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Home My WebLink About1000-46.-1-31.1 (Unit D36) Rental Permit 1424 Owner: Driftwood Cove Owners Inc (Harbich) Occupied as: Apartment D36 Located at: 1000 Ninth St Greenport 46.-1-31.1 Maximum Permitted Occupancy: 3 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: 03/04/2026 >��n Expiration: 03/03/2028 Codi Eno n i This Notice must be posted by the main entrance at all times A 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 limit s,://ww ,sotit.lioldto rni,i RENTAL PERMIT APPLICATION 4c'W4 43 2 Rental Permit Fee $300 (Application must be renewed, y two�ieqr .�'( ar s rrklr . Section A. Property Information:. Rental Property Address: Tax Map Number: 1000 SECTION -OA-O 1 -BLOCK -LOT 3/ SECTION B. OWNER INFORMATION: �+ Property Owner Name: /) 7— / 4446 ± o�1en1 t+��BAG Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) d ,per LLRnI e- -1 (AlWt z, Telephone Number (s): Daytime 1- Evening63i L''9S-12 ,kmergency Property Owner Email Address: &erV 1)09r lrl Page 1 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 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. r Rental Permit Fee: $300.00 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: I,f MIV4 Address of Authorized Agent (no P.O. Boxes): S Mailing Address of Authorized Agent: p�� '< <��6 sa i"� //9 4ir— Telephone Number(s): Daytime 04 -60 Evening�91-agJ-6 i6Emergency 631 L&L-46ol Email Address: Section D. Managing Agent Information: fiyrac�evs 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: 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: 434 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: 9&4k 9 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 0 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) p 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 Owners Name: Property Owner's Signature: Sworn to before me this_day of 20_ Official Notary Public Signature and Original Notary Stamp Page 4 of 4 Town Hall Annex Telephone (631)765-1802 54375 Main Road P. O. Box 1179 y ze , 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: at sou ° * ' TOWN OF SOUTHOLD BUILDING DEPT. +� 631-765-1802o AN& Ewa INbrPECTION [ ] 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: le- p- 2 ps a/� DATE INSPECTOR Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Te1: 631-765-1802 mZA, SCTM # - Date 3• Owner " If Phone Address �i2/ oo� ' Y - W( Visible Hamlet ,� , Inspector Floor Level Quantities Sub 1 2 3 Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress Occupant Count Building Systems Maintained &Operational Condition 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 Pool fence to code requirements CO's for all items present Comments: em 4 _ TRIM � R _ I f , e I 46.4-31.1 10/2014 m, is 46-1-31.1 2/03 I f � Extension n n i Extension Extension Foundation Rath Dinette Porch &asement Floors K. Porch Ext. Walls Interior Finish LR. Breezeway Fire Place Heat DR. Garage Type Roof Rooms 1 st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. B O. B. Dormer _ Driveway l - rt TOWN OF SOUTHOLD PROPRI T BARD - OWNER ISTREETVILLAGE SUB. :LOT, FORMER OWNER �yN E I AC -- P � R t is W TYPE OF BUILDING mc Pi 1. - FA RES. F SEAS. 'VL. FARM COMM. CB. MICS. Mkt. Value ` LAND IMP. TOTAL DATE REMARKSI-I ffi�/Z . _ F" . 1, jea > Oil 3 e r � - 1 m� f > ! - o T Ll i i r - / z�3 0 Titl�bie FRONTAGE ON WATER Z 3 Woodland Meadowland House Plot BULKHEAD I t E , Total I I I , r r COLOR TRIM ! A f` Ste 44I� ' � T A E old I izki 41 Xj E a ' 3 M. Bldg f D l - 7 _r-+ I iI7 ales . I , Extension . Extension -MOIP _ - a i C Extension a7i 7,9-,L I Foundation Bath - ?Dinette Porch Z ert Floors K. . Porch � �' r �Ext. Walls � Interior Finish i LR � Breezeway - 'Fire Place ?Heat t DR. e � Garage j Type Roof Rooms 1st Floor BR. . F Patio k Recreation Room Rooms 2nd Floor FIN. B O. B. Dormer Driveway i I i Tot®I i i i I FOUR NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. XWO. . . . . . Date . . . . . . . . . . . . . �. . . �. . . . . ., 19. 7a THIS CERTIFIES that the building located at .Itj&. F6d(jffl25).* •9tk• $t Street Map No. . . . . . . . Block No. X,. . . . . . .Lot No. _Oreeltpnr t s. Key.. . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . .April. . . .30_, 19.73. pursuant to which Building Permit No. 41W. dated . . . . . . . . . . . .April. . .80, 19.73•, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .osw & bedroosssr. apartment. --buildings. *C"q ry$. .W.Driftwwd.0. The certificate is issued to X.X.Co►ast-ruet on•Corp• - - • a'r'. •(I.Draianos). . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Pub. water. A. Saver. appromal UNDERWRITERS CERTIFICATE No. "C0,4u itss l R074 • . D"a4 VMLtssw 122'jb24V 222902 S2250271 "0- itswt--122502 ► - HOUSE ' ER . . . . . . . . . , . . . . Street . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . Nova* i►umbors to be assigned on aouplstion of project Building Inspecto