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Home My WebLink About1000-59.-5-22 TOWN OF SOUTHOLD Rental Permit a� 0966 Owner Gerald V Cruise III Occupied as Single Family Dwelling Located at 315 Lake Drive Southold 59.-5-22 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. 8/3/2023 Cod Enfo ent off This Notice must be posted by the main entrance at all times �:. � Town Hail Annexe Telephone(631)765-1802 54375 Main Road � � 1)&Y(A)765-9502 P.O.Box 1179 � . , Southold,NY 11971-0959 0 I -( � �-1 Z �?O�c,Q,_ 2.o BUILDING DEPARTMENT re-cam- l �`�d-2-7 TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: L,a Ke— F r,> . J-�h C=I. Tax Map Number: 1000 SECTION 473 ST`7 --BLOCK__ .q -LOT ZZ L-f--7 3 E'q 9 Sc:� . SECTION B. OWNER INFORMATION: Property Owner Name: r c. t c1 N/ C-ru I se- l t/ Property Owner Legal Address: Property Owner Mailing Address: 3 f-, Ic I Telephone Number(s): Daytime_1o31-9ZI-1 S-Evening t,-ii Ay.if*Emergency C i -q Z/" S-7-7 Property Owner Email Address: -v Is -La P M C T LA 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 Cou BUILDING DEPARTMENT TOWN OF SOUMOLD OLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: N) A Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: _._ Telephone Number(s): Daytime ,__,,___EveningEmergency Email Address _�. .. _. _.._ ._ �... _.�._....._..._...._ ._. _... ...... . Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: N f A Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s):Daytime Evening Emergency. Email Address: ry ... .� -..-............... SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: ._.,,,,_ �I Address of Managing Agent (no P.O. Boxes):_ Page 2 of 5 / .,. Tele Town Hall Annex hone(631)765-1802� P 54375 Main Road ;vt Fax(631)765-9502 P.O.Box 1179 �, p C" ; Southold,NY 11971-0959 �m ino BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime_-__,_,.,,.Evening Emergency_,,,....,,,,,. Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: One— 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: 1 Ke- ar"ialhzlc Requested Maximum number of persons allowed to occupy Dwelling Unit: in Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: rn"+Ar " It- �, #c►.r¢r► -7' 11 P r 1 1.. r " - Page 3 of 5 01 rVIde-1.,s,C*I—S * , 19, 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 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 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 Page 4 of 5 Town Hall Annex fit Telephone(631)765-1802 54375 Main Road ;, Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 d . BUILDING DEPARTMENT TOUN OF 3O ' OLD 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. I 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: % V, �- Property Owner's Signature: Sworn to before me this a__uay of J,(� I 2qo Official Nota Public Signature and Original Notary Stamp DANIEL MAPZLLLLA Notary Public State of New York NO. 01MA6399249 GV C21.-,afrfied if', tdr,il au Cuulfl.y 1a1 My Commission Expires Oct 15, 2023 Page 5 of 5 TOWN OF SOUTHOLD BUILDING DING DEPT. err 631.765.1802 I IN NLN S rms 1 k Em T I 4"Am"30" 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 [ teJ41ENTAL REMARKS: 0-4x hon J cSl�o% o`LriG��S iiLe� �7'IPM ak- 2 soil OGGv ah hRrS-e� c,er - DATE -�3INSPECTOR �� r� � � ' �� , �, � �� %' �i t,��.,, �� til ��„ `,��9,r � „/, ��i /� �l� fJ �� , ,. �; \ \MINE May 20, 2023 Telephone 631 765-1802 Town Hall Annex �`- P ( ) 54375 Main Road a Fax(631)765-9502 P.O.Box 1179 �"NC Southold,NY 11971-0959 coun BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PROPERTY CERTIFICATION Form is to be completed by a license architect, licensed engineer or licensed home inspector Separate form is required for each individual Rental Dwelling Unit Pro essional seal required for Architect or Engineer, licensed Horne Ins actor must t•ol 4q copy of valid current cerci icatlon Rental Property SCTM Number: Rental Property Address: 315 Lake Dr., Southold NY 11971 Owner/Name: Cathy Cruise Rental Dwelling Unit Identifier: Number & Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom #1 -100 sq., Bedroom #2-90 sq., etc.) Bedroom #1 140 s i Bedroom #3 105 sqft Bedroom #2 100 sqft Property Description (Include all improvements indicated on survey) Si I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully complies with all the provisions of the Code 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, the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New York State. Victor Cornelius III CEO Inspector Print Name and Title ceo# 1216-0283 4igina4li at Please place professional seal: 0 e f----9' 2" 101211 '511 - ------------ r= od It 00 3G W g J p � 31311 1 6' �, w x It 1 _ r-T 9'7" ' I9's" 4' 10.. 