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HomeMy WebLinkAbout26250-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26903 Date: 01/31/00 THIS CERTIFIES that the building ADDITION Location of Property: 875 SOUTHERN BLVD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 22 Block 1 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 6, 2000 pursuant to which Building Permit No. 26250-Z dated JANUARY 6, 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 ADDITION, ALTER TWO WINDOWS, NEW BILCO ENTRANCE & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOSEPH & RHODA K. VANDERNOTH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 01/24/00 PLUMBERS CERTIFICATION DATED N/A (J"�' * a, Authori ed Sig ture 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. 26250 Z Date JANUARY 6, 2000 Permission is hereby granted to: JOSEPH VANDERNOTH P.O. BOX 216 EAST MARION,NY 11939 for CONSTRUCT ADDITION ALTER TWO WINDOWS, NEW BILCO ENTRANCE AND DECK ADDITION AS APPLIED FOR. THIS PERMIT REPLACES BP#19826-Z . at premises located at 875 SOUTHERN BLVD EAST MARION County Tax Map No. 473889 Section 022 Block 0001 Lot No. 009 pursuant to application dated JANUARY 6, 2000 and approved by the Building Inspector. Fee $ 75 .00 r AuSignature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the buildinf 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 19 lead. 5. Commercial building, industrial building, multiple residences and similar buildii 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, 1,957) non-conformint uses, or buildings ai '.'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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25V. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.J00, Commercial $15.00 �DIT(!JN /O YGf/ /J✓�" Date . . . . . . . . . F'laglpp. . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . /Old Or Pre-existing /B,Viljd�}ing. . . . . .. . .. . . . . . , / / 2 Location of Property. . . .9/. . .f54)vvezt , •0• Alq)_. • • �T !/ � 4. • ./v ylv9 House No. 1 Street // Hamlet Onwer or Owners of Property. ./U�� v��. . ,V. . •� . . . • �'` �E�NOZ'/ . . _ . . . County Tax Map No 1000, section. aP:�:'.00. . . Block. ® :®® . . .. . . .Lot.e/W: Dl�d•,• Subdivision/4 l�j//}V/{7 t/�jl��.�{T�IT/•( 'G�Yled Map. .�6.a.�. . .Lot. .r4. . . . . . . . . . . . . . . Permit No. .aFA; Jd.Q.� .Date Of Permit. . . . . . . . . . . . . . . .Applicant..:. ./�.�.�7.�� Health Dept. Approval. ... . . . . . . ./.. . . . . . . . . . . . .Underwriters Approval. . Y. . . . . . . . . . . . . . . . . Planning Board Approval. . . . . ./ . . . . . . . . . . . . . . Request for: Temporary Certificate. .. . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . s . . . . . . . . . . . . . . . . • • • • . . . . . . . . . . . . . . . . . . . APPLICANT C57 �Zq coa,20 3 � P D50 THE NEW YORK BOARD OF RRE UNDERWRITERS PAGE 1 8078651 BUREAU OF ELECTRICITY+^ 40 FULTON STREET, NEW YORK;.NY'10038 . Date FEBRUARY 01,2000 Application No. onfile 1931.500`/00`. H 066999 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant na✓f&on the above,applieation number is in the premises of JOSEPH VANDERNOTH, 875 SOUTHERN BLVD. , EAST MARION, NY ; ' in the following location; ❑ Basement X❑ Ist FL ❑ 2nd Fl. Section Block Lot was examined on JANUARY 29,2000 andfound to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS CHES OUTLETS INCANDESCENT11 FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT. TIME CLOCKS -BELL, UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AM AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. "AMT., PS.