Loading...
HomeMy WebLinkAbout1000-46.-1-31.1 (UnitA9) Olt TOWN OF SOUTHOLD } Beata[ Permit .a 1006 Owner Driftwood Cove Owners Inc. (David Pultz) Occupied as Single Family Dwelling (Unit A9) Located at 1000 Ninth Street Greenport 46.-1-31.1 Maximum Permitted Occupancy 2 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. 10/19/2023 Code E orc ent official This Notice must be posted by the main entrance at all times IVISP )013 Town Hall Annexa Telephone(631)765-1802 54375 Main Road " 7 P.O.Box 1179 Southold,NY 11971-0959 ,3 BUILDING DEPARTMENT TOWN OF SOUTHOLD ' wT »TO"OrT'T RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: y f6 119 Tax Map Number: 1000 SECTION 7-3 -BLOCK , -LOT 'Ito 3 I 1 SECTION B. OWNER INFORMATION: Property Owner Name: p Y Property Owner Legal Address: Property Owner Mailing Address: G© sw-�� v\0p ul"- �-d �r[ &3f(4-04\84 Telephone Number(s): Daytime 63/'.4j7X3 Evening Emergency Property Owner Email Address: U a,o by i G SS) 6� Gn"c<c\ (C YVi Page 1 of 5 Town Hall Annex ; Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 r Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: .) � Address of Authorized Agent(no P.O. Boxes): 160 S. Mailing Address of Authorized Agent: ��o F��cl.csr std cry Telephone Number(s): Daytime-1 76S-2S'41Evening 7&5-3g6L Emergency"b ew7- 2.4 13 Email Address: G 1a�rCag� " G't"'G'` •��"'' Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime . /`� ` l�( Evenin � Emergency-M Email Address: d-ck1C\-eAC I S llA na e'-as-\ ( m4- . :(�NM 4@ T5\aV GCLS kVVI%r 4 - COM SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: —1 0`^`R J 0.C KSC) n Address of Managing Agent (no P.O. Boxes): I o0O r\, Page 2 of 5 Town Hall Annex N � Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 re Southold,NY 1]971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: fb 6 oX k%$(P 1nJ�Std.�'`� ' 6C k 01%, l�q7g' Telephone Number(s): Daytime G31-7° "" '(1 'Evenin 7 03' O 1I& Emergency 7 Email Address: jo lln =S1 and "a�S� M� -Com 14 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: V i r i va k ( 0 w t ��S 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: O` Nm 14 umber of rooms in Rental Dwelling Unit: jr Use and Dimensions of each room in Rental Dwelling Unit: i55 S1111-4V �, tj swF� 3�p Sok K' 6Y Sct� Page 3 of 5 Town Hall Annex t Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 a BUILDING DEPARTMENT TOWN OF SOL9MOLD 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. am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 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) IJ)�VlUl-Tz- ,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 VU 11 t�� ' BUILDING DEPARTMENT TOWN OF SOUTHO>r) 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 re me this 17 day of S(/ ZL/y//S(57(Z- .202 5 Official Notary Public Signature and Original Notary Stamp FNotary LWE M l�l"ri� P blic.Stat#of New Mark l.01MA6384635 ed in Suffolk County sion Expim D,et 17,2026 Page 5 of 5 s 014-N 631 -765-1802 4 - 1 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (Fil [ ] CODE VIOLATION [ ] PRE C/O [ REMARKS: J 6u, oot� e-o( o 10 DATE INSPECTOR 0 w ��� i// ii�� ���,o / ,,,,,,,,,//, �/�%%ice ����/////� �%iiia%„/�� �����%i%�%/�ji� �� iii/%ii�� iii//�///� j%i ����/�ii �iii ���������� , j ���/i� f ��� , i/ _f'� v,,,, ���� ia� rl j /�,,� ��� ��%: �` ,��< f ���% %,; Dii, �� � l�„ IJ 1 �'Ir 1s;m ills 1 �, FQ(O. ,, Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SCTM# �, d "" w . .. Date Phone Owner Address r. ...... ..... @. ..�� � .. -0-m Visible Hamlet Inspector j .:mm� .. _.... ...w.._.... .._ m._�.. _ . . .. . .... n,,... Sub 1 3 _. .. Floor Level Quantities Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms 1 2 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, maintained &safe Mechanical Handrails&guards installed & secure Pool SafetyPool on Site Surface water alar m 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: � clesat ('�e. a Qoom ►55 � �*��M �w MOO AS- 5 0. ��tpc` �Ft 5 3 � �r a e s TOWN OF SOUTHOLD PROM ID CARS OWNER STREET VILLAGE _.ST. SUB. � T ti FORMER OWNER N E ACR ` S TYPE OF BUILDING VA LjA I a - RES. SEAS. YL. FARM COMM. CB. MICS, Mkt. Vol r LAND IMP.P. TOTAL DATE REMARKS s x � _ y Y A 3 s a s . s u �_g v Tillabie - FRONTAGE ON WATER Woodland Meadowland DEPTH House Plot BULKHEAD Total - z TRIM R Ftb — — - t - _ a� 3 AL E 46.4-31.1 10/2014 F 46-1-31.1 2/03 Extemioni Extension 4 Extension i Foundation Both Dinette g i K. s; Poich ge3sement Floors Porch =Ext. Walls Interior Finish LR, i Breezeway Fire Place Heat DR. t Garage _ Type Roof Rooms 1st Floor BR. Patio 'Recreation Room ;Rooms 2nd Floor FIN B O. B, 1 Dormer - Driveway r Tr4al 3 E i i i FORM NO. 4 p TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z60 50. . . . . . Date . . . . . . . . . August . . 16 . . . . . .. 19.74 THIS CERTIFIES that the building located at .Main. Rd A- 9•th St . • . • . . . Street Map No. .XX. . . . . . . . . Block No. . . .xx. . . . .Lot No. .y—= . . . Greeport. - -2i,Y.. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . i/30/73 . . . ., 19. . . . pursuant to which Building Permit No. 6.5272. . dated . . . . . . . . . .4130/73 . . . ., 19. . . ., 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 . .one. .bedroom. apartments. bui.ldiAgS.& A.$. . .0r1;r.tw4od .CQ"r* . . . . . The certificate is issued to . Xenophon. Damiancs. . , . . . owner . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval existing. publir. .sever..system. UNDERWRITERS CERTIFICATE No.,plvSl75787,I11.75791.gNI7•5792.3- • .Br-. X11757$69 Al 601& X176017 Aug g74 HOUSE�NU�ER . . . . . . . . . . . . . . Stree? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector