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HomeMy WebLinkAbout19615-z i FORM NO. 4 TOWN OF 50UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20150 Date AUGUST 15, 1991 THIS CERTIFIES that the building ACCESSORY Location of Property 3120 ALBERTSON LANE GREENPORT N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 52 Block 4 Lot 1.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 3, 1990 pursuant to which Building Permit No. 19615-Z dated JANUARY 3 1990 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 ACCESSORY INGROUND SWIMMING POOL WITH DECK & FENCE ENCLOSURE AS APPLIED FOR. The certificate is issued to PAUL J. & RUTHANNE CORAZZINI IZI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL_ N/A UNDERWRITERS CERTIFICATE N0. N-197678 - JULY 26 1991 PLUMBERS CERTIFICATION DATED N/A uil ing Inspector Rev. 1/B1 roes: xa: a TOWN AF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUYHALD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 1 91 5 Z Date 14.~.~.~1 Permission is hereby grant o: to .~~~,rezr...aA~~G~.'.7.rn:9.~...;/..dll..,~.d....~G..~.'~'~..~r........~?,~...'~r~~'n of premises located ot ...~..~/.//JJ....F.~~.~a~°.r~5s1,~,....~ f .............................................G :?..:rl.:t~~'F.~'f,~........................................................................ County Tox Map No. 1000 Section Block Lot No....../..°..r.~......... pursuant to application doted ...I'~~..~.T 19~t'~..., and approved by the Building Inspector. 00 Fee Z..ls:~m ~....~f.. Sr~..r.......... B ng Inspect I Rev. 6/30/80 Form No. 6 D TOWN OF SOUTHOLD c BUILDING DEPARTMENT ~ ~ 5 TOWN HALL 765-1802 QODG• UEPT• T®WPJ C7F sC~UTH4Lb APPLICATION I'OR 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 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over S years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Com`mercia/lqq$1n5.00 Date ~../,1..`.~ New Construction...::... Old Or re-exis ing Building.... UUU/~.•.•.....• Location of Property... ~ ~~h~~ ' ! d ~ ~r ..~~.rr f House No. Street Hamlet Onwer or Owners of Property....~~k•.IQtC:. ~K~n~.K.~.P..t.,~7-~r~.~.?~.~h County Tax Map No 1000, Section.....` .....Block...../...........Lot.... z:........... Subdivision Filed Map............Lot.. 99/ ~J , r Permit No...L.J.C./....Date Of Permit...l/~~!.~..Applicant... ~~al2:Z!`~' Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ c~~. yav~ C d ~ ~~/.S O LICANT r1cLD I;:SP~CTiUf7 ~~lliiTF. ~ OOMMLNTS .o ''a t . ' ~ ~ '~n H N _ - - - - '-3 FOUNDATION (1st} ~ N~0 FOUNDATION (2nd} ~ ~C - - 2. z ~,1 o ~ ROUGH FRAME & p PLUMBING H 3. ~ m rh IIJSULATIOf1 PER N. Y. • - '~t~ STATE ENERGY CODE x A v FIidAL ~iL^ e.~_ n. ~ ~ ~ z j I DITI AL COMMENTS: ~ ~i i I / 4'I ' /~m...:f' .tSrna,,.,(1roA Tn g~~,Q.,,..Qa_... c~LP A ~,nm,. •dt9..