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Home My WebLink About1000-98.-1-7.11 T OWN OF SOUTHOLD Rental Permit 1089 Owner Matthew Hall & Callen Anthony Occupied as Single Family Dwelling Located at 250 Pine Treet Court Cutchogue 98.-1-7.11 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. 3/11/2024 76 -11 Code En arcs Acial This Notice must be posted by the main entrance at all times A N 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT )9 Town, Fiall Annex 54375 Main Road P. 0. Box It 79 Southold, NY ,11971, O� 5" Telephone (631) 765-1802 Fax (631) 765-9502 https�//www.southoicit(.)rmy v -gqv I�"6o -Lq -Fb,A.-ot �3000,-a r RENTAL PERMIT APPLICATION Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Proper Address: 5 Tax Map Number: 1000 SECTION �--BLOCK--t -LOT SECTION B. OWNER INFORMATION: Property Owner Name: - �A P0J( Property 'Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) V it(Age Telephone Number (s): Daytime" Evening._ Emergency__ Property Owner Email Address: —*— , k ,M-VX�3 .......... Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ___Q �•��T'•' Address of Authorized Agent(no P.O. Boxes):Aifo sbo "-A A'jQ_ M k '.•�XAL 1Ia67- Mailing Address of Authorized Agent: c� ,� _w Telephone Number(s): Daytime _ Evening Emergency Email Address: e Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: � ww Address of Authorized Agent(no P.O. Boxes): n � ck � .. M) Mailing Address of Authorized Agent: -__, _ L03►-00-72-LI�*l Telephone Number(s): Daytim1e '( Evening Emergency Email Address: � J�- 1.i�C'e'� aOlt- SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: jA Address of Managing Agent (no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number(s): Daytime . Evening __w Emergency Email Address: .. Page 2 of 4 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: ....... 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: Lr� 1= iSX� L.2z 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. PA'T 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. Page 3of4 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 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 s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: _ Property Owner's Signature: Sworn to b ore met is�day 20c9 Of icial N tary Public Signature and Original Notary Stamp LINDA MELENDEZ Notary Public-State of New York NO.01ME6363908 Qualified in Suffolk County My Commission Expires Noy 18,2025 Page 4 of 4 Town Hall Annex �` � ��°gip Telephone(631)765-1802 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: •1 Requested maximum number of persons allowed to occupy each dwelling unit.: Number of Rooms in Rental Dwelling Unit: _.. Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: _w Use and Dimension of each room: TOWN OF SOUTHOLD BUILDINGT 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLTG. [ ] FOUNDATION 2ND [ ] INSULATION/CAt [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (TII [ ] CODE VIOLATION [ ] PRE C/O [ " REMARKS: a " a- U-� ° 41 1 , Ll DATE INSPECTOR ' Town Hall Annex ew Town Of Southold 54375 Main Road +4 cm Rental Inspection Report PO Box 1179 °i Southold, NY 11971-1179 ia Tel: 631-765-1802 Date 4Owner Phone Address o45D � Visible H amlet � �� ,Inspector ' .. Floor Level Quantities Sub 1 2 3 w , Smoke Detectors(not located in bedrooms) Carbon Monoxide Detectors / 1 w Fire Extinguishers _.. Exits Bedrooms 1 2 . . 3 . 4 5 .. 6 �.... ......_Detectors Smoke Egress Occupant Count Building Systems Maintained &Operational Condition of Property Heating Building interior J Hot water �` °� ._.... .. .. . ....-...... _ .. Build .... ... .. ...,� .. .... _, .at Building j Electrical Property clean, maintained &safe .� . a��aa ...a� .. �.........,.. �.......� ..� .... _. .� ,.. .� u.,� ,r ��. �� o� .. w .,.. �.......W .....�a ... E echanical Handrails&guards installed &secure i Pool Safety Pool on Site Surface water alarm Date of CO issuance aka _. .�R��. wo� wx Door alarms Pool completely enclosed �.�.......� w Self closing/latching gates requirements .. ... , Pool fence to code re CO's for all items present Prior Rental e Comments . _.._.... .. W c 0 Living Room " Master Bedroom U ' W d ` LL O `O 01P Living Room Closet Closet 0 Pantry Bathroom Stairs to basement Bathroom Bedroom Kitchen Bedroom 0 F Bedroom =Smoke Detector =CO Detector ' z TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER ! STREET--- VILLAGE DIST SUB. LOT 0 � - I FORMER OWNER N ` ACR, - � , �. E f = S I W r s TYPE OF BUILDING s RES$ � SEAS. I VL, FARM COMM. CB. MICS. Mkt. Value _ LAND IMP, TOTAL DATE REMARKS e z 4 _ r t - -77 jkL ,.. , _ - m t r " - 1 n -- *7 0 I c ' e > Tillable FRONTAGE ON W TAR 9-1 Woodland I � a . Meadowland DEPTH House Plot BULKHEAD d Total 1 SC:TM # � TOWN OF SOUTHOLD PROPERTY RECOF �c� Ozcv _ � j OWNER STREET VILLAGE via i, SUB LOT _ -,jt ACR. _ REMARKS TYPE OF BLD. Ass s c r It 7 _ _ = ! - PROP. CLASS a LAND IMP. TOTAL DATE I scco s F g o FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL � r TRIM � - 4 - 98-1-7.11 3/04 98.4-7.11 Pool House 4/07 - 6 wi- I _ a . t - Y_ A 4= _ � n 'o .