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Home My WebLink About1000-62.-3-26 TOWN OF SOUTHOLD Rental Permit 0197 �F Owner Timothy Wood & Mira Dougherty-Johnson Occupied as Single Family Dwelling Located at 340 Locust Lane Southold 62.-3-26 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. 10/18/2023 Code No _e ent Officiai 11 This Notice must be posted by the main entrance at all times TOWN OF S 631 -765-1802 AW INSPECTION [ FOUNDATION 1ST [ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION/CAI [ FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) j ] ELECTRICAL (EI [ ] CODE VIOLATION [ ] PRE C/O REMARKS: /4 0 Pgov/ de- 5moke- z(�A-lebV4 c1c)Leaoe bAse.N4enI. O '` A-atz 6 ?„5cal7 a w, DATE /a- 6 - .g_3 INSPECTOR 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 Address .�� _,. o .e. w .. Visible HamletInspector Floor Level Quantities Sub 1 2 3 .�........ ... . ....._ ...�,.....not located.'. .b., _..... ..e... .w ..�w. e Smoke Detectors (bon Monoxide n bedrooms) .. .... .._. _� _.... ..... . de Detectors Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress Occupant Count Building Systems Maintained & Operational Condition of Property Heating Building interior. Hot water _ Building exterior ElectricalProperty clean, maintained &safe &guards � .�m.. Mechanical Handrails g s installed &secure Pool afetyPool on Site m Surface water alarm_ . _. .. . ._._ Date of CO issuance Door alarms Pool completely enclosed _. ..__ . Self closing/latching gates p Pool fence to code requirements _ �P .. CO s for all items resent Prior Rental 0/ q? Comments: £ 4 TOWN OF SOUTHOLD Rental Permit 0197 Owner Timothy Wood & Mira Dougherty-Johnson Occupied as Single Family Dwelling Located at 340 Locust Lane Southold 62-3-26 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. i 10/18/2021 cede E fir e erg Official This Notice must be posted by the main entrance at all times Town Hall Annex � I TOWN 54375 Main Road SOUTHOI PO Box 1179 Southold, rt Rental Inspection NY 11971-1179 Tel: 631-765-1802 M Fax 631-765-9502 SCTM # —2=6 Date Owner , 0"2A i 1N`ov Phone v/ Address Vd z 5 I Zip � Hamlet 50 InsQector Addrps visible from street? LEVELS SS1 Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) BEDROOMS 3 5 Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows) (Y/N) BUILDING SYSTEMS CONDITION OF PROPERTY (YIN Heating system maintained/operational Building Interior is clean/maintained Hot water system maintained/operational Building Exterior is clean/maintained Electrical system maintained/operational Property is clean/safe/maintained Mechanical system maintained/operational Handrails&guards present POOLS Y(N POOL BARRIERS Y/N Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min. 48" high resent POOL GATES YIN All openings in barrier less than 4" Self-closing, self-latching Max. 2"clearance @ bottom of barrier Latch on pool side of gate, meets height Barrier capable of being locked &child- requirements proof when unattended COMMENTS: 77L> C { ¢t TOWN OF SO THOL e Rental Permit Permit No. 0197 g Owner Timothy Wood & Mira Dougherty-Johnson Occupied as Single Family Dwelling Located at 340 Locust Lane Southold 62-3-26 Address Village g/g/1- 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. 10/17/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Pax(691)765-9502 P.O.Box 1179 Southold,NY 11971-0959 " ` s��' BUILDING DEPARTMENT 'OWN OF SOUTHOLD RENTAL PERMIT"APPL19ATION. Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: _ L6Lt,2L Tax Map Number:1000 SECTION �. a -R� : _ . .. SECTION B. OWNER INFORMATION: Property Owner Marne: Im Property Owner legal Address: Property Owner Mailing Address: �o . � VVI Telephone Number(s): Daytime Evening— Emergency_. Property Owner Email Address: \/V 1+ Page 1 of 5 ��1 k Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 F.O.Box 1179 �' Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOU HOL Section C. Authorized Agent Information: `a Name of Authorized Agent of dwelling unit, if any: _ ... Address of Authorized Agent(no P.O. Boxes)i Mailing Address of Authorized Agent: _ " Telephone Number(s): Daytime Evening _ Emergen ! - Email Address: ; w Section D. Managing Agent information: Name of Authorized Agent g ent of dwelling unit,if any: - ` ' �G Address of Authorized Agent(no P.O. Boxes) Mailing Address of Authorized Agent.; " ( ,01 �'006 L ( V6 " 412,—Mff Tele hone Number(s):Da timg Email Address i ['14.. SECTION E. SITE MANAGER INFORMATION:(required For rental properties containing S or more rental units) Name of Managing Agent of dwelling unit,if any: •4 Address of Managing Agent(no P.O. Boxes)t Page 2 of 5 'f 5� 14f So 7btivn Hall Annex Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 M1 `. P.O.Box 1174 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:. Telephone Number(s): Daytime Evening _Emergerrc)r _. Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property;.. 016�- 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." a Rental Dwelling Unit Identifier: Requested.Maximum number of persons allowed to ccupy Dwelling Unit: Number of rooms In Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: a n N Page 3 of 5 i st Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O,Box J 179 Southold,NY 11971-0959 ° IOU G BUILDING DEPARTMENT TOWN OF SO HO 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 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. H SECTION H. ,DECLARATION: Signature must he notarized and MUST be the owner of the dwelling unit. i STATE OF NEW YORK) M COUNTY OF SUFFOLK) certify under penalty of perjury,the following: 3, I am the owner of the property identified in "Section A"of this application. 2. The property owner's legal address set forth in NSection a of this application is my legal -j address and I understand the Town will use the address for service pursuant to all Page 4 of 5 010 Town Hall Annex Telephone(631)765-1802 54375 Maim Road Fax(631)765-9502 P.O.Box 1179 � Southold,NY 11971-0959 µ.. BUILDING DEPARTMENT To"OF SOUMOLD applicable laws and rules. 1 further acknowledge that I will notify the Town of Southold i 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 247 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 w regarding Authorized Agent, Managing Agent,or Site Manager. Property Owner's game:. �d Property Owner's Signature: ,. Sworn to before me this ,i day of °. 20 i Official Notary Pub Signature ar"incl N+ tary Stamp VARY JENNIFER DROWER Notary Pubgo,Mate of New York 4WM4 Qualified In SU"OtIt 004inty commlselon Expires Page 5 of 5 ti� laf sariry TOWN OFSOUTHOLD BUILDING DEPT. 765-1802 i . ,INS k, �� T I [ ] FOUNDATION 1ST [ 1" ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING ] FRAMING/STRAPPING [ ] INALI" . [ ] - FIREPLACE & CHIMNEY = ) 'FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION- [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O DATE INSPECTOR S' &)V4 td�,, (o J� TOWN OF SOUT'HOL D BUILDING DEFT. 765.1802 1 NSP Emm% T 10 N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ( ] INSULATION [ ] FRAMING /STRAPPING ( L444� f M/wl-lf [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: /A 0 DATE INSPECTOR �1� to 40-.7"t, n•sR Eu Al ..�. I q m 0' y .aL�P .. MAwM"w hA I .YEf 11 wva rrww•r " R^l, i . „..,,,..... .L 4 Ap :res-.I* "eH 01-4 ,.. M �V •MMr "w.,w0 �v:lato�Y7 wHquwr*w�,-� ''� v �ww+n• rI th�fR`f e I I F'.plr�T moopL PLiWff - '.,OOfIG aF. a _ta Irew 0 b M a ——•� ..,. 4 a,t IfL d^Y4 c L "k„0.!�`L.dL NkieN ,pt±l1' � .rn„www�W.WWwWW� � �J 1 p CC1t'tD L C33 P�u'� em.66 o,t ywlr'3°!y> ieo ` � . ` VILLAGE LOT OWNER STREET DISTRICT SUB. FOR,MER OWNER- E ACREAGE TYPE OF BU I LDI NG misc. Est. Mkt. Value RES. SEAS. VL. FARM COMMIND1 CB. LAND I MID. TOTAL DATE i REMARKS NEW NORMAL BELOW BOVE FRONTAGE ON WATER Form Acre Value Per Acre 1 Value FRONTAGE ON ROAD Tillable I BULKHEAD � Tillable a Woodland � Swampland_ | Total ------- - s y a COLOR I TRIM yv _ 62.-3-26 2/10 l 1st 2nd fPC CB M. Bldg, : :,Vt u��s 4 l r� J/._ Foundation Z Bath Dinette F I OTHER -._ \ � _.._ _.F_ULL , ...COMBO Extension Basement sLpA PARTIAL Floors , Kit. Extension n4t L-4 � Finished B. Interior Finish L.R. ,. _ .'. AA Extension Fire Place Heat D.R. Garage Ext. Walls BR. Porch (� r Dormer Baths Deck/Patio Fam, Rm.i Pool Foyer . V A.C. Laundry Library/ O.B_ 7, ' Study 1 t Dock - S 7v _ a - u M1. Bldg. n �� dct ^n Extension Basement ic�rs Extension Ext. Walls Fer;or s ;nisn x; Extension .e Plan„ - eo t PC Porch i ��<e Porch DI�_ _t Roor z ?u 'o .., s f c Eioor r 0. B. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33954 Date: 09 15�C�9 THIS CERTIFIES that the building NEW DWELLING Location of Property: 340 LOCUST LA _ — SOUTHOLDM* (HOUSE NO.) - (STREET) (HAMLET) County Tax Map No_ 473889 Section 62 Block 3 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 11, 2009 pursuant to which Building permit No. 34513-Z dated MARCH 19, 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 ONE FAMILY .u�wvw_.._....w..DWELLING WITHC?_.."RDD PORCH AS APPLIED FOR PER ZBA #6244 9 _._ _....... DATED 3/S. .0 . ... ..-...�................ _...w......w The certificate is issued to TIMOTHY D WOO 0D & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPAR NgUT OF HEALTH APPROVAL R10-08-.0108 09/03/0„9 E ..ECTRICAL CERTIFICATE NO. 4027445 07/13,/09 & PLUlBEIt.S CERTIFICATION DATED ! 5�/£�9 K & R PLUMBING...., HHEATINGNG,. "Ahor' ature Rev. 1/81