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HomeMy WebLinkAbout1000-34.-5-2.1 TOWN OF SOUTHOLD Rental Permit 0727 Owner Isabelle Lion-Betancourt & Paul Betancourt Occupied as Single Family Dwelling Located at 1050 Champlin Place Greenport 34-5-2.1 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. 8/22/2022 ode fo e n Official This Notice must be posted by the main entrance at all times r oY. � Sol& Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 ® �Q Southold,NY 11971-0959 BUILDING DEPARTMENT AUG 0 (J 2022 TOWN OF SOUTHOLD BIJiLD'iNG iiti'T RENTAL PERMIT APPLICATION TOWN OF SOUTH01-D Rental Permit Fee $200(Application must be renewed every two years) Section A. Property Information: Rental Propert ddress: Tax Map Number: 1000 SECTION ®� -BLOCK -LOT - SECTION B. OWNER INFORMATION: Property Owner Name: / �1�� t G ` Aj(V el it Property Owner Legal Address: Property Owner Mailing Address: /of 2, [ �ji`►'i�j i nb9 : �,i/b� !ry✓'S�'16N�. sly I��� 25i-67 A4A Cl DA) A� I //T? Telephone Number(s): Daytime �i Evening Emergency Property Owner Email Address: '� �-�tq®rli e!�4f41k Page 1 of 5 Town Hall Annex S t� �i��t Telephone(631)765-1802 54375 Main Road "` i Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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: Address of Managing Agent (no P.O. Boxes):. Page 2 of 5 So Town Hall Annex 1 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 Cou � BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening Emergency Email Address: l SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: �-��r l f� ✓LEr�L</ri 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: n4L Requested Maximum number of persons allowed to occupy Dwelling U Number of rooms in Rental Dwelling Unit: k, S _ Use and Dimensions of each room in Rental Dwelling Unit: Y f �� r� x � Z Page 3 of 5 Town Hall Annex �, Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 coo i Southold,NY 11971-0959 UNTI ti�� ll�' 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. c_140 A&(J C- SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I ?AV iv K 6K� , 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 o Town Hall Annex Telephone(631)765-1802 54375 Main Road 7 Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 Q �` 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:. PAyL, Property Owner's Signature: u.'1 �. CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County i Commission Expires April 14,2-�a3 i Sworn to before me this /o� day of 20� Official Notary Public Signature and Original Notary Stamp Page 5 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 UNTI ..K 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 for Architect.or Engineer,licensed Home Inspector must provide copy of valid current.certification Rental Property SCTM Number: Rental Property Address: Owner/Name: 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.) 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: apoqf SQ Town Hall Annex Telephone(631)765-1802 54375 Main Road ? ens Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 1 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Requested maximum number of persons allowed 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 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 unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: ' ho�aOF SOUIh°lo WN F N('J�I��'�S9U��1T V TC OLD BBUICDING DEPT. • ,o O O coum, 631-765-1802 yJ`� �.