Loading...
HomeMy WebLinkAbout1000-56.-2-8.1 �,� � F D'i �, TOWN OF SOUTHOLD Rental Permit 0675 Owner Catherine Verrelli (Shideler) Occupied as Single Family Dwelling Located at 175 Laurel Avenue Southold 56.-2-8.1 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. 6/16/2022 *det en icial This Notice must be posted by the main entrance at all times SO Town Hall Annex ", Telephone(631)765-1802 54375 Main Road zr� Z Fax(631)765-9502 P.O.Box 1 179 S; Southold,NY 11971-0959 <, . . V, ECEHE ` BUILDING DEPARTMENT TOWN OF SOUTHOLD APR – S 2022 BUILDING DEPT RENTAL PERMIT APPLICATION TOWN OFSOUTHOLD Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: 1:76 L. a vre I AVenue Tax Map Number: 1000 SECTION -BLOCK 02— -LOT 009 - 00 SECTION B. OWNER INFORMATION:-( /�� '��1 \/ Property Owner Name: aSOn " l,-�le r�ne V e�del I J I Property Owner Legal Address: Property Owner Mailing Address: (go Tut o ,due ue- �d T(L*- �ver�v� drat ark, &11 11001 Hca l &r-K, y //d0( Telephone Number(s): Daytime5l 7i`J� 2 E�ening S�A6'►1e Emergency J I(� �I7g- 6393 mo Property Owner Email Address: Cl�erCCI I I w m Pagel of 5 /( "ZX;:Z 0 06 Town Hall Annex is 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 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:6 fir-, 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: h/114 Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex Telephone(631)76.5-1802 54375 Main Road £ Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959OV 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: 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: -Ain._hovSe Requested Maximum number of persons allowed to occupy Dwell i Unit: Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit:.bedroom ( — 17A S�Fd- �jPdruam (OS Page 3 of 5 Town Hall Annex Telephone(6a/)765'x80z s4s75Main Road Fax(631)765-9502 P1}.Box 11?9 Southold,NY 1197/'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. |fthe owner chooses not to have said inspection performed by the Town, a certification from a licensed architect, a licensed professional engineer orm bonnm 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 ofSouthold 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 bethe owner mf the dwelling unit. STATE C>FNEVVYC)RK\ COUNTY(]FSUFFOLK) | Verfcertify under penalty ofperjury,the following: 1. 1 am the owner of the property identified in "Section A"of this application. Z. 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 4ofS Town Hall Annex f_� Telephone(631)765-1802 54375 Main Road cry ` 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: CaA+)�rl in-e, c c 1 Property Owner's Signature: �CL1vl.SL1 ,r`2 V Sworn to before this O day of �1'7 / 20 Z Z Official 6Ktary Public ignat re and Original Notary Stamp `o"`ytPTE o . Dawn Johnson NOTARY':. '�Notary Public,State of New York ". ruoLIc =No 01J®6349053 Qualified in Suffolk County Z Commission Expires 10/11/20r 4 Page 5 of 5 °t s0Ur�� Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 CA P.O.Box 1179 • Q Southold,NY 11971-0959 Q BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Profess onal.sea'i`.'reau_Ired,for•Arch'ifec#,.or-Enaineer;..licensed Home!,inspector.-must;provide: copy-of:va'lid:current certificadon.-, -- -- - - -- _- -- -- Rental Property SCTM Number: �JlQ-Z- e". Rental Property Address:_-a—!2_ -1 AU-Kg-- t'- '!�� UE Ln / L"q I I Owner/Name: J;Q1; a. •4-Vt7 CPQ .1—C-,2•Ai4 - Rental Dwelling Unit Identifier:-.1-- �- L�Ab.�`. .