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HomeMy WebLinkAbout1000-137.-4-8 Fat � TOWN OF SOUTHOLD Rental Permit 0628 Owner Neal & Lisa Elkin Occupied as Single Family Dwelling Located at 105 Fleetwood Road Cutchogue 137.4-8 Maximum Permitted Occupancy 7 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. 12/29/2023 Code Enf6rceb6t Official This Notice must be posted by the main entrance at all times R Town Hall Annex x Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 p'd� Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTIHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: S e� o o �o c.r)l �• 1 Tax Map Number: 1000 SECTION ��I -BLOCK L4 -LOT O SECTION B. OWNER INFORMATION: q Property Owner Name: �_\ S'- 4-A Property Owner Legal Address: Property Owner Mailing Address: 100 1H Telephone Number(s): Daytime Evening Emergency Property Owner Email Address: () - " A - aco Pd 11-a&)3 I&c 10(o �,, > o v Pc- 1 2r.[ c6� 10149 309 Pagel of 5 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)©s Requested Maximum number of persons allowed to occupy Dwelling Unit: ) C Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: 1 w. ,1,,,, 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 afire 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. Page 3 of 4 00 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 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) \' 1 �=\ 1�� a. 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 itea Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 " 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: ti Property Owner's Signature: Sworn to before me thiQaday of 20 3 Official Notary Public Signature and Original otary Stamp 1I wd ". 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Certificate Of Occupancy No. Z 13.29$. . . . . . . . . . Date . . . . . . . . . APRIL. Al . . . . . . . . . . . . . ,, 108 . THIS CERTIFIES that the building . NE-W • • D;n1 F L LING • • • • . . . • • . . . . . . • . • . . . . • . . . . Location of Property 105 FLEETWOOD ROAD CUTCHOGUE Nouse No. S'tree't Hamlet County Tax Map No. 1000 Section . . .13 7. . . . . .Block . . .04. . . . . . . . .Lot . . . .R. . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore flied in this office dated OCTOBER 1 1 . 19 8A pursuant to which Building Permit No. ,1 2 6 9 2 2 . . . . . . . dated . _OCTOBER* ro1.3 . . . _ . . . . . . . . 19 8 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 . . . . . . . . . FOR A. N.E.W. ONE .FAMILY. DWELLING . . . . . . . The certificate is issued to P A i1 L I N E W.„K E T C H A 2 „ . . . . , F'ow�ner,tees or�tenanrl of the aforesaid building. Suffolk County Department of Health Approval . . . . -S 0- , 13 5 . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . N 65.6 7 39. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . Building Inspector Rev.1/81 so * , TOWN T SOUTH T BUILDING T 631 -765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND j ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL {FII [ ] CODE VIOLATION [ ] PRE C/O j ok- DATE wINSPECTOR Town Hall Annex � q� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P. O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seal required for Architect or Engineer, Licensed Home Inspector must provide co2y of valid current certification Rental Property SCTM Number. 1000-137.