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Home My WebLink About1000-78.-3-3 TOWN OF SOUTHOLD Rental Permit " 0507 Owner Shivin Kwatra & Sameera Sabherwal Occupied as Single Family Dwelling Located at 2865 S. Harbor Road Southold 78-3-3 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. 7/20/2021 - Code Enforc ent Official This Notice must be posted by the main entrance at all times yyl 1 o�®g11FFQ��e,®. / G� SOUTHOLD TOWN Town Hall Annex a � 54375 Main Road o PO Box 1179 Southold, z, Rental Inspection �y • �� NY 11971-1179 Tel: 631-765-1802 Fax 631-765-9502 SCTM # 3 — 3 Date 7/ 2 Owner . 1/l��Tlrrl� Phone 3ell s I Z z g Address �� .S � �r7� Zip of Hamlet lnspecto ' Address visible from street?- LEVELS . SUB 1a 2 3' . Smoke Detectors (#-bedroom'detectors excluded), . Carbon Monoxide Detectors(#) Fire Extinguishers (#) Exits (#) BEDROOMS 1 2 , 3 4 :5 Smoke Detector.Alarms Carbon Monoxide Alarms (#) Egress (windows) (Y/N) " BUILDING SYSTEMS N CONDITION OF PROPERTY. Heating system maintained/oper"ational 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 pre-sent POOLS Y POOL BARRIERS Y/N Pool present JVIA I Pool is completely enclosed Pool surface-alarm and/or door alarm resent Barrier is a min.48" high POOL GATES YIN 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: . R wr o SSve o j2 e eD u—v oJAQ i Town Hall Annex Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road , P.O.Box 1179 Southold,NY 11971-0959 __. . _._._. ... :M!"IWDEPARTM `. TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION _ a Permit Fee$200(Application must be renewed ever} Rental P � 1 LL, . MAY 1 2 2021 Section A. E[?U. �' � `. Property Information: TO!.. 01 Renta) Property Address: o2�6S S 6,JN Howtor 9v 0j, . Snuvk,)XC .Ny Tax Niap Number: l°ODO.SECT►ON ('� -` . 3L= :-LOT, X0.3 SECTION B. OWNER INFORMATION; Property Owner Name: CN BVI tJ p Y Property Owner Legal Address: Property Owner Mailing Address: 19 Z11 E 12'-` NQ►,.�, ��ye,V� Ny LOoD ? •. hlcv3 `fiat N�I It-oo�3 Telephone Number(s): Daytime3 515226$Evening 241-�Ic,-IUSEmergency. ql�6 Property Owner Email Address: -01101\ I.fv� a� aYy►0� l 1,0 Pagel of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDiNO-DFPARTMI$ TOWN OF HOVTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: (4)A 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: N 1 ik 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: �►jIk Address of Managing Agent (no P.O. Boxes): Page 2 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 SOXJTHOLD Mailing Address of Managing Agent:, Telephone Number(s)i Daytime, Evening Emergency Email Address- J SECTION F. PROPERTY DESCRIPTION: ,Number of Rerital DW61.1ing Units on property: QYN 2. For each-Rental,Dwelling-Unit set.forth the Rental Dwelling Unit identifier(for example, pie, Unit 2, Unita or.Apt-Q, B,Q;the-use of each room in the Rental Dwelling Unit (for eprnple;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: -I- L1V I N c. duo -i -PA ^e -1-3B14TK Use and Dimensions of each room In Rental Dwelling Unit: r �ININA t I,o�rJAlffN S/v�RpE k KIDS 30 24 I Page 3 of 5 Town Hall Annex Telephone(631)765-1.802 54375 Main Road • Fax(631)765-9502 , P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT - --- -- ___.--- TOWN OF 90UTHOLD 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 Newyork State Fire Prevention and Building Code Council. 