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Home My WebLink About1000-98.-1-13 TOWN OF SOUTHOLD Rental Permit Permit No. 0360 Owner Richard & Siobhan Hans Occupied as Single Family Dwelling Located at 2125 Pine Tree Road Cutchogue 98-1-13 Village 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. 11/10/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Sol/ 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 SOIUTHOLD RENTAL PERMIT APPLICATION C��L�Q�f� Rental Permit Fee$200(Application must be renewed every tw o rs) DD A U G 1 0 2020 B DING DE,Section A. T-,rr--, ,rJTHOLD Property Information: Rental Property Address: Tax Map Number: 1000 SECTION 0 -BLOCK -LOT L 3 - SECTION B. OWNER INFORMATION: Property Owner Name: IRV C'1/1 .rCj V 's Property Owner Legal Address: Property Owner Mailing Address: �L i_a I M o Y1-I- K V o r [OS3 0 rl Telephone Number %aqyle 5'0- V3 Evening SSE Emergenc b g!� a Property Owner Email Address: �dit Page 1 of 5 n gar s0(/�'` Town Hall Annex , r Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 `O Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: '�1 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: A r Name of Authorized Agent of dwelling unit, if any: 'v 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 containin 8 or more rental units) Name of Managing Agent of dwelling unit, if any: rC Address of Managing Agent (no P.O. Boxes): Page 2 of 5 50!/�� Town Hall Annex �{ � Telephone(631)765-1802 .54375 Main Road � Fax (631)765-9502 P.O.Box 1179 .- 2F Southold,NY 11971-0959 ® 'eou �a d 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: 1 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: to Number of rooms in Rental Dwelling Unit: 5- Use and Dimensions of each room in Rent I Dwelling Unit: 1 Y22-d x- 1-t Page 3 of 5 SO 11"s 01 Town Hall Annex Telephone(631)765-1802 54375 Main Road ' era { Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 y� 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 from the Town of Southold �KI 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 k,I 14 wc/` 14 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 Annex r-� k� ?;�� ti� � Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ( a BUILDING DEPARTMENT TONT OF SOUTHOLID 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: / T• 9ltd Property Owner's Signature., Sworn to before me this-.,,/--day of 141G(S 1-1L`* 20 Offi . I Notary Public SlKatul-Aancf&rilginal Notary Stamp - ---f oaRAl E KLOPFERW V f Notary Pum Stem of NewYork 6i 28373 Qualified In Suffolk County Commission Expires Nov.30, Page S of 5 S®UjAugust 1, 2020 Town Hall Annex ~® �O Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 CA P.O.Box 1179 O Southold,NY 11971-0959 �lycaUN�l S�� 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 seal required for Architect or Enaineer,licensed Home Inspector must provide copy of valid current certification —p Rental Property SCTM Number: I g� Rental Property Address: 2125 Pine Tree Rd., Cutchogue NY Owner/Name: Rich Hans 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.) Bedroom #1 250saft Bedroom #2 235sgft Bedroom #3 250sgft Property Description (Include all improvements indicated on survey) single family home 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' coo# 1216-0283 0 'ginal Signature Please place proressionai seal: o l fitA I Solo, 1Q'46qve-"'- # # TOWN OF SOUTHOLD BUILDING DEPT. B .°`y�ou►m�'' 765-1802 C� — ---� INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND- [ ] INSULATI N/CAULKING [ ] FRAMING/STRAPPING [ ] INAL [ ' ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: c- h DATE INSPECTOR MAI t o ❑ - OCT 2 6 2020 � � � O 13DG DEPT, TOWN Off',4y T 7T OLD EXISTING FLOOR PLAN SCALE: 1/8" = 1"-0" ---------------- T�' %Amc4vr ties 10 Cox, SGC o d EX.BASEMENT I � 0 BASM i ri EX BEDROOM •-"r- � •-_�•�•-••- . 7: EX WINE CE"R T 2 6 2020 ^ �' EXISTING BASEMENT PLAIN SCALE: 1/8" = 1'-0" SCTM # _ F �1O _1_ TOWN OF SOUTHOLD PROPERTY RECORD CARD CSC, -ca.. %3 OWNER STREET �,�� VILLAGE DIST. SUB. LOT i ACR. REMARKS TYPE OF BLD. PROP. CLASS LAND IMP. TOTAL DATE f C)00 ol::) (0 (.00 i I FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL -, p, a "J; _ r TOWN OF SOUTHOLD i► ORERTY RECORg r.01?'E `1ci �, ,. ens i _ OWNERrrK, STREET: 7 VILI'AGE DISTRICT SUB. LOT �� ,•nr-. a'"a�;'F(tA l• � � s �k t t� /t_tr�� 6B f f 3� � i f', f C✓ •~ f �' � r4 a f f'—'e .