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1000-42.-1-23
P TOWN OF SOUTHOLD Rental Permit 0131 Owner A. Martinez & M. Werstein Living Trust Occupied as Single Family Dwelling Located at 220 (aka 214) Oak Street Greenport 42.-1-23 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. 1 4/15/2024 Er�f en o `iial This Notice must be posted by the main entrance at all times TOWN OF SO .. .OLD BIDING DEPART ;V1 A fq A Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 h s-`;'lv xk-vl=.so tholdtown o �} IV// 2`7 RENTAL PERMIT APPLICATION -7 � Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: 0 c _ Rental Property Address: Z ZO 0, k Stree-t o 4 q Tax Map Number: 1000 SECTION 4 2- -BLOCK ) -LOT 3 - SECTION B. OWNER INFORMATION: Property Owner Name: A . W erSiei A L-Mvl !i TyttS+ Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Adri4in4 M0'v4iAez— /�dritinc I Lc,� ZI -5D 33rd KcaJ ZI- 50 33✓d ift 2- C.. 2G A4 S+v D i u i 1 v sho r i 'i,,j t )I ) 17 (o Telephone Number(s): Daytime 10-.�b8-)S ID Evening 347-5a� ��E ergency Property Owner Email Address: ✓►� a r"�� n e 2 S v� @ o, o p . C a yh Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: /�►�Y i �► Mc.� ► +� z Address of Authorized Agent (no P.O. Boxes): 2 1-- 5 D 33+'d RvaA ,.4. 2C Ad-pri.)Y ,+ {, I11 0 l0 Mailing Address of Authorized Agent: 111-7-S log - +S)o 34'1 _ 2,'1 Telephone Number(s): Daytime Evening Emergency, -18`I'-`(1 9 -L t, 4 q Email Address: M a -fi ✓\e z S v M@ g 6 k o o .- CO l,,j Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: V A e- A S A Mr. R-on M v r► -e r' Address of Authorized Agent (no P.O. Boxes): 5 Ave , Farm i-,ayje, �Jq. 1 1139 Mailing Address of Authorized Agent: Telephone Number(s): Daytime 1 - SSG Evening � —e— Emergency l- 6D- 5 4� Email Address: ► OV) . rv►vns+ey-c yacg .sue,. com 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): 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: t 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 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." L20 ?- _ eo I`f 0A� o Rental Dwelling Unit Identifier: n 1 '- a ka X f Requested Maximum number of persons allowed to occupy Dwelling Un Number of rooms in Rental Dwelling Unit: (J Use and Dimensions of each room in Rental Dwelling Unit: LAY,0 Sedrvow, Z ; ZI�• 2sF Uni� 1 - L-iyi e.ovwl 2- Uni4 190 - 8 Sr Vni+ ,1 _ Ki4zhen 2a-7.5 ST- 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 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 A d r i A via I A a v'4 e-e ertify 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: A a Y i a naj yi e Z_ Property Owner's Signature: Al� W!� � -s Sworn to before me this day of � - _ , 20;N Official Notary Public S nature and Original Notary Stamp NNA APEL®E I -TSAGAKI (rotary Pu"Ilc,State of New,`cork E`'o...01 A 0424i2 County Page 4 of 4 TOWN OF SOUTHOLD BUILDING DI 1 7f 5 1802 - INSPEC ION j ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAl [ ] FRAMING / STRAPPING j ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAV(F L ] CODEVIOLATION [ ] PRE C/Osc/"�4vli N (A *i As Va--v IL - At cob- 4� 0�— iiv DATE ' INSPECTOR 17 E w t s APR $ , 7,1 Town Hall Annex Teiephone,(63 l)765-1602 54375 Main Road �� Fax(631)76.5 9502 4",�..., P.O.Box 1179 Southold.NY 1 1971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION 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 Professional seal re uired for Architect