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HomeMy WebLinkAbout1000-95.-4-18.11 TOWN OF SOUTHOLD Q� Rental Permit a� F 0835 Owner William Andrej ack Occupied as Single Family Dwelling Located at 1240 Gold Spur Street Cutchogue 95.4-18.11 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. 3/13/2023 c t Official This Notice must be posted by the main entrance at all times T"e� c� Telephone(631)765-1802 Town Hall Annex � Fax(631)765-9502 54375 Main Road i�, y Box 1179 ' P.O j/..a �I�/ Southold,NY 11971-0959 BUILDING DEPARTMENT [D TOWN OF SOUTHOLD 2,023 SUILUINU RENTAL PERMIT APPLICATION TC�OWNOFPT T L Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: _ Tax Map Number: 1000 SECTION 95 -BLOC: -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: 1�11A�^_ AN► Property Owner Legal Address: Property Owner Mailing Address: 2Z4`I \N,,Z0LANO c4vL L 1�1 SP1 �� a�X_.. 5�2 Telephone Number(s): Daytime Evening ( Emergency " Property Owner Email Address: \A/AN0 4 '-�'DC) Page 1 of 5 ' �f�(lDGkt9 �f Town Hall Annex 'Telephone(631)765-1802 54375 Main Road � Fax(631)765-5502 P.O.Box 1179 ������� , Southold,NY 1 1 971-0959 BUILDING DEPARTMENT TOWN OF SOUTHO►LD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ._....,1 Address of Authorized Agent (no P.O. Mailing Address of Authorized Agent; _,.., �................�..._....._�. _��.�....�.._�......._.,�..��...�_.,...� �.,. __� �.�.,.__�...� .�.�..�.,. Telephone Number (s); Daytime.......-._...m.­.._,..........w_Evening_.,,-_,-__Emergency,.--.-_.-_,_ EmailAddress:_,.. ..w, ,. _.......... _ .. ...-_�._. �...._...... �.� __.�ww. .,,,_.w�.,,�,�............._,.�,�,o. �.. .... .... __ m .,,,.._. ..�.... .....�..�. Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: K-1 rq Address of Authorized Agent (no P.O. Boxes)r,.-u__..._..���,........._�... ..�.�.�__��__.... . , __ _� _ .. .. Mailing Address of Authorized Agent: ...,,.._.� . � w ,..,..,.._��..................w�.,�,„ �w_.., _._ _ _.. �M ,,,,.....�........ ,_. Telephone Number(s); Daytime Evening EmailAddress; . _� .. . , __.. _.._......... ._,... ..__._ _ _...a._ __ ....._a . _. _ .. .., ...,__.........._. n 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. Boxes);-_�. Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road � , Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening aam,. _w Emergency, _„__, ._a­- 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, 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." Rental Dwelling Unit Identifier: _...�w_... _*­------------11 Requested Maximum number of persons allowed to occupy Dwelling Un Number of rooms in Rental Dwelling Unit: ........� I __.. ,� ._ . Use and Dimensions of each room in Rental Dwelling Unit: cIoSLT. �1X 12t �� �x Ip��µn, ATltf�oor^ '5�x13� KITcH[,rJ ' 12�h 13 1 W\J 10c, 0.00%,V��. 2'il; 15 DINING (doom: b`x 13� LA INOL °13,x5�t� i�#t.`�+oM.131n201 _.�.... _ ...................... ._ ..._..._....w....... ..... . _W.ww_. . . Page 3 of 5 j r c� � /l� � �'�rr Telephone(631)765-1902 Town Hall Annex Fax(631)765-9502 54375 Main Road 11.0.fox 1179 Southold,NX 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) 1 u,IMA tN09.15JALK w , 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 Halt Annex ,i� �1� J �©��r rt/Jr� Telephone(631)765-1802 dr 54375 Main Road ��� Fax(631)765-9502 `�,�% P.O.box 1179 Southold,NY 11971-0959 ��� a Afff 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: ............