HomeMy WebLinkAbout9264-z I~M NO. 2
TOV~H OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, H. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 926 Z
Date ......................~3.~ ..............27 ......., 1~.~ .....
Permission is hereby granted to:
~'aa_~.~e.~.;[zlt ..... S~t~,-~.~.ie~'..]Ees.~a~. be
.......... · ~r. tk..~ ........... .~en~ ........
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildlngs or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic featu res.
2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), 1'4on-conforming uses, or buildings and "pm-e×ist~ng"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings,
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
I. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
New Building ..~. .......... Old or Pre-existing Building ............ Vacant Land .............
Location of Property..-?'..~i
House No. ~ f Street - -~ / /~ let
Owner or Owners of Property · .,~.'-~,~, ,~T .~,./.~-.Lw~.~... ( .~;.o,P,J'~/'~"-t~, ~%:~...~./7/.~.W, , ,
Countymax Map No. 1000Section (:~'~/'~ Block O..~. Lot.. c:~'.Z,; ~ ,
Subdivision ........ ~. :'..- ..................... Filed Map No.., .--r~,. ..... Lot No ...... -~. .......
......... ..................................
,eatth Dept. Approva .... ............. Labor Dept, Approval ....
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $....:~...~o~._,, ~ ................
Date
Novembe ¥_ ]~_gj~__l 97 1 .........
Dear Sir:
Re'
Permit No. ,'[4083
County Roa~__. 2__7_
County Treasurer has been authorized
to refund you~ security in the
of $
(X:~) Bond No I¥~m~34~'7(~8~ to cover
work on this perm-~t ~s here,,~th
released at~d returned to the Bonding
Company~ $10~000.00
This is to advise you that work under the above-captioned permit
has been inspected and found to be completed in a manner satisfactorily
to this Departmen't.
Very truly yours,
C~/ELB/md
CC:
C: Roge~ Heeker
Chief Engineer
Bond Company - Hartford Accident & ~nc~erm%ity Co.
~uilding Department - ~.[:own of Southold
TOWN I-IF" .c::;OUTHOLD
I"tFFIE:E ElF BUILDING INSPE[CTGR
TOWN CLERK'S E}FFICE
SGIITHGLD, N. Y. 11cj71
TEL.
P
JOHN WlCKHAM, Chairman
FRANK $.COYLE
HENRY E. RAYNOR, Jr,
FREDERICK E. GORDON
JAMES WALL
Southold, N.Y. 11971
TELEPHONE
765-1938
May 26, 1977
Mr. Gordon Ahlers
Manor Lane
Jamesport, New York 119t7
Dear Mr. Ahlers:
The following action was taken by the Southold Town
Planning Board at a regular meeting held May 23, 1977.
RESOLVED to approve the site plan dated April 20, 1977
of proposed addition to the Soundview Restaurant, Route 27,
Greenport, said map to be signed by the chairman after he
has a consultation with the building inspector as to
reservation for possible expansion of the parking area.
I will let you know the outcome of the meeting as
soon as it is held.
Yours truly,
Copy to Howard Terry
Muriel Brush, Secretary
May 26, 1977
Southold Town Planning Board
Town Hall
Southold, New ~ork~,l1971
Re: Sou~dview Restuarant
Gentlemen:
In connection with my extension of the
Soundview Restaurant and your approval of the site
plan, I hereby agree that I will retain some of
my property on the sonth side of %he North Road
for possible extension of the parking field and/or
sewerage disposal.
Very tr~yours,
TEL. 765-~660
TFIWN OF SOUTHI-ILD'
F1FFIr":-E OF I::::IUILDINB INSPEE:TOR
'TrlWN F:.LERK'S nFFIBE
SOUTHOLD, N. Y. 1'19'71
December 10
1976
Mr. Rudolph Kammerer~ Commissioner
Suffo~ Couuty Dept. Public Works
Yaphank Ave
Yaphank~ N.Y.
Dear Sir;
We have pending an application for an addition on the
"Soundview Restaurant" easterly end of the existing building
which is on the North side of C.R.27~ (North Road)~ between Albertson
Lane & Chappel Lane~ Greenport.