• � 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 (F A'40L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: W PAPW DATE ��' ?i�/ INSPECTOR WINDOW SCHEDULE DOOR SCHEDULE B STAN C O U RT RESIDENCE FIRST FLOOR FIRST FLOOR 412 ATLANTIC AVE . TYPE RO NOTES TYPE UNIT NOTES G R E E N PO RT, NY OREPLACE EXIST. DH W/ 30-1/8"x52-7/8" RO LIV. RM. WEST EXIST. EXTERIOR DR. 2,_8"x6,-8„ FRONT ENTRY WEST SIDE LIV RM TW4224 (SAME SIZE) W/ STORM& SCREEN I ( I I REPLACE EXIST. DH W/ 30-1/8"x52-7/8" RO LIV. RM. WEST NEW INTERIOR 3'-0"x 6'-8" CLOSET UNDER STAIRS O TW4224 (SAME SIZE) © CLOSET DOOR LIVING ROOM NORTH EXISTING: SINGLE FAMILY RESIDENCE REPLACE EXIST. DH W/ 30-1/8"x52-7/8" RO LIV. RM. SOUTH O I EXIST. ALUM. STORM 3'-0"x 6'-8" REAR ENTRY EAST SIDE MUD RM TW4224 (SAME SIZE) © SCTM# 1000-34-5- 2 . 1 I I I I -NEW 3-1/2°x3-1/2" SQ. STEEL COL. REPLACE EXIST. DH W/ EXIST. EXTERIOR DR. 2'-6"x6'-8" REAR ENTRY EAST SIDE MUD RM ON 24"x24"x12" FTG. BELOW SLAB 4 PROPOSED: O ZONE R-40 I- �- J REPLACED EXIST. DH W/ 63-7/8"x36-7/8" RO KITCHEN NORTH E EXIST. INTERIOR DR. 2'-6"x6'-8" BATHRM. #1 I I O TW26210-2 O REPLACE EXIST. DH W/ 30-1/8"x52-7/8" RO MUDROOM EAST EXIST.POCKET DOORS (2)2'-8"x6'-8" DINING ROOM NORTH INTERIOR REPLACE EXISTING WINDOWS IN KIND. © TW4224 (SAME SIZE) I I I REPLACE INTERIOR STAIRCASE I EXISTING,2"x10" GIRDER O EXIST. DH BATHRM #1 EAST O EXIST. EXTERIOR DR. DINING ROOM WEST EXTERIOR REPLACE PLUMBING & KITCHEN FIXTURES L � _ l- I (2) 3/4PLYWD. FL. PL. ADDED NO CHANGES 2'-8"x6'-8" OREPLACE EXIST. DH W/ 30-1/8"x52-7/8" RO DIN. RM. SOUTHEXIST. SCREENED DR. SCREENED ENCL. SOUTH 8 TW4224 (SAME SIZE) 2'-8"x6'-8" I OREPLACE EXIST. DH W/ REPLACE WINDOWS W/ 6'-0"x6'-8" DINING ROOM EAST EXTERIOR GENERAL NOTES TW4224 (SAME SIZE) 30-1/8"x52-7/8" RO DIN. RM. SOUTH O SLID. GL. DR. CELLAR ACCESS REPLACE EXIST. DH W/ 1. All work shall conform to the requirements of the 2020 Building Code of N.Y. EXISTING CELLAR O TW LAC (SAME SIZE) 30-1/8"x52-7/8" RO DIN. RM. WEST SECOND FLOOR State, County and Town Department Regulations, Utility Company requirements and EXIST DR. CONVERTEDbest trade practises. SECOND FLOOR TO POCKET DR. 2'-8"x6'-8" BATHRM. #2 2. Before commencing work the Contractor shall file all documents required by the EXIST. DH STAIRCASE NORTH © EXIST. CLOSET DOORS 2) 2'-0"x6'-8' OFFICE Building Department, pay all fees required by local agencies and obtain all required NO CHANGES permits. EXIST. DH BATHRM #2 NORTH EXIST DR. CONVERTED 2'-8"x6'-8" BEDROOM #1 3. The Contractor shall visit the site and verify all dimensions and the existing NO CHANGES ® TO POCKET DR, conditions affecting the work prior to construction. Any discrepancies which would EXIST. DH OFFICE EAST EXIST DR. CONVERTED 2'-8"x6'-8" BEDROOM #2 interfere with the satisfactory completetion of the work described herein shall be NO CHANGES TO POCKET DR. reported to the architect or property owner. Do not start work until such conditions ® EXIST. DH BEDRM #1 WEST EXIST. CLOSET DOORS 2) 2'-0"x6'-8' BEDROOM #2 have been examined and a course of action mutually