The URL can be used to link to this page

Home My WebLink About1000-100.-4-5.3 1O"WN OF SOUTHOLD Au Rental Permit 0940 Owner The Grape Escape, North Fork LLC Occupied as Single Family Dwelling Located at 2600 Oregon Road Mattituck 100.4-5.3 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. 6/28/2023 Code Chfo40nt Officiiat This Notice must be posted by the main entrance at all times C� z� ., re Town Hall Annex y telephone(631)65-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179a Southold,NY 11971-0959x , BUILDING DEPARTMENT TOWN OF SOUTHOLD JUN 1 2 2023 RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property ert Address: , . Tax Map Number: 1000 SECTION `j �, � -BLOCK _ 7 --`LOTS- � SECTION B. _ . ............ ........ . OWNER INFORMATION: Property Owner Name: % Property Owner Legal Address: Property Owner Mailing Address: L - Z(x'00 � � �� nn �l7• �0� Telephone Number (s): Daytime Evening V'O" Emergency Lai - CIz1 2,q Property Owner Email Address: Page 1 of 5 Town Hall Annex ' , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959ou BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: I i ) �A 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 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 �`C 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: 0 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: 3 re"S�- rloo�. 4 SO CIUACZ Use and Dimensions of each room in Rental Dwelling Unit: 15T i-1L,0A_ Z^ Roo A- TV R. 0A i &J--oa.M W 1 11,1113 15'" F-1 o,, 13,E i,,.,,.�. 9 X to Imo..,r �Z cox \�C> 14;kLe, -� cep. Ate. )�Z X'1 1-5)( 44-9 6 x 9 Page 3 of 5 Town Hall Annex M Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 yMff 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)) �,Sc ��Al 4 tG.-, It bAl I ;c L L S6 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 "w Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 l79 11 Southold,NY 11971-0959 rou to4, BUILDING DEPARTMENT TOWN 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: Property Owner's Signature: � c� Sworn to before me this b day of 20 Z 3 Official Notary Public Signature and Original Notary Stam Re'6 ,r�". 'r fir.:,ti71'rU60744T7 0e< is s &uffoik Gounty May Page 5 of 5 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION I FOUNDATION 1ST ROUGH PLBG. FOUNDATION 2ND INSULATION/CAULKING FRAMING /STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION REMARKS:ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION PRE C/O [t,�RENTAL DATE ... �...... .._. INSPECTOR April 22, 2023 �� dk 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 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 figr Architect or Ene jineeL_ficensed Home Inspector mast provide copy of valid current ce i cation Rental Property SCTM Number: Rental Property Address: 2000 Oregon Bd. Maftituck 11952 Owner/Name: Mike Boyd 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.) Bedmom Al 120 scift 2O Bedroom #2 100 s ff Property Description (Include all improvements indicated on survey) --abgte family home 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. Victor Cornelius III CEO Inspector Print Name and Title ceo# 1216-0283 iglnal Signat e Please place professional seal: S � ..._....... w OF POO^ ;qiD ... �+ f ,�� ,, c�-�' ® � ��, w � w t r � .n.w�rvuwwuww�mw.auww qp�� Is s(ooS 10 Dt, 'r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z7209. . . . . . . Date . . . . . . . . . . . . . . 5.apt. . . .1 19.ilk W/ Elijah Lane THIS CERTIFIES that the building located at . S,/S .Oregon. Road. - . . . . . . Street Map No. . . . xxx. . . . . Block No. . . .= . . .Lot No. .7rx . . . N4ttttuck. . . . . . . . . . . . . . ' pail dwelling conforms substantially to the Application for heretofore filed in this office dated . . . _ . . . . . Jan. . aO . . . ., 19.75. pursuant to which Building Permit No. . .xr-lo dated . . . . . . . . . . . ., 19. . . ., was i — X11 conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .Private. .two. family. .dwell trig. . - .�rp�c!�ted. bp, Bd Appeals d .Housing board The certificate is issued to . .William. Heirs. . . . . owner. . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .Oct .8. . 1.975. . by. R... .`dilla . . . . . UNDERWRITERS CERTIFICATE No. . ? 53 5 . , . . . . . !* . . 6 . 1 7 . . . . . . . HOUSE NUMBER . . . . . 26.00. . . . Street . . . . . .Qr'e.ggn. Rgad. . . . .:Mattituck. . . . . . . Building Inspector FORM No. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.X. CERTIFICATE OF OCCUPANCY No 2-24969 Date APRIL 10, 1997 THIS CERTIFIES that the building RENOVATION Location of Property 2600 OREGON ROAD m_ MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 100 Block 4 Lot 5.1 Subdivision Filed 'Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 6, 1996pursuant to which Building Permit No. 23463-Z dated MAY 221996 -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 RENOVATE EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CHARLES S1IT:HEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-414966 - MARCH 25 1997 PLUMBERS CERTIFICATION DATED MARCH 27 1997-MATTITUCK PLUMBING & HEAT. Bui4Inr Rev. 1/81 Fat& Town of Southold Annex 9/22/2011 54375 Main Road Southold,New York 11971 Jgfl urm'YM<+' CERTIFICATE OF OCCUPANCY No: 35231 Date: 9/22/2011 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 2500 OREGON R D M A.I"i'r1.X,..X, SCTM#: 473889 See/Block/Lot: 100.-4-5.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 9/22/2010 pursuant to which Building Permit No. 35880 dated 9/22/2010 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 p(found swimming l with fence to code as... plied for; The certificate is issued to Smithen,Charles&Smithen, Barbara ... _.... ..... ___._...._.. (OWNER._... .. _w. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 4496 8/19/04 PLUMBERS CERTIFICATION DATED Autlr...Mod , igna tiro . . __ 3 TOWN OF SOUTHOLD PROPERTY RECORD CARD _ s VILLAGE DIST SUB, LOT OWNEERR STREET ACR. REMARKS f TYPE OF BLD. 41 PROP CLASS F �� 3 u LAND IMP. TOTAL DATE1 r f 61+11 cylen L' � « 1 - ' i FRONTAGE ON WATER TILLABLE I I i FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND HOUSE(LOT _ BULKHEAD ( _ TOTAL -T | '� � �~ ~~ - - - ` '— - -' `~~ ' ---~-- -~—�'--^' � - '� � ^` � ^ k'.�r�� / / / a2 / /- f'� .. ' -- ` ^ _�-__ / ~ ' ^ ` �* | x ' �� —' — �e �� ' k , k k t � L t %— s Tf r a A t 3 100-4-5.3 12108 — Bath Dinette M. Bldg. Foundation , I Easement r-� Floors Extension - o r — Extension Ext. Walls ;Interior Finish LR. Extension Fire Place Heat D R _ Type Roof Rooms 1 st Floor ER. a - t _ RG � Porch Room; Rooms 2nd FIoGk —e FIN. B. er '7 �F?arm � _ e ps r I Driveway i 79 - - �r I k ' — . Total s 3