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Home My WebLink About1000-108.-3-12.7 Y � $ TOWN OF SOUTHOLD s Rental Permit F 1136 Owner Constance Cross Occupied as Single Family Dwelling Located at 1045 Wagon Wheel Ln Cutchogue 108.-3-12.7 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. 5/24/2024 r)r en Official This Notice must be posted by the main entrance at all times T d ,C�� r.;✓"max � u � a 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 h( L 01 ��w.Yl �8 �GrR,. rMki� RENTAL PERMIT APPLICATION �; �� Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 1045 Wa on Wheel Lane - Cutcho ue NY 11935 Tax Map Number: 1000 SECTION 108 -BLOCK 3 -LOT 12 - 7 SECTION B. OWNER INFORMATION: Property Owner Name: Constance Cross Property Owner Legal Address: Property Owner Mailing Address: 21833 Main Rom PO Box 730 Cutcho ue, NY 11935 Cutcho ue NY 11935 Telephone Number(s): Daytime 631.553.0151 Evening Emergency Property Owner Email Address: CCGardenDesiqnPqrnail.com Page 1 of 5 /P � Town Nall Annex ��, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 197 1-0959 �V a BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: N/A Address of Authorized Agent(no P.O. Boxes): N/A Mailing Address of Authorized Agent: N/A Telephone Number (s): Daytime N/A Evening N/A Emergency N/A Email Address: N/A Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Jessica Kelleher Address of Authorized Agent(no P.O. Boxes): 7C1 a orllNheel I_arle _ Cutco ue NY 11935 Mailing Address of Authorized Agent: PO Box 88 - Cutcho ue, NY 11935 Telephone Number (s): Daytime 617.821.4462 Evening 617.821.4462Emergency 631.513.6589 Email Address: jessielou85rraail.com SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: N/A Address of Managing Agent (no P.O. Boxes):_ N/A Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 m A. 1J,, Southold,NY 1 1 97 1-0959 � a�J H BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: N/A Telephone Number(s): Daytime N/A Evening N/A —Emergency_,N/A Email Address: N/A SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 (One) 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." 1 °0 Rental Dwelling Unit Identifier. Unit 1 Requested Maximum number of persons allowed to occupy Dwelling nit' 6 Pers Number of rooms in Rental Dwelling Unit: 3 Bedroom Use and Dimensions of each room in Rental Dwelling Unit: ' Living Room (13'-5" x 23'-3"))Kitchen/Dining Room (14'-0" x 25'-4" Bedroom #1 (13'-F x 17-6"), Bedroom #2 (9'-9" x 11'-9"), Bedroom #3 ( 9"-9" x 13'-2") Page 3 of 5 Telephone(631)765-1802 � , ,Town Hall Annex o 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 � Southold,NY 1 1 97 1-0959 � „ r�b g , d BUILDING DEPARTMENT TOWN OF SO 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 ® I 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) I Constance Cross 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 1 l J; 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 SO `HOLD 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: Constance Cross Property Owner's Signature: Sw rn to before me this�,,,,,day of , 20?�'` " Official Nota is Signature and Original Notary Stamp L EA L. CHALONE blic, State of New York tion#01CH6287106 dIn Suffolk Countn Expires Aug.5,20 Page 5 of 5 p El" Town Hall Annex Telephone(631)765-1802 54375 Main Road y�� Fax(631)765-9502 P.O.Box 1179 d Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Rra dss orlat seal re aired ► "Ircilitect or�i irleer iicerlsed orlle itls actor must rovide copy of valid current certi i ation Rental Property SCTM Number: 1000-108-3-12.7 Rental Property Address: 1045 Wagon Wheel Lane - Cltcho ue, NY 113 Owner/Name: Constance Cross Rental Dwelling Unit Identifier: Unit 1 Number & Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom #1 -100 sq., Bedroom #2-90 sq., etc.) Bed rp ) 1 -� 246 - Property Description (Include all improvements indicated on survey) Two Story - Stick Frame - Sin le Family Dwelling I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State, the Building Code of New York State, the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. Zackery E. Nicholson, RA Print Name and Title Original Signature VD A kC c E.N� � Please place professional seal: �' TOWN OF S);tUITHOLD BUIL61NG 04!