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Home My WebLink About1000-31.-14-8.1 4 TOWN OF SOUTHOLD £ Rental Permit 1051 Owner Sofia Antoniadis & Ors. Occupied as Single Family Dwelling Located at 12580 Route 25 East Marion 31.-14-8.1 Maximum Permitted Occupancy G 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. 1/17/2024 e r .r r Official This Notice must be posted by the main entrance at all times w E C E � U E rs TOWN OF SOUTHOLD-BUILDING DF1AII'C"['VI NpTown Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax(631) 765-9502 htgtj.�wwvv. ho1dtown: o c-S � RENTAL PERMIT APPLICATION f Z( -7 23 Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 12580 Main Road, East Marion New York 11939 Tax Map Number: 1000 SECTION 031 -BLOCK0014 -LOT008 -001 SECTION B. OWNER INFORMATION: Property Owner Name: Nicholas, Domna, Michael, Sofia Antoniadis Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 12580 Main Road PO Box 413 East Marion, New York 11939 East Marion, New York 11939 Telephone Number (s): Daytime(631)477-6639 Even ing(631}477-6639 Emergency(646)201-3560 Property Owner Email Address: acetweety@aol.com Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Sofia Antoniadis Address of Authorized Agent (no P.O. Boxes):12540 Main Road, East Marion NY 11939 Mailing Address of Authorized Agent: PO Box 413, East Marion NY 11939 (631)477-6639 (631)°177-6639 (646)201-3560 Telephone Number (s): Daytime Evening Emergency Email Address: acetweety@aol.com Section D. Managing 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 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): Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening Emergency Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 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: House, 1 Unit .. 8Requested Maximum number of persons allowed to occupy Dwellin U i ,w„ Number of rooms in Rental Dwelling Unit. 1111 Use and Dimensions of each room in Rental Dwelling Unit: Kitchen (143.75), Dining Room (180.25), Living Room (287), Living Room (228) Bedroom (205), Bedroom 2 (20 bedroom 3 (147k Enclosed Porch (149.50) Total livable floor area, approximately 1550 SF 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. A 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 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) I Sofia Antoniadis certify under ofperjury, 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. Sofia Antoniadis Property Owner's Name: Property Owner's Signature: h Swor,,n o before me thi&S!�, -d` of 20-.,?3 Official Notary Public Sjg azure and Original Notary Stamp Sophia Angelakis Notary Public, State of New York Reg. No. 01AN0015858 Qualified in Nassau County Commission Expires 11/08/90 Page 4 of b TOWN OF SO!ITHOLD BUILDING DEPT. 631.765-1802 it.-- INSPECTION t,--1NSP TION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICALL) [ ] CODE VIOLATION [ ] PRE C/O [ (FI RENTAL � A, Al DAT a Yil I NSPE C T 0 INS uc�`� Bedroom Q Bedroom 11'6"x13' U neo 11"x18'8" e 01 Po rc Dining Room COW CL 11'9"x15'4" 0 CL on L Living Room g 14'2-'x20-6'-- ,Oct 4'2"x20'6"- a �a Family Room El 12'x19' Kitchen Bedroom C) 11'6"x12'6" 11"x18'8" Im CL LRef FIRST FLOOR SECOND FLOOR LEGEND: l co/so COMBINATION CARBON MONOXIDE/SMOKE DETECTOR 12580 MAIN ROAu, EAST MARION NY 11939 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 °y Southold,NY 1 197 1-0959 w BUILDING DEPARTMENT TOWN OF SOLTMOLD 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 Pro es Tonal seal re aired for Architect or Engineer licensed Home Inspect !r must,proig(e coALol valid current certification Rental Property SCTM Number: 1000-031-0014-008.001 Rental Property Address: 12580 Main Road, East Marion, New York 11939 Owner/Name: Nicholas, Domna,Michael,Sofia Antoniadis Rental Dwelling Unit Identifier: House 1 Unit_-. 