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Home My WebLink About1000-52.-5-36.1 TOWN OF SOUTHOLD Rental Permit 3 0648 Owner Timothy & Georgia Katsoulis Occupied as Single Family Dwelling Located at 290 Bayview Avenue Greenport 52-5-36.1 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. 5/16/2022 o e End ce r o tial This Notice must be posted by the main entrance at all times p � o e Town Hall Annex -Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 1 971-0959 F BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION : Rental'Peer'mit Fee $2.00 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION __..-BLOCK -LOT_ -_ SECTION B. OWNER INFORMATION: Property Owner Name: 1"CV :X Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): Daytime_ �'Evening, Emergency_._ _ Property Owner Email Address: _ Page 1 o f 5 � Town Hall Annex G A� l� y�r Telephone(631)765-1802 a�� f �� -F , 54375 Main Road � Fax(631)765-9502 P.O.Box 1179 r "I' Ffo"�, !o. Southold,NY 11971-0959 ��1°, �t j 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):____-,.. ....w Mailing Address of Authorized Agent: ,,,,,w 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):_ �, .. ._ w._..... _..vw......_ .._.� Mailing Address of Authorized Agent: Telephone Number (s): Daytime_„_,,,,_, ,� „--,Evening Emergency Email Address: .... .m._ _m _,._._,�.. .w.... ...mmww.�_.. � �...._ . _. _..__ .. ... . SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: ....� _........._......l----...--..—,---.-,__-.. .._... --..-.�-- Address of Managing Agent no P.O. Boxes :LLe _wwmmmm_w Page 2 of 5 oz Town Hall Annex � � �l ��,,11'a Telephone(631)765-1802 54375 Main Road " Fax(631)765-9502 r»: P.O.Box 1 179 !' �xJ u a Southold,NY 11971-0959 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: ,., ""' " 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: ...... Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: - 2 --— Use __.— Use and Dimensions of each room in Rental Dwelling Unit: ._._w..._„_..................................-__.......w__,.-__ 0 Page 3 of 5 Town Hall Annex �� Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959j 6p, CIZ" f ' p�ra4�o,.t� � '' 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. �UI am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 1 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) l ` - '� „ certify under penalty of perjury,the following: 1. I 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 r , Town Hall AnnexTelephone(631)765-1802 Ably ; 54375 Main Road '"" �" ''� Fax(631)765-9502 P.O.Box 1 179 '/ Ay Southold,NY 11971-0959 r, 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: Property Owner's Signature: _. _...: N .. ....".. " " _� Sworn to before me this day of�.. _ _, 20 Z Official Notary Public Signature and Original Notary Stamp Na6a BaiahaSh W,,tkatrtry Pubficstate,o� New York fiat"01'6A6120219 ',orfjm�ssi apt in Nassau�rt1 ut� "I C' iaMca,a�t�ec. 'C t1,�.C7,." . Page 5 of 5 59q l` TOWN OF OUTHOLD BUIL31 eGMEPT. �o 631-765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND INSULATIOWCAULKING FRAMING /STRAPPING FINAL FIREPLACE & CHIMNEY [ ] FIRE SAFETYINSPECTION FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL AFI } CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: r DATE INSPECTOR r � L �� ' �� ►'�cc,✓�c-tom -FMO. Mx €• CL E ahcomm BEDROOM - E. 4 •ae.x. -- _ = -- BEDROOM E I M, AF rr=l T—I IL _ r MASTER HE - BEDROO Fit � }§ { a- .. i• e.r"a-�uns'e`mnm� F - I €� ,+t, R � ❑ 3 s ' •- • b�cove t 7 [ jT � �4 £ 3 �E b� QI t a � e �t � -----------------. -�m->.._> € ill 7s 'FSS —e j - u SOCOZ FLOOR PLAN is FIRST FLOOR PLAN PORCH CONNECTION DETAILS o rn>sr xe Im wsr. _'-•�'g �- ' r� � t�I�r ?rnx FIRSr RD1t•1p93 wry. _ _ �< ,� ate— �'a-- �-' �.,�.