The URL can be used to link to this page

Home My WebLink About1000-25.-5-8 of so TOWN OF SOUTHOLD Rental Permit ° u . 1445 Owner: 420 Old Farm Rd LLC Occupied as: Single Family Dwelling Located at: 420 Old Farm Rd Orient 25.-5-8 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 arranginq for the bi-annual inspection. Issued: 04/17/2026 JA Expiration: 04/16/2028 Code for a ent cif This Notice must be posted by the main entrance at 11 ti es IMI@d""y,,,.. TOWN OF SO UTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 11t rs:,/ suticldtovvn� 8ca /! I P7 C( RENTAL PERMIT APPLICATION S ,ZO f 2(o Rental Permit Fee $300 (Application must be renewed every two years),. u, Section A. Property Information: Rentpertyr Address: 1�� (.� wn-� Tax Map Number: 1000 SECTION -BLOCK -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: „e Property Owner Legal Address: Property Owner Mail ddress: (Cannot be the same as Rental Property Address) 71 Telephone Number(s): Daytime Evening Emergency dd Property Owner Email Address: " 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): , 4V C &t Mailing Address of Authorized Agent: "P OX 7- 9-1-7 Telephone Number(s): Daytime "- E &ergency Email Address: � � f.I f Section D. Managing Agent Information: f Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): , LTeJ kJ - p Mailing Address of Authorized Agent: !rX.Al t ? �d 1 Telephone Number(s): Daytime 0!1�1 n i n g_ Emeergen�cy 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: 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: 61 I- kev-e, k j4c.�o (4- rc. AWI 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 :q j ,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: yj? � Property Owner's Signature: Sworn to before me th 40ya'y of�1 �p 20 Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Qualified In Suffolk County Page 4 of 4 Commission Expires April 14, 2M,�? - - 4w 0 L� inn � f Qr'"P-x TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE " TRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL ( NAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL 7R7MA:KS: Are\ Co Ztek" P014-A eA DATE INSPECTOR AKT ARCHITECTS airchitet..I Wed.d..ip 342 Bowery#3 New York,NY ID012 T:212 677,7077 (a ti vvow moc Lo 0) 37 fl CLWWDDVll5W1 OPPOSITE WALL �. ( 20 C! (If < co! uj Q z Ffl -j o Z LIVINUEA=74!iSFMNNORlITCHEN 41, MASTER BE—. C14 Uj AR iREE REQ VENTILATION=37255F REQ VENT11.AT1ON=11.75SF ACTUAU�31SF ACTUALWSF REQ LIGHT=N 55F REQ LIGHT=2355F ACTUAL=51SF ACTUAL SF GARAGE Issue Dale:4/1V.W4 00%—100.p. V MASTER j 4 i TERRACE QLTR Y x 1 1 BAT ROOM 7D OT� l j- K- 7 Ci ff CL BATHROOM EXHAUST Z �i RAERQEAV=3EWTSIL FA TION=iSSF Me: ACTUAL=56 55F t 1ST FLOOR PLAN REQ LIGHT MF ACTUAL=68 5SF Scale:AS NOTED Drawing N.: A-101.00 -NN LST—FLOOR KM SCALE:114*aVAT Page N.: 3 OF 14 AKTARCHITECTSI archlLecture+Irtarior design 342 Bowery#3 New York,NY 10012 T.212.677,7077 01. 