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Home My WebLink About1000-103.-8-3 f4f so TOWN OF SOU OLD Rental Permit 1295 Owner: Brian Quinn , Ingrid Tepshi Occupied as: Single Family Dwelling Located at: 2015 Stillwater Ave Cutchogue 103.-8-3 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. Issued: 04 28 2025 Code kn#or nt OfficialExpiration: 04/28/2027 This Notice must be posted by the main entrance at all times 1 b W"" TOWN OF SOUTHOLD—BUILDING DEPARTMENT y, Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 1� cool Telephone (631) 765-1802 Fax(631) 765-9502 htt as://www. c.t tholdtow . o C RENTAL PERMIT APPLICATION APR 10 202 Rental Permit Fee $300(Application must be renewed every two years)BuildingDepa"Ment Town of lout of Section A. Property Information: Rental Property Address: Cu J-�,JC, Tax Map Number: 1000 SECTION .BLOC -LOT SECTION B. OWNER INFORMATION: Property Owner Name: dV Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number (s): Daytime Evening -- Emergency �n,, n Property Owner Email Address: -tl I - 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, 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: 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. 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) l ) ' 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: Property Owner's Signature: Sworn to before me this1 day of 20_Q j Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No. 01 BU6185050 Qualified in Suffolk County Commission Expires April 14,2,a�r Page 4 of 4 Town Hall Annexes ' Telephone (631)765-1802 '54375 Main Road (631 765-9502 ^� � u�^ Fax ) P. O. Box 1179 Southold, NY 11971-0959 574 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seal required for Architect or Ert ineer Licensed Horne Inspector must provide copy of valid current certification Rental Property SCTM Number: Rental Property Address: � �� c O Owner/Name: ' d Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 — 100 sqft., Bedroom#2—90 sgft., etc.) Property Description (Include all improvements indicated on survey) G d .�, � .,.� t 14 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, the Fire Code of New York State, the Property Maintenance Code of New York State and the Energy Conservation Construction Code of New York State. Print Name and Title Original Signature Please place Professional Seal: TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 .3 1 N S �" E%Ao;`T 10 N [ ] 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 (FI AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: kslor-A� Ca,i21�o,� Town Hall Annex � Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 14, Southold, NY 11971-1179 Tel: 631-765-1802 µ a � SCTM# Date Owner o I VL Phone Address e9014 S 11wakP--' Visible Hamlet Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) / Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress Occupant Count Building Systems Maintained&Operational Condition of Property Heating Building interior Hot water Building exterior Electrical Property clean, maintained&safe Mechanical Handrails&guards installed&secure , Pool Safety Pool on Site Surface water alarm Date of CO issuance Door alarms Pool completely enclosed Self closing/latching gates Pool fence to code requirements CO's for all items present Prior Rental Comments: w.w.,.e g . k 1 a J� cwQy— r a ._ w W z a W O a `` o 0 .. Q LLI -y rG z-42— Y 0 J mm O f- v ,� 2 co N � Li " a U. ( o _ 3 - 0 w w a O o ~ a ~ 4 4 W U z V Q Cn �O � j d �? N lxRl F wwLLJ Q ..,,, \., � pg . 11 r� `2oj LM TNi W W Q E— m 2 w .� LU NMw ¢ -M 109 s (�•• �� Q O �y k� (�s1 , u r wago a � , Z Z LU 0 0 m p t' �r� C J � . a ..� . O> Q LU fi o cl, I w � I y L Vi � Q ,M u uj � LIJ\ a O �° e M c L L� C^' V \ � ^Ad . Q Z LLJ Z Ce � Z \ - IV � � � 4 Z u- a� o a G n _n -o p .�." i I � 0 0 0 0 a V) m` 0 � F° lQj QQ ao: LL 'o, 0 cc o®n..