The URL can be used to link to this page

Home My WebLink About1000-54.-9-18.1 TOWN OF SOUTHOLD \/OI ►'� Rental Permit �s0 a 0758 a# Owner Cheryl Feld Occupied as Single Family Dwelling Located at 300 Birch Rd Southold 54.-9-18.1 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. 10/18/2022 Code of rc . rpt o icial This Notice must be posted by the main entrance at all times �ry Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold NY 11971-0959 ou BUILDING DEPARTMENT ` �' 2022 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 2 YN-0 l 19 1 Tax Map Number: 1000 SECTION —��----BLOCK -LOT�t SECTION B. OWNER INFORMATION: Property Owner Name: �, W Property Owner Legal Address: Property Owner Mailing Address: ", 00 - Telephone Number (s): Daytime`i117-S2 Evening Emergency Property Owner Email Address: 3 0 1r-\, Page 1 of 5 Town Hall Annex 'b Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. Box 1 179 Southold,NY l 1971-0959 CoUM`( � 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: 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: L Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: " 2 X Lj Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 � Southold,NY 11971-0959 COU 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. U/1 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) I 6 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 �wV ij I, Town Hall Annex 4 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 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 Owners Signature: - Sworn to before me thiA4Aday o ° 20 a Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 oualified in Suffolk County Commission Expires April 14, Page 5 of 5 t ,3 e M SUS _ —O ` �a g _ rom _ Ilkf �wm ~ y � `` _ _ 5 , - - - - j _ i D91- 11,7t8' LVL <s � S ? I _r s e HED ROOM #1 I ml LVL 21 It I I vy I.N I / p FT / / ✓ N�/ f i% J �... �l Y w LIVING ROO C' LVL uiN��if .., w �... .......... ......_......,....,...... ___.. . .. ...,..... ..._�..__. G d rw AO s l7t QED ROOM yyy� ii OFFICE U � I[:;64'fy f FS 4"dAl, 6- ,x, / 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PTEG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL j ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN: [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIl [ ] CODE VIOLATION [ ] PRE C/O [ el Il P- &e bean V------------- D TjOa 6� DATEoINSPECTOR - T WN OF SOUTHOLD BUILDING TI 631 -785-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit [ ] CODE VIOLATION PRE C/ [ �/F REMARKS: hU � o ASTM o oe UL �0 AVs� ke os ,;;/ 4 an Ant IZ4kXf n,.Ay Poo DATEr P- IC/ INSPECTOR µµ SOUTHOLD TOWN Town Hall Annex a 54375 Main Road PO Box 1179 Southold, nt l Ins tion NY 11971-1179 Iz Tel: 631-765-1802 Fax 631-765-9502 SCTM # Date �2 �• �� Owner Phone Address ' 027 'p7i1? C k Zip Clty inspector LEVELS SUB 2 3 Smoke Detectors (#- bedroom detectors excluded) { Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) BEDROOMS 1 2 3 4 5 Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress(windows) (YIN) BUILDING SYSTEMS Y/N CONDITION OF PROPERTY YIN Heatin s stem maintained/operational Building Interior is clean I maintained Hot waters stem maintained/operational Building Exterior is clean/maintained Electrical s stem Property is clean !safe/maintained maintained/operational Mechanical system rnaintainedlo stational Handrails &guards present COMMENTS: Rental Inspection Form 4!712021 TOWN OF SOUTH LD PROPERTY PERTY REC0 <W /c? OWNER 'STREET VILLAGE 1 DIST.i SUB. LOT t FORMER NER N. E� ACR. l G S TYPE OF BUILDING i e dT SEAS. VL. = FARM COMM. CB. MICS. Mkt. Value LAND I IMP. TOTAL j DATE REMARKS f �3 ef q PC- 4O `P o --- a x f P e �l f Il La — 1= - C cp BAIL ISG C '�1�?N-` Q! _ a p' 3 I e, u ILI ,R Tillable FRONTAGE ON WATER Woodland E FRONTAGE ON ROAD a� Meadowland DEPTH , House Plot I BULKHEAD Tota'. DOCK "F � - - COLOR C r TRINA r-7- -z — - � 3 9 e _ E s-E -- 54,9-18.14/07 a a s M. Bldg, Extensione 4 -.'