The URL can be used to link to this page

Home My WebLink About1000-56.-5-39 Rental Permit 1404 Owner: Carey Flaherty , Karen Flaherty Occupied as: Single Family Dwelling Located at: 1077 Bay Home Rd Southold 56.-5-39 Maximum Permitted Occupancy: 12 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 -annual inspecti Issued: 12/11/2025 Expiration: 12/11/2027 ode n rce ent Official This Notice must be posted by the main entrance t all `m 2eCilb 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) 765-95021 :� w + othraldtor � RENTAL PERMIT APPLICATION JUL Rental Permit Fee $300 (Application must be renewed every two yA ing Department wn of Southold Section A. Property Information: Rental Property Address: tPA, Tax Map Number: 1000 SECTION - -BLOCK s -LOT - i SECTION B. OWNER INFORMATION: Property Owner Name: t F Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Pa �� CA � v-1 0 00 Telephone Number(s): Daytime 11 - � ` ' p Evening Emergency Property Owner Email Address: CCt rt r '% Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling un , ' any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s): Daytime Evening Eme�ncy Email Address: Section D. 0 , 4 Managing Agent Information: Name of Authorized Agent of dwelling unit, i y: Address of Authorized Agent (no P.O. Boxes):. Mailing Address of Authorized Agent: Telephone Number (s): Daytime Evening ergency Email Address: SECTION E. U/ A- SITE MANAGER INFORMATION: (required r 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 Xergency Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: i1 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: 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. ❑ lam requesting afire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 a, a SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I CICe � 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: Property Owner's Signature: " Sworn to before me this day of , 202 /i HUI-I CHON NOTARY PUBLIC-STATE OF NEW YORK Official Notary Public Signature and Original Notary Stamp No.01CH6290181 Qualified in New York County MY Commission Expires 10-07-2025 Page 4 of 4 Town Hall Annexes �� '�, Telephone(631)765-1802 54375 Main Road P. O. Box 1179 C4 z f' Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Requested maximum number J persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling it: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: TOWN F OUTHOLD BUILDING DEPT. 631-765-1802 1 N � �' E�T 10 N [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL T AL) ] CODE VIOLATION [ ] PRE C/O [ RENTAL t"o oo^............. VF'l (D uz.4 oin -�4) 1 DA17E INSPECTOR _.... TOWN 9F*10�UMTtHo�MidBIUSO"/iat � IL N BP coi n 631-7 5-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATION/CAULKING [ ] FRAMING /STRAPPING [ INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE TRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL ( NAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL DEMA ,fir: - _ vi DATE L70YS - INSPECTOR TOWN OF SOUTHOLD PROPERTY RECORD OWNED, j STREET VILLAGE , DIST. SUB. LOT - a _ FORMER OWNER N 1 E_ -CR. �W S TYPE OF BUILDING — — s ao R , SEAS. VL. FARM COMM. CB. MILS. Mkt Value LAND IMP. TOTAL "DATE REMARKS a wa x r k _ _= x - Tillable FRONTAGE ON WATER I _ FRONTAGE ON ROAD Woodland 3 Meadowland DEPTH House Plot BULKHEAD Total i PARE) E° _3 