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Home My WebLink About1000-117.-6-3 TOWN OF SOUTHOLD 3 Rental Permit 0672 Owner Jack & Mary H. Naldj ian Rev. Trt. Occupied as Single Family Dwelling Located at 550 Fanning Road New Suffolk 117.-6-3 Maximum Permitted Occupancy 6 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two(2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 6/3/2024 ode n�c��c nt t� icial This Notice must be posted by the main entrance at all times f4f so TOWN OF SOUTHOLD BUILDING E 631 -765-1802 mml"' EC�� ION I immo S Fp -F [ ] FOUNDATION 1ST / REBAR [ ] ROUGH PLEG. [ ] FOUNDATION ZND [ ] INSULATION/CA [ ] FRAMING / STRAPPING [ ] FINAL [ j FIREPLACE & CHIMNEY [ ] FIRE SAFETY IN [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PI [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI C ] CODE VIOLATION [ ] PRE C/O [pf DATE INSPECTOR Town Hall Annex Town Of Southold 54375 Main Road Rental Inspection Report PO Box 1179 Southold, NY 11971-1179 Tel: 631-765-1802 CTM# Date :� ..�.. .. .... _. ..... -....... ��. H .. ��._ Phone Owner . _... _.... ... m. ..... Visible Address ... fl _ cto r Hamlet ... ............ .. ....... ...� ... .. .............._. ... Inspector .m.. .... _. ..._. Floor Level Quantities Sub 1 2 3 . .. M Smoke Detectors (not located in bedrooms) �n... �..,,w. ... ... w ... _.. .... �... .. Carbon Monoxide Detectors _.... _.. Fire Extinguishers .... - — _.---- . . .....' .. .. ��. �.��... .. .�a ..... Exits ��....�...I 1 ... Bedrooms ( 2 3 4 5 6... Smoke Detectors Egress . Occu pant Count , . Building Systems Maintained &Operational Condition of Propertyp, Heating Building interior Hot water Building g ext rior m.M e Electrical Property clean, maintained &safe Mechanical Handrails&guards installed &secure _ ..._ „ ._ .. Pool Safety Pool on Site S _._.�.�....,. urface water alarm Date of CO issuance �.�,..�........al�. �w_n,..... �Pool coin I _..� etely enclosed Dooralarms p � ....a ...�.. �....... .... �..�..�.., e� .....m . �. ......... Self closing/ latching gates hing g e requirements ,..a... .. .. .........._.... Pool fence to cod ........._......a ..... ......... ... .._ _... CO's for all items resent Rental p Prior.... ........... ..�.�..... _.,,.... .m..�.....� ...._.... Comments: _....._....._.......� .�_.�.�....�...�.-..��..... _... ..Mw. ..: _.. .mm. _ _...... w ._............ ... ....... w ..,. TOWN OF SOUTHOLD co Rental Permit 0672 Owner Jack & Mary H. Naldj ian Rev. Trt. Occupied as Single Family Dwelling Located at 550 Fanning Road New Suffolk 117-6-3 Maximum Permitted Occupancy 6 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two(2)years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 6/14/2022 Ael ode orce ent icial This Notice must be posted by the main entrance at all times r7.:�,!tZ X21 • 0;��pF SOUr�o o ,� I; Town Hail Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 �our2XI EC WE BUILDING DEPARTMENT NOV 1 5 2021 _DD TOWN OF SOUTHOLD BUILDING DEPT. TOWN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental P,ro�erty Address: 15�S 6 Tax Map Number: 1000 SECTION // 7 -BLOCK -LOT - SECTION B. OWNER INFORMATION: i n Property Owner Name: z(&" hew ICXr`►,C e-) Property Owner Legal Address: Property Owner Mailing Address: / 310 -S, oceycle) /3-7C -5- eCeY-4-. y3(vc.Q r�,i 7, C(9�1 /gob i :26 o e/ k4�t,�Lranc) react, FG 33o62 Pom1br+r-,r) fie act Fz- 3 3 vG 2 Telephone Number(s): Daytime Evening -vi Emergency SICK-.e Property Owner Email Address:/-1.0- Page 1 of S ��`77pF sou ; j�i�a�� Tyo`Lr Town Hall Annex {', Telephone(631)765-1802 54375 Main Road N Fax(63 1)765-9502 P.O.Box 1179 j G O Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: y r(, e Xe i,Gt n Address of Authorized Agent(no P.O. Boxes): /370 S D I , u e �4c� 3 C 'rZ6dy Mailing Address of Authorized Agent:Z37() S ncer4n (tdd ;POVV\&4r-�D geigA 6`16L/7�W76 Telephone Number(s): Daytime Evenings Emergency 5C�f Email Address: �� c,�X • C Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION E.: SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 �s ��F SD �•� Town Hall Annex ` Telephone(631)765-1802 54375 Main Road cn lac V,; Fax(631)765-9502 P.O.Box 1 179 �i • O Southold,NY 11971-0959 'LQl iS UM';,� i�� 1 BUILDING DEPARTMENT TOWN OF SOUTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 1 For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, B, C);the use of each room in the Rental Dwelling Unit (for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: @ i Requested Maximum number of persons allowed to occupy Dwelling Uit: Number of rooms in Rental Dwelling Unit: ' j n fligSe ejo ms^ Use and Dimensions of each room in Rental Dwelling Unit: &4c 4cy3X/0 mw!'�r��Soosi ►�°fix► ec�rre2r7N Z li.riv r!Iy &r.Pr'aOeP Page 3 of 5 Town Hall Annex fit{ Telephone(631)765-1802 54375 Main Road f`f Fax(631)765-9502 P.O.Box 1179 ! Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety inspection by Code Enforcement Official is required. If the owner chooses not to have said inspection performed by the Town, a certification from a licensed architect, a licensed professional engineer or a home inspector who has a valid New York State Uniform Fire Prevention Building Code Certification is required stating that the property which is the subject of the rental permit application is in compliance with all of the provisions of the code of the Town of Southold,the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. ❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 3-l"am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit STATE OF NEW YORK) 1 COUNTY OF SUFFOLK) I i n certify under penalty of perjury,the following: 1. 1 am the owner of the property identified in "Section A"of this application. 