Fill - Free fillable INCORPORATED VILLAGE OF LINDENHURST (Incorporated Village of Lindenhurst) PDF form

(631) 957-7500

FAX (631) 957-4605

INCORPORATED VILLAGE OF LINDENHURST

430 SO. WELLWOOD AVENUE - LINDENHURST, NEW YORK 11757

RENTAL PERMIT – GENERAL PROCEDURE

ubmit the completed application to the Building Department Monday-Friday between the hours of 9:00 a.m. and

4:30 p.m. If you have any questions please call (631) 957-7511 or (631) 957-7510.

Notice to Home Owner:

1. The property owner may have an outside licensed architect or a licensed professional engineer conduct an

inspection of the premises, (at the homeowner’s expense), and provide a certification that the property is in

compliance with all the provisions of the Code of the Village of Lindenhurst, the laws and sanitary and housin

egulations of the County of Suffolk and the laws of the State of New York prior to the issuance of such permit or

renewal.

2. A

fter an application has been submitted, an inspection is required. If an outside professional was not attained, an

inspection date will be scheduled for the Building Inspector to inspect the dwelling/building(s). No inspections are

done on holidays or weekends. All structures on the property must also be inspected—garages, sheds, decks, pool,

etc. The inspection is required to determine the condition of the dwelling/building(s) and compliance with the

applicable NYS and Suffolk County building codes.

If the inspector cannot gain entry to the premises on the scheduled date, a $50.00 re-inspection fee will be charged.

3. If your dwelling/building(s) fail inspection, all violations must be corrected and another inspection must be

scheduled. If you schedule an inspection and previously cited items have not been corrected, you will be charged a

$50.00 re-inspection fee.

4. A

rental permit will be issued when all requirements have been satisfied.

dditional Notes:

1. The following structures/improvements require a building permit and certificate of occupancy, if applicable. If you

do not have a building permit, you will be required to obtain one prior to receiving a rental permit.

-A

wning patio roof -Dwelling

- Cellar entrance -Extensions

-Decks (18” above grade) - Finished basement

-Dormer -Garage

-Fences (depending upon location) -Garage conversion

-Outside second story deck and stairway -Gazebo

-Pools (in-ground or semi in-ground)

2. A plumbing permit is required for replacement of a boiler or a hot water heater.

3. For an apartment building, MR or SCMR, a floor plan for each type of unit must be provided (see attached sample

floor plan).

GENERAL INFORMATION AND INSTRUCTIONS FOR APPLICATION OF A RENTAL PERMIT

The items listed below must be submitted with the completed notarized application.

Deed/Owner’s Duplicate Certificate of Title: A copy of the recorded deed showing the liber and page numbers or a

certified copy of the owner’s duplicate certificate of title is required. If the deed has not been recorded yet, a copy of

the deed and a notarized letter from your title company, or a letter from your attorney on letterhead stating the date

he/she filed the deed for recording with the Suffolk County Clerk.

Copy of Owner’s Driver’s License or other Valid Identification

Floor Plans: Floor plans drawn to ¼” = 1’ scale of the entire dwelling, apartment, building, multiple residences (MR), or

senior citizen multiple residence (SCMR). Label all rooms with dimensions; including measurements (height and

width) for all doors, windows and the floor to ceiling heights. Show location of all smoke detectors. For two-family

and multiple family dwellings, provide separate floor plans for the owner’s unit and tenant’s unit(s) and label each

floor plan as either owner’s or tenant’s. See sample floor plan attached. Floor plan can be drawn by owner of the

property.

Certificate(s) of Occupancy (C.O.): Copy of the C.O. for the dwelling, apartment building, MR, SCMR or motel. Also

include copies of C.O.s for any addition, garage, deck, shed, etc.

Identification and Tax Bill: Identification must be government issued picture I.D. with home address, such as a driver’s

license, passport, etc. The tax bill may be obtained from the Tax Receiver’s Office.

Building Permit Application: A building permit application is required only if you plan to make changes that affect the

structure of the swelling or building(s) or if you need to legalize existing structures and/or improvements.

Fee (non-refundable):

-Dwellings—$250.00 for the first unit plus $50.00 for each additional unit

-Apartment Building/MR/SCMR/Motel—$500.00 for the first unit in each building plus $50.00 for each additional unit

in each building.

Return all documentation Attn: FIRE MARSHAL’S OFFICE

If paying by check or money order, make payable to the Incorporated Village of Lindenhurst

RENT

AL PERMIT REQUIREMENTS

1. Smoke detectors are required in each bedroom. Smoke detectors and carbon monoxide detectors are required

for any hallway leading to a bedroom no more than fifteen (15) feet from the entrance to a bedroom. One (1)

smoke detector and one (1) carbon monoxide detector is required for each level of the dwelling.

2. Outside stoops that are 18” high must have railings.

3. Stairwells must have handrails.

4. Access doors between apartments, minimum ¾ hour fire rated door assembly equipped with self-closing devices,

are required.

5. If the boiler is in a separate room, ¾ hour fire rated sheetrock is required with a ¾ hour fire rated self-closing door.

