HomeMy WebLinkAbout1000-46.-1-31.1 (Unit B17) € #P TO WN OF SOUTHOLD
Rental Permit
II 0777
Owner Driftwood Cove Owners Inc (Michael Lee)
Occupied as Single Family Dwelling (Unit B17)
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.
11/19/2024
for �� t Official
This Notice must be posted by the main entrance at all times Otte
TOWN OF SOUTH LD IBILDING DEPT.
631-765-1802 q6,- ` _ �(. (
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI AL)_
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
t
1A►'1""� __ INSPECTOR
Town Hall Annex « Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
{, 1)4
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 re aired r Architect or Brl to er licensed Name Inspector m t ralrlde
Lowy of valid current certl cation
Rental PropertySCTM Number: 1000-46.-1-31.1
Rental Property Address: 1000 9th Street Unit B17
Owner/Name: Michael Lee
Rental Dwelling Unit Identifier: Unit B17
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1-100sq., Bedroom#2-90sq., etc.)
Bedroom 1- 1 4 sf.
Property Description (Include all improvements indicated on survey)
No Change to existing survey or an 2)dstinq bulk conditions
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 Constructl n Code of New
York State.
Alyssa Manfredonia- Re d Architect -
Print Name and Title �� ( igln Igrr e
Please plane profe sto �
COI`N .° ~t
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 :t ;/� v.southoldtownrt>
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address: 1000 �7 ,4r 0/Y
Tax Map Number: 1000 SECTION _-BLOCK -LOT 31.
SECTION B.
OWNER INFORMATION:
Property Owner Name: AIMAef tee
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
,kill"
Telephone Number (s): Daytime 631-$33-0 /Evening Emergency
Property Owner^Email Address: AS L R55 e carpielt.
mf
3 d D
Page 1 of 4
TOWN OF SOUTHOLD
NN
Rental Permit
0777
Owner Driftwood Cove Owners Inc (Michael Lee)
Occupied as Single Family Dwelling (Unit B17)
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.
11/16/2022
e or _ � of Mali
This Notice must be posted by the main entrance at all times
Town Hall Annex �f Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179
Southold,NY 11971-0959 wV
Aj
°m'ld
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee $200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
p Y
1000 9th STREET UNIT 1317
Tax Map Number: 1000 SECTION 46• -BLOCK 1 -LOT 31.1 _
SECTION B.
OWNER INFORMATION:
'
Property Owner Name: oW Lte
Property Owner Legal Address: Property Owner Mailing Address:
90 e( CAme , # y
Telephone Number (s): Daytime 631-2 -60i� Evening k Emergency
Property Owner Email Address:_J45L_ ass °1 ��h�°U•Qd�(
0
Q.n✓c� 4oa`�`��
Page 1 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 SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: f
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): /600 fel r
Mailing Address of Authorized Agent: P.0- V3 IIM 1 6 11M"
(,3I-agS-SOI _
Telephone Number(s): Daytime venins _Emergency
Email Address: S�� l5�ml- qw
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): 1000 IN A
Page 2 of 5
t , ,
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179
Southold,NY 11971-0959
zr-
BUILDING DEPARTMENT
TOWN OF SO rUTHOLD
Mailing Address of Managing Agent:w, p,mmm &X `'� 4 9" N�r��?7
Telephone Number(s): Daytime6N-asp'-%61 Evening_....... Emergency w�...
Email Address: ` �J: S mM Wer• .....
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: b l _ ,_............._ �.
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: UNIT 1317
Requested Maximum number of persons allowed to occupy Dwelling Uni
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: 595 SF +l /
KITCHEN : 6 X g r ' y�sP LIVING ROOM: I S.0 X 16-.
BEDROOM 1: r�z�Y' 15`/SF BATHROOM: 77V 6'_ 3q
Page 3 of 5
Town Hall Annex ^� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 � � s
Southold,NY 11971-0959
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
X 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)
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 Nall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1 179
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: ,,,,./A
Property Owner's Signature:
Sworn to befo e e this /y day of � - 20�„,2�
Official tary Public Signature and Original Notary Stamp
KIM A TASHER
NOTARY PUBLIC-STATE OF NEW YORK
No.01TA6327039
Qualified in Nassau County
My Commission Expires 06-29-2023
Page 5 of 5
Town Hall Annex Telephone(631)765-18102
54375 Main Road Fax(631)765-9502°
P.O.Box 1179 " CC ,
Southold.NY 11971-0959
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
pro n l seal re fired&r Architect or dEn f eer llcen do a Ins ctor mut grovide
My of Mild current certification
Rental Property SCTM Number: 1000-46:1-31.1
Rental Property Address: 1000 9th STREET UNIT B17 �
Owner/Name: ��
Rental Dwelling Unit Identifier: UNIT 617 ._„w
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
Property Description(Include all improvements indicated on survey)
QNS
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.
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TOWN OF SOUTHOLD BUILDING D1
631 -765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PL13G.
I l FOUNDATION 2ND [ ] INSULATION/CAL
] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INE
[ ] FIRE RESISTANT CONSTRUCTION [ 1 FIRE RESISTANT PE'
[ ] ELECTRICAL (ROUGH) [ ELEC `RICAL (F f
[ ] CODE VIOLATION [ PRE C/0 ]
REMARKS:
DATEl ' INSPECTOR
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z60�0. . . . . . Date . . . . . . . . . ,August . . 16 . . . . . .. 19.74
THIS CERTIFIES that the building located at .Main. Rd 4. 9th•int . • • • • . . Street
Map No. .xx. . . . . . . . . Block No. . . .xx. . . . .Lot No. .x= . . . Greenport. . .N.d.. . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . /30/73 . . . ., 19. . . . pursuant to which Building Permit No. 6.527Z. .
dated . . . . . . . . . .4130/7.3 . . . ., 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. bedro.Qm. apartments. buildings.& .4.13. . .J)ri;f.%wood .90T.4k . . . . .
The certificate is issued to . Xenophon. Dawianos. . . . . . owner . . . . . . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval existing. gublio sewer. system. .
UNDERWRITERS CERTIFICATE qNo.�L*x1757$79NI-75791•VN17.5792.1• • -Br-. X175786,
HOUS96TI16 6. 0. .Ol�ER�71.7. . Aug. . Stree?74. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
75-
Building Inspector