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Home My WebLink About1000-97.-1-20 Wit TOWN OF SOUTHOLD Na Rental Permit £ 1024 g Owner Sean & Leslie Olsen Occupied as Single Family Dwelling Located at 35915 Rt 25 Cutchogue 97-1-20 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. 11/14/2023 art Official This Notice must be posted by the main entrance at all times ods c� LSC 0 IS TOWN OF SOUTHOLD—BUII.,DING DEPARTMI N O V _ 1 2023 � _t:": Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959 SuIlding 0epar ment Telephone (631) 765-1802 Fax(631)765-9502 hi-oi:_ �� Y � � ' U�,A� n .QO c% n o Southold RENTAL PERMIT APPLICATION 7T_ C- o Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: \5 ma.\(-N Tax Map Number: 1000 SECTION �) _ _-BLOCK -LOT a -� SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot bethesame as Rental Property Address) Telephone Number(s): Da tme 'i Evening Emergency Property Owner Email Address: Ww - Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: 4h Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: �� Telephone Number(s): Daytime 1 E`vening� Emergency Email Address: CA Section D. Managing Agent Information: Name of Authorize ent of dwelling unit, if any: Address of Authorized Agent P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime vening Emergency Email Address: SECTION E. SITE MANAGER INI* MATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of elling unit, if any: Address of Managing Agent(no P.O. es): Mailing Address of Managing Agent: Telephone Number(s): Daytime Even in Emergency Email Address: Page 2 of 4 Slav► (91*.ea•� 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." LRenDwelling Unit Identifier:�� '�„ A ` 1� l� 6 ted Maximum number of persons allowed to occupy Dwelling Uni r of rooms in Rental Dwelling Unit: d Dimensions of each room in Rental Dwelling Unit: n Capt1 " 1 y , -" 1w' Cni �°_ 1911 41 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. ❑ 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. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) 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 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 s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: Property Owner's Signature: S rn 5 before t day of C ;'NO.018 7727•; OUAI.IPIEU IN Official Notary Public ignature and Original Notary Stamp S SUFFOLK COUNTY CUM EXP. Page 4 of 4 404 (.,v A<0000 TOWN OF SOUTHOLD BUIL= I AIM 631 *-765-1802a INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPINGiNAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN% [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] EL C ICAL (F [ ] CODE VIOLATION [ ] PRC/OI REMARKS: SCREENED PORCH 11'10"x 7'3" &ATH E 49' P4 KITCHEN DINING i 12'10"x 16'6" 14!2"x 11'9" EtRy Xl'x 27 LIVING ROOM 18'11"x 13'9" FOYER g1l SUNROOM 10'5"x 9'3" Is 696 (1jr /u GROSS INTERNAL AREA u FLOOR 1: 875 sq.ft,FLOOR 2: 692 sq,ft EXCLUDED AREAS: SCREENED PORCH:87 sq.It TOTAL: 1567 sq.ft MEASUREMENTS ARE CALCULATED BY CUBICASA TECHNOLOGY.DEEMED HIGHLY RELIABLE BUT NOT GUARANTEED. BATH 9v411 x 71911 BEDROOM 17'9" x 117" ' I HALLWAY 13'0" x7'5" BEDROOM 14'0" x 13'8" BEDROOM 13'0" x 9'9" GROSS INTERNAL AREA �s FLOOR 1:875 sq.ft,FLOOR 2:692 sq.ft EXCLUDED AREAS:SCREENED PORCH:87 sq.ft TOTAL: sq.ft MEASUREMENTS ARE CALCULATED BY CUBICASA TECHNOLOGY.DEEMED HIGHLY RELIABLE BUT NOT GUARANTEED. R i NAAr a • z a t i i S 1 e s z � z � za a z i L £ o g t � � — c } e _ _ s-. _ e 7 M Bldg —_ — _ a TT_ Extension e v_ E E z _ Extension e - Extension �Foundation B oth r -fu Porch BasementFloors �- Parch � ', ;< Ext. Walls lInterior Finish Breezeway Fire Place `• Heat , , z arac!e Type Rco'f R o i-rts .S or , L Rcre Cion rG;rM Roo``ns door i - t j O5 R B. �� s ,-e FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. . . .Z962.2 . . . . . . . . Date , . . . x . . . . . . . . . . . . . . .August. Ek . ., 19 .7.9 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . Location of Property 359.1.5 . . . . . . . . . . min. Rd& . . . . . . . . . . . . . . . . .Cutchogue. . . House No. Street Hamlet County Tax Map No. 1000 Section . .097. . . . . . .Block . . .01 . . . . . . . . . .Lot . . Q20. . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . .XX . . . . . . . . . . .Filed Map No. . X . . . . .Lot No. . . .X . . . , . . . . REQUIREMEWTS FOR ONE FAMILY DWELLING BUILT PRIOR TO conforms substantially to the CERTIO UPANCY April. 23. . . . . . . . . 19 5.7.pursuant to hick 1 No. . . . .29622 . . . . . . . dated . . . . . . . . .A1394 St. Q . . . . . . . . . 19 79. ,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 . . . . . . . . . . . . . private .one .family. dw.ellIng .with. S4;pry .et"ntgtuY:e . . . . . . . . . . . . . The certificate is issued to . . . . . . . . . .Robert.F... .Tuthill. . . . . . . . . . . . . . . . . . . . . . . . . . (owner, IIIc ►t1� µ of the aforesaid building. Suffolk County Department of Health Approval . . . . N�R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . IM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t �. . a4_ k. . . . . . . . . . . . Building Inspector Rov 4/79 BUILDING DEPARTMENT WAIN OF SOUTHOLD, 14. Y. HOUSING CODE INSPECTION REPORT Location ` number & street —..