HomeMy WebLinkAbout26725-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27604 Date: 03/28/01
THIS CERTIFIES that the building ADDITION
Location of Property: 1565 MEDAY AVE MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 113 Block 9 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 2, 2000 pursuant to which
Building Permit No. 26725-Z dated AUGUST 18, 2000
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 BATHROOM ADDITION WITH REAR ENTRANCE TO EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to VINCENT R & JOAN C PISANO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-554015 03/22/01
PLUMBERS CERTIFICATION DATED 03/27/01 VINCENT R. PISANO
ut r
rized Signature
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 26725 Z Date AUGUST 18, 2000
Permission is hereby granted to:
VINCENT R & JOAN C PISANO
PO BOX 88
MATTITUCK,NY 11952
for
DEMOLITION OF EXISTING DECK & NEW ADDITION OF BATHROOM WITH REAR
ENTRANCE TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
at premises located at 1565 MEDAY AVE MATTITUCK
County Tax Map No. 473889 Section 113 Block 0009 Lot No. 006
pursuant to application dated MAY 2, 2000 and approved by the
Building Inspector.
Fee $ 75 . 00
Author ed Signature
ORIGINAL
Rev. 2/19/98
Form No. 6 , X 3's
a TOWN OF SOUTHOLD fi�a 7 / ra Clef IV4) //9 S o;
BUILDING DEPARTMENT
TOWN HALL
MAR 2 7 1101 765-1802
APPLICATION FOR.CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form) .
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for .the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - .Z5V
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $175..00, Commercial $15.00
Date . .:tea/!.� . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . .
Location of Property. . .��.� >� . . . . . . . .I�.'�.�D14 ('. . .AV . . . . . . s VO./T i,% .. . . . . . . . . .
House No. Street Hamlet
YlAld
Onweror Owners of Property.. . . . . . . . . . . . .... . . . . . . . . 4 NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. ,� . . . . . . .Block. . . ..?. . . . . . . . . . .Lot. . . k. . . . . . . . . . . . . . . . .
Subdivision.ff. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No.�.4,,,,: �a . . . .Date Of Permit. / ��'�. . . . .Applicant. . v^.!ee;;;T �s!¢!�! . .
Health Dept. Approval. . . . .". . . . . . . . . . . . . . . . . .. . .Underwriters Approval. . . . �. . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . Final Certicate. �. .
Fee Submitted: $. . . . . .. . . . . . . . . . . . . . . . . . . .
3 . . . . . . . . . . . . . . . . . . . . . . . .
o . . . . . . . . . . . . . . . . . . . . . . . .
APPLICANT
r
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1185152 BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10038
M� CH 22,20 01 fi : , i N 554015
DateTHIS CERTIFIES THAT Appt�Q} Nd onZ25`L
only the electrical equipment as described below and introducedbythe applicant named on the above application number is in the premises of
VINCENT PISCANO. ME-DAY AVENUE, MATTITUCK, NY
in the following location; ❑ Basement ® 1st FL ❑ 2nd Fl. OUT Section Block Lot
was examined on DECEMBER 21,2000 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENTI FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. I N.P.
5 6 5 5 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
!T]
OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
I I Li-- 5 6@@
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC COND. A.W.G. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP. 1/4W 1/JW 3 0 JW J/4W PER 0 OF CC.COND. NO.OF HIAEG OF HIAEG NO.OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
PADDLE FAN F-I
G.F.C.I:-1
SMOKE DETECTORt-1
REP ELECTRIC" L �t
P.O. BOX 635
MA:TTITUCK, NY, 11952 GENERAL MANAGER
Per
This certificate must not be altered In any manner;return to the office of the Board it Incorrect.Inspectors may be Identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT ®E,ALTERED IN ANY MANNER.
�oS�'FFO(,�co
o�Q Gyp
Town Hall,53095 Main Road y = Fax(631)765-1823
P.O.Box 1179 Oy • !yC Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
January 9, 2001
Robert Saetta
P.O. Box 72
Greenport, NY 11944
RE : Pisano, 1565 Meday Ave . , Mattituck.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
XX An application for Certificate of Occupancy is
not on file . (Enclosed)
XX No Underwriters Certificate on file .
XX The check is (not on file . ) $25 . 00
No Health Department Approval on file .
