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Home My WebLink About23170-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24213 Date MARCH 15, 1996 THIS CERTIFIES that the building ADDITIONS Location of Property 745 WATERS EDGE WAY SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 88 Block 5 Lot 62 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 29, 1995 pursuant to which Building Permit No. 23170—Z dated DECEMBER 8, 1995 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 TO BEDROOM & DECK OVER EXISTING CONCRETE STOOP OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KLAAS HONIG (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-379018 — FEB. 29, 1996 PLUMBERS CERTIFICATION DATED N/A Building Inspector 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) 0"!.A Date ...... ...f......................... 19 .,.... N2 23170 Z Permission Is hereby gr me do: P .... .. ,..... .. .. ........r ................................. .<= .... ..` .........f..t. . .� to .. .. . .. .... ...................................................... ................................................................................................I.................I................................. at premises located at......... 1••• ... .. ................... ..... ................. ,. ...... ............................... County Tax Map No. 1000 Section ..........?4K Block.......... .. Lot No. .. ........ pursuant to application dated .................. .�........... 19... ...., and approved by the Building Inspector. Fee$.., ,5...�.�... Building Inspecto Rev. 6/30/60 c Form No. 6 TOWN OF SOUTHOLD . . r..,.._.�,n BUILDING DEPARTMENT TOWN HALL MAR 1 219% 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Tn,,, 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 17 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. If. 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1155./00, Commercial $15.00 Date . .3141./, L1� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . ... . . Old Or Pre-existing Building. . . . . . . . . . . . Location of Property. . . .T (5. . . . I . . . . . . . . . . . �.QJ�V✓ . . . . . . . GAf4 � . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . County Tax Map No 1000, Section. . . . . V.j$. . . . . . .Block. . . . . J . . . . . . . . .Lot. . � . . . . . . . . . . . . . . . . . Subdivision. .!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . .0A.vDate Of Permit. . . . . . . . . . . . . . . .AppIicant. .ULl�Y�rn1 .6f7Lu-ky . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Appr.oval . . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . / Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . ✓. . . . Fee Submitted : $. . 9 ✓ . . . . . . I . . . . . . . . . . . . 56 c;4 AXO,4� . . . . . . . . . . . . . . . . . . . . Com o 1((,13 Arrr.rr,Atrr 195099 THE NEW Bate FEBRUARY ss�ORKBUREAU EOF FIRE UNDE THIS CERTIFIES TffnT VARY 29,1996 BEET. NEW YORK, EVV YOR RWR1TERS a I the electrical '4PPlicatio YORK10038 PAGE 1 egnf n No.On file 11086996/96 Pnaent w descri bed beloLo and int PEAR HONING, 7¢5 WATERSEDGE W roduced by thea N 379018 is thefDlloming Inca tio'; AY, $OUTHD ant'led on theoboe¢aPPlicotio was es ton; LD amine FEBRU d un ARZrwement X (.et F(. F N.Y. n nrrrnber in the FIXTURE 26 F 1996 2nd tt. Pren+ises of OUTLETS ECEPt andfon randtObe ' •SertiOn Block ARES SWITCHES flXTURES cO�nPltance 1 INCANDESCENT FLUORESCENT OTHEnrRANGES wirh[he National Electrical Code, Lqt 5 4 CDG DRYERS 1 t W DECKS OVENS fl/RNACE AmrKINGKw . DWAS ER'IS"WA A'ArR.w. a1 MOTOR AA'T t w. EXHAUST S M P. OAS ANT t,w AMT FAN N,v. FUTURE AWU CE FEEDERS SPECIAL N.v No a w,,a. REC'Pi TIMF CLOCKS ASERVICE DISCONNECT NO.OF AMT AMP AMT. AMPS TRANS.BELL �t"EATERS tASi UTLET DIM A/AP TYPE METER Nosy E+MS MERS U// �,2W SGF FEET EQ . AMT. wAiis I La awE 363W 304W NO.OF PCCERS ND C O OTHER APPARATUS: Or CC GOND. ND.OF NI LEa E OF HI-lEG NO SMOOF NEUrRALR KE DETECTOR:-2 �NEliipgL JIM SAGE ELEC 350 MARIAIE PLACENC LIC.