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HomeMy WebLinkAbout17416-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219410 Date OCTOBER 3, 1990 THIS CERTIFIES that the building ATTACHED POOL Location of Property 3I0 LINDA ROAD MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 01 Lot 14 Subdivision CAPT. KIDD EST. Filed Map No. 1672 Lot No. 122 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 2, 1988 pursuant to which Building Permit No. 174162 dated SEPT. 13, 198$ 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 AN ATTACHED POOL WITH FENCE ENCLOSURE. The certificate is issued to ANDREAS LIDS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N040449 OCT. 18, 1988 PLUMBERS CERTIFICATION DATED N/A 1 ~ ~O...L; Gt.L~ Building Inspector Rev. 1/81 n~oaaz xo. s 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~ o1~41s Z Dote ..../...~..~.`~...... Permission is he by nted to• ~~..:.... ~:3.f.~ .............:~.................../..gs~ ct Premises located ot ......................~t.........~~._............................................................... .. ... ......... . . .. . ... .... .. .. .. .. .. .. . . . . .. . . .. .. .. ..,.... . .Y . ..... ........ .............. .... .... .. ...... .//. . . .. ... .. .. .. . . . . .. .... . ... ... . ... .... . . .......... . County Tax Map No. 1000 Section ...~d.~......... Block .........f.......... Lot No..........~.T........ pursuant to application doted ................~~~......................., 19.A.~ and approved by the Building Inspector. Fee $• ~~0 •• ~~~y~ uild Inspector Rev. 6/30/80 ,~l~u~ ~ ~ Form No. 6 ( "° " ~ ~~°, ~) 1 TOWN OF SOUTHOLD eS"~!~ BUILDING DEPARTMENT 2~ ~~~ TOWN HALL 765-1802 ICATION 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 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 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ......~T:.?x.1990 ....................... New Construction ?:x........ Old Or Pre-existing Building ................. Location of Property..... 310. LINDA ROAD,,,,,,,,,,,,,MATTITUCK,..,.,,,,,,,,,,,,,,,,,,,,,,,,,,, House No. Street Hamlet Onwer or Owners of Property.......ANDREAS LIOS .. .,... .......:......... County Tax Map No 1000, Section...106.........Block......~~........Lot....~4 ................ Subdivision ....................................Filed Map............Lot...................... Permit No...17416Z ....,,,Date Of Permit. ..9~.13~$$......Applicant ............................. Health Dept. Approval ..........................Underwriters Approval,N040449 Planning Board Approval ........................ Request for: Temporary Certific~at"e........... Final Certicate.$?5:00 Fee Submitted: $.. ?5;O0... (i{c!,,,,,,,,,,, yoGll q IOI.3I U ^l7 G. I (/ ID ...... APPLICANT ............... i, #~,: i i t~ U1Lt''f- THE NEW YORK BOARD OF FIRE UNDERWRITERS F'acy: 7 1001381 BUREAU OF ELECTRICITY !IS JOHN STREET. NEW YORK; NEW YORK f003e OCTOBPR 78 .1.988 5818248R/88 N 04044) , Date AppltcarionNo.onJile THIS CERTIFIES THAT Daly the alectried equipment a. described 6eloto and tntraduced 6y the applicotst named ow the abode appliation number in the premtsee of ANUREAS [,IOS, .31.0 L1NOA R<)RU, /p01,!?, ~L'CL #7, NATTITUC,[C, N.X. is thsr;~llotrinp location; ^ ^ I st Fl. ^ Ynd Fl. Ot7T Sertion Block Lot OCTOBYR ) y~~ teat aramlwed on ~ and ound to 6e in rnm J plianre frith the rpulrcments of this Board. ApJK fWITt:MlS RXTURlf RAtgIS tb0ltlsq MClcS OVNif BISX WASHERS EXKAUST FANi. iNpNDtS(:eNT nUdFSCSNT v NAT. K. W. AMT. K. W. AMT. LW. AMT. K. W. AMT. H. P. 1 2 2 9 .:.