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HomeMy WebLinkAbout1000-104.-12-9 g€ $§ TOWN OF SOUTHOL Rental Permit A. 0716 Owner Breezy Shores LLC Occupied as Single Family Dwelling Located at 540 Vanston Road Cutchogue 104.-12-9 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. 5/30/2024 y c info in Official This Notice must be posted by the main entrance at all times TgN( OF SOUTHOLD BUILDING D Quo, 631 -765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND j INSULATIOWCAI FRAMING 1 STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] TIRE SAFETY IN', ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI' [ CODE VIOLATION [ ] PRE C/O REMA So INSPECTORf1 Moov DATE Town Hall Annex �� � z Telephone (631)765-1802 Fax(631) 765-9502 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 ��� I . AY 2 BUILDING DEPARTMENT arfff p, � TOWN OF SOUTHOLD %ivr^ f v RENTAL PROPERTY CERTIFICATION Form is to be completed by a licensed 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 Rental Property SCTM Number: Rental Property Address: Owner/Name: S(2-NNi FF(t 5 C(iAR Rental Dwelling Unit Identifier: S//ter,'—ice t /4rJ�► �._� I. /`'� Number& Square footage of each bedroom as depicted in the attached floor plan: (i.e. Bedroom#1 — 100 sqft., Bedroom#2—90 sgft., etc.) ��`��"��.�I — I s� SFr 13����o,�► �#Z � rav s� s JLoo r, 'r i°,7 Property Description (Include all improvements indicated on survey) h/i;LZ FA�11 L I o A-oo l noxl f �7 C �r976 Sr '� � C h - � Z S 5I l /0,1 19 71) o�Z S Y s; tzc� ,40o171iaJ .��w` Z I" w © w "wlE � "mow rt '1 l p ,J (��i=`cM fFDAirla✓ - "' pSZ 1��1 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, the Fire Code of New York State, the Property Maintenance Code of New York State and the Fr� ry Q- r , vati n Construction Code of New York State _... Pririd Iti "µ� Original Signature porn 1: TOWN OF SOUTHOLD Rental Permit tr ' aa� 0716 Owner Breezy Shores LLC . .Occupied as Single Family Dwelling Located at 540 Vanston Road Cutchogue 104-12-9 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. 1 8/4/2022 ode E or n Official This Notice must be posted by the main entrance at all times Town Hall Annex ,_ - f Telephone(631)765-1802 54375 Main Road #=p:: a';4 '. ' Fax(631)765-9502 P.O.Box 1 179 _ f' Southold,NY 11971-0959 # ;' I BUILDING DEPARTMENT 6 TO �J 4F SOTHt.LD JULR � d2� 0 BUILDING DEPT RENTAL PERMIT APPLICATION TOWN OF SODUTHOLD Rental Permit Fee$200 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION -BLOCK_ _ _ '-LOT_ - SECTION B. OWNER INFORMATION: Property Owner Name: )� Property Owner Legal Address: Property Owner Mailing Address: Telephone Number(s): DaytimewEvening Emergency Property Owner Email Address: Gy�iC��r�itlR,li� YA110a. Conj CP Page 1 of 5 Town Hall Annex 3 ;j `=�; " '' Telephone(631)765-1802 54375 Main Road "' r Fax(631)765-9502 :•<,' P.O.Box 1179 , Southold,NY 11971-0959 �b 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: Address of Authorized Agent(no P.O. Boxes) r,G rr— m/ / "-r f%TelMailing Address of Authorized Agent: 57— Telephone ephone Number(s): DaytimeO3q&L Evening Emergency Email Address: _ S�/�A.f�,� ,�a��,r ' VA17 ad ^4-4 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): Page 2 of 5 Town Hall Annex i ��'" I• . ,�� ""' Telephone(631)765-1802 54375 Main Road °f (: A 7 ;q.. Fax(631)765-9502 P.O,Box 1 179 Southold,NY 11971-0959 3i i�(� �[.,g��`"�`�. fir• {. BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: �L/L/ J•e. l Telephone Number(s): Daytime Evening Emergency 7� Email Address:� iYA&Z—(c A/ SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: For each Rental Dwelling Unit set forth the Rental Dwelling Unit i entifier(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: /0 Requested Maximum number of persons allowed to occupy Dwelling Unit: Number of rooms in Rental Dwelling Unit:. ,-G Use and Dimensions of each room in Rental Dwelling Unit: ( y�/ Z Page 3 of 5 Town Hall Annex I'elcphone(631)765-1802 ;`i r. -s;•:.',. . . -.' _x A 54375 Main Road �' \'.. _: ' Fax(63I)765-9502 P.O.BOX 1179 Southold.NY 11971-09-59 .T xcZiC... 