� - I A F'•OLDOWN GONEGTION ;, j o mgr � - � s§* __ - �s .� .. � � a � u� i SECOND FLOOR ATTACHMENT �� -x _- � � - � OPTIONS .,a r •n •e.r-or •a.ear �t LDAB.LTION DETAIL T -3 L In l0 s 3 i ' 3 �� mo°a0.rrrnrw.w� £ � I FL.I ro Ora.uws cor�croR � �"� 3 rte�r� i SYMBOL"p-&-mo w-m 5W lip MOM fw-- ------------ I----------- K R LLLI-j! - ----------------------- -------------------------- u xc A—VA-EIP ——--------- N2M ------------—-—-- - --- 19 FAST-FLOOR ----- ,ACHMENT OFTION5 N ATIO POST CONNECTION DETAILS WIT J 3 P N 16 -tl /TOWN OF SOUTHOLD PROPERTY REC O� OWNER STREET ,_ VILLAGE DI;,t-„ , ,t,,,. LOT FORMER OWNER N E ' ACREAGE S 1W TYPE OF BUILDING, G R �11SS, VL. FARM COMM. IND. CB. MISC. LANA IMP, TOTAL DATE REMARKS ' ;rill t 1 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Farm AcreValue Per Acre Value - Tillable 1 Tillable 2 Tillable 3 Woodland - Swampland Brushland House Plot Tota I Ora LA _4- f } CCLOR - . I TRIM rz, i 1 = z } t QC1 ' ' I M. Bldg. ^� Foundation 1 Bath Dinette �t Y Extension c 1 Basement ! Floors 3 K. 1 C3 _ Extension 'Ext. Walls Interior Finish LR, Extension =Fire Place Heat GR. SPOT Type Roof Rooms 1st Floor BR. Porch !Recreation Room iRooms 2nd Floor; FIN. B. Porch — .Dormer Breezeway i i Driveway ! Garage I� A � � ' t� � e _ Patio 6 u F x O B £ z , Total l ti Ai R. /7 /91 CARD l STREET PILLAGE DIST. SUB. LOT I FORMER OWNER N E ACR S W TYPE OF BUILDING RES, SEAS FARM COMM, CB, MISCMkt. Value LAND i IMP TOTAL DATE REMARKS A eo < hig AGE BUILDING CONDITION E NEW NCDR,\AAL BELOW ABOV FARM Acre Value Per i Value Acre Tillable I Tillable 2 —------- --------- Tillable 3 _T--------- Woodland ——-------------- Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD a House Plot DEPTH BULKHEAD !DOCK Taal f �.. ... - _ „ °7 z „ E � l _ P M - I o 0 ti F undati n M. Bldg ,3 Bath � I ; FI Extension - Basemenf oars - - �> - Extension F F` ! i Ext. Walls Interior Finish Fire Place Heat Extensions --,, � � � Porch Attic Porch Rooms 1st Floor Breezeway' m_ — Patio I Rooms 2nd Floor l Garage i Driveway Q. B_ I i 5 1tt _;a Town of Southold 12/11/2021 P.O.Box 1179 53095 Main Rd " Southold,New York 11971 CE T 4 ICATE OF OCCUPANCY No: 42597 Date: 12/11/2021 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 290 Bayview Ave,Greenport SCTM#: 473889 Sec/Block/Lot: 52.-5-36.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/12/2021 pursuant to which Building Permit No. 46162 dated 4/29/2021 wasissued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: •in e faipit dwellittL--wth ovcred front porch rear stor cJ Ott clt a_ e4ja plied f The certificate is issued to White,David of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL R-21-0331 11/18/2021 ELECTRICAL CERTIFICATE NO. 46162 „11/3/2021 - PLUMBERS CERTIFICATION DATED 10/26/2021 ul Rupp t Signature K GEORGIA KATSOULIS 579 HUNT LANE MANHASSET, NY 11030 917.756.8249 GAKATSOULIS t*HOTMAIL.COM May 9, 2022 Building Department Town of Southold Town Hall Annex P.O. Box 1179 . Southold,NY 11971 RE: 290 Bayview Avenue, Southold,NY 11971 Dear Building Department, I am submitting a rental permit application along with the permit fee of$200. The house is new construction. I would like to rent it for this July and August. Please review my application, and let me know if you need anything else that is not included in this application. If I have to be present for an inspection, I just ask that you please give me a couple of days' notice, as this is not my main residence. Please feel free to contact me at the telephone or email address listed above. Thank you in advance. Sincerely, �ewljia /fat vak