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HomeMy WebLinkAbout1000-103.-12-7 TOWN OF SOUTHOLD Rental Permit t 0894 Owner Konstantine & Hilary Zuckerman Occupied as Single Family Dwelling Located at 3505 Pequash Avenue Cutchogue 103.-12-7 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. 5/5/2023 de for e Kcal This Notice must be posted by the main entrance at all times 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 RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two 0 JAN 13 N2 BLpI IN1 Ui-' I: -MWN0FS0UTM01_n Section A. Property Information: Rental Property Address: Tax Map Number:1000 SECTION -BLOCK PN -LOT__ SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: °JAI m`er Telephone Number(s): Daytime 50\4venin g �� '�'�' Eenc � g y Property Owner Email Address: � �_........ l�t l `©?`113 Pagelof5 Town Hall Annex R` Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 4w Jv P.O.Box 1179 SouLhold,NY 11971-0959 , .co BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime5 5 Jr PjUvning Emergency—,__ Email Address: .LAC , � � t. 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: . ._.. ,� ,,,._,,, ._ .--�.....-m_ .-- • Requested Maximum number of persons allowed to occupy Dwelling Unit: -6-- Number nit: ,, ,,,Number of rooms in Rental Dwelling Unit:L�- Use and Dimensions of each room in Rental Dwelling Unit: �� �1 X , V\A f I�L�jLj VtA v�oven Page 3 of 5 Town Hall Annex Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road ;9 r P.O.Box 1179 Southold,NY 11971-0959 4 BUILDING DEPARTMENT TOWN OF SOU"HOLD 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) ry 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 Southold,NY 11971-0959 `p ; w40 pn 11 tip✓ rF� 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:9AA �w...._.� �--. Property Owner's Signature: Sworn to before me this_day of Cf20 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, 2-0-�,�) Page 5 of 5 0. 631 -765-1802 job, INSPEC 1014, [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION/CAt ] FRAMING / STRAPPING [ AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE L l ELECTRICAL (ROUGH) [ ELECTRICAL (Fil CODE VIOLATION [ PRE C/O [ REMARKS: 9 DATE INSPECTOR), roesour6 5/ �� ( �� � # TOWN F O THo BUILDI G DI 631 .765.1802 � l 'y , t 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 (FI [ ] CODE VIOLATION [ ] PRE C/O [ R MARKS: V�1 � � Wt� � UI rkqvell, �i cn 9v ift<t c/tl/-V vu I DATE 3 N)Y INSPECTOR C 3360459 3505 Pequash Avenue,11935 DECK S.95 mx 291m r ¢ 1. SCRtEENEDPORCH EAT•INKIT[HEN ,„„ 229 476 5.81ma4.76 1, .�. _. HALL , RAW .}rt i LIVING ROOM fu GARAGE °; 9.50 02 PORCH 6.60 mx141m J :r DIMENSIONS ARE Prepared by:Rene Giacobbe Daniel Gale Sothebys Intl Rlty (631)2984130 renegla bo danialgate.com10(516)5514987 011091202310:42 AM e�] err 6ndFx56h7odvxtlt4NRNk.O d4p oewluraRu12 3360459 3505 Pequash Avenue,11935 I i BASEMENT 14.75 m x 10.49 m SIZES AND ACTUAL' •VARY. Prepared by:Rene Gmobbe Daro W*f Gale Sulhebys la^11 Rtty (831)298-4130 rene+gaaecabbe danNelgale,tom(G)(5'@8)551-4987 C11t09=3 10:42 AM W by 9.6 AwrxwMay arras e—b—cairn 2M O-Kq*ans SCTM # s TOWN OF SOUTHOLD PROPERTY RE OWNER STREET VILLAGE DIST SUB LOT k-cic _ g -3 ACR. REMARKS aa TYPE OF BLD. ;oC eE �r PROP. CLASS IL i2L E LAND IMP, TOTAL DATE 1 i FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL TOWN OF SOUTHOLD PROPERTY RECORD CARD /// DIST. : SUB. LOT 4r Z7 STREET VILLAGE A— Am A ce 4 ------------- ! J FOWER OWNER t « N E AC5� (° raveT W S TYPE OF BUILDING RES. SEAS. I VL. FARM comm. CB. MICS. Mkt. Value LAND = IMP. TOTAL DATE REMARKS k Z kmi--) A-1 o, 0/ 70 -,-4j !7T7 J f s -cS 1-f LA 4o k X 0.00 1,z 112 t 41 Tillable Woodland FRONTAGE ON ROAD MecidowkxW DEPTH.-� 1 Z / 7rr -j� House Plot BULKHEAD Total calF=T' 1 COLOR TRIM P f £ 3 I ` S f ? 103.-12-7 9/16/2022 i f ,r i t M, Bldg Z-�A 33 LF9 { Extension /�1'�� 5 f Extension k 3 Extension I i i i Foundation Bath Dinette I Z moi " i � asement F 1t Floors � �'l K ;Ext. Walls `Interior Finish I � =LR. ✓s�,� Breezeway Fire Place Heat DR. �k i I ype Roof Rooms 1st Floor BR. -Y Garage L z u 1 = d ?. ca Patio _ =Recreation Room Rooms 2nd Floor ; FIN. Dormer O. B. Driveway i = i T- QfaI ,; FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 2-24785 Date DECEMBER 5F 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 3505 P UAS'H AVENUE CUTCHOGUE N.Y. House No. Street Hamlet County Tax May No. 1000 Section 103 Block 12 Lot 07 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 1.0, 1995 pursuant to which Building Permit No. 22730-Z dated NAY 4 1995 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE OPEN PORCH AND WOOD DECK AS APPLIED FOR. The certificate is issued to RIVERHEAD BUILDING SUPPLY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-95-0043-DEC. 2, 1996 UNDERWRITERS CERTIFICATE NO. N-402056 - NOVEMBER 4f 1996 PLUMBERS CERTIFICATION DATED NOV. 25 1996- HARDY PLUMBING & MATING ui ding Inspector Rev. 1/81