HomeMy WebLinkAbout1000-103.-10-8 Tu""WWWN OF SOUTHOLD
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4=01 Rental Permit
Al 1140
-4111
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Owner Geertrui Van De Heyning
Occupied as Single Family Dwelling
Located at 835 Strohson Rd Cutchogue 101-10-8
Maximum Permitted Occupancy 5
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.
5/28/2024
Code E rc t Official
This Notice must be posted by the main entrance at all times
�" TOWN OF SOUTHOLD—WELDING DEPARTMENT
Town Hall Annex 54375 Main Road P.0.Box 1179 Southold,NY 11971-0959
Telephone(631)765-1802 Fax(631)765-9502 htt s:/ ww thold o nn . ov
RENTAL PERMIT APPLICATION
Rental Permit Fee $300(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION 10 --BLOCK i 0 •LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name: ,
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
Telephone Number(s): Daytime Evenings_ Emergency �� �2,IZ 00,�*
Property Owner Email Address: V �� �� OI L
Page 1 of 4
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: I
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:
Rental Dwelling Unit Identifier: ) OV I
Requested maximum number of persons allowed to occupy each dwelling unit: . _
Number of Rooms in Rental Dwelling Unit: IWL
Use and Dimension of each room:
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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 afire 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.
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 E it i),T P"j, V f 0 D , certify under penalty of perjury,the following:
Hcy fJ&
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: I 1 p
9
Property Owner's Signature: a °'
Sworn to before me thi��d y of +,0, 20
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH Page 4 of 4
Notary Public,State of New York
No.01 BU6186050
Qualified In Suffolk County
Commission Expires April 14,2a��
so
TOWN OF SOUTHOLD BUILDING
631 -765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLTG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN',
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (TOUGH) [ ] ELECTRICAL (FI'
[ ] CODE VIOLATION [ ] PRE C/OREMARKS: memii [
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S�F Town Hall Annex
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�, Town of Southold 54375 Main Road
c Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
' Tel: 631-765-1802
�SCTM# "�. .. _� .. . .._ w ..... .......... . ....... _.. Date
Owner V ?+tU
6A�I1 Phone
,Address $'3S 5000 _ Visiblem.mm. . .�., �.... ,w..
Hamlet Inspector
Floor Level Quantities m_„ ....�Sub �... . _��� ... .3......
Smoke Detectors not located
bedrooms C
Carbon Monoxide Detectors �r
�. ..,. . . . .m.,
Fire Extinguishers �.... _..�. . ..__ _... .�. �..._.._ .�.. ..m... �.. .e.�_� �� , .. . . ....... �._;
,.... Exits.
Bedrooms 1 .. ., .. 3., ,.......4 5 6
I/
Smoke Detectors _
Egre
ss
Occupant Count
..n... ............... - __ ...b.., .. _ ...�,w.. _.
Building Systems Maintained & Operational !Condition of Property
�_..._�...__
'Heating ..�.�. _....,w.. �.� . .
Building interior
Hot water
�._,. . _ wBuilding
ld g exterior
Property Electrical pen rty clean main
_ ta-ne d & safe
,Mechanical Handrails &guards installed & secure
Pool Safety Pool on Site
Surface water alarm Date of CO issuance
r
Door alarms Pool completely enclosed
'Self closing/ latching gates Pool fence to code requirements
CO's for all items present Prior Rental
Comments
17
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TOWN OF SOUTHOLD PxOPERTY RECORD CARD
OWNER STREET VILLAGE DISTRICT SUB. I LOT
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E ACREAGE ZA
FORMEP, OWNEP, k-l" Tti_ N
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TYPE OF BUILDING
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RES. SEAS VL FARM comm. IND. Cs. misc. Est. Mkt. Value
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LAND lmp� TOTAL DATE REMARKS
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AGE BUILDING CONDITION
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oiE NORMAL BELOW FRCNTAGE ON WATER
ABOVE
Form Acre Value Per Acre Value FRONTAGE ON ROAD
Ti I!able I BULKHEAD
Tillable 2 DOCK
Ti liable 3
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Swampland
Brushland
House Plot
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Total
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I:x-enSEon _ .t. 3 €
Extension Piece Y
Porch v V
Breezeway POT.0 2 E
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z .55 1 . . . . Date . . . . . . . . . .Oct . . . . .1.9 . . . . . 19. .73
THIS CERTIFIES that the building located at . •Strohson. Road- .(.PVT Street
Map No. . .g . . . . . . Block No. . . .X*Q:X. .Lot No. . XXX. . . . .Cla-tdhogue i�J.Y... . .
