HomeMy WebLinkAbout1000-144.-1-13 TIOWN OF SOUTHOLD
U'a
Rental Permit
0442
Owner Bridget & Conor Nelson
Occupied as Single Family Dwelling
Located at 1880 Sigsbee Road Laurel 144.-1-13
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 inspection.
6/27/2024
Code es o Official
This Notice must be posted by the main entrance at all times
TOWN 0� S UTH LD BUILDING DEPT.
83 •76 -1802
INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] F AL
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEN TRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F AL)
[ ] CODE VIOLATION [ ] PRE C/O [ ], RENTAL
RE R ! tow __
c
DATE INSPECTOR
01"ZfF°i'��o TOWN OF SOUTHOLD
=` Rental Permit
b � yap Permit No. 0442
Owner Bridget & Conor Nelson
Occupied as Single Family Dwelling
Located at 1880 Sigsbee Road Laurel 144-1-13
Village
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 inspection.
5/18/2021
*de e t Official
This Notice must be posted by the main entrance at all times
0uryo. _
Town Hall Annex J Telephone(631)765-1802
54375 Main Road ', Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
-
BUILDING DEPARTMENT MAR -
TOWN OF SOUTHOLD 4 2021
RENTAL PERMIT APPLICATIONP .�;. ,w,
Rental Permit Fee$200(Application must be renewed every two years) x"31
Section A.
Property Information:
Rental Property Address:
I 5' s a, ; wy i i9t52-
j
Tax Map Number: 1000 SECTION 1L -BLOCK -LOT �3
SECTION B.
OWNER INFORMATION:
Property Owner Name: r_ r1 I50V1
Property Owner Legal Address: Property Owner Mailing Address:
Wn4q 2 ,
Telephone Number(s): Daytimeblq-"IB16Evening 5 Wim-- Emergency.2)14
Property Owner Email Address: rill, Iev,1 11 ac10.1
Page 1 of S
,i
J,
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ;G
Southold,NY 11971-0959 'QcOUa '.
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C. J
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: _
1
4
Address of Managing Agent (no P.O. Boxes);.
Page 2 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
lyI®t!M`I
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: I
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:
Requested Maximum number of persons allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit: �t!o Io�C�Jd nG �o_c5m)
Use and Dimensions of each room in Rental Dwelling Unit: 'o
1 d 1 110 1 II
0 I3q!)ux 9
V60 M 10 ISN 0
Iry X - �5"
Page 3 of 5
i
as
Town Hall Annex !� Telephone(631)765-1802
5437.5 Main Road Fax(631)765-9502
IV-
P.O.Box 1179 .
Southold,NY 11971-0959
our�v
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.
VII 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)
�Aon ej e� 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
1 pF SOUryo.�_
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G, O
Southold,NY 11971-0959
C°
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:. rJa J KP—(5t)V)
Property Owner's Signature: �ttA�
Sworn to before me this qday of !f�atnr` 20
Official otary Public Signature and Original Notary Stamp
Ca!Wean Nolan
NOTARY Pu:31.IC
#02A05018260
State of New York
County of Nassau
Commission Expires
Page 5 of 5
Town Hall Annex
SOUTFiOLD TOWN 54375 Main Road
PO Box 1179 Southold,
Rental InspectionPO
11971-1179
Tel: 631-765-1802
r Fax 631-765-9502
S6 TIM #" - .- Date 7/ Z/
Owner els Phone $l Y-S77 Z8
Address 1U014p,eZip ( C
HM"NefiZ_ Inspector
Address visi.bl'eftom'street?
LEVELS SUB.
1 21 j 3
Smoke Detectors (#=bedroom detectors excluded)
Carbon Monoxide Detectors (#)
Fire,Extinguishers,(#)
Exits (#)
BEDROOMS1 2 3 4_ 5
Smoke Detector Alarms.(#.).
