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Home My WebLink About1000-80.-5-6.1 T 0'"WAWIN OF SOUTHOLD Rental Permit x 1152 Owner Sunset Properties LLC Occupied as Single Family Dwelling Located at 100 W. Shore Drive Southold 80.-5-6.1 Maximum Permitted Occupancy 10 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. 6/14/2024 Cod Eno ment Ofic This Notice must be posted by the main entrance at all times 9 c l ?"24 TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold,NY 1197f.. 95��' Telephone (631) 765-1802 Fax(631) 765-9502 life„/lyVww.SoL1tl'Ioldtoww11 c ul '(3 RENTAL PERMIT APPLICATION e-c:-+t 10`15(,2 Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Property A dres : j/?7 I -. . Tax Map Number: 1000 SECTION ......-BLOCK_0 ,-LOT , SECTION B. OWNER INFORMATION: Property Owner Name: !�..� . Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) may' Telephone Number (s): Daytime e31-AX3`Wd�'Evening Emergency 97 Property Owner Email Address: Page 1 of 4 Section C. Authorized Agent Information: j Name of Authorized Agent of dwelling unit, if any: Ail A +! �,,�,{4 Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s): Daytim ' A Evening Emergency� " '"� � Email Address: a5 !►'f ��- 5 . 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: �w _ Telephone Number (s): Daytime_ Evening_--Emergency qqM... 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: w Address of Managing Agent (no P.O. Boxes): .... Mailing Address of Managing Agent: ... ....... Telephone Number (s): Daytime Evening__,Emergency ,µ,_m 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 Identifier: Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: , _. Ube and Dimensions of each r n ental Dwe 'n nit: ®" «r t ., k> Z. Of r J 11a aa� 11 fta — �E-CTION 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. Ila 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) 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, I anaging Agent, or Site Manager. iM � Property Owner's Name: w Property Owner's Signature: "' Sworn to ore me hiss l ay of , 2t Offic�a Notary P c Signa a otary Stamp JUSTIN E WLLMAN EMy tary PU! l;C state of New York NC) Q1H1617B965 Q,,alr`ie d to SUffiolk Count' onm'Js,ion Expires Dec 17„ :. . Page 4 of 4 TOWN OF SOUTHOLD BUILDING D 63 1 -765-1802 IN PECTION [ ] FOUNDATION 1ST / EEBAR [ ] ROUGH PLBG. [ ] 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 [ REMARKS: po"o s/ t � EASE INSPECTOR So FatTown Hall Annex Town Of Southold 54375 Main Road Fug� Rental Inspection Report PO Box 1179 �q Southold, NY 11971-1179 Tel: 631-765-1802 � ' SCTM # d raj= '.... .. Date (y •/O-oZ Owner 1/17 SGf lzv G �ie s (� Phone .. m.. ... Address„ W Visible.... _. . . Hamlet Inspector , . - _e Floor Level Quantities Sub 1 2 3 Smoke Detectors not located in bedrooms Carbon Monoxide DetectorsYVI„ I'll I Fire Extinguishers Exits Bedrooms .. 1 2 � 4 Smoke Detectors ,/* �/ ✓5'_ Egress Occupant Count - a Building Systems Maintained &Operational Condition of Property Heating Building interior Hot water Building exterior Electrical Property clean, maintained &safe Mechanical r 'Handrails&guards installed &secure v e . Pool Safety Pool on Site Surface water alarm Date of CO issuance Door alarms Pool completely enclosed Self closing/ latching gates Pool fence to code requirements „ _... CO's for all items present Prior Rental ........ Comments: a w � 3lAr,k DOI / � . w��__. .. w �v m e _ G 3p '� 64 f, mci /61 bvi ri Rwtn Own I`1e 9 17 . �-- �. U � wmwervr �� fl E �w..d. r r v ,,' e, /)fir'&`-` -- " - u Q JAck DO OA1 /Z wl 00 o '�� I fi 9 .,,a s�.�,I S jr d c `� w µ ac , _....... a , �.n t ?, Ito IN �ommv" ,.,,Iir�til vnA ( 14rirv�i/� Ui U i h TOWN OF SOUTHOLD P E ,-9)1q ,�q CARD OWNER r-, STREET VILLAGE SUB. LOT _ ee_ -F0%J&!iEP O` N k-- N I E ACREAGE 1 S W TYPE OF BUILDING . I i RES. �_ SEAS. VL. FARM comm. IND. CB. MISC. LAND IMP. i TOTAL DATE REMARKS 3 g , F C t AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable 1 Tillable 2 -2-1Lj Tillable 3 Wcodland Swampland Brushloncl '' �r House Plot ct;:l . I e � _- - LC — - - F t t X _ _ T _ l } M. Bldg. 4" �� 7 I Foundation I Both � ,— Floors Extension - �� - �..�r - = B � - ,�- asement - 4� Extension �cJ` �JL� 1 Ext. Walls �. ; Interior Finish E Extension ,� l 63 i Fire Place Heat -= _ l T - - Porch —_ - " Attic Porch Rooms 1st Floor - f - Breezeway Patio Rooms 2nd Floor _ �, Garage ! Driveway 0. B. li I � i � TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the IKX/ Land Pre C.O. #- Z14149 c/ Building(s) Date- ail, 986 Use(s) located at 100 West Shore Drive Southold Street Hamlet shown on County tax map as District 1000, Section 80 , Block 3 , Lot 6 doesknot)conform to the present Building Zone Code of the Town of Southold for the following reasons: On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming %�Land G/Building(s) /_/Use(s) existed on the effective date the present Building Zone Code of the Town of Southold, and may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to the Building Inspector's Office, the occupancy and use for which this Certifi- Property contains a one & one half story° Cate is issued is as follows: wood framed one family, dwelling with garage under hou d. Also pron2rtX c nt i s accessory ara a gpg. wooden bulkhead on water side. Proeerty situated in the A-Residential. agricul- tural zone with access to West Shore Drive. The Certificate is issued to (owner, 1�SPr_.qX�C� ]FXX of the aforesaid building. Suffolk County Department of Health Approval NIA UNDER'%TRITERS CERTIFICATE NO. N/A NOTICE IS HEREBY GIVEN that the owner of the above premises HAS NOT CONSENTED TO AN INSPECTION of the premises by the Building Inspec- tor to determine if the premises comply with all applicable codes and ordin- ances, other than the Building Zone Code, and therefore, no such inspection has been conducted. This Certificate, therefore, does not, and is not intended to certify that the premises comply with all other applicable codes and regula- tions. inspector .. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NOZ17146 Date AUGUST 1 1988 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property! 100 WEST SHORE DR. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 80 Block 03 Lot 06 Subdivision REYDON SHORES Filed Map No. 631 Lot No. 7-8-9 conforms substantially to the Application for Building Permit heretofore filed in this office dated. APRIL 14 1988 ___pursuant to which Building Permit No. 16947Z dated MAY 9 1988 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 DECK ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ROBERT AND PATRICIA BARRY (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL MLA UNDERWRITERS CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED N LA Building I pector Rev. 1/81