HomeMy WebLinkAbout1000-110.-7-19 TOWN OF SOUTHOLD
E{ Rental Permit
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Owner 610 East Rd LLC
Occupied as Single Family Dwelling
Located at 610 East Road Cutchogue 110.-7-19
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.
8/14/2023
Code Et e Official
This Notice must be posted by the main entrance at all times
qf so
* TOWN OF S
631 -765-1802 //G
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAN
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] TIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
[ ] CODE VIOLATION [ ] PRE C/O [
REMARKS: o« c,,c
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DATE
- ` -- INSPECTOR
Town Hall Annex
Town of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
1 " , , ► -;� Tel: 631-765-1802
,SCTM #
Dater
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Owner (.., .0 C,VS74 �.,., I Phone
Address �/O CA.51 W Visible
Hamlet I.n -.___.. ...�
... .._
pector
Floor Level Quantities 1 Sub_ 1 2 3
Smoke Detectors (not located in bedrooms)
.- , .Garb .. . .._ ..� ....... .. ..._ ....._ .- ...-� _-.
on Monoxide Detectors
-- Fire...... ....
Extinguishers
Exits
Bedrooms 1 2 3 4 5 6
Smoke Detectors
Egress
0ccupantCount._
Building Systems Maintained & Operational Condition of Property
Heating Building interior
Hot water Building exterior
;Electrical Property clean, maintained &safe
Mechanicalg installed &
Handrails &-guards inst secure...
Pool SafetyPool on Site -
Surface water ..�.._ .�„ .
ter alarm Date of CO issuance
Door alarms Pool completely enclosed
Self closing/ latchinggates Pool fence to code g drequirements
CO's for all items present Prior Rental O/
Comments:
5 -
�� ��� SOUTHOLDTOWN
Rental
- -
0164
Owner 610 East Rd LLC
Occupied as Single Family Dwelling (Bldg. B)
Located at 610 East Road Cutchogue 110-7-19
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.
8/26/2021
Code Enforcement Official
This Notice must be posted by the main entrance at all times
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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 I u
RENTAL PERMIT APPLICATION TOWNOiwmm
Rental Permit Fee $200 (Application must be renewed every two years)
Section A.
Property Information:
React Property Address:
Tax Ma Number:.1000 SECTION � W
Map �D —BLOCK �� LOT
SECTION B.
OWNER INFORMATION:
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): Z
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Property Owner Email Address: - V1q
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Page 1 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."
w
Rental Dwelling Unit Identifier: �� � 0 "
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: t�1 v Git/tA
PtI
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 laws adopted by the New York State Fire Prevention and Building Code Council.
"
I'll
I am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold.
Page 3 of 4
❑ 1 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 H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
1 �� .� , 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
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 s to any change to the information
regarding Authorized Agent, Manafr Agent, or Site Manager.
Property Owner's Name:
Property Owner's Signature: °
Sworn to before me th da of , 20-0 ONk,Sh to Ie York
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1n Su my
No.01BU 1
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Cmc �bss�" Frites Ap' 01 14, �_�.�.
Official Notary Public Signature and Original Notary Stamp
Page 4 of 4
IO 0 0 Ag C.v�rc�ii v
TOWN OF s
765=1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] I L
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
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Town of Southold 8/22/2019
Q 53095 Main Rd
Southold,New York 11971
two
PRE EXISTING
CERTIFICATE CCU.... CY
No: 40641 Date: 8/20/2019
THIS CERTIFIES that the structure(s)located at: 610 East Rd,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 110.-7-19
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40641
dated 8/20/2019 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
13uildin "W'on s�arve :seasonal wo d ila:zae one farady dWgULngwith rear enclosed porch and outdoor shower and
accessory metalara. e ap _ eessory small wood Mme shed.
Bua�"B"on survey:wood frame one family dwelling with lass enclosed pore.
The certificate is issued to 610 East Rd LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
.
Ut 0 Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 610 East Rd,Cutchogue
SUFF.CO.TAX MAP NO.: 110.4-19 SUBDIVISION:
NAME OF OWNER(S): 610 East Rd LLC
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: 610 East Rd LLC DATE: 8/20/2019
DWELLING:
#STORIES: 1 #EXITS: 3
FOUNDATION: posts&piers CELLAR: CRAWL SPACE:
BATHROOM(S): 1 w/outdoor shower TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: rear enclosed DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: electric AIR CONDITIONING:
. .......... ..........-.-
TYPE
w_TYPE HEAT: none WARM AIR: HOT WATER:
#BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE:
OTHER: This page Bldg"A"only
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: metal STORAGE,TYPE OF CONST: small wood frame
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/25/2019
TIME START: 10:08am END: 10:50am
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION RE,PORT
LOCATION: 610 East Rd,Cutchogue
SUFF.CO.TAX MAP NO.: 110.-7-19 SUBDIVISION:
NAME OF OWNER(S): 610 East Rd LLC
_
............................. .
OCCUPANCY:
ADMITTED BY ._...................._
SOURCE OF REQUEST: 610 East Rd LLC DATE: 8/20/2019
DWELLING:
#STORIES: 1 #EXITS: 2
FOUNDATION: cement block CELLAR: full CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S):
PORCH TYPE: glass enclosed DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: gas AIR CONDITIONING:
TYPE HEAT: gas WARM AIR: forced hot air HOT WATER:
#BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: partially finished
OTHER: This
page Building B only
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/25/2019
TIME START: 10:08am END: 10:50am
............. ................. ........... .......................
Town of Southold 8/20/2019
P.O.Box 1179
too
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40640 Date: 8/20/2019
THIS CERTIFIES that the building ELECTRICAL
.............................-1..... .
Location of Property: 610 East Rd, Cutchogue
....................... ..........
SCTM#: 473889 Sec/Block/Lot: 110.-7-19
..........
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/3/2019 pursuant to which Building Permit No. 43929 dated 7/3/2019
....................................
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:
1111as biiilt" I 00a electrical service with ground rod, coldwater ground and 20 circuit panel.
The certificate is issued to 610 East Rd LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43929 7/29/2019
..................
PLUMBERS CERTIFICATION DATED
........ .................
...................... ......-11,11,1111 , ..............
Authorized Signature