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Home My WebLink About1000-83.-1-5 of soTOWN OF SOUTHOLD se Rental Permit 1532 Owner: David Sack , Stephanie Sack Occupied as: Single Family Dwelling Located at: 445 Glen Ct Cutchogue 81-1-5 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 arranging for the bi-annual inspection. Issued: 08/10/2026 ��. Expiration: 08/09/2028 4den ent Officiv This Notice must be posted by the main entrance at all times E�� . �0 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 https://Nvw L s )Lq)tql�l . RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two yea s u Section A. Property Information: Dep�,r „ont Buitdin� Town of Southold Rental Property Address: 445 Glen Court, Cutchogue, NY 11935 p -BLOCK 1 -LOT 5 Tax Ma Number: 1000 SECTION 83 SECTION B. OWNER INFORMATION: Property Owner Name: David and Stephanie Sack Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 2100 Dignans Rd, Cutchogue, NY 2100 Di nans Rd, Cutchogue, NY 11935 11935 Telephone Number (s): Daytime 9173553972 Evening9173553972 Emergency9173553972 Property Owner Email Address: 2100 Di nans Rd, Cutcho ue, NY 11935 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): 2100 Di naps Rd, Cutcho ue NY. 11935 Mailing Address of Authorized Agent: 2100 Di nans Rd, Cutcho ue, NY. 11935 Telephone Number (s): Daytime9173553972 Even i ng9173553972 Emergency9173553972 Email Address: ste haniesack2011 @ mail.com Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): 2100 Di nans Rd, Cutcho ue„ NY. 11935 Mailing Address of Authorized Agent: 2100 Di nans Rd, Cutcho ue„ NY. 11935 Telephone Number (s): Daytime 9173553972 Even i ng9173553972 Emergency9173553972 Email Address: ste haniesack2011 @ mail.com 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): 2100 Di nans Rd Cutcho ue, NY 11935 Mailing Address of Managing Agent: 2100 Dignans Rd, Cutchogue, NY 11935 Telephone Number (s): Daytime_ 173553972 Even ing9173553972 Emergency9173553972 Email Address: ste haniesack2011 @ mail.com Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: kitchen, living/dining room, bedroom 1, bedroom 2, bedroom 3, bedroom 4, Number of Rental Dwelling Units on property: recreation room 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: 445 Glen Ct, Cutcho ue, NY 11935 Requested Maximum number of persons allowed to occupy Dwelling Unit: 14 Number of rooms in Rental Dwelling Unit: seven(7 Use and Dimensions of each room in Rental Dwelling Unit: Kitchen- 150 sq ft, Living/Dining Room-650 sq ft, Bedroom 1 - 180 sq ft, Bedroom 2- 156 sq ft, Bedroom 3-495 sq ft, Bedroom 4-375 sq ft, Recreation Room-546 sq ft. d 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. X 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) I David Sack 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: David Sack ,S'T-C P 44( S Property Owner's Signatur " Sworn to before me this J5 day of 20 Z(o Official Notary Public Signature and Original Notary Stamp NO LEAmw PuyStMW Of NOW b] ►O.OI E0049174 A0 Qualified to SuMolk County Page 4 of 4 z,�Zmm � TOWN OF SOUTHOLD BUILDING DEPT. -1802 N%�� 631-785 F-7, T0N im mr-� E [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION I l ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ 41 ENTAL REMARKS: -9�165 z/om �W7- 4e, _ 0�901 � t h h .. 03 cm I� - 4S � ;dam 0 DATE . _ . � 11IMSPE TOR Town Hall Annex Town of Southold 54375 Main Road ;'4 Rental Inspection Report PO Box 1179 .h Southold, NY 11971-1179 Tel! 631-765-1802 SCTM # Date Owner Sqc./c.S Phone Address GIB Visible Hamlet Inspector Floor Level Quantities A Sub 1 2 3 Smoke Detectors (not located in bedrooms) j Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress 74 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 Pool fence to code requirements CO's for all items present prlp g:e tal #t occupants: Comments: i2*11 ;-s_ E_ 0 _:S{ _ PAD C .; 1. §FOYER AREA. IV s, HALL OFIMOOMwa �_� t ,z _ P BEDROOM s I_- g x 5-- nwmy�$ stj LA sNDR—Y MATH �E ...... ,�-....., r-. ..._ _ 4ALL i 3 x r$ Tgxr ._ - _ PEA TOBE-low OPEN TO BELDIV Aw _ �LL WJIC, x { 77-X M � s Sawke DeUmtor o e Go beuctor RECRa- 7aN RMM \ .ROOM ate#££ . f r . . . . . .. ,ALL \. 1'z«t GE \ 3w»A' » t % &moe Detector l TOWN OF SOUTHOLD PROPERTY RECORD CARD A _ OWNER STREET,,',,- I VILLAGE DIST.1 SUB. LOT _ 4 Y� FORMER OWNER N E ACR. ism., -� S W TYPE OF BUILDING ka RES. _ SEAS. VL. _ =FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 17 F t y. g k _ Lja AGE BUILDING CONDITION i ... „ _ _ l • NEW NORMAL I BELOW ABOVE , 7 � - _ - FARM Acre Value Per Value Acre Tillable 1 " 4 � 3 $ LAX 0(Jx Tillable 2 - Tillable 3 3 Woodland Swampland FRONTAGE ON WATER � � �` L FRONTAGE ON ROAD Brushland =s i DEPTH House Plot ° , I I BULKHEAD i s DOCK -� Total 1 v COLOR I ' � I o� gppd� . E _ _ ' \\ v w � I � f s t 1 81-1-5 02/2016 I E { 3 3 M. Bldg r I undation F Bath Dinette. Extension ; Basement Floors fK. Extension I Ext. Walls Interior Finish LR. _ 1,67 Extension - Fire Place Heat t - J. � I Type Roof _tee I Rooms 1st Floor I BR. Porch Is I Recreation Roo - y Rooms 2nd FI � FIN. B.1 Porch _ - 'D mer Breezeway I I Driveway I Garage ° Patio O. B. Total s �. COLOR 1444 TRIM 7 y,. 30 83.-1-5 03/05/2018 1 st 2nd �dr • 3 �S Foundation OTHER Bath Dinette Extension FULL COMBO Basement LAB L PARTIAL Floors �i I;� Kit. I - .-Extension Finished B. � , ;-�f Interior Finish L.R, f Extensior �- Fire Place �. , Heat D.R. Garage x3'� = T�1' Ext. Walls ' 'L/ ILI BR. F - Porch D r ,,'h Baths ' � / Decs1 Fam. Rm. sQl 4- y fp 1 S Foyer _ s + "'�y� _ 5�� . Laundry s O.B. Library/ i Study Dock Town of Southold 11/2/2018 P.O.Box 1179 " 53095 Main Rd eau ` Southold,New York 11971 CERTIFICATE OF OCCUPANCY PANCY No: 40023 Date: 11/2/2018 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 445 Glen Ct., Cutchogue SCTM#: 473889 Sec/Block/Lot: 83.4-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/12/2018 pursuant to which Building Permit No. 42454 dated 3/12/2018 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 W T:R 1JRS"1 S1m Q,0 D f"1,00 BALCONIES,NIES�,.uR ROOFTOP'I"ERRACE 1R1N'l'E I,ER:1t7R STAIRCASE Tt RC1C11 1�RCN"1"S"1"C1C?P 111SIIED 13A.SEM 1' ( AGE DER ASAP-PI , E'D FOR PrJ Z13A DECIS1Q �#6865 DATED 08-06-2015 The certificate is issued to Sack,David&Stephanie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-15-0061 11-01-2018 ---- ELECTRICAL CERTIFICATE NO, 18-45344 06-27-2018 PLUMBERS CERTIFICATION DATED 09-29-2018 z Plu gibing d S gr at Lire 'Ft Town of Southold 1/10/2018 P.O.Bog 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39441 Date: 1/10/2018 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 445 Glen Ct, Cutchogue SCTM#: 473889 Sec/BIOCk/Lot: 83.4-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/2/2017 pursuant to which Building Permit No. 42030 dated 10/6/2017 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: rpaf mounted solar ej an existing one;familycl�v llin as a lied fear. The certificate is issued to Sack,David&Stephanie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Aut or :ed Signature n: ; t Town of Southold 11/2/2018 P.O.Box 1179 ' 53095 Main Rd Southold,New York 11971 CERTIFICATE CAT F OCCUPANCY No: 40024 Date: 11/2/2018 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 445 Glen Ct., Cutchogue SCTM#: 473889 Sec/Block/Lot: 81-1-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/12/2018 pursuant to which Building Permit No. 42454 dated 3/12/20„18 was is............ ' sued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: XCI'SSORY 1N-GROUND S)Y-JILMMING POOP.,,,FEN T7Q I"O AS AI'PLIL,1 1~OR 1 LI It ZBA PI;CISION #68 5 DATE1)0 - -2015 The certificate is issued to Sack,David&Stephanie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42454 09-20-2018 PLUMBERS CERTIFICATION DATED ... ..... _.-..... 0 0�.�. i ature Town of Southold 11/2/2018 P.O.Box 1179 53095 Main Rd a ` Southold,New York 11971 CERTIFICATE CCU ANCY No: 40025 Date: 11/2/2018 THIS CERTIFIES that the building HOT TUB Location of Property: 445 Glen Ct., Cutchogue SCTM#: 473889 Sec/Block/Lot: 83.-1-5 Subdivision: bled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/12/2018 pursuant to which Building Permit No. 42454 dated 3/12/2018 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 HOT TUB AS APPLIED FOR PER ZDA DEC S10N 8 5 DATED 08 06-201 . The certificate is issued to Sack,David of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42454 09-20-2018 PLUMBERS CERTIFICATION DATED -.. .v.__.................... _: .........................................................- hor Signature