` rti" FORMER OWNER - N E ACREAGE : S W TYPE OF BUILDING z •� `/J !~' � RES, \,j SEAS. VL. FARM i COMM. IND. I CB. `" I 'MitSC "" � f Est. Mkt.rV lue�`��M LAND IMP. TOTAL DATE REMARKS s r -�, 6 t;t �'Fl; i aC c�t `�t� f'!if st'f3 � �} /Gra rlr A,/V,?, $ �T ✓ . t�tA &121, a Kms' f ! 'f! `? pe' .'Ff" '%i1 ff, rllRffs�rrl'dj y �� fv, tr-.7n AFDC �"+ r / ()RS Jib �, L Ar,J6 � ;d � f ty Jx�� G facs "t�lG `7 "c €J S-13 ,172-4 f 'fit ? cc Gs S P -r-, ,2 f'(z W'70-0 L`-�- AGE BUILDING C NDITI Mfr r � f - FRONTAGE ON WATER , FormAcre �lu6 Per cre t Value FRONTAGE ON ROAD 150 Tillable':/:-V)0 `j` 7 0 0-; �'�'�} �� BULKHEAD - Tillable 2 '' DOCK j Tillable 3 t ,- .. c Woodlandz9JQD-4-103 007Ail Ll . r' ft sec s ' a t PLfG` i 1- Swampland /t ;i3-. Brushlan �"'.� �i House Plott I �0 Ck� Tota 7 -- t�[`Vie', t! J I ir;�- 9t • - 1 - 13 _ IT -- -- _ -—. 98.4-13 2/2014 -- - --- -- , -- - M. Bldg. -� y X ', � ^G'9 ` Foundation - R, Both $ 3 Extension . — --- - Basement � �/ Floors - -- - Extension i J }C may ° �` — rr / Ext. Walls Interior Finish ExtensionHeat-, 1 Fire Picce 1 . 'y C ,rti_ --- t� 5-;o e F �• /�►,,,�..�-3,.. ,�,r Porch Roof Type X t / 7 _ Porch Rooms 1 st Floor Breezeway ? 1 �,. 1 3� - I 13 7 Patio 'Rooms 2nd d:=Floor Garage j o `' i 1 j Dr y Dormer • r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-23719 Date JUNE 21, 1995 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 2125 PINE TREE ROAD CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 1 Lot 13 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 CERTIFICATE OF OCCUPANCY NUMBER Z-23719 dated JUNE 21, 1995 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 1 CAR WOOD FRAME GARAGE The certificate is issued to GERARD & HUGUBTTE GALLIANO (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. NOTE: THIS UPDATES PRE CO Z-20454 DATED JAN. 8, 1992. Bu lding Inspector Rev. 1/81 BUILDING DEPARTMENT TOW OFTSOEDUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 2125 PINE,-TREE ROAD CUTCHOGUE, N.Y. number b street municipality SUBDIVISION MAP NO. LOT(s) NAME OF OWNER (s) GERARD GALLIANO OCCUPANCY A-1 RES. OWNER type owner-tenant ADMITTED BY: GERARD CALLIANO ACCOMPANIED BY: SAMB KEY AVAILABLE SUFF.CO. TAX MAP NO. 10OU-98-1-13 SOURCE OF REQUEST: GARY OLSEN, ATTY DATE: JUNE 15, 1995 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME # STORIES ONE # EXITS 4 FOUNDATION CEMENT BLOCK CELLAR PARTIAL CRAWL SPACE TOTAL ROOMS: PLR. 5 2ND FLR. 3RD FLR. BATHROOM (s) 3 TOILET ROOM (s) UTILITY ROOM PORCH TYPE DECK, TYPE PATIO BREEZEWAY FIREPLACE ONE GARAGE DOMESTIC HOTWATER YES TYPE HEATER OIL AIRCONDITIONING TYPE HEAT OIL WARM AIR Xx HOTWATER OTHER: ATTACHED STORAGE ROOM ON FRONT. ACCESSORY STRUCTURES: ` GARAGE, TYPE OF CONST. I CAR WOOD FRAME STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: BP #49172-CO Z-5330 (Addition A deck) BP #118212-CO Z-11348 (ACCP GARAGE) BP #20363Z-COZ-20453 (ALTERATION-PATIO ENCLOSURE & BATHROOM ADDITION) INSPECTED BYDATE OF INSPECTION JUNE 7, 1995 GAt FTA TIME START END FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . "5330. . . . . Date . . . July. �7 . .. . . . . . . . . . . . . 19 3 . ad THIS CERTIFIES that the building located at . .2125 Pine Tree .. . . Street Nassa 19 Map No. . . . . . . P. . . . Block No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated ''ugust , 19 pursuant to which Building Permit No�?17U dated �u&s.t .21. . . . . . . . . . . .. 19 71 ., 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 . . . . . . . . . . . . . . . . . . . ... . .. . . . . . . . . . . . . . The certificate is issued to . . . F? 'ed (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . R• Pending UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER .21�5. . . . . . . . Street .Pine Tree Road'I Cutchogue, if.Y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �. . . . . . . . . . . Building Inspector FORM NO.z TOWN OF SOUTHOLD BUILDING DEPARTMENT= TOWN CLERK'S OFFICE SOUTHOLD, N. Y. , i 3 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ATO 4 917 Date ......................AII&W.t....21.......... 19.70.. Permission is hereby granted to: ............kA .:.... .. .......... .... ........... ............... ;ae.•TV661•1 ted............ - ................ .................4uk .......................................... to ............. .. .. •. i , ........................................... at premises located at t3 .. I. lam.sigg'U.. "a s:. ....................... ............................................... . : ..)? 3 ... c. ........ .. ut5aji4lm.............................. pursuant to application dated ............................A .. ......... .........., 19..."., and approved by the Building Inspector. s Pee $.5 ............. ta .f .: ....:. .... ................ Building .Irspectar A,,. FORM NO.4 TOWN OF SOUTHOLD' BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . . . . .Z.7,1 !+8. . . . . Date . . . . . .December 13 1982 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of'Property . . . �2.5 .e, .$pa,d, , �u,t� pguq, House No . Street . . . . .Hamlet County Tax Map No. 1000 Section . . 9.$ . . . . . . .Block . . 01 . . . . . . . . . .Lot . . O U . . . . . . . . . . . Subdivision . . .Nassau Farms. . . . . . . . . . . . .Filed Map No. �. ?9. . . .Lot No. 9. . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated A Px.�I. 2. . . . . . . . . . . . . . . . 1982. pursuant to which Building Permit No. . 11;$21 Z , _ . . . . , . . . . . dated , , , , , , , , , , , , , , , 1982. ,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 . . . . . . . . . ac.�e0,90 .y .zarago'. . . . . . . . . . The certificate is issued to to wner,,&essee-®r4emnt)- . of the aforesaid building. Suffolk County Department of Health Approval . . . X./,A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . NAA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A/moi.'. f!` Building Inspector Rev.4/89 ,r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20453 Date JANUARY 8, 1992 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property_ 2125 PINE TREE ROAD CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 1 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 2, 1992 pursuant to which Building Permit No. 20363-Z dated JANUARY 6, 1992 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 PATIO ENCLOSURE & BATHROOM ADDITION TO EXISTING ONE ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GERARD GALLIANO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL WA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED4/ N/A Building Inspector Rev. 1/81 I i 4" offk-t 1 j Town of Southold Annex 11/13/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37269 Date: 11/13/2014 THIS CERTIFIES that the building SHED Location of Property: 2125 Pine Tree Rd, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 98.-1-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/25/2013 pursuant to which Building Permit No. 38485 dated 11/7/2013 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 SHED AS APPLIED FOR The certificate is issued to Matelli Arthur Rev Trust&Matelli Esther Re (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Authkcff Sigdature Town of Southold 5/24/2019 0 P.O.Box 1179 O0 �e 53095 Main Rd pyay� 0� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40414 Date: 5/24/2019 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 2125 Pine Tree Rd, Cutchogue SCTM#: 473889 Sec/Block/Lot: 98.-1-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/14/2019 pursuant to which Building Permit No. 43406 dated 1/18/2019 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: "AS BUILT"DECK ADDITION TO AN EXISTING ONE FAMILY PER ZBA DECISION#7228, DATED 12-20-2018,AS APPLIED FOR The certificate is issued to Hans,Richard&Siobhan of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED nA ed Signature �FFD4CpG Town of Southold 2/4/2020 y� P.O.Box 1179 a 53095 Main Rd o��,oao� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41044 Date: 2/4/2020 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 2125 Pine Tree Rd,Cutchogue SCTM#: 473889 Sec/BIock/Lot: 98.-1-13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/20/2019 pursuant to which Building Permit No. 44464 dated 11/26/2019 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: existing accessory garage altered to non-babitable non-sleeping accessory storage building with outdoor shower as applied for per ZBA#7320 and#7321 dated 10/24/2019. The certificate is issued to Hans,Richard&Siobhan of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44464 5/28/2019 PLUMBERS CERTIFICATION DATED 1/8/2020 atti Plumb' \4L \�, Othriz ignature