HomeMy WebLinkAbout1000-139.-1-25 'OWN OF SOUTHOLD
Rental Permit
0188
Owner Cyrus Agarabi
Occupied as Single Family Dwelling
Located at 265 Westview Drive Mattituck 139.-1-25
Maximum Permitted Occupancy 5
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.
11/29/2023
Cid n � e Official
This Notice must be posted by the main entrance at all times
)le�l000-"t�v k-w Dr. M04 �4k
TOWN OF SOUTHOLD BUILDING D
631 -765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ INSULATION/CAI
[ 1 FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ j FIRE SAFETY IN:
C ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII
CGDE VIOLATION [ ] PRE C/O [
DATET'
INSPECTOR
")
Town Hall Annex Telephone(631)765-1802
54375 Main Road r Fax(631)765-9502
P.O. Box 1179 40 2M
Southold, NY 11971-0959 � u
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a licensed architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Professional seal required for Architect:or Engineer, Licensed Horne Inspector must
provide copy of valid current certification
Rental Property SCTM Number: 139-1-25
Rental Property Address: 265 Westview Drive, Mattituck, NY, 11952
Owner/Name:
Cyrus Agarabi
Unit 1
Rental Dwelling Unit Identifier:
Number&Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 — 100 sqft., Bedroom#2—90 sqft., etc.)
Bedroom 1: 138 sqft., Bedroom 2: 143 sqft., Bedroom 3: 100 sqft.
Kitchen: 108 sqft., Living Room: 273 sqft., Dining Room: 120 sqft.
Property Description (Include all improvements indicated on survey)
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully
complies with all the provisions of the Code of the Town of Southold, the Residential Code of New York
State, the Building Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of
New York State,the Fire Code of New York State, the Property Maintenance Code of New York State
and the Energy Conservation Construction Code of New York State.
Mina Agarabi, PE , Principal_ IA4� 1
Print Name and Title �,S OF N AG� �o� Original Signature
" AI„
Please place Professional Seal: �k
c? 09th "
4'oP's scov,
TOWN OF SOUTHOLDPermit4 Cell Rental
V F Permit No. 0188
Owner Cyrus Agarabi
Occupied as Single Family Dwelling
Located at 265 Westview Dr Mattituck 139-1-25
Village g/g/1-
Maximum Permitted Occupancy 5
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.
9/21/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
Town Hall Annex �� �I�� � � �
Telephone hon ( 31)765-1,802
rim-
54375 Main Road9( P
P.O.Box 117
Southold,NY 11971-0959
BUILDING DEPARTMENT .
TOWN OF S UT OLD
RENTAL PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Ren p y Address:
p
Tax Map Number: 1000 SECTION u� �.p 0 0 _ -BLOCS �. ��� -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Number(s): Daytime
f-7J)IlEvening Emergency 's ' d �
o.
Property Owner Email Address
4.....
Page 1 of 5
Town Hall Annex �� Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
0
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: ~EW
Address of Authorized Agent (no P.O. Boxes)
a'
M.
Mailing Address of Authorized
Telephone Number(s): Dayti�e � , �"'� � vening Emergency
Email Address: 4"\ c C �` � � D
w_ .�� �N .� ., • � sir �� � ,� . �:��~
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent(no P.O. Boxes).
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime ___._.. Evening Emergency.
Email Address:
SECTION E.
SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any:
Address of Managing Agent (no P.O. Boxes):_ _m
Page 2 of 5
µ I
Town Hall Annex t� Telephone(631)765-1802
54375 Main Road �' t Fax(631)765-9502
P.O. Box 1179
Southold,NY 11971-0959
IN ��Er'^9ao
13UILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: .
Telephone Number(s): Daytime Evening Emergency
Email Address:
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: w. _ITITVn I "yom
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: ®
NoOOAw I..ixII ° ° 21 3
' I ° nl J� /t-0 9#1 12X1 0 1
� .
m w 0, X I ® '
Page 3 of 5
P.Fla �Y�y��`(IP(SUS4�Hw �/fir
Town Hall Annex Y Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ry e
Southold,NY 11971-0959
vn(
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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.
I am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
❑ I am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
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
Page 4 of 5
r �
Town Hall Annex iN Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 :��
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD,
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. t 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 as to any change to the information
regarding Authorized Agent, Managing Agent,or Site Manager.
Property Owner's Name: � � � � ��� � N� p � r✓ S a �a
P'
Property Owner's Signature:
Sworn to b
foe me this Oday of a 20LA /9
........
Official N Lary ubllc ignature and Original Notary Stamp
I
Page 5 of 5
S
WNI OF
OUTHOLD BUILDING DEPT.
765-1802
iNSPECTION
] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] INALXOV�t
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
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C'ERTUIPICATIP ORCICCUPANCY
NOiCOIqVOKATIP,'G PRENUSES
'r T h V; T 0 CITU I C1 H?Y tht thc
I and Pre C.O.
Data..... July 1987
265 Westview Oxi°irc HatMucT, Nww York
MAW
shown on clatudy WX ln'p as WSWict WOO, Sc-ction Mock of
25 to Uic pri,srnt Bufldbng Zonc Codu of the
pmf ;�,ruuffioW P�n- Uiio fuHowim- reztsons-
TnsufH cWML toLal area;
uv, presc,inted to the Buildirp Inspectoir's Lffico,
mim:dl OEM UP! uOIOYO inxmonrormiing Land FIDvaIlqfing(s)
Hh-"'T0 vin thil, c[vvctIvt" flate thir prusent Building Zone C�I:Idc iJ the
"w'n n' pu+Iij spujy jbtr puj�t,suant to mid subijecL tx!,ro the appli
dfle pr.�itr3 „om; 4 Codc:-
TT T"; 1, CAAMPEA) Mal NoW upmi hdarmadon pr"pnhd M
WYH"icvj' rhv o�'Impnmr!' nnid Ilusa. for which 1Ms Ccrffll
L 1,1 V, One .37 IV
contains one L!2�- Wood r;r,
dwoMnq adth aVtachcd porch; Ntii:qiched garage,,, fen:-ung; aU situated "A'
HesidrW iaAgi:iciuHurall zone with wccess Westauie%r Brive
Thn CcrUHcMv h, b) JOHN AND LINDA SCAM
.0 W—OC
of thAnvmrid )IuP'OnW .
of
I':'l"!T) ,,1,'ll,'ftl'1 "Pt"; CEWTIU,P NtA
IS :If HW. EIIRY, kj "ar v11ur� .uUovc prendses MIS
',T I u \!p �-G WW , ,, 0, prag'�mi�'vs bY ft,, Fwiled or lw'spec-
no, smch
h TWO f°F�MHWo ' Hlcrvforfr, &)cs rv)�, and i,,,, not LrAr,nrl
t tW t th- prnor n vr"AO vtM :01 ndwr apoinAW vAes and rl"Ia-
omm.
11'4—
'9 F�14' � Town of Southold 10/11/2019
P.O.Box 1179
53095 Main Rd
" ,, Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40763 Date: 10/9/2019
THIS CERTIFIES that the building RESIDENTIAL ALTERATION
Location of Property: 265 Westview Dr.,Mattituck
SCTM#: 473889 Sec/Block/Lot: 139.4-25
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/18/2019 , ' pursuant to which Building Permit No. 44211 dated 9/25/2019
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:
"AS' BUILT"OIL TO OAS CONVERSION AS APPLIED FOR
The certificate is issued to Agarabi,Cyrus
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED 09-27-2019 Kolb Mechard : I
_.........
., c)rn?c Signature
:a�e