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Home My WebLink About1000-42.-2-10.5 (Unit 3) of so TOWN OF SOUTHOLD Rental Permit 1463 Owner: Greenport Group LLC Occupied as: Apartment - Unit 43 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 arran ing for the bi-annual inspection. Issued: 05/12/2026 Expiration: 05/11/2028 En rc ent Official This Notice must be posted by the main ent nce a all time own ill n x C Telepherw(63 t)765�-I 32 Fa�x(631) 65 9502 ,543�75 Main Road Southold.NY 1197 TOWN OF SOUTHOLD Rental POrMit Fee $200(APP11CONOn Mug be f0ntwed evIery twD years) section A. Property Iri,fOrmation4. Rental Property Address: ,. ., Tax Map Number 000 SEMON _� SEA" ON S. OWNER INFORMATION' Property Owner Name:—J-5 Property owner L8gal Address. Property Owner Mailing Address Telephone Number 13 I.&r1irt Emergency proporty Owner Email:Address; � � � , . Q. ` � �� Town Hall Ann z Telephone(631)765-13t1 " Male �R Fax(631)7465-9502 507-SCc ]BUILDING DEPAR'rh4P.M' ' OF SOUTHOLD Authorized Agent information: Marne of Authorized Agent of dwelling unit,If a Address of Autthorized Agent(no P.Q. Box Mailing Address of Authorized Agen /,, Teleptyane Number(s): Dayti _. ._ Evening, Emergency Ernall Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit,if any, Address of Authorized Agent no PiO. Boxes F Wiling Add ress of Authorized Agent: Telephone Num.ber(s}: D yt me i�' —4 a 4verlin Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (rer)uire ' r rental properties containing 8 or more rental units) Name of Managing Agent of dwelll u".It,if any: "" Address of Managing Age?�AfroP,O. Boxes):-- Page I of S i" Telephone(63 i).765 1802 , a 1VJ1iXYt,N0,is' PA TMRrNTmay Mailing AddrOss bf Managing Agent, Talieohot 1�Y-'F7ii9 be ( a M% Flu #kti T+l�, .10 "'ht Wl1'��,r:C,^amnr.grrRr,:au,udtt^'muea 'ca' EIl6F 'C'S y- wswurmamwrsm«..w . i-m ii , w u ar mm wn h �' n mn SECTION F. PROPERTY DESCRIPTION:. Number of Rental Dwelling Units on property; Far each Aental�Dwelling:Unit set forth tho Rental Dwelling Unit Identifier(for example; Unit 1, Uriit 2;Un1t 3 or Apt;14,BA C),the use of eat room in the sternal Dweliing Una (for exem:ple,:Kitchen;Bedroom 1, Bedroom 2, Uving Room) and the dihiensions of etch rooms.. `i or properties with muhlple Rental O welling Units use"rRental permIt Application ddendw mt Rental Dwelling 0hit identifi r: Requested Maximum rwumber of piers ins Qliewwed to,occupy Dwelling Veit: Number f room it! Oerjtai Dwelling 1st and Dimensions,Cif eat l µ rap . qf SO Town Hall A ne-x `fe}hone(631)76 5-1 Cr2 P.O..BOX 1179 TOWN OF SOUTHOLD NS E"C IO i pursuant to the Town Cade olfthe Town of Southold Chapter 207 fl�eritsi lsroperties,a safety inspection by Code Enforcement Official is required, if the ownerchoos.es not to have said inspection performed by the Town, a certification from a licensed architect, a licensed professional engineer Q.r a home inspector who'has a valid New York State U111form FIi'e Preventi0h,8uitdiiig Code Ceitificat oh is;required stating that the prnil"which is the subject of the rental permit applicai`ion is in compliance with all of the provisions of the code afth I Town of Southold,the taws and sanitary and housing,regulations of the County of Suffolk and by the.lawt ddpted by tine New York Suite F€re:Preventidn and Building Code Council, i am requesting afire safety inspect-Ion to be performed by a Code Enforcement Official: from the town of Southold 0 l an, submitting a co€noloted Town of Southold,certification form from a licensed architect or a:licensed professional engineer, SECTION N. D ECL RATION lgne Lure must be notarized e,d and MUS be the owner of the dwelling unit. STATE OF NEW YORK): COUNTY OF S€ FFOLK) l . r, certify under penalty of perjury,the following-, 1. i am the owner of the property identified in "'Section,A,`of this application. 