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Home My WebLink About1000-96.-2-2 TOWN OF SOUTHOLD cm Rental Permit 0696 Owner Rebbie Straubing Occupied as Single Family Dwelling Located at 4900 Depot Lane Cutchogue 96-2-2 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. 7/12/2022 • C de E o ce e t Official This Notice must be posted by the main entrance at all times i Town Hall Annex 1 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 • �� Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION_ _ Rental Permit Fee$200(Application must be renewed every two � AUG - 9 2019 Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION. V q6. -LOT ,cSt SECTION B. OWNER INFORMATION: Property Owner Name:,--- .�EuL— 5 I-& Property Owner Legal Address: Property Owner Mailing Address: 0.Lq �e b-e f-e-5 5- Telephone Number(s): Daytime 56 176, �l vening5t,910c Emergendy. d r –C Property Owner Email Address:_ 6AZE'tj(4 i-J 5 6-1mf41 L , C dy Page 1 of 5 Town Hall Annexe Telephone(631)765-1802 54375 Main Road _ Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 e4UNT`1t�` 'c BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION INSTRUCTIONS .Rental Permit Fee $200 (Application must be renewed every two years) The items listed below are required to be submitted with the completed application. B"Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of all smoke&carbon monoxide detectors. ED,,-Certificates of Occupancy and Pre-Certificates of Occupancy: Certificates of occupancy or Pre-Certificates of Occupancy for.each rental dwelling unit. ❑ Certification of Code Compliance(form enclosed): Must be submitted by a license architect or engineer or license home inspector if an inspection by Town of Southold Inspector is declined. 2- Rental Permit Fee: $200.00 i �a Soo, °lam Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 • Southold,NY 11971-0959 C nil OW BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:, - Telephone Number(s): Daytime. __- Eve ' .g Emergency _.-.... Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 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: d Requested Maximum number of persons allowed to occupy Dwelling Uni : ---- Number of rooms in Rental Dwelling Unit: y�Cl� Use and Dimensions of each room in Rental Dwelling Unit: KiA c� ! P„�� ,,nn 14,E°, ��'�f '' Lt✓, F aa'lraxll��„ [�Q lw.,e� ca �� i✓� d>' l �-*si-e✓fiJ -: .. wee d” �.,5 -f,✓�-e .b� � �'/l" X��1i Page 3 of 5 Sol/ Town Hall Annex 4 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 . . �c®UNTI,� BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: ,k Name of Authorized Agent of dwelling unit, if any:. _ �U (1 - Address of Authorized Agent(no P.O. Boxes). Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening_ • - Emergency Email Address: �. ( � 1 s ki �gc�5CI co- -- -- - 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 Annex Telephone(631)765-1802 54375 Main Road CP-. `c'— Fax(631)765-9502 P.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. 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�C ,certify under penalty of perjury,the following: 1. ( am the owner of the property identified in "Section A" of this dppllcation=' 2. The property owner's legal address set forth in "Section W"oflhis application;is'my legal address and I understand the Town will use the address for service pursuant to all Page'4 of 5 L Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Y Coo BUILDING DEPARTMENT TOMW 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: Sworn to befor his day of ;-2017 Official N tary Public Signature a riginal No ary Stamp DONNA LENT ! Notary Public,State of New York No.01 LE6101246 -.. Qualified in Queens County IC, Commission Expires Nove►n6er 10, Page 5 of 5 4W_ NOF S Ul�o / # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULK G [ ] FRAMING /STRAPPING [ ] INAL �G�4✓�v �l [ ] FIREPLACE &-CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT-CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: Owllf�lm __ saw ctt AA DATE V MOO INSPECTOR SOUIyO # # 'TOWN OF SOUTHOLD BUILDING DEPT. co 765-1802 : INSPECTION [ ] FOUNDATION 1 ST 1 [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [YFIREINAwf- -FIREPLACE & CHIMNEY [' L PryAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] 'FIRE RESISTANT'PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATIO [ ] PRE C/O REMARKS: Ste, r rwt �✓l (� �t � . Q*--'Xn f"X&OVA Nub* DATE Lol;,,ellfll INSPECTOR cc --------------------- 1l I Sri►+ Tf Yr Or e t /4° a. , e� pp VI TOO TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET G-1 VILLAGE DIST, SUB. LOT FORMER OWNER E CR. S W t TYPE OF BUILDING RES. 210 SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 2 ,1 6 �� • 1� �e @ 7-" /" & C! t 1.7 7,- _ C � 1Co � 'd f� S�/! 