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Home My WebLink About1000-33.-4-30 M a TOWN OF SOUTHOLD Rental Permit 0745 Owner Ourania Rauseo Occupied as Single Family Dwelling Located at 1155 Tasker Lane Greenport 33-4-30 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. 9/26/2022 ern)official This Notice must be posted by the main entrance at all times Oderca ' f &� Town Hall Annex , Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 >1E0V'E BUILDING DEPARTMENT V - 2 X022 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION BUILDING DEPT. TOWN OF SOUTHOLD Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION `eb -BLOCK -LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: Telephone Number (s): Daytime i()/ 3feEvening Emergency.......... � s Property Owner Email Address: Page 1 of 5 N,41 Town Hall Annex R Telephone(631)765-1802 54375 Main Road 1 Fax(631)765-9502 P.O.Box 1 179QL Southold,NY 11971-0959 � u 5 , 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 Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: �. Page 3 of 5 �ts �� Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 �C ��dip 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) 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 Town Hall Annex - Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 l79 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: Property Owner's Signature: Sworn to before me this_day of jl)rW---- , 20 a oL -P T) Official Not q5public Signaturea d Original Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2j�202-- Page 5 of 5 look V9,WN OF SOUTHO�LD BUILDIN DEPT. 631 .765.1802 3�, - � , �� INSPECTION ON 1ST [ ] ROUGH PLBG. ON 2ND [ ] INSULATIOWCAULKING STRAPPING [ ] FINAL E & CHIMNEY [ ] FIRE SAFETY INSPECTION 'ANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION AL (ROUGH) [ ] ELEGTRICAL (FI L) _ATION [ ] PRE C/O [ RENTAL V&iDq yv INSPECTOR %14- '1 X Snf- 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 SOUTHOILD 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 pc �essiotal seai reaalred for Architect ornaieert licensed Home lrtsoector dost arovide coy olrvalld current certil cation Rental Property SCTM Number: fax M . 1000-033,00-04.00-030.000 r 5 s r Lane, Greenport, 11944 Rental Property Address: Owner/Name: Ourania Rauseo Rental Dwelling Unit Identifier: 1 Number &Square footage of each bedroom as depicted in the attached floor plan: (i'e. Bedroom#1-100 sq., Bedroom #2-90 sq., etc.) QS Z pyx l = l SF 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 Consorvrbon nstruction Code of New York State. ' nibs A. Sertzoglou, PE, Principal Print Name and Title NEI Origin#si Mature c , Please place professional seal: SSO LD PROPERTY WN STREET �� "�u r VILLAGE DIST. SUB. pol r !� �� 4 �'�d„�� r �o ,"'� I�r /f�11�� P m 6��,. �....., .,a".M�..� �.�,:v Mme,,.,.,..»»« ...-..........�.. �r� ` � ;Y � i� �. �* ^, �..E'� �� ..,...�.,.,..,..�.,.�.,.�,...�� DORMER OWN � N E ! ACR 41 S W TYPE OF, BUILDING .. ,.. ., , _.., RAS. a '? SEAS. VL. FARMCOMM. CB. MISC. Mkt. Value w � N l'MP. TOTAL ' DATE REMARKS p ! b .� rrrn �,/� r „"". � � / r �v .�,,,�.. ..»��;�ti�yl,��..r✓,�:"�,,,„,....�....�e:^..,.:'!;,J`.�u ��,�.r'dw,�wY'.� .. �a„ .�°,”'„+ m�'.r+u�.,.�i��Mwr,'un �.«mil��. �'2u:� '�n �� Www �»ww�4,�„��..w.