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Home My WebLink About17586-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219229 Date JULY 23, 1990 THIS CERTIFIES that the building INGROUND POOL Location of Property 785 THE STRAND EAST MARION House No. Street Hamlet County Tax Map No. 1000 Section 30 Block 02 Lot 83 MAP OF PEBBLE Subdivision BEACH FARMS Filed Map No. 6266 Lat No. 81 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCT. 18, 1988 pursuant to which Building Permit No. 175862 dated NOV. 3, 1988 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 INGROUND POOL WITH FENCE AMENDEI} TO INCLUDE DECK. The certificate is issued to BASIL P. KATSAMAKIS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N057053 FEB. 7, 1989 PLUMBERS CERTIFICATION DATED N/A BB i1_~nspector Rev. 1/81 POEM NO. D TOWN OF SOUTHOLD BUILDING DEPARTMENT 70WN HALL SOUTHOLD, N. Y. BUILDING PERMIT ffHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N o G ~ 5 8~ Z Date ,1,1~ 19..~~ Permission is hereby granted ~3..~~ ct premises located at ....7d..~~..r.........T~,~~~~.,/.l~:.s~.a~ County Tox Map No. 1000 Section .....~;,~~T........ Block 2........ Lot No........~:-3 pursuant to application dat d 19.~~, and approved by the ~-x~~, ~~~/z./~ s Building Inspector. '.p 0 Fee ~ij~ eo ~T O D o Bu' n Inspector I ~i o~B~ ~ 3~ ~s~`j T 5 ~ ~ v~-~~-dZe. .-~e.t+.~.-0.9 Rev. 6/30/80 ` TOWN OF SOUTDOLD BIIILDING DEPARTMENT ~ ~~~~~,~J~ta~3~,~ TOWN HALL p~ ~ A ~"~f~ SOUTDOLD, NEW YORK 1 197 I 1~ ° J~~ 3 U a ~ 7b5 - 1802 ~~~~_~ry~. ~~_rsc. ni:~r. . rcw~~a ~o+~rFaa~~r~ APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE.. r/'~J~~~~....... NEW CONSTRUCTION ...Y__.OLD OR PRE-E%ISTING ,BUILDING......VACANT L7AND.,...... Location of Property..~~ ~`S'~ ~^r:~.~:~`f.. - llOUSE NO. STREET HAMLET , I Ovner or Ovners of Property../J.~ ~ C . /.'.F,-~_ , S,G;M^~!'L~,S . . . ~.o~+ .p':2 :aa CounCy Taa Map No. 1000 Section Hlock Lot........, Subdivision. Filed Ma .~......Lot_......._. '~<t Permit No. I7 5.~~? _.Date of __PIIe~~lrmit j1:3;~4,.Applicant .~~;5,~./ .~~~°:~~'`~~;/~?S Health DepC. Approval .......~'vl~~~!y........ Underwriters Approval.a4Ye°by, ~~Sp~'{eo PlanniaE Board Approval F Request for Temporary Certificate Final Certificate Fee Submitted; $ ~~.~~.~.o~ APPLICANT.....:.'`5~~~L'.''~Y.:~:.......... . ~i~ ~y9 Co ~ 1~~(~~ rev. 10/I4 /88 i FORM NO. 6 1` TOWN OF SOUTIIOLD ~ BIIILDING DEPARTMENT TOWN f1ALL 765 - 1802 APPLICATION FORI;CERTIFICATE OF OCCUPANCY INSTRUCTIONS I A. 'This application must 6'e filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: t. Final survey of prop~rCy with accurate location of all buildings, property lines, streets, and unusuallnatural or topographic features. 2. Final approval of Be~lth Dept. of water supply and sewerage-disposalCS-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less than 2/10 of ]Z leads 5. Commercial buildings} industrial buildings, multiple residences and similar. buildings and installations, a certificate of code compliance from the Architect or Engineer responsit~le for the building. 