HomeMy WebLinkAbout1000-104.-2-16 --___. --------
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TOWN OF SOUTHOLD
Rental Permit
0260
Owner Imelda Corcoran Farrell
Occupied as Single Family Dwelling (Unit 1)
Located at 2800 Pine Tree Road Cutchogue 104-2-16
Maximum Permitted Occupancy 4
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.
1/10/2022
Code Enfohent Official
This Notice must be posted by the main entrance at all times
Town Hall Annex
SOUTHOLD TOWN w� °n 54375 Main Road
PO Box 1179 Southold,
Rental Ins esti .
� NY 11971-1179
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Ito
Tel: 631-765-1802
Fax 631-765-9502
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SCTM # „- Da Z
Owner e O f _ m2
Address U 13
Hamlet C Inspector
Address visible from street?
LEVELS SUB r 1
Smoke Detectors (#- bedroom detectors excluded)
Carbon Monoxide Detectors(#)
Fire Extinguishers(#)
Exits (#)
BEDROOMS1 4 5
Smoke Detector Alarms (#)
Carbon Monoxide Alarms (#)
Egress (windows) ( ”/ ) b/1, 717
SYSTEMS (YIN CONDITION
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
POOLS :POOL BARRIERS t:YIN
Pool present Pool is completely enclosed
Pool surface alarm and/or door alarm Barrier is a min.48" high
resent
POOL GATES Y/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:
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TOWN OF SOUTHOLD
Rental Permit
- a 3 Permit No. 0260
Owner Imelda Corcoran Farrell / Unit One-Front Cottage
Occupied as Single Family Dwelling
Located at 2800 Pine Tree Rd. Cutchogue 104-2-16
Address Village s/B/L
Maximum Permitted Occupancy 4
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.
12/24/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
ox
� s
1 1i
Town Full Annex Telephone(631)765-1802
54375 Matin Fdoasl �� � � s Pax(631)765-9502
P.O.Box 1179 ;"
Southold,NY 11971-0959
BUILDING DEPARTMENT RV 26 2019
RENTAL PERMIT APPLICATION ,d
Rental Permit Fee$260(Application must be renewed every two years)
Section A.
Property Information:
Rental Property dress:
2800 Pietree Road, Cutchoue, NY 11935
Tax Map Number: 1000 SECTION104 -BLOCK, 2 ,-LOT 16
SECTION 13.
OWNER INFORMATION:
Property Owner e:
Imelda Corcoran Farrell
Property Owner Legal Address: Property Owner Mailing Address:
760 Peconic Bay Boulevard 760 Peconic Bay Boulevard
Laurel, NY 11948 rv �............... _...__.._W.._W Y Laurel, .
11948
Cell: (631) 379-9116 Home:(631) 298-4461
Telephone Number(s): Daytime,....._ EveninEmergency,._,_, .......�......... "
Property Owner Email Address:—ifarrell@optonline.net
Pagel of
I �
gy
Town HaU Annex At's Telephone(631)765-1802
75 Main Road Fax(63$)765-9502
M Box 1179
Soutbold,NY 11971 0959
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IIi B@JllA.11..ING N.i'ER"ARYII At:NIX
TOWN
AC` SOUTHOLD
RENTAL PERMIT U TION ADDIENDLIM
runt One
rpt V IIS IIUVr� Unit IlderttYfU Identifier,.. � . .............
�
Requested maximum number of persons a llowwed-tis occupy each d eIl ng unit: 4
Number of Roorn,s in IRen-W Dwwellluon Unit, , 6
Use and Dimension of each morn: (See floor pWi)
Living9r0"'.Yi _
3IBedroorn Ya a u
hath p
� r
...®._ .. . .... ................ .. ._......._........
�__�...
Rental DwweUUing Unit Ud ratifier Urlit T wo
(Requested maximuArn number of persons ns allowwed to occupy sada dwweMng urupt� 3
Number of Rooms in U3entM IDwweM n Unit:..'5'.w........_wu........................�..._.._.__...................nn�...........�.�.... ..�.....�.....w
Use and Dimension of each room::
U�Yt S-
en
2 Bedrooms
m... — -------------------------------- 1 � : ............
t Bath 7 � .ww. _.m.
Rerut p IDww UVru°g Unit Ild rutffieru
Requested ranaxemuartn number ber of persons aUUowwed to occupy each dweMng u niiit,.
IMurnder of Rooms in IRenW DtnreHing Unit; .�
Use avid Mrt erasion of each roam.
TOWn 1111A Annex Telephone(631)765-1802
54375 Main Road �� ��' � IFax(631)I65-9502
11�0�Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUIH01,D
IMaiiing Address of Managing AgernV
www �.....__.� ....... ......_Emergency.,.�.._..��........
Telephone I�u�o�ulb�r IDa n��m........�.....�� �:v�m�uma. _.....ee
IEmaol Addiress, .__ .��....._,�.�_ _..u.�.. �..... .. .__._u.r_.�. �. .. ....
SECTION F.
PROPERTY DESCRIPTION:
Dumber of Rental YDweiiing Units on property: -_,. .....
For each R ntaU DeHing Unit set forth the Rental IDweUVung Unit identifier(fair exampie,
Unit 1., Unit 2, Unit 3 or Apt A, B, C)®the use of each room in the RentaU Dwelling Unft
(fair exampie, Kitchen, Bedroom 1., Bedroom 2, Living Room) and-the dimensions of each
room.
For properties with muitipie Rental Dweihng U..Unks use "Rern Permit Application
Addendum."
Rental Dwelling Unit identifier
Requested Maximum nuArnber of persons allowed-to occupy(Dwelling Unit,
Number of rooms in Rental Dwelling Unit. w _....
