HomeMy WebLinkAbout1000-88.-4-29 §£ `OWN OF SOUTHOLD
Rental Permit
0522
Owner Madhu & Devaraj Southworth
Occupied as Single Family Dwelling
Located at 305 Bay Haven Lane Southold 88.4-29
Maximum Permitted Occupancy b
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.
11/25/2024
e Enf ce en idil
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802 f 6
INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] INAL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS: o 6a�
DATE I INSPECTOR
TOWN OF SOUTHOLD
Rental Permit
0522
Owner Madhu & Devaraj Southworth
Occupied as Single Family Dwelling
Located at 305 Bay Haven Lane Southold 88-4-29
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.
8/19/2021 QN�AO. %R,\
C de En orce ficial
This Notice must be posted by the main entrance at all times
�I? -,.
Town Halt Annex k: ;3 Telephone(631)765-1802
54375 Main Road ,
Fax(631)76.5-9502
P.O.Box 1179 ., `• .
Southold,,NY 11971-'0059
BUILDING DEPARTMENT MAR
TOWN OF SOUTHOILD - 8 2021
RENTAL PERMIT APPLICATION.
Rental Permit Fee $200(Application must be renewed every two years)
Section A.
Property Information:
Property Rental P y Address:
3v� $a
Tax Map Number: 1000 SECTION�y�D _ B:LC1 . . -LOT -
SECTION B.
OWNER INFORMATION:
Qahv OmA �2gol�A � am A
Property Owner Name: 1,AA"l
Property Owner Legal Address: Property Owner Mailing Address:
KW 2
Telephone Number(s): Daytime 9 348•.q veninggx+-kl•34o mergenc� t-j A
Property yOwner Email Address:. t�Vl
�lloldhu .Cr.50AWO g`M.I .
Page l of S
z
Town Hall Annex
Telephone(631)765-180-7
qz °8
54375 Main Road x a Fax(631)765-9502
r
P.O.Box 1179
Southold,NY 11971-0959 ' '~ °
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: 1y
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address: -Z
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: Oawvk
Address of Managing Agent (no P.O. Boxes):
Page 2 of 5
z `
�FS"I ?�y�'o .
3
p
Town Hall Annex : Telephone(631)765-1802
54375 Main Road < a "' Fax(631)765-9502
P.O. Box 1179
Southold,NY 11971-0959
A�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: 3AAQ,
Telephone Number(s): Daytime• 123BEvening-, 540, Emergency. NA
.1
Email Address: �� a-W vl (?) ma%l' t om
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' a dimensions of each
room.
For properties with multiple Rental Dwelling Units use "Rental Permit Application
Addendum."
Rental Dwelling Unit Identifier: un�� '•- I Q
Requested Maximum number of persons allowed to occupy Dwelling Uni
Number of rooms in Rental Dwelling Unit:
Use -nUselg-Rb Dimensions of each room in Rental Dwellin& Unit:
6Cf
�vivt9: �
�QYN ti
�` yXj V O - I Page 3 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road ,,
Fax(631)765-9502
i`'Fw- = •'
Y.O.Box 1179
r'
Southold,NY 11971-0959 '
,a3'
lou V
BUILDING DEPARTMENT
TOWN OF SOUTHOLDD
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
❑ I am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
SECTION H.
DECLARATION: Signatur must otarizedQ!►I MUST f' � ty a tzar of tlsp rig sn►linty unit
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
{ w ;.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
Page 4 of 5
Soft �.
'r °° `sgti
Town Nall Annex ¢ TF, `; Telephone(631)76.5-1802
54375 Main Road = Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
it
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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 as to any change to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name:
Property Owner's Signature:
Sworn to before me this 2?day of �~e�►"� / . 20.;-2— 1
Uylor Kurlowics
Official Public Sig nd Original Notary Stamp Notary Public,5tateof New York
Wo'-01 KU6404083,Suffolk CouMV ,L z.1
06mmission Expires,February10,
Page 5 of 5
a0F so � t
# #
TOWNUF hF SOUTHOLD BUILDING DEPT.
co 765-1802 , nia
INS PECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] INAL a z It/
[
]. FIREPLACE &CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT,PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: b �,Ad lovt 0v\_ W .&-v
- N orwvv�; .
6ew,,ALN�rewTf
I
c (�r/i I
�IIG MOn�. �Kc1 o•✓ 8f
Li 0
od Ar -Sir ?emwt
DATE 'LO INSPECTOR
SKETCHADDENDUM Fife# 0033439985
BorrovuedUent Southvaort,!MadhuiGoe1
Property Address 305 Bay Maven Ln.
City Southold' County Suffolk. State: NY' ZipCode. 11971;
Lender Citizens Bank,NA
I
i
i
43'
i
Family
v sedroo i
�ry� c
V
Bath,
43'
Second Floor
22.5"
Oen
14' 30'
Xitchen
t
Uti
• 11:5'
l my
Bedroorni
Bedroo fltntnq
ti 1 Car Garage
Fath
Bedroom- Living,
Bath' I
6'
14' a
43'
i
�s '
sCfFL UZrtd DVS f�Agra:L Am Catwladws Summ
�1cf.w.Al�':�;� x� f., � .+� :�r_2:�{'7�' 1 �:i :r:a�;•,Mt-'s' i�,• �..h�y., ,��;�`, t }:,�3��7 �ta.�.,yC4.,�.. �,y.,.y.� (r
-.../ S':...K'. �'.•::uL',.C•. .. - •..-:..�:��t•'.f'.�a .d'yfk-1K. ..,�.:P rte:. .U`,�7'.e,�.:teJ!kx�`�:.L1..r�;;eS�iXcC�atti0itiQ4��tC�•'LffL?�b^'.:via%+�,.�.w•2r�?'.:
6araOW 1528 54 rt 14 x 1L5= 361;
1'1x4 m 491
33K 29 = 6V
24x24 a 576
20 x 6, = tan
I
1032 So ft 74 x 43 m I&I
f
` T
-: T01INN, sOUT�IOL� PttOPE�I
„�. . . ,
3
Jr .y 'S-TREE VILLAGE DIST: SUB L'OT Vii'
i.�•t;., � - � .. '>�, a ?zr� -1.'rye�x �,s.- •�pt�� -i° �
'Icu L..�}' L"4";
FR OWNER= r N E ACR
ORME .
