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Home My WebLink About1000-69.-3-16 T OWN OF SOUTHOLD " W IF Rental Permit 4 0623 �a Owner Kevin & Linda Santacroce Occupied as Single Family Dwelling Located at 875 Jasmine Lane Southold 69-3-16 Maximum Permitted Occupancy 8 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. 4/22/2022 }_ ode Enforcement Official This Notice must be posted by the main entrance at all times 1 Telephone(631)765-1802 Town Hall Annex 54375 Main Road Fax(631)765-9502 P.O.Box 1179 g^P Southold,NY 11971-0959, BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) w T Section A. Property Information: Rental Property Address: p 4w? �A p^p y�No,tl 875 Jasmine Lane, Southold, NY 11971 M1 WAN Tax Map Number: 1000 SECTION 69 -BLOCK 3 _LOT 16 SECTION B. OWNER INFORMATION: Property Owner Name: Kevin Santacroce Property Owner Legal Address: Property Owner Mailing Address: 1000 Laurel Avenue Same Southold, NY 11971 631-764-3176 Telephone Number(s): Daytime Evening Emergency Property Owner Email Address: ksantacroce6@gmail.com �•t' 1�1`�� Page 1 of 5 Town Hall Annex ' ; Telephone(631)765-1802 54375 Main Road k Fax(631)765-9502 P.O.Box 1179 � F Southold,NY 11971-0959a BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: McCarthy Management, Inc. Address of Authorized Agent (no P.O. Boxes): 46520 County Road 48, Southold, NY 11971 Mailing Address of Authorized Agent: Same 631-765-5815 Telephone Number(s): Daytime Evening Emergency Email Address: tmccarthy.tmccarthy@gmail.com 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: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annexhone 631 p ( )765-1802 Tele 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: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: One 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: 8 Number of rooms in Rental Dwelling Unit: 8 Use and Dimensions of each room in Rental Dwelling Unit: Kitchen 12'X20', Living Room 12'X20', Bathroom 8'X10', Bedroom 1 10'X12', Bedroom 2 12'X12', 2nd floor: Master Bedroom 18'X24', Bathroom 8'X10', Bedroom 3 18'X24' Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 Y.O.Box 1179 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. E& I 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) 1 Kevin Santacroce 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 AI Telephone(631)765-1802 54375 Main Road �, Fax(631)765-9502 P.O.Box 1179 ° Southold,NY 11971-0959 � µ � ,ab,w � 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. Property Owner's Name: Kevin Santacroce Property Owner's Signature: Sworn to ore met ' day of ficial Notary Pu c ignature and Original Notary Stamp NOTARY �'��wrJ'1'wuk Nicr,state of Newyork J9LI No OIJ06349053 r Qualified in Sot"toila County '"r rai bbwt fi Commission t,xlk"d es to/11/202—.4 Page 5 of 5 CA. � EK10TiNG GELLAR .. S2 «........ ..........»........ l4 A• ---- ifi 9a EMERC er.TPR �NhaT�$'kw�v„NbPdN„L,^MY PE12 CODE CAR94S MONOXIDE DETECTOR ONO:'PE,P',FtOO* �.......«—..M....,...�.—JSP 0- ..............«......««.. ----^^ 1°.YSTIMab gY„kk'6p'M*Y&d P,ACY4IIpkk;'v' A" ...`..OM1"w .:..,.... .. .... UQ W v R.a.PYt. 10 $F t TG@KT.I."` OdSTING O,g,xkTO�q P, 9, SEDROOM®1 B'b" Ex1971PdG °. YIII 9'6' KITCHEN N tti:t°CLta Wr. J.6m r.r» ag �xnET EXISTING MxIrTING L[)Ta ROOM EDROOM A'a» S -1 B'O"GLCx. e'b"CLCx HCT. EXA N " Ma FRiSTfNCi Y�'MOS�I'0`A(.I fXIS I«��fi mss LIVING AREA=855 SQ,F r, EracE c ErE' 'eae �pyyR'Ea$ Pq'NE",;.'O PER CODE g M4"4NaKIDE DETCTOR 2 01aE PER PLOOR 7 u n d L4 Q I` IL M a �o � m m 5L S 2 lQ x} µm mG7 14 O O e.kYry4V VN tib^'debet rxis�wo-ti i'k'Aw%� en¢Nr,wrtr sml"W+FVk+ aa.. U rowuH w.z:e e-icv�.v. W 18kJ� �� A b`Po^ E#IBTINta 'b"p' EXIB'I"ING`s BoROOM+"3 a"p' 9'O'GLG.-T. - ro62a a94r" I.RCIUM FI.E. R'Wr" w" �' (,W,iNtiAlAM BE d{AYMW.M Q KK WH6M flt�b9:m}4 �.�yyL 6 ......—..«..,...».«,....—. ,.