HomeMy WebLinkAbout21956-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23554 Date MARCH 16, 1995
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 1075 INLET LANE GREENPORT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 36 Block 2 Lot 21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 17, 1994 pursuant to which
Building Permit No. 21956-Z dated MARCH 23, 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 FRONT DECK ADDITION & ALTERATION TO EXISTING ONE FAMILY
DWELLING.
The certificate is issued to MARIA GRZESIK
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL INSPECTION CERT. #7139 - FEBRUARY 9, 1995
PLUMBERS CERTIFICATION DATED FEB. 28, 1995-JOHN W. REICHERT
Building Insp or
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)
Date 19...
3
N2 21956 Z
Permission Is hereby granted to:
%...Pik
.....s
VV
to .......5~ 4.~-1.,.......././.,.......
c `...../~......i, s...... r? ....~J .s ........1 /
ff!>lh,..,., n~sr/. ~r .....l G~/
~%G~.... ..fe..:.....................................................................................
I K.........................................................................
at premises located at
County Tax Map No. 1000 Section C Block ......q.... Lot No. :
pursuant to application dated 19....(.,T......, and approved by the
Building Inspector.
Fee 37-
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the 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 2110 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.
3. 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.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residenti $ 5.00•, Commercial $15.00
Date
....~...1~.~1
qew Construction.......... Or Pre-e isting Bu ldin,S / '
vocation of Property ............./.v . , . . ' K. `/J/7V ~
House No. Street y r / Hamlet
)nwer or Owners of Property...../.....h„, /
;ounty Tax Map No 1000, Section...3(........ Block. . ........Lot...............
subdivision....'..... ..............................Filed ~Ma/p...........L
'ermit No Q.~././. to Of Permit. 9 g /..Applicant..1.~•
lealth Dept. Approval ..........................Underwriters Approval.........................
Manning Board Approval
tequest for: Temporary Certificate.......... Final Certicate.. .
See Submitted: k
APPLICANT
FF04
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK y x P.O. Box 1179
v- Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER
Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE
SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON APRIL 4, 1995:
RESOLVED that the Town Board of the Town of Southold hereby authorizes
a refund of $299.40 to Maria Grzesik, which sum represents the fee for a
building permit ($374.40) to construct an addition and alteration to her
dwelling, less an amended fee ($75.00) for less construction work.
JG~ Tom" Te~
Southold Town Cler
April 5, 1995
~~O~~SpfFO(k~OG~
Town Hall, 53095 Main Road co x Fax (516) 765-1823
P. O. Box 1179 0 Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
TO: Judith Terry, Town Clerk
FROM: Thomas J. Fisher, Sr. Building Inspector
DATE: March 24, 1995
RE: Maria Grzesik - Building Permit #21956-Z
Mrs. Grzesik decided not to construct the addition &
alteration to her dwelling that was applied for under the above
building permit, and amended the plans in June 1994 to do less
construction work. (See attached letter from Mrs. Grzesik dated
November 7, 1994.)
The original building permit fee was $374.40, and the
amended fee was $75.00. She is requesting a refund of 5299.40.
This request is to the Town Board.
TJF:gar
(attachement)
~1.~,-rte
-n-T-
E I~ f~ 1ui%~~'
~`t,~,v~, ; . ~ r~z~+
j a
/.ice-P~ ~ _ -
~ -
/ g ~
i
i
n
i ~
5
V ~ V~ 9
71 1 OOP-
i
aG y ~ ° )
~ tronA ~ m H ti b ~ 71 )
013
41,
fn m d O N
c° a o m C7 m J 1
~O ti °
n yzOz I Pi' `H
y x' Z H
W I n W Ulf
tv m cn rn a r m m m
oo Z o X w A tri
( mtv ccn C7 H O N Q~a
a n Z d r )
<O A H M
r o
rz LEI
zzob
Ha z a trl9~
[a"' n N n Cntl G ~
z o)
Atrlm~
01 11
n
m _ m
N
n )
o Cr
~ o )
C °
~4T"`~z?d,U.-`yi^„-""'"?'T:'atnt^~'~ri ~.,yf ~ ~ n ~ ° )
h7O ,D' txn X9-7 ~ Q v
d ~ ~ ~j C7
y °z o
cn
c° d x m fi o
0
a r
Town Hall, 53095 Main Road Fax (516) 765-1823
P. O. Box 1179 , - ;y Telephone (516) 765-1802
Southold, New York 11971
yj;
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE:
Building Permit No. ~T5
Owner: 1142!.4 G12~e~~,~L- MAR~3
lease rintk'
Plumber:
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
W~
( lumber Signature)
Sworn to before me this
day of 19 o'S
Notary Public, County
PAULA.
