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Home My WebLink About1000-104.-9-1 TOWN OF SOUTHOLD Rental Permit 1436 Owner: Ryan Hutchinson Occupied as: Single Family Dwelling Located at: 1030 Broadwaters Rd Cutchogue 104.-9-1 Maximum Permitted Occupancy: 4 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: 04/01/2026 1`- Exp i ration: 04/01/2028 Code Enforcement official 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 11971-0-95y Telephone (631) 765-1802 Fax(631) 765-9502 Bile;/Lryr �LtLlollrrry Is9Aii r RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: (p"50 Tax Map Number: 1000 SECTION -BLOCK -LOT SECTION B. OWNER INFORMATION: Property Owner Name: ' Ykg Ko: 14so Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 3 �A a ,N ?__0 Telephone Number(s): Daytime Sl6- Z�- Evening 'L'bb�Z-�11 Emergency S(b-'?7_.S6C 1 Property Owner Email Address: 6 ,A tt Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 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: uyn { Requested Maximum number of persons allowed to occupy Dwelling Unit: _. Number of rooms in Rental Dwelling Unit; Use and Dimensions of each roo in Rental Dwelling Uni ° �3�/d t"� seDe ovA t3`" l()`G `' LCYtN � tc(rko'4 61 X )l -4110110'� L-- (0'X /0 T Pil-1 ,1412'M(10 e3' . �I N t 2 1 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. ❑ 1 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) , 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: � L( + Property Owner's Signature Sworn to before me this��aday of_ Acar[l~ - 20 2 4 BRADLEY BALANO Notary Public-State of New York NO.01 BA6424235 Official Notary Public Signat a nd t riginal Notary Stamp My Commissionin x Queensr ct 25 io29 Page 4 of 4 of 0 � 103d6ewd"44,crs gol TOWN OF SOUTHOLD BUILDING DEFT. w� 631-765-1802 T 10 IN I lmz� PEG [ ] 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 [ RENTAL REMARKS: Add Aj.4w ea +► DATE a,fzozd _ INSPECTOR �L '� w,^,"x='.r-*,,<o,- ,;;�, fQCI( , ti4 Town Hall Annex SOUTHOLD TOWN 54375 Main Road PO Box 1179 Southold, Rental Inspection NY 11971-1179 ikzl Tel: 631-765-1802 ' ► Fax 631-765-9502 01 � ��; ° �. -OIIWI✓� alW ll"moo iV V ILs ��v Smoke Detectors (#- bedroomdetectors excludetl) '„ �0�'Carbon°Monoxide Detectors �s. ire Ex4inguishers M i , Petector Alarms /Itanpxitle Alarms (#) (1 If 1I0111111 (win, ) (Y/N) ;� J a, s� r I�VG`SYSTEMS n 0 U1 ,,,e �// , /0 pl Y 6 If l .1 f Y� p0 intained/a pe g t,, %,1 a�b �„ l aersystem maintained/opera stert maintained/opt XiriG;"U ' frrr,ii �g 60/1 , )system maintainet/ 1 , � u p 9 D to. f l rD 7 1 �f mG �rW/lJ//,� r l�r 1`p'resent JNNO ' rface alarm an or door alarm r ,,,>cy / f / 4 r �p n i !CNf gia ' l�ij ✓ .rnlrjy 11i rlwr rn /�i%r�yf� I� T9 1�i.dr„au„G,u,j /,��' l✓C Imp r G1,Vl� k l � G�f / F�ljl/i �y ail s d 1� , � SATES �, 1 �J N�r 1,� Jy ,Fl r ,,t , r ' N " � ,, , . /�� 6f fl//l�9 yelf closirig, self-latching c' ij ;rilerane t� ; ar n� ma.