~ -~2r ~ 190 D'o ~ d ' x H\}~ ro~ 7] A y H O z 1 h7 y r x H \ I r~ `4~ -u • H !9415.- co THE NEW YORK BOARD OF FIRE UNDERWRITERS PAC,? $0271.?.2 EUREAU OF ELECTRICITY 83 JOHN STREET. NEW YOWK, NEW YORK 10038 Date AUGUST ?.$,]991 APPtiRwtionNo.onfile 25$920134/$4 N 1)'1,410'1, THIS CERTIFIES THAT only the electrical puipment v dsecribed 6sbw and introduced 6y the aprlicant mated on the a6ors aFp/ication number itt [hs premisss of PAUi, :1. CORAZZSNI, ALAY.RTSON LANE, POLE '~2.9, GRSENPnRT, t7,X. GAR/A9'47c;/OllT in the follominA IOCa ' ent ~ /At Fl. ~ Ynd FI. Sartion Block Lot - Erna examined un end found to 6e in compliohcr with the reyuirementn of thu Board. $$a NX111U ACIB fWITCIIlS RXTURlS RANOf! EOOKRIG DlCKf OVNIS pSNW lXMAUST FANS OUT@75 INCANDESCENT RUOtFS[ENf OTNEn AMT. K. W. AMT. K. W. NAT. R.W. AMT. K. W. AMf. N. P. 30 3 43 2$ a 12.? a 1.a2 2 DRYilS RXMUCE MOTORS IUTUN AMUANp 1lWMK. SMCIAL taC'r1 TIM!CIOCRS RRl UNIT NlATNS MtMYt•OYTIlT DIMMlRS W AMT. K. W. 011 N. P. GAS N. P. AMT. NO. A. W.O. NAT. NM. 4MT. NMS. TRANS. AM7. N. P. ~df ~T AMT. WATTS ' 5 F 30 hoc) slRVla olswtracT tto.oE s ! R v I c ! AMT. AMr. TYPE T.e tw , i tw 31 tw t r ~w ~ sCOND or ~t tgi,D. No. or to ltc ~ Mi ~ No. a NEUT11Als a 'PGriAl m i j OTNN AfMRAiIK: NOTOR5s1-3/4 H.P. xNOTE: T1tia is a partial, rtot a r..omp3ete certifit:ate. i~ PAUL coRAZ~x?ar. 3120 ALHERTSON LANE GRRBNPORTr NY, 1].944 ORl11lAL AMNAON Ja Per Thu carlificats mwt not bs alHrsd in any manmr; rNurn to 1M oNb of the Rootd i(.hxorrM. tnapecrors ^bY_ bs idwMlfud b~ tMir: credatNiab. C©PY FOR SWLDING DEPARTMENT. TNK EOPY OF CERTfPIGTE M115T'NDT dE#LTEI~ED IN ANif MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS ;~G<a~ ' 17.9'1. "l `1, BVREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 1003® Date JllirY 26, 1997. application No. on file IJ89?597 J97 N :i 91678 THIS CERTIFIES THAT onl [he e4ctrical u' ment a deacrihed helow and introduced 6 the rcant named on the obooe kwtion numher in the mlaea o ~ Y e9 M Y VMd~ aPPI~ Pre f - ?AtJi, <;ORA7'/.TNi, 31.2q ALHF;R'CSC)N I,ANfi, GRF:K~NPORT, N.Y. ~ in tkefollolcinq loco ' n• nn e n[ ? /xt FL ? Ynd Fl. t)ll 1' .Ser[iun Black Lot - ,~~Lir 7.7~-, f$~1~t` u~aa examined on and found to be in compliance with the reyuirernenu of this Buord. RXTURE RXTURES RANOB COOKING DECKS OVENS DISN WASINRS EXHAUST FANS OUTIEiS AgES SWROIES INGNDtSClNT fIUWES[tNT OTNEa AMT. K. W. AMl. K. W. AMT. k. W. MIT. K. W. AMT. M. P. DRYlRS RIRNACt MOTORS RttUM AMUANCE RNDMtS fPECIAI Rttt'?T i11AE CIOCKS eEll UMT IIEATMS MULf1.O1R1ET DIMMERS MIT. K. W. OIL N. P. GAS N. P. AMT. NO. A. W.O. MIT. AIAP. NAT. AMPS. TRANS. AMT. N. P. ~ ~d Rti AMT. WAii$ SERVICE DISCONNECT NO.Of S E R V 1 C E AMi. AMI. Mt l,e tW t / tW 3 / TY 3 / KW OYtR DCOND. Of CC CORD. NO. Of N41EG Of MI'IEC. ND. Of NFUTtAlS W NEUTMAt OiNER APP11RAiG5: Y SAGF, & LADFHANN 7NC. L~(C..