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Home My WebLink About1000-139.-4-12.1 $a T'WN OF SOUTHOLD I � . Rental Permit g 0018 Owner Edward Sidor Revoc. Trust Occupied as Single Family Dwelling Located at 1155 Mary's Road Mattituck 139.4-12.1 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. 9/28/2023 Code E f ceme Official This Notice must be posted by the main entrance at all times o TOWN OF S 631 -765-1802 ,/.3�'- INSPECTION C l FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAi [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII [ ] CODE VIOLATION [ ] PRE C/O [ REMARKS: d� ail DATE '� r r ^� -� Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 SCTM # Date Owner one Address S�'�' � + /Z" "J Vis able . m _ Hamlet Inspector Floor Level Quantities Sub 1 2 311 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 Af 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 Pool fence to code requirements CO's for all items present Prior Rental 41 Comments: _ _ Owl'F 0% 0" Ll T H 0 L D T' bU Ze 1� Rental Permit Permit No. 0018 Owner Edward Sidor Revoc. Trust Occupied as Single Family Dwelling Located at 1155 Mary's Road Mattituck 139-4-12.1 Village 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. 3/26/2021 John Jarski Code Enforcement Officer This Notice must be posted by the main entrance at all times -W TOWN OF SOUTHOLD Rental Permit Permit No. 0018 Owner Edward Sidor Revoc. Trust Occupied as Single Family Dwelling Located at 1155 Mary's Road Mattituck 139-4-12.1 Address Village S/13/1- Maximum /B/LMaximum 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. 3/26/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Fr Town Hall Annex Telephone(631)765-1802 54375Main,Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 a B;iI-.1�;Dlh%G�Eg�iK%FNl�i�y 1 u TOWN OF.SO ,THQLD RENTALPERMIT A PLICATION D) d i Renta! Permit Fee' � ��i anti e _ � �: e etre wt o years) m MAR 1 3 2019 T. Section A. Property Information 1 W , Rental Property Address: m, .. s U / m n _ is , , Tax Map Number: 1000 SECTION 13 ;. Ri, C .SECTJQ1q i OWNER INFORMATION: Property Owner Name:;Pro.pert Cann ty,pwnbe the same: Re�^+� I P.rn e . Address), Pr°p�rty,Dwner Mail! Address:: (. , . p qty Oo .. MA 11.., 7 tl 1'�IV. _ l Telephone Number(s): Property Owner Email Address: - Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental-Dwelling Units,on property*... :S/�G�E �,. �{ . ;/zoosr Rental -- meg-- _.. V, i .?�{1 .� p ee. For each Rental Dwelling Unit set forth the Rental Dw.ellip + p'�,i tifie.r.( or.,exam Unit 1, Unit 2, Unit 3 or Apt A, B, C);the use of each room in the Rental Dwelling Unit ( p , Bedroom.1,.. for example, Kitchen Bedroom 2, Living Room) and the dimensions of each room. M For,praperties_with-muIt! _Rental_Dwellin ,UnM use_"Rental Permit Appliaatiga, ; Addendum." Rental Dwelling Unit Identifier: ,400" • .� Requested Maximum number of persons allowed to occupy Dwelling Un Number of rooms in Rental Dwell ....� .°ing Unit:, Use and Dirriensions oTeacFi room`fri fr"eriaxCwllin W&IPIAIOM�r W,127' at 9 / I SECTION G. INSPECTION: r e Pursuant-to the Town-Code of-the Town-of-Sou#fibld 6hhl. r207(Rental Pro.ftrties)) a safety inspection by Code Enforcement Official is required. If the owner chooses not to have said inspection performed-by-the Iowa,a-certification fr',ortfVWS liceilsied'aitliitetst a Nl(§ 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 Mid=ordvN1, ins of the co'de,bf thiol 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. ll�1 I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold. Page 3 of 4 u ❑ I"am submitting a completed,Town'°ofl 6Lcthald certification form from a Ilc'ensed architect, a licensed professional ngin r, f a-Licensed home inspector who has a valid New York State Uniform Fire Pr v nti6bild,�ng code Certification. SECTION . DECLARATION: Signature mustnotatize'd-and' ST. e the owner of the dwelling unit. STATE OF NEW YORk) 7 COUNTY OF SUFFOLK) I<.,C p1j,A 1 - d�.