HomeMy WebLinkAbout1000-53.-6-38.1 Afsfti TOWN OF SOUTHOLD
Rental Permit
rit
1350
Owner: Nicholas Stein
-
Occupied as: Single Family Dwelling
Located at: 3200 Shore ore Rd Green port- 53.-6-38.1
Maximum Permitted Occupancy: 8
Is in compliance with all of the provisions of the code of the Town of Southold the I
aws and andCounty of Suffolk and by the laws adopted by the New York State Fire Prevention and Building san(tary Code Council.iExpiration is two (2)
regulations of the
years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
Issued: 04/29/2026
Expiration: 04/28/2028 - -
)Enfor ment ei
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 `1'
-Telephone 631 7 5-1 02 fax( 31) 765-9502 litt :AlwN . ou�tl�ioldtowiiii . o 4 �
10
�'��` 2l3"'q RENTAL PERMIT APPLICATION
Rental Permit Fee $300(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION S 3 -BLOCK � -LOT
SECTION B.
OWNER INFORMATIONNichol
:,
Property Owner Name: I�1 1 f l N
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
14A9,9,rS,,,4it jj",cvZvN Sr
Nrw 3
n OU13 New YV'IC &L 1001
Telephone Number (s): Daytime 9ly-&56 03&,Y Evening Emergency
Property Owner Email Address: ale 4!l.cow
Page 1 of 4
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: Me Pr.Nc.'
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent: ,
Telephone Number(s): Daytime jl:Zj. 9wo Evening Emergency
Email Address:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: 11 r
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent: a (�
Telephone Number(s): Daytime -i.� -ool . 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:
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 Identifier: NoK4
Requested Maximum number of persons allowed to occupy Dwelling Unit:
,Number of roomrin Rental Dwelling Unit: 1
Use and Dimensions of each room in Rental Dwelling Unit:
Li
D (� (►3ti► . I C�3�►z
L C�ie aS r u `� I st
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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.
Lf I am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
I1 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)
)
COUNTY OF SUFFOLK) .�. .
1 " +4 certify under penalty of perjury,the following:
1. I 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`wit}i'h five`(5) days of any changes
thereto. - I ' :
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 y day of o n*� 20-2-L0
Official Notary Publi Signature an Original Notary Stamp RtTTANYACC"9NRAD
Not"t's.stakNo,,State apt O York
Reg.Quafified in SuffoW County
Cara miss ran Expdres July 18, C�--'7
Page 4 of 4
Telephone(631)765-1802
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959r",,
�m
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION ADDENDUM
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier.
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802 53-
3� /
P E C T N
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS:
VG
s v �: e- o
Loua
DATE •��• INSPECTOR
Town Hall Annex
Town Of Southold 54375 Main Road
�
A� Rental Inspection Report PO Box 1179
�¢
Southold, NY 11971-1179
Tel: 631-765-1802
SCTM#
Owner OF Date
Phone
Address
Hamlet Visible
Inspector
Floor Level Quantities
Sub 1 2 3
Smoke Detectors(not located in bedrooms)
Carbon Monoxide Detectors l
Fire Extinguishers
Exits
Bedrooms 1 2 3
Smoke Detectors 5 6
Egress
Occupant Count
Building systems Maintained&Operational ndition of Property
Heating Building interior
Hot water Building exterior
Electrical Property clean,maintained &safe
Mechanical Handrails&guards installed&secure
Pool Safety
Pool on Site
Surface water alarm .:Date of CO issuance
Door alarms +
Pool completely enclosed
Self closing/latching gates Paol fence to code requirements
CO'sfor all items present
A
Comments:
SCTM #
10 g
g a b TOWN OF SOUTHOLD PROPERTY RE
CC 1
OWNER STREET - VILLAGE UB. LOT
tom_ J
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M
ACR.
REMARKS
E �
TYPE OF BLD.
PFtCP. CLASS
'
F
LAND IMP_ TOTAL DATE
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I FRONTAGE ON WATER HOUSE/LOT
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3 3
BULKHEAD
TOTAL
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1000-53.-6-38.1 3/2023
f � I
f � I
M. Bldg. i L)C 3
Q Foundation °Bath
Extension
i I D nette
b q asement Floors K.