e u1 e nt r e I l� ire i ,ho ping code
conforms substantially to the A56.ra o' u a, r ' C� a�� ,
iudilt occupancy
da e bofo_& 4,r:rd-1-23-, 57 p o. . . . . . . . .
_ . T�. �, � 19. . . . pursuant to which
zl
dated . . . . • • .0 e t • . • . •1.9• . • • -, 19.73., 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 •Pri-vate- -one. family -d;.r3.11 ing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to .Frail_ •A..• -r:cOeo 4• ':,1ife. • • -Cvners • • • • • • • • • • • . • • • • • .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .pre— -exist94n-9 . . . . . . . . . . . . . . . . . . .
I
UNDERWRITERS CERTIFICATE No. .pre— -elx-i-sting . . • . •
HOUSE NUMBER - - ,JS. . . . . . . . . Street . . ,"trohson• Road. . . . . . • • • - • • . . . . . . • • • • - •
Building Inspector
1
i
HOUSING CODE INSPECTION
October 19, 1973 1
#83 5 Strohson Road, R-1
Cutbhogue, N.Y.
Tax Roll: Frank A. McGee & wf.
Uhoccupied
Upon request of the Southold Town 3uifiding Department
I made inspection of this one family framed dwelling and
found no violations of Local Law #1, Housing Code, Town of
Southold.
I picked up key from Mrs. Steve N. Stepnoski and began
inspection at approximately 2:00 P.M. This is a one story
ranch with attached one car garage.
The building consists of living room, kitchen with
dining area-, three, bedrooms -and one full bathroom.
The building and grounds are in good order.
Inspection completed at approximately 2;30 P.M. with
return of key to Mrs: - Stepnoski. -
wctf s mitted,
Building Inspector
o &
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z 5952. . . . . . Date . . . . . . . . . . . ." . . . . . .une 1 C. . . . . .1 19. '
THIS CERTIFIES that the building located at W0430n.RO". . . . . I . . . . . . Street
Map No. .XZX' . . . . . . . Block No. . XY. . . . . .Lot No. . .Cntoho . . . . . A.Y.. . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . MAY. . . .b. . ., 19. 14 pursuant to which Building Permit No. 723". .
dated . . . . . . . . . . -T. . 6 . . . . .. 19. . .74., 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 accessory, .(storagee 6c Barn) building
The certificate is issued to . Robert Horvath r* .
(owner, lessee or tenant)
of the aforesaid building.
O
Suffolk County Department of Health Approval AA . . . . . o . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. N`R'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . . 8351 s r tho
. . . . . . . Street . . ohson Rd cue
Building Inspector
Town of Southold 4/6/2024
P.O. Box 1179
53095 Main Rd
Southold,New York 11971
5 �
CERTIFICATE CATS OF OCCUPANCY
No: 45110 Date: 4/6/2024
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 835 Strohson Rd, Cutchogue
SCTM#: 473889 See/Block/Lot: 101-10-8
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/23/2024 pursuant to which Building Permit No. 50366 dated 2/22/2024
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:
k wilt"°...,.1.1.tgratior s,,_r cW(fi &b. athrc orn nd utiti,l ty ra�prp, llt 1a 1 inns z d b i�nent tr�v� mt tir�� g1gic f ra ,y
dw llixljg, s, pp[i d for.
The certificate is issued to Van De Heyning,Geertrui
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 50366 3/18/2024
PLUMBERS CERTIFICATION DATED 3/27/2024 err- cc H i ilt
o iz Signature