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Home My WebLink About1000-79.-4-40 : TOWN OF SOUTHOLD Rental Permit 1002 Owner Dina Rose Occupied as Single Family Dwelling Located at 355 Windjammer Dr. Southold 79.4-40 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. 10/17/2023 Official This Notice must be posted by the main entrance at all times C f c m Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 mmmt�m� y p 1° BUILDING DEPARTMENT TOWN OF SOUTHO ' RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 3C � nr' le, (� 1 CS u„�w w.,.s G Tax Map Number: 1000 SECTION 3 loa -BLOCK -LOT d 9 "4' q ® SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 355 k�D Telephone Number(s): Daytime(031-8 l''31 Evening 1c3'" 73 Emergency Property Owner Email Address: I b Czrv Page 1 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 a � Southold,NY 11971-0959 T� BUILDING DEPARTMENT TOMW OF SOUIMOLD 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__ ergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if an Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evenin Emergency Email Address: SECTION E. SITE MANAGER INFORMATION:(requi 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 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 .A Southold,NY 11971-0959 %`1fjjj BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: " > ��1c t� ��-11 Telephone Number(s): Daytime(obi-�3T 3' �'7 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:—L64--J-- Requested , - 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 u 2;�" Town Hall Annex �' �' Telephone(631)765-1802 54375 Main Road ``' Fax(631)765-9502 P.O.Box 1179 r " Southold,NY 11971-0959 � , BUILDING DEPARTMENT TOUN 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold V/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 �C10- , 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 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUMOLD 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 Ajqri1 , 20.,9-1 O cial Not Public Signatur nd Original Notary Stamp TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK NO.01 DW630t000 QUALIFIED IN;�(jFF0 .K COUNTY COMMISSION EXPIRES JUNE 30,26k�— Page 5 of 5 so�4 TOWN OF SOUTHOLD 785-1802 .. _ IN PECTION [ ] FOUNDATION 1ST [ ] ROUGH PTBG. [ ] FOUNDATION 2ND [ ] INSULATION/CA! [ ] FRAMING / STRAPPING [ ] INAL [ ] FIREPLACE & CHIMNEY [ ] TIRE SAFETY IN, [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ ] CODE VIOLATION [ ] PRE C/O REMARKS: I -------------- ................................ TE INSPECTOR Farmers New Century Insurance Company pz PO Box 268994 Oklahoma City, OK 73126-8994 Toll Free Phone 1-800-435-7764 Toll Free Fax 1-877-217-1389 Second Floor: 391511 -- 20'10" - 61 1 ` 111311, °i Bathroom i 3,4„ 00 00 Master Tub Room _ ,.., Master Bedroom - Linen Closet $ , 1417° - 3 - 5'1 � 1` � ` 141711 g 1 - \ 100 25'11" i \ E - Vanity/Jacuzzi Room I �\ fV 3'4" i cy—r (x)landing o 14'7" Ln l '71 Cedar Closet0-0 I NO 3 Page 4 of 7y Claim 8003087267 03/11/2014 Farmers Now Century Insurance Company PO Box 268994 Oklahoma City, OK 73126-8994 F A R M E R S Toll Free Phone 1-800-435-7764 Toll Free Fax 1-877-217-1389 Main Level: 231911 18' V91V -------------- 121211 g" Ln Kitchen En Dining Room 10 Bedroom 8 P, 4-11 -A.,m W w room I Item's M 121411 221311 4- 6'2 10, 32 11--------- 1 Hallway in BR I Closet tw. 3'4" - 1212" 314" Ln Living Room 00 I EyW2 Lloset 0-1 Bedroom 168 + L; T8 25'11" "Y P8 421911 Page 3 of 7 Claim 8003087267 03/11/2014 ,a� Farmers New Century Insurance Company PO Box 268994 Oklahoma City, OK 73126-8994 Toll Free Phone 1-800435-7764 Toll Free Fax 1-877-217-1389 Basement: 40'1" 31 i �i i P ding 0030 Co elft I [ r4 I r-ico I I I Staff f Boiler S Page 2 of 7 Claim 8003087267 03/11/2014 ` Apr 10, 2021 Town Hall Annex Via° # Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 Nc P.O.Box 1179 Southold,NY 11971-0959 all, rk� „ X 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 Ero esCtonol seal re aired Lor Architect or Bn ineer licensed llonle ins actor must rovide coov of valid current certificatiorl Rental Property SCTM Number: ce) - onv TA Rental Property Address: 355 Windjammer Rd. Southold 11971 Owner/Name: Dina Rose 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.) Bedroom #1 .q(lf t Bedroom #3 144 f Bedroom #2 132 s ft Property Description (Include all improvements indicated on survey) S 1 *IV home 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. Victor Cornelius III CEG' Inspector Print Name and Title ceo# 1.216-0283 Original Signat e Please place professional seal: TOWN OF SOUTHOLD R M CARD I� OWNER !STREET VILIAG < F - --. SUB. L0 F - 3 p l � ,e3 FOR#"SFR N I v F 3 E ASR S W ? TYPE OF BUILDING RES. 7 SEAS. VL, ' FARM I COMM. CB, MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS I I $� F �p r e s � s a r __ z--xs � r .. s a - I// 4l. _ _.a _ S V S r - � - �- s 4 27, J i F=� + ® < AGE i BUILDING CONDITION 11� NEW NORMAL i BELOW ABOVE - , FARM Acre Value Per ? Vclue - Ac re ` I Tillable i a g FRONTAGE ON WATER Woodland _ FRONTAGE ON ROAD I _ Meadowland DEPTH House Plot BULKHEAD �e Total j DOCK f 4-1 3� _ORx, TRIM € \ \ 1 - I < � 79.-4-40 2/5/2020 . } M. Bid . �- c asp i Extension I - t Extension - ------------- Extension e i E f �R X - - - i IB Dinette Foundation oth d, P,,> F Basement - t Floors ice"` I<. N ,- iExt. Wails terior F h K A In finis �S L R, Breezeway - f i e i Fire Pias Garage !3',�, 'Type Roof o Heat -— i i Rooms i st Floor Patio . _ BR. se =Recreation Room ;Rooms 2nd Floor i FII, B Q. B �— i E - Dormer Driveway Total E ; I t Bunch, Connie From: Bunch, Connie Sent: Monday, May 17, 2031 9:44 AM To: 'kitten1805@aoicom' Subject: Rental Permit application Gond Morning, The Building Inspector has denied the certification of the rental located at 355 Windjammer Drive in Southold. The second floor area has been converted to living space without a building permit. Once the building permit has been issued hewill inspect forLhepermit aswell asthe rental. All ofourformsare mnthe website sVuiho|dtovvnny.gov, click on forms, click on building department and the building permit application is there along with the electrical inspection form and the plumbers solder certificate. loapply for the building permit vveneed the following items: 1. Building Permit application 2. Electrical Inspection form 3. Plumbers solder certificate 4. Four sets of plans from a New York State licensed architect or engineer with their seal and signature. All of these items should be submitted together as one package which can either be dropped off or mailed to Southold Town Building Uept, P.[). Box 1179,Southold, N.Y. 11971. |fyou would like touse overnight mail the physical address is 5437SRoute 25, Southold, New York 11971. Best Regards, �� e0ff� /��o� Sr. Office Assistant Southold Building Dept. 631-765-1802 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy 6 78 No. Date a .November. . . , , . . . . . . . . 19. . . . r THIS CERTIFIES that the building located at . . 35.5 .Windjammer. Drive. . Stmiatc Map No. . . .4362. . . . Block No. . . . . . . . . . .Lot No. . . . , . . . 29. . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated March 24 " , 19. 78 pursuant to which Building Permit No. . . . . .9641 Z dated . . . .March. . . .24. . . . . . . 197P., 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 . . . . . . . . .PrJxe.tA Qne. FamEay.' .DwejjAng. . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . . . . . .Gregory. .Roae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . owner, . k) of the aforesaid building. 8SOSuffolk County Department of Health Approval . . . . . . . . . . . . "` �. . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . . . . .1405367. . . " . . . . . . HOUSE NUMBER . . . . . ?. . . . . . Street . . . WAndoa er. Drive Southold, N.Y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , . . . . . . . . . . . r . C Building Inspector County Tax Map # 1000-79-4-40 w % FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33834 Date: 07/17/09 THIS CERTIFIES that the building SWIMMING POOL �. WINDJAMMER DR SOUTHOLD Location of Property: .._._ 355 . WINDJ_w..................�. . . w (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 4 Lot 40 Subdivision Filed Map No- Lot No. conforms substantially to the Application for Building Permit heretofore 2 filed in this office dated JANUARY 29 008 pursuant to which_ � Building Permit No. 33657-Z dated JANUARY_29_x µ20„0..8 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued WITH FENCE TO CODE AS APPLIED FOR. is ACCESSORY IN GROUND SWIMMING POOL I _ q_ ._www.. The certificate is issued to GREGORY & DEBORAH ROSE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 4226 06/25/04 PLUMBERS CERTIFICATION DATED N A /vix .��._-. .,..__. ....._.t.%' ed S'.rgnature Rev. 1/81 &ltt4 Town of Southold 10/17/2019 P.O.Box 1179 53095 Main Rd rC, Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40780 Date: 10/17/2019 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 355 Windjammer Dr., Southold SCTM#: 473889 Sec/Block/Lot: 79.-4-40 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/22/2019 pursuant to which Building Permit No. 44009 dated 7/25/2019 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: ROOF-MOUNTED SOLAR PANELS TO AN EXISTING ONE��A IILY I WELLl i ASAI UjE-D EOR. The certificate is issued to Rose,Dina of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44009 08-21-2019 �_ ......... ..._. :.... w� � ww_ PLUMBERS CERTIFICATION DATED ...^^._w_..Nwµ.___.___._. .._.......n. .�......:. ........ - . . Authorized Signature