(Y- � 16 a 0 (31 -u c > :3 Lo LL0 LLJ m LL 's t4 o rn( 1`2 of ffII 47, �g 0 0 n V) c 4- 4- x x x LU W w CJ FORM X0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERICS OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .. Z1013......... Date .......... ............AVVI....3................. 19-61 THIS CERTIFIES that the building located at 1/0.. M!V4PK-AYIP........... Street Map No.M..S Hand. Block No. XXX...............Lot I,-To. xx=. ..........M0.0glAIP.,....I.N.Yo . ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...............S.C.Pt.eMbAr.....7..., 1960.. pursuant to which Building Permit No. ......A.19P7 dated . ......... ...........SePt---7............. 19.6A., wa.,, issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...................... ...... This certificate is issued to Karry...F.UMi:L2.0-J*,*-.................. PY4.0;r,,...... (owner, lessee or tenant) of the aforesaid building. A-A Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY 2309 ........ ....... Date ......... 19,... THIS CERTIFIES that the building located at .......... ........... t...... ..... Street Map No. Xxlx.11........... Block No. ... Lot No. .-...A.Ax—cutcholuo 0...Now I�Yoxk- conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .......... 19-Ck. pursuant to which Building Permit NA?!k..z..... dated ....,.......--Septem"ir...2.7......... 19.....Owas issued, and conforms to all of the requirements of the applicable provisions of the low. The occupancy for which this certificate is issued is ........ ................. .......... The certificate is issued to ....................Wxy..ll. A419.................................. ............ ........ (owner, lessee or tenant) of the aforesaid building. N ........... Buildings lecto f Town of Southold Annex 5/23/2011 54375 Main Road Southold,New York 11971 . ...................... ...................................... CERTIFICATE OF OCCUPANCY No: 34963 Date: 5/23/2011 THIS CERTIFIES that the building RESIDENTIAL ADDITION .............. Location of Property: 2015 Stillwater Ave,Cutchogue,NY 11935, ............... .... ... SCTM#: 473889 Sec/Block/Lot: 101-8-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/4/2010 pursuant to which Building Permit No. 35919 dated 10/4/2010 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: additions inludin covered orch with delr to an earisti.n one fanail dwellin as a lied for. The certificate is issued to Crofts,Charles&Crofts,Rose ............ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. N 425250 7/10/97 ...................... PLUMBERS CERTIFICATION DATED 5/9/11 Hardy Plumbing& Heating 0 Signi ure :ram Town of Southold 1/14/2024 P.O.Box 1179 ;. 53095 Main Rd A Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44866 Date: 1/14/2024 THIS CERTIFIES that the building M GROUND POOL Location of Property: 2015 Stillwater Ave.,Cutchogue SCTM#: 473889 Sec/Block/Lot: 103.-8-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore , filed in this office dated 6/14/2022 pursuant to which Building Permit No. 48076 dated 7/15/2022 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 e s ray..%p�x nd swirijinjWMggd q..code a w pq i d t'or The certificate is issued to Quinn,Brian&Tepshi,Ingrid of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48076 4/18/2023 PLUMBERS CERTIFICATION DATED e S �.�. �� ..�.._._._._..._. ................. th re 7-7737 r4 Ali -- J 0 r J i I/ ��a�n��lM�/��(Or"�/,�I J/(��f°"/,1 %JDll�i✓'✓U/til� ;li✓ A r U /✓>/fJ�r � ,�✓Jl�r �✓/�� IJ�/ Ji/✓t/��J 1 �i � UO� Pr'� /�/f��yNr Ji Glf�✓/ir y��J�%////pJ ✓ij,/' (� / / / o� �1(;�Il f�%f✓//��✓✓//J�eai✓`t%��t��<��✓i�d�r/r//��hi��Ji u � tll` � �i/�J)��J✓�J��' �%�il(i��'�� /✓iJ�i /�.11�J'�r�/'i��✓ J J'' u W7" f/G (J1 G i JI Y � �J � / � t ff ��✓' � T u l+�a �l f/ / JJ1 jr NEE I ilb �1 _,�'''��+r✓ ��Il r� � '� � 9;i/„'�✓�r l ///r�; �//i'// �//r/ r/Q'/�� i%, /j4 %��(��A7 - ,;.�r�y(lB"�1dr�0 1` III Ili if 4r� i ;6