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Home My WebLink About1000-104.-12-3 TOWN OF SOUTHOLD A"t Rental Permit g 0307 Owner F. Xaview Fleming Occupied as Single Family Dwelling Located at 375 Wunneweta Road Cutchogue 104.-12-3 Maximum Permitted Occupancy 4 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. 5/28/2020 John Jarski Code Enforcement Official This Notice must be posted by the main entrance at all times ; (63 F)76.5-1802trl� hog Town Hall Annex �a � I� 54375 Main Road �f ^ Pax(631) P.O.Box 1179 Southold,NY 11971-0959 7 J L 2 201 BUILDING DEPARTMENT '', " " 'r -7 '.,.. TOWN OF SOUTHOLD f RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: n (_ ( Y Tax Map Number: 1000 SECTION ! c� -BLOCK SECTION B. OWNER INFORMATION: Property Owner Name: I'll J II—VeM Property Owner Legal Address: Property Owner Mailing Address: ,.. ./�, .��-�,.., ,�...-„ .�.� .-�.. ....-.....,_. Ise .5'6�-gc�3 -5- 7 Telephone Number(s): Daytime_.--Evening„ Emergency__ Property Owner Email Address:� ' ►� a e . ,.�� ,� 5 Page 1 of 5 P Town Hall Annex Telephone(631)765-1802 54375 Main Road �i Fax(631)765-9502 P.O.Box 1179 ;kk Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOU '.OLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ! 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: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes):_ Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address ,..... � ..w SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any:., ,.AA-- Address of Managing Agent (no P.O. Boxes):, __.-,,,— Page 2 of 5 Town Hall Annex �" ?- Telephone(631)765-1802 " Fax(631)765-9502 54375 Main Road " F P.O.Box 1179 ° Southold,NY 1 1 971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime... ww.........,..w .,.. 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, 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: 00-1 Requested Maximum number of persons allowed to occupy Dwelling Uni M Number of rooms in Rental Dwelling Unit: ..... Use and Dimensions of each room in Rental Dwelling Unit: Page 3 of 5 Town Hall Annex 's Telephone(631)765-1802 �p lr Fax(631)765-9502 54375 Main Road P.O.Box 1179 ", " Southold,NY 11971-0959 HWR 5il � BUILDING DEPARTMENT TOWN OF SO'l !T ''OLD 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 ❑ 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. 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 r ' Town Hall Annex Telephone(631)765-1802 9Pl Fax(631)765-9502 54375 Main Road P.O.Box 1179 � � l Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF 3 .T OLD 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: F,)(A U e' """" Property Owner's Signature: _. h5wrn to before me this o y day of?',��u , 200 Off. c Sig and Original Notary Stamp =Public MAS"Tftt3C.00 tate of Neter York 6382LS-tuffolk Crnmtypires Oct 22,2022 Page 5 of 5 TOWN OF S 765-1802 INSPECTION [ ] FOUNDATION '1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CA ] FRAMING STRAPPING [/] F'llRE NAL 40q�� ] FIREPLACE CHIMNEY [ SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (EI [ ] CODE VIOLATION [ ] PRE C/O REMARKS: .A---- ( 4 ) �:--W— (0000� ............. r\ DATE 431,111>0 7oO INSPECTOR r. Y � � ¥ u „- s lav I ---------------- E t�G- ° I Ti r 11R EA i e 7_7 (fir ate; 3 13 15 1505 Zb t fes# ii , r a� Wit.&• `. - =�m., #� � - _ [ }i TOWN OF SOUTHOLD SOUTHPROPERTY RECORD G OWNER STREET VILLAGE DIST.' SUB. LOT I , �. FORMER OWNER ' N E ACR I S W TYPE OF BUILDING = a � RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND i IMP. TOTAL DATE REMARKS i } P - E AGE ? BUILDING CONDITION NEW 1 NCRMAL_ BELOW ABOVE FARM Acre Value Per Value ; Acre Tillable 1 Tillable 2 I _ Tillable 3 I i Woodland s i Swampland FRONTAGE ON WATER Brushland F FRONTAGE ON ROAD House Plot DEPTH BULKHEAD I Total ,DOCK t SKMIr COLOR - - � s l r a s { x { p§ �s TRIM \`. i LQ , _ ' 1 1 z` �( .Z S3 Z s_ FFoundation _s _ tte I Both M Dine i Extension / -7 X y a I 3 -7 �r'� Basement Floors K. �e Extension Ext. Walls ' Interior Finish LR. Fire Place Heat DR. Extension f 3 Type } Roams 1st Floor i Lr' BR. , T e Roof -- Porch �^ Recreation Roo ; Rooms 2nd Floor _ FIN. B �� '- � Porch Dormer ; Driveway i � } I Garage Patio i O. B. ; Total i FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . . . Date . . . . May 23, . 1 988 . THIS CERTIFIES that the building . . . . .ONE FAMILY DWEZL ING Location of Property 375 Wunneweta Road Cutchogue_,. New York House No. Street Ham%ei County Tax Map No. 1000 Section . . 104 Block . . . 12. . . . . . . . . .Lot . , .03. . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . „ . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated October 5 , 1 9 8 7 pursuant to which Building Permit No. . .16512 Z . . . . * µ dated . , October. . 1 I M, .19 8. . . F . . . 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 AS APPLIED FOR The certificate is issued to . , . . JOSEPH FLEMING . . . . » . . , , of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . „ . 8 T,.S 0-9 1 .-. 5%/ 12/8 8 . . . . , , . .. . UNDERWRITERS CERTIFICATE NO. . . . . , . , , PENDING 5/2 3/88. . . . . . . . . . « . . . . . . . . . . . PLUMBERS CERTIFICATION DATED: May 4 , 1988 - Robert Kowalski Building Inspector« µ 4 Rev.1/81 w FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . .4-. 1 6896. . . . . , , Date . . . . May23, 1988 . . . . . . . . . . . . . . . . . . . . . « . . . THIS CERTIFIES that the building . . . . .ONE, .FAMILY. DWELLING . y « Location of Property 375 Wunneweta Road Cutchogue , New York House No. . . . . . . • . . Street . . . . . . . ' w " " " . ' " ` . " ' 'flam%t County Tax Map No. 1000 Section . . . 104. . . . . .Block . . . 12 03. Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . , . .Lot No. . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated October 5 , 1987 16512 Z . • • • . • . • pursuant to which Building Permit No. . . . . . . . . . . . . . . . . . . . dated . , 0 c t o b e r ' 1 1 , .1.987 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 AS APPLIED FOR T11e certificate is issued to . • . . JOSEPH FLEMING �owner,°1x. . . . . . . . . . . . . . . . „ , . . of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . 87-SO-91 - 5/ 12/88 UNDERWRITERS CERTIFICATE NO. . . . , . 4 e „w PENDING 5/23/88 PLUMBERS CERTIFICATION DATED: May 4 , 1988 - Robert Kowalski Building Inspector Rev.1181