HomeMy WebLinkAbout37757-Z g11FFBI,f Town of Southold Annex 12/5/2013
30� c°may P.O.Box 1179
54375 Main Road
oy �� Southold,New York 11971
col � yap.
CERTIFICATE OF OCCUPANCY
No: 36576 Date: 12/5/2013
THIS CERTIFIES that the building RESIDENTIAL ADDITION
Location of Property: 4150 New Suffolk Road,New Suffolk,
SCTM#: 473889 Sec/Block/Lot: 110.-8-31
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
1/14/2010 pursuant to which Building Permit No. 37757 dated 1/15/2013
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:
sunroom addition to an existing one family dwelling as applied for.
The certificate is issued to Margaret R Gaffga
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37757 12/3/13
PLUMBERS CERTIFICATION DATED
AuXrV Sofature
of fat-too TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy • SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 37757 Date: 1/1 512 0 1 3
Permission is hereby granted to:
MARGARET GAFFGA
P.O. BOX 37
NEW SUFFOLK, NY 11956
To: 12'X 18' SUNROOM ADDITION TO AN EXISTING DWELLING AS APPLIED FOR.
REPLACES EXPIRED B.P. # 35311
At premises located at:
4150 NEW SUFFOLK ROAD NEW SUFFOLK
SCTM # 473889
Sec/Block/Lot# 110.-8-31
Pursuant to application dated 1/14/2010 and approved by the Building Inspector.
To expire on 7/16/2014.
Fees:
PERMIT RENEWAL $100.00
CO -ADDITION TO DWELLING $50.00
Total: $150.00
� I
Building Inspector
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 35311 Z Date JANUARY 22, 2010
Permission is hereby granted to:
MARGARET GAFFGA O
n n �
CUTCHOGUE,NY 11935
for
121X 181SUNROOM ADDITION TO AN EXISTING DWELLING AS APPLIED FOR
at premises located at 4150 NEW SUFFOLK RD NEW SUFFOLK
County Tax Map No. 473889 Section 110 Block 0008 Lot No. 031
pursuant to application dated JANUARY 14 , 2010 and approved by the
Building Inspector to expire on JULY 22, 2011 .
Fee $ 200 . 00
&��
Authorized Signature
ORIGINAL
Rev. 5/8/02
/ Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
/ 765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings,property lines, streets,and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations,a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines,streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is
denied,the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy -New dwelling$50.00, Additions to dwelling$50.00, Alterations to dwelling$50.00,
Swimming pool $50.00,Accessory building$50.00, Additions to accessory building$50.00, Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. j a (o —I
New Construction: Old,or Pre-existing Building: (checkdone)
Location of Property: 1 t 2t j SuT` ��� b) S
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision ` Filed Map. Lot:
Permit No. 50 Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
SOUjyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 iQ roger.richert(a)-town.southo Id.ny.us
Southold,NY 11971-0959 ;4`
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Margaret Gaffga
Address: 4150 Grathwohl Rd City: New Suffolk St: NY Zip: 11956
Building Permit* 37757 Section: 110 Block: 8 Lot: 31
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: home owner DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor. X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 8 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors 1
Main Panel A/C Condenser Single Recpt Recessed Fixtures 12 CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches F7 Twist Lock Exit Fixtures TVSS
Other Equipment: SUN ROOM-1-paddle fan
Notes:
Inspector Signature: Date: Dec 3 2013
81-Cert Electrical Compliance Form.xis
5-3
Of SO(/r�,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION-'
[ " FOUNDATION 1ST [ ] ROUGH PLOG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: ! To-
DATE �� INSPECTOR
Of SO(/l�°�
3cS-3 11
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ) FOUNDATION 1ST [ ] ROUGH PLOD.
� \FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ) FIRE SAFETY INSPECTION
[ J FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE ���,��� INSPECTOR
oF sours
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
] OUNDATION 2ND [ ] INSULATION
FRAMING STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE d INSPECTOR
\"
OE SOUT�o<o
co '
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FO ATION 2ND [ ] INSULATION
[ FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCrION [ ] FIRE RESISTANT PENETRATION
REMARKS: U
DATE INSPECTOR
i
oF so�lyo�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] F ON 2ND [ ] INSULATION
[ FRAMING / TRAPPING [ ] FINAL
[ IREP E A CHIMNEY [ ] FIRE SAFETY INSPECTION
( ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS.
DATE G7 INSPECTOR
OF SO[/r�olo
I � oy 0
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION '
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE d3 l INSPECTOR
I .. OF SO�Tyo�o
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTIO
[ ] FOUNDATION 1ST [ ] RO H PLBG.
