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Home My WebLink About1000-80.-1-4 TOWN OF SOUTHOLD Rental Permit 1435 Owner: Sally Coonan Occupied as: Single Family Dwelling Located at: 2662 Paradise Shore Rd Southold 80.-1-4 Maximum Permitted Occupancy: 6 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: 04/01/2026 Expiration: 04/01/2028 Gd Enforcem t official This Notice must be posted by the main entrance at all times " Town Hall Annex 54375 man Pm"P_O_Box 1179 SouthoK NY 11971-0959 Telephone 631 765-1802 Fax 631 "7 -"_5 htt�, Www-w_sotjo1 townnv.aov NNO , DENTAL PERMIT APPLICATION Rental Permit Fee$3W(AppEcadon-mint be renewed every two years) Section A. Property Information: Rental Property Address: �.�° t��C, t� c � 1 S Tax flap Number- SECTION , - . CK -LOT SECTION B. OWNER INFORMATION*# Property Owner Name:` Property Ownerl_-egad Address: Property Owner,Mailing Address: (Cannot be.the san-&as-Rentat Property re 216 4 " eleph ne Number(sl>11 irne ".�..M,�°..-� . ---Evening,..Emergency_ Property Ovv w Email Address Page Iaf4 Section C. Authorized Agent information.* Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(m P.O. Boxes): Mailing Address of Authorized Agent: Telephone-Number(&I.Daytfrrte. Evenft L Emergency_ Email Address: Section D. Managftftent WonTodone, Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent iino E.O. sl: Mailing Address of Authorized Agent: Telephone Number tsl•Daytime,__Evian 4 Emergency Email Address:, SECTION E. SITE MANAGER INFORMATION:(required-ft reast properties co nlas$-or more-€mtaf units) Name of Managing Agent of dwelling unit, if any: Address of Maw - nt(-no P.O.coxes): Mailing Address of Managing Agent: Telephone{Number Isl.Daytime_Evening_Emergency Email Address: Page Zcrf 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units an 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 Unit: L Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: _40 If' 4zle li4�&0 0 /t,( 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 statingthat 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. F/I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 0 lam submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 0 r� For each Rental Dweii ft Unit set fai h the Rental Dwelling Unit• i er ff or 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,laving Room]and the dimensions of each room. For properties vAth muftiple Rental Mveffing t:inits use"Rental fermit Application Addendum." Rental Dwelling Unit Identifier: co Requested Maximum number of persons allowed-to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: L2 t L (Use and Dimensions' each room in Rental Dwelling Unit: 1-6 i SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties),a safety inspection by.Code t nforcement€ ff€cial is required. if the owner cases not tG 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 Buildft Code Certification is nquired statingthat-thep rty-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. " l amTequesting s inspectiont+o be performed by a OxIe-Enforcementofficial from the Town of Southold 0 1 am submitting a completed Town of Southold certification form from a licensed architea or a licensed professional engineer. Page 3of4 SECTION H. DECK MN: Signature must be notarized and MusTbe the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF-SUFF€7LKI 1 &0 � °'C b2,A certify under penalty of perjury,the following: 1. 1 am the owner ofthe prop"kieffffied in OSection A"of-this application. 2. The property owner's legal address set forth in "Section B" of this application is my legal address and 1 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 Depwtmerrt of any charrges of address wMin dive(S)days ofany changes thereto. 3. 1 have read and received a copy of Chapter 207 of the Cade of the Town of Southold and agreed to abide by the same. 4. 