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Home My WebLink About1000-76.-1-6 Fuji TOWN OF SOUTHOLD Rental Permit q .� 0545 Owner Joanne Tantillo & Richard Lawall Occupied as Single Family Dwelling Located at 135 Bayberry Road Southold 76-1-6 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. 10/12/2021 ode f rc nt official This Notice must be posted by the main entrance at all times Town Hail Annexe Telephone(631)765-1802 54375 Main Road sw Fax(631)765-9502 P.O.Box 1179 � Southold,NY 11971-0959 Y BUILDING DEPARTMENT M�C,�a TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address Tax Map Number: 1000 SECTION � (7,...ww .,w_-.....:BLOCK D(•aD SECTION B. OWNER INFORMATION: Property Owner Name: ._ p Y ...° _LAWA Z L_......................... _. ......._�w....._.. - _. ......_... . .........�.......... .... Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): Daytime � , � Evening q73-X7-391 mergency '173-4TSL/$89 Property Owner Email Address: w w ;q D�7 7a X- Page 1 of S Town Hall Annex of Telephone(631)765-1802 54375 Main Road ; Fax(631)765-9502 P.O. Box 1 179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ,.-, . ...... Address of Authorized Agent (no P.O. Boxes):,,,,,,,. _...�.�.�.�_.�.�.�.�..._�... . Mailing Address of Authorized Agent: ��... .......M........_.�._ ..�...........�.�. �__....m...�...__.... ...._... .....................a. �__......._.............. � .�, Telephone Number (s): Daytime, Evening ..�.�_u..._��............� Emergen t....._....._.... ..... ......_..... Email Address: -, 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: __1,3j Telephone Number (s): Daytime !,/, - ,.. Evening Emergency._ . _..... Email Address: .�.�. �. :. r� . ..�:: . � �w�.....C�, _._._...._... _. SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if a n _.... ..........a...........��.. .......m......................................�.�.�.�.�.....� Address of Managing Agent (no P.O. Boxes) .......................... .......�..�.._.. ............. ........ Page 2 of 5 Sol k �p Town Hall Annex Telephone(631)765-1802 54375 Main Roadk Fax (631)765-9502 Nc 11.0.Box 1 179 Southold,NY 1 1 97 1-0959 V„ BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: �� ..... .. .... " :�. w� . � .�mm.. .....�,..w Telephone Number (s): Daytime „wwm-fib„� Evening... Email Address: ,,,,.,.,,,,, "��_�:�w.� ''�' �.. � _w..�._.....�.. ...._._. ��.�. ...._.��..._ ........._..... SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: -, ...............................�.�....... ........_ ...��...www. n .._ ....._........._...�... 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: ....�.�.�.�.��.ww ................w......... .......... �...�.�._��...._ ......... _..................P..�........�w....�.� ..�......_. .: .�:�:�.�..._..�.. ..... Requested Maximum number of persons allowed to occupy Dwelling Un" Number of rooms in Rental Dwelling Unit: .......�.�.�.�.�.�o .... .,... ...�.�.w.._..n_...w.w.......�.�u_....... �_.�.�...... ..�...�. ...............�.�.�.�.�_��...�.......a.�.� Use and Dimensions of each room in Rental Dwelli g Unit: t X"o�..�.- a ... �.. t ~.�..�3..�._ ._ w_ .�...o .......�....�� Page 3 of 5 Gown Hall Annex Telephone(631)765-1902 54375 Main Road , Fax(631)765-9502 P.O.Box 1179 ` Southold,NY l 1971-0959 w p BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. IO' 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) .�—V,0AID LPWALLcertify under penalty of perjury, the following: _ ... ..........o........... ... 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 Hall Annex Telephone(631)765-1802 5437.5 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 � " � eo BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Site Manager. Property Owner's Name: ( � Property Owner's Signature: : Swan to before this av of 200 1 _.. :..........�. _ ....................� /'Official Notary Pu IIc Si �� ture and µOriginal Notary Stamp"..µ ..., ._.... =ROSAlicerseys P'eb.11.2024 Ol Page 5 of 5 OpRttl or .0e �V (rr VAROWAVE $RO4WER " ... .. STOVE DOOR TCIBASEMENT STAIR T D�dr� i FIREPLACE BEDROOM KITCHEN °i...... LIVING ROOM 1 (13'8'x9'-9") OW.. i BATHROOM T i .C'L,0- PANTRY m .. `,,... CLO i DNING ROOM r� w (IiE-2'x13'-7') (Y� f ".