2. The property owner's legal address set forth in "Section B" of this application is my legal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 �ti!ifo`��oF so lip, Town Hall Annex i Telephone(631)765-1802 54375 Main Road G Q Fax(631)765-9502 P.O.Box 1179 , ® �� i Southold,NY 11971-0959 k'�Q�, ,11 ''�'<•y�rri;�rIJ BUILDING DEPARTMENT TOWN OF SOUTHOLD applicable laws and rules. I further acknowledge that I will notify the Town of Southold Building Department of any changes of address within five (5) days of any changes thereto. 3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and agreed to abide by the same. 4. 1 will notify the Town within five (5) business days as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name: Cq If W")'Cr) #0—iqCut fl-++ome Property Owner's Signature: Sworn to before me this 15� day of N dvCvl t6t T 20)-t L/�I�y LG�t aLo OL4 Official Notary Public Signature and Original Notary Stamp REBECCA A LUCAK Notary Public-State of New York No.01LU6386882 Qualified in Suffolk County My Commission Expires Feb.04,2023 Page 5 of 5 6-3 :SSD Alvt A Ir< New 3 u41-61 OF 50UTyo� f TOWN OF SOUTHOLD BUILDING DEPT. Ono, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] AL [. ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMA K c PPi✓ c � 11 716 Vb Davro 64 DATE 3 I � iZz INSPECTOR ho��oF souryO� � Rnn�ln �o ►, `v 2t�J �v� i llL # * OWN OF SgUTHOLD BUILDING DEPT. couffm 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [� ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] AL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FI L) [ ] CODE VIOLATION [ ] PRE C/O [ RENTAL REMARKS: r O C DATE INSPECTOR Back of House ra 1 13x12.S Storage 2Sx20 Storage/Utility 22.5%23 Stairs I 1 Smoke and Carbon Monoxide Alarm Front of House 46.2 Back Door -------- 11 x 12 I 0 Bedroom 3 Kitchen - I — Bedroom 2 1 G ® 13%10 0° a 10x12 3 1 r 1 _ 3x2.3 a 11x10 x e Closet Basement Door I e 2 I 1 I __ ____ 3.1x3 I 4.7x2.4 4.722.4 ® 7 ® I I D Closet Closet x I o 2 Closet 2.5x1.4 I o 1 I 1 1 18.3 x 13 I Hallway I 19.3x3 4 ; Family Room 4 I I 12.8.x13 4.11x2.3 I 1 8.6x73 I 2 I Main Bedroom I I I Bath Room Closet I Front Door ®Smoke Alarm 47.3 ® Smoke and Carbon Monoxide Alarm ..............._,............ . .....,... TOWN 'OF ,SOUTHOLD PROPERTY RECOR OWNER STREET - VILLAGE DIST. , SUB. LOT fa ck4 FORti4ER/�OWERp' 3 r N --- EA' p ACR. S W F TYPE OF BUILaING RES , SEAS. VL. jFARM COMM. CB'. MISC. Mkt.,Value LAND IMP. TOTAL DATE REMARKS': /' a /10 lta° +�.. f`S �p y pq .yy rho �fj p� ("� g�.�.j�;.q q .�. ,/�v Co .. La : 5x+'ys s*`.sk ,e P omro✓' 3 Z 77 `°� °` 4"ho Y , d + �-S �a '�a� ��I A 6 z:i:l*f��-v �ag�; P ',d y o a , 7A lef, jai, ' - �" I20. AGE. ' •BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value:. , Acre Tillable 1 Tillable 2 Tillable 3. Woodland Swampland: FRONTAGE ON WATER Brushland FRONTAGEON.ROAD House Plot. DEPTH BULKHEAD Total DOCK . E 1A AIAV COLOR — f 4 ft's)`�! �•. � TRIM. y� "' '�- _ ,55•A ,�,,:. +/'jam. �# 3 _ ':�•Y N e!�.:; . N,� :^d`'"..els I .n Ax �a 3 •�=1Q.s .fin: - :1:v:'.••"�•'- ,:s�'•x...`�u."+:±=.err .°^J�" - :cs.'�rx.,,..<:.�tis"3x ',r.,�'3�++,'3 '•i•r.�:�."�-y.\��`'. ,,a`c. :,�` _ '.j7" � .�J•=i�x.��v:-�Jiy"�: .�Lm`,- yu ,ri!".ta`"`": :^3;=`'" _4�..'�'`^ ^y'.," �w i.•5i'�,3"+...�� •�,v ��A'F�x•r;Vfi "t��i Ats�h '�'��f'+� 't �a ( . M. Bldg.} `� z+ el � � Foundation ��'i Bath � %� Dinette .�. t l)s C o_#�� Extens10n �1z z,;' "' Basement tl. Floors,' f K.- Extenrioii r {d _ ,; Ext. Walls { ' m Interior Finish °, LR. "' '`1<.! Ca r-.� 'F" P$µi .'y b'i e� � ss„a,s; R� 'A Lz �f'-::`T Extension Fire Place Heat DR.. Type Roof ', Rooms.l st.Floor BR. Porch i Recreation Room Rooms 2nd Floor FIN: B. Porch Dormer Breezeway Driveway Garage � <��`�- � ,=�„�' �= �°} ` �' / d, d � � tJ -- ----____-_-- ------------ ---- s t O. B. Totals ,f Hca Power of Attorney, NY Statutory Short Form Effective June 13,2021 (m)SIGNATURE AND ACKNOWLEDGMENT: In Witness Whereof I have hereunto signed my name on October , 2021. PRINCIPAL signs here: ==> Q MARY H. AL MAN STATE OF NEW YORK ss.. COUNTY OF SUFFOLK: / On the / i4l day of October in the year 2021 before me,the undersigned, personally appeared MARY H. NALDJIAN personally known to me or proved to me on the basis of satisfactory evidence to be the individuals) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the u ent. SHARIL.SUGARMAN Not UbIIC Notary Public,State of New York No.02SU6336360 Qualified in Suffolk County Commission Expires February 01 (n) SIGNATURES OF WITNESSES By signing as a witness, I acknowledge that the principal signed the Power of Attorney in r6y presence and in the presence of the other witness, or that the principal acknowledged to me that the principal's signature was affixed by him or her at his or her direction. I also acknowledge that the principal has stated that this Power of Attorney reflects his or her wishes and that he or she has signed it voluntarily. I am not named herein as an agent or as a permissible recipient of gifts. Signature of Witness 1 - Signature of Witness 2 Date: Date: Sign on the line a -ove and print name and Sign on the line above and print name and address below address below Name: Rhonda Oltchick Name: Michelle Morrisroe Address: 375 Commack Rd Address: 375 Commack Rd City, State Zip Code: Deer Park, NY 11729 City, State Zip Code: Deer Park, NY 11729 Power of Attorney,NY Statutory Short Form Effective June 13,2021 (o) IMPORTANT INFORMATION FOR THE AGENT: When you accept the authority granted under this Power of Attorney, a special legal relationship is created between you and the principal. This relationship imposes on you legal responsibilities that continue until you resign or the Power of Attorney is terminated or revoked. You must: (1) act according to any instructions from the principal, or, where there are no instructions, in the principal's best interest; (2) avoid conflicts that would impair your ability to act in the principal's best interest; (3) keep the principal's property separate and distinct from any assets you own or control, unless