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Home My WebLink About1000-97.-5-2.1 r TOWN OF SOUTHOLD O�oSUfFO�,��oG o �e Rental Permit Permit No. 0274 Owner Allan & Everett Glover Occupied as Single Family Dwelling Located at 1215 Cox Lane Cutchogue 97-5-2.1, Address s/B/L Maximum Permitted Occupancy 3 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. 1/16/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Halt Annex Telephone(631)765-1802 54375 Main Road r Fax(631)765-9502 P.O.Box 11790 Southold,NY 11971-0959 , r BUILDING DEPARTMENT JAN _ 9 2020 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: s �+ Bch o � Tax Map Number: 1000 SECTION -BLOCK 5 -LOT - I SECTION B. OWNER INFORMATION: Property Owner Name: ?QNkZ.. R 01 Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytimes S585- Even1ng-13+5-;79 Emergency Property Owner Email Address: Page 105 oa.�F`S�UrA_ Town Hall Annex Ali. Telephone(631)765-1802 54375 Main Road , Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency 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: ,C✓4-X9'-fif st,41-LAK) (a Z011cA- Address of Managing Agent (no P.O. Boxes): JIYS' 1,'LL W4e- �- C.� f��4 ut=�►�7 t 1936 Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 _. BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: 111,5 L L.v►IGe-Wy-e • . C.�c r �s-- . nj N 01 lta Telephone Number(s):Daytime".3 •.�ZOS Evening`s-' SS—Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: �r��l 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: 402 K 113 .i �pyy. �oe2 X 194, 140X 1oS" oa k ., Page 3 of 5 i Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 • `�,' , Southold,NY 11971-0959 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. I�am requesting a fire safety Inspection to be performed by a Code Enforcement Official ,)K 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 f-v1R-Ae4 f A1-1-Axl 6 Love 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 Town Hall AnnexjTelephone(631)765-1802 5437.5 Main Road Fax(631)765-9502 P.O.Box 1179 , `} Southold,NY 11971-0959 BUILDING DEPARTMENT Towle OF SOUTHOLD 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: a LoV-t_fL '-�Ro-rAAi-k LL C— Property Owner's Signature: L,4h,,,11. E f Sworn to before me this_day of .20 Official Notary Public Signature and Original Notary Stamp Page 5 of 5 �UFSOUIyo# -L y TOWN OF SOUTHOLD BUILDING DEPT. �ycou765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [/] FIRE INAL,loe6tG��,FIREPLACE & CHIMNEY [ SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: V VvOLA DATE INSPECTOR VP------------ d w f o � 3 r � a v o� vcU i _ 4 I . 1 • TOWN OF SOUTHOLD PROPERTY RECORD CARD f OWNER STREET VILLAGE DIST. SUB. LOT FORMER OWNER N E ACR. S w // TYPE OF BUILDING ,� - j KA�1 rN - ,/�/d ,S�t / (w�•! "_-T�r b Na D. RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS e a o r �r `' // > Cr7J 3 � .y t� �.S/.�� .. � X30/1"� dt"kA. c`�r ♦Y S��O - ''1 3' ^iJ� 1 G�•> �- �[.� /� It � �1`��k:� _ -----------— O u' / �j !• Ir N JC>!J V 73-0 �/30/ 7 c 5lad tl!'72Ci -� 7 '�' /o v /•fir ,:.f�I�o� s /r�� Tillable 6�s" 1--� �; �-- FRONTAGE ON WATER / ,� ?_,� i Z_0, ,o-rx AS Woodland - - FRONTAGE ON ROAD 17ZG fy(y/,-7zo) 2zct} ('h/41) C1 c, 2-206, Meadowland DEPTH jHouse Plot Total --- - - ---- -- 1 / , f 3/1 If -2--Z-0 eaLOR TRIM ■ ■■■■■■■■ ■■■■■ .-t-4 I I J F- L Extension Extension Extension ■■�■■�■■■fit■■■ ice■■■■■ ■■■�cr ■�t■■■■■�■■ ■■■■■ Foundation Dinette Porch 3asement Floors Porch Walls Interior Finish LR. Breezeway ® Place , . Garage . •.. .. BR. iTy -Patio Z", Recreation Room Rooms 2nd Floor I FIN. B • TjDormerDriveway dOLOR TRIM I M. Bldg. Foundation CPC Bath Dinette FULL Extension Basement CRAWL Floors Kit. SLAB _ Extension Ext. Walls Interior Finish L.R. _ 4 Extension Fire Place Heat D.R. Patio Woodstove BR. Porch Dormer Fin_ B_ Deck t�� C�a�1 SX .3 7 2-5x 5=625 1000 T=a Breezeway rRee+tts-15t"Fioor Garage Driveway lann 2ad-F16* O.B. csaor 3ox60 = M00>21,17 O Pool ��• 15x60 ® 9 00 [/0 OQ Z)>, ao . 1 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-20350 Date NOVEMBER 15, 1991 THIS CERTIFIES that the building AGRICULTURAL BUILDING Location of Property 405- COX LANE CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 97 Block 5 Lot ' 2.1 Subdivision - Filed Map No. Lot No. conforms substantially to the Requirements for a Agricultural building built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-20350 dated . NOVEMBER 15, 1991 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 AGRICULTURAL FARM BUILDING WITH TEN ACCESSORY STRUCTURES* The certificate is issued to LEANDER B. GLOVER, JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL_ N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspector Rev. 1/81 i o BUIL DI:;G DEP'.RT:E-NT TO'Xrl OF SOMIOLD, N. Y. HOUSIM CODE. IIIS? CTION REPORLT Location y � l/�U knL:noor a szreez) f riun.LcipaiiiL Subdivision Han No. Lot(3) Name of Owner(s) �fl Occupancy (type) (own er-renanz) Admitted by:� ?A, Accompanied by:_� Jy✓L 001— Key available Suffolk Co. Tax No. q, Source of request 4" _ Date f 3 V.-FLLI`IG: Type of construction rstories� Foundation ellar Crawl space Total rooms, lst. F1 2nd. Fl 3rd. Fl Bathroom(s) Toilet room(s) Porch, type Deck, type Patio, type_ Breeze:vay Garage Utility room Type Heat 'Warm Air Hotwater Fireplace(s) No. Exits Airconditioning Domestic hot:vater Type heater OtherOF Dp� ACCESSORY STRUCTURES: Garage, type const. �Stortype const. Swimming pool Guest, type const. Other VIOLATIONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE Location escriDtion 1..4r,.. Sec. I I Remar'.cs: Inspected by: Daze of Insp.,/-/ _f 'T.ime start [ ,` P end { Untitled Map { Legend � . Write a description for your map. 0.2 PCT ANNUAL CHANCE FLOOD HAZARD Nil 1000 1215 Cox Ln Abatelli Realty OF AE Kaelin's Service Center i Equipment \ r�iNorth ForkDancers North Fork . VE ! A, r j 1215 Cox Ln ,S Id Google Earth 9 0-2019 Google 500 ft