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Home My WebLink About1000-59.-5-4 of so TOWN OF SOUTHOLD be Rental Permit 1443 Owner: Bransbourg G Revoc Trt Occupied as: Single Family Dwelling Located at: 2045 Lake Dr Southold 59.-5-4 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. Issued: 04/15/2026 We4,,.h Expiration: 04/15/2028 (Ode moment I This Notice must be posted by the main entrance at all times ! m 1 `",, TOWN OF SOUTHOLD—BUILDING DEPARTMEN Town Hall Annex 54375 Main Road P. O.Box 1179 Southold NY 11971-0959 ti : C .soutl oldtol1:11 101. Telephone (631) 765-1802 Fax(631) '765 9502 Ii s--7 4 RENTAL.PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 2045 Lake Drive-Southold,NY 11971 Tax Map Number: 1000 SECTION 59 -BLOCK 5 -LOT 4 - SECTION B. OWNER INFORMATION: Property Owner Name: Gilles Bransbourg Revocable Trust Property Owner Mailing Address: Property Owner Legal Address: (Cannot be the same as Rental Property Address) 240 East 29th Street 240 East 29th Street New York,NY 10016 New York,NY 10016 347.622.0106 Evening�'7.622.0106 Emergency 6_696°45 Telephone Number(s): Daytime Property owner Email Address: Gilles.Bransbourg@>gmail-com Page 1 of 4 Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: Gilles Bransbourg Address of Authorized Agent(no P.O. Boxes):240 East 29th Street Mailing Address of Authorized Agent: New York, NY 10016 347 Telephone Number(s): Daytime `BDB Evening4 ' 22'0106 Emergency646.696.4599 Email Address: Gilles. Bransbourg@gmail.com 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); 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: 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,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: 1 Requested Maximum number of persons allowed to occupy Dwelling Unit: 8 Number of rooms in Rental Dwelling Unit:3 Bedrooms Use and Dimensions of each room in Rental Dwelling Unit: Lower Level: Bedroom 1, Bedroom 2, Lounge, Bathroom 1 Ground Floor: Kitchen, Living Room, Dining Room, Bathroom 2, Den Second Floor: Bedroom 3, Bedroom 4, Bathroom 3, Bathroom 4 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. A 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 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: Property Owner's Signature: Sworn to before me this day of 2026 Official Notary Public Signature and Original Notary Stamp REBECCAANN COMAN-RACER Notary Public state of New York NO.0 t COA)020086 Qualified In w York County My commission Expires Jan 19,2028 Page 4 of 4 TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 1 'Nmw S vmw a h`ft C T I 'd 0 b' N [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLEIG. [ ] 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 [[ RENTAL REMARKS: C mx-ott. ��-- C'. 0. = r DATE 'S INSPECTOR f so TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 IN .qt� rECTION [ ] 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 (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ �ENTAL REMARKS: .° s r-P 15e- _ 044-�AIR- cwa, - DATE 3 INSPECTOR SCTM # TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST SUB, LOT REMARKS TYPE OF OLD, PROP-CLASS LAND IMP- TOTAL DATE c 0— t4 FRONTAGE ON WATER HOUSE/LOT BULKHEAD TOTAL TOWN OF SOUTHOLD PROPERTY R1 1�1aG��t R OWNER `STREET �' _ = VILLAGE 1 ��.; SUB. LOT OR, iER }WNER �eI J S(-' '0 Z i rn F_le,e N E ACR. 'To�'N /y1- J-c�a�d�,J f S W ? TYPE OF BUILDING -- YY - RES. 0 �1 SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 5Zo 9 4 f v 5 j _ r t qz, rvl r - AGE BUILDING CONDITION t NEW E NORMAL BELOW ABOVE FARM Acre ' Value Per Value Ac re Tillable '; FRONTAGE ON WATER l 6 s �g Woodland 1 FRONTAGE ON ROAD Meadowland I DEPTH IA0=I 2- House Plot BULKHEAD Tota DOCK r 15 1 _ TRIM,t� �R / tom — - _ _ _ g —s t -- 59.