HomeMy WebLinkAbout1000-79.-4-8.1 m TOWN OF SOUTHOLD
I
Rental Permit
t
A
1069
Owner 400 Windjammer LLC
Occupied as Single Family Dwelling
Located at 400 Windjammer Dr. Southold 79.4-8.1
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.
2/12/2024 Ala_ I/
fo nt Official
This Notice must be posted by the main entrance at all times C de
Town Hall Amex '
- Telephone(631)765-1802
P..O.O.Boz 1117979
54Main ton Fax(631)765-9502
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL-PERMIT APPILICATION
Rental Permit Fee$200(Application must be renewed every two years)
- `' Lj
Section A.
Property Information: a
Rental Property Address:
1,V 119-71
Tax Map Number: 1000 SECTION 019.00 \LOC ` OT..Q �6- I
SECTION B.
OWNER INFORMATION:
Property Owner Name:- H O
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
g
Swim
o� Telephone Number(s):q -�-1 J H I
Property Owner Email Address: I , yl8`ba O i C-0 M
Page 1 of 4-
Section C.
Authorized 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):
Email Address:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: r
Address of Authorized Agent(no P.O.Boxes .
o�
Mailing Address of Authorized Agent:AV JAW, ii! 11 Y �1 I
Telephone Number(s): ULuOW
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:
Address of Managing Agent(no P.O.Boxes):
Mailing Address of Managing Agent:_
Telephone Number(s):
Email Address:
Page 2 of 4
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property:
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 twc C/
Requested Maximum number of personi allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
" � Af = > / D
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/(Ox o�
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 NYS licensed architect,a NYS 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.
O lam requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold.
Page 3 of 4
I am submitting a completed Town of Southold certification form from a licensed
architect, a licensed professional engineer,or a licensed home inspector who has a valid
New York State Uniform Fire Prevention Building code Certification.
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit
STATE OF NEW YORK)
}
COUNTY OF SUFF9fi0 we S4-CkeS�e
i. L Oh ZO 121
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 1 will notify the Town of Southold
Building Department of any changes of address within five(5)days of any changes
thereto.
3. ?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, IMlanaging1Agent,or Site Manager.
Property Owner's Name: `i 00 V VIM i MMC LL
Property Owner's Signature: '
Sworn tAl Ao efore me tli �rary of - J ' 20_LD.,
AA
MARIA SCHARF
NOTARY PUBLIC,STATE OF NEW YORK
Official Mary Public S` tore and Ori 'n I Notary Stamp Registration No.01 0637734
Oualified in Westchester er county
Commission Expires Jct
Page 4 of 4
'V o still
Town Hall Annex �_'�
Telephone(631)765-1802
Fax(631)765-9502
54375 Main Road
P.O.Box 1179
i:�!
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOU THOLD
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
Prof ssionar seai Etguired for Architect at En!jinqeer, licensed Mone jdjgc 1`r ust gCovidle
coy ref valid current crtcation
Rental Property SCTM Number:
R
Rental Property Address: L100 L�i � ��MiPI'i - ko &D
Owner/Name: t )
Rental Dwelling Unit Identifier:
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1-100 sq., Bedroom#2-90 sq., etc.)
Property Description (Inc de all improvements in d' ted on survey)
-St A,
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.
Print Name and Title CC& P /'Zj (,._Qa--J Original Signature
Please place professional seal:
so
OWN OF SOUTHOLD BUILDING I
631-765-1802W.-ow.� 4
INSP'EC ION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CA1
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] EL TICAL {F
[ ] CODE VIOLATION [ ] P / 1
INSPECTOR
FLOORPLAN SKETCH
RICHAR[?KASTd3A�t. AN --_ -. Fite No.: ffOi 181701A� --
Pr tt r SS'4t#0 Y r Case NO.: 35146
Lender:Bfir AGE FEDERAL CREOIT MON
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3
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3
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44.0'
g FAMILY a
r - O LANDING CJ -
€ nJ - W/D BATH s DINING STUDY t.6
[ KITCHEN
20.0 BED I
r LIVING 69 '
r
BATH
M
I
BATH BED BED
F;li
30.0' 20.0'
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z
Comments:
AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN
Code Description Net Size Net Totals Breakdown Subtotals
I
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GLA 1 First Floor 1746.0 1746.0 First Floor
GLA2 Second Floor 1267.0 1267.0 15.0 x 44.0 660.0
GAR Garage 420.0 420.0 6.0 x 33.0 198.0
120 x 39,0 468.0
30..0 x 14,0 420.0
Second Floor
20.0 x 32,0 640.0
25.0 x 7,0 175.0
10.0 x 10.0 100.0
8.0 x 44.0 352.0
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Net LIVABLE Area (rounded) 3013 8 Items (rounded) 3013
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500 WEST MAIN STREET,STE 107,BABYLON,NY 11702(888)317-6957 FAX(631)422-4605
NOWN OF SOUTHOLD PROPERTY RECORD
OWNER 4 STREET VILLAGE DIST SUB, LOT
FORMER OWNER N E ACR.
