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HomeMy WebLinkAbout1000-70.-8-52 of so SOWN OF SOUTHOLD
Rental Permit
1250
Owner: Joseph D'Esposito , Tara D'Esposito
Occupied as: Single Family Dwelling
Located at: 80 Clearview Ave W Southold 70.-8-52
Maximum Permitted Occupancy: 4
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.
Issued: 01/21/2025 )&;17=
Expiration: 01/21/2027 cod ment 0
441
This Notice must be posted by the main entrance at all times
x b"f�C,t ^w
AV 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 httg�'Sw//N w .tau iloLti,t�Na LIKly.,gov
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
CIFARV ICW AVt: wC-s-r,. :SouAt-ed
Tax Map Number: 1000 SECTION q73 881 -BLOCK -LOT V - 5 2-
SECTION B.
OWNER INFORMATION:
Property Owner Name: � T11 �� os fro
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
VtiAb IZ- K . SAMr- As � L.
1
Telephone Number (s): Daytime blq-852-7113Evening Emergency b3t-561'752-6
Property Owner Email Address: U O 25AN19 r,
.� Iocto
Page 1 of 4
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179
Southold,NY 1 1971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION INSTRUCTIONS
Effective September 27th 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
f
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: 4u AL
Address of Authorized Agent (no P.O. Boxes): (b M Ah QD M&T'rl C
Mailing Address of Authorized Agent: C
K.
Telephone Number (s): Daytim 31 `6 ,- 6l Evening Emergency
Email Address: �C.A13gp.L FX LR G . Cam
Section D.
Managing Agent Information: NIA
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. N/A
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: 1_
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: U 0 1-r
Requested Maximum number of persons allowed to occupy Dwelling Unit: 3
Number of rooms in Rental Dwelling Unit: O (to(—"W4 G pT V 4.......A614)
Use and Dimensions of each room in Rental Dwelling Unit:
5M R
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 afire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
31 I am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
Page 3 of 4
a �
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
}
COUNTY OF SUFFOLK)Jos
I 14 (7,FS- pos 1T0 , 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: OSEQ►�
Property Owner's Signature:
Sworn to before me this -day of , Q fdkkr�" 204
.
f ici l cat Public Signature and Original Notary Stamp
MARA M ZONDERMAN
Notary Public-State of New York
NO.01ZO6370215
Qualified in Suffolk County
My Commission Expires.w __w _,,,,,,
Page 4 of 4
Town Hall Annex Telephone (631)765-1802
54375 Main Road p
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 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:
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:
0 SSO
TOWN OF SOUTHOLD BUILDING DEPT.
en 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 [ 4-IR- ENTAL
MATE l INSPECTOR
s
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPEOCTION
[ ] 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 [RENTAL
REMARKS: 0&NU,
/ s
Dec 21 , 2024
Town Hall Annex W ° Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Pro esirral secrl rewired car Architect ar F freer llensedcrrle itas actor rrlst rovide
copy of valid current certi cation
Rental Property SCTM Number:
Rental Property Address: 80 Clearview Ave West., Southold NY 11971
Owner/Name: Joseph Des osi,,to
Rental Dwelling Unit Identifier:
Number &Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 -100 sq., Bedroom #2-90 sq., etc.)
Bedroom #1 145 S ft Bedroom #2. 145 s ft
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, and the Energy Conservation Construction Code of New
York State.
Victor Cornelius III CEO Inspector
Print Name and Title ceo# 1216-0283 Original Signature
Please place professional seal:
yam,,
TOWN' O�.._SOJT0LD PROPERTY RECORD
CAL
SUB LOT. R LADE
C
FIRMER OWNER" 7" -6' �� �"a� N E / AC �y� t
W 6' d� r� d �� � � ,�m ✓i of r�r�,r ,,;� d=�, /� �'�Cr o fd �r�" :, _W,,.,...�...,
TYPE OF BUILCIh1C
SEAS. VL. FARM CO
�.�...,.tAND IMP. TOTAL DATE.._ MM. �.,B MISC Mkt. Value
,.._ ......_ ._...,_,.._.�... .._wm
REMARKS
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FARM Acre Value Per V I e
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_,......_. ..,,,..,_,. ,.., _ _... ._........ f m_
Tillable 2
Tillable 3
Woodland4.
