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Home My WebLink About1000-126.-3-2 T �WN OF SOUTHOLD 'U" Wiff IC a Rental Permit _ 0909 Owner Gary Krogman Occupied as Single Family Dwelling Located at 700 Albo Drive Laurel 126.-3-2 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. 5!19/2023 V/11�� Code Eh-forderjent Official This Notice must be posted by the main entrance at all times Town Hall Annex r Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ° Southold,NY 11971-0959 e' BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed ever 1P t 11 k / MAY 15 911, LD WILUMbUIEPT TOWNOFSOMVIM Section A. Property Information: Rental Property Address: 700 Albo Drive Laurel„ NY 11948 Tax Map Number: 1000 SECTION 126 -BLOCK �03 -LOT 2 - SECTION -SECTION B. OWNER INFORMATION: Property Owner Name: Gag KrggM@i .-__ ..___ -.__.. ........ Property Owner Legal Address: Property Owner Mailing Address: _... 700 Alboe _ w- P.O. Box„902 .�_ . Laurel NY 1194, Telephone Number(s): Daytime631-806-1150 Evening Emergency____ Property Owner Email Address:,gary@krogman.net19 10 Page 1 of S 0, "° ,.GNU'-/ 2 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 SOUTHOLD Mailing Address of Managing Agent: . w __... . .._....��_ ...... ...,. . ...w. . .. ....._ Telephone Number(s): Daytime_,_._,,._ �Evening µ w ta Emergency_.,µ. .0 _., Email Address: ww w SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 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:Unit.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: Bedroom 1 10 x 10 1,OOsf m 3 13sf 10x 10 100sf Bedroom 2 10 x 10,100sf.. Bedroom 3 10 x 10Bedroom 40..,__.._�...... µ � . m_ Page 3 of 5 Gown Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 U . 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) 1 GarywKroman w� 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 Annexti Telephone(631)765-1802 54375 Main Road i Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 'y 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:_ _ w µGan/ Kro man Property Owner's Signature: ...... Sworn t f e me is ' da + .. �_, 20-z Richard D.Noncarrow Notery Public State of New Yolk No.01 NO6224106 Cluallfled In Suffolk Cou . ............ ... _.._._..�,._.. __. w ww..�.. �. My Commission Expires June icial ary Public Si pure and Original Notary Stamp Page 5 of 5 at sooty TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802INSPECTION FOUNDATION 1ST ROUGH PL13G. FOUNDATION 2ND INSULATION/CAULKING FRAMING /STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION PRE C/O Lfl RENTAL 49dZ .x Town Hall Annex N SOUTHOLD TOW 54375 Main Road ��%y ��'✓�� !�' PO Box 1179 Southold, f;lN NY 11971-1179 if, . I Tel: 631-765-1802 F, Fax 631-765-9502 SCTM # ��o- 3 -X Date Owner Phone Address Zip Inspector city LEVELS SUB ? 3 Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors Fire Extinguishers (4) Exits (#) ' BEDROOMS 2 3 4 5 Smoke Detector Alarms (#) ._._. ..._._a........... Egress (windows) Alarms (#) _..�. ...... . .w Carbon Monoxide _ -__..._....._... BUILDING SYSTEMS Y/N CONDITION OF PROPERTY YIN Heatin s stet maintained/o ,rational Building Interior is clean /maintained kecr maintained/operational Building Exterior is clean /maintained Hot waters � .to _Electrical system maintained/operational Property is clean /safe/maintained Mechanical s stern maintained/operational Handrails & guards present COMMENTS Rental Inspection Form 4/7/2021 v \ v\\ y v v y v A y A v v v v vv v A v v vv A A A v v A yy wv . \ A v \ -� �tTaE�ilc� �-3�8-ter=tri, to x la v� � 3iAtCh�:r� \ r Draink,! 1�r�- a o . � Ak \ �\ My 10 i s a a ar COLORTRIM F s a 4 f— o _ _6 f ,�_ .� F M. Bldg. Extension r m e Extension I Extension "Foundation - :Bath Dinette Porch 8r emen Floors K. Porch Ext, Walls 'Interior Finish ., 4 'Heat a D . Breezeway hire Place. Garage =: -3 Roams Ist Floor BR, Patio Recreation Room Rooms 2nd Floor F!N� B O. B. Dormer Drivewoy Total I f _ i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 3730 . . . . . Date . . . . . . . . . ." . . . . . . - .$. . . . . . . THIS CERTIFIES that the building located at . A3..bo .rave . . . . . . . . . . . Street Map No. XX . . . . . . . . . Block Ncx=. . . . . . .Lot No. X== • - -Lente:.• •NY o. . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . , . . . . .Mar. . . . . . . . . 19.66 pursuant to which Building Permit No. 300 . dated . . . . . . . . . . . . K . . . 19. 04, 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 .Priv,9.te -one. Xamily.dwoll .ng. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .R %mond. xrognian. • . • • • • O`ff=`er. . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Oct. . .2�. 1,969. . by R.., 1113A Building Inspector