HomeMy WebLinkAbout1000-40.-1-9 �p catTOWN OF `OUHL
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Rental Permit
0379
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Owner Alexandra Albrecht
Occupied as Single Family Dwelling
Located at 62675 CR 48 Greenport 40.-1-9
Maximum Permitted Occupancy 8
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.
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1/25/2023All
.
Code En� rent Official
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD
Rental Permit
Permit No. 0379
Owner Alexandra Albrecht
Occupied as Single Family Dwelling
Located at 62675 CR 48 Greenport 40-1-9
Village S/B/L
Maximum Permitted Occupancy 8
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.
1/28/2021 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
S I
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT JUN 2 4 2020
TOWN OF SOUTHOILD
RENTAL PERMIT APPLICATION
Rental Permit Fee $200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
62675 North Road, Greenport, NY 11944
Tax Map Number: 1000 SECTION 40 -BLOCK- -LOT 9
SECTION B.
OWNER INFORMATION:
Property Owner Name: Alexandra Albrecht
Property Owner Legal Address: Property Owner Mailing Address:
203 East 13th Street, 203 East 13th Street,Apt. 4A, NY, NY 10003
Apt. 4A NY, NY 10003
Telephone Number (s): Daytime 443.604.6177 Evening Emergency
Property Owner Email Address: albrecht.alexandrac@gmaii.com
Pagel of
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Town Hall Annex t ��"�, . Telephone(631)765-1802
"
54375 Main RoadC Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 U
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 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:
Address of Managing Agent (no P.O. Boxes):,
Page 2 of 5
SOf1����
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Town Hall Annexe, `:� r h Telephone(631)765-1802
A DI
54375 Main Road "g 9` Fax(631)765-9502
P.O. Box 1 179
Southold,NY 11971-0959
® a
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
Telephone Number (s): Daytime Evening Emergency
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
1
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, Q 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: Unit 1 (OF 1)
Requested Maximum number of persons allowed to occupy Dwelling n'
Number of rooms in Rental Dwelling Unit: 7
Use and Dimensions of each room in Rental Dwelling Unit: Bar/play room: 5 x 15
KITCHEN : 21x17 Living Room: 36 x 26 Bedroom 1: 14 x 14
Bedroom 2: 19 x 23 Den: 15 x 24 Master Bedroom: 30 x 23
Page 3 of 5
%Of SO�tT
�INN
Town Hall AnnexTelephone(631)765-1802
�,a, .
54375 Main Road '�_�, � � Fax(631)765-9502 '
P.O.Box 1 179 j-
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.
N 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 Alexandra Albrecht 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
Page 4 of 5
Town Hall Annex r� ti Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
CQO? �
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: Alexandra Albrecht
Property Owner's Signature:_ ZIA, V
Sworn to before me thisZ day of 20-
V
Ciciial Notary Public bwrndAinal Notary Stamp
F140TARy
ID J.Jp,]`1Nl.1ZZf
LIC.STATE OF NEWYORK
on No.02JA6052585
ed in Suffolk County�cpiras February 13,
Page 5 of 5
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# TOWN-OF SOUTHOLD BUILDING DEPT.
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INSPECTION
[ ] -FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION-2ND -[ ] INSULATION/CAULKING -
FRAMING
NSULATION/CAULKING -
FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION . [ ] PRE C/O
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-24570 Date August 13, 1996
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 62675 County Road 48, Greenport
House No. Street Hamlet
County Tax Map No. 1000 Section 40 Block 1 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-24570 dated August 13, 1996
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 one family dwelling *
The certificate is issued to Helene J. Schmidt
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REx/1"
T.
i
Building Inspect
Rev. 1/81
NAME OF OWNER (s) Helene J. Schmidt
OCCUPANCY_Single Family
type owner-tenant)
ADMITTED BY: Lynda Lee Spangel ACCOMPANIED BY: Same
KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-40-1-9
SOURCE
00 - -
SOURCE OF REQUEST: John T. Schmidt DATE: August 1996
DWELLING:
TYPE OF CONSTRUCTION Wood Frame STORIES 1 # E%ITS 7
FOUNDATION C.B. CELLAR Full CRAWL SPACE ===r- ===_-___
TOTAL ROOMS: IST FLR. 6 2ND FLR. ==== 3RD FLR. _====
BATHROOM (s) 2 TOILET ROOM (s) 2 UTILITY ROOM
PORCH TYPE Rear Wraparound Enclosed DECK, TYPE PATIO
BREEZEWAY FIREPLACE 2 GARAGE 2 Car Under
DOMESTIC HOTWATER g TYPE HEATER Oil Fired AIRCONDITIONING
TYPE BEAT Oil WARM AIR HOTWATER %
OTHER: Front Foyer
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWIMMING POOL GUEST, TYPE CONST.
OTHER:
------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
INSPECTED BY DATE OF INSPECTION August 12, I996
J K. Boufis TIME START 9:45 END 10:20
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26180 Date: 12/18/98
THIS CERTIFIES that the building ADDITION ALTERATION
Location of Property: 62675 CR 48 GREENPORT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 40 Block 1 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 24, 1997 pursuant to which
Building Permit No. 24456-Z dated NOVEMBER 3, 1997
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 ALTERATION AND ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MICHAEL FOLEY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-461334 08/05/98
PLUMBERS CERTIFICATION DATED 12/03/98 VANETTEN PLUMBING & HEAT.
BuildMg Inspect
Rev. 1/81
coFFOL.A. Town of Southold 5/15/2018
3 P.O.Box 1179
o + 53095 Main Rd
yjj�l �ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39645 Date: 5/15/2018
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 62675 CR 48, Greenport
SCTM#: 473889 Sec/Block/Lot: 40.4-9
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
4/25/2017 pursuant to which Building Permit No. 41582 dated 4/28/2017
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:
accessoryground swimming pool fenced to code as applied for.
The certificate is issued to Friedman,Kenneth
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41582 10/24/2017
PLUMBERS CERTIFICATION DATED
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