Carbon Monoxide Alarms (#)
Egress(windows) (Y/N)
BUILDING SYSTEMS Y/ CONDITION OF PROPERTY N
Heating system maintained/operational T Building Interior is clean/maintained
Hot water system maintained/operational Building Exterior is clean/maintained
Electrical system maintained/operational Property is clean/safe/maintained
Mechanical system maintained/operational Handrails &guards present
POOLS Y POOL BARRIERS Y
Pool present Pool is completely enclosed
Pool surface alarm and/or door alarm Barrier is a min.48 high
present
POOL GATES Y All openings in barrier less than 4"
Self-closing, self-datching Max. 2"-clearance @ bottom of barrier
Latch on pool side of gate, meets height Barrier capable of being locked &child-
requirements proof when unattended
COMMENTS: I014 O � SUI' Aff�—k Mir
DESIGN CRITERIA: 5-31/2' J 30'-11/4' J 4o�d� 0 ALTERATIONS
9'-0° -3'
J _J 10-2' JJ 7' J
TO THE
GROUND SNOW LOAD -45 PSF. TW2442 . TW2442 TW21� o
LIVING AREAS AND DECKS -40 PSF.
SLEEPING AREA -30 PSF.
WINO SPEED -120 NPN
SEISMIC DESIGN CATEGORY -B
WEATHERING-SEVERE
FROST LINE DEPTH-36" d
TERMITE DROOM 1 BEDROOM 2 \ DEN
DECAY-SUGHT
ICE SHIELD UEIDERIAYMENT REWIRED e RMDENCE
I RELWE EnsnNc 4 MATTITUCK, NY
DESIGN W ACCORDANCE WITH AMERICAN FOREST s 7 CENNG THIS AREA 1BBD SIGSBEE ROAD
PRODUCTS WOOD FRAME CONSTRUCTION IJANUN �r
FOR 18x2-FAMILY HOUSE-PRESCRIPTIVE DESIGN METHOD ` \ Y (3)2x6 POST /
® III \ / ILII
REMOVE
A � 8• ARC
8' EILINGHISREA s H
WINDOW SCHEDULE r W D TIL$= _� _ !— II / `- o ' �x°;;6
OII - _� _ �.�i�
GREENW,NY-11944-----
_ — - TEL 631-477 624
AL kXISTING1WINDOWS ARE ANDERSEN.REPLACEMENT 59 ��_WINOOW-2DO SERIES o �iUC
III I` J / 195 SXINK LANE
Mark sae Description OuenBly I I KITCHEN II /LIVING ROOM\ I /DINING AREA G N 516-205 65
- - -
1935
B TW21036 DOUBLE-HUNGBUG 6( -� / CATHEDRAL CENNG \\ IIII / CATHEDRAL CDUNG \
C TW30210 DOUBLE-HUNG 1 +
D TW20210
DOUBLE HUNG 1 L I / (3)2x4 POST FLUSH w/WALL\ IIII/ ` FLOOR PLAN
+ 22'-4 1/4" TW2442 M21036 SCALE 3/16'=l'-D'
GENERAL NOTES
1. ALL WORK MATERk AND EQUIPMENT SHALL BE WD(CG 2x6 EDGE LOAM U
ACCORDANCE WITH THE NEW YORK STATE UNIFORM LOO'G 2x4 COLLAR UES a
BUILDING CODE,AND THE NEW YORK STATE ENERGY
CONSERVATION CODE,AND LOCAL AUTHORITIES. D(YG 2x6 ROOF RAFTERS®24°O.C. ¢
2. ALL LUMBER SHALL BE GRADE STAMPED DOUGLAS FIR- new 2x4 IT w/2"cased cell insulation and R-19 BATT INSULATION=+/-R-31 o
LARCH STRUCTURAL GRADE r2 OR BE0(2)5x6 CONAR BEAMS ca.54'APART
DDL TV7
3. CONTRACTOR SHALL OBTAIN ALL PERMITS AND ATTIC
INSURANCE NECESSARY TO PROTECT THE ENGINEER D'G 2c6 ROOF RAFT ®24'O.C. .0
AND OWNER. R-30 BATT INS ON (2)1.75'x9.5'LVL BEAM w/R-31 INSULATION F Q
4. DO NOT BACKFILL AGAINST FOUNDATION WALLSEg
UNTIL FLOOR SYSTEM INSTALLATION IS COMPLETE. (3)1.75'x9.5°LVL BEAM
5. THIS DRAWING IS AN INSTRUMENT PREPARED TO 8
FACILITATE CONSTRUCTION AND SHALL NOT BE ,
CONSTRUED AS A CONTRACT BETWEEN BUILDER AND
R.
