HomeMy WebLinkAbout1000-42.-2-10.5 (Unit 1) of so TOWN OF SOUTHOLD
tc Rental Permit
1461
Owner: Greenport Group LLC
Occupied as: Apartment - Unit #1
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 arrangin for the b'-annual inspection.
Issued: 05/12/2026
Expiration: 05/11/2028 Co E r eJent ors"al
This Notice must be posted by the main entrance t all rues
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rg so
Town Hall Anti Telephone(63�1)765-18U2
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54375&lain Road F7 t(E+31)76s-95fYZ:
smtatold,NY 11.971-C�9
TOVN Off" SOUTHOLD
-Mff U t 3.1 -7 Y'g7W,T v ra n
ION
Rental Permit Fee $200(Application must be renewed every twO Years)
Sectf'on A.
Property Inforrrbafton:
Rental Property Address. �.
0�1
Tax Maps Number: 1000 SECTION �g ��L 0T
SECTION B.
OWNER INFORMATION:
t
Property der Na�rre: A�
'
Property Owner Legal Address: Property Owner Mailing Address:
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Telephone Number(s): Daytl:me' 1 -�03 1131&ning Emergency
PropoirtyOvvnerl=M�WiAddresss-4&14JLF4�,
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l7� 1 Page I of's
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Town H l Annex Telephone(631)765-1 W2
54375 Main Road „' (631)7,65LL9502
moo.Rox 117 ." .
BUILDING DEPA
TOWN OF SOUTHOLD
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section C.
Authorizers Agent information:
Name:r f Authorized Agent of dwelling unit,if an
Address of Authorized Agent(no P.O. Boy
Mailing Address of Authorized Agen
Telephone Number (s):DWI ��� .�. Evening-- Emergency
Email Address:
a
Section D,
Managing Agent Information.-
Name of Authorized Agent of duelling unit,if any,
b
6
Address of Auth.brined Agent(no P.O. Boxes):
°. 1 -
Mailing Address of Aiithorized Agent:
Telephone Number(s): iaytlrne jifl 4LA � ering Emergent
Email Address: _Ac.i
SECTION E.
SITE MANAGER INFORMATION: (regU1r!#. sr jjtat properties containing a or more rental units)
s
g l I nit,if any:Name ol'Mena �n Agent of drel� �,.�.�,� .�.,�_mm ...��A ..�..._... ..� .
Address of hAlanaging Agent, (O P.0 .
Page I of 5
a
,4417,1
INY 1 101$� M!
P,
TOWN
OF WATIMOLD
11 allins Addressbf ana ink Agent
Tele hoot Number ytlr"O enll�p Emarpen��.
SECTION F.
.PRGP.ER'TY DESCRIPTION::
,Number of mental Dwelling.Units on property
For each Renta[Dwelling Unit set forth the Rental Dw olfi g Unit identifier(liar example;
Emit 1, Unit 2, Uhlt 3 or Apt A; R; C');the use of each room in the kotal D elbrig lin t
(fear example, Kitchen,Bedroom,1,8e&aom 2, UvinR Room) and the di tensions off each
roorn.
For properties with multiple Rental Dwelling Units use"Dental Permit Application
ay
0111,
Rental Dwelling�Unit Identifier— IN
Requested"Maximum number of persons allowed to occupy Dwelling llnitE �, � .
Umb r of morns in Aental 0*411100 Unit;
Use and Dimensions pf,each, o � d� ?, its
F
4� 37 s aia�12o �# Fax(630 7CS-9502
P'.0.: x 11.7 E axF
Southold,NY' I 1971-D959
BUILDING!MPARTmENT�
TOWN OF SOUTH L I.
SECTION f
Pursuant to the Yawn Code of the Town.ofSovthold Chapter 297(pental Properties),a safe
Inspection by Code Enforcement Official is required, if the owner chooses not to have said
inspection perf armed'by the Town, a certifitation from a licensed architect,a licensed
profess'ior.ral_engine. er or a home inspector-who has a valid New Mork State Uniform Fire
Preventidn,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 lae adopted by the New York State Dire Preventlon and Building:Code Council,
' C am requesting afire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
0 l am submitting a co noleted Town of Southold certification form from a licensed
architect or a licensed professionat engineer, S�
SECTION H.