[ ] FOUNDATION 2ND INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE /I
AT INSPECTOR
OF SO(/T�o�
cou
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ` I " ELECTRICAL (FINAL)
REMARKS: r
DATE 1� � �' "� INSPECTOR -Fl
Of SO(/r�o
N O
�ycOUtfi`I
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE )-- INSPECTOR
F$LLD INSPEeTION REPORT DATE COMMENTS
FOUNDATION(IST) (�
-------------------- -----------
FOUNDATION(2ND) G
O
l U
� wd
ROUGH FRAMING&
PLUMBING
v ,
zllz .� py
�J
INSULATION PER N.Y.
STATE ENERGY CODE
3111111 WoJ
FINAL
ADDITIONAL COMMENTS
z
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL ^ Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO. 35 ��1 Check
Septic Form
N.Y.S.D.E.C.
Trustees
,+ Flood Permit
Examined ,20 /O Storm-Water Assessment Form
J Contact:
Approved / ,20 /0 Mail to:
Disapproved a/c
Phone:
Expiration 20_//
C E V 15 !Building Inspector
JAN 14 AFtLff JN FOR BUILDING PERMIT
Date , 20
��- - BLDG.DEPT.
TOWN OF SOUTHOLD INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months.Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described.The
applicant agrees to comply with all applicable laws, ordinances,building code,housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
W e,� _
Name of owner of premises 14U
(As on tye&fiWroll or latest deed)
If applicant is a corporation, signature 9f duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
�//5_D G rui1 wj�A f 00 sU F F-61
House Number Street Hamlet
County Tax Map No. 1000 Section /l O Block S Lot
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed constriction:
a. Existing use and occupancy N a�1n,lJ r,,,olk,,c,
b. Intended use and occupancy Srfd-y I Fn N A Y DW01 i"�
3. Nature of work(check which applicable): New Building Addition X Alteration X
Repair Removal Demolition Other Work A,,Wy_ be A< , AJA 19 t i2'. itcuw�
_ (Description)
4. Estimated Cost sa-S C) Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
r /-
7. Dimensions of existing structures, if any: Front lo� Rear . �y, m'Depth 3
He P,Z`t Number of Stories
Dimensions of same structure with alterations or dditions:'Front" Y �rr;R'ear �o
Depth 3& HeightNumber of S,tories,! i I
i
8. Dimensions of entire new construction: Front Rearj Depth
Height e, aa Number of Stories
9. Size of lot: Front 3!v a- Rear Depth
10. Date of Purchase L 7 88> Name of Former Owner
11. Zone or use district in which premises are situated res f6go ii •\
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
13. Will lot be re-graded? YES NO_Will excess fill be removed from premises? YES NO `X
14. Names of Owner of premises Address Phone No.631-7341 (023
Name of Architect N'm P"c vt 3o�g Gvy4Address Phone No
Name of Contractor (74-uAies— Address Phone No..
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO_ C
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES NO_)�
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY 06U
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
CONNIE D.BUNCH
(S)He is the Notary Public State of New York
No 01(3U,185050
(Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk County
Commission Expires April 14, 0A
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
� (� �day of 1 G� 20�
Notary Public Signature of Appl' a
dog Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
Hai PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE-SUBMISSION OF A
_' STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN
District Vec1lon Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
----------------------------------------------------
Item Number: (NOTE: A Check Mark(.r)for each Question is Required for a Complete Application) Yes No
----------------------------------------------------
I Will this Project Retain All Storm-Water Run-Off Generated by a Two(2")Inch Rainfall on Site? M
(This item will include all run-off created by site clearing and/or construction activities as well as all Site
Improvements and the permanent creation of impervious surfaces.)
2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size&Location? ❑
This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlowl
!-2F�fL'� �- C�u�S i•� �
3 Will this.Project Require any Land Filling,Grading or Excavation where there is a change to the Natural ❑
Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? —
4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of ❑
Five Thousand(5,000)Square Feet of Ground Surface?
5 Is there a Natural Water Course Running.through the Site? ❑
Is this Project within the Trustees jurisdiction or within One Hundred(100')feet of a Wetland or Beach?
6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen(15)feet of Vertical Rise to ❑ �(
One Hundred(100')of Horizontal Distance?
7 Will Driveways,Parking Areas or other.Impervious Surfaces be Sloped to Direct Storm-Water Run-Off ❑
into and/or in the direction of a Town right-of--way?
