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HomeMy WebLinkAbout1000-41.-2-3 TOWN OF S UTH LD Rental Permit 0856 �s Owner Todd & Gwenn Claytor Occupied as Single Family Dwelling Located at 1420 Middleton Road Greenport 41.-2-3 Maximum Permitted Occupancy 4 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. 4/10/2023 Code End rc ment oic This Notice must be posted by the main entrance at all times c4 10 Town Hall Annex �' 4��� Telephone(631)765-1802 +'S Main Road rax(631)765-9502 0.Box 1179 1.:hold_NY 11971-0959 " w . Co IN BUILDING DEPARTMENT MAR G 8 2 23 TOWN OF SOUTHOLD SUH. 0W DERr RENTAL PERMIT APPLICATION TOVONOFSO "RIOLD ;ental Permit fee S200(Application must be renewed every two years) £ertlon A. Property Information: Rental Property Address: 11"IT115 `=x f0ap Number: 1000 SECTION 0 -BLOCK Q2-W 6PJ -LOT SECTION B. OWNER INFORMATION: -sowerty Owner Name: � �vl� �� c Ji-operty Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytimes :'L47 EveningEmergency Prooerty Owner Email Address: C'O lM Page 1 of S Town Hall Annex Telephone(631)765-1802 -375 Main Road Fax(631)765-9502 Box 1179 ou[nola.lvY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Akent Information: Name of Authorized Agent of dwelling unit, if any: i- Ur ess of 4A- Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime_ Evening Emergency Email Address: Section D. Managing Agent Information: w 4 a o#authorized Agent of dwelling unit. if anv: -iidress of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime .EveningEmergency Email Address: SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units) "dame of Managing Agent of dwelling unit, if any: IV 1A Accsdress of Managing Agent (no P.O. Boxes):_ Page 2 of 5 Town Hall Annex Telephone(631)765-1802 --� +lain Road Fax(631)765-9502 .Box 1 179 •fnhoid.NY 11971-0959 cou rza: �A; BUILDING DEPARTMENT `SOWN OF SOUTHOLD --;hers ririroec of Mnnnaino Agent: elephone Number(s): Daytime —Evening Emergency cman Address: SECTION F. PROPERTY DESCRIPTION: 'Number of Rental Dwelling Units on property: ru.—each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, init 1., Unit 2, Unit 3 or Apt A, B, Q the use of each room in the Rental Dwelling Unit example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." r t al Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: "dumber of rooms in Rental Dwelling Unit: �,e aU Di1�lensions of each room in Rental Dwelling Unit: ( ^ Page 3 of 5 wn Hatt Annex telephone(63 1)765-1802 -- i amain Road rax tw 1)765-9502 .Box 1179 N Y 11971-0959 w � G BUILDING DEPARTMENT TOWN OF SOUTHOLD - a.M INSPECTION: Di--i rant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety rection by Code Enforcement Official is required. If the owner chooses not to have said --isuecuun uer iur reed ov the i own. a certification from a licensed architect, a licensed proressionai engineer or a home inspector who has a valid New York State Uniform Fire r-vention Building Code Certification is required stating that the property which is the subject ;permit application is in compliance with all of the provisions of the code of the Ty::n 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 f.om the Town of Southold n 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. T�TE OF NEW YORK) COUNTY OF SUFFOLK) l � certify under penalty of perjury,the following: I 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 age 4 of 5 ti gown Hall Annex 'telephone(631)765-1802 3375 Main Road X Fax(631)765-9502 Box 1179 e-mhold.NY 11971-0959 * � COQ BUILDING DEPARTMENT TO OF SO SCOLD IDlicabie laws and rules. I further acknowledge that I will notify the Town of Southold :--.1ding Department of any changes of address within five (5) days of any changes I-:ave read and received a copy of Chapter 207 of the Code of the Town of Southold and agreed to abide by the same. 7 '_. i1011TV ane i own witnin rive i5i business days as to anv cnange to the information •eearding Authorized Agent, Managing Agent, or Site Manager. 