HomeMy WebLinkAbout1000-70.-12-34 of so A WN OF S UTHOLD
Rental Permit
1354
Owner: Hufflepuff LLC
Occupied as: Single Family Dwelling
Located at: 1580 N Bayview Rd Southold 70.-12-34
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.
Issued: 07/21/2025
Expiration: 07/21/2027 Code En6rcaent Official
This Notice must be posted by the main entrance at all times
, ., TOWN OF SOUTHOLD—BUILDING DEPARTMENT ��� R '1 8 24
* Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold.NY 11971-0959
Telephone (631)765-1802 Fax(631) 765-9502 htt.s:/Iwww.souttioldtowp :;ON _
+-goo r'c C-ff/bV9,4
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information;
Rental Property Address:
15 5® tJcr+� -
Tax Map Number: 1000 SECTION �7 C7 -BLOCK y -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address;
(Cannot be the same as Rental Property Address)
LN INrc6ALi 54q �ro�
®bbs � TS6431&
Telephone Number(s): Daytime Evening Emergency
Property Owner Email Address: Ca.ro�
Page 1 of 4
Section C.
Authorized Agent Information: --~.....
Name of Authorized Agent of dwelling unit, if any;
Address of Authorized Agent(no P.O. Bo
Mailing Address of Authorize ent:
Telephone Number Daytime Evening Emergency
Email A ess:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent(no P.O. Boxes):
Mailing Address of Authorize nt:
Telephone Num sj: Daytime Evening Emergency
Ema' dress:
SECTION E.
SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any: ww.
Address of Managing Agent (no P.O. Bo
Mailing Address of M ging Agent:
Telephone mber(s): Daytime Evening Emergency
ail Address:
Page 2 of 4
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: E
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example,
Unit 1, Unit 2, Unit 3 or Apt A, B, C);the use of each room in the Rental Dwelling Unit
(for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each
room.
For properties with multiple Rental Dwelling Units use "Rental Permit Application
Addendum."
Rental Dwelling Unit Identifier: Un
Requested Maximum number of persons allowed to occupy Dwelling Uni*,
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: ky/n VOM (11*k16S"Ar13�S )j
►«1 room 15, Idl as +4" ' 13e�oo� 1 f I$ I'x 1ti' 7
(41 US
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
❑ 1 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)
l ./ 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: C M-0`
Property Owner's Signature: ""
Sworn to before,le this 2 day of 2Q:L(
Nritary Public- StOW Of NOW Yt*
3fficial Notary Public Signature and Original Notary Stamp "t ea, ui id6414697
ual1w In woswhesw
my W'rrU,4kx1
Page 4 of 4
Ofr Sou/yea
TOWN OF SOUTHOLD BUILDING DEPT.
a►
631-765-1802 7v—/a-3cINSPECTION
[ ] FOUNDATION 1ST [ ] 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 [ ,,Y'R ENTAL
REMARKS: C--z how , � �� �1���� m
4 v / has ,n s
G )c7v�Le. vim t �.
DATE — - INSPECTOR
P� a Town Hall Annex
Town Of Southold54375 Main Road
�.
Rental Inspection Report PO Box 1179
CO
Southold, NY 11971-1179
0116
Tel: 631-765-1802
mn P�
S CTM #
Date � +�
Owner Phone
vil
Phone
:^,Address ��O _....... ........�/��. � ..... .... Visible � .�_�........-..m..�. �. ....w..p...�
�l t��..��a�aa..,�..w�..�.....�. �. _.� � � .... ..
..,_......._...._�.. . � Inspector
Hamlet a ._.. ...�..�..�.�... ,........�. ......_ ._�...��.. ..._...�.... ..... .�. ..,.�...... ...
Floor Level Quantities Sub 1 2 3
......... ,�W� � ������ww����.............�� ...� .. ..e ,� . �.�. .....�.. �. .�. .w
(Smoke Detectors not located in bedrooms)
Carbon Monoxide Detectors
Fire Extinguishers
Exits .�.0. . .....
Bedrooms 1 2 3
Smoke Detectors
Occupant Count ...... ....
Building Systems Maintained &Operational Condition of Property
..... ..
Heating Building interior
� ... . ..... .... .... .... �,.� �_.. �.. w..
Hot water Building exterior
.... ... w�. m,�_..� �..e�m... . .�....w..w ...._ ._., .... mm.�_. ....� ., ....... .........
Electrical E Property clean maintained &safe
Mechanical Handrails&guards installed &secure
... .......... ... w_._. . ............. .............
..µ..mm .... ._.. .,..... .. ...... .. ..... . .,_. .... . .. ......I_ .. . ..
Pool Safety _�...,..., Pool„wRon Site ..,.a.... . .,, n. . .��� .... �. ....ww...
Surface water alarm Dat
e of CO issuance
'Door alarms � of �����completely enclosed
�,.
S
_.._
�....�.elf closing/latching gates ....�... ._ .......... ...a ... ... ......... ...Pool fence to code requirements
... ._.....,M bn.. �. ��.....m ..... .. ,�
JCO s for all items present Prior Rental
Comments:.
......—_.,....----
_-------------------------
....— .... -------
__. q.. ... __.. ....
TOWN OF SOUTHOLD PROPERTY RECOO
ONE ,STREET REET VILLAGE I D15— LOT
FORMER OWNER N E AC R.
