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Home My WebLink About1000-18.-3-11 � Fat G TOWN OF SOUTHOLD f Rental Permit t: 1111 Owner Stephen & Rachel Garrett Occupied as Single Family Dwelling Located at 400 Diedricks Road Orient 18.-3-11 Maximum Permitted Occupancy 8 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. 4/18/2024 V�� Code 04men ial This Notice must be posted by the main entrance at all times 6 on r c I""co- w 5i TOWN OF SOUTHOLD—BUILDING DEPARTMENT I UI 13 Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631)765-1802 Fax(631) 765-9502 1 �!s' // w,,g(ll�lll( cll " ql RENTAL PERMIT APPLICATION Rental Permit Fee $300(Application must be renewed every two years) gwn1od Section A. Property Information: Rental Property Address: I I T 57 C K Tax Map Number: 1000 SECTION _-BLOCK -LOT - SECTION B. OWNER INFORMATION: et.a.w Property Owner Name: �s19R1�eT� Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) ql7 Telephone Number(s): Daytime 370-2 5I Evening Emergency Property Owner Email Address: Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: LOA' ( e ICO Address of Authorized Agent(no P.O. Boxes): 2i �CI`i'7 Mailing Address of Authorized Agent: i Telephone Number(s): Dayt mle gay-097 vening Emergency Email Address: L✓n i Le-✓1 L korM • Obi'n 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: Address of Managing Agent (no P.O. Boxes); I Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency .... 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,� . nit 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: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: C7. , y. ft 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. VI 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) 1 6 drrtify 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 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: A TT Property Owner's Signature: Sworn to before me thii �- day of U U20� ( � • �� « , .,,�. ci , Lary Public Signature and Original Notary Stamp p0B410 "* y MISS10�i EXPIRES *° OF Page 4 of 4 N OF SOUTHOLD BUILDING D1 631 765 1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAl [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (EII [ ] CODE VIOLATION [ ] PRE C/O [ rat L. 40 .. ns Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 " Southold, NY 11971-1179 ' ° ► Tel: 631-765-1802 SCTM # & ..3 �/ .. Date /lo wner[Address Phone ddress Visible �. ..... ... ........ ___...._._.._..... Hamlet � 2 Inspector Floor B evel Quantities _.�...., ... Sub ..�, ,.� . , , .., owoRR�e.� 1 3 Smoke Detectors knot located in bedrooms) Carbon Monoxide Detectors w......... ��. .oa, I Fire Extinguishers e. i 1 Exits Bedrooms 1 2 3 .. �.. .. ..._a. . ....... . .. 5 6 Smoke Detectors Egress _. -.. .. Occupant Count p Building Systems Maintained &Operational Condition of Property ♦Building interior 4 Hot water Building exterior ElectricalProperty clean, maintained&safe �w } ... � w.�. . .. ro . �e .... ..� Handrails Mechanical &guards installed &secure Pool Safety 4 Pool on Site Date i Surface water alarm of CO is suance .ma...., . M......._.,.._ . ....._.. o. �.�m�.��.�m,w.. �m� .�a� ...,.�� ..�..�.... . .a,..a Door alarms Pool completely enclosed Self closing/latching gates Pool fence to code requirements g g ... . �.w .. CO's for all items present .W_ .�..�.. . ., Prior Renta,I..� .. ...... .. ......... ...�.._m�_ .....�, _ . Comments 3 I TOWN OF SOUTHOLD PROPERTY R ►R OWNER STREET ! VILLAGE ui��, SUB. LOT t € e ORMER,OWNER , J �r � t s k S W E OF BUILDING ; E RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value { . { LAND IMP. TOTAL DATE REMARKS > E (Dora j c �Q _ 4 � a { 3 3 I I i Tillable FRONTAGE ON WATER k E , > Woodland FRONTAGE ON ROAD ; I Meadowland I I DEPTH House Plat BULKHEAD Total a ,3 .. :OLOR TRIM { n e I s - n s t _ _ - M, Bldg. 3 6 f 18.-3-11 11/15/2022 � 3sfltA .. �er�sidrs - Extension I Extension 7 -N 4ci. 1 6 7f, A -7 e�14 Foundation Bath Dinette �xa � _ _ Porch i Basement Floors K. a ` i `_ Interior Finish LR- Aorch � � Ext. Walls � Breezeway t b 0 ` Fire Place Heat DR- Roof Rooms 1st Floor BR- Garage a } —_ 1 , _ L\ YPe - P o Recreation Room Roans 2nd Floor FIN. B Driveway O. B. Dormer �y� Town of Southold 7/22/2023 P.O.Box 1179 53095 Main Rd 44 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44343 Date: 7/22/2023 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 400 Diedricks Rd., Orient ., SCTM#: 473889 Sec/Block/Lot: 18.-3-11 Subdivision: _wwwwwwwwwwww - Filed Map No. ...... Lot No. . ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/12/2021 pursuant to which Building Permit No. 47212 dated 12/9/2021 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: single-farnilv dwelling with unfini ed basement.wrav around P, re rch screened rrch and deck as licd or. The certificate is issued to Solution East LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL R10-18-0116 7/19/2023 ELECTRICAL CERTIFICATE NO. 47212 6/29/2023 PLUMBERS CERTIFICATION DATED 6/20/2023 "s unbing&lhating _... .............._ ......... tl r" Signature ...._._�.. _..�. �gIFGMCq� Town of Southold 7/22/2023 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CEE'TIFICATE OF OCCUPANCY No: 44344 Date: 7/22/2023 THIS CERTIFIES that the building ACCESSORY GARAGE Location of Property: 400 Diedricks Rd.,Orient SCTM#: 473889 Sec/Block/Lot: 18.-3-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/22/2021 pursuant to which Building Permit No. 47213 dated 12/9/2021 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: gegessq.ty g tagg s a..pl ed�fgr, The certificate is issued to Solution East LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47213 6/29/2023 PLUMBERS CERTIFICATION DATED . _ te r� igratur ..w... .... ......... Town of Southold 7/22/2023 P.O.Box 1179 53095 Main Rd - Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44345 Date: 7/22/2023 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 400 Diedricks Rd.,Orient SCTM#: 473889 Sec/Block/Lot: 18.-3-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/13/2022 pursuant to which Building Permit No. 47815 mm/16/2022 ' dated 5 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: accessca in- ound swim n;iwn prof i` nced tag code as a lied fiar. The certificate is issued to Solution East LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47815 6/29/2023 PLUMBERS CERTIFICATION DATED _._ �..thoi gem , " n1ur ............_......._..M.. _....... I $ E j tff ; - i s , pltitrJ� rcboM eo ram-* apt K,r '� tIP4-R=� � ::..��Tt'- '"-v_ .. G-c'f � (� ---•a.-T�a.:x� � �� pia cy 1, 04 �a •; '5rkl9.r4 4-2 ti4r^MAZ- ( to �RS"fi�'�� ;,7o i 3a x fe 3 tt S u rF; 4 � �a k �r w CC?