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HomeMy WebLinkAbout22153-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCCUPANCY No Z-23964 Date OCTOBER 18, 1995 THIS CERTIFIES that the building ADDITIONS Location of Propert~ 575 HEA~HWOOD ROAD MATTITUCK NY House No. Street Hamlet County Tax Map NO. 1000 Section 116 Block 4 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 27, 1994 pursuant to which Building Permit NO. 22153-Z dated JUNE 27, 1994 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 A FOUNDATION AND A DECK ADDITION TO A ONE FAMILY DWELLING ~S ~PLIED FOR. The certificate is issued to SA~A ELIZABETH BARBETTA of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED (owner) N/A N/A ~/A /~ding Inspector Rev. 1/81 FORM NO.3 TOWN OF BOUTHOLD BUILDING DEPARTMENI' TOWN HALL SOUTHOLD, N.Y. NO- 22153 Z BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Counh/TaxMapNo. lO00 Section ...... ..~..~....~.. ........ Block ........ ..~....~.~. ....... LotNo....~....~.. ............... pursuant to application dated ....................... -- ~.~.. .................... 19.....?...~....., and approved by,he Building Inspector. ~ee ~...../.~..'. ......... Form No. 6 BUILDING DEPARTMENT I'~] ~'~ ~ .......... ':, OCT I 6 995 765-t802 '. APPLICATIO~ FOR CERTIFICATE OF OCCUPANCY This applfcation must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: l. Final survey of property with accurate location of all. buildings, property lin~, 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 ]ess than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 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 hy 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 Occspancy on Pre-existing Buildin~ - $]00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5, Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...... New Construction ........... Old Or Pre-existing BuildJ~ng ................. ..... Location of Property ........ ~.. .......... ~L...C~.. ....... ~ ............ ~mlet House No. Street Onwer or Owners of Property..~L~.~.~.~..7...~..,~..~r~.~,. County Tax Map No i000, Section .... t~-~ ...... Block-..O..~ .......... Lot..!.l...¢.e~....OY..~.~.. Subdivision .................................... Filed Map ............ Lot .................... .,Date Of Permit .~.,~/ Applicant.,~)~.-~¢~. Permit No,,,~.~,~,~,,,~, - ..... /' .................. '''1 ' ' Health Dept. Approval .......................... Underwriters Approval .......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.....~... .... Fee Submitted: $ ............................ .... .................. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD October 4, 1995 Diane Herold P.O. Box 884 Westhampton, NY 11978 Re: Prem: Henry & Mary Raynor - SCTM#1000-116-4-21 575 Beachwood Road, Cutchogue 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) No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22153-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUNDATION (]~t) FOUI4DATIO;.I ( 2nd ) 2. ROUGH FRAME &. .PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FI;iAL ADDITIO~IA'L CO.~.~;E~.$TS: DIANE HEROLD, ARCHITECT P.O. Box 884 Westhampton Beach, New York September 10, 1995 11978 Mr. Gary Fish Town of Southold Building Department Town Hall Southold, New York 11971 RE: building permit 221532 dated 6/27/94 Barbetta (Raynor) 575 Beachwood Road, tax map 1000-116-04-21 Cutchogue Dear Mr. Fish: Mrs. Raynor asked me to inspect the above property for purposes of helping her obtain a Certificate of Occupancy on her building permit. The following conditions exist: 1. The concrete footing is 12" high and 32" wide, acting as a grade beam under the foundation walls. 2. The foundation walls are 6 courses of 8" concrete block with a solid 4" concrete block on top 3. A 4" concrete slab ties the footings and foundation walls together for additional strength. 4. Openings in the foundation walls conform to FEMA regulations. 