~EK RIRNAC! JAt>TORf tYIFIY AIWINFi TIMfQOCKS f1fiLL ftMA1RAIMF /MRTA.OY[LLT BIbIbAlRS ~ AMT. [, W. Oll M. P. GAS N. P. NAT. Na. ' A. W. Q AAti. NM. AMT. AAVd. TAtita. NAr. 14 P. ~. ~tXt tpT AAa. WATa ~ 1 20 1 40 -- --- Ei SfXIVII'B EISOOFNACT t1 D:0i - S E R V - 1 C E AMT. AMP. TTPt F l / ew l / Svv t I aw s,e [w No.O~e. eONa a cc ioi+o. No: or h.uG of Hi'l o No. w NterKAls of 'riuTGiul ottu uFAtuyus: "t(ST/IMNING k'Q(H,? This cert:ificat.e covers compliance at The daft of inspection only. Rerause of nnusua) environments i.t .s advisable ro have fraquent tes4/tand or repairs tbade lay a quaJif.ied perso?t. _l YAT LANr,' MA1"CITUCR; NX, 17.95?. OEh1NtAt 17 n f~).C8'NSF~ NO. 2300 $ Per f" This cerlificaN must not 6e ahsrad in any mamur; rNUrn to tlta offiu of the bard, ~ iateRect. Inspscbrs may be identified by their crtderMiah. - COPY FOR lWLDING DEPARTMlNT. THIS COPY OF CERT,IFifi~ ~~IOT lE ALTlR~D MI ANY MANNER. -----___ _ _._._~_- ~ ~_ . _ ~ . _~ Y __ __... ~ ~ ~~ c'lE~.D Ii:S:'EC: iU1J ~ ~UATE ~ %OMN(ENTS ` -o ro 1 . 3 _ _ Hv y P FOUtdDATION (1st) c FOUNDATIOtd (2nd) m 2 . z ~ o , ROUGH FRAME & PLUMBING c ~ ti H 3. ~ f IIJSULATION PER N. Y, y S STATE ENERGY CODE x n ~ \~ ` ._~ ~' 4. y e 4 ~'O FIidAL ~ o. z ADDITIONAL COMMENTS: x '~ C., • - x b ~ H ~ ~ ~G o~ Z ., ~ A ~ ~~ ' m ^o H FORRI NO. v TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION fi Date ......AUGUST...~~.3 ............................... 19...89. TO ....~M.r: A Mrs. Andrea Lios ............................................................... (YJ~2eAQiee~ROa~ed agent of owner) Massapequa, N.Y. 11758 (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance `. .CHAP. 100 ................................. Other Applicable Lows, Ordinances'or Regulations ............................................ of premises hereinafter described in that ,,,,DECKS AND ADDITIONS WERE CONSTRIICTED WITHOUT .............................................................................. (state character of violation) A BUILDING PERMIT AND IISED WITHOUT A CERTIFICATE OF OCCUPANCY. .................................................................................................................................................................. in violation of ARTICLE RRVIII CHAP. 100-281 6 100-254. ........................................................................................................................................ (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers are situated at 310 LINDA RD., MATTITUCK, N.Y. ,,,,,County of Suffolk, New York, ................................................................. SUFFOLK COUNTY TAR MAP /t 1000-106-01-14 Failure to remedy the conditions aforesaid and to comply with the applicable provisions of low may constitute an offense punishable by fine or imprisonment or both. ORDINANCE INS'ECTOR VINCENT R. WIECZORER lr al r APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Chazles Grigonis, Jr. Serge Doyen, Jr. Joseph H. Sawicki James Dinizio, Jr. Telephone (516) 765-1809 ,~~FFn~K~oGy< N ~ ~oi~_ ..~~~~ BOARD OF APPEALS TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 ~6t~ , TO: `7ictor Lessard, Principa~ly,}~Building Inspector FROM: Zoning Board of Appeals T DATE: April 24, 1990 RE: Appl. 13a. 3920 - A. Lios Together with the public hearing a physical inspection shows that the swimming pool and deck area is not attached to the dwelling. We have several questions we would like answered regarding this application before we can continue with the public hearing. 