agreed upon. Failure to notify NO CHANGES the owner or architect of unsatisfactory conditions will be construed as an acceptance OEXIST. DH BEDRM #1 WEST ®NO CHANGES EXIST. CLOSET DOOR 2'-"x6'-8" BEDROOM #1 of the conditions to properly perform the required work. EXISTING PORCH ABOVE EXIST. HOUSE 4. All work is to conform to the drawings and specifications of the architect and NO CHANGES p BEYOND EXIST. DH 6 NO CHANGES BEDRM #1 SOUTH 5engineer. The Contractor t is to maintain a complete and up to date set of plans on the I NEW WOOD STOOP EXIST. DH w O NO CHANGES BEDRM #2 WEST job site at all times NEW RAILING TO CODE 6. The drawings are not to be scaled under any circumstances. w 1 5/4x6 WOOD DECKING 8 EXIST. DH BEDRM #2 SOUTH 7. It shall be the Contractor's responsibility to ascertain all prevailing procedures - - - - - - - - - - - - - - EXISTING CRAWLSPACE I a NO CHANGES P Y P 9 T I a I REPLACE EXIST. DH W/ including storage and toilet facilities,protection of existing work to remain,access to zxs @ 16" OC DECK Jor.srs work area, hours of permitted work,availabilit of water and electric ower and all I- - - - - - TECO TO LEDGER AND 9 P4045-C 145 P Y P X I �„� ANCHORED TO GIRDER N' 72-3/4"x53-3/8" RO BEDRM #2 EAST REPLACE EXIST. DH W/ other conditions and restrictions for this particular location in order to execute the I ( r SIMPSON H: HURRICANE TIE 0 zxs ACIDEc JOISTS I o0 P4045-C 145 work in a careful and orderly manner with the least possible disturbance to the public. 2X12 ACO LEDGER 8. The Contractor shall make the neccesar arran ements to utilities and services @ 16" OC TYP. �t FASTENED TO HOUSE FR!MIP1G & FOUNDATION W/ y g 2X12 ACCO GI DER EXIST. SMPSON 3/8"x3-1/2" SDvVS EPDXY COATED temporarily disconnected while performing the work as required. ANCHORE I T CRAWLSPACE TIMBER SCREWS (OR EQUAL)@ 12" OC STAGGERED REVISED 4.2 5.2 2 9. The Contractor shall provide all dimensions and Cut-outs for other trades. 14" DIA. ON . PIERS 2X12 ACO DECK GIRDER ANCHORED 10. The Contractor shall provide proper shoring and bracing for all remaining structure I I To 10" POUR. CCNC. PIERS prior to removal of existing structure. TO 36" BELQW FIN. GRACE MIN. 11. Plumbing, electrical, HVAC and similar work shall be performed by licensed _ o L persons who shall arrange for and obtain all required inspections. The General 2'-1z� Contractor shall be responsible for scheduling all other inspections as required. ► - - APPROVED AS NO77161W1 12. The Contractor is solely responsible for construction safety and shall hold the - - - ao2 owner and architect harmless from litigation arising out of the Contractor's failure to FOUNDATION PLAN STOOP SECTION # 1 DATE. BP.# provide construction safety means and methods. 1 /4" = 1 '-0" 3 . 10. 2 2 1 /4" = 1 '-0" 4. 2 5 . 2 2 FEE: 0 Y: 765-1802 8AM TO 4PM FOR THE REVISED 4.25.22 NOTIFY BUILDING DEPARTMENT AT CONSTRUCTION NOTES FOLLOWING INSPECTIONS: 1. All footings shall rest on undisturbed soil at a minimum of 36" below fin. grade. 1. FOUNDATION - TWO REQUIRED 2. Poured concrete shall have a minimum psi of 3500 at 28 days unless noted. FOR POURED CONCRETE 3. Sill plates shall be preserved, treated wood and be installed above a 16 oz. 2. ROUGH - FRAMING & PLUMBING copper termite sheild. 