HomeMy WebLinkAbout1000-97.-8-4 TOWN OF SOUTHOLD
Rental Permit
911,
0934
Owner Gianluca & Maria Gucciardino
Occupied as Single Family Dwelling
Located at 885 Little Neck Road Cutchogue 97.-84
Maximum Permitted Occupancy 4
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.
6/20/2023
odeo c nt Official
This Notice must be posted by the main entrance at all times
U/ {
Town Hall AnnexTelephone(631)765-1802
54375 Main Road z Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT n03-
TOWN OF SOUTHOLD `
RENTAL PERMIT APPLICATION
Rental Permit Fee $200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Pro eq-, Address: y j 3S
�1 �&C CUIC1,10 0C
Tax Map Number: 1000 SECTION % N _ -BLOCK 12X, 00 -LOT - d
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
� 37�
53LI
Telephone Number (s): Daytime GqG �q einglo4(a Emergency
C �� Q r C� 1
Property Owner Email Address: ..) �'
Page 1 of 5
%Ikfj� SOO
Town Hall Annex Telephone(631)765-1802
54375 Main Road iNF Fax (631)765-9502
P.O. Box 1 179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
n / I /
Mailing Address of Managing Agent: � if e-C,
Telephone Number(s): Daytime '1 (QJ�Evening _ Emergency `Z Z /6 S Sr�
Email Address: C14 Ct � 1 CSD C-0
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: I, �. yj ,-
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 Urpt: L/
Number of rooms in Rental Dwelling Unit: +WC2 be ro 6 ,
Use and Dimensions of each room in Rental Dwelling Unit:
__ � r Wil`) A_r�
J 1
Page 3 of 5
' Sol,
�0
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
Y.O.Box 1 179 '
Southold,NY 11971-0959
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.
131/l 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)
194,AI CA 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 }
Southold,NY 11971-0959
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: yG�
td t @qA qt*
Z--
Property Owner's Signature: 9-
Sworn to before me this2A--)b"may of f(l 1=A�a 2002.
..� -
Official Notary Public Signature and Original Notary Stamp
It
VICENTE M.CUNANAN
NOTARY KJBL1C,STATE OF NEW YORK
Regisuation W OICUS030964
Qwifmd in Quem county
Commission Expi Jul ,2�
Page 5 of 5
40
1o��OF S00Tj�� �V� � qAt �a4,-PO4 col/�o�j
QTOWN OF SOUTHOLD BUILDING D
"couwn,�� 631 .765-1802 �a'-� % 0-0
1 NSPEC I ON
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAI
[ ] FRAMING / STRAPPING --INAL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN:
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F}I
[ ] CODE VIOLATION [ ] PRE C/0 [� i
REMA S:
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DATE L _ INSPECTOR
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TOWN OF SOUTHOLD BUILDING ID
765-1802
IN PECTION
] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CA
[ ]
FRAMING NG / STRAPPING [ ] INAL
[ ]
FIREPLACE CHIMNEY [ FIRE SAFETY IN
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL {FI
[ ] CODE VIOLATION [ ] PRE C/O
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
ND PLA a5
Certificate Of Occupancy
No. 2.5466. . . . . . Date . . . . . .September. 19 j. 1973., 19. . . .
THIS CERTIFIES that the building located at . . Llttle. NeCI,.. Road. . . . . . . Street
Map No. _XX . . . . . . . Block No. . i' . . . . . .Lot No. .%rX. . .Cutchoguo . . . . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . December.49 19. 70 pursuant to which Building Permit No. .599.54.
dated . . . . . . . . . . 19.7Q., 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 XrIW t e. QAC.:r0A 11Y. dW Q Wn$ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . .C11'o, ,J,. �k rileen R... Ori"t o. . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . Dated.i. .Feb.e. .22,o. .1972. . . . . . . . . .
UNDERWRITERS CERTIFICATE No. .f.P .5606
HOUSE NUMBER. . . 88.5. . . . . .Street. . . .13tt s. 1NAQ1;.RD.&4 . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .cutchogue . . . . . . . . . . . . . . . . . . . .
, , . . , . . _ . . .
4-(104 75
$gilding Inspector
Ftlt Town of Southold 7/26/2016
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38412 Date: 7/26/2016
THIS CERTIFIES that the building ACCESSORY
Location of Property: 885 Little Neck Rd., Cutchogue
SCTM#: 473889 See/Block/Lot: 97.-8-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/12/2016 pursuant to which Building Permit No. 40415 dated 1/20/2016
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:
ACCESSORY GARAGE AS APPLIED FOR
The certificate is issued to Mantione,Peter
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40415 06-06-2016
PLUMBERS CERTIFICATION DATED
` s
Auth ed Sigat e
Town of Southold Annex 1/2/2014
P.O. Box 1179
54375 Main Road
Southold,New York 11971
�C �gAx
CERTIFICATE OF OCCUPANCY
No: 36679 Date: 1/2/2014
THIS CERTIFIES that the building RAMP
Location of Property: 885 Little Neck Rd,Cutchogue,
SCTM#: 473889 Sec/Block/Lot: 97.-8-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
12/9/2013 pursuant to which Building Permit No. 38588 dated 12/23/2013
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 BST"HANDICAP RAMP AS APPLIED FOR
The certificate is issued to Embrey,Catherine
(OWNER) _
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. i
PLUMBERS CERTIFICATION DATED
Attth Si attire