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Home My WebLink About1000-50.-2-19 e TOWN OF SOUTHOLD zg f Rental Permit 0457 Owner 16125 Soundview Rlty LLC Occupied as Single Family Dwelling Located at 16125 Soundview Ave Southold 50.-2-19 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. 7/10/2023 Co4 Enfc�rnent off fai This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD BUILDING DEPT. 631.765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN ) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: A. '0�E2 f2 A ,�;rvt jc�-VA pg�( � atq�o I rza 4!L kjw d .�. a �. Town Hall Annex L 54375 Main Road 1 PO Box 1179 Southold, .e +� � � 1� :�� NY 11971-1179 Tel 631-765-1802 Fax 631-765-9502 ...._.. _ _�. _... Phone Owner Zip Address _,..., . . .w..... _ _......__w _ ._. . .m_.... ... _,_ ..... city Inspector SUB 1 2 LEVELS _w.._.. ._._�. _�_.. ( _d - �.___........._�...__..., � � Carbon Monoxide Detectors # � uded Smoke Detectors # edroom detectors u,xcl �. b .. . its IT BEDROOMS 3 4 _.. ,.. Smoke Detector Alarms # Carbon Monoxide Alarms Egress windows) (Y/N) � � BUILDING SYSTEMS Y/NCONDITION maintained �DI ng �tOrorOc!PRS... ....-.�_... '...._.....� _...__ __ O d,�operational Building Ext.... is Heating ;them marntame _ Pro maintain Bui /maintained _... .. . r r atjonai s clean fined Not waters stem main tained� x rrationa P Y main aintained/o e ert is clean / Electncal s tri m ...._.._...kw.� Handrails & guards present Mechanical s,stern maintained/o rerationai Rental Inspection corm ai7/2o21 T 'O"kwN OF SOUTHOLD UWW Rental Permit 0457 Owner 16125 Soundview Rlty LLC Occupied as Single Family Dwelling Located at 16125 Soundview Av Southold 50.-2-19 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. i 6/9/2021 *C0drnjrc official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 flaT BUILDING DEPARTMENT P R 2021 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: rn s �v`e w 2'tl .n Tax Map Number: 1000 SECTION 5 0 ° -BLOC SECTION B. OWNER INFORMATION: Property Owner Name: /dal l�' Soa, AdLh'e," Q LSC Property Owner Legal Address: Property Owner Mailing Address: /ove' 10 n ,C ve 20 een "'V1 S 0 90 :llvcee 115-?o Telephone Number(s): Daytime 61 !j u? Even In %g-,4713 Emergency Property Owner Email Address: er „" S rZ'l c°"'N Page 1 of 5 Town Hall Annex °f Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Coll � ;. BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: 'A 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): Avg AJ AA1 Page 2 of S Town Hall Annex '� Telephone(631)765-1802 .54375 Main Road � @ Fax(631)765-9502 P.O.Box 1 179 yea �, Southold,NY 11971-0959 fiau�i "mCOUF BUILDING DEPARTMENT TOWN OF SOUTH011M D Mailing Address of Managing Agent: 1 1 oo 23 Telephone Number(s): Daytime i -lag EveningAll -?III Emergency lw Emall Address: S Z;c. o ?- e.r A. 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 Unit: Number of rooms in Rental Dwelling Unit: of Use and Dimensio s of each room in Renta welling Unit: ( er - ° t 1116r, q - f 'K 1 y n K.o o--� 0 'x 1 r/ �;1 6n - est 19 Page 3 of 5 d Flo., 0 Town Hall Annex , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO OLD 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 I� 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 F 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 Iegdl dddress set forth In "Sectlon 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 a Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 , Southold,NY 11971-0959 07JJNJ BUILDING DEPARTMENT TOWN OF SO 'OOT D 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: C Property Owner's Signature: Sworn to before me this of day of 20 Official Notary Public Signature and Original Notary Stamp Virginia Leone NOTAP,Y PUBLIC,STATE OF NEW YORK Registratton No.01LE6070245 rlimiiflpo in Queens County Commission Expires December 9,2022 Page 5 of 5 a , Mv,(5w,�,440j Aviv,-- .19� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 P , LINSPECTION ..