�r �✓ ,r 17 wt N /A Y a IfW side of gate, meett�f� ) � 1/ l� � � � ' r f �O(t�� IJ/ , �y lr r vrl i o ra %/rJ✓ II M �,(�f � " 'Whenit nd� Fr`^r it v P,d,6:Ynt y��r.�i�Al�/ i wOd ii i,i/✓, ,iki,nrm 91 IIIENT�• f�� Ltoa.s cr ` y4u�1 house. TOWN OF SOUTHOLD PROPERTY RECORD . 7/5//S� OWNER STREET VILLAGE DIST. SUB. LOT _2 j—.Z. V, A FORMER OWNER N E ACR. S W tYPE'OF BUILDING RES. ! SEAS, VL. FARM COMM. CB. MISC. Mkt. Value 6 LAND IMP. TOTAL DATE REMARKS 46t o 0703 T1 - 1 (L Ike rC_ Tons -7j AGE BUILDING CONDITION 700 00,� NEW NORMAL BELOW ABOVE FARM Acre Value Per Value - Acres Tillable I Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushlond I FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Total' DOCK t COLOR 'sal I t TRIM ,,. 4 t 1 5 t s i } t = 1 M. Bldg. _ I 'Foundation _` Bath Dinette Extension ' Basement I Floors K. Extension ' _ ,�� Ext. Walls( r - (Interior Finish LR. Extension Fire Place Heat DR, ^ Type Roof (Rooms I st Floor I BR. Porch Recreation Room Rooms 2nd Floorl FIN. B_ Pa 2 7{'' _ 3zs I %.. S ��` /7/ Dormer G r-( .�.- ic 0/ 4 - [. Breezeway ' (Driveway Garage Patio 0. B. Total i � � 1 ► �� o COLOR s\\ 13 I� 3 TRIM i 3 1.VIP v AM maw 104:9-1 2/08 1 st 2nd Xi? _ Pc CB i M. Bldg. 3 x�2- = 3 Foundation OTHER Bath Dinette r'�;3�5 = S S f FULL , O _. Extension i ` _ 3- 5(7 q 1 7; Basement SIB L OML? Floors Kit. Extension Finished B. Interior Finish L.R. Ft ` n j y 3Z = 3 SZ z S Fire Place f Heat �� D.R. ? Garage -l Z? = 2-6`t 3 cS S Ext. Walls ( BR. � x13 C z Porch Dormer Baths �f..,, 3 = 3zs Deck 6SS ffi /�atio Fam. Rm. -36 S / 7/ P-oot _ Foyer �.1 t 5(7 Z/SO � A.C. Laundry Library/ O.B. Study Dock 1 i FORM U0, 4 TWM Or SOUTUOLD BUILDING DEPARTMENT Office of the Building InaPOctor Town Hall Southold. N.Y. PRE BASTING CERTIVICAME OY OCCUPANCY No E-23024 Date JUNE 1 1994 THIS CERTIFIES that the building LY D ZINC Location of Property 10,30 Mb0ADW%jEjM ROAD CUTCWGUX N.Y. House No- Street Hamlet County Tau Map No. loon Section R4 Block 9 Lot 2 Subdivision Filed Map no. Lot No. confor'ns substantially to the RmpirementI3 for a Ons Family Dwelling built Prior to: APRIL 9 19S7 pursuant to which CERTIFICATE OF OCCUPANCY HMISER S-23024 dated 1, 1994 o was issued, and conforms to all of the reguiremets of the applicable N w provisions of the lax_ The occupancy for which this certificate is issued is e= FAWLY muzzam WM ATTACM TWO CAR Wimm The certificate is issued to C+t mumas (awner) of the aforesaid building. SUFFOLK CDUNTY DEPARTMENT OF RIALTH, APPROVAL NIA UNDERWRITERS cERTIFICATE no. N/71, ------------------ RS CERTIV'ICATION DATED E/, *?I-U= MR ATl'A(= rga% ION Q ild 9 Inspector Rev. 1/81 'MW,4 OF S0lPnlDj.D HOUSING CODS DISITC-rION REPORT LOCATION- 1030 BR AD RD. ctfulloon, N.Y. NME OF OMR (s) JESSICA HAMS OCCUPANCY A- RES. Own& AD.qrTTED BY: GEORGE VERITY ACC ANTED BY: ShtfE KEY AVAll.ABjF---*--,;gW— y.W-,fAX H&P No SOURCE OF REQUEST: JESSICA HARRIS DATE: XM 101 1994 TYPE—0—CONSTRUCTION WOOD FRANK STORMS OVE I EXITS TWO FOUNDATION CEMENT FULL CRAVL SPACE TOTAL ROM: IST FLR. !i 2No VM. 3RD