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Home My WebLink About1000-54.-9-10 #£ TOWN OF SOUTHOLD �� k Rental Permit 0637 Owner Kenneth Owens Occupied as Single Family Dwelling Located at 340 Pine Road Southold 54-9-10 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. 5/9/2022 � �Official This Notice must be posted by the main entrance at all times ter Y r-uwi � Raw � r nr Telephone(631)765-1802 Town Hall Annex 54375 Main Road Fax(631)765-9502 P.O.Box 1179 r Southold,NY 11971-0959 VAIMPOM � �� R 1 C 202 BUILDING DEPARTMENT BUILDING L),cpr .� TOWN OF SOUTHOLDVVAI OF RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental ProI?ja( y t Address: iCL Tax Map Number: 1000 SECTION-BLOCK C LOT,_ SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytim �Ilvening_Emergency, Mw c � Property Owner Email Address: Page 1 of 5 l' Town Hail Annex Telephone 631)765-1802 54375 Main Road Fax (631)765-9502 F.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTI40LD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency ,,._,_. Email Address:.��.,. _www.. ... . . 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: Requested Maximum number ofpersons allowed to occupy Dwelling Unit: �Mn Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit:. Page 3 of 5 a� Town Hall Annex �a P Telephone(631)765-1802 �V 54375 Main Road + Fax(631)765-9502 5 P.0_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. ❑ 1 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) 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 % ��4 � � Telephone(631)765-1802 34375 Main Road Fax(631)765-9502 ZZufc, r P.O.Box 1179 Southold,NY 11971-0959 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: Property Owner's Signature: p Y .Sworn to before me this day of MCiA a � �� Official Notary Public Signature and Original Notary Stamp CONNIE D BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14,21D-�) Page 5 of 5 o DEPT.TOWN OF SOUTHOLD BUILDING 765-1802 0l4 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: A Ca- )r a- INSPECTOR d - E = s e _ �a g e a Set - Nis \ s 64 fel s _ ` .. = s Of -r TOWN OF SOUTHOLD PROPERTY RECORD S OWNER 1 STREET- Af 1-v" VILLAGE DIST.I SUB, LOT' FORCER OVER N E ACR. N v XZ-Z S W TYPE OF BUILDING Wo rri RESSEAS, VL FARM, 'COMM, CB. MISC. Mkt. Value ,' � LAND IMP, TOTAL DATE REMARKS pr 0 2 2- e- 1C4 zz� tc I del L 0) o (A)-7 (D 7- AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value DS L Acre -G\O- Tillable I Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD I House Plot DEPTH Total DOCK t A m � 01_02. i f rRlnn s t l �tV CA I r 54.-9-10 01/26/2017 _ _ M. Bid Foundation ( Dinette Bldg, Both v tea__ Extension Basement ' Floors K. c Extension Ext. Walls >� A-Interior Finish it - Extension Fire Place Heat „U j QR. = � 1 Type Roof Rooms 1st Floor SBR. a s Recreat;an Rooml Rooms 2nd Floor FIN. B. -.�.. Porch I [ Dormer 4 Breezeway ! Driveway T r Garage Patio II ! € 0. B. a ! Total { FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20548 Date FEBRUARY 26, _1992 THIS CERTIFIES that the building ONE FAMILY 'DWELLING Location of Property340 PINE ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 9 Lot 10 Subdivision Filed Map No._ Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: — APRIL 9 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-20548 dated FEBRUARY 26 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 WITH ATTACHED SCREENED PORCH The certificate is issued to HELEN I. WISBAUER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. uilding Inspector Rev. 1/81 l TO'-'.TT OF SOUTHOLD, N. Y. HOUSIZ;'G CODE INS?-ECTION REPORT Location 340 PINE ROAD SOU`n1OLD, N.Y. knumoor * streecl Subdivision MaiD Name of Owner(s) HELEN I. WISBAUER Occupancy---A-1 Res. OWNER (type e r-r.—e n a r,T:7— A(!-,iitted by: JOAN HAMILTON Accompanied by: SAM Key available Suffolk Co. Tax No. 54-9-10 Source of request WILLIAM H. PRICE,'-JR- Date FEB. 14, 1992 DI-r: Type of construction WOOD FRAMEONE 7,-stories-- Foundation CEKENT BLOCK —Cellar PARTIAICrawl space Total rooms, Ist. Fl 3 2nd. F1—3rd. Fl Bathroom(s) I FULL BATE Toilet room(s) Porch, type SCREEN PORCH Deck, type- Patio, type_ Breezeway_ —Garage utility room Type Heat OIL Warm Air XX —Fotwater Fireplace(s) No. Exits Aircondition-iner Domestic hotwater YESOIL .�Type heater Other OUTDOOR SHOWER ATTACHED TO HOUSE AS SHOWN ON SURVEY DATED 2/10/92. ACCESSORY STRUCTURES: NONE Garage, type const. Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: CHAPTER 45--N.Y. sTxrr UNIFORM FIRE PREVENTION & BUILDING CODF- Locati, 11 Description Art. I Sec. L—J ............ Remarks: Inspected by: Date of Insp. FEB. 25, 1992 Time start 9:10 end 9:25 , QlI e,k Town of Southold 10/20/2016 P.O.Box 1179 53095 Main Rd Southold,New York 11971 m CERTIFICAI'`E OF OCCUPANCY No: 38610 Date: 10/20/2016 THIS CERTIFIES that the building ELECTRICAL Location of Property: 340 Pine Rd, Southold SCTM#: 473889 Sec/Block/Lot: 54.-9-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/18/2016 pursuant to which Building Permit No. 40917 dated 8/18/2016 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: 200A,UNDERGROUND ELECTRIC SERVICE The certificate is issued to DeMartini,Raymond of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40917 09-13-2016 PLUMBERS CERTIFICATION DATED Authorized Signature