#36i5~ P.b.80X 7768 = 50[ITHQtrD, NY, '1'1.971. p~u REAEEIIOEI! Per this urNficgh most not be altered in any manmr; roturn to tM offin of tlv fbard if inwrrM..inspettors may M iahtltif3etl Nteir cndsnfiah. COrY FOR BUILDING DEPARTIAEMT. THIS COPY OF CERTIFICATE MUST NOT ALTERED B! AMY ttWtNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PacF, 1lv5it?, r BUREAU OF ELECTRICITY 83 JOHN STREET. NEW YORK. NEW YORK 1003E! dUT.V 26,1997 ApplicotionNo.unftle 'Ti89541/9:[ R iR9Ei!$ THIS CERTIFIES THAT only the a/actr4d equipment as described 6sbm and introduced by the applicant teamed on the drone application numher in the promises of gt11, f'ORA7.ZINI, 37.2P ALEF,R'C'SOtV L,ANF:, GRI:FNPORT, N.Y. in the dbtein br n• n gy~e/rsent OiIT J R a61gT1~, 1.~, 7.941. ? lat Fl. ? Ynd FI. Section Block Lot rcea examined on JIl T~ ~ • and found to br in compliance with the requirements of thb Board. NXTUE! ACUN EYYIiCNEE RXTUEES RANWS tY1pKD18 DECKS OVENS DISH WAfIgES E%NAUST FANS DUTIETE INGNDESCFNT ~fIUORESCENi OTHER AMT. K.W. AMT. K.W. NAT. R.W. AMt. K.W. AMT. N.P. i DRYLBS RIRNAC! MOTORS N1TUEt AN{IANCE IODEES SNIpM EEC?T iYAE UOCKE EHL UNIT 11EAiiRf RNILII.OUT1lT DIMMlRS NAT. K. W. Oll N. P. GAS N. P. AMT. NO. A. W. G. AMT. AMP. NAT. AMPS. TRANS. AMi. M. P. ~ T AMT. WATTS I i~ - SERVICE DISCONNKT NO. W S E E V 1 C E _ AMT. AMP. lYN ~ 1 N ]Y/ I 1 ]W ] l ]W ] / 4\V NO. G CC. COND. A. W. G. ND. Oi N4LEG A. W. G. NO.Of NEUTRALi A. W. G. - NR a CC. C OP NI-IEG OF NEUTMI OTNER AMARATUf. Sif'CPiMT.BG POOL-1 SP~C~IAL REC.FPT.20AMP.-1 /f.l'.t:.T.-7-2 c.F.C.T:-1 ~{SW1MI97NG POOL) Ibis cartifir.atN a covers compliance at the date of. inspection only. Aecause of unusaa; / environments it is advi.satlle f,o bane frequent test and/or spars _ made tly a qualified p?rson. ~ .P <<< fontinued nn YagF l Y>> OENElILL MANAOB Per This wrei' must not be aherad in any monnar; return to iM. office of tM Eoord if incorratl. Mspectors may Fr f ntiols. COPY POR !W LDING DEPARTMBIT. THK COPY OF CERTIPIGTE ANlST NOT' BE ALTlRED tN ANY MMMiER. j / J 7651802 BUILDING DEPT. INSPECTION [ )FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU y" [ ]FRAMING [ INAL j V l/ ff ~ ,r/ / ~ 1, `~/~Y~ N lr REMARKS:c~~`'~~~ ( ~ lllAnn 4 ~ , 4 i i DATE ~ I ~ INSPECTOR ~w~ v 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: i E ~ l ~l INSPECTOR i~% '~7 .~t1t,S- ~ita~au.a::.G..:. -a.c..~:.arr. 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I. 1 ..wx ,2 , t S ' Y +5 C. ak ~ a - ;F ~ 775 Q o r~ ~ ~ °l.M1` 'nK ~`c&-. ~ x ° H - 0 SAL 3 _ ~ ~ K d ~ !`C ~~Rx ~ r x 14 `art6''`~ ~ 1' ..0 ~ ~T M, d$ "ly~~ ~ O~~I ~~~Q ~ C ` r n' 1S5 U .