STREET VILLAGE DISTkICT SUB. LOT � s 0R . E _ OWN N ' E � ACREAGE d t S ' W = .TYPE OF BUILDING RES. SEAS. VL. M comm. IND. CB. MISC. LAND IMP. TOTAL DATE REMARKS e, t Y� a s AGE L 3 I�LDING C N'D�CT I ON o = NEW NORMAL BELOW ABOVE Form `s Acre j Value Per Acre Value e c ce < Tillable 3 Wcodl and Swampland -ush cad House Plot T c t s _ - � j Rf LS s E (/ , 1 s — � E B r Foundation E t ICi ft E Bath Extension , Basement Floors i s F Fesio Ext. Walls rior r Ime ' ini ish g Extension Fire Place Heat —_ _ Por� . Attic _ u r - Rooms 1 st Floor .. Poti°_ Rooms 2nd Floor i I Garage _ ,, Driveway d� ro ... 3 s F COLOR ILL v 2 TRIM f 56. 5-39 3/2014 4 i 1st 2nd 2 2 Z �P� PG CB \ Bldg ,�„� U Foundation OTHER Bath ? Dinette 1� r act Y,3 (�y �� --- _ pp r7-7 ( tl I �Ol� FUL 4� Basement AL WL = -- Floors Kit Extension `c -,CXl-1 SLAB 7 CIO I ExtensioTr- Finished B. Interior Finish L.R. Apo �-.. �6 a0 - 0 Ext nstort y !�� x�i Fire Place Heat \ D.R- �-zx2� = 3`I`� _ �_eSlo Garage Ext. Walls � ,�, BR. I Porch Dormer Baths `- I, - Deck/Patio l� 2 = �� 4q5 1`M i L Fam. Rm. Pool- / �� 7 vav ��C Cr a Foyer sg A.C.z�;F C .- SQ0 `4 0 0 Laundry V/ — Library/ e, -2 N?q : �':'{ 2 '� study Dock Town of Southold 10/29/2015 P.O.Bog 1179 ca 53095 Main Rd Southold,New York 11971 CERT"IFICAT"E OF OCCUPANCY No: 37875 Date: 10/29/2015 THIS CERTIFIES that the building GENERATOR Location of Property: 1077 Bay Home Rd, Southold SCTM#: 473889 See/Block/Lot: 56.-5-39 Subdivision: Fled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/5/2014 pursuant to which Building Permit No. 38676 dated 2/20/2014 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: ACCESSQL&Y GaffZATOR AS APPLIED FOR The certificate is issued to Kornman,Peter&Kornman,Mary of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38676 10-23-2015 PLUMBERS CERTIFICATION DATED ?A,,thorized Signature Town of Southold 2/26/2016 P.O.Box 1179 • 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 38122 Date: 2/26/2016 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1077 Bay Home Rd, Southold SCTM#: 473889 Sec/Block/Lot: 56.-5-39 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/6/2014 pursuant to which Building Permit No. 38705 dated 3/6/2014 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: DIT'I NS A1,T T10N INCLUDING SECOND F OR B ONY AND NE CAR F TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Kornman,Peter&Komman,Mary of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38705 01-09-2013 PLUMBERS CERTIFICATION DATED 02-11-2016 Rescomm PC A . o ` atur FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28156 Date: 01 09/02 THIS CERTIFIES that the building ADDITION Location of Property: 1077 BAY HOME RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 56 Block 5 Lot 39 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 29 2001 pursuant to which Building Permit No. 27788-Z dated OCTOBER 15 2001 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ZBA #4988 DATED 9 20 01. The certificate is issued to KEVIN M SHANNON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 7 Z'4-a u or ed Signature Rev. 1/81 FORM NO. 4 r TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25739 Date: 05/26/98 THIS CERTIFIES that the building ADDITION Location of Property: 1077 BAY HOME RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 56 Block 5 Lot 39 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26 1964 pursuant to which Building Permit No. 2516-Z dated SEPTEMBER 14 1964 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 ATTACKED SHED ADDITION TO A ONE FAMILY DWELLING. Z.B.A.