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Home My WebLink About1000-53.-6-7 TOWN OF SOUTHOLD �i.CC Rental Permit Permit No. 0444 Owner James & Vicky Vavas Occupied as Single Family Dwelling Located at 3165 Bay Shore Rd. Greenport 53.-6-7 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. 5/19/2021 de End rc e trc"w This Notice must be posted by the main entrance at all times f so trG IDEPT.TOWN 0 SOUTHOLD 765-11302 •''"�` ` INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAUL G [ ] FRAMING /STRAPPING [ ] I AL �'� i [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O on DATEl ZOINSPECTOR 14f $ W Town Hall Annex � � Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 a rj BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT"APPLICATION Rental Permit Fee $200 (Application must be renewed every two years) e Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION 5 --BLOCK -LOT SECTION B. OWNER INFORMATION: 1 f Property Owner Name: `��'"`Z'-S C_ 1 V M C-icyY ON OL 5 Property Owner Legal Address: Property Owner Mailing Address: Mrd Mce-f" 15 a 193 CA_S`F-rrcF• Ic 1recctln N I1.2 Telephone Number(s): Daytime y5A144 Evenin "' ` Ernergency . `5'A Property Owner Email Address: ScA^e s-.Vo VcA.s dR7,> 110.506ra.Ace• c namesoVaVas q6- Page 1 of 5 �?0 r�' Town Hall Annex 4 Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOS) OLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: d A)fid-- 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: o 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: �''C:�/V Address of Managing Agent (no P.O. Boxes):_ Page 2 of 5 Town Hall Annex P a�. Tele hone(631)765-1802 q 54375 Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 " cou ' � � 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: uta 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." e ,u" Rental Dwelling Unit Identifier: Aoee -- r,, _ -) Requested Maximum number of persons allowed to occupy Dwelling Un i fe Number of rooms in Rental Dwelling Unit: 7 ,rd, &n 5 ' 1 OJ+4 e, CA Use and Dimensions of each room in Rental Dwelling Unit: 1A X �R 1 Ia' Kw -A 10 RA I 3f tt 1A 1 { 16 ' P,,o44 t .� Page 3 of 5 J7` Gown Hall Annex Telephone(631)765-1802 Fax(631)765-9502 54375 Main Road P.O.Box 1179 Southold,NY 11971-0959 14, ' 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. 0/1 am requesting a fire safety' ctoto be erfor e �� e f fne1n from the Town of Southold 77 ❑ 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 SlIFF1OL-K) I J o,~5 v Gt V G 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 S � Town Hall Annex '"z, Telephone(631)765-1802 54375 Main Road � Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 ` 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: �!� Property s Owner' Signature: ��` --- p Sworn to before me this day of 20 Official Notary Public Signature and Original Notary Stamp ELAINE STAMAS NOTARY PUBLIC STATE OF NEW YORK KINGS COUNTY LIC.#V01T4 1" 1 COMM.EXP (S Page 5 of 5 AIN Town Hall Annex . Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1179 a Southold,NY 11971-0959 r, BUILDING DEPARTMENT TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION INSTRUCTIONS Rental Permit Fee $200 (Application must be renewed every two years) The items listed below are required to be submitted with the completed application. Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of all smoke &carbon monoxide detectors. Certificates of Occupancy and Pre-Certificates of Occupancy: Certificates of occupancy or Pre-Certificates of Occupancy for each rental dwelling unit. zCertification of Code Compliance(form enclosed): Must be submitted by a license architect or engineer or license home inspector if an inspection by Town of Southold Inspector is declined. Rental Permit Fee: $200.00 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �U Southold,NY 11971-0959 , BUILDING DEPARTMENT TOWN OF SO HOLD 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 Prosignal seal required for Architect or err lrleer licensed Home Inspector must provide co of valid current cerci cation Rental Property SCTM Number: Rental Property Address: Owner/Name: 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.) 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. Print Name and Title Original Signature Please place professional seal: w w% rm ww, Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 a� ! 4'� Southold,NY 11971-0959 f a BUILDING DEPARTMENT TOWN OF SOUTHOILD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: Use and Dimension of each room: STATE OF NEW YORIC,COUNTY OF SUFFOLK STATE OF NEW YORK,COUNTY OF SUFFOLK as: 1 ss: 4t On the day of APRIL,in the year 2020,before me,the t on the 2A t day of APRIL,in the year 2021 undersigned,personally appeared before me,the undersigned,personally appeared DARLINE J.DUFFY JURZENIA personally known to me or proved to me on the basis of satisfactory personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is(are)subscribed to-evidence to be the individuals)whose name(s)is(are)subscribed to the within instrument and acknowledged to me that he/she/they the within inshument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by executed the same in hisiber/their capacity(ies), and that by his/her/their signature(s)on the instrument,the individual(s),or the his/her/their signature(s)on the instrument,the individual(s),or the person upon behalf of which the individual(s)acted,executed the person upon behalf of which the individual(s)acted,executed the instrument InstrumeaL � a Notary Public mmvy Puwir GPACEC.GL*TRIOA uoTARY PUBLIC,STATE OF NONY Regtoreaon No.02Gub40SM3 STATE OF NEW YORK,COUNTY OF Qua9fied to S ss: I Commiaston Fxdm On the day of ,in the year ,before me,the undersigned,personally appeared STATE OF FLORIDA,COUNTY OF Z the subscribing witness to the foregoing instrument,with whom I am On the day of November,in the year 2020,before me,the personally acquainted,who,being by me duly swom,did depose and undersigned,personally appeared say the he/shehhey reside(s)in that helsheAhey know(s) 6 personally known to me or proved to ine the basis of facto:y to be the individual described is and who executed the foregoing j evidence to be the individual(s)whoss Vis;iqm)s.ub=--ate to instrument,that said subscribing witness was present and saw said the within instrument and acknowledged to me that helshe/they executed the same in his/ber/their capacity(ies),and by hislherttheu execute the same;and that said witness at the same time subscribed signature(-)on the instrument,the individual(s),or the person upon his/her/their name(s)as a witness thereto. behalf ofwhich the individual(s)acted,executed the instrument,and that such individual