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 -205sf, Bedroom #2 - 205sf, Bedroom #3 - 147sf Bedroom #4 - 149.50sf Property Description (Include all improvements indicated on survey) Significantly important house listed on the National Historic Registry containing primary building of undetermined age age and other subordinate structures 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 Stat/e�. Print Name and Title Original Signature Please place professional seal: 0701"",( g JOWN�_.... OF °��ICY+ ....SOL PROPERTY RECRDf. .. ._.�.. -��... w .. STR.EET VILLAGE DISTRICT SUB. LOT I7 '/ k7 ORMER OWNER N E ACREAGE G F i OF BUILDING f a g W _ TYPE � . ..�VL. .. w....... FARM _ _.... comm. lD CB. MISC � Est Mkt Value ALAN MP TOTAL DATE D SEAS I REMARKS � � d v , d - r m .a� S 1 m f r � JT -- —vr ABOVE... ...... FRONTAGE ON WATER F � V�� F?s Ate Value FRONTAGE ON ROAD BULKHEACZY Hablre 2 DOC K + r }a Ilal�le 0 . �� . �a � U •�pw,. vampland „ ashlorii k ruse Plot I )to � t m.m7 m � 15 r, w y M ' I .. 14-81 � � 2/3/2021 1,_ . � n3 �ic',r ,almtF° �, M/111 P M. Bld........w. ..._., �.....-µ Both �". ...,�.�.,.....�,...........��,-,......... t Fowandation w Extension � �;;,�� Basement Floors Extension _2 L-,t, Walls "` anterior Finish t dire Place Heat Extension rr " D Porch Roof Type s Porch Rooms 1st Floor f Rooms 2nd Floor E9� as f L4 ' K 2 Garage „- � Driveway -� � � Dormer _..... i i Town Hall AnnexTelephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 "� Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD )09 RENTAL PERMIT APPLICATION Rental Permit Fee$2..00 ('Application must be renewed every two years) w J 'V 12 2022 Section A. Property Information: Rental Property Address: 12580 Main Road, East Marion, New York 11939 Tax Map Number: 1000 SECTION 031 _BLOCK 0014 .LOT 008 _ 001 SECTION B. OWNER INFORMATION: Property Owner Name: Nicholas,Domna, Michael, Sofia Antoniadis Property Owner Legal Address: Property Owner Mailing Address: 12580 Main Road PO Box 413 _ East Marion, New Tom East Marion, New York 11939 Telephone Number(s): Daytime 477-6248 Evening 477-6248 Emergency 646-201-3560 Property Owner Email Address: acetweety@aol.com tt Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road ; Fax(631)765-9502 �, ,P P.O.Box 1179 �fG , k Southold,NY 1 197 1-0959 4 �? BUILDING DEPARTMENT TOWN OF SO HOLD Section C. Authorized Agent Information: Sofia Antoniadis Name of Authorized Agent of dwelling unit, if any: IT„�._ � Address of Authorized Agent (no P.O. Boxes): 12500 Main Road East Marion, NY Mailing Address of Authorized Agent: 477-6248 477-6248 477-6639 Telephone Number(s): Daytime Evening Emergency Email Address: acetweety@aol.com Section D. Managing 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 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):---. �- Page 2 of 5 Town Hall Annex Telephone(631)765-1802 E Fax(631)765-9502 54375 Main Road P.O.Box 1 179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: . Telephone Number(s): Daytime__Evening w_ Emergency_,._--,.— Email Address: ��w..............__w........,._w_....._.ti_.. SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 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: House 1 Unit Requested Maximum number of persons allowed to occupy Dwelling U it: Number of rooms in Rental Dwelling Unit: $ .._.------- Use and Dimensions of each room in Rental Dwelling Unit: Kitchen (143.75) Dining Room(180.25), Living Room (287), Living Room (228) Bedroom 1(205), Bedroom 2(205),Bedroom 3(147), Bedroom 4(149.50) Total livable floor area approx 1550 sf Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road t I Ao Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959ro r 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 ❑✓ 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 Sofia Antoniadis , 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 `Town Hall Annex b TTT Telephone(631)765-1802 a i 46, 54375 Main Road "4 Fax(631)765-9502 P.O.Box 1179 , , Southold,NY 11971-0959 �� Ou Vi ,, �` BUILDING DEPARTMENT TOWN OF SO HOLD 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 247 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. Sofia Antoniadis Property Owner's Name: Property Owner's Signature: -- Sworn to befog me this �wlay of 2020 Official) NoPublic Signature and Original Notary Stamp IGO R OUR'EVI+CI NOYARY PUSLIC-SyATE OF 14Ew YORK No. OI GU5015664 QUalitlod in Inti$ county my commission Expites July 26, 20 p Page 5 of 5 n7/Utf/G014 14:417 b.31 lb0bb41 JIAJ 1 MJLL I Rum i Ica F0 140. 