HomeMy WebLinkAbout1000-21.-1-10 _ x `A WN OF SOUTHOLD
Rental Permit
0357
Owner 240 Strat LLC
Occupied as Single Family Dwelling
Located at 240 Stratmors Road East Marion 21.4-10
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.
10/17/2022 }
Code Eoorce t Official
This Notice must be posted by the main entrance at all times
� �" FF01
*' Town Hall Annex
SOUTHOLD TOWN
54375 Main Road
Rental Inspection
PO Box 1179 Southold,
NY 11971-1179
Tel: 631-765-1802
Fax 631-765-9502
10 /
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LEVELS ELS , � �j��� i j//11F!, //%ice /
Smoke Detectors (#- bedroom detectors excluded) "
Carbon Monoxide Detectors (#)
Fire Extinguishers (#)
Ex(ts(#)
BEDROOMS 5
Smoke Detector Alarms (#)
Carbon Monoxide Alarms (#)
Egress (windows) (YIN)
BUILDING SYSTEMS CONDITION OF PROPERTY N
Heating system maintained/operational Building Interior is clean/maintained
Hot water system maintained/operational Building Exterior is clean/maintained
Electrical system maintained/operational Property is clean/safe/maintained
Mechanical system maintaino loperationai Handrails &guards present
POOLS " N POOL BARRIERS l
Pool present Pool is completely enclosed
Pool surface alarm and/or door alarm Barrier is a min. 48" high
resent
POOL GATES )N All openings in barrier less than 4"
Self-closing, self-latching Max. 2" clearance @ bottom of barrier
Latch on pool side of gate, meets height Barrier capable of being locked &child-
requirements proof when unattended
COMMENTS:
# � TOWN OF SOUTHOLD
Rental Permit
Permit No. 0357
Owner Melina Angelson & Ors.
Occupied as Single Family Dwelling
Located at 240 Stratmors Road East Marion 21-1-10
Village S/13/1-
Maximum
/B/LMaximum 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.
10/30/2020 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
S SO
Town Hall Annex 5 Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ' " rdY
Southold,NY 11971-0959 , `
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Professional seal required for Architect,or Engineer, licensed Home Inspector must provide
-copy of valid current certification
Rental Property SCTM Number: ti 1 2 1 — L
Rental Property Address: '14 a .GJ r^R r:5 &35 /Ida r I,B oi
Owner/Name: M e ll i\n A n:)A SOA McjflA moo] -e-Lt A^4A1nft llah Se A
Rental Dwelling Unit Identifier: Ca1 W ,elGn$ 5i Je —ay\,_�
Number & Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom #1 -100 sq., Bedroom#2-90 sq., etc.)
6k #- i I AIX 1116" = 1 SLI C, � ,
P� IZ #- E,
Lz� T 91 9` F,
Property Description (Include all improvements indicated on survey)
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it
fully complies with all the provisions of the Code of the Town of Southold,the Residential Code
of New York State,the Building Code of New York State, the Plumbing Code of New York State,
the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New
York State.
NAJ'16 /Z PO tV C D -
Print Name and Title If,OFIv�y�Y Original Signafure
��v11�P 1 F� 0
. Q
Please place professional seal: rnr
t!� it J 11
®6603®A
®��SSIO
!N
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
LJ j
BUILDING DEPARTMENT OC-1 6 2020
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
2-q 0 5 NatM 0 00
Tax Map Number: 1000 SECTION 3M -BLOCK 2, -LOT C)
SECTION B.
OWNER INFORMATION:
Property Owner Name:- VVc- lina- Nyi -eksoy) l tAo,(+ha-Poq �-Aprta
ii _I—a c c)bSer'1
Property Owner Legal Address: Property Owner Mailing Address:
L8-f- 1 i a-a- Ayl — M-e- I I,
ps 0 t1d C-)f S V-0 - 12, 01
3 3 4
Telephone Number(s): Daytime 65) Evening Emergenty
I
Property Owner Email Address: dioaknSC)060e-,wa )f- C61n
Page 1ofS
sS0`
Town Hall Annex 1s 2 Telephone(631)765-1802
54375 Main Road `�s� `z�' Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized 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): Daytime Evening E ergency
Email Address:
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): Daytime Evening Emergency
Email Address:
SECTION E.