Use and Dimensions of each room in (Rental ID eihn QJnIfl' � _.. .. ..,
Page 3 of 5
'rnnwoun Hahn Annex Telephone(631)765...p 802
5437:5 Main Road Fax(63 V)765-9502
P.O.Box I n 79
Soudiold,NY 1197 -0959
BUILDING DEPAR,rMENT
TOWN OF SOUrHOLD
SECTION
INSPECTION;
Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a .safety
inspection by ::ode Enforcement Official is required. if the owner chooses not to have Saud
inspection perforimoed by the Town, a certuficaflo n from a licensed architect, a licensed
pirafessional engineer or a home inspector who has a valid New York State Uniform pure
Prevention IRu ildirng Code Certification is required .statue thatthe 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 9awws arid sanitary and housing regulations of the County of Suffolk and
by the laws adopted by-tine New York,State (Fire Prevention and 130ding Code Council.
i l am requesting a fore safety inspection to be performed by a Code Enforcement Official
from the Town wn of Southold
C. l am submitting a co mupleted'Towrwn of Southold cerdficatio n form from a licensed
architect or a licensed professional engineer.
SECTION H.
DECLARATION: Signature must benotarized and MUST be the owner of the dwelling aunrnit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
l ....� reWa Corcoran
... Farren certify under ®fperD �ry
,the frll��cr
....................�
L b aims the owner of the property ideintlf'ied lin "Section A" of this application.
20 The property owner's legal address set forth in "Section " of this application is my legal
address and l understand the Towyn will use the address for service pursuant to all
Page 4 of
Town Hall Annex Telephone(631)'765-1802
54375 Main Road Fax(631)765-9502
11.0.Box 1179
outhold,NY .t197t•• 59
m F SOUTHOLD
appIlicable ba s and iruU s, U further ack nrswied e that U wiH notify the oaf So uthoid
Building U;)ep artrn e nt of any changes of address within five (S) days of any changes
thereto„
U have resin and received a copy of Chapter 207 of-the Code of the Town of Southold and
agreed to abide by the same.
U wiIII notify the Town wrftn five (S) business mays as to any change to the information
regarding Au thorized Agent, Managing Agent, or Site Manager.
Pr prtywnera s N rn e firnelda Corcoran Farrell
... _,. .......... ..... _ . .
U�rrsry Owner's,Siirnu�r .. s7 "- a ' IL, 779
Swornto bc', rm-tiii. day ofJune. 19,
Official No,ary - u b ° Signature and Original Notary Stamp
AR...V.:VN D. FINNEG AN
Notary. Public, tate of New York
No. OIFI (66707
011n rrussVan IE.Xpires h+l arch 2.6, ....0
Page 5 of!!,
Tri
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TOWN OF
:r S
OUTHOLD BUILDING DEPT.
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765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ FINAL
-Gvwl r
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
I
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
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DATE INSPECTORd
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FORM NO4
TOWN OF SOUTHOLD
BUILDING DEIN ARTMarr
Office of the Building Inspector
Town Ha.11
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF ocCUpANCy
No: Z- 32278 Date; 04/03/07
......................................
THIS TIFIES that the bulld-ing _. DWELLING
Location of pro
..'perty 2800 PINE TRES RD CUTCHOGU
(HOUSE xo�) (STREET) (10-kMLET)
County Tax. Map No, 473889 jection 104 Block 0002 Lot 016
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 0WTIFICATE OF
OCCUPANCY MDMRR z- 32278 dated APR .
IL 3 2007
....... ................
was issued, and conforms to all of the requirements of the applicable
PrOvisiOns Of the law. The occupan-Cy for which this certificate is
issued is SINGLE FAMILY DWELLING WITH ACCESSORY SEASONAL COTTAGE*
'The certificate 2.9 isGued to 10 LDA CORCORAN FARRELL
(OWNER)
of the aforesaid building,
SUFFOLK COUNTY DEPARTMENT OF EEALTH APPROVAI N/A
ELECTRICAL CERTIFICATE No L/A
PLUMP= CERTIFICATION DATED
*PLEASE SEE WrTACHED INSPECTION REPORT,
"'7
'ELithori,�-ed iignat-ure
Rev. I/B:L
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 2800 PINE TREE RD CUTCHOGUE
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S) : IMELDA CORCORAN FARRELL
OCCUPANCY: RESIDENTIAL IMELDA CORCORAN FARRELL
ADMITTED BY: IMELDA FARRELL. ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 104.-2-16
SOURCE OF REQUEST: IMELDA M.C. FARRELL G19106 DATE: 04/03/0
DWELLING:
TYPE OF CONSTRUCCTION: WOOD FRAME # STORIES: 1.0 # SKITS: 3
FOUNDATION: CEMENT CELLAR: PART. CRAWL SPACE:
TOTAL ROOMS: IST FLR.: 5 2ND FLR.: 0 3RD FLR.: 0
BATHROOM(S): 1.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S):
PORCH TYPE: COVERED DECK TYPE: PATIO TYPE: ENCLOSED
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC RCTWATER: YES TYPE HEATER: OIL AIRCONDITIONING:
TYPE HEAT: HOT WATER WARM AIR: NO HOTWATER: YES
OTHER: CELLAR ENTRANCE OIL HOT WATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWI74MING POOL: GUEST, TYPE CON SEASONAL COTTAGE
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
—LOCATION— � DESCRIPTION
I
d I d
U 1
REMARKS: BP#32867Z—COZ-32278 (HEATING SYSTEM IN COTTAGE)
INSPECTED BY: ^^ _ DATE. ON INSPECTION: 04/03/07
GEORGE GILT. TIME START: END: