The URL can be used to link to this page

Home My WebLink About1000-117.-10-3.5 =� 1�_ - TOWN OF SOUTHOLD Rental Permit 0252 Owner Archivist Capital Jackson LLC Occupied as Single Family Dwelling Located at 410 Jackson Street Cutchogue 117-10-3.5 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 arranging for the bi-annual inspection. 2/18/2022 Code Enft- event Official This Notice must be posted by the main entrance at all times „Fr FO K Town Hall Annex SOUTHOLD TOWN 54375 Main Road Rental In ection PO Box 1179 Southold, r NY 11971-1179 Tel: 631-765-1802 „ Fax 631-765-9502 ��/e �l2 r11 I i✓f/I1J�/mrd' 1%MDU%/ i1 /r1/r/i�/loll /'11%r - rrr/%%/il%�oil( /o , �go H%//lr/'fir f l%�i/ /r/r%l%//�abir/ri%i/ / u lrJ / Irrrr/r,,!! 1//Alh/r4/f�$NiG t//%;1 LEVELS WIN, Smoke,Detectors (#-,bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers(#) Exits (#) BEDROOMS /d, ,21 r ,, moi/ Smoke Detector Alarms(#) Carbon Monoxide Alarms (#) Egress (windows)_;(Y/N) BUILDING SYSTEMS lr~ CONDITION OF PROPERTY 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 systW maintained/operational ` Handrails &guards present POOLS N POOL BARRIERS Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min. 48” high ; resent POOL GATES N All openings in barrier less than 4" Self-closing, self-latching Max.2" clearance @ bottom of barrier Latch on pool side of gate, meets height Barrier capable of being locked &child- requirements proof when unattended COMMENTS: O TOWN OF S O T O L 1169 Rental Permit r, Permit No. 0252 Owner Archivist Capital Jackson LLC Occupied as Single Family Dwelling Located at 410 Jackson Street Cutchogue 117-10-3.5 Address Village S/13/1- Maximum /e/LMaximum 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 arranging for the bi-annual inspection. 12/18/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times �C1 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 � a BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two ) 2019 a. AM Section A. Property Information: r m rff`w,C Rental Property Address: �I Tax Map Number: 1000 SECTION -BLOC SECTION B. OWNER INFORMATION: Property Owner Name: lG �h ✓ Property Owner Legal Address: Property Owner Mailing Address: i tf, qV5 NW RrWAtdtM6Z DR- '111111 RACktaldri, 01F, 011Z95 . Telephone Number(s): Daytim1_1 -5('�,-ga1vening Emergency_qI-7-5-72-14157 Property Owner Email Address: I N , y" Page 105 Town Hall Annex �� Telephone(631)765-1802 54375 Main Road r W f` Fax(631)765-9502 P.O.Box 1 179 " Southold,NY 11971-0959 �� t r. BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: 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 i � Number of rooms in Rental Dwelling Unit: 61 Use and Dimensions of each room in Rental Dwelling Unit: ( t hwx' :. boot" h OX , ftwk YA W Gweti Wikh 6 round Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 � Southold,NY 11971-0959 (n BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. IR I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I �. 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 Page 4 of 5 V' Town Hall Annex n ' Telephone(63-11765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO OLD 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: Property Owner's Signature: ". .. .._. Sworn to before me this It day of V ftb 20j, �s Offici N nary Public Signature and Original Notary Stamp o 'A=IOIA1.S r p 'U"A!.OU' E MCALLASTE" NOTARY I�tJl�1.I0-IREGO V COMMISSION Flo.985408 WO MISSION o4PM S APRIL 03,2023 Page 5 of 5 to a4l) BUILDINGTOWN OF SOUTHOLD . 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL . [ ] FOUNDATION 2ND INSULATION/CA LING [ ] FRAMING/STRAPPING [ "FINAI_444� [ ] FIREPLACE & CHIMNEY FIRE'SAFE,TY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION '[ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/ L DATE INSPECTOR�k loz �/ , 0 �/ - , 4exo 4&,U, to opj Olt of ,„ " I !?v f, I V-.1 NOOK.. �Ia" " .. ?'� � room 9 ,70 o - cn DZ Z 41 ,J w I I a�u �c C7 � O .- Si 4. 0 r> l ��w r 0oco In Irya. wr m 0 d D X u CD m N 19 o m �., D O m D q m on r t � r mJ� � wJIt ' 0 �.. r m O ��F ........... no om 5- 3 CL CT- cy a- rn < Jo to ei; ........ y. NMI rri low S IL ...... o OXI, Do ro L/I ......... ........f�. ...... "O-f,- ;n1J ea LL ea Ell ro _� , m _.,��• O� o c o o �f Om d ti m .. J I, p ._......., i f, 01 olm C 70 co T T � � 2 z —moi �^ Lel p m m ! Ln Z 0 0 n DeiW; pL w v cn — C� m O �N34 Ii r II Itz L u p m m m O] "Ito, Iaf 3 7 F . fl m A ✓ 1 J l � IGF' I1 J 'S w are p ID rt 0 0 f ntm yVVI4 a 9 N ' r � a 0 0 � Wo d . � any y i a wa 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- 30093 Date: 03/17/04 THIS CERTIFIES that the building DWELLING Location of Property 410 JACKSON ST NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 117 Block 0010 Lot 003.003 Subdivision _ I 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 NUMBER Z- 30093 dated MARCH _17 2004 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 WITH ACCESSORY WOOD FRAME 4 CAR GARAGE* The certificate is issued to JAMES G DILL JR.