HomeMy WebLinkAbout21408-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23532 Date ~%RCH 8, 1995
THIS CERTIFIES that the buildin~ ADDITION
Location of Propert~ 3485 NASSAU POINT ROAD CUTCHOGUE NY
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 9 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 29, 1993 pursuant to which
Building Permit No. 21408-Z dated MAY 19, 1993
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 DECK ADDITION TO A OWE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to
MICHAEL & JEAN MAHER
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N340527
PLUMBERS CERTIFICATION DATED
JA~UdARY 25, 1995
N/A
Rev. 1/81
-- ~~ding Inspector
I~OB~ NO. f~
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)
N-~W°. 21408Z
Permission is hereby granted to:
..... ':/.m..~...~.....~ ...............
o ...: ............................. ~.. ......... ~x..'.x. ...................... ~e~ .......... ~.z..~ ......... z~....~
et premises located at .............. .x,.,~.- ,~,.,.~. ,~.,. ............ ~.,~.7,,.~,~,~.,.,,~,,........~.,~,,./.,..~,.-~.,~,.....~.,,~,,,,. ..............
.................................................................. .~..c-.~.~: ..........................................................
County Tax Map No. 1000 Section ...... /././.. ........... Block ...~...Z. ........... Lot No ......~..~.. ..........
pursuant to application dated ................ ~.~..~.. ........................ , 19..~..., and approved by the
Building Inspector.
~a(~lng 'inspector
Rev. 6/30/80
BNILBING DEPARTMENT
~ . APPLICATION FOR CERTIFICATE OF OCCUPANCY l k ..... ~f6~Ti55P~
A. This application must be filled in by t r r n- J - t,__. TowN OF ~O~IT~!0!~
ypew ite~ v~ ~nm and sub~tt~=g~ t~ the building
inspector with the following: for new building or new use:
Final survey of property with accurate location of all buildings, property lines,
streets, and unueual natural or topographic features.
2.Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3.Approval of electrical inst~lation from Board of Fire Underwriters.
4. Sworn statement from plum~er certifyln~,,that the solder used in system contains
less 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:
l. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
I. 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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ~.', ,~,` ,1~,,, ~?.9~'~
New Construction ........... . Old Or Pre-e~i~stin_g Buil~ng ............. ,..
Location of Property .............. x .................. ~ ; · ·
4 llouse No. Street Hamlet
Onwer or Owners of Property.. - ........ ;;.. ~~/~ ........
County Tax Map No i000, Section .............. Block .............
Subdivision ' Filed Map Lot
Permit No.~].LJ.~..~..~...Date Of Permit ................ Applicant .............................
Ilealth Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
/
Request for: Temporary Certificate ........... Final Certicate..~... .....
Fee Submitted: $ .............................
tqt 5 ..... ....................
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1(~(~1~)'71 BUREAU OF ELECTRICITY
~ 8.15 JOHN STREET, NEW YORK, NEW YORK 10038
Da~e J~U~I'~Y ~5 ~ :[.0/95 /Ipplicatlon No. on file 06849.995/95 N 34052'7
THIS CERTIFIES THAT
MICHEAL MAHER, 3485 NASSAU POINT RO~), CUTCHOGU~, N. Y~
in the foltowlng location; [] Basement [] Ist FI. [] 2nd FL OL1T Section Block Lot
~s examined on JANU/>aRY 19, !995 and found to be in compliance with the National Electrical Code.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDEI
AMP TYPE E~UlP. I~f2W I~'3W 3,~3W 3~4W O O~ERCC~,COND OF CC, COND.
~wRANGEST KW COOKING DECKS OVENS DISH WASHERS
SPECIALREC'F TIMECLOCKS BELL ~UNITHEATERS MULti-OUTLeT
C
EXHAUST FANS
DIMMERS
AMT WATTS
A W G. NO, OFNEUTRALS A.W G.
OF HI-LEG OF NEUTRAL
SWIPING POOL-1
*(SWIMMING POOL) This certificate
covers compliance at the date of
inspection only. Because of unusual
environments it is advisable to
have frequent test/and or repairs
~tade by a qualified person.
