HomeMy WebLinkAbout1000-46.-1-31.1 (Unit D33) TOWN OF SOUTHOLD
20
Rental Permit
0578
Owner Driftwood Cove Owners Inc (Kotula)
Occupied as Single Family Dwelling (Apt. D33)
Located at 1000 Ninth Street Greenport 46.-1-31.1
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.
1/20/2024
Code En orc nt Official
This Notice must be posted by the main entrance at all times
631 -765-11802
IN PEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PEBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAl
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (EI
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: ken?�LAW
sv_.IulzcY 1 .
OIL,
DATE INS
" m.. Town Hall Annex
Town Of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
V* Southold, NY 11971-1179
O Tel: 631-765-1802
_ .. Date
Phone
caner
Visible
Address 1
I �,e _ .. _ ' ��.
Inspector
Hamletjee _. ..
Floor Level Quantities
2 3
Sub 1
Smoke Detectors (not located bedrooms)
Carbon _.....
Monoxide Detectors
Fire Extinguishers _ __-- --- ---- .---
Exits
Bedrooms__ 3 5 6
Smoke Detectors
Egress
Occupant Count O
Building Systems Maintained & Operational /Building
ondition of Property
Heating uilding interior
Hot water exterior
Electricalroperty clean, maintained &safe
Mechanical Handrails &guards installed & secure
Pool on Site
Pool Safety .
to
_
Surface water alarm Date of CO issuance
Door alarms poolcompletely enclosed
Self closing/ latching gates code requirements
Pool fence to
CO's for all items present Prior Rental
Comments: __
s TOWN OF SOUTHOLD
Rental Permit
0578
Owner Driftwood Cove Owners Inc (Kotula)
Occupied as Single Family Dwelling (Apt. D33)
Located at 1000 Ninth Street Greenport 46-1-31.1
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.
l
1/20/2022
oc E f c� �n Official
This Notice must be posted by the main entrance at all times
Town Hall Annex " Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
D'
BUILDING DEPARTMENT OC"T 0 021
TOWN OF SO HOLD BUILDING DEPT
TOWN OFSOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
p Ct CA
Tax Map Number: 1000 SECTION -BLOCK -LOT—.5-
t(300 (Woo 1000310d t
SECTION B.
OWNER INFORMATION:
Property Owner Name:
oc—
Property Owner Legal Address: Property Owner Mailing Address:
00o q n sr -33 100 �
Telephone Number(s): Daytim •M "A ening Emergency
Property Owner Email Address: l vv�—g YL 0 M
Page 1 of 5
Town Hall Annex Telephone Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 1
Z
BUILDING DEPARTMENT
TOWN OF SOO;D
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: 1 coop—
Address of Managing Agent (no P.O. Boxes): \JJF-S' /V
rc ty
1J L
QQ►�ct� `( t 7 9
Page 2 of 5
Town Hall Annex '; Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179 y
Southold,NY 11971-0959 NNe
.. a
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
?b Go y- (t'ae,
Mailing Address of Managing Agent. gv" u yj[51,8
Telephone Number(s): Daytime 1' 8- vening Emergency
Email Address: � �tJ - M
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 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." �.
33
Rental Dwelling Unit Identifier: "
Requested Maximum number of persons allowed to occupy Dwelling Uni -
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
I. r fh
r`�rNti
+0 L( II1
Page 3 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
Southold,NY 1197 1-0959
BUILDING DEPARTMENT
TOWN OF SOOTHOL;D
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.
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 P��i ��`����-P� 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
qa
Town Hall Annexe Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box It 79
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOS 'OF SO OLD
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: WR E- (CaTOLIN
Property Owner's Signature:
Sworn to fore me this,.-I 0 day of O CT a btl 20�\
Official Notary Public Signature and Original Notary Stamp
Page 5 of 5
1.�-b - 1-31• 1.0 00 q+` ST (tn cd 6---5
0'
TOWN! OF SOUTHOLD BUILDING DEPT.
coin 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ]
FRAMING /ST' APPING [ ] INAL
[ ]
FIREPLACE, CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATE 1
INSPECTOR
Unit D33 Driftwood Cove 1000 9th Street Greenport New York 11944
.
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. X6W. . . . . . Date . . . . . . . . . . . . . . . . . ., 19. 73.
THIS CERTIFIES that the building located at .Main Rd(IT25)-, .9th. $t Street
Map No. J= . . . . . . . Block No. . . . . . .Lot No. XXX . .ar-eeapartX.Y.. . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . .APrUL. . . .30-, 19.73. pursuant to which Building Permit No. 607.
dated . . . . . . . . . . . .April . .; , 19.73., 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. bedraox. apartment. -. .buildings. %r 9"D"9. ' ".Driftxnod.Cave
The certificate is issued to H.x..Gonstruction•Coria ar• .(X ,Dsx s)• • • •
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval Pub. -rater A. Saver. approval. . . .
UNDERWRITERS CERTIFICATE No. '"CV,1+ lits M177 4 C . ."V1 .units 1225D249
x'22 C2 X2250271 "I"-bunits-122 'D2, �r� �
HOUSE �U ER . . . . . . . . . . . . . . Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hous numbers to be assigned on Completion of proJsot
. . . . 1 ..
Building lnspecto