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Home My WebLink About1000-99.-3-11.18 TUAYNN OF SOUTHOLD 411 Rental Permit } Permit No. 0036 Owner Robert & Michele Glover Occupied as Single Family Dwelling Located at 1300 Bailie Bch. Rd. Mattituck 99-3-11.18 Address Village S/13/1- Maximum /B/LMaximum 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. 4/16/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times WIf Town Hall Amex Telephone(631)765-1802 631 54375 Main Road Fax,�� ;' ( )765-9502 P.O.Boa 1179 ��®A� ,, Souftdd,NY 119714)959 , rtl s. BUR DING DEPARTMENT TO 'OF SOUMOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every ar ) Section A. Property Information: T. Rental Propertyd � Address: � _:- Tax Tax Map Number: 1000 SECTION FLOCK q-7 3 9-�rl q9a -3 --l L 1 � SECTION B. OWNER INFORMATION: y� Property Owner Name:_.... Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) G, Telephone Number(s): _ r ' Property Owner Email Address: Cie, ii Page 1 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: ��®-.w �-�---�-�� f- 4 Requested Maximum number of persons allowe occupybwelling Uni Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 247(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 NYS licensed architect,a NYS licensed professionalengineer 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 ations 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. Page 3 of 4 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect, a licensed professional-engineer,or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building code Certification. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) (-7 certify under penalty of perjury,the following: 1. I 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. I-A Property Owner's Name: ....... .. ........ .. ................ Property Owner's Signature . _ .......... . Sworn to before me this ay of 20 OR MOHAMMAD S YUSUF ........ Notary Public-State of New York NO.OIYU6383815 Official Notary Public Sign%atur nd Original Notary Stamp Quillified!in Nassau County My Commission Expires Nov 26,2022 =1 Page 4 of 4 3\;—>?.�Nc="\ CONSENT TO INSPECTION the undersigned, do(es)hereby state: .... .................. ... ...... .................. .. ...... Owner(s)Name(s) That the ,j undersiNned is)(are)flie owner('s) of the premises in the Town of �2 & ��&---- Southold,located at 1-134� ............ which is shown and designated on the Suffolk County Tax Map as District 1000, Section Block_,Lot .............. `1'701�5 e71 0- 3 -11, is That the undersigned(has)(have)filed,or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: o f ............ ........i.. .........--------- . That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property,including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application,including inspections to determine that said premises comply with all of the laws, ordinances,rules and regulations of the Town of Southold. The undersigned,in consenting to such inspections,do(es)so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws,ordinances,rules or regulations of the Town of Southold. Dated: ............. 4igna 1.tu.rp) (Print Name) (Signature) . ..................... (Print Name) TOWN OF SOUTHOLD BUILDING DEPT. FOUNDATION7654802 INSPECTION D ] INSULATION F I L CHIMNEY 'FIRSAFE„I„ I P 'l,ION FIREPLACE & l,,,,m I"RI L (FI I CODE IriON ] CAUI,,,,KING w ... 130-0 i� "uc f7 , ,r rml i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z667.4 . . . . . . Date . . . . . . . . . . . . . .$ Pt . . . . . .12., 19.7.x. THIS CERTIFIES that the building located at 44P! .Beach, Hoag, . . . . , . Street Map No. . . . . . . . Block No. . . . . . Lot No. . . . . . . . . . . . :ttiito . .A! r. . . . . . re . . rements for one f1 11 conforms s substantially to th buief'ore April, 23 57 certificate of occupancy dated . . . . . . . . . . . . . . . . . . . . . .. 