HomeMy WebLinkAbout1000-59.-9-15.1 �Q �fFa� �o TOWN OF SOUTHOLD
�o
c S Rental Permit
0525
Owner Andromahi Eliodromytis
Occupied as Single Family Dwelling
Located at 7720 Sound View Av Southold 59-9-15.1
Maximum Permitted Occupancy 7
Is incompliance 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.
8/24/2021
de En rcil -T-1 nt fficial
This Notice must be posted by the main entrance at all times
sfi pF SU(jTN
Town Hall Annex { Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G 0 t1
Southold,NY 11971-09590ze. .
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
o
Tax Map Number: 1000 SECTION -BLOCK CA -LOT 1 -
SECTION B.
OWNER INFORMATION: i
Property Owner Name: fif)
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number(s): Daytime%9I1 10 Evening Emergency
Property Owner Email Address: 2 WO &4A ACO. CL
Page 1 of S
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fjl Q� So. a
Town Hall Annex 1 , Telephone(631)765-1802
54375 Main Road cn 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: ke
Telephone Number(s): Daytim Ste` 1Qvening Emergency
Email Address: 7 2—,=�
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 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
i
F�jQC S06
Town Hall Annex 4 Telephone(631)765-1802
54375 Main Road c� Fax (631)765-9502
P.O.Box 1 179 ; Gr,
Southold,NY 1 1 971-0959
COU � jj�'
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 Uni
Number of rooms in Rental Dwelling Unit: 4
Use and Dimensions of each room in Rental Dwelling Unit: � �1�
17 1 IL
Page 3 of 5
i
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 O rya
cou
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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.
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.
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
)
COUNTY OF SUFFOLK)
I RIM' Rt,b11 CIA0049 �/ , 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
Xk
Town Hall Annex Telephone(631)765-1802
54375 Main Road
--E2x(631)765-9502-
C/7
P.O.Box 1179 CL,-] - --
Southold,NY 11971-0959
AUG 1 1 2021 L: /
BOLDING DEPARTMENT
TOWN OF SOUTHOLD BURDENG D� .
TO
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: kftO,
Property Owner's Signature:
Sworn to be ore r 20
p9this—dayofln.
Officie,N ary Pubdic'Sig Watured Original Notary Stamp
LINDA S. CARLSON
Notary Public, state of New York
No.01 CA61371 78
Qualified in Suffolk COuntY
Commission Expires Nov. 14, 20
Page 5 of 5
# # TOWN OF-SOUTHOLD BUILDING DEPT.
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`ycourm '' 765-1802
INSPEC=TION
[ ] FOUNDATION IST [ } ROUGH PL13G:
= [ ] FOUNDATION 2ND [ ] INSULATI.OWCAUL ING
[ ], FRAMING/STRAPPING [ FINA
[ ] FIREPLACE & CHIMNEY [ ] "FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
o4.4A
DATE INSPECTOR
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TOWN OF'SOUTHOLD PROPERTY REGO
LOT
OWNER STREET VILLAGE
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ACR. REMARKS
TYPE OF BLD.. I
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LAND IMP, TOTAL DATE REMARKS. ,.,, i ; . y.
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FARM Acre Value Per Value:
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Tillable 3 f �.., o-°M
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..Swampland FRONTAGE ON,WATER
Brushland FRONTAGE ON ROAD `
House Plot- DEPTH '
BULKHEAD
DOCK
Total
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FORM NO. 4
1 iTOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. .Wao.t . . . . . Date . . . . . . . . . . . AVB. . .?. . . . . . .21977.
THIS CERTIFIES that the building located at - .S/S• Bound View. Ave. . . . . Street
Map No. . xx. . . . . . . Block No. . .= . . . .Lot No. . . .=. . . . . . jS,OuthOld.N.-.Y.. . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . Sept . 29 19.76. pursuant to which Building Permit No. . .M$Z
dated . . . . . . . . . .3ept . .21. . . ., 1976. ., 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 . ;xiva.te .one. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to R..Bayle.y to. . .Loui.s .Lombardi. . . . . . Q�%mor. . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval Apx 22 1977. by. R, Villa. . . . .
UNDERWRITERS CERTIFICATE No. . . J132630.7 . . . . . . .Feb . .17. .1977. . . . . . . . . . . .
HOUSE NUMBER . . . g72D. . . . . Street . . . . .Bound• View. Ave. . . . . . . Southold. . .
A4 Q-
Building Inspector
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FORM NO. 4
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28415 Date: 05/15/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 7720 SOUNDVIEW AVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 59 Block 9 Lot 15.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 26, 2002 pursuant to which
Building Permit No. 28126-Z dated MARCH 1, 2002
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 ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to MICHELLE L MARTOCCHIA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
/Wuth? ized ignature
Rev. 1/81