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Home My WebLink About12179-z lrOll~f NO. · TOWN OF ~ou'rHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) . 0~/ ~/ O/ County Tax Map No. 1000 Sec on ........................ Block ...................... Lot No .......... ~.. ......... ~ursuant to application doted ~1~..- / ~ 1~,.,,,~.., and approved by the Building Inspector. I~,~ Building Imgector Rev. 6/30/80 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To..~. ~.Y~-.~ .A~.-....~(..,./.~.~,'~ . .,~./~. .... ~.~.~.~. ~. ~...-~...~... ... ....... County Tax ~ap ~o. ~000 Section ...~.~.t ..... moc~ ...~ ~ .......~t .. ~ ~: .... Subdivision. "' ~ Filed Map No ................. ~t No .... ~ ......... ~ ~t~n~ ~w~t~ ~n~ ~pprow~ o~ t~ fo~ow~ng ~oun~%~t~. ~..~~ ...... B~d~g Inspector . :J:,'te: __WJ~i_D_~_ D__EC. _2_2_z- 1982 --: .\,.,er.,, if :':? .... .,'. by: (V) ": ( ~Approve as applied for' ( ( ( D'e:Lv .Li applied for Der:)' S.:y without pre.h:dice ~*'i t}td rzl',cn with..:ut ( with the £cllow£ng conditions. · . : ',.'::l'h: ~ ;:, '21:aracze:. ,~£ the :'L:'ighborhood ( '-'.~;'k~:,>? i SL~kRantia[ in Ik.~ati.;n to Code :' 't ir. h:~:.y };i~h pu:i_eses ef t:ha C~e ( : ::' :-:?:f:) ::.s: sutlicient ( .'.h:'..:et a prc'ctkient in thc. nei~/hL: )rhocd ( · ~: is ,zlre:td,, very ce~gost6d .,: u'.,;us or ;us:ice served by denting ( ( ::;:y: ( ) ( ) ( ) ( ) A..,stai,.,: ( ) ( ) ( ) ( ) :v.,:e,t: ( ) ( ) ( ) ( ) spiri: ~f the zoning code }telier i~ not m~bsmntial ~urden of hardship or difficulty she Circumstances are unique Variance will nol change charac[er lha neighborhood Interests of 3usti(.c served by g~'ant Othe= fcr Sp<~cial Exceptions FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ............. ~.~.. /.~....,19 File No ................................ TO ~.~-~.. ~..Z/~//~:z~/~Y--~ ....... · ~.c. ~,~.~. ,'.c...~'~..~?.. ....... . -~.~,~.~./%,...~.. ~ ~. .... ~L~s~ TAKS ~OT~CE that ~o.r ~tio. ~t~ ...~.~ ...... /..., 1~ /~ Hoo~ Nv. Strut Ham/et co..t~ z~ ~v ~o. ~ooo s=~tion ...~. ..... a~o~k ....Q.~ ..... Lot .. ~.~ ...... Subdivision ...... ~ ........ Filed Map No.................~ Lot No. ' ~ is returned herewith and disapproved on the following grounds ............................... ................ .~.e-~-...~,~.-7~.~..~ ~.~. c-/. .... ~C~y-~ ~../~,,~ ~,~7..~..: ............. ............................................ V? ......... ~ ................... RV 1/80 Town Board of Appeals MAIN I~OAD- STATE I~OAD 2.5 SOUTHOLD, L.I., N.Y. 11~?1 ACTION OF THE ZONING BOARD Appeal No. 3056 Application Dated November 15, TO: Mrs. Esther M. Williams and Mr% Dan Smi%h, as agent Mechanic Street Southold, NY 11971 1982 T~- L~-I";~ur~: 1510} ?,F. CEIVED AND FILED BY ,F f THOLD TOVCN At a Meeting of the Zoning Board of Appeals held on December 22, 1982 the above appeal was considered, and the action indicated below was taken on your [ ] Request f~r Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section IX] Request for Variance to the Zoning Ordinance Article VII , Section 100-71 [ ] Request for The public hearing on this application was also held on December 22, 1982. Upon application of ESTHER M. WILLIAMS, Mechanic Street, Southold, NY (c/o Mr. D. Smith) for a Variance to the Zoning Ordinance, Article VII, Section 100-71 for permission to construct addition to existing residence with insufficient sideyards. Zone District: B-1. Location of Property: West side of Mechanic Street, Southold, NY; County Tax Map Parcel ID No. 1000-061-004-013. The board made the following findings and determination: By this appeal, appellant seeks permission to construct an addition to the existing dwelling structure for additional dining area. The addition is proposed to be four feet from the existing porch area at the southwest corner near the second-floor stairway, leaving a setback from the southerly property line of approximately 11 feet. The premises is zoned B-l, and existing on the premises is a one-family, two-story structure and accessory shed in the rearyard. It is the opinion of the board that the narrowness of the lot lends itself to the difficulties in this case, and the relief requested is minimal. In considering this appeal, the board determines that the variance request is not substantial; that the circumstances are unique; that by allowing the variance no substantial detriment to adjoining properties will be created; that the difficulty cannot be obviated by a method feasible to appellants other than a variance; that the relief requested will be in harmony with and promote the general purposes of zoning; and in view of the manner in which the difficulty arose and in consideration of all the above factors, the interest of justice will be served by allowing the variance. On motion by Mr. Grigonis, seccnded by Mr. Sawicki, it was RESOLVED, that Appeal No. 3056, application of ESTHER M. WILLI~]S for permission to construct addition to the existing dwelling in this B-1 Zone, be and hereby IS APPROVED AS APPLIED FOR. Location of Property: West side of Mechanic Street, Southold, NY; County Tax Map Parcel No. 1000-061-004-013. CHAIRMAN SOU~HOLD TOWN _ ZONLNg BOARD I ~r'O" ~e~O FORM NO.