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HomeMy WebLinkAbout1000-46.-1-31.1 (Unit J67) TOWN OF SOUTHOLD Nwoo Rental Permit 1031 Owner Driftwood Cove Owners Inc (William & Kristin Von Eiff) Occupied as Single Family Dwelling (Unit J67) Located at 1000 Ninth St. 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. 11/29/2023 � � Code E rce r� Official This Notice must be posted by the main entrance at all times o 1 )-I-7--�,3 12e c__ I o o a� 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 htt,p,, ,//w w otithol(itow nt� . Iµ p RENTAL PERMIT APPLICATION NOV '1 7 2023 Rental Permit Fee $300 (Application must be renewed every two i Section A. Property Information: Rental Property Address: Ao6 crreer)PO4, Mckia Q .( 1119 46 J� Tax Map Number: 1000 SECTION L4(0 -BLOCK LOT SECTION B. OWNER INFORMATION: � , llllqf Property Owner Name: i s �r1 T1 r1 on O ,A Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) (D QIs Telephone Number s : Daytime � � ��� � ���� ✓ p O yt . Evening ✓ Emergency Property Owner Email Address: V lin ? 'i tri` f �_Cn - E.;� Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: !--un-i (0 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: I . , � X 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 0 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK) I "al 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 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 s to any change to the information regarding Authorized Agent, Managing Age t, or 'ite Manager. Property Owner's Name: AM 1 Property Owner's Signature: OFF"', w. Sworn to before me this day of N�ve-OA k-\AA 20 c)fD N,. a- , & /&� (J-2� Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01BU6185050 Oualified in Suffolk County Commission Expires April 14, 29Q�4 Page 4 of 4 1 O vg�soulw T WN OF S 631 7851 1802 y�( INSPECTIO,N ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATIOWCAI ] FRAMING 1 STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (TI CODE VIOLATION [ PRE C/O REMARKS: LKS: ATT INSPECTOR Town Hall Annex Town of Southold 5437S Main Road " - POBox ll79 Rental Inspection Report i Southold, NY11971'1179 a Tel: 631-765-1802 Date 'Owner Phone Visible Address Coot- J411 Inspec Hamlet Floor Level Quantities Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits__ ----------- -----------' --- - - -1 I 3 | 4 S ! 6 / Bedrooms ---'-------- -- -Smoke - Smoke Detectors__ _ _ _ ---Occupant Count 8uibdingMaintained ��Operat�na| Conditionof ' - Heating _ - - - Building"' ho°. - - ---' ' B exterior-, Hot water u . ----------- P d intoined0' safe Electrical ,v - ______ \y ----------� � :Handrails /� rdsinstoUed /�secune " Mechanical _ ' !______________����_�� Pool /Pom| anSite Surfacexvater_a�rn� _ .DateofCOissuance --�—�� Pool completelyenclosed_ Door alarms _ _ _ uv Self closing/ latching gates _ Pool fence code requirements ��������_�_ CQ'sU �e present Pr��, Ren1a| Cnnmnnents - _ - ' Nx 3s - V-0 �0, \ �2 BATd P,oav�acme Fire At-Af.�v► OKOYlo'G Ci Is T! FORM NO.4 -ro ! N Ol= SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . . X10584. . . » . . . . Date . . . . . . . . .1.. 1. . . . . . . . « . . « . . . .4 . , . . .119 . THIS CERTIFIES that the building . . . . . , « . . . . . . . . . . . . . . . * . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property Plain load and 9th Street, Greenport, New York House i1Co. ►treat .hCG%� County Tax Map No. 1000 Section . . . 46 . . . . . .Block . » » . * „ , . . . , . , .Lot . . . . .31 .1. .. . . . . . S>!f . * . . . . . . . . . » « » . . . « . . . » .lI &x. . . . . . . .'�."�f'f�`b . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated April 30 19 . 73 ursuant to which Building 65292 - p B ing Permit No. . . . . . . . . . . . . * . . « . . « . . dated . . .April 30 19 . . ,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 Bedroom Apartment Bldg, "J" Driftwood Cove . . . . . . . . . . . , « * . . . . . . . . . . . . . . The certificate is issued to . . . Xenophon Damiananos of the aforesaid building. Suffolk County Department of Health Approval . Existing Public Sewer System UNDERWRITERS CERTIFICATE NO. . . . 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