HomeMy WebLinkAbout1000-126.-11-17 TOWN OF S UTHOLD
Rental Permit
1325
Owner: Caracciolo Jr L 2022 QPRT , Caracciolo L 2022 QPRT
Occupied as: Single Family Dwelling
Located at: 8070 Great Peconic Bay Blvd Laurel 126.-11-17
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.
Issued: 06/02/2025
Expiration: 06/02/2027 C e rme cial
This Notice must be posted by the main entrance at all times
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 Itf ;: Iwrrv.soutlr+ dtcawn o
RENTAL PERMIT APPLICATION E t"A E 0 V E
Rental Permit Fee$300(Application must be renewed every two y t1d
R 1 2
Building Department
Section A. Town of Southold
Property Information: 3-��
Rental Property Address: C, �� C
8070 GREAT PECONIC BAY BLVD,MATTITUCK,NY 11952
Tax Map Number: 1000 SECTION 126 -BLOCK 11 -LOT17 -0
SECTION B.
OWNER INFORMATION:
Property Owner Name: LOUIS&LISA CARACCIOLO
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
8070 GREAT PECONIC BAY BLVD,MATTITUCK,NY 11952
(SEPARATE DWELLING UNIT ON THE PROPERTY)
Telephone Number(s): Daytime631.484.2097 _Evening 631, 42097 Emerge ncy831.484.2097
Property Owner Email Address: Iceastend@gmall.com
Page 1 of 4
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: f 0?4 3 .` �i3�c l�GuOld
Address of Authorized Agent (no P.O. Boxes): erlarl
Mailing Address of Authorized Agent: ��• �� 3�Z 1�,vrt l /1. 1/9`�
GWl
Telephone Number(s): Daytime 'IW%e90117 Evening Emergency
Email Address: ea ale
�i3�-CJ sew �'�.�n,�i✓�q .mom
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):
Mailing Address of Managing Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address:
Page 2 of 4
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: 1
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example,
Unit 1, Unit 2, Unit 3 or Apt A, B, C); 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: House 1
Requested Maximum number of persons allowed to occupy Dwelling Unit: 6
Number of rooms in Rental Dwelling Unit. 8 Rooms (3 Bedrooms)
Use and Dimensions of each room in Rental Dwelling Unit: Bedroom 1(11'-6"x9'-7")
Kitchen(8'-8" x 9'-3"),Dining Room(19'-5" x 7'-8"), Living Room (19'-5" x 12'-3")
Bath 1(5'-5" x 2'-11"), Laundry (9'-6" x 9'-0"), Bath 2(6'-4" x 6'-4")
Bedroom 2(17'-2" x 9'-6"), Bedroom 3(19'-8" x 12'-2")
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
X 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 LOU IS CARACCIOLO 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: Louis Caracciolo Lr,
Property Owner's Signature:
Sworn to before me this /Y day of 20,��
Official Notary Public Signature and Original Notary Stamp
ns
Notwy Publlc,State o Now Itut
No.31.4970341
Cualmed In Suffolk CO
COMISSion ExPlres February 4, Page 4 of 4
„m
Town Hall Annexe � Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P. O. Box 1179
Southold, NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a licensed architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Professional seal re urirad for Architect or Engineer, Licensed Horne Ins actor must
rovida co2y of vapid current certification
Rental Property SCTM Number: 100-126-11-17.0
Rental Property Address: 8070 GREAT PECONtC BAY BLVD-SOUTHOLD MATTIUTCK,NY 11952
Owner/Name: 8070 PECONIC BAY BOULEVARD,LLC
Rental Dwelling Unit Identifier: HOUSE 1
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 — 100 sqft., Bedroom#2—90 sgft.,etc.)
BEDROOM 1(1 V-6”X 9'-7")
BEDROOM 2(17'-2"X T-61
BEDROOM 3(19'-8"X 12'-2")
Property Description (Include all improvements indicated on survey)
+-1 ACRE LOT WITH DOUBLE STORY-SINGLE FAMILY RESIDENCE-CAR GARAGE IN FRONT YARD.
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, the Fire Code of New York State,the Property Maintenance Code of New York State
and the Energy Conservation Construction Code of New York State.
Zackery E.Nicholson,RA
° O C
Print Name and Title Original Signature ,
1 Z
Please place Professional Seal:
' 04442-5
0z
0 so�rr ,
TOWN OF SOUTHOLD BUILDING DEPT.