�",W. "' war.” f N NORMAL BELOW � B(” F r mer.. ,r FARM Acre Value Per Valu w Acre " .. Ni -17 " .._ W odiriod Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD �° u Ptat 1 DEPTH � 7 " BULKHEAD Total IDOCK ri rill.. r ,! r , r,,r , ,. ,l J 1 l / J, //.. „rr�,rn r� � �rr7 i J.i,✓..r n'....,/ y.,�Jln7l,/.zl/fY..,r..i� � r ro, .... i,..i,.,rr., .rr Jn.,r,.,.�JJ ,.,z..,....or�.r ,..,..,.�. r�..... .. ......i ...� ,.. k„�,,"��"(�%i,i✓��1�/rG��/✓r.� �9,,,�vd4,/��,J1 i,,,,:!/,i,,,//..�L�l//1�J11d1i�DY�/%/Gn`l�li,/l,�lJpS�,,., l/.,� r „ �"J. ,�,,,'/,�.,,! . . w 1� �r r r ,r r � r a -OLOR � �rtrt RIM file � ��w7k tilt �� 14 µ rr A � t Q r F i 33.4-30 10/06 33-4-30 garage 10/04 _ r Tc 122 � . . . ., -� _ .. ...... __ .� �.... �,.... oundat on Bath l eft .. .�w ...,Floors Extension Y 7 '1 warrtenw Extension � cr � f Wa I I s � i Interior Finish LR Extension 9 X` + +4 Fire Place t r�« t . DR. ✓ i ti ..a,.,. �, Heat �. �� .. . ... . ,o�_.. .... ..... _ �. . ..w�. .. .,. ��n� ,. . � r ' C2 el p s�- t e Roof Rooms 1st Floor BR. Y yp �RecreationµR..,.._.... �. ,�..�.�.�....�.��,.�.. .��...�.,....�.� ......... w_. .. ...... ..... .� ,o.�m.� �. w....�..w Porch �.. � ��+,� � v�'� � oom� f Rooms 2nd Floor � Porch Dormer ____.. o. ...!.._..._ ... _...µ _ Breezeway ��Driveway 1 f i Patio Alf- 0 lf m.a 17 ool yf� , i .s"° r ',r�'.��', �i� � ,. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32204 Date: 02/16/07 THIS CERTIFIES that the building NEW DWELLING Location of Property: 1155 TASKER LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 4 Lot 30 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 26, 2004 pursuant to which Building Permit No_ 30869-Z dated DECEMBER 28, 2004 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 WITH COVERED FRONT ENTRY & NON-HABITABLE SECOND STORY (ATTIC) AS APPLIED FOR. The certificate is issued to OURANIA V RAUSEO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-02-0189 02/07/07 ELECTRICAL CERTIFICATE NO. 93404C 04/20/06 PLUMBERS CERTIFICATION DATED 11/28/06 TODD TUTHILL Aut. riz Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32206 Date: 02/16/07 THIS CERTIFIES that the building ACCESSORY GARAGE Location of Property: 1155 TASKER LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 4 Lot 30 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 28, 2004 pursuant to which Building Permit No_ 30869-Z dated DECEMBER 28, 2004 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 GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to OURANIA V RAUSEO (OWNER) of the aforesaid building, SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 93404C 04/20/06 PLUMBERS CERTIFICATION DATED N/A Au .ori ed Signature Rev. 1/81 ROAM ,immlmm A. 11)l 43 _ .....kp .. �. w, ___... / _ arm a ..............._.... .,...,,_. ...- kIT4MEN1 6 DINCN6 MA L tbM A VA r eb M �.. - a .i r~. ® r✓ m a _ a.� . mmi k O w'UGL M ,MiR�,M,IN; aamr - K L\/L = I � XG w i� (2)2x8 MIN HDR rrr m :2 LVL O^ 1=05T5 �.0,3" _ _.._... _ _ — --�..._,,,. ..._ ......_... UNLE55 NIOTEE7 LOTHERWISE _w...___.. FIRST re" PLAN F:LQ0S FLAN SCALE: , o I��_�„ 3 30 a M1 .e r_ — — — _— --- — ----------- _.. _._ ._. r* _ r. _ ri -ter— P ( 7 a 6 V 4 4 oR A „ - Cr r .,.�,i�. � aw+n.we nx .t ��..,r.._�, ..F. L r..._. .r,.,i � � ✓ �'�„�^j y, K _J✓� K (Y ------ fit r Z 5Tt;kUGT1F�_'ALMF-M5EE25._ IN.; a ri r L\/L = IjXII � UT b « uv __.._.. .,__.. —" ----.....___...... �.?a'G_,,,,_— _._.._... 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