2 /�ol�e aw�' � /�� ,.►, e 6 �, c�Leg�, 6 Ll 3 d o 0 L 14 - h k F.4b . 4o 64oujnQ ' �sojooy r✓, ;Ewe 6',5 7 Da .S 3a0 e,191 AGE BUILDING CONDITION ie, NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 _ cry �? G •t1 - U o Woodland �9 a s• u ,s' a Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD 1 .House Plot DEPTH ! BULKHEAD Total � DOC K i NEI mom 11116MUMOMMOM OMEN MrAMMEN■■■■■■■■■■■ rn-v ■ NONE Eo ■■■■■ ■■■MEN @!9.R ■ MEMO ■p ■■■■■■■■■■■■■ NEE■ ■NEON M mom MEMEEE MME ■■■■■■■ ■RIE■■■MMEMMEM■■M - E■■■■M maim=■■E1111111COMMMMM MMEM ... . � ME ■■iE■■MMMrMEE■■ENE■ ME EM ■■lm=NEEMMM■■■EE■■■■ i . ME■MEM OMM�E■■E - MMM ■NE ■E■■ME■ M■■■EMENMmom■■■IMM■ Heat IType Roof 6A Rooms I st Floor Rooms 2nd Floo�, girlr . �% f ' ..- 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-22688 Date October 29, 1993 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 4900 DEPOT LANE CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 96 Block 2 Lot 2 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-22688 dated OCTOBER 29, 1993 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 TWO ACCESSORY STORAGE SHEDS & ACCESSORY BARN* The certificate is issued to ANTONE CHITUK (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. w� ildi g Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOunlOLD HOUSING CODE INSPECTION REPORT LOCATION: 4900 DEPOT LANE CUTCHOGUE, N.Y. number S street municipality SUBDIVISION MAP NO. LOT (r) NAME OF OWNER (s) ANTONE CHITUK OCCUPANCY A-1 RES. OWNER (type) (owner—tenant) ADMITTED BY:. ACCOMPANIED BY: KEY AVAILABLE SUFF. CO. TAX MAP NO. 1000-96-2-2 SOUP,:;Z OF REQUEST: WILLIAM WICKHAM, A1TY DAA: OCT. 21, 1993 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME 0 STORIES 2 0 EXITS 3 FOUNDATION CEMENT BLOCK CELLAR FULL CRAITL SPACE TOTAL ROOMS: IST FLR. 3 2ND FLR. 3 3RD FLR. BATHROOM (s) ONE TOILET ROOM (s) UTILITY ROOM PORCH TYPE ENCLOSED PORCH DECK, TYPE PATIO, TYPE BREEZEWAY FIREPLACE NO GARAGE DOMESTIC 13OT14ATER YES. TYPE HEATER ELECTRIC AIRCONDITIONING TYPE HEAT OIL WARM AIR HOTWATER XX OTHER: WASH M N' ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. TWO STORAGE SHEDS SWIMMING POOL GUEST,-TYPE CONST. OTHER: BARN VIOLATIONS: CHAPTER 45 N.X. STATE UNIFORM FIRE PREVENTION b BUILDING CODE LOCATION DESCRIPTION ART. SEC. BASEMENT IT APPEARS THAT ELECTRIC HOTWATER HEATER IS LEAKING NYCRR 9 (B) EXTERIOR ROOF IN NEED OF REPAIR (HOUSE) EXTERIOR REAR SHED IN NEED OF REPAIR. REAR YARD RL••MARKS: INSPECTED BY: � DA'TI: ON INSPEC'PION OCT. 26, 1993 G S. Pish TIME START 9:30 E�j 9:55 =o�guFfUl,��oG�� Town of Southold 7/12/2022 P.O.Box 1179 0 b--- �. 53095 Main Rd Southold,New York 11971 . CERTIFICATE OF OCCUPANCY No: 43240 Date: 7/12/2022 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Properly: 4900 Depot Ln, Cutchogue SCTM#: 473889 Sec/Block/Lot: 96.-2-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application•for Building Permit heretofore filed in this office dated 11/7!2019 pursuant to which Building Permit No. 44422 dated 11/18/2019 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: "as built"alterations to an existing single family dwelling as applied for. The certificate is issued to Straubing,Rebbie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT'OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44422 7/12/2022 PLUMBERS CERTIFICATION DATED 6/30/2022 Wils g ut iz d Signature Pontino, Susan From: rs <greenrows@gmail.com> Sent: Tuesday,August 20, 2019 12:06 PM To: Pontino, Susan Subject: Rental Management change to application for permit Dear Susan, I enjoyed talking with you today. To recap: My application for a renters permit is in and I"m awaiting an inspection. I will be having the following company managing the rental of 4900 Depot Lane in Cutchogue: Vacasa Services Contact: Levi Logstrom. Levi.logstrom@vacasa.com. 631-905-9567 or 631-527-7936 If you need to reach me about the house or property, please contact me directly. If you need to reach me about the rental, pease contact Levi. As you mentioned in out phone conversation, I understand that this is official notice of change in my application. Many Thanks, Rebbie Straubing ATTENTION:This email came from an external source. 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