HomeMy WebLinkAbout1000-13.-2-7.7 - - E TOWN OF SOUTHOLD
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Rental Permit
1059
Owner CVJB LLC
Occupied as Single Family Dwelling
Located at 1390 Demarest Road Orient 13.-2-7.7
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.
2/1/2024
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This Notice must be posted by the main entrance at all times
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TOWN OF SOUTHOLD—BUILDING D&AT NT ��r:. � j` c, D Lo S-t+Cp
Towp Hall,annex 54375 Main Road P.0. Box 1179 Southold,,NY 11971-0459 -3,&
Telephone(631)765-1802 Fax(531)765-9502ti� �° /r v� ��i a c�LomrmL„�r
RENTAL PERMIT APPLICATION
Rental Permit Fee$300(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
La
Tax Map Number: 1000 SECTION 13 -BLOCK -LOT - - 7
SECTION B.
OWNER INFORMATION:
Property Owner Name: NLX IB LK.
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
n
Telephone Number(s): Daytim vening_,_,,,, „_,_,,,_,_,EmergencyGUG�_--3LULj 93 QQ
Property Owner Email Address: " G
Page 1 of 4
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 ening Emergency 3e
Email Address:
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
Telephone Tele 631 765-1802
Town Hall Annex P )
54375 Main Road
P.O.Box 1179 ;
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION ADDENDUM
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimensionofeach room:
G�x to
10 V 3
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l 9 6X Ia9
Cental'Dwefltng Unit ldentifer:
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:
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."
rU
ental Dwelling Unit Identifier:
equested Maximum number of persons allowedh to occupy Dwelling Unit:
umber of rooms in Rental Dwelling Unit:
se 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 whohas 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.
Page 3 of 4
Town Hall Annex
��° �� 'A Telephone(631)765-1802
54375 Main Road
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION ADDENDUM
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit: 44
Use and Dimension of each room: 4 # 9.
a or. &Lf— Gsx �p
� 3
9 �Ala9
� x 6 : a crQ. 2o0�1 x 3
ante 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:
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 inust be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
)
COUNTY OF SUFFOLK)
t" 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 Iegar 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: ¢ -
Property Owner's Signature:
ate,...,,.•"
Swor o befog thM- dayojP(ML� 20` q'
Official Notary Public Sin ture and Original Notary Stamp
DEBORAH A,WOJCIK
Notary Public,State of New York
No.4390159
Qualified in SuffolkCounp w
Co niis�sion Expires Dec, D„ � Page 4 of 4
SECTION H.
DECLARAYION: Signature inust be notarized and MUST be the owner of the dwelling unit
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
' 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: AC—�
Property Owner's Signature:
Swor o befoMr�pt
�
Official Notary Public Sin Lure and Original Notary Stamp
DEBORAH A.WOJCIK
Notary Public,State of New York
No,4990159
Qualified in Suffolk COUn
"Onims ior�Expires Ileo. Q, Page 4 of 4
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* ' TOWN OF SOUTHOLD BUILDING DI
o, 631 -765-1802 !- . _ ).-
INSPECTION
] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSUEATION/CAl
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL {FII
[ ] CODE VIOLATION [ ] PRE C/O [ I
REMARKS:
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SCXNABEL RESIDENCE`
_ - 1390 DEMARE9T ROAD
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,= I ACCESSORY APARTMENT [
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AS NOTED
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TOTAL 2ND FLOOR AREA TOM RENOVATED;2,4485E Fir
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;iCNNABEL RESIDENCE
—FEST ROAD
ORIENT.NEVV-jyt",TI9S7
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PROPOSED SECOND FLOOR
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PROPOSED ATTIC FLOOR
24MAY 2021 -
-
4--102.04'
14 -
TOWN OF SOUTHOLD PROPERTU-RECORI 11 15
OWNER,,- -
I STREET VILLAGE DIST.1 SUB.
LOT
FORMER OWNER
IN E ACR
44Lt7
S W TYPE OF BUILDING
RES. SEAS. VL. FARM i COMM. CB. MICS. Mkt. Value
LAND AND IMP. TOTAL DATE REMARKS
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LO
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--------------
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
House Plot I BULKHEAD
Total
\\ Total
SQ FT t '" �� � '� i
x
13.-2-7.7 10/28/2022
X - D CB I
M. Bldg, Foundation Bath Dinette
OTHER
COMBO
Extensionv P. _ R
Basement PAFMAL Floors Kit.
Extension . �f £ Finished B. Interior Finish L R.
Extension FP/WBS Heat D.R.
Garage Ext Walls Color
BR,
Porch Dormer Trim Baths
Deck/Patio t - �� 1 Roof Fin°B" SQ FT Fam, Rm.
