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HomeMy WebLinkAbout1000-83.-2-7.2 TOWN OF SOUTHOLD Rental Permit 0579 Owner Linda Dambassis Occupied as Single Family Dwelling Located at 2430 Dignans Road Cutchogue 83-2-7.2 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. 7/30/2024 _ Code fo e mend o � l This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 9-4_.?_ .aA INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] 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 [ vy RENTAL REMARKS: a,w4LA1 6-7 DATA: INSPECTOR FE' Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 Date SCTM# ' Phone Owner .,... .,------ _... .. ...w,._._ ..�. .....� �°.. �'Sr .5 e..., _. ... _w. .. _ Visible Addr ss �Q •_ Addr t _ Inspector HamFloor Quantities Sub 1 2 Level Smoke Detectors (not located in bedrooms) +� Carbon Monoxide Detectors Fire Extinguishers Exits _ 6 Bedrooms 1 _ 5 .. Smoke Detectors Egress Occupant Count Building Systems Maintained & Operational Condition of Property Heating Building interior Bui ding exterior Hot water property - ,- - - Electrical clean, maintained &safe _ Mechanical secure Handrails &guards installed Pool on Site Pool Safety e Da .. _. D� Surface water alarm to of CO issuance _. Door alarms Pool completely enclosed Self closing/ latching gates Pool fence to code requirements 577,1 CO's for all items present Prior Rental Comments: TOWN OF S ke Rental Permit N 0579 Owner Linda Dambassis Occupied as Single Family Dwelling Located at 2430 Dignans Road Cutchogue 83-2-7.2 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. 1/24/2022 ode E fo e e Official This Notice must be posted by the main entrance at all times Town Hall AnnexTelephone(631)765-1802 54375 Main Road sFax(631)765-9502 P.O.Box 1179 + Southold,NY 11971-0959 a�r ffi dy 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: Tax Map Number: 1000 SECTION 3 -BLOCK 02 - SECTION B. OWNER INFORMATION: Property Owner Name: L_43QA D'�j mt ASs 1S Property Owner Legal Address: Property Owner Mailing Address: 20 SuTt-roJ PL. S 11j) 170 5,q AA C IEW �� N•.. • i OO 22- q17. 868. q772- Telephone 77ZTelephone Number(s): Daytime Evening Emergency Property Owner Email Address: i-cw,c K'I11 1 1 ��' c LLL ov Page 1 of S Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 up"' BUILDING DEPARTMENT TOWN OF SO OLD 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: Z4 Telephone Number(s): Daytime Aening 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 Evenin Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties Acontaining 8 or more rental units) Name of Managing Agent of dwelling unit, if any: .. l� Address of Managing Agent (no P.O. Boxes): A Page 2 of 5 Town Hall Annex f Telephone(631)765-1802 fig 54375 Main Road Fax(631)765-9502 P.O.Box 1179 q� ; Southold,NY 11971-0959 ,4 �t BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:_ Telephone Number(s): Daytime Eve ' g, �+_ Emergency �ww Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: Or lE 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: ` It r Lr-- 1 1Lk Oet_t_1 iJ . Requested Maximum number of persons allowed to occupy Dwelling Unit: 10 Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: b V'1 oick k-m- r V � - 13�R'2-` 22�-8" k 17'GHC0 Cl - ,x IC7- °�2c 1-,�1.. 1" it-0�, ' L4�e4: 3Ait 3 >i : I� 0l� 3 -- 13-o"/ " � � io � � / , Page 3 of 5 Town Hall Annex "� Telephone(631)765-1802 54375 Main Road y " Fax(631)765-9502 P.O.Box 1 179 �r� Southold,NY 11971-0959 2 BUILDING DEPARTMENT TOWN OF SOU T"HO 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. ❑ lam requesting afire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 1K 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) I L. ODA DAm Bess iS 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 � ) ee Town Hall Annex �; 765-1802 �' �- Telephone(631) 54375 Main Road Fax(631)765-9502 P.O.Box 1179 , 1t 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: Ll Q0 11 soss I, Property Owner's Signature: ' r )c Sworn to b f a me this 1 day of 0 Offici c-S*natu ad-O Iginal Notary Stamp WILLIAM C.COCCI. NOTARY PUBLIC,STATE OF NEW YORK Registration No.4963689 Suffolk County Commission Expires March 12, Page 5 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road w Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �y� a ;'ol" w � T BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occueach dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowe o occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: O/A Rental Dwelling Unit Identifier: Requested maximum number of persons allowe o occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: �1 Town Hall Annex r Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 > 4" BUILDING DEPARTMENT TOWN OF SOOLD 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 Professional seal re uired or Architect or Engineer,licensed Nome Insipectormust Provide co ot valid current cerci iation Rental Property SCTM Number: 1000 - 833 -01-7,1- Rental 000 -- X33 -01-7,2Rental Property Address: i - Owner/Name: Ly,)zA D Mi3Assl5 Rental Dwelling Unit Identifier: Q WELL T Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom #1-100 sq., Bedroom#2-90 sq., etc.) # I _. 132 is .� 7 #2 - J%L„ FI-1 8 r--D Iw- j «- I BED H 4t - 222 Property Description (Include all improvements indicated on survey) -'�Jtv" 'boTV:D 1�-gaJA9 2-2,2'W IL !1 `rim L Q:S�:D a -bLC" -8 c � 's-mor be-l d e u" �' lis p►A-L,- Qat w i�, WOOD I W - 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 rrk State,the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the 'clergy Conservation Construction Code of New York State. Print Name and Title " ignature So 1 , IL Please place professional seal: ,ON owl TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] F NAL [ ] FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O R ARKS: cw (ACo ? ftyx u DATE INSPECTO mvMu 'Phn I TOWN OF S UTHLD PROPERTY RECORD OWNER STREET VILLAGE DIST SUB. LOT 1 / h; ress rs i .. 