Extension � "
t. Walls i i _s
,Interior Finish f ILR.
Extension i r [
I I ire Place Heat F
DR.
4t 'D ' YPe Roof
r ,
a U! 3
I =Rooms 1st Floor
'orch BR
Recreation Room l
)orch s RoorvS 2nd Floor FIN. B
Dormer
® 5
_Driveway
garage
Patio �D. B, I
i
-otal ;
c 1 79 ► � I
kRD All
1
t,,jTOWN OF SOUTHOLD PROPERTY I
- 6 -J
C STREET, VI LLAGE SUB. p-" LOT
�A
0 C e -Q
ER OWNEDY""et V)f-
N E ACR.
In/ t-1 0h yl C-r S W TYPE OF BUILDING
RES. SEAS./L. FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
j
f7
"ki T6W T"
-717
qjK 6's
A7�
e 9 S
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
1— -1-'�- 1 L �--- 1]2 L'
FARM Acre Value Per Value
Acre
Tillable I
Tillable 2
Tillable 3
Woodland
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD
House Plot DEPTH
'BULKHEAD
Total DOCK
1 0t e' Town of Southold
11/2/2022
Y.O.Box 1179
14
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43549 Date: 111212022
THIS CERTIFIES that the building SINGLE);AMILY DWELLING
Location of Properly: 3200 Bay Shore Rd.,Greenport
SCTM#: 473889 Sec/BlocldLot: 53.-6-38.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Perrot heretofore . filed in this office dated
12/2/2021 pursuant to which Building Permit No. 47454 dated 2/15/2022
was issued,and conforms to all of the requirements of the applicable provisions of the law. '1'Ilc occupancy for
which this certificate is issued is:
;,�rt ,� ,frlptl}I�IT cdl�c INit, �lwe�B1.�s�w��rta3l�ftsaatd�Ltlrys�a:�lr,�lklaaF rrd3dtl¢,az 11f;cCITa�tlq�sad,allzl�M�a1�aN��c?a.,�
The certificate is issued to 3200 Bay 1,LC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RI O-17-0181 /1/212022
ELECTRICAL CERTIFICATE NO. 22-84936 911612022
PLU1113ERS CERTIFICATION DATED 1 1/2/2022 'aul Klipp
� lstat'"':t1 t itttit"�
S.C.T.M. NO- DISTRICT: 1000 SECTION:53 BLOCK: 6 LOT(S):38.D
#RlO-17-0181
LOT 131
N 66009'00"E 125.00'
CS...w..�,...Ep.,...—..�.,C`9 .�,,,, Cp., .......LD .....-p0.............-1';�1 h
6° PO„tit/°'wIRr. ;, dTD.I,C PoBtl.K'. C8.RV EL 7.8,
EL 8.6 P ENC:.q fl
DRY WELL I'
B'DIAx6'DEEP I n
p
o BLUE STONE DRIVEWAYQ.
ka
o /,
yB"µ G pp
O DY & NJ 7
.....: ..............r LJJ r 132 ..» ....�� G h3"
2R
O
EL 9 I
� EL 6.9
GARAGE
y- ppyy pp' O w d
.,,., GF GE 7 R . ,l
- w 0
r � trr
EL 9,5 42 6 EL
LGiC) GS
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c� C3t G4
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2 STY FRM cZ v ,,,."^.,
DM LING co w(Lx
ev 1 F8. 17.2 ey §
13 4 BEDROOM SANITARY SYSTEM
To' > 1250 GAL.S.T.
_......,:°:,.,.....,.. LOT 13.3 dr EL B.B.,,... 32:0.,...,�„ EL 8 6 (6}�44 DEEP
9 tgA TS..". . �fir,.. U
O
NffdG CAL f
CS C7 w ..,.....,,.._ ��/ 91 V � DRY4 DE W"F.l�&� ._ �.,... ,.... .... ,....
