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Home My WebLink About1000-111.-2-3.1 L C14 O O U C N O - _� o CIAo O 0 .Co u x �W O CL E O cn co L� ca co O c 0 U c r--� C13 I CD a) a) �LMI , ca m �a r.J ' a c� v �"� L O O.1 = C m cu O > ca v � � C C� =3 CL ro COLL v Q� = O ?: MC)- LAWO Q Y ,.� � a� L cn o v O CL Cld +-� U �` Z O � � cu a) a� N Z3 o CD z �- U - O H .., E ai z Ln N o o.N :E cn -OM � ~ +, > 00 E O 3 a� N a> ON E � � o M O >," N .SSx c co G °) :zj- O c tLo C!3 O . . _N Eo O m = L) = a1 � U U) U 0 N .x 0 0 N w TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 1 1971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 ltt1 ��yy � ut�letaQc9t .�tu1 .� °�v RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) P Section A. �(''/ Property Information: Rental Property Address: 1or� �, t14v 440 Haywaters Rd., Cutchogue, NY 11935 Tax Map Number: 1000 SECTION 111 -BLOCK wIT IT_wwwww.wWwww..-LOT 3.._.w............�z-. 1 SECTION B. OWNER INFORMATION: Property Owner Name: Andrew and Laura Martinez-Fonts — Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Andrew and Laura Martinez-Fonts Andrew and Laura Martinez-Fonts Ahornstr 5 .... ..w_ ........ -Ahornstr 5 14163 Berlin -14163 Berlin —GERMANY -GERMANY Telephone Number (s): Daytime 415 660 0131,Evening— w,,, Emergency_,.,,,,_.,,__ Property Owner Email Address: amartinezfonts@gmaii.com (email preferred, given time zone differences) Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if an Alfonso Martinez-Fonts --Address of Authorized (no P.O. Boxes):-."A ent _ Osprey Ln., Greenport, NY 11944 w_.g ...__......_.........._...w. _aa w ......... Mailing Address of Authorized Agent: 11 Osprey Ln., Greenport, NY 11944 Telephone Number (s): Daytime 202 744 1467 Evening same Emergency same Email Address: al.martinezfonts@gmail.com Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: _____e_ Address of Authorized Agent (no P.O. Boxes): __,_ . . Mailing Address of Authorized Agent: _w -----__....MO__wwwww_wmmmmmmmm_m Telephone Number (s): Daytime Evening Emergency__ Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any Carrie and Justin Blair, Nofo Property Mgmt Address of Managing Agent (no P.O. Boxes):_ 12900 Main Road, Mattituck, NY, 11952 12900 Main Road NY 11952 , Mattituck, , Mailing Address of Managing Agent:__w_eMO�w_MeMOOW__ w �_w.....__...._.._._...._ .__..w_ Telephone Number (s): Daytime 631-333-1400 Evening same � Emergency—same � Email Address: cb@nofopm.com Page 2 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: _ House Requested Maximum number of persons allowed to occupy Dwelling Unit: _$_, ww 10: 4 BR, 3 BA, Kitchen, Living/Dining, Den Number of rooms in Rental Dwelling Unit: .w Use and Dimensions of each room in Rental Dwelling Unit: BR1 - 17' x 12' BA1 - Tx 8' Kitchen - 9' x 13' -B R2 - 17' x 11'—BA2 - Tx 11'—Living/Dining - 21' x 15'--------------- .___...—._---------------` BR3 - 15' x12' BA3 - Tx16' Den - 13' x18' _.............. BR4 - 18' x 17'___ 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) Andrew and Laura Martinez-Fonts, 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: Andre d Laura Martinez-Fonts WYYYY YYmmYYYwwMw Property Owner's Signature: EN MANY CITY OF:BERLINV ONSNNN.ANN SER E OF TFIE SS NNN�ITEO STATES OF ANwtENNifA Sworn to before me this day of_ , 202G Maria del Pilar Cox Of riginal Notary Stamp Notarizing Officer . Page 4 of 4 * ' TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 a INSOPECTION [ ] FOUNDATION 1ST/ 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: DATE 49w INSPECTOR a Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SCTM# f — — Date Owner "li .. ,/'1 Phone Address Visible Hamlet linspector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) Carbon Monoxide Detectors 1 Fire Extinguishers Exits 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 completely enclosed Self closing/latching gates Pool fence to code requirements CO s for all items presents ° ' ,; ; D Comments: 440 Haywaters Rd. Cutchogue,NY 11935 Ground Floor Andrew and Laura Martinez-Fonts Smoke detector 415 860-0131,amartinezfonts@gmaiLcom ❑cO Carbon