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Home My WebLink About1000-104.-5-15 'A TOWN OF SOUTHOLD Rental Permit Et 0358 Owner Robert & Mara Shelton Occupied as Single Family Dwelling Located at 275 Oak Drive Cutchogue 104.-5-15 Maximum 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. 6/29/2023 Coden r Bent Offi I This Notice must be posted by the main entrance at all times so TOWN OF StI U THOL D BUILDING DEPT. co ,� 631.765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ 14ENTAL REMARKS: 7 DATE: ��a -,� INSPECTOR t�F S�Upy� TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG- [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: Ren e-w4 0 a 8- ht, R¢ -)40e O!ATE S-a a INSPECTOR Town Hall Annex SOUTHOL D TOWN 54375 Main Road PO Box 1179 Southold, Rental NY 11971-1179 Tel: 631-765-1802 Fax 631-765-9502 SCTM # � /D — S=/�� Date o � Owner . w--.... Phone �_ _._... .._.. Address � CM Zip Inspector city INS LEVELS SUB 3 Smoke Detectors (# bedroom detectors excluded) carbon Monoxide Detectors Fire Extinguishers (#) Exits (#) .,�._.. .._...�.�. ..... ..�._w�.. BEDROOMS _.,_,,.� � 2 3 4 �� Smoke Detector Alarms (#) -°__._. •w.. w__. Carbon Monoxide Alarms Egress (windows) (Y/N, �1nM1 BUILDING SYSTEMS Y/N CONDITION OF PROPERTY YIN ilding Interior is Buclean /maintained Heatin ste-111 maintained/o berational �__ - °•° - ..• Building Exterior is clean /maintained Hot_water sw sta:m maintained/opea'atsa:ana6 " Property is clean /safe/maintained Electricals stt.P1 maintained/ apo-rational __.... _.. . Mechanical s stem maintained/operationap Handrails guards present C O M M E N S. _.._.. .. ........... Rental Inspection Form 4/7/2021 TOWN OF SOUTHOLD - Rental Permit Permit No. 0358 Owner Robert & Mara Shelton Occupied as Single Family Dwelling Located at 275 Oak Drive Cutchogue 104-5-15 Village S/B/L Maximum 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. 11/5/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times ,vq- A�� Toxin Hall Annex � � ; ,:,.p-w«- Telephone(631)765-1802 5.4375 Main Read � � � � Pax(631)765-9502 P.O.Box 1179 Souttx>1d,NY 11971-0959 1h: . BUILDING DEPARTMENT TOWN OF SOUTHOLD RIENTAL PERMIT APPUCATION Rental Permit Fee$200(Application must be renewed every tvvo years) Section A. Property Information: Rental Property Address: 2,'75 OCA1c PrjkwL .s CWIZJke Y 1 l I3 Tax Map Number: 1000 SECTION r 0 1 -BLOCK /UV-LOT-_�__-ZE SECTION R. OWNER INFORMATION: Property Owner Name: R49ct J_ayAtim She— ifvh Property owner Legal Address: Property towner Mailing Address: Lye4 dtlitit L4#Tj?'18r Telephone Number(s): DWiml�617-yid-5. ` venin ?j73 Emergency t!(7-`1U" - V89 Property Owner i=trlail Address. L L4 0d erSCur-e_ `).�o0 Pale 1 of 5 Telephme(631)765-1802 Town Hell Ahfiex 54.375 Main Road Okl- Pax(6:11)70 -9102 P.O.Box 1179 Soutbold,NY 119714)959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information., Name of Authorized Agent of dwelling unit,if any: e- Address of Authorized Agent(no P.O. Boxesj* Mailing Address of Auth6r!zed Agent., Telephone Number(s), !)Wlme� Evening Emergency_ Email Address: Section D. Managing Agent Informations Name of Authorized Agent of dwelling unit,if any: 17ane- Address of Authorized Agent(no P.O.Boxes): Mailing Address of Authorized Agent: Telephone Number(s):Daytime Evening Emergency EmailAddress: SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent(no P.O. Boxes): Page 2 of 5 Town]-Tail Annex Telephone(6-11)7fi5 18t)2 54:175 Main Road! � � } :�. lax(631)70-9502 P.o Box 1179 Southold,NY 11971-09.59 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone lumber(s): Daytimg EveningEmergency. Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: ane C/) For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, 8, C);the use of each room in the Rental Dwelling Unit (for example,Kitchen, Bedroom 1, Bedroom 2,Living Roam)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: 7 Use and Dimensions of each room in Rental Dwelling Unit: Page 3 of 5 Tatun Hall Annex F � Telephone(631)765-1802 5437.5 Main Road Fax(0 1)76:5-4.%2 ; rFF.a P.O.Sox 1179 Southold,NY t 1971-0959 BUILDING DEPARTMENT TOVIN OF SOff3'.CH+( LD 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 I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold J 0 1 and submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION W. DECLARATION: Signature must be notarized and MUST he the owner of the dwelling Ui7it. STATE OF NEW YORK) 3 COUNTY OF SUFFOLK) I Ro 4-+' SPIC i''fVh . certify under penalty of perjury,the following: 1. l aryl 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 Annex `. = �. Telephone 631 )7�5-1802 54375 Main Road c^LL Fax(631)755-9502 P.O.13vx 1179 Southoki,NY 11971-0959 BUILDING DEPARTMENT TOWN OF S®YI'lE HOLD 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. i 