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Home My WebLink About1000-22.-2-26 gs TOWN OF SOUTHOLD Rental Permit f 1187 Owner Samantha Grassle & Luis Palacios Occupied as Single Family Dwelling Located at 3825 Stars Road East Marion 22.-2-26 Maximum Permitted Occupancy 5 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. 8/29/2024 CodeFinfot#ent offic° This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD—BUILDING DEPARTMENT -i rl �^ Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 1 59 Tel 1-31 - r . . � Telephone (6 ) 765 1802 Fax (631) 765-9502 �I°ittttlb s.,.//www. outflotcltorN,Il�w a � AUG 1 4 20 4 n RENTAL PERMIT APPLICATION Sowing Rental Permit Fee $300 (Application must be renewed every two yeorsl-� t Section A. Property Information: Rental Property Address: ��-- 3 S ZS .57-pms D , l n5+- MGCI'f Tax Map Number: 1000 SECTION 7, 1 -BLOCK 2 -LOT Z SECTION B. OWNER INFORMATION: Property Owner Name: L✓i S �c, p 1,4,-U& Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) I It) qT" D Telephone Number (s): Daytime.�1� 44 (-WEvening Emergency Property Owner Email Address: L V DKP tc'L. Page 1 of 4 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, 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: ►T Requested Maximum number of persons allowed to occupy Dwelling Unit: 6 Number of rooms in Rental Dwelling Unit: 3 Zoo I ; To f-e ) Lsej% to,w. �,N�SKED Q(1-SG•t�rT Use and Dimensions of each room in Rental Dwelling Unit: ac- I38 q. S.f. IttTcNEN . Z6,J S.f. L t s. : wEo 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. 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 Lis OP-I EL- QA LA c,tvS , 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: L u is �i LA c. vs Property Owner's Signature: Sworn to be' r me this�day of ��(/1 S� , 20� CAROLINE M MACARTHUR Notary Public-State of New York r NO.01MA6384635 Qualified in Suffolk County My Commission Expires Dec 17,2026 Official Notary Public Signature and Original Notary Stamp Page 4 of 4 f snrrr„ TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 quo?-c2--a fo INS" PECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN ) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: S a—le i o/7 vae bousezoc �n e DATE /G '0 - INSPECTOR fi r //� � i� IIIVIIII� / 1 r r� r a WOWdtlfl4"�WY�11YfiblJ��;. rt f t � f y , Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P. O. Box 1179 Southold, NY 11971-0959r dp m " f,owY 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 Professional goal re aired for Architect or Engineer Licensed Home Inspector midst Provide coRy of valid current certification Rental Property SCTM Number: 0 �- 2 . - Z - Rental Property Address: 3b, z`` 1 ✓' Owner/Name: Rental Dwelling Unit Identifier: Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 -100 sqft., 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 Pro Maintenance Code of New York State and the Energy Conservation Construction Code of Ne Print Name and Title O' a Please place Professional Seal: ` Cy f 7;>9-C`I r�OFrss,0a" SCTM # TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET _ VILLAGE DIST SUB LOT ACR. REMARKS TYPE OF BLD, PROP_CLASS _ I LAND IMP TOTAL DATE - _ g - FRONTAGE ON WATER HOUSE!LOT BULKHEAD TOTAL a two 4 -, -- I I I --� i t i 3 4j, I I M. Bldg Foundation f --- Bath _FIle - a Extension I Basement Floors Exterwon _ Ext. Walls �� Interior Finish _ _ �� Extension I � Fire Place Heat - a - e r Po chAttic 0 -43 ' i Porch Rooms I st Floor 1 I Patio Rooms 2nd Floor # I Garage rDriveWay f FORM 140. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerks Office Southold, N. Y. Certificate Of Occupancy No. 443.1.8. . . . . Date . . . . . . . . . . . . . . .44g .9 . . , 1971 . THIS CERTIFIES that the building located at W/S. gigs; .Read. . . . . . . . . . . Street Map No. zi . . . . . . . . . Block No. . .XX . . . . .Lot No. . . . . .E+s# t mien. - -jjj,. . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . .Jul-Y . . . 13 ., 19. 71. pursuant to which Building Permit No. . dated . . . . . . . . . . .Jxay. . . .15., 19. .71, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . .Private. one-family. dwelling . . . . . . . . . . . . .. . . . . . . . . . . The certificate is issued to .Philip. A.Marla. onti. . . . .okmers. . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval x R HOuae # 3825 Building I ecto FORK NO.2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5402 z Date .............................. .... 191.1- Permission Is hereby granted to: 11�42PJIMIA-AA M......... ......................Will Morw.............................. .......................................................................... to ....................................... .......................................................................................................I .................................................... atpremises located at ............W.At"JI-JIM&.............................................................................. ......................................................... Wk .......................I....................................... ......................................................................................................................................................