HomeMy WebLinkAbout1000-56.-5-2 =3 A WN OF SOUTHOLD
Rental Permit
{ z _ 0631
Owner Eric Baiz
Occupied as Single Family Dwelling
Located at 870 Bay Home Road Southold 56.-5-2
Maximum Permitted Occupancy 8
Is in conpliance 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.
5/2/2022
re e%Official
This Notice must be posted by the main entrance at all times *od
m
Town Hall Annex Telephone(631)765-1802
54375 Main RoadFax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 P
BUILDING DEPARTMENT
TOWN OF SOUTHOLD Ay 1 2 20
20
RENTAL PERMIT"`APPLICATION �
Rental Permit Fee $200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
S970 Say e td Z-)' �
Tax Map Number: 1000 SECTION S6 BLOCK LOT Z--
SECTION B.
OWNER INFORMATION:
Property Owner Name: �/`te-
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
;an*10V b4 r jq
Telephone Number (s): 317- X26 — 36
Property Owner Email Address: C 6oy z *1c>fue-ker. cvn►
S Z,2
�Q
Page 1 of 4 rel ,
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: &0A)E-)
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number (s):
Email Address:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: AA . qG W i e�S
Address of Authorized Agent(no P.O. Boxes): /Ydof .1 W LN Cv4eAp e. 1173s"
Mailing Address of Authorized Agent: �a'►�e)
Telephone Number (s): G3!—.ZS.2-S'6 5-3
Email Address: roI- � +
SECTION E.
SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any: ljmok
Address of Managing Agent (no P.O. Boxes):
Mailing Address of Managing Agent:
Telephone Number(s):
Email Address:
Page 2 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: 20 A4 o! .
Requested Maximum number of persons allowed to occupy Dwelling Unit: 00
Number of rooms in Rental Dwelling Unit: 7
Use and Dimensions of each room in Rental Dwelling Unit: MW 01(12-•1W Z- 1V fZ'
x 3x ► ' kT 14)e Io ` -26 X 4 ' o X!6
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 NYS licensed architect, a NYS 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 thelawsadopted by the New York State Fire Prevention and Building Code Council.
C/ I am requesting a fire safety inspection to be performed by a Code Enforcement official
from the Town of Southold. -WS was &/fraeify JoAa 6 y fAe f
4 5 fcrY of 7%c Pre-CO cess .
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)
I Tr'rc' tsaf% Z 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:
Property Owner's Signature: Ilk'
Sworn to before methis day of , 2020 s) � I
' �" �
- „ tee �,y 6 ,
Official Notary Public ignature and Original Notary Stamp �f ,°�, „;, C�
�
Page 4 of 4
3/6/2020 Footprint of House-1st Floor b.jpg
LP GAS ►
8. 9
. E. 6, 1 ' 12.0' 0 7. 4 ' 10. 1 '
* �
9.0 0 0 Dining Living
WOOD --9 Room Room t
DECK
V
Half
Bath
K%
en
Laund
5.5ry
13.9 9.0
870 Bay Home Rd stode
1st Floor Feng March 6, 2020
https://mail.google.com/mail/u/0/#inbox?projector-1&messagePartld=0.1 1 N
3/6/2020 Footprint of House-2nd Floor b.jpg
F= Filre/Smolce Interconnected
CM = Carbon Monoxide w E
6. 1 ' 11 . 4 17 . 0 '
Northcentral Northeast H
Bedroom w
Bath room Bedroom ,
00
-
FTI 0
N
o FTI
South Master Suite Southeasp.
Bedroom
Halt
Bath 28. 4'
870 Bay Home.Rd
2nd Floor March 6, 2020
https://mail.google.com/mail/u/0/#inbox?projector-1&messagePartld=0.2 1/1
TOWN OF SOUTHOLD PROPERTY RECOI
OW�NE� STREET VILLAGE DISTRICT SUB. LOT
_ � a
FORMER OWNER N E ACREAGE
E
S V TYPE OF BUILDING
RES. e� SEAS. VL. FARM COMM. IND. I( CB. MISC.
LAND IMP. TOTAL DATE REMARKS _-
f
1/0
l
I
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
Farm Acre Value Per Acre Value
Tillable 1
Tillable 2
Tillable 3
Woodland
-- -- „� x
Swampland
Brushland
Plot
TDA I_ ,�
Y
-
y
e �,t
,
y e
z
ev I
17
, -
56.-5-2 10/2014
5114
u71 Foundation SIT)C— Bath
M. Bldg - ,� � � C1 � -
1
Extensi x' - _ - Basement Floors i
�' /J �' 2- �� " ��
Extension Ext. Walls Interior Finish
E ensue Fire Place Heat
Porc'� Attic E
-
P
orc 1 Rooms 1 st Floor
B4. - Patio Rooms 2nd Floor
t
Driveway
Gcrcge
O. B.
y
.... .. .. .....
..... ......
'qI f
0 ww o 0 ilk,ffk, 11,o% 41,s ft�j o o 0 0 l�, o 11 f,
kA
iv 1, 'k I �'o, P
q Off"I wl, s 41 S
f 0 0 4 10 0 P f I M MOM 10 Of f 0 M I 1 0, �l 0 t 0$ 0 t 0 0 t t 10
11 11, ��j ,to I I 11,�10 1 1,�f I I�!� 1,�I�I f @ f t ,
16-
................................. .......................................................... .................
co Ln
U)
tA— o Lon,
cn
0 coo
0
o
0, 6wro
ff
(D
E N
...... 4-JNero
f",
0 CL f
0
tEo
'L1.