Notary Public, tata o1 Newyork
No. 5581910
Commission Expires June 30, yfo
oS~FFOLK~OGy
VICTOR LESSARD :C Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR = P.O. Box 1 179
(516) 765-1802 N Southold, New York 11971
FAX (516) 765-1823
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 6, 1995
Ms. Maria Grzesik
P.O. Box 485
Greenport, NY 11944
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 # 21956-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
~O~QgUFFOL~~oGy
o ~
Town Hall, 53095 Main Road °y Z Fax (516) 765-1823
P. O. Box 1179 • Telephone (516) 765-1802
Southold, New York 11971 y~ol ~a0!
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 30, 1994
Ms. Maria Grzesik
P.O. Box 485
Greenport, NY 11944
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.
The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 21956-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INS TION
[ ] FRAMING [ FINAL
REMARKS:
1
DATE 12Z?4W INSPECTO
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROU LBG.
[ ] F DATION 2ND INSULATION
FRAMING [ ] FINAL
REMARKS:
r
DATE INSPECTOR
cocrMCl,r~
m
. a~
_ _ ti
7OUI7DATION (1st)
cc
FOUI4DATIOF_1 (pad) _ v~
m1
2. ® r/f+es~.
• ~ z~
00
ROUGH FRAME & ~ ~j
.PLUMBING
ti
3. H
m
INSULATION PER N. Y. m
„ H
STATE ENERGY
CODE 11~
aC
4.
FINAL
o~
ADDITION L COMMENTS:
X
H
9
H 'V
O
r ?
r
~ H
BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NOTIFY 'S
CALL A. L/
2 a 3
Examined 2!~~ ! lg.q MAIL TO:
Approved 19! Permit No. o~/hSla ,
Disapproved a/c ` €3
MAR ~a. 71`
l:
(B g Inspector)
APPLICATION FOR BUILDING PERMIT
Date 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
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 necessary inspections.
Z }~i UiLt'l~FiiYS
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~'~t~~rr q~....C®lJt,9~G fie .
Name of owner of premises ....G2ZfS _,K
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No . .
Plumber's License No . .
Electrician's License No. .
Other Trade's License No. .
1. Location of land on which proposed work will be done . .
Q?q.?............0...............
House Number Street Hamlet
County Tax Map No. 1000 Section Q.?3 Block Lot ...02J.
Subdivision Filed Map No. Lot .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~S)Nlw6.e
b. Intended use and occupancy , , , , .
II
3. Nature of work (check which a?plicable): New Building Addition Other Work . . . . Alteration .
Repair val Demolition .
(Description)
•4. Estimated Cost '.`O;k . . . . Fee .
(to be paid on filing this application)
5. If dwelling, number of dwelling units I.
Number of dwelling units on each floor ,
_ If garage, number of cars . .
6. If business, commercial or mixed' occupancy, specify naturg and extent of each type 9f use .
7. Dimensions of existing structures, if any: Front ~ , . , , , , .Rear
Depth ..6~.,.
Height CVP.,`.f'al..... Number of Stories QW......... Dimensions pf same structure with alterations or additions: Front
S~~ Rear /..0"F ....I.........
Depth c:7 Height I.......... Number o Stories ..:~L!!Q. ..r .
8. Dimensions of entire new cnstruction: Front , 02y r.6....... Rear ~
Depth
Height . Number of Stories ...~~.57
9. Size of lot: Front Rear / .
Depth epth
10. Date of Purchase . . . . . . . . .
, Name of Former owner
11. Zone or use
12. Does proposedsconstruction violate are situated . .
to any zoning law, ordinance or regulation: .
13. Will lot be regraded
14. Name of Owner of premises ~ • ~vp
Name of Architect Address fill be removed fro Phone No.sL6 . Y7 s
Address . . . .
Phone No.
, 9 ~Yry
Name of Contractor . et.Z. . ~~S 380 If yes, Southold fee , Address wetland? *Yes , . Phone
15. Is this property within 3 3Q0
* 00 feet t of of a tidal wetland? No.........
own Trustees Permit may be required.
PLOT DIAGRAM .
