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Home My WebLink About1000-97.-6-6 'ot so TOWN OF SOUTHOLD Rental Permit - - 1129 Owner: 6809 11th Ave LLC Occupied as: Single Family Dwelling Located at: 470 Harbor Ln Cutchogue 97.-6-6 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. Issued: 06/10/2026 Expiration: 06/09/2028 Code Enforcement official This Notice must be posted by the main entrance at all times TOWN OF SO THOLD BUILDING DEPT. 631-765-1802 [ ] 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 [z J/RENTAL REMARKS: ......... ww Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SCTM # 97.-6-6 Date 6/10/2026 Owner 470 Harbor Ln LLC Phone Address 470 Harbor Ln Visible Hamlet Cutchogue Prispector R.E.Corwin Floor Level Quantities Sub 1 2 3 Smoke Detectors (not located in bedrooms) ,/ ✓ Carbon Monoxide Detectors Vol ✓ Fire Extinguishers ✓ Exits ,1G0 Bedrooms 1 2 3� 4 5 6 Smoke Detectors Egress ,/ ✓ ✓ Occupant Count Building Systems Maintained&Operational Condition of Property Heating Building interior Hot water Building exterior ✓ Electrical Property clean, maintained &safe Mechanical Handrails&guards installed &secure Pool Safety Pool on Site Surface water alarm Date of CO issuance Door alarms Pool complete e Self closing/latch Poo ence to code requirements r ° CO's for all items present D// ' %i / � Comments: TOWN OF SOUTHOLD g Rental Permit _ 1129 Owner 470 Harbor Ln LLC Occupied as Single Family Dwelling Located at 470 Harbor Ln Cutchogue 97.-6-6 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. 5/22/2024 Code E for e et Offi i This Notice must be posted by the main entrance at all times TOWN OF"' SOU THOLD BUILDING Di 631 -765-1802 7 IN PE TION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL j ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY WE. [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit [ ] CODE VIOLATION [ ] PRE C/O [e<F REMARKS: t DATE ��` �r o? INSPECTOR 'EO` OR 204 TOWN OF SOUTHOLD—BUILDING DEPARTMENT G _ Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971,095.9 Telephone(631)765-1802 Fax(631)765-9502 httr)s://www.SOLtboldtaw v " RENTAL.PERMIT APPLICATION `�� a 0 Rental Permit Fee$300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number:1000 SECTION _C;I 1 -RLOIC -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: i* �6 r e4 k ` CrC "° i L Lilu I- Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) « ' Telephone Number(s): Daytime) � - ~' Emergenc 1-3 Property Owner Email Address: U " 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: se and Dimensions of each room in Rental Dwelling Unit: " n 12 2 sltA 3 84 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 ❑ 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) If certify under penalty of perjury,the following: 1. I 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 Agen ,or Site Manager. Property Owner's Name: � arri�� Property Owner's Signature: AI PG % Sworn to before me thin day of Ti� "20� Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6186050 Page 4 of 4 Queiifled In Suffolk County Commission Expires April 14,i y + fF Town Hall Annex ' Town of Southold 54375 Main Road X° Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SCTM# Date Owner Phone Address p Visible Hamlet Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms f/ 2_ ...._ 3 _.......4 5 6 � Smoke Detectors Egress .._..Occu ant Count �...__.-....�.._.�._��..��.... ..... _..-.�,...�.....��.`,..�..�,. ._��.._�.....�.. .._�._..__ w.ry...�. P I' Building Systems Maintained&Operational .. ' g ytem '...ntin� p rational Condition of Property Heating Building interior Hot water .�...._._.�,.. ...._....�_...._..m...._..�„�_... �_..... .- .��_��....�.� �.,.m._.�.............._�. ..�_ _..�... �.. ._� .�..._ u _ Building exterior Electrical. ._.. 