HomeMy WebLinkAbout1000-116.-4-28 TIOWIEWN OF SOUTHOLD
Rental Permit
1056
Owner Engels Family Trust
Occupied as Seasonal Single Family Dwelling
Located at 105 Beachwood Rd. Cutchogue 116.4-28
Maximum Permitted Occupancy 8
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.
1/25/2024
od n4ced6ni Official
This Notice must be posted by the main entrance at all times
* 1
� 5
Town Hall Annex s Telephone(631)765-1802
54375 Main Road i� Fax(631)765-9502
P.O.Box 1179 ,
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APNICATION
Rental Permit Fee$200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION JJ ? -BLOCK -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name_
Property Owner Legal Address 4,v v, �L � Property Ownert,Mailing Address:
..l
CJ
Ft'vtz
QA-
Telephone Number(s): Daytime_-Evening-Emergency
Property Owner Email Address: -rm " C i w e- a�of ' C
q"l0►-
C&C b���V Page 1&5
4 Telephone(631)765-1802
Town Hall Annex
Fax(631)765-9502
54375 Main Road
P.O.Box 1179
Southold,NY 11971-0959
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 vening__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):______ _...,.. . _. .. ...m.__.. ..... .. ... --
Mailing Address of Authorized Agent: - � --
Telephone Number(s): Daytime Eveni„n _ _ 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
u� e
Town Hall Annex 11 Telephone(631)765-1802
54375 Main Road l Fax(631)765-9502
P.O.Box 1179
4W*
Southold,NY 1 1971-0959 '
�ygq ry
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: _
Telephone Number(s): Daytime vening__Emergency_ ______, „w__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, 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: _ _..
Requested Maximum number of persons allowed to occupy Dwelling Unit: _ _..M _
Number of rooms in Rental Dwelling Unit, I I'� %/o4 1 .
Use and Dimensions of each room in Rental Dwelling Unit:
� C1 �
�2 .. 9
3. 3�� r �` � ., x
It Page 3 of
l rooq-,' "I --7
fi �r x
(` Z1
yry Town Hall Annex Telephone(63 I)765-1802
�, �'�
54375 Main Road , Fax(631)765-9502
P.O.Box 1179 , ,
Southold,NY 11971-0959 � � 9
it
P
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
❑ 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)
f � � i 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 i Telephone(631)765-1802
54375 Main Road �� �, r �!„
Fax(631)765-9502
P.O.Box 1179 ,„ m
Southold,NY 11971-0959 *r
BUILDING DEPARTMENT
Towle 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;
Property Owner's Signature: - - �
Sworn to before me this L day of '� lL�
Official Notary Public Signature and Original Notary Stamp
DARLENE K BRU:20,
Notary Public State of
NO.01HR63180
Qualified in Suffolk
My Commimion Expires J3
Page 5of5
so [or
� # TOWN OF SOtJTHOLD BUILDING DI
631 -765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAL
[ ] FRAMING / STRAPPING [ ] FI
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INS
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit
[ ] CODE VIOLATION [ ] PRE C/O [
R MARKS:
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fA TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE 1 DISTRICT SUB� LOT
z7fruac, o
1 E ACREAGE
FC-QW1R OWA,ER 1 N
'c-n =S 'f 4w,45 4virer-§ w
1 TYPE OF BUILDING
V,
RES. SEAS. VL. CB. I mlsc.
IND=
FARM COMM' .
LAND !M . TOTAL DATE REMARKS
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is
za- e-c—so,
4t
AGE a�
712,
SUILDI'NG CND" ION T'
1at I itt- '60 4
B
NORMAL
NEW
BELOW /57- "ry
ABOVE I
Farm Acre Value Per Acre Value
Tillable I
Tillable 2
r
Tillable 3
Wcodland
wamDlancl
Brush lard
Hou4-rot,j_.,
Total
}
i
1 }
f
z `
r
3
•
...
e
Li
1. Bldg. V Foundation _ Bath
Extension Basement Floors
Extension Ext. Walls b Interior Finish
u
Extension Place Heot =
s
Porch Attie
Porch Rooms 1st Floor
Breezewoy Patio Rooms 2nd Floo,
Gare eQ Driveway
y
•,
o. B.
i Town of Southold 1/25/2024
cap 53095 Main Rd
Southold,New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 44900 Date: 1/25/2024
THIS CERTIFIES that the structure(s) located at: 105 Beachwood Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 116.4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 411 4900
dated 1/25/2024 was issued and conforms to all the requriements of the applicable provisions of the law,.
The occupancy for which this certificate is issued is:
wood_fram„e,
family
The
dwell,,ng
The certificate is issued to Engels Family Trust _....,..
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
... .. _...... d oriz. _ __..... . ......,, _.....
. aigztal:tarr
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE 1NS'PE'C'TION REPORT
LOCATION: 105 Beachwood Rd,Cutchogue
. .................. . .......-"' ' ' ..........
