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Home My WebLink About1000-31.-7-2 Rental Permit 1401 Owner: Koba Benidze Occupied as: Single Family Dwelling Located at: 8300 Route 25 East Marion 31.-7-2 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 insylction. Issued: 12/11/2025 Expiration: 12/11/2027 O' s d En rcement Official This Notice must be posted by the main entoceatI 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 litt)s://Nvww.sotatlioldtoNvnn tyo \3\,)\� RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two ears) 7.1 Section A. `� �°T' Property Information: ti ,� Rental Property Address: Tax Map Number: 1000 SECTION --<�- _ . . _ -BLOCK _ LOT '2) - C� SECTION B. OWNER INFORMATION: Property Owner Name: ` °") tY C Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) rd Telephone Number(s): Daytime IZ Evening Emergency Property Owner Email Address: 0 i0 2 Q0 `J (_r_1zahoolcorn Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: <71 t Address of Authorized Agent (no P.O. Boxes): (Q-2-u L"I, 0 l� NY l( q-z( Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: oo �� S . Section D. Managing Agent Information: 6VJYIPX 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. p LAX7V SITE MANAGER INFORMATION: (required for rental properti s 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, 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: cc� mwy �9 �C � Requested Maximum number of persons allowed to occupy Dwelling Unit: Lot Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: ' 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) ) COUNTY OF SUFFOLK) I k®.l�_ i y �_�, 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: K�.q:� eA °e "► f �F Property Owner's Signature: _h/ Sworn to before me this 1 day of . 20a5 Official Notary Public Signature and Original Notary Stamp MADISON MESSINA Notary Public,State of New York No.01 ME6370536 Qualified in Suffolk County �r Commission Expires February 05,20XQ Page 4 of 4 ` DEPT. TOWN OF SOUTHOLD BUILDING 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTAFPERATION ELECTRICAL (ROUGH) ] ELECTRICA ) CODE VIOLATION [ ] PRE C/OTAL REMARKS: ......... . ...... Vl DATE o a INSPECTOR R TOWN OF SOUTHOLD PROPERTY RECORE OWNER� - - STREET VILLAGE DISTRICT SUB. LOT r f FORMER OWNER = N e — E ACREAGE i S W TYPE OF BUILDING o RES. SEAS. VL. FARM COMM. IND. CB. s MISC. LAND IMP. TOTAL DATE REMARKS /u , r =tee :�-)(o00 Or7 O"p 41600 ID 0 1 Z- - AGE BUILDING CONDITION r � • �� a � y NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable 1 Tillable 2 — — Tillable 3 _p s Woodland Swampland ` Brushland House Plot �� e 1, 31.7-2 2/8/2022 31:7-2 9/10 i O s Foundation _ „ �c. Bath � M. Bldg. e.t y y o eL�-O � 2 v Basement ; ! Floors Extension s s` i Ext. Walls Extension K 6v Interior Finish / o , "• � 7s Extension ,. •. 5 , — Fire Place Heat JI Porch Attic Porch Rooms 1st Floor Rooms 2nd Floor — i Breezeway Patio rDriveway s � c,• a t FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERWS OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY November 7 No. THIS CERTIFIES that the building located A ............ Street Map No. .......... Block No. .......fr*A�.....Lot No. ... .... . ..... .. ....... ............--1--1-1- conforms substantially to the Application for Building Pormit heretofore filed In this office june 24 A.-AX0.- dated ......I............................I........... :[q.�P.. pursuant to which Building Amit No. ..... 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 PRIVA17. ONE ]M ILI DWLL11NG...................................... .......... ..... .......—....-1.1--- te;r and Camelia Pyk This certificate is issued to ........................................111—.... ... ...... (owner, lessee or tenant) of the aforesaid 'building. ... ....... ........ Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1115 - Z Date `t t..... ............ Permission is hereby granted to: Peter.. ~-JA-14. .............................................. ........... . t••Rind•...............................I........I..•. l&!!t lurl'+0 ,......,14- u.............. to Built-.an.-adad1-t-1-00 M-an.e sU a.X1 ....................................................... at premises located at ..+ •• A . ..................................................................................................... .. ,a ..... ........................................., ..................».,............ pursuant to application dated ..,»....................... ........go ............. : ., and approved by the Building Inspector Fee $. ,�................... M .. ............. ............... Bull M Inspector x:. tlfWA Town of Southold 12/18/2021 P.O.Box 1179 53095 Main Rd Southold,New-York 11971 CERTIFICATE OF OCCUPANCY No: 42631 Date: 12/18/2021 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 8300 Route 25,East Marion SCTM#: 473889 Sec/Block/Lot: 31.7-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/2/2021 pursuant to which Building Permit No. _ 45941 dated 3/17/2021 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 above- °ound swimmiLag pool,fenced to code Lis ggpligd fctrmm 'The certificate is issued to Benidze,Koba of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45941 5/24/2021 PLUMBERS CERTIFICATION DATED ..._ uth rid d ignature Town of Southold Annex 2/26/2014 P.Q. Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE F OCCUPANCY No: 36787 Date: 2/26/2014 THIS CERTIFIES that the building ACCESSORY GARAGE Location of Property: 8300 Route 25, East Marion, SCTM#: 473889 Sec/Block/Lot: 31.-7-2 Subdivision: Flied Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 5/17/2010 pursuant to which Building Permit No. 35597 dated 6/l/2010 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: n-habijAblo accessMa withg ttic space and covered It r as applied The certificate is issued to Peter&Camelia Dykovitz of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 35597 9/17/10 PLUMBERS CERTIFICATION DATED ..-......._......... � ... _.......ww.,. ..... �_�.._... Signature tptq� , Town of Southold 5/6/2022 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE FICATE OF OCCUPANCY No: 43049 Date: 5/6/2022 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 8300 Route 25,East Marion SCTM#: 473889 Sec/Block/Lot: 31.7-2 ��wwww Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/8/2021 pursuant to which Building Permit No. 45832 _ dated 2/18/2021 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'"decl addition to exisjfo gle family dwelling as apgkd for. The certificate is issued to Benidze,Koba� of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Deck 26'3"x 14'11" �_...._e ........ Kitchen. 32'6"x 13'11" Dining Area 144 x 13e. - llk-- Basement 24'1'z 1]'3' � Bea—m Bamen[ = LIv ng Room 'f 10'3"x 114" Floor i J I sex 33 1' 14'0"x 13'9" Laft pth 8'6"x—A 0] e e 7 9`x0. j Bedroom Bedroom 147 x 14'1" Master Bedroom < 19'0"x 12'11" Floor 2 Floor 3 TOTAL:1561 sq.ft BELOW GROUND:0 sq.ft,FLOOR 2: 1122 sq.ft,FLOOR 3:439 sq.ft EXCLUDED AREAS: BASEMENT: 534 sq.ft,DECK: 393 sq.ft,LOW CEILING:88 sq.ft Measurements Deemed Highly Reliable But Are Not Guaranteed ti