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Home My WebLink About1000-42.-2-10.5 (Unit 4) � of so TOWN OF SOUTHOLD Rental Permit 1464 Owner: Greenport Group LLC Occupied as: Apartment - Unit #4 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 Expiration: 05/11/2028 /%-odq Enf rce entoffi"a' This Notice must be posted by the main entra oceat tim � " Tolephoua(01)755-1 8Q2 'T'owrt HW I A nn6x r Ro2 E ,, P,O .Box 179 tS Pic(fi31 7 95 19" CJYi5L1 I 1.3T f- 9 LET bIN DEPARTMENT Toym of SOUTHOLD g ftEP -TION - •; t� Rental Permit Fee Poo(Application must be renewed every twO Years) Section A. Property (nformetion: Rental Property Address: Tax Kap Namber: 1E •$ECIION— ��M OC ' SECTION B. OWNER INFORMATION: Property owner Name:Atfjul.da o Pr€rpert:y owner Legal Address: Property Owner Mailing Address: Telephone IV.�I.m- ,ber(s):Daytlm 674c t I�renirr . � Emergency Property owner Ernaii Address;..L: ��61 �a (y Page i of 9 Town Is+�!Arrow Telepwne(631)76-5-1802 Fax(63 i)755-9502 ou,'s a� PA BOX 1179 solif Nrni . TO" OF SOUTHOLD 5ettio t C. Authorized Agent Information:: Norne of Authorized Agent of dwelling unit,if an Address of Authorized Agent(no P.O. Box Mailing Address of Authorized Agee Tefephdne Number (s): Dayti _ Evening-Emergency Email Address: Section Q. Managing Agent Information: (dame of Authorized Agent of dwelling unit;if any, Address of Authorized Agent(no P.O.. loxes.--� ),q °-2 Meiling Address of Authori ed Agent Telephone lumber(s): Ciaytlrne i /4 �' ening�� rnergency ti � r EmailAddress: i040 r)` ,SECTION E. 5i7"E MANAGER 111[FRCIA i 'OlV::(regrire r rental properties containing a or more rental units) Name of Managing Agent of dwell i unit,if any: Address of Managing Agee P,4. Boxes)-,_ Page I of 5 s wr p'4iM -4r TOWN or, rE M.tilling Address oaf Managing,Agent: 1�'�'a �k ,figbor i 4* AMB¢ ,, ',aw '¢191b ,,*guy,.w m rrm awnr,dwwrrruw.wuwpre. F 11 1, +kti'33+r ;vwwwn w.Mc::uawwwampw;uuJmW"gym :¢, fimsill SECTION FIS PROPERTY DESCRIPTIOW Number of Rental Dwelling units can property For oath wntal�.Dwellln `Unit set forth the kernel Dwelling Unit identifier(%I r example; Unit 1, Unit 2, Urift 3 or Apt Aj$,C);the.use of each room in the Rental Dwelling Unk (for example, Kitchen,Bedroom 1,8edr om 2, riving Room)and the dimensions off ekh room.. Fdr properties with multiple Rental Dwelling Units use`Rental Permit Application 'Rentel Dwelling Unit Identifsor #iequeste l Maxirrrum number of persons slio e.to occupy Dwelling Volt � Num*tier of rooms In Aental i elling:unit: Use and Mmen lorls t f each n l itt I' rr � rerwwwa� a+, " " .wamrw«nwm „. i nm.,sr w u w^wurw w xwww�w'« +��++��uw«emr«imrw+m awmawwrv..,.,,,wr,rv». xrc,"aw"%NY»"",:s+4"o-.w;:'rMN'Nrt�4'".iw.p'N6Nx"Aip9V.xuuVVll �l�ar,zwwc�um as K'ww, +a+ ...`.ate �a c � f S � Town HA Annex Telephone�i31)?65-14Q2 a 7a5"Main R Ad � � r �� Fax�(b3�t)7�r -95(�� 1=.o..Box 1;79 � A i"wrc Southold,NY 119710959 TOWN OFS M SECTION Gk 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 horsing,regulations of the County of Suffolk and by the lavers 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 frorn the Town of�iouthold 0 (am submitting:a completed Town.of Southold certification farm from a licensed architect Ora:licensed professioriat enginder, S.EMION lid. DMARATION Signature trust be notarised and -t ixe the c wo7er of the dwelfingr unit, STATE OF NEW YORK) COUNTY OF SUFFOLK) l certify under penalty of perjury,the f6flowing. L i arn the owner of the property Identified in "sectlan:Via" of this appiicatlon. �. The property owner's legal address set forth in 'Section B" of this application is my legal addrays and i understand the Town wilt use the address for service pursuant to all 'Page 4 of 5 Town Lail Artroax 2. I 3 Main fifi Rom x(G1)F5� 4 {-�F✓�> 'N� 1179 A r,, aastho14,NY.1 t971-0059 tUIt DING DEPARTMENT V SOUMOLD t�l�licahle laws and rulesF 1'further acknowledge that I Will notify this Town of So hold quil4ing Vep3a trneat of any charges of address within five(5)Clays of any changpis thereto. 