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Home My WebLink About1000-113.-9-10.1 Rental Permit 1490 Owner: 4326 Westphalia LLC Occupied as: Single Family Dwelling Located at: 4326 Westphalia Rd Mattituck 113.-9-10.1 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. Issued: 06/03/2026 Expiration: 06/02/2028 c� ?Eorcrment official This Notice must be posted by the main entr nce a ail(rr akk �i TOWN OF SOUTHOLD—BUILDING DEPARTMENT—, Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 1� 1-0959 Telephone (631) 765-1802 Fax (631) 765-9502 1 t � o t t ld r vvrra �� 2026 RENTAL PERMIT APPLICATION Rental Permit Fee $300{Application must be renewed every two years) Section A. Property Information: Rental Property Address: 4 2,(.o W Ptt r pip KA, 1 -n.TU C K Tax Map Number: 1000 SECTION i 3 -BLOCK � -LOT j o r SECTION B. OWNER INFORMATION: Property Owner Name: 43 2 Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) S 27 ....t A-RL<Z(zs Po L k)? C�.�.. .._.. E.. ........ ...�....... 0P T I AC K(MGTTON O ( (, — q74 —4 2(a SS Telephone Number(s): Daytime Evening Emergency_Emergency Property Owner Email Address: + )Oak Q t+ ' @ I'1�1a'�` e Om Page 1 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: For Parh Rental DwPllina I Init cat fnrth tha Rental DwPllina I Init idpritifiar Ifnr Pxamnla, 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: -Rt,questeid Maximum number of persons allowed to occupy Dwelling Unit: (o Number of rooms in Rental Dwelling Unit: C ' " ' o m. in R nt l D 1 i g Unit: LIV.RCA- 211s"C 22'-2'► Use and Dimensions of each room In Rental Dwelling Klt: I(. -l� oc q $ ' ` r ' EMC Lt'-O' h ► �i r I I BhTN'RwrL � c I- SECTION G. INSPECTION: Pursuanttothe 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 tho rant-al normit nnnlirntinn Ic In rmmnliynrr=y��ith nil of the nrrmicinne of tho rnr�e nf+hn F.... .,F,F .....�..,.. ..p,.. p, 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. INbPs'T.0Aj OoNje AS' pAKT of REDENJ ttiTf6CT70AJ d3� ,jot+ IJ J A*4 KI W Page 3 of 4- IA. 2t: Fok 0 . D. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK), COUNTY OF SUFFOLK) 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 forthin "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(S)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 P ✓ agreed to abide by the same. f 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, 1 Property Owner's Name: e tl 43 X 5fpAJ16 ~ Property Owner's Signature: Sworn before me this day of �,20 b Off a Nota aabll igna e&ginal Notary Stamp DAVID DELGADO Notary Public, State of New r No. 01 D E6051290 Qualified In Bronx E' County Term frir&S—Kov. 20, 20a._?A m Page 4 of 4 PA- 10�W�6N OF SOUTHOLD BUILDING DEPT. 631-765-1802 I N E T0 IN [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ( ] INSULATION/CAULKING [ ] FRAMING / STRAPPING ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE RATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL ( NAL) [ ] CODE VIOLATION [ ] PRE C/O ] RENTAL R ARKS: DATEINSPECTOR 4 TOWN OF SOUTHOLD PROPERTY )MORDCAR F VILLAGE DIS SuBa LOT FORMER, 0%DER N E AC , a o- _ lw TYPE OF BUILDING RES. ` FARE! CQ CB. mics, Mkt. Napes �. AND i PAP TOTAL DATE REMARKS m a - p 4 0. $_ _ s J Tillable FRONTAGE ON WATER 'RONTAG. ON ROAD Woodland DEPTH - House No= _ m _ - ': Toto l m )LOR TRIM e 3 111-4-10.1 3/31/2025 - w e 1 F Exi - o Exten a sib Ex-e _ _f - Foundation A= �� Dinette � - rrsr�t Floors poimh � t. 11 Interior. ice_ h . Fire Place Hect R �f 6 �. _ 3Type R---f Roo g. � popea ; n Rooms Floor �Rec at y. �. Dorrrver Driveway Total FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25379 Date N'OVEMBER 21j 1997 THIS CERTIFIES that the building NEW DWELLING Location of Property 4326 WESTPHALIA RD. 1�4,TTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 113 Black 9 Lot 10.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 29 1981 pursuant to which Building Permit No. 11499-Z dated DECEMBER 7 1981 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 ONE FAMILY DVUMJING WITH ATTACHED WOOD DECK & AS PER ZONING BOARD OF APPEALS #2959. The certificate is issued to ROSEANNE K. SCHWARTZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL JUNE 234F 1982-11-50-69 UNDERWRITERS CERTIFICATE NO. N--566733- JUNE 23 1982 PLUMBERS CERTIFICATION DATED N/A Bui ding I Spector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.X. CERTIFICATE OF OCCUPANCY No: Z-25770 Date: 06/10/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 4326 WESTPHALIA RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 9 Lot 10.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 28P 1998 pursuant to which Building Permit No. 24669-Z dated FEBRUARY 11 1998 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 ACCESSORY TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to RALPH F. & ALBA RAGUCCI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 21375 05/13/98 PLUMBERS CERTIFICATION DATED N/A uil ng Inspector Rev. 1/81 t s �, Town of Southold P.O. Box 1179 53095 Main Rd + oy Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 47015 Date: 05/01/2026 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 4326 West halia Rd Maltituck NY 11952 Sec/Block/Lot: 113.-9-10.1 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 03/15/2024 Pursuant to which Building Permit No. 51611 and dated: 02/05/2025 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" additions and alterations inclusive of a finished basement with a bathroom (no bedrooms) and an above-ground swimming pool addition with decks surround to an existing single-family dwelling as applied for. The certificate is issued to: 4326 Wes halia LLC Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 51611 4/6/2026 PLUMBERS CERTIFICATION: RESc Plumbi 11/14/2034 X UV Au orie tgn ure i s , i F 3 4� a y a \Z € TIv v FIRST FLOOR EAKTIDY RESIDENCE 4326 WESTPHALIA RD. MATTITUCK 1000-113-9-10.1 FIRST FLOOR PLAN I 1 i ff I SECOND FLOOR t' E BAKTIDY RESIDENCE 4326 WESTPHALIA RD. MATTITUCK 1000-113-9-10.1 SECOND FLOOR PLAN l ; P-� 4_ F 5 a v a i� BASEMENT I BAKTI DY RESIDENCE 4326 WESTPHALIA RD. MATTITUCK 1000-113-9-10.1 BASEMENT FLOOR PLAN I I