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Home My WebLink About21907-Z t FORM NO. 4 J TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23318 Date OCTOBER 28, 1994 THIS CERTIFIES that the building ACCESSORY Location of Property 2645 DELMAR DRIVE LAUREL, NY House No. Street Hamlet County Tax Map No. 1000 Section 127 Block 4 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 7, 1994 pursuant to which Building Permit No. 21907-Z dated FEBRUARY 9, 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 FOR AN ACCESORY INGROUND SWIMMING POOL WITH DECK AROUND AND FENCE ENCLOSURE AS APPLIED FOR. The certificate is issued to MABLON 6 KIM RUSSELL (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION SERVICE 4635 MAY 23, 1994 PLUMBERS CERTIFICATION DATED N/A -y- zxe~- B din Inspector 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) N y" Date rV................................. 19... ® 21907 Z Permission Is hereby granted to: r..x! y................... ~~-'`.?..-?~r ~ .-rid to . X~L........... W. •rf......... `-f cf..... , f'*!........~~ yE~ f'.~ at premises located at ..................T.....................................1................................................... County Tax Map No. 1000 Section ...e ~1-7......... Block ......4~. Lot No. ...QZ pursuant to application dated / 19..~ and approved by the Building Inspector. Fee ~d.... .........................f~ Building Inspector Rev. 6/30/80 ~E Ctm z ..k ut y I~sl9v ~c4,t L~cA o tiJ Qa1 3s I ~19L/ Form No. 6 r TOWN OF SOUTHOLD I, _a4 BUILDING DEPARTMENT TOWN HALL aj 765-1802 D • L =P1. S TOWfV OF SOUTHOLD e 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 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date 7.../ New Construction........... Old Or Pre-existing Building Location of Property.. pu lis-...D`?;~-A4 44 b.I~ . 0-e ....L.~ og_C_L House No. p Street Hamlet e- L( Onwer or Owners of Property.M.1 10l~..F... k. j! V County Tax Map No 1000, Section ...I........ Block D Lot.... SubdivisionkEw .'t ..Li.~..... `.r... ...FCi~led Map .....Lot... 1. Permit No. a ~ ..Date Of Permit.a...... } _....Applicant... . ~ e--,(-L „ Health Dept. Approval ..........................Underwriters Approval.y Planning Board Approval Request for: Temporar Certificate........... Final Certica e..~...... Fee Submitted: c7 a~ 4 ki$66 7 . APPLICANT ELECTRI CAL INSPECTION SERVICE, INC. 375BUNTON AVENUE Fi 11 e e EAST PATCHOGUE, NEW YORK 11772 4635 ° , 5-23-99 POOL APPLICATION No. ON FILE ESS:_2645 DelmaDrive VILLAGE: Laurel, NY 11948 TOWN Southold D TO Russell ) INSTALLED BY: Hank's Ele>Lt :Lc Inc. t IC NO 2675E ) ( ( was examined on 5-23-94 and found to be in compliance with the National Electrical Code. I Flx'rURE CEILING WASHER RANGES OVENS ( OUl"LETS RECEPTACLES SWITCHES G.F.I. FAN AMT K.W. AMT K.W. AMT K.W. ) c 2 2 (S( ORYER$ OISNWASHER$ EXHAUST FANS FURNACE MOTORS FUTURE APPLIANCE FEEDERS AMT K.W. AMT K.W. AMT K Y9. OIL -HP GAS M.P. AMTT ( e ) e ) SERVICE DISCONNECT President (~P NO. OF METER$ AMP TYPE ( -(7I ~IdAGL~C.,V ) OTHER APPARATUS: 1-500v POOL LIGM Ttlr urlihrnm marl nM hn nrwrrn In nny mnnnnr (a 1-1'kHP FILTER HNOR 1-4OAMP TIME QTR a l) 1 mRV IM I nlill.A ~Y mn ff A I11 