G & S CONTRACTOR
BOX 215
SOUTHOLD, NY~ 11971
LIC.#578-E
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
December 22, 1994
Mr. Michael Maher
3485 Nassau Point Road
Cutchogue, NY 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy
xx
xx
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is not on file. $25.00 c__~.
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 21408-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
7GS-Z.8QZ
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [~FINAL
REMARKS:
DATE INSPECTOR
/
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
FRAMING [,~INAL
REMARKS
DATE
INSPECTOR//~~-~'
~DUNDA'TION ( 1st )
'OUNDATIO~J (2nd)
~UGH FRAHE &
-PLUMBING
~SULATION PER N. Y.
STATE ENERGY
CODE
FI;;AL
ADDITIONA~L COMMENTS:
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
To llICltMlL J. MAHER
3485 NASSAU POIITg ROAD
CUTCUOGIIg t~ 11935
PLEASE TAKE NOTICE that your application dated ....... .A~..R.I.L,.. · .. ·..- .. --,29' 19 .9.3...
for permit to COSS~UC:r A ~ DECK & ALTERATION IdORK TO DECK ~ ADDING TO ~
EXISTII4[(I 'P6012; .................................................... at
3485 NASSAU POINT ROAD, CiITCItOt;UI~, ~
Location of Property ...............................................................
House No. Street Hamlet
County Tax Map No. ! 000 Section .... /, 1. I. ....... Block ...9. ' . .... Lot 3
Subdivision ................. Filed Map No ................. Lot No ..................
is returned herewith and disapproved on the following grounds..~.0..R?..I.S. ~.O..B.E..~.I.Tfl..I.N..7.5.'.(.f.e.e?.)
EROU A ~m,~.~,~EDS Z~ ~Z'ROVAL C~,V=R m0-239.3, a
Building &nspect:or
RV 1/80
3479
MICHAEL J. MAHER . ! ~
' // ~ ._19~ 210~
%C(fl"l I II/\Rl{Ih
'[h',vn I hdl
p() l~;nx 1170
.$oulhohJ. Nc'.', ~i)lL l l9/I
II(~AI(I) oi;' 'I'O'WN 'I'I(IISl'I(I<S
T()WN ()I: S(.?! lTl 1()1,1)
,luly ~l, Iqq2
p,e. Bo× 44'1
t)lJogtlc,, NY ] I
Michael Maho~
S¢;'I'M JJ/lO00--11 I -g-..~
'l'h(~ Fei Iowin(~' acl'ion was l aken by tile Board o[ '['own Trustees during
il.~] legular mectinc~ held on May 28, 1992 regarding tile above matter:
WF1EREAS, g.leml Just oil behalf of Michael Mater applied to the
Southold Town U'rus%ees for a permit under the provisions of the
Wet'land Ordinance of the Town of Southold, application dated April
16, 1992 and,
WHEREAS said. appl. ication was referred to the SouthoJd Town
Conservation Advisory Council for the%r findings and recommendatious,
and,
W~tEREAS, a publlc hearing was he]d by the Town Trustees with respect-
t'o said applk~ation on May 28, 1992 at whi. ch time all interested
persons were g~ven an opporhmity to be heard, and,
WHEREAS, thc Board members have personally viewed and are ~am211ar
wi. th the premises in question and the surrounding area, and,
WIIEREAS, the Board has consJ_dered all the testimony and documentatJ.on
submitted concerning this application, and,
WHEREAS, the ~oard has determined that the project as proposed wilJ
not affect the health, safety and general welfare of the people of
t he town,
NOW, THEREFORE BE IT
RESOLVED that the Board of Trustees approves the application of
M~.chael Maher to construct approx. 182' of timber bulkheading
w~ th a 1'7' return at the northern end. The bulkhead is to hug the
Poe of the bluff, clean sand will be trucked in for backfill. To
censtrnct a second floor addition to the existing single family
residence, to reconstruct existing stairs to beach and to add a
}and4ng to the stairway, to construct a hot tub and to construct
docking as per enclosed survey as prepared by R. Van Tuyl, P.C.
dnled MaFch 25, ]992. The applicant will use the Services of Suffolk
and permit issued within six months
DotJfJ.cat~o.. Two inspectJ, ons are required and
notJf~_e(] upon completion of said project.