-5�1 11/201 .. __ L - 8 z . -- - _ iet Scth Utension - Foundation `4 t �s - - � , doors Porch i7, 1_ �� _ �Interaor Finish � -LR. Ext Walls r - �' ion- Heat _ ;Fire Place � _ Br e `�e-a-} __. � —� }dooms 1st Floor . Mype, 62oo _ -} n �i Ilya l Rooms 2nd Floor � Recreation Room av 'Dormer p 0. =vex B Af o- - 24 Commerce Drive Riverhead, NY'11901 0,,Fidelity National Tltle Phone: (631)77-000 F Fax (631)727- insurance ScrAc s Ordered: June 28,2024 Title: 7404-018545 Premises: 2045 Lake Drive, Southold,NY 11971 Special Ha- Premises: District: 1000 Section: 059.00 Block: 05.00 Lot: 004.000 County: Suffolk TownfCO:y: Southold Owner(s): Lillian Ball, as Trustee of the Lillian Ball Trust CERTIFICATE OF OCCUPANCY FIELD FORM To Whom It May Concern, Please provide us with necessary documents for the above captioned premises. Thank you, Jessica Kelly o� mI ' 01 C ' r ip 41 pie b �Lk )Q. cv- for oafdd Printed: 06.26.24 @ 01:06 PM by NY-FT-FGW H-01020.AO1o04-T4�"016545 Municipal Groupa:mce Grder Letter(Riverhead) Page 2 NYD1706,doc d Updated: 0127 OF SO' M OLD BUnDuIJG DVARTMENI" Torn q'ews ' " Soa&old, N. Y. Certificate Of Occupancy Date ... .. . .. . .. . . . No. 76.7.1 . . . . . . Lake.give. . . . . . . . . .... a Street THIS CERTIFIES that the building located at . . . . . . . Southold IZ.Y w , . . Map NO. . .xx. .. .. .. . Block No. `.taL t No .. . . .. . d+ elfin & code AV 1 r Occupancy conforms su y to the o� occup Bu It 19. 57 pursuant to which No. Z67t6• date . . . .Before. apr. 23 . ., Se 3Q . . . ., 19? ., was issued, and Conforms to all of the require- dated . . . w . . . •. P.t certlficate is able provisions of the law.The Occupancy far which this meats of the applicable . .. .. .. . . . . . . . Private one family.,duelling. .. ... . . . . . . . . . . . . issuedis w . . . . . ...... . . .. . . . The certificate is issued to • She wner,lessee or tenant) of the aforesaid building. � pre- existing. . . . .. . .. ... .. Suffolk County Department of Health Approv . . .. . . .. . . . ��, No. ire-e. . . . . a;.. . . . . . . . .. . . .. . . . . .. UNDERWRI'Y'ERS C t Lake }rive . . . . . . . .. .. .. . .. . . HOUSE NUMBER - • . . .? . . . . Stree •• " ... .. .. .. .. .. .. .. . .. .. . ... . . . . . . . .. . . ... . . .. . . ... . . . .. .. ... ... . ... . . . .. ..... .. . Building Inspector HOUSING CODE INSPECTION September 29, 1975 2045 Lake Drive R-1 Southold, New York Tax Roll: Jeanie N. Fischer Occupied, John Fischer Upon receipt of an appliccRtion for a Pre-Existing Certificate of Occupancy I made an inspection of this one story framed dwelling. I was admitted to building by Mr. Fischer who accompanied me during this inspection which began at approximately 1:20 P.M. The first floor consists of two bedrooms, bathroom, living room, dining area and kitchen. Heat is furnished to all rooms from a forced warm air, oil fired furnace located in furnace room of finished part of cellar Finished basement and cellar contains a separate living unit with full kitchen facilities and bathroom in violation of Chapter 100, Zoning Ordinance, Article III, Section 100-30 A.1. The following violations of the Housing Code, , Town of Southold, were found: Furnace Room, inadequate openeings for air supply, Article V, Section 52-53 G. Smoke pipe from furnace to chimney has insufficient clearance to combustible materials. Article V, Section 52-54 B. Bedrooms:in cellar of building's foundation . Article V, Section 52- 3 D. (Bedrooms are being used and occupied b,y John Fischer and wife and daughter.) Inspection completed at approximately 2:10 P.M. R +ectfully submitted, w EH:mm w rn Building Inspector Town of Southold Annex 7/10/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37014 Date: 7/10/2014 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 2045 Lake Dr, Southold, SCTM#: 473889 See/Block/Lot: 59.