or EngLheer licensed Flame inspector must Provide My of valid current certification Rental Property SCTM Number: Rental Property Address: 2 + Owner/Name: I P Rental Dwelling Unit Identifier: — JI r Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e.Bedroom#1-100 sq.,Bedroom#2-90 sq.,etc.) >- Property Description(include all improvements indicated on survey) 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 Co truction Code of New York State,Anthony Portillo, R.A 2,3 Print Name and Title �tigina Please place professional seal: s LfYtt�6 [� t E t uxRr C rj F.ANVIV6 �'' t i €e BEDROOM i ` 44B SF. R L z 1 ' � � 435F. - _ � � EJINIF:S s�-- I f a t � w FIRST FLOOR PLAN i S °°M 5.n1" MARTINEZ,/WERSTEIN TZB PAFA6 3f6R EtN.A J52+ b�F4.iRID NYLL kGTEE 114©iLR I'o 3 l RESIDENCE - `��""`� ;- a�oransmarxrm xcvsaeu�z�o++atrsrrarap ; FpOrt�CCittftEL[LF�.�f0f��RII WRIMN�4� �€ ' ■O /4 FSRfa%LttWtl ER !4 .E.l tLt.0lA.11¢[ !! tt `` Feaa+Enc xxvzaxacsvr�e.r�rmr�ncn�ae*ra�s.e w+vam�+s V�L 6RE�FIFt.11RL.FF.Y,11444 �avecurrs. s i i z GMF 2102 SF. I } Ll 4T S SECOND FLOOR PLAN i 'ru39 MARF{NELWERSTEIN �!l x- RESIDENCE - .�masrauaro¢a.arr_�wscorm anrcTxes�vaxv�navw� 2?.6d��EE< %' D-3 � "_ }�i4�lLL�IDl6e maMla¢AIp�.[D18[l�t¢C%t tlSgMTIH GREENPORF,M.US" k�.waa sc� .Tuffs. 200 5r-. Lr 816 sp, BASEMENT FLOOR PLAN PpGPfSAL fcwt MARIINEZ/WERSTEIN RESIDENCE 6177- K-maT DA —G—flW`ff"-lMoA.MY—lW44 SCTM # TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST, SUB. LOT 10 ACR. REMARKS -77 REMARKS TYPE OF BLD. . ......... PROP. CLASS b -------------- LAND lmp, TOTAL DATE .. . ....... ga 0 5-4,� Z-511527, 1� FRONTAGE ON WATER HOUSE/LOT BULKHEAD LKHEAD TOTAL 1 lTOWN OF SOUTHOL ER /0 , / /JV CARD .,. r.. ___............... _._._.._ STREET �� �� � VILLAGE DIST SUB LOT g g FORMS OWNED n0 r) L N E S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. CB_ MISC. Mkt. Value ._..,_..,.,..LAND ...�._, .._._.. I.IV,P. TOTAL DATE.............._... ,�.,,,....._.._. REMARKS l 1 f c. ., ........ ...«......gym.», .,,.,m,...._.,........,...,.....,., ..... ,...:,.,.,�,,...wa.�wF..,... .,.._., � ,. ,. � ,,.,,.,, �Il ,, ,,,,. »„�« ... ..«....,.,..........,, .,....... ..... t7) !P`\ . e i✓° M � *gyp rtoa � ,,,,. .,.,,,.,,.,..,.....�...... w4,,., .J.�w.m....wm...........«w.,...4... -� 1 ,,,. l .....,.., m,�,, .. ... ... .........mm.�......._...... ....... 7 `� �...�..,, ,....., ,.,... .....,. ....,......_,. _. . w . .r ",�� .�, f� _... .. . _ .. , ,L GE BUILDING CONDI SON II r ( , 4, - ........ .. ..._.__.... ...�_... __.,_^ 1{ r �"° L NEW NORMAL BELOW ABOVE � �a; � / : � �� /�1,e1E1� �._.__.._....._ . ..._............ .. I Per Value J .p ..__ Io7rQl i d !Q (� i ! FARM Acre Value r5 ,, Acre �� i A� � '4 ° �itiGti� i wi'�EtC� Tillable I I o Tillable 2 ._. Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushlond FRONTAGE ON ROAD / y .... _... .__.....„ . , _ __ _.w_._..� .._ ....._._., a...m _,...... — .................. __., ,._ �...�. � .. ._, _....... . _. ...._ ... , House Plot DEPTH BULKHEAD otalFDOCK �... _µ ,... i , COLOR ,F pp V >� 0I i TRIM 71 , , . t` 141 42.4-23 4/09 2— ,' ti 1st 2nd M. Bldg. 7 ?Z� _ Foundation4 _ M_ Pc G9�OTHER Bath vNN Dinette �m Extension FU COMBO 1.� r µ Basement S LAB PARTIAL Floors CJ Kit,. Extension 4.i ---m-3- �L.. ._._. �'(�" _. /z Finished B. ,.............�mm. .. ._� Interior Finish L.L.R,� *� ..m..,._.. .._........,. l xaq���J rQ0 I I t n ion ©Q He Fire Place Y �� ,. � 1 Heat C►R • -, __MM M _ ._........ .... .., — Ext. Walls _.BR.aaaaa " Garage ,� 2 O �o P N n u q 3�i•w D i?f Dormer Deck/Patio 1, _ Fam. Rm, Pool r O 4 Foyer A.C. Laundr y _ t Library/ Study _. Dock COLOR o u i n � � s I 4 1 w i TRIM 1 Illy M� ^n ,F M . ' f_.. ............ .. ....... . xa. .� .a 2 1 m 1 ' A i `�j M. BIdg Foundation Bath Dinette .......w....._. ._...�� � '1--T � 3 y' � ..._,_._......... .._.�.._...�....., ,�»�...__...._. .._ _............_.�.a_a'__aw_____. a__. Extension 1 Basement Floors K. Extension jExt. Walls Interior Finish $f p , LR. �aa _M �1 P° ° Heat 1 s L Extension I.�� �" 'x � � �� �, � �,�"" jFire Place .�_._ , _.�.,� �........a��.._... _ r—' _aMMMMMMM_Maa.._M_ �\ Type Roof Roams 1st Floor BR. � •-' Porch ,,�u,,i+r 3 .� / Y�' 4/ Recreation Room Rooms 2nd Floor it B I i _ . ....... .. _,........ .... ., ,,,,.._ . _._._... w.,, .... _....._., _..... __.....M..r a_...._, _... ._.. Porch\ �Dormer �� G) .... ........___ ..- - re _.... Breezeway �V Driveway Garage o Patio I O. B. j t Total " 1 COLOR . .w 1 9J YI � i _ Z10 r ✓w Y a w'ro i� J P TRIM .w..... ,. . �I . �y �n ! 1 fi I ill fi r x 6 �1 .y 1i ll f p� ........,,. „....... .... ..... ....... �. ... ._._.w.. Dinette ..M s..l.dg. ._ 2—"r Foundation _w Bath�._..._�� `�-La �C 3 Y Extension / Base ment C,,if Floors... . K' _ Extension Ext. Walls Interior Finish LR. Extension s S �C _ �J Heat ' e /- e� DR. - s' 3 .� Fire Place i (Type Roof C'+ , " Rooms 1st Floor Porch .-r✓Y 3 Y T-- l YY y ....._._.....__.............._...�,.. Recreation Room' Rooms 2nd Floor FIN. B._... ,. .,.....�.mm�„ „_.....,.�. ..___...w.__._l._..__..._ �. ___..._. .__. Porch Dormer 1 B reezeway I y Drive wa Garage Patio 1 7 B. Total ..___� �..�..._. ..._.._ .. !� FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z10254R } Date . November .14., 80 . . . . + , 19 THIS CERTIFIES that the building .$. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property . }220. Oak Street, Greenport, N.Y.. . . . Noun moo. Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . .Block . . . . . . . . . . . . . .Lot . . 2,3 . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . .Lot No. . . . . . . . . . . . . . requirements for a One-Family Dwelling built prior to conforms substantially to theccl-in- re£f:ee-elel!ed— Certificate of Occupancy Z102 4 aril 23, r , 19 .�7pursuant to . . . . . . . . . . . .. . . . . . . . . dated . . November n144, . . . . _ * { , . . . 19 .80,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 . . . . . . . . . Private One-Family .Dwelling with Accessory Garage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . Nervy F. MOisa & Ano. . . . . . . . .. . . . . . . . . . (owner, of the aforesaid building. Suffolk County Department of Health Approval . .N.R UNDERWRITERS CERTIFICATE NO. . WR. . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. Lot(s) Name of Owner(s) Henry F. Moisa & Ano. Occupancy R-1 Unoccupied type owner-tenant Admitted by: Henry Moisa Accompanied by: Henry Moisa T Key available Suffolk Co. Tax No. 42-1-23 Source of request Henry Moisa Date Nov. 13, 1980 DWELLING• Type of construction Wood #stories One Foundation Cement Block Cellar Full Crawl space Total rooms, 1st. Fl 4 2nd. F1 3rd. Fl Bathroom(s) 1 Toilet room(s) Porch, type Deck, type Patio, type Breeze *ay Garage Utility room X Type Heat Oil Fired Warm Air Hotwater X Fireplace(s) No. Exits Airconditioning Domestic hotwater Yes TyDe heater Tankless Other ACCESSORY STRUCTURES: Garage, type const. Wood, One CarStorage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Kitchen Gas Stove No Shut Off �52,52-BE6 Remarks: Inspected by: �,� 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 OF OCCUPANCY No. . .Z..3.23S.......... Date ...........,AUguat..28....................... 