HomeMy WebLinkAbout1000-80.-2-1 g� TOWN OF SOUTHOLD
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Rental Permit
1194
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Owner DiSalvo Family Irrv. Trust
Occupied as Single Family Dwelling
Located at 455 W. Shore Drive Southold 80.-2-1
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.
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9/9/2024 aik
de r� r°c � Official
This Notice must be posted by the main entrance at all times
kra �,
° �0 TOWN OF SOVTHOLD— BUILDING DEPARTMENTpo
Town Hall Annex 54375 Main Road P. 0, Box 1179 Southold,� l 7 9 a9 �
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Telephone (631) 765-1802 Fax(631) 765-9502 litt., S://www,S(';Litlaa, ')t(�nti .gov
RENTAL PERMIT APPLICATION 'J"I°�"
Rental Permit Fee 300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Ss Ly£si 5�464-f- be, 5o L,,4k, 1 hctl l
Tax Map Number: 1000 SECTION U SO -BLOCK_ (9 O"Z -LOT 001 www_
SECTION B.
OWNER INFORMATION:
Property Owner Name: 'D) ==� 7 �s
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot/(be the same as Rental Property Address) Q
V "ru(c rl( 1�n� a z�u"a �a�f y�Tot C IAe— /D 1V6
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Telephone Number (s): Daytime ' Rti�3 Evening— Emergency,
Property Owner Email Address: wwc - (a-C) e-- (22-
Page 1 of 4
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179
Southold,NY 11971-0959
_24
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION INSTRUCTIONS
Effective September 271h 2023
Rental Permit Fee: $300 (Application must be renewed every two years)
The items listed below are required to be submitted with the completed
application.
Floor plans: Floor plans of each rental dwelling unit, please show location of all
smoke & carbon monoxide detectors.
Certificates of occupancy and Pre-Certificates of Occupancy: Certificates of
occupancy or Pre-Certificates of Occupancy for each rental dwelling unit.
Certification of Code Compliance (form enclosed): Must be submitted by a
license architect, engineer or license home inspector if an inspection by Town of
Southold Inspector is declined.
Rental Permit Fee: $300-00
e- 4i5-7 U r--f-7
2 6 2-C . 7S-1 a
Town Hall Annex ° �; Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 �
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information: ,Q
Name of Authorized Agent of dwelling unit, if any: elo-ro4-4/7 1 I1
Address of Authorized Agent(no P.O. Boxes): /V� Ile�a iL Ci
Mailing Address of Authorized Agent: S
Z 0-'.
Telephone Number(s): Daytime '76� WW� Evening Emergency &
Email Address: aar : —0��
Section D.
Managing Agent Information: /-/ L
Name of Authorized Agent of dwelling unit, if any: /� �� r,4
Address of Authorized Agent(no P.O. Boxes): °2�SS6 w Q IUG, `v/ Il 9'3
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Ll 4 1s Evening Emergency
Email Address: Kam. 1rec0 r i Co( ")ro.n C4
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
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: a
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: W
7'2—
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
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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.
I am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
0 1 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 lam* )
COUNTY OF S^i - )) ��1�Qfi14ti�
CFt f4U+Av$r 7l i�b
1 , 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:
Property Owner's Signature: � .
Sworn to befo this a day of WMAL , 20 c
Official Notary Pu lic Signature and Original Notary Stamp
4 JACK CONSTANTINOPLE
NOTARY PUBLIC
STATE OF CONNECTICUT
MY COMM. EXP 08-31-27 Page 4 of 4 y"
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� "'�VN =T631-765-1802
H+CLD BUILDINGDEPT.
W ,
INSPECTION
[ ] FOUNDATION 1ST/ RERAR [ ] ROUGH PLBG. -
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ]PFIRE
AL
FIREPLACE & CHIMNEY [ SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL 7RENTAL
[ ] CODE VIOLATION [ ] PRE C/O [
TOWN OF SO!UTHOLD BUILDING INEPT.
631-765.1802
IN S P��T I � N
[ ] FOUNDATION 1ST { ] ROUGH PLBG.