DECLARATION: Signature must be notarized`and MUST r be the owner of the dwelff»gr wait.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)�
certify under.penalty of perjury,the:f€Mowing- �
1. l am the owner of the property identified In,, "Section A"of this application.
r�
2. The property owner's legal address set forth in."Section 8" of this.application is tray legal
address and I understand the Town will use the address for service pursuant to all
i
Page 4 of 5
�f
Town 11a4i Annex a `etepl oft(631:)765-1.902
P.0 Box 1119
9
WALDING DEPARTMENT
TOWN 011? SO ,OLD
applicable laws and rues, I further acknowledge that]will notify the Town of Southold::
IWO
sullding 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 a d
agreed to abide lay the same.
4. twill notify the Town Within five(5)buslne.ss da.ys as to any charge to the information
�regarding Autliarired A
gerit,.Mahagitig.AgLiht: ,OrSittM nagern
Property Owner's Narne:
Property Own e.e.s Signature:
S,ororn to before me this�day of L) 20 M� � �
}l$iC1al lV tart'Prik�Il Si at ire and Ori Inai rotary Stamp
DIEGO F VARELA
Notary Public-State of New York
NO.01VA6392915
Qualified in Suffolk County
My Commission Expires Jun 3, 2023
Page 5of5
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O"IJVN O so
UTHOLD BUILDING DEPT.
631-765-1802 N�� `Z. 10.
I N E%Chk T I N
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] INAL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS
�1' l
DATE INSPECTOR
i
OCCUPANCYCERTIFICATE OF FOR COTTAGES
TOWN OPSOUTHOLD
WILDING DPAPLTMENT
tht RUM&N Iwr �tawr
Town 04"
Southold.Ky.
Certificate f occupzmcy
#3#. .31 r Date
"is MATMES that Ut ttltding .J.ACTUac,MIT
;.. ;.,..J, �,J.,. .,...a,. ..
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;zttafturtfalty wft APP11041ioll for UVWng pwftIt t1aaTorow flab In thts ortce dated
t+ra Pptt 1 tht low.Tam 099VW4 for wtdoh this ccxft3S o 15 isswitd is
'a3°F@$8i9ymc,& �eW&, �Wm q,�� $y&�}g, '' q Y• !IX d"'F 9'CHea®Y S'.,,b'v I ti F i I e r b e J a:6}a a k a a d....
ttdt
(IP77 )
oe
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Rear APPROVED AS NOTED
I L
Rear
DATE: -IA- L BP#--
By,
ILDING DEPARTMENT AT
NOTIFY BU
COMPLY WITH ALL CODES OF
4PM FOR THE
1-7
NEW YORK STATE&TOWN COD,
wh INSPECTIONS
INSP
AS REQUIRED AND CONDITIONS
FOUNDATION--RNO REQUIRED
6"5' SOUTHOLD TOINNII BA,
FOR POURED CONCRETE
'A 'KI
C&
- ed S1,V1 i GL 2 1 OIr L NIZG BOARD
5: ],,, ROUGH-FRAMING&PLUMBING
B
SOUIHOLDMUN TRUSTEES INSULATION
Room N.Y.S.DEC FINAL-CONSTRUCTION MUST
F6'
Bea
SOUTHOLD HPC BE COMPLETE FOR C.O.
Room C:1.L SCHD
ALL CONSTRUCTION SHALL MEET THE
9 S< 9' REQUIREME
NTS OF THE CODES OF NEVV
YORK STATE. NOT RESPONSIBLE FOI[I
DESIGN OR CONSTRUCTION ERROBSi
Additional
Wash/cry wash/dr i
4
T
Both Living Certification I
U
Both 67 U/T EP I p "
J
Be Required.
r C Room May,
C/L 3�
5' hr
Living I on
-7-17
C/L
1 3-3
E
3— LECTRICAL
L F INSPECTION REQUIRED
Kitchen
3'
0., 5jol -5. 3-3' 4�
,- 3' 31 1-5-Kitchen 1—
Q
61-,61-C
ref. rll F�- Id IQ Id/w LJ ref. I-5--t-4
/w!
L—T 3
stor,
e Bed
Dd 0,
I
1 78*
Room Front Room
UNIT 21 3-3------------T-
3- stor,
EI ec x
FLOOR PLAN 3/16" = 1'
LIX
�2 N Rd
N,
R— F-sid—tial FLOOR Pl-kN
2
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1/1 R�/�24 2 5