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
i
III
ry
I
II
STATE OF NE OR
COUNTY OF. S'S 1
being duly sworn deposes and says that he is the
Name of individual signing contract) applicant
above named.
He is the ........................1.......
ontracti agent, corporate officer, etc.)
of said owner or owners, and is duly auth to perform or have performed the said work and to make and file this
application; that all statements contain~d in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner sat forth in the application tiled therewith.
Sworn to before me this
day . Il 19.
Votary Publ c, Coun
ty~LAfREL t3.. tY
Notary Public,
Noin79505
Qualified in Suffolk County • • • • • • .
Signature . a
Commission SXpires December f3,19 pplicant)
I
~ _.......c._...,..m.....~.,«.-...ter,. ~ s. 4.
Lf_
IJ`F RAYNOP
PmVATE NY`t~9loW,. ioo,,O-
-
z Iti` ~ {C: n j 4;
p ' Ca
to t~f
t~3 z 3 )zzs Os~ N ~M-
I`~'
II
1 i..._ Ctir 1 r7
n 19
t
T]
r ~
;
f V F j `I tNv
Q% i -4
lU j
n or-s ~ S MAW AN5~C AVC-.~ S.50 JOJ E, 100.0
y ;ss
4sz POuarE rZoAD:.
fit Fuji of I P
I_
'e Hate Zo
n ~r,~=mss rx
~C - Q?S
m
{ r' s;: , ; = cn boa k ~yo r
IRV
76
. ;
Ed
Its
~ b
osg~~++ggg 7 1'4L
5£ tt~AN~~t'.~~@r 'r~aaC3~(Q" t~]t?.~
C
ig m n g ~I
gel !F X11 gal f
Oki
, it!
:7 9
all
l F. ty - Y :
r><,~SL-_ , _ . ,w21
ENERGY CODE CALCULATIONS
(For Non-Electric Heat) Design Criteria 6,000 Degree~,Days
~,J J / O.A. 10°F I.A. 7001
FOR: / % ,?kl e [ j' } 2 H 5/ PER: Z end / 'LGr p~ Ale/7//r j
r 1' P*'T u r DATED: / f
I
/o-
SUBSYSTEM AREA DESIGN THERMEL REMARKS
"U" RATING
Exterior Walls (Opaque)
Glazing Z`f % 243 .3Q _ S~
3y~ 3~ 7a
Doors '/0
Ceiling/Roof (Opaque) 2 3 fl 7s f3
Skylights %
Floor-.a3 fL ,65 D
Foundation Walls
Slab Insulation
TOTAL /
Notes:
Building Envelope Systems to meet requirements of 7815.2
HVAC Equipement to meet requirements of 7815.11
HVAC Systems to meet requirements of 7815.12
Duct Systems to meet requirements of 7815.13
Ventilations Systems to meet requirements of 7815.14
Insulation of Piping Systems to meet requirements of 7815.15
Service Water Heating Systems & Equipment to meet requirements of 7815.21
Electrical & Lighting Systems & Equipment to meet requirements of 7815.31
er r!e!~
To the best of my knowledge, o
E rG 9~
belief, & professional
judgement, these plans are in
compliance with the code.
"7 7/
s
i~
~IMAIaY ~s rtwdC4, '
.2w+. "JiT Mr$ 'des,,
J'
i' ' ~'Y~' .'~^Tn-~ ~Y~..~'~y~•~'mYR^v^'~_ yT ~in.uurL: ~y.'_,M^"Y2Y" ~ ~ .s.wNfrrvr '~w~~-- Tr.~ -h
' ~ ~-^-"-`-'-^'-+---car- i e:
40
Fl
-J: 1ALL
~
t ~
i r. f1l
i
'1
-1
I
rY lr Ali 1, i~ 5 N, V~ ~ ~ C i ~ ,
,r.
' ~-u
i
Pw BIND`
i ALLlIJlMBINGVYIM r~ lp~li
•'vomumameED ' _ ~ ~ ~ f,' „
' 'IE8TIN3 BEFCR6 COYENltl4 '
i i,d~~.