3. INSULATION 4. Shingle siding shall conform to ASTM D 3679 and be installed in accordance 4. FINAL - CONSTRUCTION MUST with the New York State Building Code and manufacturers specifications. BE COMPLETE FOR C.O. 5. Pilings shall be installed by a licensed contractor to a depth and bearing agreed ALL CONSTRUCTION SHALL MEET THE upon by an engineer and certificates shall be issued stating same. REQUIREMENTS OF THE CODES OF NEW 6. Unless otherwise noted all framing and structural wood components shall be YORK STATE. NOT RESPONSIBLE FOR #2 or better Douglas Fir. 3 3 DESIGN OR CONSTRUCTION ERRORS. 7. All framing techniques and methods shall be as prescriptive design based on 38'-104" 23'-94" AF&P Wood Frame Construction Manual for One and two Family Dwellings (WFCM) or as specified in R301.2.1.1 -102" 28'-1 14" -1"- 8. All building envelope components shall comply with Chapter 6 of the Energy n' Conservation Code of the State of New York. OCCUPANCYOR 9• Fireblocking shall be provided in all wood framed construction in accordance with NYS Code R 602.8 to form an effective fire barrier between stories and USEIS UNLAWFUL between the top story and roof space. 10. Protective panels shall be provided for glazed openings in accordance with o v UT CERTIFICATE NYS code R301.2.1.2 if they are required. REI O E XIS . All S 1 1>, STORAGE UP 13 :RISERS II 3'-2-" 7'-0 11. All portions of the new structure are designed to comply with localgeographic CLGSET REF. DW 1K � �Icv AD IN-W TO CO E Df 1 RI ER 4 4 i P 9 PY ® TO 2N FLOOR UNTER ISTAIIRS p I © CL ,SET ® OF OCCUPAII and climatic criteria as stated In the following table. I I W I T 1 T LO R (REPLACE FIXTURES DN TOG ADE _ L L L NEW APPLICANCES, CABINETS >= HANDJAI T C DE IN SAME LOCATIONS © l & COUNTERTOPS 2 f BATHRM #z GEOGRAPHIC & CLIMATE DESIGN CRITERIA REMOVE EXIST. STAIRS 0r r ADD NEW TO CODE I J0 T MUDRM. TUB W/ wC SHOWER GROUND SNOW LOAD 45 psi O LU Q I z I ® 1 1'-44" - »C;c�iv,�'L`r' WITH ALL CODcS OF WIND SPEED 130 MPH W I LAV NEW YOLK STATE & TOWN CODES SEISMIC DESIGN CATATGORY B I UP © o J I xw I WEATHERING _ wz XIS AS REQUIRED A _D CONDITIONS OF SEVERE 1. FROST LINE DEPTH 36" f o f 1,ti TERMITE THREAT MODERATE TO HEAVY rI V I OUTHMO TO,IN ZBA in O"= I N n EXIST. i00F ROOF BELOW ROOF BELOW DECAY LIVING ROOM O° I KITCHEN CLOSET SO!!TF'OLDTOV�'NFt.P"'°"JGBOARG SLIGHT TO MODERATE U co OVER FOR �' COVERED w r W I BELOW BEDROOM #1 Id T�_ AS NOTED ENTRY PORCH W u o 1 4 FLOOD HAZARD TEMPERATURE 1 1 NO CHANGES I I `C`AR ACCESS T SOUTHOLD TOW" T>"US CO z° I Q Oo N.Y.S.DEC Z<0E_- <Z0 II STOVE O0 OFFICELU ,3 PLUMBING RISER DIAGRAM O O z I • O SH ER ®CID ® • • I� � � �iddrtaonal N Certification a IP N F. o _ ® lay Be Required. .E.r „ IwAr WG . ........................................ o ............................................. - - -__--- -®� (REPLACE FIXTURES CLOSET - N SAME LQQATQN RETAIN STORP�4 WATER RUNOFF J A .I.I.I.111.11,1111'..",...."'',.,"''"'ll"'' I . ,.. ._._ © BATHRM #1 LA._E'IS-TNG SCREENED ENCLOSURE.............._.............................. / I ExISTING NO CHANGES EXIST. ROOF- PURSUANT TO CHAPTER 236 I EATH#z ...... _-- -........._...._......__.__._ . OVER PORCH- zNo FLooR.... ..............................................._.......................... �' BELOW OF THE TOWN CODE. ... __... _.................. ...