HomeMy WebLinkAbout1000-55.-5-5 T 0" WW - N OF SOUTHOLD
Rental Permit
0493
Owner TSC Holdings LLC
Occupied as Single Family Dwelling
Located at 3400 Youngs Ave Southold 55.-5-5
Maximum Permitted Occupancy 8
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.
7/13/2023
Ve e2 official
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD BUILDING D
631 -765-1802
INSPEC ION
[ ] FOUNDATION 1ST [ ] ROUGH PEBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAI
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] EIRE SAFETY IN!
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F
[ ] CODE VIOLATION [ ] PRE C/O [
RE All 0
So
-6
(on ow4hni
DATE INSPECTO
.............
i
a,
Town Hall Annex
t Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 '
Southold,NY 11971-0959
BUILDING DEPARTMENT J U N 6 2023
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION e
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
Ixro ssiolral seal re aired it Architect or bn ineer licensed Horne Inspector mustprovide
c qf valid current cerci ication
Rental Property SCTM Number: loo SS —5—
Rental Property Address: 34/a '
Owner/Name: _ TX0rs w .,,-, ' Me— CTS LLLc—
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.)
-- I a ts 1: , 5
44 4- Zes 70 q 1
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 Or'ginal Signature
NYS CEO Certificate No0822-0345
Home Inspection License#16000129107
Please place professional seal:
SUAL
�,,,j.,F0ACH1*CERTIFIED
N,1¢.IOI)P 0 N
/ /r /fir yJ U7i� T tl N4 U$9 ONLY
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STATE OF NEW YOR
Beit known that
/` Kyle Matheson
has successfully completed the requirements of a Basic Code Enforcement /
Training Program established by the Minimum Standards for Code
Enforcement Personnel(19 NYCRR Part 1208)in the State of New York as a:
CODE ENFORCEMENT OFFICIAL r
John It Addario,RE,Director /
Division ofk LdUng5tandsads and.Codes r
„f'-'awl SWIding Standards CertificationNo0B22-0345
/
and Codes
TomainlainHnsaordfiratomsW1iaeasonrptsatisfy"anawaarrar4atulwiva ,ariin-weerricOtmilwbavl`R. (
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202
TOWN OF SOUTHOLD
Co
a f Rental Permit
0493
Owner TSC Holdings LLC
Occupied as Single Family Dwelling
Located at 3400 Youngs Avenue Southold 55-5-5
Maximum Permitted Occupancy 8
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.
7/6/2021
Code of c m nt Official
This Notice must be posted by the main entrance at all times
hof-'-3
Town Hall Annex 1 !�[ Telephone(631)765-1802
54375 Main RoadN , Fax(631)765-9502
P.O.Box 1179 =G ® Q
Southold,NY 11971-0959P Y
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:
3400 Youngs Avenue,Southold
Tax Map Number: 1000 SECTION . -55- ---- - -BLOCK.-__ 5 _-_ _ :-LOT. 5
SECTION B.
OWNER INFORMATION:
Property Owner Name::- TSC Holdings,_LL.0
Property Owner Legal Address: Property Owner Mailing Address:
46520 County Road 48 __SAME-as.legal
Southold, NY 11971 — - - — -- - --
Telephone Number(s): Daytime 631-765-5815 . Evening_516-779-638EEmergenCy 516-779-6386 4
Property Owner Email Address: tmccarthy.tmccarthy@gmail.com
'71 f
J U P! 3 1021
Page 1 of
i
W.
Town Hall Annex Telephone(631)765-1802
54375 Main Road "'` Fax(631)765-9502
P.O.Box 1 179
Southold,NY 11971-0959
y✓l,=..,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Mailing Address of Managing Agent-
Telephone
gent:Tele hone Number(s): Daytime - Evening. Emergency
Email Address:
i
SECTION F.
PROPERTY DESCRIPTION:
P
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."
f
Rental Dwelling Unit Identifier: 1 '
Requested Maximum number of persons allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit: 9—
Use and Dimensions of each room in Rental Dwelling Unit;. Living Room 12'.8^X 12'.11°, Bathroom a?
#a
Bedroom one 12'9 1/2"X 12'_11",Kitchen 11'10"X 175",Dining Room 13'5"X 12'9 1/2'.'. 2nd Floor Bedroom two 1 PX 121511,
-— - -- i
Rprlrnnm fhrpc INS"X 11'11" Rprlrnnm fniir Q 11 X 11 R Rathrnnm 9-1 119"Y191-S" ------ •
i
Page 3 of 5 1
t
v 3�
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
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
❑ .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) �1
COUNTY OF SUFFOLK)
i
Y
I Thomas J.McCarthy certify under penalty of perjury,the following: j
1. 1 am the owner of the property identified in "Section A" of this application. ,
p p Y .
2. The property owner's legal address set forth in "Section B" of this application is my legal
p p Y g
address and I understand the Town will use the address for service pursuant to all
Page 4 of 5
i
Town Hall Annex Telephone(631)765-1802
54375 Main Road T., Fax(631)765-9502
P.O.Box 1179 "
Southold,NY 11971-0959f
d_
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
applicable laws and rules. 1 further acknowledge that 1 will notify the Town of Southold n
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.
..i
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:_._ Thomas J.McC by
Property Owner's Signature:
Sworn to before me this a day of __ = 20
Official Notary Public Signature and Original Notary Stamp
ANDREA RIVE
Notary Public,State of New York
No.01 814768970
Qualified in Suffolk County
Commission Expires Nov.30,20jtZ'
Page 5 of 5
43'J
SOUTiyp•4ii
-TOWN-OF S�OUTHOLD BUILDING DEPT.
courm 7654 802
[ ] FOUNDATION 1 ST ..[ ], -ROUGH PLBG.
FOUNDATION-2ND :J- ];AN.SULATIOWCAULKING
[ ] FRAMING/STRAPPING [ ] .FINAL � +
[. ] FIREPLACE & 'CHIMNEY [ FIRE SAFETY INSPECTION -- `
[. ] FIRE RESISTANT CONSTRUCTION., [ ] FIRE RESISTANT PENETRATION
[
! ,ELECTRICAL (ROUGH) [ ] ELECTRICAL.(FINAL)
] CODE- VIOLATION [ ] PRE C/O
REMARKS:
Cy � - � ` f �
U A
DATEal 7 ?7i1 INSPECTOR
- ,
is
TOWN OF SOUTHOLD PROPERTY RECORD ac,
OWNER ,— STREET VILLAGE DISTRICT SUB. ry LOT
FORMER OWNER -- N E ACREAGE
V
14� Baa
S W -TYPE OF BUILDING
N' A
...........
SEA comm. Es�tMl t. Value
RES.
VL. FARM I N6, CB. misc.
... .....................
LAND IMP. TOTAL DATE REMARKS
Fi ..............-
741
4
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�71
v
TER NEW NORMAL BELOW ABOVE FROM
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40
Form
Acre Value Per Acre Value FRONTAGE ON ROAD ,,, &
Tillable I Z*09040*B 3
........................ .............
Tillob-le 2i DOCK
..................... . .......
Tillable 3
----------- ------- ---------
Woodland
.................
Swampland �4
Brushland
.............. ............ ....
House Plot
..............
Total
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41 � _.. ...L..... ........._ ..... .. ...... ..... ........,,,._
Extension `s ! Fire Place.- Heat
J Y,C.
Porch Roof Type
' _ : •.: '
Porch I Rooms 1st Floor
Breezeway '. _ Patio
Rooms 2nd Floor C
Garage S6Y �- ( Driveway Dormer j
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OENERAL �Y1�801 <EY : b A/G clqhzo
NEW PARTIAL HEIGHT
EXISTING TO BE DEM01-I5HED -- of NOOD FRAME (L.6. STL. LLJ
WHEN APPLICABLE) Lu >-
EXI5TING TO REMAIN X
NEW WOOD FRAME (L.O.
