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Home My WebLink About1000-137.-2-20 TOWN OF SOUTHOLD Rental Permit 0868 Owner AGK RE Management LLC Occupied as Single Family Dwelling Located at 3655 Pequash Avenue Cutchogue 137.-2-20 Maximum Permitted Occupancy 8 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. 4/21/2023 c .car �� official This Notice must be posted by the main entrance at all times 4 It v"> �'-�0 (t If 12, Town Mall Annex Telephone( i31)765-180 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 197 1-0959 BUILDING DEPARTMENT TOWN OF SOUIVOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: ± w ._w. I �. Tax Map Number: 1000 SECTION 3-7 r -BLOCK " 2__. w.....-LOT AZO__ . ........,,. SECTION B. OWNER INFORMATION: Property Owner Name: A-6—{L �E YYlsErYl (� e _... ...... _.._ . ..........._.. .. ... _.._.. _. .._ .. __w...... _ ..._... ..... Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytime �Pd � -�" Evening,n ��._Emergency _,,,-.f " Property Owner Email Address: `4'C"'off Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Jam ! 'r Southold,NY 11971-0959 011 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: j/ Name of Authorized Agent of dwelling unit, if any: _ .... lc -_u0u1TS06 I WS Address of Authorized Agent no P.O. Boxes):,,,,_,_.a D"C rJ Mailing Address of Authorized Agent: _ Telephone Number(s): Daytime_... ,.,,.,,,,, ► '_2. wµ..._..m Evening , l.ga. EmergencyM , Email Address: ..._. .. � Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes):,aaA- "cow�...&VCH-'(;l&-'PLA-: r q hSl I Mailing Address of Authorized Age &9 aa.. � ��.a�...................... _..�o�... �.�.�. ....��.. _. _� Telephone Number(s): Daytime _ ` ry.. ...___.„_,. Evenin Emergency RM7-7?-2>-7 Email Address: . .. ..... M. ? lw ? .� c,(D(YI .. ....._-. _ _ ...._....,w... 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. Boxes):._,,,,,...... ._�_._� .....o..�.�.�..�....�w. ��_._.....�...�.�.�.�.�.....� _��w_ Page 2 of 5 Town Hall Annex � Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 ov G� BUILDING DEPARTMENT TOWN OF SOUT OLD Mailing Address of Managing Agent: 0 ,A Telephone Number(s): Daytime _.._ .....�,.... .�__.. .....� . Evening EmergencY,.._...._............. .....�..�......��........ EmailAddress: .� ._.. w.ww_w .��... . .................. ._....��..................._...............,...._......_..._.� ......._........... ..__w.........�.. .._. .�..._ ,_..�a. �_ SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: _. ....._ . ......_,..www..ww._....._._. 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:_.........._3 ?-57 ...._..Ver .".... ....�..................... ._....... �. � A,. __._.. Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: .._.._.....�..... .......�__�_.._........ ��_......u...�.��...�.�....� ..��.�._...�_... �m. Use and Dimensions of each room in Rental Dwelling Unit: D NTIW►- 1 1o'ic 13'-2� BPrTEk #t &F-dlRL 1o" Bet)m # tEjPaX# 2.....�_31�V'I�` -10� ...._gEDRt�YI . w ....... a '?.rr?`.......�3�w"2t�. _.__........_...........�. 6�ttQrr1 -�'2 l 31-o yx l 31-21� Page 3 of 5 4 � ��tQl�➢IN�il�rtily�� Town Hall Annex lei Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOU OLD 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. El 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 k �-.IC4— 6:1–f certify under penalty of perjury,the following: I 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 e?) Town Hall Annex / Telephone(631)765-1802 54375 Main Road I � Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO SCOLD 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 ,. . . .. .., ...... ........._.._.. ._ S o re me this Zday of . ._� 2023 Official Notary Public S(iur and Original Notary Stamp VIKRAM S RANA NOTARY PUBLIC-STATE OF NEW YORK No.01RA6376926 Qualified in Suffolk County My Commission Expires 06-25-2026 Page 5 of 5 r , Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 � P.O.Box 1179 „ gyp ! Southold,NY 11971-0959 , 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 Erp ssronal seal sere uire or Architect far r� l�aeer licensedHome I�1� �s i nols q �y'.w��!a�i crr�rrlt erti rct�crl Rental Property SCTM Number: lD -- f3"7 —Z _................................ .._......... Rental Property Address: .��...� ._ P v _A-Jei._.._ CLJTCtt0GLFc .... ........_. .w_............... Owner/Name: Rental Dwelling Unit Identifier: I Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq., Bedroom#2-90 sq., etc.) . .2__._ .. ._. ......