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Home My WebLink About1000-98.-4-14 e TOWN OF SOUTHOLD Rental Permit 0514 �4 Owner Charles Vansant Occupied as Single Family Dwelling Located at 1355 Smith Road Peconic 98.4-14 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. -)A 7/28/2023 , Code Ehorce e It Official This Notice must be posted by the main entrance at all times Of so TOWN OF S UT"HOLD BUILDING OEPT. 631-765-1802 ImbPECTION [ ] 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 [vrRENTAL REMARKS: � i J oo�L IL Con �i ve� Son pG G DATE Town Hall Annex " Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 ........r .. �..0 rmSCTM# — ! ! Date.., do. ... - " .u...,. ... ...... .. ...... ........ . .. .....� ....... .,, .. ....... .... Owner VA,Pi S Phone Address "'►SS ►.. Visible �.. .._µ..... ..' s Hamlet..... !h'F .. .. ......... ww..... ......... .... ..Inspector _ .__.. ._.... .. ............ .. 2 3 Quantities Sub or Level Qu1 l Foan ��.. ..a....... ..... .�.� ...e.._.. .�..� . in bedrooms)..�.., ... e .�.... � .. .....,�....' _...m.. .�.....� .� ��... .�.. ._...... ._. ..�.. _�. mm Smoke Detectors(not locatedooms) / ...... ..... ,�.,,, .. . . ..�. .. ...�.� ..� Carbon Monoxide Detectors �.., r..� ,... ...... Fire Extinguishers .Exits„� .,,. ..... �...N.... _ . . . . . .. ..a...,��...k .. ..... m... ... .0..w....._... ,. .�.W. �. ......... �....... _ .. .. ... ...._. ......... t Bedrooms _...., 1..., ...., ,..�......�3 � _. ._..4a. .�5 .�. Smoke Detectors .. ., . .. �...... �.... .. .... ..___... ...... ...... rvrv. ... Egress ;0;0 �, . .. _.. 1.... _ �� Occu ant Count 1 �' �.. Building �._�........ ...._.. _.a, . .. .._ . _..... ® . �.. .� . _...� Systems Maintained &Operational Condition of Property . ..Syst W.... t. � ...,. HeatingBuildmg interior Hot water Building exterior Electrical 1 Property clean, maintained &safe ical Handrails&guards installed &secure j _.... ... .. ... ... ..... ...N._ ... . _...... _.,... . ty n Site Pool Safe... .....�. ...��m, ., e.�. .w . .....m ... ..a .�.. ......... .Pool 0.,, �..... �. �,., ., .m... ..�.n. . L......_.. .. _. Surface water alarm Date of CO issuance Door alarms Pool completely enclosed g/ latching fence E S requirements _.. t elf closing latchin gates Pool fence to code . .. .r .... ..w, . sent. ...... Prior Rental OS/�.. �CO s for all items pre...__ �..... .....__ ._.. . ; �.. w_.._..... . .._... ......, Comments _.... . ............ ...... .......,,............_.......... __.. . . ... ... _.. ... ...._. . ....W ........... . ........ �... . ....,...... _.... .......... . .. __...... ....... _, TOWN OF SOUTHOLD y Renta[ Permit Q A.- 0514 Owner Charles Vansant Occupied as Single Family Dwelling Located at 1355 Smith Road Peconic 98-4-14 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. 7/28/2021 %i&%mak I de En rc e t fficial This Notice must be posted by the main entrance at all times sorry®l� . . Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 CA P.O.Box 1179 G' • a0 Southold,NY 11971-0959O`Ye® BUILDING DEPARTMENT ` TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two ears),...; 11 Section A. DEC - 9 2019 Property Information: ; Rental Property Address: - 1355 SMITH RD,PECONIC,NY 01758 Tax Map Number: 1000 SECTION 9 g' BLOCK _ LOT SECTION B. OWNER INFORMATION: Property Owner Name: CHARLES F.VANSANT Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 200 EXCHANGE ST,UNIT 513 200 EXCHANGE ST,UNIT 513 PROVIDENCE,RI 02903 PROVIDENCE,RI 02903 Telephone Number(s): (508)498-5139 Property Owner Email Address: CFVANSANT@GMAIL.COM r � Page 1 of 4 y Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: NONE Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit,if any: NONE Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): 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: NONE Address of Managing Agent(no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number(s): Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: ONE(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: STAND ALONE HOUSE Requested Maximum number of persons allowed to occupy Dwelling Un SIx(6) y . Number of rooms in Rental Dwelling Unit: SIX(6) Use and Dimensions of each room in Rental Dwelling Unit: KITCHEN 12x16, LIVING RM 14X26,FAMILY RM 16X26,13TH 16X9,BDRM 1 15X9,BDRM 2 10X9,BDRM 3 21X21 INCLUDES BTH 2,W/D AND CL ; 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. 