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Home My WebLink About1000-38.-1-20 TOWN OF SOUTHOLD Rental Permit 1525 Owner: Glen Crandall & Edina Kosachesky Occupied as: Single Family Dwelling Located at: 1845 Shipyard Ln East Marion 3 8.-1-20 Maximum Permitted Occupancy: 2 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: 07/21/2026 Expiration: 07/20/2028 Co rce r� official This Notice must be posted by the main entrant j ��4 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 https. ,N,=ww.southoldto)y . o RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must n r JUL 1 Section A. Building a mot Property Information: Town Southold Rental Property Address:/6 L � �� ' . A `oKj Tax Map Number: 1000 SECTION d3 i BLOCK SECTION B. OWNER INFORMATION: Property Owner Name: l�L � 6KA-W V fJE9NA K0,5i 44 e ' k� Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 15 Telephone Number(s): Daytime Evening $17,12-Emergency 3[ 3�v'�1212 Property Owner Email Address: �..� �i�iV R7�L•�U Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: NJ/ 4 'r� 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: ZA 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:_ N A 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: D� 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: s. � 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: 4. � .� ( D 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. 0 1 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 &L-fN C0JIDA t 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 bef a this A day of Tu�y� , 20 Zb. Official Not - P16blic Signature and Original Notary Stamp AHW SHMW 00UWPUxX-$Wx0rnWyMx county. os�oer�o3p Page 4 of 4 L000lt C<,. Rh� TOWN O_ O THO D BUILDING DEPT. 631-765-1802 �V. ^ I --w INSPECTION [ ] 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 (F AL) [ ] CODE VIOLATION [ ] PRE C/O RENTAL REM KS: • CD -w ev', DATE ilf INSPECTOR 14 ZZZM Town Hall Annex _ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 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 Horne Inspector trust provide copy of valid current certification Rental Property SCTM Number: ! 0OC2 ?2 f�!- r Rental Property Address: 119� �- �� dyv 1 ) 'C1 Owner/Name: C9 L.0t4 Rental Dwelling Unit Identifier: RO V61:'� _ Number& Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 — 100 sqft., Bedroom#2—90 sgft., etc.) Property Description (Include all improvements indicated on survey) S dl�. V 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 rk State, the Plumbing Code of New York State, the Fuel Gas Code of New York State, the F" f�at, rk State, the Property Maintenance Code of New York Stat#_ and the Energy Co Code of New York State. GLEN Cf' E Print Name and O ' al Signature ®� Please place Pea 0 t4le44 N 4P SCTM.._.. . ........._.. .....prow._..._..,wr............ ..._._. �� _. . �C�-3`6 - -^a� TOWN OF SOUTHOLD PROPERTY RECORD CAI f ........._.._.__. OWNER STREET k4 VILLAGE DIST, SUB. LOT (on n✓`0 vn ACR. REMARKS _ TYPE OF BLD_ I(;,a PROP. CLASS V-7�. LAND I " P, TOTAL DATE ':1c C) I moo r (o(s 1 A FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL 8 THOLD PROP OWNER f STREET ` VILLAGE DISTRICT SUB. LOT ........_.. "))'sC e O '+ OWN RN, � . "�� _ ._M._ �, ........ _._._.._M ... .ACREAGE S W� j TYPE OF BU I LDI NG f a ARM COM,M____..__.... . . IND _„__...__..._ CB. � misc.m W_ RES. SEAS. VL �. ...... _ .....��...M..._. ....� LAND IMP, TOTAL DATE REMARKS2c�, ., 4....ti,,,,.." .A".,"m.,,. ..... .w, A'"m...m....�rv' k./..�.. .J ,,d" „,,...�:"�......,.... .�:�,.., .,....�„�...,.,... ".......,,�.'�. ..�........,.. .". M ....,.nw.. .,...... ' . . � e " ..._. ho AGE BUILDING CONDITION , �__........_....�_ _..... .._NORMAL �._w_ B_�.�_ ... .LOW... �_�_ � ..... ....... ABOVE om. . Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable, 3 Woodland Swampland Brus Hand House Plot __ __ ..,_ i Total j 1 ^n. , �J i a r / .,. r , a .. m.... .. m ...., . _ �. .._ ..- ..._ m. . ..._ _ ... M Bld / �7 ` .g_ `.._,1/�` 1�._ ..._ ... ��l� w ... Foundation.. . ,,.. �`�! _.... Bath .. ... _...... ._....... ..._ Extension Basement Floors ........... .... ..Mw.... ._...._,., .. .. . ' Extension Ext. Walls Interior Finish ...