otherwise permitted by law; (4) keep a record of all transactions conducted for the principal or keep all receipts of payments and transactions conducted for the principal; and (5) disclose your identity as an agent whenever you act for the principal by writing or printing the principal's name and signing your own name as "agent" in either of the following manners: (Principal's Name) by (Your Signature)as Agent, OR(Your Signature) as Agent for (Principal's Name). You may not use the principal's assets to benefit yourself or anyone else or make gifts to yourself or anyone else unless-the principal has specifically granted you that authority in the modifications section of this document or a Non-Statutory Power of Attorney. If you have that authority, you must act according to any instructions of the principal or, where there are no such instructions, in the principal's best interest. You may resign by giving written notice to the principal and to any co-agent, successor agent, monitor if one has been named in this document, or the principal's guardian if one has been appointed. If there is anything about this document or your responsibilities that you do not understand, you should seek legal advice. Liability of agent: The meaning of the authority given to you is defined in New York's General Obligations Law, Article 5, Title 15. If it is found that you have violated the law or acted outside the authority granted to you in the Power of Attorney, you may be liable under the law for your violation. (p) AGENT'S SIGNATURE AND ACKNOWLEDGMENT OF APPOINTMENT: It is not required that the principal and the agent(s) sign at the same time, nor that multiple agents sign at the same time. I/we, Henry Naldiian, have read the foregoing Power of Attorney. I am/we are the person(s) identified therein as agent(s) for the principal named therein. I/we acknowledge my/our legal responsibilities. In Witness Whereof I have hereunto signed my name on October J 2021. Agent(s) sign(s) here: Y NALDJIAN Power of Attorney,NY Statutory Short Form Effective June 13,2021 required, and an agent acting hereunder shall be an authorized user for purposes of applicable computer-fraud and unauthorized-computer-access laws. It is my intent that my agent shall have full authority to access my Digital Assets in accordance with New York Estates Powers and Trust Law Article 13-A. (_) (LL) Authority to deal with any telephone, intemet:and cable companies that I have service with, and to cancel or modify any service agreement that I have with such companies. (_) (MM) The acceptance of appointment as agent under this Power of Attorney hereby constitutes a consent to the release for medical information for purposes of the Health Insurance Portability and Accountability Act (HIPAA)to the named successor agent. ( (NN) each of the above matters identified by the following letters: (Q), (R), (S), (T), (U), M, W, N, M. (Z), (AA), (BE), (CC), (DD), (EE), (FF), (GG), (HH), (II), (JJ), (KK), (LL), and (MM). (i) DESIGNATION OF MONITOR(S): (OPTIONAL) If you wish to appoint monitor(s), initial'and fill in the section below: ( ) I wish to designate whose address(es) is (are) , as monitor(s). Upon the request of the monitor(s), my agent(s) must provide the monitor(s)with a copy of the power of attorney and a record of all transactions done or made on my behalf. Third parties holding records of such transactions shall provide the records to the monitor(s) upon request. U) COMPENSATION OF AGENT(S): Your agent is entitled to be reimbursed from your assets for reasonable expenses incurred on your behalf. If you ALSO wish your agent(s) to be compensated from your assets for services rendered on your behalf, and/or you wish to define "reasonable compensation", you may do so above, under "Modifications". (k)ACCEPTANCE BY THIRD PARTIES: I agree to indemnify the third party for any claims that may arise against the third party because of reliance on this Power of Attorney. I understand that any termination of this Power of Attorney, whether the result of my revocation of the Power of Attorney or otherwise, is not effective as to a third party until the third party has actual notice or knowledge of the termination. (1)TERMINATION: This Power of Attorney continues until I revoke it or it is terminated by my death or other event described in Section 5-1511 of the General Obligations Law. Section 5-1511 of the General Obligations Law describes the manner in which you may revoke your Power of Attomey, and the events which terminate the Power of Attorney. Power of Attorney,NY Statutory Short Form Effective June 13,2021 (BB) Authority As To Insurance: I authorize my attorneys)-in-fact to deal with any and all insurance policies I may own or may be qualified to purchase, including but not limited to the following types: life, medical, disability, long term health care for home care and/or nursing home care, homeowners and vehicle. Such power shall include but shall not be limited to the purchase and/or cancellation of any such policy or the liquidation of such policy; (_) (CC) Authority As Government Benefits: I authorize my attomey(s)-in-fact to qualify me and apply for any and all government entitlements that I may be eligible for, including, but not limited to, Medicare, Medicaid and SSI. This authority shall also include the power to litigate or settle any matter pertaining to any entitlements, and to sign a statement on my behalf refusing to use my income and resources for the cost of my spouse's (if any) medical care; (_ (DD) Authority To Employ: I authorize my attomey(s)-in-fact to retain and compensate attorneys, accountants, investment counsel and similar professionals, concerning my property and personal affairs; (EE) Authority to Waive Attorney-Client Privilege: I authorize my attorney(s)-in-fact to waive attomey-client and other similar privileges to facilitate