6, Submit Planning Board Approval of completed site plan requirements. B. For existing buildings„SPrior to April 9, 1957 non-conforming uses, or buildings and "pre-existing" Iandl,uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed"application, a consent to inspecC signed by the applicant ~ and a certified abstrlact of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, Che Building Inspector shall state Che reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informationlrequired to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1, M application for vaFant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership ofjthe entire lot prior to April 4, 1957 shall also accompany the application. If ~ Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 'I D. ~ FEES: 1. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $10.00 Addition to Accessory buildings, $10.00. - Businesses $50.00. I 2. Certificate of Occupancy on pre-existing dwelling - $100,00. 3. Copy of Certificafe of Occupancy - $5.00 over 5 pears - $10.00 - k. Vacant Land Certificate of Occupancy - $20.00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $15.00 i i ~ ~ zev, 1bllGlsa r'1ELD 1.:~P~C:.U;i ~fUnir, ~ i;OMMLNT° \ ° - ~ v\ 1 . _ ~(j H H r0Ut1?ATION (1st) ti ?OUt1DATI011 (2nd 1 _ - ~ n 2, z ' o ROUGH FRAME & PLUMBING H 3. m ra y ItlSULATIOf1 PER N. Y. STATE ENERGY CODE z ~ k . l.~O~i"Ly~ FI11AL ~ _ .Q. NO,_ (1 ?cep n _ _ ADBITIOASAL COTM1NSENTS: x A/e~c ; / m x -n H_ / _ 5] \ W\ 9 H H q 0 c~ a r y ` ' S m ^o H - oS~FF~LKCOIi VICTOR LESSARD ~p~' 'yL Town Hall, 53095 Main Raad PRINCIPAL BUILDING INSPECTOR P.O. Box 1179 ~ 'z (s 16) 76s-iso2 ~ ~ Southold, New York 11971 FAX (516) 765-1823 y0~`o-~ ~a~~ OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD July 10, 1990 D ~ JIA. 2 01990 Basil P. Katsamakis TOWN~C7FSOU FIOLD 530 East 72nd Street New York, New York 10021 RE: Building Permit #17586-Z (Swimming Pool) Suff. Co. Tax Map #1000-30-2-81 785 The Strand, East Marion, N.Y. Dear Mr. Katsamakis: Pursuant to our telephone conversation on July 9, 1990, I return herewith your check #1416 dated January 30, 1440 in the amount of $25.00 as it is outdated. The reinspection of the swimming pool has been set up for today. Please send us another check in the amount of $25.00 for the fee for the Certificate of Occupancy. If the pool passes inspection today, we will be able to issue the CO when the check is received. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Geo~Rudde~ secretary 530 East 72nd Street New York, New York 10021 January 25, 1990 Mr. Victor Lasard J .;.e ~-:.y,;;' Building Inspector ~ c' Town of Southold Building Department p Town Hall ~ JqN 3 01990 Southold, New York 11971 ~ +y@ ` Dear Mr. Lasard; ~ Attached is our application for a Certificate of Occupancy for our pool. Joe Hollid of Security Fence, who installed the pool fence, has directed us to send this to your attention for final approval. If you have any questions please contact me at my office at (212)6202863 or Joe Hollid at (516)765-2090. Thank you for your assistance. Sincerely yours, Basil Katsamakis 4 ~ F w~ ~ 4 n n,A T~ Y L ~ ~ A C~ - i ~ ~ ~ ~ ~ ~ { ~ P ~ r m T`, ~ Y , ~ ` ~ e } ( tiM z eY` ~ 4 ' ~ b uA r~ ~ ~ L ~ ti ~ * J { ~ ~ ~ ~ ;;e ~ rai ~ ~ b, 41T1 ~jAa _,F ' S. ~ .raE V s d~' ~ D W ~ ~ ~ t a'~i o, y, ' ° ~i&~k :i L ~ ~ s y i a 'R 4/iiv .