SITE MANAG/INFRMATTION: (required for rental properties containing 8 or more rental units)
Name of Manaelling unit, if any:
Address of MaP.O. Boxes):
Page 2 of 5
� a� so�,���
A�� �v.
�S
Town Hall Annex �, Telephone(631)765-1802
54375 Main Road c a' Fax(631)765-9502
P.O.Box 1179 G . RZ
Southold,NY 11971-0959 � �. -✓fit
c®Um,� � ,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address:
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 Unit:
Number of'rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
3 - 1droom S
tcZd ► 1 c� ��C( .
Page 3 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road e� # Fax-(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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
' I am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
I NJ& AA C O,�Wcertify 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
Page 4 of 5
Town Hall Annex Telephone(631)765-1802
rr,
. ,,
54375 Main Road .� �U� s�;;'�- � Fax(631)765-9502
P.O.Box 1179 SeV
Southold,NY 11971-0959 _�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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 as to any change-to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name: MA CL-1 LS SL-1 (!!:7L,
Property Owner's Signature:
Swo to befor me this 13 day of QW-W- , 20215
Official PA, N b E ' nature and Original Notary Stamp
Notary Public, ate of New York
No.01 6221360
Qualifie in Suffolk Count
yY
Commis ' n Expires 05/031 aa'
Page 5 of 5
\ oxalo SOUTyp� � J��n•KIS C ! -/ Ct/'"'( " \7" I pw
# TOWN OF SOUTHOLD BUILDING DEPT.
�ycourm, 765-1802. INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] INAL � W
4AW► v
/AU
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
VAHW,44
DATE 0 />90 ' INSPECTOR
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TOWN ' OF -SOUTHOLta PROPE__ AR®
j OWNER STREET r %''~ VILLAGE DISI: - SUB. t,/ LOT
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I
FORMER.OWNER N E ACR.
Da
r7tY S tSf j `plgv)lae& dWr S W TYPE OF BUILDING
I RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP., TOTAL DATE REMARKS
+j
7 2 d Q v X -70 0
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i
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f
NEW -r�- 16RMAL W 1" °V 9/�S� -'�- /gs4 53R -7} �7 �I s �. !► �+Ae,5 ,vier
-.FARM - Acre Value Per VQthe
r7t o p -,�,e, a 1 13 2c� S D i '.� ' _ C�1 fl(3Y►S� - I
Tillable 5 8 06
10
Til �� / f s I C��21. l2'�.)� �?12 n), +n Lwi
Tillable -3 5
-SSC 1l e�-° 5-100 ;
Woodland
Swampland FRONTAGE ON WATER
Brushlond ' 1 ` ,
FRONTAGE ON ROAD- '-'"
House Plot' DEPTH /
_MElf y
0,333
ZZ P
CID
DOCK �'�3
/l�rti-- 1_ -► �O
COLOR
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Ir
10
2.
Din
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Extension Q r14 /Z�; 3 Sp Basement L ` Floors K.
Extension `��'j 7b Ext. Walls 4, O Interior Finish ���L LR.
Extec►sn u _. /` � z Fire Ploce - b N E Heat ai f/-/ DR. __—_.--
t Z s� Type Roof /.f/,.t. Rooms 1 st Floor BR.
Porch 4 ,�3 S SO �� Recreation Room Rooms 2nd Floor FIN. B.
Porch Dormer
�rwexevmy 5 nt M i�✓ / :., �!� v Driveway
Garage
Patio
O. B.
Total �d
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'• Dormer
FORM NO. 4'
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. .7o..1.9121 Date ............................ .....dap-tembor x9....6.4
THIS CERTIFIES that the building located at ..N/.S....;Xtratmgres...Road................... Street
Map No. —37. 23 ........ Block No. ...........�4;— . .. Lot No. ......5....... . s-t-Alarjolal,..� *X*...........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
............................I...... ............. ]96)+... pursuant to which Building Permit No. 234275...
dated ..............................App31.....a........19-6)f.., 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 ........
.............. ts,,vate...one..Xamily,••dwo-111 ig.................................................................. .................
The certificate is issued to .....Wi.11j,aM.6..ZCA=....,A.the aaiou...............................................
(owner, lessee or tenant)
of the aforesaid building.