. .....................
s W TYPE OF BUILDING
f
RESK/^ SEAS. VL. 1 FARM COMM. CB. mics. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
................
U
wr--
AGE BUILDING CONDITION
NEW NORMAL I BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER 1i
Woodland FRONTAGE ON ROAD
Meadowhond 1 DEPTH
House Plot BULKHEAD
Tota*...- DeCK-
SCTM #
g TOWN OF SOUTHOLD PROPERTY RECORD CAS bja.3�a--
OWNER STREET , VILLAGE DIST SUB LOT
ACR. REMARKS
TYPE OF BLD. -
_ 7z J -
PROP. CLASS
LAND IMP TOTAL DATE
FRONTAGE ON WATER HOUSE/LOT
i
BULKHEAD
TOTAL
i
COLOR
s
I
4 �
RIM
70.42-34 01/2015
70-12-34 2/04
1 st 2nd
Foundation Fin. B. Bath Dinette
a
-OM130
Extension
- � �- ,= i Basement PA
� P�RTIAi�� Floors Kit
SLAB I
Extension
Ext Walls <t Interior Finish L R.
Extension Fire Place Heat D_R
i
=sue : r ti p Qaua. I Woodstove BR
3
Porch Dormer Baths
Deck Dock Fam. Rm.
I _
i
Garage
41 AR
z
e
x
- - --
E
_ i E
_ 1 i
3
I s
COLOR-
TRIM
3
z } -
-
M. Bldg. ,.
Yt ,
Extension
= g i
E
Extension
i
t {
s Extension
f = 'Foundation ;B
Dinette ath
- e
�; Basement Floors i K.
—
Porchzj
Ext. Walls ., _ I LR.
Interior Finish
Breezeway r Fire Place Heat }
Garage 'Type
'T e Roof
9 yP ;Rooms ]st Floor
BR
P- +� =Recreotion Room Rooms 2nd Floor ,FIN. g
44
Dormer Driveway
Total
g
It)lbOt,M „
Town of outhold Annex 8/26/2014
P.O.Box 179
tl. 54375 M `n Road
Southold,New York 11971
C RTIFICATE OF OCCUPANCY
No: 37116 Date: 8/26/2014
THIS CERTIFIES that the b lding RESIDENTIAL ALTERATION
Location of Property: 15$tl N B4yvicw Rd, outllold, -
SCTM#: 473889 Sec/Block/Lot: 70.-12-34
Subdivision: Filed Map No. Lot No.
conforms substantially to the A plication for Building Permit heretofore filed in this officed dated
11/28/2011 pursuant o which Building Permit No. - 38319 _ dated !9/13/2013
was issued,and conforms to al of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued"
R`I TlNC3
IOW pI R
The certificate is issued to Carbone,Michael&Carbone,Ellen
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DE TMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFI ATE NO. 38319 08-21-2014
PLUMBERS C'ERTIF'ICA ION DATED
a
aed i ctt;t re
' t Town of Southold 1/23/2021
P.O.Box 179
53095 M Rd
*4 trr Southold, ew York 11971
- F C CUPANCY
No: 41762 Date: 1/23/2021
THIS CERTIFIES that the buildlS ACCESSORY GARAGE
Location of Property: 1580 N 0ayview Rd., Southold
SCTM#: 473889 Se` lock/Lot: 70.42-34
Subdivision: Filed Map No. Lot No.
conforms substantially to the Appli tion for Building Permit heretofore filed in this offiee dated
11/28/2011 pursuant tow ch Building Permit No. 45051 dated 7/31/2020
was issued,and conforms to all of tte requirements of the appUcable prgvi4ions of the law. The occupancy, for
which this certificate is issued is:
. o l Ii La-le a a c . ",tWo, ° garagea s,applied;f ;Dcr ZB A4,6 t l..
i
u
The certificate is issued to Carbone,Michael&Ellen
of the aforesaid building.
SUI7OLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45051 7/30/2020
PLUM1iERS CERTIFICATION DATED
Signature
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32502 Date: ��-S 0,3��'0)
THIS CERTIFIES bat the building NEW DWELLING
Location of Property: 1580 NORTH BAYVIEW RD S.OUTHOLD_ . ..
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. .4. 80 Section 70 Block 12 Lot 34
Subdivision Filed Map No. Lot No.
conforms substant ally to the Application for Building Permit heretofore
filed in this off ce dated AUGUST 8,1 _2003 pursuant to which
Building Permit N 96 EE dated AUGUST 8, 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
is ONE FAMILY DWELLING WITH COVSR17D F' ONT ENTRY REAR DECK SECOND FLOOR. .
.DECK AND..ATTACH'ED TWO CAR GARAGE AS '' p"LLIEO FOR.
The certificate i issued to MILL A. & ELLEN CARBONE
(OWNER)
of the aforesaid uildings
SUFFOLK COUNTY D PART i OF BRALTH APPROVAL R10-0 2-0 0 20 0 • 1.5�
ELECTRICAL C tTI �ICATE NO:i 11631163404(I 12 "1,2 04
PLUMBERS CERT17?1 TION DATED 0S x1 HARD" PLUMBING & HEATING
t fJZ96,' Siggature
Rev. 1/81
31
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