-4-8 Rental Property Address: 105 Fleetwood Road, Cutchogue, NY 11935 Owner/Name: Lisa Elkin Rental Dwelling Unit Identifier: N/A Number& Square footage of each bedroom as depicted in the attached floor plan. (i.e, Bedroom #1 —100 sqft., Bedroom #2 —90 sqft., etc.) Bedroom#1: 233 SF- Bedroom#2: 121 SF-Bedroom#3: 216 SF Property Description (Include all improvements indicated on survey) 2-Story Frame Dwelling, Masonry Patio, Frame Shed, Gravel Driveway 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, the Fire Code of New York State, the Property Main';t nce Code of New ork State and the Energy Conservation Construction Code of New York State. Anthony Portillo, RA % D Print Name and Title ;;;p° ` � inall Sigr re t" 7 f Please place Professional Seal � e < r �.a ( � .. WOW i „v ,„ r r �f / h r taa i uuuu IIIIIIIIIIII IIIIIIIIIIIII � i /��1i�rY/� IJV///%/1%l 0 aY ✓ " / �r�i����r, ��� r ri a ," j, yov 1 H�fi f/%oi f, / f f j/of r U X tuaopa� '�b 11,X t� y18T ` 1 f� ,,+�j/, l/ r /�//,,,,✓/� r i; „' 9,//P %r If,.FS., (.I iii r r f r,..,., /. /r,//r i/ra/ it/„- i /ol ,/%✓ /iii,, "2, r/,///� ' � l t//!✓rriir ;:ro ;,; ,, f v r p ��,j�” �l/f/�//�i%�i� _��, „r::-/r /i,�//,�/ �/// „i.rt�,,,; /ol1,oiPr,, i�ii .,,i,. /, r r/,r,,/., /,� ,„;i �-; ,// �%� �. ✓/ //l r/�� �r �0 �-,�.. rl ,l rlr ra rr/ l,, ,,; ,: 1//i/ i� � , a 000, %a ,/llyi / r, r /�� ,, //Df/�/' / ,/a�,��J�� ///�✓/-f( /i�,r%g.„, �./r/,l /; r./ i� .. r /:.. 1 / ,,ll�/�/ �//�I/i� /, //,rrf ,�f o�%,�i,� � � %�l, „..o/ / / ir,,r✓... a r/r, cr// ,., r .r/.,////i�i// / /l/�rr!/,.,,.,� / 1,� „�� r � �j�,,,✓, � it r, / i ,,iri / / %// /i / %%„ TOWN OF SOUTH LD PROPERTY RECOI OWNER _ I STREET VILLAGE = DI' 'cUb. LOT " r- _ i � I t 3 FORMER OWNER N E ACREAGE ,_ _ 1W TYPE OF BUILDING a RES. SEAS. V ! FARM COMM. 1 IND, i CB, MISC, Est. Mkt. Value LAND IMP, TOTAL DATE REMARKS C,d To � 3 L/ 7 _ t ' - - -.- _ - - - ---- L1 V a.� <./ i! ] C,% C`3 4_.%11 'vc y ��tx. s %€"ag " ` �.� , F _. AGE BUILDING CONDITION NORMAL BELOW ABOVE FRONTAGE ON WATER NEW _ a F _ s _ Form1 Acre ' Value Per Acre Value FRONTAGE ON ROAD Tillable 1 i BULKHEAD Tillable 2 ; DOCK Tillable 3 lo,jh t ff Woodland4 ca"c �r `�°,�C I?J a _.Swampland Brushland � I I � F House Plow i Total ._ -. i a u --_. 737:4-8 09/28/2017 M. Bldg. Foundation * Bath X t" r > Extension Basement � _ ;Floors Extension Ext_ Walls �t CjE - t!Jnto_r=or Finish , Qo Fire Place Heat r I >`v �� .. Porch Roof Type L Porch ` R:GYS 1st Floor_— � r - (xeezeWa L/ Patio Rooms 2nd Floor y ac) -1 C0 ` Driveway Dormer _ s - --- 1'`,p Town of Southold 10/4/2017 P.O.Bog 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39265 Date: 10/4/2017 THIS CERTIFIES that the building ALTERATION Location of Property: 105 Fleetwood Rd, Cutchogue SCTM#: 473889 See/Block/Lot: 137.-4-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/27/2017 pursuant to which Building Permit No. „41598 ._..... dated 5/3/2017 n„ 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: baft n alterationin an_w "stip ore,fa�iil yr llin s 4ppjiA fclr The certificate is issued to Donahue,John&Caroline of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41598 9/14/2017 PLUMBERS CERTIFICATION DATED 9/19/2017 ieth Danio I Signature tFt Town of Southold 4/29/2022 P.O.Box 1179 53095 Main Rd , Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43022 Date: 4/29/2022 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 105 Fleetwood Rd.,Cutchogue SCTM#: 473889 See/Block/Lot: 137.-4-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/1/2021 pursuant to which Building Permit No. 46182 dated 5/4/2021 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: adtlitioasAnd It rat ceras it cludin °"as b Alt"cc v r d pqrch altered to Liv jqg_Wace�with roof-to dgpk tca istin din jj.fagiily wellit�as l liW r.,The certificate is issued to 105 Fleetwood LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46182 12/15/2021 PLUMBERS CERTIFICATION DATED 2/15/2022 Be d P&H c ori t nature