0 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) I CHARLES F.VANSANT ,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,Managing Agent,or Site Manager. Property Owner's Name: CHARLES F.VANSANT Property Owner's Signature: Sworn to before me this day of 17,LL A hl41 .201 Zii� t , ficial Notary Public Signature and Original Notary Stamp Page 4 of 4 oF so�lyO6 ` # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ '] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING/STRAPPING - [ ] INAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION . [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: ,QJI�frY11 IJ Dr owom-cotA &A0. DATE INSPECTOR 1� 1355, SMITH RD PECONIC, NY 11958 SMOKE DETECTOR KITCHEN . � t BDRM 2 BDRM 3 CL BTH V cx As LIVING FAMILY TV ROOM ROOM BTH 2 ,W/p ;CL .-4 BDRM 1 CL FLOORPLAN Borrower:Charles F.Vansant File No.: Vansant Property Address:1285 Smith Road(a.k.a.1355 Smith Road) Case No.:04-1121 City:Peconic State:NY Zip:11958 Lender:East West Mortgage Company 16.0' SD -SMOKE/CO DETECTOR Kitchen 14.0' 35.0' m o U Bedroom Bedroom Bath 2d SD o SD Family U SD Living Room Room Cl. Bath Laundry o _ SD °' 0 20.0' Bedroom v d o U 45.0' 5'.eiN b1 Apev N WMwx^' Comments: AREA CALCULATIONS `SUMMARY LIVING AREA.BREAKDOWN Code, deseriptior, - size Net Totals - Breakdown':-' Subtotals GLAI First Floor 1742.00 1742.00 First Floor 12.0 x 16.0 192.00 26.0 x 45.0 1170.00 19.0 x 20.0 380.00 TOTAL LIVABLE (rounded) 1742 3 Calculations Total(rounded) 1742 27 North Country Road,P.O.Box 729,Shoreham,NY 11786 631-744-0600 Fax:631-744-0900 t / 1 OWNER STREET -` VILLAGE DISTRICT SUB. LOT �? b — ,f a,r l FORM ER`OWNER,,�', N E ACREAGE S W TYPE OF BUILDING RES. SEAS. VL. FARM f COMM. I IND. CB. MISC. f Est. Mkt. Value LAND IMP. TOTAL DATE I REMARKS "' D ?� � .r r9--ri .� �;Y-, c� nom'/:' h� 1 �� /��;•`' r s;- ,-o u 0U r� `�.� 3 ��;7 /f /� C�, T"��30�� ; G✓d, r,1 ,� VI/ In, x ter. S � /�� 70- cc 4i • �`a(o /c.av r r- 0 a V 3 i ? l� �� - > (��, ..�-; .r 1 �7 - ria t l 16, ;, AGE (� BTJ ILD fRG✓OND 0 ' '� /6 6/ — I�'/cc— le- / 1 ' TFRONTAGE ON WATER Form Acre Value Per Acre Value — FRONTAGE ON ROAD. / .,f/c f Tillable 1 BULKHEAD Tillable 2 �] ( ---- DOCK -� -- -- --NST T� � Ti Ilable 3 • I 9X7 cr ' ( , Woodland i Swampland -� I �� 1 P 09 e112r D v2. - 3,''� � ,�a P Brush-land House Plot C- 17 h' 0 Tata I ■ ■ i I I I I I I I j C, i i , f—IJ I I l2X! Ire � �_ ��`r-`,• '' �' 98.4-14 3/05 M. Bldg. ; ' Foundation I Both f -------- –T----_-- CSA wZ}=-- - , . --, Extension i r _ ;� ?.' A57, Basement Floors _ Extension E ✓ ., '� I Ext. Walls Interior Finish Extension ! I Fire Place !Heat - - — I Porch i -- ' Roof Type ! -: ---- I J Porch ;Rooms lst Floor 1 - -------- Rooms 2nd Floor - _ I Breezeway –---- Patio -T u Garage ` I �!'Drivewoy Dormer ' - -'�� -___-__ -y � `, _.. `'- --' �F• •t _ _. _-.ice__ S K � 3 6 _ I �O�SIIFFO1��,oG Town of Southold 7/28/2021 y� 53095 Main Rd y x Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 42203 Date: 7/28/2021 THIS CERTIFIES that the structure(s)located at: 1355 Smith Rd,Peconic SCTM#: 473889 Sec/Block/Lot: 98.4-14 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- 42203 dated 7/28/2021 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame single family dwelling:with wood frame accessory garage.* The certificate is issued to Vansant,Charles (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. A o ize S afore BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 1355 Smith Rd,Peconic SUFF.CO.TAX MAP NO.: 98.4-14 SUBDIVISION: NAME OF OWNER(S): Vansant,Charles OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Vansant,Charles DATE: 7/28/2021 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: partial CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: electric AIR CONDITIONING: TYPE HEAT: electric WARM AIR: HOT WATER: #BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 1/29/2020 TIME START: 11:25am END: 11:30am FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupahcy No. UA*. . . . . . Date . . . . . ... . . . . . . . . .AUg. . .6. . . . .. 19. 