HomeMy WebLinkAbout1000-31.-2-32.3 TOWN OF SOUTHOLD
Rental Permit
41i
0573
Owner Nicholas & Sofia Antoniadis
Occupied as Single Family Dwelling
Located at 8295 Route 25 East Marion 31.-2-32.3
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.
1/18/2024
ode 7#Ee Official
This Notice must be posted by the main entrance at all times
so AAv,tri,
TOW N OF SOUTHOLD BUILDING DI
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INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAl
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
( ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI
[ ] CODE VIOLATION [ ] PRE C/O [ 1
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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
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every tw years)
Section A.
Property Information:
Rental Property Address:
8295 Main Road, East Marion, New York 11939
Tax Map Number: 1000 SECTION 31 -BLOCK 02 -LOT 32 - 3
SECTION B.
OWNER INFORMATION:
Property Owner Name: Nicholas, Michael, Sofia Antoniadis (Cape NY LLC)
Property Owner Legal Address: Property Owner Mailing Address:
8295 Main Road PO Box 413
Last arion, New York 11939 East Marion, New York 11939
Telephone Number(s): Daytime 477-6248 Evening 477-6248 Emergency 631-477-6639
Property Owner Email Address: acetweety@aol.com
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Page 1 of 5
Town Hall Annex 1 Fl Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
eo ,'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Nicholas Antoniadis
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent (no P.O. Boxes),: 8295 Main Road East Marion, NY 119
Mailing Address of Authorized Agent:
Telephone Number (s): Daytime 477-6248 Evening 477-6248 Emergency 477-6639
Email Address: acetweety@aol.com
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
Town Hall Annex ; ty Telephone(631)765-1802
54375 Main Road Fax (631)765-9502
P.O. Box 1 179 s
Southold,NY 11971-0959
CollY
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: Unit 1 Front House
Requested Maximum number of persons allowed to occupy Dwelling Unit: 8
Number of rooms in Rental Dwelling Unit: 8
Use and Dimensions of each room in Rental Dwelling Unit: Kitchen (151.07)
Sun Room(136.67), Dining Room(229.70), Living Room (215.42),
Bedroom 1(184.50), Bedroom 2(186.77),Bedroom 3(132.75), Bedroom 4(282.79)
Total livable floor area 1519.67
Page 3 of 5
2 .m.
Town Hall Annex R, �, '
Telephone(631)765-1902
54375 Main Road q {g Fax(631)765-9502
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P.O.Box 1 179
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.
❑✓ 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)
1 Nicholas Antoniadis , 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
t Town Hall Annex Telephone(631)765-1802
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54375 Main Road Fax(631)765-9502
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P.O.Box 1179
Southold,NY 11971-0959 "
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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.
Nicholas Antoniadis
Property Owner's Name:
Property Owner's Signature:AL"
''
Sworn tobef a me this 3�srday of ®C �`� , 20/9
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Official Notary Public Signature and Original Notary Stamp
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Town Hall Annex P -� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959cou�� � �;,�
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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
Pro essional seal required forArchitect or Engineer,licensed Home Inspector must provide
co of valid current cern ication
Rental PropertySCTM Number: 1000-31-02-32.3
Rental Property Address: 8295 Main Road, East Marion, New York 11939
Owner/Name: Nicholas Anton iadis,Michael Antoniadis,Sofia Antoniadis (Cape NY LLC
Rental Dwelling Unit Identifier: Front House Unit 1
Number & Square footage of each bedroom as depicted in the attached floor plan
(i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.)
Bedroom #1 -184.5sq, Bedroom #2 - 186.77sq, Bedroom #3 - 132.30sq
Bedroom #4 - 282.79sq
Property Description (Include all improvements indicated on survey)
Significantly important house listed on the National Historic Registry containing
primary building of undetermined age age and other subordinate structures
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..
Print Name and Title Original Signature
Please place professional seal:
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1970 was when the "Hot
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Early 1980's The Watkins brothers release a spa made of Rovel, a co-extruded material from
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By the middle of the 1990's the smaller hot tub companies disappear and leave behind the
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