KITCHEN LIVING ROOM DINING AREA EXI'G 20 WALL STUDS 0 24°D.C. s
DRAWING SCHEDULE w/R-15 STONE WOOL INSULATION(e.g ROXUL)
11-7—IF-7— 11 —T fl MIF: OB/31/2017
A-1 FLOOR PIAN,SECTION,DESIGN CMA2KB F.J.®24'O.C.w R-19 BATT INSULATION SALE 3/16 1'-0'
A-2 FRAMING NOTES,KING SCHEDULE CRAWL SPACEFLOOR PLAN
SECTION SECTION
SCALE:3/16'=1'-0° � DESIGN CRITERIA
INTERIOR STRUCTURAL ALTERATIONS, KITCHEN AND BATHROOM RENOVATION Dwc.wue
SCTM#= 1000-144-01-13
A-1
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION DWG,NO
SUFFOLK COUNTY,NEW YORK
1
DESIGN CRITERIA: 5-3 1/2' 30'-11/4° D ALTERATIONS
t\• 9-0' �L 10'-2° 7'-3' ,I TO THE
GROUND SNOW LOAD -45 PSF. TW2442 r 1W2442 7MI036 0
LANG AREAS AND DECKS -40 PSF.
SLEEPING WIND SPEER 120
AREA - PSF.
\ /
SEISMIC DESGN CATEGORY -B
WEATHERING-SEVERE ' S
FROST LINE DEPTH-36` BEDROOM 1 BEDROOM 2 1` DEN 9 LOJAC
TERMITE-MODERATE TO HEAVY €
GHT
ILD SHEID U DNDERIAYMENT REQUIRED / RESIDENCE
DESIGN IN ACCORDANCE WITH AMERICAN FORESTI AEMWE FXSDNC MATTITUCK W
PRODUCTS WOOD FRAME CONSTRUCTION MANUAL )O 7'CDUNG IHB ARTA 1880 SIGSBEE ROAD
FOR 1&2-FAMILY HOUSE-PRESCRIPTNE DESIGN METHOD \ III \ (3)W POST
/
IIIA ARCHITECT
III \\ B'c�we M'NNG / A
WINDOW SCHEDULE OI I W ° IIL�_ _ _ _ _ _ _ _ 9 FRANK uDENDWL
\ / �� / P 123 CENTRAL A7'Fh11E
I _ — _ ��II, / 2 o P.O.BOx 316
GREENPORT,NY 11944
TEL:631-477 8624
ALL EXISTING WINDOWS ARE ANDERSEN REPLACEMENT O III X IIIA / i OWNER
WINDOWS,2DO SERIES _ O _ PETER LOJAC
_ _ I / \ CUTCH06UE 119NE
IIIy I_ II'/)I
Mark Ste Description Quantity -' Do I II Alf=� — — \— —�Ilf /
A Tw2442 DOUBLE-HUNG 4 I(KITCHEN / LIVING R�00M \ IIIA / CATHIEURGAL R Nuc\� 516-285 e625
B TW21 035 DOUBLE-HUNG 6 I / \
C TW30210 WUBIE-HUNG 1 1
_,A6__.r1
D TW20210 DOUBLE-HUNG 1 L J I I / (3)2x4 POST FLUSH w/WAll \ IIIA/ - rG LI C R y
FLOOR PLAN
GENERAL NOTES ! 22'-4 1/4° nr244z jr
tw2m3s S G s/1 o' f r
1. ALL WORK MATERIAL,AND EQUIPMENT SHALL BE IN
ACCORDANCE WITH THE NEW YORK STATE UNIFORM fXYC 2x6 LA BEAM
PES
y
BURDING CODE,AND THE NEW YORK STATE ENERGY EXfG 2x4 COLLAR �` y
CONSERVATION CODE,AND LOCA AUTHORITIES. EXf G 2x6 ROOF RAFTERS 0 Zr D.C.
w/ (e.