0 20 LL LU Z OPEN TO BELOW RDOF SLOPE 0 i C) Z C\l LU O LL M MEZZANINE BATHROO. Cal BEDROOM BEDROOM ARFA=1535F AREA=10SI REO VENTRATtO"" l 1 IF III'E"T 1111 �AL=29,SSF ACTUAL=TBO Two REQ.UQKr=17SF AOIAL2955l AGTUN--TBD 2ND FLOOR PLAN ` Scala:AS NQTBD Drawing No.: ME)FLOOR PLIJI A-1 02.00 Page No.: 4 OF 147 t f�ADDITIONALFW7ING FOR SCONCRETECURSTOW . DECK ROOFPCST FROST DEPTH AS BEARING FOR -- .,- _�. _,_�. �._.... .; <..• ,.� STAIR srtaxaets@Pso.o ORIENT, OLD FARM ROAD -- - - - - - NT,NY 11957 REINFORCED CONCRBmiwo 4 - - - SONDNSE FOOTING,FLARED W006FRAMEp DECK i OR S(IUAREOTO PB'x98'AT ABOVE 1 , ( BOTTON'LMDEEP - € y a...�2,11 P.T.LEDGER;FASTEN USING t l TBASERIDCKLEDGM SCREM@ PY 04. 38P.T, 3'$§ '{�+^ ( # STAGGERED,PROVIDE POLYETHYLENE - { LEDGER SPACERS FOR DRAINAGE TYP - I TRUE NOUN L eY3 may j a 1 [[ ([ ®B.4 r (UNFINISHED S0.5ENry SN a z A IS €!RWISIQN DATE i A AD RUN— 06.=4 # ' 0.CIN PCETLIG(OR SIM g SHEATHfNG} P�'Y itb"DMBERSTRAND PSSE LSL-`� , - BrvxvF.R4AueT€R I BRAWN BY;I.LACNAPRIE -. A i ' , 3•st"��. NQTETUGISANi1•a1T"SLUT QRAWwcS MAYBE PRINTED NQT_TU SCALE__< _ - z T gJ T$TOY MONGRAMASM A YdEYERHAUESFR I A � t - `Ow LaChapelle Architecture PLLC -a-- r. : t P,O,a0x 1251 DECK ( ' M.Mxk NY 11452 _ �� (646)251-5056 Jake®lachapell®eTchftecica ure. m I - 2Ai FRAMED , # T r _... -- i PARTHION AT L 'STAIRS a s P.T.2ziDBFAM € RENFORCEDCYINCRETEPD'0 SONOTUBE FOOTING.FLARED OR — ("4P POSTS WIT s T SQUARED TO FRAMING WHERE 3S DEE B'CONCRETE CUNO TD 3B' ; , PB'TJIxO BY wDiCATED TYP :sT P f FROST DEPTH AS REARING FOR { WEYERLHAUF.SERIp Ir S STAIR STRINGERS 0 Te'0.C. G.C;DIRECTAPPLYGW9 GENERAL NOTES t ( CEJUNG(ORSRL I $ 9. DIMENSIONS GWEN ON THIS DRAW9NGARE MAMMUM `^-=29 P.T.LEDGER;FASTEN USING m _ SHFATNNGJ SPANS,FOR CONTRACTORS CONFIRMATION IN THE HMeERLOCK LEDGER SCREWS 9FIELD-DO NOT BUILD FROM THESE ARCHITECTURAL PLANS FOR DIMENSIONS5i0HS;SEE iP200.CE.UAGELEDGERV� i lS-� i ( - �� 2 ALLSUBFT.00(4 SHEATHINGTOBEGLUERAND SPACERS FOR DRAINAGE-TIP. 4"" "" """'^"-" - l - 1 INSTRUCTION F THEUSEOFTRONALLMA CTIlRER _ MANUFACTURED LUMBER UMBE USE O PRODUCTS SE PSLBYWEYERHAVESER MANUFACTURED DONLUMBERPRODUCTS.TNESE 8'GION WALRCED CONCRETE c - R DIN(S DO NOT SHOWALL DETAILS,FASTENwG FOUNDATION WALLATCEilAR TYP. .> _ RED EMEMB.AND OTHER DATA PERTINENT TO S'x24'CONTINUOUSCIPCONCRETE PLACESCHEDU 30PERFORATEDPMF4PEWHOLES ---- THESE MANUFACTURED LLWBFR PRODUCTS FOOTINGATPERIMETERvd(3)PE FACING DOWN AT FOOTING PERIMETER,MR SLOPE{'IN PM BSERVE CODEANO MANUFACTURER HMITADONS ON 4. O BAR CONTINUOUS.TYP.; FT TO DRYWEJ.L;PLACE PIPE SELOWSOTTOM OF BASEMENT ALL OWABE HOLES IN MEMBERS MEMBERS WITH MR4.3'COVEi FOR BAR SLABINCRUSMED STONE(NO MNESJ WRAPPED IN - -- 3 DIES OR NOTCHES MERE NOTALLQWED WiLLBE GE4TIXTILE FRTFR FASRIC;PIPE CONNECTION THROUGH ROLj'OWDANOREPLACED, FOOTMGCONNECTSPERIMETERDRAINTOCRUSHEDSTONE FOUNDATIONS&B FOLLOW ALL CODE REQUIRBMENTSFOR FRAF8NC4, ORINAGE PAD UNDER B.ASEME4TSLAB-SEE'WDRAWINGS FIRST FLOOR S SMILOR THICKER POLYETIT ENE VAPOR BANNER UNDER BASEMENT SLAB,OVER rGRAVEL BED(No FRAMING PLAN RNES);INSULATION PER DETAILS SHEET NO: CONSTRUCTION PLAN-CELLAR NORTH PROJECT C� 00 SCALE:1/8N=1'-0" S7 SHEET 2 OF H 1 J I ` L TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER -�„- _ t STREET A VILLAGE DIST.1 SUB. LOT _ FORMER OWNMr*,w�5 N E ACR S fly TYPE OF BUILDING RE , SEAS. VL. FARM COMM. CB, MICS. Mkt. Value LAND IMP, 1 TOTAL DATE REMARKS 4 E _ g - # �- _ d E C} [ O � g s �r _ .