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HomeMy WebLinkAbout1000-81.-3-15.7 FF TOWN OF SOUTHOLD Rental Permit . 0492 Owner Edward Barnes Occupied as Single Family Dwelling Located at 2600 Paradise Point Rd Southold 81.-3-15.7 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. 5/6/2024 Code E r ent Offici This Notice must be posted by the main entrance at all times sol TOWN OF SOUTHOLD BUILDING D� 631 -765-1802 INSPECTIOri [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAI [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN; [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (TII [ ] CODE VIOLATION [ ] PRE C/O [ el REMARKS: ('.0 V INSPECTOR Town Hall Annex " Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 .. .... .... .. .. ..... .. .. ...� ..... �.. � CTM# Date /'��'- r� e2 Owner /39A4L4a. Phone Address o?!�O d Visible ._..... _ w . . ... _...... .. . .. ........ .... ,,. ...w................a.a..... Hamlet ..... _..._..... ,Inspector Floor Level Quantities Sub 1 2 3 .. Smoke Detectors(not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits . ..� � 1... .w�.. .w._ ....._� ......._ Bedrooms �� _ w � �....., � 5 � 6 1 2 5 3 4 Smoke Detectors Egress !... - .�._ ! ..._ .. .. ..... Occupant Count .�_.. ... .... e... , m._..e ..._.--- .._. . . �. Building stems Maintained&Operational a..._. . g y Condition of Property � o Heating ...�...�. �.� . .. . ..... . _�„ . ...,. , ..,.. .._ ...� � , .m.. � l Building interior ,. .. o Hot water .W,....�.. Buil� w .... .. . ding exterior ��_�.�....,.e.�... �..... .. . mm�..... �m,. ._ m .. . ._........ �.,... .. ...,. a or ... �. .9 El ectrical Property clean, maintained&safe Handrails &g.,. . installed&secure Mechanical. .Han ... ...�. .. .___�. ...___ �...�....... ..... drrails&guards i u ._..�.�,.�. ,.�. .. I ....,. � . .........� Pool Safety Pool on Site s,,.urface water alarm Date of CO issuance p(Q Q Door alarms . Pool completely enclosed Self closin.W...�latchin gates . . . ��� � . . Pool fence . .. .�a_.. .�..... .....m., n e..ma�. ...._a.� ..........� g/ g g to code requirements 1C0's for all items resent e � �Pnor, Rental Comments .....,.I __ ......... ry._W _._ _... .. ._ ._._......_ .... _....... _w .... ........................_.... ................ .. .......... . ........... ...�.. ........ ..... w ........... .......__.roWW_ .. .... .... ....... . .._......,. .. ...... . ... e e,e,. .... .., ....... .,._,... �... �� �oSofGOI � TOWN OF SOUTHOLD co c Rental Permit 0%, 0492 Owner Edward Barnes Occupied as Single Family Dwelling Located at 2600 Paradise Point Rd. Southold 81.-3-15.7 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. 7/1/2021 �� 7�7 Code Enforcement Official This Notice must be posted by the main entrance at all times Gy SOUTHOLD TOWN Town Hall Annex f-. 54375 Main Road cz PO Box 1179 Southold, C Rental Inspection NY 11971-1:179 Tel: 631-765-1802 Fax 631-765-9502 :R;y m - G 2 S:C�TIVJ';#=xis ��-� ,� ti: ` ry � ' .,. �t . b 1 S -pate ;v - Owner qtr Address �x Ti J//{�� ��'•.'