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HomeMy WebLinkAbout1000-15.-5-32 TOWN OF SOUTHOLD Rental Permit 0812 Owner Domenico & Monia Debellis Occupied as Single Family Dwelling Located at 2420 Plum Island Ln Orient 15.-5-32 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. 1/25/2023 e fo ernwt official This Notice must be posted by the main entrance at all times re ,� Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 it w y, DBUILDING DEPARTMENT D'o' " J] TOWN OF SOU OLD JUL, 2 f) 2022 RENTAL PERMIT APPLICATION BL1LDING T11 Permit Fee$200(Application must be renewed every two years) TOWN OF SOUTHOLD Section A. Property Information: Rental Property Address: 5 0© Tax Map Number: 1000 SECTION -BLOCK___5 O C) LOT - SECTION B. OWNER INFORMATION: Property Owner Name: ®►`'i fl � � i Property Owner Legal Address: Property Owner Mailing Address: h, CNS o I q So � 5 7 Telephone Number (s): Daytime t -301 ��©Evening„ Emergency Property Owner Email Address: 'I i i 1 1ut�4i Co 4 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 Al BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: 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: E T")- K m l 0� Address of Authorized Agent(no P.O. Boxes):w � Ali P-© 110n 9g8 Co-TrHoGuE /,J_y 11,135 Mailing Address of Authorized Agent: Telephone Number(s): Daytime ql- 4 S 1 Evening Emergency 31 -3Sy- 9/00 V 75- Email SEmail Address: LL� SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: .., Address of Managing Agent (no P.O. Page 2 of 5 d ^ N Town Hall Annex '- Telephone(631)765-1802 54375 Main Road ¢ �� Fax(631)765-9502 P.O.Box 1179 !" Southold,NY 11971-0959 :�Sm BUILDING DEPARTMENT TOWN OF SOUTIF]fOLD 1 Mailing Address of Managing Agent: µ � `t $ Gv`� ��'1 � 119 -35 Telephone Number (s): Daytime �'6�651" 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: 15 00 ^ :BLOM "500 -L077-. 3200 Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: G Use and Dimensions of each room in Rental Dwelling Unit: k�Q.G - GflKAGIC.1 17 0", X 16`' X" - `$AGK KCM" till 9"XGrJ"_ 9:LEGrf-I CAI. Rvq : $" li" X 3 11i1 l.fIKNDICY ; 9 " oil 'K y 9 ox 3 $ - �K+r�AiZ� '6�yttoy r�: C x tt`...1►` - ���EZoorY1 '. l8" oil 7c milll t1 - 73EvRoocn 1.Z�� 02`1 �z �D,ic I,� - PcICCN '. log 5a�c 6i0`.. $A-r44 : g ,� . X 12 0 - kk*TCREIi X I z o _ Wo MIIJG RO) Page 3 of 5 �J? Gu _ L tv1PJG Krn : 20,E -7 X 1-5 3•. ,5Lt" C"' 40" " _ `eaaL CA-< <o '. 5.. 1+ Tele (631 765-1802 Town Hall Annex , , ;` Telephone ) 54375 Main Road Fax(631)765-9502 ' y� P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUOLD 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. I 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: r Property Owner's Signature: Sworn to before me this ldday of w , 20,�,L Official Notary g Public Si. inal Notary Stamp n ure and Ori 0 g j' tjN( hV0 tlwlP 4144k��* t uw1"ttiv l an h1a W C` +aWy Page 5 of 5 TOWN F SOUTHOLD BU LDING 10 76S-1802 lim * EC'TIWA"'m [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CA [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INI [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FN [ ] CODE VIOLATION [ E C ` REMARKS: TT INSPECTOR ,, �� , Iwo Ian. zvk8o\ovf *)eqTOWN OF SOUTHOLD BUILDING DI 831 -785-1802 INSPEC ION [ ] FOUNDATION i ST [ ] ROUGH PL.BG. [ ] FOUNDATION TND [ ] INSULATION/CAL .011 [ ] FRAMING / STRAPPING [ ] E AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE I l ELECTRICAL (ROUGH) ELECTRICAL (EI [ ] CODE VIOLATION [ ] PRE C/0 REMARKS: ( I _� ... M G t 4 ----------- ` ON vr,/ C-1, t/- ,o µ DATE INSPECTOR May 21, 2022 Town Hall Annexm Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 � Southold,NY 11971-0959 H;NS 'V'� KKk BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION 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 Professional seal re utred for Architect or Engin licensed Home ins ectar rnWst provIde car o 'vaiNd current certT cation Rental Property SCTM Number: Rental Property Address: 2420 Plum Island Lane Orient NY Owner/Name: Monica Debellis Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1—100 sq., Bedroom#2-90 sq., etc.) Bedroom#1 120 soft Bedroom#3 180 sgft Bedroom #2 110 sqft Property Description (Include all improvements indicated on survey) sin 1 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 Code of New York State, and the Energy Conservation Construction Code of New York State. Victor Cornelius III CEO Inspector Print Name and Title ceo# 1216-0283 Ori inai ignatu Please place professional seal: w� SWIMMING POOt PATIO 8'4"x 23'2 .............................................................. PATIO 84'0"x 40'10" ....