5. On the north and east sides of the house, the finish grade is 3 feet or more above the bottom of the footing. 6. On the south and west sides of the house, the finish grade is at the top of the footing. This means the bottom of the footing is 12" below the adjacent grade. When the work was performed, it was the intent to raise the gra~e on the south and west sloes to the elevation of the grade on the east and north sides. Only after the work was finished that it was realized that special condition ~5 of NYSDEC permit 1-4738-00511/00002-0 dated May 31, 1994, stated "No fill must be brought to the site. There must be no disturbance to dune or beach grass vegetation." For this reason, the grades were left as existing. RRYNOR-SUTER HARDWARE INC. 3E~ LOVE LANE HATTITUCK~ N.Y 119S2 PHONE FAX ANY OF THE ABOVE INFORMATION. NOT CLEAR, P:LERSE CALL AT ONCE. Mr. Gary Fish September 10, page two I995 Because the concrete footing and concrete slab throughout the crawl space greatly exceed the requirements of the building code, I have no reservation is stating that this foundation complies with the intent of the code. If 2 feet of fill were to be placed against the west and south walls of the foundation, it would not increase the safety or strength of the foundation. Therefore, I request that a Certificate of Occupancy be granted. Sincerely, Diane Herold enc. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTIIOLD, N.Y. 11971 TEL.: 765-1802 Exan,i,,ed ..- .~/~'~'"f2 .... ,19 ~.2Z; Appro,'cd ............. , 19?¢Permit No...~..)-./..5-.3. ~ Disapl,rovcd a/c ..................................... BOARD OF HE&E. TH ......... 3 BETS OF SURVEY ................... CIIECK .................... SEPTIC. FORtl .............. . (B. Jffildi~g Inspector) . APPLICATION FOR BUILDING PERMIT Date . .'4 .U.~..E...-/ ......... 19~'~. INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing locatiou or 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 apph- cation. c. The work covered by tbis 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 ;hall lie kept on the premises available for iuspection 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 q~all bare been granted by the Building Inspector. APPLICATION IS IIEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Soutbold, 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. I he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized iuspectots on premises and in building for necessary inspections..., (Signature of applicant, or name, if a corporation) *..o...'~cr4..8.~tq,..w, .~>. T~.~.~. ~,-&~.. earO.c?t.. N.Y...I. LqTB... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Hame of owner of premises . . .B.~...t).~..'f..~.L'~¢....~. t~.~.'rt...t'3-.~.Y.O.o.g....E..'7..8.1-.. ................................ (as on the tax roll or latest deed) If applicant is a corporation, signalure of duly authorized officer. (Na~ne aud title of corporate officer) Bt drier s License No. .~xS.q..~.~,. ,,tt~-t~.u..e.~o-t'~. PI ]Tuht'r S License No. F cci ]c an s l.icense No ....................... Olher Trade's License No ...................... LoeaJj.,~.~..~land on which proposed work will be'done ................................................. .......~.,,~. .~eo,e,~ .u.,,~p~....~c~t:~ ...(.e.g~.u.~.~..~p..m~.) ...... O~ .b'T.cffp.6..u.u!(--. ........................... Ilouse Number Street Hamlet County Tax Map No. 100t') Sectiou .... I.I (-e ........... Block .... O~ ........... Lot ....~'.[ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) Slate existing use and occupaucy of premises and intended use and occupancy of proposed construction: a. Existing usc and occupancy ..... $.tt0.~../,~. ? ~..~..m.sl,'t....'x~>~..O....t-! .~.6,..-r?..c=?~... ~..w~...~.&..g.~.6.~ ................. b. Intended use and occupancy .... .~..I.~c..~. ~ p&.m.L.~...~..u.,40, c,, . . .'~..ec.~.. ,,& .~'D¢= ,Gl~-0,6ff-, ............. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ........ Repair qr.. ~7/.o~.,¥. Removal .............. Demolition ..... ' ......... Other Work ............. (DfscrJption) 4. Estimated Cost . J . 10.o0.~.. ........................... Fee ..................................... (to be paid on filing this applicatmn) 5. If dwelling, nmnber of dwelling units .... 0t4~: ....... Number of dwelling milts on each floor....&~. ......... . lfgarage, numbcro£cats ...lIJ~. 6. If husiness, commercial or mixed occ,pancy, specify nature and extent of each fy, pc of use . .,~& ...... 7. Dimensions of existing structures, irany: Front.. ..... Rear ...~(~.'1 .q,".... Depth .~.'t.'i~':'i i i i i. ! te Jg}l t ............... Nnm bet o f Stories...O Or= .................................................. Dimensions of same structure with alterations or additions: Front . ..44~ ............. Rear .................. Depth ...................... lleigi~t .................... '.. Number of Stories ............ '...~ ....... 8. Dimensions of entire newconstmction: Front ... ~ ......... Rear ............... Depth ............... Height ............... Nmnber of Stories ........................................................ 9. S~ze of lot: Front ...... ~ .............. Rear ... ~Y,.~ .............. Depth . .1~.~. t".~Y ............ 10. DateofPurcbase ..lolff~...t'r(,~. ................. Name of Former Owner .............................. 1 I. Zone or nse district in which premises are situated ..... '~ :.4~t.O ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .,:u'o ............................ 13. Will lot be regraded ........ ' ..... A, ulv ............ Will excess fill be removed from premises: Yes (~ 14. Name of Owner of premises .gF.,j,~..y . g~,~O0~, ....... Address ~J.~.Lt~.t.a~ ,,~'O'(~.t4/. l%one No..g.~.~... fi. ff. ?,e~ ..... Name of Architect 7~..lP;~....RK-4.~&'~. ........... Address ~ O.By. ~t.~.. Phone No. g~.~. $~.~..;,.. Name of Contractor .,~ .a~..s..~..O~.s..O,t~ .e~ .t~. ......Address .I~$,.o.~...~.t.~g...IITt.<... Phone No. S~,J.-.6,¥ttO ...... ~ 15. Is this property within 300 feet of a tidal wetland? *Yes. o..X... No ......... *If yes, Southold Town Trustees Permit may be required.- &'tr~c4q~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether e~isting 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. . I',VI E f)F NEW YORK, S.S ()UNI'Y OF.. ,.~,OlS.~>/-R, ..... ........ TD.I.I~LI.e-.... }4.&RD .b.'~. .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) is the .................... &C_?.~%.. ~..Cz-o .t,~."%:.. .............................................. (Coutractor, agent, corporate officer, etc.) said owner or owners, and is drily anthorized to perform or have perfo.ned the said work and to m~e and file this ,plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the otk will be performed iu the manner set forth in the application filed therewith. xorn to before me this ~ta~, Public, ~ 0 ~OL ~ Connty · ..........................., . (Signature of applicant) 4957775, New York State DepaHment of Environmental Conse~lon Bulldlng40--gUN~ gtony Brook, New York1179~23~ Telephone (516) 444-0365 Facsimile (516) 444-0373 May 31, 1994 Thomae O. Jorllng CommlellOner Mary an~ Henry Raynor 320 Love Lane Mattituck, NY 11952 RE= 1-4738-00511/00002-0 Dear Permittees: In conformance with the requiruents of the State Uniform Procedures Act (Article ?0, ECL) &nd l~a impleme~ing regulations (6NYCRR, Part 621) we are encloei~g your 9e~'1~'.'