-5-4 Subdivision: Filed Map No. Lot No. conforms substantially.to the Application for Building Permit heretofore filed in this of6ced dated 4/10/2014 pursuant to which Building Permit No. 38791 dated 4/18/2014 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: ROOF MOUNT SOLAR PANELS TO A SINGLE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Ball,Lillian (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38791 05-27-2014 PLUMBERS CERTIFICATION DATED , o Authorized Signature FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33608 Date: 94 THIS CERTIFIES that the building SOLAR„HOT WATER _- Location of Property: 2045 LAKE DR of HOLD ,... (HOUSE NO.) (STREET) (HAMLET) County Tax Flap No. 4789 Section 59 Block 5 Lot 4 Subdivision Filed Nap No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 1414, 2007 puzzuant to which Building Permit No. 33342-Z dated AUGUST 23 2007 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 SOLAR HOT WATER SYSTEM AS APPLIED FOR. The certificate is issued to LILLIAN BALL... (OWNER) of the aforesaid building. SUFFOLK COUNTY DSPARTM NP OF EBALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N A � - -- PLUMBERS CERTIFICATION DATED _.. ytr- Signature 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 l Q4 7?. . . . Date . . , . 4. . . . . . . . . . . . . . . . . . . . . . .. 198 . . THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property . . , . . . . * I,B�ke Drive . . „ . , Southold N.Y. . e - House House No. Street Hamlet County Tax Map No. 1000 Section . . .059. . . . . .Block . . „ . . 05 , , „ . . . ,Lot . . .Qa4. . . . . . . . . . . Subdivision . , . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated March 10 Be. . . 1 19 . . .p 1 pursuant to which Building Permit No. . . . . .�„ . dated . . „ , March 13, 19 . .S 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 . . . . . . . . . Second Floor Addition to One Family Private Dwelling. The certificate is issued to . . . . . . .joseph Zimmer. . . . . . . . . . . . . . . . . . . . « (owner,1eT &"'�a ilt�""`" of the aforesaid building. Suffolk County Department of Health Approval . . . . . .N/R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . X518D04 . „ . . . . . . . . . „ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev.1/81 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. . . . .Z1.003O .. . , . Date . , . .July .14. . . . . . . . . . . .. . . . . . . .. 19$9. THIS CERTIFIES that the building .. . . . . .. . . . . . . . . . . . .. . . . . . . . .. . . . . . . . . . . .. ... . . Location of Property . . . 2045 Lake Drive . . Southold, N.Y. House N0. . S&Wt " Mamlot County Tax Map No. 1000 Section . . . ; ' . . . . . .Block ., .99 . ... . . . . .Lot . . . . . .q .. .. . . . . . Subdivision... . . . . . . . . . . .. .. . . . . . . . . . . . . . ..Filed Map No. . . . . . . . .Lot No. . . . . . .... ... . conforms substantially to the Application for Building Permit heretofore filed in this office dated 'Je 6 19pursuant to which Building Permit No. 1 o776Z • . .. . . . . . . . . . . . . , . . , . , . . dated . . .. .'Tuly -14 . . . . .. . . . . . . . . 19 8O,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 ... . . . . . . . w Attached Gtarage to One F. , . ly Dwelling mm The certificate is issued to . . . ,. . Joseph Z. " ar . . . . . .. . . . . .. . . . Pes 11t, ri of the aforesaid building. NIR Suffolk County Department of Health Approval . . . . . . . .. . . . . . . . . . . . . . . . . . . . . • .. . .. . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . .. . . . . .. . . . . . Building pector Rev 4M M1 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold,N.Y. Certificate Of Occupancy 27 02x5 Date November 5, 19 »1;0 No. .. . . . . . . . . . . . . . . . . . . . » . . , . . . . . THIS CERTIFIES that the building . . . . . . . . . . » . . . . . . . . . , . . . . . . . . . . » 20 5 Lrgke Avenue, Soutbo2 d, New York Location of Property House No. . . . . . . . . . . . . . . . . . . . . . Street . . . . . . . . . . . . . . . . . . -k;1;jei County Tax Map No. 1000 Section . . . . . 