H.D. Approval lune 15, 1964 by R. 'V ill
_
Building Inspector
DORM NO.4
TOWN OF SOUTHOLD
BUILDING DVARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
cwtmmte Of Occupancy
NO. . . . . 14467. . . . . . . Date . . . .Apri1 .23. . . . . . . . . . . . . . . . . . .. 1981.
THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property . . 240. Stratmora. Roads . E88t ,Marione K.Y.
svwc . . . . . . . . . . 'Hirn%t
County Tax Map No. 1000 Section . .oil . . . . . .Block •. .01. . . . . . . . . ..Lot . . . DA0 . . . . . . . . . .
Subdivision ..Str,atmom -Estates. . . . .. . . .Oiled Map No3T23. . . . .Lot No. ..5. . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
De a embe r.3. . . . , . , , 19 .79
pursuant to which Building Permit No. . , , ,10 515 Z
dated . . Ae G .pin kq r- 3 . . . . . . . . . . . 19.7 9,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 . . . . . . . . .
. . . . . . . . .Ad •tf,4�Rp. .t4. �F. Yate ,Qpe-Family, ,DKsilia$
. . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . .Chriato. and.H*1sn. Dapbv14*s. . . . . . . . . . . . . . . . .. . . .
(ow ,nw,.fasssa�r.dorraµ.--of the aforesaid building. r
Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. .
UNDERWRITERS CERTIFICATE NO. . X5Q9A5.5. . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . .
Building Inspector
Rev.trot
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. . . .�10466. . . . . . . Date . . . . . . pri1 3 . . . . . . . . . . . . . . . .. 19 . . 81
THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property , , . ,
Nouse No. Street llamfet
County Tax Map No. 1000 Section . . . . . .21 . . . .Block . . . . . . .1 . . . . . . .Lot . . . :i 0. , , , . . , , . , , .
f
Subdivision . . . . . S.tr.atmar. .Es.t:ate. . . . . . . .Filed Map No. . .3.723 .Lot No. . . . .5. . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1.(;t u b je.r. .2. . . . . . . . . 19 .7.8 pursuant to which Building Permit No. . . . .1.004.4.Z . . . , . , , . . .
November 29 l�3
dated . . . . . . . . I . . . . . . . . . . . . . . . . . . . 19 . ,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 . . . . . . . . .
pg .Qkipd. .r9p. w1 th faace. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . Chr�PAq ,UaphniAgg & Helen Daphnides . , . . , , , . _ , ,
of the aforesaid building.
Suffolk County Department of Health.Approval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . .N43.7.163. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
() ,� ding e o
Rev.1/81
i
�f�gFFO[k��a
T4, G Town of Southold 8/10/2020
P.O.Box 1179
53095 Main Rd
� 01 Southold,New York 11971
s
CERTIFICATE OF OCCUPANCY
No: 41334 Date: 8/10/2020
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 240 Stratmors Rd., East Marion
ISCTM#: 473889 Sec/Block/Lot: 21.4-10
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/5/2002 pursuant to which Building Permit No. 44924 dated 6/25/2020
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:
alterations and additions, including enclosed front porch and rear deck to an existing one family dwelling as applied for
The certificate is issued to Angelson,Melina&Ors.
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 44924 7/31/2020
PLUMBERS CERTIFICATION DATED 7/28/2020 m ' an Plumb' Inc.
ut a Signature
October 15, 2020
a
y��
Building Dept.i U
Town of Southold'
Town Hall Annex OCT 2020
54375 Main Rd.
PO Box 1179 -NIN C'F I'A'A,r U UT-D
Southold, NY 11971 Re: Rental Permit Appl.
Dear Sirs:
Enclosed please find my completed application for a Rental Permit.
As requested, I have enclosed a copy of the House Plans; the completed and
notarized Application; a completed Rental Property Certification - signed and
stamped by a licensed engineer; the original Certificate of Occupancy;the original
Certificate of Electrical Compliance; a check covering the Rental Permit Fee for
$200.00.
I believe this satisfies all information required by the Town.
My contact information is below. I look forward to hearing from you as to when I
may expect to receive my Rental Permit.
Thank you for your prompt attention to this matter.
Sincerely,
Melina D. Angelson
350 Stratmors Rd.
East Marion, NY 11939
631-334-6129