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Home My WebLink About1000-67.-7-10 of so TOWN OF SOUTHOL - Rental Permit 1506 Owner: Pindar Damianos Occupied as: Single Family Dwelling Located at: 2030 Mill Rd Peconic 67.-7-10 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. Issued: 06/29/2026 . Expiration: 06/28/2028 �� eno�i`•a' This Notice must be posted by the main e a at tim C En �'j n� Town Hall Annex Mt Telephone(631)765-1802 54375 Main Road tm Fax(631)765-9502 P.O.Box 1179 � r�wx Southold,NY 11971-0959 � fig' eou r N OVE BUILDING DEPARTMENT TOWN OF SOUTHOLD MAY 2 0 �(J j RENTAL PERMIT APPLICATION ,,.......m .___� . ,,,.. a Rental Permit Fee$200(Application must be renewed every two years " OF SOU &Q' Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION --BLOCK_? _-LOT - SECTION B. OWNER INFORMATION: Property Owner Name: RfssQ Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytime Evening Emergency Property Owner Email Address: r v 41 Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 � Southold,NY 1 1 97 1-0959w, w k � BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. M 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: l Name of Authorized :Agent of dwelling unit, if an \� g 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: c—h� Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex °d�; Telephone(631)765-1802 54375 Main Road b Fax (631)765-9502 P.O. Box 1 179 Southold,NY 1 1971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent; •V ' � � `1 1°�35 Telephone Number(s): Daytime Evening Emergency Email Address: % C*6GV �K)Q00 '1ONIN35 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." 6r' Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: Use and Dimen " ns f each ro in ental (ling Unit: Page 3 of 5 F:- ll Town Hall Annex Telephone(631)765-1802 54375 Main Road r Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 1971-09597111111, !I COU rr BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 1 I am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I 1 M1Qi� 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 Page 4 of 5 Town Hall Annex k Telephone(631)765-1802 54375 Main Road � Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 % COU BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: v Property Owner's Signature: Sworn to before me this�0 day of 20 Iaj Official Notary Public Signature and Original Notary Stamp CONNIE D!.13U "try putft,State of Now Yo No.01 BLJ6185050 oualgw in Wfolk County Commission Expires Expites A!prH 14,2 Page 5 of 5 Loj �<<4111 Wcc� OA64eo O L i� E.,.a�., Duv�- a = ; 1 ' F 1 i 216 ._....... S F C8 83R ' CIA 64 7530 30 W03C) B30 �,, � tl W21 DISH 21— 24 -- 30 R". 24 I 1671 160 - :"33- —_ 33 .� n 15 DB W27 15 67; 27 T 30 — 52t 36 _. C �R B15L B18L OL REFRI 24 C1W2430R ww W2730 p1_5._.. W1830 W O..� 5 t S\;� booms 36 15 3'0 18 310 87 - 24 — 27 3,f0 18 -If— 10 4 - 86 g �...w 132 ._ _..__...__...,_._.__. 8 84 -- - 66 ;- 48 - -ems - 102 — wwww_ 216 ., __. ww.._... ----- I I r d I n d F=ZF= Rlul�ol —————————— -- — ——----- V_ if —————— ——————— OUSIING t: MCHM 1 i EX15TING ZTmm L EXISTING J, _R _711 _j AWL SPACE I L7j— ------------ Z 4, 12 LOFr �3 Ln 2_4 FOUNDATION PLAN 2 EXISTING FIRST FLOOR PLAN 3 EXISTING SECOND FLOOR PLAN tn z C) id Lu OCCUPANCY 0 2 m C> C USE IS M-1—I WITHOUT CE LL' OF OCCU7:;��' Ln 'j--2 1 0 '1=3 EXIST.FRONT ELEVATION EXIST.LEFT SIDE ELEVATION A-t EMSTING �' Roo_m jam, lit < 2 H d! EXIST f 7 REAR ELEVATION rs N EXIST.RIGHT SIDE ELEVATION PROPOSED FIRST FLOOR PLAN TOWN OF SOUTHOI D BUILDING DEPT. 631-765-1802 � -- to I N wv r r. '64ho"'ho" CTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE TRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL ( NAL) [ ] CODE VIOLATION [ ] PRE C/O ] RENTAL R MARKS: DATE INSP'E T01 -- V\-(� k, �q. , TOWN OF SOUTHOLD BUILDING DEPT. coo 765-1802 I N S splftvOE C T I O N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ INALjeok , [ ] FIREPLACE & CHIMNEY [ ) FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: r- 1001, V DATE - INSPECTOR _..._ fYi � I i w oC w W 1.. a „ � V � r � Qoo f v� > � W Q W W tA 616 i W J W - N F- rn C° i O I �I n) � ,k J Q ; < I CL Ua6 w N M v oLu i c v W Zm k �, . ' Q Z L° d m a� o ° a 0 0 0 0uj 0 0 0 LL CN Ln .0 co V) 1- -5 E w 0 0 41 yy LL �vo 0 0 CL Ln LL C3 U' 1 . ............. c C Cs p .2 .2 x Yl LLI uj "U4 m " FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY NO: Z- 32422 Date: 0 L.I 07 THIS CERTIFIES that the building DWELLING Location of Property _ .