HomeMy WebLinkAbout1000-110.-3-12 'at so TOWN OF SOUTHOL
Rental Permit
1496
Owner: 610 Eastwood Dr LLC
Occupied as: Single Family Dwelling
Located at: 610 Eastwood Dr Cutchogue 110.-3-12
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: 06/12/2026
Expiration: 06/11/2028 cod Enffl entoi°ici
This Notice must be posted by the main entrance at all times
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 l tt ,%,,//wNv s otlioldtoNvnny >)v
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every two years)
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Section A.
Property Information:
Rental Property Address: �
,
Tax Map Number: 1000 SECTION 1 -BLOCK -LOT -
SECTION B.
OWNER INFORMATION:
r.
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
C%
Telephone Number (s): Daytime c�' Evening Emergency � 'd
Property Owner Email Address: . `. .
ado PL4
Page 1 of 4 1f l 11 q D Ll
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 Identifueir. ,5
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 Unity
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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.
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)
Pa, 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: S(,4. i r, r=s"° µ,k "� ( w �--
`.._
Property Owner's Signature: . m
Sworn to before me this ,day of 20
r
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.01BU6185050
()uallfled in Suffolk County page 4 of 4
Cornrniaal+on Expires April 14, „,
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
E T 10%C
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[ ] 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 (FIN L)
[ ] COTE "VIOLATION [ ] PRE C/O [ RENTAL
REMARKS- ww
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DATE INSPECTOR
Town Hall Annex
Town Of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
Tel: 631-765-1802
SCTM # — — Date
Owner /C, Phone
Address 't S° Visible
Hamlet � Prispector
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 1pool fence to code requirements
Wd
CO s for all items present
Comments:
nGSS_
Town Hall Annex � �� "�; Telephone(631)765-1802
54375 Main Road "- Fax(631)765-9502
P. O. Box 1179
Southold, NY 11971-0959 '
st
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 re Mired for Architect or En ineer Licensed Home Ins ector must
provide copy, of valid current certification
Rental Property SCTM Number:
Rental Property Address:
Owner/Name:
Rental Dwelling Unit Identifier:
Number& Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 —100 sgft., Bedroom #2—90 sgft., etc.)
Property Description (Include all improvements indicated on survey)
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 SOU THOLD PROPERTY a
OwIDI SUB. LOT
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FORMER OWNER P� E � AC
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RES. ? 1 SEAS NL, IFA C-Omm. Cs. MISC. Mkt. Value
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LAND IMP _ TOTAL DATE REMARKS' 2 � � I
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Assn BUILDING CONDITION " IRP
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FARM Acre Volue Der Value
Acres
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Swampland �FRONTAGE ON WATER
Brushlorr' 'FRONTAGE ON ROAD I
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Extension � � - I � � - �� /�
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4- 1 i{
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Porch Recreation Roo = Rooms 2nd Floor FIN. B.
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Breezeway Driveway 3
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Total
]FORM NO. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 97590. . . . . . Date . . X4r. . 26. . . . .. 19?7. .
THIS CERTIFIES that the building located at Eastim.0d.DrIY . . . . . . . . . Street
Map No. .440 .WQQd 2YAk No. .. . . . . . . . . Lot No. 3. . . .CUt*h0P t . .161.0. . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . .. . . . . . lept .1 . . ., 19 ?6. pursuant to which Building Permit No. 8829Z. .
dated . . . . 09mV. . 1 . . . 19.70., was 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 -474te. orM.P894Y. dw9AA49. . . . . . . . . . . . . . . . . . . . . . . . . . . . „ . . . . . .
The certificate is issued to 04%7. . .$ChAQW-R;t . . . . or. . . . . . . . . . . . . . . . . . . . . . .
.. (owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .1'0b. . .2. . .1.97? . .i $6. 1113A . . . . .
UNDERWRITERS CERTIFICATE No. X32441.6. . . . .Fob. . .0.1977. . . . . . . . . . . . . . . . .
HOUSE NUMBER . 00. . . . . . . . Street . .*lt.9.tVQ0A .Prt.Y*. . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34101 Date: 112 aC19
THIS CERTIFIES that the building ADDITIONSfALTERATIONS
Location of Property: 610_ EASTWOOD DR CUTCHOGUE
(HOUSE NO. (STREET) (HAMLET)
County Tax Map No_ 473889 Section 110 Block 3 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 13, 2009 pursuant to which
Building Permit No. 35156-Z dated NOVEMBER 13, 2009
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
....._,.._ _._..AS
is "AS BUILT" ADDITION AND ALTERATION TO AN EXISTING ONE FAMILY DWELLING
APPLIED :FOR.
The certificate is issued to KENNETH &nCAROLANN DUNASKE µ
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAI, N/A
ELECTRICAL CERTIFICATE NO. 2005529 0 / 0 04
PLUMBERS CERTIFICATION DATED N A
r
_............ ..____......
Authorized Signature..........v..__..
Rev. 1/81
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610 EASTWOOD DRIVE
CUTCHOGUE,NY 11935
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SITUATE
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' CUTCHOGUE '
TOWN OF SOUTHDLD gI
j - SUFFOLK COUNTY, NEW YORK i
EI S.C.TAX No. 1000-110-03-12
a {. SCALE 1'=20'
` # OCTOBER 7,2024
AREA=2D.t78 a.tt.
i certrrrren rD:
FIDELITY NATIONAL TITLE COMPANY
% - _` CITIZENS BANK,N.A.ISAOA/ATIMA
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Nathan Taft Corwin 11
Land Surveyor
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610 Eastwood Drive
( \
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Family Room etch_ Rim® | |
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, | Living Room !
\ ( | Study
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a , Foyer
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X = smoke/CO detectors
g 610 Eastwood Drive
Bathroom 1
(En-Suite) Bathroom 2
Bedroom 1 (Primary)
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Bedroom 2 Bedroom 3
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610 Eastwood Drive
- - - - - - - - - - - - - - - - - - - - - - - -
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