�4-�E Number&Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1-100 sq., Bedroom#2-90 sq., etc.) z,_. Property Description (Include all improvements indicated on survey) '3e e c ( o - ----- 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 Construc ' n Code f New York State. Print Name and Title �5'��`�os Pil y Fo Original Sign re Q � 4 � Please place professional seal: 0239' yOQ qTF OF N �aOF SOUI [44yO / - * * TOWN OF SOUTHOLD BUILDING DEPT. cou631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] ENTAL W ,,n/�REMARKS: tl Ul/X�C -k 0 , Go� 1, 12 r:: �n C DATE v INSPECTOR .fenV. C2�r".(��fa�r V16�S19ae/D,y LAoA►1 ry D 00 �Cock/ 0004 � �' o f � -10 0 00 � Clese� ,tee �� 0 Ke. � C��rb�� �,►�-ec��r S -- S� 4 c I � fir' Town Hall Annex '} Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 C �!' Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 Professional sealrequired for Architect or ,Enaineer, licensed Home Inspector must provide copy of valid current certification 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 I Please place professional seal: LZ / X>Tql NOF SOUTHOLD PR JPERTY R �f �S RD OWNER STREET VILLAGE DIST. SUB. LOT � ;.!1 tom.'.! ti:�:e �ij 2..,, -``• ` .� FORMER QWNER �, �/' < _• N/1; E ACR. _ Ave 4 Sv . . - W TYPE OF BUILDING RES: ' _ SEASIt� J VL. FARM COMM. CB. , MISC. Mkt. Value i 1 f LAND IMP. TOTAL DATE REMARKS 32 c _ f / to c c� C� I/ J /"'0/ ��J " 4111 ' �JrY t!1*7 ZL [7 .1 ! ED • f �_ (., �.� PSI i r :"A C: ,J ��!•\tel %} !✓tc ��.. .r-1 AGE BUILDING CONDITION ' Y NEW NORMAL BELOW ABOVE �.y� ,�ys • I{_ � ;�1 t.r� � ��� �-,: ,:- � ^ << :-,.t�a`� ;�� ,_ j FARMAcre Value Per Value Acre << s� k Till a �, Tillable 1 n xi Tillable 2 ( ( e` Tillable 3 Woodland i Swampland FRONTAGE ON WATER Brushland -------- FRONTAGE'ON. ROAD House Plot DEPTH BULKHEAD Total DOCK ..J !x e; .. A :mss, {'. Jr. ■■■ Ise ■�■■■ ■■■�o■ ■■■■■■ ■■■.■�i�■i■�■ �i ■air■■ I WE of WHO MIN M Ems" : .. . .. an INN IN . ter ► PlaceBasement Floors Ext. Walls ..Interior Finish Fire Rooms 2nd Floor• Dormer Driveway w ?R TRIM � 1 I -_L 56.-2-8.1 House 2 09/13/2017 - I lVt. Bldg. Extension �i Extension i ! t :Extension : ---` J Foundation iBath i Dinette Porch" iBasement 3 Floors Porch Ext. Walls _ Interior Finish LR. Breezeway i Fi re Place Heat ! DR. :..Garage _....—.___ _—.�..—..� _ . . :..: ------�_- i Type Roof Rooms 1st Floor f3R, (Recreation Room - _ Rooms 2nd Ffoor. i FtNB i (Dormer --i-` --- Driveway Total i i I K` >T .............. ........... OFSOUTHOLD PROPERTI TOWN CARD bWNER STREET VILLAGE D EST SUB. LOT E A RM OW FO ER,- NER N ACR. I'A S W TYPE OF BUILDING w I" FARM comm. CB. MI'CS. Mkt. Value RES.' SEAS. TI--VL LAND IMP. TOTAL DATE REMARKS A�-z", 0 �6.p- 130A 4c 'AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE EARM Tcre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowlarid DEPTH BULKHEAD —7 House Plot' DOCK FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 34011 Date: 10/19/0 THIS CERTIFIES that the building 2 DWELLINGS & ACCESSORIES Location of Property 175 LAUREL AVE SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tag Map No. 473889 Section 056 Block 0002 Lot 008.001 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 34011 dated OCTOBER 19, 2009 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 TWO ONE FAMILY DWELLINGS WITH ENCLOSED PORCH, ACCESSORY TWO CAR GARAGE AND CHICKEN COOP.* CORRECTED 1/4/11 The certificate is issued to RUBY GAFFGA (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HBALTS APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. 