- — - 3 Extension s } 1 Foundation _ Bath Dinette Posh Basement lours K. � E - _ r r ,�- . Walls l Interior Finish LR. Fire Flaee Heat DR. T `' R sR Type Rood a corns I st Floor Rar _ = � Recreation Roomy Rooms 2nd Floor �� 3 _- _ O. B. Dormer lrivewov _ _a 3 s = re � s ,._ y a - F 3 f 46 �� x FORK NO. S s TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . . .� -r.9 Date . . . . . . . . . . . . CC 7 THIS CERTIFIES that the building located at Z5 V.P1 N E 7 R k E. COURT. Street MapNo. . , . . . . . . . . . . Block No. . . . . . . . . . .Lot No. . . , . . . . . . . . . , « . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . Q . . . ., 19 7 5 pursuant to which Building Permit No. 79d8 Z-- dated �A�(. . . . . ., 19.�.�, 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 . .F+. . �R�Y.R"r.� . . . 0!� . . . . A.M!?-`�. . . .D!�It. k i. .'. . . . . .. .. . . . . . . . . . . . The certificate is issued to . . . AD�1''l. . . . . '�.�r S W! CZ. . . . . . . . . . . „ . . . . . (owner, 1 �, ial of the aforesaid building. Suffolk County Department of Health Approval ��NI9h y� . '�. . Y' ��.� „ « • „ „ UNDERWRITERS CERTIFICATE No. . OPEN.D!!w . . .` /o�3 oI7a f, (<� HOUSE NUMBER . . . .2 �r.�. . . . Street . . . . .COU'R"r . . . . . . . CU'T CNU GUE Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32580 Date: 09 Q.ZZ.27 THIS CERTIFIES that the building INGROUND SWIMMING POOL Location of Property: 250 PINE TREE CT M_w CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 47889 Section 98 Block 1 Lot 7.11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 28, 2005 pursuant to which Building Permit No. 31335-Z dated AUGUST 5 2005 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 FRONT YARD AS APPLIED FOR & AS PER CONDITIONS OF ZBA #5340 DATED 02 12104, The certificate is issued to JOSEPH GULMI &, SUSAN BRAVER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 7751 07/24 07 PLUMERS CERTIFICATION DATED N/A ....-� Aut ori.zed Signature Rev. 1/81 ............ Town of Southold Annex 2/3/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36679 Date: 2/3/2014 THIS CERTIFIES that the building ADDITION/ALTERATION ........................... ...... Location of Property: 250 Pine Tree Ct, Cutch o g u e, SCTM#: 473889 See/Block/Lot: 98.-1-7.11 Subdivision: Filed Map No. Lot No. ............ conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/24/2013 pursuant to which Building Permit No. 38447 dated 10/24/2013 ............ 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: AD alj.IONS Q SAND ALTERA11QN5 FAMILY DWELLING AS APPLIED FOR The certificate is issued to Gulmi,Joseph&Braver,Susan (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ............ ... ELECTRICAL CERTIFICATE NO. 3383 02-19-2003 PLUMBERS CERTIFICATION DATED 12-24-2013 Cutc uc East P mbing 4t Heating Inc . ........... /ignature Town of Southold Annex 2/4/2014 P.O.Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36752 Date: 2/4/2014 THIS CERTIFIES that the building ACCESSORY .... ................ .......Location of Property: 250 Pine Tree Ct,Cutchogue, ............. - ---------- SCTM#: 473889 Sec/Block/Lot: 98.4-7.11 Subdivision: Filed Map No. Lot No. ..................... ...................conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/24/2013 pursuant to which Building Permit No. 38446 dated 10/24/2013 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: UNHEATED NON-HABITABLE ACCESSORY TWO-CAR GARAGE WITH POOL CABANA AND COVERED PATIO AS APPLIED FOR PER ZBA 5340M DATED 02/1 2L20 t4 The certificate is issued to Gulmi,Joseph&Braver,Susan ............. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RI0-04-0126 10-24-2007 —--------- ELECTRICAL CERTIFICATE NO. 7751 07-24-2004 PLUMBERS CERTIFICATION DATED 12-24-2013 Cutchogue East Plumbing& Heating, Inc ... ........... ............ A xutbo ibo z Si gnat ..to Town of Southold 6/3/2016 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38330 Date: 6/3/2016 THIS CERTIFIES that the building HOT TUB Location of Property: 250 Pine Tree Ct,Cutchogue SCTM#: 473889 Sec/Block/Lot: 98.4-7.11 Subdivision: .Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/29/2016 pursuant to which Building Permit No. 40507 mm_. dated 3/3/2016 mMµ mm ........ ......... 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: The certificate is issued to Lauren&Steven Beck of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40507 5/23/2016 PLUMBERS CERTIFICATION DATED . ..w............_........... .._._, �_............. � ��_................ ..... �._ __......_............... _- �. . ut�ho Signatur