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HomeMy WebLinkAbout1000-109.-5-14.22 TOWN OF SOUTHOLD Rental a rm it 1431 Owner: Natalie Todd Occupied as: Single Family Dwelling Located at: 2465 Fairway Dr Cutchogue 109.-5-14.22 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 arangin r the bi-ann al inspection. Issued: 03/12/2026 Expiration 03/11/2028 Codnfo nc 'a This Notice must be posted by the main entrance(ata)11mes p i 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 h s:I/wwwsouth.o_,1dtowpRyjYoy RENTAL PERMIT APPLICATION \ Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: NV Tax Map Number: 1000 SECTION -BLOCK 0 5 -LOT I L - C7 as SECTION B. OWNER INFORMATION: Property Owner Name: (7 Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) q63 -3 h 161 l-id Huse if OR:> XN l-7 Z 5/0 Telephone Number (s): Daytime Z1115-2563 Evening Emergency Property Owner Email Address:_OaAcl P Get e Page 1 of 4 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION INSTRUCTIONS Effective September 27th 2023 Rental Permit Fee: $300 (Application must be renewed every two years) The items listed below are required to be submitted with the completed application. • Floor plans: Floor plans of each rental dwelling unit, please show location of all smoke & carbon monoxide detectors. • Certificates of Occupancy and Pre-Certificates of Occupancy: Certificates of occupancy or Pre-Certificates of Occupancy for each rental dwelling unit. • Certification of Code Compliance (form enclosed): Must be submitted by a license architect, engineer or license home inspector if an inspection by Town of Southold Inspector is declined. • Rental Permit Fee: $300.00 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�� $ IvLelning Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: �Gvt1K ccv)n ks� G Address of Authorized Agent (no P.O. Boxes): 6'n-LA 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): Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Page 2 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: 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: - ► \ \ EL t4w a,` I — Ilo1. ' ►► e� .. '2_ 1 " C � . ►fin 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 Town Hall Annex � � �� Telephone(631)765-1802 54375 Main Road � P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM 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: 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) 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: d4hTlile- la d Property Owner's Signature:, _ 17;V Sworn to before me this day of (".„tvl _ f! , 2p 2 S__ Bonnie Mines 01H1614 ofOfficial Notary Public Signature and Original Notary Stamp Notary Public)9e.:e of New York Qualified In Su oOCount) Page 4of4 sacr y � � � bro V& TOWN OF SO L BUILD N DEPT. 631-765-1802 t©Q K INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] AL [ ]I FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTAFPETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL) CODE VIOLATION [ ] PRE C/O NTAL REMARKS: . A?L10,Z) ouqLew, 6;f ) _ww �, �Pv\c-e w*www ` W04, o e 7I►oli� TOWN OF SOUTHOLD CORD CARD 1a00 - y • ,s STREETS VILLAGE RACR. SUB. LOT EO 1ER.OWE 1 - E S W TYPE OF BUILDING e RES � � : SEAS. VL. FARM COMM. CB. MILS. Mkt. Value LAND IMP. TOTAL DATE REMARKS el L 1 3 „- 6_ z,,� d iz I i Tillable I FRONTAGE ON WATER Woodland I FRONTAGE ON ROAD Meadowland i DEPTH R ✓ J 7 House Plot BULKHEAD Total DLOR TRIM a� ir £ 9 3 f a I z I �r - a a a me 4 N►la e a g 109:5-14.22 09 2016 i Akre . M. Bft 77 r;xtt'rtc - � - Z �x1ion fz P _ �ensron -r a � d�. Foundation 3 f.� Both I Dinette too ►[� p Basement f 1 Floors �� 1 K. orc y3cf' t / _ t Ext. Walls Interior Finish s ,� i_R. - 1 o A 2- = Z o � Sc� � �� � C� y _� I S�t �QQ Fire Place Heat DR Pam, f'�o( _ x_ -Ica 0 '�_ Garage ' j ..