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HomeMy WebLinkAbout1000-115.-11-1 Rental Permit 1394 Owner: Gerard Diffley , Karen Diffley Occupied as: Single Family Dwelling Located at: 435 Lupton Pt Rd Mattituck 115.41-1 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: 11/06/2025 >/-Ow Expiration: 11/06/2027 c° e � men Offi i This Notice must be posted by the main entrance at all times x n h TOWN OF SOUTHOLD—BUILDING DEPARTW� G 01"➢ 7 Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959 k, Telephone(631) 765-1802 Fax(631) 765-9502 & tts: fwww.;a �taVdtawn . 'w RENTAL, PERMIT APPLICATION Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 3 S L.. .f 4-ey's %moo.Kzt 0A c4--'4'Lt� Tax Map Number: 1000 SECTION t � -BLOCK 1 -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: k a iexA , Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) o 5 o L. 4cr...d t o So L.—jo ►Mcx-F N-t' t 951a_�k Telephone Number(s): Daytime 997-5l30 Evening Emergency Ta---..A— Property Owner Email Address: "-e- i 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. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency 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: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containin 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): Daytim Evening Emergency Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: �'"� C 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: LA-.n;4- l _ YX&:Lv` kO&L%-e ' Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: `l' 4kdroow"s Use and Dimensions of each room in Rental Dwelling Unit: 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. 0 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 1 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 C.-ew ,eA -D" 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: ar- "o- c Property Owner's Signature: " IFfJ. Sworn to before me this3 day of 20 a JC Official N oy Public Signatur nd Original Notary Stamp TF ACEY L. DWYM NOTARY PUBLIC,STATE OF NEW YORK NO.01 OW6306900 P 9!1*IED IN SUFFOLK OOUN7Y COC k4l SION EXPI iES JUNE 30,2Qil(o Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 &-5 INSO" PIECTION , [ ] 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 [,,,,I'RENTAL REMARKS: oce-11 CCU /n DATE � ' b - INSPECTOR, Sept 27, 2025 Town Hall Annex :q' `��, Telephone(631)765-1802 54375 Main Road „ � Fax(631)765-9502 P.O.Box 1179 r Southold,NY 11971-0959 qp ° BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 'ro °ssioL7al seal required Lor,Architect or E"q it eer licensed i o e lns ector rrlust rOvide gLopy oL valid current certification Rental Property SCTM Number: �7 Rental Property Address: 435 Lu tons Point Rd., Mattituck NY 11552 Owner/Name: Gerard Oiffle Rental Dwelling Unit Identifier: Number & Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom #1 -100 sq., Bedroom#2-90 sq., etc.) Bedroom ##2 160 s ft Bedroom #4 220. sqft Property Description (include all improvements indicated on survey) 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. Victor Cornelius III CEO Inspector Print Name and Title ceo##' 1216-0253 Ors Anal Signature Please place professional seal: ,ram„,•,� - �� =s�S'4tiK C�sava�an 4'ede 7 � - t sa EYL'#, i13 € 'Mt� fr a aoo®r<rzm�tvr � iLSO®F - �airaw.rezru. ki iz- zero' r�E umcoaffam 15ECONV FLOOR F ataama.°:#,m m a. we : air i i► .�' lt.e C,o , t O AA, rt _ O.0 i DL t _a - , , i I f - i HUGO GIANNOVI i � RNQ A9�vOGtATC ^4^§Stern Rand f-'ZFIRST FLCCR PfAN .a.w.rovat 1 a ..,•� QIFFLEY RE510FNCE PLOCR P=I- E TOWN� OF SOUTHOLD PROPERTYRECORD � OWNER STREET L VILLAGE DISTRICTS; FORMER OWNER N ,F E Z ACREAGE S - W OF BUILDING i J� TYPE .I _ E _ - _ �+�zi ,� <,�• fft`".d4�\� ��-t.•{,-�cL �•��:-t. �f — — e { • RES. _g SEAS. VL. FARM COMM. END. CB. MISC. • LAND IMP. TOTAL DATE REMARKS s � f a as /! yj ..-�}�'' ,, ✓ t a� � 6o� 77Qa �= 3�� �g7 �ra f�,,�' a /►c AGE , B4I °ONDIIQN- �= r - __ Nt�RMAL x RELOW .