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Home My WebLink About1000-86.-7-7.1 of so lru"OWN OF SOUTHOLD Rental Permit 1307 Owner: High House Woods Inc Occupied as: Single Family Dwelling Located at: 7134 Indian Neck Ln Peconic 86.-7-7.1 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. Issued: 05/07/2025 Expiration: 05/07/2027 Co nforcement 09cial This Notice must be posted by the main entrance at all times F11.1 TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 1tt :�dw . ctoldtrvi � RENTAL PERMIT APPLICATION Rental Permit Fee$300(Application must be renewed every ears) Section A. \k Property Information: Bullding Department Town Of Southold Rental Property Address: 7134 Indian Neck Lane, Peconic, NY 11958 Tax Map Number: 1000 SECTION 473889. -BLOCK -7 -LOT -7.1 - '6e& 'Pi ob SECTION B. OWNER INFORMATION: Property Owner Name: High House Woods, Inc. Wendy Prellwitz, President Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 3 '/z Wendell St, Cambridge, MA 02138 same Telephone Number(s): Daytime 617 448-3605LEvening same Emergency 617 947-7614, daughterJulia Chung Property Owner Email Address: wendyprellwitz@gmail.com Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: one 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: High House Requested Maximum number of persons allowed to occupy Dwelling U is 10 Number of rooms in Rental Dwelling Unit: 12 Use and Dimensions of each room in Rental Dwelling Unit: First Floor: Kitchen 14 x 18 and Pantry 6 x 10 Office/bedroom above 15 x 21 Living/Dining Room 16 x 34 Powder rm 5 x 6 Second Floor: Bathroom 1,7 x7 Bedroom 1,15 x 16 Bedroom 2,14 x 16 Third Floor: Bathroom 2,4 x 7 Bedroom 3,13 x 14 Bedroom 4, 13 x 11 Bedroom 5,9 x 11 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. A am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ lam 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) I, Wendy Prellwitz, 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 Manag r. Property Owner's Name: Wendy Prellwitz Property Owner's Signature: J Sworn to before m day of �/�•�1�� 20 % :. Officia o ary Public Signature and Original Notary Stamp PATRICIA C MOORE NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 M04861668 Qualified in Suffolk Count My Commission Expires June 16, Page 4 of 4 Y 15P �457 F- d 0 lose kw Ld Aet roof DRAWING NO. . Cambridge, __.� ._ .w....._ Date B&tin No. _��. � ea o t y4-4 i—r✓ " .. I 1 .ro tact p� P � DRAWING N . Tale anle ♦... Prcrget No, _...._... Date Bulletin No. c G� rt � f5 r l c DRAWING NO. rifle ---- r 5cl� PC s acl Ntr�.�` i to p Bulletin No. :. ____ ......—__ -- {-ALL IL Project � � � DRAWING NO. rifle . Date _ Rallefla Na. _,__ w__.., .. .__. .. ....._..._.._... ATf(G An Ga,O r vow Ain- • 04 DRAWING NO. ARCHITECTS 1 11 C. Scale /d � • Ptoiect No. �� Town Hall Annex Town of Southold 54375 Main Road .� Rental Inspection Report PO Box 1179 J Southold, NY 11971-1179 �, ► �.,�,` Tel: 631-765-1802 SCTM# — Date -o2 Owner dv Phone Address ;1 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 i Property clean,maintained&safe Mechanical Handrails&guards installed &secure Pool Safety Pool on Site Surface water alarm Date of CO issuance Door alarms Pool completer enclosed Self closing/latching gates I Pool fence to code requirements CO's for all items present Prior Rental Comments: ft. * TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 g� -�-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 [ �NTAL TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER :STREET = VILLAGE DIST. SUB; LOT /I ! ER OWNER a I � � E ACR. iF s _ , _ � =�' - �� i .��-� �� ram 4-0 L� S 1W TYPE OF BUILDING RES. SF1AS: VL. FARM COlvVv1. CB, MICS. Mkt. Value LAND IMP. TOTAL 1 DATE REMARKS e , 14 i n , 3 1 r _ _. le _ z < a 'z —77 3 � x z� 4 a � _ Y Ifl -74 L 1 I Tillable € FRONTAGE ON WATER f Woodland FRONTAGE ON ROAD T _ MeadowkxW DEPTH11 f �� } House Plot i BULKHEAD Total I ` CTM 71D TOWN OF SOUTHOLD PROPS CARD OWNER STREET 9 VILLAGE DIST- SUB. LOT e ACR. REMARKS TYPE OF BLD. PROP. CLASS LAND IMP. TOTAL DATE r s FRONTAGE ON WATER HOUSE/LOT I BULKHEAD TOTAL TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET ; VILLAGE DISTRICT SUB. = LOT e. i t FORMER OWNER - N - �� , E ACREAGE - — - ` S W PE BU ILDING UILDfN TYPE G _ RES. �� SEAS. F _ VL. FARM COMM. IND. CB. MISC. LAND IMP_ ' TOTAL DATE REMARKS s 43 J-61 s I d BUILDING CONDITION _ x Tillable 1 � s Tillable 2 s Tillable, 3 Wcodland --- _ Swampland ^Pe�f3oN/ Brushland House Plot -- � -�— — d -- To'~ioll g 3 , t ti � t s t i r _ !� i 86:7-7.1 main house 2/08 T. f. M. Bld I foundation 9 5 sv Bath - S 3 - ems_ a- - Etension i /r .� 3 C Y ( 5 n - ent_ t , Floors v f, Base m Interior Finish Extension Ext. Walls n', , I Fire Place Heat Extension Porch Attic [ Porch Rooms ]st Floor i - Bree ewu ` Patio Rooms 2nd Floor Garage i � � ;r, ,, _ �� Driveway { YI-A7 1�-F�7 i , x COLOR TRIM : } £ S 3 i t � : 3 3 1 I f I E f { I ` i. M. Bldg ! . t Extension F Extension f f Extension I I ; ----- 'Foundation 1 Both Dinette Porch 113asementFloors K. Porch Ext. Walls ' Interior Finish LR Breezeway jFIre Place Heat DR. Garage ' ;Type Roof Rooms 1st Floor i BR. Patio Recreation Room Rooms 2nd Floor 'FIN. B O. B. !Dormer Driveway Total — ! i