'Property clean, maintained&safe _,_......._.�.� _ _........__�._......, fi .-._..._,.. ..�_.-�.,..��.�..��.��.�...m.�,�� .�_��.�.��..� ......�. � guards.,.......... ... , _.�._..,� ��.�..��....�...._�_ ...,�.....�..��„..�� Mechanical rv�mmo�m Handrails& installed&secure Pool Safety._�r alarm_ .....�.._...� .....�.. _ � �. ...._ .. Pool on Site Surface Ovate � � _ Date of CO issuanCe Door alarms Pool completely enclosed � �� ..�.�.�.._.��. ..� Self i closn � mwmm g gates requirements � M . ... .. g/latching ates _..�. _............ ...�.._Pool fence to code w .... . �-__.____... ..._�.. .,....�.._._.w.. CO s for all_w� �..�.._.._ .... .� �......,�.._�....._.��.. ....�. _..�._..� .. � 4 items present „ Prior Rental rnment I _._ .. .... _ __... .. _.._.._... _ _� _ ..�.M . ....._. .....,. .. ....._...�...._..._ ... A, _6 TOWN OF SOUTHOLD PROPERTY REC q ' OWNER _ - REST _r/-7 VILLAGE DIST. SUB. LOT w — Y 11)ej-6 6xrmw� O ER OW�,NER N ACR E . ,L( + � i . u S4.n S W TYPE OF BUILDING RES. .2/0 SEAS. VL. FARM COMM. CB. MICS. . Mkt. Value LAND IMP. TOTAL DATE REMARKS joe J � "'T o e) '�Oh -ter`- I ' " t-T; -F ul [€ Tillable FRONTAGE ON WATER Woodland I FRONTAGE ON ROAD ` ~ Meadowland DEPTH House Plot BULKHEAD Total ,m R G � TRIM w ice, / I E , ;F e s I 1 � I 97:6-6 10/08 s rr s _ f M. Bldg. Extension Extension I Extension -- Foundation Lv Bath �`� ✓C' Dinette Porch �® — Basement Floors K. s Porch ",< '� iExt. Walls A- Interior Finish LR. Breezeway Fire Place p Heat DR. Garage Type Roof Rooms 1st Floor BR. Patio — ' G Recreation Room Rooms 2ni Floor FIN. B Al 0. B. Dormer Driveway Total FOBK NO. 4 TOWN OF SOUTHOLD BUILDING DEPART Town Clerk's Office Southold, N. Y. N � Certificate Of Occupancy No. 34!► 6. . . . . . Date . . . . . . . . . . . .. .401 . . . THIS CERTIFIES that the building located at . .W/8.R62tor. La. . • . . . . . . . Street Map No. . ?a. . . . . . . . Block No. . . XX. . . . .Lot No. . . .=.. . C4ZehQ6W.9. .1J-, . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . .. . . . .Mr . .14). . . . .. 19. 71 pursuant to which Building Permit No. .5321Z. dated . . . .. . . . . . .1ty. .2,5 . . ., 19. 11, 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 . .ftiftte. one.f ly, voll3ttE . . . . . I . .. . . .. .. .. . . . . .. . . . . . . . . . . . .- - The certificate is issued to .*jblyt. .$1i#�OP A�11*t�i . . . . SL . . . . .. . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval *@t. . .14;. "71• . .by•1}i oil�e 4,70 µ . Building Inspector 2/4/202_ - _. ._......__. __.4_. �Utt Town of Southold _. C►1 P.O.Box 1179 4 53095 Main Rd mtx "`tl Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44929 Date: 2/4/2024 THIS CERTIFIES that the building ADDITION/ALTERATION �_..w.__...._bo utchog... _...�... _...._. . �_..__ � ..._... ..,� �_... �...._..� .. ... Location of Property: � ° -��---••- p rty. 470 Harbor Ln C Sec/Block/Lot: 97.-6-6 _ File Subdivision: Lot d Map No. No. conforms substantiallyto the Application___v._..... d for Building Permit heretofore fil ed in this office dated"" g 10/21/2022 pursuant to which Building Permit No. 48632 was issued, � 2022 and conforms to all of the requirements of the applicable provisions of dated 12n20/ p the law. The occupancy for which this certificate is issued is: additions and altcrat L. including-rc-rtt nd roar stars sand outdo r shower to e i tin�sin a �a�r�id dwedlin a Pap-lied f r. The certificate is issued to 470 Harbor Ln LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. � 48632 1/30/2024 PLUMBERS CERTIFICATION DATED 12/1512023 d Piecuc riz ignaturo Legend -, `? � e, A - 7 ;- zmes�; to � , 8 'ems � 7 6. E(r� - Ecrc.BF-tracrvl 3. � � , - s:r ».� s ,e;us = �£'• s� €tea.-i Existinq First Floor wl Alterations TIE a� a E d - � Exist Basement Plan €