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Home My WebLink About1000-22.-2-29 TOWN OF SOUTHOLD 7 Rental Permit 1040 Owner Miliokas, Ilias & Konstantina & Ors. Occupied as Single Family Dwelling Located at 4225 Stars Road East Marion 22.-2-29 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. 12/15/2023 Code pfo �ment off911 This Notice must be posted by the main entrance at all times DECTOWN OF SOUTHOLD–BUILDING DEPART ME 4 20,'),3 Town Hall Annex 54375 Main Road P. (: . Box 1179 Southold, NY 119' r r� C!0 To 11 ti t Telephone (631) 765-1802 Fax (631) 765-9502 n —IO RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Road �a s�` /17a--rr oma-- N"� 11q,39 Tax Map Number: 1000 SECTION 2-2 q BLOCK_2- -LOT 29 - SECTION 9SECTION B. OWNER INFORMATION: r� Property Owner Name: �r QT r , 0 kasW /'c&r-S' a ,�" j ji o k4j, St0.c I�r7, bkai , :?o--- irl ko kq-j Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) S2-20 wC,1 e-- 2 -2D J-e- t�c� L -C/c NY It b 2- _ ..hme,, Alf C V �13 b 1- q17 q17 Zg S -5-V b q/,7 6 '7q -32-711 l� Z Telephone Number (s): Daytime Evening___._ Emergency ....... Property Owner Email Address: _ e_: ✓Im -� a Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 7 _ 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: 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. Cy' 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. Page 3 of 4 Town Hall Annexe ;�„ Telephone(631)765-1802 54375 Main Road F� P. O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: up;� I_ - Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: l- 6ij Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: . Use and Dimension of each room: Rental Dwelling Unit Identifier: o•i '� Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: / Use and Dimension of each room: Town HWI,AnnanTulophnno(031)765d 1002 54375 Main Road , Fox(631)765-9502 P,Q,Box l 179m Southold,NY 11071 X059 �� ➢ ��' BUILDING DEPARTMENT TOWN OF SOMHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier:..--,,,, C rut Y Requested maximum number of persons allowed to occupy each dwelling Number of Rooms In Rental Dwelling Unit: Use and Dimension of each room: c rte- /o �`e 7 `e..t�- w. ... .... .. ,_ .. _. . m Rental Dwelling Unit Identifier: v" Requested maximum number of persons allowed to occupy each dwelling unit: .,.,,m Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit ..... + t °,,,,,,,,, ,� ..,.M ,.�......,�Y,o,. Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms In Rental Dwelling Unit: _ , 6 ..µ, Use and Dimension o ea ch room: ... ..........,._ _, � � `� � o S Town Hall Annex Telephone(631)765-1802 54375 Main Roads Fax(631)765-9502 P.O.Box 1179 ^ Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: y-r;r 7 Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: _ ! Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: I Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: ___— — Use and Dimension of each room: SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I 7TIL t kOt , 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 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 s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: T/I Q S rn` 1ibka4 Property Owner's Signature:, WSworntof re e this y oft' I202, Offrclal N P c Signature and Original Notary Stamp N at York No.g1K Qualified in Queens County Page 4 of 4 Commission Expires February 22, 2026 so � 631 -765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PTBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAl [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY ft [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ j ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O [ o /0? - 2 INSPECTOR em. Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 0 SCTM Date _ Phone Owner _... ._....w Visible Address e � Hamlet /�> Insp ctor Floor Level Quantities __.. . Sub 1 Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits 4 5 6 Smoke Det 3 .e _ . .. .. BedroomsDetectors -- - - - _ Egress Occupant Count Building Systems Maintained &Operational Condition of Property Heating Building interior Hot water Building exterior _. Electrical Property clean maintained &safe Handrails drails guards installed &secure Pool Safety Pool on Site Surface water alarm ate of CO issuance "' ._. ... larms Pool completely enclosed Door a Pool fence to code requirements Self closing/ latching gates COs for all items_ . . -� ' present Prior Rental Comments .._.,,.. V� to Z { �d / e� rt � L r a �obv 0 #2 v Iaom. � 7 b Foam NO 4 TOWN OF SOUTHOLI , BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. 0 Certificate Of Occupancy No. . 274. Date . . . . . ... . . . . . . . . 1 ,q. . . .�. . . ., 19.7 THIS CERTIFIES that the building located at . �,Uos. A04d, , Street WMap No.X#. . . . . . . . . . Block No. =. . . . . . .Lot N .Naat.*Arion. . .N.Y... . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . !a �- . . ., 19.09, pursuant to whish Building Permit No. 1+3782. . dated . . . . . . . . . 19,69., 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 YrIvate. oar. :rAx .1Y. AV01, 119 . . . . . . . . . . . . . . . . . . . . „ . . . . . . . . . The certificate is issued to . � �' . . , . . , • • • ', r " . . . • . . . . .. . . . , . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval U8001 •6Xi.*tJZ9 -SYSUM. UNDERWRITERS CERTIFICATE No. . .X8$1821 . . . . , tom . . . . • • •'�97� • • • . . . 6' HOUSE NUMBER . . . . .4225 . . . . Street , . .altmr s. Ro d. . • . •8Ma's • • . , . . . . . . . ^ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,. Building Inspector ]FORM No. t TOWN OF SOUTHOLD BUILDING, DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z431.Z. . . . . . Date . . . . . . . . . . . . . . . . . $ . . . ., 19.71. THIS CERTIFIES that the building located at - .W1% j; . . . . . . . . . . . Street Map No. _ . j=. . . . . . Block Nco=. . . . . . . .Lot No.X=. .&&at. Mari jj*-Y 4 . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . .July- - . 31, 19. 7.1. pursuant to which Building Permit No. .53992. dated . . . . . . . . . . .a„Fly. . 4:3 . , 19. .71, 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 -accessory-(et-oragej build-Ing. . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . . . . . . . . . . . . . . . . . . .. . ter F ►ti- ` owner, lessee. *tenant)*ant). of the aforesaid building. Suffolk County Department of Health Approval N..R.. . . . . . . . . . . . . .. . . . . . . . • . House it 4225 Building Inspector tea.- - awe TOWN OF SOUTHOLD PROPERTY OWNER STREET I VILLAGE DISTRICT ( SUB LOT — � -- — '� `t, FORMER OWNER I N E j ACREAGE � TYPE OF BUILDING RES ? SEAS. V�. FARM COMM. tND. t CB. MISC. Est. Mkt. Value LAND IMP. TOTAL 3 DATE REMARKS NO PLr�fl',5 R 7 m _ E .ro o 63� AGE BUILDING CONDITION sl NEW NORMAL BELOWABOVE ; FRONTAGE ON WATER — — Farm Acre Value Per Acre Value FRONTAGE ON ROAD f Tillable # BULKHEAD 1._ Tillable 2 �— — : DOCK Tillable 3 Woodland Swampland 1 3 Brushland 3 House Plat — . Total v! ao)3 v TOWN OF SOUTHOLD PROPERTYRgC ,O- RD CARD OWNER STREET i VILLAGE bisf SUB. LOT aI ok7o s 14 FORMER OWNER N E ACR. bc)Q Lic4i -77 S TYPE OF BUILDING 4 ff6-a 4 RES, SEAS, VL. FARM comm. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 17 e Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total COLOR TRIM pw� ti M. Bldg. Extension Extension Extension : Foundation 'Both 'Dinette floors Porch Basement Porch 'Ext. Walls Interior Finish Breezeway 'Fire Place Heat DR�-, Garage 3 Type Roof 'Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. B O. B. v Dormer Driveway Total _ e MM e , a F M. B:dg. Y -aura t c tq s t Extension - Bawer -- Extension e Fabs terior Finish - - - -- Extension F;re Place � 471 C of tz _4 Porch- _� ' _• e Porch i R2� ms i st" leor Breezeway Patio `�_ Ru--m,gnulr Gar:ge Driveway Dr-rer Q. B_