~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .~. · ,~ ·/,~- ·., 19~. ~.. Permit No. [.~./.7. ~.~- Disapproved a/c ..................................... Application No../.. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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, Now York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein de~'ribed. 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 necessarj~:jnspections. ,~ . ~.- . ~,__l~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. ..... .......................................................... , APr,, P3 IqO7[D Name of owner of promises . ~. ,,~' .Z~.~. ~-./~..: ~/,~Z-~. ~' ~ $ ...... ,~ ~ ~-~"~//~u/~ ] ........................ (as on the tax rb~6tc~.P. FEE ~ BY If applicant is a corporation, signature of duly authorized officer. .. : : NOTIFY BUILDING DEPARTM'EI~Ij'X~ .............................................. 765-1802 9 AM TO 4 PM FOR TH~ (Name and title of corporate officer) FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED ~ ~ FOR POURED CONCRETE Builder's License No. 7 ..... ~,, ' .......... 2. ROUGH - FRAMING & PLUMBING 3. INSULATION Plumber's License No. :: ...................... 4. FINAL - CONSTRUCTION MUST Electrician's License No...,'-'~"~... ................. BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET Other Trade's License No..--:-;-.; .................. THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES· NOT RESPONSIBLE..I;DR ......... 1. Location of land on which proposed work will be done .......... 1JE$1GN (Jl~ ~'CJKt~'i'l~0~¥1~'~ ERRORs. ... 3'7. 3. U. ............ ,44 . s ............. .ff a : . . .,v. g., ............... House Number Street Hamlet County Tax MaP No. 1000 Section ..... .<~. ...... Block .... {~. ~ ........ Lot..O.~ .'~....' ......... Subdivision. '"'---- .............. ·., ................................. Filed Map No. Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . ~..~.2 t~AZ .~.~... ~ .. . b. Intended use and occupancy ./[°~.t.'~.~. ~..~..~-x....."~...~/.~~l~/~.~ 3. Nature of work (check which applicable): New Buil~ifig .~ ......... Addition . ~ ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost O. ~ c9 (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front..../ff. ......... Rear . ./.~. ......... Depth . .~. ............ Height . ~../ ............ Number of Stories.. ~. &~¢.~ ................................................ Dimensions of same structure with alterations or additions: Front . t'.~. f ............ Rear ./..~f ........... Depth../. ¢~.' .... ' Height l · · · ¢'. ................. Number of Stories. ~..r4..e_ ................ 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Humber of Stories ............ , ............................................ 9. Size of lot: Front .. ,,~./.. Rear ,$.'7! .. Depth ! ~,.~..t. ............... 10. Date of Purchase ............................. Name of Former Owner ~ ............. 11. Zone or use district in which premises are situated. ~'~./~'.¢I~. i'.t~7~-~..' i[ ~i ........ 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~.~...' ................... 13. Will lot be regraded .~/.o. ....................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ...... ..................... Address ................... Phone No ................ Name of Contractor . ~..~..~../=7. ................. Address ................... Phone No ................ PLOT D, IAGRAM 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 de;[(cription according to deed, and show street names and indica~ whether interior or corner lot. a STATE OF NEW, Y~K,~.. /_ S S COUNTY O~ ' ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He 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 that the work will be performed in the manner set forth in the application f'fled therewith. Sworn to before me t~ ............. ;_;..