No final inspection has been made .
XX No Plumber Solder Certificate on file .
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 26725-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
o��g�FfOit��oG
y�
Town Hall,53095 Main Road y Fax(516)765-1823
P. O. Box 1179 �� • .F Telephone(516)765-1802
Southold, New York 11971 y 0!
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE: , a 7
Building Permit No. 020 70�
Owner:
(please print)
Plumber: 4lSAJy
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
J ea't'ee'-
(Plumbers Signature)
Sworn to before me this
,-:�,72-- ' �day of
Notary P lic, / n County
N'
Notary
Public,S e e of New York
951364
Qualified oin Suffolk Count�
Commission Expires May 22, oZ00 /
M-1802
BUILDING DEPT.
INSPECTION
[ ] F NDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ J FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: e-
DATE INSPECTOR �G�
70-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ v]ROUGH PLBG.
[ ] FOUNDATION 2ND [INSULATION
[ ] FRAMING [ ] FINAL
[ J FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG. i
[ �FING
NDATION 2ND [ ] INSULATION
[ ] RAM [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE 91)Y CM INSPECTOR
T65-1802
BUILDING DEPT.
SPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ J FRAMING [ ] FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS:
DATE (�D INSPECTOR
7z--
70-1802
suauiNa cepr.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: 42t
,DATE INSPECTOR
ELD I NSPKCTZOI�RF k'OR C DA(E - COMMENTS — i
1-3
)UNDAT I ONit
II II---------- -- d
----------
---- - -------
II _ II
JUNDATION (2ND)----------------
-
�! ----
li u
OUGH FRAME & jj It rO
PLUMBING jj - / ' `r\
II
II —JI
II
II II H n
it
NSULATION PER N. Y.
STATE ENERGY
CODE Imo— ii y
u u
Ill— —at y
II `
FINAL if
ADDITIONAL COMMENTS: Y
z k%
b
BOARD OF HEALTH . . . . . . . . . . . . . . .
-FORM NO. 1 3 SETS OF PLANS .. . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK IPAM. . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL �, 373To20 . . . . . .
0.CA. MAI I, TO: . . . . . . . . . . . . . . . . . . . .
Examined..R112.4 ........ .I
Approved....Oie........ .2-qq4Pend t No. ......... . .. ....... ... ...... ... .. .
Disapproveda/c .................................. ............ ....... .............. .
..................................................
. .... ............
(Buil ing 41ns;pe;tor)
APPLICATION FOR BUILDING PERMIT
Date. . . . . . . . 20. . . .
INSTRUCTIONS
a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the lkiilding Inspector v
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 application.
c. The work covered by this application PW not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue 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 HF.[ K41E 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, buildi code, housing code, and
ordinances, build,
for
'1 17
regulations, and to admit authorized inspectors on premises and in building for e ry inspections.
.(Signa
.4
....... . .. ......... . . .. .. ..... . ... .... . .. . ..
( L
Signa, li;aant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plurber or build(
......................................................................... ... .... ... .. ...... . ......
Name of owner of premises 111A/J!��1 -10./. ................................................. .... .... . ....... ...
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Name and title of corporate officer)
Builders License No. .................i.......
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1.
Location of land on which proposed work will be done.................................... . . .. . ..... .. . . . ... . . . .... ..
Z jf��.J�................ .mtwY
01W ...................
...... ....... .... . ... . . ... ..
House Number Street Hamlet
County Tax Map No. 1000 Section ...//.:!r>........ Block ...T........... Lot & ............
Subdivision ...................................... Filed Nap No. ............... Lot ...... .. .... . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed constriction:
a. Existing use and occupancy ......ifki 491;5-44�4�.................................. . ... . ..... . . ..... . .
b. Intended use and occupancy .......
. .........................
... . . . . . . . . .. . . ......
3. Nature of work (check wi►id► applicable): New Building .......... Addition .......... Alteration ..........
Repair ........ .... Removal ............. Demolition ............ Other Work ..................................
Aie (Description)
4. Estinr►ted Cost /eixp.P.a............. fee ..............................................
(to be paid on filing this application)
5. If &1elIing, ►,►ni►er of dwelling units .../....... Number of dwelling units on each floor .............. ..
Ifgarage, o nber of cars ......................................