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. ❑ lam requesting afire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 'I Aq-`,Z �,x t I ani submitting a completed Town of Southold certification form from a licensed VJ('° 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 Aeklai�f�/'iRC�' , 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 d € r � Town Hall Anne ` Telephone(63 ) Annex �' a. � �_`,\�'��• ;�Hs•sa;,' 1 765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 g3 FAL # �w `;3a. •j�;x ac 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 Owner's Signature: Sworn to befor a this °9 day of JUL y , 202 Official Notary Public Signature and Original Notary Stamp CAROLINE M MACARTHUR NOTARY PUBLIC-STATE OF NEW YORK No.01 MA6384635 Qualified in Suffolk County My Commission Expires 12-17-2022 Page 5 of 5 s 0 (q. # # TOWN OF SOUTHOLD BUI�DING DEPT. courm, 631-765-1802 1 plt �► ���O INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] 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 [ ] RENTAL REM RKSAimtob: • �� 1'1 DATE 3 INSPECTOR Town Hall Annex : . Telephone(631)765=1802 ,A 54375 Main Road ; Fax(631)765-9502 P.O.Box 1179 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 traessionalseaC.re Hired forArchitector..:En neer.,.iicensedilome►ns ector_music provide copy a valid cuirentmr0fl coflon:; f Rental Property SCTM Number. 100 IN- 1 Z^ 0� Rental Pro pertyAddress: 5K�.. v'ANSToIJ... Vtoicq, Gv'I�:HD(�U 1.1.. .3. Owner/Name: TENNI F e Sc041= Rental Dwelling Unit Identifier: . St"_(k fo l' L-y.. - _ 140 rF. Number&Square footage of each bedroom as.depicted in the attached floor plan: (i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.) 5 S� f � � Property Description (Include all improvements indicated on survey) 3�ING�_F_ FOILr tion(..*- st.b-..C.�.°%01�9�3). .._aoo�nou�Z-7ooZ..Cs/.vy/!9y6.)...... .. .. . DEGh itpo�ti101J #Z 138y0 C101o1 I X985) Sui�anr �OlZctl ,a�r�►Tloni�}Z l u S80 7/ot/r95rt) p��ti ,aoA�tioN•.., z.1.,b oSz ..,C�l.��.1..1:9�1..) . .. .. . . ..... ... .. [certify that I have done a physical inspection of the subject.rental.dwelling unit and find that it fully complies with all the provisions o.f,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 TRre NePV y Origin Sign e rn Please p o e � 8, . 51 MIN '` �j...�¢-� �"'�_ .��..�.— 'w•. �it.;d� � ! I �TL.:0.P�•�. � I :�� o"VVI �I 7 � \� CIF •1 ^: -�-..__ ::gin .i�- } �n.y uA P4I:IL'.. j 1 �k - ---fit,. �: •?• � ;F•r:7, 1.. air `1 Ili_....-.�. T-•.��`t'�� +r�- _ r=-ni••._:--� �.�.. • I• l _���'o"_-�_! +�•� :1 � Yc'��:.7���^��'"�'i_,'•4��i tLPit'.-r '. �� moZi IN w r.,'• G V"co �., G 'V a : '' ..i st�tw:•i'?'-f•'.,,a'yy.,�`31: 1a tg Op C .x. f tl .• p.• _ _ .s_ �.`I q r0 • CSI � Y_ lrVl � - -•. ,•:' �,`,.'..•i,;ti1""•:i... Fn_�1,: TD 21 - - '�t:•"a�{-1."moi'�'1�.s :y F l m } rO y • .. _ - � •'..::.i .tiµ_:,' - TOWN OF SOUTHOLD PROPERTY RECORD 17L� r . Oft CAI � �- OWNER STREET i,' `; VILLAGE DIST. -LOT nn �y/j �p��r/ �'',/✓ pg 4 r✓ 3d'� .F[Sri✓f rt{rpt ��,>P� i J 4.(-' i. f e`• ,+Yt L$sl L' /U. ^ G x.1':1 � r dl.P>•= ` /LZ3 } FORMER OWNER N E ACR. S W TYPE OF BUILDING ---- -- _ - 1 Value � r� .4 RES'. SEAS. VL. FARM COMM. CB. MISC. Mkt LAND IMP. TOTAL DATE REMARKS 7 ✓ c . i1 C) `I ;anis s" �'' f {Sr SL)."r¢� ltd' C� pp yy., r" t7, f!G fY h'f lr`,fs frC� NJlt i. 4. A b few• '� d? �j r J /,2 M1 3 `; J {. ,ti V. 7o o �Z C O ''�.�'' .^"[`-rC�Gi .`�� i G� r� �` .� .r,• zWL�1�`�`� i��_.ea�h:.�•`� ;%.:~`�r'� L'U'L.� ;i(..���?' �-�'..";���.�-t t�C�Q.�„A,{ 1�:w'� �'`.`=-=•r"""..a-� /'� i AGE BUILDING CONDITION r , a� C • � �a7 - �. X4'5- X11'' �a-t�t,r��7` ��,�, �° �� . NEW NORMAL BELOW ABOVE •% FARM Acre Value Per Value Acre .Tillable 1 Tillable 2 --- f, --------- ----------- ---------- Tillable 3 Pre, v---5 16 1b-1()-) 9-7- s Woodland Swampland FRONTAGE-ON-WATER Brushland FRONTAGE ON ROAD F 1 — House Plot DEPTH ' Total DOCK 6 ._..