' x.ibmer tub1m b wed
i* water dWfbWng
r system; 610frp'sW11 be of "m on on
UNDERWRRERSCERymTE
POGOIRED - i
h PLUMBER CERT/FICAT/ON ,
" ONLEAD CONTENT BEFORE
CERT/FICATE OF OCCUPANCY - -77
IN WATER SOLDER USED
SUPPLY SYSTEM CANNOT 1
1
EXCEED 2110 of 1 % , LEAD. f
- nfll
1 ' ocCruPAKY, oR
USE IS UNLAWFUL
WITHOIIT'CERTIFICATE;
s
'J CCOPANGY 77 77
/ F 9 7 E
I AP 0 AS NOTED
r i dATE'B.P.M
'NOTIFY BUILD 85 9 r ~O _ TS02 8 NG'DEPARTMENT THE 4 PNI FOR TE,
''FOLLOYVING INSPECTIONS: MAR 1 7 h9R ,
fiD IR v nYWO REOW SCP , FOUNDATION r ~ 7 :POR YROUREO' 3
CONOREtE, - , 7OUVtd
2: ROUGH ' FRAMING & .PLUMBING p g. IN$U4/iTION - .
4.-. F1 AL CONSTRUCTION MUST
F CoMPlEEfFOR C;O, -
ALL;CUNSTAUCTION SHALL 'MEET - -
THE RCOUIREMENTS OF THE N.Y. R NE GY TION E PTA CON . O 4. ' eCp C6 pnAN'N tV _
FOR ' '.DES NOT ',RESPONSIBLE'p al, k6mtto
DESIGN, OR CONSTRUCTION ERRORS
FOUW~, /ARp Irp't - p wpIN6 NU01 F
i
9 '
y x~ ERYIF]'A'k~BK JD t.'
' u~R'brAtMd2'eS syrwNOARMRP Tb'9M
T.. .rra-r• M
u..r i
HIM-
T I I ~
777777
r
I
d'
T ".l I
ERI~ I
n f
i
TC,
IFF,
I,
11
I 4
1
I
n
I I
r
I
' fi, h '1 r I
pw.u.w.?rN...~""~'_"ry i'_', "'NM1I! ~F~ ' . +Y+~+.-^M ~9 -.++rr+. I
~-r T
J
- -1-+-W
' ~ ~ Wit:'-•_- - -
III f 1 1 t if{'F
k
t fi ~
1 ~ I
a
~lr
4
t ' - _ - IA~,RW'llfiMi~XIGMfIr
p
I ~
d
1 F ,
11~ e
i
N V~P,v ,PgwWiep'~ M qq
S I- "Oo g all PROPMR
u1 {AlYydd{LtM([V4~3}116i 1 : ~~y Aperfi RlliYFdpslTkNpwk{~ md'pM ' i ~ MIYw lx v.f w
6tJO5,
R-!'9' lnlSw.. ATtoN
<-•iy 6neTTKar-K
' .&7~Rn4G2H3+u 5asnN4 2H'ya _ / ~frn S~acE
n ~
7 '~l GAS cUp.F~-~~
' . Ne..l RMm-le°ae, s~yTeµ-i.K, r c, srS+e2~M~ c'v.rsr~.r(a
N tb
M
yw~ gLµ'1^q,ry .fx~46.urs.,k 4~4449t4r+4 v ¢.~+a.aw~,o- 3..r e.wcs~u4 z..H o~.ne.,c~w '
1
Lr `O E`~/GT i./6 Y,46vt1*~P. L.- '
l /YN(rl[44hTS X g~ +n f~,1iu~0
s I~ rl
i ^.RT/r0 -pyTh1~ WrpTH Yo ~(-I~atLi-JAu~ SJ(, ^~/'55!!"r0 ~l^~%1641D' Tc H4~~`,1k+.
