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Home My WebLink About1000-109.-2-9 of so TOWN OF SOUTHOL Rental Permit 1395 Owner: 25975 Old Homestead LLC Occupied as: Two Family Dwelling - First Floor Located at: 25975 Route 25 Cutchogue 109.-2-9 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. Issued: 11/12/2025 Expiration: 11/12/2027 Jail e E o ern o�iciai This Notice must be posted by the main entran � � TOWN OF S UTHOLD Rental Permit 1396 Owner: 25975 Old Homestead LLC Occupied as: Two Family Dwelling - Second Floor Located at: 25975 Route 25 Cutchogue 109.-2-9 Maximum Permitted Occupancy: 2 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: 11/12/2025 Expiration: 11/12/2027 de fo a ntofficial This Notice must be posted by the main entrance t all times TOWN OF SOUTHOLD—BUILDING DPPARTMEN " . = Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971- 1ng ID all ent "Town of Southold Telephone(631) 765-1802 Fax(631) 765-95021a1t?.5 �/kww _soot oldtt� wl'ilI w RENTAL PERMIT APPLICATION Rental Permit Fee$300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: tq:"6 Tax Map Number: 1000 SECTION 10Cl -BLOCK 2 -LOT SECTION B. OWNER INFORMATION: Property Owner Name: ( 1 O -T (n G1 64(Ards Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number(s): Daytime(031 73'1-b5t7 L Evening b 17 (Emergency t134-Io1o0-8S_Q(C60 Property Owner Email Address: 'C'(' t Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: 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): 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: [" �C Address of Managing Agent(no P.O. Boxes): McAt N 1f 11�35 �N&AT Daoe- 'L'a OLC) t 'T 46 Lic) Mailing Address of Managing Agent: . O „ we Telephone Number(s): Daytime 1031-13+65)1 Evening(b�3 9lEmergency �ee ll) Email Address: l i Ij Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on propert For each Rental Dwelling Unit set forth the Rent " polling 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: AA , 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: LN W 6 ROO rl Iq ye12 13i3 � 1 SXI1 l y 7, 15 yr s�E A-0 DC-- u V 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. i9 I 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 P Fol Town Hall Annex �� Telephone(631)765-1802 54375 Main Road �`� P.O. Box 1179 `1 ta Southold, NY 11971-0959 ; YJ BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Val 1 Requested maximum number of persons allowed to occupy each dwelling unit: 2 Number of Rooms in Rental Dwelling Unit: a ° " Use and Dimension of each room: 1V IN6 C ("7)4 I2 l °rrctiEJZxq K ( CIA i y w Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: 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 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: ki6dw�rd5 Property Owner's Signature:"' " Swor before me this day ofJ 202.� ",A icial Notary Public Signature and Original Notary Stamp DAVID J.JANNUZ7[I Notary Public,State of NewYork No. 02JA5052585 Cualified in Suffolk Cour Commission Expires Dec. 6, I� Page 4 of 4 ° TOWN OF SO T OL.[ =EPT. N 531-765-1802 oOl I NSPECTI N [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY j FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ j FIRE RESISTAN7PE TRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL) CODE VIOLATION [ ] PRE C/O [ NTAL iEMARKS: ........ - �.. �-- -Y -ram (oyW(l§ DATE Wit INSPECTOR „a.,,�a, ,,.�.a.. �.. a.,,...,.,. .m„ „� ,� ... e, ..,, .,wD-.............. � ro � h a� .. I �^L77d ayruwmweu l r � -1.1-1.1-1141w�.'.........................................."I..............MAW o"O ST a.. P T . r r .a, a V� ' T 0. ®ow 1” 6 m r TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET �,� , _ VILLAGE DIET. SUB. LOT ah, J z FORMER OWNER N E =; ini s F s TYPE OF BUILDING Si W R� "�- B fats' 7AA/o7Z RES..' �� SEAS. VL. IFARMCOMM. CB. MISC. Mkt. Value -" LAND IMP. I TOTAL 1 DATE REMARKS - ------------ —..? ._� I C:� .r','�} �. �_. .