1968... THIS CERTIFIES that the building located at ...Oak...St . ........................................... Street Map No. ............... ...... Block No. ...................... Lot No. ....Groja pox ...New7..York............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..............May. ..:1.7!,.............I....... 19.M. pursuant to which Building Permit No. .388.8..h! dated .... 19..6(3., was issued, and conforms to all of the requirements of the applicable provisions of the low. The occupancy for which this certificate is issued is ........ ........................private-•4ancs••famity—.dw+ijLinq.........................,.............,.................... ,.. The certificate is issued to ..........rozep;3..4 eisa. ......... ............ ......................... ..... ..................... (owner, lessee or tenant) of the aforescrid building, Building Inspector FORM NO. w TOWN OF SOUTHOLD ; BUILDING DEPARTMENT' TOWN CLERK'S OFFICE ; SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISLS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N93888 Z Dote ................................ .......1.7... .. 19.. Permission is hereby granted to: ......................... .... .................... ............... t ....... . .. ......... ..........e ... i..,,...' ... ................................,,..... ... ............ 0 atpremises located at ...... . t.............................................. ................................... ............. ....... D3 "i...............- ......................... .......................................I................. pursuant to application dated ..•.......•.............Al '•••••.. •••••. 19 ••, and approved by the Building Inspector. .Fee $14M............. ,. ,., :... .......... 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 ELECTRICAL CERTIFICATE NO_ 4017645 05/11/09 PLUMBERS CERTIFICATION DATED 08/12/09 BURTS RELIABLE INC th 4rizedignature Rev_ 1/81 Town of Southold 2/25/2019 P.O.Box 1179 =g `` 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40226 Date: 2/25/2019 THIS CERTIFIES that the building ADDITIOINIhALTERATION Location of Property: 220 Oak St, Greenport SCTM#: 473889 Sec/Block/Lot: 42.4-23 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 ut ed Signature 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: ,W X y 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 A5 ) Nature Print Name and Title C" wf�H Please place profsi I seal: i tJ r� �I0NG e10 I 1 ^y 1i i I I 1 J 4hIN4 v G,�arwffa;'n N ReID M t A 5r' I I Cy I f mme m e; °^ ti ��' w ��„�.�u,of�., w �ll�aru 0 u v k�„aay•+*�h�... � t�'�. bk �^.o t!PROPOSAII IS V,HEE11114p �oM~�VJ WIL' II Z!Vll Odd ICn'r� 11944 I f {�{ 6 V If, 1 f f I f I yy . i i v� es i b.� i Fryg1.kM"�1". e f 50 1 I� .. r � I � I �. 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O < _ � r .. __ 1 n' V T S —'j Lnrn � k En 3 f T kJ 3 T O O W S _m ,. w ; .._. .. .. �� ., i �..,.�. _�.. ......m m ro _.._�_. I ; 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......... . _.