~fr{. _ pC a Q Q', a V a P ~k~ A.t . ~ } ~ f ~ S~ t }y u ~ _ 1 { tF f O ! S ~ } ' ~ 1`t, r ~ d1afi''~', k r ~ ~ ry. ~ ~ C~c, n s - \ s~ppa F ~ 'T~ yo- t ~Fy pNt Y.j?~ tl~, ~ N`~E"~ 4 A 5 y l ~ Y t ~0. Y!!~ l St` $ 6. i 1M1 ~ y~~y' 4 T ~ i~. ~ ~ ~ Y 2 ~ 7R+ ~ T~J" i a t . ~~ti '"U.rt~'b* Pl L~ l -.x t h l y ~ 111111~~` ~,Y ~ q~~ Y y ~ 99f \ F Yi n,~4r { F ,Y 1 i xli ~ g n:Y ~ i ,.m o~~FE~LKCDG VICTOR LESSARD ~ ` Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR ~ z P.O. Box 1 179 (516) 765-1802 N `~T' Southold, New York 11971 FAX (516) 765-1823 ~Q'`0• ~ ~~~`c- OFFICE OF BUILDING INSPECTOR TOWN OF SOUTAOLD July 10, 1990 Basil P. Katsamakis 530 East 72nd Street New York, New York 10021 RE: Building Permit #17586-Z (Swimming Pool) Suff. Co. Tax Map #1000-30-2-81 785 The Strand, East Marion, N.Y. Dear Mr. Katsamakis: Pursuant to our telephone conversation on July 9, 1990, I return herewith your check #1416 dated January 30, 1990 in the amount of $25.00 as it is outdated. The reinspection of the swimming pool has been set up for today. Please send us another check in the amount of $25.00 for the fee for the Certificate of Occupancy. If the pool passes inspection today, we will be able to issue the CO when the check is received. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Georgia Rudder, Secretary i ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ) ROUGH PLBG. [)FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [/FINAL '~D~ L, REMARKS: ~ ~ ~`1 ~}~,~Q~n DATE ~f,~qy INSPECTOR r l ~5~~ rss-iso2 BUILDING DEPT. 1NSPECTI~JN [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INS CATION [ ]FRAMING [ FINAL REMARKS: E ~ I r~ ` - t f II d ~ r~~ / V C~L~~ DATE ~ ~ INSPECTOR ~ ~ ~ ~~'C 765-1802 BUILDING DEPT. INS~ECT~ON [ ]FOUNDATION i5T ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS : GAO . ~tP~/ _7~- r DATE ~ INSPECTOR . THE NEW YORK BOARD OF FIRE UNDERWRITERS ' x. l.noo~loB suREwu olK ELECTINGITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 - Dete 1''KI1RtFARY- fS7,~4B9 ~ Applkotion No. onJile 6D~t33489/R9 II D57DS3 ' THIS GERTIRIE:$ THAT only the eleen/ed puipwwnt p deretibed 6dote end introduced 6y the epp(kynt named an the eboue eppBaetlaa number itt tMpromieer q/ - e_= BASTG KA'C'SAMK:[&, THR STRAND, N;. TtAR:CON, N.Y. in the fdbminq /antt~iaann~t.. 89.....~ ? let fl. ? Pad Fl. nDT .Strtion Black Lot R:1 ,)ANiIAItY 75,~ mar examined un ondfound to 6e in compllonce with the reyuiromentr of this Board. fIKTyEE tb01EN0 MCK6 DIEM W AUET LANE OUTIl1{ AC7Ef AIGWelKlM Ild7letClNT Orata NAT. K. W. AMT. K. W. AMT. K.W. MIT. K. W. AMT. X. r. DRYERE RJENAq MOTOEf IUTUY AlNIANC/ IMOMf fiEWLiEtC'H TMY GOCIIf pLL IEMTNMTEW MIN11-0UTYT gMMERf AMT. K. W. dl X. r. OA4 X. r. AMT. nD. A. W.6. MIT. AIM. AMT. AMri TEANE. MNT. M. r. ~ ~jgT MIT. WATTr :t0 ] 4D EMIVKPa DIEpOfNNCT ND.q S E R V 1 C E AMT. AMr. T'm , / tw i / rw t w 9w a R rw uo. or~c; aw. A. w. ~i+a. q0. TK ,alto a « Iii uo. a utuTMls otA'r~uniAl o11tn1 errnlatus: PANF:I.BOARDS;1-7 CCR. Fi() A(SNT.KHLNG POOT,# Tltis CRT, ti. f.lcat, ravers rola~lianre at the date rf iTTSperr,i.ou on'i.y. Because of un,asual envirantpents at is advisable tr ~ have frwquent test/and or renairv made by a qualified pPxsrn. SAF,VATOR6 C. PRATO WT6GlNS T~AN.F.. pmt R.R. BOX "lil$ GRRRNPORT, NY, aT99A p pn ll, Thir wAificole. reUSt not be akend in moaner: retwn to iMlb~~~~lTl~ford~atl. Inspecton awy be ieMrNified by 'r It. ti.. . F ILD A N MANNER. W.