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Home My WebLink About1000-56.-5-6 TOWN OF SOUTHOLD Rental Permit - 1209 Owner Eftihia Tsitiridis Occupied as Single Family Dwelling Located at 345 Budds Pond Rd Southold 56.-5-6 Maximum Permitted Occupancy 6 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. 10/8/20247"�, 2 Code fo c� gent C} c= This Notice must be posted by the main entrance at all times TOWN OF SOUTHOLD—BUILDING DEPARTMENT � d P. O. Box 1179 Southold NY 11971-0959 � Town Hall Annex 54375 Main Road � Telephone (631) 765-1802 Fax (631) 765-9502 ht as:,// . outholdtownn tl U l5 ° B ? 24 RENTAL PERMIT APPLICATION gulldtng Town of Southold Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address F-C�S�' Tax Map Number: 1000 SECTION -BLOCK -LOT -- Aq-?D68 '!�) � SECTION B. OWNER INFORMATION: p Property Owner Name: T Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) -.-4 o2, 2 a -�13 Pj 21 Telephone Number (s): Daytime Evening Emergency Property Owner Email Address: � ► �° r i c i , cam + 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 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: 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." Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: 1— W Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: 2,30 14F- e g 2 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 ❑ 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) ) COUNT F SUFFOLK) 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 1 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: k I �1 Property Owner's Signatur 4.. Sworn to before me this day of _- Official No arV u ic igna are and Original Notary Stamp George C Lazarides Notary Public, State of New York Reg. No. 01 LA4930290 Qualified in Suffolk County Commission Expires May 9, 2026 Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. - [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ MENTAL REMARKS: �P O DcG v DATE • /o• �' INSPECTOR P fat Town Hall Annex Town Of Southold 54375 Main Road c� Rental Inspection Report PO Box 1179 Vq ZL- a; ua Southold, NY 11971-1179 Tel: 631-765-1802 SUM# �`�� Date 49 Owner '� .�'Cl Phone Address .... .�� ... ��. .. ..��....w....�.�.� . .�Visible _wmm..... ._ _. ., ._...w �-- — p. - . .., .. ....... Hamlet Ins ector Floor Level Quantities .�.. .. -...._ _ ........... .. .._ ..... Sub 1 2..... 3 Smoke Detectors(not located in bedrooms) / Carbon Monoxide Detectors Fire Extinguishers .... ..Exits. .... ..N...... ..� _...w.w..._ M. ... .... ..w.. ... .... ...._. . .. 1.. ...11 .w. Bedrooms 1I 23 4 5 6 Smoke Detectors Xt� I Egress ✓ OccupantCount. �..... ... ....._ _.. _... ,...�. . .�_. _ ., `' . ... ......... ........ _ .. .�.., ._..... . Building S Operational Systems Maintained &Optil Condition of Property Heating ._ ..._ Building interior Hot water Building exterior Electrical Property clean, maintained &safe E _.. _. .. .� .,. . ,e ,c,le .i .w .... Mechanical Handrails&guards installed &secure Pool Safety ..�. -..�.,... i Pool on Site Surface water alarm Date of CO issuance Door alarms latching gates Pool completely enclosed e�lf�closin - ..l�. � ._....�._ .... _.. -_. .- ..-.w b. .__� .�� .... ...�....- _�.�._......� ..w. .. ...� ........, -m._..._ .��... �..._�......� p Y � g/ t g g es _ Pool fence to code requirements O's for all it {Prior Rental ............. . tems presen.. ................w.........._....._. .. _.. .__ _ ......... ........ _......._.... . ..... .__ ..... ._... �..Comments: ....- .. ... �.................................. ... ........ �.....��.��_..�.-....._. .�.�w........�.... �� .. ........ . .. ..._..._...... .� �_. m�...... .� �.... . ..w .._. .._._ . �.�..._. .. ...M.... �..... ......... .. ._.. .._� . ... ._..... .. ....._.�....... ........ .__ .�_ ....... .. .... .... . ...... .. .._.. �.,� F f J I TOWN OF SOUTHOLD PROPERCARD OWNER 4STREET -- VILLAGE ID ST. SUB. , _ LOT a _ s t , E ACR. E S W TYP E BUILDING Y . 3 .j RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP, TOTAL DATE REMARKS F t _ _ a r : i x AGE BUILDING CONDITION , NEW NORMAL BELOW ABOVE �¢ FARM Acre Value Per r Volue Ac re ! Tillable FRONTAGE ON WATER I i = Woodland FRONTAGE ON ROAD Meadowland f DEPTH E House Plot BULKHEAD Total DOCK h , � F LU I's cc LU t� ,o k Cs 1 g yea w ' .... ...........� µ ( i 24 IL ui 4, � I )e s OA .f p4 wr „ d F- LL uj m r a I 1 " 1411,11UY ", r..._....... 1 C r Id V f 1 ( v I f { , e r r I j N� v h f r f ff ( II I 7 � � I f r I n r .r_ e lit C.L f F fY Cad r ur a { f C7CO LL I V 1 m e J 1 4Y r. I C a � [ 3 I I LL m r w ii m l f l i / 8JIS r r r V� u I t7 0 yy ry µ o o { 4nro m w�i j o car �i s. C C —C IN LLJ FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . . . .Z 16903 Date . . . . . . . May .24., 1.9.88 . . . . , , . . , . . . THIS CERTIFIES that the building . , one-family dwelling . . . * . * . . » µ . . . . . . . ^ » » Location of Property . . » » . µBudd's Pond Road Southold fAamrxr No. Street Hamlet County Tax Map No. 1000 Section . . . . .S6 , . . -Block . , . . . .5 . . . . . . . .Lot . . . . .6 . . . . Subdivision . . . . , willow Point . . . . Filed A4a No. 4652 4 p .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated July, 24, 1987 pursuant to which Building Permit No. . . . . 16275Z . dated . . . . . . 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 decks. The certificate is issued to . . . . „ , , , , MARTSSA & IVAN TOIC of the aforesaid building. Suffolk County Department of Health Approval . . .87-So-l28, . . „ . .Mar. . l 8, 1988. . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . .N524059. . . . . . . . . . . . . . . . . . . . . . . . . „ , „ „ , , , , 4 „ „ . . PLUMBERS CERTIFICATION DATED: Henry J. Stitith & Son, Inc. May 10, 1988 Building Inspector» » » » » » µ . Rev.7/81 IFQt, :.o. Town of Southold 5/24/2024 . `: P.O.Box 1179 ., 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45203 Date: 5/24/2024 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 345 Budds Pond Rd, Southold SCTM#: 473889 Sec/Block/Lot: 56.-5-6 Subdivision: Filed Map No. _ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/24/2023 pursuant to which Building Permit No. 49304 dated 5/24/2023 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: access ; :& n i iat rrol f nc d to code a for The certificate is issued to Tsitiridis,Efthia of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49304 04/04/2024 PLUMBERS CERTIFICATION DATED t ri. d ignaturo 1C Town of Southold 9/20/2019 P.O.Box 1179 53095 Main Rd ` Southold,New York 11971 W CERTIFICATE CAT OF OCCUPANCY No: 40713 Date: 9/20/2019 THLS CERTIFIES that the building DECK Location of Properly: 345 Budds Pond Rd., Southold SCTM#: 473889 Sec/Block/Lot: 56.-5-6 Subdivision: Flied Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officd dated 5/8/2019 pursuant to which Building Permit No. 43752 dated 5/15/2019 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: DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Mamrack MD Rev Trt&or of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 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