Loading...
HomeMy WebLinkAbout1000-75.-6-13.2 66 SOWN OF SOUTHOD '= Rental Permit sit 1221 Owner Paul & Laura Tutundgy Occupied as Single Family Dwelling Located at 1435 Wells Road Peconic 75.-6-13.2 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. 11/1/2024 Code 6nforc&ent Official This Notice must be posted by the main entrance at all times tA TOWN OF SOUTHOLD—BUILDING DEPARTMENT �: � Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, N't$ Telephone (631) 765-1802 Fax(631) 765-9502 litt s://www. outholdtowt vo AUG 1 C 2024 BUMIDING DEPT. RENTAL PERMIT APPLICATION TOWN l' F SOUTU01 Rental Permit Fee $300(Application must be renewed every two years; �c 450clw' */or Section A. Property Information: Rental Property Address: l��� � Tax Map Number: 1000 SECTION ._. _-RLOCB SECTION B. OWNER INFORMATION: Property Owner Name: u Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) (V-16 Telephone Number(s): Daytime 9 '�- t O-Aq tvening Emergency Property Owner Email Address: Page 1 of 4 Section C. Authorized Agent Information: Eal Name of Authorized Agent of dwelling unit, if any: ��II 11713 2 Address of Authorized Agent (no P.O. Boxes): 4 A ( WV M Mailing Address of Authorized Agent: "' 1,4 1 11771 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): )63 aim � Mailing Address of Authorized Agent: au V011171 I Telephone Number(s): Daytime (oK �)-tff i 11rening __Emergency! Email Address: -L aa"-ftjA &fta9X�D 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: 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: I\Qo( a, � t I-J .to k I rS AP b 9 i n vG c.e oft .3to - 1s`X (a KitCKDA - 2 x 10,y 3edRDofvJ I SECTION G. be6Cooav, �,, /S.t� x !()� Y k�h- INSPECTION: X�,q 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. Wl am requesting a fire safety inspection to be performed by a Code Enforcement Official om the Town of Southold I 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) Q T` 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 (S) 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: ., Property Owner's Signatur . Sworn to before methiseday of c�Y� _ ,2 ' Official t y ubl ignature an riginal Notary Stamp D.AN rf COMMholim#50141= FMI Page 4 of 4 so TOWN OF SOUThOLD BUILDING DEFT. 631-765-1802 7,6-6- INSPECTION [ ] FOUNDATION 1ST/ 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 [ vf-'RENTAL RE MARKS: C41-P 5 o off' DATE /0•0 INSPECTOR SVFFQ(,fr Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1902 SCTM # �. .. ,, . 1 �"�. .._.. .. _.. ..... iDate Owner Phone Address 'Visible .......,r�S G HamletI Inspector ._......_w. .. __. . ... _. Floor Level Quantities Sub .. ._ W. .. ._ _. � 1 i 2 ' 3 Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers K Exits �. Bedrooms 1 2 3 4 5 6 Smoke Egress Detectors mokee De ... �. _. _.. __ . . . . . Occupant Count �+ Building Systems Maintained &Operational 'Condition . ,...... . .... . .. ..�. .�a ..,. of Property Heating Building interior �_... w n r,Hot water _. ......._ .. ___...._.. .� _. . . �_.� Building exterior . . ... Electrical _. Property clean, maintained &safe Mechanical_._ ... ��..w. ,.. .,...,. .... �..-� � �� Handrails&guards installed &. . �,..,..n_.�.. ....... _. secure ,Pool Safety Pool �.. __... on Site Surface water alarm ! Date of CO issuance Door alarms Pool completely enclosed Self closing/latching gates.. � .m.,. _.., .u.... .. . _.... ... �_...... ,..,_.._...Pool fence to code requirements....� ,�.......�� ......�._..M .._...�.. .,..�._..�_a....,. CO s for all items,.,...... ... ... . .� . ��.� ... .... . ....�..._.__.�w.___..�._„„�.. �....,M..... .�...._...._. _ ...._..._� . .�� present Prior Rental 'Comments: C 1435 Wells Rd FLOORS:2 ♦ Ground Floor ET Entertainment Area 25x12 Garage/ , ct? "lea Workshop 14x25 CI CI CI Den Entry 17.6 x 13.6 12 x 13.6 CI ♦ 2nd Floor 0 Bedroom 1 C Kitchen 12.2x10.4 ssat 12x10.4 Pantry �. CI • � ;icy p c� y�aa.r� Cak KILkliw Great Rm e e-IVL 16.8 x 25.4 eck CI � 1 D2 x 29 Bedroom 2 open to Bath 15.6 x 10.4 Below 5x7,6 Scale in feet.All measurements are approximate&not guaranteed to be exact or to scale.Design by ShanPlao 0' 4' 8` 12' 16' 1:98 Page 1/1 _ Q// t y TOWN. ,OF SOUTH OLD PROPERTY RECORD OWNER VILLAGE DIST, ` STREET t= � SUB. LOT _ - �� _- FORMI:R WNER, N - - - t E AIR _ a s W TYPE OF BUILD ING RESg SEAS, VL. .. FARM COMM. CB. MICS. Mkt. Value LAND IMP. 1 TOTAL - - DATE _ REMARKS =� V t y ,. - t he AZ Yf Z - - 1 _ .. 41 lir 01 _ Y -5 _ a z„ E a� _ €€ y c � r r 14 _ - _ - 77 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD ,ate , -- � . Meadowland DE-TH ' House Plot BULKHEAD Total 1 t E F - , I Hi i M. Bldg ;—SS A Foundation Bath Extension , 6 € => Basement Floors Ltb #, Extension Ext. Walls Interior Finish Extension I Fire Place ,f Heat a s , Parch Attic — � Porch Rooms lst Floor arezz4wa y F ti Patio ; Rooms 2nd Floor — Garage 1 Driveway F l 0. B. I s I FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. .Z 1 1 84.4 . . . , , . . Date . . . . . .August. .1.6 . . . . . . . . . . . . . . 1983. THIS CERTIFIES that the building new dwel ling Location of Property 1435 Wells Road . . Y , . . . . . . . Peconic House No. Street Ham%t County Tax Map No. 1000 Section . . 9.7.5 . , . . , .Block .Q 6. . . . . . , . , . . .Lot . . . 01 3 Subdivision . . , . X. . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . X. . . . .Lot No. . X . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated Sep t ember 2 4 , 198 2.pursuant to which Building Permit No. . , 12013 Z . dated . . . , , ,November 15. . . . 82 . . , . . . . . 19 . . . , 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 private one-family dwelling ** . . . . . . . The certificate is issued to . . . CHARLES & SYLVIA DeLUCA . . . . . . . (owner,dessee-cirrteriamj of the aforesaid building. Suffolk County Department of Health Approval ,12-S O-6 8 , 7/1 1 /8 3 , R o b t . A . Villa,W F.E. UNDERWRITERS CERTIFICATE NO. . . . , . , . ,N 605908 . **THIS CO Amended March 7, 1997 to include deck addit"on which was part of original Building Permit #12013-Z dated 11/15/1982. , Building Inspector 12/ 11/89 ADDRESS CORRRECTED Rev.1/81 So * ' TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 �5--6 _13 , 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 [04ENTAL it REMARKS: SM 6 oL t ki vt C d� L4-vKA i et los o - u wl rL DATE _ �•� INSPECTOR en TOWN OF SOU D S ILDING DEPT. 6 765-1802 75- �o-/3 . D INS ION [ ] 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: © k-CG e DATE INSPECTOR