75 THIS CERTIFIES that the building located at . . . .8j,tAl -Ro&d. . . . . . . . . . . . Street MaMap In . e� No. 41. �►, .dock No. . . . . . . . . . .Lot No, .2. RL$. . . . .PaMia . . .K.aY>,. . . . conforms substantially to the Application for Building Permit heretofore filed in this office i E - �- dated . . . . . . . . . . . .JU17. . .31., 19. .711 pursuant to whish Building Permit No. 7. 4t 2z . F dated . . . . . . . . . . . jjay . . . .3y 19.74-, 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 . 2XI-Vate. o06. f=ily; .dorelling.with.a# .addition A.Pvt .Garage. •(aeaossoil The certificate is issued to . . .Bar. . . . . .Smith — . .Owner. . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .i !. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . X .20473. . . .rxu17. . .15-197-5 . . . . . . . . . . . . HOUSE NUMBER . . . . . . . . . Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CkA r� ,Building Inspector } ::f .At 1 - FORK NO. 4 TOWN OF SOUTHOLD BUMDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 27145. . . . . . Date . . . . . . . . . . . . . 'uly . .29. . . . . ., 19.?6. THIS CERTIFIES that the building located at Road . . . . Street Map No.Ind lark .n. •Block No. . . . . . . . . . .Lot No.26& 28 „ Reconic N.Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . QV. . . .17, 19. .7.1 pursuant to which Building Permit No. .g� . dated Prov 1g 75 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 Private one family dwelling with. an addition The certificate is issued to . AArah A144 ."dC ur aChar . . . . Owner. . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .. .. . . °. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NoA-.4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . HOUSE NUMBER . . . . .1?6 . . . . Street . . .Sm3.i;h. Road Pe0049. . . . . . . . . . . . . . Bg Inspector Ins ector� FOUR K0. 4 TOWN -OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. �. Date . . . . . . . . . . . . . J. . . . . . . _ . . 17$. $. S't?171f 00A [7 THIS CERTIFIES that the building located at . . . . . . . . . . . . . .. . . . . . . . . . . . . . Street Map No. . . 7- -. . Block No. . . . . . . . _ . Lot No. . . Z g . ... . . . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .M>�t�. . t�, 19.7 9. pursuant to which Building Permit No. ...d Y Z dated , . . . _ _ . . . . _ _ . . _ _, 19 8., 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 . . . . . . . . .nCc7k-r7'�Se •?`? - - - - - • U1 L D (.V-r6—. . . . . . . . . . . . . . . . . . . The certificate is issued toS'A R A H .S C H U M A G ' -E z I. . . . . . . . . . . . . . .. . . .. .. . . . . . . . . . . (owner, 1 ) of the aforesaid building. Suffolk County Department of Health Approval . . .. . . . .. . . . . . . .. . . . . . . . . . . .. . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . . . . �. 6�. Street .. MIT j?d. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . _F:1L C_0At I L i . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .. . . . . . - • - - - - . . . . . . . . . __ . . . . .. . . I . . . . . . . . . 7� . .. . . - - - • . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector 1 . I i a FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33613 Date: 03/24/09 THIS CERTIFIES that the building PELLET STOVE Location of Property: 1355 SMITH RD PECONIC (HOUSE NO.) (STREET) (HAMLET). County Tax Map No. 473889 Section 98 Block 4 Lot 14 Subdivision Filed.Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 27, 2009 pursuant to which Building Permit No. 34472-Z dated MARCH 3, 2009 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 PELLET STOVE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CHARLES F VANSANT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL, N/A ELECTRICAL CERTIFICATE NO_ N/A PLUMBERS CERTIFICATION DATED N/A tY�o ized ignature. Rev. 1/81 J�'`•f a• " Town of Southold Annex 6/17/2013 G, P.O. Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36294 Date: 6/12/2013 THIS CERTIFIES that the building ALTERATION Location of Property: 1355 Smith Road, Peconic, SCTM##: 473889 Sec/Block/Lot: 98--4-14 ------------ Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/4/2010 pursuant to which Building Permit No. 35289 dated 1/6/2010 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: ceiling fan as applied for. The certificate is issued to Charles F Vansant (OWNER) - - of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 35289 6/6/13 PLUMBERS CERTIFICATION DATED A honed S gnature