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Home My WebLink About1000-86.-4-3 TOWN OF SOUTHOLD Rental Permit 3 0221 Owner Tremaine Emory & Andee McConnell Occupied as Single Family Dwelling Located at 1200 Indian Neck Ln. Peconic 86.4-3 Maximum Permitted Occupancy 10 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. 6/3/2024 ad n rc rat Official This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD-BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 ://' ,.sot al to ntI . ,o RENTAL PERMIT APPLICATION ° Rental Permit Fee $300 (Application must be renewed every two y � ) that " °Fug Section A. Property Information: Rental Property Address: C �`iC� N 120`� ►1J D i'�'r� m/c� L*NEF/ � f Tax Map Number: 1000 SECTIONO?b -BLOCK o`J . uo -LOT 00 3 $ 4 - q- 3 SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) --lo upc�"T sT m - T 3 �Vk Telephone Number (s): Daytime Ot�;_-Z Evening Emergency Property Owner Email Address: k"Ee 1L_V�_Ne � 3bu ,5 Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: t-J C;> Address of Authorized Agent (no P.O. Boxes): " (` Mailing Address of Authorized Agent: Ilk .- Telephone Number (s): Daytime ` Evening Emergency Email Address: 0) 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): Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening Emergency Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Z 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: V Iv,1-T— 1 Requested Maximum number of persons allowed to occupy Dwelling Uni to "Or Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in R ntal Dwelling Unit: �'� � i� l w X wd� SZi� i n` °�`' X 13 r Z" .� cam, ram►'��` x x Yo u Z`t`11' x Z�►�" 5^1NQ-4-rv% �0 S ` �1-l ( X �t5 la�l FA-.L- "tT �' ►► x il' I'�5- p_ 3'` X15�(0" r k-� i��1° I�-` I'` b�pl�h-I 7- SECTION G. I��k��'�l►� 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. 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. 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) 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:kl�JV>G'EF Property Owner's Signature: Sworn to before me this" day of Jhhow , 201y Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU8186050 Qualified In Suffolk County�y�11 Commission Expires April 14,2�2t page 4 of 4 ell Town Hall Annex �� Telephone (631)765-1802 54375 Main Road P. O. Box 1179 hw; COO as Southold, NY 11971-0959 d BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: V N \T- Z Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: 'Z— Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Nf/Ik Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: FULL BATH YARD 6'6°x 111° STORAGE UTILITY 6 Y x 15W Tx 1516` !+ ff DINING ROOM 10`60 X 15' KITCHEN VIEZ6S , 2i'4`x24`4` ' DEN . 20'3'x 15'1` HALF BATH j ,\ WORKOUT STUDIO 10'3`x102 LIVING ROOM - - 19'9`x 187 LIBRARY ENTRY 17'1"x 1T6° � HALL NO �r MAIN HOUSE - FIRST FLOOR THE OLD KING FARMHOUSE 1200 Indian Neck Lane, Peconic Scale in feet.Indicative only.Dimensions are approximate.All information contained herein is gathered from sources believed to be reliable.However,accuracy is not guaranteed and interested persons should rely on their own enquiries. BEDROOM »ue" < \ \ \ Emm, / \ RAs e� y �, \ . :AC-- x_Tj . \ FIREPLACE C 3 » % ^ BEDROOM 16Tx 15'6' \ . m «m . . E Z BATH < ® CLOSET ( _ mm , « d \ qBEDROOM . : : ,7e7 /k \ a ww . PRIMARY \ ! BEDROOM « ; ,29,9` � \ MAN HOUSE SECOND FLOOR THE OLD KING FARMHOUSE 12001ndƒan Neck Lane, Peconic Scale b feet,�d e only.Dimensions are approximate.All inform ncontained herein Ggathered from sources a�_db be reliable.However,accuracym U guaranteed and interested persons akdr«thrmnenquiries. Q J J W H PARTIALLY_ FINISHED BASEMENT p pp PARTIALLY FINISHED BASEMENT �g MAIN HOUSE LOWER LEVEL THE OLD KING FARMHOUSE 1200 Indian Neck Lane, Peconic Scale in feet.Indicative only.Dimensions are approximate.All information contained herein is gathered from sources believed to be reliable.However,accuracy is not guaranteed and interested persons should rely on their own enquiries. 