_V.1..LL1.4 v'". ..!�_ O a.CJ,CK......._..__._.... .._.--..._._. ........ Property Owner's Signature: .�..�___.�,_.�_.W�..... .......... . ......... .�.W...... ......_... Sworn to before me this day of.,/-(-'' ._..e... 23 Official Notary Public 5ignatu and Original Notary Stamp t E ANoRSJACK Netwy Pul uc,State of New Vwk No.01 AN6346660 Go~in Suffolk CountY , kwon moires August is,20 Page 5 of 5 64 �; � SOUTHOLD BUILDIII G DI w � 631 -765--1802 .� Y[ INSPEC ION [ ] FOUNDATION 1ST I ] ROUGH PTBG. [ ] FOUNDATION 2ND [ /FIRE LATION/CAL FRAMING / STRAPPING [ T FIREPLACE & CHIMNEY [ SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) ELECTRICAL (T [ ] CODE VIOLATION [ ]' PRE C/ ] I REMARKS: 1�- ov"� V'.'V� (6kmn+ws" Olt............................................ -lw........... /41, kl�� DATE INSPECT k� 5 Y- 112- 3-4 U`2- S i Vl' 4 ��� \ - -. \ r * Y: TM _ '•- 5 PAT=AM SIOMAS y �- _.. ..._ - �tl rt T i7 T_ m- par ra - — of � � NF- m MASTER BEDRLl�h1 '. e'o r n�r \ \. - H #\ ,. EX. 12I YI NGaRM o'er'R S.F. t BAB i wr. 151-Y DROOM 1 #h - ......... t ,:-s Par ��r. vorr AREA RFDU(RFp ni sr. QA55 AREM.REGAZM SN S7, FK S7. ( \ 53.{ ED, k 6LA'8 AREA 9.51 SF,VENT AREA,15-S S-F 1BR ARG RE RED 15 1 SF. 1 GAENTL AREA'113 SAF. GAY MFA RFflARFD 5iS S7. �I GAY ARE' !V.1 V�U21 r qq{{} �t T N = 1 EX. LIVING RM.` - s'? - t E� z Its - 4 x 1 n. z�vt `y r-r s r za 4 y uas. \ EX BEDRXM#2 s -H' _ Rn1G t Aa SP fiv - t yw AREA ss oar mK GLASS AREA REMPIM SN 57. t 7 �E TOWN OF SOUTHOLD PROPERTY -MORE - I� � ' OWNER STREET VILLAGE DIST.! SUB. LOT x lscz,� le FORMER OWNER N E ACR. srra J QE' W TYPE OF BUILDING till� -t-, 4 RES. SEAS. VL. FARM COMM. CB. mics. Mkt. Value t `- LAND IMP. f TOTAL DATE REMARKS 21 T5 -7U 'A �v i -5-7 t�cJ � ( 7�C�L7 ' �!a— �FIaL r� �s -- � r" � g t J 14 (c SL �L 414 0 0 (5,000i 12L PUNz. 9- T 2-17, PAP, 4, 41 C, 700 3-3_00 z 1, L 1 9 0!;' '4 7/1 ;k 0 0 U 1z ) K 0 j _7t O D 4`709 -3 J, FRONTAGE ON WATER _000 jv Woodland l FRONTAGE ON ROAD 1 S0 Meadowland DEPTH 7 House Plot BULKHEAD Total \\ � \ - .\. COLOR ;r� TRIM e 4 - - i I f 3 L I i 3 ff i, t_ — — 45.-4-18.11 2(2014 M. Bldg,, - - t Extension 5 !/Kz- � — Extension — - E Extension 1 t s I Foundation Both Di tette t r Porch Basement Floors K. Ext. WaEls ! Interior Finish LR. Breeewoy _ > _ __ _ — DR, ,. aK Fire Place -� beat ` Gorae % 3 = Fe Roof Rooms 1st Floor - i a� a — — - -- Patio Recreation Roorr. Rooms 2nd Floor FIN. B 2( Z E Dormer I Driveway TotalDo /mvpl f T og' 3�a t - �F-� t � 7/ 7 t FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. .Z 10.451 . 51 . . . . . . . . . Date . . . . . .Apri-1. .10.,. . . . . . ., 1981 . THIS CERTIFIES that the building . . . . . . . . . . . . . . . • • . . . . . . . . . . . « • • • . Location of Property 1.?40, Gold Spur Lane, cut . . . ..ue , e.w York House No. Street Hamlet County Tax Map No. 1000 Section . .Q95. . . . . . .Block . . . .04. . . . . . . .Lot . . . .01fj...l I. . . . . . Subdivision . O.r.eozivew. . $ . . . . . . . .Filed Map No. 6.241 . .Lot No. . 1 . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated June 3 , 1 g a 0 pursuant to which Building Permit No. . . . ?�.