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Home My WebLink About1000-97.-6-6 TOWN OF SOUTHOLD Rental Permit 47 1129 i r - Owner 470 Harbor Ln LLC Occupied as Single Family Dwelling Located at 470 Harbor Ln Cutchogue 97.-6-6 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. 5/22/2024 Code fore nt Offi This Notice must be posted by the main entrance at all times a 6 TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971,0959 Telephone(631) 765-1802 Fax (631) 765-9502 t tP //ern Vc c +10-7 12-1 RENTAL PERMIT APPLICATION C) 0 q—I Ira 4 Rental Permit Fee $300 (Application must be renewed every two years) SP 9 Section A. Property Information: Rental Proper ty Address: Tax Map Number: 1000 SECTION - BLOCK -LOT to - SECTION B. OWNER INFORMATION: Property Owner Name: � " (� rrn Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 153 4 ,. 1° �� " *e ,) Telephone Number(s): Daytime Emergency )� 2,y` W Property Owner Email Address: t �" ` ",. Page 1 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." LReq elling Unit Identifier: Maximum number of persons allowed to occupy Dwelling Unit: f rooms in Rental Dwelling Unit: imensions of each room in Rental Dwelling Unit: 2 r a �►� 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 ❑ I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I ? certify under penalty of perjury,the following: 1. I 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 Agen ,or Site Manager, Property Owner's Name: tiwLL JJ Property Owner's Signature: Sworn to before me this day of , 20 n � w� Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Page 4 of 4 Qualified in Suffolk County Commission Expires April 14,2_a Li f4f so TOWN OF SOUTHOLD BUILDING DI 631 -765-1802 17. M y , INSPECTION 9 fF" I ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI. [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INE [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit ooe [ ] CODE VIOLATION [ ] PRE C/O [ 1 REMARKS: DATE INSPECTOR Town Hall Annex Town of Southold 54375 Main Road ED Rental Inspection Report PO Box 1179 Izo Southold, NY 11971-1179 Tel: 631-765-1802 CTM# ..�..! " Date �.. ....�. ....m �.w ... ...._ �... ,real Owner .... Phone Address Visible Hamlet " Inspector Floor Level Quantities �... .-..... .. .....a... Sub 1 � � . 2 � 3 min o bedroom ate rs Smoke Detectors not located in s / �.,�..m , . � . .....�.. ........ �.,� ........ . ��...M , ., �ro r �,a� �.. .� ... ....., ...... ........� ......� . �.� Carbon Monoxide Detectors .1-1,,....w ��.� �v. w . .. ...�M. . . .W...... .. �.. . ... . � r 1 Fire Extinguishers Exits 1 . . .-..� .. .......� � D...... .�. ......... _.. B edroo ms 1 4 5 . 6 Smoke Detectors Egress 6ccu ant Count � ......_��.... '�.. C.� ........... .�. ...... .... . ... � �.p ..... ..... �.ware.�..�. . ....._ .. � .....� . ..... _.._�w. .. .w.... �..w. ... ., .®® [Building Systems Maintained&Ope rational Condition of Property Heating _.�. ng Building interior m m .... .w _... . Hot water Building exterior Electrical .. _..,..,...,m .a. ,...,,, �„ m ..... �w.�.� � �..w�.. ..-..� ..�.... ...�. .. . u�w�oo. Property clean, maintained &safe . N Handrails& s guards installed & ecure Mechanical .... . . .......��e._ .. ._ .. .. � caw.., ,_....i............ _ ..��......_..� ��.� Pool Pool on Site Safety �... ........ w _. . .......-., Date of CO issuance Surface water alarm Door alarms Pool completely enclosed Self closing/ latching gates Pool fence to code requirements jCO s for allitems present j Prior Rental .. w . . ... . ��........ ..��m, . ...�_ .. Comments ...... . , .m .. _......,. _ m., �......... ,.. _........ , .............. ...... _.. .. ..__.._ ...... ._. _. �...... . .... W..�... ._.............................. __ __...�. , �. , ��aw.. , _...�. ._... _. . ......... . ... _, . ............. _n.. �i trffi� OWNER zjA45L FSTREET a VILLAGE DIST, I SUB. LOT CFO"ER OWNER ,a E z N .` � � AIR. " I F 1/� ��/ dye + p _, - i S W TYPE OF BUILDING �� = i G _ RES. SEAS. VL, ;FARM COMM. CB. MICS. _ Mkt. Value I LAND IMP. TOTAL DATE REMARKS ' _ J/j £ 2 h s '� r t r _ _ i t _v g f 3q j f a f J i Y / I 7 i $ a . I Tillable FRONTAGE ON WATER i Woodland FRONTAGE ON ROAD Meadowland DEPTH 3 _ House Plot BULKHEAD i Total FORM No. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. c _ Certificate Of Occupancy No. . . . . . . Date . . . . . . . . . . . . . . THIS CERTIFIES that the building located at . .W f8 .Harbor. La. . . . . . • . . . Street Map No. . IXX. . . . . . . . Block No. . . XX. . . . .Lot No. . . . . . . Cvtaho .i. .x . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . .fty . .19. . . . ., 19. 7} pursuant to which Building Permit No. . 5321Z. dated . . . . . . . . . . .X& . . 2.$ . . ., 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 . . F.rifttS. OA*.fAMilY. .dwe]1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .400t, dl.910440r. AUSUA . . . . £meta. . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval *at. . .14t• .14971• • •by• R: Y131a. House # 470 Building Inspector µ `,. 4�I1tAll,�� ., Town of Southold 2/4/2024 P.O.Box 1179 53095 Main Rd 4 Southold,New York 11971 C Rrr1F CA"W E OF OCCUPANCY No: 44929 Date: 2/4/2024 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 470 Harbor L n, Cutchogue SCTM#: 473889 See/Block/Lot: 97.-6-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/21/2022 pursuant to which Building Permit No. 48632 dated 12/20/2022 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: addit is and alterati,c t in ludic gftc 1,t rtd3m tt stoop ai dw utdooz showrt:..to rW t- _lrlgl,� lw�1t �Ny el ��mt��g.a apj)Lt:d..for, The certificate is issued to 470 Harbor Ln LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48632 1/30/2024 PLUMBERS CERTIFICATION DATED 12/15/2023 E: d 1'iecucl `iz c Signature `'�'�✓-";_"-� ��5�-,ASKS Legend—=---�tiL 'wi EE, i ieNY. `X:v..Pena ` E 5 4 c k f� � �'sue � � _ � � ��✓�_' [ R E _..__. __�ii , � ` 1 i� 2^^ ''x R t•-€- G' -2 I � ✓`'"n ... .— _ _ .__ sn.rs m.uz.a...e�zo zuu. t� �_ �'� EXrU ExrG 3F occon 3 � iF t t v _E Existing First Floor w/Alle-otions i ".vasrnrur � � sm� a - 3 n U — O n al 4 g " a Existing Basement Pi an -- �'at f d.Stoo ddjiic+n�&interior AlteL U for gym_ _�. 470 Harne Olt f5 >go1:e,�.a.