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Home My WebLink About15780-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. Z-16505 Date December 16, 1987 THIS CERTIFIES that the building Construct One Family dwelling with attached garage Location of Property 56755 Main Road Southold, New York House No. Street Hamlet County Tax Map No. 1000 Section 06 3 .Block 0 3 .... Lot 17.3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 16, 1987 15780 Z ...................... pnrsuant to which Building Permit No, dated Uar ch I 9, I 987 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 ......... ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR The certificateisissuedto JOHN & KATHLEEN BOWNES / ..................... ................... of the aforesaid building. Suffolk County Department of Health Approval 87- 8 O- 33 UNDERWRITERS CERTIFICATE NO ............. N 8/44420 Innovations Plumbing - 12/I/1987 PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15780 Z Permission is hereby granted to: .~.~.....~.~..~ ......................... ....m..~.~.~.....~..~.~..: ............... ........................ . ........... . ...................................... ~o ..... ...~....~ ....... .~ ............... ot premises Iocoted at ..~..~....?..~....~...,...~',',~.(~t~:.....~...~.,.,...~.~~. ................................ County Tax Map No. 1000 Section .... .C~..~..~'~ ....... Block .......~..~. ........ Lot No.....L,~..:...~. ....... opprovod by the Building Inspector. Fee ,..~.~..0..:..~ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-iS-9 form or equal). 3.Approval of elpctrical 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 reqqirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 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 inforrna- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 1. Certificate of 0ccupancy New Dwelling $25 00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O.' $ 50.00 Date .......................... New C on s t r u c t i o n Old or Pre-ex isling 8u ilding Vacant Land 56.755 Main Road Southold Location of Property ............................................................... -.., Hoe~ No, Street Ha~let John & Kathleen Bownes Owner or Owners of Property ............................................................ County Tax Map No. lO00Section 065 0~. 0.0. Lot P~ of 017 001 ............... 'Block .. ... pN 108 017 .O.O3 Subdivision ................................. Filed Ma o ........... Lot No ............. Permit bio../,5,7.~,0.2, , ,, Date of Permit ...... Applicant Jo~ ~, Kc~hl~n Bo~s Health Oept Approval 8.7.-S. 0-33 ' Labor Dept Approval N.~.4.4420 Planning Board Approval Underwriters Approval ..................... , ..................... Request for Temporary Certificate ..................... Final Certificate ,, ,3~ ................... Fee Submitted $ 25. 0.0, ....................... Construction on above described building ~ pe,~m, eets all epplJcable ~s, Rev. 10.10~78 -,. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTtlOLD, N,Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /--/~/ An application for Certificate of Occupancy -- is not on file. ~ /--~ ~o Underwriters Certificate on.file. /~/ The check is(outdated/not on ~lle.) /~/No Health Dept. Approval on file. /-~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ~uilding Permit It / ~- j_~ .~ Z Building Dept. ***/~No Plumber Solder Certificate on file. ( all permits involving plu~mbing being issued after April 1,1984 ) OUNDATION ~'/~(~st) OUNDATION C2nd) OUGH FRAME & PLUMBING :NSULATION PER N. Y. STATE ENERGY CODE · ADDITIONAL COMMENTS: INSPECTION REPORT O: Her~y E. Raynor, Jr., Chairman REPORT NO. 302 Southold Town Planning Board . . FRO a John Oavis OAT , July RE: I~INOR SUBDIVISION #108, JOHN SI~dICICH ACCESS ROAD CO~.