�.�.... .........w....... _... _....._.. ......._ �.... ..... �,.__.�,._.. _ _...m..m__.....__mm__.._ .........._._.... _ Extension Fire Place Heat ace,��af.•: ,. Porch Attic Porch Rooms 1st Floor r Breezeway Patio Rooms 2nd Floor Garage Driveway 0. B. /Z, __... ..._M M__M_.. ...... .w_____ � �. _ 10 , 0soutj Town of Southold P.O. Box 1179 53095 Main Rd Southold, New York 11971 CERT CATS OF OCCUPANCY No: 47145 Date: 06/16/2026 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 1845 S darion,NY 11939 Sec/Block/Lot: 3 5.-1-20 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 11/21/2025 Pursuant to which Building Permit No. 52874 and dated: 04/17/2026 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: "As built" alterations, including outdoor shower,to an existing single family dwelling as applied for. The certificate is issued to: ° Terrence Flerning Heidi F1 ning Fletnin ` E T t Of the aforesaid building. 1`f SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 25-105705 & 26-109392 12/11/25 & 06/12/2026 -PLLTM]3ERS CERTIFICATION: it `' Boyan Vlajic 06/05/2026 - tho Si na e FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31445 Date: 02 27/0 THIS CERTIFIES that the building DWELLING Location of Property 1845 SHIPYARD LA EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 038 Block 0001 Lot 020 Subdivision Filed Map No. Lot No_ conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NOMER Z- 31445 dated FEBRUARY 27, 200 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* The certificate is issued to NATHALIE L RACKETT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTNOT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. or/zed Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 1845 SHIPYARD LA EAST MARION SUBDIVISION: MAP NO.: LOT (S) NAME OF OVMM (S): 14ATRALIE L RACKETT OCCUPANCY: SINGLE FAMILY DWELLING, NATHALIE L RACKETT ADMITTED BY: GORDON RACKETT ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO-: 38.-1-20 SOURCE OF F: NATHALIE RACKETT, 2/1/06 DATE: 02 27/06 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME $ STORIES: 1.0 R EXITS: 2 FOUNDATION. POURED CONCRETE CELLAR: CRANL SPACE: TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 0 3RD FLR.: 0 RATZROOK(S): 1.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S)- YES PORCH TYPE: DECK TYPE: PATIO TYPE: B1 Uhl(: FIREPLACE: NOT OPERABLE GARAGE: DOMESTIC RUTRATHR. YES TYPE TER: KEYSPAN AIR BONING: TYPE HEAT: KEYSPAN MEN AIR: XX HOTie . OTHER: ACCESSORY STRUC GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTBER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION i DESCRIPTION ART. SEC- — t d i j 1 i REMARKS: INSPECTED BY: s DATE ON INSPECTION: 02 13 06 GARY J_ TIME START: 10:00 AM END: 10:25 AM Of , Town of Southold # P.O. Box 1179 fi 53095 Main Rd r Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 47145 Date: 06/16/2026 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 1845 Shipvard Ln East Marion, NY 11939 Sec/Block/Lot: 38.-1-20 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 11/21/2025 Pursuant to which Building Permit No. 52874 and dated: 04/17/2026 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: "As built" alterations, including outdoor shower, to an existing single family dwelling as applied for. The certificate is issued to: Terrence Flenin ,Heidi Fleming,Fleming D &E Trust Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 25-105705 & 26-109392 12/11/25 & 06/12/2026 PLUMBERS CERTIFICATION: Boyan Vla is 06/05/2026 c uth ri -d is ature No. Revision/Issue Date =.rroR,ASE A WOk.YSh10P i 1 Prolee� ffLOOIz, FLAN I FOR RENTAL PERMIT 1.545 SHIPYARD LA. EAST MARION, NY 1 1939 PROJECT OWNER: c��scr 000 0Q III° 6 GLEN CIP'ANDALL 00 KITCHEN CG3 I ) 3G8- 122 101_01 ink.C7 "' HALL B'R14".0 All ❑ Flinn Nama and Addross Gic--n Crandall 5M CM ui Ji AF— I t I I<�w� �5 Eagle Road Rhinebeck, NY 1 2572 (G3 1) 3G8- 1 2 1 2 glen@gcarchltect.com 4vJ www.gcarchltect.com �5`-10" U LIVING Rr 1 55E1)P.00M 2 .... '"S b 1YE �y °268 �O FIN FOYER d' `SMOKE 1?E'IFCFOF: M SSINDKE CILTCCCC", CM CARBON MONDAIJt', °i Drown gG Sheet stele as noted FIRST- FLOOR PLAN 'Iebl 5111PYARD LA A I SGALE: 1/q.,, _ I,_p„ win 7 1141 2026