�.,... m,�,nyris i DGif /' L RIC L ROOM ., ... 0 .. ROOM 179 ._ 8d" A � ........ l ,•,,,, .�•� ___....... � U PRIMARY BEDROOM � l 14'6'x 11'11" DINING AREA '--'" ARbN�1R1" ._ w� 11'8"x 12'6" KITCHEN .�.. T 1 107'x 12'0" 1710'x 16'2" w 6AfWGE ENTRY 9'0"x TB" +. ..� "IMMMIIIIIIIIIIIIIwINAIAI� ............ �����° �•� �" LIVING ROOM ...... ..�_ ...----.. ..... .^. "..,.".., �.�..,.,� 8EDROO BEDROOM 207"x 15'3'• 10'0"x 101" 1212"x 10'1" Y PORCH 10'5"x 6'0" 3 _{ TOWN OF SOUTHOLD PROPERTY RECOF t -as a _ _ = 3 _- T `1 ; ��,'i ; PILLAGE DISTRICT SUB. ! LOT 10A aL ORMER OWN€ I N E ACREAGE ' 1 s i / is !W TYPE OF BUILDING -- a RES. u SEAS. VL. FARM COMM. IND. CB_ MISC. E . Mkt. Value LAND IMP, TOTAL DATE REMARKS Aj� _ - � - r� t '` f _....__... _ _ s r a J f�..�� 7, � i - _ �. v , i Z - 000 e a q; CP� FRONTAGE ON 4VATER _ Vol ' r,Acrd .$ .FRONTAGE ON ROAD Tillable 1 '� _ BULKHEAD Tillable 2 Lk p 6 s ._4 C � DOCK Tillable 3 Woodland } Swampland Brushland I co,� House Plot ry s Tota IWIN-1 l e 3 a �r E z � f 15.-5-32 2/10 -- M. Bldg, Foundation Both - xten t n 2 F o,3 Basement Floors Extension Ext. �clls Interior Finish Extension Fire Place Feat Porch Poo; Type 29 Porch Rooms 1st Floor J- B reezeway 1 Patio Rooms 2nd Floor — F G6rag i g ; Drivewayormer O. B, - , y5 0 1ZEV a v 1 s fat/( Town of Southold 11/18/2019 P.O.Box 1179 co 53095 Main Rd ' , Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40680 Date: 9/9/2019 THIS CERTIFIES that the building SINGLE FAMILY DWELLING t Location of Property: Ln., Orient 2420 Plum Island ... ._..�.....,...-.._....�...� ...... ..........___....�. wwwww_._..__....M.M.M.M..........._..wwwwwwwwww. _......_..... SCTM#: 473889 Sec/Block/Lot: 15.-5-32 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/12/1988 pursuant to which Building Permit No. 42450 dated 3/12/2018 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: gna fly dwelling with coverq gLi ch and attached ara e a p li d ca .KK 1.1,/18/2019 Corrected to remove unfinished basement house is on a slab . The certificate is issued to Thomatos,Adamantios&Irene of the aforesaid building_ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-98-0028 7/08/2019 ELECTRICAL CERTIFICATE NO. 3046845 &42450 8/4/2009& 9/9/2019 PLUMBERS CERTIFICATION DATED 7/24/2019 dam cis Thcaan<to �_ww.....wwww w_ _....... ........... -..�.� __ _w�...................._.__ ._ � firSignature �......,.�..._...... 1, fr% r, / / p 2 I W W ��//� JbC"'Ifl'9YM0 ryryW"� '/1 / IF f f „F f, f f ........... .............. ati�t P'Otk' Town of Southold 6/18/2022 P.O.Box 1179 53095 Main Rd Southold,New York 11971 .....—-—--___ ................................... .......... CERTIFICATE OF OCCUPANCY No: 43173 Date: 6/18/2022 ............ THIS CERTIFIES that the building INGROUND POOL Location of Property: 2420 Plum Island Ln.,Orient SCTM#: 473889 Sec/Block/Lot: 15.-5-32 .......... Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/9/2020 pursuant to which Building Permit No. 45356 -dated 10/20/2020 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: aq,gemsory ip:ground swinimin i g-P of A—W htsoa_g.g ip p-Ln L fo—r. The certificate is issued to Debellis,Domenico&Monia ........... ........... of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45356 12/14/2021 PLUMBERS CERTIFICATION DATED .............. t. h riz ature Ilt w„ Town of Southold 1/25/2023 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43787 Date: 1/25/2023 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 2420 Plum Island Ln, Orient _ ._._...,... ....-. ._.-_...�, _.__._._, SCTM#: 473889 Sec/Block/Lot: 15.-5-32 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/28/2022 pursuant to which Building Permit No. 48645 dated 12/22/2022 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: "°ate built""altgrations includin sty c°a e room and ball batk►lcaopi t existin .sin lq-� ca Ming as applied for. The certificate is issued to Debellis,Domenico&Monia of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 22-85094 9/27/2022 PLUMBERS CERTIFICATION DATED _ 1/10/2022 a nico Be 1. .. .................. ......... u r' Signature �__..