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Home My WebLink About1000-35.-6-33 TOWN OF SOUTHOLD Rental Permit Permit No. 0272 Owner White Dog NY LLC Occupied as Single Family Dwelling Located at 335 Osprey Nest Rd Greenport 35-6-33 Address 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. 1/14/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex b Telepho � ne(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �► Southold,NY 11971-0959 BUILDING DEPARTMENT J 1L`' NOV 18 2019 TORN OF SOU MOLD RENTAL PERMIT APPLICATION .' :�, '� Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: ��35 C�s,pre� � S �,d ,��re o�►O�<-r�. N I 044 Tax Map Number: 1000 SECTION -41558 BLOCK 3s• LOT (v a 33 SECTION B. OWNER INFORMATION: Property Owner Name: -D -ekora k r2.. k�4 7�>0 j L L C Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Scam e� Telephone Number (s): 111 C� �I 7:T � �7 (0 _ Property Owner Email Address: —D-��`J ora ' a c.La.12UL � G'fu-<re- �� • Cf/�� Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any:,_--QoL&t CkS Address of Authorized Agent (no P.O. Boxes): 1 �f�c�,n-� St . Mailing Address of Authorized Agent:�' r✓T L r Telephone Number(s): W3 - 4 3 -+ --Y-2-Z 0 Email Address: ` {tea c.� L• ,o e 6 Q rfV -a n Cowl Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any:- Address ny:_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 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: 4to - Number Requested Maximum number of persons allowed to occupy Dwelling Unit:of rooms in Rental Dwelling Unit:_ + _L _ Use and Dimensions of each room in Rental Dwelling Unit: ki+Ck1-eV1%- °_7 8 X Li vi�S�_ /c�� nv�-t wc; ra�11n�.-->---�� _ � �y --- • -��U orc�-�.9 -��' _7 -,�� I t� %cd Arco�u, a_;_ ` 4" X I j ' , Bed r-"o L 3 /a_'x 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. E2(/, 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) ,Y COUNTY OF SUFFOLK) I �7,ekJd1 oL(n � Z5 2. 1 certify under penalty of perjury,the following: 1. I 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:- _pe 9 ono_ Property Owner's Signature:- DENISE A. NAVARRA ov�� ,�� .— / NOTARY PUBLIC-STATE OF NEW YORK Sworn to before me this_day of. 20_ No. O1 NA6191295 Qualified in Suffolk County My Commission Expires _(,aJ� Official Notary Public Signature and Original Notary Stamp Page 4 of 4 1 F so yo # # TOWN OF SOUTHOLD BUILDING DEPT." �`'cou►m '� 765-1802 -INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [/IFIRE-SAFETY NAL 42/1, f�Glr 4 FIREPLACE & CHIMNEY- [ INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: ont h qLo- it .� DATE INxx INSPECTOR ren J -"drr}. , yfk , - R � Y � I T� Y 4 3 �o� f aAlt 10 I o" r Y ' f i i I _ TOWN OF SOUTHOLD, PROPERTY RECO �g r _ � 8 OWNER STREET VILLAGE DISTRICT SUB. LOT FORMER OWNER :5+O y N E ACREAGE Alm S+atzk k- rA l S W TYPE OF BUILDING RES. ' 1 SEAS. AVL. FARM COMM. ( IND. I CB. MISC. -- Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS 'Il ' k f'r I71 Dl . G CON D i /s"/g'9 - P /77 �-(',onst�-ae�d?