~ ~ . ` ~ ~ A I~G~~~' . cn a c.~ ° p ~ ~ y JOS~s~O ~ W ~ w 'won; a Z o ~ ~ ~ O~ ~ Q oe fR N * ~yo*''~ 6 ~o ~ z N ~ gp cn w6 cn D m ~ ~G. _ -C z r w ~ n o tf+ m o z~ w m ~ o ~ -u m w cp rn ~ z v ~ ca o rn w ~ ~ n a m o. ~ ~ W 14.3' zl.a' c7~~ ~„ra ~ N O N ~ I ~ p M O A ~ ~ W a X O z. a ~ ~ CT 0) z.o' ~ 26' p Izo' 11~5~ ° ~ ' ~ ~ W - z a ~ W ~ ' ~ m O 14.3' °s ~ r. a' N m u g n Ul '0 z Z ilot 5* PP 115 E ~ ~ 1e.7' A. ° ~ $0 ~ ~ N I6.0 m ~ SY~:_ r x , I o 1 j~ ~ ~ ~a A ~ ~ ~ d w ~ N r P ~a eD W ~ ~ cN S A ~ O ~ ~ c0 -n ~ . co ~ Z O mDO O ~ p 'O ~ I z "o L S I in (n p Z m m ~ gL 9 2~ 0~9 ~ cn -~r ulX„~D° r ~ ~M n ro~oOtn--~~cp-'~m rn n~-- I Cp wmp~"~ _ GD-nn O n P o ~ m z "n -J ~ z O Z Q D ' . ~ ~ c~~o -~z. t p ~ '+i z J+ z ~ ~ > = y , . a co ~.p ?.3l`~ ~ 2 ~y5 ~oQ~~ to m ~ Z ,a o y r- ~ in m 0 ~ czi n 04' ~ ~ g z w D m ~ 3 e , { ~ g w ~ A (0 w " 0) O ~ ~ V ~ ~ RI A 2 p ~ w m m ~ ~ D w ~ _ r C_ b N p 14.3' Q o Q ti 8 o ~ ~1 OJ ~ a' ' o O ao~ A rw U.5' g ~ m o D 14.3 ~ & 0 2 ~ p m 09~ ~ t c ~ S ~ rwr rtAr IIS~ Nr~. A R" Q 8 ~ ~D Z-'Intel frl ~ y i o~ a ~ ~~3~ti "ow' x m ' o ~ r `rronti~ ' ~ v ~ T ~ m n a ooo~~ r0 0 cn ~ of x N -i w 3 m n oo - a a v~ z rv - m x~~~~ m " 'i'o 8 ~rn z y cn w c .A ~ o - a N A 2 ~ ~ n (O - ~ r D to co m 'o ~ o ~ ~ ~ p C L. T D O I a~N~ O Z-imro -m - J ~ n ~ `~DO~~DV ~r~ BLaZ\o19s ~ z N m c~ ~-m0 Z2 ~ cn ~t~o -CiD~n O m °vOn'. 2~mx - Z r0 Z ~ A n -~v N~ w rn ~ t~ ry BOAKD OF HEALTH , 11 ~ 3 SETS OF PLANS u FORM NO. 1 SURVEY . Q~'~' ~ 8 19~~ TOWN OF SOUTHOLD CHECK • • • • • • • • • - u BUILDING DEPARTMENT SEPTIC FORM et.DC. oel~r. ~ TOWN HALL NOTIFY TOWN UP souTrtc~tD „OUTHOLD, N.Y. 11971 CALL ..os...,.._......~...,__.._....,... TEL.: 765-1802 pp MAIL T0: S3 / Examined 19~~5?y, Approved ..,ll/..3........., 19~!S!Permit No..~/~~~~~ Disapproved a/~c g Buildm I ector) ` '~IMMEDIATELY~~ APPLICATION FOR BUILDING PERpA1T _ / ENCLOSE POOL TO CODE Date . 19 . IYQ/ UPON COMPLETION BEFORE "WATER" 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 pazt 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~~~S~katiq~z,~f' l~µ~dings, additions or alterations, or for removal or demolition, as herein described. The applicant agree ritl iE~t a ]"'applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspe~cto~s;pt! L2xeanises,.and iri building for necessary inspections. rpq""g yq?.ei;~a~,~,~; t~?wf3btlt'3,1id P'~ ~ ' . (Signature of applicant, or name, if a corporation) ;tiS ~ Y i:j,i2 5 Yk~'~'~ N~ ~ 1 f ~~11,~, 'i.~ i i rt.~ ? , ~ q ~ C ~S'~,e'aF;'; ~'r,:?.E; ~1'y~li`!~'c".,.t~~ ~K..~...?C1....~..?~.e'~(-43~~./~:...... ¢7~~§¢3,6t"~~Y9 ~4c~"~~"t~A`~~;" ` (Mailing address of applicant) ~'1":18;1~1t?~rht~tktr:a" ~?r>=t State/'whether"1. ~°fl6ta+~tt off' tr,,gp~~~e3E agent} architect, engineer, general contractor, electrician, plumber or builder. ...'efw f x~idA:S ~t,~C9";Y4 )~fi'`,'r''"r5~t;1 . Name of own~r~d~'~r ^a . lI e31,?' f.~.i1-> 1~ kd . k~.avt~8??!e ~ 8ii13~t.b4is~&~t'-~ 5 (as on the tax roll or latest deed) If applicant isr~t pr ~t,8t~tt~l;"~g'BSturre''8'~'duIy'airthorized officer. (Name and title "co orate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. ~.S $S~, ~j~ Plumber's License No . . Electrician's License No . a.