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Home My WebLink About1000-79.-3-2 �`4� TOWN OF SOUTHOLD ca Rental Permit 0693 Owner Amy Condit Occupied as Single Family Dwelling Located at 210 Northfield Lane . Southold 79-3-2 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. 7/8/2022 Code fo cm nt Official This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 54375 Main Road 3 Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING.DEPARTMENT TOUN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: J � 21 ® pool+�i e1�I �c��ld ' I Tax Map Number: 1000 SECTION ` ®C3 C). BLOCK _ 7_2 SECTION R. OWNER INFORMATION: Property Owner Name: .. Amy Property Owner Legal Address: Property Owner Mailing Address: �r d r Evening___,.,- (0o� \� 5" g� 3e Telephone Number(s): I7aytrrne ✓ g ti Emer Cenc .� a Property Owner Email Address: 0 ; CO KJ i RM06 ` APR 2 9 2021 - Page 1 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 StOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Nt 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 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 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);;. .. . . Page 2 of 5 YM�• bY MM1�`� { �y Town Hall Annex4' Telephone(631)765-1802 54375 Main Road 4�� s1 Fax (631)765-9502 P.Q.Box 1179 r Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF svUTxOLD Mailing Address of Mahagirig.Agent: Telephone Number•(s): Daytime..... :, .,Evening Emergency Email Address; SECTION F. PROPERTY DESCRIPTION: !Number of Rental Dwelling Units on property: . For each Reiilt'al 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 propertles with multiple Rental Dwelling.Units use"Rental Permit Application Addendum." I Dwelling Unit Identifier: �� Renta D g 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: 1. c- X11 e'n L 11 1M X, - S 1) ( jq�'X )3-,>'� Page 3 of 5 Town Hall Annex Telephone(631)765-1802 54.175 Main Road Fax(631)76.5-9502 P.O.Box 1179 .. Southold,NY 11971-0959!►@ BUILDING DEPARTMENT TOWN OF SOUTHOLD 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEIN YORK) ) COUNTY OF SUFFOLK) q con d 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 Page 4 of 5 Town Hall Annex z21160. Telephane(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 = s Southold,NY 11971-0959 ",.. BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name:: h Property Owner's Signature: Sw to before me this 2 7 day of..... ' I^ I C Official Notary Pu c Signat re and Original Notary Stamp DANIEL JOSEPH PACELLA NOTARY PUBLIC-STATE OF NEW YORK No. 02PA6115293 Qualified In Rockland County """"��!� 24 Commission Expires September 07, 2O Page 5 of 5 OfS00ly� # # TOWN OF SOUTHOLD BUILDING DEPT. `ycourm,N�' 631-765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] NAL [ ] FIREPLACE & CHIMNEY [vf FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI AL) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: i01A �(/�✓ f cfA,ok Civ e 6aw -vim00000- vrqlw DATE (0 �070?jv INSPECTOR �_-- __-- ... __-- _._---- - - __--_ ___-- �„'-,` _".--^-''tel f t s ,�: — I �� } -� � �--� �_ ...-- ` j�� ,r► ,\ �� II I, I,�,�, , ,,, �,. ��,, i. /f 1 _ ��. r I Orr- Town Hall Annex_ Telephone(631)765-1802 54375 Main Road �., Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWW OF.SOUTHOLD RENTAL.PROPERTY CERTIFICATION Form is to be completed by a license architect,licensed engineer or licensed home inspector Separate form is.required.far each..Individual Rental Dwelling Unit Pra essl+:snulseat:re aired orArchlte .�rrgri neer 1lcensed:N`ome-7ns ectormust r�rvide copy o.vOrWcurrerrt cern c ti n y Rental Property SCTM Number: 1'000=19:3_2 Rental Property.Address: . 214 No�h�16ld.Ln.Southold NY J 1.971 Owner)Name: . Am ::Condit Rental.Dwelling.Uliit Number&Square footage af;each bedrot�m as tliep`Ictstl rn, he,attached floor pian: : (i.e...Bedroom.#1-4100 sq;.Bedroom;#2 ; sq,,:etc;j� Bgd :4444 4444. .,4:444.. Bedroom 2a= .:1.89 s .f Bedr-omb 25 Property DOscr..iptian:,(ln�lude�all irr proverrtentsirid at iW:,on;•survey) Two sto` frame house:arld:�* ar.a a e':.... ' i certify.thatishard.e done•aph}tsical. nspectior afth`,esabject,rental;dweIling unit and find that it fully complies withal!the provisiorisof the Chde 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, thefue[Ei"Ctiti4 of New York:State;:;erid:xhe' rtergy_Cvnservatii n Cons'ruction Code of lUe►nr York.State . AnthonyPQr#l1l0- R,.A Print Narrte:aridTtle signature � .. Please place professlonal'sseal:. 4444 ~ JF ---------— . ............ ........... OrL ........... .... RG ................. 16 Ir a Liu rp -17 .IJ ......... ........... 71- elf, -}-_ I mH I I F �10 Ak t fpIll i jE FT- .7i ----------------- .......... 