G. If ix►sh w ss, cxinnercial or mixed occupancy, specify nature and extent of each type of use......................
7. Dimensions of existing structures, if any: Front................ Rear ............... Depth .................
lkight ........ .. ............... Number of Stories ......................
Dimensions of saw structure with alterations or additions: Front ............... Rear ...............
Depth ...... .. . ........... Height .................... Number of Stories ...............
8. Dimensions of entire new construction: Front ................ Rear ............... Depth ..............
lieight ......................... Number of Stories .....................
.11 i i
9. Size of lot: limns ...41 6............. Rear ............. Depth .GR f................
10. haute of [An-chase ..................... Name of Former Owner ........................................
11. Zone or use district in whid► premises are situated ..............................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: .."Q.................
13. Will lot he regraded ...A10............ Will excess fill be removed from premises: YES NO
14. Names of Owner of pr-emi ses l�l �[fir'. JvQ..... Address
N.•me of Architect .................................... Address .............................. Phone No.m ..............
Nae of Contractor .. Address ...............................Phone No. ......`.. ..
15. is this property within 300 feet of a tidal wetland? * YES .......... NO ..........
*TF YES, StIUI YND TOWN 'IRUS'IFES PERMIT MAY BE WNQM ED.
PI.O'r DIAGRAM
Incase clearly and distinctly all buildings, whether existing or proposed, and indicate all set—back dimensions
from property lines. Give street and block ember or description according to deed, and show street names and indicate
whetlwr interior or corner lot.
SfA'IE OF N1J Y(AIZK
SS
OJIJNIY (W. ..��?. .. ......
.......•. .............being duly sworn, deposes and says that he is the applicant
(Nave of individual signing c_cmtracl)
above rowed,
Ileis tl►e .................................................................
(Q-mLractor, agent, corporate officer, etc.)
of: said owner or aarx rs, aml is (h►ly authorized to perform or have perforux-d the said work and to make and file this
application; that: all statewnts contained in this application are true to the best of his knowledge and belief; and
that the work will. he perfonned in the manner set forth in the application filed therewith.
')worn Lo beicire nie this
....�....... . . . ..d. f. ..1.!'..�. .. .. `20.4..
YYI
Notary Publ.ic .!...`o�:.....:............ ....... ............
(J LYNDA M.BOHN (Sig .o .H
NOTARY PUBLIC,
01B0tatS 012�Ybflf
Oualified in Suffolk Courdv
Term Expires March 8,2
BUILDING PERMIT T---iW CLI EC'k- LISW
Applicant/ Date
Owners Name: P",-5(2-Jn Reviewed:
Architect/ Date
Engineer: Submitted:
SCTM #:
District: ,1.000 Section: Block: Lot:
ProjectSubdivision
Location: /-507 ,���/ ,4V,-, �� ���C�� Name:
Single&separate Required - I
certification: (Yes/No) / O �ciSTi.�4
Req. 2057 Req � 'Wev
Zoning District: /�/� [Lot size: Actual: (Lot coverage Proposed:�
Req ' /Qt/A, Req / Req.
[Front Yard ��Proposed: 4 1 [Side Yard Propos :1 ,7/ /1
1 Rear Yard �/ Proposed: j
1" O'7^eQ Ora fl-��
d1
Project Description: �a�ui+oo.0 �oo �rs� �Uf-<sr /.��'�ut ,—fc•�
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A. NO YES S umber
Suffolk County Health Dept.
New York State D. E. C. ✓
Town Trustees
Town Zoning Board approval: ✓
Town Planning Board approval: ✓
Flood Pla*9 Elevation ???
Flood Zone:
41 C �er Ty
No to •
YS
7talo C"""y
J
SIze 3
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cl/ i Guarantrrn IrK%rrv.,,!herrn rn t'h^A rust
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it pr"red,and on his behalf to the
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c Q to the as W)rVaoa of the Ianein0 irtati•
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°" s- 'VINCENT & JOAN C . PISANO
FEE:.1�"— -
NC FY BUILDING DERAmMENT AT
FOILLO 41 B AM TO I P : F°R TME BATHROOM ADDITION
FOLLOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING i FILUMBING — — — ——
