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HomeMy WebLinkAbout1000-100.-1-40 , of so TOWN OF SOUTHOLD Rental a rm it k COUINIV. 1544 Owner: Kevin Romanowski , Paige Romanowski Occupied as: Single Family Dwelling Located at: 150 Saltaire Way Mattituck 100.4-40 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-annua inspection. Issued: 09/10/2026 Expiration: 09/09/2028 Code �m nt official This Notice must be posted by the main ent nce all ti es PQ-�4� ©o re-e-d t I"L-9 7 d TOWN OF SOU'If HOLD—BUILDING BEP'A►W1'MFN'T , Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax(631) 765-9502 Ll wiiL/ ALN �. oLitB ldlto m E W E RENTAL PERMIT APPLICATION Mfflding De,,pa lent Rental Permit Fee $300 (Application must be renewed every two yeT:;r#i Of solAhoid Section A. Property Information: Rental Property Address: 15-6 v k4ct k'�,( U-AA t Wsti Nk Tax Map Number: 1000 SECTION AC ' �J� -BLOCK _ 0 SECTION B. OWNER INFORMATION: N Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) ' V c7 N\' ((031) o Telephone Number (s): Daytime?1 p Evening SeLy,9 Emergenc "� T -1 5 -1535 Property Owner Email Address: l \ Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any L� Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorize Agent: %r (04(0 Telephone Number (s): DaytimeEvening Sq 58d Emergency Email Address: e4,e . Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit,,if any: ` l ( r\ Address of Authorized Agent (no P.O. Boxes): N L Mailing Address of Authorized ent: Fll Telephone Number (s): Daytim - vening Emergency Email Address: a 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): Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening Emergency Email Address: Page 2 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: Requested Maximum number of persons allowed to occupy Dwelling Uni Number of rooms in Rental Dwelling Uni, 7 . Use and Dimensions of each room in Rental Dwelling Unit: s < . �- G vV\ � .� , u C V-Ck �0 Sol, 4 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. am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 0 1 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 , 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. cl- Property Owner's Signature: Sworn to before me this Z'day of %4 _ , 20 2(a LORI T MOBRIDE NOTARY PUBLIC,sTATE OF NEW YORK Official Notary Public Signature and Original Notary Stamp Reglstratian,No.OIMC6368447 Qualified in Sufhaik County Commission Expires 11,2220, Page 4 of 4 * TOWN OF SOUTH Lb BUILDING DEPT. 631-765-1802 lip Kfl I N S P Im"o %Cr-k T It"i N [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ,] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O RENTAL / TOWN OF SOUTHOLDPROPERTY RECORD CARD _ OWNER s STREET VILLAGE ; DIST. SUB. LOT 6° rCRMER OWNER N E ACR �. Lj �t 1 st 1 1 Q P�J 4-'U i ob125 f S W TYPE O BUILDING- RES. ;: i SEAS. I VL FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS i 1 a / n C) t 3 i I AGE BUILDING CONDITION NEW NCRMAL BELOW ABOVE FARM ? Acre i Value Per Value Acre Tillable FRONTAGE i FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot��iD ° s �, "f / 71 Z} BULKHEAD - Total DOCK SCTM # ll�xi�i } TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST, SUB. LOT ACR. REMARKS ` 4 TYPE OF BLD. IT ImO PROP. CLASS / U LAND IMP, TOTAL DATE r I g FRONTAGE ON WATER HOUSE/LOT BULKHEAD JTOTAL o _+ COLOR r t TRIM s Y BC? 26 ems_ 100.4-40 3110 1 st 2nd CB M. Bldg 5 7 11 �/ ,7fs ZS 6�� Foundation Pc OTHER Bath 3 Dinette 5x17 �S FULL COMBO Extension Basement wL PARTIAL Floors Kit. / i x '3 �/ SLAB Extension Finished B. Interior Finish 5� (� L.R. I IlZ - Extensi n Sx 2-7- _ �o ZlZ j iz3� Fire Place — Heat D.R. Garage x e Zg� I JZS 3 jQ Ext. Walls f BR. Porch Dormer - Baths Deck/ is FQv- Pl 11"\5r� --S / - Fam. Rm. Pool Foyer A.C. Laundry / Library/ O.B. Study 7�V l s� o��� Al 6 s/g 3/ta I COLOR P TRIM } I} ; s is x _ e -- s � ' s 9 1 f y x 3 { E M. Bldg. I 1 � Extension l _ S s 4 E i qq s £ S s s Extension 3 I - - I , Extension t Foundation G [Bath I Dinette Pcc�, ti I .� �- !Basement I Floors ;K. Porch lExt. Walls Interior Finish SLR. 3 Breezeway ' ;Fire Place 5 Heat 'DR. Garage I 5 � € T P e Roof Rooms 1st Floor ! =BR. &C r , / o c� ± c , y Patio ;Recreation RoomRooms 2nd Floor i FIN. B O. B. [Dormer i Driveway Total � J FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. .Z 50.E. . (Z5O58) Date . . . . . . . . . . . . . .Apri;l .4. . . , . ., 19. 73 THIS CERTIFIES that the building located at . 9alt j,"- • . Street Map No. . Alta-ire •jltck No. . . . . . - . • „ .Lot No. , 37. . . . . .ftttituck 31.9y«. . . w . conforms substantially to the Application for Building Permit heretofore filed in this office . 19. ursuaAt.to which Building Permit No. .584OZ• dated . . : : . . . . . Nia . 1 2• P , dated . . . . . . - - - . . .)day „A.- . 19.?,2, 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- -family •dwel3}iag. . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . .Inland. H62ea •Ing. . . . . . . Darner. . . , . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . .Ja;a-16• ,1973• - -by. 8o Y111a• • - - UNDERWRITERS CERTIFICATE No. . - . N .166$$4)• •.Ten- - 1.5 •19"-3 ' ' ' • ' ' • ' - - - • • • ' • • ' , HOUSE NUMBER. . . .150. . . . . .Street. . . . 3altaire -tray . . . ® . . . . . . . . . . . . . . . . . . . 13ttilding Inspector i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34725 Date-. 12 03 _ .__.v._.. 10 THIS CERTIFIES that the building ADDITIONS ALTERATIONS Location of Property: .v._.. .. ww........150......... .SALTAIRE..w WAY,, ._........................................_................... MATTITUCK.....w_..__... (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 100mmmmm Block 1 Lot 40 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore ...wwww filed in this office dated JULY 27N v....M.., w 2 2009 pursuant to which ....w___... g ° .. __..._..................._�w...w 0 0 9 Buildin Permit No_ 6�3 - dated AUGUST 28...8, 2...vw _., 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 ALTERATIONS AND,AND ADDITIONSµ, INCLUDING DECK AND PATIO,Ww TOmm AN EXISTING ONE.n.. .. _ „ ........... FAMILY.......DWELLING AS........APPLIED FOR-........_1�6�11_.._CORRECTED TO._........._.._w_.................. REMOVE.DECK FROM THIS......_....._..........ww..._................_ CERTIFICATE OF OCCUPANCY. NOT BUILT PER GARY J FISH BUILDING INSPECTOR. The certificate is issued to KEVIN MA ROMANOWSKI mmyw _......_...........w.............m. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL „w..... w N/A w ELECTRICAL CERTIFICATE NO_ 12208 10/09 10 PLUMBERS CERTIFICATION DATED 10/04/10 BERTSAND PLUMBING CORP _.. ut k.dri.- d Sie Rev. 1/81 .r t_ - 3 _ fii r r J - T �. .-.�. m. e -_� .�- - -t� N 1.-..._ —_— •FAT— .—_.�.-. - - CELL NO- . � a � w € .5 � �� .:S•h"tk�zy Ghc aH g_a"vg.a at_a E� �� � @ cr,wm e r [ �.f 4� -j UNrvcnrJ �I t i 3 t - 29 4�_a 17 0 _ =g s � -Al t F - __— 00 S�a.c«�A.�de=�-. � ,�—�-.�.- s n 1{7; Ewu� ura- TOW 44-1 iFj TF XT } s ` p a �tr,>, ngs, tj qA11 -t tnir i`v Ln 1 �4 4" to g F I a d 2' P �14 - - J'CALE ��I���•D r � , t` gp 11 i = a r MI 1 t I € 41 3g z r LG- ✓,-? 7-10N �a S3� m��a e l £ z z e ll 7 sa.r.�i IF Giaota A a__$ T t� �� t M C N �' � fi -1 D i ►di1C➢flfdNL i Ed - # loan Q b $ - t , Zis I�" m r. 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