( vi I*t (AIV 631 -765 1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ l FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] AT [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (EI [ ] CODE VIOLATION [ ] PRE C/O [ I REMARKS: d DATE r o m. INSPECTOR >1140WN OF SOUTHOLD PROPERTY RCORD OWNER ;STREET �' VILLAGE DlST. SUB. LET 14d OM AC ER OWNER N E s �. l S W ; OF TYPE BUfLDING iv } 1 RES. 14 SEAS, VL. FARM COMM. CB. MICS. Mkt. Value LAND lMP_ TOTAL DATE REMARKS ni a tr �. a ', Al a= t � YY _ _2 �n Tillable FRONTAGE ON WATER z Woodland t�� w jX:RONTAGE ON ROAD s Meadowland DEPTH i ! t111r House Plot BULKHEAD Total f.� 77 < "I'VW k ........... 4 COLOR TRIM L A j. -4- i uft 108.-3-12.7 03/2016 1 i4 I Viv Lo T j 7 -Cj 1—4-1 M.-Bidjs lz'2 L 'Extension S� Extension Extension I Vj -—-------- C"llette Foundaflon Both (Z?Y i� -n = Basement Floors K Porch Ext. Wa I Is Interior Finish LR. DR, Breezeway Fir ace Heqt L I . Garage Rcoms I st Floor BR. i Paticu e( eotiom Room Rooms 2nd Floor F I N. B I Liek A-- f O. B. 5 Dormer Z I Driveway i ............ Total .;t A t""U-A V FOR14 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z26097 Date November 12, 1998 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1045 WAGON WHERL LANE. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 3 Lot 12.7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Au st 16 147? ursuant to which Building Permit No. 9406Z dated Au et 16 1977 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* The certificate is issued to SUSAN & RALPH TUTHILL III (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 7-SO-115 UNDERWRITERS CERTIFICATE NO. N372354 PLUMBERS CERTIFICATION DATED N/A _�_ *THIS UPDATES CO Z-8919 DATED JAN. 26, 1978 & CO Z-2 2 TED DEC. 24, 1991. au ing inspedor Rev. 1/81 ................ .................................... Town of Southold 7/18/2020 P.O.Box 1179 53095 Main Rd Southold,New York 11971 zr, ........... .............................. ....................... ——------- CERTIFICATE OF OCCUPANCY No: 41266 Date: 7/1 8/2020 ................. THIS CERTIFIES that the building DECK .......... Location of Property: 1045 Wagon Wheel Ln., Cutchogue ....... .. ....... ..................--- ........... ..................... SCTM#: 473889 Sec/Block/Lot: 108.-3-12.7 .1............. ...... ........................... ........ Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/2/2020 pursuant to which Building Permit No. 44913 dated 6/24/2020 .....................-................. 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 builtdm LiedIx.., The certificate is issued to Tuthill I111,Ralph&Susan ------.........--- of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ............. ................ ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ......................... ut Sipature A ZEN DESIGN t 1250 EVERGREEN DRNE v Ail CUTCHOGUE,NY 11935 PNONE:631-M6589 OWING ROOM NO. ISSUE DATE ol RENTAL PERMIT 07-12.22 MUD ROOM POWDER ROOM KITCHEN LIVING ROOM SCALE: FOYER -DATE-- 07.12.22 DRAWN BY. 7 E.N. 1ST FLOOR PLAN A-1] � V ZEN DESIGN ! 1250EVERGREEN DRIVE CUrCHOGUB.NY 11935 PHONE 63L5n6589 a M I BEDROOM 2 = NO. ISSUE DATE 01 RENfAL PER Mf( 07.12.22 I � DN i e..______-____ BEDROOM 1 �5I ' i i NI. BEDROOM 3 a BATHROOM, - a If j gam, scALe: 1t4--ro° DATE: 07.12.22 t ` BATHROOM DRAWN BY: LE.N. WALK-IN CLOSET 2ND FLOOR PLAN f A-2 X.