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Home My WebLink About1000-100.-1-18 TOWN OF SOUTHOLD J' 1, Rental Permit 0850 Owner Valerie Kokelaar & Jane Novatt Occupied as Single Family Dwelling Located at 505 Saltaire Way Mattituck 100.-1-18 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. 4/7/2023 Code nforc nt Officia This Notice must be posted by the main entrance at all times Town Hall Annex 1 T j( 31)765=1802 JEWF 54375 Main Road Fax )765-9502 P.O..Box 1179 _ ., _ _° _- Southold,NY 11971-0959 : P 4` ? BUILDING DEPARTMENT TOWN OF SOS OLD RENTAL.PERMIT APPLICATION RentalPermit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION 10 0 O -BLOCK 1 eb -LOT SECTION B. OWNER INFORMATION: Property Owner Name: -1 Property Owner Legal Address: Property Owner Mailing Address: a � C—,20Lo 1 Telephone Number(s): Daytime _-DL�2!&f EveningSd M��Emergency cl f'? -'K L-1A I(oct Property Owner Email Address: Page 1 of S sn- F Town Hall Annex Telephone(631)765-1802 54375 Main Road, Fax(631)765=9502 P.O.Box 1179` Southold,NY 11971-0959 44 BUILDING DEPARTMENT TOWN OF SO17rHOLD 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 AuthorizedAgent of dwelling unit, if any: N li�* Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening, Emergence __ 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: t�'j Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall-Annex Telephone(631)765-1802_ 54375 Main Road �` Fax(631):765-9502` P.O.Box 1 179 Al Southold,NY 11971-0959 BUILDING 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 or Apt A, B, Q 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 "RentalPermit Application Addendum. Rental Dwelling Unit Identifier: f Requested Maximum number of persons allowed to occupy Dwelling Unite# Number of rooms in Rental Dwelling,Unit: 12— Use Use:and Dimensions of each room in Rental Dwelling Unit: t4_ 4,o Y 6A in 1 �" 2-0 tFAA is 4 1 > �. it � ' c ` 3 it IZi c G, ,Pss4-b -7'6")< I I'lo'I2' "ZCD,^ 5" I 072" x 2! Ick' Page 3 of 5 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 SOUTHOILD 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 laws adopted by the New York State Fire Prevention and Building Code Council". I am requesting a fire safety inspection to be performed by Code Enforcement Official from the Town of Southold lam 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& Kpk� ,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 Town Hall Annex Telephone(631)765-1802- 54375 Main Road Fax(631)765=9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SO HOLD 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. I have readand received a copy of Chapter 207 of the Code of the Town of Southold and agreed to abide by the same. 4. I will notify the Town within five (5) business days as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. ff , Property Owner's Name: p Y Property Owner's Signature: €_a Sworn to before_ this LJC+da, 202,.� ignatlr l Notary Stamp Official Notary P li X14#ttSt17#Fittlpt 0 74 off s 0 N Page 5 of 5 soly TOWN OF SOUTHOLD BUILDING Di 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/GAL [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN% [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL. (ROUGH) [ ] ELECTRICAL � 1 [ ] CODE VIOLATION [ ] PRE C/O REMARKS: ok- e-- hx6 �� DATE INSPECTOR vx Or r F loo+m,�.oemmrr:�ou+-mRmwrnow� ', rnrL M, r:�fmiYr+�'✓,:-`rr' .�YOY, „r// /, �/�e�/I//.<�/ ... 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Jrv,lf rN ,J r��/lHm'&vyyl t�Yf� ...Ji ': r lllLriri%r2 r%/ii. v, ,/✓F, ri''1/ „,,, : 0 ,,,,,,/ ,,/ / ,,Jr ,.., / ry�Ii ,:. /'r <.., /�f, (,J l r s // r .rrr vr,. /� ,,rr .r ;- rr, ,.: „,,„ = r..,;,,, ,✓ ,,,.,c/ „;- ,!” L:�' / / / r r /io r ,< f // a � ✓ l / l/ c ,/ r,1 n� c„ t r r/r r,., r ,, / //r/i.rr /l✓i r l � t /� , , 1 I , ,,, //,: i/ /... ,,, /, ,, r,<„ �f ,✓��r,,r �&�, iii/ //.../ /�, "i// �' ��%l� r r �f�� I 1�� ,i r� Jl r,mi P, u NOW 'NQ H =j co alas ' , u 41 J t; Au LU 41 < lu LU Lu LU Llr) 6 LU 0 0 Z z .do. La LU of Ce 1 LL U- =a Lu LU >0 U- um CD Ln mj z (nC)0 V) ------ Lu < A) Q) CL lid ul 1-4 N', N4 la LU Lu UJ CL '3_31 o > ce moi- 1ui -\q tA Lu cl C) 0 0 LL, _..� TRIM m l 100.4-18 09/2016 __ __.. _. ...,... ., .m..,._.., ... _ 6 L2 M. Bid . f � I Extension _ , k Z: Extension " . ..._..,,,. . ._._ Foundation �� ... �fiafih_��......__ .��.._wDiriette K. .. i Basement M_ Floors ora . Porch a � a Exfi. Walls ._... ...... ..,,. ..` ._ `::.._ InteHor Finish R. Breezeway Fire Place Heat ,....D, ._...... .. J._.w.,_. �. _ .�� ..... .... . ._�._ ,� ._._..�._,.....� Garage Roof Room_...:.,.,.. _ ., ._ ....... s 1st Floor BR ._. ,.... gig I Type ._Patio Recreation Room ..m.,,._ �.....� _.....,.MM_ .R4om..._.....__ _.. .._._.......,..._...._...... .,,_�._,.. . ., ,.:. s 2nd Floor FIN. B _ O B ... .. ._ ..ww..mDormer Driveway _ Total '"fir` a i -5 m rh6 4 J Town of Southold 7/25/2016 C* P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERT CATE OF OCCUPANCY No: 38404 Date: 7/25/2016 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 505 Saltaire Way,Mattituck SCTM#: 473889 Sec/Block/Lot: 100.-1-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/15/2015 pursuant to-which Building Permit No. 40383 dated 1/4/2016 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: ONTE FAMILY DWELLING WITH COVERED FRONT PORCH.R R EN ATFACHED TWO-CAR G GE<AS APPL FOR _=. The certificate is issued to Zoumas,Ioannis of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-15-0038 05-31-2016 ELECTRICAL CERTIFICATE NO. 40383 06-29-2016 PLUMBERS CERTIFICATION DATED 07-19-2016 Georios Almyrou r Au Sigmnatu e Town of Southold 1/15/2022 P.O.Box 1179 *' 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42691 Date: 1/15/2022 THIS CERTIFIES that the building GENERATOR Location of Property: 505 Saltaire Way,Mattituck SCTM#: 473889 See/Block/Lot: 100.-1-18 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/30/2020 pursuant to which Building Permit No. 45437 dated 11/13/2020 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: accessary generator as applied for. The certificate is issued to Yeager,Kathleen of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45437 1/11/2022 PLUMBERS CERTIFICATION DATED tAui J51 at re