This addition if approved will require off street parking
for about 40 more cars under the requirements of our zoning ordinance.
The only land for the Additional'parking is on the opposite
side of C.R.27~ which is residentialy zoned.
I am enclosing a copy of the plot plan submitted with the
permit application~ on which I have marked in red ink some of the
existing and proposed items. The plan speaks for itself as to the
problems with the existing parking and setbacks on the North side of
C .~.27
I have has some preliminary corrospondence with Mr. Edw.
Brown~ and Mr Eisenschmeid~ and a phone call to somone in the traffic
department about this matter~ It has been suggested that I write you
directly about it.
Our Planning Board And Board of Appeals~ and I feel this is
a very bad traffic hazard area and want to get your thoughts and
suggestions to see if we can improve the situation while we have a
chance at it.
Our Appeals Board is writing to Police Chief Cataldo for
accident and traffic reports for the area and his suggestions if any.
I have suggested the possibility of prohibiting all parking
on the north side of the road~ and have all parking on the south, side
with a pedestrian tunnel under the road OR a pedestrian foot bridge
over the road. You will note on the plan many of the present parking
spaces are partialy in the road bed of C.R.27~ and they are not the
3%0 Sq Ft area which we require per car under our ordinance.
Several waivers and variances from our Ordinances and
regulations will be required~ as well as permits from Stae D.E.C.~
TOWN OF SFIUTHI3LD
[~)FFIE:E I'"IF BUILDINB INSPEOTOR
TOWN I-:,LERK'S OFFIBE
5OUTHE]LD, N, Y.
TEL.
Rudolph Kammerer~ page 2
Suffolk County Health Department~ Suffolk County Planning Commlssion~
and your department if this addition is to be permitted.
I feel this is a good time to review this area~ and put on
some controlls~ and possibly improve a bad condition
If you want to send somone out to go over this with us it
will be appreciated. We can get a representative from each Board on
fairly short notice.
Thank you for your consideration of this matter, and awaiting
your recorm~.lendations and requirements.
Yours trNly
BARNEY A. EVANS. P.E.. L.S,
DEPARTMENT OF PUBLIC WORKS
R. M. KAMMEREF~, P:E., L.S., C0M~ISSIONER
YAPHANK, NEW YORK, 1~980 ·
WILLIAM S. MATSUNAYE JR P,E.
December 6, 1976
Mr. Howard Te~r~, Bldg. Inspector
Town of SouthQld
office of Building Inspector
Town Clerk's Office
Southold, New York 11971
Re:
Sound view Restaurant
Dear Mr. Terry:
This islto acknowledge ,r~ce~p% ~o~correspondence regarding
the aforementioned area. Bef6~e'any ~comments or recommendations
can be made, a copy of site plains for ~he pr0p6sed construction
will be required.
Thank yoru for yo'ur attenqion tO ~hismat~er.
Very truly.yours,
C. EISENSCHMIED, P.E.
Prin'cipal civil Engineer
~ DivisiOn of Waterways
CE:vg
cc: Edward Brown
BARNEY A, EVAN$~ P.E.,
924-345!
COUNTY OF SUFFOLK
DEPARTMENT OF PUBLIC WORKS
R, M. KAMMERER, P.E,, L.$., COMMISSIONER
YAPHANK, NEW YORK, 11980
WILLIAM S. MATSUNAYE, JR, P.E., L.S.
December 6, 1976
Building Department
Town of Southold
Main Road
Southold, New York
11971
Attention: Mr. Howard Terry
Re: Sound View Restaurant
North and south s.ide C.R. 27,.Gre~.npor~
Dear Mr. Terry:
This office would very much like an opportunity to comment
in regard to any proposed construction on the north and south sides
of North Road, C.R. 27, including the proposed~utility crossings
of C.R. 27.
Upon receipt of three copies of the site plan, either as a
239-K notice or as a preliminary plan, we will review and indi-
cate the County requirements.
