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Home My WebLink About1000-69.-4-9.2 TOWN F SOUTHOLD Rental Permit 0028 Owner John Sepenoski, Jr. Occupied as Single Family Dwelling Located at 37302 CR 48 Peconic 69.-4-9.2 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. Expiratior is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 4/27/2023 Code nf rc r�tet Offici This Notice must be posted by the main entrance at all times aso TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION , ] FOUNDATION 1ST ROUGH m ] FOUNDATION 2ND FRAMING1 STRAPPING FINAL jFIREPLACE & CHIMNEYI INSPECTION j ] FIRE RESISTANTI FIRE RESISTANTPENETRATION ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) ] VIOLATION [1-�RENTAL REMARKS: �� ooh g-�- 4-og- DATE - � 6G - # � TOWN OF SOUTHOLDRental Permit Permit No. 0028 Owner John Sepenoski, Jr. Occupied as Single Family Dwelling Located at 37302 CR 48 Peconic 69.4-9.2 Village 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. 4/29/2021 � �4 Code Enforcement Official This Notice must be posted by the main entrance at all times Town Hall Annex SOUTHOLD TOWN 54375 Main Road PO Box 1179 Southold, Rental Inspection NY 11971-1179 `r Tel: 631-765-1802 ro j�� Fax 631-765-9502 SCTM # �'n -- 4 — g Date Owner -5F F p S<✓I Phone Address 3'"7 �o 1-2- 2T Zip Hamlet coo.' �'C_ Inspector I crOd�&& Address visible from street? LEVELS SUB 1 2 3 Smoke Detectors (#- bedroom detectors excluded) I Carbon Monoxide Detectors (#) I Fire Extinguishers (#) Exits(#) O BEDROOMS 1 2 3 4 5 Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows) (Y/ISI) BUILDING SYSTEMS Y/N CONDITION OF PROPERTY Y/N Heating system maintained/operational Building Interior is clean/maintained Hot water system maintained/operational Building Exterior is clean/maintained Electrical system maintained/operational Property is clean/safe/maintained Mechanical system maintained/operational Handrails&guards present PO Y/N POOL BARRIERS Y/N Pool present `"' - . p() Pool is completely enclosed Pool surface alarm and/or door ala Barrier is a min.48"high resent ng_ barrier less than 4" POOL GATES Y/N I'r .enihum Self-closing, self-latching Max. 2"clearance 4ottom,pt barrier Latch on pool side of gate, meets height Barrier capable of being locked &clil `" requirements proof when unattended COMMENTS: a TOWN OF SOUTHOLD -65 Rental r Permit No. 0028 Owner John Sepenoski, Jr. Occupied as Single Family Dwelling Located at 37302 CR 48 Peconic 69-4-9.2 Address Village S/13/1- Maximum /B/LMaximum 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. 4/3/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times e Town Hall Annex Telephope(631)765-1802 v 543;75 Main•Roadu (631)_765 Fax -9502 FCBD Box 1179 a 1'"southold9l 11971-0959. L 1.30J.:DiNq DEPAf TMM°sif . W0 "' ,F t `H0La MAR 2 5 2019 RENTAL PERM IT APPL ATIONI T. p ... .. _ 7 i (.i ( ' j!c�qr),�i h s) Ren e � p a� r a Section A. Property Information: Rental Property Address: tui -------------- Tax Map Number: 1000 SECTION Vtt e' W NIR INFORMATION: Property Owner Name: �d /�? _ e a. "z Proe e e a Are s: t rope O er • ailing dress: :(Cannot,e ,e the same.asRental.Prope ,Y Adgre�s) Telephone Number (s): G Property Owner Email Address: Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit; if any: Address of Adthorized Agent (no P.O. Boxes);; Mailing Address of Authorized Agent: Telephone Number(s):< Email Ad di=essz Section D. MManagingAgent Information:_ Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.Ov ocs): �., r '77r7, Mani ig Address of Authorized Agent: Telephone Number(s): 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(n g o P.O. Boxes):, .. . Mailing