__......_... -._.......__..._............__.. ® . - -_ -- ----- T BEDROOM #3 � I w Q Q ---------- __.__...._......_...._. ...... © BEDROOM #2 ' 20 I LU 0 = NEW STOO STOO <`r�» •� f{*�++Y! o BELO ® N J EXISTING IST FLOOR / I EXISTING Q I KITCHEN / BATH #i � I o I00 Lr W W p ® CCf) Z BASEMENT 3'-0" ALL 11TI11i t s�GGTO`6"Ma 2 4 2 4 14 0 'tQ� SC y REQU EMEN;sorlo A.o a� -10 ,_93„ 14'-0„ _11„ _1,. ___91-9 3,. �S 9 * v rICA * .OGREERPo.,sE-GE,aWMEN, W �= ress �, sF� 77006 FIRST FLOOR PLAN SECOND FLOOR PLAN A'��FESSION�� START A 101 1 /4" = 1 '-0" 3 . 10. 2 2 1 /4" = 1 '-0" 3 . 10. 22D rG (i X111 1 OF 1 REVISED 4.25.22 Ilpermits -draftingexpediting HAY - 9 20?2 PO BOX 49 BUILDING DEPT. JOAN CHAMBERS SOUTHOLD NY 11971 631-294-4241 TOWN ,O.F �. SOUTHOLD `iokOPERTY RECORD C 'O NERC ,vimt ,t,, -a3 .aa ,ec�� , _-- - - - �, w rr STREET # "< VILLAGE DIST) SUB: -.-LOT_.` - 4'Y `4•'eF £ L.+''r, \s��-�'4; %ir`vs t�6 s C, ed scR. . q y FORMER OWNER $^ N;, E,:: ; ACR. ,:�F,y.` g;e R x�; �- W _ TYPE OF BUILDING RES. i :) SEAS: I VL, FARM COMM. CB. MICS. Mkt. Value OL C Y% — LAND IMP. TOTAL DATE REMARKS r,,•,<' ��.,L.w} Com°^ f✓ t'b :d,i f., s,t�,,,x '.� �t"''N ,.�t,�r 5+`J ?/�'jj L7� J� '{} t,{�`j rpt 1 J/ � �f//�9 fJj�� f�f p` /�Ty f�`'�y{ ��^�fJ ,rte �".. re^ .���-�� •>� _ ., t LJ� r.� I !. r V � L1 �y "` t d %d+aY r'n"" _�J"—'�'`:r--�a:..�'----c��',��. �`-'� f--=LT_�-6.. 1 �* ^$• '6�<-£—�t,,,,a .� C;� t �-�,A� • rs.,f/j�����''``"��� ��� � gyii_r� I AGE j' BUILDING CONDITION NEW NORMAL BELOW - --ABOVE �z 'FARM Acre Value Per Vclue - Acre t Tillable - _ -- FRONTAGE ON WATER! _ - Woodland FRONTAGE ON ROAD - Meadowland,' DEPTH House Plot BULKHEAD TotaF I .�� DOCK TOWN OF SOUTHOLD PROPERT A, OWNER STREET — VILLAGE DIST. SUB_ -'LOT I FORMER OWNEN ;E ! i r:d ACR. �y S W TYPE OF BUILDING RES. j SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION NEW NORMAL BELOW — vABOVE — FARM i Acre Value Per Value - Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD . Meadowland --- _-- f DEPTH- House Plot BULKHEAD Total DOCK i COLOR �� j� ' TRIM rill at c , , 17 Now i 11 II T1 I M. Bldg. i ExtensionI— ' _ Extension — i � I � I � 1liil � ll I I� iI � I I ! 11l : Extension 1 I j i Foundation IBath Dinette; — I Porch I I 1 Basement i Floors : I I K. ; Porch Ext. Walls I Interior Finish' I LR. Breezeway I I 6 I T e Roof m Fire Place i Heat DR. Garage I I yp 1 - IRoos 1st Floor i BR. I I I Patio I — : Recreation Room - Rooms 2nd Floor I I FIN. B ; O, B. I I I i Dormer I I Driveway Total ! I I I I COLOR TRI14T M i t i .. I ............. `�;� •,i. II f.�( rya .�.y 4 1'� �x ti I � � i -�—t � E 1 ; 1 i ; 1. � `, `�,��11, N�/� '3 fi�.�'�v�xi�. v�6' 6,t�p `•,i-m.{y=,� , i , ( I !i j ;.. (' h1 / M. Bldg. it k Extension ! \ Extension, .. Extension. <� f f -6 0 Foundation ;,moo .. Bath ;' I Dinette Porch 6 g♦d ... Basement Vit? jFloors i I<. - Exfi, Walls .fit s Interior Finish j ' ' LR. Breezeway ---� Fire Place ' �, $� j Heat r DR. L -- i- Garage,..' Type Roof Rooms 1 st Floor BR. �- - I Recreation Room I Rooms 2nd Floor FIN. B'! Patio�...__.� � I t -- ---- , t Dormer Driveway O. B. 1 Total f:t�.�•�.� .s :J yrs, +�� . .