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Home My WebLink About1000-80.-1-44 r TOWN OF SOUTHOLD , Rental Y Permit No. 0008 Owner Stephen & Susan Capozzoli Occupied as Single Family Dwelling Located at 575 W. Shore Drive Southold 80-1-44 Address Village S/13/1- Maximum /B/LMaximum 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. 3/15/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 01 m BUILDING DEPARTMENT TOWN OF SO OLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION 0-1[11) BLOCK LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) .. ,� a f Telephone Number (s): 3 1 3 - Property Owner Email Address: _-Sc- 0 �" its. c'" PY Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): I ;or®j 4 Mailing Address of Authorized Agent: C� �0 I f Telephone Number (s): Email Address: e �� ,. �� Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s): 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: Address of Managing Agent (no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number (s): 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, 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 U 'it: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: K.,j 6,f 3 bec r t x x Ia eci t t° no r r" — 02 I ', �� /.2 x 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 NYS licensed architect, a NYS 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. VII am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. Page 3 of 4 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect, a licensed professional engineer,or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building code Certification. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) �''' �,� � �� r"�` •� �rti'�runder penalty of,perjury,the following, 1. 1 am the owner of the property identified in "Section A"of this application. G 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: _ . .w m Property Owner's Signature: J Sworn to before me thi /day of G , 20 Official Notary Public Signature and Original Notary Stamp �� Page of Nota'fYork 1 y 'it 1 f so Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: I Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: 1 . 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: 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: q4 TOWN OF L D 1E -' INSPECTION 1°:° 111%IIE„ IIII IGIM 1ST IE w IIII°°1111 IIIE:)IIE,,,,,,11BG. IIC ;Ilf 1lll::::`0UMDATl0N IIND 1111114 L ""I°'10114 IIC ;III IPlll::IAMEIMG S"I'lIE° IIII::)III IICFINAL 94w* IIC IIP::lIIE 1;;I IIR111,,,,,, III;;;a & GllI°°1 III M '11 ;Y IRE S 11R 11 1111 ""I 11GIM IIC FIRE II IIE;!!!1 11! "'� IIIA"'>rt"' IIS °'T11 "' IIIS IIC ;III III!!!!!!11111 ,EG""IIS' IIII In,,,,,, IIROUG1°°III Illi;;;;!;Illi llf IIII° IIII III,,,,,, Ilf°°IIID JIII IISC0111�)E VIOLKIII""IIII I IIICAUll KING m� ........ ............wwww.......ww ««....wawa __._ ._ww.. n " O 0 O Oa r 0 . x z �z 739 i tj " _ w c i ... 0 to 0 z o k � D O 0 0 CLI _..... z m q�➢ i p' m '5M, f Y.. A�POZZOLI wRESIDENCE �ITECNOLOGIES b a yy NEW YORK mmramwzawr'�+urapa�"�.waraam-exr" v mo fl (m0 ® ca �. a„ �, rE.- a �0 ��r;, w �� "I Df T ` s ... lz FUR. IL ,m m i I 'T m^ lJ Z 0 p Z . O � Y [T Z Y VI �. �m.... Baa vSm D M � OZDZOI RESIDENCE CAP �NL'1N0 We49YaLLkI¢[I8I O V � WIN.117Bi1EYMG;`l�WIM9�E1:'4Y!'ISt'.4 r�ei.aiuie k FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31023 Date: 06/30/05 THIS CERTIFIES that the building NEW DWELLING Location of Property: 575 WEST SHORE DR SOUTHOLD Wv (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 80 Block 1 Lot 44 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 18, 2004 pursuant to which Building Permit No. 30577-Z dated AUGUST 19, 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 SINGLE FAMILY DWELLING WITH COVERED WOOD DECK AS APPLIED FOR. The certificate is issued to STEPHEN & SUSAN CAPOZZOLI (OWNER) of the aforesaid building, SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-04-0027 06/23/05 ELECTRICAL CERTIFICATE NO. 2039605 04/28/05 PLUMBERS CERTIFICATION DATED 04/08/05 BERTSAND PLUMB.&HEATING __..........._ ..... Authorized 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: Z-31863 Date: 09/26/06 THIS CERTIFIES that the building ALTERATION Location of Property: 575 WEST SHORE DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 80 Block 1 Lot 44 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY__7_, 2005 pursuant to which Building Permit No_ 31276-Z dated JULY 14, 2005 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 CONVERT PORCB TO SUNROOM IN EXISTING SINGLE FAMILY DWELLING AS APPLIEDFOR. The certificate is issued to STEPHEN L. & SUSAN A. CAPOZZOLI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2069795 08/21/06 PLUMBERS CERTIFICATION DATED N/A Aw hor'fed .signature r Rev. 1/81 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET .5 =j VILLAGE DISTRICT SUB. LOT K' —---— —--------- - FORME IZ OWNER N E ACREAGE S W TYPE OF BUILDING SEAS. VL. FARM comm. CB. 1 IND. MISC. Est Mkt. Value LAND IMP. TOTAL DATE REMARKS Ll 06 ,7 J? All L-Z-�O-(D A 6 -510 e) ID r eiff:"- ve AGE ISL (Nf3-CO W DjTI A' on of NEW NORMAL BELOW ABOVE/ FRONTAGE ON WATER Farm Acre I Value Per Acre Value FRONTAGE ON ROAD Tillable I BULKHEAD r-xL-- A Tillable 2 DOCK Tillable 3 Woodland +D -tknrcom Swampland Brushland House Plot Totcl%.o- s t t e� 80.4-44 3/06 M. Bldg. - Foundation Bath >� ss� _ 5D —� • Basement I Floors s �� ten on5Z) Ext. Walls - Interior Finish ` � T ensign i2 LL Fire Place Heat —� — - Porch-, Roof Type a a s ZL — — — i Porch; Rooms 1st Floor F I Breezeway Patio Rooms 2nd Floor Garage I Z r �L Driveway Dormer x - — O. B. o tx,