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Home My WebLink About1000-106.-11-6.2 -of so SOWN OF S UTHOLD Rental Permit 1286 Owner: Thomas Lenz , Melissa Lovric Occupied as: Single Family Dwelling Located at: 515 Cedar Dr Mattituck 106.-11-6.2 Maximum Permitted Occupancy: 4 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 ins eetion. Issued: 04/03/2025 Expiration: 04/03/2027 code forc m t cial This Notice must be posted by the main entrance at G11ties qb 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 )itt _:_'/NNrNNr o h d 1 ? RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed et To " ) E APR 2 2025 Section A. Property Information: Building Department Town of Southold Rental Property Address: 515 Cedar Drive, Mattituck, NY 11952 Tax Map Number: 1000 SECTION 106. -BLOCK 11 -LOT 6.2 SECTION B. OWNER INFORMATION: Property Owner Name: Thomas Lenz&Melissa Lovric Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 142 East 16th Street, #19G, New York, NY 10003 SAME Telephone Number (s): Daytime 1-917-545-2785 Evening Emergency Property Owner Email Address: meltom@513e12.com Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Age Ne Box Mailing Address of Authori Telephone Number (s): Day Even Emergency - _ Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Age n P BtA Mailing Address of Authoriz A .H ' 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 AgenUe Mailing Address of Managi __ Telephone Number (s): Daytime Evening Emergency Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property; 1 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: Private Home Requested Maximum number of persons allowed to occupy Dwelling U it: Number of rooms in Rental Dwelling Unit: 6 Use and Dimensions of each room in Rental Dwelling Unit: Porch(7'x2T), Open Concept Living Room (15'x 19) Kitchen (I Vx9'), Bedroom 1 (9" 12'), Bedroom 2( 'ac10'), Storage Room 1 (7'x8'), Bathroom(5'x9') 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. ***The house was inspected 1 month ago to get to CO that is attached to the application. I 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. 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 Thomas Lenz 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: Thomas Lenz Property Owner's Signature: Sworn to before me this day of March 2025 KEVIN CLINTON NOTARY PUBLIC,STATE OF NE:20,0]228 NO.01CL0031200 Official Notary Public Signature and Original Notary Stamp QUALIFIED IN KINGS COUN MY COMMON I'II ES NOVEMBER Page 4 of 4 TOWN OF SOUTHOLD tBptlDlNG [KEPT. 631-765-1802 t O INSPvtowuTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI ) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL RE RKS: DA TE INSPECTOR _ __ �- uizoC "AI _ IS . � ' u o.. s _ OWNER LOT in- x R kp- � \ o II `ice _ ` € ... jy ou� _L AN ' TOTAL DATE REMARKS 3 y - b,. e -a: � - ti r Y - o M IF \� �� - YV - �� - `c IUM e cd u t ffi W Acre- AcmeVC pm _..._. _ .2�- ��.._. 14 'i'lo-ble 2 - s Woodhow - RD T - F'RONITAGE ON ROAD nd d �ROTH ��,. T P. DE t aU KHIE , a { L4 ' € — �: — 3 SOLO x � I x 3 s } s I s i TRIM ; g ,I v ' I 4 E x I x � I - 106:11-6.2 3/7/2022 i x ° M. Bldg. I Foundation i Bath = Dinette r2 � �tensi h � } !Basement F - ,r loors 1 K Extension jExt. Walls ' I Interior Finish �= LR. � 7 1 1� i H�Extension I Tire Place Heat DR. - ;Type Rood I -_ Roomsst Floor BR. Porch _ creation Room Rooms 2nd Floor FIN. B. Porch !Dormer 5Po Driveway Garage!, i Patio I ! O. B. _ F i I Total FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20366 Date NOVEMBER 20 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 515 CEDAR DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 11 Lot 6.2 Subdivision Filed Map No._ Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-20366 dated NOVEMBER 20 1991 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 ACCESSORY STORAGE BUILDING * The certificate is issued to JOAN NELSON WM. A. RIEDELL & JEANNE CRUM (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECitION REPORT. '�A� i A� ilding Inspector Rev. 1/81 tsr� Town of Southold P.U. Box 1179 53095 Main Rd Ilkouthold, New York 11971 �. ., ..._. CERTIFICATE OF OCCUPANCY No: 45969 Date: 02/11/2025 THIS CERTIFIES that the building AS BUIL,r ALTERA,riON Location of Property: 5 ISedr Dr Mtttt itucL NY 11952 Sec/Block,'Lot: 106.41-6.2 Conforms substantially to the Application for Building Permit heretofore, filed in this office-dated. 04/15/2A24 Pursuant to which Building Permit No. 50728 and dated: 05/22/2024 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" alterations including a sink in an existing bedroom to an existing single-family dwelling as applied for. The certificate is issued to: Thomas Lenz, Melissa Lovric Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVALv ELEC ld L C F'1C TE; 50728 '�9 'Yv9dM95;�IPfvJ�Jrm¢?�orm,�r1Y1�'u�mr ,mrrie��i��, , ,. CERTIFICATION: Ro Eller Sander At on e Signature * 50-7a8 AM N SENT -1 TV, .— SKYLIGHT(rM.) .. SKYLIGHT(typ) Yelex Velux - - 214#x45.754nFbtedDeckMourK ( II•hrx54.44-In Axed DeckMoum } - - - �� 3r w/Larnhwtw Lowe Argon - w/Laminated Lower Argon { -. - - WINDOWS Andersen 2B-3/81n.x4Bh 4DO Series White Cad Wood Casement a WINDOW WfrnlwwRh Pine Interior, I I Anda Low-E Gass&Stne Hardware 481n.x 35-15/16 to White Clad Wood Casement Wmdow with Pine Interior, _ _. Low-E Gi—&Stone Hardware ' ra n a w—k. l BATHROOM F I I a I s x I I z94$ I I? L----J L----J t; KITCHEN - J � s I r��a.,=-I ROOM F___..—, ( I X I I s I s.�x t L L I [ r I s g F -,PORCHREAR FRONT i - a�°} I r DECK l STAIRS r - e—tf a I ` - R \ .# / PRIMARY I I BEDROOM THIRD SECOND. II BEDROOM BEDROOM R -_.. _ tawie lee tnaen..mn ` I .._ -.-. .__...._.._ 515 CEDAR DRIVE, MATTITUCK, NY 11952/ HOUSE PLAN SCALE:4 I'—on