HomeMy WebLinkAbout1000-103.-4-12 TOWN OF SOUTHOLD
Rental Permit
0466
,rf�Y
Owner Michael & Rosie Nardo
Occupied as Single Family Dwelling
Located at 470 Moose Trail Cutchogue 103-4-12
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.
6/15/2021
Cod nfo c men Official
This Notice must be posted by the main entrance at all times
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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 i
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RENTAL PERMIT APPLICATION '
Rental Permit Fee$200(Application must be renewed every;two years)'
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MAR 3
1 2021
Section A. L`:,.r
Property Information:
Rental Property Address:
1110 M OyS F —11-LAIC-
Tax
1-LAI Tax Map Number: 1000 SECTION i D3 -BLOCK - - -LOT I'L _
SECTION B.
OWNER INFORMATION:
Property Owner Name: �1[c,t�A(L U A(Wo
Property Owner Legal Address: Property Owner Mailing Address:
IJf:'O j4$_()J�_ PA&IC 0� tl0Llo 06,j I+SPF_ P.a.2IL 0q_ t(ald
Telephone Number(s): Daytime�(��-3Z � Evening Emergency *?
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Property Owner Email Address: MCIA&,r�o ®oQ co"\
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Page 1 of S
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Town Hall Annex, Telephone(631)765-1802
54375 Main Road , Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 Q � ;
r
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 Emergency
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: i
Telephone Number(s):Daytime Evening Emergency
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Email Address:
SECTION E.
SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units)
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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 Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box I 179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytime Evening EmergencyL__
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: Ewa r-Amity, a<kxe-
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 U i
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
3!
Page 3 of 5
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Town Hall Annex J Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ;
Southold,NY 11971-0959
cou
BUILDING DEPARTMENT
TORN 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 3
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.
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SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. ;s
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STATE OF NEW YORK)
COUNTY OF SUFFOLK) #;
I WA1C}IKL L QAC ,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 {{
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Page 4 of 5
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Town Hall Annex 1 �L Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 e
Southold,NY 11971-0959 d
��COUMy;
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
applicable laws and rules. I further acknowledge that I will notify the Town of Southold
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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 j
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�NAI'l C Wk6b,
Property Owner's Signature:
Sworn to before me this day of ► , 20-�
Official Notary Public Signatur a d Original Notary Stamp
THOMASJ.UHLINGER
Notary Public,State of New York
No.01 UH47330 t
Qualffled in Su"Cou
Commission Expires
8,yko
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/)off TOWN OF SOUTHOLD PROPERTY
OWNER STREET 4Z• 70 VILLAGE DIST.' SUB. LOT
ACR. REMARKS
TYPE OF BLD.
Rook 1 Nok v
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TOTAL
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LAND IMP. TOTAL DAl E REMARKS
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. . 25652. . . . . Date . . . . . . . . . . . .Nov . . . . 1.5. . . . ., 19. . 73
THIS CERTIFIES that the building located at .Moose. 2rai1 . . . . . . . . . . . . . Street
Map No. !Moose .CoveBlock No. . . . . . . . . . .Lot No. 37 . . . . QUtchQgu®. . .NPX.•. . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . Aug. . 24 . . ., 19. 12 pursuant to which Building Permit No. . . .60?3Z
meted . . . . . . . . . . . . .44B. . .*: ., 19. .72 was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . . .private- •ose• -faml-ly-dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . .George. Ahlers . . . . . . . . . Owner. . . . . . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk'G"ounty Department of Health Approval
UNDERWRITERS CERTIFICATE No. . I. 1 QQ430 . . .;01Y. 2. . .1973 . . . . . . . . . . . . . .
HOUSE NUMBER . . . .470 . . . . . . Street . . . Xoose. .Trail. . . . . . . . . . . . . . . . . . . . . . . . .
.'�. . . . . . . .
Building Inspector
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. .Z899 . . . . . Date . .Ari . . . 26. . . . . . . . . . . . . ., 19 78
THIS CERTIFIES that the building located at Mo ge.Trail. . . . . . . . . . . . . Street
Map No. . 3230. . . . . . Block No. . . . . . . . . . .Lot No. . . . . 37 . .. . . . . . . . . . . . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . October. . . .29. . . . ., ig.7� pursuant to which Building Permit No. 8270Z . .
dated . . QPt0:bQr. . 29. . . . . ., 197i ., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . . . . .PRIVATE ANE FAMILY DWELLING . . . . . .
The certificate is issued to . . George AhZex°sP Bug.l rk Inc.
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . . .N/R . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . .N/ . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . . .470 . . . . . . . Street . . . . . . . Moose Trail. . . . . . . . . . . . . . . . . . . .
Cutchogue, New York. . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
FORM NO.4
TOWN OF SOUT14OLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. . . . .Z1491b. . . . . . Date . . . September. 29 . . . . . . . . . . . . . .. 19 .86
deck addition
THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property4 7 0 M o os e. .T r a i l. . . ,`. . . . . . . . ,C u c h o ue t , N.-A
House No. Strteet No.
County Tax Map No. 1000 Section . . . ..•. . . . . .Block . . 4 . . . . . . . . . . .Lot . . . .1 ?. . . . . . . . . . .
Subdivision M/o Moose Cove . . . . . . . . . .Filed Map No.3.2.3 0. . . .Lot No. . . . . . .37. . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
19 A6 pursuant to which Building Permit No. . . . 5 3 5 0, Z. . . . . . . . . .
dated S e p t e m b e r 2 9 , . , . 19 8 6. ,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 . . . . . . . . .
deck addition to existing one family dwelling . . . _ . .
. . . . . . . . . . . . . . . . .
The certificate is issued to Patrick & Louise Ireland �►x
. . . . . . . . . . . . .
(owner,Agsi�:ox:te
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . V iA . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE N0. . . . . . . . . . . . . .NSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
Rev.1/81
�o�SU�Folk�pGs Town of Southold 2/18/2016
0
P.O.Bog 1179
N 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38102 Date: 2/18/2016
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 470 Moose Trail,Cutchogue
SCTM#: 473889 See/Block/Lot: 103.4-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/10/2015 pursuant to which Building Permit No. 39668 dated 4/10/2015
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:
ELECTRIC IN KITCHEN ONLY
The certificate is issued to Nardo,Michael&Nardo,Rosie
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 39668 02-02-2016
PLUMBERS CERTIFICATION DATED
Authorized Signature
Town of Southold 1/23/2018
P.O.Box 1179
ry 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39463 Date: 1/23/2018
THIS CERTIFIES that the building SOLAR PANEL
Location of Property: 470 Moose Trail, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 103.4-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/5/2017 pursuant to which Building Permit No. 41955 dated 9/8/2017
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:
roof mounted solar panels on existing one family dwelling as applied for.
The certificate is issued to Nardo,Michael&Rosie
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41955 12/27/2017
PLUMBERS CERTIFICATION DATED I
T Authorized Signature