2 44� LIVING ROOM/ BEDROOM KITCHEN ER 4�1 FULL BATH HALF BATH DOUBLE HEIGHT GREAT ROOM j" ARTIST STUDIO & COTTAGE OWL HOLLOW ARTIST'S STUDIO 12001ndian Neck Lane, Peconic Scale in feet,Indicative only,Dimensions are approximate.All information contained herein is gathered from sources believed to be reliable.However,accuracy is notguaranteed and interested persons should rely on theirown enquiries. _ VING ROOM/ BEDROOM KITCHEN '\ `•= DOUBLE HEIGHT\ FULL -`` GREATROOM - BEDROOM UTIUTY 16'x 161 - a 7 X 156 t f IL �_ {{ f SUNROONV DM7 J f DININGROOM 166'K WV J 166' 15 KITCHEN LIl ARTIST STUDIO&COTTAGE � OWL HOLLOW ARTIST'S STUDIO d PARTIALLY FINISHED 'P1 OO 20 DEN 61 i6BEBp fi BASEMENT 1K HALF a _. BATH iL c _ _. . _�0- PARTIALLY 0 � r WNC ROOM = BEDROOM - r - FINISHED t � tee•:tsr �_= BASEMENT � LIBRARY ENIRY 17'1'x 17'8 - ' 5 HALL r 41, 1-1 �� MAIN HOUSE-SECOND FLOOR MAIN HOUSE LOWER LEVEL THE OLD KING FARMHOUSE THE OLD KING FARMHOUSE MAIN HOUSE-FIRST FLOOR THE OLD KING FARMHOUSE 1200 Indian Neck Lane, Peconic Scale in feet.Indicative only.Dimensions are approximate.All information contained herein is gathered from sources believed to be reliable.However,accuracy is not guaranteed and interested persons should rely on their own enquiries. ro r y . t ATi R-m M r J = TOWN OF S UTH LD PROS M :OR CARS? OWNER ; . 1;_ 1 STREET _ � ' VILLAGE DIST. SUB. LOT s FORMER OWNER , ,,, N ACR. F J � S W TYPE OF BUILDING RES 1 SEAS, VL. FARM COMM. CB. MISC, Mkt. Value S LAND IMP, TOTAL DATE REMARKS ------------ Ec Wa s _ >' ( z Y s 14, E b_ =LDI rx F d NEW NORMAL BELOW 0-VE - FARM Acre Value Per 1 Value Acre a - E Tillable 1 _ L Tillable 2 ' <' Tillable 3 Woodland '_^ Swampland FRONTAGE ON WATER FRONTAGE ON ROAD Brushlond House Plot DEPTH BULKHEAD I : DOCK total j t 3 s e 41 ITCOLOR — v — _ € - I Lr f , I _ ` 1 TRIM I I I r I _ E e _ - .. r - - 7 86A-3 10/2014 ; n _ i M. BI L ette Foundation Bath i �� = Floors , = � K Extension � Basement "K Extension E - _ i i 1 k m xt Walls Interior F•n sh � ''I_R m f Extension -. _ I Fire Place [ Heat / �� DR. m _ a, a Type Lh».`j Root R B ooms 1st Floor R �® FiN Porch , Recreotion Roon i F B. ohms 2-- 1 ;Dormer Porch10 i Driveway I B ree-- o ` f - Q 3 • 7 � I i _ e c Total11Vr - 7 E FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No_ . . .Z9810 . . . . . . . , Date . . . . December 28 . . . . . . . . . . . ..ry 19 ?9 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . a . » • . » , Location of Property 1200 Indian Neck Lane Peoonia,. N.Y. House No» . » . Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . .Block . . .4. . . . . . . . . . .Lot . . . . . . �» , . » . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . » . .Lot No. . . . . . . . . . . . . . requirements for a one family d wre11in built prior to conforms substantially to tla April 23 . , 19 �7 pursuant o wrhicifi0 t9er t o'. ancy . . .. . . . .29810. . . . . . . dated Deo , ,r 28. . . . . . . . . . . . . 19 79. ,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 . . . . . . . . . A one .fly.R!el-Li 8. . A .Studio.v/.4tt .oh4d. 0* 1inl .unit P.. A .storage building and A two car garage The certificate is issued to `U".' ')1N ' +•. .A #. . M:C t . . . . . . t't�uvrter, of the aforesaid building. Suffolk County Department of Health Approval . . . . , . . . , N . . , » . . . . . . . . . . . . . . . . . . . .. . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . « . . . . . . .N . . • . . . . . . . . • . • . _ • • • . . . . . . . Building Inspector Rev 4/79 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location,._,=. num � � � � 1 *�-�--- number & street ��unioa.pali� y Subdivision Map No. Lot(s) Name of Owner(s) Richard G. Rath & wf. Occupancy (type`& owner owner-Mara° Admitted by: Mrs. Rath Accompanied by: Mrs. Rath Key available Suffolk Co. Tax No.1000-86-4- Source of request ' Wm. H. Price, Jr. , Esq., Date D 2O 1279 DWELLING: Type of construction Wood framed stories 2 Foundation trick Cellarnant .a:C, Crawl space rest Total rooms, lst. Fl 6 2nd. Fa,. rd. Fl Bathroom(s) 2 Toilet room(s) 1 Porch, type-roof v �m eck, type_ Patio, type cement Breezeway Garage Utility room X Type Heat arm Air Hotwater, Fireplaces) 4 No. Exits 3 Airconditioning Domestic hotwater yes Type heater___2ffjqjl er Other ACCESSORY STRUCTURES: Garage, type const. Wood 2 car _ Storage, type const. Wood Swimming pool Guest, type"const. Other Large studio w/attached 3 room Gotta e VIOLATIONS: Housing Code, Chapter 52 Location Descri tion Art. Sec. Rear steps UP No hand rail _ 2_2 B' Cellar steps Not even & level _... - - - . .,,.— Front pch. sec onA- Side pore & deck Cement oracked - " ad . - I 5 =" . -A—. Wood shed Very bad shape _- '- C Remarks: Date of Insp. , Inspected by:2. D 1 9 Curtis Horton Time start 1:20 end 2:0 a'w e � n f IAMp ! Y wwM� i / JSmmr rww,,,nq ., a lkd r �/ ryf'rzAwawwy MII w, r r�r ,6 l m o w,.W M nWi d�. a,.p5 �r pp III�YINII iYr I wwww,. 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