.� 631-765-1802 7
IN Si` �'' E(Ck T lu"k N
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ 44ENTAL
REMARKS:ARKS: (2-
a_ a S R
DATE INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802 7
INSPMUT140"' N
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [L�ZRENTAL
REMARKS:
dC
DATE 5��i'o� INSPECTOR
QF Sol/����
TOWN OF SOUTHOLD BUILDING DEPT.
� '631-765-1802
INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ �ENTAL
REMARKS: r 4e-
DATE
FORM NO- 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y_
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No_ Z- 30470 Date: 10/01/04
THIS CERTIFIES that the building DWELLINGS AND ACCESSORY
Location of Property 8070 GREAT PECONIC BAY BLVD _ LAUREL ryesµ_
(HOUSE NO.) (STREET) _ (HAMLET)
County Tax Map No_ 473889 Section 126 Block 0011 Lot 017
Subdivision � � filed Map No_ Lot No_
conforms substantially to the Requirements for a ONE, 'FA14IL D�JEL;LI'HG�
built prior to APRIL 9 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 30470 dated OCTOBER 1, 2004
was issued, and conforms to all of the requirements of the applicable
1
provisions of the law. The occupancy for which this certificate is
_ � SCREENED PORCHES P1dD OUTDOOR SHOWERS
issued is TWO ONE FAMILY DWELLINGS WITH SC PORCHES _ D OUT
AND AN ACCESSORY TWO CAR GARAGE.*
The certificate is issued to WILBUR F OSLER III_
(OWNER)
of the aforesaid building,
SUFFOLK COUNTY DEPARTMENT OF BT{ALTH APPROVAL
ELECTRICAL CERTIFICATE NO. NIA,
PLUMBERS CERTIFICATION DATED —NIL
*PLEASE SEE ATTACHED IMSPFCTION REPORT.
Z F..cad*~ red -i ature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 8070 GREAT PECONIC BAY BLVD LAUREL
SUBDMSION: MAP NO.: LOT (S)
NAME OF OWNER (S): WILBER F OSLER III
OCCUPANCY: DWELLING B - SINGLE FAMILY WILBUR F OSLER III
ADMITTED BY: WILBER OSLER III ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO_ TAX MAP NO.: 126.-11-17
SOURCE OF REQUEST: WILBER OSLER III DATE: 10 01 04
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 0
FOUNDATION: CONCRETE BLOCK CELLAR: 1 5 CRAWL SPACE: 4 S
TOTAL ROOMS: 1ST FLR.: 3 2ND FLR.: 3 3RD FLR.: 0
BATHROOM(S): 1.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S)
PORCH TYPE: SCREENED PORCH DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER. YES TYPE BEATER: KEYSPAN GAS AIRCONDITIONING:
TYPE BEAT: KEYSPAN WARN AIR: X BOTW'ATER:
OTHER: OUTDOOR SHOWER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST-:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION AR"8". SEC.
I
I
R22CIRKS: $y.
^9 B
1
INSPECTED BY: DATE ON INSPECTION: 09 24 04
GARY J FI TIME START: 10:30AM END: - d
a + gFFlll
Town of Southold 2/3/2020
7 P.O.Box 1179
7 �!
53095 Main Rd n�
Southold,New York 11971 1"-
CERTIFICATE OF OCCUPANCY
No: 41030 Date: 2/3/2020
THIS CERTIFIES that the building RESIDENTIAL ADDITION
Location of Property: 8070 Great Peconic Bay Blvd,Laurel
SCTM#: 473889 Sec/Block/Lot: 126.-11-17
Subdivision: Filed Map No. Lot No.
confonns substantially to the Application for Building Permit heretofore filed in this office dated
_. ._8/14/2013 pursuant to which Building Permit No. 38285 dated 8 27/2013
was issued,and confonns to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
AD DlTI( N SAND-I t I;IATIQNS IN I�1,�ING I ;1_ w i PC R aI l'1"'O AN 1 i I 1 4 )l l".I Alvll
DWELLING IN(i AS APPLIED FOR PI; B l 1 i ;1 t AT�D 103-12-20
The certificate is issued to 8070 Peconic Bay Blvd LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 38285 05-28-2014
PLUMBERS CERTIFICATION DATED
_... ., � �� .�..