- ` Type Roof Rcoms i st Floor R. r�4P �y kzg y&�S -, Recreation Room Rooms 2nd Floor FIN. F r ter`_t /8 x lti' 2. . g g- i Dormer Driveway = it761 ; Total , / _ 4410 MVA 1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No: 9-27312 Date: 09/22/00 THIS CzRTIFIES that the building ACCESSORY Location of Property: 2465 FAIRWAY DR CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 109 Block 5 Lot 14.22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed is this office dated JULY 19 1999 pursuant to which Building Permit no. 26014-Z dated OCTOBER 5 1999 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to DONALD J & NATALIE J WIL SKI (OWNER) of the aforesaid building. SUrFMA COUNTY Dom'' S8T OF HEALTH APPRAYVAL N/A XLXC` CAL CM=lrxchTz NO. PENDING 09/22/00 PLUMBERS CERTIFICATIOK DATED � N/A ylhori ed Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27311 Date: 09/22/00 THIS CERTIFIES that the building _ NEW DWELLING Location of Property: 2465 FAIRWAY DR CUTCEOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 109 Bloch 5 Lot 14.22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 19, 1999 pursuant to which Building Permit Ito. 26014-Z dated OCTOBER 50, 1999 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 WITH SCREENED IN PORCH COVERED FRONT ENTRY SECOND FLOOR DECK AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to DONALD J & NATALIE J WILCENSKI (OWNER) of the aforesaid building. SUMMA COUNTY HEPAV 't" OF ENALTH ]APPROVAL R10-99-0106 09/18/00 XIM: CAL CERTIFICATE NO. N 529255 07/07/00 PLDMMERS CAWMFICATION DATED 04/18/00 TALBOT PLUMBING & HEATING tho.ized S g'nature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32266 Date: 22LL9 0'? THIS CERTIFIES that the building GARAGE ADDITION ALTER. Location of Property: 2465 FAIRWAY DR CUTCH G E (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 109 Block 5 Lot 14.22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 21 2006 pursuant to which Building Permit No. 32312-Z dated AUGUST 24 2006 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 GARAGE ADDITION & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DONALD J & NATALIE T. WILCEN;SI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 3008228 12 0 06 PLUMUMS CERTIFICATION DATED N/A uthorized Signature Rev. 1/81 20' 11' 8' x }` LANDLORD STORAGE 14' 1$' s� TENET 13' STORAGE 30' 16' SHARED STORAGE UTILITIES/ ELECTRICAL PANEL 28' 13' - r 1 C[g P.f is crA.D w1cc oA2 • PGEN GE ort2}4AHd�R?eL S �i { _ - ` € -,('"' CRM1•i! p� ~�1 E .-...€.''# N�#'S#ads �3 < J 5 Y e c a [ F r t _ i 066•a"ce;EvtAf gf cow ��P'rCr+Er� CEFLt+1G � 33 IV— IN a E '92 Ax `s z \AALCE4 K1 iLesIr�€�cE r+Mb,�;asi+a' P joje FIT' Of-18 - - Qo8E2T.TOWa+SE�FD ,}e.JFS rV(LNtTE� c�� K , o- f , t� E Pnv�1r f i i t - Tr- s+ T r' r s v € m s Oa- 3 ' "� r.E al rq+.w: nGr rE •"_-<_®� 3— _ ��._ - i �' �.� > ..� � � €t �-`; £ __ ',IfLC.El.SK I �r?a4eF- 72. F+awp.r.F cMs Cotc+oau.Ef wt y � i � ¢y I.NO wJNPONS r4s MAP€E BY .�rtDfiBA4'.rl -F.'OdEBf �ir.�.tsr;.Jo',JOrIES AIFG f+f"fC�t �' ExTsrtJv2 Goss pa> - > Tl�Il �uS6 �m-�Po2r'-15 �To ACL l�M�ti O+•7R4 ��G`/ Cewtik2YafJC�.J CaiJS7, [OPEf. Jude- -Fj9 SF�ECT 1 or-, tmal il &uj -r 0 cy ha wt o 1 I � Fi it w € I I MUD ROOM x - NGW Otk k HOOF f 1 -oft `- NYMl..lII..IW a1.4-IltN1 L4:u!•YNiII/Sn> t€ - GARAGE PANTRf/STORAGE -4 �L 4i -- IWi-CLn11Y.•IH fLLV. �€ � - _ M'?A l lI l.W.€l'Yn.I I\I.tl•AIH<t.�Yl I 3a--}it�-.��R C i n r 1?. FLOC ,' ' ._SURVEY 0F LOT ...#.._22..�....._. ....... ....._.. .._........�_._._......-- . . � ...-.. . . ... ._..._.._� MAP OF "FAJRWAY FARMS" FILED JAN 15, la-74 A5 FILE #6066 OCCUPANCY OR 51TUATE: GUTGHOCGUE TOWN OF 5OUTHOLD USE IS UNLAWFUL SUFFOLK COUNTY, NY SURVEYED 04-25-gq WITHOUT CERTIFICATE AMENDED 05-20-11q N AMENDED Oq- -1-ci OF OCCUPANCY � '.... AMENDED Og-2q-qq �.l'LJt�i '`t4d FOUNDATION LOG.10-25-V W �„ "», E SUFFOLK COUNTY TAX# 1000-IOq -5- 14.22 SUFFOLK COUNTY DEPT,OF HEALTH 5ERVIGES RIO-qq-OIOb GERTIFIED TO: DONALD WILCENSKI "IMMEDIATELY" NATALIE WILCEN51<I k ENCLOSE POOL TO CODE 15LAND EAST SERVICING CORP. UPON COMPLETION NORNEST MORTGAGE]NC. BEFORE"WATER" FIR5T AMERIGAN TITLE INSURANCE COMPANY UNDERWRITERS CERTIFICATE REQUIRED Lot 021 I_nl.kE2 [).el llr�n Cdrtw I linr� P Lot rt24 CJwF'f(IYIC� S89°12'10"E 200.00' f 1 Loc "13 '✓accent w wr Y c F Lot r.23 o w o S Vocant uz A,A Lot n., C;>weulin a '^ N89°12'10"W 175.00' Green Way d ._..... ...... �...._ Lot#1-7 Lot 0185 L➢weea Nn� P7 elllnq f NOTES „'`"'' ... ■ MONUMENT FOUND • SPIKE FOUND Cp HE06E ''9"4a' N19 u."7. AREA = 43,566 5F OR 1,01 AGRE5 JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.LIC.NO.5020% GRAPHIC. SCALE: P= 50' RIVER1 .N.Y.11901 369-8298 Fax 369-8287 REF.D:U0BS\99-166(