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Home My WebLink About1000-46.-1-31.1 (Unit J70) TOWN OF SOUTHOLD Rental Permit } 1134 �Y Owner Dylan Van Gorden (Driftwood Cove) Occupied as Single Family Dwelling Located at 1000 Ninth St (J70) 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. 5/22/2024 ent Official This Notice must be posted by the main entrance at all times Code Etr TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 MainRoad P. O. Box 1179 Southol d,NY 971 0959 17 " Telephone (631) 765-1802 Fax (631) 765-9502 hUs:f/wwr a,.southoldtc�, 3 2024 RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Renta Property Addre &f6'e-q Et p" � --LOT— SECTION Tax Map Number: 1000 SECTION `7 -BLOCK B. OWNER INFORMATION: Property Owner Name: w Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number (s): Daytime 31` d3'I'Evenin fw Emerge cy Property Owner Email Address: 'k V CIIN 114(16i'!�I ... c Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: �6A Address of Authorized Agent no P.O. Boxes): � Mailing Address of Authorized Agent: (H 5 �� 4 Telephone Number (s): Daytim � '"i)"e �"�! Even ing's-W-L-' .Emergency � Email Address: 6k" ` Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if an i . Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: = w U 1COO— 91 Telephon Number (s): DaytimeD-V Evening Emergency Email Address: V- � a� 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): 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, 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 Identifie l- Requested Maximum number of persons allowed to occupy DwellingUnit: �. Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: I" 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) __ 1 GGC�`` f' ,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 this —; day of a , 20a-y n ' Rebecca A. Lucak Official Notary Public Signature and Original Notary Stamp Notary Public, State of New York Reg. No. 01 LU6386882 Qualified in Suffolk County ' Commission Expires 02/04/20�-7 Page 4of4 TOWN OF' SOUTHOLD BUILD I 631 -765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] TIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN [ ] CODE VIOLATION [ ] PRE C/O [ REMARKS: Dle4 wet4 J 10 Dlow WSW DATE �- ' INSPECTOR Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 ��..... ...._...��... .....,............�.��...........w. �-�. � ....�....�..�..�.��......�. ..._................................... .................. ........_�.,.,. ._...............�.............�..... ......,.,.��.,..�. .� _........ _�. .. ._.. �.......... SCTM# _. Date �"-a . Owner0,0 Phone �.. Address Visible Hamlet Inspector .... . . .... _.......w �.... ... (Floor Level Quantities Sub 1 2 .w- ..--ors (not located in bedr m .........._. .... ..... �....�....... Smoke Detect ooms) ........a ........ _..... . . . �....... Carbon Monoxide Detectors Fire Extinguishers Exits ..a. , _. ....... �..... ..... m... . .. - .M w a.. .......a. ..aw. .. _._... _-. ..... . .... _._.....�..w.. _.... ... .....__. . .. _.. ... ........... ... . Bedrooms 1 ? ..... 3 _...... ... . 4 5 6 �. .. .....,.w�...� �.. . ...... .... _, .., Smoke Detectors ..,.�. . ...w.. .� ._� .�..� Egress . ..._ �_I ... pOccu ant Count ..... ... ..,.... :� ... .._.. _.. ........., Building Systems Maintained &Op ......._ ' Operational Condition of Property Heating Building interior Hot water Building exterior Electrical.�.��.. . ..�..v.. P.�. ...... . Property.. gds ins td clean, maintained&w secure safe .. .......... rails �I Mechanical ,..... .� ,�.., .... ..� �... . �... . ...... Hand & uar alle & ._,_.Ma ..T . .. . .w ..._..._.a _ . .......... ... _ .. . _ -.u...... ..... Pool Safety Pool on Site _.............. .._. ... _., . .,.. . .m.w. _ ..... .._. .. -, . Surface water alarm Date of CO issuance Door alarms Pool completely enclosed Self closing/latching gates Pool fen to code requirements _ _... ..fence_. ... .. q.... . ... . . _.....� . w.. CO s for all items present Prior Rental Comments.,-.u.........�. .�,�.......�,�.......�....,�...._w..____.....�.. ... w ....�..-�,. ..... ..........__.......-...... _..... .,....M._M.. .µ _..,_..µw.... .... .Ww.W....... ,µ. ... ,.�,.M. _ µ... .M... ..w ...µ..... ............ _ �....... ... . ._. mm..,.a..._......... .W .�.._ .. ..... ....... .._. - . . mm..... ..., .M1...... ... _. M. �fl. �............ ......................._.......... ._................ ........w.. ......... ._.... ........,,w ..... ...... .... I ... .. ........... ------- Ny-- L eiJCUM Vatic y National Bank 19 . 81 CI Bedroom Bath Kitchen Living Room Cl 19 .8' First Floor TQTALSI-h 1, 1. � Area Calculations.Surnmary Lk4ag Ate* Cakwlxtloo DOWU Ut Floor 615.78 Sq ft 31.1 x 19.8 = 615.78 Total Living Area(Rounded). 616 Sq ft r, FORM NO.4 'rot N OF SOUTHOLD BUIWING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . Z 10584. . . , . , . . . . . . . .Ju.ly, 17. . . . . . . . . . . . . . . . . 81 Date ., 19 , THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property Main Road and 9th Street w Greenport, New York House No. Street Hamlet County Tax Map No, 1000 Section . . . 46. . . . . .Block . . . . . . . . . . . . .Lot . . . „ 3 . . . . . . . . . . Slid �I "i*N*F. . . . . . . . . . . . . . . . . . . . . . . . . . . . a x . . . . . . .�o xx. . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated April , 19 . ?p 6 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 Damiananos The certificate is issued to . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. to weer,�r vrTwwiil- of the aforesaid building. Suffolk County Department of Health Approval , Existing Public Sewer System . . . . . . . UNDERWRITERS CERTIFICATE NO. . , , N317691-N317692-14317693N317694 4�L Building Inspector Rev. 1/81