Perml l will be f.qsued tl[~Ot~ payment' of {;he following foes for wc~rk to)
FACILITY PROCR^,"A NU.MBERJ~E , PERMIT
~ ~ Under the Envlronmentat Conservalion Law (ECL)
Nov. 23, 1992
EXmR^nON D^rE
Nov. 22~ 199~
J TYPE OF PERBAIT (Check All Applicable ObxbS)
[] New [] Renewal F'~ Modif IcaUon [] Perm,t tO Construct
J-----J Article 15, Title 5: L-------] Artlcle 17, Titles 7, 8: ~
Protection of Water SPDES
[----~ Article 15, Title 15: [-----] Article 19: [---'--']
Water Supply Air Pollution Control
I
, [~Permn to Operate J
Adlcle 27, Tttl~ g; 6NYCRR 373:
Hazardous Waste Management
Adicle 34:
Coestal Erosion Management
~--~ Article 15, Title 15:
Water Transpqrt .,
r-'-q AdJcie 15, Title 15:
Long island Wells
~---~ Article 15, Title 27:
Wild, Scenic and Recreational
Rivers
{--~ 6NYCRR 608:
Water Duality Cedification
PERMIT ISSUED TO
Adicle 23, Title 27: r----]
Mined Land Reclamation
Adlcle 24: J------]
Freshwater Wetlands
Adlcle 25:
Tidal Wetlands J-----J
Adicle 27, Title 7: 6NYCRR 360:
Solid Waste Management
Adlcle 36:
Floodplain Management
Adicles t, 3, 17, 19, 27, 37;
6NYCRR 380: Radiation Control
Other:
JTELEPHONE NUMBER
[5]6 ) 734-6384
Hichael J. Maher
AODRES$OTPERMITTEE
3485 Nassau Point Rd., Cutchogue, NY 11935
CONTACTPERSONFORPERMITTED WORK
J.M.O. Consulting
TELEPHONE NUMBER
t516) 653-0607
N^ME^NDAOORE$SOEPROJECT/FACILITY
Maher P~operty, Same as Above
LOCATION OF PROIECTIFACILITY
Cutcbogue
COUNTY TOWNI(~J I WArERCOURSEIWETLANDNO. NYTM COORDINATES
Suffolk Southold J Littie Peconic Bay E: __ N4
DESC~mT~ON OE^UmOmZED ^CT~WT¥
Construct a new bulkhead~ re-constrUct exiSking stairs, install stone armor, and
vegetate the ~ace of the blqff. All work sha~l' b~ done in accordance with plans
prepared by Roderick Van Tuyl dated October 23, 1979, last revised on August 24. 1992~
and plans stamped NYSDEC approved on November 19, ~992.
By acceptance of this permit, the permlttee agrees that the permit is contingent upon strict compliance
with the ECL, all applicable regulations, the General Conditions specified (See Reverse Side) and any Special
RCo~ditiqns included as part of this permit.
eg~ona~
Robert A. Greene
l~e~,ton I o BIdO. do suMY
· ' ' J 1/19/92 Page I of
95.20~6a (10190)-- 25c
ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Ttlle 5), :24, 25, 34, 316 and 6 NYCRR Pad 608 (
9 T~at if future operations by the State of New York require an al-
teration in the position o~ the structure or work herein authorized, or
if. in the opinion of the Department of Environmental Conservation 13.
it shall cause unreasonable obstruction to the free navigation of said
waters or flood tlows or endanger the health, safety or welfare of
the people of the State, or cause loss or destruction of the natural
resources of the State. the owner may be ordered by the Department to
remove or alter the structural work. obstructions, or hazards caused ~4,
' thereby without expense to the State, and if, upon the expiration or
revocation of this permit, the structure, fill, excavation, or other
modification of the watercourse hereby authorized shall not be com-
pleted, the owners, shall, without expense to the State, and to such
extent and in such time and manner as the Department of Environmental
Conse~ation may require, remove all or any portio~ 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 a~alnst
the State of New York on account of any such removal or alteration. 16.
