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Home My WebLink About1000-53.-4-44.27 fE TOWN OF SOUTHOLD Rental Permit 0136 Owner Philip Walters Occupied as Single Family Dwelling Located at 690 August Lane Greenport 53.4-44.27 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. 10/15/2024 _ d o r t fFeial This Notice must be posted by the main entrance at all times S (A rtgA- * TOWN OF SOUTHOLd BUILD["-PT. C: -PT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. - [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY IV FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN TRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: AU N U OUU HU U T `W& F 5 ET2 0 Lw% Rental Perm }£ 0136 Owner Philip Walters Occupied as Single Family Dwelling Located at 690 August Lane Greenport 53-4-44.27 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. 7/19/2021 Code Enforelrylent Official This Notice must be posted by the main entrance at all times = Town Hall Annex J SOUTHOLD TOWN 54375 Main Road Rental Inspection PO Box 1179 Southold, NY 11971-1179 k� a Tel: 631-765-1802 Fax 631-765-9502 SCTM # $ -- �� .`�� Date �i Owner �l�e rS Phone S 16 —?Z Address �0 tf v In Zip 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 (#) ,i Carbon Monoxide Alarms (#) Egress (Windows) (YIN) V/ BUILDING SYSTEMS CONDITION OF PROPERTY N 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 N POOL BARRIERS IN Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min.48"high resent /P POOL GATES N 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: Phillip Walters, DDS From: mike.verity@town.southold.ny.us Sent: Sunday, June 13, 2021 1:00 AM To: waltersp@optonline.net Cc: Mike.Verity@town.southold.ny.us; Connie.Bunch@town.southold.ny.us Subject: Rental Permit 0136 due for renewal Attachments: 1000-53.-4-44.27.pdf; Rental_Property_Certification.pdf To whom it may concern: The following Town of Southold Rental Permit is due to expire soon: Last Name: Walters Tax Map Number: 1000-53.-4-44.27 Permit Number: 0136 Expiration Date: 7/13/2021 email address on file: opgIinee net A copy of the current permit is attached to this email for your reference. If you wish to renew this permit you must submit the following: 1. updated Certification of Code Compliance form (attached to this email) or request for a Town inspection (respond to this message) 2. certification that the property information in the current permit has not changed or updated property information if it has 3. renewal payment of$200. If you do not wish to renew this permit please respond to this email stating this and we will consider the permit invalid as of the expration date. Thank you for your prompt attention to this matter. Building Department Town of Southold 54375 Main Rd PO Box 1179 Southold NY 11971-0959 (631)-765-1802 r r f 1 1 TOWN OF SOUT OL Rental Permit Permit No. 0136 Owner Philip Walters Occupied as Single Family Dwelling Located at 690 August Lane Greenport 53-4-44.27 Address Village S/B/L 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. 7/31/2019 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 P.O.Box 1179 Southold,NY 11971-0959 � �� jf�` BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: r Tax Map Number: 1000 SECTION 573 BLOCK LOT fli- SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) vtNlymy)s "ie- A, L'5*6bV1,011 d" Telephone Number (s): Property Owner Email Address: � � p Y Page 1 of 4 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, 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." Rental Dwelling Unit Identifier: " Requested Maximum number of persons allowed to occupy Dwelling Unit."fid � f Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: 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 NYS licensed architect, a NYS 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. Page 3 of 4 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect, a licensed professional engineer, or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building code Certification. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I � µ 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 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: m " W F .. Property Owner's Signature: Sworn to before me thiab day of, J 02019 w fficial N ry Public Signatur Ilynd Original Notary Stamp T AEY L. DWYER Page 4 of 4 NOTARY PUBLICO,STATE OF NEW YORK NO,01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30, �jo �S x DEPT.TOWN OF SOUTHOLD BUILDING � u 0 765-1802 INSPECTION r ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]' INSULATION [ ] FRAMING /STRAPPING � [ ] F ALlem [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING JA X ((hU 0 AYAUA DATE INSPECTOR ; w ................................................ _.,,�... P�R.. 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TI — N I ............. 7 0 mom �. � Y l k PO 9 ,w. n w :33 j , b u FROM :J GOULD ESQ FAX NO. :6314772601 Oct. 27 2004 04:36PM P1 FORM NO. 4 Tom AF SOUTHOLD Pu.p,mo 4.,3 BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Dates 07/20/99 NO: Z-26569 THIS CERTIrIES that the building NEON DWELLING POR Location of Propeztys 690 AUGUST LA otter"HAMLET) (HOUSE N0.) (BTRBET) ( County Tax Map No. 473889 Section 53 Block 4� Lot 44.27 subdivision _ . Filed May No. Lot No. _ conforms substantially to the Application for Building Permit: heretofore filed in this office dated RVER 7'L 1998 pursuant to which Building Permit No. 25375-Z dated DE KBFR_4j1998 was issued, and conforms to all of the requirements of the a�?Plicable pxovisione of the law. The occupancy for which this certificate is issued is ONE FAMIT-Y IsNELI+TN2 NI ATEA Cs GARAGEGARAGEt 6 COVERED PORCH_ AS APPIr1_H0 The Certificate is issued to sCfIEMBRI IioMBiS (OWNER) of the aforesaid building. BUFf'Om COUNTY DEPARTMENT OF UMTH APPROVAL R10�93�0116 07/08/ 9 ELBCTAICAL CERTIFICATE NO. 26642 24/14/99 PLUMBERS CERTIFICATION DATED 07/16 99 WARREN J�KWANF. Building Ise 'mtor Rov. 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-28733 Date: 08/22/02 THIS CERTIFIES that the building FIRE REPAIR Location of Property: 694_ AUGUST LA �... _ .... ....w GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 53 Block 4 Lot 44.27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 5,, 2002 pursuant to which Building Permit No. 28628 •Z dated AUGUST 5, 2002 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 FIRE DAMAGE REPAIR TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BARBARA A BOULDIN-PUPINO (OWNER) of the aforesaid building„ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 535652 09/07/00 PLUMBERS CERTIFICATION DATED 08/15/02 ROBERT DAWSON Autho rized SiYAture 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-30615 Date: 12/08/04 THIS CERTIFIES that the building ADDITION _ Location of Property: 690 AUGUST LA P y ....... _..._ ---- GREENP RT (HOUSE NO_) (STREET) (HAMLET) County Tax Map No. 473889 Section 53 Block Lot 14.27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 12, 2004 pursuant to which Building Permit No. 30773-Z dated _NOVEMBER 15, 2004 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 AS APPLIED ..... NG SINGLE FAMILY DWELLING s "AS BUILT DECK ADDITION TO EXISTING FOR. The certificate is issued to MICHP.EL J. & BARBARA BOULDIN-PUPINO (OWNER) of the aforesaid building. a SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A N/A ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A u —4e40 dtizorized Signature Rev. 1/81