HomeMy WebLinkAbout1000-54.-9-10 ze
TO WN OF SOUTHOLD
Rental Permit
0637
�4e
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.
4/15/2024 'L-�- .
Cod E ement Offtial
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD BUILDING 0
631 Ef i5r 1802
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PTBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAt
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
[ ] CODE VIOLATION [ ] PRE C/O [ i
REMARKS: 65
DATEr INSPECTOR /
Town Hall Annex
Town of Southold 54375 Main Road
' Rental Inspection Report PO Box 1179
41' Southold, NY 11971-1179
" Tel: 631-765-1802
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CTM # _ �.,. Date o�
Owner Phone
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Smoke Detectors(not located in bedrooms) /
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Fire Extinguishers
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Electrical Property clean, maintained &safe
Mechanical Handrails&guards installed &sec u r e"-'-"
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Surface water alarm Date of CO issuance
Door alarms �, Ra, .,..�,�..... �. ...�.� , .e ..�...... �...w ..... Pool completely enclosed
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Self closing/ latching gates Pool fence to code requirements
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#£ 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
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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
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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
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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
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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