#710. The certificate is issued to IRENE MARY WARNY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Buildi Inspector Rev. 1/81 • 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-21095 Date OCCTOBER 15 1992 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property, 1079 BAY HAVEN ROAD SOUTHOLD NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 5 Lot 39 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-21095 dated. OCTOBER 15 1992 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 ATTACHED GARAGE * The certificate is issued to CASSEL TRUCK LEASING CORP. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. NLA PLUMBERS CERTIFICATION DATED N A *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspector Rev. 1/81 :!T To:.7r CF SCUT'OLD, U. Y. HGI; I::C CC: INSPECTION il:_PC-.T Locatiaq 1079 BAY HAVEN ROAD SOUTHOLD, NEW YORK �nu:.ovr .x .:Cre_C) o-lu::_c-i)u-11wy1 Subdivision Ho. Lot(s) NaMe of 0t1ne=(S_) CASSEL TRUCK LEASING CORP. Occupancy l cypel 70.mer-Lenanc) Admitted bXZMRgLL1LA HA11 Acconpanicd by: SAME Key available Suffolk Co. Tax LNro. 56-5-39 Source of real est. RUDOLPR BRUER, AiTY* Date OCT. 14, 199 Type of construction D VRAM, #stories 2 Foundation CANT BLOCK cellar MW�ra.l space � xx Total roods, . lst. Fl 5 2nd. Fl 2 3rd. Fl Bathroom(s) 2 Toilet roon(s) ONE Ponca, type RED Deck, type Patio, type Breezeway Garage I CAR tility roan Type Heat OIL "farm, Air Hcrt:aa er m Fireplaces ONE _Aro. E.i,,, Ai:co^diticnirg Do-mestic hot pater YES Tyke heater OFF BOILER Other FRONT ENTRY. SMALL FRONT EXCLOSED POkR b LAUNDRY ROOM. CROAR CLOSET 2X0 FLOOR ACCESSORY S�^ U& rs: G?raoe, type const. Storage, type corst. Swi=ino pool Guest type const. Other..' PLATFORM IN REAR YARD . ' T(" .�. CIIAPTER 45—N.Y. STATE UNIP0*1 rJ11Ui PIUSVENTION 6 BUILDING CODE r+catiort Descrinyion Art,µl Sec. FLUE FOR BOILER CHIMNEYS, SMOKESTACKS, FLUES ETC. SHALL BE F MAIMATURn SAFE &M RWTIM SO AS SEC 1243.1 (b) TO SAFELY COVER THE PRODUCTS OF COBBUSTION TO OUTER AIR. N � Y I 1 l 1 Re..-nr%s• BP #2277Z-COZ-2098 for Addition In:,pccted by; Date of Incp. OCTOBER 15, 1992 " FISH Time start 10:00 end 10:30 FORM NO. 4 TOWN CF SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS OFFICE CERTIFICATE OF OCCUPANCY No. .Z...2Q90..... ...... Date ............ ftbrtt+ 65 N .............. 19. THIS CERTIFIES that the building located at .......... .. ....... Roadr +'SOUthold Mop No. .$j6ri1QX--.p 0t;ock No. ...."rw+.rr}r ................... Street Lot No. ..........«r.r.�.rww+r.sr conforms substantially to the Application for Building ......................................... Permit heretofore filed in this office dated ...........'T � y 2.................... ....... ., 19.44. pursuant to which Building Permit No. � 77 Z dated ..$,AA.Lt�4xy'..� ...m.. ...w..... """"""""" 19... 4, 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 .............................,,................................. ►...(sully dwell Ing The certificate is issued to ................ ..... +4U1 ki (owner, lessee or tena�ntj� �"«..."""'"."" .`.'.'