4 TOWN OF SOUTHOLD HUILD32M DISFARTMENT Of:Efce of the Building InspeCtor Town Nall Southold, N.Y. PRE sXISTM CERTIFICA= OF OCCUPANCY 13oe Z- 34031 Dates 10/26109 TSTS CMVMMS that the building nMLLM0 AND ACCESISORIES 2"T MMU x.4cation Of Prcpeity 1255•- RD (KOM NO.) ( 'ET) ( 'RT) Cmmty Tea= Map Wo. 79. 3889 section 031 Block 0014 Wt 008.001 Snbdivision Filed Map No. xot 314. canf=mO subatMiallY to the RequiVeMMta fos built prior to APRIL 9. 1957 pursuant to WhiCb1 CTI=C= OF OCCDpS= NMMW Z- 34D31 dated ERR 26 2009 wan issued, and conforms to all of the requiremexsts of the applicable provisions of the law. The oecupaccY for Which this certificate is issued is M ]PAWLLING' WIC OI"bN RCN SIDE AC. ..O A ''y SHED. The certificate is issued to of the Aforesaid building. SUFE+= CODM DSPATTIONT OF FffiALTH APPROVAL bT A r xaCTRICAL =IPI PSCIATE 90. N A PIMMM czm=FICAION DATED __AZA *PLEASE SEE ATTACHED INSPECTION REPORT.-4L �r Al.1riz SiPsLtu= Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 12580 MAIN RD EAST MARION SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): WILLIAM P HUKILL OCCUPANCY: ONE FAMILY 'DWELLI'NG WILLIAM P HUKILL ADMITTED BY: BILL HUKILL ACC)MPANIED BY: HEY AVAILABLE: SUFF. CO. TAX MAP NO.: 31.-14-8-1 SOURCE OF REQUEST: WILLIAM,P HUKILL DATE: 10/26/09„� ... ...... ........... DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS- 0 _w_.. ONE CELLAR: 1/2 CRAWL SPACE: 1/2 FOUNDATION: CONCTRETB BLOCK_AND...ST.. .. ........p�... TOTAL ROOMS: IST FLR_: 6 21ND FLR.: 3 3RD FLR.: 0 BATHROOM(S): 1.0 TOILgP ROOM(S) 1.0 UTILITY ROOM(S): . PORCH TYPE: FRONT OPEN, D DECK TYPE: __...,_.. PATIO TYPE: SIDE .ENCLOSED.....E. m,. ......... ....... BREEZEWAY: FIREPLACE: .1 GARAGE: �. DOMESTIC HOTWATER- YES. _�. TYPE HEATER: NATURAL GAS AIRCONDITIONING: ,,,_,_..... .... .... TYPE HEAT: NAT GAS WARM AIR: HOTWATER: X OTHER: DWELLING IS A PARTIAL 2 STORY ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME STORAGE, TYPE CONST_: SMALL WOOD FRAME SHED SWDOCEM POOL: GUEST, TYPE CCNST.: 0111m. __....... .,,,,,,, �. ..........�.,,,..... __ VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE BX C 7w P9J ....._ _DESCRIN ON..... ............ . ..........,,,, , 4...........ART .. SFC ........ .. k f I I I I I V � I I � p f I I V B 1 I I R I V 8 B I A 8 d 0 9 I ! f M � f ALT REMARKS: BP4928 ADD....COZ5097.R. 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J I! i { I ui i /” Property 12580 Main Road, East Marion From: Horton, LisaMarie (lisamarieh@southoldtownny.gov) To: acetweety@aol.com Date: Tuesday, December 12, 2023 at 01:18 PM EST Good afternoon Sofia, Recently we received the $300 fee for the rental renewal on property 12580 Main Road, East Marion. Unfortunately, the rental permit was never issued. There are 2 open permits on this property that would need to be renewed and addressed before you receive the rental permit. BP#44530 renewal fee of$310.00 and BP#45963 $200.00. The building inspector would need to inspect all three when the building permits are renewed. If you should have any questions, please give the building department a call. Kind Regards, Lisa LisaMarie Horton Town of Southold Building Department Annex Building 54375 Main Road Southold, NY 11971 (631)765-1802 Nicholas, Michael & Sofia Antoniadis PO Box 413 East Marion, New York 11939 (646)201-3560 Certified Mail w/Return Receipt Requested 9589 0710 5270 0565 7236 70 December 5, 2023 Building Department Town of Southold Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 RE: Rental Permit 12580 Main Road, East Marion NY 11939 Dear Sir/Madame: We herewith enclosed Rental Permit Application for the above referenced premises including all required documentation and fees. Thank you for your assistance. Sincerely, Sofia Antoniadis