� ,;. �C� C' w / /` `��Ya 7:eE ,�°d, ) / 9 / w.aar45,.;,yy,..:+.ke.v ..p da's�•: ., ,�,:''%�' �\1 6y, n f ;.; ems., t a� _ ;_. , .' = CIL n j�5 =Inspector. ung t!I' CS '"`Y1i`s :.�,-"'y;Yh'.2,' +>i;�Y.1`;ti^ _ +'�i5''k'A:'3t4:; �.X�N; ;,L 4::. _ 3•�,{w-..a.�,�_is:r _ •�. L.7,EVELS : !`,... _ { '�`.�' /'-.;^ ,�tr _ w ��,�B �7' � T � °d` - �- - ice. �.utro',.,,�•'f�i,',�y'-,<Rq`;v, ..a, "''Smoke D�ettecfors(#{ bedroom>detecto'rshp xclud' 13.rq on M_onoXide Detectors' #11*`` ` ILI -, .>.,. - Fi�e°E%xtinguislers(#)=y`> , ;.gym.•. ^y»;»_ •¢==e:a�,:�;�."a �.t%` a:�'7.:� •�,., r's;::�"s�: BEDR .OM ,1s {,,Smoke.rDetectorn'Alarms # �� � �����•y.'�"u-" � �q Mr, .AtP Carbony_IVlorioxidejAla"tris,(#)tri .v YE cess%.windows. ;YIN. �: �,r,;:•a;r. a;:aJ ;,�.ti^m,:tx, .�.;. :.vs:,'cc aa>r,,,r,;,,� -�.aa'.,^,e�. -•�', F i rJy.'y . ro 3 , .,;ea','mdre:,, ;'�'irtie .,z:'g�.'.r�' B;UILDING.SYSTEMS * '} § ` ='rv•,`} '} r: :Y1N::r.-z.CONDITIONOF'PROPERTY' :n,'x.aat....w1�:d+:.:J.^F::;: .-..-,:?'a}':'Y=:•... �✓!ff f? ):,,i.��'., c:.�`n=':Sfi+�°+.f):r, •,::::.Wi"_„ta;�`.•>.-'as",;=o-,,.��Y zrv'�.,:-. - - : r - mainta nedlo`e atio..a� .i. h .Y.t:s yt>.. . .�,..u. :^ Y.::i ' r:•<l `Heatiigxsyst'e_m°�- � _i�,,p •>a,pt„`rl,� n, ..�� ,.��� �B.ultling�lntenbr�is�elean; � �< _ - H,ot;water's. stem.maintained%o`�e�afional _ Buildir"g EXte�ioi isc ed :: "I'ean4/%maittan '':4'. �,�;'Yt>•ar'e*:a.�"s,=.z;yh': ,e:� es:: 'r ry Me'%!�; :,:rtn ..y,., .r.s. •.:s:imr,..a,:^. Electncalsystem maintained%o eratonah ' roy Fro"ert :,is;cl'ean l safe;%mamtairetl§?"x .,:�:K'"ra3^'x-rda-j.„' >e:5.-.,r..:.'�+.*,..�:vN;-- -tq,�.�,_ rte..`, ,/. - .,.. y� ���•���`�•- Mechanieal;sysfem-r°m,'aintained/o eratonal:� �Hantlrails&� wards'"""�' e� µ � a"� �.: ' ,{: .;,r,•l:r+k::. "„v'ik'w'k'k:%i7"xv• ri'•5,� r;'r..e,.Y,.` ,:,�5�. .}o"dl.: r;3:'> :°,:k',r _ x:y,;,.. .:.1-,+r !,r•', +t•: *� :%h;'Lt�..&:-sv _,y,^'• ='�Jr z.tr rvk.+' .,�. ,+�., @.J; /x,, •,'.fa r311,.•>X,r.. 'YIN;'��__. Q"4�:+'^z'.X=; eG-s:":'w,:'l,:mc'c'>;J,'.^ :i;.Yh :),'. -'triy:: .�t.5:... -t,-�:i,:aN,•`.' :r Ai TS>r '� y:;;gb�.�y?:+ae,^, ;r,�r• N'G'''�'C� `�•"f t.>i�"';0t.:ri Pool resent,; ��.. .,:�,)„r,.;�;'a!,t�;�::az��.�,:, tt-�.�.resent- .xr :::,, ':s.'•4.;', :�M �:'>nw,�_ ,:-.;4.;_r;.. ., ;' fir. .r.�...�r._ "�]:-,,.c> �i'J: - .st'i��` ...vs.,rr+t r.a,;:,:'"' s'S=•` _ '','..�'�'� r.�y.a � =a°��yrzT.?.-, .;g+ :t=• �'�'r `gip„ ..,.�r ",",�,„,�:y:z:•�rs��rf:;,.:M.,�-� -`-Y''.`<a,+ .,_a� PO.O;L TG�1TESx ,ti. .'. Y/N =: :r Allxo eniY s in`tia�rer�less``than 4./ '+: 7 'a:fa�>�Ws•'a y" !� Self=closin self.-latctiri ,w,�= Ma'x '2-,.clear'arice s'M r°�>�'a�� '�.s- -av w '7:tr�,, .�.,rr,....u,,.•..e. _., �.0 � n.:c%.,. a-r.e••.h. ,°.__; -.r_•7a - �"- - -Y, LatehAon;pool ide of gate .meefs;f etght•� ��; Bacner�ca able:of;_bein' locked&=°ch ld- "- .,.,M1.^." :fccx� s -WRi, .g��`i;'' .+, ` re uirernentstt =F roof,whe : ,yf iaiiatteridetl �Yh r de Le �< l z QI� 1 6 R Cev, l ,s I �f i Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 i. P.O.Box 1179 �� \ `, Southold,NY 11971-0959 - .,!?