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Home My WebLink About1000-33.-2-32 TOWN OF SOUTHOLD Rental Permit All 1186 Owner Katherine Dimiero & Brendan Clifford Occupied as Single Family Dwelling with Accessory Apartment Located at 1075 Moores Ln. N. Greenport 33.-2-32 Maximum Permitted Occupancy 4 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. 8/29/2024 John Jarski Code Enforcement Official This Notice must be posted by the main entrance at all times srbjFAUG — 72024 Town Hall Annex RIIPIIrI llNrn9 °MIIeaaw,Cali P 'w.w I1CC) 54375 Main Road t' �� n of Southold (f)31)765,9502 P.O.Box 1 179 1 Southold,NY 1 197 1-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 1075 Moores Lane North, Greenport, New York, 11944 Tax Map Number: 1000 SECTION 3 -BLOCK 2 -LOTT2 I I SECTION B. OWNER INFORMATION: Property Owner Name: Brendan Clifford& Katherine Dlmlero I Property Owner Legal Address: Property Owner Mailing Address: 1075 Moores Lane North 420 Fowler Ave Greenport, NY Pelham, NY 11944 Telephone Number(s):Daytime 917-330-8545 Evening,, .w......... .. ...-Emergency 831-239-3259 Property Owner Email Address: ._baclifford@gmail comm, -.. . .. _.. ..._w.. .......�.� ............_..�... .w ...... .......... ........_ Page 105 Town Hall Annex Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road � P.O.Box 1179 Southold,NY 1 1971.0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit,if any: Bridget Elkin w„ Address of Authorized Agent(no P.O. Boxes):-. �100 Main Rd. Southol d, NY 11971 _,, Mailing Address of Authorized Agent:_ ..........._.. _..... .. ................... ...._.. Telephone Number(s): Daytime 516-330-6086 Evening Emergency, ,_,_ __ Email Address: bnd et.elkin@com ass.com g.��.�.�.. ....„w,, p ��- _ww.._....._ ........_� ...... ......_...._...w_. .........._ww..ww....w_...._....M Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit,if any; Address of Authorized Agent(no P.O. Boxes):_„ „a,_ �,.._... ..._. ...__._ ...._.._ m... a.. am....._.....r Mailing Address of Authorized Agent: ._.___..... .w . . _ ,......., .. ...... Telephone Number(s): Daytime..........,_.---,-...Evening_Emergency. .....,. Email Address;m ._. .....,. _ __ , ._. . . m___.,.�.. ��w.�... ._ .... .__.. .._ 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 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, 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: 7 Use and Dimensions of each room in Rental Dwelling Unit: L I y • FM'* KtT '-7 is 23 AZ 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 C `a hone(631)765-1R02 Town Hall Annex „1,,y it � �� ;�s� Tele P 54375 Main Road l Fax(631)765-9502 11.0.Box 1 179 Southold.NY 1 1971-0959 V. BUILDING DEPARTMENT TOWN OF SOUTHOLD SECTION G. INSPECTION: (Rental Prop erties), a safety 2 7 Ren Y Chapter 0 } Pursuant to the Town Cade of the Town of Southold Chap ( p 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 IR 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) I Brendan Clifford 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 Annex � ' Telephone(631)765-1802 54375 Main Road 1 fax(631)765-9502 P.O.Box 1 179 a 1 r Southold,NY 1 197 1-0959 �ba 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: Brendan Clifford ,..... __.......w.w ._. _ B Property Owners Signature: '". .... .__ __w.. ... _ ......... ..mw. .. Sworn to before me this �day of _ u' .� ,20u- P blic Si n tt re an.d .ww._..�...�w... ... e.