_... 2t3 2�6... _ Property Description (Include all improvements indicated on survey) ..��_:_...�._.. 'i�' �1.D U t t�t�►� $ DUz"d�l�IZ Kt.T�tt�n► '. 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 Code of New York State, and the Energy Conservation Construction Code of New York State. ; Print Name and Title � � ol Original Signature Please place professional e 077 �, EWOOL A4, (.Al V& kv 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PLTG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII [ ] CODE VIOLATION [ ] PRE C/O [ ] jr 14" a e e Yu 9 `4. N, ( ♦/ �,..,+BMW. I " M1 M /'� Vr �xw ca ck l r�i� itwomx CO.e , �,... k M y Z>i • z U'jLLJ r " < " y i w ry .... �... _ ... .... � ,_ �� t y Ln ` V x • J , `" > Ln toe z t i - " d J � p m I m G LL .. ..... _. ....... _ ....._ ...._. w, N LL LL LL C N o 1 44 E I mxxx Biwa. .. �•• .•' � Y+. C ' I 8 ,...,g n,..w... n.... ...... ...�.�,.,... N ILL ................. N \ N O w� h r c �CCX L pN� C IB,. W W d m d M FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22993 Date MAY11 1994 THIS CERTIFIES that the building NEW DWELLING Location of Property 3655 P8 DASH AVENUE CU ,HouseNo.No. Street Hamlet County Tax Map No. 1000 Section 137 Block 2 Lot 20 Subdivision Filed Map No. Lot No.� conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 29, 1991 ureuant to which Building Permit No. 19822-Z dated APRIL 29 1991 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 ATTACHED GARAGS & WOOD DECK AS APPLIED FOR. The certificate is issued to GREGORY & THEODORA LEPERIDES (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL Be-so-109-MAY 3 1994 UNDERWRITERS CERTIFICATE NO. N-276188-MAY 17 1993 PLUMBERS CERTIFICATION DATED FEBRUARY 23, 1993 - HARDY PLUMB.&HEATING i ing Inspector Rev. 1/81 �gFEI#, Town of Southold 12/13/2021 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE E Off" OCCUPANCY No: 42152 Date: 7/11/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 3655 Pequash Ave,Cutchogue SCTM#: 473889 Sec/Block/Lot: 137.-2-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/4/2021 - pursuant to which Building Permit No. 45678 dated 1/13/2021 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: acce soryit - u tad %0 r0 l g poc S v tl_s a fenced to code sµ rPt c!1<ar er 'B #"446,,dated 12/22/2020. /lµ / qurrc: t _to.A d s,, a. The certificate is issued to AGK RE Management LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45678 6/11/2021 PLUMBERS CERTIFICATION DATED C:h rye ,a e 11t Town of Southold 12/23/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE E OF OCCUPANCY No: 40958 Date: 12/23/2019 THIS CERTIFIES that the building WINDOWS Location of Property: 3655 Pequash Ave,Cutchogue SCTM#: 473889 Sec/Block/Lot: 137.-2-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/21/2019 pursuant to which Building Permit No. 43585 dated 3/27/2019 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: ALTERATIONS TQ AN EXIST1NQQN FAMILY D\kE1jLQy AS APP[I l QR The certificate is issued to AGK RE Management of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43585 09-04-2019 PLUMBERS CERTIFICATION DATED 12-13-2019 Jack Gismond` __. ... .. ... _.... ri° H._ ..............__... ,. _.__ Au µe Signature , gt ft ; Town of Southold 3/23/2023 P.O.Box 1179 53095 Main Rd q ° Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43936 Date: 3/23/2023 THIS CERTIFIES that the building ACCESSORY Location of Property: 3655 Pequash Ave, Cutchogue SCTM#: 473889 Sec/Block/Lot: 137.-2-20 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/13/2022 pursuant to which Building Permit No. 48592 dated 12/13/2022 �... _. 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: "g,s built""acc sM ij 'with mini frid e and BB as a ied for. The certificate is issued to AGK RE Management LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48592 3/6/2023 PLUMBERS CERTIFICATION DATED �r Au 017.cd. .nature Z0=0° 2 S • ,, HCAXTAIn M k-YB �..__�"¢� f'• _�._.a t it hy�: al.sl4n 4 r uI�-amu_ .x' a rQ 3n O H d r"n _............__`w{!?,"_.� n q S { , t r NFER c m c' c� C I 6' PIT u 6—b° "' I r 1 1 I r s w_ I I I�yl I f I i 18-9° I w b I f- 74' all gill- .4111 ! 1 *1 .I gi fill I I I 1 I � 1 CA I f I Nro C I I f. �S� !•rr - � I a $� { C f ! All t k k n a 0:31]4 I ( i 70 I I 6 � � � I I , I ( tl I tl 7 a I fdnlL NCo- I til BALCONY ,- 8-0 IV 4SIf7", ( N o Ir Ilk U3 LM a �? s O mNr m c g , 71 C7 °aoxean c C n