HomeMy WebLinkAbout1000-70.-9-28 Rental Permit
ac
INIM
0580
Owner: Michael Michelini , Lauren Cunningham
Occupied as: Single Family Dwelling
Located at: 200 Breitstadt Ct Southold 70.-9-28
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.
Issued: 03/21/2025 7>�L
Expiration: 03/21/2027 c rere Offoal
This Notice must be posted by the main entrance at all times
eft
TOWN OF SOUTHOLD BUILDING DEPT.
CCU 631-765-1802 �?o
INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS:
aL
DATE INSPECTOR
Town Hall Annex
Town of Southold PO
Main Road
PO Box 1179
Rental inspection Report
Southold, NY 11971-1179
Tel: 631-765-1802
SUM # 0— ' '� 02 Date O�
Owner �" / Phone
Address o�0� 13 1 Visible
Hamlet Inspector
Floor level Quantities Sub 1 2 3
Smoke Detectors(not located in bedrooms) F
Carbon Monoxide Detectors
Fire Extinguishers
Exits �
Bedrooms 1 2 3 4 5 6
Smoke Detectors
Egress
Occupant Count
Building Systems m^s Maintained &Operational Condition of Property
HeatingBuilding interior
Hot water Building exterior
Electrical Propel clean,maintained&safe
Mechanical Handrails&ivard installed&secure
Pool Safety Pool on Site
Surface water alarm Date of CO issuance o�0
Door alarms Pool completely enclosed
Self closing/latching gates I Pool fence to code requirements
CO's for all items present Prior Rental
Comments:
Docusign Envelope ID:38921 F03-52AB-47EC-8030-BFCBASC9B304 �-0�� I /� 14�
<$ aO Pd
(a c, i o lz y
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
„ Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax(631) 765-9502 littps://www..Southoldtowiiiiygov
RENTAL PERMIT APPLICATION
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
200 Breidstadt court, Southold, NY 11971
Tax Map Number: 1000 SECTION 70 -BLOCK 09 -LOT 28 -
SECTION B.
OWNER INFORMATION:
Property Owner Name: Michael Mi chel i ni
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
187 Kin Bland Ave 18Z Kingsland Ave.srggklvn. N.Y 11222
Brooklyn, NY 11222
Telephone Number (s): Daytime702-235-7640 Evening Emergency
Property Owner Email Address: mikmic@gmail .com
Page 1 of 4
Docusign Envelope ID:38921F03-52AB-47EC-8030-BFCBA8C9B304
Section C.
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: Michael Guanci
Address of Authorized Agent (no P.O. Boxes):44632 Route 25, Southold, NY 11971
Mailing Address of Authorized Agent: po Box 1502 Southold, NY 11971
Telephone Number (s): Daytime 781-608-0014 Evening Emergency
Email Address: mike@neversweatpm.com
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
Docusign Envelope ID:38921 F03-52AB-47EC-8030-BFCBA8C9B304
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, 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: Home
Requested Maximum number of persons allowed to occupy Dwelling Unit: 8
Number of rooms in Rental Dwelling Unit:8
Use and Dimensions of each room in Rental Dwelling Unit:
Living/Dining Room (12.5 ft x 22.5 ft) Kitchen (13 x 11.5),
Laundry Room x "OfTi ce s tt!ng Room (11.Sx13. Be room x
Bedroom 2(12.5x10) Bedroom 3 (11x9) Bedroom 4 (12.5 x 13)
First noor 172 Bathroom . x eon Floor hroom 5 x
second Floor Bathroom 2 (W)
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.
Page 3 of 4
Docusign Envelope ID:38921F03-52AB-47EC-8030-BFCBA8C9B304
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
Michael Michelini
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.
Michael Michelini
Property Owner's Name:
Property Owner's Signature:
State Florida county Okaloosa pp��
Sworn to before me thi �,+day of December 2 4
by Michael Michelini.provided NY State DL for ID
w /K---- M -- OZELLA MAE MOORE
Official Notary Public Signature and Original Notary Stamp
OZELLA MAE MOORE
u fry Notary Public-State of Florida
., Commission#HH 391605
Expires on June 13,2027
Page 4 of 4
Notarrzed recnoMy on ne u7g conurca71c"roat technoiogy via Proof,
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TOWN OF SOUTHOLD PROPERTY tEC Kaw
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F019K NO. f
TOWN OF SOUTHOLD
BUIMING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy ..