consultations between the attorneys)-in-fact herein appointed and my attorney and other advisors; (__) (FF) Authority as To Domicile: I authorize my attorneys)-in-fact to change my domicile to another state or within the state; (GG) Authority to Enter into Trust Agreement(s): I authorize my attorneys)-in-fact to enter into trust agreement(s), including but not limited to pooled income trusts; (HH) Authority to Purchase an Annuity: I authorize my attorney(s)-in-fact to purchase and/or enter into an annuity contract with third parties, including my attomey(s)-in-fact; (II) Authority to Purchase United States Savings bonds: I authorize my attorney(s)-in- fact to purchase or surrender United States Savings Bonds, including, but not limited to, Series I and Series EE Bonds; (_) (JJ) Authority to make inquiry into my,employment benefits, from current and/or prior employment, including but not limited to, any and all personnel records and human resource records; ( ) (KK) The agent shall have (a) the power to access, use, and control my digital devices, to include but not to be limited to, desktops, laptops, tablets, storage.devices, mobile telephones, smartphones, and any similar digital device which currently exists or may exist as technology develops for the purpose of accessing, modifying, deleting, controlling, or transferring my digital assets, (b)the power to access, modify, delete; control, and transfer my digital assets, wherever located and to include but not to be limited to, my emails received, email accounts, digital music, digital photographs, digital videos, software licenses, social network accounts, file sharing accounts, financial accounts, banking accounts, domain registration, web hosting accounts, tax preparation service accounts, online stores, affiliate programs, other online accounts, and similar digital items which currently exist or may exist as technology develops, and (c) the power to obtain, access, modify, delete, and control my passwords and other electronic credentials associated with my digital devices and digital assets described above. This authority is intended to constitute "lawful consent"to a service provider to divulge the contents of an communication under The Stored Communications Act (currently codified as 18 U.S.C. Sec. 2701 ct seq.), to the extent such lawful consent is Pourer of Attorney,NY Statutory Short Form Effective June 13,2021 POWER OF ATTORNEY NEIN YORK STATUTORY SHORT FORM (a) CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the"principal,".you give the person whom you choose (your agent ) authority to spend your money and sell or dispose of your property during your lifetime without telling you. You do not lose your authority to act even though you have given your agent similar authority. When your agent exercises this authority, he or she must act according to any instructions you have provided or, where there are no specific instructions, in your best.interest. "Important Information for the Agent" at the end of this document describes your agent's responsibilities. Your agent can act on your behalf only after signing the Power of Attorney before a notary public. You can request information from your agent at any time. If-you are revoking a prior Power of Attorney, you should provide written notice of the revocation to your prior agent(s) and to any third parties who may have acted upon it, including the financial institutions where your accounts are located. You can revoke or terminate your Power of Attorney at any time for any reason as long as you are of sound mind. If you are no longer of sound mind, a court can remove an agent for acting improperly. Your agent cannot make health care decisions for you. You may execute a "Health Care Proxy"to do this. The law governing Powers of Attorney is contained in the New York General Obligations Law, Article 5, Title 15. This law is available at a law library, or online through the New York State Senate or Assembly websites, www.nysenate.gov or www.nvassembly.gov. If there is anything about this document that you do not understand, you should ask a lawyer of your own choosing to explain it to you. Power of Attorney,NY Statutory Short Form Effective June 13,2021 (b) DESIGNATION OF AGENT(S): I, Mary H. Naldjian, residing at 2401 E. Atlantic Blvd. Pompano Beach, Florida 33062, hereby appoint: (name and address of principal) Henry Naldjian, residing at 3001 Thornbury Place, Old Hickory, TN 37138 _as my agent($) (name and address of agent(s)) If you designate more than one agent above and you do not initial the statement below, they must act together. ( } My agents may act SEPARATELY. (c) DESIGNATION OF SUCCESSOR AGENT,): (OPTIONAL) If any agent designated above is unable or unwilling to serve, I appoint as my successor agent(s): Kristina A. Naldiian residing at 625 Chester Avenue San Marino CA 91108 (name(s) and address(es) of successor agent(s)) If you do not initial the statement below, successor agents designated above must act together. ( ) My agents may act SEPARATELY. You may provide for specific succession rules in this section. Insert specific succession provisions here: (d)This POWER OF ATTORNEY shall not be affected by my subsequent incapacity unless I have stated otherwise below, under"Modifications". (e)This POWER OF ATTORNEY does not revoke any Powers of Attorney previously executed by me unless I have stated otherwise below, under"Modifications." Power of Attorney, NY Statutory Short Form Effective June 13,2021 provisions if you ALSO wish your agent(s) to be compensated from your assets for services rendered on your behalf, and you may define"reasonable compensation." (Q) Authority to engage in real estate transactions, including transactions with respect to all fixtures and articles of personality therein; (R) Authority to Enter into Personal Service Contract(s): I authorize my attorneys)-in- fact to