= TRANS., AMT. I H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METERNO.OF CC GOND. A.W.G A W G A.W.G AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 e dW pER 0 OF CC.CONO NO.OF HILEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: - ELECTRICAL SURVEY AS PER 1/24/00-1 *NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated. " "No obvious unsatisfactory condition was found. l-. L JOSEPH vANDERNOTH P. 0. BOX 216 GENERAL MANAGER EAST IMION, NY, 11939 Per }} This certificate must not be altered in any manner; return to the office of the Board if Incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE JUST NOT BE, ALTERED IN ANY MANNER. o��$pFFO(,�co � Gyp Town Hall,53095 Main Road o Fax(516)765-1823 P.O. Box 1179 ,? Telephone(516)765-1802 Southold,New York 11971-0959 Oy • �� BUILDING DEPARTMENT 0 I U TOWN OF SOUTHOLD - p January 13, 2000 Joseph Vandernoth P.O. Box 216 East Marion, NY 11939 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. ) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984 ) . BUILDING PERMIT # 26250-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. i M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ]/FINAL [ ] FIREPLACE & CHIMNEY REMARKS DATE / INSPECTOR _'IELD IN:SPEC:i0 DATE COMMENTS 1 . &Veu ro FOUNDATION ( 1st) a C FOUNDATION ( 2nd ) _ m 2 . C� / Z 06 o J ROUGH FRAME & d� PLUMBING 3 . x m m I1dSULATI0P1 PER N . Y. STATE ENERGY �-�- CODE a 4 . -1 <� ~ � r m FINAL o z y� ADDITIONAL COMMENTS : ?cb L_4t4 a -- Lp P:h>z���@ x ' H s 70 9 ' ' H H O 4 z M r t ; x til ro A3t)F. yS^y{l Qy q a�31-.tiu..:fa'cv:c.x..... <.:::wsr.,m,s=R'W�.,.s.>.a�.4'.r�iti�;divk..�v..s�c3w,w�,x`+:;.>�s„aYrLN.GS1rkaswa iv`a+»"w' i5 w��':'d��.w'�' .� •�• r 765.1802 BUILDING DEPT. INSPECTION ( ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INOULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY ell DATE INSPECT0 M-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST ( ROUGH PLBG. (G' FOUNDATION 2ND INSULATION [�RAMING [ ] FINAL REMARKS: ����` DATE INSPECTOR �4�,4 .s-ep ,;is sec4,biv - - �tps dower � to e_o - ��,� �krfr�Nr� oZx1C� evax� lb` oN � 3 re AM E ovT- Z 0 o7x$ CCa , r 1 �looc 1'xa rn s o J 0 Undo- +, d 4041 3)�x% o yu it s 31 de zP . I S�S/c�x (� Aou�se dick n5 G„Al 1, Xtio Pecos . ` r � CtC�OIC . ttff L✓rll jJL p�c.E_ t_N7KUW; k:i (va.;an hj 4 � I • i I ' MAI-) OF 020F fSQ-7 � SUG'vGYND r=oc: r4NO - ar i �A5•r M�•.�rcx� ,� �T UWN Ar• �'XXITr,Y�t..D ,hi: l I i ti i Ow t? O •� ,;5:, s O [�irs-P I11arr,wi,iV. �• I c (Il 'I t�'_'rr� 1. �•Z 'U ((1 y W ,y ,GU !-i dfy:<.'i'4 % 'UUI,._r::�4/r!►�'t� f _ . . _ l•vucarrf•�.. _. 13 rannvnterfl -JOUNDA� 1aN -P�N FOR s Lel12 � M2S. DG-2 N07H . W N C, 4" SIQb TSN -ro 6x -ntiU FLoo2 3'I6 UILQ- acct W Ru--- F�usr+ &,j 'rrH Xts71 6- W U , PtSo T 2 -ro &CAVE S` .Ef C-SN me VENTS. I N Gw taG��T�o�v -t AFTL12 Ti C-S S RAFT�CS . —1l� Tt; 96oF a q,)(Z j� Sux -PING ZER -- -1hry ALL EXTC-C io'K WRLLS aX i�-1�1 SNSUL_l�T b1y X 0 LOOZ Lo Cly T=' vNORT oIv �/$ FLYWOOp S"e� FLO02 36t� �jCl-,OW Cs'21a`Ot- , Ash vG V [ eve Fc zivsw --DOME— SrYLI(-5H—I i Z LI—H-TS Ixg c--2E i Wooer 6� �KGtic H Wood -DooK i FORM NO. s 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) Na 19826 Z Date ...... . .. ........:41,1k............. 1991. Permission is hereby gra &0:... yy�as,x .... .. ... QCg ,.. ... ..f .l. .......................................... `...4..v,l....C? .... ..! !?s ... .