HomeMy WebLinkAbout1000-88.-3-20 �� m£ TOWN OF SOUTHOLD
Rental Permit
0390
Owner Isaac & Ashley Itenberg
Occupied as Single Family Dwelling
Located at 9325 Main Bayview Rd Southold 88.-3-20
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.
7/2/2024 �) 4"/ W*/1
Codetrunent WNW
This Notice must be posted by the main entrance at all times
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TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802 89' �
Imm' "SPECTION
[ ] FOUNDATION 1ST [ ] 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 [ TIRENTAL
REMARKS: e-&VUW&O O�210
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TOWN OF SOUTHOLD
- 2-- Rental Permit
Permit No. 0390
Owner Isaac & Ashley Itenberg
Occupied as Single Family Dwelling
Located at 9325 Main Bayview Rd Southold 88-3-20
Village
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.
2/25/2021 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
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Town Hail Annex Telephone(631)765-1802
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54375 Main Road % Fax(631 765-9502
P.O.Box 1179 , fi 'E ,
Southold,NY 11971-0959
BUILDING DEPARTMENT r,
TOWN OF SOUTHOLD `j ` v;
JAN - 8 2021
RENTAL PERMIT APPLICATION
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Rental Permit Fee$200(Application must be renewed every two years),".r,'i '': _ "i
Section A.
Property Information:
Rental Property Address:
G1,3 M,a� n1 V3a- y �.vJ _ tz-Va./O ;. S oy��a-t o L4> , N
Tax Map Number: 1000 SECTION I V 6lr4- -BLOCK 4 3%S I -LOT 97 v-3, '®
SECTION B.
OWNER INFORMATION:
Property Owner Name: 150
L 6U C-- h-S H Imo/ I T-eN i3-�i►�-C1
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number(s): Daytime Evening S°-yV`?- Emergency�t�
Property Owner Email Address: Q1.�1� L F�I •�T-Qi�1 f3 @ �t ► °�-� �'�
Page 1 of 5
Town Hall Annex =t y Telephone(631)765-1802
54375 Main Road 'k,^' TMn' Fax(631)765-9502
P.O.Box 1179 c,:• °
Southold,NY 11971-0959 C/
P
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit,if any: Ac. me,&)
Address of Authorized Agent(no P.O. Boxes):
Mailing Address of Authorized Agent: °I-VL-15- AA-9,4 nl ►L,0-,4 V U^1 1 R--n
51--L- I
3 `
Telephone Number(s): Daytime Evening 3
Emergency
Email Address: CfZANJ t AA Llk [a Nn/ AA L-- 00-"
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: VJ 1 V L-k aivA
Address of Authorized Agent(no P.O. Boxes):
Mailing Address of Authorized Agent: 6AAIN S"�'_ Pc7m-l-- N
Telephone Number(s): Daytime Evening Emergency
Email Address: Vy%11 aw•W .., S
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):
Page 2 of 5
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Town Hall Annexsz Telephone(631)765-1802
Fax 631 765-9502
54375 Main Road -J �`,, '�R;y�r,� �' ( )
d� -
P.O.Box 1179
Southold,NY 11971-0959
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 altoed to oe u y Dwelling Unit: 6 Rer�
1__G1 L'.'
l d V N 4_
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
A-Tt-a C t1-ern =�ri YL- P"Vk w 1 fro NA
4—tm ee�j r I v-rIS
Page 3 of 5
Of Sol,
Town Hall Annex " `�, �. ` F,� �,> Telephone(631)765-1802
*fit ;:r
54375 Main Road _ ;? _ Fax(631)765-9502
CA
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.
i9X1 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.
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
I ,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
Page 4 of 5
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Town Hall Annex3� = ;?, ,:;; , Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 �, � ,
Coyer
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. I 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: i�
Property Owner's Signature:
Sworn to before me this day of 20,:1
t
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.OIBU6185050
Qualified in Suffolk County 1
Commission Expires April 14,
Page 5 of 5
souryo
# # TOWN OF SOU OLD BUILDING DEPT.
765-1802
,-INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG. -
[ ] FOUNDATION2ND - [ ] INSULATIOWCAULKING
[ ] FRAMING/STRAPPING [ ] INAL �t'_V4�
- [ ] FIREPLACE'& CHIMNEY `[ FIRE SAFETY INSPECTION =
[ ] FIRE RESISTANT CONSTRUCTION [- ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ .] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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DATE Y INSPECTOR
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TOWN OF SOUTHOLD PKCPERTl(
OWNER STREET I VILLAGE DIST. ! SUB. LOT
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- -
fake Town of Southold 10/23/2020
+• P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41556 Date: 10/23/2020
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 9325 Main Bayview Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 88.-3-20
Subidivision: bled Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/26/2018 pursuant to which Building Permit No. 43241 dated 11/26/2018
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 family dwelling with covered front porch rear and side landings and attached two car garage as applied for.
The certificate is issued to Calabrese,Giovanni
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-18-0029 10/16/2020
ELECTRICAL CERTIFICATE NO. 43241 8/17/2020
PLUMBERS CERTIFICATION DATED 8/15/2020 uke Bug
A t ed Signature