[ ] FOUNDATION 2ND { XFIRE
ATION/CAULKING
[ ] FRAMING / STRAPPING {
[ ] FIREPLACE & CHIMNEY [ AFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANX(FL)
ION
[ ] ELECTRICAL (ROUGH) { ] ELECTRICALCODE VIOLATION [ ] PRE C/O [ L
REMARKS:R S:
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DATE INSPECTOR ,
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Extension - _ ��..�- � � � Basement F Lit = Floors
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Extension Ext. WallsF,. Interior Finish.
Extension - Fire Place Neat
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Roof Type
Porch Rooms 1 st Floor -
Breezeway Patio Rooms 2nd Floor
Garage Driveway Dormer
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TOWN OF SOUTHOLD PROPERTY RED
OWNER- STREET 1 VILLAGE DISTRICT = SUB. LOT
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FORMER OWNER = N E ACREAGE
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RES, - ' SEAS. VL. FARM COMM. i IND. CB. MISC. Est. Mkt. Value
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LAND € IMP. TOTAL I DATE REMARKS
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AGE BUILDING CONDITION 74 E
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NEW NORMAL BELOW ABOVE ; FRONTAGE ON WATER
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Tillable 1 BULKHEAD
Tillable 2 I DOCK
Tillable 3 t
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Woodland
Swampland
Brushland ;
House Plot
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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 Z19788 Date MARCH 13 1991
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 455 WEST SHORE DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 080 Block 002 Lot 001
Subdivision REYDON SHORES Filed Map No. 631 Lot No. 5
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 18 1990 pursuant to which
Building Permit No. 18976Z dated. A:PRIL 24 1990
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 LADED TO INCLUDE DECK. Z.B.A. #3900
The certificate is issued to SALVATORE & ARLINE DI SALVO
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-120 JAN. 23 1991
UNDERWRITERS CERTIFICATE NO. N174032 FEB. 13 1991
PLUMBERS CERTIFICATION DATED TRT PLUMBING MARCH 1 1991
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Building Inspector
Rev. 1/81
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BL OCK ��0.. CERTIFIED IED ro,
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TOWN OF SOUTHOLD ° eIw
SUFFOLK COUNTY, N.Y.
1000 - 80 - 02 - 01
Scale Y' = 20'
A49 18
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Dec. 10, 1990�1 3. r,u: ° ( C7 Q ;" P.C.
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Southold Town Board of Appeals
MAIN ROAD - STATE ROAD 25 SOUTHOLD. L.I., N.Y. 11971
TELEPHONE (516) 765-1809
APPEALS BOARD
MEMBERS
GERARD P. GOEHRINGER,CHAIRMAN
CHARLES GRIGONIS, JR.
SERGE DOYEN, JR.
JOSEPH H.SAWICKI
JAMES DINIZIO,JR.
AR
ACTION OF THE BOARD OF APPEALS I .„ -
Anpl. No. 3900
Matter of GERHARD SCHREMMER. Variance to the Zoning
ordinance, Article XXIV, Section 100-244 B, for permission to
construct aone family dwelling, proposed construction will have
insufficient-front and side yard setbacks, lot has insufficient
width. Property Location 1380 Oak Drive, Southold, County Tax
Map No. 1000, Section 080, Block 02, Lot 001.
WHEREAS, a public hearing was held and concluded on February 1,
1990 in the matter of the Application of GERHARD SCHREMMER under
Appeal No. 3900; and
WHEREAS, at said hearing all those who desired to be heard
were heard and their testimony recorded; and
WHEREAS, the Board Members have personally viewed and are
familiar with the premises in question, its present zoning, and
the surrounding areas; and
WHEREAS, the board has made the following findings of fact:
1. The premises in question is located along the
southeast side of Oak Drive, Town of Southold, and is identified
on the Suffolk County Tax Maps as District 1000, Section 080,
Block 02, Lot 001.
2. This is an application for Variances from the Zoning
Code Article XXIV, Section 100-244 B, for permission to
construct a one family dwelling, proposed construction will have
insufficient front and side yard setbacks, lot has insufficient
width.
