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Home My WebLink About1000-76.-1-22 ¢£ TOWN OF SOUTHOLD 15E Rental Permit 0263 Owner Jonathan & Joy Ellinghaus Occupied as Single Family Dwelling Located at 155 Smith Drive N. Southold 76.-1-22 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. 1/29/2024 o o t Official This Notice must be posted by the main entrance at all times fatsa 1537- �ve-- 17'* Q � TOWN OF S UTHOLD BUILDING D 631 -765-1802 IN PEC I ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. ( ] FOUNDATION 2ND [ ] INSULATION/CAl ( ] FRAMING / STRAPPING ( ] FINAL ( ] FIREPLACE & CHIMNEY ( ] FIRE SAFETY IN! ( ] FIRE RESISTANT CONSTRUCTION ( ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) ( ] ELECTRICAL {FI C ] CODE VIOLATION [ ] PRE C/O [ 0 v o DATE INSPECTOR _ .. _ OF SOUTHOLD Rental Permit 0263 Owner Jonathan & Joy Ellinghaus Occupied as Single Family Dwelling Located at 155 Smith Drive N. Southold 76-1-22 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. 1/20/2022 Code Enfofidment Official This Notice must be posted by the main entrance at all times dc � I �a�� "� Town Hall Annex SOUTHOLD TOW �," 54375 Main Road Rentaon PO Box 1179 Southold, � � � NY 11971-1179 Tel: 631-765-1802 Fax 631-765-9502 SCTM # 6 Date It�1-2 Owner v,h Phone Address C "" f � u) / z.1 Hamlett InspectorJ5 I ddres Vs n E , trot"? LEVELS SU 1 3 Smoke Detectors (#-bedroom detectors excluded) ° Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) BEDROOMS 13 4 5 Smoke Detector Alarms 7Carbon Monoxide Alarm ( ) ( ) Egress wi ndows' �Y/N BUILDIN CONDITION 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/op rational Handrails&guards present POOLS / L BARRIERS Y1'N Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min.48"high resent POOL GATES Y/NAll 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: (% J n3 0k =-4 TOWN OF SOUTHOLD p IS Rental Permit Permit No. 0263 Owner Jonathan & Joy Ellinghaus Occupied as Single Family Dwelling Located at 155 Smith Dr Southold 76-1-22 Address S/B/L 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. 12/30/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times S Town Hall Annex Telephone(631)765-1802 54375 Main Road I?a - a )765-9502 Nh P.O.Box 1179 Southold,NY 11971-0959 y " q BUILDING DEPARTMENT TOWN OF SOUT OLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map umber: 1000 SECTION —7 00D BLOCK LOT SECTION B. OWNER INFORMATION: Property Owner Name: J Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 2 Telephone Number (s): Property Owner Email Address: 4 Page 1 of 4 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): Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: 11 "gym �a 6 Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s): 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): Mailing Address of Managing Agent: Telephone Number (s): Email Address: Page 2 of 4 Sir 1* �)Y-1 LAItAd, ky R71 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 occupybwelling Unjl:Vf (0-.- Number of rooms in Rental Dwelling Unit: 15 � .. Use and Dimensions of each room in Rental Dwelling Unit: '. co r Jam. DUnn iLeht . - -, ea 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. b/I 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) P Ioa � ,, 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: ' ) t� S Property Owner's Signature: n ub4aao Sworn to before me thi;day of " w b "' , 20 N o 01BI16185050" �. b";.raw*w *M rye " r '�w'� � ..) Official Notary Public Signature and Original Notary Stamp Page 4 of 4 So Town Hall Annex Telephone(631)765-1802 54375 Main Road CA Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 C BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form to be completed by a NYS licensed architect, NYS licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Pro essidnal seal re aired airrhitect or Fn inset licensed Norxe ins actor nlust rovide a copy of a valid New York State Uni orrn Fire Prevention Building Code C erti ication. Rental Property SCTM Number: -G ?L)01) Rental Property Address: � r i Owner/Name: Rental Dwelling Unitidentifier:"-) 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 the unit 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. Print Name and Title Original Signature Please place professional seal: ® S&4( - s TOWN OF SOUTHOLD BUILDING DEPT. ;w e765-1802 INSPECTION C [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] NA L [ ] FIREPLACE & CHIMNEY [ " i FI E S F I S ECTIO [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/ _m. e _ mm OOm -n 0 CJs C) V) 01- CO ur or CD cl o m m m -n Z :1 0 :3 m m IL ::) 0- GM) a CL D as m CD z Z Z to m G) -V m r) (D On (D m (D m m m PIZ 0 UD -n 71 0 C ;Q ;a T,,� d", 0 0 (-A Z Z m m 0 z ml z, mw n ni Le) m nl m G) CA 71Z (D 's i ® W m Y'n m X Sc x m •D (-r W O N 3 . 3 W CD w do (aY f U I ��p r f � I �i�wM A a�a "n rn 1 ro rt O O � CD 3' 3' I i a QYp S/ Qi�b 4D, aY i i I I m�G Town of Southolda 6/26/2013 54375 Main Road t10 SouthoK New York7 PRE EXISTING CERTIFICATE OF OCCUPANCY : 36319 e: 6/26/2013 THIS CERTIFIES that the structure (s) locate t: 155 N Smith Dr, Southold SCTM : 473889 c ot: 76.-1-22 Subdivision: ile of No. conforms substantially to the requirenients fora built prioro APRIL 9, 1957 pursuant to which CERTIFICATEF 36319 to 6/26/2013 was issued and conforms to all the requriernents of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame one Tamil _dwelling with rant ppgmclt and,rea.r cement paflo,,* The certfficate is issued G Holding Corp (OWNER) of the aforesaid building. HEALTHSUFFOLK COUNTY DEPARTMENT OF ELECTRICAL CERTIFICATE NO. CERTIFICATIONPLUMBERS *PLEASE SEE ATTAC14ED INSPECTIONREPORT, rr�t t 1 Si- h.t�r BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 155 N Smith Dr, Southold SUFF.CO.TAX MAP NO.: 76.-1-22 SUBDIVISION: NAME OF OWNER(S): P&G (S} Holding Corp OCCUPANCY: ADMITTED BY: Glenn Heidtmann SOURCE OF REQUEST: P&G Holding Corp DATE: 6/26/2013 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: CRAWL SPACE: X BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: front open DECK TYPE: PATIO TYPE: rear cement BREEZEWAY: FIREPLACE: GARAGE: T P ME TI Ilt1 AI I�� .rrrr R• XR � electric TYPE HEAT T WATER: 1 rid "FARM AI _ _ is AIR CONDITIONING... #BEDROOMS: 2 #KITCHENS: BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: G 'T DATE OF INSPECTION: 6/26/2013 TIME START: END: �fff(Y �r II II r,,l r 1 i i i N�l��d//dib//y�/Nf✓ /jAJNl S( %�i/% r; i f r r l 1 9 0 r lir /r J r= r { r ! { a „ r a rry � � w bo, m ° q � � � by •� ,�� „�,„ C9 oh I, o 1p. a C5 tj 41 � Y i ^ 5 O >10 �V -0 0, r ora -rAPP � vEA-r0 y m coo $ G�O O x�'z ,y D m oZozy O X n O Z W O < C7 z n y Q #^ N 0>(,,Zz v ia' m m Z K o b rrI C o z a � r ars 00o oo lio� O � b � Zr �\� D r m n V O O (p D oIM Z = y C y `° rrt(A Lrl O m x r zz rn v /'11 �{ n O 0 z w m N ? z 0 (a h [[ D