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HomeMy WebLinkAbout1000-33.-4-39 Of so TOWN OF SOUTHOLD Rental Permit 1478 Owner: Philip & Errika Mijares Occupied as: Single Family Dwelling Located at: 750 Tasker Ln Greenport 33.4-39 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: 05/18/2026 Expiration: 05/17/2028 co a Enfa ent ' l This Notice must be posted by the main entrance at all times ��uFgd 4 4# TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box H 79 Southold,NY H 971-0959 Telephone(631) 765-1802 Fax (631) 765-9502 RENTAL PERMIT APPLICATION Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Lix. Ge fiP4'1 1094 Tax Map Number: 1000 SECTION 033 -BLOCK 04 -LOT 0 3 I - SECTION B. OWNER INFORMATION: Property Owner Name:� Cof w\V�4( � Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 6aYjrJ&V1 � s © _.6� ✓1 �..: o l\l`/ 1 1 Sao Telephone Number(s): Daytime 5 to--182-23-6Evening Emergency —72.D-3t?'t u45 Property Owner Email Address i -. �-Vlo+rY\ 1.-.t Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on 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: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: � � 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 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 laws adopted by the New York State Fire Prevention and Building Code Council. be I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) certify under penalty of perjury,the following: 1. 1 am the owner of the property identified in "Section A" of this application. 2. The property owner's legal address set forth in "Section B" of this application is my legal address and I 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 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 and agreed to abide by the same. 4. 1 will notify the Town within five (5) business days s to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: -EI'y O� 1"1A �. Property Owner's Signature: jOffici to before me this y of CA"f! , 20 2-(o I Notary Public Signature and Origin otary Stamp JESSENIA A MEJIA Notary Public-State of New York No.01 ME6267105 Oualified in Suffolk County MY 0ornmission Expires,4ai .13,202g Page 4 of 4 F O&I TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 N 5 r E(Ck T 10 N [ ] FOUNDATION 1ST/ 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: ,C ' DATE INSPECTOR 6 � k Town Hall Annex � � � ' Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 � Southold, NY 11971-1179 Tel: 631-765-1802 SCTM # 33- _3 Date „; Owner Phone Address ,� , Visible Hamlet Inspector 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 I Pool fence to code requirements r /��iI/ CO s for all items present ,�,,, Comments: g halt w a� (V,.a x 6-eAMovv► o j e X-It In . 41, \ \\ 777 ------------ Ifts,M---_-7 _ -` �_ � ��• \\�\\\\.��\����\\�\\��\�\\\moo\\�\� .� .. �:,_\\\\ �\�\���, ... � R } f TOWN OF SOUTHOLD PROPEL D BARD OWNS , !� i STREET -7 VILLAGE f,` SUB. LOT s /C.Jt1�. ' a ra FORMER OWNER 1 N E ACR. F S W TYPE OF BUILDING e - RES. .Zl L SEAS �VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS - T f Oa t L) v G o Iro VQ S /J L AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value i I i Acre i Tillable 1 Tillable 2 Tillable 3 Woodland - Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot ; DEPTH c 3 BULKHEAD - i Total DOCK 4 s }— z s ! r r _r -i e. f E -- --g S - a M BW n L Att�n�a1 t - Extensior. Bo,ement Flogs :_ <. Extension E-<t, Malls lntaricrr Finish _ LR, Extension :Eire Place j i I��at L•I. Type ( of 11 Rnoms Is( Flag �R f,�n>> 1 RPorchc., ���CrE'r�lsi)r'i h '�ti�n11 — ,1i1 FI � Porch ' Q�-,rTjer . i ige E _ e F g 0- I✓ =e 3 Total [ FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No, . , . . .Z106921 . . . Date . . . . . .4al3ter4�er .21 . . . . . . . . . . 1�.1. . THIS CERTIFIES that the,building . . . . . . . . . . . . . » . . . . . . . . . . . . . . . . , . . . . . . . . , . . . . . . Location of Property . . , 7,5Q �',ask�er. Lane ,, , , , . Greenport., I York House No. Street Harslet County Tax Map No. 1000 Section 03.3. . . . .Block . . , ,a4, Lot . , 039. . . . . . . . . . . Subdivision . . .>klptqrp. . . . . . . . . . . . .Filed Map No. .4021. . .Lot No. .27. . . conforms substantially to the Application for Building Permit heretofore filed in this office dated J u I y 15 , , . . . , 19 8 q pursuant to which Building Permit No. „ „ 10787 Z. µ . F . m dated . . . . .July. .2.1. . . . . . . . . . . . . . . 19 . ${}was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . . , . . . . . . . .. . . . Private, Odle-Family Dwelling . The certificate is issued to . . . . Coris tpLAf inpe, ,anti Anas tia,ia Karavas (owner,!* � R�XXX. . . of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . .3 97!3 q-S Q> 5/1/81 ,R. A. V i 11 a P.E. UNDERWRITERS CERTIFICATE NO. . . . .135.0.7.Q33. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bui ing Inspe or C ' Rev.1181