~NTS: ...... .The 25 ft. R.O.W. as shown on map dated 11/4/76 is in a well kept lawn area throughout in Lot No. i and in unused farmland through Let Ne, 2. Ther~ is some minor small tree growth, most of~w~hich is .along the eas~ side of the. R.O.W,, that may have to be ~emoved. The existing surface with the exception of the first 70 ft. (probably · a an old dr~vew y) appears to be topsoil and loam. - Test holes (location shown on map) as follows~ Hole No. i 2" topsoil, 4" sand and gravel. Hole No. 2 9" topsoil and loam, Hole No. 3 9" topsoil and loam Holes t~o. 4 & 5, 12" topsoil and loam. Based on the Van Tuyl field elevations shown, I can see no drainage ~problem. However, if runoff from heavy storms is carried into the ~.~ain Road, leaching basins should be installed at the south end of the road.' The necessity for leaching basins probably could not be determined until the read is graded and runoff observed. Recommendations: 1. Clear R.O.W. where necessary. 2. Road width 12 ft. centered in R.O.W. 3. Remove topsoil and loam. If this material exceeds 12", for 12" only. ' n 4. Depending on the depth of topsoil and loam excavatmo , fill may have to be placed prior to a 6" bankrun course. material can be a good grade of clean fill. 5. The 6" compacted bad, run course to contain 20% or more of gravel and 10% or more of loam. 6. Place a compacted 2" crowned top course of 3/4" stone blend on the bankrun. 7. LeachiQg basins to be installed only if found necessary. remove additional This RECEIVED J U L 1 q 1983 / HELEN J, ROSENBLUM ATTORNEY AND COUNSELOR AT LAW RIVERHEAD, NEW YORK 1 1901 (516) 727-I Ot 0 Mr. Curtis Horton Building Inspector Southold Town Hall Southold, New York 11971 April 27, 1987 Re: Building Permit ~15780-Z John & Kate Bownes Dear Mr. Horton: This office represents Mr. and Mrs. Vincent Dolomite who live in the middle lot of the John Simicich Minor Subdivision off Main Road, Southold, New York, Tax Map No. 1-63-3-14.4. You may recall that prior to the issuance of a building permit in 1983, my clients appeared before the Planning Board con- cerning the right-of-way; a copy of the Planning Board's Inspection Report is enclosed herein for your review. As you can see, the Planning Board required my clients to improve the right-of-way to their house to a 2" crown of 3/4" stone before issuing a building permit. However, the road beyond that point and before the rear lot has not been touched, the sur- face is topsoil, and it is potentially unpassable for emergency vehicles. It appears to me that, under these circumstances, the building permit for the Bownes was wrongfully issued, and should be rescinded until the entire right-of-way is in an improved and stable condition. I would appreciate any light you could shed on this matter, and I thank you for your usual courtesy and assistance. Sincerely, HELEN J. ROSENBLUM Enclosure cc: Mr. and Mrs. Vincent Dolomite HELEN J. ROSENBLUM ATTORNEY AND COUNSELOR AT LAW 737 ROANOKE AVENUE RIVERHEaD, NEW YOrk I 1901 (516) 727-1010 June 10, 1987 CERTIFIED MAIL Mr.- Curtis Horton Building Inspector Southold Town Hall Southold, New York 11971 Re: Building Permit ~15780-Z John & Kate Bownes Dear Mr. Horton: On April 26, 1987, I wrote you a letter concerning the above matter. To date, no reply has been received. Furthermore, building has continued on the lot. Please consider this letter as a formal complaint on behalf of my clients, Mr. and Mrs. Vincent Dolomite. I would appreciate your investigating the matter and responding to the undersigned. Sincerely, HELEN J. ROSENBLUM HJR~ CC: Mr. and Mrs. Vincent Dolomite TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No./~(~ Owner ~10¢%~ ~OuO~l~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of l%'lead. (plumber's signature) Sworn to before me this /~ day of ~M~ , 19 ~7 Notary Public,~& /~ County KAREN W. BOE~C-~SSO~q NOTARY PUBLIC, S!