}2030 MILL RD _ _ PECONICMMMM (HOUSE NO (STREET) (HAMLET) County Tax Map No. 473889 Section 067 Block 0007 Lot 010 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRILM 9_, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 32422 dated JUNE 21, 2007 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 SEASONAL ONE FAMILY DWELLING* � The certificate is issued to KURT R YOUNGBERG (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N�A *PLEASE SEE ATTACHED INSPECTION REPORT. Au prized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 2030 MILL RD P CONI SUBDIVISION: ..._wwww.,_.w._...� MAP NO.: ...�, LOT (S) ....� NAME OF OWNER (S): KURT R YOUNGBERG OCCUPANCY: SINGLE FAMILY—DWEELLING (SEASONAL KURT R YOUNGBERG_ ADMITTED BY: KURT R. YOUNGBERG ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 67.-7-10 SOURCE OF REQUEST: KURT YOUNGBER.G 6 16L?7ggaa� DATE: 06 21 07 DWELLING: TYPE OF CONSTRUCTION: „ WOOD FRAME # STORIES: 1.5 # EXITS: 2 FOUNDATION: CEMENT BLOCK PIERS CELLAR: -- CRAWL SPACE: -- TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 0 3RD PLR.: 0 SATHRTHROOIM(S): 1.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S) : PORCH TYPE: SCREENED ,....... DECK TYPE: .w .................... PATIO TYPE: BRHEZEWAY: FIREPLACE: YES—ONE GARAGE: .. ... _ �...�, DOMESTIC HO'TWATER: XX TYPE SEATER.: AIRCONDITIONING: .............. m TYPE HEAT: NONE WARM AIR: HOTWATER: XX OTHER: HOT WATER HEATER NOTE: LOPT ON 2ND FLOOR) ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SN13DE IG POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION � DESCRIPTION._................—...._____.. ..........�� :_. SEC'. _. G Q p � g REMARKS: INSPECTED BY. DATE ON INSPECTION: 0Nt 2CLCI GEORGE GILLEN TIME START: END: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREh•IISES THIS IS TO CERTIFY that the Land Pre C.O. #- g215747� /XX Building(s) Date- May 12, 1987 %/ Use(s) located at 3745 Mill Road Peconic Street Hamlet shown on County tax map as District 1000, Section 067 , Block 02 Lot 10 , does.'not%conform to the present Building Zone Code of the Town of Southold for the following reasons: Insufficient total area; insufficient front yard set-backs. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming / I�and /-MTBuilding(s) /_/Use(s) existed on the effective date the present Building Zone Code of.the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- Property contains 1 story, one family, wood Cate is issued is as follows• framed dwelling with attached porch and garage in foundation; brick pillars; patio; burner; retaining wall,in A-Residential Agricultural zone with access to Mill Road; a town maintained road. The Certificate is issued to DOROTHEA SCHULE (owner, 1N51a%(XX)rX*X4Vnt) of the aforesaid building. Suffolk County Department of Health Approval�N/A UNDERWRITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises 1LAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. _raSp ecror FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19523 Date NOVEMBER 20 1990 THIS CERTIFIES that the building ALTERATION Location of Property 3745 MILL LANE PECONIC NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section— 67 Block 2 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 29 1988 ursuant to which Building Permit No. 16869-Z dated MARCH 31f 1988 