#3635 E GREENPORT, NY' 11944 this certificate must not be altered is any manna r, Tatar GENERAL MANAGER oard n to the office of the B "•*w„a,ww, if incorrect. Ins Per +.....,,� Inspectors maY be identified by their credentials. Og0FF0[�-C WD .L Town Hall, 53095 Main Road p • Fax (516) 765-1823 Southold, Now York 911971 y�O� ��0� Telephone (516)765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 8, 1996 Mr. William Conway P.O. Box 1902 Southold, NY 11971 Re: Ruth & Klaas Honig - SCTM#1000-88-5-62 Prem: 745 Watersedge Way, Southold 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 # 23170-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. n ��C/ V III�T.I)—ar)l•'.�ia'Li.11oil—atLPl)lal DAlria__= AM, 4�4 foII NDAT lora ( IS'I•) it FOUNDATION=--=UNo)ae_ ------------------._._----------'--- - M V ROUGH FRANK 6 I --------------- It I'LIIM8ING �- - 1 Nsua.rcrsola PER to . 1 . .-� _�__ ---®�';--- - -�"----- ---- ------- )I CODE �----- ---------- _ I -------061 ------------- ----- - - -- ' ------ -'-- - - — ----= ____====e==no== =ate= = ------ ==e====.__- _ I I 1 FINAI. AnuITaoNAa. COHMENrS: -Asa------ –=------ ------ ----- --- _ C `` — —.__------------------ --_,_____._____._--____.__._ b� � v 7 � G � M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: Li UZ DATE INSPECTO V � M-1802 BUILDING DEPT. INSPECTION [ ] FOUND ION IST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE && CHIMNEY REMARKS: DATE INSPECTO M-1802 ' BUILDING DEPT. -NSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ 44OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: E i� f r f i `t DATE 11314 _INSPECTOR tp F �t ►P s �� 6•AcY3 = - a „ _ w S,b Met fw z - " ------------ IL ' ' / l"' rya. 5' <i ss•• c "+rM ^ - • �' ,. _ i 14 CTI f { A 1 'i itf { ,I a.c .: .�•t l'S�!"'3 ~ :r7►.' �i '.'i»oa,arm� eIon er anekion� 1 this survey is a vioftt+on W ! LOT SZ T' " 'S ` lt4utt4tC idY' soaanawaatmarieer«ssxw e-dncaewn.L.w_�. - 3 inked nM basrGlQ --� ".� " ^mz k ,-s, .�urvi{'a%'e inet cava " ''- ,c,- ".y •-` - m&. `� ti-We valid "uet ("in"d:.antaBe laan W¢+�d•Nmtad horsi rEtn `onN m the poison tot vgmn tho survey ' Is evened and on his B m iho a bsha i •,�.. 6•• - 1� ` r "'s' <:= o- , �'F`_�l1�T'CttL7f Ct3'�- " Fs` +t8isoomnstit tion limmntsjed her on, nd aced ; _ y n. ¢ ienrhng institution listed hereon and 0 the ing lroti- N ." at - ..:s ;� itnwn.tusrantee's aro nMdtran srabis • `a)� "'tom A: " ' ' ^` -' �' ;, taadditionai-mstiuuions or suinaqumt r d 4C1+ v� ' T -o`ib• � r r � � 'Q, s N•bb rEr 1 �� NEby 01,141, e hC uartst,fi '. (eut7YRn'�'P.EC .��oni:X K ti pry r e . ¢ �L (525 - SF�LANDSJ i.i.L,Cr258 .4t1z..'$uN,i3s,oJS -- %t. i Lek N i' , fi. q .•4 � s ,�- = --•acv... � 2 � .� � tA g. •! L i �, _+ate y 1. to 5,U �1 t.. ." - - ..,�, - �.�, z I co Lrl .S.—.{I I �•Fu fTi �—.---- ,t BAY' r I,A y S Unaauthorlmd eltaretion n aCdkvs\ L _l • ,'m this survey is a vmlehon of ,n t LCT 5z ,N ISuff(DIV. County �_T ll2d-tt1q J HO � Soction 7206 of the N-r:York Stot^` Eduction Lew.. C�- TON/ N Or Sou-rNvz c.-o, 3 ,.Capps of th4 eurwy mep not baanno survNor'a Ir�kof�a=.aJ w _'' 0 .r arnboasud sonl Nall ml bn canrid-re, _ v to tro s valid true oopq. MM SCQl8 _��.? �� Gua an oaa Ind cat dhnrr,M ph 11 - .'' , ;only to in,.,person hr vrlrm the Is prepared,and on lug kholf to ma .tilts c,,,Mny,gom-nrtr,n•al mperny rnC land;ng instnubrr,I'atcd M'-on and �,Saq,N61�' fY' —r-' _ �) thcassargnaeso'tnaland,np,rr:n- ,.DOr t tenon. Guarantees mo n^'trane'e-ahle No -:-1,nnmuonal instwionc or sutr * uent l d3 r^n� f T� J rei SOFNE�1 h Guararv7elA -to.. Counf� �tfe Guarnt t �PeP\GKYpNrO�P Septf t{lorlga9E co . as 5urveced 11 1, �r ; VAN TU4IL `- SO to LANDLQt'1G;: SuNe_s.�o{S "l Core�r�or�; t1. Y. p`pN1a�o 9p�� ly �z�rtl n n\�cry lam / i, aS I I I ` J � _ ,l ^9 1 ice- -•• •.