Loading...
HomeMy WebLinkAbout29148-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29351 Date: 04/09/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 30100 MAIN RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 102 Block 3 Lot 7 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 10, 2003 pursuant to which Building Permit No. 29148-Z dated FEBRUARY 10, 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 MICHAEL MORRISON & ANO. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 497842 08/17/99 PLUMBERS CERTIFICATION DATED N/A ""-d' /'44 th ize Signature Rev. 1/81 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. 29148 Z Date FEBRUARY 10 , 2003 Permission is hereby granted to: MICHAEL MORRISON 35 WEST 16TH STREET APT. 6 NEW YORK,NY 10011 for CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE & AS PER CONDITIONS OF ZBA #4703 DATED 7/1/99 . -REPLACES BP #25858-Z at premises located at 30100 MAIN RD CUTCHOGUE County Tax Map No. 473889 Section 102 Block 0003 Lot No. 007 pursuant to application dated FEBRUARY 10, 2003 and approved by the Building Inspector to expire on AUGUST 10, 2004 . Fee $ 150 . 00 Author zed Si nature ORIGINAL Rev. 5/8/02 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. 25858 Z Date JULY 8, 1999 Permission is hereby granted to: MICHAEL MORRISON NEW YORK,NY 10011 for : CONSTRUCTION OF AN ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE & TO CONDITIONS OF ZBA #4703, DATED 7-1-99 . at premises located at 30100 MAIN RD CUTCHOGUE County Tax Map No. 473889 Section 102 Block 0003 Lot No. 007 pursuant to application dated MARCH 30 99 and approved by the Building Inspector. Fee $ 150 . 00 Authorize Sides gnatu COPY Rev. 2/19/98 THE NEW YORK BOARD OF FIRE 'UNDERWRITERS PAGE 1 1185077 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK,-,NY 10098 Date AUGUST 17,1999 Application No. on file 1$77009999 N 497842 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant nlamed on the above application number is in the premises of MIKE MORRISON, 55 PEQUASH AVENUE, CUTCHOGUE, NY in the following location; ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on AUGUST 09,1999 and found to be in compliance with the National Electrical Code.. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 1 1 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT., AMPS. .TRANS.. AMT. H.P. NO.OF FEET AMT. WATTS 1 20 1 ­40 . SERVICE DISCONNECT NO.OF S E R V I C E METER NO. CC COND. A.W..G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.COND. NO. HI-LEG OF HIAEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: ;SWIMMING POOL-1 GrCI-1 ''(SiM24ING POOL) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent .test/and or repairs - made by a qualified person. «e Continued on Page 2 >>> GENERAL MANAGER Per This certificate must not be altered In any manner;return to the office of the Board if Incorrect. Inspectors may be identified by their credentials. r3 I imp§M1 MP 110§N 0111EM9311113111110M COPY FOR BUILDING DEP7771FENT, TRIUbI. NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIFREA UNDERWRITERS PAGE 2 1185077 BUREAU OF ELECTRICITY`,,.< 40 FULTON STREET, NEW YORK, N* 1.008' Date AUGUST 17,1999 Application No. on file 8770099199 N 497842 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of MIKE MORRISON, 55 PEQUASH AVENUE, CUTCHOGUE, NY in the following location; ❑ Basement ❑ 1st FL ❑ 2nd FL OUT Section Block Lot was examined on AUGUST 09,1999 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCE FLUORESCENT OTHER AMT. K.W. AMT.. K.W. . AMT. - K.W. AMT. K.W. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT.1 TIME CLOCKS BEL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. 'AML AMPS. TRANS. .AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I~ C E METER NO.OF CC COND. A.W.6. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. 10 2W 1 0 3W 3 0 3W 3 0 4W pER B OF CC.CONDI. NO.OF Hf-LEG: OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: - ROSLAK ELECTRIC L L P.O.BOX 154 CUTCHOGUE, NY, 11935-2453 GENERAL MANAGER 11 Per This certificate must not be altered in any manner;return to the office of the Board If Incorrect.Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. APPEALS BOARD MEMBERS O g%3FF0j4, C�� Southold Town Hall Gerard P. Goehringer, Chairman �� y� 53095 Main Road James Dinizio, Jr. C-0 P.O. Box 1179 x Lydia A. Tortora - • f Southold, New York 11971 Lora S. Collins y z%. ZBA Fax (516) 765-9064 George Horning l �a Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JULY 1, 1999 Appl. No. 4703 - MIKE MORRISON STREET& LOCALITY: 55 Pequash Avenue, Cutchogue 1000-102-3-7 DATE OF PUBLIC HEARING: June 24, 1999 FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property consists of a total lot area of 16,143 sq. with 99.86 ft. frontage along the Main Road and 153.90 ft. along Fleet's Neck Road (a/k/a Pequash Avenue) at Cutchogue. The property is improved with a single-family 2-1/2 story frame house with deck and 1-1/.2 story barn/garage. BASIS OF APPLICATION: Building Inspector's April 20, 1999 Notice of Disapproval citing Article IIIA, Section 100-30A.4 of the Zoning Code with respect to a location of a proposed swimming pool in one of the lot's two front yards. The code requires a rear yard location with a minimum rear setback of three feet. AREA VARIANCE RELIEF REQUESTED: Applicant requests a Variance to locate a proposed 14 ft. by 28 ft. in- ground swimming pool with fence enclosure to be located in the southwest yard area. No raised decking or raised patio area is proposed. The setback of the pool construction is proposed at approximately 18 feet from the south front property line at its closest point. No raised deck or patio areas are proposed in this application. ADDITIONAL INFORMATION AND EVIDENCE: Along the front property line of Fleet's Neck Road, on applicant's property,are a continuous row of hedges which screens Yard areas from view. REASONS FOR BOARD ACTION. DESCRIBED BELOW: Based on the testimony and record before the Board, and personal inspection,the Board makes the following findings: 1. Grant of the area variance as applied will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties because the proposed location of accessory pool is at least 80 feet from the intersection of Main Road (Route 25) and Fleet's Neck Road (a/k/a Pequash Avenue). Although the proposed pool would be set back a minimum of 15 feet from the westerly property line (along Fleet's Neck Road), the pool will be screened from this road by privet hedges existing along the boundary. 2. The benefit sought by applicant cannot be achieved by some method, feasible for appellant to pursue, other than an area variance because there are septic systems and large mature trees existing in the rear yard that prevent the location for a pool there. 3. The requested variance is not substantial because applicant's need for a variance is created by the fact that the property has frontage along two roads (two front yards), and applicant's request conforms to code requirements with regard to setback from Main Road (State Route 25). 4. There is no evidence that grant of the variance will have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district. Page 2 -July 1, 1999 ZBA Appl. No. 4703 - M. Morrison Parcel 1000-102-3-7 5. The difficulty has not been self-created. In considering this application, the Board deems this action to be the minimum necessary and adequate to enable the applicants to enjoy the benefit of a new swimming pool, while preserving and protecting the character of the neighborhood and the health, safety, welfare of the community. RESOLUTION/ACTION: On motion by Member Dinizio, seconded by Lora Collins, it was RESOLVED, to GRANT the variance, as applied for, subject to the following CONDITION: Screening over 4 ft. height along the westerly front yard area is required and shall be maintained, except for the first 30 feet from the intersection which is restricted to a code height limitation of 30 inches. VOTE OF THE BOARD: AYES: DINIZIO, TORTORA, COLLINS, HO AY: and Go r' er. This Resolution was duly adopted (4-1). GERARD P . OEHRINGER , AIRMAN For Filing about 7/7/99 vBV mr.2ryram<v A© .. - e.,iE tp1YW not d em:••x:..r .s: t rtxaw Mw4Ahongn sn ,- , a.' 31AP, ; OF P20PEIT UQVEYED FOtz 110 410 - 1 � ` �. � ,gyp, � IXC Ma�RiSoti r T� ` �C�.�•4/rtJ13�` _ — CUTI-IOGU k a'n T4OF•.ECCMJQLD N.Y t SJECX - i6a SCALE L L•1•_MC}NUMENT .OQl vgl .. - ._ 91.41 r' T�TI,..B NO_Tf29Q-202 „ CpU Kt�ii'� 7 TSCi?P3�71Tt •C�11b12A,y :Gatt�1p girtTAt J 7 1 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE, April .20,. .1.999. . . . . . . . ToMgrrison) . . . . . .. . . . POBox9 .. . .. ... ... . . .. . . . . . . . . . . . . . .. .. .. . . . Cutchogue NY 11935 .... ... . . .. ... .......... . . PLEASE TAKE NOTICE that your application dated AUT0.39.J 999. . .. . . . . . . . for permit to construct an accessory inground swimming pool . . ..... .. .... ...... .. . . . . . . . . . . . . . . . . .. .. . . . . .. .... .. . . . at Location of Property .. .30100 _, Main Road . ,•, ._ _ • , . , _, _...Cutchggue........ . House No. Street Hamlet County Tax Map No. 1000 - Section 102 .... .. BLOCK . . . 