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Home My WebLink About1000-33.-3-19.4 r T uvw W SOUTHOLD N 0 Rental Permit r 1183 Owner NF Beach House Occupied as Single Family Dwelling Located at 1250 Sound Dr Greenport 33-3-19.4 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. 8/7/2024 odeo e e Official This Notice must be posted by the main entrance at all times Town Hall Annex "f Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �" Southold,NY 11971-0959 � ��" of BUILDING DEPARTMENT TOWN OF SOUTHOLD JANI RENTAL PERMIT APPLICATION BUILDING DEPT Rental Permit Fee $200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Q SoLtn d ► "V-e . �e,►n u( Tax Map Number: 1000 SECTION ..W....w,-BLOCK _ _ -LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 1 �✓ L�LI L L-I Telephone Number (s): Daytime, ;� Emergency Evening Property Owner Email Address: Cx-y—SLk Q 6L oU. -01, at�'C'-w)qo-j Page 1 of S Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 " r BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized 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 D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: l sca A k-,jvl Address of Authorized Agent (no P.O. Boxes): 1Z a Sod& C�r,�z. yen L Lj`I Mailing Address of Authorized Agent: cx5k �, �"S� �3k A/v P J C t ZZ Telephone Number (s): Daytime �P Evening b Emergency )(C 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): Page 2 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O. Box 1 179 lq Southold,NY l 1971-0959 f BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent:_, I Ju '� 160 ZZ5 z, Telephone Number(s): Daytime Evening Emergency v L/ Z z1 S Email Address: -,- �. SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: µ 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: Use and Dimensions of each room in Rental Dwelling Unit: -Works ��'� I b I ,^ 1 7- x 6o , I ZZY Page 3 of 5 z30 4� � '1 r Town Hall Annex Telephone(631)765-1902 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �� Southold,NY 11971-0959 11 ttzr"(.� r BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. 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 Page 4 of 5 Town Hall Annexk Telephone(631)765-1802 �w 54375 Main Road Fax(631)765-9502 �^ P.O.Box 1179w , Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name:.... Owner's Signature: Property _ - - -- i-4D — Sworn to bfbre me this a f V , 20 �3 _.. �l ri' .. Off �al Notary Pu Si ure and Original Notary Stamp WEK,oY p.STAPOR WM Polk,, ref IlM tsk Nit.C1I091 �l1 to COVI* d sits.i8 .C. .. Page 5 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road ; Fax(631)765-9502 P.O.Box 1179 �µ`a Southold,NY 11971-0959 � BUILDING DEPARTMENT TOWN OF SOXY OLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Professional seal required for architect or Fn /Weer Licensed Home Lns actor mush prolride gogy of valid current certL ication Rental Property SCTM Number: Rental Property Address: J - .So 5flte /� Owner/Name: 0,('-In Fa;Y-- 6ec�c Rental Dwelling Unit Identifier: Number &Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom #1 -100 sq., Bedroom#2-90 sq., etc.) ` OJ A; 3 — Z mcol ee 6L — Z o sCY Property Description (Include all improvements indicated on survey) 2 ( Gr 1 certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code of the Town of Southold,the Residential Code of New York State,the Building Code of New York State, the Plumbing Code of New York State, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. r� Print Name and Title Original Signature" b kt Please place professional seal: , �r S ' WINDOW SCHEDULE ' - 3 A WINDP'A5 400 SERIES TILT hA54 OOLIELE LtMC PE¢AN'CCR5EN 3. { u - ALL WINCG�SHALL BE LPA`E HI5H PERFORNANLE RX t f 4 - FI R5T AND 5EOOND FLOOR: 3'r @ _ All'4206 ANDERSEN r3056 t55RE53) AN7=R5EN 0,132if ( _ ANDER5EN 124:6 { ANCER5EN 4_A2 ( ANDER5EN 9.442 - � Z k ( ANDER5-N°356 .MPER5EN 42446 _ } r ANDERSEN 43Ob2 C6RF5i _ Z F LU ANDERSEN"1'473011"'I'm) - i ANOFRHN a 542 ANCEP.5EN 43020(DA5F NT W NDON5) _ r _ ` ,ANCERSEN 43010 iINALTIVE COCP.! (S .. '' F✓` _ I I AlIOERSEn w3110 Ai TIDE{ t A\DEN.SEN 12610':07 _ - .V+OERS{V ridEB fD0.'