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Home My WebLink About1000-110.-5-8 TOWN OF SOUTH ; N Rental Permit Permit No. 0339 Owner Peter & N eha k f y Occupied as Single F ily Dwelling Located at 3075 West Creeks CU nog�e 110-5-8 Village --S/g/L Maximum Permitted Occupancy 6 Is in compliance with all of the provisions of the co e ffTown 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, 10/2/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times 00 Telephone(631)765-1802 Town Hall Annex 54375 Main Road �) Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 "" "�✓fib W+ BUILDING DEPARTMENT TOWN OF SOU MOLD RENTAL PERMIT APPLICATION F E'd 2 7 2k20 Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property ��k � ,/'��'�� j/�3✓� Tax Map Number: 1000 SECTION Ile, 410 -BLOCK ",,_,, -LOT Feec - SECTION B. OWNER INFORMATION: Property Owner Name: E � " % Property Owner Legal Address: Property Owner Mailing Address: U Telephone Number (s): Daytime °/�/o YV Vening S,'! 5 Emergency Sd/ Property Owner Email Address: 0 a,�V -�-� Pagel of 5 Telephone(631)765-1802 Town Hall Annex 54375 Main Road �� Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 197 1-0959 coin« „ BUILDING DEPARTMENT "TO OF SOUTHOLD Section C. Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes):_ " jvq Mailing Address of Authorized Agent: A) -k--39 6 E. 1kXrl DA , (?Sly Telephone Number (s): 63) - —` Z 4 — / b Email Address: Yl 6tk'' 'qpv-Sf � ► C3v� � �C4) w�a��agn�6 A6c..a ■.nar■ ..va.v... Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes):w_- 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 a �� a Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:_ " Telephone Number (s): Daytime -�01 2/c 16 J Evening jc ` Emergency " J� 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: ._ '.L 'x Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: �z Use and Dimensions of each room in Rental Dwelling Unit: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling uni Number of Rooms in Rental Dwelling Unit: Use a d Dimension of e ich toorn: Y 'Y t 3� � - F, Town Hall Annexx �: Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road P.O.Box 1179 , Southold,NY 11971-0959 y 11 �n ti 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 ❑ I 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) 1 � 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 Page 4 of 5 l d Town Hall Annex J�<< Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 rz P.O.Box 1179 r Southold,NY 11971-0959 'N � ; ` rz , ?aa BUILDING DEPARTMENT TOWN OF SOTHOLD 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: Property Owner's Signature: `111flIJI/t�� Sworn to before me this"" of , 20 Z� _ .• ... PBy ^= 0 t] Offic' ary Public Signa ure and Original Notary Stamp P�3 10; � " '� S 'BSO E BEFORE 0A RD." . S uOR `, ANDtlftt►IkII THIS _ 20 2S� " II "' SMYHAND D0 �- 2l MY "I N EXPIRES ' ,meµ" Page 5 of 5 ��ry`*rya Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 th I ,Ypk Southold,NY 1 197 1-0959 ' BUILDING DEPARTMENT TOWN OF SOUT aCOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit l ro ssional seal re aired dr Irchitect or Fn inset licensed home ins actor must rovide co S1 of valid current certl Ication Rental Property SCTM Number: Rental Property dre s: Owner/Name: 1 Rental Dwelling Unit Identifier: Number& Square footage of each bedroom as depicted in the attached floor plan: (i.e. 0 droom#1 -100 sq., b'edroo #2-90 sq., etc.) 19d's 6 0S >` Property Description 11 cI de all improvements indicated on survey) 07, eolk AzdVJ 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, and the Energy Conservation Construction Code of New York State. Print Name and Title Original Signature Please place professional seal: Building De artment A jlie.ation AUTHORIZATION (Where the Applicant is not the Owner) l t residing at. ........ _...ww......................... _.. _,w , (Print property owner's name) (Mailing Address) do hereby authorize CA 0 ..........._. . ___�...ww_._._...._......... . _.... w w_ ............._..._...._. (Agent) __..._..... �......._..__ .w_...............to apply on my behalf to the Southold Building Department. (Owner's Signature) _...................................._........,.�..... _w_....._... .._......_....._�.wwww.(Date)w......_.........._.._�_....... . ��. wwwww_w_.................... _..........__............M .w_ _�.._._.�.....w.�.�.�.�.�.� _�....._ (Print Owner's Name) TOWN OVSOUT""hIOLD BUILDING DE PT. 765.1802 //O, -- .