enter into a personal service contract(s) or caregiver agreement(s) on my behalf with third parties, including my attorney(s)-in-fact; (_) (S) Authority to Accept Gifts,.Transfers, and Distributions: I authorize my attorneys)-in- fact to accept gifts on my behalf and to-accept transfers and distributions from any Trustee of any Trust on my behalf. (__) (T) Authority to Purchase a Life Estate on Real Property: I authorize my attorney(s)-in- fact to purchase a life estate on my behalf on real property, including the home of the attorneys)-in-fact; (_ ) (U) Authority to Make Loans: I authorize my attorney(s)-in-fact to make a loan(s) on my behalf to third parties, including my attorney(s)-in-fact, and to accept a promissory note(s) as security for said loan(s)at a interest rate no less than the minimum Applicable Federal Rate; M Authority To Purchase Exempt Resources: I authorize my attorney(s)-in-fact to purchase any type of property that is considered to be an exempt resource under New York's Social Service Law, or any equivalent Law in another jurisdiction; (W) Authority to Access and Disclose Medical Information: I authorize my agent(s)to request, receive, and review any information regarding my physical or mental health, including without limitation, medical and hospital records; to execute on my behalf any releases or other documents that may be required in order to obtain this information; and to consent to the disclosure of this information. My agent(s) shall have the power and authority to serve as my personal representative for all purposes of the Health Insurance Portability and Accountability Act and its regulations; I authorize my agent to request, receive and review any confidential information regarding my personal affairs and/or my physical.or mental health and to provide such information to any person and/or entity designated by my agent; (X) Authority to Access Safe Deposit Box: I authorize my attorney(s)-in-fact to have access to any and all safe deposit boxes in my name and to open, inspect, inventory, place items in, or close said safe deposit box or boxes. In the event that the Rey to my safe deposit box cannot be located, I authorized my attorney-in-fact to drill it open; (_) (Y) Authority As To Retirement Benefits: i authorize my'attorney(s)-in-fact to make all necessary decisions and elections, of whatsoever kind and nature, regarding my Social Security benefits and any annuity, pension or other retirement plan(s) or fund(s), or similar types of plans, that I may possess, including, but not limited to, lump sum payouts, installment payouts, roll-overs or contributions; (Z) Authority to Borrow: I authorize my attorneys)-in-fact to borrow funds on my behalf for any reason; (AA) Intent to Retum Home: In the event that I am a patient in a nursing facility or health care facility or of any type, kind or nature, it is and shall continue to be my wish and intent to return home, and such, I authorize my attorneys)-in-fact, orally'or in writing, to express my intent to return home to my personal residence; . Power of Attorney,NY Statutory Short Form Effective June 13,2021 (f) GRANT OF AUTHORITY: To grant your agent some or all of the authority below, either(1) Initial the bracket at each authority you grant, or(2) Write or type the letters for each authority you grant on the blank line at (P), and initial the bracket at (P). If you initial (P), you do not need to initial the other lines. I grant authority to my agent(s) with respect to the following subjects as defined in sections 5-1502A through 5-1502N of the New York General Obligations Law: ( ) (A) real estate transactions; ( ) (B) chattel and goods transactions; ( ) (C) bond, share, and commodity transactions; ( ) (D) banking transactions; ( } (E) business operating transactions; ( ) (F) insurance transactions; ( ) (G) estate transactions; ( ) (H) claims and litigation; ( ) (1) personal and family maintenance. If you grant your agent this authority, it.will allow the agent to make gifts that you customarily have made to individuals, including the agent, and charitable organizations. The total amount of all such gifts in any one calendar year cannot exceed five thousand dollars; ( ) (J) benefits from governmental programs or civil or military service; ( ) (K) financial matters related to health care; records, reports, and statements; ( ) (L) retirement benefit transactions; ( ) (M)tax matters; ( ) (N) all other matters; ( ) (0) full and unqualified authority to my agent(s) to delegate any or all of the foregoing powers to any person or persons whom my agent(s) se ct; (P) EACH of the matters identified by the following letters You need not initial the other lines if you initial line (P). (g) CERTAIN GIFT TRANSACTIONS: (OPTIONAL) In order to authorize your agent to make gifts in excess of an annual total of$5,000 for all gifts described in (1) of the grant of authority section of this document (under personal and family maintenance), and/or to make changes to interest in your property; you must expressly grant that authorization in the Modifications section below. If you wish to authorize your agent to make gifts to himself or herself, you must expressly grant such authorization in the Modifications section below. Granting such authority to your agent gives your agent the authority to take actions which could significantly reduce your property and/or change how your property is distributed at your death. Your choice to grant such authority should be supervised by a lawyer. ( ) I grant my agent authority to make gifts in accordance with the terms and conditions of the Modifications that supplement this statutory Power of Attorney. (h) MODIFICATIONS: (OPTIONAL) In this section, you may make additional provisions, including, but not limited to, language to limit or supplement authority granted to your agent, language to grant your agent