�s ,.� j.�',.��`�„:.� .6_ �s+�._tf i±:."Gu�iffi...-• I "t�.+.& �.°>;[� `'e `,..�--fig��r`-' .I•• -
t, -&, '1 $ 1
' W , TYPE OF BUILDING
SEAS. VL., FARNC' COMM,. .,G'B." MISC.;.:' Mkt .Value "
LAND IMP. TOTAL DATE' ` ` REMARKS:
2 55ej
_ ,! z I/,ys �P t,,i-"ir'« '»fir :G,l; f ra '•°,.� !,,: 't�"�G7 d�, _
AE < BUILDLNG .0 `�DFT
G s,l d:>F s.�'1 3 4-sy fa E (
,,,,(�' :""t
A �,,..- �R•�py'�,,-^c, } ,, - r J�f f,.p � .�.,`'.t � � �`" ,<„- ,p'"',f`� �+-� t
??r�t;r-t' I - 4.1d t- :'Dw'` 4,r"%A:,�a'k,T•iF'§.? ..f:,A. a'� -/ $ $...{.a-'`e&✓ 5
;. ;.
}7 f
„n ��lo3 -S-1' h. E 1' tJ'Aw.(�4 i4+ Ln 5i � Cr ,d Y' � ra�� Z '/1 tL S`. f{
1 I?"
Tillable 3 3 r ,
'Woodland,, I 0.q4 .to- q
..Swampl,and ON WATER
1=f20NTAGE;:
v ,
Brushland ERONTAGE:ON [COAD " if . i ---
House Plot DEPTH'
`BULKHEAD.
� 3
,
Total '
. OGK.
k. h ..< ■■ ■ ■■■■■■ ® ®■®■■■■
6'xr N. SRS xY` J •
IS ■®■ ■■® ■®® ■■■■■ I
_ y ■■■ ■■■mom■■■■®■■■■■ ■
� ■®■ ®®■®■®■®® �■■■■■■■
�, �� =rte � s�* '���.. ®®■■ w�s��
� � `° ■ N®■® ■■I'M
MONSOON
£r. ®■■® rNI'sbads■�■■■■■e■■
* ■■■■■■■ ■®■E■■■■■■
.: :
■■■■E■l ° ■ll®® ■■® ■■■■■■
_ u -. ■�■■Nle
MINIM ®®m=NEON 'NUMMOMME
® ■ ■
■■■N■■ ■Eli■■■EN■OlN ®PE
®■ ■® ■■■■■■■M■ ■■®■■
■■■■■® OMEN®®■■■■a■�■mom
■■
-
Porch
Breezeway Driveway
Garage
Patio ®�
• B.
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z . Y 7 5.s Date . . . . . . . . . . . . . . . �3. . :A V.6.-, 19.7.Z
THIS CERTIFIES that the building located at p. . . .A f HAVE Al kA"Street
Map No. . 91.a . . . Block No. ... . . . . .Lot No. . .��. . . . . . . . . . . . . . . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . .. . .MIAX, 19� pursuant to which Building Permit No:~?P.?--
dated . . . . . . . . . . . . .M� . ., 197Z,, 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 . .A . . d b . . . . FAM 1 L `r . . . ..6.w t.L� ►.�.�'... . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . . . . . w 1 x,1- 1 A. M . W lA L. Ls .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval `. . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. . . .lv�. . . .4.707 d . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER. . . . 3... . . .Street. . . . . A H A . .1.. . . . . . ... . ..1. . . . . . . . . . . . . . .
SOUTHu L-ID
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
r FORM NO. 4 d
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22650 Date OCTOBER L_1993
THIS CERTIFIES that the building ADDITION
Location of Property 305 BAY HAVEN LANE SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 88 Block 4 Lot 29
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNK 15, 1987 _____pursuant to which
Building Permit No. 16138-Z dated JUNE 26, 1987
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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to PATRICIA RYAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-023180 - JULY 25, 1988
PLUMBERS CERTIFICATION DATED N/A
/Ouilding 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-22837 Date JANUARY 18, 1994.
THIS CERTIFIES that the building ADDITION
Location of Property 305 BAY HAVEN LANE SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 88 Block 4 Lot 29
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 24, 1993 pursuant to which
Building Permit No. 21682-Z _dated SEPTEMBER 28, 1993
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 SECOND FLOOR ADDITION TO EXISTING ONE FAMIIX DWELLING AS
APPLIED FOR.
The certificate is issued to PATRICIA RYAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE No. N-301743 - JANUARY 11, 1994
PLUMBERS CERTIFICATION DATED JAN. 12, 1994 - ROBERT VANETTEN
ild'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-34375 Date: 05/26/10
THIS CERTIFIES that the building PORCH
Location of Property: 305 BAY HAVEN LA SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 88 Block 4 Lot 29
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 25, 2010 pursuant to which
Building Permit No. 35414-Z dated MARCH 25, 2010
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 PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to BAYHAVEN PROPERTIES LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO 11064 09/08/09
PLUMBERS CERTIFICATION DATED N/A
c
A orized Signature
Rev- 1/81