77' Wv t 7--LAW Nl� 4 W�Q AVI 5 777 PW T 77- d �777777� 777- T 7 ..7T 77" ...... . ..... 4; T.) s. ..n m. 1. 7 77 ................ AS Fs fit 74 7 �'i:' tot 41 0-11 -77 io [`7 1-777-7 v LAI 49F T 77 77 77 7— -74� ap W 4-1 Wi t.: 1 W. 7r 1 1 1 i TOWN OF SOUTHOLD PROPERTY RECO i)Ps — — OWNER {s STREET VILLAGE DIST. _ SUB. LOT } /�n I f fi r`01�k ; i t �� I C ,I� Z4 FORMED OWNEFC-. E ACR. v'r1 r, S _-- j-_r 4a _` view S W TYPE OF BUILDING %i RES. ! SEAS. VL. FARM COMM. CB. MICS, Mkt. Value LAND IMP. TOTAL DATE REMARKS � .�I.G., 'gyp c�''� �� C"i � � :"✓C3 .0?e '�.1t'N A j�... (.9.��i f' r^.r, _ C� ,� / _��ap�jr.��'., ��o- {�n/�,C�Fa✓��-,�y4�/e`��QTe� rY,�1 .�onr��Pr��d's:.L�.s a:.a :; �lJr ?�✓7 6 '14U I ref '" ;a R ---. b Co �z-L 1z r77-(� a13l,?,Q -5 - 19 t� ---7 zSo Tillable :FRONTAGE ON WATER Woodl°'� FRONTAGE ON ROAD Meadowkx� DEPTH / House Plot BULKHEAD Tota _.. 1 wi \^''COLOR . ,� t .: TRIM �1 �fA\: :� — _.._. _ e I 79.-3-2 3/2014 g M. Bldg. Mg 1 1 "' — Extension xte Sion Extension FoundationPd— Both �'° -- Dinette , Porch Basement Floors F4tj- U - . a Y K. � r t �. V1ialIS r\( p ,gInterior Finish LR. p Breezeway r Fire Place Heat M< DR. Garage. - = r t-j Type Roof Rooms 1st Floor ° BR. ,,t Patio Retreat.ion. Room Rooms 2nd Floor qq, FIN. B S .. ' i '4,,v, +tt .<. O. B. 0 J-R Dormer Drive' y ; � Y T �J'r Qtal tG4,6w 1"DIAi\[� gip:: FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18384 Date SEPTEMBER 19, 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property, 210 NORTHFIELU LANE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 079 Block 3 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed .in this office dated DECEMBER 1, 1988 pursuant to which Building Permit No. 17661-Z dated DECEMBER 1, 1988 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 DWELLING WITH ATTACHED GARAGE & ATTACHED WOOD DECK The certificate is issued to THOMAS & EILEEN CITRANGOLA (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-228-JM 22, 1989 UNDERWRITERS CERTIFICATE NO. N-074503-JUNE 5, 1989 PLUMBERS CERTIFICATION DATED SEPT. 11, 1989-THOMAS CITRANGOLA Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24077 Date DECEMER 13, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 210 NORTHFIELD LANE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 3 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 13, 1994 pursuant to which Building Permit No. 22424—Z dated NOyEM9ER 1, 1994 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 AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE ENCLOSURE AND DECK SURROUND AS APPLIED FOR. The certificate is issued to JOSEPH & ANGELA SAVINO (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N352435 MAY 22, 1995 PLUMBERS CERTIFICATION DATED N/A Building Ins ctor Rev. 1/81 Town of Southold Annex 8/28/2012 V S, P.O. Box 1179�z 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35920 Date: 8/28/2012 THIS CERTIFIES that the building HOT TUB Location of Property: 210 Northfield Ln, Southold, SCTM 4: 473889 Sec[Block/Lot: 79.-3-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 7/20/2012 pursuant to which Building Permit No. 37381 dated 7/20/2012 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"accessory hot tub as applied for. The certificate is issued to Savino,Joseph& Angela (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37381 8/16/12 PLUMBERS CERTIFICATION DATED A o ed S ature Town of Southold Annex 8/28/2012 P.O. Box 1179 54375 Main Road v, Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35921 Date: 8/28/2012 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 210 Northfield Ln, Southold, SCTM#: 473889 Sec/Block/Lot: 79.-3-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 7/5/2012 pursuant to which Building Permit No. 37380 dated 7/20/2012 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" finished basement with full bathroom as applied for. The certificate is issued to Savino,Joseph&Angela (OWNER)of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37380 8/16/12 PLUMBERS CERTIFICATION DATED 8/27/12 Joseph Savino ZWOri4sipat _ Town of Southold Annex 8/28/2012 �`. P.O.Box 1179 54375 Main Road ' Southold,New York 11971 •aru, CERTIFICATE OF OCCUPANCY No: 35920 Date: 8/28/2012 THIS CERTIFIES that the building HOT TUB Location of Property: 210 Northfield Ln, Southold, SCTM#: 473889 Sec/Block/Lot: 79.-3-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 7/20/2012 pursuant to which Building Permit No. 37381 dated 7/20/2012 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"accessory hot tub as applied for. The certificate is issued to Savino,Joseph& Angela (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37381 8/16/12 PLUMBERS CERTIFICATION DATED A o ed S' ature