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: pe&rt Sir lfnn a�'1241pl/J Property Owner's Signature: w€>~rn t e this c23day of U til C- 2023 1 Official Notary Public Signature and Original Notary Stamp Rita Renee Adams Notary Public COMMONWEALTH OF MASSACHUSETTS My Commission Expires December 23,2022 ' ' -3 JUN 2 5 2020 F Page 5 of a z ® so0� - May 23, 2020 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.)3ox 11,79 Southold, I4ou C U j U N 2 5 2020 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional se-al ieguired for Architect,or Env,inger ceased 14ome Inspector must provide copy of valid current certification Rental Property SCTM Number: Rental Property Address: 275 Oak Drive., Cutchogue NY Owner/Name: Bob Shelton Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom #2-90 sq., etc.) 7 6 13alw441 *3— Property Description (Include all improvements indicated on survey) 3 one —0L �elm CM,6-e A�. �e— ixlh 6W�vy�m,r,le I zho I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold, the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. Victor Cornelius III CEO Inspector Print Name and Title ceo# 1216-0283 Original SignKJF Please place professional sea]: i # TOWN OF SOUTHOLD BUIL NG DEPT. 765.1802 o�• , — 1 INSPECTION . ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING/STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION - [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: Gvo•— _ D Pity - /I r\ f-\ DATE INSPECTOR Main Level 49'6" 10'T' 6' 10" 18' 12 11'S" 00 "v 00 '3"{ bath Kitchen 00 "oo 1' 1 _ back bedroom b closet ) 171111M t-2' 3'3" 19.�" 5 IT 7" LL Garage c OS&Y-MI c OsN Hallway Living Room s middle bedroom C 4"- 2'T �_9'3 1612"— 2' 14' 11" - ter-61 -et M ly Fs-6'11" N t-.--T 5" 0 3'8" Master Bedroom VMaste, r 6, Bath 23'2" -t Y�eiec�l- � CO I�J�-��1- Main Level ROBERT SHELTONI I/2/2020 Page: 11 0 0 -A/15/._ - TOWN OF SOUTHOLD PROPERTY RECO_ al a�I� 'ao 0 NER STREET `l' VILLAGE DIST. SUB. LOT 141+x( a d�l u sE S a A 71ee�1- NC��/a��r ��v,�'a� E C �e� I�� A�R"�' I �� y � � �o )1 `fl)61600-vs .1. � Q (40r\ vv+ SY W / TYPE OF BUILDING !f ,4( 7j e/ .�. _ Jct �! ;L° —1 c_ti, ARESSEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS fG/� ��D �0 d � �ri'�'- �'/C> � �G/c� b/d 7 /8 -.r. G ) � 3� �e.�� 7`o c��i e/%o.a. • 00 F S" i_: 5• u Jr Ci 7% 7/G;F �l� E a _ 194 7 4 SL4&°l 4c," 4" 5 K&EVl� �CSO pi70 6 o o /6 1.-5 V4 -10 S &:!�i cr 4e,2 -.tit k,- 4� L4 "14-- (5 gqAGE 4--(5gqAGE Pf3CL IgN7a® } 4 L)2-W 4'-7q"BILIAS - L/2ZO NEW NORMAL BELOW ABOVE a1�' boo\ 6yT_ FARM Acre Value Per Value Acre Tillable 1 Ti I lable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH ��f rr1; BULKHEAD i Total DOCK 1 } -" ,, . ■ NOON EMMON ■■■■■■■■ NOON■■MEN ■■ ■ ■■ ■ ' : -. .r ' NOON■ ■■■�■■■ ■■EE■■■■ ' NONE • a......�.�...� t r - t�tTLi��EIII■■■OEM OEM N ■ : .- ''' NOON ■ ■■■F Malmo III■■■■■■■ MEN E ■NOME± EEiif ■■l11ii■■�■■■■■ ' r 'iPP E■N■N■9ei'iI, ;_ NOON■■ ��■�:22wall■■,1�.�■�■�■■ s E■■� ■ONES■■NEEE!MANOM■ ■ ■■i ■ E■■■E■■ EE■■■■E■N■E■NNN■E ■■MEN ■■�■■■■■■■■■■■■■■■■■ ■ r • • "Interior •• Recreation Room, Rooms 2nd Floori FORM Na.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. 98 ,1 Date August .18 . , 19 67 THIS CERTIFIES that the building located at Nf8 Oak I& . . Street Map No. Xason Block No. X= Lot No. MCMI . ftteho t i X&Y-w . .... conforms substantially to the Application for Building Permit heretofore filed in this office dated . NIEarch. 30 , 19 617 pursuant to which Building Permit No. 34$8 Z dated . Me-rah ai , 19 67 , was issued, and conforms to all of the require- ments of the applicable provisions of the lacer. The occupancy for which this certificate is issued is PxiVate ons Family. awalling .. . . . .. . . . .. . . . . . . . . . .. . .. . . . .. . The certificate is issued to Ted She-Itco . ..Owner . . . . . . . . . .. .. . . . . . . . . . . .. .. . (owngr, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . U11. _ s MR �?T.R° -VM4. . . Building I4ector FORM NO.4 `}, �v I'� Ir TOWN OF SOUTHOLD � BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. 8 1 . . . Date August 18 . ' 19 67 THIS CERTIFIES that the building located at NIS flak 3r . , . . . . . Street Map No. Mason Block No. M= Lot No. 3a= fttehogUoq .N.X. . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . March. 30 , 19 617 pursuant to which Building Permit No. 3428 $ dated . &TCh 31 , 1967 , was issued, and conforms to all of the require- ments of the applicable provisions of the later. The occupancy for which this certificate is issued is ltivate Ono fam,41y tvt(al l.,tng . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to Ted SheItari . . .Omer . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . AU5. .�s 41 .Tib A4. . . . . . . . . . . . . . . . . . . . . Building I4pector