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Home My WebLink About1000-50.-3-8 �Four TOWN OF SOUTHOLD Rental Permit 0961 Owner Richard & Julie-Ann Fleming Occupied as Single Family Dwelling Located at 200 Hyatt Road Southold 50.-3-8 Maximum Permitted Occupancy 10 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. 7/27/2023 Code E foreljer�t Official This Notice must be posted by the main entrance at all times I` f (� -"AA Town Hall Annex 1 lelone a` 54375 Main Road P.O.Box 1179 �,rv.....� Southold,NY 11971-0959 TONBUILDINGOF SOUTHOLD ,,I,A'." RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION U 1000 -BLOCK e� -LOT 3 - SECTION B. OWNER INFORMATION::, Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: Z.do 14 "-Vk e y9() Lus 4A —,A or °1 oL 4 L �1<-. I)2-0s Telephone Number (s): Daytime �`�� Evening, Emerg cy 41y- Property Owner Email Address: ��"` 2� c'' M Page 1 &5 Town Hall Annex �' Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O. Box 1179 " p, Southold,NY 1197.1-0959Al", r BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:_......... �w_ww Telephone Number (s): Daytime _ Evenings 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." Rental Dwelling Unit Identifier: U Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: <V-0— Q-\ <',-,L Y. la x I i x � 3 �G��f�0 r-, )< Li 2— )e Ll Page 3of5 Town Hall Annex Telephone(631)765-1802 54375 Main Road �� Fax(631)765-9502 P.O.Box 1 179 y" Southold,NY 11971-0959 eZ e `11 Y u ✓r :Q %" 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 ❑ 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) 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 �, TOWN OF SOUTHOLD BUILDING D 631 -765-1802 50 . .2 INSPEC ION [ ] ,4f so FOUNDATION 1ST [ ] ROUGH PLEG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL C l FIREPLACE & CHIMNEY [ ] EIRE SAFETY INV [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI' [ ] CODE VIOLATION [ ] PRE C/O [ t DATE INSPECTOR FO( Town Hall Annex ell " Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 W Southold, NY 11971-1179 �,,,, ► �,g. Tel: 631-765-1802 SCTM # _ _. m w..._ Date . Pt Phone 4f,114 GN4 i ..,.. . __,. Visible ....... .. . . e.. .....�.. ......_e.. Owner Ss �� . ... .n Hamlet �a ._ Inspector.... ... 'Floor .M,.. .�..._� . ._. ....._ ..� . Level Quantities _.. ._.... �... . Sub ��. .....,..a �....� .k 3 Smoke Detectors (not located in bedrooms) '.......Carbon Monoxide Detectors Fire Extinguishers Exits . .,�. _ -Bedrooms 2 3 4 5 6__. . .. / . .� Smoke Detectors 11 . e v E 11 gress Occupant Count Building Systems Maintained &Operational Condition of Property Heating Building interior Hot water Building exterior Electrical Property clean, maintained & safe Mechanical Handrails &guards installed & secure Pool Safety Pool on Site Surface water alarm Date of CO issuance �flZ Door alarms Pool to code Pool completely enclosed Self closing/ latching gates requirements CO's for all items present Prior Rental Comments:nts: . . �. w .. . .. ._.. ___ REAR DECK 28'0"x 14'0" REAR ENTRY DINING ROOM 8'0"x5'0" 14'2"x19'8" FT. Y LAUNDRY '! jo W2'x T3- f GREAT ROOM 12'10"x 19'8" CLOSET Re KITCHEN 14'0"x 16'8" 2 CAR GARAGE 21'0"x 24'0" tw BAT HRS 0 IOR 2,x 5,cr 0 w 0 BEDROOM FOYER TLIVING ROOM 0 11'8"x13'0" 8'0"x13'1" 12'8"x12'10" FRONTPORCH 10'10"x5'0" 1st Floor . ................ MASTER BATHROOM, O 11'8"x 9'2" BEDROOM 3 MASTER BEDROOM 11'4"x11'5" 15'0"x15'0" LAUNDRY WALK-IN WALK-IN CLOSET CLOSET 14'6"x24'1' 7'4"x 5'5" 7'4"x 5'5" ui 0 BATHROOM BEDROOM 2 Q� 0 14'0"x15'2" "1 BEDROOM 12'8"x14'1" -1z A w F- MA W� 7F4 E CLOSET 3il. 1 2nd Floor _= a rogi =a 4 4 b= Lu 7 n [ _ , f os� TELA icn \ ` Ir LrF CL — - _ tM �' 1 < t t c F s ,A = _ i _ Charles M Thomas a I 0 i — FOUNDA-uN P.Ar4 TA E HANGER S TOWN OF SOUTHOLD PROPERTY RECON OWNER ir STREETS o-:' VILLAGE DISTRICT SUB. LOT, fol !LIA F R iER OWNER b6' 1 ": N E _ ACREAGE _ STYPE OF BUI'EDING s RES. SEAS. VL. FARM COMM. IND, CB. MISC. Est. Mkt. Value LAND IMP. TOTAL DATE ( REMARKS Cj 17 F AZs q j)� 1 f J pg G V #' t <? < a - Lv AGE BUILDING CONDITION - .g d ' 3 , s NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD (�C>b X,4 QG tiff Tillable 1 BULKHEAD Tillable 2 DOCK Tillable, 3 Woodland Swampland Brushland House Plot Tota } s f � Mri —'I ! t t � r a t 50:3-9 9/19/2022 e PCfL l£ F M. Bldg-) . 3, g'Z) c'7 J = Foundation 9'��i Bath I Extensior k �L Basement Floors Extension Ext. Walls G-tCIAr Interior Finish Extension l Fire Place / Heat - C , OR 1 L4Porch ; Roof Type °I � vLg 6 : , � I Porch l ' Rooms lst Floor lap. B - - 1 _ � � Patio Rooms 2nd Floor �,/►et� V6v Pte. � � 694e ��X . �, � �� ; Driveway �Dormer � ............... ......... Town of Southold 8/4/2022 P.O.Box 1179 53095 Main Rd Southold,New York 11971 ...................... ............... CERTIFICATE OF OCCUPANCY No: 43309 Date: 8/4/2022 THIS CERTIFIES that the building SINGLE FAMILY DWELLING ...................... –---—----- Location of Property: 200 Hyatt Rd., Southold -—SCTM#: 473889 Sec/Block/Lot: 50.-3-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/24/2021 pursuant to which Building Permit No. 46936 dated 10/7/2021 11-............. -—----------------- 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: entry. rear deckgutdoor shower.,and At .Laphed aragg witli recreation room above as aolied for. The certificate is issued to GCG Bayberry LLC ........... ............................. ........ of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-21-0143 6/28/2022 ELECTRICAL CERTIFICATE NO. 46936 8/1/2022 &H in PLUMBERS CERTIFICATION DATED 8/1/2022 it Swot Plun bing W t _-f-LLC onz nature jlFllt,�ell Town of Southold 8/11/2022 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICA`I°E OF OCCUPANCY No: 43319 Date: 8/11/2022 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 200 Hyatt Rd., Southold SCTM#: 473889 Sec/Block/Lot: 50.-3-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/6/2022 pursuant to which Building Permit No. 47792 dated 5/6/2022 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: accessoU in-grrogundd swimmin s pool fenced to code as p li d far. The certificate is issued to GCG Bayberry LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47792 8/8/2022 PLUMBERS CERTIFICATION DATED _. Au.. or ecl i nature