- cmit :pNI-It '� Subdivision xx Map No. X Lot(s) x Name of Oimer(s)_ Rnhar+ F m,lthill Occupan o type —'owner-tenan ) Admitted by: Mra Ti,thill Accompanied by: Mrs_ T,,thill Key available„ Suffolk Co. Tax No_ ()g7_n1_O?0 Source of request Dzte sjy 30, 1979 DWELLING= Type of constructionatoie Foundation CellarjtiACrawl space rPGt Total rooms, 1st. Fl tL_2nd. , rd. Fl Bathrooms) Toilet room(s) q Porch, type Deck, type Patio, type Breezeway Garage Utility room Type Haat Hotwater Exits--4- Domestic hotwate t"O w Type heater Other ACCESSORY STRUCTURES: Garage, type const. Storage, type const. Swimming pool Guest, type const. Other t t VIOLATIONS-. Housing Code,Chapter 52 wLcraatian Descri tion Art. Sec. : r_on .orrb Sari: . s.,.. ',nd.lands ne n� I I _. Inspected by: + of Insp..__u._ aag.? 'l, 7 10-00 10• .. _........_. _......... .�.�.__m�.___,__�- .30 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY "No: Z-30438 Date: 091161 THIS CERTIFIES that the building ALTERATION Location of Property: 35915 MAIN RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) y County Tax Map No_ 473889 Section 97 Block I Lot 20 Subdivision Filed.Map No. Lot No_ 0 F conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 2004 pursuant to Which Building Permit No. 30296Z dated MAY 6 2004 Bwas issued, and conforms to all of the requirements of the applicable W provisions of the law. The occupancy for which this certificate is issued a is PORCH DECK ENCLOSURE OF ky.ISTINC, SINGLE FaI41 Y DUELLING AS APPLIED FOP.. The certificate is issued to MARZON A TERRY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO- PLU14BERS CERTIFICATION DATED N/A Lam. �AI%Aai Authorized Signature Rev. 1/81 a room M0. 4 TOWN OF SO OIC BUILDING DEPARTMM Town OeWs Office Southold, N. Y. Certificate Of Occupancy No. 17B12. . . . . Date . . . . . . . . . . . . .Au& ..8. .. . . . . ., 19.77. THIS CERTIFIES that the building �ocated at .glg. Main -Read . . . .. . . . .. . Street Map No. xx.. . . . . . . . Block No. . xx . ' . . .Lot No. . Z . . .QVtAbQ9W . .WAX i . . . . . . . . conforms substantially to the Applicati a for Building Permit heretofore filed in this office dated . . . . . . . . . . . . . .pap . . .1019 pursuant to which Building Permit No. . . $5rp+Z dated . . . . . . . . . .MAY. . .1.1 . . . .I l9! ., was issued, and conforms to all of the require. meats of the applicable prow the law.The occupancy for which this certificate is issued is Private.ona -rwdl &011jxg .VP h ,Additipn . deck). .. . . . . . . . . . . . The certificate is issued to . as�e�t •Tuthill. .. . . . . . . r. . . . . . . . ... .. . . . . . • . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department f Health Approval . 5 OR . . . . . . . . . . . . . . . . . . . . . . • . • . . 4CATE UNDERWRITERS C No.g,g„. . . . . . . . . . . . . . . . . r . , . . . . . . . . . . . . . . . . . » . , HOUSE NUMBER . . 3 . . . Street . .Main.Boad. . . . . . .Cutcho . .. . . . . . . . . . r n . . . . . . . . . . . . . .. .. . . . . . . b. .. . . . . . . . . • . . . . .. . . . . . . . . . . . . . . . . . . w . .. . .. . .. r. .. . . . . . . . . . �a . . • .. •��`` ��..� aN�. . w . a, . ♦ a Building Inspector b e 46520 COUNTY ROAD 48 SOUTHOLD, NY 11971 (631) 765-5815 FAX (631) 765-5816 Int _........•___w _.__M. w............ _ ......... ... ... _._ w.M_M.... ._ ..�,.._w_.... � ,r. _.�w _�'" r..w.__....� ��_......��w�ww_..... w�m...._w_._ ,�,....._...__....._....._w_...�._......w.....www._�.�.�..ww.._w.......�_. .. .www..�_�.._........_.___.M......H��.,. WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via_ following items: y ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order �.... .... w_..... w_......... ._.....__�......._.__.. w __.... ..... ..._........ .._........_. w .. _.._w.........._.wu.. . ....... , �_..�_.......... ...� _R �ww�_____._._................... _.�._�...._....... ......_ �w.... _._.wwww_.. _....._..w..........._mmmw�w�.�W__w..__._.M....�ww ..w___........�....�_ _..........._�.....w-______._.....�_....w._...: ..M.M.mm � .w_.__.___._.......... �.r_w__. M._..�...� . _�.............M.....m.....-w ....._.�.._ .._�_...w...�.�_.. THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints y ❑ For review and comment _ _...w_ ... ..... ......... ---...__.. ....... ❑ FOR BIDS DUE ....................................... ............ M__w.�.�..... ❑ PRINTS RETURNED AFTER LOAN TO US _......... ...._. ... _ .. ._ REMARKS _............... W .. .. _.. ...._ _ ..__. w.,, ., .µ. .. _. .... _ . ...__ ....,� COPYTO .................. ........ ..__............._ .. . SIGNED: _., ....,,, _..... ........ ..... .............. If enclosures are not as noted,kindly notify us at once.