>K4 N P s _ J FAMI'r ROOM L F 33 fx (p S s� y - a- � s y F 1 E 1; �1 FIRST FLOOR PLAN = e fed �vfi= Sm C, �� s ,� � � F 2 _ -------------- - mII1 -------------- 1 AV a, f ll� W i E� a Alig - r { ¢ 8 =` --------- lotWASIS - -�s • [ a r `0 2A _ } ' FOUNDATION FLAN 6 € tF 1 � Ll F _ s� 01! l4f xaJan 3 Ll — �s p3 O i`? r LU r, s r ; t 4 1 a l 3 E N f l -` ' _r Aa ' - < -41 ik1 , 1/4 a. if- § s s F r F E 1 e{ e r Ar � E z LUJ Lw C A a „ I VV �'400, � 9 6 l w 4 i r "� F�xacx✓6 OR nr Rv mw " 4 � G w 0 n �w' w d"O fi " µ, 1L A N F ,y l a, 1. lv� ,. �.� � r:.,mm �,.. �. M ^ rff ,W l . I G P ` � y �✓ � k\^ M N 1r A e d. ^ loo ''Olt . ,."•' " 'q'" ,,, F Q k "d" f R ,^*a ( .521 ar� .r � ^ U ptt ,a :&ZrVv)& TO rN OF SOUT'HOLD BUILDIN DEPT. 631-765-1802 1 N S Ph E%C"T I N [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] INAL [ ] FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O ] RENTAL �i-M)7-evb��Av v ` 5 vi 0119, WADrv, A--D dZI � ego DATE INSPECTOR, TOWN OF SOUTHOLD BUDDING DEPT. 631-765-1802 Nbv =CTl0N0% [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE.. VIOLATION [ ] PRE C/O RENTAL REMARKS: DATE INSPECTOR __ � f w --3- TOWN OF SOUTHO D CARD f OWN DI SUB LOT STREET VILLAGE _ - __ - - _ ACR. REMARKS TYPE OF BLD. a f } qq PROP CLASS { Ilk LAND IMP. TOTAL DATE , _ t ; 1 = TILLABLE FRONTAGE ON WATER FRONTAGE ON ROAD J , WOODLAND DEPTH MEADOWLAND BULKHEAD 6, t HOUSE/LOT I TOTAL I E. 33 i F 7 x ;.in a IT tig 33.-3-19.4 12/23/2020 M. Bldg r� Dinette A Foundation Bath s_ . - d'? - Extension rn ' Basement ; Floors Kit_ '2 77 SLAB i c #" Interior Finish L.R Extension Ext_ Walls C", W� f r �. � Fire Place Extension s ��~° Heat D R. F g e, 15�" Woodstov � _ �F 4 Dormer Fin =aee-x _ Attic a , ` O mway r-� �� Rooms 1st Floor ��. 4 � Ems. ,� ,`'`� Garage _ a �� Driveway Rooms 2nd Floor e - v9 f( � 1 - u - i_ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31539 Date: 04/18/06 THIS CERTIFIES that the building NEW DWELLIN Location of Property: 1250 SOUND DR GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 3 Lot 19.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 12 2004 pursuant to which Building Permit No. 30582-Z dated AUGUST 23 2004 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 FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE COVERED FRONT ENTRY & UPPER BALCONY AS APPLIED FOR. The certificate is issued to ROBERT & BARBARA SEELEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-03-0136 11 30/05 ELECTRICAL CERTIFICATE NO. 97316C 01/16/06 PLUMBERS CERTIFICATION DATED 03/22 06 JOHN DEACY th ize Signature Rev. 1/81 lF0J Town of Southold 9/27/2020 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41478 Date: 9/27/2020 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 1250 Sound Dr., Greenport SCTM#: 473889 Sec/Block/Lot: 33.-3-19.4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/4/2020 pursuant to which Building Permit No. 45101 dated 8/13/2020 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: roof-mounted gqkr,Mp ncl as alaplied for. The certificate is issued to N F Beach House LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45101 9/21/2020 PLUMBERS CERTIFICATION DATED Authorized Signature