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Home My WebLink About1000-37.-4-1 Ar TOWN OF SOUTHOLD _ 71 Rental Permit 1007 Owner Paul C. & Diane M. Goleb Occupied as Single Family Dwelling Located at 360 Bayview Drive East Marion 37.4-1 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. 10/20/2023 0 E r4ro ce ent Official This Notice must be posted by the main entrance at all times Town Hall Annex ° Telephone(631)765-1802 54375 Main Road Fax-(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ' m � W1 . "` BUILDING DEPARTMENT TOWN OF SO YMOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: X10�' � Ali� .�.� �. �a.s f (r�u✓i�=, � f I R.�°� Tax Map Number: 1000 SECTION 11--BLOCK_ _LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 2-0J/ _� 0 oX 3 �. 31 Cac.j.l f I gum, 3o l eo I .6(a Telephone Number(s): Daytime Evening, Emergency Property Owner Email Address: -0,L' 0 le Page 1 of 5 Town Hall Annex ��` Telephone(631)765-1802 54375 Main Road ' Fax(631)765-9502 Nmw, „d P.O.Box 1179 i Southold,NY 11971-0959 � d BUILDING DEPARTMENT TOWN OF SOUOLD 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 __ w__... . Evening.,,, Emergency ,,.„ Email Address: Section D. Managing Agent Information: Ay(A' Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): ....... ..w__ww... 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) Ji/A- Name of Managing Agent of dwelling unit, if any: Address of Managing Agent(no P.O. Boxes): ,.,,, ... e_ . �_ Page 2 of 5 Town Hall Annex ; Telephone(631)765-1802 54375 Main Road e �� Fax(631)765-9502 P.O.Box 1179 r Southold,NY 11971-0959 , ouff BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: ...,__._..,,.__—_ Telephone Number(s): Daytime Evening Emergency Email Address: _. ..w._ � 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:— �` 4t Requested Maximum number of persons allowed to occupy Dwelling Un! Number of rooms in Rental Dwelling Unit; . ? ..:_. Use and Dimensions of each room in Rental Dwelling Unit: IC Page 3 of 5 Y Town Hall Annex Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 F 'a P.O.Box 1179 ` " Southold,NY 11971-0959 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold WI 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) 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 w Town Halt Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 " 4 BUILDING DEPARTMENT TOWN OF SOUT OLD 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 day of &6-tM �Z . 202-1 Cie f(�»-+�� , Official Notary Public Signature and Original Notary Stamp .;•« `. A 0 Zp '. m: 5Z): �;;� ; ► 11111 Page 5 of 5 TOWN T T BUILDING 765-1802 IN 0"' EC ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSUEATION/CAl [ ] FRAMING / STRAPPING [ ] 'NAL AA44toe [ ] FIREPLACE CHIMNEY [ FIRE SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O REMARKS: NO ►l' - c 4 � W k4ol&) oft �� fillyn.11, 111, v . TATE 601oll�� NSPECTO f 0 Town Hall Annex Telephone(631)765-1602 54375 Main Road 1' Fax(631)765-9502 P.O.Box 1 179 9oud"d,NY 11971-0959 MfnIW BUILDING DEPARTMENT TOWN OF SOUMOLD 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 Prq&sslonol seal required for Architect orfn lneer llcn ffore lrs or rrrlrt prrvc( coov of valid current certification Rental Property SCTM Number: Rental Property Address: Owner/Name. Rental Dwelling Unit Identlfler: Number&Square footage of each bedroom as depicted In the attached floor plan: (he,Bedroom#1-100 sq„Bedroom#2-90 sq.,etc.) c Property D criptlr� (ln Dude all ifrlproveme is Indic to on sur y) 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 Cade of New York State, the Fuel Gas Code of New York State,and the Energy Conservti .h Construction Code of New York State, w Print Nam e and Ale iOrfg1 al Signature D AFJ sm eta C k,i1'F . Please place professional seal: , s. XI " ,r - o TOWN OF SOUTHOLD PkP RTY 'rcc CARD ,. OWNER STREET ,� VILLAGE DIST. SUB. ' LOT �QF S ER QWNER L' -`t -,11f lf: N E ACR. S W SPELOFBU[LD � RES SEAS, VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP_ TOTAL DATE REMARKS � s 61 y . � orr Q, _ - - f7 777 7 a s AGE crt� ' U L f NG C N�IMOM 73 f .x s a E € FARM Acre Value Per �- _SZ _ ` _ _ Tilloole1� .Ct4 V' 1 Woodland p j f Swampland FRONTAGE ON WATERgr ' B �sh?and _ FRONTAGE ON ROAD I mouse Plot DEPTH � 1 BULKHEAD Total ; DOCK r 3 I _ 3 _ i AW �- TRIMg Ai a .. 37.-4-1 iaiio M. Bldg. :, nation Bath Dinette. tip 1,4 - �� Extension �__ s �nent � ` Floors _ k , �- < Interior Finish = - LR, Extension r_ , Ext. Walks j m Extension : �� = Fire Place feat DR. Heat F Type Roos Rooms 1st Floor BR, R Porch1r' �Recreation Roorr ° n Rooms 2 d FIo° Porch _ � Dormer { r, Driveway R Go e l\ t s z i Total roanz No. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No, .2..22 .0,........... bate .,.........M..M........ 00-tober....3.8..... T9fCaS... THIS CERTIFIES that the building located at ....,Bay..V: ova..Driva............................... Street M NI:3.i:3PTS..13M.10k No. ......... ..X...... Lot No. . ... .rest..k1ar1on$,,,X*X- conforms substantially to the Application for Building Permit heretofore filed in this office doted ............................Mg.�ry.........246................. 19,64.. pursuant to which Building permit No. .2)406,,Z dated .............................ay....26............ 19...61+., 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 ........ ,......privatr••gine,•-ftmily' ,..dwelliTig............................................................ ...........................u., The certificate is issued to ...G,01ey. T-,..Rr0-}n.........,.»......».....f 'wrier:................................»....,..... Cowraer lessee: or tenant) of the aforesaid building. H.D. Approval Oct. 1965 by fit, Villa Inspector » . »µ........LL Building nspect y V E $yy V F P tla y 4�, R ' h� 1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20336 Date NOVEMBER 12,__1991 THIS CERTIFIES that the building ADDITION Location of Property 360 BAYVIEW ROAD EAST MARION N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 37 Block 4 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 26 1990 -----Pursuant to which Building Permit No_ 18762-Z dated JANUARY 29, 1990 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR AND TO CONDITIONS OF THE ZBA #3852. The certificate is issued to RICHARD DiBLASI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. NLA PLUMBERS CERTIFICATION DATED N A uIldinng 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 l y No: Z-30651 Date: 12,/23,:04 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 360 BAYVIEW DR _ EAST f•9AP.IO1J (HOUSE NO.) tSTREET) (HAMLET) County Tax Map No. 473889 Section 37 Block 4 Lot 1 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 9, 2004 pursuant to which Building Permit No_ 30555-Z dated AUGUST 1.0., 1004 U p was issued, and conforms to all of the requirements of the applicable pro,.risions of the law. The occupancy for which this certificate is issued _..............., _. __.... . AS APPLIED is ROOM ADDITION OVER EXISTI2dG DECK IN S217GLE FAMILY DWELLING �w...__ ._� FORa The certificate is issued toJUDITH DIBLASI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2027034 12✓ . PLUMBERS CERTIFICATION DATED N/A __...._ _._mm.......... than..... .....�. ed Si . ,.nature n Rev. 1/181 Town of Southold 7/13/2016 P.O.Box 1179 CIO 53095 Main Rd Southold,New York 11971 ............... ............... ........... CERTIFICATE OF OCCUPANCY No: 38389 Date: 7/13/2016 THIS CERTIFIES that the building ALTERATION Location of Property: 360 Bayview Dr.,East Marion .............. ...... ..................... SCTM#: 473889 Sec/Block/Lot: 37.-4-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore Med in this office dated 11/30/2015 pursuant to which Building Permit No. 40322 dated 12/3/2015 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: INTERIOR Al'E xt Ejt.�F10N[STQ-ANHZX1ffiMLQ ONE, FAM EL i LZL -AS APP1,j'C3QfQR The certificate is issued to Goleb Paul C Revoc Trust ............... of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40322 06-30-2016 PLUMBERS CERTIFICATION DATED 06-23-2016 Thomas Maffeto� ---------- A" i ,e Sipatt -e ell, Town of Southold 10/20/2023 P.O.Box 1179 �9 53095 Main Rd 4r Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44673 Date: I-0 1 20 202 11 3—1-111111111 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 360 Bayview Dr, East Marion SCTM#: 473889 See/Block/Lot: 37.-4-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Pen-nit heretofore filed in this office dated 6/30/2023 pursuant to which Building Permit No. 49580 dated 8/1 11 5-/2023 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: 4" hroom to ex in si g i as i t' '--le'll .......... ---pg _11 I �Palji Illy fi ish b sen �,Jp lud n be and bat -ist _lied for.. The certificate is issued to Goleb Paul C&Diane M Revoc Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49580 8/18/2023 PLUMBERS CERTIFICATION DATED 8/31/2023 aul Gole th zed Signature � J u ... .._; ......_..... W M k m fl 1 1 �w n a ,mr ' �I w I M1 [ rn 70 0t rV a li W. Po r"W,/"a„ ry ai ii kan ii pd W ie +� 06 PI A II n II If 4P W �;� eW pr 4? ❑ nKi n w o % N Pb A4 ti � Ir d4 FE pb� pr �II ti r ..... _.... ....... .._ rc OR 0 3 1n, ' 1 l i /G v YIOOK OF CJ ��•-� EXISTING ENT UNDERCANNET LIGHT5 130�T" ry� A5 REOUI :C7 FOR DMR G GF �A✓ � 1 i GI _� . �4k m 4 e3 i I '114"- GFI C EX15TING CABLE GFI iMO- 4a V00 EN il'1C.� FAN TO BE RELOCATED C7..1 FAN 10�x-��7 �,....__....._.,� 62�+G1 al FAN 5UTCH TO , ryllyr'Nr�OUT 11 b G. Epp I PROVIDE U14C _.. . . _ _ .... LIGHTS IN KJTI 5 k 3 5 5 42" TRACK LIUn' -----_ ON TOP OF COLLAR TIES REMOVE FX1571NG OUTLt'T5 AND.-/, REPLACE WITH WATERPROOF OUTLET5 AT DECK LEVEL 6c NEW WALL 5CONCE5 AT 5G" V I I I