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Home My WebLink About1000-115.-15-18 T '"kwN " F SOUTHOLDU' WW UC* Rental Permit 1004 Owner Anagnostakos PN Rev IV Trt. Occupied as Single Family Dwelling Located at 900 Donna Drive Mattituck 115.-15-18 Maximum Permitted Occupancy 5 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. 10/19/2023 Code -Ifo me t Offici This Notice must be posted by the main entrance at all times Town Hall Annex p' Telephone(631)765-1802 54375 Main Road �� Fax(631)765-9502 P.O.Box 1 179 , Southold,NY 11971-0959 � UNT'l1014 23 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: 1000 SECTION -BLK [ ,-LOT- "' OC -� Tax Mar Number. � _..�.. SECTION B. OWNER INFORMATION: 24 If 4C Property Owner Name: ' Property Owner Legal Address: Property Owner Mailing Address: 70,3 ( 4 + Telephone Number (s): I ay sme EveningEmergency Property Owner Email Address: Page 1 &5 � µ kyrp App' CS i � Town Hall Annex Telephone(631)765-1802 54375 Main Road , Fax (631)765-9502 P.O.Box 1 179 Southold,NY 1 1971-0959 e" f° BUILDING DEPARTMENT TOWN OF BOUT ILO Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening_...- ergency ww..... 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 H Town Hall Annex J Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 a P.O.Box 1179 Southold,NY 11971-0959 ✓„ U®UNTy 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. 0/1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ E 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) 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 Town Hall Annex �x Telephone(631)765-1802 54375 Main Road ] w Fax(631)765-9502 P.O.Box 11790 ss Southold,NY 11971-0959 OU 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: :t;=— th_ �^L�I�,N Sworn to before me this l�day of Or+dDCF , 20� j ial No y Public Signah and Original Notary Stamp TRACEY L. DWYER NOTARY Pl STATE OF NEW YCJPX NO01 DW6306900 OLIALIFIECI IN SUFFOLK C� i F. C�Ot"04 b Sl P1RFS JUNE�, Page 5 of 5 Sb TOWN OF SD BUILDING DEPT. 631.765-1802 I N50' P E%Ck T I o" 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) ELECTRICAL (FINA"L) CODE VIOLATION PRE C/O -]"RENTAL REMARKS: DATE 123 - INSPECTOR Town Hall Annex ✓� Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 mTel: 631-765-1802 9 Date ., ., ....._.... ; SCTM# ... . Owner l�7� Phone s� �. Address Visible ... Hamlet �G _.. _...W _.,. .- .m_ . Inspector y Floor Level Quantities I Sub 1 2 3 Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors rs i Fire Extinguishers ... Exits _ Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress Occupant Count Building Systems Maintained & Operational Condition of Property Heating _ _ Building interior Hot water _ Building exterior Electrical Property clean, maintained &safe Mechanical Handrails &guards installed &secure Pool,...°,. l Safety Pool on Site Surface water alarmDate of CO issuance ... Pool completely enclosed alarms Self closing/ latching gates Pool fence to code requirements CO's for all items present Prior Rental Comments: t W 1 e TOWN OF SOUTHOLDPROPERTY RECORD�13 Al OWNER STREET VILLAGE DIST., SUB. L-oT t �. OR1vER A�1tNER N E ACR O ,:�F. S W TYPE OF BUILDING 13 I`,Y i � ( f RES SEAS. VL. FARM COMM. CB. MISC, Mkt. Value LAND IMP. TOTAL DATE REMARKS /1112 _ F 7/ E I 161 - a k,(_v SB 11 L ltd f 1J ,� s = lx n z NEW ' NORMAL BELOW ABOVE FARM i Acre Value Per Value Acre ti - I Tillable 1 t s_ - £ �r f - n r� s Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot , DEPTH 'BULKHEAD Total I , DOCK COLOR E - E I /VA-r;p,,4 TRIM E I p o � E I �� T:E— 3 I El I S s F M. Bldg. 1 ` _ _ 4, Foundation ,_ ' Bath - Dinette i Extension ? y ;Basement 1 Floors i K. 4 3 Interior Finish LR E . Extension I 3 �' ! . xt Walls Fire Place ;�,a \� ,y DF< Heat Extension � , rV Type Roof € Rcoms 1 st Floor , BR. 3 C I 'Recreation Room Rooms 2nd Floor' f Fill. B. Porch - Dormer i Breezeway 1 !Driveway i Garoge i /3 Patio 7 - - - n, O. B. ; Total �; q I I i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. .26085. . . . . Date . . . . . . . . . . . . ....ug. . . . .30. . . . .. 19. -74 THIS CERTIFIES that the building located at . .Donna.Drive. . . . . . . . . . . . . Street Map No. j)eep•11010. 9ioLAt. . . . . . . . . . .Lot No. 29. . . MattL.tU* . .Ii.Y. . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . _ . . . . l°ag. . 3A ., 19. 73 pursuant to which Building Permit No. . . 0b 1.94 dated . . . . . . . . . .JUM . . . 1. . . ., 1943, 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 . . . .Private. .one. F.ami ly. .dwlllA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . Ly.=. . • •Manarel• . . . ."wner . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . -mg. . 29 . . 1.974. . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . Aug. . 2-8 .1974 . .T., Q nlan. . . . . . . . . . . . . . HOUSE NUMBER . . . goo. _ . . . . . Street . . . .Dana. Drive. . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector „ FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . ?.13050 . . . . » . . Date . . . Decembe,r 1 1, . , . . . . , , 19 .$4 THIS CERTIFIES that the building . . . . . ., , , , , . Location of Property . . . 900 , Donna Drive. Mattituck Hour No. 'tract Hamlet County Tax Map No. 1000 Section . .1.15. . . . . . .Block . . . .15. . . . . . . . .Lot . . . . . . . . . . . Subdivision . . deep, Hole Estates29. _, . , , , , , .Filed Map No. . , . . . . . .Lot No. . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . IV o y e m b e r„1 F , 19 8 3 pursuant to which Building Permit No. 1.2 7 7 4.Z . . . .. . . . . » . . . . . dated . . . . N oV�T b r: . �P. , , , , , » , . » 19 PA , 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 . . . . . . . . . Construct screened porch eclosure to existing dwelling The certificate is issued to . . . . . . . . . .P a t r i c.k S t . a i.r, and d wife e . . . . . . . . . . » lou ire r,l A 1tf. K of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . .N/A„ . . . . . . . UNDERWRITERS CERTIFICA'T'E NO. . . . . . . . . . . . . . . . . .N 1A . . . . . . , . . , . . . . » , . . . . m . . . . . . . Building Inspector Rev.1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the wilding Inspector Town Hall Southold, N.X. CERTIFICATE OF OCCUPANCY No Z-22317 Date MAY 11 1993 THIS CERTIFIES that the building ADDITION Location of Proper'tMy 900 DONNA DRIVE NA`TTI''lUOK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section �lS Block 15 Lot 18 Subdivision— —Filed Map No. Lot No.� conforms substantially to the Application for Building Permit heretofore filed in this office dated 14ARCH 3.1 1993 ____pursuant to which Building Permit No. 21310-Z dated APRIL 6 1993 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued isCHI1NEY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to PATRICK & MICHAELEEN ST. JOHN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N I PLUMBERS CERTIFICATION DATED N/A A7YR11 �g�rn�npact�or �� Rev. 1/81 paw IIA