1. Regarding lot coverage, Can you show in writing how you calculated that the lot coverage is 65a over the excess of 2002 Please indicate a total percentage of all the improvements on the property including swimming pool, deck and house, etc. 2. It is our understanding that the Building Department has not issued a Certificate of Occupancy on the swimming pool, are we correct on that? 3. Why was the permit granted far the swimming pool in the sideyard area? VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 r-'', ~ ; °.~~~~~, 5 a;f OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD To: Zoning Board of Appeals From: Building Department Subject: Appeal #3920 - A. Lois Date: April 25, 1990 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 S will try to answer your inquires and attach copies to help clear the air. 1. Lot coverage: Property: 10800 (90 x 120) 20%: 2160 1394 =.65 3554 =.30+ Proposed: 3554 2160 10800 Over allowed: 1394 650 over allowed 200 30+~ lot coverage 2. & 3. Swimming pool permit is still active and not not done as applied for. 4. At present there are some "Orders To Remedy Violations" on this property. A. Construction of a porch without benefit of a building permit. B. B.P.# 100342 without a C.O. (now obtained) C. B.P.# 87012 without a C.O. {now obtained) D. Expanded deck with permits. li FORM N0.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL fr ~ /~ / Date ...t~l.~/!? ................. 19 ~~. To 7.(~ ~~.. gG... ~! ~t G841. ~ W~ ..:~t~..~-3: ' ..................... . PLEASE TAKE ~NO~~TICE that yo-u/r application dated .....~~....; ..........., I9 ~9. for permit to G~!2 . ~/~ G3.%Z~~.. ~,~%~ . G~~.. a~ ~ .. iC. ... Location of Property .:-~~D '"~.!>~ ~ ~~~ House No. Street ~~~~~~~~~~~~~~~~~~~''~//Hamlet County Tax Map No. 1000 Section .... 1~ .<?.... Block ...... ~...... Lot .... ~.7`..... . Subdivision ................. Filed Map No. ................ Lot No. ................ . is returned herewith and disapproved on the following grounds .Cl~p!~..~v~GG ,_~~ . ~ .. . ~ ~~ .~~.. .. ..w.:... ....... _ . ~~ a:~ =~ Ytd ... _---,. ......:............................................ .............. ................................................................... ................................................................... ,~ • •. Builds g Ins ct r ~ ~~~ RV 1/80 JCY ~ L 17DV CANT Rq L I A 11 1 1 x 3 m b 1 ~' O O •' j~ O N i 4. H ~ io 0 J o•. t 3 s!•-v ti ,~ N ., ~ f r'ne h[Ne+ y +Y 8 . tXl //1 :.\ ~ I~a~ ~ e/r S1~~p600 N: / X01 123 1 ;. . . ~, Thi's~orv~e.ar/y se'rV~e~6y;~ ~iiYA7°t IvolJVr CJOr»~OOgY , ~, .r NDFEy ~ ~ 'N:ai': ,,; , ~' Ij ~V ~ • MONUMENF''' ' '. SiY SUBD/V/S/ONMAPF/LED/N7HEOFf7CE ' •; OFTNECXERKA~SUFFOLA'COUNTYCN •~ /AN./9,/9t9ASRLEN0.f6TP. ,, . ' ~~, , y ... k~.} „j~lyJr :It V, ~ [ () ~ ' , ,9 .. ' , . ' ' ~' e 3 +•: :~kiC f L . '~ P ~ :J 1„. dlr) .~L ~ ~y ~ . 1(`!i L4I' _1, 1r, 11 1 ~1 ' ~e' ` ~,4. ti ;i ~'` '~~' ~~ ' :; s , 1•,s; ~t j; ' . s ,.~ ; „ '., ~.k}~}f»j{ : Ayli''' ' ~~5. ~.~ f'1:. ~ :1 i ~ . ' .-(!~ 'il - ,. '4 s ~~ _ ~ ~ ' W J'.I I ~ ' C'L •S tit -! I T "D ~ ~ d `tt i Z :C : ~,., , nl-~..