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Home My WebLink About1000-46.-1-31.1 (Unit B16) TOWN OF SOUTHOLD Rental Permit Permit No. 0375 Owner Driftwood Cove Owners (Geoffroy Penny) Occupied as Single Family Dwelling Located at 1000 Ninth St. (B16) Greenport 46-1-3L 1 Village S/B/L Maximum Permitted Occupancy 2 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. 12/21/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times 4 Town Hall Annex Telephone(631)765-1802 54375 Main Road C/> Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 cou BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION JUN 3 0 2020 Rental Permit Fee $200(Application must be renewed every two years)- Section A. Property Information: bR&rVj CbQ!-: Rental Property Address: & V V Tax Map Number: 1000 SECTION BLOCK I 16t- SECTION B. OWNER INFORMATION: f�Y-0 Property Owner Name", Property Owner Legal Address: Property Owner Mailing Address:, (Cannot be the same as Rental Property Address) C --- <j— —- --- - 3 ---— - K Telephone Number (s): Property Owner Email Address: Page I of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: - -�Vv0yAo-s �, Rc-&-F l �,f PG, Address of Authorized Agent (no P.O. Boxes): 7iD�o?0 C��N - g Mailing Address of Authorized Agent: �El wl 071- Telephone Number(s): Email Address: C F G C-e- ED d via GZS VY1 C Section D. Managing Agent Information: bei r�UO �v a 2� Name of Authorized Agent of dwelling unit, if any: V1 4'C� Address of Authorized Agent (no P.O. Boxes): 75' 5tWf&! ,5 Mailing Address of Authorized Agent: -1:�X IjV Telephone Number (s): Email Address: jo SECTION E. SITE MANAGER INFORMATION: (required for ren properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, ' ny: Address of Managing Agent (no P. . oxes): Mailing Address of Ma ging Agent: Telephone Num r(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: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: 3 Use and Dimensions of each room in Rental Dwelling Unit: � o Oaf // K /' 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. VKam requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. Page 3 of 4 f x ❑ 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) 1 et Pe-4n Acertify 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 Argent, or Site Manager. Property Owner's Name: Property Owner's Signature: Sworn to be day of 20- Official i na re�andnal Notary Stamp THOMAS J.MCCARTHY Notary Public,S-Ve of New York Suffolk Counly-No.500780 Page 4 of 4 Commission Expires N3VEZIber 23rdt- )-6�-) IP SO(/ly� I f V v �1 # # TOWN OF SOUTHOL BUILDING- DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL ReA e [ ] FIREPLACE & CHIMNEY [ r FIRE SAFETY INSPECTION' [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE INSPECTOR Xv/ �m r QL � 0 U� � * �! J - I a{ ' I L e,DRoo rc,\- —Smo �E1>e.Tec-'oR CC �- a TOWN OF SOUTHOLD PROP _ � LITRD CARD �3 �j mow+. ��-� .�+•�\ ,/,� ------- -— - - - - j C'OWNER GSTREET �F VILLAGE DIST. ! SUB. _ FORMER OWNER L GJbfd t`. c,s N E ACR. L/ s7 i Z; } S W TYPE OF BUILDING t tb RES. fr SEAS. VL. (FARM COMM. CB. MICS. Mkt. Value "�ti r LAND IMP. TOTAL �: ' DATEREMARKS ///j J �64,A L? ( c �A. n + LJ1 �� p✓ P: /� �/ �/ �/'r� °% A Fi' � `� �F-� •� ` t' ' -i.�,ci-"m F_7 t O o � 0 r� - �I.4 L5 3 in 533- - r, j I "Ls.9 I G� ' j t U is G? ^� ��/3D l -I �s, ��( - C��d l� K Gv�r�rb ce.�� -1J IJ`3't lhlrnC,t( "�l��rl�'4 1ly 4 1 / �,-o 00 I { O c J/� l J`t'� 'ir �G` �G i°f tp G��+i Yx G't /4;61— .�"P�" �" �; l p C, o °!��J fJ "J '- f f`7�i ' ' y �/ % '�a�`7 1✓�n rGa.,.a' o W,,40,Y /,I1.�7/.,�Ln�r.r�- '-fat co 0 A ,) �� v ' ! ,S =�'-'� d � �/�,�' ! f�� J'�'� �P-� ��? /�� — �1�c.Tra cr.! feiYJ-1 i r r /F Z ,6)11N a c� l i „��r�1�Y1)�S �(a--'7 ----; / �,a, f� l=t` �� 4 D3 l�> # ci� f i(L c�,r Li Y', lie c6f s5 t r-�� ,/' e"pla c4p 113 13 5so?lp 61 2 15,00-,D -z(9 c-,(D 1111 cis U�,�a`�= Tillable I FRONTAGE=ON WATER r— 'Woodland ( FRONTAGE ON ROAD Meadowland F DEPTH a House Plot I BULKHEAD Total MEN ■■■■■■■■■ ■■■■■ ■■■ ■■■■■ ■■■■■■■■■■■■■■■NNMEN mp .,� --.� ■N■■■■■■■■■■■■■■N■N■■N■■■ ■■ ■■■■N■■■■■■ MEN N■■■■■■ ■� ■IME■■ ■■■■■■■ii■■■■■■■■■■ 0IME■■■■■ OMEN■■■■■■MIN■■■■■ ■■■■■■■■■■■■■■■■N■■ ■■ ■■■ ■■■■■■■■■N■■■■■■ ■■N■■I■ • ■■■■■IME■■N■■■■■■■■■■mom ME Interior Finish • �e 103 FORM NO. 6 TOWN OF SOUTHOLD_ , BUILDING DEPARTMENT'`- Town Clerk's Office Southold, N. Y. \ Certificate Of Occupancy No. . . . . . . - Date . . . . . . . . . August , ,16. . . .. . . 19.7 . ----- -- - - -THIS CERTIFIES-that the building located at .1:=11rl.13d. : .9th .Vit. . . .. . . . Street Map No. °qac. . . . .. . . . Block No. . . x. .Lot No. .xxx . . . Greenp.Qrt. : A�y.. . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated---.--. _19. . . . pursuant to which Building Permit No. §5972. . dated . . ... . .. . . . 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 ; one bedroom apartments buildings .A € B . Driftwood Cove, , . . . . The certificate'is-issued-to_:_!�ehnphon— amanos;; , ; ,or�ner . . . . . . . . .... .. .. ; (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval existing,public sewer .,system, . I UNDERWRITERS CERTIFICATE No.A.. 757.7:r l.75791,4r317579?:..B 141.757869� N 176016 1 14176017 Aug 9 197+ HOUSENUMBER . . . . . . . . . . . . . . Street . . . . .. . ... . . . . . . .. . ... .. .. .. .. . . ..... . . .. . . .: .House numbers .to. be .assigned .on. comtiletion .of.�ro3ec't ........ . . . . . . . . . . . . .. . . .. . . . . .. . . .. . . .�.... ... . ..: . .. .: . . . .. .. . . . . . - __-_-- Building Inspector ° 1� 6`ev'