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RESu � SEAS. VL. FARM COMM. CB. MICS. Mkt_ Value
LAND IMP. TOTAL DATE REMARKSm
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Value Per Value
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Tillable FRONTAGE ON WATER
...,_ _...,__W._w__�....._. ,.... _..__.u_�._.._..:�___..,...w.. _ .. . .. .. . ........._.._.�m.__. ...._....d FRONTA.,.._. .,,.. . ._..... .._...___._ ...___._.. _. ..._. ...u.,.�.IT_��. _,....,.�_.�,.___ ,_.._....�
Woodland GE ON ROAD
Meadowlcnd
m., _. ..,_ ,,.._..�...��.__.�...._.. . _ ..... .... ....__ ._ ,. ..�........_._.,�.M., ._._...... . .DEPTH,.,........_ m._ .,�,._..,,..m_.�....�..__�_W......_,.______._.�.,,.,_.__,ry ....____�...�_. r....... m„�_...._.__.,M_M�., .... ..._
House PIS BULKHEAD
Total DOCK
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lob TOWN OF SJTHOLD PROPERTY RECORD CARD
.m„f. ........VILLAGE,�..........�._._. ......._� ._..�,_�.DIST.- ... .....w. SUB.
STREET LOT
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RES. SEAS. j VL.---,t l,,jj FARM COMM. � » Mkt. Value
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LAND TOTAL DATE REMARKS
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Woodland FRONTAGE ON ROAD
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House Plot BULKHEAD _
Total
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Xleezeway- Fire Place / Heat DR.
Garage _..m......_._w..:.�. .mY�e Roof P t F oor r BR.
...,Patio_._.. Recr I FIN.
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9
Rooms 2n_
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Q. B. / Dormer Driveway
Total ,���
STATE OF NEW YORK
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{ FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No -20673 Date APRIL 24, 1992
THIS CERTIFIES that the building NEW DWELLING_
Location of Property 400 T'l�TAMMER DRIVE UTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section_ 79 Block 4 Lot g
Subdivision Filed Map No. trot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 27, 1991 _pursuant to which
Building Permit No. 20179- dated—SEPTEMBER 27? 1991
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 DECKS AS APPLIED FOR.
The certificate is issued to ROBERT H. FREY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 14-SO-50-DEC. 30F 1991
UNDERWRITERS CERTIFICATE NO. H-027430 - MARCH 6, 1992
PLUMBERS CERTIFICATION DATED DEC. 29 1991 - MATT. PLUME._&_ _ NG
*NOTE: THIS UPDATES CO #2-20566 DATED MARCH 5, 3992.
Building Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office Of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-26026
Date: 1%/g8
THIS CERTIFIES that the building ACCESSORY
Location Of Property: 400
WINDJAMMER
-�-�-� DR{ SCUT IBJ }
County Tax map HOUSE NO.) (STREET)No. 473869 Section 79HIOc, 4 (HAMLET)
� t 8
Subdivision
Filed Map No. Lot No.conforms subotan_ially to the Application for Building Pe heretofore
filed in this Office dated
FEBRU 27 . 1997 pursuant to which
Building Permit No. 2972-
dated - CH 10 1997
was isaued, and conforms to all of the requirements of the applicable
provisions the law. The occupancy for Which this certificate is issued
is NON- <T TABLE A SSORY S
HED AS APPLIED FOR.
The certificate is issued to ROBERT & ffjLDEGAp
FREY
Of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE No. N1A
N
PLUMBERS CERTIFICATION DATED
---- N/A
Bui ing InsPeC r
Rev. 1/81
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