0--nertv Owner's Name: a nrn-e <y Owner's Signature: �`� ° a,— i5� c:icial totary iSig r daaanOrigina� A-k-c-�L ,20� aturel Notary tamp 'tee S of 5 so WN OF SOUTHOLD BUILDING D a 831 -785-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. FOUNDATION 2ND [ ] INSUEATION/CAl FRAMING / STRAPPING [ ] FINAL FIREPLACE & CHIMNEY [ EIRE SAFETY IN! FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI [ CODE VIOLATION [ ] PEE C/O [V( REMARKS: lCke-bon !�94_4 bo t0e*_ wl o c., re,094T t M D/,:::A� r1 �� DATE — �, — INSPECTOR i Bedroom 3 Bedroom 2 Bathroaual Oink*loom K then I j Bathroom i uvMgroom Germs � eeermom 3 ' i f , s 3 ig I �V R-st Bedroom, Bedroom i __m! ___m | mm ! . . Bathroom! � , , . _._m __ __m! : . . . . , | :COzdetector � =Smoke detecto __t . .. . . . . . . | � | � � ! � ( � ! ��. t ;. I i _ . ss x_ g I �£ :BED r2oor. ;'&Rrx DdN,v�rico s ferreKtu 0-0 F v lu 3 � p cto On c[a € ' - - a `r R_4' Y n F Ide b i SaCRL6 114!1:0" ED ?gj. gA iC#Sfft Kki=€a.�P - g 33Ts�3 Vs z .§ V s ,? MIA R a se A VA TOWN OF SOUTHOLD PROPERTY RECO.U) 2L OWNER OWNER STREET 1 VILLAGE DIST. SUB. LOT INA, 3 . FOR MER�OWNER K fe w N ACR. o S TYPE OF BUILDING w --4 �SEAS,U- VL. FARM COMM. CB, MISC. Mkt. Value LAND IMP, TOTAL DATE REMARKS If s. t 4%, in AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre i Value Per Value Acre -7f- Tillable I Tillable 2 A 6711 v zv Tillable 3 Woodland Swampland 'FRONTAGE ON WATER Brushland !FRONTAGE ON ROAD House Plot DEPTH BULKHEAD DOCK Total Total - �- -- COLORF € _ i I [ S � ( i I � i k P q. i p TRIM - - i z � , v 4-41 �— f � E a , € K Bldg. ;FoundationBath Dinette nette o � Extension Floors K. 3 � -- Extension Ext Walls Interior Finish i LR. r 3 r _- iFire Place I Heat Extension t i DR � - N �� 7ype Roof i Rooms 1st Floor ®i BR. - Porch z Re reatian Room! Rooms 2nd Floor! FIN. B Forth Dormer -�« Breezeway _ Driveway Garage Patio O. B, Total xX� E _ OWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Offic: Southold. N. -I Certificate V Occupancy, . . . . . Date . . . . . .. . . . . . . 3vne. . .6. . . . . ., 19-7 "IS CERTIFIES that the building located at . X4.11144 ..et4A.Rood-Ett Street Map No. xx . . . . . . . . . Block No. . .xsc . . . . .Lot No. 1 . , . oreenport. . .11.7.., . . . . . . conforms substantially to the Application for Building Petmit heretofore filed in this office dated . _ . . . . . . . . .re'b •- • .• ., 19.73, pursuant to whish Building Permit No. . .&36OZ dated . . . . . .. . . . . .?eb . . . 7. . ., 1973, was issued, anal conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is -Private •©na Xamily.dwalli.ng. . . . . . .. .. .. .. .. .. . . .. .. .. . . . . .. . . .. . . The certificate is issued to . -Edward. Rulhall. . . . .uwrler , .•. •• 1,vner. lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .May. .:301. .1973. ..by. A, Villa. . . . UNDERWRITERS CERTIFICATE No. . >•AUdIA9. .(G;rptA$A4 . . . . . . . . . . . .. . . .. . . IIOUSF NUMBER. . .11-X24. . . . . .Street. .14iddWim-Road.;.. . . . . . . . . . . . . . . . . . . . . . . . . . . . Building InspectorV .a u NO_ 4 ,7j'N OF SOUTHOLD _.s of the Buildinc Inspector ,:;'.-n tfa11 Southold. F.' CERTIFICATE OF OC k:Z-- No Z-22523 Date AUGUST 12 19C >_HIS CERTIFIES that the building ADDITION Location of Property 1420 MIDOLETON ROAD GREENPORT N.Y. -,use No. Street Hamlet . ,;:.-.tY Tax Map No. 1000 Section 41 Block 2 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 1993 pursuant to which Building Permit No. 21572-Z dated AUGUST" 3 1993 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to MARJORIE M. BUNYAN {owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A xild ng Inspector A° •n, �! - ��. { ��w� ��� � � �>: x= a �y. ,� © �« «© y�« © �° ^ `���� ��^ .�� �9 . ,« � ������« :? < ����. v�����������y>. «: - � m:� � �\� 7 \ ° .:\� � \� � /� � \ \ � \ ? � v��2 ��� j { ] � ����� �� ��\ - . ���< - ���< ��m I d �:� »\ � } � -���� ` � . ��.� . : . \\\1