. Please read all conditions carefully. If you are un&ble tO Om~ply with any conditions, pleaae, oontaot ua &t ~l%e above add, eel. Also enoloaed is a permit sign which ia':to be conepiououaty posted at the project site and proteoted £roat the weather. Very truly yOUrS, Marilyn~B, Paterson · nv~ronment&l Analyet I MEPtcg enclosure NETW YMIK ITATI: OEPNITI4~NT Of ENVIROIMENTAL CONJERVATIOil DEC pERHIT IILiI4BER I- ~T38-0051 l/OO00:P-O FAC I L I TY/PROGRA/4 #eMBER(S) u Under the EnYIronmhtll C~r~4nMt I ~ L~ I~XPII~TZONDATE(S) D Nodificetl~n D Per. It to Conltruet ~ Permit to Ol~rete J 1YPE OF PERHIT I Ne. D RinMwl Art cie 15, Title Sz Protection O &NyCRR 608: Veter OuaLIty Q Article 27, Title TI MYCIIR 3601 Article 15, Title 15= Vater O Article IT, Tlttfl 7, 8c ~ES O Article 2?, Title 91 ~ty HaZI~ WltiMWt Article 15, Tltte 15~ Vater C~trot ~ Article ~s C~ltit Er~lm Tr~rt N~g~t 0 Arttc&e ~, Title 2Ts NI~ L~ Artlctl 16, Title 15~ L~ R~t~tl~ G ArtlcLe~t Ft~tiln Article 1S, Title itl Vlld, ~ Artlctfl 1, 3, 17, 1~, ~T, and licr#tl~nil Ilvlrl I Article 2~I Tidal Uettinda MIYCRR $801Ridlltlofl ~ontrol COUNTT I TM IIMSIICOURIE IIYTN coOIIINMII Suffolk . . · I IJUthotd II~lt Q~O:IIPI'ICN ~ ~1~1:11~l:r] )C~IVI~I' . .. IIIll exlitlfll dgelilr4 $~ In iievlttas. Conltruet nM4 eoheFeti block fmJndatlm kith ne, poitt ~cllr de~k Ir#o AIl uerk Ihitt bi In leeoh~i~t ulth the attached NT~EC By aeoN)lance of thle pir~it, the pemltt# egre~ that the ~lt 18 ~ti~t ~ itrlet ~ll~e ,lth the ECL. ill ~tll~lJ ~litl~. t~ ~ril Mltl~ wtflM (M~a) ~lli ~ltl~ I~L~M ~rt of thll ~lt. r ~ 03~ITIO~ I n~ pect i one 1. The permitted site or facility, including relevant records, is subject to In- spection at reasonable hours and Intervals by an autherized representative of the Deperbient of Envirc~,untal Conservation (the Deparln*ent) to determine v~ether the permittee is cu,plying with this permit and the B~I.. Such represen- tat ive rmy order the work suspended pursuant to EEL 71-0301 and S~PA 401(3). A~ copy of this permit, Including all referenced rTeps, draNings and special conditions, mJst be available for' inspection by the Deper~iu,~t at all tlrms at the project Site. Fei lure to produce a copy of the perm, t upon request by ~1 Deparbient representative is a violation of this permit. Pe~nit Changes and R~rm~la 2. The Depar~ient reserves the right torrodify, suspend or revoke this permit v~en: e) the 8c0pe of the permitted activity is exceeded or a violation of any condlt Ion of the permit or provisions of the ECL and pertinent regula, tlor~ Is found: b) the pen~lt ms obtained by misrepresentation or failure to disclose relevant facts; c) neNrmterlal Info,,atlon Is discovered; or d) envlro, Yentel conditions, relevant technology, or applicable le~v or regu.latlon have material ly changed since the permit was issued. 3. The i~trnltt~t ~uat subnlt a separate written application to t~ re~l~ ~lflcatl~ or tra~fe~ of this ~lt. a~ {o~, fees or s~l~tal Info~tl~ re~l, ~lflcatl~ or transfe~ grant~ I 4. ~ ~ltt~ ~st s~,,~t s re~l ~ll~tl~ at I~st: a) 1~ d~a ~fore ~plrati~ of ~lts for'State ~llutant Dlac~r~ ' EIIml~tl~ '~st~. (~), ~zar~s ~te ~nt ~cllltlea {~), ~Jor Air ~ilutl~ ~trol (~) FaCilities {~)~ a~ b) ~ dws ~fore ~lreti~ of all ot~r ~lt t~s. 5. U~Iess expressly provided for by the Deper~unt, Issuance of this pen~lt'does not _rmdlfy, supersede or. rescind any order or determination pervlously"issuad by the I~lpllrln~t or ~ of the ta~*~,~, conditions or requlremnts co~teinad Ifi"~such order of datanmlnatlon. ' · ' ' I~S or Interfere ~th t~ rl~rl~ ~i~t~.of'~t~rs )n order 'to ~'rfO~:"t~' Iptere~t. In teal or ~rs~l pr~rt~"~ldot ~t~ In a ~t~ ~t' e'~rty~to eaa~ts ~ rl~ts of~ t~t ~ ~ r~lr~ for;'thls proj~t, 2 ,, ADDII'IONAI- GENeRAl. CONDITIONS FOR ARTICLES 15 (Tills 5), 24, 25, 34 and 6 NYCRI~ Part 60g f "~[dg]. Wetland waters or flood flow~ or enclanRer the health. ~afpt¥ or we[fare oF rnn~lificatinn of the watercourse hereby authorized shall not be com- pieced, the owner~, shall, without expense fo the State, and to such Conservation may require, removi~ all or any portton of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against 10 That the State of New York shall in no case be liable for any damage or in~ut~ to the structure or work herein auth~ottzed which may be caused by or result from futdre operatlon~ u~dedaken by the State for the no claim or rillht to compensation shall accrue From any such damage 11 Granting of this permit does not reheve the applicant of the responsi- bility of obtaining any other' permission, consent or approval from the U S ArmyCorp$ of'Engineers, U $ Coast Guard. New York 5tats 'Office of General Services or local government which may be required. 