8 Will this Project Require the Placement of Material,Removal of Vegetation and/or the Construction of
any Item Within the Town Right-of-Way or Road Shoulder Area? F-1 —
(This item will NOT include the Installation of Driveway Aprons.)
9 Will this Project Require Site Preparation within the One Hundred(100)Year Floodplain of any Watercourse? M
NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark in the Box, a Storm-Water,Grading,
Drainage&Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permitl
----------------------------------------------------
EXEMPTION: Yes No
Does this project meet the minimum standards for classification as an Agricultural Project?
Note: If You Answered Yes to this Question,a Storm-Water,Grading,Drainage&Erosion Control Plan is NOT Requlredl _
————————————————————————————————————————————————————
STATE OF NEW YORK,
COUNTY OF .....tv.............................SS
o
That I. ...............................................................................being duly sworn,deposes and says that he/she is the applicant for Permi
(Name of individual signing Document)
Andthat he/she is the .................................................................................................. .. R��JJ; 8UN.CH.
. .......... . ... .. ...............
(Owner,Contractor,Agent,Corporate officer,etc.) Notary u IcI, Late of New York
No.0lbU6185050 Owner and/or representative of the Owner of Owners,and is duly authorized to perform or ave i@c to
Om I ion Xplr rlmake and file this application;that all statements contained in this application are true to the estof 1Svs know ge anJ&d
iefi and
that the work will be performed in the manner set forth in the application filed herewith.
Sworn to before me this;
,....i. ..........,20 j..
day of ...... /1�
NotaryPublic: 1P ... `(' ..................... I
:. ... .............................. �////�....-
(Signature of Applicant) (/
FORM - 06/07
SO!/T��
<o
Town Hall Annex J�f J�[ Telephone(631)765-1802
54375 Main Road y ye (631)765- 5 2
P.O.Box 1179 G ' iQ roger.richertC7F own.soutFioQd.ny.us
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: �j� M� Qw��� Date:
Company Name:
Name:
License No.:
Address: U, �7 etj su prz'1 K li`e I lct5G
Phone No.:
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: (Sri:Z
*Cross Street: Ate ,
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION-OF WORK (Please Print Clearly) SQ N Q66 d6s AAclJwA)
(Please Circle All That Apply)
*Is job ready for inspection: YE / NO Rou. In ,� Final
*Do you need a.Temp Certificate: YES / NO
Temp Information (If needed)
*Service Size: 1 Phase 3Phase 100 150 20 350 400 Other
*New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for Inspection Form `,
Southold Town Building Department
��g�FFOI�CaG P.O.Box 1179
Permit#: 35311
�A 54375 Main Road
; Permit Date: 1/22/2010
a Southold,New York 11971
4� # �yo� (631)765-1802 Expiration Date: 7/22/2011
Parcel ID: 110.-8-31
BUILDING PERMIT RENEWAL LETTER
Dated: 5/9/2012
Applicant: MARGARET GAFFGA
Location: 4150 NEW SUFFOLK ROAD NEW SUFFOLK
Work Description: RESIDENTIAL ADDITION
12'X 18' SUNROOM ADDITION TO AN EXISTING DWELLING AS APPLIED FOR
A FEE OF $100.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT.
Owner: MARGARET GAFFGA
Address: P.O. BOX 37
NEW SUFFOLK,NY 11956
The permit listed above has expired. Please contact our office as soon as possible to begin the renewal
process. All work on the project must stop on the expiration date.
No work is permitted or authorized beyond the expiration date.
THANK YOU,
SOUTHOLD TOWN BUILDING DEPT.
Southold Town Building Department
�SOFO(K P.O.Box 1179
Permit#: 35311
54375 Main Road
Southold,New York 11971 Permit Date: 1/22/2010
'jx�l �yd`��� (631)765-1802
Parcel ID: 110.-8-31 Expiration Date: 7/22/2011
BUILDING PERMIT RENEWAL LETTER
FINAL NOTICE
Dated: 1/11/2013
Applicant: MARGARET GAFFGA
Location: 4150 NEW SUFFOLK ROAD NEW SUFFOLK
Work Description: RE5IDENTIAL ADDITION
12'X 18' 5UNROOM ADDITION TO AN EXISTING DWELLING AS APPLIED FOR.
A FEE OF $150.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT.
Owner: MARGARET GAFFGA
Address: P.O. BOX 37
NEW SUFFOLK, NY 11956
The permit listed above has expired. Please contact our office as soon as possible to begin
the renewal process. All work on the project must stop on the expiration date.
7011 2970 0000 4786 2691
THANK YOU,
SOUTHOLD TOWN BUILDING DEPT.
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