~t,.? o~ N~w Ya~k Notary loo~1~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~- kh BUREAU OF ELECTRICITY t, love~,'ibe~- 23, L~8'~5 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT N O~y t~ electrical equipment ~ ~scribed be~w end interlaced by t~ applican t ~med on the a~ve application ~umber in the premises of John Bownee~ Private Rd. off ~t. 25, n/side ~ e/o in thefollowlng Iocotlon~ ~ B~g[nent ~ Ist FI. ~ 2nd FL Section Bilk Lot ~ove~er -~.~'~ 1987 ~s exatnined on attd/ound to be in compliance with the require.tents {~f this Board FIXTURE I FIXTURES ~ RANGES IC~KING DECKS I OVENS DISH WASHERS EXHAUST DRYERS UR~ACE UTURE APPLI NCR mEDER ,PECI LRECPT MECLO KS B L U THEAIER ~ DIMMERS ~w~ 2 . I 50 D ~ONNEC~ ~O OF S ~ mu~,[. ,~w ,~ ~w ~ .o. %~o.~[ o~ ~?~2/0 .o o~ .,.~ o~ ~. .o o~.~,~[ o~.T0~2/0 SMO~ DE~ECTO~S -1 Howard Dillingham ~~e~ Box 574, MaAn Rd. Laurel, N.Y. 11948 lic.#756E Per_ This certificate must not be altered in any manner; return to the office of the Board if incorrect. }nspectors may be identified by their credentials. COPY ~ BUILDING DEPAR "OPT OF CERTIF BE ALTE ~NY MANNER. HELEN J. ROSENBLUM ATTORNEY AND COUNSELOR AT LAW 737 ROANOKE AVENUE RIYERHEAD. HEW YORK 1 1 901 /516) 727-1010 BLDG, DEPT, TOW~ OF SOUTHOEt'~ June 10, 1987 CERTIFIED MAIL Mr.~ Curtis Horton Building Inspector Southold Town Hall Southold, New York 11971 Re: Building Permit ~15780-Z John & Kate Bownes Dear Mr. Horton: On April 26, 1987, I wrote you a letter concerning the above matter. To date, no reply has been received. Furthermore, building has continued on the lot. Please consider this letter as a formal complaint on behalf of my clients, Mr. and Mrs. Vincent Dolomite. I would appreciate your investigating the matter and responding to the undersigned. Sincerely, HELEN J. ROSENBLUM HJR~ cc: Mr. and Mrs. Vincent Dolomite H',:'L'.:'N d. RO~ENBLUM ATTORNt~Y AND COUNSELOR AT LAW 737 ROANOKE AVENUE RIVERHEAD, NEW YORK 1 1901 (516) 727-1010 April 27, 1987 Mr. Curtis Horton Building Inspector Southold Town Hall Southold, New York 11971 Re: Building Permit ~15780-Z John & Kate Bownes Dear Mr. Horton: This o~fice represents Mr. and Mrs. Vincent Dolomite who live in the middle lot of the John Simicich Minor Subdivision off Main Road, Southold, New York, Tax Map No. 1-63-3-14.4. You may recall that prior to the issuance of a building permit in 1983, my clients appeared before the Planning Board con- cerning the right-of-way; a copy of the Planning Board's Inspection Report is enclosed herein for your review. As you can see, the Planning Board required my clients to improve the right-of-way to their house to a 2" crown of 3/4" stone before issuing a building permit. However, the road beyond that point and before the rear lot has not been touched, the sur- face is topsoil, and it is potentially unpassable for emergency vehicles. It appears to me that, under these circumstances, the building permit for the Bownes was wrongfully issued, and should be rescinded until the entire right-of-way is in an improved and stable condition. I would appreciate any light you could shed on this matter, and I thank you for your usual courtesy and assistance. Sincerely, HELEN J. ROSENBLUM Enclosure cc: Mr. and Mrs. Vincent Dolomite INSPECTION REPORT '0: Her~ry E. Raynor, Jr., Chairman REPORT NO. 302 Southold Town Planning Board.~.'..' FROSh John W. Davis J~h~ ~t'~ DATE: July 2, 1983 RE: I~INOR SUBDIVISION #108, JOHN SI~ICICH ACCESS ROAD C0~,~ENTS: ...... Th~:['~5 'ft. R.O.W, as shown on map dated 11/~/76 is in a well kept 'lawn area throughout in Lot No. i and in unused farmland through Lot No. 2. There is some minor small tree growth, most of which is 'along the east side of the R.O.W.: tnhat may have to be removed. The existing surface with the except~o of the first 70 ft. (probably an old driveway) appears to be topsoil and loam. Test holes (location shown on map) as follows; Hole No. i 2" topsoil, 4" sand and gravel. Hole No. 2 9" topsoil and loam, Hole No. 3 9" topsoil and loam Holes ~o. 4 & 5, 12" topsoil and loam. · e n Tu 1 field elevations shown, I.can see no.dra~nag Based on the Va Y. ....... ~e .... storms ~s carrmed 'problem. Howev , ....... ~ ~ ~ a~-tatted at the sou~n the ~,~ain Road, leaching oas~.n,s s~o~_[~h~ ~osins nrobably could ~ ~ +~ ~mad. ' The necesslzy xor m~au.