�,R. ... . .... ....... / ................... ,. at premises located at ...� 74........ . ....... ....I... .....:. . 4r+p!...... 4? ! 1 ................................................................................................................................................................ .................................................................................................................................................Q................. County Tax Map No. 1000 Section . ....2 ""..... Block .....5�...1........ Lot No. ...©..l............. pursuant to application dated ........ .. . ....... ..... 4 ............. 1911., and approved by the Building Inspector. Fee 5...�r ..:. GAN&,,k G111/y / Bu I for Rev. 6130180 -PLA Fad 5 N 20o2 4' dab lu51V -To FLOOR , i 31 6- WN , ()Uso -r q -_rd 6-rADc- C-SFS AtR VENTS, ?RT SL-IR'e IN NGw n-cyIrlokv 1?`4 CLQ �s MRs W�w�>✓?- wo-04 . P�>✓T�%12 T1 G-S s a)Q Z��TC�S . -1 ►� �Lax V bo FK6M gyu' ���I'iyC ` 1 M G-/&,r-k4 CONC-F, 2-')OLT,Q 7hr2�ArWS . ALL EXTGeWRLLS aX(� i 1 X 0 'FLOOR t5�s 3X I b i-o o-nN(TS I EAS-r- SCDCy f eve FO2 . 3D X30 =ivSLy -'D0 MG ,SKY U(:5-V4 i a L�Es`�TS Llx� WobD -DocK o SANS f�b1� PR M45 V AN)PC /Vo-rk4, ,54-g0 h8/e -orb. reps Cvc CMTr,4Nd2Xib eue-Y reAcm pvr 0� aXga - lxa VA 5 � -r _ � - , •__ •__� _ J� X11 -�'raw�tv�5 3�0ai 5 7ders w�{� pwz GHQ- X'�S vncic� nd �ookvt4 �- 3�,:;2x}p 0,30ov-54 3i dem • "All g�S/yR,b �ooSe tK� �zcoi� d�ckn5 4„A-�„ xko Aecos . *k� cc-Jarb G - � JS QVlzf �� C��Ci� Size a��jc jao ,� / PQM ' N ...... BOARD OF HEALTH FORM NO. 1 3 SETS OF PLAYS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY 301991 �!., BUILDING DEPARTMENT CHECK - !}1 TOWN HALL SEPTIC FOR:1 • •<a.�•._,. .__.W wy�= �� SOUTHOLD, N.Y. 11971 1,1 tILOU'. L7Li''i'. TO1nJN ctp Sf14rfMCsLP'i � TEL.: 765-1802n*At � J+✓gNDIYwdOy77. a�o215 . .Examined . . ,�" 199TO • . . . . i(3ax _a�.Ip� . Approved . .�. . ., Permit No. 19�a`� ,�=, .Frt4�-J�[�"bA1,N�,V�;( Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . }. (6 uilding Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . . INSTRUCTIONS �'•'; A. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 As of plans,accurate plot plan to scale. Fee according to schedule. Ii. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by this application may not be. commenced before issuance of Building Permit. d. Upon approval of this application, the Building In.pector will issued a Building Permit to the applica t. Such permit fall 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 '.hall 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 wilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with an applicable laws, ordinances, building code, housing code, and regulations, and to Smit authorized inspectors on premises and in.building for necessary inspectio s. � . . . , Signature of applicant, or'name, if a corporation) (Mailing address of applicant) -tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. �W.11/EIQ.. . . . . . . . . . . . . . . . . . . . . . ./. . . . . . . . ./�. . . . . : . . . . . . . . ./. . . . . . . . :. . . ... . . . . . . . . . . . . . . . . . . . fame of owner of premises �SEN'. ,!