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Home My WebLink About1000-104.-7-3 0 TOWN OF SOUTHOLD '7z 'N' 4 Rental Permit 0767 Owner Corbley Family Trust Occupied as Single Family Dwelling Located at 680 Mason Drive Cutchogue 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. 11/3/2022 C de En rc m t ficial This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road �r s P.O.Box 1179 ' d 16 Southold,NY 11971-0959e ' 1i : 1 , BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 93 Tax Map Number: 1000 SECTION b -BLOCN< 9 -LOT -� SECTION B. OWNER INFORMATION: Property Owner Name: 1 Property Owner Legal Address: perty Owner Mailing Address: � �„ AAA) Telephone Number(s): Daytim Evening �� ency_5 Property Owner Email Address: Page 1 of 5 7 Telephone(631)765-1802 Town Hall Annex 54375 Main Road �` mt Fax(631)765-9502 P.O.Box 1179 , C�SjA Southold,NY 11971-0959 BUILDING DEPARTMENT TONW OF SOXYMOLD 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: Telephone Number(s): Daytime Evening r 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: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annexr Telephone(631)765-1802 631 765-9502 54375 Main Road �„ ��„� � �� Fax( � P.O.Box 1179 Southold,NY 11971 0959 <Ak BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent.- Telephone gent:Telephone Number(s): Daytime______:::_Evening Emergency_„_..,,_ LL 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, 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: ~ '. Requested Maximum number of persons allowed to occupy Dwelling U Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: c)-7 1-1 MAV) Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 cn P.O.Box 1179 Southold,NY 11971-0959 if BUILDING DEPARTMENT TONVN 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 ❑ 1 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 NEW YORK) ) COUNTY OF SUFFOLK) rtify under penalty of perjury,the following: 1. 1 am the owner of the prope y 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 Town Hall AnnexJTelephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 4 e 5 Southold,NY 11971-0959 , 1' ON BUILDING DEPARTMENT OF SOUMOLD 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. I 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 �, �, 70-L Official Notary Public Signature and Original Notary Stamp SABRINA M BORN Notary Public,State of New York No.01606317038 Qualified in Suffolk County Commission Expires Dec.22,20� Page 5 of 5 1,111e 1 �µ Telephone(631)765-1802 Town Hall Annex 54375 Main Road " Fax(631)765-9502 1C7� �iy P.O.Box 1179 � ,Southold,NY 11971-0959df � orf a BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect,licensed engineer or licensed home inspector Separate form is required for each Individual Rental Dwelling Unit Fero essr'i nal seal required for architect or Engineer, licensed Horne Ins ector rnu rovide co of valid current certification Rental Property SCTM Number: Rental Property Address: �'�ss Owner/Name: -J� c� 9 Rental Dwelling Unit Identifier: w � Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 s Bedroom#2-90 sq., etc.) Property Description (Include all improvements indicated on survey) I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Co stru on Code of New York State. YAkK Print Name and Title a ,. Original Signature Please place professional seal: m #UlovPr-' 6140 Vt-'-o T SOUTH LD TTL I TG DI 631 -765-1802 L) INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION/CAI ] FRAMING / STRAPPING ] FINAL C ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE. C/O [ I REMARKS: Prl'a..,o, CdCi"(Jew-__' 10L6 `0 7 TOWN OF SOUTHOLD BUILDING I 7654 802 INSPECTION I l FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION I l FRAMING / STRAPPING [ ] 11NALAI, ,W [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY 11 [ J FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT P [ J ELECTRICAL (ROUGH) [ ] ELECTRICAL (T [ ] CODE VIOLATION [ ] CAULKING Pmo/ REMARKS: skv, + F, �, DATE INSPECTOR WA �" y 9ALc MASTER DEN DINING ROOM FAMILY ROOM BEDROOM 1512'x 18' 13'4'x 18' 14'8'x 18'10' D eLAIMORV CALOSWET O Cww ATT BATH � IC STORAGE MOW 8 "x 7' 12'x 13'6' 4'l PAKTRY 2�- 7 xD3' BEDROOM 12'x 15' FOYER HT HALL 0 - BEDROOM CLOSET 9'3'x 14' AT xWill 7'8'x8' 0 _a LCET 6'9'x 51' 1 IQ SECOND FLOOR FINISHEDATTIC Vn SHED i 7'x 13'8' STONE PATIO FIRST FLOOR:1530 ft= I SECOND FLOOR:1050 ftz ATTIC:295_ftz x SHED:98 ft= FIRST FLOOR TOTAL INT:2973 ftl T/1TA1 CVT.�'fM 4i Sm a In feet Indiath a any, ere A I Informotlon contained herein isp0mradiftorm wurceo we be leve to be re Iib e.However,we Ito ac 680 Mason Drive , Cutchogue 7,131$ s TOWN OF S UTHOL PROPERTY RECOD CCA OWNER STREET VILLAGE � DIST_ SUB. Lt;T FORMER, OWkIER N - ACR. I u� s R 9 S W -TYBUILDING E RES. �41 SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP, TOTAL DATE REMARKS . r i t, f _R -2157 dr J h ! t t r _ I f . -P J � 111�DIN G/C0 fDITION li7 J NEW g'z A FARM Acre Value Per Vcpue . _ Acre Lo /k7 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD _ 3 Meadowland DEPTH �' e House Plot- BULKHEAD a Tota.L. DOCK F £ _ s h /0 dO (J R 01-0R TRIM _ TRIM " E n } , 104.-7-3 12/2013 - 7 e 37 131, 7fi a f Extens!on Extension Extehision „.._ .. 4-Foundation Both B Dinette � ? Porch 3/' s< Os BasementF loors il< Ext Walls n`o g i_R Fire Plac H e U 2 a i " - 517!Type Roof Rooms s[ Floor BR. 64 Garc IF Pat.#o F t i o ns 2nd N rj Recreation Room � O. B. r� Dormer Driveway f Total . ,' a FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z42.52. . . . . Date . . . . . . . . . . . . . . .May. . .28. . . . ., 19-71 . THIS CERTIFIES that the building located at .Mas®n .Dr. . . . . . . . . . . . Street Map No. . VlAsen . . . . Block No. .