HomeMy WebLinkAbout1000-42.-1-23 F.
TOWN OF SOUTHOLDN =
Rental Permit
0131
Owner A. Martinez & M. Werstein Liv. Trust
Occupied as Single Family Dwelling
Located at 220 Oak Street Greenport 42-1-23
Maximum Permitted Occupancy 7
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.
f
6/16/2021 `
Code Enfor t Official
This Notice must be posted by the main entrance at all times =}F
Town Hall Annex
SOUTHOLD TOWN 54375 Main Road
PO Box 1179 Southold,
Rental Inspection
a ' NY 11971-1179
av
Tel: 631-765-1802
Fax 631-765-9502
n � VV M 6
SCTM # LIJV\e _ Date 6171ZI
Owner e Z_ Phone �►7 -.� ��5��
Address a a lZip
Hamlet �� Inspector
Address visible from street?
LEVELS SUB 1 2 3
Smoke Detectors (#- bedroom detectors excluded)
Carbon Monoxide Detectors (#)
Fire Extinguishers (#)
Exits (#)
BEDROOMS 1 2 3 5
Smoke Detector Alarms (#)
Carbon Monoxide Alarms(#)
Egress (windows) (Y/N)
BUILDING SYSTEMS Y CONDITION OF PROPERTY Y
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 maintaiineWoperational Handrails&guards present
POOLS YeAfi POOL BARRIERS Y
Pool present Pool is completely enclosed
Pool surface alarm and/or door alarm Barrier is a min.48" high
resent
POOL GATES Yd 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 tjBarrier capable of being locked&child- /
requirements proof when unattended ►v t
COMMENTS:
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X
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TOWN OF SOUTHOLD
3g
Rental 1
Permit No. 0131
Owner A. Martinez & M. Werstein Liv. Tr.
Occupied as Single Family Dwelling
Located at 220 Oak Street Greenport 42-1-23
Village S/13/1-
Maximum
/B/LMaximum Permitted Occupancy 7
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.
7/29/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
µ f
Town Hall Annex Telephone(631)765-1802
54375 Main Road h Fax(631)765-9502
P.O.Box 1179 ; .
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF 5 UT 'OLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A. WAY ';9 0 2019
Property Information:
Rental Property Address:
����
Tax Map Number: 1000 SECTION 04 2_ ,O o BLOCK 'o 1 . O 0 _-LOT 02.3 - 0 O
SECTION B.
OWNER INFORMATION:
Property Owner Name: "T e. ....� s
Property Owner Legal Address: Property Owner Mailing Address:
2-1- d 1- 5C) 33rd.
.m
-V- _ �- -
. ._.......... _._.. _
Telephone Number(s): Daytime i2�'jt,y � V50 Evening m� �),V"e mergency� � �` ',L'44
Property Owner Email Address:
Page 1 of 5
%kaiJ� d
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
:
P.O.Box 1179
Southold,NY 11971-0959
0'00U
OU
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):
1-CWic. 4 NWti1es �--\A mea\ Epic ie-
Mailing Address of Authorized Agent: 5. -vo J?C[' � r lel, u� {►��1
Telephone Number(s): Daytime_ --16 "341(oEvening S at m e— Emergency,
- �
Email Address: "� W ,
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent (no P.O. Boxes:_ w . _ _ ....,�m
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
n
Town Hall Annexa Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-09-59
tl
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: m
Telephone Number(s): Daytime,._ Evening Emergency
Email Address:
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:_ .._ n
u o
Requested Maximum number of persons allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit: � >
Use and Dimensions of each 2o F Rental
� �
d w p' m ru � ........ a.o.
� � pi uVllll
9CCNr01DA -2
Page 3 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
r nr
P.O.Box 1 179 �'°° ,•
Southold,NY 11971-0959
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.
J 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.
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
I A�r8 ,� ,,� Kct v"+ Y) _ , certify under penalty of perjury,the following:
et t.A
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 alf
Page 4 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road rf Fax(631)765-9502
P.O.Box 1179 '
Southold,NY 11971-0959 , 4
BUILDING DEPARTMENT
TOWN OF SO OLD
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:
Property Owner's Signature; � ITITIT� m, _�
Sworn to before me this da of, �
ficial Notary Public Signature and Original Notary Stamp
DENISE A. NAVARRA
NOTARY PUBLIC-STATE OF NEW YORK
No. OlNA6191295
Qualified In Suffolk County
My Commission Expires
DENISE A. NAVARRA
NOTARY PUBLIC-STATE OF NEW YORK
No. O1 NA6191 295
Page 5 of 5 Qualified in Suffolk County
My Commission Expires
"
140
Town Hall Annex Telephone(631)765-1802
iu u�
54375 Main Road �� n�; Fax(631)765-9502
JJ
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
CERTIFICATIONTOWN OF SOUTHOLD
RENTAL PROPERTY
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
fro essiorlal'seal re aired or rcllitect or F'n #neer 1iensed home ins actor must rovid'e
co o valid current certi ication
Rental Property SCTIVI Number: 1000-42-1-23
Rental Property Address: 220 Oak Street,Green ort, 11944
Owner/Name: Adriana Martinez 8r Matthew Werstein
Rental Dwelling Unit Identifier: #214
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1-100 s ., Bedroom -90 sq., etc.)
Bedroom#1 - 94.8 sq.ft.,Bedroom#2 - 190.8 s .ft. Bedroom 3 -210.2 s .
