HomeMy WebLinkAbout1000-31.-16-8 g 4 TuwN OF SOUTHOLD
co Rental Permit
0569
Owner Samual Cooper & Moushin Majafi
Occupied as Single Family Dwelling
Located at 2400 Bay Avenue East Marion 31.46-8
Maximum Permitted Occupancy 4
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.
5/28/2024
Cod nfo ce e t Official
This Notice must be posted by the main entrance at all times
.
TOWN OF *OUTHOLD BUILDING
631-765-1802
INSPECTION
[ FOUNDATION 1ST ROUGH P°L 13G.
FRAMING /STRAPPING I FOUNDATION 2ND INSULATION/CAULKING
RESISTANTFIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION FIRE
ELECTRICAL (ROUGH) ELECTRICAL
CODE VIOLATION PRE C/O RENTAL
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Town Hall AnnexTelephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT SEP __ �
TOWN OF SOUTHOILD
RENTAL PERMIT APPLICATION F �
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address: -
Tax Map Number: 1000 SECTION �3 1 -BLOCK OM
SECTION B.
OWNER INFORMATION:
Property Owner Name:
SAH\ (100 t NbJVnV\ NA
Property Owner Legal Address: Property Owner Mailing Address:
*2-
1122
2—
Telephone Number(s): Daytime � 2 ening Emergency
Property Owner Email Address: N� WLR ` N k VI
Pagel of 5
Town Hall Annex u, Telephone(631)765-1802
54375 Main RoadFax(631)765-9502
P.O.Box 1179 °
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SO HOLD
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:
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
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Town Hail Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 1197.1-0959
le W0
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: 1
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: -2,wmywaI It
Use and Di ensions of each room in Rental Dwelling Unit:
Page 3 of 5
4,
Town
Town Hall Annex �t Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
n
Southold,NY 11971-0959
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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.
VI 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)
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
Town Hall Annex u��� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 a
" 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: V-� \N
Property Owner's Signature:
Sworn to before me this day of �W 20 2`
Official NotqIPubic ignat a and Original Notary Stamp
Page 5 of 5
1- It,- o (yo )&j A � ��
14V sora
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ]
FRAMING / STRAPPING AL
[ ]
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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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No. Z- 32290 Date: 04/16/07
THIS CERTIFIES that the building DWELLING
Location of Property 2400 BAY AVE EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 031 Block 0016 Lot 008
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 32290 dated APRIL 16, 2007
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*
The certificate is issued to INGER BOYAJIAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
:/,uorize-'d Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 2400 BAY AVE EAST MARION
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S): INGER BOYAJ'IAN
OCCUPANCY: SINGLE FAMILY DWELLING INGER BOYAJIAN
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 31.-16-8
SOURCE OF REQUEST: BRYANJ. VILLANTI 4/10/07 DATE: 04 16 07
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2
FOUNDATION: PIERS (CEMENT) CELLAR: CRAWL SPACE: OPEN
TOTAL ROOKS- ISTP1 3 2ND PLR.: 0 3RD FLR.: 0
BATHROO JIS;,) : 1.0 TOILET ROOM(S) 0.0 UTILITY ROOM(S):
PORCH TYPE
DECK TYPE: WRAP AROUND PATIO TYPE.
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: YES TYPE HEATER: ELECTRIC AIRCONDITIONING: YES
TYPE HEAT: PROPANE FIARM AIR: XX HOTWATER:
OTHER:
ACCESSORY STRUCTURESw
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
TOCAI'1d?&a _...__. ChBS'CRIPTIOAI VwRT � _ SEC.
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INSPECTED BY: T ,—. DATE ON INSPECITON: bSII,/'07
GARY J. 'I5 TIYlB START: 10:10 AM SND: 10:40 AM
...._.m.... _.m........, FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-32754 Date: 11/27/07
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 2400 BAY AVE EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 16 Lot 8
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 16 2006 pursuant to which
Building Permit No. 32125-Z dated JUNE 16,_2006
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 REPAIR & ALTERATIONS & DECK ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR & AS PER CONDITIONS OF Z #5540 DATED 11 7/04.
The certificate is issued to INGER ROY"AJIAN
(OWNER)
of the aforesaid building.
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SUFFOLK COUNTY DEPARTM@TP OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2022553 06/05/06
PLUMBERS CERTIFICATION DATED p6 06/46 GREENPORT PLUMB.&HEATING
t'h/edignature
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Rev. 1/81 O
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