HomeMy WebLinkAbout1000-48.-1-13 Rental Permit
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Owner: Isaac Israel , Stephanie Israel, Herbert Israel
Occupied as: Single Family Dwelling
Located at: 75920 Route 25 Greenport 48.4-13
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.
Issued: 02/02/2026 ML
Expiration: 02/02/2028 c entofficiai
This Notice must be posted by the main entrance I times
0 ON
TOWN OF SOUTHOLD—BUILDING DEPARTMENT re,c=0 1 1 l 0 2 t4
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-09593b0�
Telephone(631) 765-1802 Fax(631) 765-9502 1itt as://www.sot thot, . 11 E � V E
n., U 2025
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every tw pr ouffi"-,Irj
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION --� ,� -BLOCK -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name: ' C".(_:� �
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
� 1 6 \1
Telephone Number (s): Daytie Evening Emerger c
Property Owner Email Address: o �: .
Page 1 of 4
a
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:
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
❑ 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 SUFFOLK)
i ISAA-c s ,.. , 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: c-
Property Owner's Signature.
orn to before me this W day of 01 +0 , 20 075
Lyywwtarrwrtrrrr
Official Notary Public Signahke nd Original N ary tamp
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o r�Pta �p ,
Page 4 of 4 rraaeNr++ `
f4f so Co
TO N OF SOUTHO D HG DEPT.
631-765-1802 qfo 13
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN ATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
DATE: IIIISPECTO44
uWL t
r e
OCT2025
Town Hall Annex v' � ���d`aw Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 co
Southold, NY 11971-0959y
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a licensed architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Professional seal required for Architect or En ineer Licensed Horne Inspector must
provide cop
y of valid current certification
Rental Property SCTM Number. i )o-- q$-- 1- la
Rental Property Address: f r r
Owner/Name: f-45 M - "416
Rental Dwelling Unit Identifier:
Number& Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 —100 sqft., Bedroom#2—90 sgft., etc.)
i7t,'t
Property Description (include all improvements indicated on survey)
I 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,the Fire Coded Y State,the Property Maintenance Code of New York State
and the Energy Conservas d' hbC nsl ae � of New York State.
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Print Name and Title I Origin Si n tore
Please place Profes" 0 (� i F "
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TOWN OF SOUTHOLD PROPERTY REC MNO ..
OWNER S4RE T VILLAGE 1 DIST.1 SUB. LOT j>
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FORMER OWNER r N E ACR.
x€ s g W TYPE OF BUILDING
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RES. t SEAS. VL. FARM =COMM. CB. MISC. Mkt. Value
LAND IMP, TOTAL DATE Rpry, RKS
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UI�DING C"I 10 -
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FARM Value Pe- 6661 -
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Tillable 1 -- -
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Tillable 2 [ _ _ " '
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Tillable 3
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FRONTAGE ON WATER f
Brushland FRONTAGE ON ROAD �.
f DEPTH
House Plot I
; BULKHEAD
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Total I i DOCK
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Extension :Basement Floors ; =K- i
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Interior Finish .
'Ext. Walls � �
Extension �
Extension e s I _ Q
4 F,
_� F're Place Heat
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Type Roof` �- R ooms 1st Floor i BR.
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Porch 'Recreation Roo rri ;Rooms 2nd Floor! FIN. B
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of Sftp,y Town of Southold
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
PRE-CERTIFICATE OF OCCUPANCY
No: 46845 Date: 02/06/2026
THIS CERTIFIES that the building PRE-CO
Location of Property: 7592-0 Route_25 Greenoort.-NY 11944
Sec/Block/Lot: .--1-1
Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 02/05/2026
Pursuant to which Building Permit No. 52657 and dated: 02/06/2026
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:
Wood frame single family dwelling with front covered porches and accessory wood frame
two car garage.
Comments:
None
Violations:
None
The certificate is issued to: Isaac Israel, Stephanie Israel.Herbert Israel
Of the aforesaid building.
Please see attached Housing Inspection Report.
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Housing Inspection Report
Property Info
SCTM #.�.�w..�...._mm�48.:.-1-13 w._.........�.��_..... � _..., _.... _............._�......,�__......_� .,Property Class..:_�w........_.._210 ONE FAMILY RESIDENCE�_�_�_�_..._�._ �............
Address: 0 Route
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.._.._�� Israel mm
Ow .....�.�.�_.w�.�.�.�M... ._. �. ..� ......... _ .�.....�.�.�.�.�.�.._ Co dition of Property.
y ......��............
................_m_.w�........_....�.._m�_..... __............._._...., ...... .
Structure
Construction: Wood frame Number f Stories: 2
FopundatCon �,.w�._. ._ww..w_._ �........... of Exits:
Construction: Stone w_. w _........w...w�............_...� ...�.�.�_..�.. .._..., .__m.ber�_.. its: ......�.3,._. .................._._.w�_._._.._..._....� ........._._.,_ �............wwm.