Please remind the applicant that any work within the
Right-of-Way of C.R. 27, including access to C.R. 27, requires
a permit issued under Section 136 of the H~ghw~&y
very truly yours,
Edward L. Brown, A.C.E.
Permit Section
gLB/am
Proposed Additional Facilities.
Keview of the proposed site plan forwarded by the Town of
Southold leads to the following suggested requlr~ments at the above-
(1) '~b should be installed by the owner along the
restaurant frontage. This would effectively eliminate
"head in" parkin~-~hich iS pxesently'disruptive and
dangerous. It should be noted that the vehicles camxot-
park in this location now without utilizing county
right-of-way.
(2)
It has been shown by the Mighway Research Board that
pedestrians ~ill not us~ oveZpasse~ and underpasses of
tbs type suggested. An alternative would be to have
the owner install a traffic signal ~ith a pedes~ria~
push button.
It does not appear that the situation'wlth respect to the
Jet~ies will be changsd by the proposed construction.
Curb should also be required along tbs parking lot
frontage on ~he south side of C.R. 27'~m order to channel
A. Barton Cass
'Principal Civil Engineer
Ed Brown
MEMORANDUM
TO:
FROM:
'Bart Cass, Acting Chief Engineer
C. Eisensc~ni~d, Principal Civil Engineer
Division of Waterways
COPY TO: E. Brown, Permits Division
H. Ter~ry, Sr. Building Inspector
/ Town of Southold
DATE: December 27, 1976
Mr. Terry's letter to C.o~nis~ioner R.
(CR 27 - Soundview Restaurant)
SUBJECT:
M. Kammerer
Existing parking facilities and drainage encroach upon Suffolk
County access to existing groins East and West of proposed
activity.
CE:vg
November 30 1976
~m4thcld Town Plannin~ Board
To~n Clerks Of~iee
$outhold,
~entlemen~
At~achea please ~i~ ~1 nfer addition &alteration
on E/ end of existing Sound View Restaurant, N/S C.R,2?, Greenport,
' There is a new sewe~agedis~osal p!aa being developed
for the resta,o~ant which ~illlhav~ to b~ installed en th~ south
side of ~he roa~ and will".Pm~i~e~a permit fP~ml 0eunty Highway
Dept. ('S,O,Dept Public Works} %e run la line ~nder the roa~.
A perm~.t will be rc~uir~f~om D.E~O. as part of the
building will be supported by p~ling (see plan)i~ ever the sea wall,
The Appeals Beard has~&~p~ewed semelpar~n~ on the
ef C~R.2? for 8oundview, howeve~ Iest~te ca~itF ef the addi}ien
for public assembly at t8~ people.~ A~ i Spaee'~or ~ seats it will
require 3g spaces @ 3~0 S~ Ft each ~ l~,9~Oa~itienal Sq Ft of
off street Parking,
Additional toilets are ~rovi~e~, an~ exit requirements
for public places are met.
Kimdly advise as Soe~ as you have reviewed this proposal.
¥o~rs truly
ilding Inspeeto~
Suffolk County Dept, public Works
~aphank Ave
Ya~.hank~ N.Y,
Attn~ Edw, Brown
Dear
To~a7 we reeeived an application fo~ an addition on the
easterly end Of ~ound View P. es~av~a~t~ N/S O,R,2~ - east of
Albertson Lane on L,I.$ound~ S~eenport.
Enelosed is a eopy Qf my~r to the 2outhold
plannin$-Board~ ~o have to review the~ite
' ~ ShOed you have any ~peclal req:mir~ent~ to p~otect.~our
easment and jett~ adJ°~ing th~ peopos~ additie~ and
needed from your depart]~ent~ploa~e advise both th~ Plm~ning Board
and me aa soom as pos~ible.
Yours truly
~aildln£ Inspeeto~
February 3, 1977
William Matsunaye,
Chief Engineer
liighways Division
Suffolk County Department of Public Works
YaphankAvenue
Yapha~ New York 11980
Re: Permit for Underground Crossing of
CR 27A, Greenport, E~ Y.