�iT I toed) p p 1�l -<*''1�� ,�,- i• � '-,�' Jai•e O . i0 a fillip to .'�`. �Y��y{'' .- 1 �7n°v � r - u' f..�. .� w.0 ., ' 'S -- .x rs BAY' WAtfEN, - u�:in'hnlcMilia Violation .1 t4 �N N to this survey k-s viektion of c� , LOT SZ (suf fc k C9uM4 ftfed.mai cc. 9� . tD> O -Ssatran 72W d the Nsty York sr+b �� 04 TOWN CF SOUT E ,rW,laae ; s MIT this wrvov mw net EexlnO lt4#d w,r WWO Inked eee!or MnLbased said"not be wnsMxed to lig a valid tries ooeY. ° Sca I e504 Guarartew li�catsd horrson shell run 4 - only;n;M Matson for vdmm the survsY ''' '_Is papered.and on hie behalf to du 6•, _ O - Mcnetnlf[nt ' ,:: ,alk m>oa^Y.tiownrimnma!age"ad ,N�S1 ,anr.:np• ,nution listed horoon and ,c the awgnsss of the fording imrd- Cott �, th • Y: -.:;,.- tuonn Gvaramees are not vensfsreble ,tqQ bS' t�(� are li tea•institutions or subsequent j �itf ni 30,E K�a�T � .,,�,.,.. ete'r t A�pFNEtq.y 6uarawreed to. tntar-Coknt_ 4 1MM duararlil !v\.�lt tJ �Pq r?P�Pt,K VANa�'p•F Mortgage co. QS -SUPV d .S�st. Q1, 19'-'i I � PEu F�IAND`'J VAN TIOL LIccnssdp;'; Lars Se 140r6 Cvre4�or�s:. NsYz :' � U. 3 � THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195099 BUREAU OF ELECTRICITY If F— 85 JOHN STREET, NEW YORK, NEW YORK 10038 ! Date FEBRUARY 29,1996 Application No,on file 11086996/96 N 379018 THIS CERTIFIES THAT only the electrical equipment"described below and introduced by the applicant named on the above application number in the premises of PEAR HONING, 745 WATERSEDGE WAY, SOUTHOLD, N.Y, in the following location; ❑ Basement ® lst Fl. ❑ 2nd F'1. Section Black Lot 4 tras examined on .FEBRUARY 26,1996 and found to be in compliance with the National Electrical Code. i FIXTURE FIXTURES j RANGES ICOOKING DECKS OVEN$ DISHWASHERS EXHAUST FANS OUBETS ECEPTACLE$ SWITCHES INCANDESCENT FLUORESCENT I OTHER AMT. K W. AMT. K.W AMT K.W. AMT K W W. H P. 1 5 4 1 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEUL UNITHEATERS MULTI-OUTLET DIMMERS AMT. K.W. Ol H.P GAS H.P AMT. NO A.W G. AMT. AMP. MIT, AMPS. TRANS. AMT H.P SYSTEMS AMT, WATTS NSYST FEET SERVICE DISCONNECT NO F1 5 E R V 1 C E METER NO. CC COND. A.W G. A.W G. A.W.G. AMT. AMP. TYPE QUIP )B'2W I,e3W 303W 3p AW PER OF CC.COND. NO.Of HbLEG OF HbLEG NO OF NEUTRAl3 OF NEUTRAL OTHER APPARATUS: SMOKE DETECTOR:-2 JIM SAGE ELEC. INC. LIC_,#3635 E 350 MARINE PLACE GENERAL MANAGER GREENPORT, NY, 11944 11 Per This certificate must not be altered in any manner; return to the office of the Board it incorrect. Inspectors may be identified bylheir credentials. COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . 9 TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CtIECl; TOWN HALL SEPTIC 17011H . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OT I FY ; '�6 '• : VPermit CALL . . . . . . Examined . . . . . 19 MAIL TO : 19pC . . . . . . _ . . . . . . . . . . . . . Approved . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � (Building Inspector) P LICATION 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 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, 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 inspectors on premises and in building for necessaryt}ons. � . . . . . . . . . . . . . . . . . . - (Signature of applicant,�n , if a corporation) .x. 1 . . 1 gds. . . . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . .C + .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises , 1 .45. (`� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on th�'tax roll or latest deed) If applicant is a curl oratioh"Isignature of duly authorized officer. {Name'artdlftie of corporate officer) Builder's License No. . .1.35. i. . .8.2. . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .715. . . . . . . . . . . . . . . . . . . . 1 �.�-e�-s �� . ��. . . . . . . . . .��'o I�/. . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . .F.?. . . . . . . . Block . .15.. . . . . . . . . . . . . . Lot . .6 . . . . . . . . . . . . . Subdivision . . . . .&,y �Ta X4''1. . . . . . . . . . . . . . . Filed Map No. P.549. . . . . . . . Lot . �a . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . S 15/c. . .4'--mt 1/1. . .P141).6il5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . as=1Gf.�.l./.aria �. .�J2G� t�0!!1. .�'�?k�'L• • t• • �Q Kl-• • • • • • • • • • • • • • • • • 3. Nature of work (check which applicable): New Building . . . . . . . . . Addition ✓. . . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . , , . . . , . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . 4. Estimated Cost . . . .�7 . . . . . . . . . . . . . . . . . . . . . . . . . (Description) � Fee (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . .-1. . . . . . . . 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 . . . .. .? . Rear . . .`tv, Depth .6Y. , Height . . . . . . . Number of Stories . . . . Dimensions of same structure with alterations or additions: Front 3.? Rear .Yo. . Depth . . . . . 6`� . . . . . . . . . . . . . . Height . . . . . ?`.•(. . . . . . . . . . . . Number of Stories . 8. Dimensions of entire new construction: Front . .7. : Rear f. . Height . . . . r�'. . . . . . . . . Depth . .-�f.'. . . . . . . . . . . Number of Stories . . . . .I . 9. Size of lot: Front . . . Rear . /.?Q Depth . . . Og. . . . . . . . . . . . . . . . 10. Date of Purchase . . ' �((��6y , , . . . • ... _ , , , , , , , Name of Former Owner ¢/,.;5 It. Zone or use district in which premises are situated . . . .R ' ' ' ' ' ' ' ' 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . .� P. 13. Will lot be regraded ✓1,0, . . . . . . . . . Will excess fill be removed from premises: a No 14. Name of Owner of premises K��:4 s�:R�H, , , , . Address .W.�fw,'s,e�,Q u;�y, , Phone No. .7.Cv .as.��. . Name of Architect Address . Phone No. Name of Contractor .G s«<4►+�. .lw 4y, , . Address . Rq,i3on 1 Sv ?t . Phone No. ._?k 15. Is this property within 300 feet of a tidal wetland? *If yes, Southold Town Trustees Permit may be required. ' No, , , , , , , , , PLOT DIAGRAM 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 description according to deed, and show street names and indicate whether interior or corner lot. APP O D AS (NOTED DATE: B.P.# -P3120 FEE: __Ire— B . NOTIFY BUILDING D T 765-1802 9 AM TO 4 M FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION • TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING $ PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION A ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS :TATE OF NEW YO ,K, 'OUNTY OF . . . (/L, . S.S. . . . UJ��W � �ny (Namee of individual signing• • • • • •contract)• • • • • . . . . . . . being duly sworn, deposes and says that he is the applicant bove named. ie is the . . . . . . . . Co'•��.��'� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; 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. worn to before me t 's . . . . . . . . . . . . . . . . . . .day of . . . . . . . . . . 19 otary Public,G . my HELENE D.HORNE f � Notary Public,State of Now York No.4:151364 . . . . . Qualifies!in Suffolk County (Sig of applicant) Corninission Expires May 22, 19_..1 , hS w G j. i erg rogn<rl-e� VIA+- ,2xgR4+'+-eI-s fb"o.c. i - icd,er ya"GnK ser�Nir;g �It 111�} ext5�r�f4 E�fS Fef i` 5k,a�(e _ �Kb G'�. iM�J.4 L'tlr/IICG 40 fl14�21t P.�15�w � tEx6 x'o.c. 1wcOxShcafA n� Tyfe 4ouse of T , S"d'„5 �, 3/y cox 3+5Fbor I R-pq I a�EP F•� Ib'°•@• ft]Brl�'#k �!L7 i- elk �D TERSCERTIFUTE PROVIDE OPENINGS FOREMERGENCY ESCAPE ASREQBiREU REQUIRED BY PART. 714 OF” N.Y. STATE BUILDINGCODE ) -�� i t' 2 9 �a Loll . I" a i P Min s ��,� rpQadin,,po5F11) C i Z b ?i) r Pr, a Mrs Klaas /-�°ntc _ i J� aPtf rt?Ofef Mdr{tb>rr! �rbe� s� Cbsc� C i AI<w Wmc1 �aremL- �„c+; 9x8. 3oe 5p• i ��- 1�0� rt/fs /c!� i of-. 3iCot� Rzicrr,,}e kx;5}ea5 9ff� _ (aorCti over � F{rle >rn yy 4o S CanCPf A4. �_� i fp �v