HomeMy WebLinkAbout1000-46.-1-31.1 (Unit H65) TOWN OF SOUTH OLD
Rental Permit
Al
1112
Owner Driftwood Cove Owners Inc. (Miae Kim)
Occupied as Apartment 4H65
Located at 1000 Ninth Street Greenport 46.-1-31.1
Maximum Permitted Occupancy 3
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
Code E ordent offii I
This Notice must be posted by the main entrance at all times
%
TOWN OF SOUTHOLD—BUILDING DEPARTMEN f
2024
59
+ Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 01-0 9
Telephone(631) 765-1802 Fax (631) 765-9502 litt
jot J3006-,
RENTAL PERMIT APPLICATION Q C * /0-7 0 38
Rental Permit Fee $300 (Application must be renewed every two years) L(I it
Section A.
Property Information:
Rental Property Address: AJ 11 4
/*L
Tax Map Number: 1000 SECTION -BLOCK -L
Li (0
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
Telephone Number (s): Daytime(,3 2, Evening Emergency(o-i
Property Owner Email Address:— VO
Page 1 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, Q 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: 5
Requested Maximum number of persons allowed to occupy Dwelling Unit: 3
Number of rooms in Rental Dwelling Unit: Z
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.
L�1 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
i`
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
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 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 thi!dL day of _ 2Q2
Official N ry Public Signature and Original Notary Stamp
aYlinn C intron
NOTARYPtjt'BLlr, nTA,�'L OF NEW kt'DRK
1Cegisar3tio t gar.0106442796
QualiCrwal in mrolk County
t ut»r¢t exxta c�B xlsrrdx 10117026
Page 4 of 4
TOWN OF SOUTHOLD BUILDING*of SO
W 631 765 1802
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PLRG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAl
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INS
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
[ ] CODE VIOLATION [ ] PRE C/O [ wKI
REMARKS:
(2- -3 peg-son occu
n
DATE INSPECTOR
qf so
TOWN OF S M I TT Bo
DING T
"'931 -765-1802,,,,/
IN iP"'� ECTION
[ ] FOUNDATION 1ST [ ] ROUGH PTBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
[ ] CODE VIOLATION [ ] PRE C/O [
INSPECTOR ,DATE
Town Hall Annex
Town of Southold 54375 Main Road
Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
Tel: 631-765-1802
SUM # Date :.+' _. .
��� Phone �
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Owner
Address �j►2-I �/G S Visible Insp et
,Hamlet ...,,... .. ._ .. _...... ..._.m. .. _ cor
.. __
Floor Level Quantities Sub 1 2 3
ro.�eMa..... �R�...... ., ... e .a- . _ -......�� ......
Smoke Detectors (not located in bedrooms) /
Carbon Monoxide Detectors
. �... .o,..w ... ,. .... .M. ..... ........�....�. .......
Fire Extinguishers P
_ .,.
Exits . ...,. _. . . ......... l
_...�..., a�. .� cam......�..... ..........��......�...._ �...... .
JBedrooms
.,..
1 2 4
� i � � � 5 �� 6
�... � 3 �
Smoke Detectors
Egress
..— -, ..........a,. . ......... .. . ....... �...................... .�. ...... papa
Occupant Count
Building Systems Maintained &Operational Condition of Property
.
Heating Building interior
�u. w..,.�.., . ...... ...�,w.. ._. .. Buildin.�._. �. .. .... �. ...� . ,�,,... ...
Hot water exterior
�,.... . w.... ....... .......ro. .. ��., � u. ,.� ,�,,,,,, ......, ....... P���g ���.. , ,.,.... .... .. ........ .....
Electrical Property clean, maintained &safe
_. .. . ..
Handrails&guards installed &secure
Mechanical �.... �.� �...�.-�w... .� � Handra .......� ............ a..... �.....,_�.� w.�.�.,.. .. �.. ...�.W ._..�..�...i
m,...w _..o _ ... . ..... ... .. .. .. ...� .... .
rrPool Safety Pool on Site
Surface water alarm Date of CO issuance
_.._
Door alarms - Pool
..�...._._...-...-,. � ... ... , m.., ....... �.,� �
completely enclosed
Self closing latching gates Pool fence to code requirements ments.,o,
.. ..... .. .�
O's for all items present Prior Rental
C _ .....
omments _........
...�,_. ..m. . . . ...,,, �... .....min ..� .__. ,, _. .. ....._ .. ........., _ .......... ......... ... ........_ ....,
�, ..... .ry.ry._. .... ..........
_.__.. . ..............
. .. _...... . . ....... .....:
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M..... _...ry __..... -........
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PLAN 3D 9th street
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TOWN OF SOUTHOLD PROPER ��f��� AR
OWNER TREET I VILLAGE _- SUB, LOT
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FORMER OWNER .. ..- - r N E ACR. 3 —
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RES. SEAS. VL. FARM COMM. CB. MiCS. Mkt. Value'
4
04741
LAND 1 IMP. TOTAL DATE i REMARKS :
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House Plot BULKHEAD
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46.1-31.1 10/2014
46-1-31.1 2/03
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Extension
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Extension I ;
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Extension I
- nth Dinette
Foundation
Poi+ch = cement
Floors K, v
z 'Ext. Walls Interior Finish I LR.
Porch
Breezeway 'Fire Place Heat DR.
Garage Type Roof Rooms 1 st Floor !BR.
Recreation Room
2nd Floor FIN. B I
Patio � � � _
O. B. Dormer 'Driveway
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FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. , 4 .Z 10586. . . . . . . Date . . . July 17 . . . . . . . . . . . . . . . . . » , ., 1��, . .
THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property Main Road & 9th Street, 4reenport, New York
House No. Street .Hairlet
County Tax Map No. 1000 Section . . .46. . . . . . .Block . . . . . . . .1. . . . . . .Lot . . . .3I.•.1. . . . . . . . .
xSr ter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . k�1SdtI�1II�G�A§. . , . . , . . . V .x. . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
April» ICpw x 19 .73pursuant to which Building Permit No. . . . . .653O. .Z . . . .
dated . . . . .Apr;U .30. . . . . . . . . . . . . . 19 .74 ,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 . . . . . . . . .
On,e , Bedroom Apartment Bld$. 'ix" Drif twood Cove . , * . „ . .
The certificate is issued to . . . Xenophon Dsmiananos
(owner�esset er"ePrTdlf'fj
of the aforesaid building.
Suffolk County Department of Health Approval . . . . , Existing Public Seaer System
UNDERWRITERS CERTIFICATE NO. . . . . . . Aq1 Tb9.7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building»Inspector
Rev. 1181