HomeMy WebLinkAbout1000-139.-1-13 T 0"kwN OF SOUTHOLDU' V WRental Permit
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Owner Donald Hoyer & Michael DeFazio
Occupied as Single Family Dwelling
Located at 460 Westview Drive Mattituck 139-1-13
Maximum Permitted Occupancy 8
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.
5/19/2022
t Official
This Notice must be posted by the main entrance at all times f� c� e
Telephone 631 765-1802
Town Hall Annex p ( )
54375 Main Road j% %a%i ' Fax (631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
➢ .7
BUILDING DEPAR'T'MENT JUL 2 8 2021
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION sV11- r�
....................,....,,.,........`.,..........................:.«,.............,.,,..............�..,...... i'j 01,111
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Rental Permit Fee $200 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address: 4to
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Tax Map Number: 1000 SECTION -BLOCK lJ...^�_..._......._-LOT! ... .....,-.! _
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SECTION B.
OWNER INFORMATI -°,- ',
.,
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
Telephone Numbers : Daytime Evenin r�n'L Emergency
Property Owner Email Address:
Page 1 of 5
Town Hall Annex / ����%��� Telephone(631)765-1802
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54375 Main Road � Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit if an
Address of Authorized Agent no P.O. Boxes :
Mailing Address of Authorized Agent:.—....�......_�_..... .....�....� ...... � _.. __ _,..... __.....�_..
Telephone Number (s): Daytime....... . . ...... Even ing„_..._ ..._...... Emergency. ..
Email Address:__..w__._..._._ _..., ...
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any: _ _. .,.,....w....._.,.�_... �....
Address of Authorized Agent(no P.O. Boxes) _ ...._ .w.. -........
Mailing Address of Authorized Agent: _.._ ....._...M ... _.w._w_._.
Telephone Number (s): Daytime.,_....,., Evening,
Email Address: .
SECTION E.
SITE MANAGER INFORMATION: (required for rental propertiel containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any:_................ .....,, ....W....... .. . .... _._.._._.
Addressof Managing Agent (no P.O. Boxes):.......w._....w...�_..�. __.n..�. w......_�.._..�.�a�.... .............�..M.._.._.........�_,_.�_......................_____..w.,
Page 2 of 5
Town Hall Annex Telephone(631)76.5-1802
54375 Main Road ,�,�,� �%/"',� "' � Fax (631)765-9502
P.U. Box 1 179 wi
Southold,NY 1 1971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent: Al
.1A-., , - -
Telephone Number(s): Daytime,,_,,.,,,, . ....... ...._. Evening. ... ......_.._.._wM Emergency.. _..._
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on ro ert
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 Uni :
_...._... ..... .. . . ._,. .a. .. .
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: ............... ...,,.,..._
Page 3 of 5
41
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'Telephone(631)765-1802
'['own Hall Annex /
54375 Main Road %�/ �y// Fax(631)765-9502
P.O.Box 1 179 j/
Southold,NY 11971-0959
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 saf ty inspection to be performed by a Code Enforcement Official
from the Town of Sout ov
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 „_ _... ...„ certify under penalty of perjury, the following:
.�.—
1. I 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
slily r
ri%�r�j Ery
Town Hall Annex lr "err Telephone 631)765-1802
54375 Main Road ;%i % %f Fax(631)765-9502
P.O.Box ]l79
Southold,NY 1 1971-0959ice,r
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.
r
Property Owner's Name �A� .;.'� .
Property Owners Signature:__m, ,, mm,
. _...
Sworn to before me this 11 day of, 1110 ,� 202-
Official Notary Publi Signature and Original Notary Stamp... .._..... ..
I
LUCILLE M,ftNC1RAN
NOTARY PUBLIC,State of Now York
I60IM04746664
Qualified in laiaaaaaa Countv
Commission
Page 5 of 5
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TOWN OF SOUTHOLD BUILDING DEPT.
c 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLRG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ]
FRAMING / STRAPPING FINAL
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]
FIREPLACE & CHIMNEY r ' FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION1 [ ] PRE C/O n ,
REMARKS: 0A
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TOWN OF SOUTHOLD PROPERTY
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TREET -< �' : VILLAGE DISTItic.� � �u ' LOT
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LAND IMP. TOTAL DATE REMARKt=
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M. Bldg, Foundation = BothD` _
Extension ; BasementFloors 1
Extension Ext. Walls Interior Finish L
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Extension � � Fire Place Heat
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Porch Rooms 1st Floor
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FORM, NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOt7THOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. .. . .$3.1 ...,..., Date .. . .... .................. .
THIS CERTIFIES that the building located atN/S....V`;f3,%t.)tJeW�_Dr............................. Street
MNlap No—KA90XA.......Block No. .........=.....Lot No, ... . ..•....fttUtUS ky.,,.,Rplt........................
conforms substantially to the Application for Building Yerrnit heretofore filed in this office
dated ....., .....Dec--31• ............. •, 19,5°9• pursuant to which Building Permit N'o. .z ..........
Gated ................•,,,,.,..7 6C,., 1, ....., 19...9,, 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
e..one"'famidy..dwelling. .........................................w,.;.....,...,.,.............,.,.,..,...,.,,.,,.
This certificate is issued to ...—NOSI...,.,1 lbrelcbt........� , P .,,.,...,.<..........................o,.,,.....,.,.
(owner, Iessee or tenant)
of the aforesaid building.
ua" ig'"In^ to . ,
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FORM No. 4
TOWN Or SOUTHOLD �61 (� OL
BUILDING: DE PARTM ENT � C5
TOWN CLERK'S OFFICE
SOUTHOLD. N. Y.
CERTIFICATE OF OCCUPANCY
No. Z 2500' » . , Date . x . . . . . . . . . .... . ..•nao.t. U. ,, 19. 0
THIS CERTIFIES that the building located at Street
Map No. .=. . . . , . . . Block No. . .=, . . . . . . .Lot No. XX, �17.C�i�. .��►;�'.e� . . . . , . . . .
conforms substantially to 'Che Application for Building Permit heretofore filed In this +office
dated . . . . . . . . . . . .AAr .� •, AO, pursuant to which Building Permit No. ���u. Z .
dated , . . . . . . . . . . jUyie . • 1)+• • 1�•F� 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 .PT:LV-at0. .=a -:CamilY-dWO1.1ing. . . . . . . . . . . .. . . . . . . . . . . .. . . .. . . . . . . . . . . . . .
The certificate is issued too . ,Robert•&: •iBli n&. •Gua.r blit . . . • . . . •Owners
(owner, lessee or tenant)
of the aforesaid building.
,Suffolk County Department of Health Approval . . . . '3.4],,%. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
Building Inspectoa° .
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FORM NO. 4
TOWN OF SOUTHOLD ( `
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. �. 640 . . . . Date . . . . . . . . . . .Oct. . . .31. . . . . . . .. 19.69
THIS CERTIFIES that the building located at Ii/S. . We stv. jov. IIrj Street
Map No. . .XX . . . . . . . Block No. . . .cc. . . . .Lot No. xz . . .Mttituc . . H.Y.. . . . . . ...
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . .Jun.* . . . 1,6 . . ., 19.69. pursuant to which Building Permit No. . 43442. .
dated . . , . . . . . . . . June. . .16. ., 19.69., 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 . . . . . N!�Tkks ,*01749e. .4:r. Agq§@PPr7.1314141IA6. . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . Robert .Gu=YeUa , . . . . • . . . • • . ,. . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . . . . .
�... . . . . . .
Building Inspector
Town of Southold 1/26/2021
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41779 Date: 1/26/2021
THIS CERTIFIES that the building ALTERATION
Location of Property: 460 Westview Dr.,Mattituck
SCTM#: 473889 Sec/Block/Lot: 139.4-13
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/14/2020 pursuant to which Building Permit No. 44839 dated 6/8/2020
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 bu:ijt!alteratiorLs,, l d.ir ts-Clra �,r; g q erLc�L� 'V-kl s @c t _ 4.cX t n sj l��ly langA�AWLiqd
for.
The certificate is issued to Daly,Matthew&Laurie
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-20-0449 12/18/2020
ELECTRICAL CERTIFICATE NO. 44839 11/6/2020
PLUMBERS CERTIFICATION DATED 11/27/2020 N i bing vices
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