1 will notifythe Town within sae JS)businessdays sto any change-to the information regarding Authorized Agent, Managing Agent,or Site Manager. Property Ownees Name: 4 4 Rropertyt3r's Signature: S r t befo e t ` day of �,(11��1, , 20Z5 gi al Notary Stamp NEVA HOFFMAIER NOTARY PUBLIC,STATE OF NEW YORK Registration No.02HO6097177 Qualified in New York County M•>KNiHit g1t_imP?RlSIN3Ad�[�1�t18:2A27 Page £ VIIAIM TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 00_/ 1 1 IN S Pmcm Cm;` T Ro% IN [ ] FOUNDATION 1 ST/ 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: /CA/w.�) 0 O, Sj(40 fie. n i v` kS o �2 �Sd✓L � w DATE ��• _ __ INSPECTOR � Town Hall Annex TOV1/n Of SOUtI1OlCI 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 N SCTM # Date 426 Owner Phone Address s,C, Visible Hamlet Prispector 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 � / //� /✓//fly ///�r � ,,, CO s for all items present Comments: r'7 TOWN OF SOUTHOLD T �/� 8/��CARD OWNER STREET `' ' VILLAGE vi,)i Kit-1 1SUB. ' LOT I FORMER OWNER N E ACREAGE 's 1.:•, S ) W TYPE OF BUILDING RES,�2 � (� � SEAS. VL. FARM ( comm. IND. CB. � MISC. LAND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Wcodlond Swampland Brushland House Plot } I T s e Q § - { ZL i- i { 3 80.4-4 09/26/2017 _I _ E I � , �, „ Foundation .G� Bath M. Bldg, �� , l;' — ,'!r� a �3 / ,' i Extension Basement -U j f� ; Floors Extension �£ Ext. Walls Interior Finish _# P Extension I ! Fire Place �` Heat L � Porch � Attic t ti -� Porch Rooms 1st Floor fin — �. o l �a5C , _ m Breezeway! Patio Rooms 2nd Floor Garage Driveway O. B, IrU 1 L Fitt t Town of Somthold 5/1412015 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 37557 hate: 5114/2015 THIS CERTIFIES that the structure(s)located at: 2662 Paradise Shore Rd, Southold SCTlbt 4: 473889 Sec/Block/Lot-. 80--1-4 Subdivision: Riled Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 37557 dated 5/14/2015 was issued and conforms to all the rerluriem ants of the applicable provisions of the law.. The occupancy for which this certificate is issued is: The certificate is issued to Potts Jr,William&Potts,Acme (OWNER) of the aforesaid building_ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO, PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED hNSPECTION REPORT_ ' ....... 'gym ..... r .... ....... A�l �rtd Signature LOCATION: (number&street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S)': OCCUPANCY: (type) (owner-tenant) ADMITTED BY: - ACCOMPANIED BY: KEY AVAILABLE: SUF+F.CO.TAX MAP"NO.1000- SOURCE OF REQUEST: DATE: DWELLING TYPE OF CONSTRUCTION: und � - ' #STORIES:_�#EXITS: J� FOUNDATION:� .__. ..�.BASEMENT: /C4,ff _CRAWL SPACE: #OF BEDROOMS: IST FLR: 2ND FLR: 3RD FLR: DATHROOM(S): TOILET ROOMS{ } ��. � ,,.UTILITY ROOM:_. PORCH TYPE: DECK,TYPE:,. PATIO;TYPE: BREEZEWAY:' . FIREPLACE: GARAGE: DOMESTIC HOTVI ATER 'AEJ' TYPE HEATER: A:IRCONDITIONING: r— TYPE HEAT: 0 � WARM AIR: HOTWATER: #OF KITCHENS: ov-p— FINISHED BASEMENT: YES NO OTHER: i ACCESSORY TRtjff RES GARAGE;TYPE OF CONST.: STORAGE,TYPE CONST.: SWIMMING POOL: GUEST,TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144&N.Y.STATE UNIFORM FIRE PREVENTION&BUILDING CODE LOCATION DESCRIPTION ART. SEC.. REMARKS: r INSPECTED BY: DATE OF INSPECTION: TIME START: END: I SURVEY OF PROPERTY t LAND 5ul�EY ...� �� .m�t �-�rroFso►macv SiWRXKCO[ItMNEWYORK Sq b&Tax MV No__mw*-8o-oz-4 foal iwaca� e^�r�r� SrAl.IE:a"=3d arvmmwarruvaw�a�, xrarao sy�,�, .. tTs i .a� L:9 �''"'�, to �r i CV QLl ,. _ DRY w a 44_95 DRIVE ON Or) f rs;C '�" 5 Al £! 4e €f i _¢ e C } 1 1qS --------------------------- co � i�� pl�nnniii i iouououuu �q � �i 1 lwwo�" i �W %i 11r1 " f r Downstairs bedroom#1 2 I IIIIIIIIIIIIIIII „,,,,, uuum / J / / / If 1 Downstairs bedroom#2 3 �f 1 ; t Basement 4 �w ,, rr M� Hole repaired by outdoor shower 5 l„ i r rr / r r G' a llr��rn" � rn n G JN e >a„ r r On Feb 27, 2026, at 2:44 PM, Mejia, Evelin<evelinm@southoldtownny.gov>wrote: Good afternoon, We received the fee and the room dimensions,thank you for sending that in. I will contact you for scheduling once the permit renewal is processed. Kind regards, Ivef n Meia Office Assistant 6