Pool Solar 1st Fir Foyer !
A.C./GEN 2nd Flr Laundry
Library/
O.B. Study vi
Dock
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Pr
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13.-2-7.7 6/11
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'Bg. Formation Bath }
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Extension [ Basement ' loors 'A
Extension _ Ext. Walls '_ IntoTior Finish
sin
Fire Place
s
1 Heat
s
Porch Pool Attic _
Deck
Patio i Rooms 1st Floor I
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Breezeway Driveway I Rooms 2nd Floor -
----------
Garage -
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TOWN OF S UTH LD PROPER -R C R 11 15 la')
OWNER,= t I STREET VILLAGE DIST. SUB. LOT
o
FORMER OWNER - E AOR
a S W TYPE OF BUILDING
RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
LAND ` IMP. TOTAL DATE REMARKS
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- -
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f
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Tillable FRONTAGE ON WATER Yl ,
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
E
House Plot BULKHEAD
Total
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. . ,215123 . . . . . » • . Date . . . . . . . . . . .November. . . . . . . . . . . . . . . . . . .. 19 .86
THIS CERTIFIES that the building . . . . . . one. family♦ ,dwelling. . . . . . . . . . . . . . . . . . .
Location of Property Demarest R.O.W. off Main Road Orient
House No. r . . . r . . a µ ,Street flamlec
County Tax Map No. 1000 Section . . . . 0.13. . . .Block . . . . . . . . . . . . .02 .Lot . .p�° r . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
„
Aug.-_41,21• I9 .$ pursuant to which Building Permit No. . . 15 4 2 7 Z. . . . . . . ..
x ,
dated . .Oc.t' 217 . . . . . . . . x . . . . . . 19 .$ , 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 . . . . . • . . .
On.efamily dwelling including deck. w µ a
The certificate is issued to . . .CON5TANTINOS & HED[�ITG 2ERVOS . . k .
. . . . . . . . . . . . . . . (owner � a •
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . .85-SO-131 Nov,.. .21,,, 1986r . «
UNDERWRITERS CERTIFICATE NO. . . . • . . . . . . . . . ?17 5 0 5 4 8. . . . » . . . . . . . . . . . „ . . . . . . .
Plumbers certificate Nov. 24, 1986
wl'
• m « r .'. ♦ • • . ♦ a . « x x . m m w n • . a . . . a x . . . .
Building Inspector
Rev.1/61
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. . 215424 . . . . Date . November 24. . . . . . . . . . . . . . . .. 19 86
THIS CERTIFIES that the building . . . G ar ac1e. . , , , , „ „ . . . . . . . . . . . . . . . . . . . . .
Location of Property J).=arP-Ati.F.•.O.,W, off,Main,Road , , , , , , Orient . . .
House No. Street Hamlet
County Tax Map No. 1000 Section . . .013. . . . . .Block . . .a 2. . . . . . . . . .Lot . . .p1 Q. .7 . . . . . . . .
Subdivision . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
. . .. 21 . . . . . . . . . . 1•.9 85 pursuant to which Building Permit No. . . . 114277. . . . . . . . . . .
dated „ , Oct. 27 . . . . . . . . 19 . $6 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 . . . . . . . . .
Accessory two car garage.
The certificate is issued to CONSTANTINOS & HEDWIG ZERVOS
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . . . . NSA. . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . 4 3 0 8 0
4 N 9 . . . . . . . .
Building Inspector . .
Rev. 1/81
1WtCP
Town of Southold 2/1/2024
P.O. Box 1179
53095 Main Rd
u , Southold,New York 11971
'CERTIFICATE OF OCCUPANCY
No: 44916 Date: 2/1/2024
THIS CERTIFIES that the building ADDITION/ALTERATION
........ .... .. ...... ... ........ ..... .............
_—..... ---
_...... . ............ ...... .... ......... ,. ....... .... ..........
.. .........
Location of Property: 1390 Demarest Rd, Orient
SCTM#: 473889 Sec/Block/Lot: 13.-2-7.7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/24/2021 pursuant to which Building Permit No. 46799 dated 9/9/2021
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:
additions and aalt r twcaa, riludzolg�c c�Ntc�flct�r„cr�I��ng .e�Ml l���c�c� l?�ar 1R� e�a�t �����..�l�a��v �_ar�c� INraxi ��cr�r�c�rl I ilrg
tlt .lcat e,W ?w titlg ,lllg l lrtNly...c t lwl�rtg �1pl lied for p t, C3 _7 d r c c1_ /4 / 023...
The certificate is issued to CVJB LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 46799 9/8/23 & 1/3/24
PLUMBERS CERTIFICATION DATED
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