HomeMy WebLinkAbout1000-54.-8-5 3 TOWN OF SOUTHOLD
Rental Permit
0706
Owner Melissa DeSimone
Occupied as Single Family Dwelling
Located at 10105 Soundview Ave Southold 54.-8-5
Maximum 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.
7/21/2022
ode E or en Official
This Notice must be posted by the main entrance at all times
f '
. ..
651
Town Hall Annex ; ..y�, Telephone(631)765-1802
54375 Main Road . �y ' Fax(63.1)765-9502
P.O.Box 1179
Southold,NY 11971-0959 .
MAY J
BUILDING DEPARTMENT
TOWN OF SOUTHOLD __,;,:�,.•,r. �.
TOV'Jl�)(,r S0Uj-;,0LD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address: 1�
Tax Map Number: 1000 SECTION U. -BLL-CK, 6A, n , ;-LOT.
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number(s): Daytime vening._ Emergencyy
Property Owner Email Address:,,
Page 1 of 5 ' \�
Pa \
g -�
Town Hall Annex °° Telephone(631)765-1.802
54375 Main Road , Fax(63 I)765-9502
P.O.Box 1179 ;R` F
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: -
Use and Dimensions of each room in Rental Dwelling Unit,
hap uwi& UVW.0-. laves 20, K -A
Page 3 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road .` Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 `13
, '
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
bythe 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 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 ,,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
� so
w
Town Hall Annex Telephone(631).765-1802
54375 Main Road Fax(63.1)765-9502
P.O.Box 1179 :.
Southold,NY 11971-0959 . , E
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: AACS8E!S� J
Sworn to before me this 15 day of M, aa -- ;2 0
Official Notary Publ c gnature and Or'g' al Notary Stamp
TRACEY L. DWYER
TRACE! —V!\/ER NOTARY PUBLIC,STATE OF NEW YORK
NOTARY PUBLIC,S- i ='Al YORK NO.01 DW6306900
NO.01 DVv:::" QUALIFIED IN SUFFOLK COUNTY
QUALIFIED IN SUFF,' '- , it-0 (,Y COMMISSION EXPIRES JUNE 30,2
COMMISSION EXPIRES JUNE:36,2:,0�)d
Page 5 of 5
o�aOF SOUIy° lot ® $000" ' /a4wNKJ Ave,,- 1704 8%
# # TOWN OF SOUTHOLD BUILDING DEPT.
cou631-765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ rAL
FIREPLACE & CHIMNEY [ E SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENET TION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI Q
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS:
'r
-v
0 k444 vqvwv, 0uvpAAcm-
•
t�tiL
DATE Y?/ INSPECTORyi)L/ V
Pontino, Susan
From: melissa melissahyatt.com <melissa@melissahyatt.com>
Sent: Wednesday,July 20, 2022 4:04 PM
To: Pontino, Susan
Subject: Smoke detector 10105 Soundview ave
y
1
Installed on first floor
Melissa
Melissa Hyatt Artist and Designer www.melissahyatt.com
ATTENTION:This email came from an external source. Do not open attachments or click on links from unknown senders
or unexpected emails.