7;)(zed)4natuz;�Z- Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 175 LAUREL AVE SOUTHOLD House #1 on survey SUBDIVISION: NAP NO.: LOT (S) NAME OF OWNER (S): RUBY GAFFGA OCCUPANCY: ONE FAMILY DWELLING RUBY GAFFGA AI14IZTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO-: 56.-2-8.1 SOURCE OF RBQUBST: GEORGE GAFFGA DATE: 10/19/0 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EKITS: 2 FOUNDATION: CONCRETE BLOCK CELLAR: 1/2 CRAWL SPACE: TOTAL ROOMS: IST FLA.: 4 2ND FLR.: 0 31D FLA.: 0 BATHROON(S): 1.0 TOILET ROOK(S): 0.0 UTILITY ROOM(5) PORCH TYPE: REAR ENCLOSED DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOINATER: YES TYPE HEATER: PROPANE AIRC@IDITIONQ�: TYPE HEAT: PROPANE HARM AIR: X HOTWATER: OTHER- ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST-: 2 CAR WOOD FRAME STORAGE, TYPE CONST.: SM316CEM POOL: GUEST, TYPE CONST.: OTB�t: 8 X 12 CHICKEN COOP VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. I � I F REMARKS: SP3537 ADD COZ2798 INSPECTED BY: DATE OM INSPECTION: 10/0B/0 GARY J P T]lO; START: EL®: BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT 1A)CATrON: 175 LAUREL AVE SOUTHOLD House #2 on survey SUBDIVISION: MAP NO.: IAP (S) NAME OF OIRlER (S): RUBY GAFFGA OCCUPANCY: ONE FAMILY DWELLING RUBY GAFFGA ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 56.-2-8.1 SOURCE OF REQUEST: GEORGE GAFFGA DATE: 10/1910 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2 FOMMATION: CONCRETE BLOCK CELLAR: 1/3 CRAML SPACE: 2/3 TOTAL ROOMS: IST FLR.: 4 21M FLR.: 0 31M FLR.: 0 BATHROOM(S): 1.0 TOII18T ROCK(S) 0.0 UTILIW ROOMS) PORCH TYPE: ENCLOSED DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTMATER: YES TYPE BEATER: PROPANE AIRCONDITIONnM- TYPE HEAT: OIL WARM AIR: X HOTHATER; ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME STORAGE, TYPE CONST.. SWIMMY POOL: GUESP, TYPE CONST.: OTHER: 8 X 12 CHICKEN COOP VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION I ART. SEC. REMARKS: 3MPECTIM BY: - DATE ON INSPECTION: 10/08/09 GARY J F START: END: _,r'wv I n . I b yl LOCATION: �. (number&street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): OCCUPANCY: (type) (owner-ten ADNIITTED BY: ACCOMPANIED BY: C � KEY AVAILABLE: SUIT.CO.TAX MAP NO.1000- SOURCE OF REQUEST: DATE: .DWELLING: TYPE OF-CONSTRUCTION: !L #STORIES: N..Q_ _#EXITS: FOUNDATION: ��,6- CELLAR: /v CRAWL SPACE: r TOTAL ROOMS: 1ST FLA: 2ND FLR: 3RD FLR: BATHROOM(S): TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: DECK,TYPE: PATIO,TYPE: BREEZEWAY: FIREPLACE: "~— GARAGE: DOMESTIC HOTWATER: TYPE HEATER: AIRCONDITIONING: �— TYPE BEAT:- J WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST.: STORAGE,TYPE CONST.: SWIMMING POOL: GUEST,TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144&N.Y.STATE UNIFORM FIRE PREVENTION&BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: P -)S32 AA d C;--)-R= a-� I INSPECTED BY: DATE OF INSPECTION: Q TIME START: END: LOCATION: (number&street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): OCCUPANCY: (type) (owner-tenant) ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF.CO.TAX MAP NO.1000- SOURCE OF REQUEST: DATE: .DWELLING: TYPE OF-CONSTRUCTION: � �tf►..E #STORIES: _#EXITS: y' FOUNDATION: C.16 CELLAR CRAWL SPAC TOTAL ROOMS: 1ST FLIT: 2ND FLR: 3RD FLR: BATHROOM(S): dl^&— TOILET ROOM(S): r UTILITY ROOM: PORCHTYPE:- � DECK,TYPE: PATIO,TYPE: �— BREEZEWAY: - — FIREPLACE: GARAGE: DOMESTIC HOTWATER: - TYPE HEATER: AIRCONDTTIONING: TYPE HEAT:- WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE 'OF CONST.: Zt c � STORAGE,TYPE CONST.: SWIMMING POOL: GUEST,TYPE CONST: OTHER: eyri.t<.l VIOLATIONS: CHAPTER 144&N.Y.STATE UNIFORM FIRE PREVENTION&BUILDING CODE LOCATION DESCWPTION ART. SEC. l REMARKS: INSPECTED BY: _ DATE OF INSPECTION: 7 -Zd 9 TIME START: /"0 f lT- END: �'�� awwnffs+�arlr®�sovswa aun i uv.rro me�roa�xw me aaysr WRP�AvcA.Va OVImnOMVm nE mlELEYPiWY.O01'FR'eB/IKAf.BCY, aLat x 'emumt ..am�xsml,vc 10 216' N/ OTH ,� ^ ro mEwssr.