HomeMy WebLinkAbout1000-104.-2-3.2 eel-
Rental
TOWN OF SOUTHOLD
IV Permit
Z
19
All
0817
Owner Jeremy Klein & Marissa Malick
Occupied as Single Family Dwelling
Located at 105 Bittersweet Lane Cutchogue 104.-2-3.2
Maximum Permitted Occupancy 8
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.
2/8/2023
de �rr> pial
This Notice must be posted by the main entrance at all times Iwr� �-
Town Hall Annex �� t'�i� `���r���� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179N'lltk
Southold,NY 11971-0959
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19'C
BUILDING DEPARTMENT FE'B o 6 2023
TOWN OF SOUTHOLD Neo
41"Me OR
RENTAL PERMIT APPLICATION
Rental Permit Fee $200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
r.
Tax Map Number: 1000 SECTION _,,_,_,-BLOCK_ -LOT .;
SECTION B.
OWNER INFORMATION:
Property Owner Name: :lki , r"r ✓° 1 "
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number (s): DaytimelLZi-6 - % 13 Evening l` � � � Emergency "
Property Owner Email Address: e '��'� "drA4 a 11,�41 04
_ _
Page 1 of 5
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Town Hail Annex �
� i/ri��i ��1�� � //� � Telephone(631)765-1802
54375 Main Road/ '��/�i�%1 l" Fax c631>765-9502
Y
P.O. Box 1 179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: _µwww �m m _µµµµ_µ w
Telephone Number (s): Daytimeµ _ __ Evening..... w................„wwwµ Emergen(:y_,_ ____.._,_
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property:_ x „ , ,W,,,,,,,,,,,,,,,,
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
L
Addendum.” Tl 4L llS'f Y'00 0A Ur IIM�YIS[G-YlS
Rental Dwelling Unit Identifier:
Requested Maximum number of persons allowed to occupy Dwelling Unit: S ,_,,,,,,,,,,,,,,,,,,,,,,,,,
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental DwellingUnit;
Page 3 of 5
�u hM1
r A A
Town Hall Annex i� f%f���yf�� ""m Telephone(631)765-1802
54375 Main Road Fax(631)765-9502� l�///�� ����i/%�
P.O.Box 1 179 a
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
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 � 0 , 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
// P" 4;wj VW✓p
631 765-1802
Telephone
Town Hall Annex Tele
P ( )
54375 Main Road i'% i'%%f% Fax(631)765-9502
P.O.Box 1 179
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:r e "re '✓I✓�_
Property Owner's Signature: �_. .www _....... _.._.................
Sworn to before me this d9day of :6, 20 3
Official Notary Public Signature and Original Notary Stamp
F`U UC-STA OF NW—raEW
G 474 4
�I1� YORK
021n New York
Corn la ion + 11
Page 5 of 5
0 wer �mK./ Gu�
BUILDINGT"W klS UTHOLD
631 -765-1802
INSPECTION
[ ] FOUNDATION 1ST ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ]
ELECTRICAL (ROUGH) [ ] ELECTRICAL (F
[ ]
CODE VIOLATION [ ] PRT.. C/ ]
REMA 0
O
,�VcAA
..........................
DAT
T INSPECTOR
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 o
Southold,NY 1 197 1-0959 ."
6B
Fu
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
i?rofesional seal re aired or, rchitect or Fn ineer licensed Home lns ec"tor rnust rovide
copy of valid current cerci icatio
Rental Property SCTM Number: I D U Z OU U U 3 C �
Rental Property Address:
Owner/Name:
Rental Dwelling Unit Identifier:
Number&Square footage of each bedroom as depicted in the attached floor plan:
e, bedroom
Property De cription (Include all improvements indicated on survey)
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it
fully complies with all the provisions of the Code of the Town of Southold,the Residential Code
of New York State,the Building Code of New York State,the Plumbing Code of New York State,
the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New
York State.
Print Name and tle i rir�,•�Signature
y^
Please place professional seal: m "� rw"-r
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FIRST FLOOR PLAN 105 BITTERSWEET LANE
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SECOND FLOOR PLAN :105 BITTERSWEET LANE
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TOWN OF SOUTHOLD PROPERTY RE{3 x I t
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OWNER STREET I F, VILLAGE SUB LOT
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ACR. REMARKS _
TYPE OF BLD.
PROP, CLASS
LAND IMP, TOTAL DATE
I
14,
a�
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-44
"-1 £,
ZP
FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD lee, WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
TOTAL
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716
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5171
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'31IL
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104.-2-3.2 9/10/2021
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1. 13J �' Foundation Bath Dinette
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-Z)N 5" , 6
Extension Basement SLAB Floors Kit i
�xterso P cExt. Walls Interior Finish , L.R
F I c-` ` Fire Place Neat D R
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1-5- � onPatio, _ _
S-
Dormer Fi ove BR
Woodst �
Porth
Fin. B
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Deck `, Attic
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Breezeway Rooms 1st Floor IN
Gara e , Driveway Rooms 2nd Floor
9 a [. 5 F;
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TOWN OF SOUTHOLD
:q BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
a` SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 47006 Date: 10/20/2021
Permission is hereby granted to:
105 Bittersweet LLC
,.,.�__-.... ... ..
PO BOX 162
S Jamesp T , NY 11970
To: Install a deer fence as applied for. Replaces BP# 45348
At premises located at:
105 Bittersweet Ln
SCTM # 473889
Sec/Block/Lot# 104.-2-3.2
Pursuant to application dated 10/20/2021 and approved by the Building Inspector.
p
To expire on 1/1/1900.
Fees:
PERMIT RENEWAL $75.00
Total:
..._..........,_................... (V'7....
Q75.vv
Buildin ector
Town of Southold 3/26/2022
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42955 Date: 3/26/2022
THIS CERTIFIES that the building GENERATOR
Location of Property: 105 Bittersweet Ln., Cutchogue
SCTM#: 473889 Sec/Block/Lot: 104.-2-3.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/16/2021 pursuant to which Building Permit No. 46471 dated 6/23/2021
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 g erat r aga i d fear.
The certificate is issued to Klein,Jeremy&Malick,Marissa
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46471 3/23/2022
PLUMBERS CERTIFICATION DATED
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