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HomeMy WebLinkAbout1000-114.-7-3 TOWN OF SOUTHOLD Rental Permit 0363 Owner Ronald & Teresa Mc Caski Occupied as Single Family Dwelling Located at 2790 Westphalia Rd Mattituck 114.-7-3 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. 12/2/2022 Code Enforc nt Official This Notice must be posted by the main entrance at all times ` Kms , "a SOUTIOLD TOWN Town Hall Annex "�` - `tMµ 54375 Main Road PO Box 1179 Southold, 52 Rental Inspection rr, NY 11971-1179 r "P w ► Tel: 631-765-1802 Fax 631-765-9502 ,,,,,/ Orli, o;,,'; /,!�, ,,;'�;�% •_ — DatAz e' „��� QWilX�'J%,i'%i %l%'i''%% !%u/o ; �1�(� c� Pf10C�e /r ✓!�"� I S �v r/,%Ilrlrii i' p� _ l `I e Zln/i .,i�rr,k,r.,/c+Li��r/,if//��/�i/��%%�%/%�; %/!'ri � v '"• %o ii..!,%%r,: ��— %'�rggx' Ha �����/�/��/�/%ir LEVELS /,mr/�a�/� Smoke Detectors (#- bedroom detectors excluded) vz Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits �i% l/i ri / j%��lf/�r U/�// A�/� /� BEDROOM$ ,i / /� l��i / , Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (windows) (`r''Il ) t BUILDING SYSTEMS / CONDITION OF PROPERTY Heating system maintained/operational i Building Interior is clean /maintained Hot water system maintained/operational Building Exterior is clean /maintained Electrical system maintained/operational Property is clean/safe/maintained Mechanical system maintained/operational Handrails&guards present POOLS YIN POOL BARRIERS YIN Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min. 48” high resent POOL GATES YIN All openings in barrier less than 4" Self-closing, self-latching Max. 2" clearance @ bottom of barrier Latch on pool side of gate, meets height Barrier capable of being locked & child- requirements proof when unattended COMMENTS: �� w . iuLu "2 TOWN OF SOUTHOLD Rental Permit CO Permit No. 0363 Owner Ronald & Teresa McCaskie Occupied as Single Family Dwelling Located at 2790 Westphalia Road Mattituck 114-7-3 Village S/13/1- Maximum /B/LMaximum 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. 12/2/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times t ' V Soar ! ' 4Vr� r, Telephone(631)765-1802 y Town Hall Annex 3 P 54375 Main Road c� ® Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed eve(11,two years) I N o V - 2 2020 Section A. YD Property Information: Rental 2Property ddress:�� Tax Map Number: 1000 SECTION 000 -BLOCK 1 / -LOT C, ' - o3 SECTION B. OWNER INFORMATION: Property Owner Name:,,_ 4eo,,74 4,,?/ Te reser' llyei��esilire_ Property Owner Legal Address: Property Owner Mailing Address: f%® /.moa c�� [c ✓)n �� 1741�e lVY ll,-9S—Z_ 993 -25G.3 Telephone Number (s): Daytimed&j ce/i Evening Ho^c Emergency e iz � e c ll Property Owner Email Address: P've //4 0/-0, y41 foo. c.0/7'! i co laada Page 1 of 5 - Sol 51) Town Hall Annex P i-'1Telephone(631)765-1802 j 54375 Main Road �t � 1� � Fax(631)765-9502 P.O.Box 1179 `t"� , ,)©� Southold,NY 11971-0959 � �?�•, ��• �a �, •a> BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized 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 D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: V 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: 1-00 Address of Managing Agent (no P.O. Boxes): Page 2 of 5 ,rr-^� sof Town Hall Annex �? � Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: A//14 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: S.� l i �n`'l /,,.he, 027 61a 41-es �.t 41114/r 4 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: ✓/ae 1 /g'Y">c 1Z ' L",/'hd 4100 A �/,?,V" '�/C'�f r/J�fCh / /z f-"A/�'//" "e ,1,1,- 2- Page 3 of 5 sou Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959V ou U 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. 0 1 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) I �( - 1\ CC-C 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 aso Town Hall Annex ;, Li Telephone(631)765-1802 54375 Main Road c Fax(631)765-9502 P.O.Box 1179 ,. z ' Southold,NY 11971-0959 G?, COY �n �a{.�}/00 1.4t1✓..,•i.T j 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. 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 as to any change to'the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name:_. Property Owner's Signature: Sworn to before me this day of20_Qp Official No ary Public Signa ure and Ori a{ Notary Stamp MICHELLE L TOMASZEWSKI NOTARY PUBLIC-STATE OF NEW YORK No.01 TO6156671 Qualified in Suffolk County My Commission Expires 11-27-2022 Page 5 of 5 OE SOUL �h # # TOWN OF SOUTHOLD BUILDING DEPT. `yComm, 765-1802 - INSPECTION [ ] FOUNDATION-1 ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] -INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] NAL A AApcpr,", [ ] FIREPLACE-& CHIMNEY FIRE AFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ J, FIRE RESISTANT.PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: p q- cpj DATE 1164 "y0 INSPECTOR x� 613" • �' L � � - �•�'giYt�[fT.yl J$AK�t `• _____� IC,��,tn - ___ _ 36 cYL z_- O a � ED • 3 Lr/2 17r0�1{41�r �Xi3hld� - . Rz�n z- _I,o •�-Wig--— I ,-.i _ � qt 2 aedr„"jr3 B�wm gay. _ - � �Z194z GvL• Cz)9'/s GVC - • � r- "cwz3f tx.ehfy `Gwzy awzy - " O KIT �GyY7"��G Auto,4Y - 10 N • _ � T � 6ASfM[Nr , 1rzv&- - °` { 561 a Ex--S77"6— ` - - - -", -' '" � - - • Ali�}1� ` ' '. '� -. ' Af co TOWN OF SOUTHOLD,- ' -'-' OPERT- -' "-r Rib- ab OWNER - STREET \_ i , - { ILLAGE DISTRICT SUB. LOT iF t"���i� ��-- �L; N {�1 '���,-1� -�� ."*¢r�.� <t/ .,�`�,•r°`�"s' /%°� '��fr'it`"^'xri y��,,,'." f� �' �� e .. r ,` --�- _ — __ ____---- .` ��""' ��c.. t�"�` uY FORIiER OWNER N E �" ACREAGE — � C(� S W gf� � y/ TYPE,OF BUILDING ] _ ' '...n�'^�•"'L'�.,r..3wr.w?"�„�.- .t� RES. Nq SEAS. VL. FARM COMM. I IND. E CB. (` MISC. LAND IMP. TOTAL DATE REMARKS C -� � - 1 ( � , �{�}( *'� _:r�`�$ £� - Z7 4400 AGE BUILDING CONDITION ' NEW � NORMAL ---�---- BELOW ABOVE T Farre ( Acre Value Per Acre Value Tillable 1 Tillable 2 --------------- ---- Tillable 3 F __ ;--5 r -- - -------- - -- �i Wrodland - Swompland Brush"Mrsd`--''- <•, Nouse Plot k, tT za t "0 ( .. _ I I -- — ��, �_ i kA i s ,.., e. _�_.... .. _ r r J 114:7-3 3/22/2021 - - - - I I i sI I N _t xr Y m a �. ir ,, — -- { 114.-7-3 3/20/2019 a ° rt M. Bldg' Foundation Bath Extension BasementFloors $ , ----- ---- _ .._. _ _ ._.. _._ . Extension Ext Wolfs Interior Finish _ ....._ A ..... ..... ....... . _ -r - — —_ -----...— ----- Extension i Fare Place I Heat ........ 1�_---.............. " ........_—. __ - _.._...... " ��OC Porch Attic Porch Rooms Floor _..... _ __ _) __............-._:,.....- -.............................. 1st - ,L 43 r - Breezeway Patio Rooms 2nd Floor _........._-- ................................. Garage Driveway -� ...... ... ....... . .. ._. -�Z('a, �►-' ��� - ... " . .,. �, �.:. .'� ,..�, � '� .. �..�� �� �e . � � tis, •`, ,. FORM NO. 4 TOWN OF SOU THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY 41- 07.1. .......... Date .... ...... ....... .......3 - .....ten ... 19. i . ... ... . . THIS CERTIFIES that the building Iocated at .-RO$4............. Street Map No. xX.X................ Block No. ....;I ............Lot No. XZ........ ttjt?l4.ks y.... ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated Sept.......2Q...... 19.�r�.. pursuant to which Building Permit No. dated . ......... ..........Sept........26....... 19..15.8., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is" issued is ......Frlvats• or1e_family..dwelling..................... ..... .............................................. .... .`his certificate- is issued to ....?hjj:Ljp.....p.01BSc .....................Owner....................... .... (owner, lessee or tenant) of the aforesaid building. ...................... .... Building Inspec or