� . ►-�P�ac� eat. . e4k01, ch DCS 15L /0 ABOVE ON WATER / Form Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland 7Z S�Z 6kV Brushland G 119 —LZ3-76 — StOT k Tb +6 ' House Plot Total SIC I0-1,1:8IR \ - -N a Mo 35. -6 33 S- �: Over 100. y - I t t r - M. B Idg. 1� Foundation ��, i Bath Extensicnl r 71 Basement Floors Extension Ext. Walls Interior Finish p0q. - Extension Fire Place ; Heat Alo 7 X/ 3 Porch Roof Type �E c k, K�� ✓ 6 y I Porch Rooms I st Floor 6 reez6�vayr j x� '3 - I Patio Rooms 2nd Floor ;-,,)rage Driveway j Dormer 3. B. i FORM NO 4 TOWN OF SOUTHOIA Runnrc Dffi' BTMMM Town Qerk's Office Cedif ecate Of Occupancy Na ....... Date . . .. . .. . . . . �. . 1�. ., 19..73 THIS CERTIFIES that the building located at 08prey 400:4.404 .. Street Map No.CIMIAa P01$lack No. . 809J.. Lot No. 0 . G33 eenport_ N.Y.. .... .. . conforms substantially to the Application for Building Permit heretofore filed in this office dated . ..K4y . 15 , 19.73 pursuant to which Building Permit No. 65715Z . dated 16 ., 10. , was issued, and conforms to all of the require- nients of the applicable provisions of the law. The occupancy for which this certificate is w issued is .?rXTate, flap fau4. y 4ye3. 4tng . . Y The certificate is issued to MTithes A ala . Stot*ky. Oriters , (owner, lessee or tenant) of the aforesaid building. i Oct18 1973 4 Suffolk County Department of Health Approval by, R r Villa, UNDERWRITERS CERTIFICATE No.N .11?316. . .. .Se 'L . 18. .1973_ .. . .. .. . . . i HOUSE NUMBER 335. . . Street . ospr®y Drat Road... .. .. .. ... .. .. .... E DOTS: bedroom occupancy kited 84 s ft nor person &dfng31nspector ' P k ' V � F' �1' I {{� k ;x' f 3 � FORE NO. 4 TM CIF SOUTWED BUILDING DEPARTEUM Office of the Bui-ldmg Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18136 Date JUNE 21, 1989 9MI CERTIFIES that the b►aild�g HDDITIE)NS Location of Property 335 OSPREY NEST RD. GREOPORT NEW YORK Ouse N0_ street ElamI at County Tax Map No. -1000 Section 035 Block 06 Lot 33 Subdivision Filed E6v No. Lot No_ conforms to the Awlicaticm far Badding Permit a, ,,re filed in this office dated January 3, 1989 purs=uant to Which Building Permit No. 17743-8 dated AMIArY S, 1989 was issued, and conforms to all of the requirements of the applicable P provismns of the law. The occupancy for which this certafscate is issued. 3s BDDMCNS Et MOM ON MSMG CM EMNIZZ i` DWELL31M AS ASS 330 TM. M The is i.smed to RAM N (owners) C of the aforesaid building_ 1 i SUFFOLK COUNTY DEPS OF HBALTH APPRO9BI< H/A UNDERWRITERS CERTIFICATE NO. PENDING - June 15, 1989 � s b : b Ba a;ng Inspector Rev. 1/81 1 1 f i { t { R._ j e FORK NO. 4 T= OF SOUTHWD BUILDING IWC' Office of the Building Inspector Tim Ham Southold, N.Y. CATS OF OCCUPANCY No—Z-18137 Date J= 21, 1989 THIS CERTIFIES that the building ADDIITIIaN Loc#tion of 33� E?. NgST Rpt 1�_Y. House No. Street Hamlet minty Tax KIap No. IBM section 033 Block 06 Lot 33 S@bdi��irnn Filed gap lib. Fit Bo. i conforms substantially to the Application for Building Permit heretofore filed iij tb s office dated 7=MMff 3 ISM to Muchi' Building Permit No. 27818-Z dated FERNMU 9, 1989 was issued, and comfous to aU of the of the ap�a e t prov1Riona of the law. The occupancy for which this certificate is ry s` issued is ADDITION TO ffiSTING ONE FAMM DWELLING AS APPROVED DT 1 ZB8 ,#3820. ' The certificate is issued to RALYA & GUENMM STDZZCr Ems? of the aforesaid building. z ` SUFF�=, COUNTY DEEMR32M GF D 'd'H APPRIGZAL, NJA >' r NO. PBNDnr. - JUNE 15, 1989 PLUMBERS CERT MCATION DATED N/A y jaw I B ilding Inspector Rev. 1/81 I t i'