2
lxl�
w. .:1
F
S
p
k
v a }
c
L 1 ,
I
I' ZI .1
n �n° A
jI — — — — — — — — —" — --I —— — -- - — Fx,rrnrG aaremewT `---._.._..--------•-- —_.i—" °
I I I'�i IVW'F1UllNE, C>.V,•ErE Toc11uD:
j I � I Wusgtir. ,
I ,I
j i j I I I h 2 36';ryvE-rk J I
j a 3NE6T,('o4C y SVxt(£
Agow sw"'t O,L---BWNtR
Ex ItTING `�'l�� /y!N/OOS4.FT.ON CFjq Nr,
i CEMENT .%LRP, Albp I = N
ON
Q sNmw- I mI
O� 2
1' ' Exls;IxrG 20°,cxo"x Iz° �=
CONCRETE FOOTINGS E'X,577lJ(>-
3 ple 2910 GIP DCR F4uSN
ftrovA LC LALLYC. _
N � 4
I I � OLD I
I ExrSnNG srems I ._`_
4 ONE CouRSE C-NCR(T'E F7DoR 1 --�0p
t
„a 'C€mDvF oLD—T---• �DoT,N05 qLt M.;D�NC
�� aTA.kS I I o
�1 RCARAA C
� � J o1 FNING I I
41C
sus A. zra 6TEP uPof RFif�s, t JJ ! c W
� FLATraRm
—
—
IEEE
I,
Ex l zov(" BASE
�,--, _ _--_ _gA•'7'1 EXIST,MG
.I "MC,PT BDCR wlLL ryR 1 SERS
£u /Ntr
UPON v
�u F'
%.
' 9/0104
r
I rNEET
L Pltd RECORD$-TOWN OF SOUTH6 D, P
STREET LOT
VILLAGE'
DIST.
SUB.
-111W,104 4
'J
R 4-7,/��, N r 0 A
'FORMER-'0WNE
�E
z
nS ft W. TYPE OF .BUILDING
� o
SEAS. VL. FARM
COMM. Ct. MICS. Mkt.,Value
LAND IMP, I TOTAL
DATE REMARKS
r o
A
-61
{ y , 5
At/
eV 7,
meWf
-
/Z' 7 n"r
> 34- 4p
A 5�4 on 4
P D 0 t/
d". . 'i6 n
��9 �q4
-7/
-7'1
5f f 7///
L 12W
-L— 2 qqq gorlo -pv/no,'vL owo
J14 L
10
r
AGE BUILDING CONDITION
-F NEW NORMAL BELOW ABOVE
FARM ...... ..
Acre Value Per - -—----------Value
Acre
Tillable FRONTAGE ON WATER
Woodldnd
-FRONTAGE.'ON, ROAD
-z
Meadowland
DEPTH.
House ;Plot
BULKHEAD :
Total
DOCK
}
_ate' `T•�+vc���*AT' w,-r ,>....>.v �� Yy, '§•�f�2�,s."�� {,G t,,. ' ■■ � 3�1f�� ■ {�
gpp��
lil1
ra
■
i _
f •�
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29163 Date: 12/30/02
THIS CERTIFIES that the building DWELLING
Location of Property 10105 SOUNDVIEW AVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 054 Block 0008 Lot 005
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 29163 dated DECEMBER 30, 2002
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 ACCESSORY 1 CAR GARAGE
The certificate is issued to ALICE KNOBLOCH
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Au o ize Signalure
Rev. 1/81
t 7
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 10105 SOUNDVIEW AVE SOUTHOLD
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S): ALICE KNOBLOCH
OCCUPANCY: SINGLE FAMILY ALICE KNOBLOCH
ADMITTED BY: MARYANN FEAVEL ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 54.-6-5
SOURCE OF REQUEST: MARYANN FEAVEL, 12/4/02 DATE: 12/30/02
DWELLING:
TYPE OF CONSTRUCTION. WOOD FRAME # STORIES: 1.0 # EXITS: 2
FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE:
TOTAL ROOMS: IST FLR.: 4 2ND FIR.: 0 3RD FLR.: 0
BATHROOM(S): 1.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: WOOD DECK PATIO TYPE:
BREEZEWAY: FIREPLACE: _GARAGE:
DOMESTIC HOTWATER: YES TYPE HEATER: ELECTRIC AIRCONDITIONING:
TYPE HEAT: ELECTRIC WARM AIR: HOTWATER:
OTHER: SUN ROOM NO HEAT
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: 1 CAR WOOD FRAME STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION I DESCRIPTION I ART. I SEC.
