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Home My WebLink About1000-98.-4-38 G* M� Rental Permit . TOWN OF SOUTHOLD 0113 Owner Andrew Stole & Linda Leung Occupied as Single Family Dwelling Located at 210 Robinson Lane Peconic 98-4-38 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. 7/28/2021 - 3 Code Enfo ent Official This Notice must be posted by the main entrance at all times � � A FF 1.4t Town Hall Annex SOUTHOLD TOWN 54375 Main Road rcn ro y�f, C=) � `� R@fltal InSp@Ct1011 PO Box 1179 Southold, r" NY 11971-1179 '+4 � Tel: 631-765-1802 Fax 631-765-9502 SCTM # , , �� Date7/2i;z— Owner, -rp a Phone 6 Z7y,SYo Address 2-10 k.9 61/LSo Zlp -77 Nsrne Inspector, Address visible from street? LEVELS SUB 1 3 Smoke Detectors (#- bedroom detectors excluded) Carbon Monoxide Detectors (#) Fire Extinguishers (#) Exits (#) lis IiIIII BEDROOMS 1 2 3 5 Smoke Detector Alarms (#) Carbon Monoxide Alarms (#) Egress (window ) (Y/ i) V BUILDING SYSTEMS N CONDITION OF PROPERTY Y Heating system maintained/operational Building Interior is clean/maintained Hot water system maintained/operational Building Exterior is clean/maintained Electrical system maintained/operational Property is clean/safe/maintained Mechanical system maintainedloperational Handrails & guards present POOLS Y POOL BARRIERS Y/N Pool present Pool is completely enclosed Pool surface alarm and/or door alarm Barrier is a min. 48" high resent POOL GATES Y/N All openings in barrier less than 4" Self-closing, self-latching Max. 2"clearance @ bottom of barrier Latch on pool side of gate, meets height Barrier capable of being locked &child- requirements proof when unattended COMMENTS: l- July 7, 2021 y JUL To Whom It May Concern: r We would like to renew our rental permit that is about to expire on 7/12/21. There have not been any changes or updates to our property since the last permit issued 7/12/19. Th nk you. r 1 M„ w . Linda B. Leung Andrew Stole ,.f. �'" ( 031 ?q, � � �zi TOWN Mto Rental Permit q Permit No. 0113 Owner Andrew Stole & Linda Leung Occupied as Single Family Dwelling Located at 210 Robinson Lane Peconic 98-4-38 Village S/B/L 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. 7/12/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times H Town Hall Annex i Telephone(631)765-1802 54375 Main Road j Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOILD RENTAL PERMIT APPLICATION Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 1( 0 SON Tax Map Number: 1000 SECTION e BLOCK LOT 39 SECTION B. OWNER INFORMATION: Property Owner Name: L l N P P" LE U N G AN DK VV S TO LC Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) Uy, 5f. k3A- Asa, Telephone Number (s): �4 Property Owner Email Address: FI N MC-A 6r*A I L• ct-w A74pRc�WS o ~yn }IL-, Ci'n Page 1 of 4 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): Email Address: Section D. Managing Agent Information: / Name of Authorized Agent of dwelling unit, if any: N Address of Authorized Agent (no P.O. Boxes). Mailing Address of Authorized Agent: Telephone Number (s): 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: Address of Managing Agent (no P.O. Boxes) Mailing Address of Managing Agent: Telephone Number(s): 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, 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: a � <<u nitNuRequested Maximum number of persons allo to occupy Dwelling Unit- Number mber of rooms in Rental Dwelling Unit: 0 Use and Dimensions of each room in Rental Dwelling Unit: r Az- bt4W wik, z 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 NYS licensed architect, a NYS 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 thelawsadopted 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. Page 3 of 4 ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect, a licensed professional engineer, or a licensed home inspector who has a valid New York State Uniform Fire Prevention Building code Certification. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) COUNTY OF SUFFOLK)) ,, I L� Ll ,, 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: ` Lcunm Property Owner's Signature: p Y Sworn to before me this&L day of TU rK— , 2 0.0 icialN APubiric tuand Original Notary Stamp TR CE "L. DWYER N'OTARY PUBL.R ,sTkre OF NEW n� Page 4 of 4 N . 1 f.WC)1,306�) C7 QUAL.RED IN UFFOL COUNTY COMMISSION EXPRES JUNE 30, � µ A0 af Sou TOWN OF' SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION I ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING /,STRAPPING [ ] IN' L 41�w [ ] FIREPLACE & CHIMNEY ]� FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS,-m 5 DATE INSPECTOR o Y B m� tt Milt w nol8 �� .......