the specific authority to make gifts to himself or herself,.and/or language to grant your agent the specific authority to make other gift transactions and/or changes to interests in your property. Your agent is entitled to be reimbursed from your assets for reasonable expenses incurred on your behalf. In this section, you may make additional Power of Attorney,NY Statutory Short Form Effective June 13,2021 STATE OF NEW YORK ss.. COUNTY OF SUFFOLK: On the day of October in the year 2021 before me,the undersigned, personally appeared HENRY NALDJIAN personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument.and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) jaryon the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed rument. Pu Ilc SHARI L.SUGARMAN Notary Public,State of New York No.02SU6336360 Qualified in Suffolk County Commission Expires February 01 Al[I (q)SUCCESSOR AGENT'S SIGNATURE AND ACKNOWLEDGEMENT OF APPOINTMENT: It is not required that the principal and the successor agent(s), if any, sign at the same time, nor that multiple successor,agents sign at the same time. Furthermore, successor agents can not use this Power of Attorney unless the agent(s) designated above is/are unable or unwilling to serve. I/we, Kristina A. Naldiian, have read the foregoing Power of Attorney, I am/we are the person(s) identified therein as successor agent(s) for the principal named therein. In Witness Whereof I have hereunto signed my name on 221. Successor Agent(s) sign(s) here: KRISTINA A. NALDJIAN STATE OF CALIFORNIA ss.. COUNTY OF On the day of in the year 2021 before me, the undersigned, personally appeared KRISTINA A. NALDJIAN, personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. Notary Public Power of Attorney, NY Statutory Short Form Effective June 13,2021 (q) SUCCESSOR AGENT'S SIGNATURE AND ACKNOWLEDGEMENT OF APPOINTMENT: It is not required that the principal and the successor agent(s), if any, sign at the same time,.nor that multiple successor agents sign at.the same time. Furthermore, successor agents can not use this Power of Attorney unless the agent(s) designated above Ware unable or unwilling to serve. I/we, Kristina A. Naldiian, have read the foregoing Power of Attorney, I am/we are the person(s) identified therein as successor agent(s) for the principal named therein. Successor Agent(s) sign(s) here: KRISTI A A. NALDJIAN STATE OF CALIFORNIA ss.. CO OF On the day of in the year 2021 before me, the undersigned, personally appeare RISTINA A. NALDJIAN, personally known to me or proved to me on the basis.of satisfactory evidence to a the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me t t he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on th instrument, the individual(s), or the person upon behalf of which the individuals) acted, executed the itrument. __ Notary Public i All-purpose Acknowledgment California only A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of _r, �i �,� On LE) t 1"Z4 before me, a�"` � ��,C=(here insert name and title of the officer), personally appeared _ t S `L r1-' A `t kn who proved to me on the basis of satisfactory evidence to be the persons)whose name(s)is/are subscribed to the within instrument all tot II I IIII toIII 121lNalil0lliRill Its ;:and acknowledged to me that he/she/they executed the same in his/ GREGORY RAPANOT her/their authorized capacity(ies),and that by his/her/their signature(s) 4 COMM.#2289t99 z on'the instrument the person(s),or the entity upon behalf of which the v, 1° NOTARr PU13UC•CALIFORNIA ST z • LOS ANaELFsCOUNTY o pli�rson(s)acted,executed the instrument. w MyCommissionExpires 05/19/2023 ;1ernnnu4uutotal annIIIIIIBealer I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Notary Seal WITNESS my hand and official seal. Signature t/ . 'Ir®r�aiiit Picrgitsses'C3ati6y _ Description of Attached Document 1 Type or Title of Document &CC1255° Q�6- A ', z-0 S Document DateI OZ-I Number of Pages 1 Signer(s)Other Than Named Above P C. DSG53SOCA(Rev 02.05/17) FO01-OOODSG5350CA-01 Oct 30, 2021 pf SO�r '.� Town Hall Annex Telephone(631)765-1802 54375 Main Road, Fax(631)765-9502 P.O.Box 1179 G�` • O Southold,NY 11971-0959 Q Y BUILDING DEPART ENT TOWN OF SOU HOLD RENTAL PROPERTY ERTIFICATION Form is to be completed by a license architec, licensed engineer or licensed home inspector Separate form is required for ch individu Rentalawelling Unit Pro essfonal seal re aired for Architect or n i_neer.licens d "sIP2 ormus` ovide copy,of valid current certification Rental Property SCT Number: Rental Property Addres 550 Fanni Rd. New Suf fNk NY 119 6 ' tY Owner/Name: Mary Naild'ian Rental Dwelling Unit Identifie 1 Number & Square footage of eac 'edroom as depicted in the attached floor plan. (i.e. Bedroom #1 -100 sq., Bedr,-om 90 sq., etc.) Be oom #3 110 sqf Bedroom #2 fi 30 s ft Property Description (Inclu a all improvements indicated on survey) single I certify that I have don a physi al inspection of the subject rental dwelling unit and find that it fully complies with all t pro -ions of the Code of the Town of Southold, the Residential Code of New York State,the uil ing Code of New York State,the Plumbing Code of New York State, the Fuel Gas Code of N York State, and the Energy Conservation Construction Code of New York State. Victor Cornelius III CEO Inspector Print Name and Title ceo# 1216-0283 Or nal Signa re Please place professional seal: t k Smarter energy decisions 888.838.4638 Sign In Get Competing Solar Quotes Online How It Works Research Solar Solar Calculator Community Solar Energy Upgrades Your zip code j <SOLAR NEWS _ r Solar pool heaters: what you need to know Reading Time:5 minutes While pool owners are fortunate to have a place to cool down during hot,sticky weather,it's not without its pain points:in an effort to keep pools comfortable and open for as long as possible,pool owners may spend a good amount of money