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Home My WebLink About1000-42.-2-10.5 (Unit 6) TOWN OF SOUTHOLD Rental Permit 1466 Owner: Greenport Group LLC Occupied as: Apartment - Unit #6 Located at: 920 Chapel Ln Greenport 45.-2-10.5 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: 05/12/2026 V AnLi Expiration: 05/11/2028 natal de n rcement Official This Notice must be posted by the main a TowaHail A.nntac ' 54175 MaRl ROad Pic(fill)'? 5=95 Yd Southold,fly 11.971 tjjLf)1 G D8PARTMENT A U r, - 2 2019 .,. TOWN of SOUTHOLD MAELLISATI :�: Rontai Permit Fee$20.o(Application must be renewed every Mo years) Section A. Property informetiGn. Rental Property Address: Tax Map Number: 1000 SEl:710N �". - LOCK_ - C��" :SECrION B. OWNER INFORMATION: Property owner Name: �, r Peoperty Owner€qai Address: Property Owner Malling Address: telephone Nomber(s):Iiayt�:me i�ver�irr� Emergency Praporty Owner1mail Address. q Page I of 5 W Town Telephoft(631)?65-11;a2 Hall Ar ne 502 7'S Main€dos Fu��S3i)7C�4 TOWN OF SOtrrHOLD Authorized Agent#nfbrmatlon: Name of Authorized Agent of dwelling unit,if an • �� Address of Authorized Agent(too P.£�. Bo Mailing Address of Authorized Aged .. Telephone Nurnber(s): Dayti Evening _ _ ._ g Email Address; Section Q. Managing Agent Information: Name of Authorized Agent of dwelling unit,if any,, _ .. Address of Authorized Agent(no P.O. Ma'ilingAddress oaf Authorized Agent; Telephone Number(s);Daytime i;�. 041Wl venic�g��. Emergency Email Address SECTION E. SITE MANAGER INFORMATtitJiV:(require r rental properties containing or more rental urEdts) Name of Managing Agent of dwelli unit, if any: Address of Managing Agen P.O. Bo es)__ Page I of 5 � r n c (631)765-'95 2 6 "- Fp TOWN OF, T: LD l 41ling Address bf Manogjng Agent: SECTION F. PROPERTY DESCMPTIOW: Number df Rental Dwelling Units on property �. For each iRentgl`Owelling.Unit set forth xbe Rental Dwelling Unit identifier lf�r example; ,unit 1, urot 2; Unit 3 or APt Ao 8,CJ,the'use of eacb room in the lkental Dwelling Unit (fear example, Kitchen,Bedroom J, Bedroom 2, riving Rom) and the dimensions df each morn. For properties with multiOle Dental Ow lling Units use#`Rental Permrl Application 7Renttil Dwelling i.init id'ontiftoi Requested Maximum number of;plersons all r et!1 tooiccupy Dwelling Unit. 'Number of roams in Aerital DWellin ,0nit. � Use and Dimensions ofeach, al ° � � ;It: ` p IV S. s, of S A 11;�Z� Town Hall Ahn&x Telephone(631)765-1 80 2 �" 7 s Main RbAd � � �� Fax(531)7�s5-9SU2 TOWN OF SOUTHOLD INSPECTOR. Pursuant try tho Town Code afthe Town of Southold Chapter i7(mental Properties),a safety inspection Ely Code Enforcement Official is required. If the owner chooses not to hav,6 said inspection performed by the Town', a cortificatlo.n frorin a licensed architect, a licensed prisfesslonal ongineer o.r o home inspector who has a:valid New York State Uniform rime Pteventidn.SiAildiq 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 ofthe County of Suffblk and 'by the lads addoted by the New York.State Fire:Preventldn and Building Code Council, l am,requesting a fire safety inspection to he performed by a Code Enforcement Official from the Towel of Southold 0 lam submitting a co€ ptoted Town of Southold certification form from a licensed arch'ltect or a:licensed professional engineer, . ... .. ..... . ... S.EC`I"'IO.N. M. DECLARATION: Signature ture Faust be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFF01X) ! �� „ certify udder pen4lty f perjury;the:ft�llowirrg: 1, i yin the owner of the property identified in "'Section+ 'of this apptiCation. 