NEW FOUNDATION WALL h
5TL. NHEN APPLICABLE) ® �
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�----j NEW I-HR FIRE RATED a MIN. (2) 2"x4" STRUCTURAL- Ll
I----�1 WOOD FRAME (L.G. 5T1_. POST FOR 4" WALLS ® X A X * o X 0 0
WHEN APPLICABLE) (MIN. (2) 2"xb" 5TRUGTURAL a`� ��
POST FOR b" WALLS), U.O.N. z
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NEN 2-HR FIRE RATED p� N pL►� �wJ-T . u p
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WOOD FR` ,tE (L.G. 5T1_. - /�
WHEN APF. GABLE) - (� 2 EXIST. CRAWL
NEw OAS
SPACE �-•
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EXIST WIOx22 _ _, ,- _ EXIST. b"XB" WOOD
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FLOOR PLAN NOTES I�_q
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DOOR NOTE: �_ x A x A x
O 1. INSTALL NEw INTERIOR DOORS WHEN GALLED
N i Q �N 1
OUT ON PLANS BY 'JELD-HEN' (OR EOUAL).
2.INSTALL NEW EXTERIOR DOORS WHEN GALLED O N O N O L►J
n x n m LL Lu
OUT ON PLANS BY 'THERM��TRll' (OR EQUAL). I� _
3.DOOR TYPE TO SELECT
4.INSTALL AS PER MANU 5PEC.'s PUMP 0
IDE 2) 2"xb" HDR.,U.O.N. ��
3.PROV (
4.5EE PAGE 6-003 FOR ALI_ OTHER FRAMING 6111
ELEMENTS AROUND DOOR`S (TYP. FOR ALL) U.O.N.
SMOKE DETECTOR / CO DETECTOR N TE
>� I. CONTRACTOR SHALL PROVIDE CODE COMPLIANT
SMOKE /CARBON MONOXIDE COMBINATION DETECTOR Lu
HARD WIRED TD EACH OTHER H/ BATTERY BACKUP. �t
2.INSTALL ALL A5 PER MAN). SPEC.'S MONOXIDE DETECTOR
3.SMOKE DETECTOR AND CARBON MO q '
IN COMPLIANCE WITH LOCAL. CODE EXIST. CRAWL I"-
SPACE W
~ U
NEW LAUNDRY ROOM:
O 1. NEW WA5H /DRY HOOK UP'
2.COORDINATE LAUND.ROOM 4 DOOR DIM.'s V .J
H/517E OF EQUIP.
3,PROVIDE HOOK UPS A5 RE:Q 5 PER MANU.
FOUNDATION PLAID
DRYER EXHAUST NOTE:
SCALE: 1/4" = I'-O"
1. DUCT SHALL TERMINATE TO EXTERIOR
2.DUCT SHALL TERMINATE VIN. 4'-0" FROM ANY 0 S,F, HABI TABLE SPACE; 831 S.F. OROS5 AREA
OLCT SIZE
3.DUCT SIZE AS PER MANU. T 5
4.DUCT SHALL BE EQUIPPED w/A BAGKDRAFT DAMPER g
5.TRANSITION DUGTS SHALL NOT BE CONGEALED WITHIN
GONSTRUCTIt7N.FLEXIBLE TRANSITION DUCTS USED TO EXI T
CONNECT TI-- DRYER TO THE EXHAUST DUCT SYSTEM - REF MUDROOM
SHALL BE LI, •TED TO SINSL a LEN&THS,NOT TO Q i'-10"�I`
EXCEED & F =T AND SHALL BE LISTED AND LABELED `fl EXIST.
' BENCH tr BENCH BEDROOM
IN ACCORD.* :.E WITH UL 215bA. GAS D W.
b EXHAUST DUCTS SHALL BE: MIN 0.016" THK RI61D I 4 II
METAL w/SMOOTH INTERIOR SURFACES WITH JINTS 4 2'-b" 3'- 2" i'-4" 2'-O"-�1 1_ "
RUNNING IN THE VIRECTIO14 OF AIR FLOW. EXHAUST -�`_p --- bd rm 1 ��"
DUCTS SHALL NOT BE CONNECTED WITH SHE ET-METAL
SCREWS 1
'T. MAX.LENGTH SHALL NOT EXCEED ED 25 FT FROM DRYER y V 03 �
LOCATION TO THE WALL OR ROOF TERMINATION' THE EXIST. 2"x8"
MAX.LENGTH OF THE DUCT SHALL BE REDUCED 25 ?� G.J.
FEET FOR EACH 45' BM), AND 5 FI=T FOR EACH q0' u;p / v O Ib" D.G.