+i+.k' r-:1 03 ~k' Cg orb :~z° c a'' f ~3-: i- pa- - ~t~t _s'~ + , < f' S iF `o o''<ou~ E € ~ $ E- ~ ~ r Y ~ v ~ ~ o ~ 09 9 t` r,~e ~x .i i. Ct 1~~ . (E. C,. 0 ~ a.~~ ~.+~9~~1~~' P~ ~i9. `te`a-f v+ ~ " s3 ` ~ itL_(p - 2- . 4~- Z ~ - a 0 eq l a~ xR;.4 N.E$% ~iy4"(~ _ ~'71Cti. _S~~Fry .'Lit,. ~1~=~r ~.t :C a ~a . -~.7.: w = ~ . r.,s.~~ 'lT''_ ~c~~t., . ~ ~ Lei R }dV. v ,,~ryy ak , , r' ~'(x . ~ ~rij r s° 1 1- r 3 _ f {,~H,~*, ~ ~'°hG~. ` =x vyE '~z ry, lll. ( .ti - s'1- y' t - -T,ts._ a ~4 C ~ '~(T Y ~ f11R1 ~ , a Y L f 0• _ l~kS S ~ F ~i ~ y. ~-r F r-, r r „ ii' .f "twat ~ I a3i, i e `;3r ~ ~iMai •~"T~f i~V'JN OF ~ UtPT. - - d~ ~ ' 1/ ,Ly. a _ _ SQUTHOL a, t ::cam ~ ~'~~°•'S-~'' •P >~x ,i;r;•. _ D ~S 171'(3, y t~~ ~~r~ T _..~.-n..:-:a.-.'W-+-'^~°' . - ~.r_,~__.`__ _ _ ems. ~.-s---. GaL~~~.-~ i~t I ~t Zo Y~ i3 ~ ~ ~-,yr.; rsS-iso2 BUILDING DEPT. INSPECTItJN [ ] F UND ION 1ST f ] RO H PLBG. [ ] FO DATION 2ND [ ] 1 ULATION [ 7 F Mi [ FIN REMARKS: l~-~C-l~ ~ t~""t" I~~GIC S DATE ~ ~ INSPECTOR r - ' FORRI NO. 5 TOWN Of SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OffICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date DECEMBER 1 I 19..9.. _ PAUL J. CORAZZINI III TO . (owner or authorized agent of owner) 3120 ALBERTSON LANE ........IoBEENEA&T.,..N..X.......L12rx~ (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance CH. 100 Other Applicable Laws, Ordinances-or Regulations at premises hereinafter described in that A SWIMI~fING POOL IS BEING CONSTRUCT)?D (state character of violation) WITHOUT A BUILDING PERMIT. in violation of ARTICLE $XVIII.r..CH:...100-281 (State section or paragraph of applicable law, ordinance ar regulation) YDU ARE THEREFORE D1REC•TED AND ORDERED to comply with the law and to remedy the conditions above mentioned IMMEDIATELY DO NOT CONTINUE The premises to which this ORDER TO REMEDY VIOLATION refers ore situated at 3120 ALBERTSON LANE, GREENPORT County of Suffolk, New York. S.C.T.M. #1000-52-04-01.2 SUFFOLK COUNTY TAR MAP Failure to remedy fhe conditions aforesaid and to comply with the applicable provisions of low may constitute an offense punishable by fine or'imprisonment or both. u ~~....•••...u.••.....u.. ...u. u..„ueu ORDINANCE INSP CTOR VINCENT R. WIECZORER Cert. Mail) B0,1t:D OF HEALTH , FORMNO.1 SURVEY OF PL.IYS ~ 3 (QQ( t TOWN OF SOUTHOLD ~~°^•-•.x~~~• ~r..~.~ 1NG DEPARTMENT CHECK . • BUILD SEPTIC FORtI BLL3G. DE'P7. TOWN HALL TL1WfU UP SOU7_MOLD ~r SOUTH • • • • . • • . QLII,l~1.Y_t1r171 t:pTIFY~ TEL,: 7G5•1II02 CALL , ~O/Lo`T Examined 19~~ . MAIL T0: A roved ..