HomeMy WebLinkAbout1000-90.-4-5.1 3f TOWN OF SOUTHOLD
Rental Permit
0882
Owner David Schwartz
Occupied as Single Family Dwelling
Located at 1015 Lakeside Drive Southold 90.4-5.1
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.
12/17/2024
Cod o c ent Official
This Notice must be posted by the main entrance at all times
Wk4�t, by ,
TOWN OF SOUTHOLD BUILDING DEPT.
n� 631-765-1802
1 NSPE�TION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] AL
[ ] FIREPLACE & CHIMNEY 4FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
7REARKS: .., ..
D s�v
r
DATE INSPECTOR: «"TOR
R TUWNOF SOUTHOLD
40 Rental Permit
0882
Owner David Schwartz
Occupied as Single Family Dwelling
Located at 1015 Lakeside Drive Southold 90.4-5.1
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.
L
4/26/2023
Code Eytfotce e t Official
This Notice must be posted by the main entrance at all times
Town Hall Annex "i a$, Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179i
Southold,NY 1 1971-0959 1 "!"" �°
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PERMIT APPLICATION
Rental Permit Fee $200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
O/ ij
~
Tax Map Number: 1000 SECTION &--BLOCK -LOT
SECTION B.
OWNER INFORMATION: ,
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
Z / 2y q - 1632 _
Telephone Number (s): Daytime
� -7W1 Evening 6 ' Emergency —1,679
Property Owner Email Address: �z- /0-0 2M -fBV 12 D
�.,. .
JUL 2 7 2020
Page 1 of 5
BUT1,I)ING DFff.
2023
Vol
dUOLUIN(J OEM'
Town Hall Annex Telephone(631)765-1802
$4;175 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 14
BUILDINO 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:
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:
Requested Maximum number of persons allowed to occupy Dwelling Unit: r s
umber of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: r - r
I r 52
f1bf � P' 21 11 .1 . w- 0w t#4 4133 q +l t !
Page 3 of 5
W
Town Hall Annex �, Telephone(631)765-1802
54375 Main Road 4 Fax(631)765-9502
P.O.Box 1 179 sV
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.
❑ I am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
IKI 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)
1 -061,6`1-. S �✓ +` 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
q,
Town Hall Annex Telephone(631)765-1802
5437.5 Main Road Fax(631)765-9502
P.O.Box 1179 A�
Southold,NY 11971-0959
� r11
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. � °� 'A � ..
Property Owner's Signature:
Sworn to before me thisQ=Aday of_ , , 20�
Official Notary Public Signature and Original Notary Stamp
E
LISSAR DEBOER
BLIC STATE OF NEW YORK
UFFOLK COUNTY
UC.# ID 9898
t �.r...
Page 5 of 5
6W5-&�
TOWN OF SOUTHOLD BUILDING
631 -765-1802 tQ c
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING / STRAPPING [ 7] FIRE
INAL
[ ] FIREPLACE +& CHIMNEY [ SAFETY IN!
[ j FIRE RESISTANT CONSTRUCTION [ j FIRE RESISTANT PE
[ ] ELECTRICAL. (ROUG [ ] ELECTRICAL (F
[ ] CODE VIO TI [ ] PRE / [ ]
Ilk
if
ft!�:-
40W
INSPECTORDATE
Town Hall Annex I e-, 'Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179 1
Southold,NY 1 197 1-0959
'm "M
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
Professional seal re uired for Architect or Engineer,licensed dome Inspector must ro%l@
co v valid current certl icotlon
Rental Property SCTM Number:
Rental Property Address:
Owner/Name: yjdVV
Rental Dwelling Unit Identifier: •.,w
Number & Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom #1 —100 sq., Bedroom#2-90 sq., etc.)
Property Description (Include all improvements indicated on survey)
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. e 4na
Print Name and Titlnature
Al 4'
" 1
'-
Please place professional seal:
w
rEX15TINBALCONY E4 1"ING BALCONY
\ 1
BEDROOM
\ / MDR.00M 3
\ /
OPEN Td BELOW
BEDROOM 2 \
\ 'A5HNG
\ f Md6�t!k,B IN
DOWN
co
EXISTING DLCK
O
EXISTING SECOND FLOOR
DAVID SCHWAIZTZ Robert I . Drown
10 1 5 LAKESIDE DRIVE NORTH Architect, P. C .
50UTI-101-D, NY 205 bay Ave. Green ort NY
5CALr_: �/&' = i, info@ inforibrownarchtect.corn
JULY 3,2020 G3 1 -477-9752
E,xi`-TING RAGED DE:Cry
EXISTING DINING KUOM
EX15-nNG LIV NL ROOM
o�
EXISTING KITCHEN
PXI_`MNG C}EN
Dow, EXISTING
EXISTING PC7YEK I3ATIIKC bm
EXI5TING DECK
0
EXISTING FI R5T FLOOD
DAVID SC H WAIZTZ Robert 1 . Brown
101 5 LAKE5IDE DRIVE NORTH Architect, P. C .