Soundview Restaurant Extension
Dear Mr. hatsu3~aye:
It is requested that the necessary papers for a permit for
underground crossing of CR 27A as shown on the enclosed plans
be forwarded to the undersigned so that this work may proceed
forthwith.
Approval has been received from Greenport Utilities, Suffolk
County Department of Health and LILCO has been notified.
It would be appreciated if this work could be kept separated
from the Curbs and Gutters and Site work involved in reworking
this Site and Highway for access.
Because of the peculiar nature and problems involved in Site
work for the above~ it is requested that an On Site Reetin~
be arranged at your convenience for a representative of your
Office, Southold Town, the Owner and the undersi~ned~ so that
these conditions may be speedily settled. Tha~< you.
Very truly yours,
Gordon K. Ahlers, ~'. E.
GKA:oa
Enclosure
~,~c: H. Terry
Southold Building Dept.
cc: J. J. Levin
(p-136) (5Mj-L9/$/68)
Permit No .................
PERMIT UNDER SECTION ]3& of ARTICLE VI of HIGHWAY LAW
WI-IER, EAS, a certain highway known as the Am ~ ~*~' No.
h~ been ~p~v~ ~d is on ~he Suffolk County Road System and
~,_~RE~RE, pe~issJon is hereby grant~ to said
to do said work u~n the following conditions:
B~iH ~nd thoroughly compri fill us~g POWER TAMPER, pl~lnK ~ils so that
o~ su~ace.
I:1~ :l~ ~ s~ne m~ co~rete; ff bi~nous m~te~al, replace using s~e ~
&. If eon~r~ curb Is r~mov~, replace with sin~l~r curb 1:1~ :3YZ ~.
of Pmvement. No undereut~ ~owed lo
6. ~o~f~ the Depar~en~ m~ ~mph~k 4-8~1 wh~n ~he work Is to ~n ~ tha~ ~n
~ls ~it shall not be assigned or tra~f~r~ without the wEtten consent ot the Commissioner of Public Works.
The work authorized by this ~it shah be perfo~ed under the su~rvision and to the satisfaction of the ~m*
missioner of Public Works or his representative.
Particular attention is call~ to the necessity of thoroughly c~pacting the bac~ fill, which w~ll ~ requ~r~
by the Com~ss/oner of Public Works.
~e C~missioner of PubUc Works shEl ~ given one w~k's notice by said applicant of the date when it in-
tends to ~n the work autho~z~ by this pe~it, and prompt notice of its ~mpletion.
~e said applicant he.by agrees to hold the State, County and T~n ha~less on ac~unt oi damag~ of
kind which may arise during the progress of the work authoriz~ by this ~it or by reason ther~f.
Applicant cerfifi~ all perso~ concerned with actual work under this pe~it are duly covered by Workmen's ~m-
~nsation Insuran~ ~d the State, County and Town shall be held ha~less on account ther~f.
~e ~m~ssioner ~ Public Works ~se~es the right to at any t~e reveke or annul this ~it should the
said a~licant fail to ~mply with the te~s and conditions u~n which it is grant~.
~e appl~can~ a~s to pay all necessa~ e~nses lnEdent to supe~ision and inspection by reason of the
~ting of such ~it ~ certifi~ by the Com~ssioner of Public Works, such pa~ent to ~ made within ten days
f~m t~e rende~ng of the ~rtified accent.
Work under this pe~it ~ ~ commenc~ within ~h~riy ~ays f~ 1he date of ~it ~d ~ntinu~ in an
ex~iflous ma~er.
~e appUcant shall submit a detailed pl~ of structure to ~ built, with a desc~ption ~ p~ meth~ of
correction.