�jd BY
WELL p
IQ f a LOT 1.'�4 B'DIAx Ef'
p
I- .,� E T�^�—OVERSIZED FOR 'C$OL
T^.^."..64'..,......„✓ t 1 WASTE WATER
q 7'' DRY WFIA
4. EL 9,2 �`-'� B'DIAx6'DEEP
.a"B 6 �"P�i FENCE O;Ei'N� EL H.0
S 66009'00"W EL 9 y 125.00'
P/a LOT 134
CID�.. ,
SEPTIC LOCATION
POINT „A„ POINT„g•' ,......_....................................w...„......
ISLAND VIEW LANE
Low 40,5' 26..5'
L............................ .. ._...- ..........-
G'„A 48 20
LO,T�_..,..�. ;. ....�� ._.}fir.
tla6�4 ...........
_^_..........................................................
. .39° .37'
q,�lo-..b,,,,,,,,,,,,,,Ji .....M.,.....�o..
EF6 57.5 ,2JA
DRAINAGE CALCULATIONS.
A)DWELLING FOOTPRINT--1,892 SO.FT. FINAL 09-28-22
1,89' r 0,188=3146 REQUIRED
(2)1,—x 4'DEEP ORYWEU1 354d PROVIDED FOUNDATION LOC. 04-20-22
".OVERSIZE ONE DRYWELL FOR POOL WASTE WATER 6'm®6'DEEP
ADD PROP. POOL 02-18-22
O)DRIVEWAY=1,415 SOFT.
1,415 x OJ66=235d THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL
(i)8'DIA x 6'DEEP DRYWELL=265d PRO14OLD LOCATIONS SHOWN ARE FROM FIELD OBS'ERVA TIONS
AND OR DATA OBTAINED FROM OTHERS.
AREA: 15,625.00 SQ.FT. or 0.36 ACRES ELEVATION DATUM. _NAVD8t3
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUF_ COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TIRE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USF N'N'rffl,,7"0RIr THEY ARE
NOT INTENDED TO MONUMENT THE PROPFRTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUf.YURF_5'Fv^,T'S()0'W„F D OR I.dAds/i"F,`P,d.'AR'L,➢Y:`D ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
surtvEYOF:LOT
2 PO I CERTIFIED 10 SFAN
LOT PMCA
MAP OF: AMENDED MAP A v PECONIC BAY ESTATE; i0 SARAH ELAS BENTON
... ....,.,_....,...
11 DERAL CREDIT UNION
SITUATED AT:ARSHAMOMAQUE NAVY FE ,.,,... ..............
FILED: 1124 FIRSr AMFRICAN rIILE INSURANCE COMPANY,
PE
SOUTHOLD ' D .. _,.
TOWN OF: d PN6B2. k'✓ .. _ «911R. "'p°I1��m", PLLC
KENNETH
SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
P.O. Box 153 Aquebogue, New York 11931
FILE #221-175 SCALE: 1 =20 DATE: OCT. 22, 2021 PHONE (631)298-158B FAX (631) 298-158B
N.Y.S. LISC:....... ... ..........
NO. 050882 ro,iwoe Lee records or BoeerL J.aeoneaay a xeonem M.lloyceuk
al rd Town orsinuilloill
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�91 5311}S.l Liiu
tinufhuld,Fore•Yurk 1071
CERTIFICATE OF OCCUPANCY �,
`q
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tic'K fir n: d 7 6s9 S'JdI
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t. si 1 r t Y N 115aIIdV I u v i6 M1;i 47579 arm
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SOWN OF SOUTH OLD
Rental Permit
1350
Owner: Sean McKay , Sarah Elias-Benton
Occupied as: Single Family Dwelling
Located at: 3200 Bay Shore Rd Greenport 53.-6-38.1
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.
Issued: 07/09/2025
Expiration: 07/09/2027 c €nfo ent official
This Notice must be posted by the main entrance a times
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
. � Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax(631) 765-9502 i tlp ,
�L.southold.t.ownn v
RENTAL PERMIT APPLICATION
Rental Permit Fee $300(Application must be renewed every r R
Section A.
Property Information: Bulldlnq E)epalfrnant
Town Of Southold
Rental Property Address:
3200 Bay Shore Rd., Greenport, NY, 11944
Tax Map Number: 1000 SECTION 53 --BLOCK-6 -LOT 38.1 -
SECTION B.
