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Home My WebLink About1000-99.-3-4.2 TOWN OF SOUTHOLD o a- Rental Permit 0757 Owner J & Wendy Mocco Occupied as Single Family Dwelling Located at 580 Lloyds Lane Mattituck 99.-34.2 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." 10/17/2022 de nfora Official This Notice must be posted by the main entrance at all times Town Hall Annex ,,� c3f Telephone(631)765-1802 54375 Main Road r: ' ;. Fax(631)765-9502 P.O.Box 1179 G + Southold,NY 11971-0959 L - Cc� BUILDING DEPARTMENT �'`. J 1 I TOWN OF SOUTHOLD AUG 3 0 2021 RENTAL PERMIT APPLICATION itis.F��• Rental Permit Fee$200(Application must be renewed every two yers) ; r Section A. Property Information: Rental Property Address: Lloy � s Lh , M� C,iC �`� +159 Tax Map Number: 1000 SECTION —/ -/ -BLOCK -LOT SECTION B. OWNER INFORMATION: Property Owner Name: IT ot-yy enA54 moc-C 6 Property Owner Legal Address: Property Owner Mailing Address: ah s ` l Q!, ro h a en 0� 66844 Telephone Number(s): Daytime q f7 &-73 `Eveni It Dng_ Emergency_ Property Owner Email Address: --ane 'M 0 Cc&S& �LMAOC) com Page 1 of S Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G 4 Southold,NY 11971-0959 O�coy(ViY BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized 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 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: P 4S6NCJ1-'4119d Telephone Number(s): Daytime.ta 4 vnilg_ Emergency_ e O Email Address: 15 he- re in c c 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): Page 2 of 5 sow Town Hall Annex i, 'rs' Telephone(631)765-1802 54375 Main Road �.' Fax(631)765-9502 P.O.Box 1 179 e Southold,NY 11971-0959 OU �' BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime. Evening Emergency_ Email Address: 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 the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Zon Rental Dwelling Unit Identifier: 15'J ouL L Requested Maximum number of persons allowed to occupy Dwelling Unit: f� Number of rooms in Rental Dwelling Unit: l Use and Dimensions of each room in Rental Dwelling Unit;. V floor: Sunroom 9x12, EIK 22x9, LR 17x18,Den 20x22, DR 14x13,Library 13x10, Master 22x4 bed 11x19 2 floor: bed 23x13,Den 14x18,Laundry 10x13,Bedroom 22x13,bed 14x16 Lower level: game room 28x23,room 37x 18, storage 11x13, storage 14x 13 i Z� O � S U ry��Q�sc; Town Hall Annexa' Telephone(631)765-1802 54375 Main Roadri Fax(631)765-9502 r P.O.Box 1179 Southold,NY 11971-0959 � s ;' COUNT� ; , . BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. ❑ 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF 16RtC) �►'l Yl�-�1(,tT� COUNTY OF StJfF� ,(1✓ q I �rs� �l MoCGo , 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 -r it Town Hall Annex Telephone(631)765-1802 54375 Main Road "} Fax(631)765-9502 P.O.Box 1179 ;.. 1' Southold,NY 11971-0959 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:_�e� p CC a Property Owner's Signature: Sworn to before this"ay of NU , 20� Official Notary Public Signature and Original Notary Stamp YESID STEVEN ROMER0 Notary Public,State of Connecticut My Commission Expires Sept.30,2023 Page 5 of 5 o�a0FS0UTyo! h O ✓ V l hh ,f n 1C/ # # TOWN 0 SOUTHOLD BUILDING DEPT. � `ycourm, 631-765-1802 1` 3 u INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTA REMARKS: n DATE 1/ INSPECTOR k/ �o # # TOWN OF SOUTHOLD BUILDING DEPT. `comm ' 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING';ot4"galp�FRAMING/STRAPPING [/] FIRE INAL [ `] FIREPLACE°& CHIMNEY [ SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REM lb AIAKS I ov, X10• y -Go - Q. Po✓ . 