� - _ b - � E Extension — , d r ----------------- Extenslori ¢ 3 ®i 1 Foundation Bath ,Dinette Porch v , !Basement ;`'v i, t,. !Floors K. Posh Walls ;interior Finish LR. ° t ' Breezeway ! Fire Place ! Heat DR. tf—i arae -7 �x �•, e Roof _ Rooms 1st Floor m Patio ( ,i Recreation Room 'Rooms 2nd Floor FIN. B {� ( O. B, _ IDormer Driveway Total 70 � a i J • - 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-19313 Date AUGUST 22 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 300 BIRCH ROAD & 755 CHESTNUT RJB. SOUTHOLDt N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 9 Lot 18.1 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a private one family dwelling built prior to: APRIL 9 1957 pursuant to which CERTIFICATE OF OCC. #Z-19313 dated. AUGUST 22 1990 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 ACCESSORY WOOD FRAME GARAGE* The certificate is issued to FRANCES EPP SUSAN KUJAWSKI CONSERVATOR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE EXISTING UMERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING PLUMBERS CERTIFICATION DATED NO RECORD PRE EXISTING *PLEASE SEE ATTACHED INSPECTION REPORT. M i1 ing spector Rev. 1/81 _.. . ,. y BUILDI--,, DEPtRT.IEFIT TO*11,1 OF SOUTHOLD, ff. Y. HOUSITM CODE INSPECTION REPORT Location 300 BIRCH RD. & 755 CHESTNUT RD_ SOUTHOLD, NEW YORK (numoer do street) ffunicipaiity) Subdivision Flap No. Lots) Name of Own er(s) FRANCES EPP. (SUSAN KUJAWSKI, CONSERVATOR) Occupancy ONE FAMILY DWELLING OWNER (VACANT) ktype owner-tenant Admitted by: F.HEIGL,REALTOR Accompanied by: SAME Key available Suffolk Co. Tax No. 54-9-18.1 Source of request SUSAN KUJAWSKI, CONSERVATOR FOR ate �. 8/15/90 « D ]DWELLING: Type of construction FRAME A 1 stories Foundation CEMENT BLOCK Cellar 40Z Crawl space ROY— Total rooms, 1st. Fl 4 2nd. F1 - - 3rd. F1 Bathroom(s) 1 Toilet room(s) Porch, type CLOSED INDeck e typ Patio, type Breezeway Garage Utility room Type Heat OIL Warm Air Hotwater Fireplace(s) 1 No. Exits 3 A.irconditionirag_� Domestic hotwater xx Type heater Other ACCESSORY STRUCTURES: Garage, type const. WOOD FRAME Storage, type const. Swimming pool Guest, type const. Other NOTE: GARAGE HAS TOILET 6 SHOWER VIOLATIOFdS: CHAPTER 45—N.Y_ STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE L oath on Descri.:ati.cn Seo. (FRONT ENTRANCE GROAN OVER 1242.3 EXIT CELLAR ELFX.TR'ZC GENERATOR 1 CELLAR FURNACE (OIL BUMER) CHIMNEYS 1243.1 Remarks• BP #12530-Z Co 2-17875 t sad+ xt:1On Inspected by. '" Date of Insp. 8/21/1990 i1m Time start 9:30 end 10:00 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17875 Date MARCH 22 1989 THIS CERTIFIES that the building ADDITION Location of Property 300 '.BIRCHROAD SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 054 Block— 09 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated, jULy to which Building Permit No.-,12530Z dated JULY 30 1983 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 ADDITION TO EXISTING ONE FAMILY DWELLING, The certificate is issued to FRANCES EPP ESTATE (owner, XXXXXXXXXXXXXXXX) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N631743 JANUARY 27 1984 PLUMBERS CERTIFICATION DATED NLA i ilding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33080 Date: ,06/09/08 THIS CERTIFIES that the building ACCESSORY Location of Property: 300 BIRCH RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 54 Block 9 Lot 18.1 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 15, 2006 pursuant to which Building Permit No. 32132-Z dated _ J2UN=E 1.9 2006 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODEAS APPLIED „FOR PER ZBA (# 5875 DATED 5111/6. The certificate is issued to CHERYL FELD (OWNER) of the aforesaid building. SUFFOLK COUnTy DEPARTMM OF HEALTH APPROVAL NA .._ ELECTRICAL CERTIFICATE NO. 3248 07 29/06 PLUMBERS CERTIFICATION DATED AW rized Signature Rev. 1/81