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Home My WebLink About1000-46.-1-31.1 (Unit J78) 3 T Um'NOF SOUTHOLD Rental Permit 1077 Owner Driftwood Cove Owners Inc (Heitner) Occupied as Apartment J78 Located at 1000 Ninth Street 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. 2/20/2024 � g Code Enf rc nt officiafl This Notice must be posted by the main entrance at all times . I �- TOWN OFSOUTHOLD—BUILDING DEPARTMENT k 1 Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631)765-9502 gn, J AKi 2. RENTAL PERMIT APPLICATION '1024 Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: T W Tax Map Number: 1000 SECTION .-BLOCK -LOT SECTION B. OWNER INFORMATION: Property Owner Name: tAk.A�a&� Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) T- Telephone Number (s): Daytime Evening Emergency Property Owner Email Address: /-I ASL CL-11, her C,, yn q cDM Page 1 of 4 �3 2- X317 Section C. Authorized Agent Information: Name of Author izedJAgent 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 D. Managing Agent Information: Name of Authorized Agent of dwelling u/iany:Address of Authorized Agent (no P.O. Bo Mailing Address of Authorized Agent*, Telephone Number (s): Daytime Evening Emergency Email Address: SECTION E. SITE MANAGER INI MATION: (required for rental properties containing 8 or more rental units) r�� Name of Managing,agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Mailing Addss of Managing Agent: Telepho Number (s): Daytime Evening Emergency Email ddress: 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: J 7 Requested Maximum number of persons allowed to occupy Dwelling Unit: 2 Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: 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. 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 (r, J , 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 tQ 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 Agent, or Site Manager. Property Owner's Name: Property Owner's Signature: �� Sworn to before me this-�day of _ , 20-c�Ll Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH -Notary Public,State of New York No.01 BU 185050 Qualified in Suffolk County Page 4 of 4 .oirt nission Expires April 14,2,JPQN TOWN OF SOUTHOLD BUILDING DEPT. 631.765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] 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 [ wl"'R ENTAL REMARKS: cJ her 00 o lrue� w 4 OLr k- i'U2 So/I 11CGv IA'T`E INSPECTOR FLOO a- ?'-,bj �✓� I Ftwoa ( C)vL�5- uAj,T- a J�7 0,01- a � t -7 C�� Town Hall Annex Town Of Southold 54375 Main Road 0 Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 4� � r, Tel: 631-765-1802 SCTM # " � _ ...... _ . ....a.. . ...... _. Date n.....m. ` Pone Owner h ��.. . � � � .........._..�... ..M.... Address Visible � .. _.. v� .... , °". �....... Hamlet Inspector Y, . . ...... _ .. w _. _. �._._.......w. ... ............. _. .._....,.........,. .............. .. . _._.__ ........a... Floor Level Quantities .......... .. . .. .._ �...... .._............._...w.. �...__...,..... ._ .w.. �_...,_..........�... _ Sub 1 2 3 Smoke Detectors (not located in abedµrooms) mm mm� ...�. Carbon Monoxide Detectors Fire_Extinguishers Exits F�Bedrooms .��.. .. .. 1 .... ...� w 3 w........ �._�_ 4.. ... 5 6 Smoke Detectors Egress 1/ w Occupant Count Building Systems Maintained &Operational Condition of Property ...�o mm.. . .,....... .. .....,, .,,,� o�� .. ..�.. .. .. ...... . �. ��, u..�..,u... ... .. , �w Heating..o .i .. Building interior o . ,..,.. ....m..... Hot water Building exterior 1 H 'Build � Electrical Property clean, maintained &safe Mechanical 1I Handrails&guards installed &secure Pool SafetyPool on Site Surface water alarm Date of CO issuance { �.......R�� ,�,.�m_��,R��. .. _ �.� �,w.a,�� . ...,w "-,,-w�r, a.R.......e.......... .w.mm� Door alarms Pool completely enclosed Self closing/latching gates w. Pool fence to code requirements „ Prior Rental CO s for all items resent Comments: .... _.rc., ...... �. b.._... .. ...... r, , I �► FORM NO.4 TOV N OF SOUTHOLD BUIOING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy 210584 July 17 81 No. . . . . . . . . . . . . . . . . . Date . « , . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,�, 19 . . . THIS CERTIFIES that the building . . . . . M . . . . . . . » . . . . . . . . . . . . . . . . . . • . • . . • . • . . . . . . • . Location of Property Main Road and 9th Street, Greenport, New York House No. Street Hamlet County Tax Map No. 1000 Section . . . 46. . . . . .Block , . . . . . . . . . . « . .Lot . . . . 3 . . . . . . . . S1I gi xx. . . . . . . . . . . . . . . . . . . . . . . . . . . . .ITl Awe. . . . . « .�c � a. . . . . . . . . . . „ . conforms substantially to the Application for Building Permit heretofore filed in this office dated P 65292. . . . . . . . . . . . . . April . . , 19 . pursuant to which Building Permit No. dated . . .April 30 , 1973. ,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 Xenophon Deaiananoe The certificate is issued to « . . . . « . „ . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner,ltldtr µ "« of the aforesaid building. Suffolk County Department of Health Approval , Existing Public Sewer System . . . . . . UNDERWRITERS CERTIFICATE NO. . . , N317691-N317692-N317693N317694. . . . . . . . . . . . . . . . . . . . . Building Inspector Rev. 1181