-_....__................._.-.-._.—.._..__.... ._-.ate.--.. .—__-.--...—..------- --._..,.�..-.... t r.. ■■■imp ■ t■r��■■■■■■■■■■■■■ xmpa MEMO ■ ■■■■■■■■■■� :.. y` ■■�■ ONE ■■■ ■■■■ ■ a` .' 'moi _. .. sry ■ M■ ■ ■■■ ■■■ION ■■■■■ ■ ■■■ ■ • r O ®I • •• • 1• Dormer ■ • 1riveway s ss- FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy . . . . . . Date . . . . . . . . . . . . dCt. . 10 . . . . . . .. 19. 73 THIS CERTIFIES that the building located at Manston .Road . . . . . . . . . . . . . Street Map*0. . I'daSS kt. BlocR 10. . . . . . . . . . .Lot No1.95 . . . . .QutChogue- . .IR-P"i . . . . . . . . requirements for one family dvellin & housing code conforms substantially to the i+2 .4141t. b .e. .pefe� Pp. , 319 57. pursuant to which Ce if ate, o 0 occupancy Z. .5516. . dated . . . . . . . . . . .Oct . . .40. . ., 1.9. 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 issued is Private. .Que. family. .( . suer) . dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to Tre.44.13r. .I?4arAAg. . . . . . . onor of the aforesaid building. (owner, lessee or tenant) Suffolk County Department of Health Approval . .pI'e!N1X1#ttng. . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No.pre-existing . . . . . . . . . . . . . . . . MOUSE: NUMBER. . . . .. . . . .Street. .V"st%Qzl. .RQ4G1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . .� BLIilding Enspector HOUSING CODE INSPECTION Octoker 10, 1973 # 540 Vanston Road R-1 Cutchogue, N.Y. Sub-Division Nassau Point, Map # 156, Lot # 195 Tax Roll Freda B. Dearing Unoccupied Upon request of the Southold Town Building Department I made inspection of this one family framed dwelling and found the following violations of Local Law # 1, Housing Code Town of Southold. I picked up the key from Mrs. Charles Rausch, Broadwaters Road, Nassau Point and began my inspection at approximately 10:50 a.m. The building consists of two bedrooms, one full bath, living room, dining area and k c ene . Th re is a partial full cellar with accessable crawl space from inside cellar. Access to cellar from exterior entrance. An open screened porch is on South side of building with entrance to dining area. Entrance $om screened porch: No electric light switch on entry: to control light in room-Section 529 b. No heating system, occupancy seasonal only-Section 513 a. Exterior: Electric service to building-house side of meter conduit not secured to building and meter box- Section 528 a. Building and grounds well maintained. Inspection eladed at approximately 11:15 a.m. and key was returned to Mrs. Rausch. R pectfully s mitt4d, ' war annL�� Building Inspector Foga[ No: s TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . . . . . . . . . . . . Date . . . . . . . . . . . . . . M THIS CERTIFIES that the building located at 54 011Am sT n N RV A 1) . Street Map No. -5.S.6. . . . Block No. . . -. . . . Lot No. . .(9 5 . . . . . . . . . . . . .. . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . . OCT 8 ., 197,`' pursuant to which Building Permit No.�a.��3 Z` dated . . . . . . . . . . . . . . . .�. . . ., 197 5., was issued, and conforms to all of the require. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .A. . . �7R% v A-t r U 1�+c FA 1H I �.Y DW k LL I n r e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . .w' LL I A INA f. . BEVERLY 3 rR U M E T . . . . . . . . } of the aforesaid building. (owner, Suffolk County Department of Health Approval �'�'�. . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . .N . . . Z$. L/, 9 . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . .J��! . . . . Street .V A N 5 T 0 N. . �D A D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . �U .r . C' (I 06 U �. . . . .. . . . . .. . .. . . . . . Building Inspector FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. . . . . . . . . . . Date . . . . . . . . .October '! 5 THIS CERTIFIES that the building . . . . . . .deck addition. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Propertytreet Ham%t 540 . . . , , Old Cove Rd. Southold House No. S . . . . .. . . County Tax Map No. 1000 Section . . . . 04; . . . .Block . . . . . . . . ..?. . , .Lot , , , , , ,9, , , , , , , , . . Subdivision . . 1"Iap, A Nassau_Point, . , , , , ,Filed Map No. . . !?6. .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ,August 9 , . , , , , . , 19 85 pursuant to which Building Permit No. . . . . �.y:282Z ,, , dated . . . . . ,S.Ppte}1:bsr, 16 , , , , , , , , 19 . 8.5,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 . . . . . . . . . . .D .C . a�,dt�Axl .tP. .e. �;;tng, one-family, dwelling . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . . . . . . . . . . . . . �11�11BRUNET of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . 1V/A, , , , , , . . _ . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . . . . /.$. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector 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. . . . 2.1.45$0. . . . . . . Date . . . . . . . . JulY. .� . . . . . . . . . . . . . . . .. 19 86. THIS CERTIFIES that the building . . . . . s•c r e. n e d-i n ,porch Y Location of Property . 5.4Q. . . . . . . . . . . . . Vanston Rd . Cutchogue House No. . . Street - " " " " " " ' " "Ham%t . . . County Tax Map No. 1000 Section . . . . . .10 4, - -Block . . . . . . . . . I? . ..Lot . . . . 9. . . . . . . . . Subdivision . .N� �au. P 4?p t, .Map. A . - , . , , .Filed Map No. . 7 5 6 . .Lot No. . . . . . ?.95. . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated • •`I a r'uar x• 2.1• • . . . . . . , 19$b.pursuant to which Building Permit No. '572Z , . . • . dated . . . . . . . . . ,k'e.b ruary. 19 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 . . . . . . . . . Screened. . Screened-in porch addition to existing one family dwelling. The certificate is issued to . . . . . . . . . . . . . . WILLIAM BRUNET of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . N/A . . . , . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . .N/ .. . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . z_' Building Inspector Rev.1/81 i R FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy NO. 16052 August 14 , 1987 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . THIS CERTIFIES that the buildingD E C K A D D I T I O N . . . Location of Property „ 540 Old Cove Road Gutchogue , New York Mouse No. Street Hamlet County Tax Map No. 1000 Section . . 04. . . . . . .Block . . . 2. . . . . . . . . .Lot . . . . 0.9 . . . . . . . . . . Subdivision .Map.A. of.Nassau.Point . . . . .Filed Map No. 156. . . . .Lot No. . . 95. . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated July 10: 1987 16236 Z • • • • • • • • • • • • • • • • . . . . pursuant to which Building Permit No. . . . . . . . . . . . . . . . . . . . . . dated July. 19, 1987 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 . . . . . . . . . DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to . • . WILLIAM BRUNET . . . . . . . . . . . . . . . . . .(owner,%aWVOGP. . . . . . . . . . . . . . . . . . . . . . of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . N/A . UNDERWRITERS CERTIFICATE NO. . . . . . . . . N/A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBERS CERTIFICATION DATED: N/A 77-7 ding Inspector Rev.1/81 7/6/22, 11:39 AM FuxJt-QwIWRMXb8svbSX3wO9zviDByheTDh3TWCLbwUYcvzZ_QAzHFkkSHh1acJlrU9dtSNjYZ9LPxprE_kWK6LNr7PSUJgJVtF... 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TOWN OF SOUTHOLD A1 p4anyp COUNTY OF SUFFOLK STATE OF NEW YORK Profassiona! Ennh $urvrslar �r�Y CC LOT 195 ON'AMENDED MAP OF NASSAU POINT' r y �r N,Y.S.Lic.No 04936 Fled: AUGUST 16 1922 Mp2 Number.156 DIST.:1000 SEC.:104 BLOCK:12 LOT'9 5 CIRCLEDALE LANE ` SURVEY DATE:MAY 26,2022 JOB:22-264 HOLBROOK,NEW YORK 11741 • --�-1' _ 718-486-5408 631-585-5317 M1 J https://gml.ggpht.com/FuxJt-QwIWRMXb8svbSX3wO9zviDByheTDh3TWCLbwUYcvzZ_QAzHFkkSHhl acJlrU9dtSNjYZ9LPxprE_kWK6LNr7PSUJgJV... 1/2