2. ALL LUMBER SHALL BE GRADE STAMPED DOUGLAS AR-
STONE BOOL INSIATKIN ROXUL)
FlR- 1W0(2)5x6 COLLAR BEAMS ca.54 APART
LARCH STRUCTURAL GRADE#2 OR BETTER. ATTIC (2)1.15'x9.5°LVL B
3. CONTRACTOR SHALL OBTAIN ALL PERINS AND
INSURANCE NECESSARY TO PROTECT THE ENGINEER EXYG 24 ROOF RAFTERS 0 24°O.C.
AND OWNER R-30 BATT INSU RON (2)1.75'x9.5°LVL BEAM w/R-23 STONE WOOL INSULATION(e.g ROXUL)
4. OD NOT BACKFILL AGAINST FOUNDATION WALLS a (3)1.75°x9,5°LVL BEAM--"' t2
UNTIL FLOOR SYSTEM INSTALLATION IS COMPLETE
S. THS DRAINING IS AN INSTRUMENT PREPARED TO
FACILITATE CONSTRUCTION AND SHALL NOT BE °
CONSTRUED AS A CONTRACT BETWEEN BUILDER AND m ;
OWNER. F3
DRAWING SCHEDULE KITCHEN LIVING ROOM DINING AREA �'G 1,4 WALL STUDS 0 24'D.C. s
w/R-15 STONE WOOL INSULATION(e.g ROXUL) DATE 06/22/201116
2xB FJ.0 24'O.C.w R-19 B4TT INSULATION SCALE: 3/I6'I'0'
A-1 FLOOR PLAN.SECRON,DESIGN CROEPoA
A-2 FRAMING NOTES,NNIING SCHEDULE CRAWL SPACE SECTION �OOSECTON
scaLE:3— /16'=I o' te 2DESIGN CRITERIA
INTERIOR STRUCTURAL ALTERATIONS, KITCHEN AND BATHROOM RENOVATION °WC NAME
SCTMj=1000BUILDING PERMIT APPLICATION ®� MNO
A ,
TOWN OF SOUTHOLD OUTHOID
SUFFOLK COUNTY,NEW YORK 1
SCTM #
TOWN OF SOUTHOLD PROPERTY RECORD CARD �
OWNER STREET . .VILLAGE DIST. SU'B: LOT
ACR. a REMARKS
TYPE OFBLD.
PRO ,:CLASSia
LAND IMP. TOTAL DATE y _
Lill, w? t t
r
. ,
W
, f
s
FRONTAGE ON WATER' HOUSE/LOT
BULKHEAD
i TOTAL
: -7/ 3SJ x)6
TOWN OF SOUTHOLD PROPERTY kELVIKU `AKD
OWNER STREET VILLAGE DIST. SUB. LOT
,FARMER-OWNER_ , N ,T E - — AC
Ro
c �c
-4,CA>i S W TYPE OF BUILDING
RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP, TOTAL DATE REMARKS — —�_ � ------------�
o 71
f�
11
AGE
BUILDING CONDITION-_-- -- - _
; s
NEW NORMAL I BELOW A13OVE
FARM Acre �i Value Per Value;
Ac re
Tillable 1
Tillable 2
Tillable 3 �— --------- - -- -.� _.__
Woodland
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD __
House Plot DEPTH
BULKHEAD —
Total iDOCK
I
ffffff � Y
COLOR I
bf
TRIM — — -
1
t r
0
144.-1-13 01/20/2017
—
M. Bldg _ � - l t Foundation ��.
Bath Dinette
I,
I
Extension `f Basement " Floors _ v.fir` K. _—
Extension --- ' 'I Ext. Walls " , a '.., '' interior Finish f ti-. BR,
tw tensin Fire Place Heat � � ° DR. —
� Rooms 1st Floor; � ' BR.
Type Roof _ _
Porch -!Recreation Room Rooms 2nd Floor FIN, B.
