HomeMy WebLinkAbout1000-35.-5-40.1 Rental Permit
0888
Owner: Michelle Psaropoulos
Occupied as: Single Family Dwelling
Located at: 185 Wiggins Ln Greenport 35.-5-40.1
Maximum Permitted Occupancy: 10
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.
Issued: 02/14/2025
Expiration: 02/14/2027 Code Eftforc t Official
This Notice must be posted by the main entrance at all times
so
TOWN OF SOUTHOLD BUILDINGDEP'T
� � ,�� 631-765-1802! 2�-
INSPEECTION
[ ] 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 (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ,,RENTAL
REMARKS: to,o'�-�'��y
O`er Ca✓l �n v, D �Gv
al DA,W-kj bl �a QS Ao�a09- //1
( 1/!S �hav�
DATE o? /3r�Sr INSPECTOR
-= � Town Hall Annex
Town of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
z k
k� Tel: 631-765-1802
SCTM# pate
Owner cry Phone
Address &S Gt// " S Visible
Hamlet linspector
Floor Level Quantities Sub 1 2 3
Smoke Detectors(not located in bedrooms) ( I
Carbon Monoxide Detectors
Fire Extinguishers
Exits /
Bedrooms 1 2 3 4 6
Smoke Detectors
Egress
Occupant Count
Building Systems Maintained&Operational Condition of Property
Heating Building interior
Hot water Building exterior
Electricat Property clean, maintained&safe
Mechanical Handrails&guards installed&secure
Pool Safety Pool on Site
Surface water alarm Date of CO issuance �I
Door alarms Pool completely enclosed
Self closing/latching gates Pool fence to code requirements
CO's for all items present Prior Rental S /O
Comments:
$. TOWN OF SOUTHOLD
} Rental Permit
} 0888
Owner Michelle Psaropoulos
Occupied as Single Family Dwelling
Located at 185 Wiggins Lane Greenport 35.-5-40.1
Maximum Permitted Occupancy 10
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.
4/28/2023
This Notice must be posted by the main entrance at all times de E r Nce e Icial
Town Hall Annex w Telephone(631)765-1802
54375 Main Road � `a Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 �
BUILDING DEPARTMENT 44AR
P
TOWN OF SOUTHOLD ,a
RENTAL PERMIT APPLICATION
ISI ( �t) la +
Rental Permit Fee $200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address: N �/
Ae S L, �✓E e o� J
Tax Map Number: 1000 SECTION y 7.3989 -BLOCK3.S_ -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name: 1' f 6 C.) /0 S
Property Owner Legal Address: Property Owner Mailing Address:
363 6-, 83`4 sr
IS
lbsAJ1 IUY
.sass 3 9/ y- y�'S- 892�
Telephone Number(s): Daytime 86d -Ny6 - Evening —' Emergency
Property Owner Email Address: 14 Lse q T 7-OA1 6T ' L C L M
� ✓�N, �s��PdP� vLoS� G/✓I.�iL, C6M
C.' ��`� b` Page 1&5
004
,1 a ,
Town Hall Annex
Telephone(631)765-1802
,�" �°
54375 Main Road Fax(631)765-9502
P.O.Box 1179p a�"g
Southold,NY 11971-0959 "
Coll
ou
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: fq
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):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address:
SECTION E.
SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any: A
Address of Managing Agent (no P.O. Boxes):
Page 2 of 5
Town Hall Annex w " Telephone(631)765-1802
54375 Main Road '+ Fax(631)765-9502
P.O.Box 1 179 �q
Southold,NY 11971-0959
� .
00UM`l x
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: NIX�
Telephone Number (s): Daytime Evening Emergency
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: U /
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:
--2/6z��......
Requested Maximum number of persons allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwell! Py „ �„ � "
Use and Dimensions of ch-rco i R` ��„ elling Unit: P ��°°� .
' ,
/`/ i►' ` " ' f�r„ y „.M /,34 7 / / Cha l 3 /q c,n 012 7
/6 'X e" ` �a/•/c ,,,,,,,,,,,,,,, � /3 �` ,�, R 6 4r /S"
.'✓�n/G
/g %1'/g/
Page 3 of 5 J `7„„
(P
' � , .
Town Hall Annex °s Telephone(631)765-1802
54375 Main Road ;t Fax(631)765-9502
P.O.Box 1 179 p1w
Southold,NY 11971-0959
Coni.
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.
❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
C�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)
I /�c�„fg S , 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
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e
Town Hall Annex Telephone(631)765-1802
54375 Main Road �� Fax(631)765-9502
P.O.Box 1179 ;^
Southold,NY 11971-0959
w
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BUILDING DEPARTMENT
TOWN OF SO' THOLD
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: 11111
54..Rd o v /0 S
Property Owner's Signature:
Sw,,Qmto before me this day of mii� 202-3
Official Notary Pu lic Signature and Original Notary Stamp
DIAA MOHAMED ALFAHHAM
Notary Public-State of New York
NO.OIAL6443545
Qualified in New York County
My Commission Expires Nov 7,2026
WW-i
Page 5 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
'00
11�""
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION ADDENDUM
Rental Dwelling Unit Identifier: Awq
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier: Al1/A—�
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier: All
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
looe
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TOW SOUTH��LD BUI=XING D
631 755-1802
INSPEC 10N
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [/FIRE
INSLATION/CAI
[ ] FRAMING / STRAPPING [ L
[ ] FIREPLACE & CHIMNEY [ SAFETY IN;
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) ELECTRICAL
(F
[ ] CODE VIOLATION [ ] PRE C/
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Building Sketch (Page - 1)
Borrower Michelle S Psaropoulos_
Property Address 185 Wiggins Ln,
City Greenport County,Suffolk State NY Zip Code 11944
Lender/Client Guaranteed Rate
23'
N
Garage 4
6' 3-
1/2 v
Bath w
N W
O
Dining Rm
m
23'
56' Living Room
Frbter'
Closets Kitchen
7:a Den Bedroom .Np
N
Den
Bath Bath Bedroom
n.w 21" t„,aMV Enter
21' 9' 42'
1ttrrra..^,w.emn sr�a is maa-o-ic. Area Calculations Summary
First RcKw 2656 Sq rt 9 x 2 = 18
22 x 21=462
20 x 33= 660
14 x 26= 364
42 x 22= 924
2x3 = 6
6 x 37 = 222
Total Living Area(Rounded): 2656 Sq ft
Non-living Area
2 Car Attached 529 Sq R 23 x 23= 529
Farm SKT.BLDSKI-"TOTAL"aooraisal software by a la mode inc,-1-800-ALAMODE
Building Sketch (Page - 2)
wrztr Vin.. .
^ tf?t... _
LdadarNC 9rpt Guafanta4f,9at Rate
�. C
42'
1V k �0
I� BedrooM Bath
Bedroo � �edroorn C)
UP
42' , r
JY �
0 1 v
42'
v
N Basement
X X Y
42'
C✓41' 61YrnW.Yxum ww�w+m«rmm ma
m � Area Calculations 8omrrnarry
8atioara&F4utur � 940 Sq ft Caku""0044* ZO x 42= 640
..
Total Uwtnq Arun(Rounded): 840 sq ft
'�" pb Vin`• 6asemen `" IdaM
loos sq n za."42- s
A
Form SKTADSK!-'TOTAL"aooraisai software by a la mode,inc.-1-800-ALAMODE
Aug 6, 2022
Town Hall Annex �,� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 t
Southold,NY 1t971-0959 ^ 0
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 required for Architect or Engineer, licensed Home In iector must provide
co y of valid current cerci icati'on
Rental Property SCTM Number:
Rental Property Address: 166 Wiggins Ln., Greenport NY 11044
Owner/Name:. Michelle Stratton
Rental Dwelling Unit.ld•entifier:
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 #1 160 s ft Bedroom #3 140 sqft Bedroom #5 170 sqft
Bedroom #2 225 sqft Bedroom #4 180 sqft
Property Description (Include all improvements indicated on survey)
(ROOM ABOVE GARAGE NOT FOR RENT)
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.
Victor Cornelius III CEO Inspector
Print Name and Title ceo# 1216-0283 original Signatur
Please place professional seal:
10 4-
WN OF SOUTHOLD PAOPERTY7
STREET LOT 2 5-
-�o ST VILLAGE
FORAItER OWNER
N E ACREAGE
T�V
S
TYPE OF BUILDING
W
4
RES. SEAS. VL. FARM comm. IND. I CB. mlsc,
LAND ImpTOTAL DATE REMARKS
C
tt
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MJIbD -3-COP46ITTON,
NEW
ORMAL BELOW ABOVE
_,� t -,e MV-- �jly Per A�e �j ---Volae
n
4
Tillable 2
Zi L
7
Tillable 3
Woodicnd 0 1D i7:q-J,
Swampland
Brushland
House Plot
- ---- ----- - -- -------- ----
Total
'Al
TOWN OF SOUTHOLD PftOPERf6/7//5 CARD
I .
DT
OWNER -LAW STREET VILLAGE DISTRICT SUB.