A a ri
�d ignaturo __a.._�.. .._n..�
1
g FORM NO. 4
f
TOWN OF SOUTHOLD
d
BUILDING DEPARTMENT
Office of the Building Inspector
j Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29970 Date: 01/20/04
THIS CERTIFIES that the building ADDITONS�
Location of Property: 8070 GREAT PECONIC BAY BLVD LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 126 Bloch 11 Lot 17
Subdivision Filed Map No_ Lot No.
conforms substantially to the Application for 'Building Permit heretofore
filed in this office dated NOVEMBER 13, 2003 pursuant to which
Building Permit No. 29871-Z dated NOVEMBER 13, 2003
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
EXISTING SINGLE is TWO ADDITIONS & DECK ADDITION TO EXISTNGLE FAMILY DWELLING�.....,,
AS APPLIED FOR, & AS PER ZBA ##4470.
The certificate is issued to WILBUR F. OSLER
(OWNER)
of the aforesaid building,
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECITRIC'AL CERTIFICATE NO. N-311143 04/21 94
PLUMBERS CERTIFICATION DATED 01/20/04 PERFECTION PLUMB.&HEATING
6
�.._.,.....�.....�...... t.._. or'zed S1ry,.mat„ .. ..�..»
re
Rev. 1/81
1
j
a
f
_, TOWN OF SOUTHOLD PROPERTY RE O
I GWNEI I: —N= VILLAGE DIS' LOT
" f, `r�
Sr
I FORMER OWNER N — E ACR.
r i �
z
S W TYPE OF BUILDING
o- s
RES. - ; SEAS, 'VL. ;FARM COMM. CB. MISC. Mkt. Value
LAND I IMP. TOTAL , DATE REMARKS
1-7
I L 71 NT�2
F 6
d
. .
NEW AL - t
Qp
Tj
FARM Acre Value Per 'Value
Acre
Tillable 1
i
e, r` c,
Tillable 2 _
K .
Tillable 3
Woodland
Swampland FRONTAGE ON WATER
Brushlond FRONTAGE ON ROAD
House Plot DEPTH l
s
t BULKHEAD i
s
Total jDOCK
1
. .
\ \ ` TOWN OF SOUTHOLD PROPERTY RECUKLO oAD ,
OWNER STREET ILLAGE DIS, SUB LOT
z77 : reds «
FORMER OWNER 2 N E ACR
! |
| S W TYPE OF BUILDING
a �
am-
RE. ! SEAS. VL �FARM `EOMM. Ek MISC. Mkt. Value
LAND IMP. , TOTAL DATE REMARKS
| �
=\ z
;
,
: . . . . . . . . . . . . . . - - -- -
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
... �
ARM ! Acre Value Per Value
Acre
Tillable l !
Tillable 2
� ; !
Tillable ] ;
Woodland |
Swampland ; ) FRONTAGE ON WATER
, ; . . .
. ,. .
Bms@on | | FRONTAGE ON ROAD
House mJ ( DEPTH'BULKHEAD
T ter ! , \DOCK
- |
t
1
r -
N
�
All _
c t
1
e,
N.�
3
v
L
126.41-17 #1
1 81d �i� 5C3�$ g�G� 25 Foundation Bath I �Z Dinette
3?� _E
Extension Basement Floors Kit.
zX �1 zz
Extension .ab
y Interior Finish L.R
E Walls ,
� Ext. 3��
K 2,!, - �m
Extension ,� Xto r Fire Place o�E Heat l=S D.R,
Patio ofl21 qz Woodstove BR.
Porch e.,r ,4 27k Dormer Fin. B.
-Deck 5y,_�S= 75 �+ ,C Attic
Rooms 1st Floor
i
Garage] 2�OX E$ 3�a / Ic 636 Driveway Rooms 2nd Floor
0.8. Z
Pool _t
��- i�7
E
t
COLOR
i
E
[ TRIM '
of
Jf
7TT:
i
=
i
= I
r
E i
I i
3
12 .41- 7 ##2 1-
M. BBldg. - v� s ,Foundation Both Dinette I
a
�. _.� u
Extension I �- Floors K.
�` .q � 6o k{p 'Basement
Finish LR.
Extension Ext. Walls Interior
I �� ""
Extension Fire Place �;
1 Heat DR.
1 � T e Raof !Rooms 1st Floor ' BR.
_ yP
n7 i
Porch a — Recreation Room Rooms 2nd Floor ; FIN. B .