��• ���•�. -- ,--., ���(�{f" U� BUILDING DEPARTMENT M AY - 4 2021 TOWN OF SOUTHOIA) RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) -f €i Section A. Prop\y Information: f Rental Property Address: i3 J�00 POMI'm JAI Tax Map Number: 1000 SECTION 091 ,00 -BLOCK 03,00 -LOT D l� -OD-7 -1 It SECTION B. OWNER INFORMATION: �I Ai Property Owner Name: kc4i ('n6 Property Owner Legal Address: Property Owner Mailing Address: �A f w yc_, s V l_0011 Baa �y 0011 gl7-L10i- SdU(��llq 337-/e�1k3 Telephone Number(s): Daytime`10-901� q�0 Evening(a�1�a337 �y�3Emergency VrY� ; Mord Un��j r� Property Owner Email Address: e_&W Gird,b a(-nes 103©Mac.Corn , 1mej @ rnP— Com i� Page 1 of 5 i fJ{ 0- .S: 4 off`... .,�.• ' � :�` it Town Hall Annex Telephone(631)765-1802 54375-Main Road Fax(631)765-9502 P.O.Box 1 179 Southold,NY 11971-0959 ' . . BUILDING DEPARTMENT Ili TOWN OF SOUTHOLD i' Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency �! ,i Email Address: i I SECTION F. II PROPERTY DESCRIPTION: i 1i Number of Rental Dwelling Units on property: j For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, �i it Unit 1, Unit 2, Unit 3 or Apt A,B,C);the use of each room in the Rental Dwelling Unit �1 (for example,Kitchen, Bedroom 1, Bedroom 2, Living Room)and the dimensions of each room. s. For properties with multiple Rental Dwelling Units use"Rental Permit Application I Addendum." Rental Dwelling Unit Identifier:_ Ol) cQ- 1 Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit: q _ if Use and Dimensions of each room in Rental Dwelling Unit: wn Q'oom - DA )( 73 �Xann ' 1 x 11-7 r - !Sx 2-5)-11, d om Zkq x o - x - x � 11n I1S II, I �n�o(�n ISI ll,� Page 3 of 5 m``I Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 -CC Southold,NY If 971-0959 '(� �� BUILDING DEPARTMENT TOWN OF SOUTHOLD s 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. 1 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. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit STATE OF NEW YORK) COUNTY OF F SUFFOLK) certify under penalty of perjury,the following: 1. 1 am the owner of the property identified in "Section A"of thisa001`116666.* 2. The property owner's legal address set forth in"Section B"of thi$application"is Fny,)egal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 SDUT-14V ti Town Hall Annex 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: CA Property Owner's Signature: Sworn to before me this 6M day of �u�e 20� Official Notary Public Signature and Original Notary Stamp CARL R.KOLBET NOTARY PUBLIC,State of New York No.02KO6005616 Qualified in New York Coun�r Commission Expires April 20,20 2- Page 5 of 5 C I. si !` Town Hall Annex ,�, F ( Telephone(631)765-1802 54375 Main Road ; Fax(631)765-9502 t' P.O.Box 1179 S ' Southold,NY 11971-0959 :�C`_., ,`, ���.