made such appearance before the undersigned in the State of FLORIDA,County of Notary Public Notary Public BARGAIN AND SALE DEED 1 WITH COVENANT AOAINsT GRANroWs ACTS TITLE No.: 'g I DARLINE L DUFFY JURZBNIA,As SURvrVINO TENANT To SECTION:053.00 JAMES D.VAVAS and VICKY VAVAS BLOCK: 06.00 LOT: 007.000 COUNTY of:SUFFOLK RETURN BY Men.To: i t J 1 CONSULT YOUR LAWYER BEFORE SIGNING TNIS BVSTRUMENT-1'HLS INSTRUMENT SBOULD USED BY LAA7ERS ONLY. THIS INDENTURE,made the 50 day o£ /-lc,-/ ,Two Thousand and Twenty-One BETWEEN DARLINE J.DUFFY JURZENIA,as Surviving Tenant by the Entirety of Edward P.Jurzenis,who died a resident of Suffolk County on December 2,2019. residing at 3165 Bayshore Road Greenport,NY 11944 party of the first part,and JAMES D.VAVAS AND VICKY VAVAS, A-S Te:AC--0S (i..t residing at 152 8311 Street Brooklyn,NY 11209 party of the second pari, WITNESSETH,that the party of the firstpart,in consideration of Ten Dollars and othervaluable consideration paid bytheparty of the second part,does hereby grant and release unto the party of the secondpart,the bens or successors and assigns oftheparty of the second part forever, DISTRICT 1000 SECITON See Schedule"A"attached hereto and made a parthereof 053.00 P BLOCK 06.00 LOT 007.000 Being and intended to be the same premises conveyed to the Grantor herein by deed dated July 28,2009 and recorded in the Office of the Clerk of Suffolk County on August 5,2009 in Liber 12595 Page 599. Premises known as 3165 Bayshore Road,Grecnport,New York 11944. TOGETHERwiththe right title and interestifany,ofthepattyofthef=partinandtoanystreetsandroadsabuttingtheabove described premises to the center lines thereof TOGETHER with the appurtenances and the estate and rights of the party of the fust part in and to said premises;TO HAVE AND TO HOLD the premises herein granted unto the party ofthe second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. AND the parry of the fust part,in compliance with Section 13 of the Lien Law,covenants that the party of the first partwill receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word"party"shall be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first above written, IN PRESENCE OF: e� I 11s -'1'a 3 DU lvinetre a s e Tide No.3020-1051104 AMENDED 05/03/2021(AS/SIP) SCHEDULE"A" ALL 71 HAT CEKrA,N PLOT,PIECE PARM 01 tAND,SrvjATE,LYING AND BEING AT �- T, TOWN Ot< 'U - -- -. s -'.OE r ANN,S A=E Of NEW YKNOWN--- tL ,DMGNAT AS LOT 5-5 AND HE wORTriERLY ON--Z HAS OF LOT S6,0111 A CERTAIN! $1 MOTTLED,` _MAP OC 3AY E I ,A ,BLED Trt = CEOFTHE KOFTH i OF zFVX KAY 1S, 933A`MAP t 'I i SAID LOv'AND PART or Jor,W . TA)SN TOGEimmAS OK EAnCV—IS NME P Ii OY-ARLY BOUb1DED AND DE50LMM As FOJXCMS - BEGINNING AT A POINT IN THE NORTHEASTERLY SIDE OF-3AY-SHORE ROAD WHERE THE SAME IS INTERSECTED BY THE DIVIDING LINE BETWEEN LOTS 54 AND 55; RuNNIuG IMS CE NORT,H18ASTE P!Y ALONG SAID DWIDING LINE BF—EWEEN LOT.54 AND 55 ON A-'COURSE Tlf 66109'00'EAST A DISTANCE OF 175.E u MEAN HUGH WATER MARK AS PER FILES MAP,145.38 TO CURRENT MEAN HIGH WATER MARK OF PECONIC BAY; THENCE SOUTHERLY ALONG THE MEAN HIGH WATER MARK OF PECONIC BAY SOUTH 73°31'_49"EAST,75.00 FEET TO A POINT; THENCE WESTERLY SOUTH 66°09'00"WEST 175.00 15 FEETTO THE ORDINARY HIGH WATER MARK OF PECONIC BAY; Tt 4 W S 'Y XONG THE SAME COURSE,SOUTH 660 9'WEST A DISTANCE-E OF 175.00 TO MEAN HUGH WATER