. .___w.... ........... ..._.. .............. . w
..fi n_ishe_d..m..B._a�s e.m�...... v.�....ww.wwwww......_....,��...�_...�..�..____w_.�.. .,�......_�
Cellar: www .....M_ww_..__.._. �. __w_.._ �w_............_.
Cr.w.w�.._�_...�ml..Space:
...
_....w. w....__ w.....
w .................
Garage: Breezeway: k Type: ,_........... _..w......w..M,.,.,.,........._.................., _.......
Porch Type: 2 Front covered porches Patio Ty e: Mudroom:
_.
Building Systems
Electric .__..mFuel lyp : Oi.l... _.
Type of Heater: . _... __ .._.......___._.. ...........
Hot...Water::.�.�.�.�.w.-.,_...Baseboard &domestic hot water....... _. .w. ....... ,._Electric Panel..°.. ._. w.. .. ....... .._ ..__..w.. _...... _.... ...........
.� _ .._.m�w�_ .. ...__._W...._.............. .
Air Conditioning: Fireplace: 1
Dwelling Components
Rooms/Floor Levels Sub 1 2 3 Additional Items:
_....... ... .
Kitcheni _�_� �.�.....�......�_. .............__...� ._�...�..�.....�...........�
Living Rooms _..............
Dining Room -
Bedrooms _.... ._..........._�.._......_.�.................... ........3�.�.�_..�.._.............__.w.._�, ._.._�........�.�.................�,...�w .w�_�.�.�....................,._w_...._ _..........._._........... .w.w_.�......... ...._._.........,
Bathrooms 1 ......
�.�._..__..,.�_. _..�.�...._�w. _w.... ....�.., _w�. ....ww�._..............._.....w�.........w�._._....__��..........
�_..._..
1 __._�_...�.� ..._.�.� _�._....._._.
Toilet Rooms........._._ ....�._..__m�w��..__.. ....._w ......._......................... �..._...........�.. �......�w_. ._..� ........... ww...�_�_�...................._.w�...�.��......,w.._..._.... �._�.��w.�w.........M�
Utility Rooms _. �.�.�.�_..._�.._. _.�_�_......�.._._....,.
Entry Areas _.._.
Other. ........�....
Accessory Structures:
Garag: e: .. ....Construction......._......Woodfr._aamwew .. _._w.. ... ...m Foundation:
ation
_ .
Barn
_... w......................_. __.......
Construction: _....w_M....
�. ___......�......vw..... _....�._.�.�._�....... _....... Foundation: _.�.M_ .....�w
Shed: Foundation:
w_�_�..�w ..�............_.__.__... ...._�.�............_w_.....��........�................_. Construction_a...............ww.....m..�....�... _._..,_ _..__ ............www_.............__........_. _..__._,. ._..........__ ..._.
Sleep Quarters: Kitchen Facilities: Plumbing:... _.......w... ._._.............
Swimming Pool:
...............
Other ...........
Comments:
Violations:
None
Inspected By: John Inspection Date:�..._..._.,. 02/06/2026 .............................. m w. _�....
..........w_ J.Jarsk Inspecti................... ....w....mH....... ....... ............._.__...._.ww.._._._
$ Town of Southold
P.O. Box 1179
53095 Main Rd
� ON".,�� Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 46437 Date: 08/22/2025
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 75920 Route 25 Green ort NY 11944
Sec/Block/Lot: 48.4-13
Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 03/15/2024
Pursuant to which Building Permit No. 50978 and dated: 07/24/2024
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:
In-ground swimming pool addition fenced to'code as applied for.
The certificate is issued to: Isaac Israel Ste hanie Israel Herbert Israel
Of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL:
ELECTRICAL CERTIFICATE: 50978 8/18/2025
PLUMBERS CERTIFICATION:
l
utho '°° Si tore
of savvy Town of Southold
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
. .,,_. __.......�...._ _ ._.. ._._.. �_. .. _............_...._...........�._....._...... _.._......... � .......�..............�..�.�w.._.�...._....w.....�........_................._............_M.m_w..._ ._......._
CERTIFICATE OF OCCUPANCY
No: 46835 Date: 02/02/2026
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 75920 Route 25 Gr e ll.p t NY_11944
Sec/Block/Lot: 48.-1-13
Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 04/19/2023
Pursuant to which Building Permit No. 49312 and dated: 05/25/2023
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 to existing single-family dwelling as applied for.
,
The certificate is issued to: Isaac Israel, Stephanie Israel , H„w...vw.erbert Israelww.w ...� . w...w.w.�._ ......._m__....w.w..__.w__
Of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL:
2 01/13/2026
ELECTRICAL CERTIFICATE: _. .._.....� .w....._.................___.493_.._._..w__.. ...�.....,_._..........�....
PLUMBERS CERTIFICATION:. Nate.Edin ors 01/08/2026
Autl on)dS gi'maire