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Home My WebLink About1000-126.-5-19 Rental Permit 1360 Owner: Robert Finn Occupied as: Single Family Dwelling Located at: 8908 Great Peconic Bay Blvd Laurel 126.-5-19 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-annu inspection. Issued: 07/30/2025 Expiration: 07/30/2027 ode ' a ent Official This Notice must be posted by the main entrancjI tim TOWN OF SOUTHOLD—BUILDING DEP RTM E C E U E c Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,' 971- 59 r 2025 .., Telephone(631) 765-1802 Fax (631) 765-9502 ijap p .so t( _gqy 80d'ing Department Town Of SOLIthold RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) -719•4 I a; � IIU� P6 v 3w Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION 1.26.00 -BLOCK OS,00 -LOT O 1 cl - 000 SECTION B. OWNER INFORMATION: Property Owner Name: QABfkT- ElUi3 Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 7b T�Ll- ATE r ,3 0 Telephone Number(s): Daytime 631.807.9505 Evening 54ML Emergency a"C Property Owner Email Address: SUAL-Et kAP ca L .C.0m 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): N Mailing Address of Authorized Agent: A Telephone Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: ,,11 Address of Authorized Agent (no P.O. Boxes): N Mailing Address of Authorized Agent: Telephone Number(s): Daytime ening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or mo rentai units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Z4 Z1- 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: 0AX 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: Coe P L)ro Sul_ V 440 I~ + ll 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: k1l F IS' 11 "" c I! Suoepom 28, 1"Y. 'T- 1" 1 A t -O`,v *411 . Hut>Roots 8'-9 x 10.-Ip.. fir . 6'-9';,- S, ►o" I 1; `6 0 1 ^ " E 2 1a`- ', !3-II 2 R£De- 3 �2 3�g ,- IZL03l4" , 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold X 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) 1 LoW- Fizv4.11 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: ko�er� /,it/i� Property Owner's Signature: Sworn to before me this day of ��, 2025 Okial go ary Public Signature and Original Notary Stamp JANINE VALENTI �40TARY PUBLIC,STATE 0P N1EW YOPK NIO.O"V VA5065I358 CIUALIPIEIC INa SUPPOL 00UNITY NAY COMMISSION EXPIRES MAY 20 2'�C 27 Page 4 of 4 bA TOWN OF SOUTHOL BUILDING DEPT. " a 631-765-1802 ��,(p , --,�� t9 IN ph mombb, T UN [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ FIRE RESISTANFPE TRATION ELECTRICAL (ROUGH) [ ] ELECTRICALL) ] CODE VIOLATION [ ] PRE C/O [ NTAL REM 1 .S« .ww. t4� 1 ....... im ` ww DATE INSPECTOR Town Hall Annex r�� "Po Telephone(631)765-1802 54375 Main Road n Fax(631)765-9502 P. O. Box 1179 Southold, NY 11971-0959 a-0 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 re aired for Architect or Engineer, Licensed Home Inspector must provide copy of valid current certification Rental Property SCTM Number: 4 - 00 - Q�-00 - Qlcit.OQU Rental Property Address. PCIOB Pr-cok)jc- 8&4 8�pQI�g ` Owner/Name: p 100 Rental Dwelling Unit Identifier: F D F-W&-) t V P- 411 Number& Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 - 100 sqft., Bedroom#2-90 sgft., etc.) H -k Is 9F- O - 15-0 0 . -r- Property Description (Include all improvements indicated on survey) H.OT- I certify that I have done a physical inspection of the subject rental dwelling unit and find tha it fully complies with all the provisions of the Code of the Town of Southold, the Residential Code o New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel s Code of New York State, the Fire Code of New York State, the Property Maintenance Code of o and the Energy Conservation Construction Code of New York State. �G Print Name and Title Original Signature, 14 Please place Professional Seal• Town Hall Annex � ,b Telephone(631)765-1802 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 r BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occ y each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occ each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Z M CL ry, CL .+ + u to r 6 D o �1 -v 5 c � � _.__. _ ._.. Z •, on c� C r . W TI T u U �� ._ rM � 3 2 = ZIZi D GDi Ln ,.. O m m y � O O Z Z ZP w„„ f °D Cris ch- (Al s M Ln - �.. 7t. Cv r G pp P q Ic —{ -p Cl o0 - - m X X 0 0 o rn i n m m m . n CDN n G� fy O �-a Kj 11 1r aCy >> Ilk r-+ 1 0 ap n o 'D � -n x c - --a fl T7CD p p 0 -h CD O 60 o _ _. - n kk a ° CD rn p p _.,.., ..w. _. _..._..... _.,. ..I �.... r rt (D ^'' 's -t o � _ _ n .....,._ IT` a IDo -n m r- � .. CD I� P r � . Town of Southold Annex 4/10/2012 54375 Main Road Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 35473 Date: 3/6/2012 THIS CERTIFIES that the structure(s)located at: 8908 Great Peconic Bay Blvd,Laurel SCTM#: 473889 Sec/Block/Lot: 126.-5-19 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 35473 dated 3/6/2012 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame brick veneer pw funil y dwelling with glass e_ncl msdporches. front wood t wised PAtigt NOTE: BP 7217 attached twg=g1ragg Z 387•BP 35653 solar ,cis COZ-34 49: BP 36759 heat to COZ-35471 The certificate is issued to Firm,Robert _�_ _...........