__._ _.. �._ Official I rr at, g Original Notary Stamp Augusta Denunzio NOTARY PUBLIC,STATE OF NEW YORK Registration No.01DE6381154 oualified In Westchester County Commission Expires September 24,20'a-1 Page 5 of 5 s woX I brte,�,?A- TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPOECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] (IRE [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: Al "7 'SATE 1NSPECPTOR 3 TOWN OF SOUTHOLD PROPERTY RECORD TREET VILLAGE DPI T OVD. OJT - F e FORMER OWNER. N E _ ACR S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value — LAND IMP. TOTAL DATE REMARKS i t r a _ e ,e e R 3 e - f ti j I � € d � € BU � « - ✓ _ _NEW NORMAL BELOW ABOVE FARM i Acre Value Per Value Acre Tillable FRONTAGE ON WATER, Woodland i i FRONTAGE ON ROAD � I Meadowland i DEPTH I House Ploty BULKHEAD Total i DOCK I ' � COLOR 0 �e t i a t TRIM w-t-W330 � TV- _ 33.2-32 10/10 F 1 st 2nd _ M. Bld - pc ce 9 __ _ Foundation HER Bath r Dinette x Extension Basement sLAa Pnar Floors Kit. Calf �- ,r s extension Nt, %. ; - Finished B. -Interior Finish L.R, li? l tom' I xt nsion = ! 2 Fire Place 1 Heat � ; D.R. ` Garage Ext. Walls BR_ _ -ve; Porch AC6 {£ z }_ Dormer Baths Deck/Patio t down Fam. Rm. 0 130Foyer A.C. Laundry O.B. _ _ Library/ f- Study Dock SV717 1 ftn a .... z r} �- 5 ' zVe, =1.:' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMMT Town Clerk7s Office Southold, N. Y. Certificate Of Occupancy No.44537 . . . . . . Date . . . . . . . . . Yeb. . . 1#• . . , 19.72 THIS CERTIFIES that the building located at . Moores Lj% •11 & .Inlet.pofAreg Map No. Eee ,0= Sri!Block No. . . Lot No. .96 . .�resnpt�t �.Y� . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . Dot . . ., 19 --,J. pursuant to which Building Permit No. . dated . . . . . . . 1971. , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .pi-smate •owe t ily•dwensmg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .A.. -Townser o er, lessee or tenant) of the aforesaid building. Suffolk, County Department of Health Approval . .D . . 16t, 4-9g1 . by.R.. VIXI& House # 1075 Moores La Building Inspector k FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Mall Southold, N.Y. CERTIFICATA OF OOMPANCY No S-24508 Date JULY 19 1996 THIS CzRTIFIES that the building ADDITION 950 INLUT PCND RD. & Location of Pr rty 10 5 Ss B NGramwPOW& N.Y. Rouse No. Street Hamlet County Tax Map No. 1000 Section 33 Block 2 Lot 32 Subdivision Filed Nap No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 25 19�9'6 rsuant to which Building Permit No. 23581-8 dat Y Isir 1996 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate in issued is DUCK ADDITIONISTI FAMIX DWKMXMG (19 BIDR YARD) APPLIEDAs VOR "AS BUILT" The certificate is issued to Y GKWZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH API' M A UNDERWRITERS CERTIFICATE NO. l9/A PLUMBERSCERTIFICATION DATED N/A~ 101 Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28643 Date: 08 01,/0 THIS CERTIFIES that the building ALTERATION Location of Property: 1075 MOORES LA GREENPGRT (HOUSE NO.) (STREET) (HAMLET) County Tax flap No. 473889 Section 33 Block 2 Lot 32 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 30 2002 pursuant to which Building Permit No. 28076-�Z-Z dated FEBRUARY 7 2002 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ETTA J SIEGEL & ELLEN M GOLDSTEIN (OWNER) of the aforesaid building. SUFFOLS COUW" DEPARTMENT OF HBALTS APPROVAL NIA ELECTRICAL CERTIFICATE NO. PENDING 05 24 0 PIATMERS CERTIFICATION DATED 05 20 02 ROBERT VAN ETTON W 11 N :52 �- Authoriitle4d, Signat e Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34352 Date: O r UL1 THis cERTiFISS that the building .ADDITIONS ALTERATIONS Location of Property: 1075 MOORES LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889, Section 33 Block 2 Lot 32 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 1 2009 pursuant to which Building Permit No. 35091-Z dated OCTOBER 21 2009 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 ALTERATIONS AND ADDITIONS INCLUDING DECKS, TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. _.... The certificate is issued to ETTA J SIEGEL & ELLEN GOLDSTEIN (OWNER) of the aforesaid building. DEVARTME11T OF HEALTH APPROVAL /A ... RLBCTRICRL 00rEIFIECATE NO. 132426C 04 29 10 PLUMBERS CERT373ECATION DATED 05 10 10 GEORGE FREDRICKS th ized ignature Rev. 1/81 .......... ......... Town of Southold Annex 11/8/2013 P.O.Box 1179 54375 Main Road Southold, New York 11971 ----------- CERTIFICATE OF OCCUPANCY No: 36597 Date: 11/6/2013 THIS CERTIFIES that the building AS BUILT APARTMENT ...................... . ...... ........... ...................... ..... Location of Property: 1075 Moores Ln,Greenport, ............................ ........................... SCTM#: 473889 Sec/Block/Lot: 31-2-32 .......... Subdivision: Filed Map No. Lot No. -—- --------------------conforms substantially to the Application for Building Permit heretofore filed in this officed dated 2/12/2013 pursuant to which Building Permit No. 37832 dated 2/27/2013 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: 41aLs uilr ac o tmenL�in.Ag f dwelling as a lied for._g� ks�jipj mijy _Qqe A 0 The certificate is issued to Siegel, Etta&Goldstein,Ellen (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ...................... ELECTRICAL CERTIFICATE NO. 132426C 4/29/10 PLUMBERS CERTIFICATION DATED 5110110 George Fredricks . ..........�Auth W7S p��tu�� Frank Wolfgang Uellendahl Architect 123 Central Ave POB 316 Greenport� NY 11944 t: 631.477.8624 e:fra,nk@frankueilendahl.com October 19, 2009 Owners: Ellen Goldstein and Etta Siegel 61 Jane Street, Apt. # 6b New York, NY 10014 Project: Addition to the Goldstein/Siegel Residence, at 1075 Moores Lane North in Greenport SCTM# = 1000-033-002-032 LETTER OF CERTIFICATION - EXISTING SEPTIC SYSTEM According to the owners of the above referenced residence the original block septic pool was broken and was in imminent danger of collapsing. Morris Cesspool Service Inc. installed a new 1000 gallon concrete septic tank and a cesspool which has a diameter of 8 feet and a total depth of 12'. Mr. Morris stated that the leaching pool was placed on very good sand. The exact location of the septic system is indicated on the attached site plan. ..... m.,. . ..,, . .... . . .. . ..... ................ ...... .. ..... ....... ...... .......---.........a.. .....o.....a...�...... .._ Based on the Department of Health Services regulations the replaced septic system is sufficient for a 4-Bedroom Residence. „ �� .,a..... .. .. ,,, ._... , �mm ..- ............ ............ . .. I hereby state that the information provided above is true to the best of my knowledge. 0 rank UellendahI TOWN OF SOUTHOLD PROPERTY RECORD OWNER STREET VILLAGE DIST" L-JT iv 1 i FORMER`OWNER N E ; AOR, . - i S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value z- LAND IMP. TOTAL DATE REMARKS 17 ------------------------- I � 7 f t - ` L/ .{ 5 f P r AGE BUILDIMI,CONDIT 0 y NEW NORMAL BELOW ABOVE A FARM I Acre j Value Per Value Acre i Tillable _ FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowl.and DEPTH i House Plot BULKHEAD I Toto I i DOCK COLOR TRIM ax FT- 3 _ _ l i 3 = E z a m� , e 3 � i \ — \\\\ \ i ' a _ x M. Bldg. Extension _ T 3. Extension = . _ t Extension Foundation jBath ;Dinette ;Basement Floors K. - Porch ' I !Ext. Walls -" Interior Finish :LR Breezeway y 2 — 'Fire Place � Heat i; iDR. - - _ - iType Roof d Rooms lst Floor -BR. � Pa-i cos 11 Recreation Room !Rooms 2nd Floor O. B. {�am21 sir t Dormer I 'Driveway I ( iNA Total ( C) a f P COLOR ' 2 c JK_ tz TRIM w" ., a F-0-0- 33,2-32 10/10 1 st 2nd l f M. Bldg. g3� e ccx t to Sro Foundation Pc (—CBHER Bath 2 �(L Dinette lL LL COMBO Extension Basement SLAB L PARTIAL Floors Q\ Kit. f tens' �o vO� �2� BeFinished B. Interior Finish L.R. � n LO � = t�� Ext nsion Fire Place Heat DA y� = �� 3 — �03�, � Garage Ext. Walls r` cCctn bo Porch 14 � z5 l Dormer Baths 1 Deck/Patio 2� t 3( Fam. Rm. Lf Foyer A.C. - Laundry 9? ,�. Library/ O.B, C L00 _ 1 1 Study Dock ro97 _0 .................................. ----- rr ........ ...... ...... / hair ............. Inq 11111111��-1111111111111111........... ...... ....... ....................... ........... 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