HomeMy WebLinkAbout1000-103.-10-12 TOWN OF S UTHOLD
Rental Permit
0754
Owner Robert & Linda Kenney
Occupied as Single Family Dwelling
Located at 635 Strohson Road Cutchogue 103-10-12
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.
10/18/2024 Y 44q')i;�4
bode no ment ofi �
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802 /03- /D/a-
INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ q/RENTAL
REMARKS: -4?e-
DATE
INSPECTOR
ell Town Hall Annex
Town Of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
. ' Tel: 631-765-1802
SCTM.#_.. ... .. ........ p..,._,t.� w..,... � .. ... . " _. _µ..,...,, . . _ .._.. Date. ...... . ..... 1 .�1!_ ._.... ..w....
Own er Phone
;Address 3 S �OAso /1 Visible
Hamlet � Inspector
Floor Level Quantities Sub 1 2 ; 3
Smoke Detectors (not located in bedrooms) �.._.._.. , . . . �... , ,.. .,,.__ �.... . .... .. W_F..._ _..;
Carbon Monoxide Detectors
Fire Extinguishers
Exits
Bedrooms 1 2 _ � 3 4 1 5 6
11 moke Detectors
✓ � .., , � � �� . . ... a�mn
Egress
Occupant Count
BuildingSystems Maintained
._ N &Operational Condition of Property
Heating Building interior.. .a . .... . ..,.� m ,... . u ...,. ,. �.... . m
..._. .. . .,... ,.�. .... 1
Hot water Building exterior
Property clean, maintained & safe
Mechanical cal E ec Handrails&guards installed &secure C
1
Pool Safety ,. _.. .... . . Pool on Site
Surface wa
ter alarm Date of CO issuance
alarms 1Pool completely enclosed
Door a � ....__... .. . .�_�.__-_
_.... ._t m
Self closin latchin ates._ .. code ._ . .. ..
�,_W.. ... ...�. g/ g g .�...... _�.......�.. Pool fence to re requirements _ __..�__.._ ....�..... ..n..._�_ ..�
CO's for all items present Prior Rental
Comments
TOWN OF SOUTHOLD
CP Rental Permit
tr Q1` ate 0754
Owner Robert & Linda Kenney
Occupied as Single Family Dwelling
Located at 635 Strohson Road Cutchogue 103.-10-12
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.
A
10/17/2022
ode nfo me t Official
This Notice must be posted by the main entrance at all times
pf S011T1�o -�
Town Hall Annex .lam �, Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
�y��UN1y tai
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Proper y Address:
A 3. OO
Tax Map Number: 1000 SECTION _ -BLOCK IV-9
e
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
oe,tj
'J�
Telephone Number(s): Daytime Evening Emergency /
Property Owner Email Address:
OCT 0 5 2022 1 ;
Page 1 of 5
TO.,.
Town Hall Annex Telephone(631)765-1802
54375 Main Road CO- Fax (631)765-9502
P.O.Box 1 179 G.s�'
Southold,NY 11971-0959 Qom.
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 occupy Dwelling bni :
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
jr;;'2
Page 3 of 5
F SO ,
Town Hall Annex Telephone(631)765-1802
54375 Main Road JW to 5e Fax(631)765-9502
P.O.Box 1179 ® O
Southold,NY 11971-0959 0 �`
r�C4UM`I
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.
q/ I 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) "" pp
I nTiV 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
®zov SO&��o
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 p a
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: a`l 2/VJAf9-
Property Owner's Signature:
Sworn to before me this day of b` 20 �
ficial Notary Public Signature and Original Notary Stamp
MNEVALi:M MACCHIA
NOTARY PUBLIC STATE OF NEWYORK
SUFFOLK COWRY
LIC.i0tVA50TW
CO K EXE W 1X;Q 0�
Page 5 of 5
aOF SOTtio /
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U � (��S �„�• /�
# TOWN OF SOUTHOL6 BUILDING DEPT.
�ycourm,�� 631-765-1802 l 01/.— to _ (v
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [/FIRE
LATION/CAULKING
FRAMING /STRAPPING [ L
FIREPLACE & CHIMNEY [ SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS:
r
DATEd 1� INSPECTORA Llk-�
O�aOF SOUTy° ro (�iJ
# f
TOWN OF SOUTHOLD BUILVING DEPT.
cou631-765-1802 l o-�, .. `p _ 11/
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] AL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L)
[ ] CODE VIOLATIO Ko
[ ] PRE C/O [ RENTAL
REMA KS: L-als. obV-0ttirn,
DATE ANSPECTOR
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4
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BEDROOM t13-4
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OCLOSET
77
c%> BATH 2 — •""`��' TRAY CEILING KITCHEN
-: .. O.C.(TV-) FR
❑2 ����iC ...._ . .. CLOSET
OF,
WALLS
_ RELOCATE EXSTING
WINDOW _
LNMG'
BEDROOM 2
EXISTING DOOR
1 t' TO REI"
NEW WPIDOWSTO
MATCH SWING
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e+c-G�Ca��
i T aq J )�—JTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE DIST. SUB. LOT
C 61
FORMER`OWPE N - E {� ACR.
L1171 0
S W TYPE OF BUILDING
RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
4
LAND IMP. TOTAL DATE REMARKS
(APF Z
_
3.6 0 d12,6 ? � P,« A�'s=�P. 7.s- r�df "r>vdis Ff � OPS'.
L/ -Tqq e. de n�zl r � : ^� ��
7 4 D6 �� sd S ime, -Rimilo.a�t r � M9
1900 Z//00
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J I r` ir ® C--0Z6019-7
--A6 BV�qD1F)C0jjqq'Timzjj 1-,0 r7fiq - �C 3IN-14-700 . 12,11-7 Ll -7 q I Y#S; Li'VP';
NEW NORMAL BELOW ABOVE l f f C 1 -7 14 p e
FARM Acre Value Per Value
Acre
Tillable 1
Tillable 2
Tillable 3
Woodland • I• / a
,z " e , e '.
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD ®
House Plot D e 11600 Q DEPTH
BULKHEAD
Total DOCK
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A,-!-I 4F� Town of Southold Annex 6/14/2013
P.O.Box 1179
54375 Main Road
��w` Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36299 Date: 6/14/2013
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 635 STROHSON RD CUTCHOGUE,
SCTM #: 473889 Sec/Block/Lot: 103.-10-12
Subdivision: Filed flap No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
pursuant to which Building Permit No. 32396 dated 9/28/2006
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:
one family dwelling as per ZBA 5624,dated 12/29/04, and"as built"accessory pergola as applied for.
The certificate is issued to GRACE M KEHLE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-05-0061 4/24/13
ELECTRICAL CERTIFICATE NO. 3019354 4/29/08
PLUMBERS CERTIFICATION DATED 4/29/08 George Fredricks
A riz �gn=
uth o
11j, ��tF�,tcr Town of Southold Annex 7/1/2014
P.O.Box 1179
54375 Main Road
P4 • q Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36997 Date: 7/1/2014
THIS CERTIFIES that the building WINDOWS
Location of Property: 635 Strohson Rd, Cutchogue,
SCTM#: 473889 See/Block/Lot: 103.-10-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/19/2013 pursuant to which Building Permit No. 38288 dated 8/28/2013
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:
WINDOW REPLACEMENT TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Kenney,Robert&Linda
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
A�bffrized Si ture