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Home My WebLink About1000-95.-1-7.1 Folk TOWN OF SOUTHOLD Rental Permit 1181 Owner Dina Anderson Occupied as Single Family Dwelling Located at 7045 Oregon Rd Cutchogue 95-1-7.1 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. 8/6/2024 ` Code I rc nt Official This Notice must be posted by the main entrance at all times sorry, '11 rCAI TOWN OF SOU HOLD BUILDING I EP T. n� 631-765.1 sot INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATIO [ ] PRE C/O [ RENTAL REMARKS: wk-�t (-,fm/kg -6 A) �vk � --- (�Y) c" 0 R941 • N 7W V ,, V-) 8�2 OPT -o� k 1v -rev\ i DATE INSPECTOR Town Hall Annex �` 'r ltphone(631)765-1502 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT "' L 3 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION f I MAR 2023 Rental Permit Fee $200(Application must be renewed every two years OFSOIJI'HOLD Section A. Property Information: Rental Property Address: 7045 OREGON ROAD &Jc4k 060 C_ Tax Map Number: 1000 SECTION 095 -BLOCK 0001 -LOT 007 _ 001 SECTION B. OWNER INFORMATION: Property Owner Name: DINA ANDERSON Property Owner Legal Address: Property Owner Mailing Address: 7045 OREGON ROAD SAME CUTCHOGUE, NY 11935 Telephone Number(s): Daytime (917)279-9584 Evening SAME Emergency SAME Property Owner Email Address: JB@3-BY.COM / DRDINAANDERSON@GMAIL.COM Pagel of S Town Hall Annex 54375 Main Road Telephone(631)765-1802 P.O.Box 1 179 Fax(631)765-9502 Southold,NY 11971-0959 4" t ; BUILDING DEPARTMENT TOWN OF SOUT OLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: NONE Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: NONE 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: NONE Address of Managing Agent (no P.O. Boxes): Page 2 of S m Town Hall Annex �`. 1ej iloree(631)765-1802 54375 Main Road h p I � 1 765-9502 P.O. Box 1179 rr; , s 1 f Southold,NY 1 1971-0959 � U r , BUILDING DEPARTMENT UI]X V1% TOWN OF SOUTHOLD NY Mailing Address of Managing Agent: _, .............-........ �_ _.......... �_w w_. ...._.._w__� Telephone Number (s): Daytime µ µ_ Evening_.__..__ Emergency___,_,,___,,,,,-,,-, Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental DwellingUnits onproperty: __.. ..,. 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: .UNIT 1 ....µ� Y Requested Maximum number of persons allowed to occupy Dwelling Unit' 1 Number of rooms in Rental Dwelling Unit: 1_4... ...._.,_ ...__ ... , _._...-......_....... ......_... ...._._.. ...-.�- Use and Dimensions of each room in Rental Dwelling Unit: KITCHEN (1M6-11"x11'1"), MUDROOM 7'-9"x10-2"), DEN (15'-9"X13'-5"), LIVING ROOM (22'-8"x117"), FOYER (5'-0"x16-0"), BATHROOM 1 8'-3"x5'-8"), BEDROOM 1 (10'-0"x10'-3"), BEDROOM 2 (14'-10"x12'-3"), BEDROOM 3 (18'-8"x25'-4"), B.A.._THROOM.._2 w( ' .3.._..�.x._7..g,"_) ..BE..D........R.....00M 4 (13 .6"_x,.1...V.._.-_8"), BATHROOM ....3..(.9.....'-0 x .�.-.g.�� BEDROOM....M...W 5 ------ (14'-1"x1 T-3"), W.I.C. 2 (9'-9"x1 V-8"), POWDER ROOM (4'-6"x 3;-0") Page 3 of 5 Town Hall Annex P Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box I t79 Southold,NY 11971-0959 110 fOl BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: ...... Telephone Number(s): Daytime Evening Emergency Email Address: ._w .....,_ w SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 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: UNIT 1 Requested Maximum number of persons allowed to occupy Dwelling Unit . 10 Number of rooms in Rental Dwelling Unit: 13 Use and Dimensions of each room in Rental Dwelling Unit: KITCHEN (16'-11"x11'1"), MUDROOM 7'-9"x10-2"), DEN (15'-9"X13'-5"), LIVING ROOM (22'-8"x117"), FOYER(5'-0"x16-0"), BATHROOM 1 8'-3"x5'-8"), BEDROOM 1 (10'-0"x10'-3"), BEDROOM 2 (14'-10"x12'4), BEDROOM 3 (18'-8"x25'-4"), W.I.0 1 (T-3"xT-9"), BEDROOM 4 (13'-6"x11'-8"), MECHANICAL(9'-0"x7'-9"), BEDROOM 5 (14'-1"x1 T-3"), W.I.C. 2(9'-9"x11'-8"). Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road `� Fax(631)765-9502 P.O.Box 1 179 " ` Southold,NY 1 1971-0959m , n 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. ❑ 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 DINA ANDERSON 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 i Telephone(631)765-1802 Town Hall Annex 54375 Main Road t„ Fax(631)765-9502 P.O.Box 1179Zi r�, SOUdKM,N 11971-095J BC BUILDING DEPARTMENT TOWN OF SOUMOLD 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 2L day of Get' 0 20Z3 Official Notary Public Signature and Original Notary Stamp oaniel Elffson Cie rmr goner pf 0eeycf�y+�,City Of News York 97 C:.ert,Red 3n New York County commission Expires March 1 st 2024 The UPS 't rr;� )tl t?t"tasarAU 2 1 .406,001 tt Page 5 of 5 Town Hall Annex ,°w Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 197 1-0959 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 F'ro essional seal re aired or Architect or `n iraeer licensed Nome Ins actor mint coDv of valid current certl cation Rental PropertySCTM Number: 1000-95.