16. If granted under 6 NYCRR Part 608, the NYS Departrneflt of En~lt'on- 3/96,- SPECIAL CONDITIONS Any debris or excess aater~al froa construction of this pro~eot Shall be ooaplete~y FavOred £rOa ~he. adjacent area (upland) and r~oved 20 an approved 'upl~a:area ~matmr ~an S0 linoa~ feet. dis~nt ~r~e'~tidal :.vetiand ~,.~:' ' a minimum' of $0~ ' :' Root runo£f shall be direotld:,.tc ~_~vellS recharge ": ~' ' Page ~ of A _. A: .$U~PLEM~-NT]%RY SPECIAL CONDITIONS The Following Conditions Apply To Ail TIDAL W~-TLANDS; FRESHWATER WETLANDS; COASTAL EROSION Fu%NAGEMENT; and WILD, SCENIC, and RECREATIONAL RIVERS PERMITS: A copy of this permit, including all conditions and approved plans, shall be evailahle at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in · conspicuous location at the work site until all authorized worm has been completed. The permittee shall recl~ira that any contractor, proJec~ engineer, o~ other person responsible for the overall supervision of this project reads, understands, and complies with thiB permit and all its general, special, and supplementary special conditions. Any failure to comply precismly with ell cf the terms and conditions of this. permit, unl%se authorized in writing, shall be treated as a violation of the Environmental. Conservation Law. If any of the pe~it conditions are unclear, the permittae shall contact the Division of RegUlatory Affairs at the address on page one or telephone (516) 444-0365. If project design modifications 'become necessary after permit issuance, the perm~ttee shall submit the appropriate plan changes for approval by the Regional Adminie~ator prior to undertaking any eu~h~modifications.'. The pez~ittee is &~vised that substantial m~ification may At l&aet 48 hours prior to pez~2~e and e~nt~l~or.lhall-;iig~'and TRUSTEES John M. Bredemeyer, II1. President Albert J. Krupski, Jr., Vice President Henry P. Smith John B. Tuthill William G. Albertson Telephone (516) 765-1892 Fan: (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L~ HARRIS 'Ibwn Hall 53095 Main Road EO. Box 1179 Southold, New York 11971 August 2, 1993 Diane Herold P.o. Box 884 Westharflpton Beach, NY 11978 RE= Henry ~ Mary Raynor SCTM %1000-116-4-21 Dear Ms. Herold: The following action was taken by the Southold Town Board of Trustees at the regular meeting on July 29, 1993t RRSOLVRD that the Southold Town Board of Trustees grants a waiver to elevate an existing house screeded porch and wood deck in same loc&tics to elevation S of flood plan m&p A-4. If you have any questions, please do not hesitate to contact this office. Very truly yours, ee't ant, oa d'o£ Trustees HENRY E. RAYNOR 320 LOVE LANE MATTITUCK, N.Y. 1t95~ 516-298-84:~0 516-~98-~127 FAX TO WHOM IT MAY CONCERN~ JULY 20, 1993 THIS IS TO CERTIFY THAT DIANE HEROLD, OF WESTHAMPTON BEACH N.Yo IS OUR .AUTHORIZED AGENT FOR PERMIT PROCESSING IN RAISING OUR HOME ON PECONIC BAY~ CUTCHGSUE N.Y. ANY QUESTION8 CONCERNING THIS ~HOULD BE ADDRESSED TO THE ABOVE. THANK YOU. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY , _--5/./-- · REMARKS: ,~~~ [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] ROUGHPLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ --']'~INAL [ ] FIREPLACE & CHIMNEY THE NEW YORK BOARD OF FIRE UNDERWRITERS lt~O0 {43 BUREAU OF ELECTRICITY ~1 85 JOHN STREET, NEW YORK. NEW YOR~ ~0~38,. Dare AIIGHST fi9, ] 99 [ Application No. onfile THIS CE~IFIES THAT "X'~ I T i "XTURE5 I ~NG~5 IC~KI~K51 OVENS I~s" WASHERSI EXHAUST FANS MATTITT]~, NY, ]1952 t ~ " Per 1 ~s ~ ~ ~t ~ oh~ in any ma~er; rmurn to the off~e of ~ ~rd if incorr~. Ins~ors ~y ~ i~nfifi~ by t~Jr cmdKtials.,~ ~UL 17 '95 13:14 P.1 I:tNY OF THE ~EIOVE INFORPtI:ITION NOT CI. EGIR~ I;~LEi:tSE C~I-L lCIT ONCE.