�?1 . Z. . . . . . . dated June 10. . , . , , , , . . . . 19 . P.01 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 . . . . . . . . . . . . . I . . . . . P.rivate .One. .Fami.1y. . Dwgl i.n.9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . ... t a.1 r„i'�s s O.C.t a ta. . . Pow�rrrer«�l ,ssee or t �a?t1_ of the aforesaid building. Suffolk County Department of Health Approval . . .1.0-SO-42-1-2/1 2.1-80 . Rab e r t. .A. . U.i.l l a UNDERWRITERS CERTIFICATE NO. . . NA Q 7 5.7b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . « • . ., «„ ° . Building Inspector Rev.1/81 6 1 4 1 1 ­ A� FORM NO.4 If TOWN OF SOUTHOLD BUILDING DEPAPTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . . . . . . .1.5. .7 I . . . . . Date . —, .. . . . . . .. . .April 2 , 1.9.8 . . . . . . . . . . . . . ... THIS CERTIFIES that the building C. b§e n Bre e z e w a y & c o n v e r t g a r age t o d e n Location ofProperty „ 1240 Gold Spur Road Cutchogue , New York House Ato . Street Hamlet County Tax Map No. 1000 Section . . .0 9.5. . . . ,Block „ —4 . . 1 . . . . . . . Lot . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . » . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore Bled in this office dated May 11 , 1984 13124 Z . . . . . . . . . . . . . . . . . . . pursuant to which Building Permit No. . . . . . . . . . . , . . . , . . a . . . dated M a y. 1 2 , 19 8 4 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 . . . . . . . . .. CLOSE IN BREEZEWAY & CONVERT GARAGE TO DEN AS APPLIED FOR The certificate is issued to . . JOSEPH & ALICE S MA L L E Y f e oraer,1 " X ;qX of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . ./. . , . . . . . . . . . . . . . . . . . . . . . . . . . .. UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . N 7. .9 1 6x84 , . . . . . . N/A PLUMBERS CERTIFICATION DATED:____,__ Building Inspector Rev. 1/81 It21t Town of Southold 1/14/2023 P.O. Box 1179 CO 4M 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43770 Date: 1/14/2023 THIS CERTIFIES that the building ALTERATION Location of Property: 1240 Gold Spur St., Cutchogue SCTM#: 473889 Sec/Block/Lot: 95.-4-18.11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated P g /2022 5/3/2022 pursuant to which Building Permit No. 47778 dated 5/3 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: , It ti s c> ac trl gn it l - du lye e lMi lg.. a a el... ....for.... The certificate is issued to Andrejack, William of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47778 12/28/2022 PLUMBERS CERTIFICATION DATED 6/8/2022 Mich l Algox ` _.. .._.w... .. ......... �11k1- ............ ........ ori- d w i �.ro .. FORM NO. 4 v TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22093 Date JANUARY 11 1993 THIS CERTIFIES that the building ACCESSORY Location of Property 1240 GOLD SPUR DR. CUTCHOGUS NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 95 Block 4 Lot 18.11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 9 1992 ---Pursuant to which Building Permit No. 2:1023-Z dated OCTOBER 16 1992 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" STORAGE SHED AS APPLIED FOR The certificate is issued to JOSEPH SMALLEWY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NLA 'UNDERWRITERS CERTIFICATE NO. NLA_ PLUMBERS CERTIFICATION DATED NLA Building Inspector Rev. 1/81