~p~ Other Trade's License No . U?'ON COMP TO COpE BEFORE'•WA ER 1. Location of land on which proposed work will be done . , House Number S>>treet Hamlet County Tax Map No. 1000 Section .......J. o, Block Lot lJ ~3 . Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intende/d~use and occupancy of proposed construction: a. Existing use and occupancy 1 • • • . b. Intended use and occupancy ...~.~1 x4~( .~~~??a~^~ . Ewer-- ,~?u,~~ ~,`T~'~j'~ . . ~ r~ ~ 3. Nature of work (check which a licable :New Buildin , Addition Al ~ { ' ' Repair Removal Demolition , ...........Other Work .SWiv.~ ~1r; , , 4. Estimated Cost .1.~/~ I Fee . ` (to be paid on filing this application) 5. If dwelling, number of dwelling unfits . Number of dwelling units on each floor , , , . , , . 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 structures, if any: Front . ........Rear Depth . , . Height ...............NumbeiofStories........................................................ Dimensions'of same structure with, alterations or additions: Front Rear . Depth Height Number of Stories , . imensions of entire new construe tion:Front Rear...,........... Depth Numbe . 9. Size of lot: Front .'F of Stories ~ ..........Rear.........' Depth 10. Date of Purchase /.9zt7....~...... ..Name of Former Owner . . . 11. Zone or use district in which premises are situated .....piws~ . . ' 12. Does proposed construction violate any zoning law, ordinance or regulation: . i 13. Will lot be regraded ....C`!~ ....Will excess fill be removed from;.premises: ' Yes; do 14. Name of Owner of premises 13A2~4r.~~,SAh~A~S. Address .73'Jr. 1"Nw ~14Phon0 No. ~l2 _ SS~• Name of Architect ...........,,~.,,-.l Address ...................Phone No............... . Name of Contractor 5.r,~.iLl~1D. If yes, Souphold TowntTrust''T~ 'Address R~841>,.~3y..~Id,....Phone o.7~va.-31?~.... 15. Is this 'thin 300 feet of a tidal wetlandY *Yes * ees Permit may be required. PLOT' DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from uroperty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~~r ~n ~l ~®q,AT~~ oDE Up®N GON)PLETION a~wOr+~ wATeR APPROVEq AS NOTEq DATE: / ~ &R 8 FEE: ~ ~ DEPA T NOTIFY~~ 78&•18Q'~ 9 AM 'ID 4 PM R THE FOLLOWING INSPECTIONS: t. FOUNDATION TWO pECU1RED FOR POURED CONCRETE ~ 2. ROUGH - FRAMINa a Pl,UM81NQ 3. INSULATION ~a~ ~ ~ ~ g ~ 4, FINAL • ' CONSTRUCTON MUST D' p 1~ BE COMPLETE FOR C.O. ti ~ tl~o.,,~ R ALL CONSTRUCTION BNALL MEET ~ ~ THE REOUIREMEN7$ OF 1'HE N.Y. STATE CONS'IpUC11ON aw ENERGY rr"?,!r°' pslg~,sq~ CODES. NOR RESPOIV$19LE FOR ~ t,,- ' . ! ~ ~ DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, S S , ~OUNTY OF . C~~el.~ , , SWw.~.2t I,~ ~I, , , , , , , , , , , , , , , , , , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) zbove named. 3e is the i 2A~C 1112, l', . . (Contractor, agent, corporate officer, etc.) ~f 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 sit forth in the application filed therewith. iworn to before me this ~ .day of Q 19 .y ~ Votary Public, .......T.1. ~ ~ County HELEN K DE VQE (Si nature of a licant) t New York NDT~ 470787N, Su~folk I y' ~ ~ g pp . Term Expires March 3D,1loo~/ I