. ~ h7Cw YS'^ `+V+l$^ 3 ^ 2H / ~Nt OM ~e f'! /tiC ct fa:z+aAiiw+ bfal-air/, +IKti ~P]Si r51+4rA' 81..p VIP
M1lL O~+ (W.hlfY4T.ll Q*4WA
t Ek+SnNi~ 80L'E9 E'wst'inLy, dbb6
'YA(Er..+ h..+,:1AaL ' " : Ek1STIw 41 .4.YA4N~p~~-__. ~t6tr7~ A (.'L) ',~t
"Y~2irL N I I C~ 'e~'it12Y t]. -RM ([3o LL+-'FJ GuNTINVGJS aoK &'!r(jI.AM vR, -
4 tiFliRiPY "r..xl4T~l`~E+ HEA4C11~
ill
m' 72A~~I$f kirA 1 I d
~,t s AN NuN ' I I '
~ 7£th~E; .,1rt171r~ ..~=(_s`` I 41VIW_ [a~6o_n y I I AIn1iNU 52oow~
3ox3o sKt'tlgkr SKt'LI(ykT 2K@-Ilo~a.c R,aF 7.s2< '
Mws'r4.R ~.tri I I d: d 'Z r a S
~Z WA~4 +1 / ~ R-~^a ¢~p~ 2ya ~3. ri-ao>= sr,u-JC,~cs
ED %2 u cll-nse-~t7
rl
m-~o d rZ N R-3o i'~uv'~Gascr.a 'R-3o~slim S eq f P+.o~
p
4ft
N ~1~`w/~.=.°•Ga~ ~c~~+'~4~~ C- 19 JNSUt~FTTW
r 1G r" ' ~ "L ih-W..paCS
3c~auQ. MGR~~FNTA4 crT?F4R 6rJ1,Jy4a - 4J rc:Pu9uQ¢
V.'~a.ee+q`t t'~IF?12.I44:e w./AY ~ Cf.Y ^.K,., dy w/F+w h.-rr,,v 3A~ffi'S' .,~',--IZw/H «°~.9rc4M ,
rzrm yF.~ T,.rdy w/F+wl TRi-Yia 4' Pc'aT~£
wiT+l sEi„F CLaWM4 HINlJ(~~
A..EL.K-n'T~b .GBH Nh4w f.~.a NEB,./ F 'S ti",~'~ LKY^/4'a. c.
E?xl~Tl~-w~f2'Sz F' . fi-tK$,T F',-cxaZ ~~L ~uYwpoQ ' W PEFx-T '
r ~ r' ~Sr au ~ TI~M,f .~1Mti' R-11 Ir-~SVr.AT,wy ,.4'-.. ~.~T. Vepr'{i~A? $~C:*~~
AWCYA!I?,~l~j'NA^/ ~ :I\5,~A{RS AY6Y 4tr .I~~,+es.,a
i R-14 in R-14 INS'. 2x1 ewrtiG_,~
•~_•-•••T•••.•- 1~~~•:f'W$~NLa N-G.A Tk':1Lw119L'. °J~a.~%fnA
.~.xQi LRi {S}' 12 4 AIR ~2nE 1- AiT ;~-T ~ SQL O"~ 6LPG?.~N(a- m.na 8-0''0.4
N ~J 3 j" \ ST>t~c+uf4Gp i:'~, ~.FVS4 .-JM
^Ny r
Nc IFiT I*.Mtr ~vFCfkACb~
Z VM/I.LL'S M,D GP',L•1N F'ICO yA~TGd '
4~I~REY>'W!Trt O ~ ~Fn~tf'(1~-PLUG . a4 Fl1in+~ I.,F~'S ~uCE'. - -
IH n w ~r
~9N&i~ 94k,f} .'F'hN¢k,NdG (7) StFbs ~ .
El~.Srralb #b a x', 7io~ '
S2wl~~n W~xwN a.lcDG4'iA, ~4'~xf(e5
. iNWRE A,, ArATS MnIW ~ AU Q , pp Q d IIElq ypp
. R{?tiw'S+rAE:w`ew'!'~ AP;~ 4Etr6{n,44
rx~r. ,aI
e~
Y
-f ffr- I ra xro cG. ~,.,,~N E55lg"p
Z~L/Py
1. j! R+ I yY 1 _ ~KM l i
- hjc"M; A4-~ IJG-w W~NOd..~:~i 5t,D6'RS 1b w a ^ Pk- Pnit~P~c'wi H. P. ....+F-'~.._........-....e-+m..-...-..-ti ...........-r~....-ter •r ~ L ~ A4A'V1
~f eY,: a° aew~e owwWNBV Mw 1~t ~ ~ 'e r N'I pcvlsco
drE: ~NS~v.s S>~-"~ Bwr-c,~e. Tv :Y~
FovN9nr,a-i Br-u o.aTMi A .-'2~wR~u~ ~ PdWfS. J
~ lFi.ST, N :Yb">?IRY M,~. 7,7:rvm '"NS~pNS G.Vw, olTl pn+*> _
f ppTE wEwpOVQp BY OpwWINp NIIMBEp
b a
r'
- wlwpc p+ u s.w.
