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Home My WebLink About1000-40.-3-10.6 TOWN OF SOUTHOLD AF M& Rental Permit 0277 Owner George & Demetra Tsirnikas Occupied as Single Family Dwelling Located at 65400 CR 48 Greenport 40-3-10.6 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. 2/9/2022 Code Enfp4nnent Official This Notice must be posted by the main entrance at all times app 7 Town Hall Annex �I IUl cru Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 i BUILDING DEPARTMENT TOWN OF SOUTHOLD � m 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 iPro essional seal re uireld or Architect or En sneer, licensed Monte Inspector nest provide co o valid current cerci ication Rental Property SCTIVI Number: Rental Property Address: ��. � ) MI Owner/Name: Rental Dwelling Unit Identifier: 10 — .0 — .0 — Number&Square footage of each bedroom as depicted in the attached floor plan: (' q•, q ) i.e. Bedroom #1 �00 s Bedrvo 7xb '��0�� e OX ) eel i oz) Lr .4 &C, Property Descri tic n (I clude 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 Construction Code of New York State. 6S 6W yl Print Na �e and Title Ox,ginaISI atu a ,�� wy I Please place professional seal: U �� TOWN Town Hall Annex ��y � F 54375 Main Road RentalWInspection � � i PO Box 1179 Southold, MIT NY 11971-1179 Tel: 631-765-1802 Fax 631-765-9502 SCTM# Date Z uvner : Phone ( -z- (W 0� AddressZip �" a C Hamlet eefl o ° Inspector Address uisibie fr'o'm street? tZ LEVELS SUB 3 Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers(#) Exits (#) BEDROOMS 2 437; ' 4 5 Smoke Detector Alarms (#) - Carbon Monoxide Alarms Egress(windows (YIN) DIN SYSTEMS CONDITION OF PROPERTY BUILDING S S 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 0 POOL BARRIERS Y/N Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min. 48" high resent POOL GATES Y/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: n 11191(KI T 'WN OF SOUTHOLDUJPr-1 Rental Permit � ££ 0277 Owner George & Demetra Tsirnikas Occupied as Single Family Dwelling Located at 65400 CR 48 Greenport 40-3-10.6 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. 1/17/2020 John Jarski Code Enforcement Official This Notice must be posted by the main entrance at all times rj� so Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �Q Southold,NY 11971-0959 UNC,. . f BUILDING DEPARTMENT TOWN OF SOUTHOLD t' 3 - RENTAL PERMIT APPLICATION U '- OCT 2 9 2019 Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information:- Rental Property ress: tell Tax Map Number: 1000 SECTION -BLOCK -LOT J D - SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 70 fV V/ � J r �7J Emer encCql;�)qq,- I Telephone Number(s): Daytime Evening Property Owner Email Address:. rO �r Page 1 of 5 � A ,> LL\oF So"01 Town Hall Annex Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �® �� BUILDING DEPARTMENT TOWN OF SOUTHOLD .V Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ►'�'� r - 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: 6pjk)e—.r— Address of Authorized Agent(no P.O. Boxes): 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: IV g g g g Address of Managing Agent (no P.O. Boxes): Page 2 of 5 ti Town Hall Annex A Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 , Southold,NY 11971-0959 -- BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: `1700 17V 7� IiV43S-9 Telephone Number(s): Daytime - Evening Em gency Email Address: , X6(2 , C-,--C-21Z SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: �Me 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 occupLDwellring � ��,Number of rooms in Rental Dwelling Unit: _Use and Dimensions of each room in Rental Dwelling Unit:- fv Page 3 of 5 Town Hall Annex s , .� Telephone(631)765-1802 54375 Main Road y;� y^. x-.'a Fax(631)765-9502 P.O.Box 1179 " Southold,NY 11971-0959 ®�® 1�r®� v , , 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 ❑ 1 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 r4 ��ri �J �2certiiy 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 11971-0959 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. 77 � Property Owners Name Property Owners Signature: efore me thiIs�[� `da of � 20 Sworn to b ` y Cin Official Notary Public Signature and Original Notary Stamp CONNIE D.®UNCH Notary PublicNo.01 BU61856State of 50w Y®rk ®ualifled in Suffolk County Oommission Expires April 14.20 Page 5 of 5 01/ qOD �arjl So # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 z INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] ' FOUNDATION 2ND [ ] INSULATION/CAU KING [ ] FRAMING /STRAPPING [ YFINAL/aj,� [" ] -FIREPLACE & CHIMNEY [ ] FIRE'SAFETY"INSPECTION" [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ' [ ] ELECTRICALS(FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS:fA?4-4z -/ SIV�V�\� rl • 4; '_ cq) DATE P INSPECTOR DL N CATHEDRAL EILING CWITli BEAMS _ X66'-S" 54.82• 34 9' 2-''G4 _ I7• 4 5=7f3j � I 11�2�z" : 2 , g'y� 1 l�4s 1 •-0 1/2" 7.6 I 10•-Il 1/2" ewe: 1C4,, I 6F= FR1HOSE DID F , PIER onE 3069 lee panel) , 3ry i JE3027B 80698 : ,14278 V 61 =� accea 8430 ; t,s C4 .,/y a..j 3816 4224 1363E ; n _ closet 1EEFEli _ ' UTILITT --- O O _ 2 IT \ i i AREA 6' filler z4 ' J Is�� ( °1 34• Ir24" 18"I 472• PIER Two c L _J KITCHEN !p^'f�t3lF?NW —41 bila 11 FAN I BWE: 74;' •• BEDROOM #1 it el ? OM E m PIER ONE s o " O BEDROOM *2 turn _I'••I m� - ° I 6Duet ane inert �? o i 1;a i sJ1 ^r` a ii AER Two $� , Ile -( i4 DEuER h tlin m 24 24- 4'0 0 tl a WK o: 1 o '• 9 4 29• o V it 28 - co RO } a s { PANEL �e 30698 3 88 50698 80538 _a' \��1 E�7RA •-- I � I .I ao63B r54'8{ � � � GPI 3�t•8±. I __, a ._� , _ ;- 4 40ZOR ' , K TED r~r.c0%,re=A""Ol P�O, ORON HOIVI ERTIFI$�S ME #18669 IS BUIL `~ C F J TE�O �B1E 1; 1 S C ATIONS. HUD SEAL 134906. F`Y;CY EsvllJtl+l�' �t"4F!T11f.. b ` , ,902 g AAc •ro j $'rl. ;FEE le O!i Tr—= �e �t F��E jt1p 1:cy TtO uSP7-Ch I l t_Dr vµvpATlO� - -=r^UiR-D # 18669 T HUDRM S M/H M :=� p'�ii1+��1 i:7k,I•C•`I:i�G ljtl� ' .$ .a. ILnT•!•, r"�::s�. :ai ti it£T t - ZONE II - 3n'`�► ii,�tJ o- - I - S:�.� i _-. _ E—6. 115 C H R TOWN OF SOUTHOLD PROPERTY RECt,nu uAKli OWNER STREET VILLAGE DIST. SUB LOT ACR. 1. 53 REMARKS TYPE OF BLD. tvt-.)61 (c �q,(-?w PROP. CLASS. zllo LAND IMP. TOTAL DATE lACj !FL7 z/,o I- FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH / MEADOWLAND BULKHEAD HOUSE/LOT TOTAL , ( I LRD TOWN OF SOUTHOLD PROPERTY I� 1 �g OWNER j _t.�p, _� - I O.L. STREET u VILLAGE DIST- SUB. LOT -' i n F6L f Lt % - FORMEP. OWNER L�-nh S,FEa ve ( ! 4�; / E I l ACR. •t. �iF I (9 conk}ova/Stiff �� S J, Vd TYPE OF BUILDING S i, EM►moo t r ( c (1 " (e� �i t _ CSM I' r� ✓2�3 Qv y . Lq RES. �j,TD SEAS. VL. FARM COMM. CB. MISC. Mkt. Value ' 3 LAND- - IMP. TOTAL DATE REti'.ARKS * _ ;r�1 6, c a �� Z/ G' 11-� G� `y� C,cpit, Drr,� /0 DAN1r't okXL�ti �fr�M '�Y n '73 oa yrs, fI f r2h 7 c� r l s z�� 8Z x r D G V/6/I f c `r coLi oj L- 93 c-, --� ' Bl�ll DING CO (TION A- NEW, Y N1 9 6Aw 1- BELOW EOYE Value Per F 'M. J Tillable 1 ' , i 7 .A C _� >'�:: '_ .•r. _ c..•- r i' r Tillable 2 � �j /bpi 4 L11 Woodland y 7 t �fQ ! ��- /� -77 ! 7 -f7-) 1FGf✓Ot SGC Swampland ! FR Z NWA -t FCS 671 Brushland !,� 1 q. FRONTA E ON ROAD C House Plot ( ter' DEPTH �R �, .. BULKHEAD Total r;; =- DOCK l v�t �7_ X7007 • r' li NEON 0 NNOMMENEM I No FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-23328 Date NOVEMBER 4, 1994 THIS CERTIFIES that the building MODULAR DWELLING Location of Property 65400 COUNTY ROAD #48 GREENPORM, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 40 Block 3 Lot 10.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/10/86 & 9/11/87 pursuant to which 14498-Z & Building Permit No. 16456-Z dated 1/10/86 & 9/11/87 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certif issued is ONE FAMILY MODULAR DWELLING WITH -�►rvun un�ry The certificate is issued to ESTATE OF DANIEL G. CONKLIN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-001922 - JANUARY 7, 1988 PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES CO Z-16603 DATED 1/21/1988 & CO Z-17730 DATED 1/31/89 Bu ing Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspect Town Hall uthold, N.Y_ CERTIFICATE OCCUPANCY 0oroperty Dat JANUARY 31 1989 /H-1She building ADDITION Z-1 00 NORTH ROAD GREENPORT, NEWYORK ouse No. Street Hamlet County Tax Map No. 1000 Section 040 Block 03 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 9, 1986 pursuant to which Building Permit No. 14498-Z dated JANUARY 10, 1986 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 HANDI-CAPPED RAMP TO EXISTING ONE FAMILY DWELLING The certificate is issued to DANIEL G_ CONKLIN (owner) of the aforesaid building_ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81