OWNER INFORMATION:
Property Owner Name: Sean & Sarah McKay
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
52 Waltham St, #1 52 Waltham St. #1
Boston, MA 02118 Boston, MA, 02118
Telephone Number (s): Daytime781.738.0039 Evening Emergency
Property Owner Email Address: spatrickmckay@gmail.com
Page 1 of 4
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179
Southold,NY 11971-095§ '
cou
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
y
RENTAL PERMIT APPLICATION INSTRUCTIONS
Effective September 27th 2023
Rental Permit Fee: $300 (Application must be renewed every two years)
The items listed below are required to be submitted with the completed
application.
• Floor plans: Floor plans of each rental dwelling unit, please show location of all
smoke & carbon monoxide detectors.
Certificates of Occupancy and Pre-Certificates of Occupancy: Certificates of
occupancy or Pre-Certificates of Occupancy for each rental dwelling unit.
Certification of Code Compliance (form enclosed): Must be submitted by a
license architect, engineer or license home inspector if an inspection by Town of
Southold Inspector is declined.
Rental Permit Fee: $300.00
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: ;C'� ftk GvRNci
Address of Authorized Agent (no P.O. Boxes): ri rt � 6t t
Mailing Address of Authorized Agent: k goy ksg2, of It t
Telephone Number(s): Daytime y-Gc -000t Evening Emergency
Email Address: (,A,'Kg
r
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 Identifier:
Requested Maximum number of persons allowed to occupy Dwelling Unit(,
Number of rooms in Rental Dwelling Unit: I
Use and Dimensions of each room in Rental Dwelling Unit: 65`0.1 ' D:Na�
RY Ok tieuw c ,11 r to M I N,k� M4, ;3 1' I �, MCriMt �,ctl
w p ��
I a" v� IS' i 'c a & ta A.2 4 6,6
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 SUFfA FOLK)
I� O--i !`!!�e,N/W----1,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 ,' day of Jr� 201-�--
Official N aryJPuic Signature and Original Notary Stamp
BRITTA�NYAid
Notary Public,State of New York
Real.Now 01C0624 a1 a4
C1ui6fied in Suffolk County
Commission Expires My 18,20 21
Page 4 of 4
Town Hall Annex �"
� � � Telephone(631)765-1802
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION ADDENDUM
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
Rental Dwelling Unit Identifier:
Requested maximum number of persons allowed to occupy each dwelling unit:
Number of Rooms in Rental Dwelling Unit:
Use and Dimension of each room:
TOW P �t ll�" + .D BUILD 13i �►�PT.
631-765-1802 s _ 36,1
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING / STRAPPING [ ] F AL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
[!ATE INSPECTOR
r
SCTM #
TOWN OF SOUTHOLD PROPERTY RECC 14�
OWNER STREET VILLAGE
SUB. LOT �
C
�'1J�• �i+-`O F� 4`'�:_"`� `( �'c®r-.r J�'��-k- t f C Q/7�
ACR. REMARKS
00
TYPE OF BLD.
PR P. CLASS
LAND IMP. TOTAL DATE
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f
FRONTAGE ON WATER HOUSE/LOT
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BULKHEAD
i
ETOTAEL
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s. TOWN OF S UTHOLD PROPERTY � �ab) as XR
O N,E L � STREET, t) VILLAGE SUB. „" LOTS u _
[ORME R OWNER`S nee n N E ACR.
`S1 iC!
{ wl4d�' lnJ . �14h✓1 J f �� girt;r; = S W TYPE OF BUILDING
RES. SEAS, L. (� IFARM !COMM. CB. MISC. Mkt. Value
L_ 72 R,w.
LAND IMP. „
TOTAL DATE REMARKS
s
auJP' L,-9
LJ f7f�
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value i
z
Acre
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Tillable 1 _ �j-15-7
Tillable 2
Tillable 3
Woodland ! f
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Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD
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House Plot - ''DEPTH -
,BULKHEAD
3 � -
I DOCK
Total i i
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1000-51-6-38.1 3/2023
6 k' 3 = IBath ' 3 5 Dinette
M. Bldg. 13. Foundation
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Extension I i c C� (Q® asement cRIkWL_ 'Floors ( K.
Extension txt, Walls �L'bcev�''� ,Interior Finish
Extension
®dire Place Heat CDR.