� BOVE Farm Acre Value Per Acre Value ' T c T illable 1 Tillable 2 ,2 7 i a Tillable 3 Wcodland Swampland Brushland .✓ `� �0 2 � g House Plot a Tcta f \ s jnol , d x_ 1 U COLOR � 4 TRIM F 115:11-1 3/05 E - ► � 1 st 2nd M. Idg. I ��X21 Foundation CB _ Fin. B. Bath �% Dinette \S Y r = Extension © �' �� 7 '4 3 O FULL COMBO Basement PARTIAL Floors Kit. V SLAB ei Ext- Walls ra �� � Interior Finish L R ��, E ten _on 3 ? � Fire Place �eS I Heat �� D.R. 72 c -�—_ _ Patio qcrWoodstove BR. 1 ts Porch y`� i2c� (po Dormer - Baths I Deck Dock Fam. Rm. fma = e® - I A.C. Garage _ 1cLu, y J r O.B. Stec- 1 Z Pool i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z545$ Date kept. , 19 . , 19 73 THIS CERTIFIES that the building located at NIS Lupton Pt Road. Street Map No. ]x Block No. sac Lot No.3= Mttltu* 11•Y• conforms substantially to the Application for Building Permit heretofore filed in this office dated Arrtl 22 , 19 73 pursuant to which Building Permit No. 6501+7, ..� 'dated . . . . . . .kpril . 23 , 19 73 , 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 .P .vto. QUO fam:Q.y. ,drelllnB . . . . . . . . . . . . . . . . . . . The certificate is issued to Jules & Dorl-p. Adr$aenssenp. . OVners (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval by R• Villa UNDERWRITERS CERTIFICATE No N. 1.14274 Sept 12 . .1973 IIOUSI NUMBER 435 Street. . . Lupton Pt Road. . [3uilcling InSt�r�tcn rOXX Na A TOWN OF SO OLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.4046,3 . . . . . . Date . . . . . . . . . . . . . a . . .1 . . . . . . ., THIS CERTIFIES that the building located at . .Wp xi. P.t.A90 , , . . . , . . , Street Map No. . ? x.-x. . . . . . . Block No.X= . . . . . .Lot No. . .*p; _.fttti tuck ,1-i .Y. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . . Jan. . 1. 19. 74 pursuant to which Building Permit No. 70 4Z dated . , . . . „ . . . . .JIM . . 19 74 ., 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 . . Private accessary. (.storage) building . . . * „ . . . . . . . . . The certificate is issued to . . Jules. . . . . . . . . . . . . . .Doris. Adriaenssens (,aners . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R. . . . , . µ . . . . . . . . . . .. UNDERWRITERS CERTIFICATE No. . h.•R• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . .4 5. . . . . . . Street . . ,�4ptq�. Pt ~Road . . * . . , . , , , , , , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . Building Inspector esre+x�rw f� Town of Southold Annex 4/23/2012 P.O.Box 1179 54375 Main Road ` M Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35555 Date: 4/23/2012 THIS CERTIFIES that the budding ADDITION/ALTERATION Location of Property: 435 Lupton Point Rd,Mattituck, SCTM#: 473889 Sec/BlocklLot: 115,11-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this otBced dated _.... . _.._.._ 5/14/2008 Pursuant to which Building Permit No. 36909 ^„µ dated 1/6/2012mmmµFMµMµV ^ 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: alteration and additioanncl + rn-oae c ar ra a to an er:istln one farnal dwcllin a _ pll .tiar..pr;SBA#5431 dated 10/23/03. The certificate is issued to Gerard&Karen Dit2ley _........._ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 87431 4/8/05 PLUMBERS CERTIFICATION DATED 3/7/12 GENCO Authorized Signature .....w__ .._.._m.w... gtFt0� Town of Southold 5/26/2023 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERT" CAT E OF OCCUPANCY No: 44131 Date: 5/26/2023 THIS CERTIFIES that the building GENERATOR Location of Property: 435 Lupton Pt Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 115.-11-1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/19/2022 pursuant to which Building Permit No. 48613 dated _ 12/19/2022 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: accessoa stanft gqneLat.� as a lien fir, Maintain 3 foot clearance to al!shtpbbery.: The certificate is issued to Diflley,Gerard&Karen of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48613 5/16/2023 PLUMBERS CERTIFICATION DATED ut, ed Signatur s