KApK AS t FRES MAP,145.38 TO CURRENT MEAN HjDH WAIVk MARK OF PECONIC BAY TO THE NORTHEASTERLY SIDE OF BAYSHORE ROAD;AND - THE!,a NORTHWESTERLY ALONG THER T=1t -s -.Y SIDE OF BAYS140PJ ROAD ON A COURSE NORTH 23° 51' A DISTANCE OF 75.00 FEE:TO THE PONT OR RACE NING. THE policy to be issued under this report will insure the title to such buildings and improvement,erected on the premises,which by law constitute real property. FOR CONVEYANCING ONLY:TOGETHER with all-the right,title and interest of the party of the first part,of In and to the land lying in the street in front of and adjoining said premises. BUILDING DEPARTMENT TOWN OF SOUTHOLD T ? "'SRT; LOCATION: 3165 Bay Shore Rd.,Greenport SUFF.CO.TAX MAP NO.: 53 ?_.....ww___... _.__ ....... -- _�w.SUBDI_,—IS-... &_: —'...... ----............._...�.� .....�w�... . .-6- ... VIS1<ON: NAME OF OWNER(S): Edward Jurzenia&17ar1ine Du Jurzen is ffy . .. _ _........._-w_____ia OCCUPANCY: ._.�.�.. ......_�.....�....._.._ ....... .�...._.._,.._wM_�wwww._ww�..__� ADMITTED BY: �.� wwww_, .--.........__.-........ �.. �w.._w._.•. SOURCE OF RE V�EST• _Ju_rz_e...nia..E. .d_w.a_r..d......._.........w..www_w__ _._._.w_._ ...._.....w............._......_._..�.. �.._._w..... w.�.. �..._........_..�_... DATE: 3/ /24/202_1w ...w.w .........M_�_._......._,... _....�.�................. DWELLING: #STORIES: 1 #EXITS: 2 _...... ..._._....... ..w __. __ _. FOUNDATION: poured con crete CELLAR: full CRAWL SPACE: ( ) _ L_.,_...ROOM(S):..w_._ �......_. w... 1 TOILE K.._...w .�� 1 UTILITY ROOM(S): PORCH TYPE: DEC TYPE• PATIO TYPE: masonry AT ROOMS BREEZEWAY: ,. FIREPLACE: 1 GARAGE: one car ___... DOMESTIC IIO AR des TYPE HEATER: gas AIR CONDITIONING: __..._.. FAIR: forced hot airx.....ww_.... ._vww TYPE HEAT: i.2' .. air_'___"H.OT WATER: ......� #BEDROOMS: ? w KITCHENS _ 1 W BASEMENT TYPE: `___a. unfinished M OTHER: _. w�. _ .. ....... _ ..._ �._�_ A CE S» ORY STRUCTU S: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIM:MING POOL: mm YNN�N^y GUEST,TYPE OF CONST: OTHER: _ _.w_ .� w.._.......,._ VIOLATIO1vS: __..,..�.._.�.v....,.,.�w_._...._..,.�_......www_��..._�w REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 2 TIME START: 10:32am END: 11:10am SOU " Town Hall Annex � Telephone(631)765-1802 54375 Main Road Fax (631)765-9502 P.O.Box 1179 Vi Southold,NY 11971-0959 a n.dev1in tcwn.Si utho1d,n .us I BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF='E EC" RICA„C VOLIAN CE SITE LOCATION issued To: Edward Jurzenia Address: 3165 Bay Shore Rd city Greenport St: NY zip: 11944 Building Permit#: 45939 Section: 53 Block: 7 � � Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE ! Contractor DBA: AS BUILT License No: I SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Commerical OutdoorX 1st Floor Pool i New Renovation 2nd Floor Hot Tub t Addition Survey X A#ic Garage i INVENTORY Service 1 ph Heat Duple,Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 200A AIC Condenser 1 Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixture4 I Time Clacks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment: Notes: " AS BUILT N4 VISUAL DEFECTS " 200A Service and Panel , AC Inspector Signature: S?