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Home My WebLink About1000-88.-4-29 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