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Home My WebLink About1000-61.-4-9.2 TOWN OF SOUTHOLD g Rental Permit E Permit No. 0312 Owner Dominick Miserandino Occupied as Single Family Dwelling Located at 53557 Route 25 Southold 61-4-9.2 Address Village S/13/1- Maximum /B/LMaximum 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. 6/23/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 Pax(631)765-9502 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959 a � i 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: Tac Map Number: 0,00 SECTION ��(� ��-BLOCK LOT -�) SECTION S. OWNER INFORMATION: Property Owner Name: Mclr4 'C-A Property Owner Legal Address: Property Owner Mailing Address: 1" 10'7-6 Telephone Number(s): Daytime Evening Emergency_2 Ir Property Owner Email Address: I"Purt c. <k2'D 0 ((2uc-, 0t(.0 Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 r 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: Telephone Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit,if any: g 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 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �. BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime EveningEmergency 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: cx V1 u Requested Maximum number of persons allowed to occupy Dwelling U Number of rooms in Rental Dwelling Unit: 3 • 0kr 'i��°° � �ro.' �� r i- y-t Use and Dimensions of each room in Rental Dwelling Unit: ;° 2'00 1 � x ! ° 3'° ►tet I 23` �j' ... x i�'- �� 8 .,..._...,w ._m.w_., ...�IT,.,....._ 3 Page ._�...._,._..._�...._ ......_.. ....._ .. ... ,.. ..... . g of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 " Southold,NY 11971-0959 b� MUM > p 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) k.. 4(e ( '"A, A( A W) ,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 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 ,', P.O.Box 1179 �0� Southold,NY 11971-0959m„ BUILDING DEPARTMENT TOWN OF SO HOLD 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: Property Owner's Signature: A s Sworn before me this day of �; �e-ucs U , 20d,6 fic115 ial Notar1 y Public Signatsr d Original Notary Stamps � � � �� ar r� Page 5 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 , Southold,NY 1 197 1-0959 w py m m 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 re Hired or Architect ar Fn1 lneer licensed Home Ins ector must rovide coAy a lralid current certl catlonn Rental Property SCTIVI Number: Rental Property Address: owner/Name: > -A. Rental Dwelling Unit I entifier: , Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq., Bedroom#2-90 sq., etc.) 6 L, . ., 5 2Q E-L-.- Re S&DooM k3- 149 , *341", r Property Description (Include all improvements indicated on survey) 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 C?r l °ai" 'i ature IN �• "4 Please place professional seal: CA iP f4f so vk CTOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ' FOUNDATION 1ST ROUGH PLBG. FOUNDATION [ ] INSULATION/CAULKING FRAMING /STRAPPING [ZFIRE L L I SAFETY I SP CTI N [ FIRE RESISTANTI IRE RESISTANT PENETRATION ] ELECTRICAL ( ) [ ELECTRICAL ( I L) ] CODE VIOLATION [ ] PRE C/O ZONING/PROJECT INFO PROJECTINFO: ADDRESS:5355,'MAIN RD.SOUTHOLD,NY 11971 ZONING INFORMATION: SECTION:E1 BLOCK:04 LOT:?.2 DULLING`t PE R O S-CRY SINGLE EAN'ILY _- RESIDENCE - LEGEND _. GENERALNOTES 11 ALL INDICATED IBICK€DETECTORS TO RE REPLACED WITk NEAT COVESNATION SMOKE,I _- CARBON MONOXIDE DETECTORS.PROVIGI NEW DETECTORS AS REQUIRED PER PLANS, - RFSR�ARo D—IIBGSA.RE NOTTOoEUSEGPOR CONS—RUCTION,ALL DICENS'ONS.ER€ APPROXIMATE MARGHERITA MISERANDINO ---------------------------------, - new yqTKMesign I v —111 DECK I --------------------- -------- ,v 53557 MAIN RD.SGuTHGLD, € NY 11971 15683 0722.19 _ T :JD A G BB CELLAR FIRST FLOOR,SECOND ---_a - w ( FLOOR&ATTIC PLAN SS-100 13OF 1 i r (D.CEL PLAN FIRST FLOOR PLAN SCALE:1/4"=1'-0" SO ALE 2, -..., ZONING/PROJECT INFO PROJECTINFO: ADDRESS:53557;MAIN RD,SOUTHOLD.NY 1197' ZONING INFORMATION: SECTION`.61 BLOCK-C -0-9.2 BU:Ll-INC WPE TV.G STORY SINGLE FAMILY RESIDENCE - - LEGEND -S- 1 GENERALNOTES Al-INDICATED SMOKE DETECTORS TO BE REP'LAC=D Wl1 UEN C_MBINAT'CN SMOKE.' - - CARSON MO OXIDE DETECTORS,PROVIDE NEW -- DETECTORS AS REQUIRED PER PIANS. - - vRAih9fkSARE NOT TO 6E USED EOR. CONSTR"CTIO\.AL-DIA'ENSIONS ARE _ APPROXIMATE � MARGHERITA MISERANDINO -.0 `- I new york,design --------------------------------------------- 41 I_ ;7;57 MAIN RD SCUTHGLD.I ------------------------ y 19063 :07, - I ( CA iJD BE i CELLAR,FIRST II57- FLOOR,SECOND FLOOR&ATTIC PLAN rr- SS-100 7-10f`1 SECOND FLOOR PLAN 04 ATTIC PLAN SCALE:1t4"=P-0" SCALE 114-l'-O' 3 TOWN OF SOUTHOLD PROPERTY RECORD 9 - TREEi' VILLAGE � DIST. SUB. LOT Fo,RER OWt F; � .