4fc-Avv DATE l 1 INSPECTOR *1200938 580 Lloyds Ln, Mattituck, NY 11952 Stephen Flanigan Douglas Elliman Real Estate t�� [ 317 Jackson Ave Doual�Asl',.J_I_1.,��1.:'�..6:C111 .. Syosset NY 11791 REAL ESTATE Direct Phone:516.921.2262 Mobile Phone:516.491.4365 Email:Ste phen.Flanigan@elliman.com First Floor Sun Room/ F-, 9'4'x12'3' Eat In 1�/t=n= =f=? \� Kitchen Master ten w o :: . 22't x en Suite raa•(� _ 22'4"xlg'2' jLiving Room 88 iI 17'2"x18' I W-`c I fQ BaN euear it`. 11'11'x10'1' ••' .Pans,€i /• }'...'i Den • IT 207"x227 Dining Library Room 129°x19'11° 14'1'x12'9° wood Deck Wootl Deck _U_C_9 snea ' ' eau, Bedroom+{ Bedroom Open Bedroom 7_.13•s 23'3"x13'8° TO 22'2'x13'3' 7 Below WJL Sm . B a's�sz' % t + C�_�. on Sr r, P BaOiB'xT0• �i In leun0ry _a- �t i'eatB 5110'. f 10'B'a13'B' a - 2 Den I I 14'4'x18'5' 1 0° Op T Bedroom ow F t 14'9'x16' storage U �i\ 4L�ng Game Room _ 37'8'x18'3" 28'9'x23'5' O n'31uo. wax a,a.� eae OJ O1 � W a Cellar B'aa 1 \ Garage 23'7"x39'8" 4'2'x13'5° four and Content Copyright®20 04-2014.Thlsticar plan Illustration Is an approxim all on of existing sinlctures and features and Is pmvidad for convenience only vAth the penri[ad on of the seller.All measurements are approximate and not guaranteed to be exact or to wale.Buyer should contian measurements udng thelrown soutoo& .TOWN OF SOUTHOLD PROPERTY. RECORD a 1 OWNER STREET 4f "' VILLAGE DIST. SUB. LOT t / r� i <t �' p,r,A t'N--'rr 6 �_11 C� fsr 7`5 y r P i�i . � '% ? `X'i 1 �t,s` >F° !� :. l i f 4 C�� 1 C' (4l 1 ) e ORMER OWNER N' E C ACR.. S W CODE DATE OF CONSTRUCTION LAND IMP. / TOTAL DATE REMARKS �� '1 �✓J J /� ,(' ,r` (tea ..�.ti:-�+ ' u" " � i r�. _ c �GQ"•CJ �'�� t� ff % �s•I /C.r�I�'jG1� 3639 _.'�_ �^''' '?:>v O �?" J � / .;o /•fo 7' V � V ��7 "ifi"-�^ (�7`f0 �v°S�`��iJ t�4�: i(r GCS G,r �'r �J�.r10 �� ""�•` BOJ:')ZIN 16 (1?n _r �C�'.`,.;,e J .�,1'S � .�j l "pnt * d nt .>.;,)C. /700(02 Q 101 0 03 /? �-lam �.�0' ��'t�1�--��cic�'c.��- ?� �''�"tica�C,^� •-�> � �r t Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROADq Meadowland DEPTH House Plot BULKHEAD Total ■■■■■■■■■■■■■■■■■■■ ■tel■IY■®®ii.■�■■■�iiil . �,f, . . ,_ ■ham,■�.:7■■■■■■■■■®I■■■ ■■i■®■��®�a■■.�■e■_.�■■■ Foundation Bath Extension Basement Floors Ex-te Ext. Walls Interior Finish . _" 20 k4 2V) - Place �L� Heat Porch _ � .. . T /•A -J QF Patio Rooms 1st Floor r 5p,97-1 Driveway Rooms 2nd Floor Garage \4 I�ZZs �® 777 " . r. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30394 Date: 08/31/04 THIS CERTIFIES _that the huilding NEW DWELLING Location of Property: 580 LLOYDS LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 99 Block 3 Lot 4.2 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 27, 2002 pursuant to which Building Permit No_ 28980-Z dated DECEMBER 6, 2002 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 SINGLE FAMILY DWELLING FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to ROBERT E. FOX & VICTORIA_ FRIEDMAPJ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTM]M OF HEALTH APPROVAL R10-02-0179 08/24/04 ELECTRICAL CERTIFICATE NO. 76348C 07/15/04 PLUMBERS CERTIFICATION DATED 08/24/04 EZ PLUMBING, INC. I i i A t riled Signature Rev. 1/81 I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30696 Date: 01/20/05 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property: 580 LLOYDS LA MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 99 Block 3 Lot 4.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 12, 2003 pursuant to which Building Permit No. 29646-Z dated AUGUST 13, 2003 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 INGROUND SWIMMING POOL WITH FENCE TO CODE IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to ROBERT FOX (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 76348C 07/15/04 PLUMBERS CERTIFICATION DATED N/A Authorized Signature Rev. 1/81