HomeMy WebLinkAbout1000-33.-4-3 TOWN OF SOUTHOLD
3£
Rental Permit
= 0491
Owner 1000 Sound Dr LLC
Occupied as Single Family Dwelling
Located at 1000 Sound Drive Greenport 33.4-3
Maximum Permitted Occupancy 10
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.
3/1/2024
Code n rc net Official
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD B ILDING DEPT.
631-765-1802 L(
INSPECTION
[ ) FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] INAL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ) ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C [ RENTAL
REMARKS:
TOWN OF SOUTHOLD
Rental Permit
0491
Owner Michael Phillips
Occupied as Single Family Dwelling
Located at 1000 Sound Drive Greenport 33-4-3
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.
6/30/2021 2!!
Code Enfo&Kment Offi al
This Notice must be posted by the main entrance at all times
so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
enu
M Ay 5 2021
BUILDING DEPARTMENT
TOWN OF SOUTHOID
RENTAL PERMIT APPLICATION r7c
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
d 3)
Tax Map Number: 1000 SECTION -BLOCK - -LOT
SECTION B.
OWNER INFORMATION:
Ib Sit�,d. FZA LLC)Property Owner Name: j_r (mo ke� 00
Property Owner Legal Address: Property Owner Mailing Address:
Aj-q jj7q,
Telephone Number(s): Daytime Evening Emergency
Property Owner Email Address: I nn : )( , co
Page 1&S
" ^ r
r
Town Hall Annex J Telephone(631)765-1802
54375 Main Road cn Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-095943�
UM
�1
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION INSTRUCTIONS
Rental Permit Fee $200 (Application must be renewed every two years)
The items listed below are required to be submitted with the completed
application.
lid Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of
all smoke &carbon monoxide detectors.
Certificates of Occupancy and Pre-Certificates of Occupancy: Certificates of
occupancy or Pre-Certificates of Occupancy for each rental dwelling unit.
D
C' Certification of Code Compliance(form enclosed): Must be submitted by a
license architect or engineer or license home inspector if an inspection by Town of
Southold Inspector is declined.
lfa° Rental Permit Fee: $200.00
C
so
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765=9502
P.O.Box 1179 ,
Southold,NY 11971-0959
r 4U�JTd
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
lbs S U 0
Town Hall Annex Telephone(631)765-1802
54375 Main Road cs� Fax(631)765-9502
P.O.Box 1 179 t
Southold,NY 11971-0959 Q�eCO
�UhTI,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytime Evening Emergency-
Email Address:
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:
Use and Dimensions of each room in Rental Dwelling Unit: 4V*L R®®
4
t '
Page 3 of 5
*rJV MIN,, -
Town Hall Annexe Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 A'..,�tlr y
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
I 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)f
wc. ��l���� .,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" Alis;applcatiori is,;my,legal
,.,J
address and I understand the Town will use the address for service pursuant to all
Page 4 of 5
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road s Fax(631)765-9502
P.O.Box 1179 , YO ly5
Southold,NY 11971-0959
onyw
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: /��C� Of °4AP,
Property Owner's Signature: oo4l
Sworn to before me this 3 day of 20
qc-�_n/\N JA_A
0 lal Notary Public Signature and Original Notary Stamp
Thomas S.vitale .
Notary Public,state of New York
Registration No.01VI6276 un6y DT
�u 1A t
Qualified in Expires '
Commission Exp'
Page 5 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 a �Q
Southold,_NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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
Professional seal required for Architect or Engineer,.licensed Home Inspector must provide
copy of valid current certification
Rental Property SCTM Number: 1000-33-4-3
Rental Property Address: 1000 Sound Drive.Greenport NY 11944
Owner/Name: Michael Phillips
Rental Dwelling Unit Identifier:
Number &Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.)
Master Bedroom - 331 sq ft.
Bedroom 1 - 163.75 sq ft.
Bedroom 2 - 185 sgff
Property Description (Include all improvements indicated on survey)
2 story dwelling
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 Co tion Code of New
York State.
Anthony Portillo, R.A
Print Name and Title Original Signature
A.
Please place professional seal:
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Town of Southold Annex 7/16/2012
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35821 Date: 7/16/2012
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 1000 Sound Drive, Greenport,
SCTM#: 473889 Sec/Block/Lot: 33.4-3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
11/2/2011 pursuant to which Building Permit No. 36821 dated 11/18/2011
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 Kitchen Family Room Entry Hall Office Covered Entry Stud
3 Bedrooms, 3 Baths, Washer/Dryer, Walk-In Closet Balconies Covered Deck Fireplace
Attached 2 Car Garage Basement Mechanical Room and Cellar Entrance as applied for
Per ZBA#6500,Dated 9/15/11.
The certificate is issued to Phillips,Michael
- (OWNER) - --- -of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-11-0017 6/15/12
ELECTRICAL CERTIFICATE NO. 36821 7/5/12
PLUMBERS CERTIFICATION DATED 7/3/12 Christopher Nappe Plumbing&Heating
Autho0ed Signature
F64 Town of Southold Annex 7/16/2012
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 35820 Date: 7/16/2012
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 1000 Sound Dr, Greenport,
SCTM#: 473889 Sec/Block/Lot: 33.4-3
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this ofl6ced dated
4/4/2012 pursuant to which Building Permit No. 37114 dated 4/4/2012
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:
accessory in ground swimming pool with fence to code as applied for per ZBA 46500, dated 9/15/11.
The certificate is issued to Phillips,Michael
- - (OWNER) -
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37114 4/30/12
PLUMBERS CERTIFICATION DATED
Auth6&ed Signature