REMARKS: BP#9765-Z-COZ-9 7 (ADD) BP #15216-Z-COZ-15057 (DECK)
INSPECTED BY: DATE ON INSPECTION: 12/11/02
GARY J. F TIlME START: 10:00 AM END: 10:20 AM
r r
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No. . Z.9 5 8 7. . . . . . . . . . Date . . . . . . . . . . . . . . July 11. . . . . . 19�9 .
THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property . . . . . . . . . . . . . . . . . .
House No. street Hamlet
County Tax Map No. 1000 Section . . . .54. . . . . .Block . . . . .$. . . . . . . . .Lot . . . . . . 5. . . . . . . . . .
Subdivision . . . . . . . . . .XXX. . . . . . . . . . . . . . . . . .Filed Map No. . XXX. . .Lot No. . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
. .►. . . . . . . . . . , 19 7A pursuant to which Building Permit No. . .9 7 6 5.Z . . • •
dated . . . . . . . . .J gAq .6.,. . . . . . . . . . . 19 79. ,was issued,and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . • .
• •DECK•ADDITION .TO• PRIVATE, ONE FAMILY DWELLING .
The certificate is issued to . . . . . . . . . . . . . . . . . . . . . . . . . . .
(owner,%q� Aklemik
of the aforesaid building.
Suffolk County Department of Health Approval . . . , •N/A . • • . • • • . • • . . • • • . . • • • . . . • • . . . • . • . •
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . .IVA • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
• •�.�Y.? . . . . . . . . .
Building Inspector
Rev a/7s
4 1
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. ... .Z15.R57. .. . . Date . . . October •30... . . . .. . . . . .. . . . . 1986.
THIS CERTIFIES that the building . •1)9P •adds.•tion•, • , • • • • • • • • • • • • • ., • • • • • • . . ••
Location of Property 10105 •Soundview Venue • • Southold
House No ' • • • . • • • • • • • • • • Sireei . • • • •Hamlet
County Tax Map No. 1000 Section • 0 5 4• • • • • • •Block . . .0 8. . . . . . . . . .Lot . . .�5• . . • • . . • . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . .. . . . .Lot No. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
August• 12 , • • • . • • • • • , 19 8§pursuant to which Building Permit No. • • ?21.6 Z. • • • • . • •. • •
dated . ,A u$u s t• 2 9 i • • • • . • • 19 8 b ,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 adds fiion to •exa sting one family dwelling , • . . . .. .. . . . . . .
The certificate is issued to . . .. . . . . . . . . KrI4 DA.o q l� . . . . .
(owaer�lg+ktlt4�Ai5kxx• . . . . . . . . . .
of the aforesaid building.
Suffolk County Department of Health Approval . . . N/A. . • . • • • • • • • • • • . , • • • • • • • • •
UNDERWRITERS CERTIFICATE NO . . . . . . . . . . • N/A• . • • • • •• • • • • • • • • • • • • •
Building 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-32299 Date: 04/18/07
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property: 10105 SOUNDVIEW AVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 54 Block 8 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 18, 2005 pursuant to which
Building Permit No. 31102-Z dated MAY 3, 2005
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 ADDITION & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR & AS PER CONDITIONS OF ZBA #5652 DATED 3/10/05.
The certificate is issued to JON M & KATHLEEN MARINO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2082935 04Z12/0
PLUMBERS CERTIFICATION DATED 04/16/07 HARDY PLUMBING & HEATING
A ri d Si nature
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-32298 Date: 04/18/07
THIS CERTIFIES that the building ALTERATION TO ACCESSORY
Location of Property: 10105 SOUNDVIEW AVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 54 Block 8 Lot 5
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 3, 2006 pursuant to which
Building Permit No. 31772-Z dated FEBRUARY 6, 2006
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 ALTERATION TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR & AS PER
CONDITIONS OF ZBA #5831 DATED 2/2/06.
The certificate is issued to JON & KATHLEEN MARINO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2082935 04/12/07
PLUMBERS CERTIFICATION DATED N/A
)7ri ed sZgnature
Rev. 1/B1