3. i have read and received a copy of Chapter 207 of the Code of the ToWn of Southold a0d agreedlo abide:by the same. 4, twill notify the Town within five€5)business days alto ally tI ange to the information regarding Authorizod M erit,M naging Agarit,Or Slte M nager. Property Owner's Name, Propertyowner's Signature: Sworn to before m this day of_ 20Lq Off'icl l Notary Pubk Signature and Ori nal Notary Stamp DIEGO F VARELA Notary Public-State of New York NO.01VA6392915 Qualified in Suffolk County My Commission Expires Jun 3,2023 Page 5 of S clw aqA I/i"4e, TOWN OF SOUTHOLD BUILD C DBPT. w 631-765 1802 I N S E T I N [ ] FOUNDATION 1ST/ REBAR [ ] ROU H PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION/CAULKING [ ] FRAMING / STRAPPING [ ] INAL [ ] FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENS RATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI AL [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: I A,-- 4 l Tom✓ A a DATE INSPECTOR ` CERTWICATE OF OCCUPANCY Few YW d N F4 Office of the attlidlos,ftnspootr Towo Hill Sftthatd,KY. rli °c toixuparKy 1"Z,14190rt. ., ♦.. #�mt .1tpr 1..� . .,x yy�}�� Nuoiy TU Map wb l000.soctift . . :5,.,Y.®.. I k: F, .. .. •t• MthfMA:iu .14 :to the App3"tWo for t*:twmit lofoTt Mod Pa Ws office dmtw vm,rkl d mrdrml to ef#erfihm re"Itmeras ct ap t'ico lovulo of tho hw.The oempamy&r WWK IN]Ott #a i9 tmtd is .. ,. . .,Y r rnr» Mm )t attTte arr� 1t�C9itg, ma mirsit's CERTIFICATE Wo •�laE�iClg fC13�tk°G'�St r � ftoo 109 grtl P d a d°',; Drv� fi 'down Hal!A0009 �, 5437E 601 it084BUILDING DEPARTMEW rM TOWN OF OWTHOLID RENTAL PERMIT APPLICATION AOD. EINDUM. Rlenta4 i.Weilirrg Unit in�mber of persons al lowed to orcu each dwelling Lrr�it: �equest�cl�xt��ciilrtWm u P �y NuMber of Rooms In Rent l i ell n9 Vnit: Use:and Dlmerislon of edorn, &Atai.L w+ Iling Unit Ida'nti ri . � :R4L,�quQsted maximum riuMbL-r 6f: ersorns allowed to occupy each dwelling urtlt Mari of Rooms.irr Rentat dwelling Unit: .. ...... ... rise and DimensIon of each rovro Rehtai dwelling 'nit Identi et; Requested maximum numb ed to occupy each dwelling runt: Number of Roorns to Rerzt*l.Owelling Unit Use:and Dimension of each roam: APPROVED AS NOTED II �I DATE:r B t5 1� 5075b -P.# 1 FEE - BY, ch, --- NOTIFY BUILDING DEPARTMENT AT z 631-765-1802 BAM TO APM FOR THE FOLLOWING INSPECTIONS: COMPLY WITH ALL CODES OF FOUNDATION-TWO REQUIRED NEW YORK STATE&TOWN CODES ' a fU I � imR1 • � � J FOR POURED CONCRETE A REQUIRED AND CONDITIONS ROUGH-FRAMING&PLUMBING SQt1TH{Kp jO�+jN Z6A INSULATION SOUTH0I.oT01INPLANNiNGS00 - FINAL-CONSTRUCTION MUST j a E E BE COMPLETE FOR C.O. SQUTHOLD TOW 1 TRUSTEES G O o N.Y.S.DEC m ] I ALL CONSTRUCTION SHALL MEET TH - SQ(TNG D HPC — REQUIREMENTS OF THE CODES OF N YORK STATE. NOT RESPONSIBLE FOR_ SCHD DESIGN OR CONSTRUCTION ERRORSpul I �' I ELECTRICAL in ' i I - � i € i I INSPECTION REQUIRED ash dry I� AJp *" Additional i [ Certification 10 r ! l; j TIkj Ql i i o U � O Ii I`Z > Rewired. May Be q i i711 ' f J IE v ( - i LI u =q LFOI (n ri MlP I i m/p LI I ;k c' i 6 F O �, co 4� — — (' 1 , 3 s 1 31 i I 'I ,