No. Date . . . . . . . . . . . . . . ! . . , 19. .
THIS CERTIFIES that the building located at . 3w to # .0 ."" S
Map No. !3A .mock No. . . . . . . . . . .Lot No. 15 . . . . 004WOU. - A J 9. . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . .Oot. . . $ . . . . . ., 19.70. pursuant to which Building Permit No. . 9% .
dated . . . . . . . . Oct. . . . . . . . .. 1970. ., 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 .P'gIT00. .W. X Y.0 1 g. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .
The certificate is issued to . . ' r .Wabor• • . • • r • � • . . . . . . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
d
Suffolk County Department of Health Approval Xalw. - -24- 1971. . .by.
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FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
No. . . Z 14 31 . . . . . . . . Date . . . .March. . . .24. . . . . . . . . . . . . . . .11986.
THIS CERTIFIES that the building . . . . . . . . Addi. i.Qn. . . . . , , . , , , , , . , , , . . ...
Location of Property . . . . . . . . . . . . . . Breitstadt Courtµ . w Southold
House No. Street
'Hamlet
County Tax Map No. 1000 Section . 0 7 0. . . . . . .Block . . . 9 . . . . . . . . .Lot . 0?$. . . . . . . . . . . .
Subdivision . . Smithfield Park I Filed Map No. 4.7 7 9. . .Lot No. . . 15 . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
. , ,Marq4. . 13, , , . , . . . , 19 PA pursuant to which Building Permit No. . . . . . 14647Z rt ,
dated . . . , . . . , . . , . March 14 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 . . . . . . . . .
--- Construct Deck, Addition. to.Existing Dwel ling. ---�--
The certificate is issued to . . . . . . . . WEBER, ,P,DRl1 fNE E. & FREDERICK R.
. . . . . . . .
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . .i`?j R . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . .N/R, . . . . . . . . . . . . . . • . . . > . . . . . . . . .
r�C
. . k * M Building Inspector
Rev.1/81
Town of Southold Annex 6/24/2013
P.O.Box 1179
54375 Main Road
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36307 Date: 6/24/2013
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 200 BRETTSTADT COURT, SOUTHOLD,
SCTM#: 473889 Sec(Block/Lot: 70.-9-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this offeced dated
7/6/2009 pursuant to which Building Permit No. 36888 dated 12/27/2011
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:
.4gosskq bAMound vwirnrra� l with , try c oc ocie a a for.
The certificate is issued to MERYL GREENBAUM
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36888 6/12/13
PLUMBERS CERTIFICATION DATED
Auth ',z' ignazirc
FORM NO. 4
TOWN OF SOUTHOLD
BURDING DEPARIIMT
Town Clerk'e Office
Southold, N. Y.
Certificate Of Occupancy
No. . . . . Date . . . .. . . . . .4140t. As . . . . . .. 19 73 .
THIS CERTIFIES that the building located at ft1d:%At4dt . . . . . . . . Street
Map N44.W$44. Block No. . ,ZX. . . . . .Lot No. .15. . . . . . . . . Aqut#QZ40. NITO. . . .
Park
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . AP rJA.34,P., 19.73. pursuant to which Building Permit No. .b522Z .
dated . . . . . . . . . . .AprU -34 ., 19.73, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issuedis . . . AU .OW. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . .
The certificate is issued to . . rP4 Ak. "0*r. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . w . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . .
HOUSE NUMBER . .200. . . . . . . . . Street . BXd*tatadt. C.ourt . . . . . . . . .. .. . . . . . . . . . .
. . . . . . . . . . . . . . . . . . „ . . . . . . . . . . . . . . . . . . . . . . . .Sontholat .B,X&I . . . . . . . , .
Building Inspector
+ FC 2/6/2023
Town of Southold
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 43821 Date: _w ._......2/6/2023
THIS CERTIFIES that the building HVAC ..... .... _._._ ..�..., ...... ..._�... _.�....