Address of Managing Agent;,. - _- Telephone Number (s): . Email Address: Page 2 of 4 'w 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 p ), 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 App,licti,cn. 3. Addendum." Rental Dwelling Unit Identifier: . Requested Maximum nuber.of persons allowed to occupy Dwelling Uni Number of rooms in Rental Dwelling Unit . - Use and Dimons'lons of each room'in-Rental'L wlejllinj 0,.K MI a A I i SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Propertiesy;'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 licensb&nechitect,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. am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. ,Page 3 of 4 Ei 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 . DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK} COUNTY OF SUFFOLK) 11 a_ .; e �: r certify, penalty of�perjury;the following: 1. I 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 notifythe 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 Na. e � �e: .. � . .,q r�>w e Property Owner's Sig nature: k�� Sworn to before me thi. of Woj- 20L cial tary Public Signature and Original Notary Stamp Page 4 Of 4 LYNDA M RUDDER a g Nnfary Public, State of New York. No.01 RU6020932 Qualified in Suffolk County Commission Expires March B,2 TOWN OF SOUTHOLD BUILDING . 765-1802 INSPECTION 11III)ATIr III„ ROUGH P111 11M. III„ 11FOUIRIDA"nollM 211MIlDIII„ 11INSUIll,,,,,,,AT111011M III„ 11IRAI11I r1lRAPP11111MG III' ]JI E Lx"'kt, III„ III �IIREIR,,,,, lllm & C11HIMINEY I11111 E SAFE ry 11111MSPEc rici ilF-lll iii m iR111 ° -- iii „ ii iii 1 III.. il1R111,,,, ii iii iii „T ii °T 111P1iim1MIE-TRAT 1 �Ei� r111:, 111111 ( 11,,,1) llm "Tlll l,,,,, (IF11111L) C0111)111:11:1. V1110111 KI-1110N CAULIK11111MGDATE INSPECTORly S G.....ItlL a q r. �d l °�r �r� _ amara'" r ra�x m g ,0 ^7 ._ �.... _ .. ....,e......_ N .. V CD I* t 4 Cu,a y unz 0 r-4 rn C- Liz_ __ q° co J p f n a r NJ..„.,, lop rn r "All .. ............ FORM NO.a TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . Z] 6974 , . . . . . , . . Date . . .June. .�Qa. .1.988. . . . . . . . . . . . . . THIS CERTIFIES that the building . . . . . O,n e f am i 1 y dw e 11 i n g. . . . . . . . . Location of Property7 3 2 R. O.W . off C t y. Rd. #48 S o u t h o l d Ho r , Street Hamlet County Tax Map No. 1000 Section . . . b.9 . . . . . .Block . . . 4. , . . , , . . . . .Lot . . . . .9 . , . . . . , . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated S e p t ; ]9 , 1 9 8 6 pursuant to which Building Permit No. .1.7.088Z. , , , , , , , , , , , , dated 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 . . . . . . . . . MODULAR ONE FAMILY DWELLING. The certificate is issued to ,JOHN B SEPENOSRI, JR. of the aforesaid building. Suffolk County Department of Health Approval . . . . . .g7-50-70, Nov. 4. .1987 . y UNDERWRITERS CERTIFICATE NO. . . . . . . . „ . , . , N83S994 Oct: PLUMBERS CERTIFICATION DATED: N/A 4 Building Inspector Rev. 1/81 C q t q � TOWN OF SOUTHOLD PROPERTY RSC- RD CARD - - - - STREET j VILLAGE DIST, SUB, LOT FORMER t WNEE � E ACR. Zc _ S W I TYPE OF BUILDING jow RES. SEAS. VL. FARM COMM_ LAND IMP. TOTAL DATE REMARKS - - `A _ _a 3a :" 70 J � S � 3 !! I FRONTAGE ON WATER TILLABLE I _ f FRONTAGE ON ROAD WOODLAND l i :-:PTH I MEADOWLANDI c � BULKHEAD HOUSE/LOT ' TOTAL \ \\ 4COLOR i ` I TRIM I I � M. Bldg 4L _ - Foundation Bath Dinette PC FULL Extension Basement CRAWL Floors Kit. SLAB Extension Ext. Walls Interior Finish L.R. Extension Fire Place Heat D.R. Patio Woodstove BR_ Porch Dormer Fin. B. Deck _ Attic Breezeway Rooms 1st Floor Garage Driveway Rooms 2nd Floor O.B. Pool