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Home My WebLink About1000-76.-2-27 flit .} TOWN OF SOUTHOLD } Rental Permit 0179 Owner South Ladybug Realty LLC Occupied as Single Family Dwelling Located at 555 Smith Drive S. Southold 76.-2-27 Maximum Permitted Occupancy 4 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. 8/14/2023 Code fore ent Official This Notice must be posted by the main entrance at all times 631 -765-1802 --� IN PECTION [ ] FOUNDATION 1ST [ ] ROUGH PEBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAl [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] EIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (EI [ ] CODE VIOLATION [ ] PRE C/O [ e17 ' INSPECTOR ` Town Hall Annex ` Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 ' ► ., Tel: 631-765-1802 SUM # (. ...-.a,-oZ _ ro e Date Owner ....... :_ ... . .._. w . . .. .- LG Phone Address I �� b. Visible , . —.res , . ...... .. _. _ _ a.._, _. _ . . – Hamletm ,o Inspector Floor Level Quantities ..�._._.,...�. ,.. Sub . _1.. . ., .a., �,.., . ..2. Smoke Detectors(not located in bedrooms) ..�_ Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms 3 6 Smoke Detectors Egress Occupant Count C9"' Building Systems Maintained & Operational Condition of Property Heating _ Building interior Hot water Building exterior . Electrical Property clean, maintained &safe Mechanical draiIs&guards installed,&,secure Pool Safety 'Pool on Site Surface water alarm Date of CO issuance alarms-Door a� ... Pool completely enclosed Self c..... .... ....... __ _.. _ _ .. .. _ .. losing/ latching gates Pool fence to code requirements CO's for all items present Prior Rental Comments: TOWN OF SOUTHOLD y ell t' Rental Permit Permit No. 0179 Owner South Ladybug Realty Occupied as Single Family Dwelling Located at 555 Smith Drive S. Southold 76-2-27 Village Maximum Permitted Occupancy 4 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. 9/9/2019 John Jarski Code Enforcement Officer This Notice must be posted by the main entrance at all times 01- Town Hall Annex 1 Telephone(631)765-1802 54375 Main Road i Fax(631)765-9502 P.O.Box 1179 mj-& Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee 200(Application must be renewed every two �W @ . k JUL 1 2 2019 Section A. Bu -a'311' I � � Property Information: w � tak .,nNf Dental Property Address: Tax Map Number: 1000 SECTION -BLOCK -LOTi'� - NQ,w IYlai�i n9 Ac�o��Ss I T ) SECTION B. b':�74+6 o OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: h b� Telephone Number (s): DaytimeaU a- venin al a - -elmergency _- Property Owner Email Address: .._ Page 1 of 5 r Town Hall Annex Telephone Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 ' 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): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent:,, Telephone Number(s): Daytime, Evening Emergence Email Address: w� 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 Town Hall Annex P Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 ' O BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent; Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on propertyi: 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 Uni " Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: -0,wk- p Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 Y.O.Box 1 179 It 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. 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) 6,=�41 hW /00, v I 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 Page 4 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 1 197 1-0959 , BUILDING DEPARTMENT TOWN OF SOUTHOLD 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: LANRU& U k Property Owner's Signature: w6x Www - � �� . Swo to before me this) day of �/ 20 Official Notary Public Signature and Original Notary Stamp VIKRAM S RANA NOTARY PUBLIC-STATE OF NEW YORK No.01RA6376926 Qualified in Suffolk County My Commission Expires 06-25-2022 Page 5 of 5 vg suryw TOWN OF SOUTHOLD BUILDING DEPT. COO 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL 9404If [ ] FIREPLACE . CHIMNEY [Vf FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING prlq� LIP" , A 0 Nil • SLkvmm DAT E INSPECTOR .. 4 g CIQ .1, a. u qr IN IN, RRm �V k ryrygqpp Ml 0m -n C: 0 (A 0. En 0 0 U- C—D co -n m :3y Z rn CL 01 rn 23dw tory jo ..........�;- ........ 17- CID m m N-1 Ali � m m rri rn M I71� Ln -n -n 0 0 rn 7K z z 411 IM 0 0 Z m CIS rn Ln ........... 7 a 0 f r i w^«•agti d m a ��uwR O 9 m� t D I1 Y r r a hwllhl ' a O G) X X X W f p m m m W j L' T �, d SII 0 0 j f0 , �r y� r >t ag, jo 3/ jr aria CID ill i r 'w ', ��NW CD 0 0 ' 5 , a 3 � COO , � 1 0 0 0 o m o o o o o m 3 :3rt f S � � 1 a -T7 O O S wI^ ° O77O 71 i i m �wun i FORM NO. 4 TOWN N SOUTHL BUILDING DEPARTMENT ENT TOWN CLERKS OFFICE SOUTHOLD, N, T. CERTIFICATE OF OCCUPANCY No. .. ate .......................... 1 THIS CERTIFIES that the building located at .. .. Street ) l o. 1E.............. Block o. .. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........................................NOVOIn'borrU 1 pursuant to which Building Permit No. .. dated ...........................Xov ... , 1961.— 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 ........ The certificate is issued to ..... ` r, lesseecarten ,ant) : . ...............® ant) of the aforesai 'ebuiling. u� P Building Inspector ...,.. FORM NO. 4 60, TOWN OF SOUTHOLD 3 BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy- ® . . . . . . Date . . ° . . . . . ° . . THIS CERTIFIES that e building located at . . Map °Goose-Ne0k Block No. . ZZ. . . . —Lot No. . . .Southold conforms substantially to the Appl°ce °t heretofore filed . . . 19. .68 pursuantto which Buildingt No. at . . . . . . . . _ . 68, s issued, and confonns to all of the require- ments s c le provisions of the law. c c r which thiscertificate is issued . . . Pr ivate y- . . . . . . , . . ,� . . , . . . , .� . . . , , . . . . �. . . , .� , ° . The certificate is issued to A2.fred -Reber lau . . . . . . .� e• lof th . . . (ower, lessee or tent) e ore Suffolk County Department of HealthApproval . . . . . . . . . . . , . . , , . . . , , . . . n . . , Building Insctrar. . . {. . . . . . . . Yom No. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 1&.7*. . . . . Date . . . . . . . Xay. . .M. . . . .�� THIS CERTIFIES that the building located at . .fti.th.orive. amt . . . . Map NoGoass.Nactk. Block No. . . . . . . . . . .Lot No. .124. &12`�. . .$4atA414. . .�i conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . . Qct. . 2 ., 19.71t pursuant to which Building Permit No. .75au. dated . . . . . . . . . . . . . Act. . . .9., 19. .7.4, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . Psiva cae s sort'. . . . . . ... . . . . . . . . . . . . . . . . . . . . The certificate is issued to .gdward. schwanke r . . . . . r. . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid :building. Suffolk County Department of Health Approval R.H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. N..R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . 555. . . . . . . Street . . .Smith Drive. . South . . . . . . . . . . . . . . . . . . . . . . .NW Building Inspecto ti fF0 Town of Southold 9/7/2019 P.O.Box 1179 " 53095 Main Rd " Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40676 Date: 9/5/2019 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 32345 Route 25, Cutchogue SCTM#: 473889 Sec/Block/Lot: 97.-5-5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/15/2019 pursuant to which Building Permit No. 44102 dated 8/27/2019 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 built"AQ unit and furnace&as+ n ersionto existing;sib-famil.y dwelling as alaled For. The certificate is issued to Doroski,Michael&Ors. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40676 8/30/2019 PLUMBERS CERTIFICATION DATED w� Authorized Signature