FORMER OWNER N E 1 ACREAGE
S W TYPE OF BUILDING
RES- SEAS. VL. comm. IND. C.
FARM CB. MIS
LAND IMP, TOTAL DATE REMARKS
-----------------
Li
S/.20/7&
J 7,?
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
Form Acre Value Per Acre Value
Tillahle I
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House Plot
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Alt. BRd
Foundation R Bath
9
Extension Basement Floors
Extension Ext Walls z Interior Finish
Extension
A Fire Place Heat
Porch , ' Attic
Parch ROOMS I st Floor
Breeewo Patio Rooms end Floor
Garage Driveway
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FORM NO. 4
TOLD,
mm
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE CIF OCCOPANCY
No. . . 4, . , Date . .. . . CAmbOX. . 13.. . . . . . . ., 19.60
THIS CERTIFIES that the building located at W:499 40 .b '0. . . . .. . . .. .. . . . Street
Ma3F&c.. , 1 Block No. .. . . . . . . . . . .Lot
PAI-ew
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . .. , .. . . , .JUh s , ,11,, . , ., 19.00 pursuant to whl�h Building Permit No.
dated . . , . . . . . . 19, •641, 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 . . . . 1?xiv h4.pAq. .9amAjV. .cjwa11ArAV . . . . . . . . . . . . . . . . .. . . . . . . . .. . .
The certificate is issued to . . JQhU.CQste1I0.. . . . .. . . . .. .. .. . . . . .. . . . . .. .. . . .. . . . . .
(ofner, lessee or tenant)
of the aforesaid building.
,Suffolk County Department of health Approval . . .6.�• •�.�68.r. .1Etat1?ex .V.113'ea
Building Inspector
w
4
pp m.
rom I(O. 4
OF SO O
B. ING DEPARTMENT
Town Cakes Office
Southold, N. Y.
Certificate Of Occupancy
No. 26M7. . . . . Date . . . . . . . . . . . May. . .19. . . . . . . ., 19. .75
THIS CERTIFIES that the building located at . .V ggilaa. Ian*. . . . . . . . . . . . Street
Map No. . Fd.Ac. . . . . Block No. .rI. . . . . . .Lot No. 23,24,25 . . .Orvwnport. . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . . .NAT. . . 1.5, 19.73 pursuant to which Building Permit.No. .699M.
dated . . . . . . . ov. . . .16. . . . ., 197-3 ., 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 . . PrIVILtQ.a wr .pool .wLth. AceosscryA A. fAncing. . . . . . .. . . . . .
The certificate is issued to .John«8o- S&r&. Cest*,l:Io. . . omora . . . . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval pai3 . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. !1. 1.75580• Aug• 8 . .19.74. . . . .« . . . . . . . .. . . . . .
HOUSE NUMBER . . . . . 415. . . . . Street . . WISC us. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . .. . . . .. . . . . .. . . .. . . . . . . .. .. . . .. . . . . . ... .. . .
rm « . Building
FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27185 Date: 07/
10/00
THIS CERTIFIES that the building ACCESSORY
Location of Property: WIeIWS LA GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 section 35 Block 5 Lot 40.1
subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 9 1995 pursuant to which
Building Permit No. 226 dated MARCH 27,F 1995
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 .ACCESSORY SHED IN REAR YARD AS APPLIED FOR.
The certificate is issued to OiN COSTELLO &(WR)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H-068440 06/
29/00
PLUMBERS CERTIFICATION DATED N/A
Au orixe Signature
Rev. 1/81
Town of Southold Annex 5/14/2013
w P.O.Box 1179
54375 Main Road
" Southold,New York 11971
CERTIFICATE OF OCCUPANCY
CY
No: 36241 Date: 5/14/2013
THIS CERTIFIES that the building RESIDENTIAL ADDITION
Location of Property: 185 (aka 415)Wiggins Ln,Greenport,
SCTM#: 473889 Sec/Block/Lot: 35.-5-40.1
Subdivision. Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
p g 19 dated 11/8/2012
11/7/2012 pursuant to which Building Permit No. 376„ ..w_._.....-..........-�..w-- _
s issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
addition ;altcxation to an eistin one Tamil dwellin cr". A#fa96 dat�:d 10/18/12 as a lied.for
The certificate is issued to Poncet, Renee
of the aforesaid building.
_ ... ....
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RIO-12-0028 4/4/23/13
-. ._.__.
ELECTRICAL CERTIFICATE NO. .....37619 5/14/13,.,...... .,..,..µq...
E Plumbing.
PLUMBERS CERTIFICATION DATED 4/17/13 _._ ... cutchogue East m
t rtr Si ure