� /1 I � f — I , s AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acres Tillable 1 Tillable 2 Tillable 3 j Woodland Swampland FRONTAGE ON WATER - - Brushland FRONTAGE ON ROAD r House Plot DEPTH ,. BULKHEAD Total 'DOCK z In I a I COLOR i : I - s � I TRIM ! F 1 i 7 s i M. Bldg< vt, s- ,; Foundation %� , c Both Dinette[ Extension ;Basement Floors �. K. F�! r ., l Extension � _ � � - sExt. Walls nterior Finih .a LR. 1 Extension Fire Place Heat DR. i ;Type Roof Rooms 1st Floor BR. Porch 7 A , Recreation RoorrRooms 2nd Floo�, FIN, B,1 Porch Dormer r i � Breezeway Driveway - Garage Patio 0. B. s Total of sou r,��a Town of Southold P.O. Box 1179 53095 Main Rd � aars � Southold, New York 11971 PR:E-CERTIFICATE OF OCCUPANCY No: 46664 Date: 11/12/2025 THIS CERTIFIES that the building PRE-CO Location of Property: 2,5975 ,Route 25 Cutchoguq� yr mt,l} 5 Sec/Block/Lot: 109.-2-9 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 06/30/2025 Pursuant to which Building Permit No. 52446 and dated: 1 1/12/2025 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: Two family dwelling with partial unfinished basement, enclosed front porch, accessory wood frame garage in disrepair and accessory wood frame shed. Violation: None The certificate is issued to: 25975 Old Homestead LLC Of the aforesaid building. Please see attached Housing Inspection Report. At or zed Sig. attire Housing Inspection Report Propear ' Info SCTM # 109. 2 9 w_.._.._.._......,.,.................. _.___............._.w�__w___........__... ,..Property Class: 210 ONE FAMILY RESIDENCE Address: _.......___..75 Route _.____. M._..._.................._ _.�_Ha..m.�.etw.. ....--o ;ue ........... ...._w_ ..._.........__259 _.. ..,_ _. Owners: 25975 Old Homestead LLC Condition of Property: Structure Type of Construction: Wood frame Number of Stories: 2 .?.......,.,_.......................... ....... .......... �ww__...__ .._._._._,..�__........._.,,_. _...............,..� _..._..w.__ww_....,..w __w... Foundation Construction _.........e�ww ..w W: wwCement block and brick Number of Exits: 4 .._�..._.�..w�.�...www_w....._._, ___.___ .M�w�www�..w..._._... w. �....,�__�w�w_ r...................��.._.�...........�...�.__.,�w�._.__. �.....__ .._.._.._..�,...._._.. _ ._._awl Space; Finished Basement;._.ww..........._ _w__ _M.M. w. Cellar: Cr _ __ _.._..m.. .w ......... Garage: ...................... .H. w w Breezeway: ...__.._......._.www._._.,, ww . Deck Type:..............._ .m,,,__ _ .._........... _.,.ww.. ..ww....w_..... Porch Type: Front enclosed Patio Type: Mudroom: Building Systems Type of Heater:.... .......................... .._�............... .....__�w ......w................... _.w...FuelwType: Gas .._ _ .. _� ..................... Hot Water: Baseboard Electric Panel: ww.. wwww •w_._m......__. . _...___.._ _. w� . wµ................_.._.__.._.. _................_w�_. Air Conditioning: Fireplace: Dwelling mpone t Rooms Floor Levels Sub 1 2 3 Additional Items Kitchen1 1 _. ..w..............._.._................. .... Living Rooms 1 1 _-_.wwwwww_..__..... Dining Room .Bedrooms................ 2 1 Bathrooms M mm Toilet Rooms —..,_.........____,.w_ Utility Rooms Entr Areas 1 ..ww.... ..w�.�. _........ ........... .. �....._.., .�.�.�_.�.�'.,.._....__.. ww.._..__.w�.... � �..._.�ww _vw .�...._.. _._........_..,.wwww ww..�.,,.�.._ ,.,...._..w.w._w __._......._m..w_.._.., Other Accessory Structures: Wood frame in Garage:w.� 1 ......m. ..rr , _w___. Construction: disrepair.....__. w _............. _._._w. Foundation: _w_._._...._.......,,.M. .,...........�_.......... Barn.............. .._._.....�...............�__�w.w._.� Construction:........_......,__...................., _...._......_m_.......—._..........� ...._w_w _.. Foundation.._........... ._................. _.�..____..........._„__�w _.._.. .Mw_ Construction: ........W..........�.......me Foundation: m. Wood frame .....,....Shed: 1 Constru..__.,,...�............... w_......M...�w.._......ww__ .....w...._...._.... .�.._.._......_._.w..._._..�._._._......._....�,_www�__.�.......__,. .............. Sleep Quarters: Plumbing: ................._m....__....w._....._.........................._...w.. _ ..Kitchen Facilities: w w w w�.....................M,... .........................w .w_.._w._n.. _.. _....... ..... ...._....... wwwww._ Swimming Pool: Comments: Violations: Inspected By: John Jarski _w_.w..__._....,,...w..................._.... Inspection Date: _. .._.........07/11/20,25_..wM_...... ..w�.�.�.�w_...�.�_.......... ._