&JONATHAN DILL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Wriature Rev. 1/81 I ��L BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 410 JACKSON ST NEW SUFFOLK SUBDIVISION: MAP NO.: LOT (S) NANE OF OWNER (S): JAMES G DILL JR.&JONATHAN DILL OCCUPANCY: RESIDENTIAL JAMES G DILL JR.&JONATHAN DILL ADMITTED BY. JAMES DILL ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 117-10-3.3 SOURC$ OF REQUEST: HARVEY ARNOFF. 3 4 04 DP4 0 / 3 17 04 DWELLING- TYPE OF CONSTRUCTION: WOOD FRAME I STORIES: 2.0 # EXITS: 4 FOUNDATION: CONCRETE BLOCK CELLAR: 2 0 W CRAWL SPACE: 801d TOTAL ROOKS: IST FLR.: 7 2ND FLR.: 2 3RD FLR.: 0 BATHROOM(S) 3.0 TOILET R0014(S) 0.0 UTILITY ROOM(S) : PORCH TYPE: DECK TYPE: PATIO TYPE: CONCRETE .BLOCK BRHBZEWAY: FIREPLACE: TWO-1ST.FL.. -GARAGE: DOMESTIC HOTMATER: YES TYPE HEATER: OFF BOILER AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: HOTMATER: XX OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: WOOD FRAME 4 CAR STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DErCRIPTT014ART. SEC. N II I Q I I d I C A G I I fl I I f REMARKS: BP #1718Z-COZ-1424 (ADDITION) INSPECTED BY: DATE ON INSPECTION: 03/16/04 GARY J FS'H TIME START: 9:40 AM END: 10:15 AM FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY No. 1.1424 ..,....,. Date .... ... .. ..... .Sleptember....21 ... 19.. 7.2 ,THIS CERTIFIES that the building located at .. .JallkScn.St. Street Map No. = . .. . Block No. . . -.ot No. = .. . t'? ..k41 .. . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . pa .,, 2.5., 1962. . pursuant to which Building Permit No. 9 .71.8 dated . ...,... . . April . .227, 19.62.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ..Pxivate...one..fami.ly..dwellizlg ... .. ,...w, .... ..... .... . This certificate is issued to Zamea G. D13.1 ., .. Owner . (owner, lessee or tenant) of the aforesaid building. Building �7 _. ...._ 8/31/2015 ..... __ .... .-W Town of Southold P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37752 Date: 8/31/2015 THIS CERTIFIES that the building ACCESSORY ALTERATION Location of Property: 410 Jackson St,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.40-3.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/8/2014 pursuant to which Building Permit No. 38795 dated 4/18/2014 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: additions ition„ aLd aerations, snclu rr�g half bath and second floor garage t a:,an ex�5lc�a k�cca ��ry 1 � g r g as ARP ict:I for per ZBA#6730, dated 3/20/2014. The certificate is issued to Higgins,L Patrick&Higgins,Jennifer of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-14-0051 8/25/2015 ELECTRICAL CERTIFICATE NO. 38795 10/28/2014 PLUMBERS CERTIFICATION DATED 7/21/2015 1ca,ra.c Plumbing&Heat. ... �, — 7Ai/Ii d Signal" -C Ftt :, Town of Southold 9/1/2015 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37756 Date: 9/1/2015 THIS CERTIFIES that the building POOL HOUSE Location of Property: 410 Jackson St,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-10-3.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/10/2013 pursuant to which Building Permit No. 38424 dated 10/21/2013 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 pool house as applied for. The certificate is issued to Higgins,L Patrick&Higgins,Jennifer of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-13-0018 2/10/2015 ELECTRICAL CERTIFICATE NO. 38424 8/25/14 PLUMBERS CERTIFICATION DATED 7/1/2014 George Berry Jr Aute : a A e Jxd t Town of Southold 9/1/2015 P.O.Box 1179 53095 Main Rd '• � rqr Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37754 Date: 9/1/2015 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 410 Jackson St,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.40-3.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/10/2013 pursuant to which Building Permit No. 38424 dated 10/21/2013 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: gcccss9j i! 0rcund 9juluu Ipool with fence to code a applied for. The certificate is issued to Higgins,L Patrick&Higgins,Jennifer of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38424 8/25/2014 PLUMBERS CERTIFICATION DATED Aut] Town of Southold 9/1/2015 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE O . OCCUPANCY No: 37755 Date: 9/1/2015 THIS CERTIFIES that the building HOT TUB Location of Property: 410 Jackson St,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.40-3.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/10/2013 pursuant to which Building Permit No. 38424 dated 10/21/2013 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 hot tub with locking-goycr as applied f"or. The certificate is issued to Higgins,L Patrick&Higgins,Jennifer of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38424 8/25/2014 PLUMBERS CERTIFICATION DATED Aut7"Ild S: iature