3. .. ... . IAT .7... . . . .... . Subdivision . .. ........ . . ... . .. . . . . . . . . . ... Filed Map No. . . . . . .. ..Lot No. ... . is returned herewith and disapproved on the following grounds that_the,proposed.__ _._ . _. .$CGQ�S4CY.;VECQVgd.S51lsP1;gg,pgol is in tpe frPPF. yprfl. iiFlrd.. .Up4@F.�Ft]Cl2.III�. . . . . ... . Section 100-30A.4. Accessory buildings, buildings and structures or other .. . . . .. ..... . .... .. .. . . . ... . . . . . . . .... ... .. . . . .. . . . . . . . . . . . . ... .. . .. ... . . .. . . . . . . ... . . . . accessory uses shall be located in the required rear yard. .... . .... .. ... ... . . . . . . .. . . . .. . .. . . . . .. ... . . ... ... . . . . . .... .. . . .... .. . . . .. . . .. . . . .. . .. . . . . . ... . ... ... .......... . . .... . . . ...... .. .. . .. .. . . . . ... . . . . . ...... ....... . .. .. . .. .... . .. . .... ............... ....... . ........................ . ... ..I. .. .................... ....... .. . ..... ............... .... . . .................... . ... . . ...... .. .... ... .... ..... .... ..... ........................ .. ... .. . . . .... . ...... .. .. . . . .. .. . . ....... . ........... . . . . .. .... . (Lot coverage +/- 13Z) ................... ........ . ....•......... . ........ .. . . .... .. .. ..... .. . . ... .. .. ...... ... ..... .... ............... ... .. ... . ..... •••.••••. .. . . . . .. . . . ........ . .... .............. . .. . . . . .. . .. . .. . ... . . . . . . • •• . . . . .. .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . ,. . . . BUILDING INSPECTOR Michael J. Verity RV 1/80 BUILDING PERMIT REVIEW CHE_—CK' LIST Application Name: Architect/Engineer: SCTM #: District: 1 000 Section: Block: 3 Lot: Subdivisions Name: Req /r`5 Zoning District:/(— [Lot size O �V Proposcd:fC;� [Lot coverago��Proposed: /O Req. Req. Req. [Front Yard Proposed: J [Side Yard Proposed. J [Rear Yard Proposed: Project Description: AGENCY PERMITS Permit REZUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: Notes: 7-7 7651802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: B/ ,- C�Sir✓- �{�� L�f 7 DATE O 'J INSPECTOR A4�1 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]�IULATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE 00 Q3 INSPECTOR, CLD_INSPECT.. --RREPORT=a DATE __� -------------------==«COMMENTS-----_ �S{I> MMATION ( IST) 74 )UNDATION_– (2ND) --_-- – _----- ,. N M OUGH FRAME & �• �� - \,`� PLUMBING r u r4suLATION PER N. Y. H STATE ENERGY u �=- CODE p tl u H X q tl d N p u FINAL u p tl r �p r M � ADDITIONAL COIMNTSa �- _ --=— ------------------------ — ---------- 1 i H H m O GOZ.t�'� Of if�lf.1E OCCUPANCY OR USE IS UNLAWFUL APP VED NOTED WITHOUT CERTIFICATE DATE: LI .P. � I OF OCCUPANCY FEE: � `�"� Y: ALF NOTIFY BUILDING )EPART T 765-1802 8 ET 4 PM R THE FOLLOWING E NS: 1 FOUNDAT - O RE UIRED FOR POURED ETE 2. ROUGH - a SING 3. INSULATION 4. FINAL - CONS RUCTIO MUST BE COMPLETE C.O. �y< ALL CONSTRUCTI N SHAL MEET THE REQUIREMEh rs OF 7 IE N.Y. B� STATE CONSTRUC 1ON a I NERGY CODES. NOT RE PONSIBI E FOR DESIGN OR CONST IUCTION RRORS UNDERWRITERS CERTIFIU E �cvc REQUIRED IMMEDIATELY" ENCLOSE POOL TO CODE UPON COMPLETION BEFORE "WATER" u/4.04 IA_eZ ��r�< Matte ,4Ti�t>ar, -goV, it d--&4aL6 Ox i< 76 FL'.te'E w �E 01� LcaoD� � icvt.) w/7H .�iF G�1c�e.I.� ¢.d7�S �iNA7 Wlt�- a`—/E'FT yz�.v Olaf BOARD OF HEALTH . . . . . . . . .: . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTUOi.D SURVEY .. . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . S0UTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CA . Ivmnined .. , 19.99 MAIL TO: . . . . . . . . . . . . . . . . . . . . Al�xovtti . , 19.../ PermiGt� No. d:" '" �6• ................................. .. . Disapproved a/c .... l.C.fa.. .............................. .... . . ............ ... ................................... ... ir);, Mcg (Ifuildrg Inspector)-� O 1999 APPLICATION FOR BUILDING PERMIT c7�, Date. . . . . . � J.. . . , 19././. . BLDG. DEPT, -PVVN OG SOUTNOf i--.i iNSTRUCTIONS a. 'Deis application mist be completely filled in by typewriter or in ink and submitted to the Building Tnapector wi 3 seta 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 giving a detailed description of layout of property mint be drawn an the diagram which Is part of this application. c. 'Bre work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building inspector wilt issue a Building Permit to the applicant. krch permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in dale or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by die Building inspector. APPLICATION IS HEREBY MAIL to the Building Department for the issuance of a ifuilding 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, aelitiona 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 builde ' .......................... .................................. .... Name of owner of premises l.J� :.. U �1' ..:'.T/M...