*? . . . . . .Lot No. . .7c� . . .Cutahe9," . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .APT.0. . 26, 19. 7.0 pursuant to which Building Permit No. . . . 4722Z dated . . . . . . . . . . . .April_ 28 ., 19 70 ., 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 . Private .ane. .f'ami.ly.dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .Martin. & .Catherine .Bakken. . . . .NnOVS • • . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval April 7- 4971 -by- B. Villa• • • • • • Underwrite a Cert. N839.7668 _ . -- - ►nse # 6 Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . Z.5-458 . . . . Date . . . . . . .September .19.9. . . . . .. 19.73. THIS CERTIFIES that the building located at .680 24ason -Drive• • • • ° . • • . Street Map No. . .Xy. . . . . . . . Block No. . . XX. . . . .Lot No. _XX. CUtChvgus. . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . Nov . 16i. . . . . . .. 19?1 , pursuant to which Building Permit No. .563.3Z. dated . . . . Nov: la • • • • • • • •. 19.71-, 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 - -Private- accessory(storage)- -building. . . . . . . . The certificate is issued to 14artin .Beli;�en. • • ° . I • • ° • • . . — . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . NjR j. . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . .NsR*- . . . „ . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER. . . . . 5,80. . . .Street. . 14aaorr .I3rive . . . . . . . . . (Q� Building Inspector FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z51+57. . . Date . . . . . . . . . . .Septamber. 290. ., 19.73. THIS CERTIFIES that the building located at -1-W-Pri-pri,g$. . . . . . . . . Street Map No. . . . . IM. . . . . Block No. XS. . . . . . .Lot No. . .XX . .CAC 499,4 . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . Doe#, 15 . , ., 19.7.1. pursuant to which Building Permit No. . . . 5052 dated . . . . . . . . . DCC o. 19.71., 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 . .PrIV411` .OXIV. .t a,Y. .4Y.01 .tng. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . 114r-Um.Pte:Q11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER. . . .660. . . . . .Street. . .M#PA4.D1ige„ . . . . . . . . . . . . • . .Cutchogue• . . . . . Building Inspector 1lFFpt Town of Southold 9/28/2015 P.O.Box 1179 53095 Main Rd ` Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37801 Date: 9/28/2015 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 680 Mason Dr, Cutchogue SCTM#: 473889 Sec/Block/Lot: 104.-7-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/2/2015 pursuant to which Building Permit No. 39936 dated 7/13/2015 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: roof mounted solar anels on an existipZ ne i`4 dl)y,llin s afor. The certificate is issued to Corbley,John&Corbley, Susan of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39936 9/8/2015 PLUMBERS CERTIFICATION DATED Authorized Signature FORM NO. 4 1' (;TOWN OF SOUTHOLD BUILDING DEPARTMENT . m Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY 00 No: Z-34701 : 11/22/10 THIS CERTIFIES that the building ALTERATIONS/ADDI T IONSp"s, r ° Location of Property: _ 680 MASON DR CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 104 Block 7 Lot 3 Subdivision w_..._....M,....---- Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 27 2010 pursuant to which Building Permit No. 35979-Z dated OCTOBER 27 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 ALTERATIONS AND ADDITIONS INCLUDING COVERED PORCH, AS APPLIED FOR AND PER ZBA #6119, DATED 3/13/08. The certificate is issued to JOHN R & SUSAN K CORBLEY (OWNER) of the aforesaid building„ S19FFOLK COUNTY DEPART14ENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3061699 05/26/09 PLUMBERS CERTIFICATION DATED N�A ,.._....m.". ._................._..._.ww_._ww ins ;)'orized Signature Rev. 1/81 .............................. Town of Southold 11/20/2015 rw P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37913 Date: 11/20/2015 THIS CERTIFIES that the building ALTERATION ...... ....................... ... ..... Location of Property: 680 Mason Dr, Cutchogue SCTM#: 473889 Sec/Block/Lot: 104.-7-3 .......... ...... Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/15/2015 pursuant to which Building Permit No. 40086 dated 9/15/2015 -11-1-1-1-------------......... 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: ALTER-N- FIONS, REAR DECK ADDITION ANT)FEMA COMPLIAN'r FOUNDATION UNDER EXIsTf.NG ONE, ........................... ......... FAMILY'DWELL AS APPLIED FOR �G The certificate is issued to Corbley, John&Corbley, Susan ............- of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40086 10-29-2015 PLUMBERS CERTIFICATION DATED Aut cI ?'nature �s° 111 Town of Southold 11/23/2015 P.O. Box 1179 � me 'a 53095 Main Rd Southold,New York 11971 tf CERTIFICATE OF OCCUPANCY No: 37916 Date: 11/20/2015 THIS CERTIFIES that the building HOT TUB Location of Property: 680 Mason Dr, Cutchogue SCTM#: 473889 Sec/Block/Lot: 104.-7-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/15/2015 pursuant to which Building Permit No. 40086 dated 9/15/2015 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 HOT TUB ON AN EXISTING DECK AS APPLIED The certificate is issued to Corbley, John&Corbley, Susan of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40086 10-29-2015 ............ PLUMBERS CERTIFICATION DATED .utl ri,, . ,n tur,