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FRONTAGE AGE ON ROAD
DEPTH
House Plot
BULKHEAD q r
Total f DOCK
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COLOR.., 8 ..... _.;
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Foundation------
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Base
Extension � � � � „� Floors K.
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Extension Walls Interior Finish LR.
.✓ ` Place . . :.�°� t...�w�....�..,.
Extension _ r Flea... M.m_.. F u DR.
......,r.,...w. .. .._,,,_�.._.�..�....� � �.w_.�jType Roof _... .,. ...... ....._
Rooms 1st Floor BR.
Porch Recreation Room Rooms 2nd Floor FIN B.
Porch 'Dormer
Breezeway Driveway
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O. B..B.._._,w _. _.. ......._.. �._.
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a.
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��1Flel Town of Southold 3/16/2024
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OIL OCCUPANCY
No: 45053 Date: 3/16/2024
THIS CERTIFIES that the building AS BUILTDECK
Location of Property: 80 Clearview Ave W, Southold
SCTM#: 473889 Sec/Block/Lot: 70:8-52
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
p m37 dated 2/6/2024
�l/16/2024 pursuant to which Building Permit No. 500 mmmm Ymµ.
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 built"deck addition to xistin in g:faniily dv llin as appla (if rµ_
The certificate is issued to Tandy,Tara _ww.................._...w _ .__......._.......www .. ..._.w_ _ _.._ ._. a
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
o t
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z4185. . . . . . Date . . . . . . . . . . . . .April. . . . 5. . ., 19.71.
THIS CERTIFIES that the building located at . . Bayview•Road•& .Cle i,*VeeU**t
Map No. . .xx. . . . . . . . Block No. . .xz. . . . . .Lot No. X= . . . . Seuthald. • • . .N.Y., • • • • -
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . • .AM& - -30-, 19. .71 pursuant to which Building Permit No. . 4835 L
dated . . . . . . . . . . f'aY. . . . . V -, 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 . . . . Rrivate •one -Easily• dwelling • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . .Anthony. Plylke -&- wife• • • • • • . • • • • • • • . • • . . . . . • • . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval Apr13 . . 14 •197•1• • •by •R. Willa.-
Heues # 16 5 bayview Rd
80 Clearview Ave west. . . . ,
Building Inspector
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 24219 . . . . . Date . . . . . . . . . . . . . April 27 . ., 19-71 .
THIS CERTIFIES that the building located at . .Bayv-jew. Rd A. G1e ew$Wtwest
Map No. . . . . . . . . Block No. .X= Lot No. . mm. . . . .Seuth*U . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . .Nov, . . .zo. . , 19?o. . pursuant to which Building Permit No. . . 5. 059Z
dated . . . . . . . . . . . .)1ev. . . W., 19. 7—p, 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. ate• •(&ccaesery• building). . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . .Anthony. •Pylko• • • • • . . Owner • • . • • . • • • • . . • • • . • • . . . • . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . .1.*R„. . . . . . . . . . . • • . . • • • • .
House # 16 5 B&Yview10 --- "
*arvieu Ave beet
Bu g inspector
FLOORPLAN SKETCH
Botro tt JOSEPH D.AND TARA DEI,3PO$rrO Fde% 4515
Case No,_06-066.0776151—
21, 11911
a0—U—TL±(LL2--.--- ",raw NY
Londoc NAW FEDERAL CREDIT UNIOWDE P1,OF VA
........... ........
24.0'
29.0'
Garage
Uncovered Dock
34,0' 143,
o Family bed
Floor
31,T
Kitchen Pantry Laundry Rec Room
17 I Be" A fail!T i"T
Dining Living Room Bed Basement Area
32 V 325 71--1
ARVA
Coda Description rac"r "Itsiza "'TOW0 Namt 16" a Height X, Wdth -
Aroo
GLAI First Floor 1.0 1488.0 165.0 14800 First Floor 36.5 x 13.5 = 492.8
55MT Unfinished BSMT 1.0 1279.7 164.8 1279.7 34.5 x 20.5 - 707.3
GAR Garage 110 576.0 96.0 576,0 24,0 x 12,0 = 2136.0
Net LIVABLE (rounded) 1,406 3 total items (rounded) 1,488
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