10~ That the State of New York shall in ~o case be liable for any damage
or in)u~ to the structure or work herein authorized which may be caused 17.
by or result from future operations undertaken by the State for the
conservation or improvement of navigation, or for other purposes, and
no claim or right to compensation shall accrue from any ~uch damage.
11 Granting of this permit does not relieve the applicant of the responsi-
bility of obtainin~ any other permission, consent or approval from 18
the U.S, Army Corps of Engineers, U.S, Coast Guard, New York State
Office of General Se~ices or local 8overnment which may be required.
12 All necessary precautions shall be taken to preclude contamination
of any wetland or waterway by suspended solids, sediments, fuels,
solvents, Jubdcants, epoxy coatings, paints, cm~c~ete, [eachate or any
other environmentally deleterious materials associated with the
project.
Any material dredsed In the prosecution of the work herein permitted
shah be removed evenly, without leaving large refuse piles, ridges across
the bed of a wa{[en~,ay or f|oodplain or deep holes that may have a
tendency to cause damage to navigable channels or to the banks of
a waterway.
There sh~ll be no unreasonable interference with navigation by the work
herein authorized.
If upon the expiration or revocation of this permit, the proiect hereby
authorized has not been completed, the applicant shall, without expense
to the State, and to such extent and in such time and manner as the
Department of Environmental Conservation may require, remove all or
any portion of the uncompleted structure or fill and restore the site
to its former condition. No claim shall be made against the State of
New York on account of any such removal or alteration.
If granted under Article 36~ this permit does not signify in any way
that the project will be free from flooding,
If granted under 6 NYCRR Part 608, the NYS Department of Environ-
mental Conservation hereby certifies that the subject project will not
contravene effluent limitations or other limitations or standards under
Sections 304,302, 503. 306 and 307 of the Clean Water Act of 1977
(PL 95-217) provided that ali of the conditions listed herein are met.
All activities authorized by this permit must be in strict conformance
with the approved plans submitted by the applicant or his agent as part
of the permit app!ication.
Such approved plans were ~tFe~ J~K approved by _
NYSDEC on 11/19/92
SPECIAL CONDITIONS
The permittee shall vegetate all exposed faces of bluff
to prevent erosion within 6 months of bulkhead
completion. No lawn grass or tree species shall be
planted on the bluff face.
No discharges or rUnoff shall be directed down the face
of the bluff.
Ail fill shall consist of "clean" gravel and soil (not
asphalt, slag, flyash, broken concrete or demolition
debris)..
Equipment operation below mean high water is strictly
prohibited.
All peripheral rip rap berms, cofferdams, rock
revetment, gabions, bulkhead etc. shall be completed
prior to placement of any fill material behind such
structures.
Ail repairs to existing structures shall be confined to
replacement of existing structural elements with no
chafige in design, dimension, or materials, unless
specifically authorized herein.
DEC PERMIT NUMBER
1-4738-00404/0000I-0
PROGRAMIFACIblT¥ NUMBER Page 3 of 4
gS-20-6f (12/85)--25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
8.
Supplementary Special Conditions
SPECIALCONDITIONS
ForArticle 25 ( Tidal Wetlands
No stones or other material shall be removed from the bluff
face or below mean high wa%er.
The bulkhead shall be constructed with filter cloth and
a splash pad designed to attenuate over topping waves.
(A) thru (J) attached.
DEC PERMIT NUMBER
1-4738-00404/00001-0
PROGRAM/FACILITY NUMBER
4 5
Page of __
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
File No ................................
... y...q.. ~..o7....~.~.
Location of eroperty ...J..~.~. ~. ~ .~~~..~~
County Tax Map No lO00Section ll..~ ..... ~o~k ....~ ........ ~ot .Y ..........
Subdivision ................. Filed Map No ................. ~t No ..................
is returned~erewith and disapproved on the following grounds .... ~. ~...~~
.~~;~.~..~...~...