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR_ The certificate is issued to ROBERT BERNARD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Buj1 ng Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19798 Date MARC11 15, 1991 THIS CERTIFIES that the building ALLMERATIONS Location of Property 3745 MILL LANE PECONIC House No. Street Hamlet County Tax Map No. 1000 Section 67 Block 02 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVE BER 19 1990 __pursuant to which Building Permit No. 19528Z dated NOVEMBER 21 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 ALTERATIONS TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ROBERT & ABBIE B ..RNARD (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 9/A UNDERWRITERS CERTIFICATE NO. N171694 JAN. 30, 1991 PLUMBERS CERTIFICATION DATED N/A B ilding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28059 Date: 11 13 01 THIS CERTIFIES that the building ADDITION/ LTERATION' Location of Property: 3745 MILL RD PECONIC (HOUSE NO.) (STREET) _ (HAMLET) County Tax Map No. 473889 Section 67 Block 2 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 6, 2000 pursuant to which Building Permit No. 27057-Z dated FEBRUARY 12, 2001 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 ADDITION AND ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT BERNARD & WF _._._._. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. N 570890 09 2E01. PLUMBERS CERTIFICATION DATED N/A /ti ..4d ' ature_....� Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28483 Date: qS/ 02 THIS CERTIFIES that the building ALTERATION wwwww_ _µmmmmM µ Location of Property: 3745 MILL RD PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 67 Block 2 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 2001 pursuant to which Building Permit No. 27877-Z dated NOVEMBER 7b .2001 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 INSTALLATION OF WOOD STOVE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT BERNARD & WF. �w � ww._...._.... (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A.._............ ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED ...A ...,i.. �_.._...... vw.,..,_........_. zed Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30915 Date: 05/13/05 THIS CERTIFIES that the building �µADDITION Location of Property: 3745 MILL RD SOUTH/PEC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 67 Block 2 Lot 10 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 19 2003 pursuant to which Building Permit No. 29970-Z dated DECEMBER 23 2003 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 EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & ABBY BERNARD _w......... (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A qq ELECTRICAL CERTIFICATE NO. PLFERS CERTIFICATION DATED N/A w uthorized Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33896 Date: 08 13/09 THIS CERTIFIES that the building INTERIOR ALTERATIONS ECONIC P Location of Property: 2030 MILL RD........... .........w._....... ._. .,., (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 67 Block 7 Lot 10 , ..... Subdivision Filed Map No_ Lot NO. conforms substantially to the Application for Building Permit heretofore .._........... __....filed in this office dated MARCH 31, 2008 pursuant to which„ g W 9Z' dated APRIL 14, 2008 Buildin Permit No_ 338 . ..-. was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ED is INTERIOR ALTERATIONS TO AN ,EXISTING ONE FAMILY DWELLING AS APPLI FOR. NDA The certificate is issued to PI R DAMIANOS ......,.__.................................... ..... .....__..... .w.........._. (OWNER) of the aforesaid building. A SIIFFOLR COUNTY DEPARTMENT OF HEALTH APPROVAL .__www___N....__ ........... ...................w._.....__...._. �..___________�. ELECTRICAL CERTIFICATE NO_ 882.. 11/15/0 8 mm� I PLIINIDERS CSRTIFTCATION DATED 07/01/09 WILL AM GREMLER_�...._.. __.._.� ....... _................... Aurized Signature Rev. 1/81