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Home My WebLink About1000-65.-1-14 of so TOWN OF SOUTHOLD Rental Permit 1277 Owner: Seafarers Bungalow LLC Occupied as: Single Family Dwelling Located at: 2845 Hobart Rd Southold 65.4-14 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: 03/25/2026 Q WXL Expiration: 03/24/2028 /Codk E fo meet official This Notice must be posted by the main ent Uncet all ti vs TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax(631) 765-9502 liMr �wwsouthq (to MIII YA"IW V RENTAL PERMIT APPLICATION R( -tal nermit Fee $300 (Application must be renewed every two Oro V 1, '55 96 %1�00 W1.0"621) w�\ Section A. Property Information: Rental Property Address: Qw— 4(-)Vw4 Tax Map Number: 1000 SECTION BLOCKj2Q=-44:g(, SECTION B. OWNER INFORMATION: Property Owner Name: aeakfacs Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same-as Rental Property Address) N 2w ,mloef -Lah�l I Telephone Number (s): Daytime77q-q9j-"vening Emergency I7q-45q—(440 Property Owner Email Address: (S&CA I q,CLMC(j @qMCA d -06VVI Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: 0A .'' (O.Ww Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s): Daytime Evening Emergency Email Address: 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: m 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: Requested Maximum number of persons allowed to occupy Dwelling U (,�7 Number of rooms in Rental Dwelling Unit: wa� Use and Dimensions of each room in Rental Dwelling Unit: 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 0 1 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. ST) TE OF ,: tB ) Q C\A r ) COUNTY OF SU ) Qu 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 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 06 day of MCV'CN 20IG ed Sect IV op( Qua nrl ^CLtrq Official Notary Public Signature and Original Notary Stamp MARCIA DU:ofNeva]da llotary Public,StaAppointment No.MyAppt.Expires J Page 4 of 4 f s A" TOWN OF SO THOLD BUILDING DEPT. 631-765-1802 & I-11f INS"' PECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANX(FIL) TION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICALCODE VIOLATION [ ] PRE C/O [ L 7RA RKS: DATE 6 90W INSPECTOR z TOWN OF SOUTHOLD PROPERTY RECORD CARD STREET ' VILLAGE DIST, SUB, LOT FORMER OWNER N ACR, S W TYPE OF BUILDING RES. SFAS. YL. FARM COMM. CB. MILS. Mkt. Value LAND IMP, TOTAL DATE REMARKS F - — --------- 'Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meaclawkind DEPTH House Plot Total t. V .A a _ F C}LL�R d TRIM ti � v r f — —, 65.-1-14 2/2j20F5 s Exterisian - Extension F Bath Poich Basement ' �FEQoa -. Fact. waits Interkr Finish L Beway i Fig Place Heotxj Gorcqw Roof — Rooms 1 st Fkxw Patio Aecmation Room Rooms 2nc!Flaw I t Cl. D. iDastx�r STY 7t�tal PROPOSED € Ex INTERIOR t cAE ALTERATIONS EEC k i « - -A a TCZ SF ° R I zn4¢nob-aRi—A. so.-MoLn.i.n:nsv 12 - --- (� r h lJ a�-'l i O,`a. -� ? I i4ICNYELR CE O.' PE I3.0 r a .- 4 g _ !!-!!EE GE o m CRtANLSPACE « - e-a --- -- —NDPLAC � t I —RRAY.NY,1«t ElT EZ E .6 C_ i.. Sib dS-fiaa_ - 140D L CSC £ 1FTT8 i £i k -6 S z i ll khYt3G To"Is t`'Y - j _ PENPJc _; 4i Cyi t 131 , - "f"" E h: 6 - f r ans ry Tr -:r ne roo>�rom L r - t T• .e F t. i,a.An— ;,EXISTING FOUNDATION PLAN =s:,PROPOSED IST FLOOR PLAN C WINDOW&Rh EXT.SCHEDULE v£ L DQOEC SCHEOU<_E n IG—ors e pn s - ( - 10 E L h.0 _Loi' u I �� Y� C R f « F — th— W. a ^cE Ferse. EX FND'D; ,ST PLUMING R16ER DIAGRAM PLANS&DETAL A-1