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Home My WebLink About1000-85.-2-1.1 of so TOWN OF SOUTHOLD Rental Permit 1531 Owner: Laurene Herwald Occupied as: Single Family Dwelling Located at: 3155 Bridge Ln Cutchogue 85.-2-1.1 Maximum Permitted Occupancy: 5 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: 07/28/2026 Expiration: 07/27/2028 Code Enfo a official This Notice must be posted by the main entrance at all times -NYbwJ11"Y d�'�r Ma TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold.NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502�1 i1 : F w .y.: t��1„dloldto wnny_g RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) E C E � U E Section A. J U L 2 0 2026 00 Property Information: Rental Property Address: Building Department 3155 Bridge Lane Cutchogue,NY Town of Southold Tax Map Number: 1000 SECTION 85• -BLOCK -2 -LOT SECTION B. OWNER INFORMATION: Property Owner Name: Laurene Herwald Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 2801 Sunset Drive 2801 Sunset Drive New Smyrna Beach NSB,FL 32168 Florida 32168 Telephone Number (s): Daytime 386-690•1.678 Evening same Emergency 386-690-8739 Daughter Megan Donley Property Owner Email Address: Laurenez77@gmail.com 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): 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: N ,A. 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: One Single Family residence 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: 3155 Bride Lane Requested Maximum number of persons allowed to occupy Dwelling Unit: 4 Number of rooms in Rental Dwelling Unit: 8 Use and Dimensions of each room in Rental Dwelling Unit: Laund /Mud room 5'x 10', Kitchen x , Dining Room x , Living room x , Full Bathroom x ,Masterbedroom x Bedroom 2 x , Bedroom 3 x � , � w" 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. [� I am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 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 LAUC H9i?-WAL.,C> , 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 ite Manager. Property Owner's Name: LA f C% I- ALD Property Owner's Signatu e: Sworn to before me this day of , 20210 Official Notarg ublic Signature and r ginal Notary Stamp `r AC EY L. C.` WYE NOTARY,Y PUBLIC,STATE OF NkW YORK NO 01OW6306900 O'JAOFIED IN SUFFOLK COUNTY t:.CM"o SION 1EXPIVSJU E 0,2P--_3 Page 4 of 4 t� ry Town Hall Annex �� °0 xo Telephone(631)765-1802 54375 Main Roads P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Ste' , O Requested maximum number of persons allowed to occupy each dwelling unit: 2, Number of Rooms in Rental Dwelling Unit: _ 8 Use and Dimension of each room: Rental Dwelling Unit Identifier: M -0-2 Requested maximum number of persons allowed to occupy each dwelling unit: W Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: , -'P " . Ne 4*-3 Requested maximum number of persons allowed to occupy each dwelling unit: I Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: " TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 �5 -o? C T I o'gmlh' N [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/ STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL l S / en 1 b-4f0al2 ►c hGtS�K�( ww..wwww•� hcs� e, ,�ovGave i cu�� o� '� s .� �✓I �ccv �' . DATE INSPECTOR .w� FFQt Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 o `A +_ Southold, NY 11971-1179 Tel: 631-765-1802 SCTM # Date , Owner Phone Address /S5 i,.+l G Visible Hamlet Pnspector Floor Level Quantities Sub 1 2 3 Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors r Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors Egress Occupant Count 2. Building Systems Maintained &Operational Condition of Property Heating Building interior Hot water Building exterior Electrical Property clean, maintained & safe Mechanical Handrails&guards installed &secure Pool Safety Pool on Site 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 [PLOoc Rental #: " occupants: Comments: TOWN OF SOUTHOLD PROPERTY RECORD CARD Y, L OWNER STREET VILLAGE DIST. SUB. LOT 4-1 C FORMER OWNER N E AC IL va s W TYPE OF BUILDING N RES. COMM. CB. MISC. Mkt. Value SEAS. VL. 4FARM- LAND IMP. TOTAL DATE REMARKS �-6 V s A Z/ v i3 AGE 12J BUILDING CONDITION ---------- N6 B if FARM Acre i Value Per Va ue Acre' Tillable I Tillable 2 s x, Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRO NTAGE ON ROAD House PlotS� DEPTH BULKHEAD DOCK Total I CN ) - . COLORL:r_ 6 s x i _. - - TRIG ,1 - t "T? 2 "1 imp W-t-t�_ - I . F _ I t E i I F i M. Bld r f I g. / D:_ �a- 3 O b `F undation Both s R . B � i Dinette Extension :Basement C� Floors 3 K. Extension Ext. Walls = nterior Finish °' LR. Extension Fire Place �'� Heat s i Type Roof -( Rooms 1 st Floor BR. Porch ' lRecreation Room' ! I Rooms 2nd Floor FIN. B. t Porch ! §Dormer Breezeway Driveway Garage Patio I i Total i #% TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST, SUB. LOT LQ ACR. REMARKS k TYPE OF BLD. ' { PROP. CLASS LAND IMP, TOTAL DATE FRONTAGE ON WATER TILLABLE f FRONTAGE ON-ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT 4 - TOTAL FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. , Certificate Of Occupancy No. . . . .Z 10334. . . . . . Date . . . . .January 6�. . . . . . . . . . . . . . . „, 19 81 THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2705 Bridge Lane, Cutchogue, N.Y. Location of Property . House%Uo. Sheet Hamlet County Tax Map No. 1000 Section . . .85. . . . . . .Block . . . 