HomeMy WebLinkAbout1000-99.-3-4.2 TOWN OF SOUTHOLD
Rental Permit
' E 0757
3
Owner J & Wendy Mocco
Occupied as Single Family Dwelling
Located at 580 Lloyds Lane Mattituck 99.-3-4.2
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.
12/17/2024 >314
Code E orc ent Officia
This Notice must be posted by the main entrance at all times
¢ SO#/*�
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
o REMARKS:
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DATE INSPECTOR
' S�FFOL,� Town Hall Annex
Town of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
4,, Tel: 631-765-1802
Date
SCTM#
_ G cry
_.. ___..._..... Phone
Owner f visibleAddress
Hamlet Inspector
t
._.,._..,._.. ,.�_ ....�.,._. ..�._..�_.._.....
Floor Level Quantities Sub 1 2 3
Smoke Detectors (not located in bedrooms)
Carbon Monoxide Detectors
Fire Extinguishers
Exits
�-Bedrooms 1 2 Smoke Detectors . -. ._ . � 3 4 5 6
Egress
Occupant Count
Building Systems Maintained & Operational Condition of Property
Heating Building interior
Hot water Building exterior
Electrical �Y1N41Y . ..,._. -Property clean, maintained & saf
e
_.... . _
Mechanics! Handrails &guards in
stalled.ed & secure. ..w . .,M... . . _
Pool Safety Pool on Site
Surface water alarm7 � Date of CO issuance
Door alarms Pool completely enclosed
Self closing/ latching,gates Pool fence to code requirements
O's for all items present l Prior Rental
Comments:
TOWN OF SOUTHOLD
N4
Rental Permit
0757
Owner J & Wendy Mocco
Occupied as Single Family Dwelling
Located at 580 Lloyds Lane Mattituck 99.-3-4.2
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
d �nc�r � 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
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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
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y -Go - Q. Po✓ .
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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