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HomeMy WebLinkAbout1000-115.-17-17.21 TOWN OF SOUTHOLC Rental Permit 1245 Owner: Kevin Cande , Jayne Cande Occupied as: Located at: 675 Halls Creek Dr Mattituck 115.-17-17.21 Maximum Permitted Occupancy: 8 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 insp ct o . Issued: 12/20/2024 Expiration: 12/20/2026 Cord of cement Official This Notice must be posted by the main entr Once all times TOWN OF SOUTHOLD—BUILDING DEPARTM ENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 �t ��an {fin 2 Telephone (631) 765-1802 Fax (631) 765-9502 hu s:''-,Tv.southdto J 2024 RENTAL PERMIT APPLICATION T �s Sow Rental Permit Fee $300 (Application must be renewed every two years Section A. Property Information: Rental Property Address: b:15 tt ,.v s UL61r VO V E' M k i9 t r d c k . S Z Tax Map Number: 1000 SECTION S "8 % -BLOCK •1'1 -LOT I —' Ili I-T - 11 ,21 SECTION B. OWNER INFORMATION: Property Owner Name: KFvIN AND :T ,:f N1) E Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 6,15 4-Alt, fnArf tT.1 1!151 JANN6 CkNDE' 63 � 'b5�•tb�9/ KF N NtN@f (P�r�•`E`�� -53-7' - Telephone Number (s): [daytime -A Evening Emergency -� Property Owner Email Address: y candc, 1 co Z� van. ca t��, rh�� l CO vn Page 1 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, C); 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: 615 tih CI-F 6 t- O F,t� n -- 5Z' Requested Maximum number of persons allowed to occupy Dwelling UM Number of rooms in Rental Dwelling Unit:JA R°a m s Use and Dimensions of each room in Rental Dwelling Unit: t. hTL-f1gV 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 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 JAYNE & KEVIN CANDE 675 HALLS CREEK DRIVE MATTITUCK, NY 11952 USE & ROOM DIMENSIONS FIRST FLOOR FOYER- SIDE DOOR ENTRANCE OFFICE - PERSONAL/ BUSINESS - KITCHEN - FOOD PREPARATION / COOKING - DINING ROOM - FAMILY DINING - 1 ' I r 1 LIVING ROOM - FAMILY LIVING - -.7 ?C l y RECREATIONAL ROOM - FAMILY ENTERTAINMENT - BEDROOM l / tt BEDROOM - GUEST BEDROOM - Z X 1 q t BATHROOM - GUEST BEDROOM - X / HALLWAY LEADING TO 2ND FLOOR STAIRCASE - 1 ?C 3 SECOND FLOOR STAIRCASE - LEADS FROM 1ST TO 2ND FLOOR - MASTER BEDROOM - OWNERS' SLEEP AREA- b 1 4 tr MASTER BATHROOM - OWNER'S PERSONAL AREA- I) X �- / HALLWAY BETWEEN 3 BEDROOMS - :2 g X MIDDLE BATHROOM - GUEST BEDROOM - LARGE CLOSET/ CLOTHING AREA- t G l� it THIRD BEDROOM - GUEST BEDROOM - a �ui pa V 29-5� SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I JA`(N@ e-A*a 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 (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: dtt cria�l~ Property Owner's Signature: t� _ Sworn to before me this 5 day of lUa[ 20 Official Notary blic Signature an riginal Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMIAISSION EXPIRES JUNE 30,2. ato page 4 of 4 4^�M1 Cry D 6Va.,- M44,w�_ TOWN OF SOUTHOLD BuiLDING DEPT. 631-765-1802 INSPECTION �r� r�- [ ] 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 VIOLATION [ ] PRE C/O [NofRENTAL REMARKS: bc44i DATE '� INSPECTO - ,. 1 7/ / '7/ ) � .. _MM _........_ _. TOWN OF SOUTHOLD PROPERTY RECORD CARD STREE `Ir VILLAGE DIST. SUB. LOT ti FORMER!IWIER � , , N E R. , 8 W TYPE OF BUILD) R RES. SEAS. VL. FARM COMM, LAND IMP, TOTAL � � ...,. 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