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Home My WebLink About1000-113.-8-13.1 € � TOWN OF SOUTHOLD a Rental Permit = h 1147 Owner David & Joann Stavola Occupied as Single Family Dwelling Located at 545 Meday Avenue Mattituck 113.-8-13.1 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. 6/5/2024 Code EAforcWnent offi I This Notice must be posted by the main entrance at all times 30c) TOWN OF SOUTHOLD-BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1 179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 htgL,:/ m �a stltvls4t a r�k� r RENTAL PERMIT APPLICATION Rental Permit Fee $300(Application must be renewed every two years) Section A. Property Information: Rental Property Add ss: Tax Map Number: 1000 SECTION —fi-2?--BLOCK tl -LOT —0-1 SECTION B. OWNER INFORMATION: Property Owner Name: 4 A- �*\Y-OtA Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) L4 tt bss ems:",34 RDZ6 z n�-P Telephone Number (s): Daytime �wen?ng ;mergency_ Property Owner Email Address: -e- Q'60Z (3 J\0b Page 1 of 4 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, 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 "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: t 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: 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. [] 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. Page 3 of 4 SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I to �rAv�►lJ� , 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 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 s 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 of o,-11 200? T Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Page 4 of 4 Qualified In Suffolk County Commission Expires April 14,2-0g 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 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 re aired for Architect or Engineer, Licensed Horne Insl2ector mast provide cogy of valid current certification Rental Property SCTM Number: 1000-113.00-0&00-013.001 Rental Property Address: 545 Meday Avenue, Mattituck, NY 11952 Owner/Name: David Stavola Rental Dwelling Unit Identifier: N/A Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 —100 sgft., Bedroom#2—90 sgft., etc.) Bedroom#1- 105sgft., Bedroom#2- 126sgft., Bedroom#3-158sgft Property Description (Include all improvements indicated on survey) 1 story frame house, garage, asphault driveway 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. Anthony Portillo, RA oar r, w, Print Name and Title �O ( inz gna e Please place Professional Seam �n fr 4,µ� TOWN OF SOUT OLD BUILDING D � 631 -765-1802 I mi kmo S mr"hE %4�"-rk T� 10 N [ ] FOUNDATION 1 ST / REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN! [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FII [ ] CODE VIOLATION [ ] PRE C/O [ ql E KSM oz. 4 TOWN OF SOUTH SOUTHOLD PW PERTY RE 2N :�o'-I� OWNER STREET VILLAGE DISTRICT SUB. LOT FORMER OWNER N E ACREAGE W TYPE OF BUILDING RES, f SEAS, VL. FARM COMM. IND, CB. MISC, Est. Mkt. Value �_. I LAND IMP, TOTAL DATE REMARKS I , AGE i 4,13LALMNt C NISI i NEW AL ';` BE � 1 ABOVE FRONTAGE ON WATER 11 m� Value Per Acres Value FRONTAGE ON ROAD s , Tillable 1 BULKHEAD Tillable 2 DOCK 4 Tillable 3 - - — - — - Woodland g - Swampland ? Brushland House Plot 'I .V Toto I�' 1 1 113.-8-13 03/21/2017 i NA. Bldg. — Foundctior-) Bath t e_ Extension Basement 0or Extension Ext. Walls Interior Finish Extension Fire Place Feat Porch ' Roof Type Porch . Rooms 1st Floor Breezeway Patio Rooms end Floor Garage - Driveway Dormer O. B. l F0RM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Towii Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z6988. . . . . . Date . . . . . . . . . . April . .26 . . . . . ., 19.76. THIS CERTIFIES that the building located at .gRe :ay T. . . . . . . . . . . . . . . . . Street Map Nclollexood. . . Block No. . . . .Lot No. 61.b2r6 . . .;`;attituc . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . De c. . . .11., 19.7 5. pursuant to which Building Permit No. �a j 7Z. . dated . . . . . . . . .Dsc. . 1.5 . . . . .. 19.75., 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 Private. one .f=11-Y. wQ11t49 . . . . . . . . , . . . . . . . , . . . . w . . . . . . . . . . . . . . . . . . The certificate is issued to Fraa . .Tucc jj),q . . . . . . .Owner (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .AprA1. . ?b „ 1976. . . . . . . . . . . UNDERWRITERS CERTIFICATE No. .pending. . . . . . . . . . . . . . . . . . , . , . , , . » HOUSE NUMBER . . . . . . . . Street . . . . . . . . . Meday. .ATP. . . . I . . . . . . . . . . . . . . . . . . . . . .j. . . . is . . . . . . ", . . . . . . Building Inspector 9F14 Town of Southold 5/13/2024 P.O.Box 1179 53095 Main Rd cv Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45171 Date: 5/13/2024 THIS CERTIFIES that the building AS BUILT ADDITION Location of Property: 545 Meday Ave, Mattituck SCTM#: 473889 Sec/Block/Lot: 113.-8-13.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. ... .._.2/28/2024 pursuant to which Budding Permit No. 50518 dated 4 55/2024 „ 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"addition rtc alteration_ w, c lLidrrag s cl r..:.iAt..I? tctLall .. °.� r gc.:..�(?r)ygrsion tc1_lia it ble 5p t ;clwu l mg ,t t,1r,1,g one harni,ly_clay%el1l1l , as gjaplJ d Via►. The certificate is issued to Stavola, David&Joann of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 50518 05/01/2024 PLUMBERS CERTIFICATION DATED .. ..... ........ ... ..... u1l rt lzed S�gr r,rt ._._ � w.. ..... ..._.. e « — U — Y + 1` L U e- s_ Q J� a Li i >z= 3 _ AS BOLA UILT 545 MEDAY AVENUE `- M19A7TITUGH NY 1452 _ �('. -EYISflN6 645E IENR PL1N£I `. —. _ � --_ x � �_ •- �^` �— }� ��.` —`' s'—�.r.�� `— __ _E515iiN6 FIR5TGlOGR PLAN f - A-101.00 EXIST:\v 5A5;=N;cNT CLAN >„_.�. --.,�._; _ - - -- -_ 12_s-j z spa EX15?LNG r=R5T F_OGR PLAN --<_ «. ,•; ---- -.