2. The property ownees legal address set forth Ifs 'Section 8' of this application is roy legal address and l understand the Town w1k use t#,e address for service pursuant to all Page 4 of 5 Sr r tekp io t(631:)765-1.8,0 'T"own Full A:nmx ¢" fax(�31)765:9s02 54,375 Main ROW CA ui P.o i 8e9 1179 �a ' BUILDING DEPARTMENT TOWN or SO OLD. *ppi#table lave and rubs, i further;acknow adga that I wilt n0t4 the TOWO of ovthold Biullding Departrnerit of any changes of address within five{5Y days of any changes thereto, 3. i have +read and received a copy of:Chapter 207 ofthe to&of the Town of Southold and ag-reed to abbide by the samla'. 4; l Wii n f ify the Town withio fiva f$)business days as to airy chagge to the infornlattior+ regarding Autfiorizdd Agent,Wnaging A ent; r Site M na er. Property o wnees Name. Property 0wner's Signature: Sworri to before me:this 1day of ."� � 013 official Notary i faiic Si nature:and Original Notary.5tamp DIEGO F VARELA ENotary Public-State of New York NO.01VA6392915 alified in Suffolk Jun 3ty2023 rntis;ionmcp` Page 5 of 5 a 1,ei iot 463 t.j,7654 f SS2, To";Hli Aritsdx: N 46u €al NY I1r'r,, BUtLIING DEPARTMENT OF SOVTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dw-tilling.Unit ldentrflgr: Requested maArrIUM number of persons aCCowed to otcupy each dwelling ur�ia: Number of Rooms in Rental Dwelling Unit: Use:and 01mensloh.of each tbbrn Rer:tal Dwelling Unit I en i r;;i+ii oIeaes#ec maxmurr ruim c helCitgrit �5re Number of Roo ns:hi Rental Dwelling U'Wts. else and'011mens.1tty of each room Rerr€al dutirelling Unit lcleiitikit Requested tnaxirnuro number of persons allowed to occupy each dwelling unit: Number of Room's in:Rental:O welling Wiits w Use and 01menMon of each room- of weir, ovi TOWN O SOUTHOL. BUIL. INO DEP°T. CCU 31-7 5-1 02 ��" '' � " �► I Nto`ik P mm"m T 10 N [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] INAL [ ] FIREPLACE & CHIMNEY [V FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN RATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: Intl -�Of �7 P4.1 i DATE INSPECTOR CERTIFICATE OF OCCUPANCY FOR COTTAGES TOWN OF WnHou BUILDINO 09PARTMONT t) t of the$0114 � ln"' tor IOWA C codolofe or, occupmty pr,91 tea r, ,t ...... ,.i4 owl the buadingawMUM,V XT.rtwit.it. ....ar... 9 gat � �014 "WI . vi a ." C'ounty TAX WP No. t eonn ,..» , .. as ara t 'iy t t9uC ti tt e €� i r e food oklkg do ig Al permit M6, ttv x � Wes hstied,W 4mr0mg toad of the Muirommls f 9M a0ficabli(wWwovis of ula 3g , a-s occvpwwy tor wMgh ch4 ottifi to Is lsy Pluxbora CgFecit`ic4t,e ter A : 19€t.Cs X e.,wP ,A 1!, aw µ ttq +3y/«x»nrq��..nax eb b �r�'.+�+wuc;�draxara:wm'r..�+r.Mvtlwr�gmrv*Gsygemnmw,m„w<-,.�mv�„..w,auum�weewsw.z� W CQ- APPROVED AS NOTED ZG - DATF j .3-t912k w B.P.# i' z $ � 5 G NOTIFY BUILDING DEPARTMENT AT 4� z35 631-765-1e02 BAM TO 4PM FOR THE COMPLY WITH ALL.CODES OF Q " NEW YORK STATE&TOWN CODE FOLLOWING INSPECTIONS., : "f AS REQUIRED AND CONDITIONS 9 i f FOUNDATION-TWO REQUIRED SQUTH4LD Ta6NN ZSA FOR POURED CONCRETE i n ROUGH-FRAMING&PLUMBING SOUTHOLD TOWN PLANNING SO L INSULATION SOUTHHOLLD TOWN TRUSTEES FINAL-CONSTRUCTION MUST N.Y.S.DEC ozo II ry o e' F BE COMPLETE FOR G.O. SOUTHOLD HPC i —J n I ALL CONSTRUCTION SHALL MEET THE SGHD Q € REQUIREMENTS OF THE CODES OF NEW - R YORK STATE. NOT RESPONSIBLE FOR75 DESIGN OR CONSTRUCTION ERRORS I' ! F�j z o j 01 i 3�I Additional I 17-71 \ ; iGshfd } P u Certification �., � .! i ,; �� May Be Required. 1 m ` ' " _ €( 61E I I C U: U 3 tt"� I I `� _�-�� `^'• ft \ 1\_�j' r� U Ifs 1 p 'C,� p' J Y mli if iE � � �I�C m s ELECTRICAL i - INSPECTION REQUIRED \ J �--� v j _ I [ III — ! iaa . I �n�1 P3 i E � I _ i I � � I I ;E t.'J