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Home My WebLink About1000-37.-3-8 TOWN OF SOUTHOLD g Rental Permit } 0775 Owner John & Constance Cronin Occupied as Single Family Dwelling Located at 1935 Old Orchard Rd East Marion 37.-3-8 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. 11/29/2022 od nfor e e t Official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-180 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 i BUILDING DEPARTMENT TOWN OF SOUTHOLD N U:_DNG D iF F RENTAL PERMIT APPLICATION 'TOWN IF�. OU-IirHOt. F Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: , C-1 Tax Map Number: 1000 SECTION BLOCK.,-," 3'7 - 3 SECTION B. OWNER INFORMATION: r Property Owner Name: C7 f 1 �l�1 CC, YtCe 1j(4Z� J Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytime Evening-- Emergency__._ Property Owner Email Address: Page 105 ^, W <15 Town Hall Annex � ��` 5 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUMOLD Section C. Authorized 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 . _� ..._� veningEmergency___ Email Address: �� , ,` U YA 6 Wil c-e Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: �� ►1 I Address of Authorized Agent(no P.O. Boxes):_____, q Mailing Address of Authorized A ent: �� 'e e � -Ca(elf Telephone Number(s): Daytime, Evening Emergency_ Email Address �► "`� "`...... M .......�E�!R�� . � �'" .;S Yom'� � C �i 4n'1 .. 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. Page 2 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 i o 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: (1) One 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." Bedroom 1, bedroom 2, Living room, kitch0,,, Rental Dwelling Unit Identifier: Breezewaye__ewww Requested Maximum number of persons allowed to occupy Dwelling Unit.° 4 Number of rooms in Rental Dwelling Unit: 5 room Use and Dimensions of each room inental Dwelling Unita _ Bedroom 1 - 9'-11"x11'-7" (115 sf) edroom 2 - 11'-0" x 13'-5" (154 sf) . Living room 13'-4" x 20'-1" (267 sf), kitchen 11'-7" x 16'-4" (189 SF) & Breezeway - 13'-7" X 13'-2" (178 sf) Page 3 of 5 i Zrk Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 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. 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) C1,on I I�[al�n C'1-Ohln And Cn�s'}G"�, 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 �j� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 f Southold,NY 11971-0959 BUILDING DEPARTMENT "TO 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:..—JO Crmm r'it c( ®,t sjetn u Cr®ox Ll Property Owner's Signature: Sworn to before me this LL441day of__I , 20 �2 O ictal Notary Public Signature and Original Notary Stamp MORGANT W. FIEDLER NOTARY PUBLIC-STATE OF NEW YORK No.02FI6304179 Qualified in Suffolk County My Commission Expires 05-27-2026 Page 5 of 5 o��OF 80bty� � t�� TOWN OF SOUTHOLD BUILDING DI �emmm,�"a 631.765-1802 .y��. .•'�� INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND INS AT ION/CAl [ ] FRAMING / STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN: [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE GO [ REMARKS: nn ........ �pl�ef 4UA OLk/ r -k L Q ou DATE l0 1t Y INSPECTOR C r q■; 3 40X53 40x53 40X53 4 53 DH 31 x53' DH24x36 6ARA6E TUB 12` (246 5F) I 3 CC,,--1I AA f' } N .t � EKA Y 30° 13'-l"xl3'-2° x (1'18 SF) m x BEI?ROOM `I KITCHEN (115 SF) 1050 tLALl ( E 1 40 x 53 40 x 53 40 x 53 6ARA6E DOOR I � € 30"] GEORGE BLONOC40RE 135 OLD ORCHARD RD x M EAST MARIAN NY I Ic 71 `m BEDROOM LIVE ROOM LE6ENP: x w bTr,w,LL eoARn az rLAs,se per. I (154 5F) (26-1 59 m ^ um m MMOR MIS, _ Q5D 5MOKC PGTWTO¢ ® CmTaKma (� 13O GR4 awAi*T FAN FX5r FLOM ROAR ICWD 9P. 6MAff 51. 