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Home My WebLink About1000-129.-1-5.2 of so�� OIAWIN OF SOUTHOLD Rental Permit Nt 1349 Owner: Cinchsure LLC Occupied as: Single Family Dwelling Located at: 1025 Great Peconic Bay Blvd Laurel 129.4-5.2 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. Issued: 07/14/2025 Expiration: 07/14/2027 tfies t � en Official This Notice must be posted by the main entrance TOWN OF SOUTHOLD—BUILDING DEPARTMENT �-d 0 Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY l 11DD 9 tJ !! i �� Telephone (631) 765-1802 Fax(631) 765-9502 litt s:/�J ww,sotitlioldtowriii �� ,v RENTAL PERMIT APPLICATION BULKING DEPT. TOWN0F SO Rental Permit Fee$300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address J Tax Map Number: 1000 SECTION AZA--BLOCK -LOT - Z SECTION B. OWNER INFORMATION: Property Owner Name: '� ,.�� ' ) l Tl�, LL Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) LL' E ff i-"w �j 1 U!" ' Telephone Number(s): Daytime' a' �, Evening Emergency Property Owner Email Address: 0 C- ME,-. (dM Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: I _ ' -1 `,, ^_.. Address of Authorized Agent(no P.O. Boxes): / n� wQ�'"C` ��7� Mailing Address of Authorized Agent: %d D�GG�+ L/� G + [(J-7 7 Gi,736g 3'�� Telephone Number (s): Daytime I Evening Emergency Email Address: rS �u Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent(no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, B, Q the use of each room in the Rental Dwelling Unit (for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: o` er Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit:�$f -fbim, t; k . � Use and Dimensions of each room in Rental Dwelling Unit: I-A P,3 12. 3 x Z�`? +` i : IZ.► V 13,36� '�r r ml z 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 flaws adopted by the New York State Fire Prevention and Building Code Council. 241 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold IV' 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) 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,, day of 202 ° Official Notary Public Signature and Original Notary Stamp NQ1. R. V B1.9 1 TE O i E)t1 ) "yORK 79AC6428747 Page 4 of4 0ualiiiad in t3ro`nx county-2026 yCammission Expa TOWN F SO L-' BUILDING :PT. 631-765-1802 I S P E CT 101" 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. (FI ) [ ] CODE VIOLATION [ ] PRE C/O [ RE'NTAL ARILS: 1,40 TOWN OF SOUTHOLD BUILDING DE 755-1 SCI2" lNbvr.CTlw' N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O RIVEMARICS.. OY-j 4 bc vimyt h v so go,,< 6,eat �PL �,� hv> t,6*�Pk, 'N OF SOUTHOLD BUILDING G DEPT. 631-765-1802 1N b P E%Ck T 10 N [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION ] FIRE RESISTANT PENETRATION oe [ ] ELECTRICAL (ROUGH) ( ] ELECTRICAL (F AL) [ ] CODE VIOLATION ( ] PRE C/O [ RENTAL !R;EMARKS:-- vW&" 6�, — wt A tv r�o O(P v AV koo( � DATE °" INSPECTOR VIA_ .,_._.. ' Telephone(631 765-1802 Town Hall Annex 54375 Main Road Fax 631 765-9502 '` Ze P.O.Box 1179 C4 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seal required for Architect or Engineer, Licensed Home Inspector midst provide copy of valid current certification) Rental Property SCTM Number: Rental Property Address: 1a25e rd Owner/Name: ++ «-�� Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan; (i.e. Bedroom#1 — 100 sqft., Bedroom#2—90 sgft., etc.) , 3 = IZI, 1 Property Description (Include all improvements indicated on survey) :;: ' r r a »f R*�N t I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold, the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State,the Fuel Gas Code of New York State,the Fire Code of Ne ,e,the Property Maintenance Code of New York State and the Energy Conservation C t :µ ew York State. t Print Name and Title w w nywal r Please place Professiona e l 01 4 TOWN, OF SOUTHOLD PRQPERTY RECO� /311 JIL, j , OWNER STREET VILLAGE DIST,ch:s L��re L Lc- V SUB. LOT "Vp1-(X Lc FORMER OWNER 12 N E ACR. • At W TYPE OF BUILDING N -1) AIA RE$. SEAS. VL. ' FARM comm. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS ed LILL L, e2 `5/� t171 V600, j-- D z z ail Ll w" d) one L211, -'A PC-v 75-0 -7k) su�)qlz 0' IKO o 7300 114�4 -54' 1 (-Z-, 4 17' o Pj/Y�i— I • V. e) o o C) /AC2 4i A 's 'r 71 — Tillable FRONTAGE ON WA 1 Woodland FRONTAGE ON ROAD MeQdowtoM DEPTH House Plat BULKHEAD Toto I s ` I - i ° TRIM g �� J 110 tu `_ i - i spm � °s y _ I 2 FT s € > 77 ki - i s 129:1-5.2 2/05 I _ f I � ; i M. Bldg. I � �- 3 I s Extension ° E � a Extension a �- �Foundation Both _ 1 Dinette Poitivi .mot t - 2 0 Basement _ Floors K. . = Ext. Walls Interior Finish LR R `�� Fire Place Heat 37 Roof' Room it� Type s I st Floor 3 BR. io i Retread R � Rooms 2nd Floor FIN. B = e O. B. i Dormer Driveway _ i Teal I i � a - 0 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28068 Date: 11/15 01 THIS CERTIFIES that the building NEW DWELLING Location of Property: 1025 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 129 Block 1 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SE EMBER 26 2000 pursuant to which Building Permit No. 26897-Z dated NOVEMBER 1, 2000 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 FIRST AND SECOND STORY PORCHES AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to WILLIAM & LINDA ZILZ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-00-0112 11 02 01 ELECTRICAL CERTIFICATE NO. 1965 08/30/01 PLUMBERS CERTIFICATION DATED 11 01 01 GAH PLUMBING -4hor/edSilature Rev. 1/81 Town of Southold Annex *� 1/13/2014 P.O.Box 1179 54375 Main Road �> Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36712 Date: 1/13/2014 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 1025 Great Peconic Bay Blvd,Laurel, --------------- SCTM#: 473889 Sec/Block/Lot: 129.4-5.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this ofliced dated 12/23/2013 pursuant to which Building Permit No. 38612 dated 1/6/2014 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: " ui t°"deck i i Ia to an existina sin sinele fa m:i welly lied for. The certificate is issued to Zilz, Linda (. .................................... ....mmm.mm_.mmmmmmmmmmmm..,____...._NN._,___._,�_..._.._.._mm_ OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL .________............ ....... w........M..... _......, ......_._.__._. _...................... ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ._. Au g�ctamt Of SOVI ollk Town of Southold P.O. Box 1179 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 46317 Date: 07/14/2025 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1025.Great Peconic Bay Blvd Laurel,N 11948 Sec/Block/Lot: 129.-1-5.2 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 05/24/2019 Pursuant to which Building Permit No. 43792 and dated: 05/24/2019 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: Accessory in ground swimming pool with fence to code as applied for. The certificate is issued to: Cinchsure LLCT_ .._...._ ...........__._._.. ........._�wMMM__W- Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 38809 06/03/2014 PLUMBERS CERTIFICATION: M_ ...._._.........M ,_ ...... _.........___....... ........................M_.____ uCht ire Si nature 30Stl5' • OUTSIDE CELLAR E ENTRANCE L� O Da7 l 13 5'x22-4' �+•,+�-au�r nmre n,v+ ROOM RF/BF&T1l�.l AQFA 12'-4"x28'-10` 12'-2'x20'-10' UNFXCAVATM Co 3Y QSD ISR P BATHROOM t=a ROOM 2?-SSC'f-8' - 1 > z m 5 a v z� 8�45EMENT PLANo p� oE,�crax 6�- 2441 SQUARE FOOTA6E5, -—— m�su,. wNsrea,v�w� u°tae sr'. i�Aar+, -lauas ss. .�sF. iw>Hs�w .4'�aona ss. 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