«.. o LL aY �• �.. w co z 9 b' CLC7. t0" SS LIVING AREA=819SQ.FT. E"aOK'E KJ';CI.;O'1'OfO q. � kadT'I"jWrt":dA"wN�°aC9" FOR CODE CARBON MONOXIDE DE'TCCTOR ONE PER FLOOR Wry,M,yMru'w'WWO'4R✓* " T.NA4YIt.YzR pz-p^'C,omp'"ImMV'1494 IN ANY%' WH ro MaM OWOM WO tiA lT"Il!MM rI-04 d.aTM*W—0"J-FIEY 4. � a 16- TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST- SUB_ LOT S ACR. REMARKS2- ja — } Al eet a YPE OF BLD_ PROP,—CLASS ) p q � jo LAND IMP, TOTAL DATE ri--i2T /14 �-- .- e i a FRONTAGE ON WATER TILLABLE .................... z FRONTAGE ON ROAD WOODLAND i DEPTH MEADOWLAND BULKHEAD HOUSE/LOT t JTOTAL a s .7 ME ME MOMMEM IMMENuMMMMEREMMUMEMMEMMIN NEMESESInterior Finish I • Heat • • Woodstove BR, Attic .. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21160 Date NOVEMBER 19 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 875 JASMINE LANE SOUTHOLD NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 3 'Lot. 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2 1992 ______pursuant to which Building Permit No. 20794-Z dated JULY 9 1992 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 FIRST FLOOR ONLY The certificate is issued to PECONIC PROPERTIES MANAGEMENT INC. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-42-NOV. 17 1992 UNDERWRITERS CERTIFICATE NO. N-258492 - NOV. 1992 PLUMBERS CERTIFICATION DATED OCT. 8 1992 - ARTHUR MALANSSENA JR. ding Inspector Rev. 1/81 Town of Southold 4/22/2022 P.O.Bog 1179 'a 53095 Main Rd w Q Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43003 Date: 4/22/2022 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 875 Jasmine Ln, Southold SCTM#: 473889 Sec/Block/Lot: 69.-3-16 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/22/2022 pursuant to which Building Permit No. 47581 dated 3/22/2022 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: "ate- wilt'"alterations finislted 2nd it car toe s i sin 1 arr il�v gIlis d for. The certificate is issued to Santacroce,Kevin&Linda of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47581 4/4/2022 PLUMBERS CERTIFICATION DATED 1/20/2022 Samaritan Plumbing,Inc Auth rized Signature McCARTHY MANAGENOff, INC. 46520 COUNTY ROAD 48 SOUTHOLD, NY 11971 w_ DA t � JC3r3 NCN � (631) 765-5815 FAX 631 765.5816 ATTENTION "` ...._._ w .._. w.. _w_... .. _._. TO _7 ....... _....... rVU _.........._.w.ww_._... . .Y.. ..._ „.,, ..,.,.._._....,.__._.Xµ.,M_..._M..M.M.._ -----------....... WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via ,.__the following items: y ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ ... _...............M....ww _........,.....ww ..w. _.__.........._... .__w . .._...ww_......_.....µ„Hww_ ......... _ ,.w. .._n_......_.M._. _, __. _.. _r..._.. . .._ .........,.w wvaw__. ,. _.._ .....M.......w w .......... ..vw www .. .. ._.........m.M ...... ..... . _ ” _www.. M� _ ._. _ ., w........ ...............w._....w__._.......... ... ........... ... . ......... _a_.. __.._ .... _......_..............._ ...._......... _........ .�._..................._.... .., vm.u. M .. .._.._. .........___..................._w...._w............w...._.M,,,,ww.._ww.w_ .w....................._ THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit ....�..............................copies for approval ❑ For your use ❑ Approved as noted ❑ Submit ..................._—_.......copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return .................................corrected prints 5 ❑ For review and comment _ _. ..... . _ .... ..,.._. ❑ FORBIDS DUE ....... __....___.. .......... ... ............._._ ❑ PRINTS RETURNED AFTER LOAN TO US ......... REMARKS............... KS -17 ` d .. ' � _... .w... _._ ! .. ......__..... ... Ofrt ............. COPY TO _._ .. ....... _ .. ..._. SIGNED: _w.......... .. ........ ..... ..... ._ . ...... .... If enclosures are not as noted,kindly notify us at once.