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Home My WebLink About1000-59.-3-12 TOWN OF SOUTHOL Rental Permit Permit No. 0111 Owner Karen Suskevich Occupied as Single Family Dwelling Located at 2120 Kenneys Road Southold 59-3-12 Address Village S/B/L Maximum Permitted Occupancy 5 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. 7/12/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times In Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 jfo BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rentaoperty A dress: 1 ?V * � (k Le Tax Map Number: 1000 SECTION SECTION B. OWNER INFORMATION: Property Owner Name:._- Property Owner Legal Address: Property Owner Mailing Address: Po - Telephone o Tele hone Numbers : Daytime, a Evening.. ��_,��- Emergency Owner Email Address: Property � Page 1 of 5 NVS Town Hall Annex " Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: mm �_ ...._,. ,,._....__._._. Telephone Number(s): Daytime Evening Emergency Email Address: �.. 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, Q 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: :.._..... Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room.in Rental Dwelling Unit: n t)6 �5 ly� Page 3 of 5 a , Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 Y.O.Box 1 179 Southold,NY 11971-0959 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. Cid' I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 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) ) COUNTY OF SUFFOLK) certify under penalty of perjury,the following: 1. 1 am the owner of the property identified in "Section A" of this application, A Xr. ,_ 2. The property owner's legal address set forth fh`Section B" of this application is my legal t'.'w�SII•rnz:r:rit.:dt k:,t,..1>;,„ ,,;�,,:�r�R address and I understand the Town will use the address for service pursuant to all Page 4 of 5 tO TOWN OF SOUTHOLD 13UILDING DEPT'. 7654802 INSPECTION I FOUNDATION lST ROUGH PlLBG. FOUNDATION 2ND INSULATION FRAMING /STRAPPING OPNA� FIREPLACE & CHIMNEY FIRE SAAFEOTkYIINSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESP 'SAINT PENETRATION ELECTRICAL ( I ) ELECTRICAL (FINAL) CODE VIOLATION CAULKING REMARKS,: ......... DATE INSPECTOR . .. ..... .... .... FLOORPLAN rca e t Addr a�„��a ��s FAY' Rtr�� _ Case No,:TFCW00ra�aF t ruczL _State:mLsr 1-- Lender,, Lende,r',,TVkCHF.RS FEE'ER L CREDIT L9NL9fi�CON i f '6 t 14 j i V n k� 22.0' { t o Living Room r � Q 4 34.0' i 7 Bed Kitchen Bed . N mm a 4 Bath Bed , 11.0' D'onong Q � cd r 21.0' "v( I F ~ Sketch by Apex IV Window5'•' � ,_„_•,„,,,,, AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN Code �Desdcap'tXara Size Totals Breakdown Subtotals GLhi -r 7 1 airsc _laor 1201.00 1201.D0 First F1o1 11.0 x 21.0 231.D0 9.0 x 16.0 145.Od 5.0 x ii.0 55.00 9.0 x 47.0 523.00 �. 2.0 x 9.0 18.00 { 15.0 x 22.0 330.00 V V { i I, II V l V V TOTAL ENABLE (founded) 1201 6 Areas Total(rounded) 1201 0 _ U 4��`W()MFVAI..IJEZ ff l 917/1� TOWN -.. _ PROPERTY-- ase � 3..... - ARD OWNER STREET VILLAGE DISTRICT I SUB. LOT / ! v 1 j FORNAFR OWNER N - _ E ACREAGE s , W � ' TYPE OF BUILDING r RES SEAS. VL. FARM comm. IND:` CB. MISC. 361 LAND IMP, TOTAL DATE REMARKS - - _ s p AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE � ' Farm Acre Value Per Acre Value Tillable 1 Tillcble 2 Tillcble 3 Wccdland Swampland Brushland House Plot Total r e _ e L t t i i , z � � h P i r A- i M. Bldg. f �r s tJ i Foundation Bath@ _ t _ Extension �. - Basement Floors Extension C/ Ext. WallsInterior Finish t.4,J = Extension ' � � Fire Place ` Heat Porch = i Att€ I _ 'e; Porch ours t Pt F!_ or Breezeway=: - -� Patio Rooms 2nd NO- ?Garage Driveway O. B, l 7 09-25-2007 18:11 SWHDLD BUILDING DEFT 16317659503 PAGES FORM MM8 of sus DEPARTAMW Town awile OEM Sca�►ol�, N. � . certirkals, OF occltpmey bro.Z. . ...... ..SoAt..3v..., 19-75. TWS CMTII`EBS that the b • g loCated at R,IS. =jy, 34...... ...... SUvot Map No.= ......... BIMk No.-t........Lot No. . xs.,. .d MUWA.X px. ........ 012for:ma " to the MaNI&MA&MA &MIAWMW code C,before-JLpr 3.