50UTHOLD, NY 205 Day Ave. Greenport NY
5CALf: 1/8" _m I' info@nbrownarchtect.com
JULY 3,2020 G3 1 -477-9752
TO ' 7/9
� WN S SOUTHOLD PR -- - -►R CARD
STREET 10 VILLAGE DIST. SUB. LOT '
„FORMER OWNER 5;�r n�, �l c� x��. , �� sN' �=, E ACR.
r 1
SW
TYPE OF BUILDING
RES _ SEAS. VL. 1 FARM !COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE MARKS
i
7e4 A
,
_
�-
-
-e F
Y
AGE
BUILDING CONDITION ' F
NEW NORiMAL BELOW ABOVE
FARM Acre Value Per Value
Acref
Tillable 1 ., v_ y, Lr1G, N.f✓
Tillable 2 -
i I
Tillable 3ti
_= -
Woodland
WATER
FRONTAGE ON W
Swampland �
Brushland FRONTAGE ON ROAD
House Plot
DEPTH
' BULKHEAD
4
Tota
DOCK
Iz
a fie_.
?Rt
s
a
�
i
tt EE `
s
1
r t
a
,
� � 3
a
FT
! I
17-
90.-4-5.1 3/06
r'/ter x' ff d�
Foundation E Bath = Dinette
9
Extensic�r , f ,,`3; :Basement K.
,
Floors
e
s
ll
Ext. Wai , Interior Finish LR.
Extension �/I /
t
Extension Fire Place Heat ; DR.
'Type Roof Rooms 1 st Floor ' BR. f
I Y ,
i ;Recreation Room= Rooms 2nd Floor; ` FIN. B
Porch f. �� QLi ' d�.`� I`t Dormer ;
i
i
Breezeway 1 Driveway
I
Garage
Rcticr
Total
I
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31315 Date: '12 02 0
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 1015 LAKESIDE DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473559 Section 90 Block 4 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 15, 2003 pursuant to which
Building Permit No. 2951.4-Z dated OCTOBER 16 2003
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 SINGLE FAMILY DWELLING WITH GARAGE UNDER & ATTACHED WOOD DECKS AS
APPLIED FOR.
The certificate is issued to ERNEST SCHNEIDER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-03-0117 11/1S/05
ELECTRICAL CERTIFICATE NO. 2035757 ».0 03/05
PLUMBERS CERTIFICATION DATED 11/30/05 PECONIC PLUMB.& HEATING
a.
Aut.,orized Signature
Rev. 1/81
Town of Southold 12/8/2016
P.O.Box 1179
°+ 53095 Main Rd
` Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38696 Date: 12/8/2016
THIS CERTIFIES that the building HOT TUB
Location of Property: 1015 Lakeside Dr, Southold
SCTM#: 473889 Sec/Block/Lot: 90.4-5.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/5/2016 pursuant to which Building Permit No. 41075 dated 10/13/2016
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:
LI"O"N _ _ ., 1.; T CII:±t,OC _ _.1' AJC `OR
The certificate is issued to Schwartz,David
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 41075 11-29-2016
PLUMBERS CERTIFICATION DATED
t o ed Signature
q, EF
Town of Southold 3/23/2023
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43939 Date: 3/23/2023
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 1015 Lakeside Dr, Southold
SCTM#: 473889 Sec/Block/Lot: 90.4-5.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/21/2020 pursuant to which Building Permit No. 45333 dated 10/15/2020
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:
in-ground swinirning_ pol,., ddition to existing sin l ai yydwelling as applied for..
(Maintain selflos.iji action of at
The certificate is issued to Schwartz,David
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL.
ELECTRICAL CERTIFICATE NO. 45333 /2 2021
PLUMBERS CERTIFICATION DATED
__.. . stature
Town of Southold 3/25/2023
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43956 Date: 3/25/2023
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 1015 Lakeside Dr,Southold
SCTM#: 473889 See/Block/Lot: 90.-4-5.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/8/2021 pursuant to which Building Permit No. ^45777 dated 2/4/2021 M. µM„
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 b4itr finished laasement with wet laar reise rncanasnd bath°ocan no be rac r,stea existing ipgle amil'µ
N_qj jjAg„as aid for.
The certificate is issued to Schwartz,David
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 777 2/24/2023
PLUMBERS CERTIFICATION DATED 2/28/2023 Jo n I ennedy
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