It is unde~t~ that should future ch~ges in the aiig~ent or grade of the highway ~quire changes in the
~rk cover~ by t~s application and permit, the a~lic~t shall on reasonable noti~ f~ ~e C~ssioner of Public
Works make such n~essa~ ~anges at his o~ expense within the time so s~cifi~ in noti~,
~c sh~l ~ maintained by the applic~t on this s~tion of the highway while the work is in p~ss and
until its ~~
~ ~nd ~. in the ~um of *..~.~r.;.~yable to the ~unt7 We~urer of Suaolk Count~
on file
d~lt~ ~ s~urtty t'hat the highwa~ will ~ ~tor~ to its original ~ndition where d~stur~ at the e~ense of
app~e~t, ~ soon as t~ work h~ ~en complete, ~d the s~ ~m~s~ono~ ~ ~blle Works is horoby autho~z~
to ~nd ail or as much of such de.sit ~ ma7 be nec~sar7 for that pu~e, should the said applicant n~l~t or ~fuse
In consideration of C~ting this ~mit the undersign~ accepts it subject ~ ~nditio~ des~.
~k~.~ , Xpplieant
....... ?.. ). ..........
~ Date
TO AVOID SERIO~3S DAMAGE TO VITAL UNDEP~GROUND FACILITIES, PLEASE CALL LONG ISLAND LIGHT-
ING COMPANY AT JUNIPEIt 2-9000 OR FOR TELEPHONE FACILITIES CALL N. Y. TEL. CO. FLORAL PARK
2-OFFICIAL 25 BEFORE STARTING THE WORK AUTHORIZED BY THIS PERMIT.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
4/T 97 '
Examined .~ 0 1 Application No.
~proved ................ ~. ....... 7. ........... , I~Z.. permit No...~ ..............................
BUILDING PERMIT
A~PLIGATION
FOR
I~T~CTIO~
~. Thi~ ~p~li~otio~ mu~t ~ ~ompl~t~ly filled in by ~rit~r o~ i~ i.k ~nd ~u~itt~d in tripli~t~ to
I~tor, ~ith ) ~t~ of ~1~, ~urot~ ~lot ~1~. ta ~1~. ~e~ ~c~ordin~ to
b. Plot plo~ ~ho~ing Io~otio~ of lot o~d of buildi~g~ o. pr~mi~, r~lmio~hip to ~djoi~i~g pr~mi~ or public ~tr~t~ or
c. Jh~ ~ork covered by thi~ ~p~li~tlo~ m~y ~t b~ ~om~d b~ore i~uo.c~ of B~ildi~ P~rmi~.
sh~ll b~ k~pt o~ th~ ~r~mi~ ~r~il~l~ for i~s~tio, throughout the
~. No building ~h~ll b~ occupied or u~d i. ~hole or i~ port for ~y purpo~ ~hot~v~r ~.til ~ C~.ifi~t~ of Oc~up~.~y~
ARRLICATION I~ H~R~BY MADE to th~ Buildi.g ~e~rtm~t for th~ i~nc~ of ~ Buildi~9 ~r~it p~rs~t to
B~ilding Zone Ordi.~nc~ of th~ Jo~. of ~out~old, ~uffol~ County, New York, ~d oth~r ~pli~l~
R~gulotio~, for ~h~ ~on~tru~tio~ of b~ildi~, odditio.~ or ~lter~tio~, or for r~mor~l or d~olitio~,
The o~pli¢~.t ogree~ to comply with ~11 op~li~obl~ b~, ordinances, buildin~ ~od~, ho~i~9 ~od~,
o8~it outBoriz~d in~tor~ o~ pr~mi~ ~d in buildi.~ for n~e~?
(Sign~tt~re of applicant, or name, if a corporation)
...........
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nome of owner of premises .....~.~...~' ~
If applicant is a corporate, signature of duly authorized officer.
(Nome and title of corporate officer)
Builder's License No. J~ ~' o~
Plumber's License No ....................../....,~.....~...~...z.(.
Other Trade's License No ...............................................
1. Locotion of land on which proposed work will be done. Map No.: ............................. , ........... Lot No .........................
Street and Number .....'~.....~....~.....°...l',~..s.~.........~....~.,~..?...."~".~....~..~,~.......).~......~:, .........................................
Municipality
2. State existing use and occupancy of premises and integded use and oc(~upancy of proposed construction:
a. Exisiting use and occupancy ..... .~..~.....~.. ] .~....~..i.~.. i .~. ,.I, .~..~...~...... ].~.. ?...~.....~...9..~..~.~'.~.1% .~..~.... ~.~..~..)~..~.~ ........
b. Intended use and occupancy .................... ; ................