~ V ~ ~y ~ T. e ' .: f'i , ~ '_ ,. I ~~. ' ~. • ~.. r 1A0 ;,,; ± ' `'t y ... ' .. +, I - ` I !RB LOCAfION 01' t4ELt$ AND C$$5POOL3 $N034N NEREIN AR6 FROM FIELD OBS$RVAfION$ ARDIOR FROM DAlA 01iTAINHD FROM OfHBR$ 1_ - , . vnwtllalt[D utuAnuN on ADDmoN ro reu [voter 1! A vlaAnoN or ![enoN riot 0) tNt NfM THIN t1Atf tOUCAfION ut Cal[! D( iNl! lUNVCY MAP MOT of ARlNe iN( UMD NnV[TOA'1 INk[D ![AL 011 t LIe01lt0 lCAL pull NO1 DC CONl10ln[D to er A vote twt Dar Lv,e+Nrrr! 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RAVE " ° ~ ~ I~ ro~ ti W W 3 ,*yb ~°o~at"a ~~('~Nyj9~ ~3' ?~'0 a OP m N i'~ ~ Yll ~ b O p ~ ~~~~] ~ 1 I N ~ P Ay ~ m SIA 8ej ~ ~ to M a~ ~ tT1 ~ ~ q 0 n ~ N ~~ ~ ,,it'd ~',pPsa'~-",~~' ' d.4 ~~~~ ~ 1 ~, .od b DD 6 11 L/t~O~"T~132A?,~"/}C~AtPtA /N K/DD ESTATES" ~A NAl Eno1ME Ar MA7r~/TUCK SOURTM~LD SAV%NCS BANAL SECU4/TY T/TLEB 6UAR4Y1 7oWN OF sourNOCa ~~~~..;,;,,. ::,...:,r: .,~~il~~',F:'~~~X~~h:Cr~ SUFFf~LK CO.; N, Y. ' 'J ':,';,' eY ^ ~ ~<s:1~Y i 9CALE1 /JJ ~ ~„! ; : DAtRI APR. l,~/9T4J~' ' ~l'4 2/d `~ ~';: ~N. ; i~r; + I,i. ~ ir,l' i'. n~' , 'i w `~~31 ~NI f'{ k' '..~~~' a I 1 .. ~, Gr ~, ! ,~... ~. '~ :~`~~ r. ~ . '• .t ~•.~r 111 ~~~ :~ ~? '• 1, ~i, ~. ., I'S. '. ~yt .. ~: I MI sr Its F' D ~ r BOARD OF• HEALTH•,::::::- `'~Im,~l 3 SETS OF PLANS FORM NO. 1 SURVEY . ..... ~- ~ ~ TOWN OFSOUTHOLD CHECK ••••• BUILDING DEPARTMENT SEPTIC FORM ........•....: TOWN HALL ~'I °OUTHOLD, N.Y. 11971 NOTIFY TOWNO SOUTkOLD ~ CALL •-•••••••••••••- TEL.: 765.1802 MAIL T0: ,,~ Examined . 9 ~3 .., 19 ~~ 9 ~,~ ...... e~ ,~.,( y / Approved ... ~~~ ......, 1 ~J. Permit No. ~~~. ¢- ~J~d, bisapproveda/c .................................../. .......................................... ...... . ~ .!....x:22 C//l~n Spector) APPLICATION F R BUILDING PERMIT 99 Date ... 1~~.........., 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. z~• r ~,~ .,,, It`~ ~ ~~„~•~~ APPLICATION IS HEREBY MADE to the Building Depaztment for t1;je rssuange of a,B.uilding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York; and.other~ apj~licable Laws, Ordinances or Regulations, for the construction of. buIIdings, additions or alterations, or fo"r removal o~'c~emolition, 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. (Si,nature of applicant, or name, if a corporation) ~.....,- y.~.~r~~..~.,~a ~Tm.r1 l' d:. /.~. ~:X....`~.3.5!,..~'rl.~~:°%~~"rl`7~crl. ~Y8'..°'^'~°'~° - "I-1'i (Mailin address of a hcant) ~p Tftf~+cAr?ils'~ ~HtC1J3it@! 4''',?ili+"~ g PP ~!T ft~r~ MH9 ~ ~fP'f ~tA4 ~~t d~s~ State whether applic~pts is 'p1vD;e,17;e~,i agent, a/rc~h7itect, engineer, general contractor, electrician, plumber or builder. tt~+~.a.~~ ~ ~s~l~~~~ ~ s~~/.~~,E~-~. L~IO.S. Name of owner of premises ... wRi?ft.. a.;,;:= f ........ ...................................... . C?>lt11~A s~~pr,f:,?t;+:°c.~q (as on the tax roll or latest deed) officer. ~~~ ~NTY LICENSED EN UP NC~~yIp~ RN .. gPcF®R Electrician's License No. .zvGD.ln,~.~~ ...~.~-~« Other Trade's License No . .................... . 1. Location of land on which proposed work will be done. ...T I~... ~: ~~~~ . /w.~~/...~~~..f~/../r/~~/~ .... ,~lv ...................~ iW~.~ .. ~!~~ .............~1~-~-, ~e.rc .. !l!. y. , .... . House Number Street Hamlet County Tax Map No. 1000 Section .....~~.6. • • • • • • . • Block ...... ~........... Lot ......1. y......... . 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 ........... • 4..:-+ .., .. ~~ ~• ~a.It~'c3.bu[r~~ '' &rt ..:.: ............. . b. Intended use and occupancy ..............7•V ~~~.~??~/~~:: L/, {,~~, ; :~(~ !