£ $ = f _ rEen _ _ e 1 � _ _ f e 3 a s Tillable FRONTAGE ON WATER 7Wa�odland _ FRONTAGE ON ROAD Meadowlond D � I EPTH House Plot BULKHEAD ; Total i WL4► T g � r uJ t T 2s:5-8 2/14/2025 i lit �t Bldg, JL 0 , Sq 9 G Foundation, ,� Bath 1 i Extension Floors _ � � Basement � F'u6.i,—. Eterson Ob Ext. Walls _ Interior Finish x r et- Fire Place N Heat Porch Pool Attic tl x -�ac� ,a.5 rya Deck l Patio Rooms 1st Floor Bream ay l AC- 1 Ctriueway Booms 2nd Floor Garage � __ - v.A' a 0. B. l ....................... ----------- of SO& Town of Southold P.O. Box 1179 53095 Main Rd 0 Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 46982 Date: 04/17/2026 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 420 Old Farm Rd Orient, NY 11957 Sec/Block/Lot: 25.-5-8 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 05/08/2024 Pursuant to which Building Permit No. 50888 and dated: 07/01/2024 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: Single-family dwelling with an unfinished basement, covered front porch, partially covered rear deck, outdoor shower, and an attached gat-age as applied for. The certificate is issued to: 420 Old Farm Rd LLC Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: R-21-0769 4/10/2026 ELECTRICAL CERTIFICATE: 50888 10/16/2025 PLUMBERS CERTIFICATION: Jack Gismondi 3/11/2026 i A t ize Signature of$00r, Town of Southold P.O. Box 1179 53095 Main Rd r� Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 46983 Date: 04/17/2026 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 420 Old Farm Rd Orient NY 11957 Sec/Block/Lot: 25.-5-8 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 10/08/2024 Pursuant to which Building Permit No. 51483 and dated: 12/17/2024 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: Roof-mounted solar panels and (3) energy storage systems in the attached garage of the existing single-family dwelling as applied for. The certificate is issued to: 420 Old Farm Rd LLC Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 51483 6/2/2025 PLUMBERS CERTIFICATION: Au io ' ed ignature of SOO� Town of Southold P.O. Box 1179 53095 Main Rd 1 COUNIt, 1 Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 46986 Date: 04/17/2026 THIS CERTIFIES that the building Swimming Pool with Fence- In Ground Location of Property: 420 Cold Farm Rd Orient NYw 11957 Sec/Block/Lot: 25.-5-8 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 02/07/2025 Pursuant to which Building Permit No. 51745 and dated: 03/14/2025 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 fenced to code as applied for. The certificate is issued to: 420 Old......FarmRd LLC Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: _M. ...... _._ ELECTRICAL CERTIFICATE: _..._.._...._.v.........._w _ ____..._.....51745 _10/16/202,5 _._... ...... PLUMBERSCERTIFICATION: __._....._. _.........._........vw....__ _.. .—.._w_.._. _. .._......._.._,..__. ._._.w_ ......_.... _ _ .................... _..._. Aut ori:re Si' nat tre