towards heating the water to swimmable temperatures.If you have a pool and pay a lot to keep it warm,you should consider renewable energy options for heating.While you can rely on warm weather to passively heat your pool,solar pool heaters are a good option to consider if you want to save money while extending pool season. Find out what solar panels cost in your area in 2022 Enter your zip code Save u- 5-digit zip code Q a solar p Register n 100%free to use,100%online compari QAccess the lowest solar prices from Installers near you QUnbiased energy advisors ready to help Enter yo What are solar pool heaters?How do they work? A solar pool heater uses thermal energy from the sun to warm your pool water.Similar to solar photovoltaic(PV)panels,solar energy collectors are typically mounted on your roof.Water from your pool is pumped through a filter and up to the solar collectors on your roof to the collectors.These solar collectors look similar to PV panels but include tubes throughout the inside so that pool water can circulate in the collector and absorb heat. What's more,you can save money with a solar pool heater!Heating a pool with solar energy is eco-friendly and helps save you money because you'll be relying on free energy from the sun instead of purchasing the fuel you would otherwise use to heat your pool.The amount you'll save transitioning to a solar pool heater will depend on the existing source of heat for your pool,the efficiency of your system,the upfront cost,and more. Many solar pool heaters also include flow control valves and automated sensors.These components will detect the temperature of the water coming from the solar collectors compared to the desired temperature.If the pool water is cool and it's sunny out,the flow control valve diverts water through the solar collectors to be heated and enter your pool.Alternatively,if your pool is too hot,the control valves ensure that additional hot water doesn't enter your pool. Solar pool heater installation and operating costs According to the Department of Energy,solar pool heaters typically cost between$3,000 to$4.000 install on your roof.Your payback period for this investment depends on how much you would otherwise spend on fuel to heat your pool and how expensive this energy resource is in your area.Most homeowners investing in solar pool heaters will break even on their investment in less than seven years. The upfront investment of the system is the largest cost associated with this technology—operating and maintenance costs are relatively low. Properly installed,high-quality solar pool heaters should operate efficiently for 10 to 20 years. How many solar collectors do you need to heat your pool? The size of your solar pool heater will depend on a number of factors,including the size of your swimming pool,the desired temperature for your pool, and how much sunshine the collectors will receive(dependent on your geography,tilt of the collectors,possible shading factors,etc.)You can install as many solar collectors on your roof as can fit,but if your roof is covered in shade for most of the day,the solar collectors won't meet your pool heating needs. As a general rule of thumb,the surface areas of your solar collector(s)should be 50 to 100 percent of the surface area of your pool.This means that if you have a 10 by 20 feet pool(200 square feet total surface area),your solar collector surface area should be between 100 and 200 square feet.If you live in a climate where you're using your pool for the majority of the year,you may consider sizing the system on the higher percentage end versus if you live in an area where you only swim in the pool for a few summer months. Any qualified contractor offering solar pool heaters will be able to properly size your system given the specifics of your pool and the location of the collector system.If you live in a climate with a lot of cloudy days or experience some shading on your roof where the solar collectors might go,your contractor may suggest keeping an electric backup system. Buying a solar pool heater:what are your options? Most"solar pool heaters"you'll find online are actually just the panels,which can be hooked up to most standard pool pumps.If you plan on installing your solar collectors on your roof,its definitely a good idea to consult a solar installation company or roofing professional to get the job done correctly and safely. What solar pool heating products are available?There are many companies that sell solar pool heaters,so we've compiled a list of some of the popular options online in the below table for comparison: Best solar pool heaters for si Save u• PRODUCT PRICE solar p Fafco Solar Bear Economy Heating System $230 Register SmartPool S601 Pool Solar Heater $289 compari SolarPoolSupply Industrial Grade DIY Solar Pool Heating System $2,240 Other types of solar gadgets for your pool You don't have to install an entire solar pool heater to benefit from solar power.Here are some other solar-powered gadgets that you can use come pool time: Solar pool pumps You can use solar energy to power the motor in your pool's pump,which is the component responsible for pushing water through a filter and returning it to the pool.There are a number of ways you can do this including powering your existing electric pump with a solar PV system,purchasing and installing a DIY solar pool pump kit,or using a stand-alone solar pool pump that floats directly in your pool and requires no installation. Solar pool covers If you're looking for a lower-cost solution to heat your pool,one purchase you may want to make is a solar pool cover.Solar pool covers are more translucent than standard pool covers which enables sunshine to warm up your pool while keeping the water clean from debris.Covering your pool, with a solar cover or traditional one,will also help trap the heat and prevent evaporation. Solar Sun