41 FORMER OWNER N _— E ACR. err :�' � �; �_. C7UM✓t� � X41 � °� 'SZ - S - W _ TYPE OF BUILDING - .• � , �C�r�rN���� —AN� I � %� ��'l�✓''1 L--� S � xDlo RES. 5EA VL, FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS F o as a e ar r ea - Tillable FRONTAGE ON WATER v Woodland F FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Toto I [ I 1 /noo3.- G% -- LOR TRIM i I f { t _ I k i I . > s a C , .4 _ —C _a 83.-2-7.2 7/08 - P 83-2-7.2 4/01M. Bldg., a d o � I Extension L — - i Extension ( [ - - Foundation f Bath i Dinette � I d Porth � Basement Floors _ Prc - I Ext, Walls l Interior Finish LR, iEI _ Jw Breezeway _ Fire Place Heat / LR, 3 _ f` Type Roof . Rooms 1 sY Floor � R. Recreation Room -I[,!.Rooms 2nd Floor B E _ -{'- O. B. Dormer i Driveway Total � \� fl e "am NO. a TOWN OF SOUTHOLD BUILDING DEPARTAUNT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . z. .G� .�.�. Date . . . . . . . . . . . . . . . .T. . .! . . . 19.78 . . . THIS CERTIFIES that the building located at ?.So . ��.G N �`{ T?o A D Street Map No. . . . .� . . . . . . Block No. . —Lot No,' . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . .Y G. . . . 47.g. pursuant to which Building Permit No.93 91-.Z— dated dated . . . _ . . . . . . . . fa-�(: . . . 197 g., 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 . �. . . I?.�V A ►. . . . . .4. N E. . . . A i� t� {. . . . . . )t,.L.L .I r'. 6'. . . . . . . . . The certificate is issued to . . . .DA.V. ! D . . . . . 0. r7.C .T�.S. . . . . . . . . . . . . . .. . . . . . . (owner, of the aforesaid building. Suffolk County Department of Health Approval . .. . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . , . ,��. . .3 .L(.` . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . . .2$p U. . Street . . .D.Q.G. . . . . . .�.,. . . . . . . ?�. . . . . . . . . . CU7 06 UL Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26807 Date: 11/29/99 THIS CERTIFIES that the building ADDITION CUTCHOGUE Location of Property: 2430 DIGNAN'S ROAD (HOUSE NO.) � (STREET) (HAMLET) County Tax Map No. 473889 Section 83 Block 2 Lot 7.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26, 1992 pursuant to which Building Permit No. 20933-Z dated SEPTEMBER 2 1992 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 TWO STORY ADDITION TO EXISTING ONE FAMILY DWELLING & AMENDED TO INCLUJDE A GREINHOUSE' ADDITION AS APPLIED FOR & AS PER ZBA #3903. The certificate is issued to LINDA DAMBASSIS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-505761 11/03/99 PLUMBERS CERTIFICATION DATED 11/22/99 PECONIC PLUMBING & HEAT.. +IB3 ArjIns ctor Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27780 Date: 06/28/0 THIS CERTIFIES that the building ADDITIONS Location of Property: 2430 DIGNANS RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 83 Block 2 Lot 7.2 Subdivision _ Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 22 1999 pursuant to which Building Permit No. 26459-Z dated APRIL 20 2000 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 WITH INGROUND SWIMMING POOL AS APPLIED FOR. The certificate is issued to LINDA DAMBASSIS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _ N/A ELECTRICAL CERTIFICATE NO. N 548143 01/119/01 PLUMBERS CERTIFICATION DATED N A 4kAu/or4izeSignature Rev. 1/81 tt fC Town of Southold 1/24/2022 P.O.Box 1179 53095 Main Rd sy Southold,New York 11971 CERTIFICATE, OF OCCUPANCY No: 42703 Date: 1/24/2022 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 2430 Dignans Rd,Cutchogue SCTM#: 473889 Sec/Block/Lot: 83.-2-7.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/27/2021 pursuant to which Building Permit No. 46666 dated 8/9/2021 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: "as built"additions and alteration&including attached sliedupperLievel deck with orcli below,outdoor shower,deck eaitension and ebo to e r tin msin le family dwelling asa lied for,per ZBA r 7 09.dated 7/15/202 1. The certificate is issued to Dambassis,Linda of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 12/10/2021 A 1 'a Darn µsis I t o Signature rtttdt Town of Southold 1/26/2022 P.O.Box 1179 53095 Main Rd w�� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42706 Date: 1/26/2022 THIS CERTIFIES that the building HOT TUB Location of Property: 2430 Dignans Rd,Cutchogue SCTM#: 473889 Sec/Block/Lot: 83.-2-7.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/14/2021 pursuant to which Building Permit No. 47322 dated 1/11/2022 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: "'' s built!'accessoty hot tub as applied for, The certificate is issued to Dambassis,Linda of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. N 548143 1/19/2001 PLUMBERS CERTIFICATION DATED th riz ignature tF ,'t� Town of Southold 1/26/2022 v P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42704 Date: 1/26/2022 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 2430 Dignans Rd, Cutchogue SCTM#: 473889 Sec/Block/Lot: 83.-2-7.2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/14/2021 � pursuant to which Building Permit No. 47321 dated 1/11/2022 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: accesspZ deck as applied.,f rp r BA#750-9 dated 7/15/2021., The certificate is issued to Dambassis,Linda of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 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