BEND THE MAX. LENGTH OF THE EXHAUST DUCT DOES EXIST.LIVINGON
13 to
NOT INCLUDE THE TRAN51-rION DUCT. ROOM w e O
NEW EXHAUST FAN SHALL BE: INSTALLED WHERE
OVENTILATION 15 NOT MET BY MEANS OF NATURAL
CIRCULATION THROUGH WINDOWS OR DOORS TO
OUTDOOR SPACES AS PER!NYS MECH. CODE SECTION 3'-5' b'-O' ��O:2
bath 1 n
403.3.2.3;INSTALL AS PER'MANU. SPE05 � v
p I O2 /U \
Ft ECTRICAL PANEL: �'0 - - -' EXIST.
O5 NEW ELECTRICAL PANEL LOCATION;ALL I %". NEW q5" LVL HDR ►�
INSTALLATION A5 PER NYS ELECTRICAL CODE W e KITCHEN x 0
O O
EX15T. HDR
0 REM METER: I
REMOVE t RESET EXIST. 645 METER REGULATOR/VENT �.J
AS PER NYS MECH.CODE,FUEL GAS CODE, E UTILITY CO. - EXIST. 2"x8"
STANDARDS. &AS METER SHALL BE P051TIONED o &RADE - 6"
i 2 o Ib" O.G. Q
EXIST. h -j n
ONEW FLUE: SMIVCD ±HALLWAY u;�
I. PROVIDE ZE- GLEARAIJGE FLUE THROU&H WAl-L IN _� N
M. FR.GHA1- . NL #105 OR UL#103 HT) - INSTALL AS W • u
Z
PER MANU. 5 °G.'s.
2.PROVIDE "AL 3Go FP200 FR EXPANDING FOAM" (OR EXIST. EXIST. LID 0
EQUAL) AT ALL PENTRATION5 AT UP GL_ W/D
FLOOR5/wAL.L5/CEILIW5;PRODUCT CONFORMS TOLu
° C3
ASTM E 614,ASTM E b4, AND UL 14101. cr
3.MECHANICAL FLUE TO FJTEND 3'-0" MIN. ABOVE ANY 1
ADJACENT GOMBUSTIBL.f: STRUCTURES WITHIN 10'-0".
EXIST. EXIST. DINING
ui
HAT014 ROOM ►-
SHELVING EXIST,
LAUNDRY
Q Q Q ° ROOM
PROJECT:
F I RST FLOOR PLAIT
88
6 S.F. HABITABLE 5PACE; 886 S.F. OROSS AREA SCALE: 1/4" = I'-O" TSC HOLDINGS
ALL NEW WINDOWS d DOORS SHALL_ BE ANDERSEN; INSTALL AS PER MANU. 5PEC.'s. SEE PAGE "6-003" FOR NAILING d 5TRAPPIN6 LLC
DETAILS.
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WIDTH HEIGHT OPEN REOV. 5.1 S.F. � v _ � x v EXIST.
EXIST.
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BEDROOM N •O
�p BEDROOM DRAWING TITLE:
A DOUBLE-HUNG ADH 1650
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bd rm 2 w ® 2' 4" w FOUNDATION PLAN
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600 S.F. HA51TABLE SPACE; 600 S.F. OR055 AREA
FORM NO. '4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z. 4958: Date . . . . . . . . . . .December. . -27. 19 72
--THIS:CERTIFIES.that-the building located at Z/5:Youngs .(Railroeti :J► t-eet
--.Block. _ . . . .Lot'No. apcz. . . Southold.' . N:.Y.
_ . . . . . .
conforms substantially oto the.,
eme t� f o �' 1 el & lou ing code
at beforeAp� _ �3 T =19: }fir pursuant to which it?fo.c cu
dated . . . . . . . ._.DeQember 27-19,.-19,.2 ; was issued, and conforms to all:of the require
ments ,of the-applicable_provisions of the law. The occupancy for which this certificate is
issued-is -Private-:one:family.-dwallirig. with. accessory. bldg. &-swimming .pool
-' - T-he.certificate.isissued-to..itnieph A.LoirainaAtU v h. . . . .Owners. .