2. The property owner's legal address set forth in:'�Sectlon 13"of this application!s ray legaG address and f understand the Town will use ttie address for service pursuant to all .Page 4 of S 15S Telephone<631)76.5-1 t3 Tarn Hail,Anmx d" 43 75 Main Rx<OaO 765.9-102 Moi Box .1199 a 5ot)ovo1cl,NY #1371-0 BUILDING DEPARTMENT IrOWNOV-SOUMOLD applicable laws and rules., t further acknowledge that I will nM4 the Town of S".hold Building papartrrlent cf any changes of address Withi'r,five(5)days of any changes 3. f 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. i will notify the Town within five(5)business days as try any change to the information regarding.Authorized Agent,,Managing Agenf ear Site ivl rnager. Property Owner's Name' Property t3wner'4 Signat.pre: Sworn to before roe this dey of � —,2013 f Official Notary l ublie ignature nd Original 1Notary.$tamp Milo EDIEGO F VARELA Notary Public-State of New York No.01VA6392915 ualified in Suffolk County y mission Expires Jun 3, 2023 Page 5of5 r 1 3r Aitn x xi Telephone(631)755;1802. 1q " Pic(631)7.65 9502 ,543-75MRIA Road P (� P b MOM TOWN 01F SOUTHOLD ENLAA PfaMff 1 �ATION o-P Rental Permit Fee$20.0(Applic ton must be renewed every twD Mrs) SeCtI.On A. Property InfOrnlatiOnq. Rental Property Addres : Tax Mai p NiamEer< 1000 SiiON—±. flaw» -L T 12 SECrION B. :OWNER INFORMATION: Property+ wryer Name:ALU-1100-ri Property Owner tegal Address: Property Owner Mailing Address: Telephone Number(s):Da�lrn�� 13 l ite,rtlrt _Emergency----. y Property Owner E-mail Address., Page Tofu uq. Town H 1,�Mnixe Telephone(63l)165-1 it l 7:5 main Row ��r3f��dS-9� P; :14ox It 79 ro IMWN OF BOUTHOLD Authorized Agent Information: Name of Authorized Agent of dwelling unit,if an Address of Authorized Agent(no. P.O.Box Mailing Address of Authorized Agen Em- ofenc Telephone Number(s):Daytia �..��.�Evening__- i3 Er€iai!Address: Section D. Managing Agent information:. Name of Authorized Agent of dwelling unit,if any: Address of Authorized Agent(no P.O. Bt�xe } �� _. _�� .�, � + Ul Mailing'Address of Authorized,Agent-. Tele0hone Number(s):Daytime-1 . 'ivening .. �. Emergency Em ail r : SECTION E. SITE MANAGER 1NIEORMATIOiY:(require r rental Properties containing&or more rental units) Name of Managing Agent of d relli unit, if any: Address of Managing Agent o P.O. Boxes): Page I of 9 .i.. k Pen PeR i 71 BVILDINCI VASPARTMONT TOWN ()v ROMHOLD IwJlalling Addr6ts of Myna ing Agent imoll MOW', SECTION F. PROPERTY DESCAIPTION: Number of Rental dwelling Units on property: For each ftntal'IDWelling i; nit set forth the Rent4i Dwelling Unit identifier(for example; Unit 1, Unit 2; :Unit 3 or,apt Ai 8,0;the use Of each roorrr In tha Rental Dwelling Unit (for example, Kitchen,Bedroom 1, Redroorn 2, Uving Roorn) and the d1hiensfons V etch room, For properties with muklple Rental Oweiling Units use"Rental Permit Application d. .. " _ 'Rental Dwellinga init:idontifl r� � ---- Requested sted aximum number of persons allowed to occupy Dwelling Vnit4 Number of robrnt in tontal Dwelling n t.,Us e:and Dimensions,ofeach- ew kt. w„ar„"»,w:�ixrrnm �. n�w^rwncfduuwrrnuu+aa�„u�w,,�aa�w.m�wwaw�mmrnmvwu' �w .wa+ so A 1 r vn 11 hn x r t ohoiie( 1)7t:+�5-18c11 +1 7 11' i 1 1 i" Pax(631)35 - 9502 Southold,NY 11971-0959 "�:"+" F f3OUTHOLD SECTION Gi� INSPEMC N... Pursuarit fo the Tavern Code of the Town of Southold Chapter 207(Rental Properties), a safety Inspection by Code Enforcement Official is regv red. If the owner chooses not to have said inOectjori performed by the Town, a certification from a licensed architect,a licensed pro essiona engineer Q:r 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 nitary and#dousing regulations of the County of5uffbik and .by the laws adopted by the New York State Fire Preventivrl and Building Code Council, 1 aril requesting afire safety