HomeMy WebLinkAbout1000-103.-4-2 A W. TOWN OF SOUTHOLD
Rental Permit
aryl
0553
Z &r�,C
Owner Ryszard & Krystyna Wisniewski
Occupied as Single Family Dwelling
Located at 1455 Beebe Drive Cutchogue 103.4-2
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.
12/27/2023
CoA Enfo c ent Official
This Notice must be posted by the main entrance at all times
Ao,
TOWN OF SOUTHOLD BUILDING D
631 -765 1802 /03- 7
INSPECTIO �m
[ ] FOUNDATION 1ST [ ] ROUGH PEBG.
j FOUNDATION 2ND [ ] INSULATION/CAI
j FRAMING / STRAPPING [ ] FINAL
j FIREPLACE & CHIMNEY j ] FIRE SAFETY IN!
j ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
j ELECTRICAL (ROUGH) [ ] ELECTRICAL. {F11
]
CODE VIOLATION j ] PRE CIO j
L)PApc4-,-,l
iL
DATE
** W
� � f, Town Hall Annex
% Town of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
Tel: 631-765-1802
,
SCTM #
Date
Owner Phone
Address Visible
Hamlet Inspector
_�__ - —
Floor Level Quantities Sub 1
SmokeDetectors (not located in bedrooms) -- - - -- -
Carbon Monoxide Detectors - - -- -
Fire Extinguishers -
Exits -
Bedrooms _ 1 4 5 6
Smoke Detectors
Egress
Occupant Count
Building Systems Maintained & Operational Condition of Property
Heating Building interior
Hot water
Building exterior
� -- - -- -
Electrical Property clean, maintained &safe
Mechanical Handrails &guards installed & secure
Pool Safety Pool on Site
Surface water alarm Date of CO issuance
Door alarms Pool completely enclosed
Self closing/ latching gates Pool fence to code requirements
-
CO's for all items present Prior Rental
Comments:
E TOWN OF SOUTHOLD
Rental Permit
g
0553
3
Owner Ryszard & Krystyna Wisniewski
Occupied as Single Family Dwelling
Located at 1455 Beebe Drive Cutchogue 103-4-2
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.
10/25/2021
Cod rc Official
This Notice must be posted by the main entrance at all times
Town Hall Annex i � �� Telephone(631)765-1802
54375 Main Road " Fax(631)765-9502
P.O.Box 1 179 iZz ;!
Southold,NY 11971-0959
M
BUILDING DEPARTMENT
TOWN OF SOUTHOLD Y 1 7
RENTAL PERMIT APPLICATION
Rental Permit Fee$200 (Application must be renewed every two years) '- r
Section A.
Property Information:
Rental Property Address:
w a
Tax Map Number: 1000 SECTION 103 -BLOCK d y -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name: . �azc _F -fi Y a ncG
Property Owner Legal Address: Property Owner Mailing Address:
Oawa
Telephone Number (s): Daytime___ Evening„
Ctvyl
4-i< 64
Property Owner Email Address: " l�'' ''' ) "
Page 1&S
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
a
P.O. Box 1 179
Southold,NY 11971-0959eouffri
'BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: f�
Telephone Number(s): Daytime Evening Emergency......
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: C .._...
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: l
Requested Maximum number of persons allowed to occupy Dwelling U t:
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
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Page 3 of 5
ell
Town Hall Annex li Telephone(631)765-1802
54375 Main Road ' Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959 ,
�U
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.
❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
G I 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)
) N
COUNTY OF SUFFOLK)
rLu _ �rT I 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 Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
UN rli, "I 1971-0959li, I u7
BUILDING DEPARTMENT
TOWN 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.
� q
Property Owner's Name: ,. ��'
.... . c r �
Property Owner's Signature: C,
Sworn to before me this1`1 day of 0 , 20x1
ry
Official o f Public Signature and Original Notary Stamp
M�CWA-
NLL.C E YC
c
OTCRY PUU .STATE O
Regsrataon ro.01��6274028
uabfied in Suffolk Coue
Commission 1xires Deo.24,20 f
Page 5 of 5
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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
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 re uired or Architect or Enineer licensed home ins actor must rovid
copy ot valid current cerci ication
Rental Property SCTM Number: 1000-103-04-02
Rental Property Address: 1455 Beebe Drive Cu cho NY_
Owner/Name: R zard 'V`11"isiviewski
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: 144 s
B dmm 2; 2Q1 sq
Bedroom 3:143 N.-
Property Description (Include all improvements indicated on survey)
2 story frame house and 1 sto frame house with ara a and wood deck,.
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 Plumbin C de of New York State,
the Fuel Gas Code of New York State, and the Energy ConservatL'na
uction Code of New
York State. �
Anthony Portillo, R.A
Print Name and Title Origure
Pleaseplace professional seal.
Dv%° stay
TOWN
ki
765-1802
INSPECTION
] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND I LTI
] FRAMING /STRAPPING [ FI
[ ] FIREPLACE & CHIMNEY [ ] I INSPECTION
] FIE RESISTANT CONSTRUCTION [ ] FIE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ELECTRICAL ( I
] CODE VIOLATION [ PRE C/O
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TOWN OF SOUTHOLD POOPC
OWNER - STREET VILLAGE DISTRICT SUB LOT
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TYPE OF BUILDING x
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RES SEAS. VL. FARM COMM. IND CB, MISC.
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LAND INAP_ _ TOTAL ! D=ATE REMAR d � � � � � _ xtl
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NEW NORNAAL BELOW ABOVE _
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Farm Acre Value Per Acre
Value � }
Tillable 1 v
Tillable 2 '
Tilleble 3
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 24340 . Date August 20,.
THIS CERTIFIES that the building located atE/S Beebe Drive Street
Moose
Map No. Cove Block No.XXXX Lot No. 11 Cutehogue, N. Y.
conforms substantially to the Application for Building Permit heretofore filed in this office
dated April . 6, 19 71 pursuant to which Building Permit No. 5::.'a Z
dated '.' 6, 19 7.1, 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 . . . . . . . . . . .
The certificate is issued to wi1.Liam. & -Nancy•HIggins
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval July. 15., 1971, -Robert A villa
wCX
ilding Inspector
House # 1455 Beebe Drive
Fire Underwriters Cert. # N 894673
`�. FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23279 Date OCTOBER 12, 1994
THIS CERTIFIES that the building____-ADDITION
Location of Property 1455 BEEBE DRIVE CUTCHOGUF, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 103 Block 4 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 17, 1.994 pursuant to which
Building Permit Na. 22308-Z dated SEP IR 8 1994
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 DECK ADDITION TO EXISTING ONE FAMILY' DWELLING AS APPLIED FOR
The certificate is issued to STEPHEN & GENEVIEVE LESKODY
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building In ector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25584 Date: 03/13/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1455 BEEBE DR CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 103 Block 4 Lot 2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 19, 1997 pursuant to which
Building Permit No. 24567-Z dated DECEMBER 19, 1997
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 STORAGE SHED IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to STEPHEN F & GENEVIEVE LESKODY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inst+ for
Rev. 1/81
_............ .............. ... ....._� ... .......
Town of Southold 8/14/2021
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42235 Date: 8/14/2021
THIS CERTIFIES that the building ALTERATION
Location of Property: 1455 Beebe Dr,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 103.4-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/8/2021 pursuant to which Building Permit No. 46595 dated 7/21/2021
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"'air conditioittrig-m .9Vied for.
The certificate is issued to Wisniewski,Ryszard&Krystyna
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46595 7/26/2021
PLUMBERS CERTIFICATION DATED
_. Autho.. _ _ .....
rized Signature