----o T~ ~ ~ed. en¥ ~* -~-Z~,~ad until the road is graded anm runo~ ~0~ O~ ~eb Reco~endations: ' ' ' ~ - :. 1. Clear R,0.W, where necessary. 2. Road width 12 ft. centered in 3. Remove topsoil and loam. If this material exceeds 12", for 12" 'o~y. ' n 4. Depending on the depth of topsoil and lo~ excavatmo , f~l! may have to be placed ~prior to a 6" ba~run co~rSe. material can be a good grade of clean ~ill. 5. The 6" compacted ba~run course to contain 20% or more~ 0f and 10% or more of lo~. remove additional This gravel 6. place a compacted 2" crowned top course of 3/4" stone blend on the bankrun. 7. LeachiQg basins 'to be installed only if found necessary. RECEIVED JUL 1 1§83 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECFOR P.O. BOX 728 TOWN ItALL SOUTIIOLD, N.Y. 11971 TEL. 7(;5-1802 Whom ~hls May Concern, We are unable to complete your Certificate of Occupancy because ~of the following reasons. /_~/ An application for Certificate of Occupancy is not on file. ~c~3_~ · /-~No Underwriters Certificate on file. /~/The check is(outdated/not on file.) ~-.~o /~/No Health Dept. Approval on file. /-~/ No final inspection has been made. Please contact ()ur office on Thank you for your cooperation. Building Permit I~ / O--, 7 .Z ~ Z Building Dept. ***/~No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) this matter. Memorandum from .... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1502 March 17, 1987 Mr. John Bownes 2696 Cheshire Drive Baldwin, New York 11510 Dear Mr. Bownes: Enclosed please find herewith application for construction of cesspool. Kindly fill out this application and submit with a survey and a check for $10.00 to the Town Clerk's Office. Thank you. pouthold Town Building Dept. Georgia Rudder, Secretary 'ii BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ~SULATION FRAMING ~ FINAL REMARKS: ~ ~/~ ~/~/~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~FINAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL , / I NSPECTO~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INS..ULATION FRAMING 765J.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [,~ROUGH PLBG. FOUNDATION ZND [ ] INSULATION / [~/~RAMING [ ] FINAL DATE IINSPF. CTOR~ 765-1802 BUILDING DEPT. INSPECTION [ F~UOUNDATION ~.ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL DATE..//~/~'//~ 7 INSPECTO.~ ~r ITt Approved .... .~..C~. ! .~ BOARD OF HEALTH 3 SETS OF PLANS FORM NO. I SURVEY TOWN OF SOUTHOLD CHECKt/4/~ /~o~ ~- BUILDING DEPARTMENT SEPTIC FORM- ~.~c~ TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19~. ?. Permit No. ~ .~.~. ?..'~.0.-~. . Disapproved a/c ............................. ~..~ (Building Inspector) NOTIFY CALL MAIL TO APPLICATION FOR BUILDING PERMIT Date .......... .~. -/.~- .~/.~. ~. ~ 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 tiffs 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 regu~tions, and to admit authorized inspectors on premises and in building for necessar~ i~lsp~ons./~-~ ~' ~//7 ~ e 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. Owner John~ P. & Kathleen Bown~ Name of owner of premises .......................................................................... (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. Builder's License No. not scCe~tzd Plumber's License No. not selected Electrician's License No. ?g.t..~.e~..~.c~..o.d. ......... Other Trade's License No. ~g~. )~g~ ......... 