HomeMy WebLinkAbout1000-87.-3-30 TOWN OF SOUTHOLD
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y
ental Permit
Permit No._ 0332
Owner Peter & Stephanie Cosola
IT
Occupied as Single Family Dwelling
Located at 425 Opechee Ave. Southold 87.-3-30
Address Village S/B/L '
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. \
8/20/2020 John Jarski
Date of issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
•^
Telephone(631)765-1802
Town Hall Annex ;'>R•, Fax(631)765 9502
54375 Main Road
P.O.Box.1179
Southold,NY 11971-0959 4.
9URDIN43 DEPARTMENT
TOWN OF SOUTHOLD
RENi'AL PERK[APPUCATION
Rental Permit Fee$200(Applkatfon must be renewed every twa years)
Section A.
Property Information:
Rental Property Address:
1
Tax Map Number: 1000 SECTION
SECTION B.
OWNER INFORMATION:
Property Owner Name:. �! 2
Property Owner Legal Address: Property Owner Mailing Address:
- V
-
Telephone Number(s): Daytime -/°7,)-�.I_Avening Emergency _
Property Owner Email Address. C So 1,4 i V
_
MAR - 6 2020 Page of 5
Town Hall Annex ` Telephone(631)765-1802
54375 Main Road
' Fax(631)765-9502
P.O.Box l l79
Southold.NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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):
Page 2 of 5
Telephone(631)765-1802
Town Hall Annex t-
' Fax(631)765-9502
54375 Main Road
P.O.Box 1179 �•
Southold,NY 11971-0959
.C�UII I'+•
13 ILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: -
Telephone Number(s):Daytime Eve niRB_ Emergenly _
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental DweHIng Un is on property:,
For each Rental Dwelling Uni
t let forth the Rental Dwelling Unit identifier(for example,
Unit 1, Unit 2, Unit 3 or Apt A,�,Q the use of each room in the Rental Dwelling Unit
(for example,Kitchen,Bedroom 3, 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: _
Use and Dimensions of each room in Rental Dwelling Unit:
��r aosu ®iPg/v
r ,
Page 3 of 5
Town Hall Annex [
Telephone(63))765-1802
54375 Main Road , Fax(631)765-9502 ,
P.Q.Box 1179
Southold,NY 11971-0959
ILDINO DEPARTMENT
wlv OF SSOUTHOLD
SECTION G.
INSPECTION:
f
Pursuant to the Town Code of the Town of Southold Chapter 207(Rental Properties),a safety
inspection by Code Enforcement Off cial is required. if the owner chooses not to have said
inspection performed by the Town, .certification from a licensed architect,a licensed
professional engineer or a home insl lector who has a valid New York State Uniform Fire
Prevention Building Code Certificatic n is required stating that the property which is the subject
of the rental permit application Is in:ompliance 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 Yor State hire Prevention and Building Code Council.
0 1 am requesting a fire safety i sp.ection to be performed-by a Code Enforcement Official
from-the Town of Southold
0 I am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
SECTION H.
DECLARATION: Signature must b notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SU OLK)
1 _
ertify under penalty of perjury,the following:
]. I am the owner of the prope 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 1 understand the own will use the address for service pursuant to all
Page 4 of 5
"* 765-1802
Town Hall Annex � Telephone(631)
Fax(631)765-9502
54375 Main Road
P.O.Box 1179
Southold,NY 1 1 97 1-0959 y;� [
BUILDING DEPARTMENT
rJN3W v OF SOUTHOLD
applicable jaws and rules. 1 f.irther acknowledge that I wi11 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 wits notify the Town within f ve (5)business days as to any change to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name:
Property Owner's Signature:
Sworn to befor a this day of �G 20 0
� yv -
Official Nota Public Signature and rTginal Notary Stamp
REBECCA A 4UCAK
Notary Public-Sty a of New York
No.01 LU6386882
Qualified in Su folk County
My commission Exp es Feb.04,2023
Page 5 of 5
rtsf so qlr<OP"Att AV.-,'f C74AVU
# TOWN OF SO`UTHOLD BUILDING DEPT.
•
°`ycourm,�F`' 765-1802
INSPECTION ,
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ;]' FOUNDATION 2ND [ ] INSULATION/CA KING, l
[ ] FRAMING /STRAPPING [ ] N A L
[ ] FIREPLACE-& CHIMNEY [ ' FIRE'SAFETY INSPECTION —
{ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANI-RENETRAT-ION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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�guFFOt,��OG Town of Southold 8/20/2020
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a y� P.O.Box 1179
0
o�- 53095 Main Rd
Southold,New York 11971
CERTIFI ATE OF OCCUPANCY
No: 41371 Date: 8/20/2020
THIS CERTIFIES that the building ALTERATION
Location of Property: 425 Opechee Ave.,�outhold
SCTM#: 473889 Sec/Block/Lot: 87:3-30
Subdivision: Filed Map No. L-ot No.
conforms substantially to the Application for juilding Permit heretofore filed-in this office dated
12/2/2003 pursuant to which Building Permit No. 44627
P � g dated 1/28/2004
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:
Alterations to an existing one family dwelling_as applied for as per ZBA#5648 approval dated 02/03/2005
The certificate is issued to .Cosola,Peter&Stephanie
= - of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 2052781 07/08/2005
PLUMBERS CERTIFICATION DATED 02/28/2020 NNituck Plumbing
A tho 'z d Signature
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