-1-7.1 Rental Property Address. 7045 Oregon Road, Cutcho ue, NY 11935 Owner/Name: Dina Anderson 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.) Bedroom #1 - 120 SF Bedroom #2 - 180 SF Bedroom #3 - 440 SF Bedroom #4 - 160 SF, Bedroom #5 - 185 SF Property Description (Include all improvements indicated on survey) 2 1/2 STORY ONE FAMILY DWELLING WITH ACCESSORY STRUCTURES 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. Jonathan Baker, RA Print Name and Title Original Signature Please place professional seal: :r e r TOWN OF SOUTHOLD PROPERTY RECORD CARD VILLAGE DIST, SUB, OWNER STREET LOT E. ACR, REMARKS w- TYPE OF BLD- PROP. CLASS LAND IMP, TOTAL DATE 77" A zt -4 1 L ---- ------------ FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT ----T-TOTAL f i _ t f { <� r toAll ! Y 45.4-7.1 02/2015 Al- _ ! {{ 9 - .a Foundation Bath l �'"-- - �r�bidc i Floors i t x n . �' n �- a - �_�_ • - — - -54 I � I Ext. Walls Interior Finish_ � # E ten - �. e -_ - - r Heat Extension Fire w At liG j Or! �?Rooms 1st FfO s i ova - � - - � i tea#ra�•` r • ! Rooms n o t. iAe t - � t , fllgwr_ , 1 { I e - .9 � . FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hal Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 25536 Date: 02/10/98 THIS CERTIFIES that the building DWELLING Location of Property 7045 OREGON RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 095 Block 0001 Lot 007.001 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 25536 dated FEBRUARY 10 1998 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 WITH ACCESSORY STRUCTURES The certificate is issued to SOPHIE STYPE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Bui ding Spector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD LOCATION: SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) OCCUPANCY: ADMITTED BY: jQkUE STXPE ACCOMPANIED BY: KEY AVAILABLE: BUFF. CO. TAX MAP NO.: SOURCE OF REQUEST: DATE: 02/10/98 DWELLING: TYPE OF CONSTRUCTION: D FRUM STORIES: 2.5 # EXITSo 2 FOUNDATION: 9 CELLAR: 1/2 CRAWL SPACE: 1/2 TOTAL ROOMS: 1ST FLR. : 2ND FLR.: 3RD FLR.: _ BATHROOM S? : 1.0 TOILET ROOMS) : 0.0 UTILITY ROOM(S) : PORCH TYPE: ** DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATERa YES TYPE HEATER: _ jj _ AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: HOTWATER: OTHER: GARAGE, TYPE OF CONST. : _ STORAGE, TYPE CONST.: ........._......_ SWIMMING POOL: GUEST, TYPE CONST.: OTHER: **' VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE rART. S ACCESSORY BUILDINGS IN GOOD SHAPE. 0 C C x m x R REMARKS: t INSPECTED BY: DATE ON INSPECTION: 01/26/98 MICHAEL J. VERITY TIME START: I0:10 AM END: 11:15 AM L c i I a a � rl d J I ,1'arrr-ll i "f 9r a tv m 4 I I 1 4 f w u Y Ih Iw SurVeyev ntw;'.�7•�,r� � , f rs i'f a pp 4a. p m i I '1 3 CYI .�reL.Ye t Ir 1 c. .e � rnc•off'. ,�u �nrm� ,., .. .,...,. ,�Gan.M1�;`•� �O�~ IX I b [ Ipi G p[ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18225 Date JULY 28 1989 THIS CERTIFIES that the building ALTERATIONS Location of Property 7045 OREGON ROAD CUTCHO N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 95 Block 1 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY ill 1989 ursuant to which Building Permit No. 18112-Z dated MAY 11, 1989 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 ALTERATIONS TO EXISTING PORCHES AS APPLIED FOR. The certificate is issued to VAL STYPE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED NIA Building P •Ins ector Rev. 1/81 U { LEGEND �DU CARBON MONOXIDE B SMOKE DETECTOR 7 _ .m..- KITCHEN FR T1ROOM #1 PWDR- � b x - DEN BEDROOM i1 _ tr �` i MUDROOM e 3g — — L CL CL 2r-r 5 D' __ 14-10' f �C0 LIVING ROOM FOYER BEDROOM #2 I �co 1 FIRST FLOOR PLAN DRAWING FIRST FLOOR PLAN SCALE 1/8' = 1'-0" A-001 ;PROJECT 7045 OREGON ROAD i i � x _ = LEGEND - 1 �aa CARBON MDNDMDE&SMOKE DETECTOR KITCHEN � ter_tt• v mmti,.A { BATHROOM 1 L 'r DEN BEDROOM #1 s ca M�OROOM s ca CL. CL CL t b �= LIVING ROOM FOYER BEDROOM #2 Qca I 1 , 1 FIRST FLOOR PLAN 0 O DRAWING FIRST FLOOR PLAN SCALE 1/8' = 1--0' A-001 PROJECT 7045 OREGON ROAD I i LEGEND IIDD CARBON MONOADE&SMOKE DETECTOR MECHANICAL * WALK—IN CLOSU #1 BEDROOM #5 ~ ----- ----- --- -- �co CL 1 I € I BEDROOM3 �? f ttr� WALK—IN CLOSET 2 BEDROOM J4 1 t `x 1 N LOF FLAN ' Air RAWING SECOND FLOOR PLAN SCALE 1/8' = 1'-0' A-002 'PROJECT _ 7045 OREGON ROAD