~Zl'~ :............. . Plumber's License No . ....................... . ~'~ / ~cu 1 u/G `l6'OL rb' 3. Nature of work check whiRemo licable): New Building .......... Addition .......... Alteration ~".... .. . Repair ...... (..... p,val .............. Demolition ..............Other Work ........~~.,7C.. . ~. /~s~, I ~scripSion) 4. Estimated Cost ....... .:. ~-! U ............... Fee ..................... . i (to be paid on 61ing fhi~apislcation) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each fiooY :'::j.:°:~......... . If garage, number of cars ..... '', ............................................ . ...... . ............. . 6. If business, commercial or mixed, occupancy, specify nature and extent of each type of use ......... . .......... . 7. Dimensions of existing structure, if any: Front ............... Rear .............. Depth ..... , ........ . Height ...............NumperofStories....................,................................... Dimensions'of same structure with alterations or additions: Front ................. Rear ................. . Depth .................... ';..Height ...................... Number of Stories ..................... . 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. . Height ...............NumperofStories........................................................ 9. Size of lot: Front ........... !........... Rear ....................... Depth ..................... . 10. Date of Purchase ........... ~ ............... . ..Name of Former Owner ............. , .............. . 11. Zone or use district in which premises are situated ........ , }?G-t'/ h'J.C~T.i/9:1- . . . . . .. . . . . . . . ............ . 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~ ......... .. .. 13. Will lot be regraded ........ ~y~~,~~., ~..`~.,,.,.~............ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . /(/,`~/.icGlr..a .. x./.4.5. ,Address .. /:tZ/4,7,'/,,? fcr,aG ...Phone No. ,~. ~...p0'~ Name of Architect ..... .. ' . ........... ...Address ...... . , ... Phone No.... .........:~ ..... Name of Contractor .. . ~ f.?,.~7.Gc Y (; . ,~~~'. Address .. ~1.~.~"Gt-Q l~'. ,Phone No..rL. 7.~:' ~~5. . ,. .. 15. Is this property located *aithin 300 feet of a tidal wetland? *Yes ..... No~... *If yes, Southold Town Trustees Permit ma be regwired. PLOxI' 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. "IMMED~ATE~.Y" ENCLOSE LTO CODE UPON CO~W.ETION BEFOR~,'yV~TER"~~~~~ fk~~~~ aATE: ~~~ ~'`~ 766-18D~ • AM R14 .lilt FOR THE fouawlNO INSPEC~na~is: 1. ~NhO~h~0~1 ED 2. ROUGH • FRAMING i IN.tIMlIFIG S. INSULATION 4. FINAL CONSTRUCTION MUST SE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REOUIREMENT$ QF ,THE N,Y. STATE•CONSTRUCfION 8 ENERGY CODES. NOT RESF'ONSISLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW Yf~~Rl~., S.S COliNTY OF ...mod.`.`/'T~.L '~.. ~~,,~~ ,~~j!G,I!!'t!~L/ , , , /~ , , ,/yiG,t'!GG tf, , , . ~ ; , , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..............~~"",Tw/~}'C-~~...........,.................,...................,..... j (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly' authorized to perform or have performed 'the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~A1 ............. ~ V\.C~- .day of .~~. ~......, 19~Y /rip ~. .. ~ ~ . . Notary Public, ..l`1 ~~:-~:".': `'t. . '~ ....... County Notary Publb, State Nsw York .... . No. 48788 11ua1Nled In Suffolk County nmisslon Expires December 8,18 (Signs a applicant)