_ - -- --- —
/, I
I
Porch 's — 'Dormer
Br 'z"eway ✓` '. Driveway IN
Patio 1
Cj
Total
C�'• -7` 7 `
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, NEW YORK
CERTIFICATE OF OCCUPANCY
NONCONFORMING PREMISES
THIS IS TO CERTIFY that the
Lq Land Pre C.O. - Z-16504
Q Building(s)
/-7 Use(s) Date- Dec. 16, 1987
located at 1820 Sigsbee Road Mattituck, New York
Street Hamlet
shown on County tax map as District 1000, Section 144 , Block
01 , Lot 13 , does(not) conform to the present Building Zone
Code of the Town of Southold for the following reasons:
Insufficient total area, side yard of accessory shed
On the basis of information presented to the Building Inspector's
Office, it has been determined that the above nonconforming ® Land
Building(s) Q Use(s) existed on the effective date the present
Building Zone Code of the Town of Southold, and may be continued
pursuant to and subject to the applicable provisions of said Code.
IT IS FURTHER CERTIFIED that, based upon information presented to
the Building Inspector's Office, the occupancy and use for which this
Certificate is issued is as follows:- Property contains a one story, one
family, wood framed dwelling, with attached enclosed porch; outside shower, post
and rail fencing; all situated in 'A' Residential Agricultural zone with access to
Sigsbee Road, a Town maintained highway.
The Certificate is issued to FRANK & ELEANOR SCHMIDT
(owner, 1VPV9LXZTXWA*XqCX
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO. N/A
NOTICE IS HEREBY GIVEN that the owner of the above premises HAS
NOT CONSENTED TO AN INSPECTION of the premises by the .Building Inspec-
tor to determine if the premises comply with all applicable codes and
ordinances, other than the Building Zone Code, and therefore, no such
inspection has been conducted. This Certificate, therefore, does not,
and is not intended to certify that the premises comply with all other
applicable codes and regulations.
Building Inspector
FORM[ NO. 4
TOWN OF SOUTHOL D
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y. N0 19WAL5
CERTIFICATE OF OCCUPANCY
No. ......?I..1745 ...... Date .........................Vove).v 0- 4 19. 63
.......
THIS CERTIFIES that the building located at .�1191" ..: _ ! s... ' .......... Street
ManittitUck Park Prop* 3$
MapNo. ...................... Block No. ...................... Lot No. ....................................................................
conforms substantially to the Application for Building Permit heretofore filed In this office dated
'7uty 9 2116
, 19. .... pursuant to which Building permit No. ........... ..
Jtx 9
dated ............. ...................................... 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 ........ 1,
r.
1tr~AT.r!. OW, VAKXLY DM?r LMG
.............................................. ......................................................................................... ......................
The certificate is issued to ....... !zk
(owner, lessee or tenant)
l'
of the aforesaid building.
�(II
........................ .guilding..lnspector .......
�o�gUFFtit,��pG Town of Southold 9/19/2017
a
P.O.Bog 1179
• 53095 Main Rd
y4jp� �a0� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39223 Date: 9/19/2017
THIS CERTIFIES that the building ALTERATION
Location of Property: 1880 Sigsbee Rd,Laurel
SCTM#: 473889 Sec/Block/Lot: 144.4-13
Subdivision: )Fled Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore fled'in this office dated
6/22/2016 pursuant to which Building Permit No. 40808 dated 6/29/2016
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:
ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Berger,Suzanne&Lojac,Peter
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 1745924 09-06-2017
PLUMBERS CERTIFICATION DATED 09-11-2017 J, eds Plumbing
t o ' ed Signature
ggFFD[X TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o • SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 40808 Date: 6/29/2016
Permission is hereby granted to:
Berger, Suzanne
35 Baldwin St
Farmingdale, NY 1.1735
To: make interior alterations to an existing dwelling as applied for.
r
At premises located at:
1880 Sigsbee Rd., Laurel
SCTM #473889
Sec/Block/Lot# 1",1-13
r
Pursuant to application dated 6/22/2016 and approved by the Building Inspector.
To expire on 12/29/2017.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $392.00
CO-ALTERATION TO DWELLING $50.00
Total:' $442.00
g------B-ui1jding'1hspkctor --