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HomeMy WebLinkAbout1000-40.-2-12 `SOWN OF SOUTHOLD a€ Rental Permit 0947 Owner LeMarie Laureano Occupied as Single Family Dwelling Located at 380 Homestead Way Greenport 40.-2-12 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. 7/10/2023 ode E o e 0 cial This Notice must be posted by the main entrance at all times Town Halt Annex Telephone(631)765-1802 54375 Main Rood � � � Fax(631)76-S-9502 P.O.Box 1 179 Southold,NY 11971-0959 .a BUILDING DEPARTMENT J U N 2023 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200(Application must be renewed every two years) I e cCt1 Vn PA %. !1a Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -BLOCK -LOT - 1 SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 2-6)Z i -Pe �t A Vim. '�[ 2e4 . �� �ol,......_. 914 g2&eiI Telephone Number(s): Daytime Evening Emergency Property Owner Email Address: Le-MC(f-'te'LcA,u , Page 1 of 5 SO Town Hall Annex µ ry Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 CA P.O.Box 1179 -" Southold,NY It 971-0959 a BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authored Agent Information: Name of Aut " rized Agent of dwelling unit, if any: N 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: ---f4 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�r more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes):_ Page 2 of 5 ,, ,. W v� Town Hall Annex S Telephone(631)765-1802 54375 Mala Road q Fax (631)765-3502 P.O. Box 1179 x Southold,NY 1 1971-0959 o 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: .h 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." ,o Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: wig-7 Use and Dimensions of each room in Rental Dwelling Unit: bv,N /�►"co Arecz, (LI BD*1 _...128 x 10.3._ ... 311— 2 .4,',,4 1, 133, ,_P+ - -f(age 3 of 5 LZ 2c3-5 = 18Z`I ,ij-k SfJ& :,µani Gown Hall Annex 41 "Celephone(631)765-1802 o- 54375 Main Road Fax(b3 i)765-9-502 P.Q.Box It 79 R " Southold.NY 11971-0959 BUILDING DEPARTMENT TOWN OF 15OUTHOLiD 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 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 �. •'°"� ..� � certify under penalty of perjury, the following: Z. 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 '- w , Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 a Southold,NY 11971-0959 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. i 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. i 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: -�-+vla►2► .e .r~ c w _ �w .._,.__ . Property Owner's Signature '�� 2 Sworn to before me thislD-16day of_ 7TAt-\ w 20A3 Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County , Commission Expires April 14,2 Page 5 of 5 " + V � "� "w F �^µ Town Hall Annexe Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 4 coq P.O.Box 1 179 a Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO TOLD 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 l>ro es iorlol seal required or Architect or Engineer licensed Norrie lrJs eg!E� rotride c;?py of valid current certification Rental Property SCTM Number: P Y Rental Property Address: 1191+4 r" . " W Owner/Name: Le Lia % D Rental Dwelling Unit Identifier:. Number&Square footage of each bedroom as depicted in the attached floor plan: 1.e. Bedroom #1 -100 sq., Bedroom #2-90 sq, etc,) 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 Original Signature Please place professional seal: s ut �X Town Hill Annex ,, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179m Southold,NY 11971-0959 n BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM ntal Dwelling Unit Identifier: Req sted maximum number of persons allowed to occupy each dwelling unit: Number Rooms in Rental Dwelling Unit: Use and Dim cion of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons a wed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling u Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: TOWN OF SOUTHOLO 3&rLSDZN DEPT. *c 631.765-18 2 qo t T 0 lorkim' SPEC lAmhkN [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENET ION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: . ! • 1 � t 115 ' i ;t 4t . BATH 15 in I KBIT LGNEN I ! } BATS! 1 m 1 1 GL FU p� t S# € ryARA6L 9-0"CLE Hf _ a•!a t=r T 1, • � tet}!NAave 11 ! BEDROOM i _ T BEDROOM 61-01 aa.KT 6oi r< ! i +-IZ -------------------- - ' } lit1` ' 1 � s< -15/4 K 3-1YL SCTM # TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST SUB_ LOT ACR. REMARKS _ s TYPE OF BLD, PROP CLASS LAND IMP, TOTAL DATE 1 k 3 FRONTAGE ON WATER HOUSE/LOT i BULKHEAD TOTAL TOWN OF SOUTHOLD PROPERTY RECORD OWE STREETVILLAGE DIST- SUB. LOT e 3 F f DORMER OWNEk- N E ACR S _ W TYPE OF BUILDING � RES.� SEAS. VL � FARM COMM. CB. MICS. Mkt. Value i LAND IMP. TOTAL DATE REMARKS _ _ I j e � i a f t I AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre TillableI FRONTAGE ON WATER I Woodland FRONTAGE ON ROAD Meadowland DEPTH House PlotBULKHEAD f _ e t Total DOCK F Es - GLA� OL R TRIM i m At z 4, 6 . .o L LL.L IN 40.-2-12 - 09/27/2017 SQ. FT. Fin°B" 1 st flL�j? 'T 2nd fl __ TOTAL L M.,B 2-; _ �� t�� Foundation OT Bath Dinette i OTHER _ — -- t S,91VW�L COMBO xtension z� �p Basement SLAB PARTIAL FIOOrS Kit. <" �-:,. J�� �,d L SLAB - -_ � %-A Extension �;� Finished B. Interior Finish R=._`_ L.R. ExtensionFP/WBS Heat ©A D.R. �! , zk� Garage 1 3 z, �b Ext. Waflsa:;, ,�_.._ BR t Porch "S 0 t2_ Dormer Baths F Deck/Patio Roof Fam. Rm. Pool _ C9 0 Solar Foyer A.C./GEN - Laundry Zoo _ Library/ 0.B. frj `2 1 E Study Dock = L - • '�UG Vol F- F -firZ t 'A�c�o ' a3 I COLOR TRIM , x i t t of i 3 - -; ' x x f f v M Extension - 3 i i Extension n : t Extension j Foundation Dinette Ar I I s. Bath « Ar- Porch A Porch - - r ; Basement 3 i €Floors K. Porch 'Ext. Walls h i Interior Finish ! LR. j Breezeway i i ; t i Fire Place � Heat � ISR, Garage x,, '. I Type Roof Rooms Ist Fiaor' BR. 9 I i Patio e Recreation Room ;Rooms 2nd Floor � O. B. E Dormer Driveway i Total - F 3 Town of Southold 5/17/2017 P.O.Bog 1179 53095 Main Rd Southold,New York 11971 CEILTIFICATE OF OCCUPANCY No: 38953 Date: 5/17/2017 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 380 Homestead Way, Greenport SCTM#: 473889 Sec/Block/Lot: 40.-2-12 Subdivision: bled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/1/1900 pursuant to which Building Permit No. 41102 µXX y dated 10/24/2016 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: QM,.FAMU,Y DWELLING WITH COVERED 'C I CII RE I�A CI�II G AT'I"AC1I ( ARAGEAlm FI 1.TS11:ED Bl ,Ml R ZBA ISI I alC l9#5332 DA:I 17,1 -200_ 1' ED FC R: The certificate is issued to Equity Trust Co/Home Buyers LI Inc of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-15-0001 04/27/2017 ELECTRICAL CERTIFICATE NO. 41102 05/04/2017 PLUMBERS CERTIFICATION DATED 05/13/2017 1' ul J,Rupp _. _ ........ ... _.. .... ._... __... . ._. , .. . -................. u ho .. 1g lature