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HomeMy WebLinkAbout1000-70.-13-19.2 TOWN OF S UTHOLD Rental Permit 1118 Owner Daniel Walsh Occupied as Single Family Dwelling Located at 4200 Pine Neck Road Southold 70.43-19.2 Maximum Permitted Occupancy 3 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. 5/6/2024 Code E orc nt Official This Notice must be posted by the main entrance at all times 1 30- TOWN OF SOUTHOLD—BUILDING DEPARTMENT r Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax(631) 765-95021i�tVL//www ,out(ic)I(ltor nn�g R RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two year r� Section A. Property Information: Rental Property Address: o 0 pvv�, �C Tax Map Number: 1000 SECTION 0 70 -BLOCK -LOT 02, SECTION B. OWNER INFORMATION: Property Owner Name: Lam"k_'& Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number (s): Daytime 2,S1t%ning Emergency Property Owner Email Address: � �k^'�" " �,5 9 6 p Y Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units bn 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: Number of rooms in Rental Dwelling Unit:— 17 Use and Dimensions of each room in Rental Dwelling Unit: �`,,��77 d_��"�- 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. IV I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold C1 I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK)�� 1 2,/ , 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 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 s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: ., ,.,r Property Owner's Signature: Sworn to before me this�y of t _, 20,O)y 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 I, _ Page 4 of 4 TOWN OF SOUTHOLD BUILDING I Z 631 765-1802 gyp--/ INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSUEATIOWCAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fil CODE VIOLATION [ ] PRE C/O [ 1 REMARK " : Sort D� ++ a INSPECTOR Town Hall Annex ell 'k TOW11 Of Southold 54375 Main Road w Rental Inspection Report PO Box 1179 Southold NY 11971-1179 Tel: 631-765-1802 /3 Date CTM # ��.. �� _ . . .. w .......�.w. Owner Phone .... n ..ti.... �.w.�.. ,..�_ .�.. ��.... �. ... . . ...., .. ......_...... .. ...._ ....... IAddress ,v70Q f'/LGG Visible �.... ao�� �.�„���.����.�., ............_..�..........................� �.,.., �....�..a� ..... _Hamlet Inspe ctor Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) / ��.. �o,u.mRRRRRwn..�. _.�......... ,.�.. ... . .,,�. w��a� �. m... �.. .W., ,,. -.. �... . �........ .��� .._ m. ............ Carbon Monoxide Detectors Fire Extinguishers ...w�. ... ............ ....... ....... �� � �. �.. .... ......... �...�.� ...o�... .. ��� Exits. .. Bedrooms 1 2 3 4 5 6 . w .. � . . . ea Smoke Detectors 1 Occupant Count a . ...m�w ..17 _...... . ...... ...ry.. Building i Systems Maintained&Operational Condition of Property „ .. .......... .. ®, .e e m n H Heating Building interior Hot water ... ,.v,� .. .,,. .. ..a ,.. , .. Building exterior Electrical Property clean, maintained &safe .... ._....,.. . ..... ...�.�. r . guards� .i .. s_c installed &secure .Mechanical � Handrails& wards i . r,w Pool Safety Pool on Site Surface water alarm Date of CO issuance .. . .m. . ....... �.m..�aW,_�w ...... .,�.. ..... ... ..... ....�,�.,...e..�,., �, _...., waa, .�..w..o ,.. .m.w �.fl , �... Door alarms Pool completely enclosed Self closing�/latching�gates Pool Pool fence to code requirements CO's for all items present �I Prior Rental J . ... mments i 1 �......................�,,,,.,.,. .,,,. .........,., ..._. ..,....,,,,.. ., ,..... . ..�._,.,�_....,.,.., Fv. .. ..,..,._.n.. ,, ._......... . ........ __,.,., ., .,,....,,,........... � _.. . ...,.,.,... �....... _�..... ..ww. .,._.._.. ...., 7-1 © ZZ© D ® 'one �e� � ���, �o� 74Aol� y1 �Af� �`1` �� 10 tea_ E TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET--- VA-LL'A-G-E 1 DIST. SUB LOT tK L N!t-k ACR 4; �c�J -7 s ' TYPE OF BUILDING RE S SEAS. VL, FARM 5 M,C& Mkt- Value LAND IMP, TOTAL DATE EA-RM KS 1`1 u, Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Mead(ywkxW DEPTH House Plot BULKHEAD Total i I TRIM _ 3 COLOR T I t I f t ' f t _ r s s i t s s � , t w E E m a. - , E M. Bldg. 1 I Extension , t € Extension i I Extension i -? tFoundation :Both Dinette Porch Basement Floors K. Porch - Ext. Walls In rior Finish LR. to Breezeway , Fire Place Heat I DR. Type Roof Rooms 1st Floor BR. Garage �- - _ Patio 3 `Recreation Room 'Rooms 2nd Floor FIN. B I � 0. B. :Dormer ;Driveway € Total FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31590 Date: 0S 02 06 THIS CERTIFIES that the building DWELLING Location of Property 4200 PINE NECK RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 4738B9 Section 070 Block 0013 Lot 019.002 Subdivision Filed Map No. Lot NO. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to A.PRIL 9 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 31590 dated JUKE 2• 2006 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 SEASONAL ONE FAMILY DWELLING WITH ACCESSORY GARAGE. NOTE:THIS UPDATES PRECO Z-10184 DATED 10 6 80. The certificate is issued to RUSSELL F PELUSO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLa7MBERS CERTIFICATION DATED N/A uthorized Signature Rev. 1/81 FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. X0973 . . . . . Date . . . . . . . . . . . . THIS CERTIFIES that the building located at . P Rock. A .S o. Sw Street Map No. . . . . . . . Block No. .ZXX . . . .Lot No. . . th*U. . . .11 07 4 . . . . . . conforms substantially to theme * 19M SEE a � befog , ; ril. 23. . .5? a zt� m ate of e 19 pursuant to which No dated . . . . . . . .April.. %. . . . .. 19.76., was issued, and conforms to all of the requirg- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is PrIvM4. am. faxtly. 4V,011 JAi ,with.qwAq s*p ry.bn114 . The certificate is issued to a �tg . r! ! . . . . . .©!'!�!or. . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval P ? !! : . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . .4200 . . . . . Street . . . . .�1ue .Weak . . . . . . . . . . . . . . . . . . . . . . . , „ . . , . . .! �' . * . . (no o*nt * beau . rste�r). „ . . . . . , . . , . . Building Inspector HOUSING CODE INSPECTION April 16, 1976 4200 Pine Neck Rd. and 50 N. Bayview Road R-1 Southold, N.Y. Tax Roll: James Crosby & Wf Seasonal occupancy Upon receipt of an application for a Pre-Existing Certificate of Occupancy, I made an inspection of this one story framed dwelling. Accompanied by Mrs. Crosby, I began this inspection at approximately 1:15 P.M. The building consists of a living room, two bedrooms, kitchen, and a full bathroom. An enclosed porch on the south side serves as a dining area and rear entry off kitchen. An enclosed porch on west side of building, accessible from bath- room, is being used as sleeping quarters. An enclosed porch on north and east side serves as front entry to dwelling. Building rests on locust posts and cement piers and is skirted. A one car detached wood framed garage is located in side yard. The following violations of The Housing Code, Chapter 52 , Town of Southold, were found: Entrance front and rear - no means of controlling light in room on entry. Article V, Section 52-56 B.2. Building is wood framed shell only and has no central heating system and is used on a seasonal basis. Inspection completed at approximately 1:35 P.M. Ydward ectfull submitted, EH:mm Hndermann Building Inspector