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Home My WebLink About1000-53.-6-30 TOWN OF SOUTHOLD Rental Permit 0995 Owner Kasey Harbes Occupied as Single Family Dwelling Located at 536 Conklin Road Greenport 53.-6-30 Maximum Permitted Occupancy 3 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. 9/28/2023 Cod nf_ ement ofi This Notice must be posted by the main entrance at all times 1 3 4 2 0 0 °z - Town Hall Annex Telephone(631)765-1802 54375 Main Road 3 Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 � " BUILDING DEPARTMENT G 3 1 2023 'll:"'OWN OF SO 1 HOLD RENTAL PERMIT APPLICATION 1,011"N 17�C. 1r (,I Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 53�,o Tax Map Number: 1000 SECTIONJ� -BLOCK l0 -LOT 3 O - SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 3h Telephone Number(s): Daytime Evening Emergency Property Owner Email Address: a Page 1 of 5 r Town Hall Annex Telephone(631)765-1802 54375 Main Road ` y Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �� r�rr'� BUILDING DEPARTMENT TO 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:- N �- Address of Managing Agent (no P.O. Boxes): Page 2 of 5 a Town Hall Annex Telephone(631)765-1802 54375 Main Roadt Fax(631)765-9502 P.O.Box 1179 c " Southold,NY 11971-0959 kN, n b; 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, Q 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 Uni : ✓ Number of rooms in Rental Dwelling Unit: Z � Use and Dimensions of each room in Rental Dwelling Unit: b Page 3 of 5 Town Hall Annex f Telephone(631)765-1802 54375 Main Road h Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ., �t BUILDING DEPARTMENT TOWN OF SOUT OLD 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 CY 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) I , .,� „ ., 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 µ Town Hail Annex �7` �I �: Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 �� P.O.Box 1179 Southold,NY 11971-0959 ' "� � d 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: CA.r, Property Owner's Signature: Sworn to before me this �day of 202-3 Official Notary Public Signature an riginal Notary Stamp HELEN E.BIEUNG Notary Public,State of New York No.OI 815()58858,Suffolk County Term Expires 04/22/ ZOZ-p Page 5 of 5 Town Hall Annex ti '� Telephone(631)765-1802 54375 Main Roadpr o Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO 0LI) 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 re uired for Architect or Bn ineer licensed glome Ins ector must ro ide My ovalid current cerci Mcati; n Rental Property SCTM Number: Rental Property Address: v L1 N 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.) c f�rvL # l '�[n " 0 13 'l e'--Q'-7 = 716 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 Ori nal Signatu eRF J,' Please place professional seal: � . TOWN OF SOUTHOLD BUILDING DI 631 -765-1802 -3 � INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (TIl [ ] CODE VIOLATION [ ] PRE C/O [ " 6ui c -- it V" ole, 066ao"—!�*o DATE �� INSPECTOR � Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 W Tel: 631-765-1802 SUM # _ . �� (7�-m�C7 Date _ ee a- e. w Owner e S Phonew, .. .. ,31, 411017 -/i Visible _ Hamlet �� Inspector Address Floor Level Quantities Sub 1 2 3 Smoke Detectors not located in bedrooms Carbon Monoxide Detectors _ Fire Extinguishers _ Exits _ 1. Bedrooms 1 3 4 5 6 Smoke Detectors Egress Occupant Count Building Systems Maintained & Operational Condition of Property Heating Building interior Hot water Building exterior Electrical Property clean, maeinmtained &safe _ e Mechanical Handrails &guards installed &secure Pool Safety Pool on Site _ Surface water alarm Date of CO issuance Door alarms Pool completely enclosed Self closing/ latching gates Pool fence to code requirements CO's for all items present Prior Rental Comments: _ _ G A R A G E WASHER/Myr-R- -ri EC WATER HEATER f7,4 \Nl- N KITCHEN 2023 B E D R 0 0 M r T,��Mf 7, T LIVING BEDROOM ROOM SMOKE/CO DETECTOR 0 GFI OUTLET 536 CONKLIN RD. GREENPORT, NY 11944 a a A }-6 a _ e AH" Kit, ILi } FEC NE a NEW I i1tlt' �' yt _ �t rop 2 m` _ ,. � � aV tNE W) 'mv MVIRAl WE ta- ro Rg-A CT,� s 4 TOWN OF SOUTHOLD PROPERTY REC, OWNER STREET VILLAGE DISTRICT SUB, LOT P I CJ �tER OWNER N E ACREAGE 'q t. i S W TYPE OF BUILDING 3 .es RES, l SEAS. VL. FARM COMM. IND. CB. I Misc. LAND IMP. TOTAL DATE I REMARKS-.