SUFF.CO.TAXMAPNO.: 116.4-28 SUBDIVISION:
NAME OF OWNER(S): Engels Family Trust
OCCUPANCY:
ADMITTED BY:
:
SOURCE OF REQUEST: Engels Family Trust DATE1/25/2024
DWELLING:
#STORIES: I #EXITS: 2
FOUNDATION:...... .... cement I block-p-osts CELLAR: N/A CRAWL SPACE: N/A
A I
BATHROOM(S): TOILET-ROOM(S): UTILITY ROOM(S):
1
PORCH TYPE: . ......... DECK PATIO TYPE:
BREEZEWAY: .............11111111-FIREPLACE: GARAGE:
DOMESTIC HOT WA I T E R: yes,s, TYPE HEATER: electric AIR CONDITIONING: .............
TYPE HEAT: electric rad. WARM I AIR: HOT WATER:
#BEDROOMS 111111111-1-4--- #KITCHENS: 1 BASEMENT TYPE:
OTHER: .............
.......... .............
ACCESSORY STRU CTIJRES;
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
............
INSPECTED BY: JOHNJ DATE OF INSPECTION: 2/10/2023
TIME
/10/2023TIME START: I 1:00am END: 11:45am
tt Town of Southold 1/25/2024
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44899 _ .....,... /2024............. ....
Date: 1/25....
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 105 Beachwood Rd, Cutchogue _m
SCTM#: 473889 Sec/Block/Lot: 116.4-28
Subdivision. Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
P ...
8/28/2023 pursuant to which Building Permit No. 49758 dated 9/21 2023
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:
"as E laxlt""cic , addition m ecntt k wtll.e w It tr ata ll,g, ,ca, window awepla +�l lts j mexiss]tl � , t n I L11�;1e.f" 1111 y,_9 + 11�r1
q:., 1?Pjic el, fior.
The certificate is issued to Engels Family Trust _.....
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. ..4975,$. .�...... ...._...,1/17/2024. _� ....
PLUMBERS CERTIFICATION DATED
utl grit ignature
FORM NO 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 26694 . . . . . Date 1 . 1 . . . . . . ., 19.7�.
THIS CERTIFIES that the building located at . Beachwood Incl Street
Map NoB a ajahwo od . . Block No. . . . . . . . . . .Lot No. 2 . . . Cut chague. . . .?;.y.. . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . Aug. . 19.74. pursuant to which Building Permit No.7.4802 . .
dated . . . . . . . . . . .Put . .1 b. . . ., 1974. ., 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 .$rlvate. . .ne. Iaml.l.y.dwelling. with. alt. & .addn. . . . . . . . . . 1 . . . . . . . .
The certificate is issued to William. Engles . . . . LVner. . . . . . . . , , , . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval t?.11.•. . . . . . . . . . . . . . • . . . • • • • • • • .
UNDERWRITERS CERTIFICATE No. V2f3605. . . .liar. . .13. . .1975. . . . . . . . . . .
HOUSE NUMBER . , .1 O - -Beazhftmd X& . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building L
FORK No Z
TOWN Of SOUTHOLD
BUILDING DREPARRTM04T
7WWN CURKS DF
SOU LD, K Y.
BUILDING RT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
° 7480 Z Date ...................... 1R >t........*4...... .. .
Permission is hereby granted to:
........... . WIC1lk..........................................
to .....ftW... .....................................,.......................
.................................................................................................................................................................
atpremises located at . x... :.......... IpMt ................................................. . ............ _ .....
.....................................AAQ.KW.+►..aff..D ..Dr . r, ...... .I ...................
...........................................................I....................................................................................................,
pursuont to application doted ....................... t........14......, 1974...., and opproved by the
Building Inspector.
Fee $tIs ............
ll is .I". tar
a
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Nall l'
Southold, N.Y.
. P
Certificate Of Occupancy
No. 1 15 3 7 . _ . . , . . . . Date . . , . . , .March 7 . . . . . . . . . . . . . 1983.
THIS CERTIFIES that the building . Accessary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property105 Beachwood Road Cutchogue , N.Y.
House No. Street Hamlet
County Tax Map No._1000 Section . . ...�:� . . Block . . . ,0� . , , . . . • .Lot « . •028 • . . .
Subdivision , . ,Beachwood Colony , , , ,Filed Map No. .77. . . .Lot No. . 2 . . . » . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
February 2419 29 pursuant to which Building Permit No. . . . . 'I�'I'14Z. . .
dated ar
Februy 24 79
. . . . . . . . . . . . . . . . . . . . . . . . . . . 19 . . . ,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 an accessary garage in the. front yard . . . 1 —, , t , * , .
The certificate is issued to . . ,William EnGelp , , , . . . . . . . . . . . . . . . . . . . . .
(owner,lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . • . , . . . . . . . . . .
N/A
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . • . . • . . . . . . ,
B/A # 2509 Approval as applied for
Building Inspector
Rev.1181