Location of Property: .�...w_._..
._.__�.m..._....... . _ ....__.�..... ... ._......
.�.....D Breitstadt Ct., Southold -
..........�.�_....�....a�_.n..�.__......�...�.mw�...�_.__w._�_............�._
SCTM#: 473889 See/Block/Lot: 70.-9.. 28 �.... .... .... .. ... . ._ . _ .._. _..._ ................. ... .__._....._.mm.
Subdivision M� wJ..�.�. ..
^ „
4 Filed Map No. Lot No.
conforms substantially the Application a y t pp tion for Building Permit heretofore filed in this office dated
1/10/2022 pursuant to which Building Permit No. 47375„ dated 1/24/2022
was issued,
and c onfonns to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
°ems w11' " lw° �a alr
The certificate is issued to Safran, Gregory&Laura _... .__....... .... ...
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47375 2/4/2022„
PLUMBERS CERTIFICATION DATED
Signature
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TOWN OF SOUTHOLD
Rental Permit
g
c
R
0580
Owner Gregory Safran
Occupied as Single Family Dwelling
Located at 200 Breidstadt Court Southold 70.-9-28
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 t -annu pec on.
1/25/2022
od_ n mento icia
This Notice must be posted by the main entrance at all tim
" °i so#
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-950:
P.O.Box 1179
Southold,NY 11971-0959 I "
p
SEP 1 4 2021
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:
Tax Map Number: 1000 SECTION 0 -BLOCK -LOT 9-
SECTION B.
OWNER INFORMATION:
Property Owner Name: f ` G'AU(&
Property Owner Legal Address: Property Owner Mailing Address:
GO �Ce-;4 4,,J� 0, d
So✓- -L 0.1.1 !V
-3,1
Telephone Number (s): Daytime Evening� Emergency
Property Owner Email Address: gr e" r
Page 1 of 5
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box I t79
Southold,NY 1 1971-0959
C
BUILDING DEPARTMENT
TOWN OF SO J"" 'HOLD
Mailing Address of Managing Agent:
Telephone Number (s): Daytime Evening Emerg n+cy
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: U 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: n d
Requested Maximum number of persons allowed to occupy Dwelling U
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: t, K,2 : i2S XdD
1 'L
l � ��b� 3 ; �) x °� �� 'f� l2. 5
Page 3 of 5
F
Town Hall Annex AL Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
coum
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.
la' 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 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
Page 4 of 5
*14f so
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 SOUTHOM
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: C r
Property Owner's Signature:
Sworn to before me this_„day of 20
r
Official Notary Public Signature and Original Notary Stamp
r<
J
Page 5 of 5
y
o CT-
TOWN OF SOUTHOLD BUILDING DEPT.
7651802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAUL IN
[ ] FRAMING /STRAPPING [ ] NAI. "
[ ] FIREPLACE & CHIMNEY [ FIRE SAFETY IN,S CTI
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
UAX
DATE
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1 301 2-1 INSPEC,7TORJ
SECOND FLOOR
bedroom bathroom bedroom
11.5x9 8.5x9 12.5x10
stairwell }
bedroom
bedroom bathroom 12.5 x 13
11x9 8x7
Powder rm
Kitchen
13 x 11.5
laundry room
7.5 x 10
1 I� living/dining
YY 15,5 x 22.5
stairwell office
11.5x13.5
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TYPE OF BLD.
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PROP. CLASS
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LAND IMP TOTAL DATE 3:4-F
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FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND
I BULKHEAD HOUSE/LOT
TOTAL
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TOWN OF SOUTHOLD PROPERTY RE
jOWNER pj) ISTREET VILLAGE DIST.' SUB. LOT
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FORMER OWNER aillt( rf!ale N E ACR,
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SEAS. ` VL. FARM COMM, CB. MICS. Mkt. Value
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FARM Acre Value Per 1 Valuet--f-
Acre I �� 12�"
U-5 J wmf,- j C-)
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
House Plot BULKHEAD
Total DOCK
DLOR TRIM -
F
i-
r
v
E
_ 1
I
I € 1
3
Tiff, -
a° ,
3
t.