5 O i Q Type Roof Rooms 1st Floor BR.
A -
-` Porch - ` _ aE recreation Room Rooms 2nd Floor FIN. B. i
�[ a, fQ -
s
Porch Dormer s.
Br eway �v e $ (�� € �� Driveway Si vie r V
- — - -
Garage 1 St 5
Patio
i f
O. B. i
. qq
Total I ujU
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, ► C '„ Town of Southold 11/2/2022
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43549 Date: 111212022
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 3200 Bay Shore Rd.,Greenport
SCTM#: 473889 Sec/Block/Lot: 53.-6-38.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/2/2021 pursuant to which Building Permit No. 47454 dated 2/15/2022
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:
The certificate is Issued to 3200 Bay LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-17-0181 1112/2022
ELECTRICAL CERTIFICATE NO. 22-84936 9/1612022
PLUMBERS CERTIFICATION DATED l 1/2/2022 'attl Rupp
i ttatur
S.C.T.M. N0. DISTRICT: 1000 SECTION: 53 BLOCK: 6 LOT(S): 58.1
#R 10-1 7-0181
LOT 131
N 66009'00" E 125.00'
0,13`E,.{ ....__.------- ...._.—g ...____. �.......,_.._...L� _.... �..m. .__.,0 BELL. BLK CURV EL 7.8
1.3 6' POST/WIRE
a_
EL 8.8 FENCE
DRY
WELL
8'DIAx6'DEEP I 1
of
> u BLUE STONE DRIVEWAY w
} rn
W �
Cn
0 EL 8.5
w 3 6.9' ........
z 22.7' .......
LOT 132 0
� .. . EL 8.9 .�2 � GARAGE 1.0" � EL 8."��"
0LG2 OOLG6
20.8' GF 9.0 J
EL 9.5
4 I LG10OLG5
o5.5' ._w._.....,......W...... 7.0
J CL o
> X oOLG4...�
] Q z- �y 2 ....v._.'
g°p 2 STY FIRM. a
Of
DWELLING � o z
a FFL 11.2 °cn
.T
C)O U O
C) 4 BEDROOM SANITARY SYSTEM
10" 1250 GAL. S.T.
W ..2.0" "A"" (6)2' DEEP LEACHING GALLEYS
44.9"
Iv _........_.LOT 133 E EL 8.8 EL 8 6 WIRES
W o° WATER LINE
Q G V E __ .._ DRY WELL W.M„
�! /P/0 LOT 134 W
> 8'DIAx4'DEEP
E + _
CL POOL EQP/
E �— **OVERSIZED FOR f'�OOL I /
WASTE WATER
E,M DRY WELL
C EL 9.2 8'DIAx6'DEEP
0.5E 6' POST/WIRE
0.5'S
FENCE 0.8'N„ EL 8.0
S 66009'00" W EL 9.5 125.00'
_ P/0 LOT 134 0
00
co
0
SEPTIC LOCATION
t n. Town of souththhi /� �15N"
P.O.no,1179'
r�
530951Visln Rd � j ����1✓r D
Sonlhold,NewYer'1(1I47I i/%/���I,
i��/
CERTIFICATE
/,MA"
THIS CERTIFIES that the hulldIng IN GROUND P(M39 /
Location of Property: 3200 Bev Shone Rd.Grim npnort
SCTh7N: 473989 SrcesUhachALrrt 1.•.ht
ol'� V o III IIV a o
Subdivision: FNM
Fdred MAP
conforms substantially to the Application for Uut6drflrgt S"otuMxdr
222CO22 pura ant to which Building Pormlt
was issued,and conforms to all onto uw°rpduirtrineautu w+P bBYt°etatdda p'¢rrr Ilgu4r',e�
which this certificate is Issued Is
699+^�t�P.`u3.M1„6Y'pWIMMAN„YfM,SLti4..7,t.1.°t)Jl'"nrfll.tlt.'e0v"4 ,?bwMkwUM
i
Tbc ccnlncete Is Issued to 3200 nay IJ.0
ofihe aforesaid buihling
SUFFOLK COUNTY DEPARTMENT CIF tIV,81 Mtl
ELEC'1'WCAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
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