� �u ma, 00 f, z w u � a ��1"h�"m'W'1¢Km0'ttuWCM^U u.�WWl'M,ub51W-0"tt�mlY.�"•" � Illi oil All 11 11 1 1 � 1 Cl) ............ ffa HUI ....... ........................... ..... U ku ................. Tm T"N", ilk! FIT'\ 7 OW G 01 m v N � r � u sa Y w y Voll I� ply MiRl r r w w e z, J ` Mc _ A � i Z Dr o trne O n � I � o �. r w .. o Tj 1 131 m 41 I C Q —I � � I kk B O ° N (D m 0. y O O O to if p : r ° 0. co 64 I ac h .., CO � m p c , OI h 1 �„gib I i �yy I „� T rt r a � d ro N e, __ : P � -3 T44 Ll wµ T 7 � o q: rJ v I W FORINT NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. x • ;g6G............. Date .....................e'7 +<-1........5................. 19.6... THIS CERTIFIES that the building located at .Tftree.,Wat ars...La. Street Mu rl to n� thP.. 1 No. .......=.......... Lot No. 37.............. ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated „.....................................NO�-0aer.....U 19..63., pursuant to which Building Permit No. ..2P-4,5Z.. dated .......................... wnbe '.....12, 19,,.6 ,, 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 ........ ..,.,�°:�,�1'F.3.'lrE:...�111P...1wi3,�i��..;y'...l�W�t�.�.�.rig ........ ......... ......... .................... ......... ......... ................ The certificate is issued to .....Wa:Lter. Mj.jr...J.ne...... . ............... '0W 0j ......... ... own .... er, lessee or tenant) of the aforesaid building. R.D.Approval Juno 51 1964 by R. Villa Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31855 Date: 09 25,/06' THIS CERTIFIES that the building ADDITION Location of Property: 210 ROBINSON LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 98 Block 4 Lot 38 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 9, 2000 pursuant to which Building Permit No. 26808Z dated SEPTEMBER 29, 2000 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 SCREENED PORCH ADDITION 17' X 18' TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR, The certificate is issued to SANDRA EKBERG-JORDON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-579466 12/26/01 PLUMBERS CERTIFICATION DATED N/A /�&h/i ze Signature Rev. 1/81 74 Town of Southold 9/27/2017 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39246 Date: 9/27/2017 THIS CERTIFIES that the building ALTERATION Location of Property: 210 Robinson Ln.,Peconic SCTM#: 473889 Sec/Block/Lot: 98.4-38 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/16/2016 pursuant to which Building Permit No. 41184 dated 11/21/2016 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: f ADDIT°ON'S AND AL` ER-AnONS 1*0 AN EXISTING ONE FAMELY D EI',l NG AS APPLIED D FOR The certificate is issued to Stole,Andrew of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL - ELECTRICAL CERTIFICATE NO. 41184 09-06-2017 PLUMBERS CERTIFICATION DATED 08-22-2017 J`J ' hitecFage _ _.:... y t:atlit eac9� Signature.. �_..__ _... ... ,y ti o .� M c g ' r� (B L O00 v, X 4' M a� w ' L 4 00 �, o CO p 00 0 uj CUcz U c cu a cu LA cn AOMbk ... a� .—a (B c O ai G� 3 CU t a E ca c o . N c �' Q .� > t v 0 C3 cc c Q 2 Lro LEv O Cd U U 0 0 c a U p Owoo CL O - p v c Y 8- 0 p p et V � �.� a-J N p � N � O%AO CD O � 3 E E � ) �l 0 = z p p N O� E o cu .U) F- low .X cn _o ti3 0 Q (1) -v m O :2 o cc ac�i +-+ � U) o N a KK c o40 3 i 'Q E w �rvry, U U0 0 r so TOWN OF SOU' ""HOLD BUILDING DEPT. � , 631 -765-1802 N*rm-Nm Em T N [ ] FOUNDATION 1ST [ ] 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 [ ENTAL REMARKS: Coll-�in v Town Hall Annex Town of Southold 54375 Main Road ter, Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 ,�° " ► •� "� Tel: 631-765-1802 SCTM# S _ .._............_. �. �. w. �_.m �.�' �.. _..... ._ ._ .�_ _. Phone.... .. ,Owner �f Address b/,07 5-00 Visible Hamle. ... . T t ![i Inspector 1 3 Floor Quantities Sub 2 Smoke � (not .�.._� ..__.......�.._r...,. � � .. ... .�._ Sm Detectors ( d in bedrooms) Carbon Mo / noxide Detectors Fire Extinguishers .. , _.... .. . . . ..... _,...., .. . ..... ,, ,,,,,. �I ... .�. Exits Bedrooms 1 2 3 4 5 6 �. , Smoke Detectors Egress Occupant Countw Building Systems Maintained &Operational of Prod')ey Heating Building interior Hot water Building exterior ElectricalProperty clean, maintained &safe ;Mechanicalrails &gLIards installed & cr Hand. ._.._..._.._ ..�. . � _...._se_..r ue_ .__ .._.� Pool Safety Pool on Site ....�m _.ea..., ...�._.,.._ _ ._ . _ _ ..,.. .. e.. Surface water alarm Date of CO issuance Door alarms Pool completely enclosed Self closing�. ..� . . _._. _ . . _ _ . � �..�...... �.. , / latching gates Pool fence to code requirements CO's for all items present Prior Rental Comments: