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HomeMy WebLinkAbout16099-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z.I.6.6Z.0 .......... Date January 29, 1988 THIS CERTIFIES that the building A d d i t i o n L ~. on · 600 01e Jule Lane Mattituck ocauon oi rroper[y ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section 114 .Block 12 .Lot 13.2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .. ~.a.y...2.9.,.. ! .9.8.7.... pursuant to which Building Permit No.. ! .6.0.9.9. Z. ............. dated .. ~.u.n.e.. J .9.,.. ! .9 .8.7 ............ 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 ......... 2nd story addition to an existing one family dwelllng.(Home occupat±on) The certificate is issued to ..... DONALD & PATRICIA FEILER ................ /oh;n'o;~'~'~,'~ ..................... of the aforesaid building. Suffolk County Department of Health Approval . N/A UNDERWRITERS CERTIFICATE NO ..... N000396 I 1/30/87 PLUMBERS CERTIFICATIOIq DATED: Mattituck Plumbing & Heating 1/13/88 nspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEP. MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 16099 Z Permission is hereby granted to: .... .... .~.,~,.~.=~=.==~ ........... ~ ........... ~.5 .... at premises I~ated at ...~ ............... ~......~....~ ...... ~.~ .......... County Tox Mop No. JO00 Section ...... 1..(..~.. ........ Block ...... ./...,,~'~.. ...... Lot No ....../....~...:....~...... pursuant to application dated ........ ~..~.....~...~. ............... , 19..~...~.., and approved by the Building Inspector. BullclJng 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 m ~ to the Building In~ec- 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-{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- lions, 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), 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 u~, 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: Additions $25.00 POOLS $2,5.00 1. Certificate of occupancy New Dwelling $25.00, Accessory .$i0.00 Business $50,00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 yea~s $10,00 4,Vacant Land C.O. $ 20.00 5,Upda'[ed C.O. $ 50.00 Date ~an,u,ary 13, 1988 NewComst~uctJon ...... Old or Pre-existingBuildi~§ .~. .......... Vacant Land ............. Location of Property ..... ~.!~ Ole,Jule La,ne . Matt.ituc.k House No. Street Plato~et Owner or Owners of Property Donald and Patricia Feiler- County Tax Map No. 1000 Section 114 Block 12 , 13.2 NA Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~,6,q?.9.Z... Date of Permit 5../.2?./.8.7..Applicant ,..Dp>n.a.~,~. Health Dept. Approval ................ ' ........ Labor Dept. Approval ........................ Underwriters Approval ,...X .................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...X. ................... Fee Submitted $, . .2.5...Q0. ..................... Construction on above described bu ilding and p erlr~ me~~ ,/~.~J~ / a~ ap~p~licabie:~r.z_U~' codes and regulations. Applicant ...... ~'. ~.~ .............................. Donald Feiler Rev. 10-10-78 TOWN OF $OU.T~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 1 I971 TEL. 765-1802 CERTIFICATION Building Permit NO. (please print) ' (please I certify that the solder used in the water supply system contains less ti]an 2/10 of 1% lead. Sworn to before me this , [~t, day of ,,~.,~o.~?, ,' 19 F. Notary Public,~ u ~o/~ County oUNDATIO~ (1st) OU~DATION ( 2nd ) OUGH FRAME & PLUMBING i~;SULATION FER N. Y. STATE ENERGY CODE ADDITIO~;A'L COMMENTS: 7~.Ui02 BUILDING DEPT, INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG, FOUNDATION 2ND [ ] INSULATION [ ] FRAMING RE:MARKS: INSPECTION 76S.1802 BUILDING DEPT. FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL DAT. ~'y:,~ ,NSPECTOR~: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~UGH PLBG. FOUNDATION 2ND [ ] INSULATION [~1~MING [ ] FINAL INSPECTOR ~~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ 1 ROUGH PLBG, REMARKS: FOUNDATION 2ND [ ] INSULATION FRAMING INSPECTOR omp " And Level Of Humidity R-19 Mineral Wool 3/4" Foil Faced Rigid Foil. RayS Insulation Foam Board 2" x 4" Studs 2" x 6" Studs 2" x 4" Studs R-11 Mineral Woo! Bait 6 Mil. Poly R-11 Mineral Wool Bait Foil. Ray· seams taped Foam Board seams taped with Aluminum Tape with Aluminum Tape Average R value at zero relative humidi~y, calcu- , lated with 30% frame wood space and 70% spaCe between studs. Approximately R.14.61 Same Configuration as above, but increase humidity to 75% RI-I. Reflective Capability None Air Infiltration Barrier Capability Approximately R-9.00 Approximately R-16.2~ Appvo×{~6ateby R.14,60 FAIR Approximately R'13.Q0 Approximately With 20% Printing orr No 2ur(ace t ~'~,~ Suff~e: Estima~d ~osses ~oss h'~; - - in Refl~tive p~ffor~anee 20~ m 25~ POOR (If Unmped) GOOD (If Taped) POOR (If Untaped) Water Vapor Blocking POOR GOOD (~ Taped) BEST (Complete Block) Capability Gasses Can Pass Through - - 20% - 20% of heat loss is caused by an !nfl,ira;ion. Complr~.on Of Thermal Resistances For ~qt~tctur~l Cavitie~ With And ~p m 50% loss o[ themal insulation effectivene:~s Without Foil-Ray~ Insulation caused by high humidity. Experts agree that up to 65% of the heat ~,hat across the space from the warVa ,mdl to tlc, :, in summer and winter is cad{ant heal Summary: To be properly 1. Effective ' """' 2. Air [nfiltr~:~,ov, ..... 3. Water V~ or MARLO M~ CUON~O STATE OF NEW YORK DIVISION OF HOUSING AND CC~_;,MUNITY RENEWAL ONE FORDH,NM PLAZA BRONX, NEW YORK 10458 WILLIAM Mr. Walta~ E. Adamko, President American Lifestyles Group, Ltd. 346 North Highway Southampton, N.Y. 11968 MAY 2 0 t9R7 Foil - Ray Insulation Dear Mr. Adamko: As a result of our review of the data you submitted, this is you that in our opinion the subject product meets the the N.Y. State Uniform Fire Prevention and Building Code. Our conclusion is based on the fact that the insulation is test~ 1) Butler Manufacturing Company Research Center, and; Grandview, Ni...~ ....., 2) United States Testing Company, Inc..Los Angeles, California, both · testing organizations being accredited by National Bureau of Standards for testing such insulation products. The installation of the insulation shall be in accordance with the Hanufacturer.s installation instructions. Please be advised that the enforcement and the administration of the Code are under the jurisdiction of the local building depar'~ent. We trust that this advisory opinion provides you with the information you requested. Sincerely, Fred L. Kessner, ~.E. Director: Housing and Building Codes Lureac~ FLK:im eneral Product Guidelines/Cautions Foil Ray~ 9reduets should be installed with a minimum inch clearance around flues, chimneys, fans, blowers, re~ e~.sed lighting fixt~rd~--ballasts/w{{'ing components, heaters and other heat~producing'devices' F°il'RaY® preductS should also not be installed directly above lighting fixtures or any other h~'t producing devices. In existing homes and buildings, the siding, roof, walls, ceiling, and attic floor should also be inspected by a qualified exper~ to [dent{fy areas where moisture might have caused a previous problem. Evidence of paint peeling, warping, stains, fungus growth, rotting and the like must be repaired prior to installing the product. A qualified expert should inspect ali visible wiring for such defects as frayed, cracked, deteriorated, or missing wire insulation. Repairs must be made by a qualified electrician prior to installing any aluminum products. NOTE: Be sure to turn off electricity in the area that you are working. Aluminum surfaces can conduct electricity and a shock could occur if brought into contact with an electrical MANUFACTURERS NOTE: Always install Foil-Ray'° products on the "warm" side of the structure. Installation instructions vary according to climate zone ant{ level of humidity. Please follow ail manufacturers insmaet'ons fully for best results. STANDARD R-VALUES REFEF, f~ED TO IN THIS MANUAL ARE "SYSTEM VALUES" ASSUME THAT THE PRODUCT IS iNSTALLED WIT,q A MINIMUM ¥~" AIRSPACE ON BOTH SIDES ©FT HE FOIL- RAY® PRODUCTS. All R-values given are the re,~,u!t of individual product testing by accredited testing ~ab,'~ramc~- using ASTM C-256 standards. Your individual resul~ vary. Foil. Ray® Reflective lnsulation and Reflective Banners are combustible and should be properly stored, u~ed and installed. Do not expose to open flame or other ignition sources. Energy Saver Imports, Inc., makes no warranties. expressed or implied, as to the properties, characteristics end system performance if conditions are different than sugges~d or recommended. Energy Saver Imports. Inc.. assumes no responsibility for the effects of structural movement~ or other effects. Foil. Ray® Reflective . nsulation Testing And Certifications 1. ASTM-C-236 2. ASTM-C-236 3, Stud~ D,W,Y, 4, Study D.W.Y. 5. ASTM E-84° 6. Test Report 82-1740 HL 94 7. ASTM D-240-76 8, B.J, 476:7:71 9. NEN 1076.B4C 10. NEN ~:5 IL Test Report 81.331 12, ASTM E-96-80 , [3. Test Report ESS-0825R 44. Tes~ Repo~ ~2.231 15. Study H.E. 16. ICBO Re~e~ch ~PO~ 17 U.S, Depa~men~ of Housing ~d Urban Development 18. U.S. Depa~ment of A~cultum 19. ~ of CMif~{a System R-value Complete Wall System Calculations of Systems R-value Calculations of FoibRay® Insulation Applied as Cr~v[s:;ac, Insulation. Surface Burning Characteristics Comparison Flammability Between Foil-Ray® Insulation and Krv,Jt Backed Fiberglass Bart potential Heat Large Scale Surface Spreed of Flame Flammability. Fuel Contaqbutlon Flamespread and Smoke Developmente Temperature S~ability Water Vapor Transmission Compression Stress Vs. Deflection Emission Factor and Infra-Red Wall Remsmnce Calculations *~ Evaluation of Wall System Using Foil-Ray® [nsul~tmn Minimum Properly Standards Food Contact-Meat mad Poultry L[eecsed Insulation Manufacturer ASTM E-84 is comparable to UL 723, NFPA 255. and UBC 42-1 Foil. Ray® Plus 20. ASTM E-84' ASTM E-9640 Surface Bumlng Characteristics Water Vapor Tyansmi~sion Foil. Ray~ BTU Saver 21. ASTM E-84' KraR-Flex 22. ASTM E4~4' Surface Burning Characteristics Thom~n B~gi~tsr products & Service Volume · Insulations: Buildings, Duct, Foil, Reflective, Thermal Product Information Sheet Foil-Ray® Insulation FOIL-RAY® INSULATION is a completely new type of insulation material with many advantages over existing materials. It's high thermal insulation value is based on the properties of aluminum to reflect radiant heat, together with the insulation qualities of the dry statio:~ gr~j air in the polyethylene bubble sheeting. The approx. ~/~ inch material is composed of a double layer of polyethylene air bubble laminated on both sides with a 99.99% pure aluminum foil. This composition provides a h]ghiy effective barrier against the transmission of heat by both radiation and conduction and gives the material (when hung in cavity) a thermal resistance value equivalent to traditional insrllation materials up to 8 times as thick. Technical Data Dimensions - Available in standard rolls 48" X 75' and 59" X 75', These rolls can be cut to any size. Thickness ~ Approximately V4" Thermal Resistance- Depending on heat flow direction and application, from tested results: Down R-14,9, Up R-6.0, Horizontal R-7.52. Vapor Resistance - Perm rating is .006 Fire Resistance - NFPA - Class A, UBC - class I. The results of the ASTM E ~ 84 tests wes.e: Flame spread 20 - Fuel contribution 5 - Smoke density 30. Durability - FOIL-RAY® Insulation is rot-proof and durable and should remain effec~'ivc insulation material for the life of the building. Water and Vapor Resistant Economical to store and transport Tough and Durable Light and easy to handle Easy to