59. . . .Block . . . . . . . . . . . . . .Lot . . . . . . . . . . • . . • . . » Subdivision . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated Oc tnbex' , 19 Mpursuant to which Building Permit No. . .1o914.?. . • • • • • • • dated . . .NoveTnbe""» .5'• . • . . • • . . . • . 19 . 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 . . . . . . . . . fic1di-tion of Deck to ,ExiS tine .Dwelling. . . . . , . . . . . . The certificate is issued to . . . .Joraeph- -7.j=n.r .*n . M . • . . • . • . • • • • • . • • (owner, of the aforesaid building. Suffolk County Department of Health Approval . . . . .N/R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . 11* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . « . . . • . . .. . . • . » Building Inspector Rev 4/79 HOUSING CODE INSPECTION September 29, 1975 2045 Lake Drive R-1 Southold, New York Tax Roll: Jeanie N. Fischer Occupied, John Fischer Upon receipt of an applicdgtion for a Pre-Existing Certificate of Occupancy I made an inspection of this one story framed dwelling. I was admitted to building by Mr. Fischer who accompanied me during this inspection which began at approximately 1:20 P.M. The first floor consists of two bedrooms, bathroom, living room, dining area and kitchen. Heat is furnished to all rooms from a forced warm air, oil fired furnace located in furnace room of finished part of cellar and basement. . ' hed �b ,set eht- end", cellar contains a separate living unit w .th full kitchen fa i1 of Chapter __100, Zoning Ordinance., Article III Section 100-3Q� A.1. The y following.violations,,,of the Housing Code,_.Chapter, 50, Town"' of Southold, were found: Furnace Room, inadequate openeings for air supply, Article V, Section 52-53 G. Smoke pipe from furnace to chimney has insufficient clearance to combustible materials. Article V, Section 52-54 B. Bedrooms:in cellar of �(building's foundation . Article V, Section 52-23 D. Bedrooms are being used and occupied by John Fischer and wife and daughter. ) Inspection completed at approximately 2:10 P.M. R pectfully submitted, EH:mm w r 1 h �, n, Building Inspector Head 1-1=7-1" Head H=6'-8" Op _N o ZEN DES \ POST OFFICE 1 11 = i Lt1 CUTCH00UE,N) TO _ BEDROOM _ ]—Lnm 11 11 PHONE:631.51 =: F _ C3 = mmepn.eremK ea me. c.om�sna�iir"us°n a�n'wwo LEA,d=R NO. ISSUE 01 RENTAL PERMP 02 RENTAL PERMIT'. _— ----------- a— `r-C WtD ---- M- `a OD _ ap2ED A10 DEN .. ---------------- _ - {?tg.{E.Nt< m UP ILI vj 04442 Head H=6'-8" 4re OF Ne Sill H=4'-8" BRANSBC Head H=6'-6" RESIDEP 2045 LAKE DI SOUTHOLD,NY: S.C.T.NI M 1000-I SCALE DATE DRAWN BY: LEGEND LOWER LI _= Garage � SMOKE DETECTOR FLOOR P a� N= HEAT DETECTOR �� COMBINATION SMOKE # ' &CO2 DETECTOR Head H=7'-1" Head H=6'-8" 7�— OP 0 ZEN DESI cr) 11 POST OFFICE E ;D CUTCHMUE,NY PHONE:$31.51 BEDROOM 1 LoMpt L E V P� --------- -- LOUNGE B-A7H Uos NO. ISSUE 01 RENrAL PERmr Y, MEECH ------------- WID ---- ------- ---- - - MECH op I----------------- 2 B- UP Head H-6'-8"-- Sill H=4'-8" BRANSBC Head H=6'-6" RESIDEI 2045 LAKE D SOUTHOLD,NY S.C.T.M.*1000- SCALE DAM CRAM BY: LEGEND 10 co LOWER L Ln H: Garage FLOOR P SMOKE DETECTOR -17 CO2 DETECTOR COMBINATION SMOKE A .1 &CO2 DETECTOR SW H-2 Sm H=3'-4- S. ZEN DES Head H-l'-F Head H 6-s" POST OFFICE E CUTCH GU`NY Head H=6 IT PHONE O 63151 '- D t K--1 CHEN NO. ISSUE 01 RENTAL PERWIT -- —------------ - ----- W/D b 2; H 2'BA -------- ----------I ---------- ---------- ---------- "JiNG �om DINNG ROOM UP BRANSB( RESIDEI 2045 LAKE D SOURHOLO,NY SIC.T.WL#1000- SCALE-. Head H=6!-6- Head H=6'-B" Head H=6 DATE: DRAWN BY: LEGEND GROUP SMOKE DETECTOR FLOOR P CO2 DETECTOR COMBINATION SMOKE A-1 1`3 &CO2 DETECTOR ZEN DES' POST OFFICE F CUTC140GUF M PHONE:63L51 EDF00M 3 •�� mew.eF mhe o.. �- N0. ISSUE 01 RENTAL PERMC --- B _,_F 00 �xg BATH 4 ON BRANSB( v - RESIDEI -- 20451AKE D M_—DR`jOM 4 SOUTHOLD,NY S.QT.M.91000- _ SCALE: DATE: DRAWN BY: LEGEND SECM SMOKE DETECTOR FLOOR P CO2 DETECTOR COMBINATION SMOKE Ass &CO2 DETECTOR