Rings Similar to solar pool covers,Solar Sun Rings float on the surface of your pool and absorb solar energy to heat the water below.These rings are also useful to prevent evaporation.One of the biggest differences between Solar Sun Rings and pool covers is the shape;Solar Sun Rings are smaller and circular,and you'll likely want multiple of them to cover the surface of your pool.Because they are smaller,they're easier to remove and can be better suited for uniquely-shaped pools that may not have a perfect shape for a more standard solar pool cover. Floating solar lights If you're looking to light up your pool at night,consider solar floating lights as a solution.Many companies produce colored lights that will absorb solar energy during the day as they float on the surface of the pool and then use that energy come night time to provide lighting. Installing solar PV with solar pool heaters If you have a sunny roof and are looking to save the maximum amount of money on your utility bills,consider pairing a solar pool heater with a solar PV system.This is a feasible option for property owners who have a sufficient amount of roof space to fit both solar PV panels and solar thermal collectors on their roof.Alternatively,if you have a limited amount of roof space,you can install a solar PV system to cover the electricity needs of your electric pool heater and other home appliances with solar power, By signing up on on the EnergySage Marketplace,you can receive multiple quotes from pre-screened installers to compare costs and savings estimates for installing a solar PV system.If you're interested in also exploring your solar pool heating options,simply note it in your account—many PV installers also install solar pool heaters(or can recommend a reputable company to do so). 0, Find out what solar panels cost in your O f $10,800 area in 2022 O CD Enter your zip code O 5-digit zip code e $15,200 O See o a es Save u• More reading on EnergySage solar p Solar heating systems explained Register How is solar energy used?The 5 most common examples... compari Saving Energy with EnergySage,part 6:Heating&Cooling Why is my gas bill so high? Pros and cons of electric water heaters Posted on OCTOBER 27,2020[HTTPS://NEWS.ENERGYSAGE.COM/SOLILR-POOL-HEATERS-WHAT-YOU-NEED-TO-KNOW/I by KERRY THOURBORON. Categories:HEATING AND COOLING Tags:SOLAR HOT WATER,SOLAR TECH,SOLAR THERMAL About Kerry Thoubboron Kerry has worked in solar for more than 6 years,starting her career as an Energy Advisor dedicated to helping customers compare their options and make well-informed solar decisions.She graduated from Boston University with a degree in Environmental Analysis and Policy.Outside of work,you can find Kerry snowboarding,watching The Office,or having passionate debates about which New England state is best(spoiler.it's Vermont). l FORM xo. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.&4683. . . . . . . Date . . . . . . . . . . . . ..jhM. . 27. . . . .. 19.72. THIS CERTIFIES that the building located at .5/9 .yid. Read. . . . . . . . Street Map No. . .1X . . . . . . . Block No. . . .XZ. . . . .Lot No. .g . . .11dr .9aff.al. . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . .Doe. . d . . . . .. 19.0 . pursuant to which Building Permit No. y668Z . . dated . . . . . . . . . . Dae. . . 5. . . ., 19.74., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . P*Jxate •ease lax ly•Air*ll#rid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to Virgltau. spesatv • . • • • • •pnag • • • . . . . . . . . . . . . . . . . . . • • (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .,;Vna . .13- 4972. by•Rw YLU. a UNDERWRITERS CERTIFICATE No. . .1. 2473& . . . . . . . . . . . . . . . . . . . . . . . . • . • . . • • • • . • . HOUSE NUMBER. . 550 . . . . . . .Street. . . . .Fa=ing' toad. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . x.56$2. . . . . Date . . . . . . . . . . . .neC. . .b. . . . . . . . ., 19.73 THIS CERTIFIES that the building located at . . FA=1Ag .IRoAd. . . . . . . . . . . Street Map No. . .X. . . . . . . . Block No. . ?X. . . . . .Lot No. xxx . .New Suffolk N.Y• conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . .Oct . .6, . . . . ., 19. .7.? pursuant to which Building Permit No. . .69684 dated . . . . . . . . . . !0�G t 6 ., 19.??., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is I'rivat® (Accessory) storage buil The certificate is issued toSalvator Sposato Owner (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . N'R... . . . . . . . . . . . . . . . . . . . . . . . . . . 450 HOUSE NUMBER . . . . . . . . . . . . . . Street . . . . A':arining Road . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector 1 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z11237. . . . . . . . . . Date . .October.6. . . . . . . . . . . . . . . . . . . . .. 1982. THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' Location of Property 550 Fanning.Road# .New.Suffolk House No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Street �ldamfet County Tax Map No. 1000 Section . .117. . . . . . .Block . .6. . . . . . . . . . . .Lot .3. . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . i conforms substantially to the Application for Building Permit heretofore filed in this office dated Mayr .19 . . . . . . . . . . . . . . . 19 .78. pursuant to which Building Permit No. 97702, . . . . . . . . . . . . . . dated .surae •9 • . . . . . . . . . . . . . . . . . . . . 19 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 . . . . . . . . . . ., . ,, . .$wa �ng.Roo�.and.fenca. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .Jack.eta ld j iaU. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner%ssee or�tenantl of the aforesaid building. Suffolk County Department of Health Approval . .Nl,&. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE N0. .4389929 . . . . . . . . . . Building Inspector Rev.1/81