3. INSULATION 1565 MEDAY AVE. M;ITTITUCK NY.
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O. 51 16-298-8 983 1 DOONI.Il--ll,giNAN,1,11
111 ^1
ALL CONSTRUCTION SHALL MEET .,I
THE REQUIREMENTS OF THE N.Y. 1 ^111-1i
STATE CONSTRUCTION B ENERGY
CODES. NOT RESPONSIBLE FOR EXISTING WOOD IRA
DESIGN OR CONSTRUCTION ERRORS —
rvi w
W
DO NOT PROCEED WITH 'N
PROVIDE OPENINGS FOR FRAMING UNTIL SURVEY
EMERGENCY ESCAPE AS OF FOUNDATION LOCATION
It L9 IN '„"'I,,
REQUIRED BY PART. 714 OF HAS BEEN APPROVED.
N.Y. STATE BUILDING CODE. DOOR AND WINDOW SCHEDULE
OCCUPANCY
•CUPANY Oil
r,068 ANER%I'.N SLIDRIZI'tiGL A SCRYEN h SPON KIIA[IDWAHI?-
I 12
USE IS UNLAWFUL Dx INOT n MATCH
F.X%TIN11 SY W11
�_OGA HOLLOW CORY MASONITL:8 HIMCIE COLONIST KWIKSET 1111TH LOCK. Vmrt sol
EXISTING HOUSE
ovn
WITHOUT CERTIFICATE [2] ANDNNSEN I tASRMItN'I WINDOW 2 N I:I hN('V F:1•`1
OF OCCUPANCY ANDERSEN AWNING WINDOW AN I IL SCREEN. -11
PROVIDE SMOKE-DETECTING UNDERARREQUIRED i1FlCOE Ex1srlNc Eou"urcr10N. L G
ALARM DEVICES
AS TO PART.721.1
111S BUILDING CODE. I'll'.CONI'RPITII
111.
PLUMBING 3'-0"o C
ALL PLUMBING WASTE
WATERW D
TER LLINEE o S NEED u
TESTING BEPORE COVERING
v
Ifcopper
rwatertubing luting used
WALL LEGAND
for water distributing
em;piping shall be
TYPICAL TI IROUGI I SECTION
Of types jjRLL0n& EXIS•17ni, I NOTTO SCALE
UNDERWRITERS CERTIFICATE REMOVIA) — — — —
REQUIRED N Et W
4'4,11,l, I WOOD DUCK
PLUMBER CERT MCAT/ON
ON LEADCONTENTBEFORE
''ERT/F/CAM OF OCCUPANCY
SOLDER&SED 11V ATER
VPPLYSYSTEMCANNOT
_
EXISTING HOUSE
EXCEED 2/10 Of I%LEAD. r
scn1.E, 1/4"- r
d r
0
PROVIDE ANTI-SCALD AND/OR
TNERMALSNOCK PREVENTING
DEVICES Al TO PART.902.6(K)
N.0STATE BUILDING CODE. �o.an�y �,rH .yYSGc. O
LINK OE EXISTING DECK REMOVI?D. �n 712
L"
BATHROOM
4' IU" X 8'-4" 0 CRAWL. SPACE
O � �
x
V
CC.,r�y wrru f+'%55T. y.
i
) 3 ��� 9%N Ili'OC
a�
I e
I axD III'()('_ �
I
CROSS IIATCIIED AREA INDICATES 1'ROPOSE,D ADDITION. I C a
DO NOT PROCEED WITH 1 4'- 10" X 5'—<s^ A
I FRAMING UNTIL SURVEY
u
OF FOUNDATION LOCATION x I
N STAIR I
CUNSPII IIC'PIUN 'ICI III•] 1EbCK SIti P IN 110'1"I %
HAS BEEN APPROVED. _ I DID K TOL'BLOCK
zxls ccA rnlDUncn DuuEv.D INTO Ir Xlsrwr,
2X18 NB CEDAR THEM A FOUNDATION,
L� �o �o i ExcEE4 /D Jc sior Y n0 567AAC1' I aJ0y�
J "AI. • �
FIRST FLOOR PLAN FOUNDATION PLAN
SCALE 1 /2"- V SCALE 1/2"- 1'
I20BE12T c5A -' TTA CON6TIQ UCTION
01' l' 1C1.' 323 - 392S I-01CL' .11.1 / 1. ? S4 -0379