E
[ I
70.-9-28 zeas - €� ,
} 4—
IL1
I 1
77—
IM. Bldg. . 3
>
_ i
Extension
C)
E
Extension '
i j 3 F
A
Extension
C ,•::..
�# E Foundation ��-t' �S? 1130th ;Dinette
I ;
Reams _ ;Basement I .Y. _ Floors IK i
n �_
_ y
Parch' x� Ext. Walls,
_ ,>w = J1L Interior Finish SLR,
_Breezeway
Fire Place Heat ; µ
'DR. i
Garage Type Roof Rooms lst Floor I 6R,
Patio I ;Recreation Room € Rooms 2nd Floor FIN. B
O. B.
S i is Dormer ;Driveway
Total ; � � i -
FO$M NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Date . . . . . . . . . . . . . . :; , ", . �', 19.7f.
THIS CERTIFIES that the building located at . ftj*tSW!t ,G .-Btre
Map No.SuM !U .Mock No. . . . . . . . . . .Lot No. 15 . . . . AfRO !. . A.1.. . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . 00t . . . & . . . . . .. 19,70. pursuant to which Building Permit No. 4"X. .
dated . . . . . . . . . Det. . . .8. . . . .. 1970. ,, 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 .PtAT00. . . XOWLAY.0013U9. - - . . . . . . . . . . . . . .
The certificate is issued to . .Fer .Mlrp 3r. . . . .Owaor . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval Mar. . .24. .49?1. . .by, R .Yi
Building Inspe
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. . . 536 . . . . Date . . . . . . . . . ..&WM4. . . . . . . .. 19 73 .
THIS CERTIFIES that the building located at ArIOAUdt. .G4lrt . . . . . . . . Street
Map N $44. Block No. .=. . . . . .Lot No. 15. . . . . . . . . AQV%hQj'40. AVT.*. . . .
Park
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . . .ApTU .30.9., 19.73. pursuant to which Building Permit No. .652= .
dated . . . . . . . . . . .APrJA .30* ., 19.73., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issuedis . . . &t0 .M44. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . .. . . . . .
The certificate is issued to . .ft .wok.Wober. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . . .. . . . . . . . . . . . . . . ,
UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . .
HOUSE NUMBER . .200. . . . . . . . . Street . Briotatadt. gourt . . . . . . .. . . .. . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Southold.$. N.X., . . . 11971 . . . . . . . . . .
Building Inspector
" Town of Southold Annex 6/24/2013
P.O.Box 1179
54375 Main Road
Southold,New York 11971
"o
CERTIFICATE OF OCCUPANCY
No: 36307 Date: 6/24/2013
THIS CERTIFIES that the building fN GROUND POOL
Location of Property: 200 BREITSTADT COURT, SOUTHOLD,
SCTM#: 473889 See/Block/Lot: 70.-9-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
7/6/2009 pursuant to which Building Permit No. 36888 dated 12/27/2011
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:
It cssor iia around srrrzaza poo!with flee to code as aatlilar.
The certificate is issued to MERYL GREENBAUM
..__ .. ....._. ..... ..,.. _..._ _.(ow..__......... �._...._._ . _� w. .... ....
N ER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
... .... . ........
36888 _ _ .... .
ELECTRICAL CERTIFICATE NO. 6/12/13
PLUMBERS CERTIFICATION DATED
—... ..:. Aut....... Pure
h z ign
1 f Town of Southold 2/6/2023
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
,m.
CERTIFICATE F OCCUPANCY
No: 43 821 __ 23
Date: .�...._ 2/6/20.................._...___.. ..W._._.
THIS CERTIFIES that the building HVAC
Location of Property: 200 Breitstadt Ct., Southold
SCTM#: 473889 Sec/Block/Lot: 70.-9-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/10/2022 pursuant to which Building Permit No. 47375 dated 1/24/2022
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:
IV knilt" EIT1 sa P p lied,1(al.
The certificate is issued to Safran, Gregory&Laura
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 4.7375 - 2/4/2022
PLUMBERS CERTIFICATION DATED
t orij Signa.. .....
ture