_-- n e- owner., ssee-or-tenant.-)_-- .. .
of-the:.aforesaid=buildin —==IQO�Ss_ d _fi :r ....r,.=_��_=,--= - - - —
== - _. - -gam—= _ --A-_- �t _ cart .brie line b ae s�pro t
-_---= -- =Suffolk_count -IDe artment of Health Approval . .F�1s3•-.E':r: � i1g
—y-., -P . . . . . . . . . . . . . . . . . .
-_ __U-NDERWRITERS CERTIFICATE No. .. _ .p"! 4AU09. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
_ -- HOUSE NUMBERStreet. .
--- T .......340a.. . •Youngs -Ave.
Exceptions�to .housing;codes.
1 :.No, shut off valve at stove--&-oven appliance f
o0rJ ',S/W+Bedroom--Goose_ light..fiacture � :�". :.�
_3: sellar - several`open:electrical_bozes
.W®11=pit
I
HOUSING CODE INSPECTION
December 27, 1972
#3400 Youngs Avenue
Southold, New York
Tax Roll: Joseph P. Milovich and wife
Occupied, owner
Upon request' of the Southold Town Building Department
I made inspection of this two story, one family, framed
dwelling and found the following violations of Local Law #1
Housing Code of the Town of Southold. I was admitted to the
south side entrance by Mrs. Milovich and began inspection
at approximately 1c15 p.m.
FIRST FLOOR
Kitchen: Gas range and oven, separate built-in units
no shut off valve at units - Section 508b.
SECOND FLOOR
Ceiling height, six feet ten inches - violating the
Building Zone Ordinance, Town of Southold, Suffolk
County, Article I, Section 101 (Floor Area Livable)
- Bedroom -, southwest - ceiling fixture loose.
Cellar - Partially finished with recreation room,
ut—qty section, three open junction boxes, Section
528a. Partially open well pit requires full coven -
.Section 107.
I was accompanied by Mrs. Milovich during inspection
and pointed out these violations to her. This residence
is heated and contains four rooms and half bath on first
floor, three bedrooms and full bathroom on second -floor.
An enclosed porch surrounds the west and part of south
side of building covering the former outside entrance to
cellar. There is a one car garage with attached accessory
addition and a fenced in-ground swimming pool in rear yard.
Exterior of residence, accessory building and yard area well
maintained. Inspection completed at .approximately 1:40 p.m.
Res tfully subm', ted,
ward Hin erm. nn
Building Inspector
EH:te
FOUN NO. 4
TOWN OF SOUTHOLD
BUHMI VG DEPARTMENT
Town-Clerk's Office
Southold, N. Y.
Certificate -Of -Occupancy
= No.$36�53 :, . . . Date . . . . . . . . . . .X . . . . . .6. . . . . ., 1969.
_ :-:_THIS.CERTIFIES that the building located at Street
�. . . .Lot`No. . : .:: odd-==Nom ,-:. . . . . ----- =
•Soiih
- - ---conforms-substddt ally'to the Application for Building Permit-heretofore filed in this office
- -- dated -. :Ay . .3� :, 19. g pursuant to which Building Permit No. _ 41.8Z. .
:b -
dated . . : :. :. :. . _ , 19: , was issued, .and conforms to allof the require
- At�g "�� • • - bg - . - - - -. -. - - . - q
=the-applicable-provisions of the law. The occupancy for which this certificate is=-
-_ Private.-swtm. ing . . . ... . . . . . . .. . . . . . . . . . . .
is=issued=tooseph •L+ormaim - il.ovieh .: . Mr. ..: . . .. .. .
_:-:J •&
ownlessee ar-t
er, enant
_ - - — .)-- -, -
of-the_aforesaid building. -
-==—Suffolk=County-Department-of Health Approval . . .. . . . . . . . . . . . . . .. .
Building Inspector
8oua3e,.# '3409
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32214 Date: 02/26/07
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 3400 YOUNGS AVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 5 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 12, 2007 pursuant to which
Building Permit No. 32714-Z dated FEBRUARY 12, 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 ALTERATIONS TO AN EXISTING ENCLOSED PORCH TO CREATE OPEN PORCH
AS APPLIED FOR.
The certificate is issued to JUDITH L BERGLUND
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
tho zed Signature
//X/,�
Rev. 1/81