HomeMy WebLinkAbout1000-71.-2-11.2 £ _ TOWN OF SOUTHOLD
Rental Permit
0074
Owner 240 Windjammer LLC
Occupied as Single Family Dwelling
Located at 240 Windjammer Dr Southold 71.-2-11.2
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.
4/28/2023 ,
de Enforcement Official
This Notice must be posted by the main entrance at all time
Ile lraf so�t� � �� L✓��� J f����
ITOWN OF SOUTHOLD BUILDING DEPT.
31
IX7
INSPECTIO
FOUNDATION 1ST ROUGH PL13G.
FOUNDATION 2ND INSULATION/CAULKINGFRAMING f STRAPPING FINAL
FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
CODE I PRE C/O ��ENTAL
TOWN OF SOUTHOLD
5
Rental Permit
Permit No. 0074
Owner 240 Windjammer LLC
Occupied as Single Family Dwelling
Located at 240 Windjammer Dr. Southold 71-2-11.2
Village
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.
5/14/2021
Code Enforce Official
This Notice must be posted by the main entrance at all times
Town Hall Annex
SOUTHOLD TOWN
54375 Main Road
PO Box 1179 Southold,
Rental Inspection NY 11971-1179
Tel: 631-765-1802
Fax 631-765-9502
SCTM # — Date 3�Z
Owner; LCA Phone 6 q6 7 1-733,57-
Address Zip 7
Hamlet Inspector
Address visible from street?
LEVELS SUB 1 2 3
Smoke Detectors (#-bedroom detectors excluded)
Carbon Monoxide Detectors (#)
Fire Extinguishers (#)
Exits (#)
BEDROOMS 1Z 2 3 4 5
Smoke Detector Alarms(#) LIZ
Carbon Monoxide Alarms (#) V Z7
Egress (windows) d
BUILDING SYSTEMS Y CONDITION OF PROPERTY "wI'
Heating system maintained/operational Building Interior is clean/maintained
Hot water system maintained/operational Building Exterior is clean/maintained
Electrical system maintained/operational Property is clean/safe/maintained
Mechanical system maintained/operational Handrails&;guards present
POOLS YiV POOL BARRIERS d"
Pool present NA I Pool is completely enclosed
Pool surface alarm and/or door alarm Barrier is a min.48" high
resent
POOL GATES Y All openings in barrier less than 4"
Self-closing, self-latching Max. 2"clearance @ bottom of barrier
(Latch on pool side of gate, meets height Barrier capable of being locked &child-
requirements proof,when unattended
COMMENTS:
TOWN OF SOUTHOL
} Rental Permit
t.
101
s Permit No. 0074
Owner 240 Windjammer LLC
Occupied as Single Family Dwelling
Located at 240 Windjammer Dr Southold 71-2-11.2
Address Village S/13/1-
Maximum
/B/LMaximum 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.
06/203/2019 John Jarski
Date of Issue
Code Enforcement Officer
This Notice must be posted by the main entrance at all times
Town Hall Annex Telephone(631)765-1802
54375 Main:Road Fax(631)765-9502
� e�
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TO 'OF.S01ffHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee $200(Application must be renewed every two
MAY i V 2019
Section A. TOWN M SOUTUOLL
Property Information:
Rental Property Address:: _
Tax Map Number 1000 SECTION RLO -SOT
SECTION B.
OWNER INFORM,AT,I,ON:
m
: ..
Property Owner Name:
'b
Property Owner Le'i0l.`Add ress: Pr'detty Owneu°"N� mi6 A dress:
E� g: „y � . /V 6 D
en ng
Telephone Dumber (s): Daytime l �Emer en -
Property Owner Email Address: /t N2 ryA/` 1 C!9 K
F
Pagel of 5 �^M✓ � (�
r� / /
s
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765=9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section
Authorized Information:
14 Name of Authorized Agent of dwelling unit, if any: -
Address of Authorized Agent (no P. oes):
Mailing Address of Authorized Agent:
X11
Telephone Number(s): Daytime vening ,Emergency ���
71,E l3
Email Address: dy
"
j -
Section D.
Managing AgentInformation
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent{!no•P.Q. Boxes)': e "
Mailing Address of Authorized Agent:, mm.
Telephone`Nuirnber(s): Daytime Il::vening IE.mergen
µ;ry� IIS �ry IImI��IIM�IIIII
III III III a W III d W�Mi IIIi����N tl I w
SII
SECTION E.
