HomeMy WebLinkAbout1000-109.-2-18 TO WN OF SOUTHOLD
Rental Permit
1116
Owner Alexander Compagno
Occupied as Single Family Dwelling
Located at 1100 Alvahs Lane Cutchogue 109.-2-18
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.
4/22/2024
cue fc Official
This Notice must be posted by the main entrance at all times C)
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 litter» wwWctllit< wr
RENTAL PERMIT APPLICATION
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Rental Permit Fee $300 (Application must be renewed every tw ,,y rs)
ni P�R 1 2024
Section A.
Property Information:
Rental Property Address:.
Tax Map Number: 1000 SECTION -BLOCK Z -LOT $ -
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
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Telephone Number (s): Daytime A1,00 Evening Emergency -72 ,02-4
Property Owner Email Address: &V& A �COltt G C H C0
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Page 1 of 4 ge,C'
Section C. �p
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 Evening Emergency
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
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: I
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 Unit:
Number of rooms in Rental Dwelling Unit:
se and Dimensions of each room in Rental Dwelling Unit:,
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SECTION G. qx
INSPECTION., 20
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Pursuant to the Town Code of the Town of Southold Chapter 20 (Rental Properties), a safety 3 � —
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.
❑ 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)
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COUNTY OF SUFFOLK)
l ( , 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: _ A v*m,,ko,
Property Owner's Signature:
Sworn to before me this day of °" _ 20 �
Official Notary Public Signature and Original Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.01 BU6185050
Qualified In Suffolk County
Commission Expires April 14, Page 4 of 4
Town Hall Annex
54375 Main Road
Telephone(631)765-1802
P. O. Box 1179 �� Fax(631)765-9502
Southold, NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a licensed architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Proferssion l seal re uired for Architect or Engineer, Licensed Home Inspector must
rovide co of valid current certification
Rental Property SCTM Number:
Rental Property Address:
Owner/Name: "'
Rental Dwelling Unit Identifier: / f l , , +d
Number& Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 — 100 sgft., Bedroom#2—90 sgft., etc.)
Property Description (Include all improvements indicated on survey)
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, the Fire Code of New York State, the Property Maintenance Code of New York State
and the Energy Conservation Construction Code of New York State.
Print Name and Title Original Signature
Please place Professional Seal:
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TOWN OF SOUTHOLD BUILDING DIsits mam
6317851802 p ,-
INSPEC ION
C I FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAL
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN%
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fit
[ ] CODE VIOLATI [ L PRE C/O
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DATE INSPECTOR
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Ground Floor Plan 1100AIvahs Lane
Cutchogue, NY
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Basement Floor Plan 1100 Alvahs Lane
Cutchogue, NY
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GOYA HIRAM RANDALL
Address JACKSON HEIGHTS NY
Profession Architecture(003)
License Number 023878
Date of Licensure October 14, 1993
Status Registered
Registered through Date July 31,2027
Additional Qualifications Not applicable in
this profession
in
April 9,2024 06:15 PM(ET)
https://www.op.nysed.gov/verification-search?licanseNumber023878&professionCode-003
2/2
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
Z 2 MA.R 1973
No. .5 Date . . , ,. . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . .
1100 ALVAl-IS LANE-
THIS CERTIFIES that the building located at . . . . . . . . . . . . . . . . . . . . . . . . . . . . Street
Map No. . . .'. . . . . . . Block No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . . . . . . . . . . . . . . . ,
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . , , . . . . . » Jt1ati —, 19 72 pursuant to which Building Permit No. 9 y 9 z—
dated » . , . . . . . . .�O . . . . . . . . . 19.. was issued and conforms to all of the require-
ments �I
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . »A. » .O�I . . . . .A .M. !t Y. » . . �w L` L 4 1 *F,�. . . » . . . . » . » ., . . . . . . . . . . . . . .
THE N E SA W A ST Y N Ow 1 C Z
The certificate is issued to . . . . . . . . . . . . . . . . . . . . . . . . . . . » . . . 1 . . . . . . . . . » . » , • . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval
UNDERWRITERS CERTIFICATE No. . . . . . .n� 7Z . . »ioe
HOUSE NUMBER. . 0 0 V. . . .Street. . . . . . . . . . . . . . . . . . . L.A n/t . . . . . . . . . . . . .
of L/T C H 0 6 1/ A '
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
1FQt Town of Southold 2/17/2023
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
f CERTIFICATE OF OCCUPANCY
No: 43860 Date: 2/17/2023
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1100 Alvahs Ln,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 109.-2-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/10/2022 pursuant to which Building Permit No. 48469 dated 11/10/2022
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:
200 am under round electric service.
The certificate is issued to Compagno,Alexander
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48469 1/19/2023
PLUMBERS CERTIFICATION DATED
��Auth�orizedA Signature
q «UtF47l,fCal
ti Town of Southold 10/17/2023
, P.O.Box 1179
53095 Main Rd
�w cr Southold,New York 11971
CE .TI: ICATE OF OCCUPANCY
No: 44654 Date: 10/17/2023
THIS CERTIFIES that the building ELECTRICAL
Location of Property: 1100 Alvahs Ln,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 109.-2-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/5/2023 pursuant to which Building Permit No. 49644 dated 9/5/2023
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:
electric for shed.
The certificate is issued to Compagno,Alexander
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 49644 10/10/2023
PLUMBERS CERTIFICATION DATED
ue
thorizcd S gnatur
r
gif0t,f Town of Southold 11/4/2023
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44713 Date: 11/4/2023
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 1100 Alvahs Ln,Cutchogue
SCTM#: 473889 Sec/Block/Lot: 109.-2-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
l l/,16/2022 pursuant to which Building Permit No. 48686 dated 1/4/2023
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 s ter ti wn5�l&i i nl pd.�aa e ent and scar c avere l irc:lt t ea i t r sin le-�f,,am ly dwelli_g, s
p-plied for.
The certificate is issued to Compagno,Alexander
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 48686 10/10/2023
PLUMBERS CERTIFICATION DATED 10/12/2023 rely tessey
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