CD
co
V
N,lf�
ej
>
LL or) t Ln
4-J °CS
m Qj —
CL 10
N r—
CL
C
CL
cy')
0 (0
a°a4-J 0
ea
H CD
rro ms i CJs � r- El 0
co v U) 2� cn
C m
z
C, w CID
tj
. ... ........
EC
...........
"S
ne
rnZ
11w c�rMa,%Y4S
-J
Z,
e LL :7
.........
0
0 o 9
0 CL w
,ql
"Y"6/
Yfff
;'?'I 11TI' rrq'Tn,f..........jrrrrrn� �rtrf'rrrf �rrrlvtlr�f ro pirrry'ry"� fllr..........
Ill t F?I v
fl P, W 04 M 40 Mi Mf MHO Mo,
Vo t, k MjfjM 10OW MNNMMOfd 0 1 Gf 0 t If if OMMI MtW MMO AMMi t ff,0 MIH4 10 0 M'M
. .......... ........
Town of Southold 12/13/2019
53095 Main Rd
Southold,New York 11971
00 1#0
........... ................
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 40894 Date: 12/11/2019
THIS CERTIFIES that the structure(s)located at: 870 Bay Home Rd., Southold
SCTM 473889 See/Block/Lot: 56.-5-2
Subdivision: Filed Map No. Lot No.
..........--.................................. ....... .....................................
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40894
...........
..........
dated 12/11/2019 was issued and conforms to all the requriernents of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
�Koq I MAjthAqqes
�l fTaTne,Qnqf4wj1y dwqtj t_LQry wqQ -a
.
dote:42004'gLs baht!alt qrACLqtgs and add i(RovL
_
)LIQ
IAJJOl L: deck addition r _!rgsa variance from s_4nd
qqu /,onui,,RQ l_ofA)IV�& a.Building ut.
jtjg-� 4jj _Pern
The certificate is issued to Baiz, Eric
........... ......
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
t riz- ignature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
H IJSING CODE INSPECTION REPORT
LOCATION: 870 Bay Home Rd.,Southold
SUFF.CO.TAi-MAPNO'------ 56.-5- �... �-www.....a�._....�.� _.......,�.,��,-SUBDIVISION:
NAME OF OWNER(S): Baiz,Eric
OCCUPANCY:
ADMITTED BY:
SOURCE OFREQUEST:-.
Baiz,Eric......_
ric...... DATE......_...12/11/2019
.......... .......... ... ____
................................. .............__._.._._..........................
DWELLING:
#STORMS: 2 #EXITS: 2
FOUNDATION.............
................ brick.., CELLAR: partial CRAWL SPACE:
............... .........._........ ................
BATHROOM(S): I TOILET ROOM(S): 1 UTILITY ROOM(S):1111111111
PORCH TYPE: DECK TYPE: PATIO TYPE:
,,,,,,,,,,,,,,,,,,,,,,,,,,,_.,.....................,,,-w.__.
BREEZEWAY: µX µµ FIREPLACE: I GARAGE:
DOMESTIC H06fWA—HR- x TYPE HEATER: electric AIR CONDITIONING:
TYPE HEAT: oil -.1-1.1-....,... . HOT... jk radiator
.4....... ...w
....... ...........
#BEDROOMS: #KITCHENS: I BASEMENT TYPE: unfinished
...........
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: ........................
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
................-.1--.-
"as built"deck addition requires a variance from the Zoning Board of Appeals and a Building Permit.
- ----------_1111-
REMARKS: .' 11111-11............................. .... .......
........... .. ....
.......................... ......
.11,111,111,11,...............11111111111111--_,"....... ........... ....................
INSPECTED BY: JOHNJ DATE OF INSPECTION: 5/1/2018
TIME START: 11:35am END: 12:20pm
tkt4" -,;,tz Town of Southold 12/11/2019
tt� �
P.O.Box 1179
n 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40893 Date: 11/25/2019
THIS CERTIFIES that the building RESIDENTIAL ALTERATION
Location of Property: 870 Bay Home Rd., Southold
SCTM#: 473889 Sec/Block/Lot: 56.-5-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/24/2018 pursuant to which Building Permit No. 42604 dated 4/25/2018
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:
"'as built"alterations andadditiorxs clic g paw cr par .w pa yc t d_to llv c ��c 4nd e:aclosed )ox•ch to a:a e:cisti:a
one familydwelling s qlplied fc�rmn
The certificate is issued to Baiz,Eric
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42604 7/17/18& 11/11/19
PLUMBERS CERTIFICATION DATED 7/6/2018 enry Srnit
:tl Signature
FQC�p Town of Southold 10/5/2021
�
P.O.Box 1179
53095 Main Rd
w„ Southold,New York 11971
Zzd
CERTIFICATE OF OCCUPANCY
No: 42404 Date: 10/5/2021
THIS CERTIFIES that the building AS BUILT ADDITION
Location of Property: 870 Bay Home Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 56.-5-2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/4/2020 pursuant to which Building Permit No. 45462 dated 11/18/2020
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:
deck addition with partial roof over to existine sin le family dwellin 01.i.0 for per ZBA" I ,d4ted 9/17/2020.
The certificate is issued to Baiz,Eric
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
_............................ _., Aut�� r e..... nature
�at" � ................_ ..