�-- 6 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAAAFEITYIINSPECTION [ ] FIREPLACE & CHIMNEY [ ] FIRE [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) , ] ELECTRICAL (FINAL) [ ] CODE VIOLATION � 'v [ ] PRE C/O )01 REMARKS: DATE INSPECTOR, D� r /,6 OSr e t-,l6 MARK SCHWARTZ seas Maw soap errnaacue knvro um asauncnma 0 U Z. P4 IG -9 FOUNDATION PLAN-EXISTING FOUNDATION PLAN -PROP05ED - 2- RMA-R. P�. ts�t Plan A-2 x TOWN OF SOUTHO .D PROPERTY R + ORd OWNER STREET .,_ VILLAGE DIST. SUB. LOT _. Ave / a FORMER OWNED N E ACR. S W TYPE F BUILDING RES. VL. FARM 'COMM. CB. MISC. Mkt, Value JV LAND IMP, 3 TOTAL DATE REMARKS r - 7 } e� s t - .1 j AGE i BUILDING CONDITION E - NEW NORMAL 1 BELOW ABOVE FARM Acre Value Per Value t Acre _ T-- Tillable 1 Tillable 2 Tillable 3 - - Woodland Swampland I ` FRONTAGE ON WATER Brushland FRONTAGE ON ROAD /Q - ' DEPTH House Plot i DOCK Total ' i ea - , DLOR a ZIM 3 e F f - A i m _ I I f I I ---14--- 61 I l 10.-5-5 9/11 I Foundation I Bath Dinette M. Bldg r 0v , ?�o - _ - _ 'Floors Extension 7 �' ! basement rs� Extension lExt. Walls Interior Finish ` r= ,:, LR. l o 4-3 I x l 6 = l aQ J re Place - ;DR. xt�ension Fi il! I _ .� ; :Heat Type Roof i Rooms 1 st Floor BR. ecreation Room l Rooms 2nd Floor. FIN. B. R Pfi x 7 v �° `-�i L?ormer i I 336 Driveway a � E � bra � � � �-- -'` ;�-��—--�_i� ,'�� _! A [? Total l / 1 1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRS EXISTING CERTIFICATE OF OCCUPANCY No Z-24392 Date MAY 31, 199f THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 3075 WEST CREEK AVE. CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 110 _Block 5 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-24392 dated MAY 31 1996 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 ONE FAMILY DWELLING * The certificate is issued to HERBERT YOUNG (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Building I pector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD flOUSTNG CODE INSPECTION REPORT LOC ATI ON 3075 WEST CREEK AVE. CUTCHOGUE, N.Y, r street. municipality) SUBDIVISION-... __-MAP NO --- ---- I'm(s)1 NAME OF OWNER (s) HERBERT YOUNG OCCUPANCY SEASONAL (owner—tenant ADMIT,rED BY: HERBERT YOUNG ACCOMPANIED BY: SAME ................. ........ .......... KEY AVAILAOLT MAP NO.,_!qqQ7!uU7,5,74........................................ SOURCE OF REQUEST DEBORAH,DOTY,..,ATTY.., Ih%Y 20199(i ---------- ---------- ---------- ------ . ................... TYPE OF CONSTRUCTION WOOD FRAME f STORIES I I EXITS 3 __ __ ___.......... FOUNDATION CEMENT BLOCK & PIERS CELLAR PART CRAWL SPACE TOTAL ROOMS: I ST FI.R. 5 2ND FI-R. 3RD FT.R,_ BATHROOM (s) ONE TOILET ROOM (a) UTILITY ROOM. PORCII TYPE FRONT SCREENED COVERED DECK, TYPE PATIO CEMENT BLOCK BREEZEWAY FIREPLACE ONE. GARAGE ....... DOMESTIC IJOTWATFR xx TYPE HEATER LILCO AIRCONDITIONING TYPE HEAT NONE WARM AIR ITOTWATER_................ ................... OTHER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE SWIMMING POOL GUEST, TYPE CONST- OTHER.__ VIOLATIONS: CHAPTER 45 N_Y_ STATE UNIFORM FIRE PREVENTION & BUTI.DiNG CODE ................................ ...... LOCATION DESCRIPTION ART. SEC. ........................... .............. .......... REMARKS.-__,-, INSPECTED BY n DATE OF INSPECTION MAY 24 1996 TIN M. BOUFIS TIME. START _9-45 END 10:05 tglt f Town of Southold Annex 8/23/2011 54375 Main Road +� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35168 Date: 8/23/2011 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 3075 WEST CREEK AVE CUTCHOGUE, SCTM#: 473889 Sec/Block/Lot: 110_-5-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/4/2010 pursuant to which Building Permit No. 35300 dated 1/12/2010 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: ltgr tipn nd...addition to an e istin iMe f r ies dwellin %applk Uor:,. The certificate is issued to Eichacker,Peter&Eichacker, Nancy (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 35300 8/5/11 PLUMBERS CERTIFICATION DATED 11/12/10 Walter Marzewski Atxt (� t ed i n e 'r.'a"a. Town of Southold Annex 1/28/2011 k 54375 Main Road s Southold,New York 11971 ......... ... ......... .. .......... -......... ...... _..», _,..... ....,._.... ......... ........,.,.. ........_ .,...._. CERTIFICATE OF OCCUPANCY No: 35305 Date: 11/28/2011 THIS CERTIFIES that the building DECK Location of Property: 3075 WEST CREEK AVE CUTCHOGUE, SCTM#: 473889 See/Block/Lot: 110.-5-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/22/2011 pursuant to which Building Permit No. 36097 dated 1/5/2011 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: d k ad lit ion tra an g�sLs tit, tic Aniiiy )k l-ing—m.. liad foL. The certificate is issued to Eichacker,Peter&Eichacker,Nancy (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 35300 8/5/11 PLUMBERS CERTIFICATION DATED 17 A 1t)r w.k d rtcttu