SITE MANAGER INFORMATION: (required for rental properties contain(ng a 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
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
�ww 'oo w4
UILVING.DE:PART ENT
Mailing Address of Managing Agent: _
Telephone Number (s)
° Da one w °venin . Emer en�;y
a
Email Address:' ,
ft
PROPERTY IDESC IPT11 :
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, C);the use of each room in the Rental Dwelling Unit
(for exat�ple, N ! hen, I e�rpcirp 1, Bedroom 2, Living Room) and the dimensions of each
room.
For.properties with multiple Rental Dwelling Units use "Ronit l it it-Application
Addendum."
p
Rental Dwelling Unit Identifier:
Requested Maximum numh�er of persons allowed to occupy Dwelling Unit:VIZ
Number of roorns 1n Rental Dwelling,Unit, Jet
Use and Dimensions f each room in Rental Dwelling Unit'
Page 3 of 5
Town'Mall Annex o Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
Y.O.Box 1 179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
SECTION G.
Pursuant to>the:Town,Code of the Town of Southold.Chapte.r,..,2Q7(Rental,PXop.eri;i;es)„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 Certificatian.is;required stating that the prgpprty which:is th.e s_ubject
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 Councill.
I am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
❑ lam submitting a completed•.,Town ofSo�thold cei`tification form from a licensed
architect or a licensed professionalmeflginer.
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK ...� 'F
�5r� STf e���� r nY of"perjury, the fllorirg;.
1. I am the owner of the pro!i � 1 � �1Klg fction 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
so
Town Hall Annex Telephone(634)765-1802
54375 Main:Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOUD
applicable laws and rules. I further acknowledge that I will notify the Town of SCouthoild
foil' in drtrn t f any than' es -ad r ss -i ift"fiv ) a s f 66y changes
thereto.
w
. I have ae d an d r6 eiv d a"copy of Chapter 2 7 ofthe'Code of the i..a d bf Southold and
ag�,
esd to bmd
by th '�wn
4. I will notify the 'own within five (5) business days as to any change to the information..
regarding Authorized Agent, Managing Agent, or Site ana ` o '
. ., , , A �
g
Property. Owner,s'N'ame:
Property Owner's Signature:
LIV
Sworn to before me this_J�Z day of _ 20
Offic I Notaub c Si Lure and Origina
INtaM ��
am N6bqPu' ' '1 of N,W York
Na 01146225827
Ckafified in Brprtx
TWM aoresJuly '
Page 5 of 5
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217616 Date DEC. 20, 1988
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 240 W" N 1U7�E DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 071 Block 02 Lot 11.2
SubdivisionHARBOR LGTS SEC. 2 Tiled Map No. 4681 Lot No. 42
conforms substantially to the Application for Building Permit heretofore
filed in this office dated. FEB.. 24 1988 "______pursuant to which
Building Permit No. 16"790Z dated MARCH 10 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 ONE FAMILY DWELLING WITH DECK AND SCREENED PORCH.
The certificate is issued to BRUCE & EDITH ROMBOLI
(owner, XXX_XXXXXXXXXXXXX)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-04 12/14/88
UNDERWRITERS CERTIFICATE NO. N04609 NOV. 21 1988
PLUMBERS CERTIFICATION DATED MC SHANES PLUMBING_ 12f/88
Building Inspector
Rev. 1/81
' tFt1t� �._
e Town of Southold 5/31/2019
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40423 Date: 5/31/2019
THIS CERTIFIES that the building ALTERATION
Location of Property: 240 Windjammer Dr., Southold
SCTM#: 473889 Sec/Block/Lot: 71.-2-11.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/15/2018 pursuant to which Building Permit No. 42408 dated 2/22/2018
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 TOAN EXISTING ENCLOSED, PORCH AS APPLIED FOR
The certificate is issued to 240 Windjammer Dr LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 42408 06-29-2018
PLUMBERS CERTIFICATION DATED
At t .F Signature
/N
a
765-1802
I
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] IN L ".�
[ ] FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
i
kin
DATE
i
i
I
INSPECTOR ,
..........
TOWN OF SOUTHOLD BUILDING DEPT.,
765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] INSULATION �
[ ] FRAMING STRAPPING [ ] FINAL
[ ] FIREPLACE CHIMNEY [ 'FIRE SAFETY" INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION
[ ] CAULKING �
REMARKS:
DATE INSPECTOR
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