The URL can be used to link to this page

Home My WebLink About1000-103.-6-1 of-soup TOWN OF SOUTHOLD Rental Permit 1500 Owner: Diane Corazzini Occupied as: Single Family Dwelling Located at: 100 Lupen Dr Cutchogue 103.-6-1 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: 06/18/2026 Expiration: 06/17/2028 ce Eno ement of i ' I This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD—BUILDING MIPARTMENT Town Hall Annex�54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631)765-1802 Fax (631) 765-9502 1"t.,L.,I/NNLNm.sou thole towLinyg(,)y RENTAL PERMIT APPLICATION Rental Permit Fee $300(Application must be renewed every two y rs) JUG 2026) Section A. Property Information: Rental Property Address: 10(2 1-U rev �12 CY0 rc�&Vs Tax Map Number: 1000 SECTION t 10 13 --BLOCK— (10 --LOT SECTION B. nwNFR wnRIVIATnN. Property Owner Name: R LCt-t*Fk-0 Q(A&-2-ZlN1 Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) A-6S A-0 Fr - 6.1 0 . 60.%c I Ls,. 4f-S - -7079 Telephone Number(s): Daytime Evening Emergency_ Property Owner Email Address: rvic (05 * i<doud-. com-, Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ) ' Z't-i Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: r C 1 c 6c( • Corm Section . Managin Agent Information: Name of Auth !zed Agent of dwelling unit, if any: Address of Author ed Agent (no P.O. Boxes): Mailing Address of A orized Agent: Telephone Number(s): D ime Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (re ired for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if y: Address of Managing Agent(no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: 8 Number of rooms in Rental Dwelling Unit: Ir _.................. Use and Dimensions of each room in Rental Dwelling Unit: L,tV. tom. 65 7,12 "LL I3 icS� S PWA*1 IeX it� ►*SA'r 8•Sx 7•6 � �.,4, rbwi. b, an+ « . (alvelz' _..J?..EiPRrrt #L i?KI,q,l $!Ttt2rrt #2 Sx5 � ar►t + 8e Qm 3 12 k t L-L . 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,:..1 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. o DECLARATION: Signature must be notarized and MUST he the owner of the ff k, STATE OF NEW YORK) COUNTY OF SUFFOLK) 1J certify under penalty of perjury,the following: 1. •I am the®awn®r.of the-property identifiard in Qdg-Qction-W'.of this application. 2. The property owner's legal address set forth to"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, Managi g Age ,or Site Manager. Property Owner's Name: Propertyner`s Signature: Sworn to before me this 1&day of _ ,Ll&4 Mal Notary Public Signature and Original Notary Stamp CHRISTOPHER B BONDARC HLIK NOTARY PUBLIC STATF OF NFW YORK Registration No 0113( 038444 Qualified in Suffolk C'"pun s N4%Commission Expires Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 103-6-1 I N vio 3 E(";`T I %A 3' N [ ] 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 [ ENTAL REMARKS: ►: MATE: - INSPECTOR Town Hall Annex b Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SUM# Date Owner pAA Phone Address /B'D 0 d1 Visible Hamlet Prispector Floor Level Quantities Sub 1 2 3 Smoke Detectors(not located in bedrooms) Carbon Monoxide Detectors 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 presentee, Comments: r- cl fcT- TS " it Z i aa= i f 3 TOWN OF SOUTHOLD PROPERTY RECORD �ARD O WNER VILLAGE DISTICT RI SIB. L& N E A C R 6 G E_ftAM t a yM I R ........ L7� Rw s YPE OF BU I LDl NG p1,0-- AJ D. m1sc Eat, Mkt. Volm RK SEA& IL A "Y FARM. Comm, N LAND Imp. TO L DATE REMARKS Z_ Lee j- jee ee- e t —7 j T GO AGE BUILDING CONDII N ew NORMAL BELOW ABOVE FROW,-AGE ON WATER Form Acre Vokm Per Acre VOW FM%fT1AGE CON, ROAD A Tillable I Till-able 2 DocK Tt-W 3 A Wmd1wd -Swampland Houm Mot i f z f - - �s — - - — 17 _. a oar M. Bldg ct✓1 -Foundation � Bati-� Extension Basement Floors Extension - Ext. Walls Interior Finish Extension N - r Fire Place Y Heat Porch Roof Type Porch: Rooms 1st Floor Breezeway Patio Rooms 2nd Floor Garage Driveway Dormer O. B. NAME DATE BP# TYPE BLDR.- LOCATION C.O. l" _.39373938 r !�: (1,Q q 3940 . : ._�...__.. 3 W -71(o% 3941 � n �� _.. : ► i 399-43 1� z N433 . AAle 7 1 3945 ,._ '....�. ". .. . .3946 ? __39 ..._ .. ` __ ...:...., �, .. .._ �. ,. 3950_ .rv_.., ._ 131k)bo .. . � _Z�7_— - rr 77/4� µr �. ..: i; jo?6a 3956 3959 771 . 39 .w..._ - �.. . �. . � �, �.. . _ ... At � � 1... ° ._ . .. m394 �` �. r M. 3966 �t. , 967 � _.... " ..` . .. —3969 3970 � .� '3 . _ . ....39"7.371(0% . .. �. m _. 974 10 ° FORK NO.f TOWN OR SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3975 Z Date ............................w....w.n ....... ....:, 19A! Permission is hereby granted to., . ..............ft�F.T v ................................I........... ................................................................................ to •« " •• •• •. Y..t fl) Ir ................................................................................. ..........................................................................................w.............w.........w...........,.................................,........ atpremises located at ..yy. r..l .. ...... .4 ""w' " ... ................................ ............................... .A" .f................ w ................................................... d ................................................................................................................................................................ pursuant to application dated ............................A .......30........... 19..168., and approved by the Building Inspector. Fee $.....1.011 x0!..'....... .01 «.......w.. ... '.w..wa.......................................:1......... Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE 3 7 S SOUTHOLD,H. Y. M F Examined ...... ... 19....`...� Application Na ,�"�. ....— Approved ............................................ + , 19. Permit No.'3....�.5 Zak Disapproved a/c........ .................. ..............I............................... ............. ............ (Build ing,.lns ctory.......................... ....... APPLICATION FOR BUILDING PERMIT Date ......,< ....................................... 19.... .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showinia�^ location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and giving a detoiled description of layout of property must be drawn on the diagram which is port of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant.Such permit shall be kept on the premises available for inspection throughout the progress of the work, e. No building shall be occupied or used 'in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zane Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinonces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws„ ordinance wilding code, housing a regulations. (Signature f plica t,or name, if a corporation)M....... (Address of applicant) State whet 1� ter�er, lessee,agent,architect,engineer, general contractor, electrician, plumber or builder. ............... .... ...... ....0 ...... ................ .,., , ...........-......................................, /I1411 Nameof owner of premises .................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which sed r ill b ne. p ca.: .............. ....Lot No.: ... �rr 'I Streetand Number ........ ................................................ ...................... ........CU.�, " Municipality 2- State existing use and occupancy of premiseg s a intended use and occupancy of proposed construction: o�G a. Existing use and occupancy .. .. ... ........................ b. Intended use and occupancy ................................................................................................................................. � 3. Npm,w of work (check which applicable): New mu|dmm ._—_-- Addition _........_. Alteration ... Repair �h�Y�m �o��b� �m��|, .----- Demolition __________~__ ^k Estimated Cost ..... ..................................Fee .............................. ..........___~........ —__.................. (to be paid on filing this application) 5. K dvehing, number of dwelling units —~.. 0 w of dwelling units ameach floor ...___.................. Ifgarage, number oFcars .........___ ................................................................................................................... 'i If business, commercial o, mixed occupuncy, specify nature and extent of each type of we ---------. 7. Dimensions of existing structures, if any Front............................ Rear ..... onp*` _—_..~—. Height .. ......___....— Number mfStories ........ .-,~~,____......_____.... ^__~. Dimensions of same structure with o-itv,atiunsmadditions: Front ... mep, ..-------.—. Depth ................................ Height 3tx�a __--.—_—_-_. Dimensions construction: ' �� o�m 8 m�ns nemw� mn r,�" ~ ....... Rear.___,__.___ ._,._._.__.. � � ""� = �.. ^~...^` . '. � _— . Height .---- of Stories .—. °�._-'_'— ....... _..... ................... ....... ......_...... Rear ' - Depth �.�� * Size of �� Front _' — ' '------------ -----�x��w ' 10' mote of Purchase ..............__......... ..Nome of Former Owner ............. ll. Zone or use district in which premises one situated ....____...... —....... _,._~~_,_,_~.___~__._~~_,__~ 12. Does proposed oonstruct,ion o, -- ... .___ .... ___.. 13. Nome of Owner of premises ........ ..... Phone No. ._.—._—. Name of Architec ',Addms .. =~-- Phone No. � Nome of � w�..^,� __Add,ea ......... Phone No .................... PLOT DIAGRAM distinctly all buildings, whether existing n , and indicate all set-back dimensions � m ----�- —'property lines. G�,early �st �, t and block numb* � � or description according to don6 and show street names and indicate whether interior or corner lot. L �� ~ 'STATE OF NEW COUNTY F duly sworn, deposes and says that he is the applicant (Nome of individual signing applicat, ) ounvv named. He is the -----------------..---.—~—.~~----.—.-----~------------ (C,ntmctor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to nmka and file this application; that all statements contained in this application are true *o the best o* his knowledge and ow/er; and that thek will be performed i theforth in the application file /-) "I Notary Public, (Signature ofapplicant)