`• ,!, ,i BUILDING DEPARTMENT TOWN OF SOUMOIM RENTAL PROPERTY CERTIFICATION I I� ;t i, 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 Professional seal required for.Architect or Engineer,licensed Home Inspector must provide copy of valid current certification l� Rental Property SCTM Number: Rental Property Address: J600 MC) V.. aa3c4IA: ►vim 11171 �} Owner/Name: C&�G2. r)PA- LmOma mem }� Rental Dwelling Unit Identifier: u�t)4e ii Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq.,Bedroom#2-90 sq., etc.) ;f - C 4f, 'f �i 4! Property Description (Include all improvements indicated on survey) n 4 i i f 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, i the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New j York State. Print Name and Title Original Signature I I Please place professional seal: �,i M• � . a O�O�cyJ(/CSU�� �4}�U�c�J 7 �,, r �. + < t �� a� '� .. _ ., r '� � s s �. � � � � o�o��a�� ��o� . I w r +� MEW= 130 • i , OCA IM21 18.*m a r R�.. r h~i .x S:. I ' 1 • I �j all f �:►� sir` tArb.- \� flMI, -KIAM ly f t r �\ t <F Sunroom 14x11.8 1 I PIR "4 0 6x58.2x5.3gi Master Suite 25x17.6 I - Living Room 17.10x22.8 Eat-in Kitchen j 17.2x23.7 EI, Master Bath W-I-C Dn� 17x15 2x5 9.7x17.6 '.Q• ' 4.2g x 3.3 c u 0 FP Ref yl Entry Up Library -- 18x21 ; 15x14 Dining Room 13.1x17.7 .I 2600 Paradise Point Road 1 of 3 First Floor Tour and Content Copyright O 2004-2020.This floor plan illustration is an approximation of existing structures and features and is provided for convenience only with the permission of the seller.All measurements are approximate and not guaranteed to be exact or to scale.Buyer should confirm measurements using their own sources. rTp.y --- 2x4 W_1_C Bath 3.9x8 8.10x7.9 [� Bedroom I 14x15.10 Open to Below I . ,Dn Office i 12.1x8.9 9.8x2.4 c Bedroom 11.5x11.1 ., i Bedroom 11.5x2 _-_.- __-___ X 13x15 smo l &o n Nye \ 2600 Paradise Point Road 2of3 Second Floor Tour and Content Copyright O 2004-2020.This floor plan illustration is an approximation of existing structures and features and is provided for convenience only with the permission of the seller.All measurements are approximate and I guaranteed to be exact or to scale.Buyer should confirm measurements using their own sources. 12.8x12.1 a x HVAC Q I Unfinished Basement 0 40.6x48.7 I 18.8x51.1 f— U Up_ 2600 Paradise Point Road 3 of 3 Basement Tour and Content Copyright O 2004-2020.This floor plan illustration is an approximation of existing structures and features and is provided for convenience only with the permission of the seller.All measurements are approximate and not guaranteed to be exact or to scale.Buver should confirm measurements tisinn their nwn cniir— ....... LD 70 F RD.. ? N,:'''O STR Sup. LOT- T STREET ' ; .OWNER. 75 T A `'ACREAGE FORMER OQ R-�'� iN &) " �s W, i AF,) TYPE-6'F-BUI LDING II'�t3 CB M C, RES. SEAS V CO:Mm D�\ LAND IMP. TOTAL ,, REMARKS ks. , R .............................. 6 ....... ...... ......... .......... ........... ,"t ry en.e 0,Lj V Y T9 U "At E Ad I -'G,0k ABOVE ' ........... _Tillable 1 -77 Y' 13 Goa> —----------------- Tillable 3 ..................... ................ ------- .................................. ............. IT R; Woodland -04,1,) .....................................................-............................... ............ 7 ac(�ESSZ) Swo r.10 land BrUSh[bnd '7 ............................................ House Plot , ..............................................