inspection to be performed by a Code Enforcement Official, from the Town of Southold a i an, submitting a completed Town of Southold certification form from a licensed arefiltect or a licensed professional engineer, S.ECI"ION. H. DECLARATION Signature must be notarized and MU$r be the owner of the dwel//rig unit. STATE OF NEW YORK) COUNTY CIF SU O K) 1 -- ,certify lamer penal p tteflowii r nng: a, l am th°e owner of the property identified In"$ection A" of this appllcation- 2. The property owner's legal address set forth in "$ectIon B" of this application,is ray legal: address And i understand the Town will use the address for service pursuant to all Page 4 Of S ass-i�i�� Town Hail Ar►xs>✓x ?s 54,375 Mato ei x(631}7�5-9sCi2 ,Oj ftx i1 79m w -09 q l �A -OUILDING DEPARTMENT TOWN OF SOUTHOLD applicable laws:and rubs, I.further acknowiedge that i will notify the Town of Southold Building Depo tment of any change s:of address within,five(5)days of any changes thereto 3, l have read and recelved a copy of Chapter 2.07 of the Cade of the Town of Southold . nd agreed to abide by the sere, #. twill notify the Town within five(5).business days as to arty Change to:the information regarding Authorized A4gent,ivlanaging Agent,ear Site nager. PropertyOwner's Name; PropertyOwner's Signature:, ,,._ Sworn to before Moo this day of ��20a f icl i Notary Publk ignature:and Original Notary Stamp. DIEGO F VARELA E y Public a State of New YorkNo.01VAb392915 ualified in Suffolk County mmaissw Expires Jun 3, 2023 Page 5 of 5 S � , k � �w µ �; T�tephone��631�755-18t3� Town Hall Avrnex Fax:(631)765-95U2 54375 Man Road P.0,BOX 1179 BUILDING D PAP.TMENT TOWN OF SOVTR()LD RENTAL PERMrr APPLICATION ADDENDUM Rental Owellitlg Unit rt�lrr��*r of persons Requested MOXIMU p' ns allowed to occupy each dwelling unit:--�, Number of R orns in Rental Dwelling Unit;_ - use nd DlmenMon of each roio M t � l Rental Dwelling knit Identi r ,1 Ret nested oxit wm.numberof persons a owe to occupy each dwelling unit, Number of rooms in Rental Qwe. 11ing CJltit:. � Use and Dimension of each room; gental Dwelling Unit id"entifter U Requested maximum number of persons aftowed to occupy each dwelling ni Number of Rooms In mental DweilIng unit; Use and Dimension of earl:roam ` s out =UILD TOWN OF" S`�wIR UTHO D B G DEPT. 31 lNbrr.CTIU' N [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I SULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE TRATION F [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: _04 �w (q) DATE o4 INSPECTOR ti CERTIFICATE OF OCCUPANCY FOR COTTAGES TOWN O T LD S3 INS R "tom O"BUM svispotor "town fj#m southow. . certirkaleo mcy 1 . Date Pril 14— t4vdian of Poxrmty p¢Co,pay� x I ,e,�t ,......Pock .... ,a..�,d, ,� �� •.,.,,.a. &12d�bR�7� ,i r a a.•'...r,n.,n t..a 4,1¢k....,w� �i �w ,, .'.'r,.�t�. car � acmtiwr ? kh aq tv1 ft+ ibis d •, p,,; ,e>w. ,, l"1414WfthW4d,and MIMSID9' : t a t a sp of tho dowwa IgAwks, Y s 4 as �tM s : 1 ...vg4.iilau t,.e Y�•+i.NF Y1 rxe,Y,rs ax ,xis sm Pit iiI i�- I ro APPROVED AS NOTED CD DAB B.Rft—� A COMPLY WITH ALL CODES Ob-nFy BUILDING DEPAr-4ENTf NEW YORK STATE&TOWN CO -765-1802 BAM To M FOR --Ap HLUUiHEL)AND CONDITIONSFOEOWING INSPECTIONS: SOUTHOLD TOWN ZBA FOUNDATION-TWO SOUTHOLD TOWN PLANNING BOAR:OR POURED CONCRETE ING > S05OLD TO6VN TRUSTEES ROUGH-F1AMING&PLUMB 1 N.Y.&DEC INSULATION JUCTION MUST SOUTHOLD HPC FINAL-CONSTF (D (D R�= BE COMPLETE FOR C.O. 3 U TT I T SCHO ALL CONSTRUCTION SHALL MEN REQUIREMENTS OF THE CODES OFF NEV NOT RESPONS I EF)l RK STATE.CONSTRUCTION E'ROR IGN OR CO Additional 1 i Certification I May Be Require P/tTSDhS wash/dry' r— F1 ELECTRICAL r m, INSPECTION REQUIRED 111E—��Jlm I i0c4I4 00 201 �4 10 o0i d/M ref. ref. T 3 Q CT) Un