31x�'UP 3x DH?9x51 DH 63x51 DH 26x51 € TOTAL 2,'ffiID 3�. i -1-008 PLAN O 21 4' g' 05-16-2020 . 2 OF 2 n� EX. UNEXCAVATED ts°s-x2o°-o} EX. UNEXCAVATED ' 13'-'T'x[2°-T• N x �AO+EMFNT 24�_B°x88-3" (116 5F) CA �SD LTMiR CHIMNEY GEom 9UON000RE 195 OLD ORCHARD RD EAST MARIAN N7 11971 N x SEND: F?aSTBU FYXD FWNt07 iM115 t 10'04 5 SYP.tW1[ aR fi lzII3x Fl. sVE ox s+TsxoR mus SMOKE DE=TGR 05D ® E�TOR� i SQUARE 1=00TASES: --_ ---_ - FFWKDOR FLOOR I{84.D sP. MD sp. 1 22 x 12 Mme' n (- Tar& utas sp. -FQjI`lAT j ON PLAN F 4' 8i 4 r.�r OS—IEr2020 F F)— I ---. �f 3 �ao �� TOWN OF SOUTHOLD PROPERTY! RECORD CARD _ f5� _- i VILLAGE a LOT - I - _ - D I ST� S U B O f -FORMER OW ER II ff N tf Itr E ACR. $ I W i TYPE OF BUILDING z a S RES. SEAS VL. FARM COMM. CB. MICS, Mkt. Value LAND IMP, TOTAL DATE REMARKS yl b ` c �� md � { r A - Z e i E I E AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre - I Value Per Vclue Ac re Tillable FRONTAGE ON WATER t Woodland FRONTAGE ON ROAD Meadowlund DEPTH House Plot BULKHEAD Total DOCK } a = COLOR � s _ ` ;.. . TRIMi F E _ 4 f r z - a ` v M Bld9 e _ �- — Exterosion F Extension Extension -- � i Foundation Bath Dinette Porch i Basement :Floors K_ Porch Ext. Walls Interior Finish ,,, f �` Breezeway w LR re Place Heat - DR. _ Garage _ Roof Rooms x �lQ u 1st Floor BR Patio Recreation Room Rooms 2nd Floor FIN. B ' T-- --- Dormer Driveway Total — � [_ z j 1 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- .32411 Date: 9 19 07 THIS CERTIFIES that the building DWELLING Location of Property 1935 OLD ORCHARD RD EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 037 Block 0003 Lot 008 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- 32411 dated JUNE 19 2007 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 GARAGE* The certificate is issued to DORIS P MILLER .. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT_ ut rized Signature Rev. 1/81 LOCATION:._w.._ � w ,...,. (number&�.._...� ,�_ ...._ �_.... ._ .. ........ � .... .... ........ street) (municipality) SUBDIVISIONz e w MAP NO.:�wwww LOT(S): NAME OF OWNER(S): OCCUPANCY: (type) (owner-ten nt')m ADMITTED BY: � _ ACCOMPANIED KEY AVAILABLE: SUFF.CO.TAX MAP NO.1000- SOURCE OF REQUEST. _ DATE: DWELLING: TYPE OF CONSTRUCTION: ( #STORIES: EXITS. FODATION: CELTOTAL ROOMS: 1S FLR I AR.� FLR:SPACE: T 2ND FLR. 3RD FLR: — BATHROOM(S):_ �m I OBIT ROOM(S): UTILITY ROOM: �- PORCH TYPE: DECK,TYPE: PATIO,'I°YP . . BREEZEWAY: _ FIREPLACE: _ _ wwww ...___ GARAGE: DOMESTIC HOTWATER: TYPE H ATER: _ AIR('ONDAONING: TYPE HEAT: �WARM AIW HOTWATER: OTHER: ACCESSORY STRUC."TUR GARAGE,TYPE OF CONS STORAGE,TYPE CONST.: SWIMMING POOL: _w GUEST,TYPE CONST... OTHER: VIOLATIONS: CHAPTER 144&N.Y.STATE UNIFORM FIRE PREVENTION&BUILDING CODE ._ .........� ._.......w�...�... ...�........_...w_ .�_........._........_ LOCATION. DESCRIPTION .. _ __..........w._. �.. ... ART. SEC. _._...... _.. _ww_.... ........_�. ....., .. .. _....... .. _..... ._..�.M.m...ww._ ..... _. w... _ ..........._W. ...... __ _...... ...µ_.............._. ._....._._...I __ ............___------__. .......v. _. �. _ww....... . __.._.._www.. . .. ... . ,...._�..__. ......M. .. ..www_ _.m,..__. ....... ...... .......- ...... ...,., _ ... ......_............. .. ... _. .,.,.m.. .._..I .- ...�.... REMARKS: INSPECTED BY:. ...__w _w.,.l........F�..................wwwwW. ..- DATE OF INSPECTION: ..�� .. m _............... TIME START:_O'��........ END:._....I'Q_�, .._,...._w_