R1. M LI~C.f'L3 L3PLLrQfL3rL3PLfLI~LI ;1 1~LfC - iL f 1 i I iC lC fLI@.I: i I : ! I : i I : R(LIi , i 1, fLI@I~C fC lC fC foC fC fC tC fC lC nC IP CPC nLI~CJC 1@Pi PLPLC.PLrL3PL.f PLLIPLC PLrL3 5 I T BY THIS CERTIFICATE OF COMPLIANCE THE S 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 BUREAU OF ELECTRICITY 5 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT L J 5 Upon the application of upon premises owned by ti' J 5 MAHLON RUSSELL MAHLON RUSSELL 5 5 2645 DELMAR DR. 2645 DELMAR DR. LAUREL, NY 11948 LAUREL, NY 11948 5 raj Located at 2645 DELMAR DR. LAUREL, NY 11948 5 Application Number: 2096880 Certificate Number: 2096880 rS rr5 Section: Block: Lot: Building Permit: BDC: ns11 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of 5 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 Basement, Attached Garage, Outside, Pool/Spa, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed r5j 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other C5 5 authority having jurisdiction, and found to be in compliance therewith on the 4th Day of May, 2006. 5 Name 2 Rate Rating Circuit Type I' 5 Miscellaneous 5 5 60 amp disconnect for 5 5 self contained hot tub 5 5 work includes basement and 5 5 hot tub 5 5 as built 1991 5 5 Appliances and Accessories 5 5 Exhaust Fan 1 0 F.H.P. 5 5 Wiring and Devices 5 5 Outlet 5 0 Fixture 5 5 Fixture 5 0 Fluorescent 5 Outlet 14 0 General Purpose 5 Receptacle 10 0 General Purpose S 5 Switch 6 0 General Purpose f5 5 Disconnect 1 0 60 amp Pool/ Spa f5~ GFCI Circuit Breaker 1 0 50 amp Pool/ Spa 5 5 An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the install$P A is believed to 5 be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. 5 Continued on Next Page I of 2 5 r1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. r5j 5 5 17 LrLI~LI~Lrr PcPLrLrLfr~crLrLrLrLl~rrLrrrLnLrLrLPLrLI~LI~LrLrLI~LI~Lrr~LI~LPLrLI~LrLrLI~LrLI~LI~LIIIII~LI~LI~LI~LI~LI~LI~LI~LI~LIRI~LI7rnCPCnLPrnLrL3rL3E3 M° rJ~ cPrJrJ~rJrJ~rJ~rJ~E fc forJF frJrJ~rJrJ~rJcP~ fc1cP~J arJ~~ (r frJ~rJ~JrJrJ~Pr~c frJ@PrJ~r~rJcPrJ~PcTrJrJ ai PrJrJrJ@JrJ~cJ~ frPc PcPrJdJdJ arJ~ ~ 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 5rj 40 FULTON STREET - NEW YORK, NY 10038 5 5 CERTIFIES THAT 5 5 Upon the application of upon premises owned by 5 5 MAHLON RUSSELL MAHLON RUSSELL ~S 5 2645 DELMAR DR. 2645 DELMAR DR. 5 c~ LAUREL, NY 11948 LAUREL, NY 11948 Located at 2645 DELMAR DR. LAUREL, NY 11948 5 C 5 Application Number: 2096880 Certificate Number: 2096880 5 5 Section: Block: Lot: Building Permit: BDC: ns11 rS Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of S electrical devices and wiring, described below, located in/on the premises at: Basement, Attached Garage, Outside, Pool/Spa, e5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 4th Day of May, 2006. 5 Name (QTY Rate Rating Circuit Type 5 5 5 5 5 5 S S 5 5 5 ~ 5 5 seal 5 5 ~5+ 5 2 of 2 5 r5j This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 ~ c.frJrJ~rJr~rJ'rJ'arJ~rJ~rJ~rJrJcPrJ~rJ~rJ~rJ~cPrJ~r>1'~lo~fcPrJ~rJ~rJ~rJ~cPcPrJ~rJ'rJ~rPcPcP~.frJ~r~~PrJ~rJ~rJ~rJ~rJ~~PrJ~~P~PrJ~rJ~cJ~rJ~Pr.PrJ~cPrJ~cPcPcPrJ~rJ~cP o 7 .1.r.: f. ION . _~e-.~.