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Home My WebLink About1000-14.-2-24 Rental Permit 1405 Owner: Droege MC Fam Rev Tr Occupied as: Single Family Dwelling Located at: 885 Pettys Dr Orient 14.-2-24 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 aria ing for the bi-annual inspectio . Issued: 12/17/2025 Q\-".tnA A Expiration: 12/17/2027 0o official This Notice must be posted by the main entry ce at 11 ti (LM"9 Town Hall Annex APR 1 r "ele ne r� 1)765-180 P 54375 Main Road LA P.O.Box 1179 r r{Q "r Southold,NY 11971-0959 ""'tZZ�, 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: -1L041 -LOT �� Tax Map Number: 1000 SECTION SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: ,&31-3a3- 3 31 � � Telephone Number(s): Daytime nin gncy " 3d'51 b Property Owner Email Address: L '� Sa tj ma,l v rvnad i 1 @ atil. Pagel of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 m Southold,NY H 971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: 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: W ireA� 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: x &.oL i 60,0( Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �` Southold,NY 11971-0959 . CO ".° r � BUILDING DEPARTMENT TOWN OF SOUTHO RENTAL PERMIT APPLICATION ADDENDUM r) Rental Dwelling Unit Identifier: m 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: 2y Rental Dwelling Unit Identifier: )PU0,0!) Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: -5 Town Hall Annex Telephone(631)765-1802 54375 Main Road �,N Fax(631)765-9502 P.O.Box 1179f 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: N Y Property Owner's Signature: "Sworn before me isi ay of 2�3 O Ic al Notary Public Sign to a and Original Notary Stamp 1)EgC1RAH A. JCiK Notary Public,State of New York No.4990159 � Qualified in Suffolk Coun Commission Expires Dec.30, Page 5 of 5 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 COU 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. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 1 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) 1 � 1 i 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 q 41 �e- �OA� � vy-. .00 TOWN OF SOUTHOLD BUILDING DEPT. ur 631-765-1802 NS"' PECT 10 N [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] E SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ,, [ ] ELECTRICAL (FI AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMAR S 4 L 64 POW" fl/Il\ 064 DATE &10"07 INSPECTOR low N OF SOUTHOLD PROPERTY RE;, OWNER r STREET ! VILLAGE DIST. SUB. LOT { 1=�ME� Z Al NEE N E ACR y i €si s� a 1N TYPE OF BUILDING RES. SEAS. = VL £.., FARM COMM. CB. MILS. Mkt, Value LAND IMP. TOTAL DATE REMARKS a ,3 t .- ji- 3 a -Liz IN j tI& 4 . 0 , , 3 € f�r• f i 1 i Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD I Meadowland DEPTH _ House Plot ' BULKHEAD I Total i F I� - Co ��.` - iI OLR h� Q ,sc,a , TRIM -- . i = I E I ' - I � s i 1 t - 1 a 4 i R I 14.-2-24 6/11 14.-2-24 2/10 M. ,, -� s i .{Extansion r -- �1 --------------- i c 1 ._Extension 3 - i e -� Extension } 3 Foundation �r,, Botha Dinette 4 = �g t Basement k Floors oich -2 FE FCt. Walls Interior Finish . I R Porch .',ito 4 i i Fire Place `: - 'Hear 'DR t ._ � r Y'7' I <� 2 T Roof Rooms 1st Floor 5R, God i l - Petro F ' - ;Recreation Room Rooms 2nd Floor ;� ,FI B f Q• B. I � � =Dormer DrivewTool �� FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20568 Date MARCH 5, 1992 THIS CERTIFIES that the building INGROUND W ING POOL Location of Propert 885 PETTYS BIGHT ORIENT4 N.Y. House No. Street Hamlet County Tax Map•No. 1000 Section 14 Block 2 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25, 1990 pursuant to which Building Permit No. 19102-Z dated JUNE 7 1990 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 INGROUND SWIMMING POOL, WITH DECK & FENCE ENCLOSURE CE AS APPLIED FOR. The certificate is issued to CIPITE'LLI BROTHERS REALTY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N-197666- - JULY 26, 1991 PLUMBERS CERTIFICATION DATED N A r 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-20568 Date MARCH 5 1992 THIS CERTIFIES that the building IN GROUND SWIMMING POOL Location of Propert 885 PETTYS BIGHT ORIENT N.Y. House No. Street Hamlet County Tax Map•No. 1000 Section 14 Block 2 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25 1990 _____pursuant to which Building Permit No. 19102-Z dated. DUNE 7 1990 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 INGROUND SWIMMING POOL WITH DECK & FENCE ENCLOSURE AS APPLIED FOR. The certificate is issued to CIPITELLI BROTHERS REALTY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-197666 _, JULY 26 1991 PLUMBERS CERTIFICATION DATED NIA Building Inspector Rev. 1/81 :- -. ti.. j R NMI R NIA" II•YR' � � - - I _ V !J Cl--ptoo �...__a A �ylaILL= FLOOR .AREASr pMASEMENT, *5626 $F s� BATHROOM *AS OF rntcaEo�.t�nLs° MP-CW. ROOM 342q SF &F1Yk AHt.B 3TtLt4i ..ems..«.� di 1tSrcf we It:wmt. Nkfrtrt w A Vcro, Ux fhaxx�tr1. ftltF!iti.��t(�ti PLAN, Ersge�;4R: F anuss-_-- -- ---------- -I -_a__.---- ---------- ~� F_ rd MINOR MEN Sol --------------- ------------- t e t t - - . 3 pLOOR AREAS ([ (I INC FLOOR.DRZAKPAST'Wq 5F ARlA((INCL.`may SEGOND 1=LOOR PLAN ROOF DECK 3853 9F �� aGALs. Ir1'.M-M 2 BATHROOMS :L"4 a � c 11 O IL � �µ #yam# #.: g to f PARTfAL REAR ELEVATION FOR PRCMOSED STA;IRCA.9E p -- - - 3