*ASTER BA'R OFFICEIPL1 YROOM CLO. - F ... ... a Pw .. CLO. CLO, r �a,w MASTER BEDROOM BEDROOM i....... »� (15'x12'-7') (12'-6'x15'-1') SCREENED IN PORCH I .._.__.............._.........-., LF GAPAGE FlPEPLAtE NRCNEN xNGO (D ENLARGED P--HOUSE BASEMENT ao ENLARGED PLAN-GARAGE YASfEA DR.—4-111.1 SCREENED M "S—) LED-a-D Proje,t S.—CIECIDN LAWALL RESIDENCE 135 BAYBERRY RD, SOUTHOLD,NY 11971 ENLARGED PLANS ENLAR�GE�PLAWHOUSE FIRST FLOOR D, oe s I�� Aows �ao I� TOWNIw SO�JTI` OL BUILDING DEPT. ` 765.1802 �6 i INSPECTIO [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] INAL QP,&VM4- f) [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: vc" c w DATE INS °'ECTOI WEER F � STREET PILLAGE DIST SUB}. LOT . w 7 . 3 } g s FORMER OWNER � 4�gCl7 I N E _ I A, , ` S W TYPE OF BUILDING RES. SEAS. ;FARM COMM. CB. MISC. Mkt. Value a i LAND IMP, TOTAL DATE REMARKS _ F c � 7 J / f p 3 I = L L - -77 AGE BUILDING CONDITION E NEW NORtvtAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable 1 Tillable 2 L Tillable 3 I , Woodland Swampland FRONTAGE ON WATER Brushfand ` FRONTAGE ON ROAD House Plot ; DEPTH I =BULKHEAD Total i DOCK j I � z t t � t i COLOR11 Le -- i � 1 3 , a TRIM R y { s i i 46 { M. Bldg , = Foundation = Bath i i Dinette _ Extension �� Basement ✓ = Floors K. ,. t E �� P Extension Ext. Walls Interior Finish LR. Extension f Fire Place ' Heat R. tj Type Roof Rooms 1st Floor 1 BR. Porch _ / ,, . / r Recreation Room, Rooms 2nd Floor = FIN. B F �� , _ as 4 Dormer Breeze--` Driveway Garage - s Patio o. B Total j ! / f 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-24747 Date NOVEMBER 15, 1996 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 135 BAYBERRY ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 76 Block 1 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-24747 dated NO ER 15, 1996 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 ONE FAMILY DWELLING * The certificate is issued to DOROTHY MIHALKO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEAS$ SEE ATTACHED INSPECTION REPORT. Z I i ing Inspector Rev. 1/B1 oo/uo/xo osrAm'Mxwr `nvm or oounm/o /mUS/no CODE INS,00/ow REPORT wrxnnw /»» nxrmnnnr ooxo uoommo�o , N.Y. �numbe�&��ee�7-------------------- --' xonv/v/nino nxr wo. /u�(") __ nxms or nxwnx ("} _'. — ... - �'�� nxcorAwn, u-/ ooa' OWNER DECEASED ------��T--------''--------'---------�� ----'----- - ADM rrr o By:: nzxmn CAacaom xooxpxwcnn BY: wn �xvx� mnK _______--------RlIjrl!".00-"'-7xxxxr NO. _100 p xmm;n OF ncm/cx-r, oIAoNE «ARLuON _ _ DATE! OCT. 29, 1996 h��iH��----------------------�------'-'-------�—�---------------- --- — ,,,x o, nonxrxncrTnn w RAW. I STORIES ONE I EXITS FOUNDATION CEMENT BIA)C CELLAR CRAW1. SPACE BATHROOM BREEZEWAY FIREPLACE DOUBLE FACE GARAGE nownnrIx xo'IVxrcn _YES__ rrrn xn^rnn OIL ^rnoowo/r,on,mn zxrs xoxz oxxm x/x /xnwxrcx orncn: �g��'� ACCESSORY oxxxcn, r,vc OF romnr._______�__________ xznnxGn. T,rs Conoz. n*/nmrmv non/. rocx-r, rr/'E cnmyr. --- orxcx. — ------------- — '--' VIOLATIONS: cxxrrcn 145 n r- STATE nn/pnny rzno ,xsvEsrznw u nnI/o/nG 000n LOCATION ROOF ROOF SHALL BE MAINTAINED IN A WATERTIGHT CONDITION. NYCRR VOL 9B PART. 1242.5 (u) EXTERtOR EXTERIOR SURFACES SHALL BE MAINTAINED IN GOOD CONDITION (e) SURFACES NOT INHERENTLY RESISTANT TO DETERIORATION SHALL BE TREATED WITH A PROTECTIVE COATING OF PAINT OR OTHER SUITABLE ncw^nno. ..... /nxpnono n ox�s or �no�nc�xun NOV. * /**^ �-��_________ -�^�~'�~^~" r/mn x`xnr 9:45 xm con /0,/5 um ~ ° ____- ___ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24746 Date— NOVEMBER 15, 1996 THIS CERTIFIES that the buildJ.,ng'_µ_ ADDITION Location of Property 135 BAYBERRY ROAD.-- SOU".CuOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 76 Block 1Lot �6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 1976 � _mw „pursuant to which Building Permit No. 8566-Z dated MAY 5 1976 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 DECK ADDITXON TO EXISTING ONE FAMILY D E*LLIN'G The certificate is issued to- DOROTHY MIHALKOwww (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ng, Inspector Rev. 1/81