___ _ .. .....�.�. _._ .�� w..w. . (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. /ig;nat�re BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION- 8908 Great Peconic Bay Blvd, Laurel ......................... ................................. .......... ---------- SUFF.CO.TAX MAP NO.: 126.-5-19 SUBDIVISION: -- ------ ................................... NAME OF OWNER(S): Finn,Robert ................ ........... OCCUPANCY: . ... ......................... . .... ... .............................. ........ . ...... ADMITTED BY: Robert Finn . . ...... ..... SOURCE OF REQUEST: Finn,Robert DATE: 3/6/2012 ..........— DWELLING:, TYPE OF CONSTRUCTION: #STORIES: 2 #EXITS: 4 FOUNDATION: cement CELLAR: CRAWL SPACE: ................................................................. ... ........ ............. ....................... . TOTAL ROOMS: 1ST FLR.: 2ND FLR.: 3RDFLR.: BATHROOM(S): 2TOILET ROOM(S): UTILITY ROOM(S): .............PORCH TYPE: DECK TYPE: yes PATIO TYPE: raised patio ... ........ ...BREEZEWAY: FIREPLACE: I GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: oil AIR CONDITIONING: yes TYPE HEAT: oil WARM AIR: x HOT WATER: .............. #BEDROOMS-- --—--------" .......... ... #KITCHENS.--' —I .....BASEMENT AS'EMENT TYPE: unfinished OTHER. . ..... .... -—------ .................... .............. ........... ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: .............. ....... .... VIOLATIONS: .......... ---.................... ..........- .................... ..... .... REMARKS: ................................... ... ......... ---------- ................ ....... .......... ............ .. ...................................... .. ............ INSPECTED BY: DATE OF INSPECTION: lO ..................................... TIME START: END: FOM x06 s TOWN OF SOUTHOID BUELDING DEPARTUM Town Clerles Office Southold, N. Y. Certificate Of Occupancy No. . . . . . Date . . . . . . . . . . . . . .Kar THIS CERTIFIES that the building located at .Peconle. •Bair. Blvd• . . . . • • • Street Map NoDzrns. . . . . . . Block No. . . . . . . . . . .Lot No, 5. . . . . .Y,&tt3twck. (. l.aural.Dist 11 ) conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .M^y. . 1. . . ., 197.4 . pursuant to which Building Permit No. 721.7Z. . dated . . . . . . . . .May. . . . a. . . . . ., 19.74., 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 . . .PrLvate. .one. gamily. •welling.with. ,garage .addno . . . . . . . . . . . . . . . The certificate is issued to . All .J.v. -TuA . . . . . .fier. . . . . . . . . . . . . . . . . . . .. . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N.R... . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. 3/.27/7S . .by A o."baclri . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . . . .9000 . . . Street . . . . Paconi.n Bay. Blvd . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . .. .. . . . . . . .. .. . .. .. . . . . . . . . . . . . .. .. . . .. .. .. . . . . . . . . . . . . . . . . .. . . . . Buildifig FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y_ CERTIFICATE OF OCCUPANCY No: Z-34649 Date: 1.1/04/ THIS CERTIFIES that the building SOLAR PANELS Location of Property: 8908 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 5 Lot 19 Subdkwision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 9, 2010 pursuant to which Building Permit No. 35653-Z dated JUNE 16 2010 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 SOLAR PANEL ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JUDITH FINN (OWNER) of the aforesaid building. SO MOLK COUNTY DEPARTMNT OF HEALTH APPROVAL NZ EX RCTRICAL CERTIFICATE NO. 35653 08/03/10 PrlA4HT{RS CERTIFICATION DATED N/A _ - ,...,. 4ditho zenature Rev. 1/81 � ... Town of Southold Annex 3/6/2012 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35471 Date: . _ .. ..3..6 2012.._....._.A_ . THIS CERTIFIES that the building HOT TUB Location of Property: 8908 Great Peconic Bay Blvd, Laurel, SCTM#: 473889 See/Block/Lot: 126.-5-19 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this ofilced dated • 0/17/2011 9/30/2011 pursuant to which Building Pit No. .. .36759, . dated .1........ ...�.. ... . 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: "ate t" emu, as a_pp c f a The certificate is issued to Robert Finn (OWNER) of the aforesaid building_ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 36759 10/21/11 PLUMBERS CERTIFICATION DATED ut Signature t � r x D, A C: Q' 0 OD 03 in op r to 1 Sp i� CO " 0 c Inz .r D' .p 4 dA � pomw 0 �n O O 7.1 O -A O 4 w Ni el Ro ert Williamson Architect P.(7.Box 1758 Southold N.Y.119Z1 Phone � 834,9740 ✓ - -� w... s ] i ... I T LI FT 'Z ao rCl .-.. i i 0 o d t o �U oto O r 3 r fn -S, D cn z 0 a a 0 a zs' 8" 0 -O A -b N Q Nigel Robert Williamson Architect .r, Cry RO.Box 1758 Southold N.Y. 11971 Phone 631,834.9740 0o -0 F � (fjn) 0 OD CA D � r C7 r- p3/ 03 10 0 - o Col 3 r LA � Ir p -T- tjt T- w n � o 0 o LoI 13"119z" i b a O O :A DA D 3' 4, -1 INMFVWAT µ r� d " � 7'•1 �+ Nigel Robert Williamson Architect W PD.Box 1758 Southold N.Y.11971 Phone 631 M4.9740