�::��:Y.����� ....................................... (as on the tax roll or latest deed) It applicant is a corporation, signature of duly authorized officer. 4-0Z3 ..-'/6 ZZZ>......... .......... (Name and title of corporate officer) Builders License No. ....1�i.��t�.:!`�.4..... /1 n �04- plcmbers License No. ......................... �� Electricians License No. 3 O I l�a..�n Other Trade's License Na. .................... I. location of land on which proposed work will be done....................................................... ...... .....................1�Esi'uci. ...dk4F................... .....................:.... (louse Number Street Hamlet County Tax Map No. 1000 Section ..1.U,r�,�.�....... Block ....3 ......... Lot ..7........... Sulxlivision l`ly KiSc:V,...t*4iF y(!/ ... Piled lisp No. ........:...... lot ............... (Name)/- 2. 2. State existing use and occupancy 'o'fypremises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................... b. Intended use and occupancy 2 `,-... `... 1! ...lfF'.4`1�...F.:pi t...l�•tr�.c.�sJlL .: :44:/. '`��•-7- 81HTATO A HMASU3 r7e'11 _ lheY Nret1 to sfsf2, 1.181%9 VAATCN tfm!nC 41nyv2,fCiB00tiT2tG.oN _. .- .P.:'IJL 2HaaM_Rn9T 3. tt:ture of work (duecit widdt spplfeeble): New Wilding .......... Add ition Alteration ........ .. 14e1mir ............ Ilenwal ............. Demolition ............ Ujer Work J1i��.�F'.-C '14 .sx`.�r!�(!1L't`r..,•rcc. 'z p .........(Description) 4. Idstineted Cost 0 rfC1Ol� OJ fee ,. r�J7:•D,d ................. (to be paid an filing this application) 5. If (1welling, iRni:er of dwelling units ............ timber of dwelling units an each floor .. . ....... ...... Ifgarage, umber of care ..................................... . A. If 1■(eh(ess, comnercial or mixeif oca:pency, specify nature and extent of eacl( type of use...................... 7. IHmenaions of existing structures, If any: Iknnt....v?li........ Itear ,1l.......... Depfh .......... i Ik:iglmt ...3(?.................. Mnber of Stories .r ..1......... ... .... Dinensions of sane structure with alterations or rxklitions, Front ..............rloac.,_....... .,.,,...,: depth . lleigl(c Risher of Stories S. Dinenaions of entire new construction: Front ................ hear ............... Deptl( ... .... ....... lleiglnt ......................... Rnier of Stories ..................... //// 9. Size of Iota Front ..w^Q..... . Rear ...�.It ......... Depth /Lo ...� .. .. ._.� 10, Dale of Purchase ..................... Ham of Former Owner .......... ......... .. ....`..�.......... ... .. II. Zan or use district In udiidn premises are situated ....................................... ... 12, thea proposed construction violate nary z(xuing law, ordinance or regulation: ...... ...... 13. Will lot be regraded .J..�............... Will excess �.fill be removed from premieea: (lip NO M. manes of Owner of premises Nave of Ardni[ect ...............................I.... A(klreas .............................. flare lb. ....... .. ... . Mare of Contractor .......... .......l1one 15. is this property within 300 feet,of a tidal wetland? * YFS .......... 1l0 ... ... *1F YLS, $Wncw M4N ==W PEIHf•I• HAY W RO(VI1lM. PLOT DIAGHAH locate clearly and distinctly all buildings, whether existing or proposed, and Indicate all set-hick. dimensions from property lines. Give street and block number or description according to deed, and slaw street nares and inxlicate (Anther Interior or corne'rr loot. NU Y(N(K, liS ..f-�'? ..�.... .............................being duly sworn, delxmsea six[ says that be is the appl.i(�aol. (R,me of individual signing contract) Axme maned, Ile is the .......4- OiUC�o.�..................... :.- .. (CILntracCor %alit,-corporate officer, etc.) of said outer or (xaera, and is duly authorized to perform or have perforned the said work six] to nnke six] file this nigralicaLion; that fill statements contained in this application are true to the beat of his knowledge and liedieh amxl (list the work will be performed In the manner set forth in the application filed therewith. Sworn to before me this (711 // f/�!!//// �l ..... Notary Hnhli, 19 4": /K✓ .. l - �J'`- ..... ... ......... EUZABETHASTATHIS (Signature of Applicant) NOTARY PUBLIC,Stateof NewYork No.01 ST6008173.Suffolk County Term Expires June 8,20_"