- 7� ....................... �r..���^,k<;� i _ ,,.;.i? Viii`` : yy:'`• :•' µ'•• Z:�'�a. •i •• (jjQ��,��, � %4 1\ '''`�',',�,'� gip,;,R�¢A.tY;,i,. '�✓.`.y��g-,,,J ti;e /^-�' ^,, 5;�tt..='.-..v iY' _-•,,,...,��-�I�� '�,,. 1p,;��,� ',� 4� ,J*L�°�i 'dT��t, f•"lfav^�,i•� �� ". .. - -'liJ,,;..�t��..j '��.,P.,''""�,°` �„C-” „ * ` ,(' `_v ",' ,.. >�"::a .7 ;'z•'"q. r ti 's;. h. �., �- (( A`"®'kyr `'p.3•;`� _ ...7._, — I , n 1�1. '.il _ rl{ ! v Lv FA r 1 .4 w Jv h; t?'."`• ..:,..:..',.";. .r,... r.s,-,,,:.�....t cs: ��a�� 1 �s , l� 81.-3-15.7 4/07 -- - I - , : , i f _i 71 FoundationBath' -a } x - �._..... . ........_._.._ - --........._..._........__ '. 'Extension :� z �t„ � :Basement`....._ Floors �'{ '� _.. .............. ----'----.......................----- xtension >- rr Ext. Walls j rr Interior Finish Extension ; J i4"E = -'� Place Heat , ' Fi`re ..___....:. .... - — -' _..................__._...__..._................. ........_ I Porch jAttic LY Porch I' I Rooms ]st Floor s. g Breezeway .... -- Patio ;," __. _.__..:...-I, Rboms`2na F(ao..._� ----=--'--- -----._ ..._ __� y Y , i .Garages ' . Driveway .p,.,,,, -..........'.. ,moo _...... I , • b t t ” _• • s FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27369 Date: 10/24/00 THIS CERTIFIES that the building NEW DWELLING Location of Property: 2600 PARADISE POINT RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 81 Block 3 Lot 15.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 22, 1999 pursuant to which Building Permit No. 25975-Z dated AUGUST 25, 1999 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 SUNROOM AS APPLIED FOR. The certificate is issued to GEORGE KAYTIS & ORS. (OWNER) of the aforesaid building. SUFFOLK COL1WfY DEPARTMENT OF HEALTH APPROVAL R10-99-0117 10/20/00 ELECTRICAL CERTIFICATE NO. N-529259 07/07/00 PLUMLiERS CERTIFICATION DATED 09/28/00 KEVIN REMPE PLUMBING&BEAT Authoriz d Signare 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-29631 Date: 08/11/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 2600 PARADISE POINT RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 81 Block 3 Lot 15.7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated pursuant to which Building Permit No. 29146-Z dated FEBRUARY 6, 2003 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JEFFREY & SUSAN KAYTIS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 1218 06/28/00 PLUMBERS CERTIFICATION DATED N/A Authorized S' ature 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-33606 Date: 03/19/08 THIS CERTIFIES that the building ACCESSORY Location of Property: 2600 PARADISE POINT RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 81 Block 3 Lot 15.7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 22, 2002 pursuant to which Building Permit No. 29145-Z dated FEBRUARY 6, 2003 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 ACCESSORY NONHABITABLE THREE CAR GARAGE AS APPLIED FOR PER ZBA #4.784 DATED 3/2/00. The certificate is issued to JEFFREY & SUSAN KAYTIS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A thor'zed Si nature Rev. 1/81