3. Nature of work (check which applicable): New Building,. ................. Addition ....~. .......... Alteration ................
Repair .................. Removal .................. Demolition .................... Other Work ...................................................
(Description)
4. Estimated Cost ,.~.~.t..~ ................... 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 elach~type of use ................ ! .........
7. Dimensions of existing structures, if any: Front .......~/...~..~.../../. ..... Rear ..,../.../../....r.Z..~.. .......... Depth ..~/....~.
Height ........................ Number of Stories ........... ~ .....................................................................................................
Dimensions of same structure with alterations or additions: Front ....................................Rear ............................
Depth Height ............................ Number of Stories ............ ! ................... -
................................ ' " Depth
..... ...........
8. Dimensions of entire new construction: Front ........... ~.~ .................... Rear .......................
Iqeight .................... Number of Stories J ......................
9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................
10. Date of Purchase ......... )..~...~.,~ .................................. Name of Former Owner ,~...~.....~...~..~.?.:~.~..e...%.,?.~.~.?.....k~.,.e.).-~!~?
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ...~... ............................................
13. Will lot be regraded. ........................... Will excess fill be removed from premises: ( ) Yes ( ) No
14. Name of Owner of premises ......r.~...~...~¢.....,...~.,..~....~.....~..~ .......... Address .~.p....q.~....~..~.~.....~2. ...... Phone No.~...b.~..~..~.~..~..~....
Name o~'] Architect'~ ~ ~ .r.~...9...~....~...9...'~.....~..t~....~...-~.....~'...~...~. ............. Address ..~..}~.~.~..~.~.?..~'~"~.... Phone No' ./..~.~. ~.~..~ ~
Nome of Contractor"~' ~~.~..Q.~.~..~....~-~.O....k~.....~..~-,.~.... Address .~..~i,,.~..~..~.~..~.~,~.~.. Phone No.~'~..'~.~..~..~
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEW YORK, [ c S
COUNTY OF .... ~.LI f f.Q.],~ ...........
......... ....~.~.......~ ........................................ being duty sworn, deposes and says that he is the applicant
"-~(Name of individual signing contract0
above named.
Fie is the ....... ~ .....................................................................................................................................................
(Contractor, agent, corporate officer, etc.)
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
thor the work will be performed in the manner set forth in the application filed therewith.r,`
Sworn to before me this
............ .3..Q.t..~.. day of ...... ~.O.~.~b.~r ................... , 19_7.6..
Notary Public, · ....... .~, ........... ~.?:~.~..o..~..~. ...... ,C°unty ........... ~.~...~-~ ..........................
.~ . , . / ) ~1/~ // // ~ ~ (Signatu~o~ applicant)
-%
I
,I
I,;
N
J
"Altemllon of this Oomimeni
except by ~ Llcer~sed Profes-
Alteration of this I~c~cumeef
except by a Licensed Profes-
sional Engineer, Is Iltegal",
S~on 7]09, Subdivi~n ~,
N. Y, Stale Educotiofl Law.
~
4
-
......... ~;¢cept by a Licensed Profes-
sional Engineer, is Hlegal".
Su~,,-~ion 7209. Subdivision
N. Y. Slate Education Lay,
Offio~ O!
K. Ahlets, P
"Aiterallon of this
except by cl Llcens~t Profes-
sional Engineer, is illegal".
Section 7209, Subdivision
N. Y, State Educahon Law,
Offtee Of
Gordon K. Abl~., IP.
Office..
Gordon K.
"Al~rallon of this Document. --
'exce~ by a Llcens~
slonaJ.En9 neer, Is II1~1".~ , .
Y,' State Edu~t~
Office Of
Gordon K. Able,s, P.
"Alierallon df this Document
except by .a Licensed .Prates-
' Sed~n 7209, Subdivision 2, 9in~er Approval
N, Y. Stale Education Law, i:g~lure onsame.