�E,vasms'emnoersmwwx F BO A00l/YW4fa5777NY1\TOR6(BSEOEENfOKTgB. —0.O b twwmKrsuravavnmmwroncv niawasr�remuMrov N 68-43'00"Ea 34 4' . m ONE-STORY oa+rFsormasrrverYwnores�rmo 25.00' c neWoa�.aYe�vresamsSmsKSMvc 1 , 26.9' 9.2' casosrEoroes�vKo mus Z m5. IL m SopEy�N�y.CELn s o FRAME m .�1' 22.4' O o GARAGE Nppp PAW 4+. o C �TWE o�5 a DEa 5.4 6.3' I o c N/F R& K GAFFGA o i. oo 8.2' a 0 2' ONE-STORY m " 8.2 RESIDENCE 8.2' N > r 1 BLUESTONE RIBBONS ORNEWAY w WELL 10.1 mNc.ulK � � 76'45'10"E 6.2. E. �J x 0 N ^' FO / Meq p{L1mE O O I C ) 2.2' me Q z WRELL -I,: IA wyoas ti (BACKFILLED) t*1 Q ems\ N �1.4y / 332.96 io L4z a N � v L4 �a own nrt S 68'43 00 / F mow N/F HEHR FRAME GARAGE ' b c NYS RT 25 i MSN ROAD i N/F HUBEL SURVEYED: 7 NOVEMBER 2005 SURVEY OF SCALE 1'= 30' DESCRIBED PROPERTY SENATE AREA = 43.734 S.F. SOUTHOLD, TOWN OF SOUTHOLD 1.004RACRES SUFFOLK COUNTY, N.Y. SURVEYED BY SURVEYED FOR: RUBY GAFFGA STANLEY J. ISAKSEN, JR. TM# 1000-056-02-07.3 P.O. BOX 294 TM# 1000-056-02-008 >�fs �mL6 NEW S FFOLK. N.Y. 11956, 631-7 4-5835 GUARANTEED TO: RUBY GAFFGA ACENSE N SURVFYOR NYS Lic. o. 49273 05R1450 r i FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF ®CCUPANCY No. Z ��9�. . . . . Date . . . . . . . . . . . . . . . A ngup*1- .10. ., 19.67. THIS CERTIFIES that the building located at W/O .4tt 0— AVS. . . . . . . . . . . . Street Map No. =` . . . Block No. . . X=. . . . .Lot No. .MM. . . 8011thold t. KA.. . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . a41Y.. . . .10. . 196W W . pursuant to which Building Permit No. 35372. . dated . . . . . . .JUly'. . . .10. ., 1967. ., 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 !14T4te .One 4p4y.oxge m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .qP©* .1,.4. .4art.ga . . . . . . . . . Q=er . I . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . * . . . . ... . . . . . . . . . . . . . . . . . . . . . . Building Inspector Of War Town of Southold �o`p oma= 12/19/2017 P.O.Box 1179 o • 53095 Main Rd 'y& �a0� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39411 Date: 12/19/2017 THIS CERTIFIES that the building WINDOWS Location of Property: 175 Laurel Ave., Southold SCTM#: 473889 Sec/Block/Lot: 56.-2-8.1 Subdivision: Fled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/5/2017 pursuant to which Building Permit No. 41296 dated 1/19/2017 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 FOR WINDOWS AND DOORS IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR PorkVw O- The certificate is issued to Shideler,Stephanie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A th Signature 6 '+ }ffO��S11FfUt,f�o. Town of Southold 2/2/2022 P.O.Box 1179 53095 Main Rd ' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42741 Date: 2/2/2022 THIS CERTIFIES that the building OTHER Location of Property: 175 Laurel Ave,Southold SCTM#: 473889 Sec/Block/Lot: 56.-2-8.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/27/2021 pursuant to which Building Permit No. 47353 dated 1/19/2022 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: centeral air conditioning to existing single family dwelling dwelli #1 as er Pre) as applied for. The certificate is issued to Shideler, Stephanie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 4 353 1/2 022 PLUMBERS CERTIFICATION DATED tho ized i nature