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HomeMy WebLinkAbout1000-110.-8-28.1 TIOWWWN OF SOUTHOLD Rental Permit 0938 Owner Arthur & Gina Picchione Occupied as Single Family Dwelling Located at 4520 New Suffolk Rd New Suffolk 110.-8-28.1 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. 6/27/2023 rteent official This Notice must be posted by the main entrance at all times odeof 5 m /iN Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 .- u BUILDING DEPARTMEN TOWN OF SOUTHO 1 G � z 'JI�fl ���.o RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewWvery o cars Section A. Property Information: Dental Property Address: (4 Tax Map Number: 1000 SECTION JL(�_..... ..._.-I LOCK .LOT SECTION B. OWNER INFORMATION: Property Owner Name: e--, � rt �� Property Owner Legal Address: Property Owner Mailing Address: c,L)A_ r `� _ ....... ...... Telephone Number (s): Daytime_7 7 2 Evening.,_ Emergency, _.... Property Owner Email Address:-4. '" P-Jlp-&-Aa' Page 1 of 5 � �, Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1179 � Southold,NY 11971-0959 " "ou G "i,; 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: g e— ..... .�.... Requested Maximum number of persons allowed to occupy Dwellin nit mm1 p off, _mm Number of rooms in Rental Dwelling Unit: -, .. .,,. Use and Dimensions of each room in Rental Dwelling Unit: t ............ Page 3 of 5 Town Hall Annex ! Telephone(631)765-1802 54375 Main Roads Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ° l 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. CSI 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) n . I F- V1 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 d Fax(631)765-9502 P.O.Box 1179 w . Southold,NY 11971-0959 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: Q Property Owner's Signature: Sworn to before me this d day of ��� _, -, 2 Offici".ot.rblic Signature anfriginal Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATF OF NEW YORK NO.01 L,lry<;acs;J(70 QUALIFIED H: ..�:� :.,.7iK�COUNTY COMMISSION E:,HRESJUNE;p, Dd— Page 5 of 5 so Y�(W OfAd &4C R00A SUIWL'--� TOWN OF SOUTHOLD BUILDING DEPT. 631.765-1802 _ I N S Or"" E C T 10' N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL7RENTAL L) [ ] CODE VIOLATION [ ] PRE C/O [ REMARKS: NOF A DATE _ INSPECTOR ..--poet. ... - --- - -- ----. - w1wd Deck - - - �B a #-. o E f J7 £' IMEDW 57EP5 i0 �i sauffa°Iraa�c 6t Kit RCI C�IPCPGtP I �tBT EXISTMG GIRDER 3 z gLY+R _ 18. AmLl @dsement � - - .„ € rt I GI v �£ v s PROVIDE 0 D-At ,I POURED ` ` PIER FOOTW Tb 42 _- > 6ELOW ADJ.GRADE _ £ _ TYPICAL r,-'\ Pw tat Floor . MINIMUM UNIFONM UISTRIBUTIED NDESIGN LOADS w $TRAPPING INSTRUGTlONS e'p° §sk€' Itf6iL 4' :t'M IS+rt-]9 xyLAIY.N SMpwn AmbnE L5107wNO3 a✓�!6copt - I Fa1[w to 31H GomoctYxl Ux 9hpxm'Y2 I �� ffiSi��i3€ t -� ; -. F 4N'^E S a Ny Fx eVry taysz Yb?1«_ plrvsmonL Plow-t Pm '- S. @ .�- .•' � � t IAWI'( O�IE € Is4'tppty �cA&W € oEeDtEF VEu�D.uGwalT . t € _ - �s For EecA Rotten SOw..+ 4520 New SURope Rd orae Keerett ta>Qa 1, [€If - # € It ' New 3uftolk,New York SOI1G ftarnoA G.m+are n¢0. a� q - '� t - roA®RFNA SD .A&F ra6t6 R'RC --- PK I apl ru( [# Of 1 S , _T Plana ` _ s mc�wm na�reoraaas �� - �� s s Axa _ f A � I ®R- Martin +�-2 antsPas e BE it � f Zg- _ ••• r`ws '- Rae's iot.c. > atss�aasw dQFFtTDETAtL ���,•��l,�Nb.��.fare 4 N. �� umoe Dd! r�pccRpsr m� inn 1. g,_ � E - NOffECI e j fR.SllitGs �� ; '_ _ F�9nRF6�10.144Q6 iIE LWIIV."I�l Exist.61ab ' � t Q'i t Ui nl3t Mi4ff9IX1 -ToUlm RRIIrE6 tl1 MH Of`ET(9R'RR RIFOPRit 1 Air f OC!C7fdCte S Kt -p� s a ' Basement Hol PRavIpE s• @_ = re ��Ts t j i �} ' flchl.B�tl6atttll PIER '.a TO 42 € � BELOW tl ADD ADd GRADE � 1 '-ONE,�gE TYPICAL E ,,,_.