install Low wastage Pleasant and clean to work with No masks or gloves required ~ FQ~I-Rayr ~nsulzton has been tested and/or accepted by: Midwest Research Ins~itute/But]er ManufacturingCornpany. Reaearch Center ~ An · independen~tes~ingcen~er*HauserLab~ra~ries*British~ard~fAgr~men~TheUniversity~fEdinb~rgh(Certi)~K~M~O~EqeNether~ands · TN.O. Ins~ituVe for Building Ma~eri~ls and Constructions · C.O.T. (Institute for Surface Technology) ® I.I.R.S. (Dublin) · ]~UL~ rnimrnum prope~y standards U,S. Department of Agr culture · Sta~e of Cahfom~a L~censed Insu afion Manufacturer ~ [.C,]].O. Research Report #4221 Thieknsse: (ASTM System R-velt,~m:; '~ . Roil Slse~: Thiekness: Flame Spread: iAi{TM E-84) Pm~neanee; 8ysten R-values: Approx. ii" NFPA Clall A USC C~I~I I Up Hee~low R-6.0, DoW~ l'[l~tt~ow R~I~.{ H~ ~awl ap~, co~ w~i~ pl~ ~d duet ~p~ window ~v~n~ bubble p~k ~ ~uminum foil ~nd~ ~ ~ sides but ~ a ~ly~ylene on ~ ou~ lmye~ ~ pm~t ~e ~um App~x ~" ~e 8p~ ~ ~ ~n~bo~en 0 Applications; Rff~ltve insulation and vapor/air infllta~tton bander for helv~ duw ~,':," ~ under or over concrete slabs, or anywhere Foil. Ray® Insulation ia used. FOILL-RAYm BTU 8aver. An economy version of Foil-Ray~ Insulation with a ~ {aY~r ~ polyethylene bubble pack with aluminum foil bonded to bOth sides, ' Thiekne~l , , Flame Spregh '' ' (ASTM E-84) Pennennee · System R-value~; (ASTM Oil{a) Emltt~nce; 4' X 100' 400 ~q. ft, Approx. Ps" NFPA Class B UBC Class I , Flam~ Spread 80 Fuel Contribution 5 $11moke Dens Up ltea~low ms,so, ~wn Hent.qow App~x. 0.05 Both Aluminum Surface Appitea~ons: A ~ suing ~magve ~ ~y appHeagon ~ven ~ Poil-~ I~ Foil-Flex - 9~gle sh~ o~ ~uminum wi~ a ~l~pylmne ~n=~ ~d side wall appiicagons, : KrwfPFlex ~,Singlo ~hcot of aluminum foil with a glass scrim web and paper bagkil0g {pr0illated together with a flame res s~nt ~lye~ylene ~{I 8{~:. ' ' ~,~; ~, ' 49 X ~ 1~ sq,~ ~ 8p~l ~ NFPA Cl~s A USC (ASTM ~)~. :.;'. ~p~ 5 Smoke Density 5 EmJt~nce;' ,'~ ' Approx, 0.05 ' Sp~JfJcaUo~$; ~a~ change an aJ~pace in~ a refl~ve airspace, ~qdamen~ ~9817 Chap~r 13 for va usa Aupli~o~si ,',~mica~ ¥~p:,r, ~,~r inf Itcation and mfle~e brier for ~ in ~f and 'I'O~qN OF SOUTtIOLD OFU[CE OF BUILDING INSPECTOR ILO. BOX 728 TOWN IIALL $OUTIIOI,D, N.Y. 11971 J~nuary 7, 1988 TEL, 765-1802 Donald G. Feller 61-H Ole Jule Lane Mattituck, New York 11952 To Whom This May Concern, ~;e are unable to complet"e your Certificate of Occupancy because ~of the following reasons. /~/ nn application for Certificate of Occupancy is not on file. ENCLOSED /'~/ HO Underwriters Certi~icate on file. /~/ The check is(~R~Y~/not on file.) /~/ No Health Dept. Approval on file. /~/ Ho final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit tl I 6 0 9 9 Z Building Dept. ***/~ No Plumber Solder Certificate on ( all permits involving plumbing issued after April 1,1984 file. being BOARD OF HEALTH -,~,,,,.--- 3 SETS OF/-PLANS ....... 'FORMNO. 1 SURVEY~'~ ''-'. - TOWN OF SOUTHOLD CttECK ~-- BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL $OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL 0-~'~'~;~-~'~' ~' ..... MAIL TO: Examined....~ . ./'~fiI%'%...../.'~., 19~...~. Approved ....x'//,4Cbt,../.~., 19~.~. Permit No./. .~ .°.~.7..'~. · Disapproved a/c .................................. ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , 19... INSTRUCTIONS a. Tltis 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- catioh. 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 uhtil ~ Certificate of Occupanc) 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 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, buil,~i~g code, housing c~de, and regulations, and tc admit authorized inspectors on premises and in building for necessary insp/~cttons. ..... l...tw, xtuc ............... (Si=nature of applic"a'ht, or name, if a corporation) . :E ' . .N: !..