~-per IIUniL I COMMENTS a~ OUJJDATIO`J (1st) rOUtIDATI0t1_ f2nd~ I J 2. Z o~ ROUGH FRAmf: 3 PLUMBING 3. y x INSULATION PER N. Y. my STATE ENERGY CODE t\ FINAL ADDITI AL CO-M."-TENTS: s $ 3S, or, erg. ,0 y~2sI9 - s y77_V m H O • C*1 5 \ r - \11.1 v .n H • BOAKD OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY . TJWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM y TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL -fog- - MAIL TO: . I Examined .....P~ 19~lj.T q 7 Approved , 19Z. -Permit No. i. ~.~~1. . Disapproved a/c . (Building Inspector) APPLICATION FOR BUILDING PERMIT •c Date . I 199 Y. 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 uhtil a Certificate of Occupancy shall have been ;ranted 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. ~•6aP,6 .~..°a`R..,I~~ (Signature of applicant, or name, if a corpor ENCLOSE PCO'_'t:,) CODE UPON COM--i-iiTION vc. 6EFCfiE "LV,+tTER" ~ `.~.t . o~.~~ kx ~ (Mailing address of applicant) I l r l'I 8 State whether applicant isowner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. QA.e3.\.Y~l.~-'~OYJ...................................................... Name of owner of premises m 0.n 16.v-r, U.~S.s 21 . (as on the tax roll or latest (leed)APPRO'JED AS NOTED If applicant is a corporation, sg-riaturS,9f duly aut orized officer: L DATE- < 14o7t 9V B P # Ic ;I:iicrtl 1 ; FEE: Jo DEPARTMENT (Name and title of corporate officer) NOTIFY SUIL ING EPA 765-1802 9 ANI TO 4 PM FOR THE ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. .....a1.y.l.?, . FOLLOWING INSPECTIONS: 1. FOUNDATION YO REQUIRED Plumber's License No. Fr)R t'OJR=DCONCREfE N . _ 2. 1+0; *.A FRANJING & PLUMBING 3. INSULA-flOrv Electrician's License No. "r.L - C',i:i;;-1Tr ucT;ON irusr Other Trade's License No. E C0Ir1I"1_ETF FOR C.O. yLL CONSTRUCTION SHALL MEET 1. Location of land on which ro osed work cvilCbe do THE REQUIREMENTS OF THE N.Y. p p ne .r • • v"T;^:;E• •COP•18T"ritJCTSON' & 'EP7ERfiY' • . COO' S. NOT RESPONSIBLE FOR cDr.. ~-QU 0s;:UOR•OONSTRUCTIONERROR$- House Number Street Hamlet County Tax Nlap No. 1000 Section Block , LA Lot Subdi%ision LQJYQ. (.QeJntr. ..C5-f-0,+,es...... Filed Asap No. K(p....... Lot ...I`1 ( amel 2. State existing use and occupancy of premises and untended use and Occupancy of proposed construction: a. Existing use and occupancy UyI-Q... ~0.rttcl~f... r Pt.d$gG. r . d b. Intended use and occupancy su) .I~H X~ ~(P. • ~ l~ • ~ rQt1V.)• ~ • ~ IMY.rilnf~.. ~.odl J 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal , Demolition Other Work .LSr 3rP. .1 t1 q- oand. (Description) ~ v~inlnln~°al 4. Estimated Cost ~ Fee r (to be paid on filing this apldication) 5. If dwelling, number of dwelling units 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 Number ofStories 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 Number ofStories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Fortner Owner 1 L Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded Will excess fill be removed from premises: Yes NO 14. Name of Owner of premises Address Phone No............... . Name of Architect Address Phone No............... . Name of Contractor Address Phone No. ' 15. Is this property located within 300 feet of a tidal wetland? *Yes