�.certify under:penalty_of!perjury,-the follawing:, 1. 1 am the owner of the property identified in "Section A"of this appliFa;tion. 1 2'. Th-e property®wer 5 legal address set forth in "Section 8"-of this application is mylegal M address and I understand the Town will.use the address for service pursuant to all r 9 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 Ff any;cbange�s. 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: .. ,.RD S/.... Property Owner's Signature: tjf Sworn to efor me this day . 20 Officiai N ublic Signature and Original Notary Stamp DANIEL C. ROSS Page 4 of 4 Notary Public, State,of Now York No. 4$0,7175 Qualified In $uffolk County Cornnill"lon eg, i .Auq.31, . tqo k4 M TOWN OF SOUTHOLD BUILDING C moon III EV. 114 ,SPEC'TION VIII°° IIID "'11111""11111 IIID " 1" IIII VIII VIII°! lIIEIIIIG IIIA°°! IIID IIICIIII "'° IIIA 2114 113 "' IIII IIIA IIIIL....... ""'11111""'11111 IIII' (IIII IIII IIIII IIIISlTlllI!!!!l.AllPPlllNlG 4 A4 *t IIIII°!- IIID,IIS IIIIIAGE, 11°uIIID IIIIIIII �I� I IIII°°°II III E' IIII 'r IIID, IIID '711FRucl riGN I Pi IIIl JE IIIII""'111 IIIIICAIIIIIII °° III IIIE111111IIII IIIA° Illf IIII IIIII°°�°'I� C1011DE MIDI 1 11101114CAU111 IIIIIIIII111 el'�. P47BUILDINGTOWN OF SOUTHOLD INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCANULKING [ ] FRAMING/STRAPPING [ ] INAL/A,�,� 4V,4,v� FIREPLACE- & CHIMNEY I FIRE SAFETY INSPECTION [ ] [ ], [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS:. �w4t/ pZfmV'A- .. DATE b -xm INSPECTOR cp _. . - - DIN,91AI& R en Ix, T3,q1- 7 . Room 7 _ iII L) '. 6 IR e,16A 13 x Ig _ 'Ito N E .Awl Roo ni 74 _ FRONT ; po� /Owl$ Eft f) n _ _ 3 '� Co q s� LR�em s TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No: Z-30045 Date: 02/26/04 THIS CERTIFIES that the building NEW DWELLING Location of Property: 1155 MARYS RD MATTITUCK (HOUSE NO.) (STREET) _ (HAMLET) County Tax Map No. 473889 Section 139 Block 4 Lot 12 .1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 5, 1962 pursuant to which Building Permit No. 1934-Z dated NOVEMBER 9, 1962 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 CONFORMING ONE FAMILY DWELLING WITH SCREENED PORCH. THIS CERTIFICATE OF OCCUPANCY UPDATES CO #Z-2008 DATED 10/28/64 .. The certificate is issued to EDWARD & ALTHEA SIDOR TRUSTEES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N/A PLUMBERS CERTIFICATION DATED N/A F at /i :e 4cdig' nature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No: Z-30045 Date: 02/26/04 THIS CERTIFIES that the building NEW DWELLING Location of Property: 1155 MARYS RD .__._.__. ._..... MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 139 Block 4 Lot 12.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 5, 1962 pursuant to which Building Permit No. 1934-Z dated NOVEMBER 9, 1962 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 CONFORMING ONE FAMILY DWELLING WITH SCREENED PORCH. THIS CERTIFICATE OF OCCUPANCY UPDATES CO #Z-2008 DATED .0 864.. The certificate is issued to EDWARD & ALTHEA SIDOR TRUSTEES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N A PLUMBERS CERTIFICATION DATED N A a .. A tho zed ignature Rev. 1/81 7/Q3/ IS TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST.' SUB. LOT, 3 -3, C41 0 d. FORMER OWNER N E ACK. S W TYPE OF BUILDING RES t SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP, TOTAL DATE REMARKS Z-112- -A fvir -�7 td $ N D ITI NEW NORMAL BELOW ABOVE FARM Acre f Value Per Value Ac re i WL Tillable I p,, Tillable 2 Tillable 15 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD 40 House PlotDEPTH ~ ;BULKHEAD Total 1 IDOCK t1(� s 3 RIM 3 I 3 � 139.-4-12.1 11/2014 :, 1 Ii Q M. Bldg a { Foundation Bath Dinette Extension J. a _ Basement Floors _ K, i s Interior Finish LR. Extension ( E Ext. Walls e -� _ Extension € `Fire Place ! Heat f.; r i DR.Aj3 1 i ;Type Roof Rooms 1st FloorBR. P =Recreation Room Rooms 2nd Floor !FIN. B, - V,a Porch jDormer a Breezeway 'Driveway s : Garage Patioit � 3 o. B. J E i Total