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner and Architect Donald G. and Patricia'Fei3~er Name of own? of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CON, TRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder s License No ......... .P.e.n..d .i.n.q ........ Plumber's License No. " Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done~ ................................................. 61-H (~ Ole gule Lane gattibuck . House Number Street Hamlet County Tax Map No. 1000Sectioo 114 Block 12 . . {~-~,.~.f- lot 13,~ ' Subdivision ..................... 7 ............... Filed ~ap No ............... Lot ............... (Name) 2. State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... S. J:..n9.1.~' . P..a.m.i.l.y..9.w.e. 1..1.i.n.g/ ....................................... b. lntended use and occupancy Single Family Dwellin9 and' Home Occupation ;(Architect) 3. Natur~ ~ RepairI L Estimalfe ;. If 5. If busil 7. Dimen Dimen~ Depth Dime~ Height ). Size of ). Date o: t. Zonel~ 2. Does ;. Will Name ~f Name of Name df ~ork (check which applicable): New Building ' Addition .......... Alteration . ..X ....... ........... Removal i ........... Demolition .............. Other Work..P.rgt~.q~.e.d..D. 9.ck (Description) ;est $2.°. e 9.o.q: ' ,' '" (to be paid on filing this application) number of dwelling unit's, .....On.e......... Number of dwelling units on each floor ............... .. amber of cars commercial or mixed oc5upancy, specify nature and extent of each type of use ..................... of existing structures, ifiany: Front..5.2...f.g.. ....... Rear .5. 2...f.t... ...... Depth . .2 .~..f..g., ....... . f..t.. ........ Number iof Stories ...!. 9.fy' .............................. ; ......... of same structure with dlterations or additions Front ...n.o..c.h..a.n.9. e. .... Rear .. in..o..c.h.a..ng'.e ..... change ~ ttei,ht ............ II ' ' '.' o .......... Number of Stories... ~..1./. ~..s.e.c~r7 ...... of entire new construction: Front ' ' '('r[~')'.' '... Rear ............... Depth ... ............ Number :of Stories Front 35.0..f.g. : Rear 360 ft....... Depth ..6~l.9..~t... ............ '. Ma ch 17i~. 19' ' . r. ~ a o ; ~' Elsie D. Johnson ........................ er 0..~. ........................... district in u,hloh nr~rnle;s ~r~ ~t-ate,~ A Residential and Ac/ricultural construction violate any zoning law, ordinance or regulation: No ·...N.q ...... ~ ................ Will excess fill be removed from premises: Yes X No ),~,~i~e~Donald G. Failer a~a~ 61-H Ole J.u. le .L.nphoneNo. 29a.-5.250 Don.eld O. Fe~ler ...... bah ' fi .................................................. .......................... Address .... : ............. Phone No ................ 3. Is this ,roperty located within 300 feet of a tidal wetland? *Yes ..~.. No ..... If yes,l:$outhold Town Trustees Permit maybe required. Locate 01~a~ly and distinctly ail buildings, whether existing or proposed, and. indicate all set-back dimensions from operty lin~!t. Give street and block number or description according to deed, and show street names and indicate whetheY tenor or c~l~n~r lot. ' e Survey attached. 'ATE oF N )UNTY OF 'eve name¢ ; is the .,. said own~ ptication; t~ )rk will orn to befb )tary Publi~: YORK, S.S :nald G. Feiler · .................. , ................ being duly sworn, deposes and says that he is the applicant ne of individual signing c )ntract) .er , : (Contractor, agent, corporate officer, etc.) owners, and is duly authorized to perform or have performed the said work and to make and file this all statements contained in this application are true to the best of his knowledge and belief; and that the ormed in the manner set ::forth in the application flied therewith.' ne this ! .... a o .......... · ~ ............ Count. y ~~~ ~" (Signature of applicant) _NOTARy.. PUBLIC, State of New No,~_, 4707878, Su.~.lk County~ q Tern ~Xl~re~ M~ 30, lQ :/