1 am requesting a fire safety inspection to be-performed by Code Enforcement Official.. - fromth�-i°own-of-Southoi�------------- -- -------------------- ---------- --- 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 YOR ----- - ----- Brim x � COUNTY OF S4FF®tlf) SN 1 V (0 VW KV ,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 1-understand--theTown-will-use-the address for_service.pursuant to all Page 4 of 5 •4�,�0� soU� _ • Town Hall Annex Telephone(631)765-1802 54375 Main Road y Fax(631)765-9502 P.O.Box 1179 . i• Southold,NY 1.1971-0959 �f BUILDINGDEPARTMENT 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. I have readand received a copy of Chapter 207 of the Code of the Town of Southold.and agreed to abide by-the same.. 4. :1 well notify the Town within five(5)business days as to any change to.the Information- ' - - ----------regard n Auth�rized-Agent,-ManagingAgent;or-Site-Manager:- ----------- -— ------ Property Owner's-Name: SH i V I P/ I�Wpr l Prooerty Owner's Signature: Sworn to before me this_'day of ✓t 2=' LAKSHMI I—PERSALID No.01 RE6312557 Official Notary Public Signature and Original Notary Stamp Notary Publie,State of New York, Qualified.in Bronx County My Commission Expires 10/06/20' LAKSHMI I.PERSAU® No.01 PE6312667 NO"Public,State of New Yfflk in=%0U tb�ii'llbJianlG ^.... � .7f+� Page 5 of 5 I r I nT- n-n--T-177-1 II � l 11 l II I il � t � � it n 77~j j7�7f - , I_ I l n i n ! 17-T _ii T;. I 7- T-7 I IF 1- _ - r/ Ei L_ I I I I _L I 1 I - 6 i - AL - - ole-- i r - t C. - -- - �.- ,, �- ; t '- .. _ �. .< ;, ' a � : _ -,, .� .� .. .. x : ,. : - ..� g .. ., ,. �{ i ,.j >' '.. : w :� S• s �7M. -PROPORT :,-`R��o3-jq /Q,-)a rov�/f�' �OVSOUTHOM'� y SU OWNER. - :STkEET,,, VI B., Lo Y DIST, IF 'FORMER OWNER N C T S ...'TY 0 tw PE Y,v4i� vv 'I , mu VL. ARM'SEAS.' PCOMM. , CB.' ::Mkf',Vdi6a'' LAND IMP. TOTAL DATE ' REMARKS. , 7 ?A -A 71P L 7 (5� AGE BUILDING'CONDITION bd A` BO NEW NORMAL BELOW FARM Acre Vdlue'Per .�-- QUel" 000- --Acre.-- Tillable I Tillable 2 Tillable 3 Woodland SwamplIc'Ind (NATERJFR NTAG8.bN, -FRON OAD :ON R Brushland' TAGE House Plot. DEPTH:: - H;` BULKHEAb. ' Total ; DOCK 7, , COLOR 1' —__ i : TRLM:RX ------------ �7"�.» e p ,kV i�'•'':•»,:rer it;S-...rd.c.,` •....�. .. OW '7^a._3,ati.: ��,�' ,.:�<�7, ?•a.r i"=s:,":moi., �-��.3�.yr >� . ... '�. , M. Bid9;F, ' ' ! Foundarion �. Bath ;.d Dinette _ Extension Baserrierit Floors Extension Ext:. Walls" > Inte-rior. Finish LR. Extension Fire Place. -Y- He f;� r DR. Type Roof Rooms Ist Floor BR. Porch 'Recreation Room Rooms 2nd Floor FIN. B. Porch IDormer Breezeway Driveway Garage / €v P ,. m336 Patio O. B. , i i FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall i Southold,N.Y. Certificate Of Occupancy No. . 214164. . . . . . . . . Date . . . . ?aPtiaXy. . . . . . . . . .16. . . . . . THIS CERTIFIES that the building . . . . .New •Dwelling Location of Property $65. . . . . • . . . . • •South, Harbor Rd. Southold House No. Street . . . Hamlet County Tax Map No. 1000 Section . .0 7.8. . . . . . .Block . .Q3. . . . . . . . . . .Lot . . . . . . . . . . . . . . Subdivision . . . . . . . . .X. . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . ... conforms substantially to the Application for Building Permit heretofore filed in this office dated 5e�t. 9 , , 1 8 3 pursuant to which Building Permit No. . . 3-2623Z . dated . . . . . . . .Sept.•• , , A. • . . . . . . 19 8 ,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 . . . . . . . . . ------ New .Priva• te. One. FamilX Dwelling .7-777.777.. . . . . . . . . . . . . . . . . . . Th ------ The certificate is issued to . . . . . . . . . . . . . . . . PROBE, EDWARD (owner,4 . . . . . . . . . . . . . . . . . . . . . of the aforesaid building. Suffolk County Department of Health Approval . . . . �3 ;50-150 • . . . . _ . . . . . . . . UNDERWRITERS CERTIFICATE NO: . . . . . . . . . . .N 6 39QO . Building Inspector Rev.1181