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Keep in mind, I'm an American, our oldest cities are only about 300 years old, and most of the buildings around me are at most, a century old.

If you're someone who lives in a city that's ancient, been around for centuries, if not thousands of years, how does residency work for those regarding the old buildings?

For instance, old houses in, say, Florence, Rome, or Vienna. Are they still bought and leased out to families, or preserved to prevent damage? Does it go from one family to another? Is there some sort of caretaker relationship/duty with the family regarding the building?

Does the preservation of these buildings matter to people at all in present day, as compared to families having a place to say, and any damage that happens to said buildings is just a fact of life? Are the buildings gutted to make way for modern conveniences and modern building codes?

Please, enlighten me.

In the UK there are listed buildings. These can be bought and sold and rented like any others but you're restricted by what you can do and / or how you do it, e.g. what materials can be used if repairs are needed (different levels of restrictions depending upon the level of listing). Not all of them are old, even fairly modern buildings can be listed if they're of sufficient interest, and that's not always the same even as attractive, even allowing for taste.

The restrictions obviously carry additional cost as well as limiting choice, so anyone who buys one needs to be careful that they're not going to get stuck with something they can't afford to maintain or offload to someone else. Sometimes grants are available for such maintenance (although I wouldn't be surprised if people owning them told you good luck in getting one).

Some locations are owned by bodies like the National Trust (that's probably the big one).

There are also "scheduled ancient monuments", covering places like Stonehenge (but most are far less well know, apparently there are 20000 of them). Just looked it up and apparently it's owned by the crown these days. Scheduled ancient monuments are specifically things that can't be lived in (or a church or a protected shipwreck).