�:r' -Y 1, ma3j , t Y ±i i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 25526 Date: 01/23/98 THIS CERTIFIES that the building DWELLING Location of Property 1050 AKA 412 CHAMPLIN PL. GREENPORT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 034 Block 0005 Lot 002.001 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 91 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 25526 dated JANUARY 23, 1998 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 ONE FAMILY DWELLING The certificate is issued to SANDRA DAVIDS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. )"ing Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE-INSPECTION REPORT LOCATION; 1050 AKA 412 CHAMPL N PL. GREENPORT SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : SANDRA DAVIDS OCCUPANCYs SINGLE FAMILY SANDRA DAVIDS ADMI'1'TED BY: ANITA STULSKY ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO, 'PAX MAP NO.; 3Q.-5-2 1 SOURCE OF REQUEST: SANDRA DAVIDS DATE: 01/23/98 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES; -._2,0 # EXITS: 3 FOUNDATION: CONCRETE. STONE & BRICK CELLAR: FULL CRAWL SPACE: TOTAL ROOMSs IST FLR.t 2ND FLR.: _I 3RD FLR.S —a BATHROOM(S) ; 2.0 TOILET ROOM(S) s 0.0 UTILITY ROOM(S) ; PORCH TYPE: " DECX TYPE: PATIO TYPE; CONCRETE BREEZEWAY: FIREPLACE; NOUR GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: OFF BOILER_ AIRCONDITIONING; TYPE HEAT; OIL WARM AIR: HOTWATERs OTHER: REAR ENTRYWAY WITH PANTRY "WRAP AROUND/PARTIAL SCREEN ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.+ 1 CAR WOOD FRAME STORAGE, TYPE CONST.s SWIMMING POOL: GUEST, TYPE CONST. : OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION S BUILDING CODE LOCATION I DESCRIPTION a ART. I SEC. I f I f I I I I E I I i f I i I f I I I I I I I I I I I I I I I I I I I I I I 1 I I I I I I I f REMARKS; BP #5236-Z-QQ Z-4299 ACCESSORY GARAGE IN6PECPED BY: (� DATE ON INSPECTIONS 01128/98 GARY SH TIME START; 11:00 END; 11:30 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.24299 Date JAly 28 , 19 71 THIS CERTIFIES that the building located at Champlin Pl & A.tlantiMtreet Map No. . 7X Block No.= Lot No. X= Greenport, L.I• conforms substantially to the Application for Building Permit heretofore filed in this office dated April 6 , 19 71 pursuant to which Building Permit No. 5238 dated April 16 1971 , 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 #'xiYgte Qaxag (4ceE..sQ?"Y EId ) —.a,,,proved by Bdz�peals The certificate is issued to Ethel Annestead. . . . . . vomer . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N,$, Rause # 1050 Champlin n 170 &tlan.tiC Building Inspect/ Y;�QSUFFOLk�oY . Town of Southold 8/4/2022 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43311 Date: 8/4/2022 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 1050 Champlin Pl, Greenport SCTM#: 473889 Sec/Block/Lot: 34.-5-2.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/18/2022 pursuant to which Building Permit No. 47801 dated 5/11/2022 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: "as built"windows interior alterations and deck landing to existing single family dwelling as applied for. The certificate is issued to Lion-Betancourt,Isabelle&Betancourt,Paul of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47801 7/28/2022 PLUMBERS CERTIFICATION DATED 7/14/2022 n onthqNPiscitell' t riz ignature