•P}111 7,. ptu =t to which '"O?'o�r-*- " mated _.. ..._.. ..$*Rt.-3Q , ,, IVY-, wax iigusd, and emforma to an of tie Mqutre; meats of the applicable provW= of the law.no oocup=7 for WbIch this oftiiftow in irsued is . Fri74ta,gne.f JY.$yq?j�pg of ,VW,AQ9Q.4 q 9TX ;,4#gA.. The oerUfiaete is fawmd to .$ObPart,a 4.Y'o1 yox.....6tan". . ...,,. . .., ....... of the afor"d bWWipg Suffolk county Departftent of Health Approva3 DrP , .o-14AUZ9........ ........... UNC .. ........................... HOUSE NLTMER . ..21 2A...... SUvot .... ...................... .... .. .... ............ .. . ............>.................. ...... ................ ZT/80 3@dd 3NVIQSIV 8868E59TE9 ti9=80 L00Z/9Z/60 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SSOUTHOLD, N. Y. CERTIFICATE OF' OCCUPANCY No. .....75-697...... Date .... .... .. ..................... ............, 19-0. THIS CERTIFIES that the building located al .. .. .Kenny..Road....•..Q't • jd•.••.• Street Map No. .......*.**........Block No. ...* ........Lot No. ... atr�Trs� conforms substantially to the Application for Building Perinit heretofore filed in this office dated September, 9.5.��.. pursuant to which Building Permit No. .......Z....83.3.... 5 dSept.ember ated .................,.••.•.• ..••�••� ....... � ••••�+ 19••59•, 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 PRIVATE ONE FAMILY DWBLLIPqj" This certifzcale is issued to . ,arex1 ..... ;Kx..... ? ? 4. ...,.«. .«.........................«....�.,.............,.«. (owner, lessee or tenant of the aforesaid building. (Building Inspector ~ j. mature ofv7o*k '(check which applicable): New Building------..Addition ....k--._}\homomn --_.~-.~^ .. ................Demolition------./JtherWork (Describe) ------. 4. Estimated -----------+ee ..................................................---................ _~-.-_.~ �tnbepaid on filing this application) 5. Kdwelling, number ofdwelling units........./ ...............--Number of dwelling units on each eno,^--------.. If gomge, number of cars._ ...... h. If business, commercial or mixed occupancy, specify notu,e and of each type ofuse... _.-� LL/ �� , 7. Di"e,oiuns of existing structures, if any: Pm - n� .��x--..--' Rear -'w------- m ..�� uep . __, / / Height .-.��.-....'Number of Stories --.x.. .......---....-..'~.,._. -~.-.--.-`... ' ~ ^ 11- Dimensions of nu�a structure with alterations or additions: Front --=�]�._-__~. Rem~ ~z��---..-_. Depth ' —'� Height —,-....--Number Stories _~'�7 .............. T / 8. Dimensions of entire new construction: Front......�^�- ......... Rear ........ Depth .......-.-___...... Height �� of �ohs ''^' -----' '-~^}~' ~ / / ��> 9. Size of lot: Front --^ -. �eo, -.+�=°°_--_. Depth 10. Date of Purchase ............ .----------. of Fmrrwier Uwrie, ll. Zone o, use district in which premises are situated...-ue'15.'tn*mr1u4..c .............. -__..--- ...... _~_---. 12, Does proposed construction *rm .......... 13. Name of Owner of p remises.A. . Address C�ry/ ,Rwe#KPnu"v nw.17.7"+=++- Name of Archi�c�...._.��_—.._---_-Add�s ---'��` ------Phono NO. Nmno of Contractor.... __--...-_,_-.Addres ...........~_ ........... - ...........Phone NO, PLOT DIAGRAM Locate doo,ly and distinctly all buildings, whoher existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers descriptionordescription according to deed' and show street names and indicatewinterior or carne, |om. ether sit STATE 0 NEW 0 OF COUNTY � ---- ........ �.�� no 6o(y sworn, deposes and says that he is the applicant (Name of inclMdum( signipg application) above named. He is the..... ___-- .................................-............................................... '--^^-'-^----''^'^---' (Contractor , agent, corporate officer, etcJvnd to make and file"' said ""'e` `" ~~'^~' arid is dul' authorized' t�� q�w� p"w' true no the best o; his knowledge and belief; this application; that all statements contained in and ihot the work will be performed in the manner set forth in the application filed therewith, Sworn to before me this _ T NotaryPublic, «�_�~/