HomeMy WebLinkAbout1000-88.-6-13.30 alit
TOWN OF SOUTHOLD
Rental Permit
71
0956
Owner Numero 1 LLC
Occupied as Single Family Dwelling
Located at 60 Water Terrace Southold 88.-6-13.30
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.
7/24/2023
code rc n cfi
This Notice must be posted by the main entrance at all times
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Town Hail Annex i,,,' ro P1 }
/�/i Telephone 631 765-1802
54375 Main Road � ��� � ( 765-0,502,
P.O.Box 1179
Southold,NY 11971-0959 ............... Z '�P
-= N 1 6 202
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:
60 Water Terrace, Southold, NY 11971
Tax Map Number: 1000 SECTION -w_„- 88 ...._._n„w w-BLOCK 6 -LOT 13 --3–7)
SECTION B.
OWNER INFORMATION:
Property Owner Name: Enzaw riq,,,Nummero 1 LLC_....._ . .._._w ... . ...... _.. ._.__._n._ _._ .o.o...,....
Property Owner Legal Address: Property Owner Mailing Address:
74 Marshall Avenue
Floral Park, NY 11 _...._.. _... -
001 Floral Park NY 11001
Telephone Number (s): Daytime (516)639-2151 Evening (516)639-2151 Emergency (516).. w - 151
Property Owner Email Address: „ -evario1020@vahoo.com
Page 1 of 5
Town Hall Annex if °%i% `% Telephone(631)765-1802
54375 Main Road J��j��� ��i;��j�% Fax 631 765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: Maria Michos „ .. ....
Floral Park NY 11001
Address of Authorized Agent (no P.O. Boxes):_208 Tul,in
Mailing Address of Authorized Agent: 208 Tu„Iip,Avenue -Floral w_Park�NY 11001
Telephone Number (s): Daytime., ( )„s57w.._s..M�4...........0....... EveningLs12),u ��-t_860,Emergency_ _s)578w4860
�._
Email Address: __angel Ijorwesnofo mailw.corn w
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: Maria Michs
g ( Boxes):, ..lAvenue Floral Park NY 11eQ01
Address of Authorized Agent no P.O. 208 Tulip
Mailing Address of Authorized 20.8
T�
Telephone Number (s): Daytime (516)578-4860 Evening(516)yrs-4660 Emergency (516)578-4860
Email Address: an elshoresnofo@ mail.com
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): w .__....._............__..w _w
Page 2 of 5
P � t
Town Hall Annex Telephone(631)765-1802
54375 Main Road ��, ay; Fax (631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytime____,,----,, Evening _,_w,.._..._......_._._. Emergency_____
EmailAddress: .........w ._....................._. ._._-m..._._.. ..._.... ........
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, Q 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 Uni .......,_
Number of rooms in Rental Dwelling Unit: 7
Use and Dimensions of each room in Rental Dwelling Unit: w w_ ,_....,.,.,..,_ ......
q q 2 sq.; Study- 182.24 sq,
Kitchen - 284.08 s ., Dining 9 1
-_..,....�..._..�...�.�... ....,..__..�..�..._� Room.....203.28 sem, Great Room 4 .....�.-.._,�.
Master Bedroom - 211.20 sq Bedroom #2 158.40 sq,, Bedroom#3 193.12 sgwm
Page 3 of 5
jl
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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(63 I)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
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
❑ 1 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 Enza Vario , 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 ����io�rl�� yi Telephone(631)765-1802
54375 Main Road ' Y 1 Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
fF
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,
w Owner's Name: Eza Varies ...... W,, _....,. ..... __..... ......._. _u..... __ _.
Propertyn _... µ„
Property Owner's Signature: ' " ,
Sworn to before me thilV"'day of 20)3
. .... . .............
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.01BU6185050
Qualified in Suffolk County
Commission Expires April 14,2 _a
Page 5 of 5
os WAS,
TOWN OF SOUTHOLD BUILDING 0
m
631 -765-1802
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCA
[ ] FRAMING l STRAPPING [ ] NAL
] FIREPLACE & CHIMNEY FIRE SAFETY IN
j ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (E
[ ] CODE VIOLATION [ ] PRE CIC? [
REMARKS:
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DATE
INSPECTOR
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TOWN OF SOUTHOLD PROPERTY REM,7
OWNER -STREET . - , VILLAGE 17=
ACR. REMARKS
TYPE OF BLD,
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PROP. CLASS
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LAND IMP- TOTAL DATE
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a
FRONTAGE ON WATER TILLABLE
I FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
I TOTAL
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Exerlsion Fire Place _ Heat D R
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Porch Dormer t _
Deck [ 6,�� e F _
Attic
Breezeway �e Rooms 1st Floor
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Garage c= Driveway Rooms 2nd Floor
Pool
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28015 Date: 10 16 01
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 60 WATER TERRACE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 6 Lot 13.30
Subdivision Filed Map No_ Lot No.
conforms substantial the Application for Building Permit heretofore
filed in this offi dated MARCH 13,q 2001 pursuant to which
Building Permit No. 27227-Z dated APRIL 11, 2001
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 COVERED FRONT, PORCH, REAR DECK AND ATTACHED
TWO CAR GARAGE AS APPLIED FOR.
The certificate is issued to ZOUMAS CONTRACTING CORP
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-01-000722Z2701
ELECTRICAL CERTIFICATE NO. PENDING 10/12/01
PLUMBERS CERTIFICATION DATED 09/20/01 HI-TECH PLUMBING
c
u niori e Signature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33899 Date: [ U9
THIS CERTIFIES that the building DECK ADDITION
T
Location of Property: 60 WAER TERRACE SOUTHOLD.......... .....�_�w .,... .__ ..._�wwww_
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 6 Lot 13.30
Subdivision Filed Map No. Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 2„9m, 2009 pursuant to which
Building Permit No. 34758-Z dated JUNE 8, 2009
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
i8 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR,
The certificate is issued to RICHARDJ SIMEK, .......... w.w„w
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _..�N/A
ELECTRICAL CERTIFICATE NO_
PLUMBERS CERTIFICATION DATED --_NIA w..�........_
Agna�
Aut or° edre
Rev. 1/81