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 W�04W , Tel: 631-765-1802 SCTM# S— —/ Date -3d Owner /ins Phone Address: S-5 &A—cownxlxVisible Hamlet` a(/ Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) �I 1 Carbon Monoxide Detectors Fire Extinguishers Exits 1 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 oh Site v Surface water alarm Date of CO is ao8� Door alarms PI ::dool co mpletely.enclosed Self closing/latching gates tPool fence to code requirements CO's for all items present Prior Rental Comments: t 1LQI717 Apn3S 9$ /Aaeaglg Aipuneg ZOOKO.d t aaAod 'Pe-a I wa wed �� ' o fie' �a d/�1 G s43e9 �,5 f `�d ale O— U d �- a oa o slleM '1x9 �� .� ,.� �---� �bl�'�rl Jk''� a6eaeO a a t' S/ WOH aoeld aai- uolsualx3 4sluIA aolaaIuI x --� 9 pausiuld % = I 0 I �a01sua; 3 1 �o �j fi s�oold -Ivildvd ')Mv o luawaseg 9 9 b l ( . �l A oawooaosua x ai�auip 43e9 a3HioS�-u f'/ uoi;epuno4 9a Od puZ is 1 124 ' j Lloz/ZZ/£0 IT-o-•StiT /, 1 - r_ Y WIl�1 r, z� 2 0_100 I HA � j w - o 9 a f 10 0n- �i- -71 \ - s COLORv vv v NIN �E \ I f q f O 1 TRIM - � I i i tt 1 3 ' 9 _ l t t t , I I# tF , e 3 t t j x rJ— c t j M. Bidg Foundinette ation �. r D Bot h t. i Floors 1� r K. Extension Basement t i t t Interior Finish Y t ' LR. Extension `` i ! Ext. Walls .i ~Fire Place = - Heat _ , a= URx Extension I _ Type Roof Rooms 1st Floor BR.I Y s Porch I !Recreation ROo� Rooms 2nd Floor �'a',� I FAN. B Porch Dormer r t D i _ I � I riveway } 1 Garage qa _ 3 t iD Total �` ` Town of Southold 1/15/2022 ° P.O. Box 1179 _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42685 Date: 1/15/2022 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 455 Macdonald Rd., Laurel _.ry............................. _. SCTM#: 473889 See/Block/Lot: 145.-4-17 Subdivision: Filed Map No. Lot No. . _,. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/15/2015 pursuant to which Building Permit No. 43167 dated 10/25/2018 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: girt<�i f rlail d IlIwyi _cc red �ataw Il s cc sfc:..floor cl� ��xt t_l?�2°gc!l �tl �l�_��t, Batt l�cci � itl� o<2�'cl cic L-W.cwd i%- .�r L!q, R1 #6 .djjte /20/ ,015 W The certificate is issued to Ariens, Christopher of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RI 0-15-0053 11/4/2021 ELECTRICAL CERTIFICATE NO. 43167 10/7/2020 PLUMBERS CERTIFICATION DATED 12/18/2018 plum _..... _ . _.._. _._..._... g __.. ....__ . ..µ ,_ -._ ..... 1 ctr°w. .e Signature t Town of Southold 1/15/2022 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42686 Date: 1/15/2022 THIS CERTIFIES that the building HOT TUB Location of Property: 455 Macdonald Rd., Laurel SCTM#: 473889 Sec/Block/Lot: 145.-4-17 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/15/2015 pursuant to which Building Permit No. 43167 dated 10/25/2018 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: a p, c l o tub a plaRk( 1ol, The certificate is issued to Ariens, Christopher of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _...._ ....._.__�. ...._ .. / µ.�. ELECTRICAL CERTIFICATE NO. 43167 l O 2020 PLUMBERS CERTIFICATION DATED u .or d t nature............._._w .... __. Goraga 52B sP w..................�_......a,a, ........................ ........... ..................... U,C�4 ..a .. ... ,..�..Glo� ENTRY ..Hedroom... .. yr onlcal a A 4 p Masker B dr— tl Hablkable Flaor Area=1552 sq,Ft.. Roof Deck ..._�..w.�.�, ....___._ ......___ ......... ........_a�s' . .,,w_........... .........,...., ....__......_ ,,..,.. ....._....... .,....,rqs...............,,_..,...,.,..,.,.,.,.,.,....,.,......»--wwww.,�......._..W..W.,..............................,:d..�,,........, ...,...,.�.,.....,,... ��. open ..w............_.,...��OFFIee ........,...........� Kitchen Dining A "l of Room ,„,„........ .�.•""' .,.�.�.:. .. �www6. * Pining Deck b -••��••••-�� SEGONd,FLdOR PLAN "" M Habitable Flo-Area=1455 sq.ft.