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Home My WebLink About1000-111.-6-19 g TOWN OF SOUTHOLD kv� Rental Perm•*t Alf 1141 Owner Nicole Procida & Stephanie Durand Occupied as Single Family Dwelling Located at 2550 Haywaters Road Cutchogue 111.-6-19 Maximum Permitted Occupancy 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. 5/30/2024 bode c nt 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 m � i Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION D Rental Permit Fee$200(Application must be renewed every twnyrs) ju - 6 2022 L,rIIT.,D G DET"T. TOWN OF CATVTI "T: Section A. Property Information: Rental Property Address: :d1 Tax Map Number: 1000 SECTION -BLOCK -LOT - SECTION B. OWNER INFORMATION: � Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytime Eire'ning Emergency Property Owner Email Address: ��" �-A t�' ° ' �� Page 1 of 5 Town Hall Annex h1 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 00 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: �w_�,,, __ Address of Authorized Agent(no P.O. Boxes): , , , __ , Mailing Address of Authorized Agent: .� Telephone Number(s): Daytime__,ww Evening Emergeny _ Email Address• _mm_w..... 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 Emergent' 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. Page 2 of 5 Town Hall Annex 1 Telephone(631)765-1802 54375 Main Road ; Fax(631)765-9502 P.O.Box 1179 - Southold,NY 1 1971-0959 T j 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: _� � 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." "' t I Rental Dwelling Unit Identifier: persons ed to occupy Dwelling Unit: s Requested MaximumVnumber wuWM„� „NNW o per o s s � ii�u enal Dwelling Unit:Number of room and DiMensions of each room in Rental Dwelling Unit: Page 3 of 5 Town Hall Annexo Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �� w BUILDING DEPARTMENT TOWN OF SOD°1'"HOLD 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 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 Nall Annex ;, � Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 f P.O.Box 1179411,5 Southold,NY 11971-0959 " % BUILDING DEPARTMENT TOWN OF SOUTHOLD applicable laws and rules. 1 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 u day of , 201' IN P ��p NEW YC4K " O Nal N ary Public Signature and Original o� � p REc r^ tip 13129 Page 5 of 5 TCM"1�1 N OF ��UTHOL D B�UIL DIN Mw► EPT. INSPECTIUM [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ]�FIRE L FIREPLACE & CHIMNEY [ SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL/FAL) CODE VIOLATION [ ] PRE C/O [ ENTAL REMARKS: a A,16 Prl(w11 t � *VS DATE � � � INSPECTOR A. TOWN OF S UTH LD BUIL G D P'T. 31 IN*PECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [YFIRE LATION/CAULKING FRAMING /STRAPPING [ L FIREPLACE & CHIMNEY ( SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI AL) [ ] CODE VIOLATI!,QK [ j PRE C/O ( RENTAL I' EMASI S: 4YtReA. .I-h9 fy�:(�Vk K ow � �4VA Wye\ k2vzo m C4, -v (_3 DATE _ INSPECTOR V/h/ OVIV LL p 0 0 N-NaSHFOMSMENT UTILITY ROOM p � 6 O .a..W. UTILITY a CLOSET 00 "D CL CL BASEMENT PLAN 5CALE:I'-9= 1/8" 06/06/2022 2550 HAYWATERS ROAD BASEMENT PLAN CUTCHOGUE, NY 11935 f fl,�f �n� O SCE DINING ROOM LIVING ROOM CLOSET FL BATH 0 IJIIBOi VET O " 2 CL w... O ME 0 o GET 00 BEDROOM 2 117 fR L��ON,CKITCHEN BATH CONCH �.....„..�.. STEP.. o o O DU wwze onr . CL, CL LAUNDRY HF BATH SIM UEf BEDROOM 1B3fF GARAGE MAIN FLOOR PLAN SCALE:I'-O"= 1/8" 06/03/2022 2550 HAYWATERS ROAD MAIN FLOOR PLAN CUTCHOGUE, NY 11935 Fl A BURNER f" FL BATH O a O Pt 4.✓ O O Y=M1@d1�fMlfi�*,x"::Lut�?p�d"tl' UTILITY ROOM py O f,9Tll+ O UTILITY q,m CLOSET o OO „ BASEMENT PLAN 5CALE:1'-0"= 1/8" 06/06/2022 2550 HAYWATERS ROAD BASEMENT PLAN CUTCHOGUE, NY 11935 Bl ENCLOSED CONCRETE PATIO A. Q nee. z � I ' ; ergo: Der BEDROOM 1 195 W DINING ROOM LIVING ROOM CLOSET FL BATH Gant In ttT O a CL O sm 0 G � � 0 BEDROOM 2 117 ft2 CONC KITCHEN STEP ---- FL BATH •••.. ..._. -_ CO NC A2jL—CL STEP 0 0 wm DRY CL LAUNDRY HF BATH sm wr 4 W* BEDROOM 3 183 ft2 GARAGE MAIN FLOOR PLAN 5CALE:1'-0"= 1/8" 06/03/2022 2550 HAYWATERS ROAD Fl CUTCHOGUE, NY 11935 MAIN FLOOR PLAN � a Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 j4 s Southold,NY 11971-0959 00'' BUILDING DEPARTMENT TOWN OF SOUTHOID 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 P'ro slonal sea!re ulred or Ar+clritect or Fn leeer licensed Dome lns actor mast rovide My valid c rren c�ertl ication Rental Property SCTM Number: (0 — 19 Rental Property Address: -Z 57D HAYL-ATCAS 20*0 CUTC H a fea r N y It 93 S Owner/Name: I , /V Rental Dwelling Unit Identifier: S'^� ' " N VIE Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom #1 -100 sq., Bedroom#2-90 sq., etc.) M701100h4tI. : 19 S Sa 13e0(L00el r-1 2)( 1 S+Q Property Description (Include all improvements indicated on survey) Co# -L-7b'Z : 0^/s= rAn"Lf 0)— L-i_1A/6, CoFF Z19 3 SeOtft;v Punelt co4f Z(955� : � c Boon rN C0"-'A& C0 V z`Z00 Ste{ S1t� vP�N Pe1JMcT j ON PO()L CoA1s,rc�CT-1vov Poop 1(vc01-7PLC7-6-, 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 Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. Print N -Pth�"N Original Signature CID L bLb Pleas p �'� I _ 6 Zo z� , SCTM # I colu- I; . TOWN OF SOUTHOLD PROPERTY RECI— OWNER STREET ,- 4 VILLAGE DIST SUB LOT _ ik, 5 ACR. REMARKS TYPE OF BLD. - 4 COP 1A, c en, PROP. CLASS LAND IMP, TOTAL DATE I I FRONTAGE ON WATER HOUSE/LOT sg_® 1 BULKHEAD TOTAL l � ✓" _ 1 C �� f TRIM iv s I F t { • # 3 � € � I t ' i }a _ # t F r t s m� F f i M. B Idg Extension I Extension g. F , Exte - f �4� "t I /,a o : @ Foundation i Both f nett Basement Floors =K. =`Ext. Walls Aj . , Interior Fi ish � �L R. I - - _ 'Fire Place , ;Heat nil r -N Roof Rooms 1st Floor ,Type ! 5 = .x BR, Patio iRecreation Room Rooms 2nd Floor I FIN. B v b 'Dormer Driveway I - _ Total , F -------------- Lttit��lsle P — jS'.'t°�'-j _ P xa s TOWN OF SOUTHOLD BUfLDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 376,23 . . . . . . Date . . . . . . . . . . . . . .Apr . . . 26. ., THIS CERTIFIES that the building located at HayVaters. Read • . • • • • • • • • Street Map No. IrBss.- Ft.• Pik# No. . . . . . . . . . .Lot No- - -365r. . . . .Cutab • Na is- . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . .NoQ- .23 •, 19.76 pursuant to which Building Permit No. . .8968E dated . . . . . . . . Nov. . . .30. . . . .. 1976 ., 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 - . . .Prf.V&tQ. ow •family. dVQ3.3#n . . . . . . . . . . . . . . . . » . . • . . . . . . . . . . . . . . . The certificate is issued to -Edward. bank. . . . . . . . . . • • . • . • . • • . . . . • . • . of the aforesaid building. (owner, lessee or tenant) Suffolk County Department of Health Approval -Har. .22. . 1.977. . -by- R; -VIA . . . . . UNDERWRITERS CERTIFICATE No. .11332655. • • • •Apr . •12• • •197g • • • • • . • • • • • • . HOUSE NUMBER . . . . .25%. . . . Street . , SiRyzoater s• Road• • #as sau•Pow#- . . . . . Building Insp FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19583 Date DECT ER 13 1990 THIS CERTIFIES that the building_ ALTERATION_ Location of Property 2550 HAYWAT;'RS ROAD CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section ill Block 6 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DULY 16 1990 __-_Pursuant to which Building Permit No. 19214-Z dated DULY 221 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 RECREATION ROOM IN CELLAR OF EXISTING ONE FAMILY DWELLING The certificate is issued to LOU CARIO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N-156599 - OCTOBER 19 1990 PLUMBERS CERTIFICATION DATED DEC. 133 1990 - WALTER MARCZEWSKI, JR. Buildjrag 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-19136 Date JUNE 12 1990 THIS CERTIFIES that the building ADDITION Location of Property 2SZ0 HAYWAT'ERS ROAD CCD".'C"C:F. E N.Y. House No. Street Hamlet County Tax Map No. 1000 Section ill Block 6 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 2 1978 ursuant to which Building Permit No. 9699-E dated MAY 2 1978 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 SCREENED IN PORCH ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to— EDWARD BACHORIK (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NIA UNDERWRITERS CERTIFICATE NO. PENDING _ JUNE 12 1990 PLUMBERS CERTIFICATION DATED N/A .wilding 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 Z20054 Date JULY 3 1991 THIS CERTIFIES that the building ACCESSORY Location of .Property, 2550 HAYWATERS ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section Ill Block OAS Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 31 1991pursuant to which Building Permit No. 19922Z dated JUNE 5 1991 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 SHED IN REAR YARD. The certificate is issued to LOINS & PATRICIA CAIRO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL AI A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N A �` uilding Inspector Rev. 1/81