1. Location of land on which proposed work will be done'. ?~. )ff~. P.~. ~. ~PJf.,. PPPPP . ffl?~. ~.~bpA. ~:.. ............................................ york. JJYTJ ..... , ............ House Number Street Hamlet County Tax Map No. 1000 Section ..fl~fi ............. Block 0J.00 Lot. 017.003 Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . g.mp.ttj, p.~.0.~. ....................................................... b. Intended use and occupancy ...0~g..f.a..n~. g...dg0.~..L~.'.~q..".~.a.n, qh.". Jt.o.~...~. ................................ 3. Nature of work (check which applicable): New Building .. ~(. ' AdditionI .... ~ ..... Alteration .......... Repair .............. Removal .............. Demolition ......... ..... Other Work ............... (; $0,0 0 0 ~ (Description) 4 Estimated Cost Fee ' tto 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, comm. ercial or mixed occupancy, specff, y nature and extent of eachitype of use ..................... 7. Dimensions of existing structures, if any: Front...~.o.n.e ......... Rear .... i ......... Depth ............... Height ............... Number of Stories ......................... ~ .............................. Dimensions of same structure with alterations or additions: Front ......... i ....... Rear . Depth ...................... Height ...................... Numbe~ of Stories ...................... Dimensions of entire new construction: Front . ~6 ....... ' ..... Rear . ~.. i ......... Depth 30 Height ............... Number of Stories ......... i .............. .. . 9. Sizeoflot Front 172.,0~ Rear ./6.5.59 ~ Denth ''306'14 " ....... '" 10. Date of Purchase 12[30{86 ................ ,' tCih~aco'~' 'P'~'~ ............ ......................... Name of Former Owner .................. 11. Zone or use d/strict in which premises are situated ................. i .............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .f.o ............................. 13. Will lot be regraded . {J.e~.. ........................ Will excess fill be r. emove, d from premises: X Yes No 14. Name of Owner of nremises .Jo.~n P: g Ka~Pff, een A&h.~,~ 2696 Cge/3rvot¢ pa,cveph~,,~,,~a,, .223-1034 n " ....................... " ......... ................... Name of Architect .¢.n y ./r¢.m.t2.~.. ..Address ~ccc~. t(ct. ee~poh~. Phone No 4~'~g~O'i ..... not selected ............................. Name of Contractor .......................... Address .... ; ....... 4 ...... Phone No. 15. Is t:h±s propert:y located with±n 300 feet: of a t:idal wet:land? ~Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, andi. indicate ali 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. Penny Lumber, Main Road, Greenport, New York 11944 STATE OF NEW ~9'P2.K_,,,,./,, / COUNTY OF.r,:'.J/. 'ffg,(,,g-K'~q/.... S.S ............. (Name of individual signing .contract) being duly sworn, d~poses and says that he isthe applicant above named, i He is the ......................... ~ ........... ! ..... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed th ~ said work~ &o~ and file this application.; that all statemen, ts contained in this application are true to the best o his knowle~affi~'~[ and that the work will be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this ............... ~ ..... day of?./Z/~... County;) QUOJif::.,] in Ncsscu County / / (Signature of applicant) Commlss:cn ~xpires March 30, h 'r o. Z o~ L~ 14. 7 // \ "' pLUMBER cERTIFICA _..,,,-rENT BEFO,q E oN LEAD CERTIFICATE OF occUPANCY soLDER uSED IIV WATEr_ uPPLY sYSTEM cANNO; ~cEED 2/10 of 1% LEAD. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY Phone 47%0400 Main Road GIREENPOR'I[, N Y. I 1944 2 t C,W- 2.b o t -, -k GREENPORT, N,Y. I 1044 .......... fl ,~ __'-. ~_~ /v,',~: v~,-r ~!s,~^,s , ,, Phone 477-0400 ~ Main Road 12. J Phone 477-0 "'~~ ' GREENPOR f, N.Y. I 1944