-� ; E - } z r z l F AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable 1 a, - -. _ eritaJ , Tr. Tillable 2 ' Tillable 3 ' Woodland I ` Swampland � �5 Brushland ' Nouse Plot Tota I rt T- - • LA [ 4y 53.-6-30 11/1/2019 _.. I � , t ld = Foundation Both Basement Flors o Eaten Extension Ext. Walls �� f Interior Finish �- ,_ .. _ Extension Fire Place �w Heat Porch Attic 1 Porch Rooms 1st Floor < Breezeway Patio Rooms 2nd Floor __ Garage Driveway �� O. B. v� room NO. i TOWN OF SOWHOLD G DEPARTNMNT TOM Owes office soudkddl N. Y. if to Of Occupancy No.Z6373 . . . . . . Date . . . . . . . . . .. . .Xamh. . 2i. . . . ., 19.75. THIS uWrIFJ Imi that the building located at .R#0-.W US-Lw1and.VI . WNt map o s + d Peec Rsl�taa. .Lot No, ,Xk3C- -0rsport. . K.Y*. . . . .. . conforms subStSUtAiAgly to s t +�►lor d . bb re -Apra,.2a . ., 1957. .. pursuant to which rgWrey dated . . . . . . . . . k?grab. . . . 21, 19. 75, was issued, and conforms to all of the require- ts of the applicable provisions of the law.The occupancy for which this ce ., "nate is Woodis .. ... . . . . . . . . . . . . . .. .. .. .. .. . . . . .. . . .. . The certificate is issued to .Hubbard. .Iiendrickaoz. . . . -tuner . . . . . . . . .. . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . Are-r. eXUtJX9- . . . . . . . . . . . . . . . UNDERWPJTERSNo. prja, .esistizig .... . . . . . . . . .. .. . . . .. . . . .. . . HOUSE NUMBER MO. .. . . . Street d. Yiex .lam . . . . . .. ... . ... .. . ... . . . . . . . . .. . . . . .. .. . . .. .... .. . . . . . ... ... . .. . ... . . .. .... .. . ... .. .. .. .... .. . I.. . . .. . . . . . . . . . . . . . Building TEL. 765-266E3 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 11971 HOUSING CODE INSPECTION March 21, 1975 #480 R.O.W. NIS Island View Lane R-1 Greenport, N.Y. Tax Roll: Hubbard Hendrickson unoccupied Upon receipt of an application for a preexisting Certificate of Occupancy, I made an inspection of this one story framed dwelling. I was admitted to the building by Mr. Hendrickson who accompanied me during this inspection which began at approximately 10:45 A.M. The building consists of a living room., kitchen, full bathroom, and two bedrooms. A gas fired floor frunace is centrally located in building, so that heat generated by furnace is supplied to all rooms. The building foundation is cement block with crawl space. An enclosed porch is on the south side of building. City water is furnished to building and hot water is supplied from an electric hotwater heater located in lean-to on the east side of b a ld n A ons' t ar ge Mi ° .� �e rear y-a rd." Ings and grounds a e- `ih go o d order. I found no violations of the Housing Code, Chapter 52, Town of Southold, N.Y. Inspection was completed at approximately 11:10 A.M. R pectfull s fitted, Edward Hindermann Building Inspector ED/bn cc: f FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy 211494 February 24 83 No. . . . . . . . . . . . , Date . . . . . . . . . . . . . . . < . . . , . . , . . . . . , , . ., 19 , . , THIS CERTIFIES that the building addition Location of Property $$A4dyievl, ��(PenP.ort, , . _ , . . . . , , . . . . . . House No. 0S3 9eet 030 Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . .Block . . . . . . . . . . . . . .Lot . . . - - . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated J"A:Nh .29. . . . . . . . . . 1982. pursuant to which Building Permit No. . . A16!!.Z . . . . . . . . . . . dated ..APX:l. 2 . . . . . . . . . . . . . . . . . . 1982. ,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 . . . . . . . . . addition to existing dwelling . The certificate is issued to . .Lonraine. .A.. Hoey. . . . . „ . . . . . . of the aforesaid building. Suffolk County Department of Health Approval . .IST/A . . . , . . . . , . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . .rj91359 . . . . • . . . . . • . . . . . . . �P .. .. . . . . .. Building Inspector Rev. 1/81