° of the aforesaid building. .............Building M lnsp�ctor........... ............. FORM NO. 2 TOWN OF-SOUTHOLD BUILDING DEPARTMENT TOWN CL9RWS OFFICE SOUTHOLD, N. Y. BUILDING MMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 19? 2277 z Date ............:.......... Y........�.......,., 19. .. Permission Is hereby granted to: ............. .,..w................:............,....................,............. tot# + .. i..I , ,ii ..A ..GY3.. ., i .. 'IUD � .......................................................... .............................................................. .................................................................:................:..„,......... ptpremises located at 0q.w.... g.... ......................................:.......:.:................ ..........................................i...........m thold... ................................................................................. .... w.a........................M............s1....................e...................................J................a......................................... ..... " pursuant to application dated .........«......... .. , ..... .........»., IcA3...., anal approved by the Building Inspector Fee $1.4.00............ .................... " Building"Inspector � a .., �_ .. ..,.. ...:w m�i"� •' ._�.:-r_-� .._ -._ �� "�:"�» �...'� m sum �v'�.v } .._ S'�r;, ✓`""da:r. S.1CC,w""m,�.��^.<�',aro�;'�.^�"":;t� �s r N�,r tw, ci Q # e ELL ■ R3TN 1■S {Bt OF # Ql 1_71 iP. 11 t i # ; # 6EN PANTRY # NI TCNEY C[ N i � D�YY�YGUIA 1 1 _ UE OF ROOF(MW4 - - ONE OF ROOT(IBOQ —�- t UE OF ROOT(MOTE) [ ;_nR 4 t t 1 F f e # # j � it�814E i # I S 1 1 # # # 1 # # ! 1 # # i d � # I # # 1 IlE OF ROOF(MOPE) f a E Room= RAW I ULM a tin LLLLL r e O Yll f MAN a[LAJLD a lil low m ff�3-f� .� gsw i ! l k ! I t f t C c t f it, i f i f i It e f f i P ONG Rt TO BE SECOND FLOOR PLAN— i 2 3 4 5 6 7 8 9 10 II 12 13 14 15 16 17 N ,.evsou M ti v K C m a A} { 22� _. Y x °moon•�23 w+�ixv _ •`„ `� � •w.ow.nawc. � _ F 55 -3 a -14 ._, i ra SECOND FLOOR RRDEE awe w is A3 +, a--_ BAY HOME RD, h tl 5DUrHa D.NEW YORK E _ GARAGE R 2ND STORY RENOVATION lJ 4 G sEcoND RooR 0 �• � "eli,Y 21 itn,awe O � n.+.c,c�II��•nn � pF� �� 1109 G 7 8 9 101 12 13 14 15 16 17 ti q, 311 AF ------------------ -I ;Av 9 P" 4-1 t ul -44 7 GROUND FLOOR KORNMAN RESIDENCE BAY HOME ID 5OUTMDLD.NW PORK STORY RENOVATION GROUND F=R A2 1109 J- I 2 3 4 5 6 7 8 9 10 II 12 13 14 15 16 17 N N ti ti K M. �J �� ou°av 23 m�O'•rouv 22 � �'�' �B w m• 24 -�'s - _t 4 - 7 F � z 4 wv 02 EE fjs c a Oi r s �- L———_————.<..<.— KORNN7AN 5 E O O N D F L O O R RE9,oENOE BAY 90UNOME MOLD,NEW PORK k '� GARAGE 12N11 C. � - �' � Ca STORY RENOVATION 2 s / 5,cO o FlDOR pE� -� 4 --iiT 2/"0 •we i CI m 6 AIS ;a o 10 1 12 13 14 15 1 G 17 MM6 T '-PIT I iff a -------i-7\,Aj ----------- ZH Irl, GROUND fl 0 0 R MY HOME R QkkA� 4 M VA 4-a M4 M,"S , v ____ 1 'EOL- _ i j I J— , Z; _L E q q ox a05Al _,. 0 - GROUND F LOOP, € I I SEP -5 2012 :Y iS A VIOLATION OF THE D EIS: LAW FOR ANY PERSON, , UNLESS ACTING UNDER THE O y' DIRECTION OF A LICENSED € ARCHITECT,TO ALTER ANY -- -_ ITEM ON THIS DRAWING IN y - - 3 ANY:NAY.ANY A-JTHORIZED - -• -• ALTERATION MUST BE NOTED,SEALED,AND DESCRIBED IN ACCORDANCE NEW WITH THE LAY]. ROBERT I. BROWN ARCHITE , P.C. KORNMAN W/ fWKWEATIIER DE51GN A550CiATE5, INC. 04/25/201 2 205 HAY AVENUE 1'-01 GREEN PORT,N.Y. I I944 G31-477-9752(Fax)G31-477-0973