__^_..._ MINIMUM UNIFGFVAUI9IRIUUiFD DESIGNLUAGS STRAPPING INSTRUCTIONS Gwrncl on a fgvMabrt- rt/61E i[t tllR•!f'F� a#6 P• 5 , 2 roG.l n l Str•rx�cw rvar b S'•mlM�t cmwh uXns attrGltfD xrewcl+I co ofIXf 4 _ _ _ T= _ _a -"y i _ j local MM�ariul or Strap 6apoclbn Ii Fogvred. _ ms�x:.vc I P` a•` E �. �_ _ .1 mea I - ' My E.i eL•rq E#e•L+Ybll/f+aaf floptc:anonG •yryjp!. ! _ ! '" � - � �s t!€ �� - i<.w!e 1 94'µyrg fm'F M1�vd Por Fka-F Pvr aeF fioftar as 5lui.a+anWoo[ct ¢ mute rn�Pa>unv Miar+n reroen Wi npeP ;� I4S3 I` #� € 45 N,e�Suffolk Rd N� ro k.Naw Yolk E NE[i^RG B lkl Pramad cw.wn as flag rad m�nnn ;, a•m i W ^• - € - 1 maum mtt. Floor Piens Is RIM i rfl-5N e �� � =ate �� '®.aa"""°a�,a• � � � zaFz _ � _ � ,�"�.z �.a.a.v+ :� s -nir.4•rorrtale A-2 a - Martin A. Passante mss,. t 'ss• a TIA s Si7 'ITtIItL ---_ ` =>t#- 5 •�. .lx D POOPERTY RECI 5 TOWN OF SOUTHOL OWNER STREET e VILLAGE 'DISTRICT LOT 06L v J j C1 �v v FORMER OWNER N E I ACREAGE � S 1W TYPE OF BUILDING f VL. FARM COMM. �RES. 0 SEAS. IND. CB. misc. Est, Mkt. Value LAND I Mpx TOTAL DATE REMARKS J-1 y' Co 16 Ei 4Zk _ ,'17 2 v _0� L)�q _,P AGE BUILDING CONDITION -T NEW NORMAL BELOW ABOVQ FRON )t ��, �YA, Sl 6L Form Acre 11 Value Per Acre Value I FRONTAGE ON ROAD /-V- Tillable < 4 Tillable 2 5eeK j Tillable 3 jr 7 P Woodland Swampland Brusfysoncl House Plot Ilk j tj -A3 Total �t kLA v bo C) -Il c) a �3z 3 £ l 110.-8-28.1 03/2016 —_— t I M. Bldg. {15 _. -dation '-Beth Extension �� i �ement Floors ' Extension T Ext. Wa!!s ,n#erior Finishg r Extension Fire Place HeatAl J J X 1b � C # Porch Roof -I ype Porch Rooms 1st Floor -'" Breezeway Patio Rooms 2nd Floor _ Garage '., ' y �! a /irivewoy =Dormer — ©. B 011 Ah S "14 N e FORK NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Z7576 No. - - - . . . . Date . . . . . . . . . . . . . . . .Nor . .21'. . . . THIS CERTIFIES that the building located at . . 119V SUf f of k,L.�, Street Map No. .Xx . . . . . . . . Block No. . . .101 . . . . .Lot No, ? . . , New 5ttff o.2k. conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .pct, . .117. . . 19.?�. pursuant to which Building Permit No. . 8248 dated . . . . . . . . . , , ?. ., 19.-1., 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 Pr'V&to 0". famlly dtfelllng with addition (dock). . . . . . . . . . . . . . The certificate is issued to . Frank .&. Peggy. Maj®ski. . . hers . . * . of the aforesaid building. (owner, lessee or tenant) Suffolk County Department of Health Approval N o ll.. . . . . UNDERWRITERS CERTIFICATE No. HOUSE NUMBER . . . . Street . . . . stew Suffolk Lane . . . . . . .Xev .SUff.olk Building-Inspect fl a' i u r FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . Z- 16289 October 15, 1987 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . THIS CERTIFIES that the building . . , A C C E S S.ORY B U I L D I NG Location of Property 4520 New Suffolk Road New Suffolk, New York House No. Street — * 1 • , * < . . • , . . . , . , — * 1 . * • a*mnl1st County Tax Map No. 1000 Section . . . 1 ?. . . . . .Block . . 0 7 . . . . . . . . . .Lot . . . . .08. . . . . . , . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated May 20, 1987 16065 Z pursuant to which Building Permit No. , , ,, , , . , , . . . . . . . „ . , . . .. dated June 14 , 1 9 8 7 . • • 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 BUILDING AS APPLIED FOR The certificate is issued to . . . , FRANCIS J . & P E G GY MA J E S K I (o.wner,/9AX X'AF9XX. . . . . . . . . . . . . . . . . .. of the aforesaid building. Suffolk County Department of Health Approval , . w , . , . . , , ,N/A. , • , „ • , , . „ µ . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . N/A PLUMBERS CERTIFICATION DATED: N/A Build" g Inspector Rev. 1/81 x