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Home My WebLink About1000-76.-1-24 TON OF SOUTHOLD Rental Permit 0555 Owner Peter McDermott Occupied as Single Family Dwelling Located at 45 Smith Drive N. Southold 76-1-24 Maximum Permitted Occupancy 3 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. 11/3/2021 od n orc ent Official This Notice must be posted by the main entrance at all times Town Hall Annex w ro �2 �s Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 � Southold,NY 11971-0959 � s. BUILDING DEPARTMENT AUG' J ' TOWN OF SOUTHOLD 1011�0 �"" RENTAL PERMIT APPLICATION rr Rental Permit Fee $200 (Application must be renewed every two years) *� � � � " t .. Section A. Property Information: w °2021 Rental Property Addres O Tax Map Number: 1000 SECTION BLOCK 0.01 lop -LOT SECTION B. OWNER INFORMATION: Property Owner Name: p A4,:j> �v Property Owner Legal Address: Property Owner Mailing Address: 09 L / 4/971 Telephone Number(s): Daytime Evening � P_Emergency � �� Property Owner Email Address: " Page 1 of 5 9/ „�/ � ' Telephone(631)765-1802 Town Hall Annex ✓ laiii�J ��j�° � r�i�i�y r✓� 54375 Main Road W �y Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ��/! �Et ^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: w� 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 Emergen y,_,__.-.__„_� ...,, 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 Town Hall Annex iTelephone(631)765-1902 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 ¢ q � Oh, Southold,NY 11971-0959 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, Q the use of each room in the Rental i. wellin Unit (far'example, Kitchen, Bpd m 1, Bedroda n 2, Living Room and the. dimensions of each "ikti1 �� 4 i1 ' - 11611 61. I P, room. � I 1 ." For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: 1 ' 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: Page 3 of 5 B Town Hall Annex sir lr°J W ,f. Telephone(631)765-1802 54375 Main Road r � � h" Fax(631)765-9502 P.O.Box 1 179 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. 1 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) I z �.�7"'r 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 �" i� 1P�� i��r'�i% �,,',� Telephone(631)765-1802 54375 Main Road 'rl;r% ayit f' '' Fax(631)765-9502 �� rip �� j �j�qui/ y �;' P.O.Box 1179 t Southold,NY 11971-095926"' �` 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: . )__ Property Owner's Signature: Sworn t before me this LD day of lu 20V Official Notary Public Signature and Original Notary Stamp REBECCA A LUCAK Notary Public-State of New York No.01 LU6386882 Qualified in Suffolk County My Commission Expires Feb.04,2023 Page 5 of 5 I MG_�'922.jpg httpy8mai I.gooWexomim a i I m T,' rp v WARS,rq ' r 4 Mat-0,07 - � dj l �5 G�v ref t � ✓ ��rr�'eiP tad,,✓s'f �l d i i rvo;�,y.' vrv�Fjd ��x;P isJ WHIr � rNl fr rr / " BU)1 LrI / ST „rrr f,, ff �1ZQlISCf�trY�rl � 11 �' Y�f a /l fl / of / r /'/rr/i t/ ' r/r r/r�/�r 1nr✓r//Ir r )�r,,x sS�//r r�i rrp r r/aE1klr r N u `�1�r1 ,ion , „ rr r � � � � � ,rrr r woo f } rhaf"1 � r KNOW r r r yrs r r /.. r / « yrrr/r rir/ / / f > yJ/ /r ./,a n ✓i,v / f/J a �v` r ✓ f �"6 r /!r fi r r rN 1 r rum r �✓ &urnrum+u./ e e J - , - " , nxa*p»tiN w 2 r/Nr 1 'r"7`i rr'" j //rx/// N/✓,, low- N 4, ( ' ,x MINK,! ' r .�". 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Property Description (Include 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, Print Name and Title Origina na ry Y� 00674 �1 Please place professional seal: �� rllva,, �ot4 BUILDING 1 5cx�4�, TOW OF SOUTHOLD DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ]j ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ]' FINALA&44,., [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE 0 i . J F r 5UPZVEY OF LOT 5 $ PART OF LOT 2 I "MAP OF 6005E NEGK." N FILED ON NOV.22, I-i28 A5 MAP NO. 1663 51TUATE: BAYVIEN w . E TOM. 5OUTHOLD 54JFFOLK COUNTY, NY 5URVEYED 03-21-05 5UFFOLK COUNTY TAX# E 1000-�6 - -24 CERTIFY T®: Fetes I.McDe¢mon Commonwealth Land Title 7nsatanee company 1 0 y u M p� Nt W" p ! r- ti rf ¢ ✓ ,x n `� � ( \ •'4 0. 0010 a �t ..k NOTES: /.. W S � MONUMENT FOUND JOHN ' ^' AREA = 11,250 5.F. C. HLER LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 GRAPHIC SCALE =20' RIVERHEAD,N.Y.11901 _..,.. 1 369-8288 Fax 369-8287 REF.S\Hp serverldlPRO —]. .pro W T- � O U tD m (D a w F N m V 70 I r y, goo y N _ ZI L CD n 0 „ N (D o o 4 � o r rn r� Ln uN p T -n b b m m `uNJ y O m �° r N 1 0 m m Gl n e n. C1 a CNI LA 1w, �. �—�- �- ,�,„�, owe• � 1 6 ii 4 h ' k i h 1 ti r � k ! w. 4 LLLL i �,.. ...., 4 0 I .gym a r u I. CL n � t o l o r Is � tl i 1w � ua � u m N A I r ly � Y i I I I ggS N fY.t N t (U O m w x ( x w w TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREI\4ISES THIS IS TO CERTIFY that the F/ Land Pre C.O. #- ZI3695 Building(s) Date- August 2, 1985 l l Use(s) - Road located at 45 75 Bayview Smith D ve .Ilor- Southold Street Hamlet shown on County tax map as District 1000, Section 76 , Block I Lot 24 doesknot)conform to the present Building Zone Code of the Town of Southold for the following reasons: Insufficient total area. On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming /%/Land /_/Building(s) /_/Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- cate is issued is as follows: Property contains a one story, one family, wood-framed dwelling with attached garage. Property is corner lot &Smith Dr. North both nti Ari s Bayview Rd. ° cultwaxr�^�l. Zone apt access �o Main B t town maintained roads. The Certificate is issued to PHILLIP & ROBIN GRATTAN ) of the aforesaid building. (owner, Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- arar,es, other than the Builadina Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does riot, and is not intended. to certify that the premises comply with all other applicable codec and z•eirtala- Lions. _�aaiid'zrr�; !nspector;_ _.,.