--.... pursuant to application dated ..........................jl*U.........IS.......... 19."..., and approved by the Building Inspector. Fee ............. . ....... ......... Building llI I FORK}NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy 11,I No. . .Z-17.7.22 . . . . . . . . Date . .3anuaxy .30, .1989 . . . . . . . . . . . . . . THIS CERTIFIES that the building . . . . .ONE FAMILY DWELLING Location of Property . .38 STARS ROAD EAST MARION, NEW YORK „ . . . House No. Street f atnlet County Tax Map No. 1000 Section . . .?? . . . . . . .Block . .2 . . . . . . . . . . . .Lot . . .26 . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Buildinc Permit heretofore filed in this office dated July 17,. .I„961 . . „ . pursuant to which Building Permit No. .1497Z . . . . . . . „ . . . . . . dated . . August 1,. ` . . . . . T y „ w w e 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 DECK The certificate is issued to . . . . PHILIP FRUMENTZ & MARIA ELENA FRUMENTI . . . . . . . (owner, &jWmq of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . .N/.A . . . . , . „ . . . . . . . » . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . .N4A . . . . . . . . * % . . . . . . . . PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev.1/a1 a FORK No. s TOWN OF SOUTHOLD BUILDING DEPARTMENT Towel Clerk's Office Southold, N. Y. Certificate Of Occupancy No.70127 . . . . . . Date . . . . . . — . . . 26 . . . . . .$®Pt . . ., 19-74 THIS CERTIFIES that the building located at W/.S. At4ro-110A . . . . , . . . . . Street Map No. .XX . . . . . . . . Block No.XX. . . . . . .Lot No. . . . . .East,t►anion x.Y conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . .)*Y. . .U. ., 19.73. pursuant to which Building Permit No. .b 5874 dated . . . . . . . . . .gay. . .22. . . . .. 19. 73, was issued, and conforms to all of the require. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . . . . . . . . . . . The certificate is issued to .?44P, Frwwlmti, Qwnor . , . , . a , m r . . w (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R. I . . . , 1 . „ . . I . . , , . . , . . UNDERWRITERS CERTIFICATE No. N1 1.1 ob83. . . . . Aug. . 22 . .197.3. . . . . . . . . . . . . HOUSE NUMBER . . . 825. . . . . . Street . . . .Stars Road. * w w . . , "' . . . . . . . . . . . . . . . . Buildin��4 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk'a Office Southold, N. Y. Certificate Of Occupancy No. Z. Date . . . . . . . . . . App. . 23. . . . . 197- THIS CERTIFIES that the building located at . . N/8 . .Bt"g.P,*.. . . . . . . Street Map No. =. . . . . . . . Block No. . -X=. . . .Lot No. Alt. . iaNt• Masl.Qa • •1•x•. . . . . . conforms substantially io the Application for Building Permit heretofore filed in this office 11�' dated . . . . . . . J . . . .1g. . . ., 19.'J1. pursuant to which Building Permit No. .94p39 dated . . . . . . . . . . .A4. . 1.Y . ., 1971. ., was issued, and conforms to all of the require. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . P,�irha puttah �i0+ es�ol�► b1o>Sldta�} . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to p2,Zf!.1*11@Mti.& 1S.. . . . . .WSW%. . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .#.*A f. . . . . . . . . . a . . . . n . . . „ , „ . „ . . , . . UNDERWRITERS CERTIFICATE No. . . , .lag,* . . . . . . . . . . . . . . . . . . . . . . . . „ . . . . . , — „ . . . HOUSE NUMBER. . ,382 ". . . . . .Street. . . . . . .atar!s . . . . , . . . . , . . . „ „ , „ . . . . . . . . . . . . . (,. .7—L Building Inspector lit Town of Southold 7/25/2024 W P.O.Box 1179 53095 Main Rd Southold,New York 11971 ........... ...... ............. CERTIFICATE OF OCCUPANCY No: 45392 Date: 7/25/2024 .............. THIS CERTIFIES that the building AS BUILT ALTERATION ............. ....... ................ Location of Property: 3825 Stars Rd, East Marion SCTM#: 473889 Sec/Block/Lot: 22.-2-26 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/11/2024 pursuant to which Building Permit No. 50437 dated 3/15/2024 ............ 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: '"as uilt" finished basement toe 4,P P-Lle—d forry �xistin�sin t.e..-fa m.,ily d,,yelli The certificate is issued to Grassle, Samantha&Palacios, Luis D ..... ...... of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ..................... ELECTRICAL CERTIFICATE NO. 50437 6/8/2024 PLUMBERS CERTIFICATION DATED 6/11/2024 Bu 's Reliable, Inc. -- --------- ......... .. ......... � th r* ZSignat:t { j � C N � | � - � t � � « - !p ;f C tau z)Na & ::._ -. . . lat5E - . % 22 # LNMROOM § - - J Qsr AffMOMMIL ! mG&. � »�� 0« _ K- , ,� . Q omrm - ^ l nun+ m HR ■P / < & / 5c . SHEET NO: . \ —2 M C H At» r 77.1 FLOOR ABOVE ---- SHEEP-ROCKED ----- - ---------- -- t o COUNG GRADE R211NSULATION 4 S A 3 z 2X4STUDWALL Q` _>______---- -------------- �+ O CAAUWALL R13INSULATION �£ 4 __ -------- - --- W �p �'-- 1/2-DRYWALL uvuaunra m¢ow.m.+ {'� pp Zin EPDXY COAT OVER ' N COtdC.SLAB wAM PARTIAL SECTION SCALE:VY'-I,-(r F BASEA+tENT PLAN N~Vv DRAWN BY:MH Fx3i'rtNt,�it��SE �= SCALEf P6' �� 3/13/2024 c SCALE:SEE PLAN u � SHEET NO: A-1