Monoxide detector Pagel of 3 Exit p Bath 1 °, d-r Bedroom 1 c-: 197 sq.ft. / Exit Laundry oo°°r Garage Exit Den °r Dining/ Living G °°°°' Bedroom 2 Outdoor Bath 2 180 sq.ft. Kitchen Shower C1O6B` '' cioser Sndi�mor Sndirgdwr Exit Outdoor Exit Screened Exit Porch Outdoor Deck Exit � 9 - 440 Haywaters Rd. Cutchogue,NY 11935 Second Floor Andrew and Laura Martinez-Fonts Smoke detector 415 860-0131,amartinezfonts@gmaiLcom ) [c� Carbon Monoxide detector Page 2 of 3 Bedroom 3 Bath 3 190 sq.ft. CA— Attie CWset � over garage (not available to tenants) + cm.t Bedroom 4 290 sq.ft. Outdoor Balcony 440 Haywaters Rd. Cutchogue,NY 11935 Basement Andrew and Laura Martinez-Fonts 415 860-0131,amartinezfonts@gmail.com Page 3 of 3 Crawlspace Crawl space RG Crawl space Basement Crawlspace (unfinished) TOWN OF SOUTHOLD PROPERTY RECORD CARD 7-7 - SUB. a '=Arl t FORMER WNE . eS wc, v, w TYPE O BUILDING 3 e �L FARM CORM, Co. MISC. Mkt. Value D IMP. TC T ,$ DATE REMARKS ek _ r Al .. I a e s R `- - -ti1 - - wit 'tC A 01 s AGE BUILDING CONOI,I a W NORMAL_ BELOW ACE A Ace Value Per Value Acre � If all € Tillable V- T,.II _ Tillable 3 Woodland Sway Mond I FRONTAGE ON WATER B, a frla� FRONTAGE ON ROAD House Play DEPTH _ -BULKHEAD Total DCC s_ L l COLOR tr _ _ . I TRIM I , 3 —4' i s . _ — — z o 4W l ... ` \\\. \ \ € [ _ I a aF a M. Bldg y i F� c1t ion Dinette Extension �' Basement Floors K, . Extension 'Ext.. alls ,c°`� a` _ Interior Finish _ LR. f ~l = D Extension � f _, �,� � = ,� �. IFire P-Irate � f� ; Heat - ` ;#_ , i R. ,Type Roof Rooms 1st Floor - �BR. Porch _- R reation Room s Rooms 2nd Floor i N. B t { PO r� > e r Dorm Breezeway !Driveway Garcge Patio O. B. Total l I t i 1 0 x s .r a 711 3 10 ; o IiF 4 �. ✓ J � h 5 1lZ- 111-2-3.1 4/01 i F F�' M. Bldg, ^>`� 98 SSZS I/tVia` Foundation ce P� Bath Dinette 7 1'7 Yy FULL Extension 7•� S�j S.�� 279, Basement sflne� ter. Floors Kit. Extension 3's �o- 3 Ext. Walls e-cp'q2 Interior Finish ; , <=;r�_ L.R. Extension Fire Place Heat D.R. y` PtiQ r7 Woodstove BR, e Porch F Dormer Fin. B. Deck. / 5 Attic Breezeway Rooms 1st Floor Garage r7,,2.0 j L ,00 Driveway Rooms 2nd Floor O.B. Pool 3 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. UPDATED PRE E%ISTIM CERTIFICATE OF OCCUPANCY No 5-24591 Date SEPTEMBER 6 1996 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 440 BAYWATERS RD. CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section ill Block 2 Lot 3.1 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 5-24591 dated SZPTMUM 6 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 is ONE 'EMILY DVZLLING WITH ATTACHED PORCH 6 PATIO i ACCESSORY CARPORT * The certificate is issued to CAROL SIM=N (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES PRE CO 5-13454 ISSUED MAY 17, 1985. OWNER OF PRMIISES HAS NOT CONSENTED TO AN INSPECTION. itding Inspector Rev. 1/S1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.X. CERTIFICATE OF OCCUPANCY No: Z-27246 Date: 08/15/00 THIS CERTIFIES that the building ADDITION & ALTERATIONS Location of Property: 440 HAYWATERS RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 111 Block 2 Lot 3.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 21 1999 pursuant to which Building Permit No. 26153-Z dated NOVEMBER 15, 1999 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 ADDITION & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ALFONSO & CHRISTINE RTINEZ-FONTS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1317 07/27/00 PLUMBERS CERTIFICATION DATED 06/ 2/00 GIUSEPPE SFERRAZZA PLUMB. A prize Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: 2-25977 Date: 09/18/98 THIS CERTIFIES that the building ALTERATION Location of Property: 440 HAYWATERS RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 111 Block 2 Lot 3.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 24 1998 pursuant to which Building Permit No. 25088-Z dated AUGUST 12 1998 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 TO AN EXISTING ACCESSORY CARPORT AS APPLIED FOR. The certificate is issued to ALFONSO MARTINEZ-FONTS JR. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uil ing Inspector Rev. 1/81