HomeMy WebLinkAbout1000-33.-4-20 0I TOWN OF SOUTHOLD
Rental Permit
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0704
Owner Mark Rosenblum & Abigail Wharff-Rosenblum
Occupied as Single Family Dwelling
Located at 660 Sutton Placo, Greenport 33.4-20
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.
7/18/2022
C de Etporc ent fficial
This Notice must be posted by the main entrance at all times
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Town Hall Annex 1i Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 . 1�
Southold,NY 11971-0959
09d1�,
BUILDING DEPARTMENT JUL ] J ,
TOWN OF SOUTHOLDBUILDING Q2�
RENTAL PERMIT APPLICATION TOWN OF SOUTHOLD
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
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Tax Map Number: 1000 SECTION Q31-00 -BLOCK . dq. G o _-LOT__Q10 %(VO
SECTION B.
OWNER INFORMATION:
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Property Owner Name: 1
Property Owner Legal Address: Property Owner Mailing Address:
/1/ 6c96-1os( 0r- /V ve�1sG�rC o�
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Telephone Number (s): Daytimes -A-6- Evening. Emergency
Property Owner Email Address: 1M ) o/a5 f'0 )0 f J v`I S3 04 a
Page 1&S
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
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, 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: 0�
Requested Maximum number of persons allows eLd to occupy Dwellingthi(:
Number of rooms in Rental Dwelling Unit: —I
Use and Dimensions of each room in Rental Dwelling Unit:
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Page 3 of 5
Town Hall Annex Telephone(631)765-1802
Fax(631)765-9502
54375 Main Road
P.O.Box 1179
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.
❑ 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.
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J cc o 1 t�C./ (/Yl'�-f 1 �S r e (+ S W w
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
C P-o5Y0 9 luVV1 , certify under penalty of perjury,the following:
1. I 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 Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
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. 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: / "►oma T2aS-c bI%j v'''
Property Owner's Signature: �—
Sworn to before me thday of 20-C)O-
Official Notary Public Signature and Origins{ Notary Stamp
CONNIE D.BUNCH
Notary Public,State of New York
No.OIBU6185050
Qualified in Suffolk County�,�a
Commission Expires April 14,W--
Page 5 of 5
pF SOUlyolo U/�/'✓ j�P-(f-, c7 D'l , (o(of ' V
* # TOWN OF SOUTHOLD BUILDING DEPT.
cou631-766-1602
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION , [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [�f] RENTAL
REMARKS:
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fi �� �p Town of Southold 7/8/2022
ao Gym` P.O.Box 1179
v ® 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43226 Date: 7/8/2022
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 660 Sutton Pl., Greenport
SCTM#: 473889 Sec/Block/Lot: 33.4-20
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/10/2021 pursuant to which Building Permit No. 45847 dated 2/25/2021
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:
single-family dwelling with unfinished basement covered porch attached garage and outdoor shower as applied for
The certificate is issued to Miller-Ostler Building Corp
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-20-2079 6/23/2022
ELECTRICAL CERTIFICATE NO. 45847 4/26/2022
PLUMBERS CERTIFICATION DATED 4/20/2022Ch rl s Sand
u o ze Signature