-/::-7 ....... Notary Public~~i..-~...: · .'-rr~.. ~..'~.~.~4y~ d./~ JUDI'r~ 'r. TE~¥ ~ ~:~ ~ ~ ~ Rotary Public, State of New Yorl~ ~ ~ . .(¢~__~ .~ .... No. .o3449- 3 .......... ~omm~ssion Lxpires ~arch .~0, J.!!;~:r 'x.._. (Signature of applicant) CrH~S .~? Mus'r "~ COCs4PLETION OF THE ' N.° 12179 Z iP~is$ian is hereby grante~ ;ES UNTI~ FULL R ~.~6/30Z80 at I~remiSes located at ~t~nty Tbx Map No. 1000 Section ::; ...... 6~,.. ........ ~.. Block: ....~..,........! ~il~lng l~nSpector. ~ ~ '~ : r,~...~'.'i .......... ~ ..... ~ , [o~ No: ......... ~ ......... ~, and approved by the FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To..~. ~.¢. ~.~..~...A6..~./.~.~,-~ ... 7, ....... PLEASE TAKE NOTICE that your application dated · .~ ~ P ......... ~ ............................. ~..~ ~ ..... at / nou~ No. S~reet .............. co~.t~ ~.~ ~.~ No. ~000 s~tio....~.~.4 ..... ~o~ ...~ ff. ...... Lot ...~¢~: .... Subdivision ...... '.. ;'. ....... Filed Map No. Lot No. ~ r~t.~.~, ,~t, .~ ,~.~o~ o. t~ ro~ow~.~ ~oun,. ~/~ ~. Z~..~~ 1982 ( ) ~App~'ove as applied for ) D.eny ,ts appHed ) Der:,'.' ) D,.,ry :.'iti~out projud[cr: ) with the fo] lowing conditions: Subj~',"t to Co,Intv Plar:r~.inq rc-fo, rra! ., : 'v.':thL: ;:? '2haTaatot' ,of t?:e b.'<'ighbor'hood V.::'...:,-c. ~- Std:~tant~a[ in Retati.m to Cod~ ""- in h'~:n~:,l, };JUN puri_osas of t_ha C~e .': r,u: ustangos are i: ,q ~s alreaciy very comsesta, d u',=.;ts of ',mz[c,e served by ct,orc:ing ( ( ,xt',z,(mr: ( ) ( ) ( ) ) Orarltmg z[:~; Relief Requested is wit. spir~: of the zon/n~ code Relief is not ~ubsmntial ~JUrldOfl Of hardship or ctfffkuhy she Circumst. ances are unique Variance wil~ not cha~]ge charac[er the neighborhood Ints, res[s of Just!c,.~ served by gr'aBt Othem for Special Exceptions () ( () ( () ( FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ............ i.~.../~...., File No ................................ To ~.~/~g7-....~./..L/,//&-~.~r~.~...~ ....... · ....... PLEASE TAKE NOTICE that your application dated.· .~/~~ ~d 19 .~4 for pe~it to const~ct.. ~~.. ~..c~~... ~ ............ at County Tax Map No. 1000 Section . . .~ ~C ...... Block .~ .~ ..... Lot ..... K~ Subdivision ~' Filed Map No - ' Lot No is returned herewith and disapproved on the following grounds ............................... ................ _~.~...~'~...o~..c.,~.~.c:x'. .... Cz~ ~.~,-zT. (~r~; ~...-57..: ............. Building Inspector RV ;/80 Appeal No. Application TO: Tom Board of Appea4 MAIN ~OAD- STATE ROAD 25 SOUTHE)LD, L.I,. N.Y. ]197] ACTION OF THE ZONING BOARD 3056 'Dated November 15, 1982 Mrs. Esther M. Williams and MrL Dan Smith, as agent Mechanic Street SouZhold, NY 11971 ECEIVED AND FILED BY Town C~e~, Town o~ At a Meeting of the Zoning Board of Appeals~held on December 2.2, .!982 the above appeal was considered, and the action indicated below was taken on your [ ] Request f6r Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section [X] Request for Variance to the Zoning Ordinance Article VII , Section 100_71 [ ] Request for The public hearing on this application was also held on December 22, 1982. Upon application of ESTHER M. WILLIAMS,. Mechanic Street, Southold, NY (c/o Mr. D. Smith) for a Variance to the Zoning Ordinance, Article VII, Section 100-71 for permission to construct addition to existing residence with insufficient sideyards. Zone District: B-1. Location of Property: West side of Mechanic Street, Southold, NY; County Tax Map Parcel ID No. 1000-061-004-013. The board made the following findings and determination: By this appeal, appellant seeks permission to construct an addition to the existing dwelling structure for additional dining area. The addition is proposed to be four feet from the existing porch area at the southwest corner near the second-floor stairway, leaving a setback from the southerly property line of approximately 11 feet. The premises is zoned B-l, and existing on the premises i~ a one-family, two-story structure and accessory shed in the rearya~d. It is the opinion of the board that the narrowness of the lot lends itself to the difficulties in this case, and the relief requested is minimal. In. considering this appeal, the board determines that the variance request is not substantial; that the circumstances are unique; that by allowing the variance no substantial detriment to adjoining properties will be created; that the difficulty cannot be obviated, by a method feasible to appellants other than a variancei that the relief requested will be in harmony with and promote the general purposes of zoning; and in view of the manner in which the difficulty arose and in consideration of all the above factors, the interest of justice will be served by allowing the variance. On motion by Mr. Grigonis, seconded by Mr. Sawicki, it was RESOLVED, that Appeal No. 3056, application of ESTHER M. WILLIamS for permission to construct addition to the existing dwelling in this B-1 Zone, be and hereby IS APPROVED AS APPLIED FOR. Location of Property: West side of Mechanic Street, Southold, NY; County Tax Map Parcel No. 1000-061-004-013. CHAIRMAN, SOUT~HOLD TOWN ZONING BOARD F O RNLhtQ,,.[ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~..~.~,., 19 .~. J~ Approved .~..~. · lt.., 19~. mem~it No./.~/.7 ~& Application No../...~./. '..'Z ~. ~.. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 promises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 A~u..~,...~......~~ . inspectors on premises and in building for necessaz~.jnspections. ,-, ~ ~ , k_[Signature of applicant, or name, if p ' ) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ..... ~./c4 .//d~,e..:. c~-.o/~,...x',4~ .7'~: ' 5' APt - ./;d,~..~ ~ ............. ~ ........................ hTame of owner of premises. ~ ¢.4~,. (as on the tax r~ .P- If applicant isa corporation, signature of duly authorized officer. ~EE:~_~_ BY: NOTIFY BtJILDtNG DEPA~T~ A~ 765-1802 9 AM TO 4 PM FOR (Name and title orco~porate officer) EOLLOWiNG INSPECTIONS: 1. FOUNDATION - TWO REQUIRED " 4 FOR POURED CONCRETE Builder's ~icense No ....... u ' .......... 2. ROUGH - FRAMING & PL[JMBING 3. INSULATION Plumber's ~ice~se No ......................... 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. []¢ctricia~'s License No.( ................... ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. Other Tmde'sDice~seNo.~ .................... STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE..,EOR ......... i. Loc~tio~ o[ b~d o~ which p~ogosed work will be done ........... DESIGN ~ ~dR~0~'~I~N ERRORS. ... ~.( ............ ~¢~e~J.~. ~m ............. %~¢&¢.. ~.y- ............... Bouse Numbe~ Street Bamtet co.~ T~ ~,g ~o. ~000 s~o~io~ ...... ~¢Z ...... moo~ .... ~. ~ ........ ~ot..~/~..' ......... Subdivision.....'F-~-~..: ............................. Filed MapNo ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~?.~2 ,~. ~,4d4:.~g.. 6F?,4.~E'... Z. ....... 2-: ...... ~ ....... J ' ' /? b. Intended use and occupancy 3. Nature o£work (check which applicable): New Bult0~s~.'. ........ Addition . ~ ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost .................. Fee .......... : (to be paid on filing this application) 5. If dwelling, number of dwelling units ...mw...T. ...... 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 ..................... 7.Dimensions of existing structures, if any: Front Dimensions of same structure With alterationfi or additions: Front . t'.~..' ............ Rear .d .~.t .............. Depth ../Of. ........ ~... !... Height ...,ff./. ................ Number of Stories . ~. ~ .e.. ............... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ............................................... 9. Size of lot: Front ............... Rear... De ................. 10. Date of Purchase .......... i .................. Nam e o f Former Owr~r....~ 11. Zone or use district in which prCmmes are situated ~6,~./~.~'~. 12. Does prbposed construction vioiate any zoning law, ordinance or regulation: ...... . .)f~i:.~..' ................... 13. Will lot be regraded ./~.o.... i ................... Will excess fill be removed from premises: Yes No 14, Name of Owner of premises .. i ................. Address ................... Phone No ................ Name of Architect ......... i ................. Address ................... Phone No ................ Name of Contractor . ~..e..z:..~. ................. Address ................... Phone No ................ PLOT ~IAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or de~criptionj according to deed, and show street names and indic~.~ whether interior or c.orner lot. ~ . ~ STATE OF NEWY6~K,/,/ / [ ' / ...... ' being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~ He 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 that the work will be performed in the manner ~et forth in the application filed therewith· Sworn to before me t,h, is~ .................... ~..day of. i" 19''~.~ /~"- JUDITH T. TERRY [qo. 52-0344963 Suffolk CoQntyf-/~ .............. gomreission Expires llaareh a0, ~9,~- (Signature of applicant)