—tLz' Date: March 22, 2021, S.Devlin-Cert Electrical Compliance Form.xls A �Wti 'i�k'�pdCmh9py '6v„ *� � s, OIL Thr,i 4', 1 E..Xi5Tjwc. B6SE!IE3147 . k,r-ecWrsi Dih ri.l& RH. .k f ry atm fit+. PWIDP lzm, CD MM CAL p. Y, -�-Nr,FL-OOP. P„ &-JLj r a Q o SID E ro U1 +9 m x 31(n.5 B k y'5 HO R.E ROR,D, SOU HO D, O Y 61 q V py 109 SG.T.M 1000-53-41-7 5<:. %' I'O' . o DA-AE: U'-s46uaP aaa� G,r:, ...m..... Z Building Sketch (Page - 1) pro 0 Addres6 3165 Bs Shsare R.d G r n rr � COu�FF Sime NY ZlpCade 11944 LenderlClient WELLS FARGO BANK NA 12' 10' Uncovered Deck 0 0 28.9' Itchen N 1 Car Garage Living Room Dining 1/2 Bath -P 12' 16' Uncovered Porch Bathroon 0 N Bedroom Bedroom 22.9' Drawing Not To Scale -MrAL by a A&-&,Ix. Alas C.I..I rtl—Sumnw First FW lio2.6 Sq it 10 x 10 100 14 x 16 = 224 22.9 x 34- MA Toil lPwdrq A4rrp, �NAausdrrdio27103 Sq R t Sari Adaditl 286 sq ft 12 x d:4 a 26a Form SKT.BLDSKI-'TOTAL°appraisal saftare by a la mode,inc.-1-800-ALAMODE Flu Town Town of Southold 3/24/2021 P.O.Box 1179 53495 Main Rd Southold,New York 11971 CERTIFICAI`E OF OCCUPANCY No: 41898 Date: 3/24/2021 f THIS CERTIFIES thatthe building AS BUILT ALTERATION Location of Property: 3165 Bay Shore Rd,Greenport SCTM#: 473889 See/Block/Lot: 53.-6-7 Subdivision: _ _ Filed Map No. Lot No. conforms substantially to the Application for Buildingb Permit heretofore file -. _... _.. din this office dated I 312/2021 pursuant to which Building Permit No. 45939 dated 3/17/2021 . w. f ...., .... .�............._.�. .__.. ............ . 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: °"a uilt"alterations including w a dow lectr7ic a d fir cors itiooi�a a >r The certificate is issued to Edards Jurzenia&Darline Duffy Jurzenia of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL .,.__ ELECTRICAL CERTIFICATE 39 3/22/2......CERTIFICATE Na -NCS, ,. 4S9 021 __� ... _m.- x._,......._... . PLUMBERS CER CATION DATED A d ig aturo I �_. ..............._._ww_.. tC Town of Southold 3/2.4/2021 53095 Main Rd Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY PANCY f No: 41899 Date: 3/24/2021 THIS CERTIFIES that the structure(s) located at: 3165 Bay Shore Rd., Greenport SCTM#: 473889 Sec/Block/Lot: 53.-6-7 ............. Subdivision: Filed Map No. Lot No. .. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 41899 dated 3/24/2021 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is. Iv ocl fiarr�e one Tamil dwallils�„rvvitl�rr rta:ason atio ad attached one car ara c.* Riots: :13P 45939 "tas built"'alter tr"oras COZ-41989 The certificate is issued to Edward Jurzenia&Darlme Duffy Jurzenia (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICA'l-KNO,, PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. ,... a r'� Signature ww.�. z r_ � s g TOWN OF S UTH L PROPERTY RE e OWNER STREETVILLAGE DIST. SUB. LOT z aa, FORMER OWE _ N E ACS. � ov-71;-in € S W TYPE OF BUILDING RES, SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP, TOTAL DATE REMARKS ij a AM L 25i E 4 y AGE BUIL.PlNG dNDlT NDN NORMAL BELOW ABOVE FARM; Acre Value Per Value Acre Tillable 1 THlabse 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER - _ Brushland FRONTAGE ON ROAD _ 1 House Plot DEPTH BULKHEAD Total DOCK v a s y .� a Y f CLO t AUIAL. 7 F7 77GI ={ ¥ A L-4- 53.-6-7 � 53.-6-7 09/2015 �. s = Dinette 3 3 M� B'.dlg. ° _ t animation Ex e ,sickn Basement --- r Fi L Ext Walls nterica Ext , � . - t _ _ Place _�E _.� Lxfension - —�-- z� r 3'� r� = X. 'Tv p ` Porch _ !Recreation Room' �`aorl5 'n <, P��a Porch Drise��c - e_w'A'a r _ - - - t 41 z � I To to 1 k,_