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Home My WebLink About1000-137.-4-27 TOWN OF SOUTHOLD gam. ZZ Rental Permit 1203 R Owner Annette Campbell Occupied as Single Family Dwelling Located at 1185 Fleetwood Rd Cutchogue 137-4-27 Maximum Permitted Occupancy 4 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. 9/25/2024 Code E ore em—off—iciaff This Notice must be posted by the main entrance at all times Soot Town Hall Annex TetePhone(6�J1)765-1802 Pax(631)765-9Sp2 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959 Nu BUILDING DEPARTMENT TOWN OF SOUTHOLD e 10(o 4 3 RENTAL. PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address'. p y s:A -elvl ell LJ Tax Map Number: 1000 SECTION � _ _ -BLOCK_-LOT__C.�,L - SECTION B. OWNER INFORMATION: ... c Property Owner Name: d Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): Daytime veningcl� Emergency Property Owner Email Address: c Page 1 of 5 tv S 11 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 SO HOLD Section C. Authorized 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 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): Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O. Box 1 179 Southold,NY 1 1971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: L. ' Page 3 of 5 Town Hall Annex " Telephone(631)765-1902 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 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. ❑ I 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I 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 io "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 S Town Hall Annex 54375 Main Road Telephone(631)765-1802 P.O.Box 1179 Fax(631)765-9502 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTIJOLD 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. 1 1 have read and received a copy of Chapter 247 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: d Property Owner's Signature: ,r before a this day o Swo n to � �� l 2t�" CA 0L R HAR13AJAN Official Notary Public Signature and O 1 nal NotaryStam TARY PUBLIC-STATE OF NEW YORK P No,0IHA6261716. Qualified in Oueens County MY Commission Expires05.13-2025 Page 5 of 5 ftc TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 3 _ f1-7 l 7 7 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: DATE INSPECTOR „a Town Hall Annex Town Of Southold 54375 Main Road Cz Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 ISCTM # ....v . ....a... .... .... .. ._ Phone . ,.......� ... .. �. Ownere w._.._._. .. .. �..w...w._ ..... .�,� �M hG Address Hamlet . . .....w. _... . �. Inspector .. . Floor Level Quantities . .............. _ ._....... .. �._..._._ .._..�.._.. ..... . ...... .�........ Su.. .. ...... _ ..�m..:.._... .�.,..m..:. 2 Smoke Detectors (not located i —, .. ” .n bedrooms) �" � Carbon Monoxideµ .� _.. �_. Detectors �..... __.._b _. .Dete_. ._....w .. ..�.. ..... Fire Extinguishers Bedroo� ..... .........�. ........ ........ __ �._. .�,�.,_ ... _.r. ... .:......_„ ....w_ ._.....`.... ............. .... Exits ms _ 2„r» 3 4 5 6 Smoke Detectors Egress I'll- Occupant Count S r,.,. m _.. .....,. "Building Systems Maintained&Operational Condition of Property Heating Building interior �.a..._.. ._ ....... ... Hot water _ Building exterior y[ ._. p.. n, maintained,M._.. ...�......_... ._�_. ......��.� Property clean, maiained &safe_ ._,,..._. ........._.., .,..w.....�. . ......... . .. ........ .Mechanical installed &secure ....W....._...�...,,.�. _.��_......_.._..�...., ....., ,._.L,_.. ._......_.. Handrails&guards installed�. .... .._.�.��___......._...... .....�.. ............_.,d y..._... . ._ ..._... _..._.. .._...... w_ _.. .. .....Ns... ..... on Site ... ..... .......... ....... ....... ... __......... . Pool Safet Pool Surface water alarm. �., _. �_�....._.�......_w..,w. .. .. .... Date of CO issuance Door alarms Pool completely enclosed ence to code requirements... Self closinglatching gates Pool f ........ . . ._... ..... ... . ......... �.. .�.w_ .. ..... .. . .. .... .... ...�. .. _... ... . ......... p .. ,. ....... w. ...,. _. CO's for all items resent Prior Rental .�,..�...�.....�.��.....m._��.a ............ ...m....... ..........., ....,.�.�.�_��.....,�.....�.�.�.�...._..w_�.� Comments: .........w._...�.�.�.�.�.___�.�...�.��.......w.��.�.�_�_�._... �.�.�.�.�..w..�.�.�_.