8
Page 2 - Appl. No. 3900
Matter of GERHARD SC
HREMMER
Decision rendered February 15, 1990 Zfi .•w
' s ..
3. Article XXIV, Section 100-244 B, A nonconforming lot 1,
separately owned and not adjoining any lot or land in the same
ownership at the effective date of this Article and not
adjoining any lot or land in the same ownership at any time
subsequent to such date may be used, or a building or structure
may be erected on such lot for use, in accordance with all the
other applicable provisions of this chapter, provided that proof
as such separate ownership is submitted in the form of an
abstract of title showing the changes of title to said lot,
which abstract shall be in the usual form, shall be certified by ,A'�
an attorney or a company regularly •doing such work in Suffolk , ``
County or by a corporation duly licensed to examine and ensure '
title to real property in Suffolk County and shall contain a .
certification that no contiguous property was owned by an owner w
of the property involved since the date of any previously
applicable Zoning Law. Such lot shall be granted relief for
front side and rear yard dimensions as follows.
4. The subject premises for the proposed house is known
and referred to as being 35 ft. from the south property line, 10
ft. from the east property line and 27 ft. from the west
property line. The house will be 28 by 40 ft. and contain
11% of lot coverage, approximately 0,673 sq. ft.
5. In considering this application, the Board finds and
determines:
(a) that the circumstances of this application are
uniquely related to the premises and its established
nonconformities; ;
(b) that there is no other method for appellants toCNJ
pursue; and placing the proposed one family dwelling in any
other location on the premises will require other variance
i.
relief;
(c) that the are chosen for the one family dwelling is not ......
.,_ Fw
unreasonably located;
(d) that the variance will not in turn cause a substantial
effect on the safety, health, welfare, comfort, convenience
and/or order of the Town;
(d) that in carefully considering the record and all the
above factors the interests of justice will be served by
granting the variance, as applied.
Accordingly, on motion by Mr. Goehringer, seconded by Mr.
Dinizio, it was
a
Page 3 - APpl. No. 3900
Natter of GE A' D SCHREMMER
Ddcision rendered February 15, 1990
RESOLVED, to GRANT a Variance in the matter of the
application of G M ARDSC; ER as applied under Appeal ppeal No.
Vote of the Board: Ayes: Messrs. Goehringer, Grigonis and
Dinizio, (Absent Serge Doyen and Joseph Sawicki) . This
resolution was duly adopted.
df
GER p. GO; R INGl-R, C�1
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THE NEW YORK BOARD OF FIRE UNDERWRITERS �Ai*; ?
1
SUREAU OF ELECTRICITY
85 JOHN STREET,NEW YORK,NEW YORK 10038
FA:5I�CIAIIY 1 3, 11-61
Dare 7)22pfi3O/yo
THIS CERTIFIES THAT plrl€ratinn NO,on file
jf l'1 C if
4
Only the a#eatrica!equipment as described below and int roduced by the applicant named on the above application number in the premises of
11. > c 3-g i,,AK ItltlTJk;: l>JY'r i.�, sry4'�[l;x(r�111, N,Y.
in lArjo Lou inq location; Basement L! Is!Fl. {)ilg`
ta*aa€€*rsxmineri aN
A'f;1+t2t1�Fy i15,19gf 2nd Fl. Aiertian
andjoundtobeincwnpliartecuith the
reyuirarrxentxu i Block
Lot
FIXTURE
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OTHER APPARATUS:
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GENERAL MANAGER t
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This certiflcote must not be altered in*0)p manner;return to the office Of the Board if incorrect. inspector.
COP ynroy be identified by their credentiolsm s
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MAW ROAD
� � f SOLPMOLD, N Y. 119n
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No ' Z-21169 Date NOVEMBER 20 1992
THIS CERTIFIES that the building ACCESSORY
Location of Property 455 WEST SHORE DRIVE SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 80 Block 2 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 22 1992 -----Pursuant to which
Building Permit No._20667-Z dated MAY 29 1992
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 SHED IN REAR YARD AS APPLIED FOR.
The certificate is issued to SALVATORE J- DiSAL O
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICAATION DATED N/A
Xui;l.ding Inspector
Rev. 1/81
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