� v N E ` ACR. S , TYPE OF BUILDING -7 LJH RES /G SEAS. VL. FARM COMM. CB. MICS. Mkt. Value v LAND IMP. TOTAL DATE REMARKS DOD 3� SD o O -�) /^ I g v ` - - A BCLDt� CONDII, N, � � - ° f NEW NORMAL BELOW ASO E = j ' Acre Value Per Value FARM V Acre �� Z/l �.� Tillable FRONTAGE ON WATER � x g� Woodland ; FRONTAGE ON ROAD U 7 Meadowland DEPTH House Plot BULKHEAD Totals `� ✓ DOCK g l i v;. ✓t' COLOR a _ w I g. yy 4 i M. Bldg. I E Extension sro ?. �s \ �� _ �5� i d Exteni '? 5 Extension Foundation o Both ?Dinette Porch ' Basement f• Floors I � . K , lnteriorFinish LR Perch { - S �� Ext. Walls ., . ; 2, i2 Fire Piace ;Heat 1 �+, IDR. ` ' Garage "]`ye Roof Rooms ]st Floor BR. f ; n 2 vim- 'Recreation Room Rooms 2nd Floor FIN. B 0' Bi �y-'c'`r 1Gp CO Dormer :Driveway Total 441 / 1 191 j G 0 s 1 FORM NO.4 n TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certlflcate Of Occupancy No. 2.1.1.300. . . . . . . . . . Date . . . !,gveniber.. 1,T . . . . . . . . . . . . » . 1952. THIS CERTIFIES that the building 5. . .(2.)... . . . . . Location of Property 3 . . . . . .Private i�d : !k2 off Main Read Southold House No. Street Hamlet County Tax Map No. 1000 Section . .0 61. . . . . . .Block 4 . . . . . . . . . . .Lot . ,Part o f 0.0.9 . . Minor Ph Subdivision . . . . .e. . e 1M. Bridge . . . . . . . . . �e&.h%p No. .Z . . .Lot No. . 1 . . . . . . . . Requirements for a private one-family dwelling built prior to conforms substantially to the catirm-fbT'Bulding-ftmiit-MMtMM-fMd-in i Qft& dat6T Certificate of Occupancy A Dr i 1 '13 , 19 5.7Z to which-Bufldirgg ennit-No. , .1 1 3 0 0 dated . . . . !»io v em h e.r 1.7. , _ . . . , . . . . 19 S.? ,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 . . . . . . . . . . . a. .private one-fanil� dwelling and acces8ory two-car garage . The certificate is issued to . . . . P h e b e 'A,. R r i d-e (owner,lessee orty ffo of the aforesaid building. Suffolk County Department of Health Approval n/a UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . » . . . . . . . Building pInspector Rev.1/81 Vol" 17 Tc 4. Y I n, n=u d o u 1 c 7 c�y) -------- 2145 o t s Fh, 4, Drid��f� 0 c c u,r i o c c u p.J.e d 0 W r!C Y"-c eri ari ........1 IU 2cco��!r)221i-d. by- Kev Sulffolk Co, x. q'o o r) o/4 9 S,c 7, err, u C U 1 V n c .............. I 10 8 2 C, _"� In �1�� "ck C .............................. �'l. 3 3 r z' F.1 large, af.l., �c .......................... ...... (S) .......... .1........ r c)o r,,i s :JLO, ty p Utili-tv room 0 i f El d c x Y,- c e c 1"".7.. .......... s or, -I a �:o 3 d, .....c.C: e poc "'J, CCRIS U. ............ C ........... IC S r c D a Y.r,s L A f 152 •31 ryry -------------............. ba�A�lr,caru T F 7 ��2-32-D ...... IfT 1� E ------------ L 'I r 0 u �J_I) anm c or 's j I t ................ ........... ----------- n p d ......LL", _n—A Ti. e s r't, Gi :_20—er,,d-4 :40 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y_ CERTIFICATE, OF OCCUPANCY No Z20176 Dateryww AUGUST 281991 THIS CERTIFIES that the building ADDITTON Location of Property 53557 MAIN ROAD House No. Street Hamlet County Tlax Map No. 1000 Section 61 Block 04 Lot 9.2 Subdivision -,.,.----Filed Map No.__.—Lot No.------ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 20, 1988 pursuant to which Building Permit No. 174462 dated SEPT. 20, 1988 was issued, and conforms to all of the requirements of the applicable provisions of Lhe law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to STEPHEN & SHERYL-LEE ALBERTSON (owners of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL---..NIA—----- UNDERWRITERS CERTIFICATE NO. N195951 JULY 12 1991 PLUMBERS CERTIFICATION DATED PECONIC PLUMBING-DEC 28 1989 Kklilding Inspector 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-21135 Date NOVEMBER 6, 1992 THIS CERTIFIES that the building ADDITION Location of Property_. 53557 MAIN ROAD SOUTHOLD N.Y. House No- Street Hamlet County Tax Map No. 1.000 Sect ion.61' 9.2 SLi bd i.v is ion _Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated-, JULY 10, 1990 -- pursuant to which Building Permit No. 19199-Z dated JULY 17, 1990 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 AS APPLIED FOR .......... The certificate is issued to STEPHEN & SHERYL-LEE ALBERTSON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL !4yA UNDERWRITERS CERTIFICATE PLUMBERS CERTIFICATION DATED—, BU A ing Inspector Rev. 1/81