�.�.�.�.�.�.�.�.�.�.�...�..w�_.� ,,......�...�....�.�.�."...._.... ...... _ _..,..... ,. ._... .. .. ..._........ .. _._....._ �......... ... ...... .... __ ...... _m._. ..,. . . . ..... . _ 3 TOWN OF SOUTHOLD PROPERTY RECORD i OWNER STREET VILLAGE D I STJ SUB. LOT FORMER OWNER N ACR. �. h � Y 6 . . ' S f W TYPE OF BUILDING l e :. ' SEAS. FARM COMM. CB. MISC. Mkt. Value I LAND IMP, TOTAL DATE REMARKS 1 � 3 3 e r rd I i 4 AGE BUILDING CONDITION 1 NEW NORMAL BELOW ABOVE FARM Acre Value Per Value ; -f(e Acre �I I Tillable 1 I Tillable 2 1 I Tillable 3 s 3 Woodland I = Swampland FRONTAGE ON WATER�c Brushland FRONTAGE ON ROAD { House Plot DEPT 4,, �BULKNEAD ...► .,� I 1 `DOCK i Total i i TOWN OF SOUTHOLD OFFICE OF BUILDING INSI'L:CT,-)R TOWN IIALL SOUTHOLD. NEW YORK CERTIFICATE OF OCCUPANCY No. Z 1 2144 NONCONFORMING PREMISES December 13, 1983 THIS IS TO CERTIFY that the /X/ Land Building(s) Use(s) located at 1185 Fleetwood Road Cutcho ue Street Hamlet shown on County tax map as District 1000, Section 137 , Block 04 Lot 027 , does!knot�conform to the present Building Zone Code of the Town of Southold for the following reasons: the' Droperty has insufficient area_; the accessory garage is locat,:d in the frontyard. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /X/Land /X/Building(s) / /Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: a private one-family dwel.ling with a detached ar:.ge in the frontyard and shed in the rearyard. Also in the rearyard are steps and a dock. This property is located in the 'A' Residential-Agricultural Zone. The Certificate is issued to MICHAEL A. HAMWAY (owner, -lesseev:-tenar, of the aforesaid building. Suffolk County Department of Health Approval no record UNDERWRITERS CERTIFICATE NO. no record NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. Buildia ..nspector _w_.... ............_ ...w....w.w .-w.... .�......w..wwww........_ m_m..w._. _._... ww. _..w._..............mmmmmM.M........mm..._..................... _ ..._._._.. w_____....m.wwwww.w.w _.._... ............................. Town of Southold 1/14/2024 t-1 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44860 Date: 1/14/2024 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1185 Fleetwood Road, Cutchogue SCTM#: 473889 Sec/Block/Lot: 137.-4-27 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/18/2010 pursuant to which Building Permit No. 35974 dated 10/27/2010 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: Add tioal w rnd alterationsingluding suLitooinjeckextension and covered eq to cacistin sirs lc fh��il clw ltinr� s, .ak— Ior. The certificate is issued to Campbell,Annette of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 35974 10/28/2011 PLUMBERS CERTIFICATION DATED _.... ..._ _ Aut c,ri- d St tiro i - f TTL F1 ILj �- .� SOUTHEAST ELEVAT1� ---. 3 1">`. RDN 1 r E*'g K,tchen t - - L Ext--LivnQ Rm ug r�Oinir Eig Uxh 4_S� E SOUTH L:x T�h istina i Sal 2J, f` 0 s C _ e Livv u r FLOOR PLAN c J IML Y J PROPOSED SUNRQQM FQR — -- " Mr &Mrs. J. CAMPBELL , 1185 FLEETWOOD ROAD CUTCHOGUE NY 11935 FOUN['iA ION.,..'PLAN 223 FI. , . Hai NORTHWEST ELEVATION Sr_Ti"e57 =LPJn-:C=d SCt, -E.ST EL,'ATIGN ,. `a ,. PLUPOWS I � Exig Bed-m - 3 � Llgice Bd � t ) _ -`-- - +�at �, =„y� a� r A -- OPP E FLQDR WARUAL! .__ v - = OCCUPANCY)L AWPUL j tL t ri Lr. _ Extg Cmwispace mr e -g� f ' t d �, � §� .zxs�•f�'ia. - � )� #� b` aura � c[� t.4. tx ®uaau nrv¢ � R= Ted � ,PARTIAL) rs�wc rza Fw. �' ® uw.usr Fw ?• 8 swat unama{wa+a...<e.^=•y as6Mm) PROPOSED ADDITION FOR ® m 4 Mc & Mrs. J. CAMPBELL 1185 FLEETWOOD ROAD CUTCHOGUE NY.,11935 S TM IOCO-137-&-27 294 &q R a_ 0 D G RJR sores sro�s g � \ I do 14" 1.9E MICeOLLA11 WL. � V- 6" post. Extg. Living Rm. Ext . Dinin gy Extg. Dec 0N5.L3)- `4 MAP- S N 1 1 ' y f � g L Proposed Sunroom o 'DEckiJ4,. 0'{big Q W i L7 Extg. Bedroom Extg. Bedroom y� oEas, � b rnE_ Extg. Bed room BAGkT $pd,Qb'}'b ^^^��TUB Extg. Bath D FL2.`t e. kn Foyer Mwooa Ft a p Mstr. Bath s Closet . TILL woe. 4 4)4X 6NDC �2)1"ab'NOA.•, }7�b'"Nbp,. 3'6" 12'di..a.o 3'-1''''I_ �SLUEST0uE. FLOOR PLAN (PARTIAL) Extg Crawlspace :7 I i ( � TF F - J I— J I L IIJ L 1� L�� I n b-114 6 IIq 6'- 6'1�L ' S a Q`._ ..... 5 4 .s FOUNDATION PLAN (PARTIAL) °u`� � �F'Z°P,;> PROPOSED ADDITION FOR Mr. & Mrs. J. CAMPBELL 1185 FLEETWOOD ROAD CUTCHOGUE N.Y. 11935 S.C.TM. 1000-137