Property Description (Include all improvements indicated on survey)
11/2 story frame dwelling, 1 story garage
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it
fully complies with all the provisions of the Code of the Town of Southold,the Residential Code
of New York State,the Building Code of New York State,the Plumbing Code of New York State,
the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New
York
Anthony Portillo,PA
Ory) ig
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) Nature
Print Name and Title C"
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Please place profsi I seal:
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FORM NO.4
aw TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
„
Z10254 „ , „ November 14s . 80
No,
Date . ' , 19
THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property .220 Oak Street, Greenport, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section . . . . .42. . . , .Block . . . . . . . . . . . . . .Lot . . 23 . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . .
requirements for a. One-Family, Dwelling built prior to
conforms substantially to the rip tier Epi ioeimr!- 5 �i}ec�in-t3effree-elel`ed—
Certificate of Occupancy
Aril .23, , . . . , 19 .�7pursuant to wMnr13r1iTtiT gP'eM1t11T.—. . . . . . . Z10254
dated . , November 14, , . , , . . 19 .g9, 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 . . . . . .
. . Pr. . . . . . . . .ivate One-Family .Dwelling with Accessory Garage.
. . . . . . . .
The certificate is issued to . _ . Henry F. Moisa & Ano.
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval . ,N/R
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 220 Oak Street, Greenport, N.Y.
number & street Municipality
Subdivision Map No. Lots)
Name of Owner(s) Henry F. Moisa & Ano.
Occupancy R-1 Unoccupied
type owner-tenant
Admitted by: Henry Moisa Acoompefftied by: Henry Moisa
A
Key available Suffolk Co. Tax No. 42-1-23
Source of request Henry Moisa DateNov. 13, 1980
DWELLING•
Type of construction Wood #st-ories One
Foundation Cement Block Cellar Full Crawl space
Total rooms, 1st. F1 4 2nd. F1 3rd. Fl
Bathroom(s) Toilet room(s)
Porch, type Deck, type Patio, type
Breezeway Garage Utility room X
Type Heat Oil Fired Warm Air Hotwater X
Fireplace(s) No. Exits Airconditioning
Domestic hotwater Yes Type heater Tankless
Other
ACCESSORY STRUCTURES:
Garage, type const. Wood One Ca.rStorage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
L ,cation Descri tion Art. I Sec.
Kitchen Gas Stove No Shut Off V 52,52-BE6
Remarks:
Inspected by: 7^V . Date of Insp. Nov. 14, 1980
Curtis Horton Time start 9:20 end 9:40
FORM[ NO, 4
TOWN Of SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE:
SOUTHOLD, N. Y.
CERTIFICATE Y
No. .......... Date ...........,Auguat...28....................... 19168...
THIS CERTIFIES that the building located at ...Oak-aj ...............,,.,.,,,.„,,,,,,,,,,,,,,,,,, Street
Map No. ...................... Block No. ............,...,.,... Lot No. ..........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
... ............... . ............ .1 19.1613.. pursuant to which Building Permit No. .
dated ...................May..17.1................... 19..16$., 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 ........
.......... pGidatre...Q tr -44aMily..dwelI.ing..,. .. . .... ......... ..... ...............
The certificate is issued to ........ ........ ..... ... ..... ....» ..,,..,,.......
(owner, lessee or tenant)
of the aforesaid building,
Building Inspector v
FORM NO.
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)
9 3888 Z Date . ......... ......1.°1'.... ., 19...
Permission is hereby granted to.
...............° ... .......................
1d addition
to ...................... ..» ......... .. »,.....»... ». ,i 3xr .. � .».. ..... ........a» ....,...» ..,...,...,..
atpremises located at ...... ............................................. ............. ..... .............» ».., ..».».»..,..,.
D ., . ......... ....................
........... ».» ........... ........ ..»...».».. ..... .........»..., .. ,. .»,...,,...»..
pursuant to application dated . ••.•-,.. '.•••••. ••••••• •, 19.6g.., and approved by the
Building Inspector.
.Fee $."*910.............
Building Inspector
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33962 Date: 09/21/09
THIS CERTIFIES that the building ADDITION/ALTERATIONS
Location of Property: 220 OAK ST GREENPORT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 42 Block 1 Lot 23
Subdivision Filed Map No- Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 16,
2008 pursuant to which
Building Permit No- 34245-Z dated OCTOBER 20, 2008
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, ALTERATIONS AND REAR DECK ALTERATION TO AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to CRAIG J GEIER & CATHY RICHTER
(OWNER)
of the aforesaid building,
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
R1 CTRICAL CERTIFICATE NO_ 4017645 05/11/09
PL KRS' CERTIFICATION DATED OB/12,/09 BURTS RELIABLE INC
_...........
t1i riz�ed Signature
Rev. 1/81
eQxq "'bra
Town of Southold 2/25/2019
P.O.Box 1179
9
53095 Main Rd
pV
Southold,New York 11971
•r�A,.zr, „°
a
CEI ."IFICATE OF OCCUPANCY
No: 40226 Date: 2/25/2019
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 220 Oak St, Greenport
SCTM#: 473889 Sec/Block/Lot: 42.-1-23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/30/2018 pursuant to which Building Permit No. 43032 dated 9/11/2018
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:
ADDITIONS AND ALTERATIONS INCLUDING_WOOD STOOP TO AN EXISTING ONE FAMILY DWELLING
AS APPLIED FOR
The certificate is issued to A Martinez&M Werstein Liv Tr
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 43032 02-01-2019
PLUMBERS CERTIFICATION DATED
�t od.ed Signature......... . _.