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Home My WebLink About1000-75.-5-2 of-so 'OWN F S UTHOLD Rental Permit 1391 Owner: Zella Holdings LLC Occupied as: Single Family Dwelling Located at: 825 Peconic Ln Peconic 75.-5-2 Maximum Permitted Occupancy: 5 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: 10/29/2025 Expiration: 10/29/2027 code€ force Official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road P Fax(631)765-9502 ATM, P.O.BOX 1179 "m o Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address- Tax Map Number: 1000 SECTION_ �5 BLOCK LOT ,,_ SECTION B. OWNER INFORMATION: Property Owner Name: Zf— I k H 1 �LL—C' Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) � �.� � � � L Telephone Number (s): �� ..,, « .. Property Owner Email Address: � of 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: 1 l0 Requested Maximum number of persons allowed occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: -III_(2-, [,q'i 1'15- t "� 13" '� `�'C Laa 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 NYS licensed architect, a NYS 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. Page 3 of 4 ❑ I am submitting a completed Town of Southold certification form from a licensed architect,a licensed professional engineer, or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building code Certification. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I J(Ki(J�'� 0J Q/ , 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 1 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: I, occ , C) / Property Owners Signature: Sworn to before me this day MELISSA R DEBOER NOTARY PUBLIC STATE OF NEW YORK Official Notary Public Signature and Original Notary Stamp SUFFOLK COUNTY LIC. 0 0E 989S Page 4 of COMM.EXP. aw ..�.., , of sou TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 75- ,5-,d I N S rm" E C;`T 10 N [ ] 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 (FINA ) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: 0 ��n occ v RATE /o E V?5- _ INSPECTOR OR TOWN OF SOUTHOLD BUILDING 765-1802 ImplMSPECTION" [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING [ ] INALt64 I to,I [ ] FIREPLACE & CHIMNEY [ FIRE ;SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR Town Hall Annex Town Of Southold 54375 Main Road g Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 w Tel: 631-765-1802 SCTM# �jr— Date �O •,�� Owner Phone Address " *l;.c Visible Hamlet �, Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) r Carbon Monoxide Detectors Fire Extinguishers Exits ) Bedrooms 1 2 3 Z 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 I Prior Rental Comments: FLOORPLAN SKETCH =orr�mm—Lc—c pLovERjAmES AND—jo,ANNe--.-----Foe—No—,—lq4--4Lo--.— Pm0FttAddre-w826 PECONIC LANE Case Nw yAOqr4i ,C4y' PECONIC SwLe« Zi 11950 Lender FARM CREDIT EAST ACA 41' BATH BEDROOM BEDROOM BEDROOM GARAGE FOYER KITCHEN LIVING ROOM 8, 41' 'A, co A c" s GLRI First Floor 1291.50 1291.i0 tlYixvt Floor 3.0 x 41.0 123.00 4.0 x 41.0 164.00 20.5 . Wo 1004.50 Net LIVABLE Area (rounded) 1292 3 Item (rouncled), 1292 Mrt 300 WHEELER ROAD,SUITE 302,HAUPPAUGE,NEW YORK 11700 (631)434-3300 TOWN OF SOUTHOLD PROPERTY RECOk�u OWNER- 'STREET = VILLAGE DIST. SUB. LOT _-LZ Y'S MER OWNER 1 ACR. z.rn a 5 S W TYPE OF BUILDING RES.j I 'SEAS. VIL. [FARM COMM. CB. MISC. Mkt. Value 6/ LAND lmp, TOTAL DATE REMARKS E N 0 A, AGE BUILDING CONDITION NEW NORMAL i BELOW ABOVE J L J2 FARM f Acre Value Per Value bc- -j Acre Tillable I Tillable 2 A Tillable 3 Woodland Swampland 'FRONTAGE ON WATER Brushland FRONTAGE ON ROAD 4 0 0 0U 0 House Plot DEPTH IBULKHEAD Total iDOCK r ,i XOR iL is AIM i 3 i z 75.-5-2 04/03/2018 t € 2= M. Bidg roundation Bath 4-_ s I D nette Extension i J r= y cement f F, � loons Extension xte Walls Anterior Finish %R. Extension Fire Place Heat iGf', [FYPe Roof ERooms lst Floor BR_ - �a I Porch , j Recreation Roo B. m 'Rooms 2nd Floor FIN. Porch £mer Breezeway 1 rive ray 1 I Garage _ s e; Patios f Total0/ } FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTWOLD, N. Y. , CERTIFICATE OF OCCUPANCY No. ..Z.....2081......... Date ....................�i"qk....4............... 19M.. THIS CERTIFIES that the building located at ....W/.S.....keCsonia..�6)ie.......................•. Street Map No. ....y 3M. ......... Block No, ..... .......... Lot No. . ..... G+O :4q• �'jR+ .. ..............•..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......Augn,,4.......2..0., 19-06, pursuant to which Building Permit No, .2502.2 dated ..........................A11911at.....27...... 19...64,was issued, and conforms to all of the requirements of the opplicable provisions of the law. The occupancy for which this certificate is issued is ........ . .......................................................................................... The certificate is issued to ..4,3ta't-l•A• �v�4x' :�1....& r .........................w (owner, .,....,.»..,..,,...,.,....,.. , lessee or tenant) of the aforesaid building. H.D. Approval Pevemary A 1965 by R.Villa Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . z 448 . . . . Date . . . . . . . . Saptember.14t . . . ., 19.73. THIS CERTIFIES that the building located at Peemic. Lane. . . . . . . . . . . . . . Street Map No. . . .XX . . . . . . Block No. . XX. . . . . .Lot No.EX. . .P.econiC. _ . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office -dated . . . . . .October.lfif . . ., 19.72. pursuant to which Building Permit No. .61.82Z. �____,. dated . . . . . .00tc ber 1 lb 19.72., 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. 1kcces.Sary. b-UlldLAg .(t00,1 -29t'P I . . . . . . . . . . . ... . . . . . . . . . . . . . The certificate is issued to 5. -e .Gera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 34 JI,-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE: NUMBER $25. . . . .Street. . . 000MC. ;4AQ. . . . . . . . . . . . . . . . . . . . . . . a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .PeCMIC. . . . . . . . . , . . . . , . . . . . . . . . . . . . . , . . . . . Building Inspector4 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No -19700 Date JANUARY 31 1991 THIS CERTIFIES that the building ADDITION Location of Prope:rt YORK House No. Street Hamlet County Tax Map No. 1000 Section 75 Block 5 Lot z Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 1.7 1,991 ______pursuant to which Building Permit No. 19640-Z dated JANUARY 28 1991 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 GREENHOUSE ADDITION TO EXISTING ONE FAMILY DWELLING AS BUILT The certificate is issued to THOMAS & JOANN PERRY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ✓ uilding Inspector Rev. 1/81 .......... Town of Southold 10/11/2017 P.O.Box 1179 53095 Main'Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39278 Date: 10/11/2017 .......... THIS CERTIFIES that the building ELECTRICAL ........ Location of Property: 825 Peconic Ln,Peconic SCTM#: 473889 Sec/Block/Lot: 75 5-2 Subdivision: Filed Map No. �WmmLot No. conforms substantially to the Application for Building Permit heretofore filed id this office dated 8/8/2017 pursuant to which Building Permit No. 41862 dated 8/8/2017 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: 2 Q�A_MPILEC'M (7,.SERVICE The certificate is issued to Wilmington Savings Fund of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41862 09-26-2017 .......... PLUMBERS CERTIFICATION DATED ........... ........... Authorized Signature