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Home My WebLink About1000-63.-1-31 3 Tu"WN OF SOUTHOLDV Rental Permit 0836 Owner Charles Lauer Occupied as Single Family Dwelling Located at 895 Greenfield Lane Cutchogue 63.-1-31 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. J 3/13/2023 f ce e �eial This Notice must be posted by the main entrance at all times rT �n Town Mall Annex �� Telephone(631)765-1802 54375 Main Road A Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT F R 1 9023 IL TOWN OF SOUTHOLD h ; 8l,)1lj.)11Vb 1Airwa T RENTAL PERMIT APPLICATION 110WN OFS01M401 D Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION . . -BLOCS_ ) .,.W....-LOT SECTION B. OWNER INFORMATION: rr.� Property Owner Name: " TU �. .. �.a ...._....... _...� ........, �...._. .! _._.. _.,. .. ..__..._ �. W Property Owner Legal Address: Property Owner Mailing Address: ) Daytime,,.,_.,,,x'57 --16471 ( Telephone Number(s): �� Even ing.�.�.�_ ..._...... ..��......., Emergency___.._.... .�.�-._.._._..�_..,....u� Property Owner Email Address:_d.._.. .... .... JAD lct(v$" 4 D-0 Page 2 of S J e �S �Vi"9➢41'r�P� ��F e° Town Hall Annex ,0 Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1179 " Southold,NY 11971-0959 rµ1 V0�14�5m� BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: -.,--,-,--,,. a` Address of Authorized Agent (no P.O. Boxes):rc._ _ .. ... ............_w_....��...................._... ......_.�-�.........._�.�,.. �.�. ..._ MailingAddress of Authorized Agent:..._.................._._............ ....-..u .._..,�.__.�....... .._....� ...... ..................... ..._�.�_.-..�..........�.._._ Telephone Number(s): Daytime .„ w ._._�..._ Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: m�. µ ..............0 . _.. .._._,__-- Address of Authorized Agent(no P.O. Boxes): o„,._.... .__.. .......,._... ... ..,.. .._.._ .. . _ ....._. ._.. ._. ........_..... Mailing Address of Authorized Agent:_.. _ _...._._.._...........,_......�.._...�.., ...-.,._. ._. ....._ ..._... ,.. ...._....._... Telephone Number(s): Daytime Evening Emergency_..._................ �_..... EmailAddress:...-.mm........... .......��.�.�..�...�.... _-.........._... .........�.�.�.�.�_......�_........._... �. .��...��. .� . _....__ _ .. .a..,. ....._.._...�_.... ._.�... .,..._....� � _._ SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: _..�.._.�_ww�.. .. -...w� �� .. ._ ............ ......�.-. . �.�.._.�.._ Address of Managing Agent (no P.O. Boxes): ... ..._....__.._...._ _.... ..__ ..._... _.www .ww_. .. _w.w__..._._._..._ Page 2 of 5 q Town Hall Annexe 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 Mailing Address of Managing Agent: N ,.. ._ _.�.._.. �._�. Telephone Number(s): Daytime_,,_,..__,___ Evening Emergency_,_.. ._.,, ............. .. Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property:mm_ µ�, ......... ..._..µ..._.,___._.w_.._ ....,_., .,. ... 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: ... _.......... ri .._,_ ...._...,,. ... . '506q �� Requested Maximum number of persons allowed to occupy Dwelling Unit:,,,, Number of rooms in Rental Dwelling Unit:_..............o.......... .._....,......w�w_......!........._._. ....._..... ��.o._. .�.�.�. ...�.�..�.�...�. n �. Use and Dimensions of each room in Rental Dwelling Unit: _Kt'tC0e-?1J------- 2-3'4 Ck..w..a..,,.,.,. -p11 .1l (-70 6-!uLIVCr f."M Page 3 of 5 .n x 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 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) 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 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:_ ., .,...o......... a .. � k ��DT??.. a__o ..................w Property Owners Signature: _..,.. � Sworn to before meth! 6'41vof aa!' ,,._,_. . 200 - Official 200Official Notary Public Signature and Original Notary Stamp Page 5 of 5 faf$0 TOWN OF SOUTHOLD BUILDING I w 631 -765-1802 -- INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PEBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAL [ ] FRAMING / STRAPPING [ ] FI L [ ] FIREPLACE & CHIMNEY FIRE SAFETY IN* [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL L CT ICAL (Flr [ ] CODE VIOLATION [ ] PRE / [ F REMARKS: r DATE INSPECTOR t TOWN OF S UTH LD PROPERTY,--,WORD CARS OWNER I STREET VILLAGE DIST.; SUB. LOT FORMER OWNER e0r `.S N E - - - CR. -- ' S W i TYPE OF BUILDING RES. 1 SEAS. 1 VL, FARM COMM. CB. MICS. Mkt Value ..1, LAND i IMP. TOTAL ; DATE REMARKS 'ra LO f A F � , _ �- �f /✓{ a� I I • r e�_ . I _ Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD t , Total i i COLOR -- ` TRIM -- 4 4 I E Wow -- oT LA its 0 MW f E a - � E c v i t A Bldg. } Extension T Extension Extension E Foundation Bath _ Dinette Porch 1 Basement Floors K. arm, Ext. Walls Interior Finish LR. E 3 = Fire Place Heat DR. Breezeway [ _ f _ Garage ¢. ! a; ��` ' —r Type Roof I !Rooms 1st Floor �{ iBR. - Patio RecrearionRoom I Rooms 2nd Floor ' j riN. B = O. B. f Dormer Driveway g Total i _� t MIND FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N Y. Certificate Of Occupancy No Z- 16078 * * * . w Date August 19, 1987 . . THIS CERTIFIES that the building ONE FAMILY DWELLING WITH ATTACHEDa GARAdt' & WOOD DECK` Location of Property 895 Greenfield Lane Southold, New. York, House Na Street Ham%ei County Tax Map No. I000 Section 063 Block Lot 31 . Subdivision . . . . . . . . . Filed Map No. . . . . . . . Lot No . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated September. . . , 19. 6 pursuant to which Building Permit No. , ,1.5 2. 4 Z September 21 , 1986 dated . . . . 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 ATTACHED GARAGE & WOOD DECK AS APPLIED FOR The certificate is issued to CHARLES & DOROTHY LAUER (owryer, X, of the aforesaid building. Suffolk County Department of Health Approval . . . .8 6.'SO-. . . . 158 8 . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO . . N 8,2 6 4 8 6 . . „ . . . . . . PLUMBERS CERTIFICATION DATED:_ July 6 , 1987 Building Inspector Rev 1/81 -DECK -------------- LL 00 Q-1 0 O 234 SQJ: KITCHEN T. DINING ROOM BEDROOM # 1 170 SQ.FT. BEDROOM # 2 1� 143 SQ.FT. 185 SQ.FT. ONE CAR GARAGE 422 SQ.FT. F 6 SQ�F T 0 Q ------------------- SMOKE DET. & CO2 IN UNFINISHED BASEM R. r GFI SQ.FT.FAMILY ROOM LIVING ROOM. 185 SQ.FT. 209 SQ.FT. F.P. BEDROOM # 3 204 SQ.FT. 43 SQ.FT. G-i ENTRY DEVITO RESIDENCE 895 GREENFIELD LANE STOOP SOUTHOLD NY 1000-63-01-3111 2.13.2023