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Home My WebLink About1000-59.-6-25.3 TOWN OF SOUTHOLD =� � Rental Permit � j � ��-.�' 0764 Owner Thomas & Kathleen D'Antonio Occupied as Single Family Dwelling Located at 2985 Kenneys Road Southold 59-6-25.3 Maximum Permitted Occupancy 3 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. 10/26/2022 Code Enf rc ment qyficial This Notice must be posted by the main entrance at all times Town Hail Annex '',i C Telephone(631)765-1802 "'" '"' ` ----Fax-(631)765-9502-- -- 54375-Main-Road__. .. .. ___ __ . .----—._.-. _. — _.--.- P.O.Box 1179 � Southold,NY 11971-0959 `�,• r BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION "1 6 �� -BLOCK- . -LOT SECTION B. OWNERINFORMATION: Property Owner Name: X40 aA f S rt-re-L,5-ay 1) 'kjT-PM,g j; Property Owner Legal Address: Property Owner Mailing Address: ®2- IrV& Telephone Number (s): Daytime 5�Fjt"_i/.0-01ening 04?,Emergency ��a Property Owner Email Address: i v a �`� ✓� . �' � " t aDD 92o,C— 10 q - � q �a� Page 1 of 5 } Zoof SUUlyDI Town Hall Annex Telephone(631)765-1802 54375 Main Road cn Fax(631)765-9502 P.O.Box 1179 • Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: �1G ti _ 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: N cN Address of Authorized Agent (no P.O. Boxes).- Mailing oxes):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: I Address of Managing Agent (no P.O. Boxes), Page 2 of 5 Town Hall Annex "'' '` �. Telephone(631)765-1802 54375 Main Road ...Fax-(631)765-9502 - P.O.Box 1179 +~ moi}# 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, 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: �--- Use and Dimensions of each room in Rental Dwelling Unit: _ Page 3 of 5 l z� - sp soar, Town Hall AnnexJ, t ,1 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 ��_G S O Southold,NY 11971-0959 ' 'Zoou 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold tizf l 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) /A oar ) COUNTY OF S14FFetK)) I //,1/�1�f .� • �J krzAlu ,,,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 per SO(!p , 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:, 0Z ffo _( NF��✓�� r Property Owner's Signature: a S nr before m isday of 20 �a- Official Notaryublic S' nature d Original Notary Stamp DONNA D. DERWOYED NOTARY PUBLIC,STATE OF NEW YORK Registration No.01DE6426886 Qualified in Monroe County Commission Expires December 20,2025 Page 5 of 5 OE SOGTyo� # # TOWN OF SOUTHOLD BUILDING DEPT. °ycourm�F'' 631-765-1802 INSPECTION -� [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: 0dL 40 sow 0c� a DATE Ib ' �S �'� INSPECTOR ir i+ 1 I ' ' Mq Er f 0 . r Ll Att 1 11 Mi - -►-- L i +1 LIN --_�;Z[��11 /r IIS 1y_�r� a - '�:� Town Mall Annex �� '� -:r, •�- Telephone(631)765-1302 54375 Main Road ° °' Fax(631)765-9502 P.O.Box 1179 �? Southold,NY 1.1971-0959r , + . (t0l�,�z,, DD BUILDING DEPARTMENT TOWN OF SOUTHOLI) SEP 1 2022 RENTAL PROPERTY CERTIFICATION BUILDING DEPT. TOWN OF SOUTHO1LD 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 Professions!seal required far Architect or Engineer,licensed Home Inspector must provide copy of valid current certification Rental Property SCTM Number: i000-S4-6- ZI Rental Property Address: 4o Zs Owner/Name: ?'14��ctvcs lC,�rN1 G��/ D�ia,�Tvtil ra Rental Dwelling Unit identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (I.e.Bedroom#1 -100 sq.,Bedroom#Z--90 sq,, etc.) &-Mr-V.44 i.(o.? = foq,3a <,f, Property Description (Include all improvements Indicated on survey) I certify that I 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 Cod rk State, and the Energy Conservation Construction Code of New York State. � D '� '�,�, A. yr � Print Na e° nd T '. Origin S' atur M1 f Please place - a a ( - --- - - - — -- --- -- t /.. t rf � r s " r I ♦y:5,... _ :�".`i:'.x'.i:L,`t"i`.<N:.'�u::^+_��,'"'�•S''s":rL`-'":twi ,.5... �� <u., - �„„w^°<'.»-' .. Av si< .•M' i : 1 _ i o-4 s - T i : i : ' ph i r` ,A. 5 ' Foundation at ; : Extension a .: �+< •Basm eent rjL Floors .v Extension ' ry , _...'— �' ' i I r : , i Ext Walls ,nter _q Extension Heat : Fire Place ' ♦ .q E �. f Porch .Attic ,fPorch Rooms ]st Floor i Y .. , _ _._..................... ,.,,. E B rel3zeway " i -- - -- --- --- -------- — __. ...__.._.__ --------- - - ............. Patio, Rooms 2nd Floor vw ,�ia„4 — - va w r: . :,, �?. ems' �:• Driveway •E E J , , < FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. P L—A CERTIFICATE OF OCCUPANCY No. .......... Date .... ...... ....................August......29. ..., 19-.161 THIS CERTIFIES that the building located at Kertny. Rd-.*..S A4Ave ................. Street Map No. ..Y=............. Block No. ...7m............Lot 1\To. ..Y=.......SoUthold............... ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......................pW. eh.....30..., 19...6), pursuant to which Building Permit No. ....Z13. 5.3... dated . ......... ...........Hwah.....30..... 19.61., 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 ...p..V.J.Vat. e...one...faMi-.1-y-Avelling........................ ..... .............................................. .... This certificate is issued to T.]a0Me..V.e.RP..................Omer...... .... ............................ .... ......... (owner, lessee or tenant) of the aforesaid building. Halw ... ............................... .... ............. ................. . ... Building Inspecto FORM NO. 4 s TOWN OF SOUTHOLDj BUILDING DEPARTMENT TOWN CLERK'S OFFICE J "' SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z...2330............. Date .............................DOA&....1`41.• THIS CERTIFIES that the building located at .V ............ Street Map No. ....=.......... Block No. ..........XX...... Lot No. .X7ix.......S0Uth0.�1d+iX'.•N14*A................ conforms substantially to the Application for Building Permit heretofore filed iP lithis dVice dated ...•................•........•...•...1.6..�IQil�trtk?�x'. ., 19��... pursuant to which Building Pe'rf�iit dated Mme! ..., 19..6.5.., was issued, and conforms to all 6f1he requirements of the applicable provisions of the low. The occupancy for which this certificate iso issued is ........ ............................................................... ........................ The certificate is issued to ....ThAB....Mep'•t....................................... WAPI ..... .. ... ...................... (owner, lessee or tenant) of the aforesaid building. Approved by Bd/Appeals a Building Inspe for I ff� ,tl FORM N0. 4 .�-- TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219566 Date DECEMBER 6, 1990 THIS CERTIFIES that the building ADDITION Location of Property 9025 SOUNDVIEW AVE. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 06 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31, 1987 pursuant to which Building Permit No. 158512 dated APRIL 3, 1987 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 TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ARVA M. D'ANTONIO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N842912 NOVEMBER 12, 1987 PLUMBERS CERTIFICATION DATED 7/17/89 MIRE JACOBI Bfailding Inspector Rev. 1/81