~~3 pp . PP 19/.x. Permit No. ~7~0 ~ . Disapproved a/c ' . (Bing Spector) APPLICATION FOR BUILDING PERMIT ' Date IS~ INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Ins ,sets of plants, accurate plot plan to scale. Fee rrcco[ding to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining Pecinr, aril! nation. ,premises or public sire: or areas, and giving a detailed description of layout of property must be drawn on the diagram which is par[ of this apF c. The work covered by this application may not be commenced before issuance of Building permit, Upon approval of this application, the Suildin~ shall be kept on the premises available for ins ection throupector will issued a Building Permit to the applicant. Such petr. e. No building shall be occupied or used in whole or in parttfor any purpose whatever until a Certificate of Occupant shall have been granted by the Building Inspector. ' APPLICATION IS HERESY MADE to the Building Department for the issuance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein desctibec The applicant agrees to comply with all applicable laws, ordinances, build' admit authorized inspectors on premises and in building ode housin, code, and regulations, and t for necessary insp (Signature of I appli a , or name ' - ~r , tf a corporauon)~ (D1ailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ...........Q~x _ _ Name of owner of premises LYU l e~ < ..C"oo'~z z Z,'n • • • • • . n (as on the tax roll or latest deed) • ~ ~ ~ ~ " " " IC applicant is a corporation, signature of duly authorized oftcer, • • • . • • (Name and title of corporate officer) $uildct's Liccnsc No..., , d C . Plurnber's Liccnsc No . Electrician's License No. ' Outer Trade's Liccnsc No . . 1• Location oCland on which proposed work will be done; 3~ ~z~ .r,~/~~~~fo~ Lq (louse ~?/'~'c®•7~or~1-- Nuntbcr Sircct ~ - - • , Harnlct County Tax ,,\fap No. 1000 Section • :Block Subdiv' ~ ' ' Lot rsion F.il~d l,la • • /f.~. P No. State existing P yNnt~e) Lot o use and occu Inc of remises and,i~n./t~,ended a/se an/d,, occupancy of proposed construction: A. Existing use and occupancy.... ;y ; C y, , ~'"lOGI S'~ • . • • B. Intended use and occupancy.:.... . • , 3. Nature of work (check which applicable): New OuildinS • • • • • • Addition p~nation . , Repair , , RFmolvIal Demolition .Sw~mrai t>poo1.. Tennis Court , Accessory~IIuildin ~ 4. g.,........Fence .......Other Work:.......... Estimated Cost ~ U ~ 1? . Fee ~ 4ta be paid on filing this aDplication~ 5. If du•ellin^, number oC dwcllin^ units , , , , , , , , , , , , , , , Number of dwelling units on tack floor . e If gars^c, number of cars . 6. If business, commercial or mixes! occupancy, specify nature and extent of each type of use 7. Dimensions of existing structurc$, if any: Front . •Rcar Depth . Height .Numbcro(Storics, Dimensions of same structure with alterations or additions: Front Rcar . . Depth IIcight . • • . Number of Stories . . 8. Dimensions of entire new construction: Front Rear . . . . Depth • • Hcigltt ,,,,,,,,Number ofStorics..........•...