Porch I � Dormer
I— -
Breezeway y
Drivewa i t
Garage
_
Patio
a i E
O. B.
Total
J I
Jj
s � e
1h�t� -I�t .--tl-tom
s
s
COLOR ,r i
I I
f ;
I
' TRIM '
L1,x
J i
LL
{
4
3
'
Bath r; : Dinette
M. Bldg, i � ® � � � D l�, ��_ � 'Foundation �
Extension i
�' i � Floors � K.
_ �? �: :Basement r 'T _
a
r
Extension X /;� =�1 Ext. Walls Interior Finish _ LR_
f<
Extension ?Fire Place ' Heat r ,,- DR.
1
TYPe Roof Rooms R -
= 1st Floor 6R
r 3 Recreation Room Rooms 2nd Floor; ! FIN. B
Porch P A �`� � y � #� � � v
6
Porch KN �.n s' € ;Dormer
Breezeway 1 l ! 'Driveway
I
Garage L
Patio
O. B. I
Total
s
I
SYMBOL' Imc gzN
e
vv S 10KE D rECTOR
CO2 DETECTOR
ZEN DESIGN
Cil`-=.'`=<B;aAT',IION SMa`-ME&C 2D< MO EVERGREEN DRIVE
CUTCHGGUE,NY 11935
PHONE:63151&6589
I
I NO ISSUE
01 RENTALPERMIT 12A
ii
i
E€ '-
3 OOQ!
'I o c SCREEN PORCH
ig t<
t
FR(DGE i E IdisROOM
I
3
044423 4�
DINING ROOM' r�OF r4s"ti�
3 �
CARACCIOLO
RESIDENCE
3 _ 8070 PECONIC SAY BLV
i MATTFTUCK,NY 31952
1000-126-11G0-17000
SCALE: 1(A'
DATE 12
DRAWN BY:
EXISTING
FIRST FLOOR PLA
A '
3,N: O
S CO2 DETECTOR 7— v
ZEN DESIGN
COMBIN,Ai;ONSMOKE&-a'-.LG Ci s;Ei'. 1250 EVERGREEN DRIVE
CUTCHOGUE.NY 11936
PHONE:631513.6589
n.gw.�aox%�ia Wnn
- moMO��.tn iT YSa.xee�+xe WwmMissnmss
NO. ISSUE
LAUNDRY
01 RENTAL PERMR 12.i
-T I I
s 15 _ j �tE� ABC
! 16 {E,tVt� '�
6 c 9'-6" 04442'' i2
I 4lF QF�E`'`�y
O
CARACCIOLO
RESIDENCE
{ t j 8070 PECONIC RAY BLV
MATTRUCR,NY 11952
MUD-126-1100-17000
SCALE 1/4--
DATE: 12
DRAWN BY:
EXISTING
SECOND FLOOR Pt
N ✓v�•• t NEAR 1'A 1 1 ITUOK
W E S�1�G ac4uNly,, NY
u"/ SURVEYED 10-12-99
f n PROPOSED PORCH 10-10-03
�'�g. ( i
°� �qq �+yy ! SUFFOLK COUNTY TAX
'"� �vf'f C 1000-126-11-IZ 1
CERTIFIED TO:
WIL51 F.OSLER HI
� � Y
,day a V^y ° LOT COVERAGE TABLE
EXISTING COTTAGE FOOTPRINT 657 S.F. I
o x EXISTING 6ARA6E FOOTPRINT 56l S.F.
EXISTING HOUSE FOOTPRINT 050 S.F. 1
TOTAL LOT GOVERA6E 2gO4 S.F.
'6' 1
r+a LOT COVERAGE 9b%
PROPOSED PORCH FOOTPRINT 156 S.F.
�} NEW LOT COVERAGE 3040 S.F.OR 10% y
3 ,
0 \
1 %
k1.
r
"A yno l
O
? I
AQ
6
m �
%r ✓.k^" �S`,f�t � ,Nt[m of vet N+b�.`5te�d`PAuet[1m•Ya
V NOTES:
41 MONUMENT
0 PIPE " :awes AREA=30,154 5F OR 0.6G ACRES "�. fij� t,���" """`�` "�°"'°�"
JO C. EHLERS LAND SURVEYOF
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
6RAPHIG 5GALE 1"= 30' RIVERHEAD,N.Y.11901
_.
369-8288 Fax 369-8287 REF.-T[GER\PROS\99-265