2w 1011 n, _ �. to N A v Q24' L17 —+-5' lo" 2' 10"-+-- cm r , � _ 9 Y 8,,,... —6' ..,. a 00 t _ = N 8f-], 311111 «4" 1 (�1 f oil 1=3r ..S Jz N ..6 X M - a N C � � C � e E m 917/1g OWNER STREET VILLAGE DIST SUB. LOT R . FORMER OWI��R E � ACR. S I W TYPE OF BUILDING RES _` SEAS. VL. FARM C M CB. MISC. Mkt. Value v § LAND IMP, I TOTAL DATE REMARKS = A t r s _ £ f z BUILDII46 CONDI ' a e ABOVE NEW NORMAL BELOW FARM Acre Value Per Value Acre Tillable 1 Tillable 2. Tillable 3 Woodland i Swampland = FRONTAGE ON WATER Brushland FRONTAGE ON ROAD I House Plot DEPTH , BULKHEAD ------------------------------------ Total I DOCK & COLOR 7 Wi 7- '4— 4- TRIM -T-17 J 1 TJ -4 4- t T M. Bldg. Foundation Both Dinette FK. Basement A Extension Floors Extension Ext. Walls Interior Finish LR. Extension I 'Fire Place Heat DR, Type Roof Rooms I st Floor BR. Porch ' 4- Recreation R FIN. B.1 corn Rooms 2nd F100r: ---------- Porch iDormer Breezeway 1 Driveway Garage j Ratio O. B. Total ----------- FORK NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. . §.............. Date ........................October...... ......... jq. `2.. THIS CERTIFIES that the building located at A/5,,_Lake Drive .................................................. Street Map No. ....XXX.......... Block No. .....X=......... Lot No. .......ftUthPld ................. ........— conforms substantially to the Application for Building Permit heretofore filed in this office dated ..1, .......................I............ :.q.....�3...... 14g... pursuant to which Building Permit No. 4W.... dated .................................Jme 23--, 19�?.., 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 ........ Private .....................o...ne.. fa..m.Ii..ly..dw...ell .n ............ .....—.—.......... .................... ............................. ..... The certificate is issued to ....Qexala..Cruise. ... ........ ..&oraer.......... ........... ....... ....... ............. (owner, lessee or tenant) of the aforesaid building. H.D. Approval Oct 99 162 by P, Majkowski . . .... ...... 6:��tiding Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. t Certificate Of Occupancy No. . ZJ566. . . . Date . . . . . . . .0C.Ubpr 109. . . . . . ., 19.73. THIS CERTIFIES that the building located at . .U0.DrATO. . . . . . . . . . . . . . Street Map No. . . . . . . . . . Block No. . . . XX. . . .Lot No. .XX. . .80Ut►%Q10. . . . . . . . . . . . . . . . . . �. conforms substantially to the Application for Building Permit heretofore filed in this office dated . . a • . . , ftvmbor. ,16j, 19. 7.0 pursuant to which Building Permit No. . 'S XOVAAbo . ,"BMs„ 19. .7Q was issued, and conforms to all of the require- rents of the applicable provisions of the law. The occupancy for which this certificate is issued is V&t*•0A* •f ly. dW* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . .G#. CvA*a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . .$.Rs . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. —PUDING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a . HOUSE NUMBER . . . .315. . . . . . . Street . . . . UM. Prl-VO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building pecto FORM NO.2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE , SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 5049 19-- Permission is hereby granted to: ...Bau*r ................ .................. ............................ .......... .............. ......... ...................—........ ........... to ......buill..8a.-Ad4lkloa.. Ift.......................................................... ...................... ................. ...... ............................ ......................................................... atpremises located ..............................g.......................... .............................. ........ .............. ...... ...... . .....I Air .................................... .......... .............. ....... ...... ........ ......... ......... ......................................................... pursuant to application dated .......................... .....,.+ . ....,- 19..-*, and approved by the Building Inspector. Fee ............ .............. .................. J�Building Inspector FORK Na S TOWN OF SOUTHOLD BUILDING DEPARTMENT Tows Clerk's Office - ) Southold, N. Y. Certificate Of Occupancy No.4111. . , . . . . Date . . . . . . . . . . . . . 1p . . .16. . . . ., 19?!+. . THIS CERTIFIES that the building located at0/$ . * .Dri . . . . . . . . . . . . Street Map No. . . . . . . . . . Block No. . . . . . . . . . .Lot No., . . . . .Santhold . .N*Y conforms substantially to the Application for Building Permit heretofore,filed in this office dated . . . . . . , . . . . .1 p►T . . .9. ., MT . pursuant to which Building Permit No.6155y. . . dated . . . , . . . . . . X7. . . .4. . . ., 1973. ., 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 fawiI7 a;.with addition The certificate is issued to gr*X4.PrOso. . . . . . . or.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N�R... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a° UNDERWRITERS CERTIFICATE N0434349 . . . . .. . . . . . . . . . .�. . . . . . . . . . . , . , . . . . . . . . HOUSE NUMBER . 31.5. . . . . . . . . Street .40 .Qr;kV*. . . . . . . . . . . . . . . . . . . . . . . . . . a` . . . . . . . . . . . . . . . . . . . . . . . . . . . . u . . . . . . . . . . . . . . . . . . . Building Ind IN ff� r t ,ye