HomeMy WebLinkAbout1000-123.-3-7 � � z TOWN OF SOUTHOLD
Rental Permit
f.
1127
Owner 505 Bungalow LLC
Occupied as Single Family Dwelling
Located at 505 Bungalow Ln Mattituck 123.-3-7
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.
5/10/2024
Cod nr e_ nt Official
This Notice must be posted by the main entrance at all times
23 2,X
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Town Hall Annex � � Telephone(631)765-1802
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54375 Main Road r Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 �
3 JUN 2 9 202
BUILDING DEPARTMENT
TOWN OF SODOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address: 505 Bungalow Lane, Mattituck, NY 11952
Tax Map Number: 1000 SECTION 1231 -BLOCK 3 -LOT 7 -
SECTION B.
OWNER INFORMATION:
Property Owner Name: 505 Bungalow LLC
Property Owner Legal Address: Property Owner Mailing Address:
42 Turtleback Road 42 Turtleback Road
Califon, NJ 07830 Califon,NJ 07830
Telephone Number(s): Daytir 908-507-3248 Evenin Emergency
Property Owner Email Address: g,en42@comcast.net
Page 1 of 5
A4
Town Hall Annex Telephone(631)765-1802
54375 Main Road „ Fax(631)765-9502
P.O.Box 1179 ,q
Southold,NY 11971-0959 -�.
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit,if any:_ Michael D'Angelo
Address of Authorized Agent (no P.O. Boxes): 12 Little Neck Rd, Suite 201, Centerport, NY 11721
Mailing Address of Authorized Agent:_—
Telephone Number(s): Daytime 631-626-4005 Evening Emergency
Email Address: mike@newhamptonhomes.com
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 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 Annex ; Telephone(631)765-1802
54375 Main Road Fax(631� n�ti )765-9502
P.O.Box 1 179 a
Southold,NY 11971-0959
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: One
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: Primary Rental Unit
Requested Maximum number of persons allowed to occupy Dwelling Unit: 6
Number of rooms in Rental Dwelling Unit: 9
Use and Dimensions of each room in Rental Dwelling Unit: Family Room (15' - 5" x 31' - 8")
Kitchen (18' -4"x 16' - 9"), Bedroom 1 1 `- 2"), Bathroom 1 (10' - 11" x 7'- 8")
Bedroom 2 (11'-1" x 13' - 3"), Bathroom 2 ( °- 10" x 7% Bedroom 3 (10' -8" x 11' - 3")
Laundry Room 13' - 10" x 15' - 1" , Lower Level Family Room 14' -4"x 34' - 9"
Page 3 of 5
Town Hall Annexe Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 1 1971-0959 g ��
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BUILDING DEPARTMENT
TOWN OF SOUTxOLD
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/ 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 4of5
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Town Hall Annex deli Telephone(631)765-1802
54375 Main Road n �a Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 ���
BUILDING DEPARTMENT
TOVIN 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. 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 S Mana er.
Property Owner's Name: tm
Property Owner's Signature:
400!S5X MA
Sworn to before me this day of 0�. � ;« ' STATE
e OF NEW Yt18K `•O
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NOTARY PN� K:
QWfftedin »'
Official Notary Public Signature and Origi { Notary Stamp -.w 4S a, `. at 1
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Page 5 of 5
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TOWN OFSOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORMING PREMISES
THIS IS TO CERTIFY that the
lx]f Land Pre C.O. #- -
/x71 Building(s) Date- _XAX h,,M_ -,,,,, 1987
rl Use(s)
located at 505 BUNGALOW LANE MATTITUCK
Street Hamlet
shown on County tax map as District 1000, Section 1 23 , Block 03
Lot 07 does{not conform to the present Building Zone Code of the
Town of Southold for the following reasons;
Insufficient total area. Insufficient side yard set-back.
