HomeMy WebLinkAbout1000-111.-14-40 # - TOWN OF SO TOL
Rental Permit
Permit No. 0117
Owner Joseph & Barbara McCartney
Occupied as Single Family Dwelling
Located at 3915 Vanston Rd Cutchogue 111-14-40
Address Village S/13/1-
Maximum
/B/LMaximum Permitted Occupancy 6
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.
7/23/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
S
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.p.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT'
TOWN OF SOUTHOILD
RENTAL PERMIT APPLICATION
M 751 U�. FIN
Rental Permit Fee$200(Application must be renewed every years)
JUN 1 9 2019
Section A. TOWN OF SOUTH��;
Property Information:
Rental Property Address:
Number: K 9 LOT VO
SEICTION B.
OWNER INFORMATION:
k
G
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
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Telephone Number(s): LG J r Lf 0
Property Owner Email Address:
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Page 1 of 4 r4- C „ a
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent(no P.O. Boxes): ,a
Mailing Address of Authorized Agent:
Telephone Number(s):
Email Address: �.
CtJ��
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit,if any:
Address of Authorized Agent(no P.O. Boxes):
14V
Mailing Address of Authorized Agent:
Telephone Number(s):
Email Address:
SECTION E.
SITE MANAGER INFORMATION:(required for rental properties containing r 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):
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, C);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:
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 NYS licensed architect,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 Ia 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.
Page 3 of 4
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JUL 2 2
Town Hall Annex � rlaa ne(631)765-.1802AV'
-5075-Main Road-- 1 x ( 1)7 a5 950
P.O.Box 1 179� MA)MG
Southold,NY 11971-0959
TOWN 0FS0LUU0LD
BUILDING DEPART ENT
TOWN OF SOUTHOLD
0
Mailing Address of Managing Agent: h
p ( ) Daytime � c g y . ( v8c)
Telephone Numbers : Da Ime
venin Emer enc '�,
Email Address: Aye
SECTION F.
PROPERTY]DESCRIPTIO
Number of Rental Dwelling Units-on propertL �
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)andthe dimensions of each
room.-,-
For
oo -.__For properties with multiple Rental Dwelling Units use "Rental Permit Application
Addendum."
Rental Dwelling Unit Identifier: "
Requested Maximum number of persons allowed to occupy Dwell.i.ng.Unit :-
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit;
\5 '
"F
�
"'rte
Page 3 of
Ziam submitting a completed l certification form from licensed
architect,a licensed professional engineer, or a licensed home inspector who has a valid
New York State Uniform Fire Prevention Buildingcode Certification.
SECTION .
Signature s r of the dwelflngunit.
STATE F NEW YORK)
COUNTY F SUFFOLK)
I „ certify under penalty of perjury,the following:
. 1 am the owner of the property identified i "Section " of this application.
. The property owner's legal aress set forth i "Section " of this application is my legal
address and I understand the Town will use thea dress for service pursuant to all
applicable laws and rules. I further acknowledge that I will notify the Town of Southold
Building e any changes of address within five( ) days of any changes
thereto.
. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold
agreed to abide by the same.
. I will notify the Town within five ( ) business days s to any change to the information
regarding Authoriz n , Managing Agent, or Site Manager.
PropertyOwner's Name: ,� -, A
Property is Signature:
Swo
r o re a this y 2 ,
..,
Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH
Notary Public,State of New York
No.01 BU6185050
Page 4 of 4 Qualified in Suffolk County
Commission Expires April 14, 2D-0-0
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Telephone(631)765-1802
Town Hall Annex
r l' Fax(631)765-9502
54375 Main Road
P.O.Box 1179 u"
Southold,NY 11971-0959 "�
to,t
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION D EN Dv
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
srr .
vC 41 • -- _IID
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND . [ ] INSULATION
[ ] FRAMING /ST APPING [ ] NAL
[ ]
FIREPLACE CHIMNEY [ FIRE F'ET"Y dtTION
i
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
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FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. 21.1.447. . . . . . . . . . Date . . . . . February. .24. . . . . . , , . . , 19$3 .
THIS CERTIFIES that the building , . . . . . . . . . . . . , . ,
Location of Property 3915 . . . . . . . . . , , Vanston Road Cutcho.gue
House No. Street Hamlet
County Tax Map No. 1000 Section . • , 1 1 1, • , , • •Block . . •14• . . . • . . . • ,Lot • Q49. , • • . , . . , ,
Subdivision . X . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. A . . . . . .Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
April 16 , • • , , , , , , 19 8'2 pursuant to which Building Permit No. . . . 1636. wZ
dated . . .Ma.3' .6 . . . . . . • . • . . . • , - - . . . 19 82 ,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 . . . . . . . . .
a private one-
. . . . . . . . . . dweZlin
The certificate is issued to . . . .ROBERT. &, JOAN LEHNERT . , . , . . . . . . . . _ . • , , .
(owner,lessee er-tenant}
of the aforesaid building.
Suffolk County Department of Health Approval 1 2 2
UNDERWRITERS CERTIFICATE NO. . . . . . • . . . . . . .
Building Inspector A
Rev.1/81
� lEt ' Town of Southold 5/22/2019
P.O.Box 1179
w" 53095 Main Rd
Southold,New York 11971
CERTIFICATE F OF OCCUPANCY
No: 40402 Date: 5/22/2019
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 3915 Vanston Rd., Cutchogue
SCTM##: 473889 Sec/Block/Lot: 111.-14-40
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore Sled in this office dated
10/25/2017 pursuant to which Building Permit No. 42119 dated 11/6/2017
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:
ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to McCartney,Joseph&Barbara
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42119 06-25-2018
PLUMBERS, CERTIFICATION DATED 04-10-2018 W 'am Grcml
u h 17d Signature