'''R1aG •fleN~IT[RTe`i'~'~NY3"TO FOhm ~ ~ ~ ~ - ~ - '
E~'IbTih~{~ ~ Hdr~yg
' ~!`la
Q
f X6~
ill
m .
m
x
L~fR`°~x`VS
I~
- _ _ - _ _ - - _ -I
f i
C xISTINU PQ-+
20., ~n,,t ~y. ,~,t
Ynvfc Yn4°<u.~ Aasi} I-L•~YGxOS ~'7 cw =L. ~ Q7
`Q /=o"x ~
~ ccnt. r N, ca.,c, rrv. ~
7
fro
- ~JryQ /H (yN
~?~-l6~a. t. -r/wK FSOM 2~p~6` f0 ~ .
Jrys ~ 7=x e'
' AbY ':.iWp~Itu" GHU?NtY i3 RA18G? - o cen+w M wrlW NX.L ~dloG. '
ss-tas; ' ~ 1 I
Pea~P.NOF
II
4.
~I
C~
4 . V ~ N s ~ i' Ic+c c vK'lvT LX 6 VKTlT
~ ?vrllb 'R.iC ~y?vr~lb p...iTXt~Nv ,'~IF.h~M
u ~ 2.
QR ra µlAS ` ~ .7<4iII-1lp ~~q/.. ~IMI4NOM-s y7R.r¢k. ~ ~ 't~'~"
..R';10 L9. R.CwNC SM'ilMCtl-I45,
soro~ auk.,. ..obA BVFFa..e ~ ``'J °rY-e~..D S+ogT-tar ~ ~ 2-30 u+s.
_ 4~-~IN ~6 Cmcc~rw
D8~ 2w'o ~1,. A'I5. ~ K-~Cl inLSVF-~ K-~Cl iNSVF-w4?Rr.~ / ~1N~ y^y0¢'FI'r w~~r!c'~J? _
h,IF.W R'K6 ibY"o. c,
. 2_ 2.e'fcs'$A12' Nom/ CsR~'R V- txrsM M n.~19 IN6VL~'*~pAJ
~_VZ P~.YJRgCi,
- it f~ li-rr -
V~CL: Eµ$~ ~l~^.'~TINy k=,nr 9 ac R,3aQ~ N~eaz.N.+'rsu, &~c>w(a IFw.S=MC)
nr~w Q~eu~ a -~S+IBLLautL -
MA G'F2.'6'AT Rc+C N`h R~+N-/m'a..- ~T uGT Ex 'Ct+F L~ W~~1 /R~6 swaF i I I
1 ` Rao; wsut-A-noN (vniA,l7 B'"ca'-111
- '1
1 I~ ~ ~ "111f ' II ~ Qwsr>,N4 2Nk5 -!6'~a. A. w S,t,rJr w $.4r/9G.rn,KU 2x/`#' 1'SCw BEAM (wr'rarf rM
' NDI H/IA4.I.S AMO CGI tr Y
ElAG c'd..r4P.N'Y5 wIr?:~
K! 2A TC2y'^.'aMAeM , h 1~7L & C.^u1C. S+FI~PNty Ne7LT C.H [.wS~WU.SL -"+~F3rrvt~
2 1^ I
. EWS77AJ(9 ' Ggf2y>~LC' '
t ~ ~ '(s12~v"s
/~---A~.,^~t+,LSTeN fn 2Kb-r6"GC., W'eM1kl` I
- ~J~3YL~~xi1 %II gu~y3VV
F'4s4J $(`ffi s v. Ay/~U. ~M Fv.nH 0f$AP M~MJ T~~.k9RS /~.ULN[Q- (db~.'Ma
9
, Mf. k^.,pcr, R~DL4r* }M~~ZY~.II' f/b U.C. ti.,..- K.. ZIAF3
pt O
T w 2 4
O=N
W
z' I
O 0 z 64-1
n~•tOFFSSIOl~a~A~
NE'1~J,WINCiOWS.,
T~ ' AN'CEA_AN MA.
fCl!A{.[ oRAWry pY
,4 'Y~I~'~ 'Revispo l~Mh
~<S'W P Fa~MRf~- rwn.wJ
CLP&.S, , 'RCM,1 ~3
t.t4x1'6i: ^pt,MF,~Iff~" T4-M ginh!ikJ, bleiF*1.5~ ~~j.. Cie F341T1ti~, I RAT[ n t/ROV6B pY tlRnWING NpMpCrt
I-19794 Wes: Y
' QyµC CRYST.T4EWf W 24Y2f ~ ~ i ,
NT G FRCFITf CT!'4TGNOgRd FORM, i ~ , Mwtle m v.p.n.