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Home My WebLink About1000-71.-1-5 Rental Permit } 1279 Owner: North Parish Dr LLC Occupied as: Single Family Dwelling Located at: 495 N Parish Dr Southold 71.4-5 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. Issued: 03/26/2025 Expiration: 03/26/2027 eE o ent official This Notice must be posted by the main entrance t _I times TOWN OF SOUTHOLD— BUILDtNG DEPARTMENT fe" Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold, NY 11971-rP959 Telephone (631) 765-1802 Fax (631) 765-9502 httvs://www.soutlioldtowill,MIL RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: ve S C Tax Map Number: 1000 SECTION . --BLOCK LOT S SECTION B. OWNER INFORMATION: (L� V1\iN COS 5 c Property Owner Name: L L C_ 0�A Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Telephone Number (s): DaytimeWA4k%AS-2_q Eveningl I'VI VZ41-Emergency Property Owner Email Address: 5 k...s U_'\ 5 e c::, k-k A . Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: N 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: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number (s): Daytime Evening Emergency 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: t`J 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, 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 Uni Number of rooms in Rental Dwelling Unit: 8 � 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. I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold C� a� ��-� A-1 '�"� -q� " J ��> ❑ 1 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) Jn ) COUNTY OF SbFFOLK) 1 (.. ✓)✓\S c 0 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: L�l " c �� J o L N Y Property Owner's Signature: Sworn to before me this�L tk day of 20 LS Official Notary Public Signature and Original Notary Stamp e �`aa�aw�r� Page 4 Of 4 +ray s� bars k ypireS E a, 22 ,202 ,, w;, so TO OF SOUT OLD BUILDING ?PT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETR TION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL R MARKS-, _w �- 04 DATE INSPECT R 495 North Parish Drive Room Length Width Bathroom Length Width I st Floor I st Floor ---- ---- ..... Master Bedroom 19 12 Master Bathroom 20 6 ---- - - Bedroom 2 16 12 Bedroom 2 Bathroom 10 5 Kitchen/Family 36 22 Cabana Bathroom 12 5 Room -- - --------------- Laundry Room 11 11 Powder Bathroom 8 3 2nd Floor 2nd Floor Bedroom 3 16 12 Bedroom 3 Bathroom 9 5 Bedroom 4 16 12 Bedroom 4 Bathroom 9 5 Bunk Room 21 16 Bunk Room Bathroom 11 5 ------------- Family Room 20 16 --- ------- ........ .... ........ Garage 23 21 ........... . .... .... Screen Porch 30 14 S l�eke c� ccut bo v�, Ap- a f f opot m€wvu€rauwNa s , _ - � [ 7 : "1 ,a , ._ MM IM � ix sS it tit i w a f , i i I � �. � � Flret Floc - 6CNb:Ne1eYJ� rx oewr 2 1 s n�O A VAO o UWi' 5 1 cv # t E # � 54'#6 ate--- that--- P4 -- � �� _ _ 4 �+ � H •� �, NN. a a 11 �.R ems_- -2 7 # WIMM I E( sa i S a E➢4• # � �a> # �# •�l�-- aex M-4 g .`## # } 1 € OEM - 1 # 1 # # F € TEa A--ef �� 1 (� � 4Soullaltl NY � s w F ; a T• t't� Town of Southold P.O. Box 1179 53095 Main Rd rµ Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 46033 Date: 03/14/2025 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 495 N Parish Dr Southold NY 11971 Sec/Block/Lot: 71.-1-5 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 09/01/2022 Pursuant to which Building Permit No.48449 and dated: 11/02/2022 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: Additions and alterations (demolition as per Southold Town Code) to existing single family dwelling, including unfinished basement, enclosed porch, deck, outdoor shower, roof terrace, attached garage and cabana(outside access only) as applied for per ZBA 97594, dated 2/17/2022. The certificate is issued to: North Parish Dr LLC Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: R-21-2997 3/11/2025 ELECTRICAL CERTIFICATE: 48449 09/18/2024 PLUMBERS CERTIFICATION: Plumb Tech 03/13/2025 I tit on d 'gti tt arc FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z1214.3w . DECEMBER 12 83 . Date . , . . „ . „ „ . . . „ . . „ „ . . . „ 19 THIS CERTIFIES that the building . NEW DWELLING . „ » + „ „ . „ „ „ „ „ . ^ . . Location of Property 495 NORTH PARISH DR.4 . Y „ SOUTHOLD House No. „ Street "Hamlet County Tax Map No. 1000 Section . . . 071 Block . . . „ . „„ „ „Lot „ „ ., , ��. „ . ,', . . , . Subdivision . . „ . . . . . „ . . . . . . . . . . „ . . . „ „ „ . „ „ . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . „ . conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY .„26 . „ „ . . . , 1983.pursuant to which Building Permit No. . „ 12483Z , . . „ M dated . AUGUST 10, . . . . . , , , , 19 83,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 . . . . . . . . . family„dwelling . . . . . . . . . . — . . . . . . . . . . . . . . . „ „ , . . . . . . . . . . . The certificate is issued to . . S99I,WN SALZMAN Csavrrer,%s or tenantl . . „ . . ,. . . „ . . „ . . . . „ . . . „ of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . .N-2-32884 . . . „ „ , „ . , „ , „ „ „ „ , , , „ , „ 4 „ „ , . . . „ Building npector 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-20679 Date APRIL 27 1992 THIS CERTIFIES that the building ADDITION & ALTERATIONS, Location of Property 495 NORTH PARISH DRIVE SOUTHOLD N.Y, House No. Street Hamlet County Tax Map No. 1000 Section 71 Block 1 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 16 1991 ursuant to which Building Permit No. 20225-Z dated OCTOBE'R 23 1991 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 ADDITIONS & ALTERATIONS TO EXISTING ONE FAMILY DWELLING WITH ATTACHED GARAGE & DECKS AS APPLIED FOR. The certificate is issued to SHELDON & HELEN SALZMAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-232659 - APRIL 20 1992 PLUMBERS CERTIFICATION DATED MARCH 30 1992 - H.SMITH PLUMB.&HEAT.INC c I'W ilding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26416 Date: 04/30/99 THIS CERTIFIES that the building ADDITION Location of Property: 495 NORTH PARISH DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 71 Block 1 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 25, 1998 pursuant to which Building Permit No. 25318-Z dated NOVEMBER 10 1998 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 SECOND STORY ADDITION CONNECTING ACCESSORY GARAGE TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID S SALZMAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A y_ ELECTRICAL CERTIFICATE NO. PENDING 04/05/99 PLUMBERS CERTIFICATION DATED 03/01/99 PECOTIC PL ` C HEATING Buildi. Inspector Rev. 1/81