2. . . . . . , . .Lot . . . . . . . . &*qr Sub F Zanowski F 1 Su ivision . . . . . . . . . . . . . . . .Filed Map No. x10. . . .Lot No. . . . . . . . . . . . . . conforms substantially to the e ttj " a e Fa it e n �u It ;Prior to Mttlet01 �txr amd.... April. 23, . . . . . . . , 19 . .5�ursuant to which 0 �imm tt of Occup>anc: dates `�iary .6. . . . . . . . . . . . . 19 . 8'1 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 . . . Private. One Family. Dwe113ng. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . _ .Mike.Zonovski . . . . . (owner, of the aforesaid building. Suffolk County Department of Health Approval . . . .X/R . . . . . . . . . . . . . . . „ , . . . . . . . . . . . . , . .. . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �G~. Building Inspector Rev 4179 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 2705 Bridge Lane, Cutchogue number & street Munioipa i y Subdivision Minor Sub. Map No. 210 Lot(s) 1 Name of Owner(s) Mike Zanowski R-1 Unoccupied Occupancy oumer- enan tYPe Admitted by: Self Accompanied by: Self Key available Wickham's Office Suffolk Co. Tax No. 85-2-1 Source of request ` Wickham, Wickham & Bressler,P.q)ate Dec. 17, 1980 DITELLING Type of construction Wood storiesOn�° Foundation Poured Cement, Cellar Full Crawl space Total rooms, ,lst. F1 4 2nd. PI _ rd. 'F1 Bathrooms) 1 Toilet rooms) Porch, type beck, type- Patio, type Breezeway Garage Utility room Type Heat Oil Fired '"Farm Air Central Hotwater �Fireplace(s) No. Exits P Airconditioning Domestic hotwater Yes Type heater Oil Fired Other ACCESSORY STRUCTURES: None Garage, type const-. Storage, type const. Swimming wool Guest, type Mconst. Other VIOLATIONS:. Housing Code, Chapter 52 Location Description Art. Sec.. .t C,h en a 52=52-E6 Front Porc -St2ps 'notec+ua c�L try front Porch Porch and st s need r airier I 2- O . Remarks: A strong gas odor was detected I sh t off. Inspected by: Date of Ins 1/5/81 Curtis Horton Time start 3-0Cb_end 3:15 ................. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ........T...2331..... Date —,..... ..............q4Aw!FV.Aq........ 1966... THIS CERTIFIES that the building located at ftidga 1anat,,..CLMCh0%U6.. ............. Street MapNo ..2=............ Block No .....2=. - - .. Lot No ......... ...............-.. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. ... .. ........morph.. .............................. 19.6s.. pursuant to which Building Permit No 10.71_:.4. dated ....... ..#W d X..1.7.......... . ......... .1 1964...., was issued, and conforms to all of the requirements of the applicable provisions of the low The occupancy for which this certificate is issued is ........ . .... ......I...................lIt"..<)M. .f."ixr..Awdaling. ...... ........................... ............ ....... ...... The certificate is issued to -Hen ry.Zanomaka :E= X1ke .Z4X%QW-4kA..XN**k#..... .............. (owner, lessee or tenant) of the aforesaid building ...................................... .... ..... 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 . .I.56.1.2. . . . Date . . . . .April 9 , 1987. . . . . . . . . . . . THIS CERTIFIES that the building . . Addition t o ,existing, shed. . . . . . . . . . Location of Property 3155 Bridge Lane Cu*tchogue , Nbew York House No. 085 0 2 Street� 1 . I Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . .Block . . . . . . . . . . . . . . .Lot . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No,. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated October 25 , 1984 13503Z . . . . . . . . . . . . . . . . . . . . . . pursuant to which Building Permit No. . . . . . . . . . . . . . . I . . . . . . October 25 , 1984 dated . . . . I . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . ADDITION TO EXISTING SHED The certificate is issued to HENRY Z A N 0 W S K Z . of the aforesaid building. Suffolk County Department of Health Approval , . . . . . .N .A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . .. . . . . . w . . . . . .. .A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/A PLUMBERS CERTIFICATION DATED: uilding inspector . . . . . . . . . . Rev.1/81 UVING ct a� L� ')az cl it TFW 41 PA noWm x srwKr00 �ALL dC4 WETS r TWA iTG�EN EL I to , i . o �2"X33 "r33"` AtsE , 2, Cfi��Ltt c)r,Uk'ff— , 1-4� rn/ r I � j al 4104flf f ( mollP s / I '�li i uu �U ;J I� wA rrm�� r gp f�^ y 1 {I r f i fpr � f 1 f f' I 1' !III iVi I i �� ,� ,��, 1� 1 ��,�,� �,,/, . ,, �1,f��/��% ,,, �� /ia�� i� f�/�%��ii ,,,�� `a�% / �/, �, J1 ,�fi „/,,, � ; , ��//% %i%�,,,, �r �� y III{i Ih I I ��j/��/ �Il�li�„ 1'i ///�j �i /i ✓, �� . /D��/ �„„ � ��i ��I%��%/� �i' I � ,�ii��% �„�r� ��1 11 1f ��/�//��// / o o� ioi�/�� i i // „/