19. . . . pursuant to which Nq;66, dated Sept. . 2 ., 19. 75, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this ce-r,1 " a te-is .,,,,. issued is Private one family dwellin.( approved by Bd A�C eel e . The certificate is issued to . ttituck Investors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval p . . . .e? � UNDERWRITERS CERTIFICATE No. J? , -. P40#9. . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . .1.500 . .4 500. . . . . . . Street . .Bailie Beach Rt „ y . . . . . . . . . . . . . . . . . . . „..". , Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219576 Date DECEMBER 111 1990 THIS CERTIFIES that the building ADDITION & FOUNDATION Location of 'Proper'ty 1300 BAILIE BEACH ROAD MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 99 Block 03 Lot 11.18 Subdivision Filed Map No, Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEB. 151 1990 pursuant to which Building Permit No. 188172 dated FEB. 261 1990 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 ADDITION AND FOUNDATION TO EXISTING ONE FAMILY DWELLING The certificate is issued to MICHAEL CARBONE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NLA UNDERWRITERS CERTIFICATE NO. N146191 AUGUST 2.8 1990 PLUMBERS CERTIFICATION DATED WILLIAM KNOERNSCHILD 10 14 90 / Building Inspector 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 220120 Date July 30, 1991 THIS CERTIFIES that the building ;ADDITION Location of Property. 1300 BAILIE BEACH RD. MATTITUCK House No. Street ]�' amlet County Tax Map No. 1000 Section 99-Block 03 Lot 11.13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated.„ JULY 29 1991r�'.a to which Building Permit No. 20051Z dated JULY 29 1991 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 EXISTING DECK ADDITION TO ONE FAMILY DWELLING. The certificate is issued to MmMEL CARBONE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A YA T . � ng Inspector 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-27039 Date: 04/13/00 THIS CERTIFIES that the building ADDITION Location of Property: 1300 BAILIE BEACH RD MATTITUCK (HOUSE (STREET) (HAMLET) County Tax Map No. Section 73889 on 99 Block 3 Lot 11.18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 9, 2000 pursuant to which Building Permit No. 26378-Z dated MARCH 9r 2000 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL CARBONE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H-067310 03/09/00 PLUMBERS CERTIFICATION DATED 05/24/94 A.R.M. PLUMBING & HEAT. Vtor'/,?d ignature Rev. 1/81 no „ 0 d cep a. N s a .� -z AW ' � &r la ,r O'fir aw I"4 G'� r �^tl I' ,✓�io7 �' M µ, h, ..1•.. _ fir. 00 19, 14 If 311 .4 } � N Yy`.m7�f7 �iYnYN o fl r tl cry s Ir! y.a1,y,,,r��,'{;�""�dvnaen�,'N °' ,• � "' 1 +� a+"" 5�71:,,„ "s, ” Y rr) j 13 . M ,rryn'Rwr'zy� r.a+rdu,`,r+n lx q4�•'tmui...k^ysrn^uv°hro•��n>,"ern,r�.-�.�:w:,�.4..�_. _ ]CO1-j 9111 1 Ai.A I I li, i 11H-,1 4•i , INA 1 0 RP r `ic dKI f 3 TOWN OF SOUT OLS► PROPERTY RECORD CARD OWNER ,STREET I VILLAGE DIST_I SUB_ LOT zv I i = FORMER OWNER N TE �r s ". ACR. SW TYPE OF BUILDING r- z a RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value r LAND IMP. TOTAL DATE REMARKS s _ ` /ps Aff __P t _ �. 4_ Ci COP 13 ,z _ E s� - FRONTAGE ON WATER Tillable , . it Woodland FRONTAGE ON ROAD Meadowbnd DEPTH - House Plot BULKHEAD E Total r 4 COLOR _ TRIM-4 O W/1 - 715 l j - � l i Bldg. ;-�(� = } , Extension _ on 1 _ q - Ede nsion I - F on Both Dinette --P_'= h SasementFloon1 Sb K. Porchg ' � !Ext. alls g l for Finish Q ,� LR. 3 7s 7 Fire Place `s t y�, DR. Breezeway € 2 -- y rya Garage Type Roof R 1st Floor g ;BR. _ � Recreation 2nd Floor y FIN. B - 70 _ r Driveway $ /_ Total