VLR. BATBROO-11 TOILET ROOM ONK UTILITY ROOM FORM TypE REAllt SCW= PORM ------------ DEm' TYPE FATIO BREEZEWAY FIREPLACE an 2 CAR WOE—FRAM DOHESTIC HOTWATER YES TYPE BEATER ELECTRIC 'AIRCONDITIOMNG TYPE BUT OIL WAMi AIR HOTWATElt OTHER: ACCESSORY STRUCTURES: GARAGE, TUS OF CONST. S70RAGE, TYPE CONST. SWIhWNG POOL CUM, Tm CmT. OTHER: UWATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION A BUUMING CODE tDCATION DESCRIPTION ART, SEC. CHm- BASEMENT PROBLEM WITH FOUNDATION & FIRKPL&CH ROOTIM AS INDICATED RyCRR 0. 9 ON ENGMM nrm (SSE FoRm no, 4 MWN or SOUTEOLD WILDING DZPARTMAZITT Office of the Building Inspector TOWn Hall Southold, N.Y. CZRTIrICATA OF OCCUPANCY No 24S36-E Date Jul v 30, 1996 THIS CERTLIFIES that the building—im-1-tion Location of Proporty_A031) arowaters Road CutEPDM�q_ House No. Street ffamlet County Tax Map No. 1000 Section 1,04 Block 09 Lot 01 Subdivision Filed Yap No. Lot No. conforms substantially to the Application for Building Permit heretofore Med in this office dated Jqqq±r 1996 --pursuant to which Balding Permit No. 23S43-r. dated June 28, 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 Indeck addition to sinaLe f!RAAX dwell kS as The certificate is issued to Willi= L. ft Vir-toria, A. Gordon (owner, lessee or t*=nt) of the aforesaid building. VrFor.K COUxTr DEPARVOW OF SMTH APPROVZL N/A MEMIT22S CK]MVICATH NO. K/A PLUMBERS CERTIPICMON DATED IF/A Building Inspector Rev. 1/81 'f"n of Southold Annex 6130/2014 P.04 Box 1179 54375 Main Road � Soud)olel,New York 11971 CEWFIFICATE OF OCCUPANCY No: 36917 Date-, 6/30/2014 THIS CERTIFIES that the building AL1TRXf10N________. Location of Propaty: 1030 Broadwaters K Wthoguei SCTNJ#: 473889 SedffiaddLet: 104,9-1 SubdMsfon: yned Map No. Lot No. confumu substantially to the Application for Building Permit heretofore filed in this officed dated 5/15M14 pursuant to which Building Pauk No. 39887 -- dated 5115/2014 was issued,and conforms to all of the requkements of the applicable provisions of the law. The occupancy for which this certificate is issued is: &I tqat iqqs to an od t�inf�kmfl dw�dra�slic d� fpr- The certificate is issued to KadWaoi Quim,Mmy (OWNER) of the aforesaid building. sumLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERMCATENO. 38897 6/9/14 FLUAMERS CERTIFICATION DATED urc Ut iLCyr Q� uv!U�oX t� �= JPAX g IAN L 1 V N _jam. • t�•��,91� __- - s GENERAL NOTE: H # l; Thee papa ane draannee reneec wak performrd appren—r a reams ' i - _ { Ae roroWRnn hae been compbLW.m shown,and to Me beat d my krowl W e. € # ; EtECT CAL NOTE: Mid BOArsD OF Ptrse uNDeRwwTeNs approvrd wrd to ukwx -- _ inatallakan aF fwbwm per apeolrntwna.GPI ovtbb reyuined.[e1 w arua.WHeb.a pc # rndc.NI work donc in etnct auardar xdh the New Yak Strte Code by a licertxd electnoan. '' �� PLUMBING C HVAC NOTES: [V �bw State Atl plim Y E work n.a beer done bra day lircreed pu.xr.ne conhnm adhee S all Ncw ork k4ry rode aaFety mquremmb. 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