- [ ] FOUNDATION 1ST [ ] ROUGH PLI§G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL r �Q��`, Gvw1f1 - FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O 4 0--h 10 r\ w DATE INSPECTOR Town Hall Annex Telephone(631)765-1802 54375 Main Road k Fax(631)765-9502 P.O.Box 1179N Ntw Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUMOLD 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 F'ro essional,seal re aired br Archltec°t or n ineer licensed l�'or^ne Ins actor r�lust ravide coov of valid current certification Rental Property SCTM Number: l Rental Property Address: Owner/Name: L2 Rental Dwelling Unit identifier: — "iC V ,I ._ L.-! f 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� .- � . Property Description(Include all improvements indicated on survey) 122I certify that 1 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 Conserv o str ction Code of New York State. � �,. Print Name and Title ;� )9 C"' D g nal Sign Lure Please place professional seal: - ! 21 bb ' � II �3 TOWN F SOUTHOLD PROPERTY .SEC{ _ 1 _ 3 � — M � s I OWNER , STREETVILLAGE DIST. SUB, LOT I - FORMER OWNER N E ._-- ACR - �`- S W TYPE OF BUILDING _ . RES. ' SEAS. ¥ YL. FARM COMM. CB. MICS. Mkt. Value i LAND IMP. TOTAL DATE REMARKS I E Y _ I i 3 Tillable FRONTAGE ON WATER l� Woodland FRONTAGE ON ROAD Ioe Meadowland DEPTH t House Plot BULKHEAD I Totai t TOWN OF SOUTHOLD ER- Y... E CARD OWNER ;STREET VILLAGE DIST. SUB. LOT t , FORMER OWNER N R E � ..� AO 4, _r �.� _ 72) ,- , n, 7 - � S `W TYPE OF BUILDING , I RES, SEAS, VL, FARM COMAA. CB. MICS. Mkt. Value l0 LAND ' IMP. TOTAL DATE REMARKS .e p� �F s s E m > 1 J < 3. i 3 z 7 , I [ Tillable ' FRONTAGE ON WATER Woodland FRONTAGE ON ROAD DEPTH Meadowl�e'od � � 'House Plot BULKHEAD i Toai f r 4 A7 COLOR TRIM t - ,. s i I � { t E • -. `� _� � �� ISS _ � `"}� � _ , , �s f � f f , , t 2 40 t \ 37 F Extw-psion Extension fr • r 4 € z L4-1 C- f Extension i _ r Foundation1 ; �- r _ Both Dinette = Poirc13� ' 7 P- I ,._ Floats K. I ;Basement i ` Porch lExt. Walls f Interior Finish ! LR. Breezeway [Fire Place ,,.M Heat ~ DR. i far£ ; , , 3 ; `. Roof Rooms 1st Floor BR. Patio lRecreation Room Rooms 2nd Floor I IDormer €Driveway rivew ' Total FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25330 Date NOVEMBER 10, 1997 THIS CERTIFIES that the building NEW DWELLING Location of Property 16125 SOUNDVIEW AVENUE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 50 Block 2 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 21, 1995 _pursuant to which Building Permit No. 23053-Z dated OCTOBER 11, 1995 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 WITH ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to BORIS & CLAUDIA GRZIC (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-95-0079-OCT. 23, 1997 UNDERWRITERS CERTIFICATE NO. N-411239 - FEBRUARY 14 1997 PLUMBERS CERTIFICATION DATED MARCH 8, 1997-PECONIC PLUMBING & HEATING Bu" ding insp or Rev. 1/81 ------------ .�...._._._...a.s..,.,..._. Nom' ......_.M�.........._.�....._ ., , _.._,,..._. .. 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