On the basis of information presented to the Building Inspector's Office,
it has been determined that the above nonconforming %xkLand /x$Building(s)
/_/Use(s) existed on the effective date the present Building Zone Code of the
Town of Southold. and may be continued pursuant to and subject to the appli-
cable provisions of said Code.
IT IS FURTHER CERTIFIED that, based upon information presented to
the Building Inspector's Office, the occupancy and use for which this Certifi-
cate is issued is as follows: Property contains a one story, one family,
wood framed dwelling with attached garage and all situated in the A
residential zone with access to Bungalow Lane.
The Certificate is issued to BERTHA SEH (ROBERT SEH)
(owner, I751KRffiNil1
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO. N/A
NOTICE IS HEREBY GIVEN that the owner of the above premises IiAS
NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec-
tor to determine if the premises comply with all applicable codes and ordin-
ances, other than the Building Zone Code, and therefore, no such inspection
has been conducted. This Certificate, therefore, does not, and is not intended
to certify that the premises comply with all other applicable codes and regula-
tions.
iiuiiding inspector
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATS OF OCCUPANCY
No E-23186 Date AUGUST 30 1994
THIS CERTIFIES that the building ADDITION AM ALTERATION
Location of Property 505 f4 LANE MATTITUCK NY
House No. Street Hamlet
County Tax Map No. 1000 Section 123 Block 3 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 28 1992 pursuant to which
Building Permit No. 20952-S dated SEPT EMBER 11 1992
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 A PARTIAL SECOND STORY ADDITION AND ALTERATIONS TO EXISTING
ONE FAMILY DWELLING AS APPLIED
The certificate is issued to JANES & JANET NII,LONEY
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. B034278 APRIL 12r 1993
PLUMBERS CERTIFICATION DATED TANDY PLUMBING & BEATING 4 1994
7",'d, C, A?,e
/Oailding 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
No 2-24006 Date NOVEMCBER 2r 1995
THIS CERTIFIES that the building ADDITIONS
Location of Property, 505 BUNGALOW LANE HATTITUCK01 N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 123 Block 3 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 29 19,94 ursuant to which
Building Permit No. 22192-Z dated JULY 18 1994
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 COVERED PORCH ADDITION & DLCK ADDITION TO EXISTING ONS FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to JAMES MALONEY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-047433 - OCTOBER 19 1995
PLUMBERS CERTIFICATION DATED N/A
uk1ding 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
No: Z-31643 Date: 06 28 06
THIS CERTIFIES that the building PORCH ENCLOSURE
Location of Property: 505 BUNGALOW LA MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 123 Block 3 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 7 2005 pursuant to which
Building Permit No. 30884-Z-Z dated JA UARY 7, 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 FRONT PORCH ENCLOSURE TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JAMES A. & JANET HUGHES MALONEY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _ NA
ELECTRICAL CERTIFICATE NO. N/A
PLUM CERTIFICATION DATED /A
r
thorized Signature
Rev. 1/81
Town of Southold 3/4/2017
P.O.Bog 1179
53095 Main Rd
` Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38848 Date: 3/3/2017
THIS CERTIFIES that the building SOLAR PANEL
Location of Property: 505 Bungalow Ln,Mattituck
SCTM M 473889 Sec/BloddLot: 123.-3-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application,.for Building Permit heretofore filed in this office dated
11/18/2016 pursuant to which Building Permit No. 41190 dated 11/23/2016
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 vanels on existingpne amity dry i fbr.
The certificate is issued to Maloney-Hu es,Janet&James
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41190 12/28/2016
PLUMBERS CERTIFICATION DATED
Autbori ed S taature
eh Town of Southold 9/1/2022
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43392 Date: 9/l/2022
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 505 Bungalow Ln,Mattituck
SCTM#: 473889 Sec/Block/Lot: 123.3-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/24/2022 pursuant to which Building Permit No. 48087 dated 7/19/2022
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:
"as-built"oqtdomushpmerr,as wliqd,for.
The certificate is issued to Maloney James A Rev Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED 8/2612022 am loney
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