• 9. Sizcoflet: Front Rcar, .....:.............Depth...................... 10. Date of Purchase ~ ...Name of Pot7ner Owner 1 1. Zone or use district in which premises arc situated , _ IZ. Does proposed construction violy~te any zoning law, ordinance or regulation: . 13. 1Vi11 lot be regraded , , , , , , , , , , , .1Vill excess fill be removed from premises:. Yca l4, Name of Owner of premises i, , , . _ , ,Address ..Phone No....... Name of Architect......... ,Address .PhoneNo.. Name of Contractor , j, ...Address . ~ ~ ~ • Phone No.. • • ' IS_]_s this gropertp located aithin.3gq feet of.a tidal wetland? =YES....ND....S *If yes, Southold Town' Trustees Permit rosy be required. _ PLOT DIACRAhf Locate clearly and distinctly all'ibuildings, whether existing or proposed, and, indicate all set-back dimensior:•. t: property lines. Give street and block cumber or description according to deed, and show street names and indicate interior or comer lot. • ~I • A)~ RA D AS I~GdTEp P~Ein B NOTIFY L NG DrV-'. ~ 7Gra• -PART taa~ ~ Ann TO a PM FOR THE FOLLOWBNG INSPECTIONS: ti. FgUNDATION Tt/y0 REQUIRED . FDR POURED CONCRETE 2, ROUGH -FRAMING PLUMBING S. INSULATION 4. FINAL - CONSTRUCTION MUST . ~ BE GOMPLETE FAR C.O. kE REO()tREMEN~ SHALL MEET . ' STATE CONSTRUCTION F THE N.Y. GODES. NOT RESPON BLENEFOR DESIGN OR CONSTRUC•I•ION ERRORS STATC OF NEtV YORK, I;I COUNTY OF 5.5 • ~ ~ ~ (Name of individual si^nl' • • • • • being duly sworn, deposes and says that he is the applica: • • • lrrg contracI) about named. ~ ' ]icisthc ~ ~ (Contractor, agent, corporate officer, etc.) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ oC said owner or owners, and is dulw authorized to perform or have performed the said work and to make and tilt tl: application: that all statements contained in this application arc true to the bast of his knowledge and bclicC; and that t:: work will be pcrforntcd in the mannc;r set forth, in the application filed therewith. Sworn to before qqme this ...........°S ..........day of!... 19 1~~ ~i , Notary Pu61ic, t . G[ Y,~t.-.... County HELENK.DEVOE ~ NOTARY PUBLIC, State of New Yak No.4~01878, ChBaiount~ (Si;nature oCapplican' Term Ex res MMar I ~ i 1~ s . --(I- ~ - ~ ~ _ I ~ I I 1 1 ; t i ~ ~ 1 , ! € . .v._._~.., z.. _ I _ { __i_ , { ~ i 7 I \ I / ~ ~ , ~ ~ i i ~i ~ I ~ _ ! ! / 1 I , , ~ ~ C W ~ ~ _ ~ , _ _ ~ _ ~ _ ~ i L. N ~ , _ -t T II I" i ' a i ~ I I i I+ i I I > - _ ~ , r t I ! ~ , ~ i ' : - ~ r - - ~ ~ - - ~ 1 . i ( ~_I _ ' I . . ! i / i ~ ~ ~ ~ I ~ , 1 I ~ _1__ _ _ _ ~ ' _ _ J 1_. M ~ _ ~ i _ ~ 11 ' _ _ _ fi ~ ~ L t -1-~ i ~r---~- ~ , _ _~._J_ ~ _ a _ _ i y ~ ~ ii L ~ rao ~'n i 3 ~ I 'I i I i I I E i ~ ~ I i I ~ ~ I _ _ _ I ' ~ _ ~ _ _ { I I i ~ ~ ° I I ~....s._ v__ 1 ! 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