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Home My WebLink About1000-96.-3-8 , TOWN OF SOUTHOLD Rental Permit 0871 Owner Farm Creative LLC Occupied as Single Family Dwelling Located at 1355 Cox Lane Cutchogue 96.-3-8 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. 4/21/2023 cid f� e Official This Notice must be posted by the main entrance at all times r ' r Town Hall Annex a Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 1 971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two years) FEB 202 Section A. BUIL 1146 EPI Property Information: Rental Property Address: 1355 Cox Lance Tax Map Number: 1000 SECTION -BLOCK .:.. -LOT—B-- SECTION B. OWNER INFORMATION: Property Owner Name: �'"^� Y �.�-� I Cs? �►df� J Property Owner Legal Address: Property Owner Mailing Address: 13S75 221 �` I as Telephone Number(s): DaytimeEvening qt2 72�f 'Emergency a+2 2Z4 <- l� Property Owner Email Address: Y1�Y )N/ @ +2V�t1C►VLt7 . a Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-09594 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Evening Emergency Email Address: Section D. Managing 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 Evening Emergency Email Address: 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 '0 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O. Box 1 179 Southold,NY 11971-0959 rc + 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 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." Rental Dwelling Unit Identifier: 1, Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: I 1b � Use and Dimensions of each room in Rental Dwelling Unit: � / U 1 ' '' X 1 " 1' 'P X x" '11" 11'j, w b+Y 22 lm" x 1�;-''f u T yQo' Page 3 of 5 a ' Town Halt Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 cou 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. l 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 hv,d� , 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 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 y 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: V-, ✓ v .. " Property Owner's Signature: Sworn to before me this jLaav ofe�r'c,( 20 mm _ lj Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14.2y Page 5 of 5 � so cxy, * ' Tr&iWN OF SOUTHOLD BUILD NG Di 631 -765-11802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSUEATIOWCAt [ ] FRAMING / STRAPPING [ ] EINAL [ ] FIREPLACE & CHIMNEY [ EIRE SAFETY WE [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O C REM vs o o A4*A tA IAVA6 vN lift `�►. eA V(acA kk000lv INSPECTORC44Iovor DATE 1�1 1 Z>ti I � C OVJ- 22` U) I------------ el 7,5 VA,d Vz � 5. TOWN OF SOUTHOLD PROPERTY RECt _ OWNER ; _ STREET VILLAGE DISTRICT SUB. LOT c.C? F _ F FORMER OWNER � N � E � ACREAGE 1 ff. -A z. �,c fuc s S / . kf Y- W �` TYPE OF BUILDING .«.w pe 1 z z o� RES. !C7 SEAS. m VL. FARM COMM. IND. CB, MISC. LAND IMP. TOTAL DATE REMARKS a JV F t 3 z AGE 5�114DING CONDITJON ,, c NEW NORMAL BELOW ABOVE sr� t _ V tAcr 1 Ora-b II TiFI®ble 2� k T Tillable 3 e , L? �a 8+SiQ WcMland Swomplar B rushland House Plat F I �s s e ——R F 46.-3-8 3(13 t F s } M. Bldg. Foundation t%j, Both_ Extension _ = Basement - Floors - - - - — - - - Interior Finish Extension. � � �_� _ `� � b 4 �:� Ext. Walls - �,� _ _ �� i Heo��t Extension : Fire Place Pore Attic 4 Porch Rooms 1st Floor ' s _ B, - eezew e Patio Rooms 2nd Floor, Driveway E O B a ; t � A V FORK X0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT ENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . .Z7737. . . . . Date . . . . , . . . . —June . .24 . . . . . .. 19.77. THIS CERTIFIES that the building located at . . W/'.Cox La Street Map No. . .?x . . . . . . . Block No. ?9�. . . . . . .Lot No. . .? . . , , Cutchogue N.Y. conforms substantially to theme ' e is f , o f l dellIng built before Apr 23 fi ate of Occupancy. . . 19. Fpursuant to which Z7-737- dated • .June 24 '7? • • • • • • • . • . . . . . . . . ., 19. . . ., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is private one family dwelling; with accessory garage The certificate is issued to . . .Eno Johnson & Wife Owners of record (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Pre-Pxisting . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. ire-existing^ . µ . . . . . . . . . . . HOUSE NUMBER . . . . . 355 . . . . Street . . . Cox Lane (hztci*ogue* k Building Inspector HOUSING CODE INSPECTION June 22, 1977 #1355 Cox Lane R-1 Cutchogue, N.Y. Tax Roll: Eino E. Johnson & wife. Occupied: Margaret Johnson Upon receipt of an application for a Pre-Existing Certificate of Occupancy, I made an inspection of this two-story wood framed dwelling. I was admitted to building by Mrs. Johnson and began this inspection at approximately 1:30 P.M. First floor has a kitchen with dining area, living room, half bathroom, and den. Second floor has tree edrooms and a full bathroom off hallway. Heat is furnished to al r"Roms from an oil fired hot water furnace located in partial cellar of building's red brick masonry foundation. A wood framed accessory building is located in rear yard area. The following violations of the Housing Code, Chapter 52, Town of Southold, New York, were found: Half bathroom - inside room, no means of ventilation, Article s Section 52-26 B 4 (b) . Entry - living room, no means of controlling light in room on entry, Article V, Section 52-56 B 2. Laundry drver - located in cellar, electric hook improper, requires juFFtion box, Article V, Section 52-56 A 1. Garage - roof shingles missing and deteriorating, Article III , e on 52-31 C. Inspection completed at approximately 1:50 P.M. Key picked up for.:^building from office of William Wickham, P.C. , Mattituck, New York, was returned to Mrs. Joon. Re ' e tful °y submitted, Edward Hinderxann �. Building Inspector EH:med FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No E-21186 Date. DECEMBER 3 1992 THIS CERTIFIES that the building DECK ADDITION Location of 'Property 1355 COX LANE C'CJT OUE " House No. Street Hamlet County Tax Map No. 1000 Section 96 Block 3 Lot $ Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 23 1992 ______pursuant to which Building Permit No. 21110-; dated NO'V'EMBER 30 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 DECK ADDITION TO AN EXISTING ONE-FAMILY DWELLING A.S APPLIED FOR. The certificate is issued to E. HANSEN & WIFE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED NLA Bui ding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22110 Date JANUARY 14 1993 THIS CERTIFIES that the building ADDITION Location of Property 1355 COX LANE CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 96 Block 3 Lot 8 Subdivision Filed Map No._,,,_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE. 12 1989 _____pursuant to which Building Permit No. 18226-Z dated JUNE 16 1989 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ED & SARAH HANSEN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NLA UNDERWRITERS CERTIFICATE NO. N-099344 - OCTOBER 255 1989 PLUMBERS CERTIFICATION DATED JANUARY 14 1993-MIKE JACOBI PLUMB. Buf lding Inspector Rev. 1/81 .......... .......... P, Town of Southold Annex 6/3/2013 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36278 Date: 6/3/2013 THIS CERTIFIES that the building IN GROUND POOL .............- Location of Property: 1355 Cox Ln, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 96.-3-8 Subdivision: Filed Map No. Lot No. . ... . ................................ .. ..... conforms substantially to the Application for Building Permit heretofore filed in this officed dated 4/23/2012 pursuant to which Building Permit No. 37173 dated 4/27/2012 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: ggeessoryu u to nin l with fe r q t<>code as a ltedf�r, 1) The certificate is issued to Kaufman,Aaron&Kaufman,Susan (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ............. ELECTRICAL CERTIFICATE NO. 37173 6/21/12 ............ 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