6. If the boiler is in an open room 5/8” fire rated sheetrock is required over the boiler only.

7. Driveway must be improved (asphalt, concrete or bituminous surface) and in good repair.

8. No unlicensed motor vehicle(s) or commercial vehicles on property.

9. No debris or any other material that could be considered debris.

10. Proper storm windows and doors (with screens) must be installed.

11. No cellar bedrooms.

12. Electric outlets must not be exposed. All walls and flooring shall be in sound condition. GFI outlets required

in bathrooms and kitchen counter walls.

13. Tiles and grouting in bathrooms must be in good repair.

14. Dwellings must have proper heat, hot water, etc.

15. Property must conform to Maintenance Code of New York State.

16. Any changes or additions, i.e., awning, dormer, carport, extension, pool, etc. must have a building permit

and certificate of occupancy. The owner will be held responsible for obtaining the proper permits and certificates

of occupancy.

17. Premises identification: address numbers; new and existing buildings shall have approved address

numbers, building numbers or approved building identification placed in a position to be plainly legible and visible

from the street or road fronting the property. These numbers shall be Arabic numerals or alphabet letters.

Numbers shall be a minimum of 4 inches (102mm) high with a minimum stroke width of 0.5 inch (12.7mm).

18. Bedrooms must have a secondary exit (window) as per New York State Fire Code.

It is the responsibility of the property owner to schedule an inspection of the rental property.

Owner/Tenant Authorization Form (which is attached) must be signed by both the owner and the tenants before

inspection can be done.

INCORPORATED VILLAGE OF LINDENHURST

RENTAL PERMIT APPLICATION

Property Owner Name: _______________________________________________________________________________________

Company/Corporation Name: _________________________________________________________________________________

Rental Address: _____________________________________________________________________________________________

Suffolk County Tax Map Number: ______________________________________________________________________________

Owner Mailing Address: ______________________________________________________________________________________

____________________________________________________________________________________

Home Telephone: _________________________________________ Cell Phone: ________________________________________

Agent’s Name/Title: _________________________________________________________________________________________

Agent’s Mailing Address: _____________________________________________________________________________________

_____________________________________________________________________________________

Agent’s Telephone: _______________________________________ Fax: _______________________________________________

Name and Address for Service of Process Name: __________________________________________________________________

(P.O. Box is not acceptable)

__________________________________________________________________

Type of Rental (check one)

One family dwelling

Two-family—number of rental units: ______

Multiple Family dwelling—number of rental units: ______

Apartment complex—number of buildings: _____ number of units: ______

Mixed use—number of units: _____

I (we) hereby affirm the following to be true:

 There are no existing Code or New York State Uniform Fire Prevention and Building Code violations at the

subject premises.

 There are no existing safety or health violations at the subject premises

 I (we) do not have any knowledge of complaints from tenants or others regarding any existing code, safety or

health violations at the subject premises.

 The statements checked on this application, together with the documents, survey and plan(s) on file are true

and accurate for the subject premises.

The owners of the property and the undersigned agree to

conform to all applicable laws of the Village of Lindenhurst

and the state of New York.

Sworn before me this ________ day of

_____________ ________20_________

__________________________________________________

________________________________ Signature of Property Owner

NCORPORATED VILLAGE OF LINDENHURST

RENTAL INSPECTION CHECKLIST

Inspection date: _______________________ Permit Number: _______________________

(office use only) (office use only)

roperty Owner Name: _____________________________________________________________________________

ompany/Corporation Name: ________________________________________________________________________

Rental Address: ___________________________________________________________________________________

uffolk County Tax Map Number: _____________________________________________________________________

wner Mailing Address: ____________________________________________________________________________

____

_________________________________________________________________________

ontact Person: ___________________________________________________________________________________

Cell Phone: ____________________________________ Home Phone: _______________________________________

ontact Address: __________________________________________________________________________________

__________________________________________________________________________________

INSPECTED

1. Smoke detectors/carbon monoxide 7. No debris

2. Outside stoops have railings 8.

torm windows and doors

3. Stairwells have handrails 9.

o cellar bedrooms

4. Boiler area properly fire rated 10.

lectric outlets, walls, floors

5. Driveway improved, good repair 11. Tiles/grout in food repair

6. No unlicensed motor vehicle(s) 12. Heat, hot water, etc.

*This does not constitute a certification of structural, electrical or mechanical fitness

Other Building permits required: ______________________________________________________________

nspector’s comments: ______________________________________________________________________

nspector’s signature: _______________________________________________________________________

Check if applicable:

______ No entry _____ Previously cited items corrected _____ $50.00 Re-inspection fee

e timeframe to correct the above items is thirty (30) days from the date of this inspection unless otherwise

noted. Please call 631-957-7511 to schedule the Rental Inspection. If an inspection has been scheduled and

the above items have not been properly corrected or if the inspector cannot gain entry to the premises, you

will be charged a $50.00 re-inspection fee.

ENTAL PERMIT OWNER AND TENANT AUTHORIZATION FORM

I of

Owner of Record Rental Address

Grant permission to the Village of Lindenhurst Building Inspector to enter my property and dwelling for a

Rental Inspection of the premises listed above.

The owner of the property and tenant agree to conform to all applicable laws of the Village of Lindenhurst and

the State of New York.

Signature of Property Owner Date

Tenant: