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Home My WebLink About1000-115.-7-4 ffal Tu'm*'WWWN OF SOUTHOLD Rental Permit �z 0935 a Owner Mohammad & Amana Rasani Occupied as Single Family Dwelling Located at 450 Eastward Ct Mattituck 115.-7-4 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. 6/20/2023 cedeE Official This Notice must be posted by the main entrance at all times a Town Hall Annex �o �i�i� Telephone (631)765-1802 54375 Main Road „ "' ;Jf%jf ` Fax(631)765-9502 P.O. Box 1 179 Southold,NY 11971-0959 � BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) L= Section A. JUL 2 0 20M Property Information: o, DEPT.BInDING Rental Property Address: T0'VVN OF SOUTHOLD Tax Map Number: 1000 SECTION D U -BLOCK Q �- Uo -LOT 00 c-1 _- 000 SECTION B. OWNER INFORMATION: Property Owner Name: l�"LD�Ccn-,nom fvxlkA�rmKu `li Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): Daytime` e " ` � Evening ` K-197- dpEmergency ` �. 351/0 Property Owner Email Address: Page 1 of 5 Town Hall Annex � ��„t/�� i Telephone(631)765-1802 54375 Main Road q '°� ` Fax(Q l)765-9502 a d ff Fr iF mi ✓., �i ii��a/i rJN s°� P.O.Box 1179 �� rk�x Southold,NY 11971-0959 , BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: . .............w_� r`�f��. ._...w_....._m..--..-.. Address of Authorized Agent (no P.O. Boxes): w � ..... Y /1952 Mailing Address of Authorized Agent: w,,,,, � Telephone Number (s): Daytime'0-1 -9Su0 Evening�?!9 �fr " �? EmergencywcJ` '`fL�-3�i Email Address ✓3?✓`�c��'1i J�2 r' ✓vtv(� cd/1�j ............w_...._...w___�. _. Section D. Managing Agent Information: / Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes):,,,, /lf Mailing Address of Authorized Agent: Telephone Number (s): Daytime /f" 11 dJ Even! ergency 2dq- ` .(-3 9 yo Email Address: .. SG/lf 5 2 r � �� ...... 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__. ... _ w...__Hw ..._......M...........w_....�...._.......... Page 2 of 5 Town Hall Annex i1j //'epi o-�'�� M Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 Box. I .OB1 179 � Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: �_�._�.�.w._........... ....�.�......................_ _._ _..... w.ww�_._ _.�__...-.._, Telephone Number (s): Daytime Evening_ _„ Emergency_ ........ .w.,,,.......w.. EmailAddress: _.....,_.._w.. -. ._ w� _.. ._�_......__... ....�....�__�� _._ _......._w. .... _ — —� SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: �.wn��. .__._ w _�-. 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: Orl f w_ _ �. ........... ..........._....__._---_....._-_ Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: „__3_..... a2cS 3. ,�rJ°n'S_(PIS ae See OLj Use and Dimensions of each room in Rental Dwelling Unit: W__ w� _...,._ ...........w_.. ........................_w_ .µ_........ 19NA- C, Sem � , .._ l o✓.... www.... _.__ w..._ a Page 3 of 5 Telephone(631)765-1802 Town Hall Annex 54375 Main Road Fax(631)765-9502 i �i�i P.O.Box 1 179 r 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 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 , 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 sou? d1 i n 7 Telephone(631)765-1802 Town Hall Annex Fax(631)765-9502 � 54375 Main Road r j% J� /',, Zl P.O.Box 1 179 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. 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. x Property Owner's Name: Property Owner's Signature: -�L Sworn to before me thisvo day of V� , 201Z, Official Notary Public Signature and Original Notary Stamp BRADLEY SETH MAMAN Notary Public-State o&New York NO.01 MA6395938 Qualified in New York County My commission Expires Aug 5, 2023 Page 5 of 5 May 16, 2022 Town Hall Annex " Telephone(631)765-1802 54375 Main Road n( Fax(631)765-9502 P.O.Box 1179r Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Pr°o ession+ai seal re uir°ed Lor,architect or Engineer licensed F9ome Inspector rny9AE9F4q copy olid current certification Rental Property SCTM Number: Rental Property Address: 460 Eastward Ct. Mattituck 11952 Owner/Name: Mohammad Rasani Rental Dwelling Unit Identifier: Number & Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom #1 -100 sq., Bedroom #2-90 sq., etc.) Be room #1 1aQ— Bedroom 144 f Bedroom #2 144 s ft 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, and the Energy Conservation Construction Code of New York State. Victor Cornelius III CEO Inspector Print Name and Title ceo# 1216-02$3 Original Signature Please place professional seal: So (0 kkO�WW( TOWN OF SOUTHOLD BUILDING D 631 -765-1802 Clf,-- -I-,- INSPECTION FOUNDATION 1ST ROUGH PLBG. FOUNDATION 2ND INSULATION/CAI FRAMING / STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY IWI FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PE ELECTRICAL (ROUGH) ELECTRICAL (TIl CODE VIOLATION PR C/O [loof I ENIARK ow —----------- ...... ..............—----- DATE INSPECTOR i i z i u� e y i Ilei �N r i 41 y r ,J v' s r y i ilii 9�u�l y _1 G , 00 �I A 10' - za aa' Breakfast Laundry Bath Dining Roam r0'`t' I 13 ,,x 17'? Iq y xi3 Kitchen Family �- <<j Living Rooml I Garage g 676 sf FP Foyer 1 r1.5a' Cl r �i Bath, =� Bedroom 25.00: Bath S � First Floor 0 2041 .69 sf oF ClosetY, C-060A O s O Swio�e. Bedroom 0 = Smoke- Bedroom U X = �� MDA ok f de bp-e-I-V-Cf DY5 28.00' AJ } Co-r6dk� _ i X = Crwon AGnok 6e�,--,c- e,�/1 TOWN OF SOUTHOLD PROPERTY RE41 D mOWNER STREET I VILLAGE DIST. SUB� LOT % F ASR. CR. W TYPE OF BUILDING --4 RES. SEAS. VL. FARM COMM. CB. mics. Mkt. Value LAND IMP. TOTAL DATE REMARKS es g j7 -4-2 7 (5 7 zo q130 c At C L Tr 4 i?-!7c! f4CI'��c i-ecin� --TTir cl,I J4 lz,y r eJ 4�u -t c; k D Tillable FRONTAGE ON WATER ' Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total 7 4 4 COLOR TRIM t4l,�11 M. Bldg, X I Extemian 57 X J- 4- Extension Extension i e 6 Foution Both Dinette nda Basement K. Floors Poich LR. Interior Finish Ext. Walls Porch Ore Place Heat 0" A :DR . Breezeway kl/ IS rF Roof Rooms 1st Floor i BR. Garage ype Patio iRecreation Room Rooms 2nd Floor 1 FIN. B Dormer Driveway FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy N60b4. . . . . . Date . . . . . . . August- o., THIS CERTIFIES that the building located at . �A$twaXd C;=t . . . Street Map No.'arztWdo4 NAWAk No. . . . . . . . .Lot No. .7. . . . . . M ttt tuck. . 14*� .. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . �Ikty. 23 1973 pursuant to which Building Permit No. 6.5962 dated . . . . . . .1!ay. . 23 19.7.3., 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 Priva, a one family .welling . . . . . . . . . . . . . . . . . . . . . _ . . I . . . . . . . The certificate is issued to , Plln. X10.511e r. . . . . . . ime r . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Lug. 22 1974. by. F.. .Villa' UNDERWRITERS CERTIFICATE No_ .1.34 5R . . .Dec U-1 9.73 . . . . . . . . . . . . . . . . HOUSE NUMBER +50. . Street . . . . . . . . . . . . . . . . f 4 Building Inspector FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. 1 1.1 15.3 . . . . . . . . . Date . . . . . RLI-I tr. 24 . . . . . . . . . . . . . . . 19 U. THIS CERTIFIES that the buf that . « .P9o2 « , . . . . « . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 450Eastwood Court, , , , ,Matt�tgpk Hoose 11do. . . Sttset Hem/et County Tax Map No. 1000 Section ? . . . . . . . .Block . .97. . . . . . . . . . .Lot . . . QOk . . . . . . . . . . Subdivision . , a s t x 9,p d M a n pr « . . . . . . . .Filed Map No. 5 d b. , ,Lot No. . ? . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated November. . . . . . . . . . . . . . . . . 1981 .pursuant to which Building Permit No. , l 14 7 3. . . . . « . , . . « . dated . . N o v e m b e.r . 2 3, , , , , , , , , , , , , 19 81 ,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 . . . . . . . . . aninground swimmin fi pool. . . . . . . . . « « « . . . . « . « . . . . . , « . « . . . . . , , , The certificate is issued to . . . . . . ,James & j�e t t ar r sµc h a f t of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . .n1a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . .t? . 4 4$3 7„ « « . . . . . . . . . . . . . . . .� .. . . . . . °: . . . :/. . . . . . Building Inspector Rev.1/81