�!', , Q • ICI}�A1/� , . K• !''raN� OTF} (as on the to roll or latest deed) `applicant 's a corporation, signature of duly authorized officer. . . . . . . . . . (Name and title of corporate officer) Builder's License No.) . . . (,'1W. E l2, , , , , , , , . , , Plumber's License No. . . Q.W N bt Electrician's License No. . QW.Q.t.-No Other Trade's License No. .P tal.IJM(. Location of land on which proposed work will be done. . . . . . . . . . . . . m— . . . . . . . . . . . . S -.r- 1 . ./'�Gu7 . . . . . . . . . .��Si . ./Vttq.2(0�? . . . . . . . . . . . . . . . . . . . . f House Number Street Hamlet County Tax Map No, 1000 Se tion . . . . . aA� . . Block . . . .1 . . . . . . . . . . . . Lot . . . . Subdivision a(LIC . . . . . . . . . . . : . . Filed Map No. / , (Name) J.Q� f . �. . . Lot . . . .4. . . . . . . . . State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy , D5t4CJ. .T14 L. . . . . . . . . . . . . . . . . . . . . . . . . . '�.t� 41? ?Ly m Btw.yIJ?:'.3°P r:17tli,`.t4 ntended use and occupancy '. . . ilf� .t �. . . . . . . . . . . . . . °'�' `1iE � Ati .�S . . . . . . . . .....n n.i.;i}�+4i`<4�Y.q'Ntlt'E fFllt��'. . . . . . . . . ature 3 Repair o f work check which aP'plicable): New Building . . , , . . . . . . Addition . . .�. . . . . Alteration Removal . . . . . . . . . . . . . . Demolition . Other Work . 4. Estimated Cost . . . .AOQ..Q.�. . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . .P. . (D) pijption) . . . . . . . . . . . . . . . . . �' (to be paid on filing this application) If garage, number of cars nits�,�IfFY1r17pYA • . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . 5. If dwelling,number ofdwelling 'I .it 6. If business, commercial or mixed occupancy, specify ature and extent of each t peiof,use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of ei isting structures, if any: Front . . .�y Rear yy f yy Sy . . . . . . Depth Height .,.a G. . • , i ,,, ; , . Num her of Stories . . . . .l. Y3r• . $ P �r f �h alterations or additions: Front STq . , • • • • , , , , . . . Rear . . .'� . .', , Depth f •LKI imension . Height . . . 1,0. !. Numbe/f� tories . �yY, . . . . . urc p / !4 . .t. . . . . . . . 8. Dimensions a snt re new t��st 1'ction: Front . . . / •{!, , , , • Rear . . (�T.v. . . . . . . . Depth . .�1y # • , , . , , Height . . . .�. �. . . . . Number of Stories . 9. Size of lot: Front . . , / I ear . . ... . , ( " o� jXt Rear . . .lo?S:�% /. . . . . . . . . . Depth 3-�r3a,3.�5`rS95T- 11. Zone or use district in which pre Name of Former Owner pNQ�E7y1 10. Date of Purchase . . ..7 ,,3}•/Y - I are situated . . .LfA$T, 0.412tON 12. Does proposed construction violate an zoning law, ordinance or rem Y g � oulation: .NQ. . . . . . . . . . . . . . . . . . . 13. Will lot be regraded ,/,s/Q,'„ , Wille ess 611 be removed from premises: Yes No 14. Name of Owner of premises �.NI+ �C.,✓406?4VjOddress pOYA"i' Phone No.y7.7.'•c5 /„K, , , , Name of Architect . . . , 04Wni 90drAwd). 'KUO' • • • . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. Name of Contractor . . . . Wtil . Address . . Phone No. property within 30 ' *' " " " " " " 15. Is this y 0 feet of a tidal wetland? ,� " " " " " " " Yes. . . . . . . . No. . . . . . . . . If yes, Southold Town Trustees Permit may be' required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and b ck number or description according to deed, and show street names and indicate whether interior or corner lot. '141 T F 1 � I PAoIA��l3 � �✓/�GIA'a3{�T1 p Ncwi f Po (Y EK., M Hu�S6 3�'Iy' I SC�t1•l.P I` (K (S, + A440SgPT, /aS 5nurw� 15NI�D, t�15► Wukf?'10KJ �1sr, 1 0O0 TATE OF NEW YOI� , :OUNTY OF . . . `. kV_; . . . . S.S • • • • •�©Ae- •' N . . . .1A ' • • • • V.0 - K f4ktT� . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) )ove named. e is the . . . . . . . . . . . . . . . . . . . . . . ©"? C-. . . . . . . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly autMiorized to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief;and that the ork will be performed in,the manner set forth in the application filed therewith. vom to before me this day of.'. . '. . . . . . S�� . 19 I tart' Public, . . . . . "� Cou `� X 6 91, (Signature of applic VF� )EF-P-3C) WROVEO ASM id) oR qqq n DATE:14ta49- -B.RN19 22 � NOTIFY BUILDING DEPARTMENT A7 -- 765-e802 9 AM TO A PM FOR THE I FOLLOWING INSPECTIONS: 1. FOUNDATION - TWOREQUIRED asp FOR1 Pn1IBE1.-MIMrocF T ^"•�Ce AI.IY A� w 'I - C,`n% 2. ROUGH - FRAM9NG & PLUMBING 43 FIINAL N SULAYIOCONSTRUCTION MUST SFSBE COMPLETE FOR C.O. J� ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF 'FHE N.Y. j STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS �-2mF A= Ln n aW � j I /+ Tns�:ac\ c^F I-).tl-� k'a✓iso Crn� 7o s{-c�.�- �'� I •n -fro r� Ca r�«�e� ce -E� the t;��.� �1 7 YrGv"v Cc\¢ . I��ii� IeRv CS ., .� . J W a�do•�- _.__ _.____.__ ._.._ _�_.._.�._,____.___.._,�..___I�`'uf�Ei{c Co. Ncalt•!-1 Q:fyf' �r.r�l'vv.n C�NT6COy1/;�prl (vn^;rhrF� H._,.rVo. � IY) I 1 I i I I, 1 g �. SU2VEYFD FO2 N. iCd rar/a - - ' - — � BAST h�i?k?PQ(J 4. = A' r� T3 fI y ��,.I re NI„yyaN D�nDDIDD� S ` W OWMeYS FaddYe:aL: I— ro Tws sucveY rs A JI uYCI oTA �N.lG(YhIT( O VCYYIdE 1'hl�'F'1? EDUCATION N I W, WE NEW YOPK siAlE pp EDUU110N IAW. Pp�sS� 064 44voirdJa CO HE Or TITS SURYPY MAV NOT PEAKING' I, UU LAI D SUi.V Vt�n'S IIIhU '[AL OR p Ln f Mal'IO/'t,AF.}: l/;139 Emoosno sTnL sxnu cowsmenm TO 0 A VALID IrUE mrr I P1 '2 tiP' nr 6cAPANT6 H!)C FFn uvnmw SHnu nun i 1'h-•.Y�U1341)- "� (FL OPUL'i TU Ill nc'O,E n sou rou vdonnHE sulrrE, r I EM' IIlALISA.• 15 AI m Oa THE IC ALV TO UIE I 3['l-_�,�.� � 1DLe mrArnLly. GavJll:rneml-1”' CY ANo t . LENTHO II,,IIlTUT1FIFTH 'JAO 1 LRU p6 AIVD 10 THE A35IOd¢5 OE TUL ILNUDIG INSTN I TUl' Gtl ARE NOT 11lANIIIIAELE TO ADOFT1ONAS IN4ITUTIOPIS OR EUPEEOUENT DE7 AlL owNERs I Iv, I F I .`_iOrJ7-f �/_L�'fJ mA �iC7(1LF=I,ffi�M'L3 ; (va(,e MITI 1 Ay... a Su/f�4!!C Cn. "lax rYt«� Gec.ir�rrrrbir_v: ' I ? '� a = rnora,rncnr �, _ � SFa(-eruEuP o!=_ltt Feat f^ I �" = pgqunvre++ I — Iirf^ W 'her :Urh�Iei :Ir-rrJ bawevga dr9�ieveal I = `�' � \ &j&,r-ems fr�r F1rls rro*sr�dc�nccm n'i!! corr{crrn 1 -- '19pfo F&e s>:andard5 bf' {He SuffblL Coun/y \ ne F-(ea(ll krvrcrr:. �c�ice • ,, ' � � For .7-�hhrovctl of Cor:,.Fr-uc,r`iun Only ' ! ,I 11M'(E� G'= FJu'7U.^avlEs'W P I Ij Gl�e�7hrk.•�' to thre I .r62t) .- SECURITY TIT'I-E ANP GUARANTY COMPANY ANP 1MA_�F M FEDERAL. SAVINGo5 ANO LOAN r ALI16,11)N1 W4N' ,7)Y"t P C. Vim.,..._, 1 "� d LiC�rtncd :.�Jnd SurV�•r�ar-a _ ___. 8`,•81 Greert�:erN- -� ft_vv 'fora: 70 I