..... ...........................
........ c~../~ .... ~~...~ .........................................
Building Inspector
RV 1/80
TOWN OF SOUTHOLD
"~:, ^PR 2 919,93
BmLDING DEPARTMENT
TOWN HALL
' ' SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
J SETS OF P,~NS ..........
SURVEY ...~,,,~ ..............
CllECK ....................
SEPTIC F 0 R.*t ..............
CALL ...................
HAIL TO:
· (.~,45i1~g Inspector)
APPLICATION FOR BUILDING PERMIT
Date ................... 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 location of lot and of buildings on premises, relationship to adjoining promises or pubI/c streets
,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
ation.
c. The work covered by tiffs application may not be Cbmmenced before issuance of Building Permit.
' d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
h~ll be kept on the premises avaQable 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
roll 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
uilding 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.
he applicant agrees to comply with ali applicable laws, ordinances, bui)cl.ie~,erd~e,, housing cod~ and regulations, and to
~mit authorized inspectors on premises and in building for necess~~
(Mailing address of applicant) ' ~;",,~C~y
tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
'ame of owner of premises ,. . ~d¢o
(as on the ta% roll or latest deed)
'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 ....... ': ...............
thor Trade s Dcense No ......................
Location of land on~ which proposed work will be d'c~ne. ·
......... ....... ....
llouse Number Street ..... Hamlet .........
,
County Tax Map No. 1000 Section ............... Block ................ Lot ................
Subdivision ..................................... Filed Map No ....... Lot
(Name) .......................
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
· ' ~ · ' , , ! ~',h d~-'b~'' '
b. Intended use and occupancy .(Y/.x/~..~.Z,fd~,,:.~......,~.../..,~..--W....c,&....~./.¥44. ,~,~WZ:~ ~c~
..... ~[',~.~ ............. Demolition ........... Other Work. ,.
4. Estimated Cost .... .'7':...Y~. ~ .~.~ O .-. (Descnpnon)
i (to be paid on ~ling this ;;;li~a'tion)' ' '
5. If dwelling, number of dwelling qnits ...... --. ........ Number of dwelling units on each floor..
: If garage, numberofcars ..... i .............
6. us,ness, commercml or m~xe occnpancy, spec naLure and extent of each type of use ......-, .........
Dimensions of same structure, w 1 alterations or additions: Front ..... ;.. Rear
, . · .................. NomberofStoNes .... ~
8. Dimensions of entire new constrUct,on: Front...w- ........... 'Rear . .=-. ........... Dc . .= .......
Height ....... ~ ....... Nt tuber of Stories ... ....... -x-. pth ....
10. Date of Purchase ........... I .............. Nanle of Fo'r~ner Own;; ....... , ...................
1 1. Zone or use district in ~vhich premises are situated ..... .,g~..'7.~. ~.. . '
12. Does proposed construction violaie an,, zonin~ ' ....... ' ....................................
13. Will lot be regraded ,(./e.9 :' ~ ~,w, urumance or regnlation: . . .,4_~...~. .....................
..... ' ~/~ ~, · ....... ~. :.._. Wdl excess fill be removed frommrem,ses:
Name of Contractor ......... ..'~. ........... Address ..... '~ .......V=,~" ' Phone No...=- ............
15. Is this property within 3~0 feet ~'a tidal wetland? Yes...~.... No .........
· If yes, Southold Tdwn 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 ndmber or descfiptioh according to deed, and show street names and indicate whether
interior or corner lot.
['ATE OF NEW YORK, S.S!
................................ being duly sworn, deposes and says that he is the applicant
(Name of individual signing [contract)
eve named.
(Contractor agent corporate officer otc ) .............
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
~lication; that all statements coutained i,l this application are true to the best of his knowledge and belief; and that the
.rk will be performed in the manner se forth in the application filed therewith.
om to before me this
EL~IN£ k ttOL~MAN
Notary Pub ic, State of New York ' ..
No. 24-01H04728752 , , ......
~ommissio, Expires Nov, 30.
.i
PECO~ t C