No *If yes, Southold Town 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. STATE OF NEW 1 R(i COUNTY OF 'rt- S.S a41 ~.,d T.. 0 ~_e= -4 being duly sworn, deposes and says that lie is rite applicant (N me of individual signing contract) above named. He is the ntY-q c. td'Y . (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 { . . ..........day of+,Qlx'k;a.r 19q~. . Notary Public, County d- NOREEN ta Stale HAGER of f t4" York No. 52.452o Naw York t No. 52-0526433 ciumlied in Suffolk Couutly (Signature of applicant) a Expires 4~,' 9~ l STREET C~NA 4~,~199 W a° ~m -o _ A R1 f• N N O ~ iV O W Q m LEE 2 0 Lof ~ .33 150.00 \ X4 1 0 E• w Er 1 •23 ` cb A W J o N Y, LO 4 G.t N -1 'Z q Y O m •r ~ O t \a ~6t Y~ 150.00 O A /I c` 3 ' 0 pp ° - . 40EEw, O TEA of L \ NOTE Ar :MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLEAA'OFSUFFOLK COUA?Y ON JUNE 92, 1970 As MAP AV. 5486. REVISIONS YOUNG & YOUNG AP11.9,1972 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK MAY 1,1972 ALDEN W. YOUNG HOWARD W. YOUNG JUNE 19,1872 PR0F10010NAL 1NOIN1011 AND LAND 0URVIYOR -'NAUTHORED ALTEIATION 01 AMITIOn LAND 0URVIEVOR, III LIC. NO. 11048 N.Y.O. LIC. NO. 40091 TO THIS SURVEY R A VIOLATION Of SECTION 7209 OF THE NEW YORK STATE SURVEY FOR: EDUCATION LAW. CC`IIS OR THIS SURVEY MAR NROI kA,INC S.PAA. ENTERPR/SES, MC. THE LAND SUlV1YU9 'S INRED SEAT Ol EMBOSSED SEAL SHALL HITE N CONSIULRED LOT NO. /9, 'FLAUREL - COUNTRY' =TA-TE~.ER fG N A VALIC [RUE C(NT C1E Nrw GuA,.w TEE. umYnrED NERErn, All wn - CNU H. THE ELLSON FOR w, ~N I... SU,,[ AT GUARA TE O: IS "'I;AeEU ANT Vi. HC 1.,rAU n. IHi LAUREL Nm «wIAN1. 1011. LI.A; BOUT p~A RaIS: BANK u]IU. H SECU T-Y 171 'OUAR T SAO. IC INI ASS.i'1' ,;1 Eft ll 1, Ulna. ."I TOWN OF SOUTHOLD z•.4' fµ P ;l. T,uv u, -1111 A" '1i, I SUFFOLK CO., N.Y. er o :utld - SCALE: N DATE: 40, FEB. IB, /972 4711 .723mQ6. I 1 Il/LC /VV. 0-N70V/0V f STREET G I N A P~tiy199 b / V N iTa w w w° m ~ C, a u N a # f. WIl 20 160.00 j '0t bi N w \ -4d 'f 11 \ ti Z 1 Ste P %Z:3 • ~ N 19 (p, L.Ot o m e 15p.0 Q 3 ,a0 g.~l Z ~ j8 • ~0 \ NOTE r :MONUMENT SUBDIVISION MAP FILED /N THE OFF/C£ OF THE CLERK OFSUFFOLK COUNTY ON ?UNE29, 1970 AS MAP NO. 9466. REVISIONS YOUNG & YOUNG APR.9,1972 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK MAY 1, 1972 ALDEN W. YOUNG HOWARD W. YOUNG JUNE 19,1972 ?ROFEBSIONAL ENGINEER AND LAND SURVEYOR UNAUTHORIZED ALTERATION OR ADDIT.On LAND SURVEYOR, N.Y.S. LIC. NO. IE840 N.Y.B. LIC. NO. 45803 to THIS 5UVEY H A VIOIATIDN O, SECTION 1209 o, THE HEW YORE STATE SURVEY FOR: EDUCATION EAW. COPIES or THIS SURVEY MAP Hay NAI,I.- S.P.A. ENTERPRISES, INC. THE EAND SUEVTYGR'S iN'm SEAL C, to N A EMBOSSED SLAV sH..,, w:, N :~.rv>,~.ar LOT NO. /9, "LAUREL COUNTRY S'-TA-TE.~'." fG N A VALID TRUf COPT C y NEW GUARANTEES 44[HCArf L• HERtGN SnAil Un ONLY Tc THE PlcsoN F.S rvEU,p p„ „p rl s IS'PRE; P A..c COMPANY. AT LAUREL GUARA E5.t:)'70: E COMP.nrvi, WG..vlRO.s,D.r,,..,, l .i- n. BOUT YS (S. BANK LENDinc ~NStnw~orv USTit.... TOWN OF SECU Ta' I 9UARANT '01). rG THE ASS"' IS uE mt ,t 11~. SOUTHOLD z rUTiGN GUA„'aIILS e.E ,:I i.n 5 r"(r T~ A" w ;,,.rv., SUFFOLK CO., N. Y. By SCALE: DATE: 40' G ' FEB. /B, /972 s,Dh Zy QO. I /ILC /YV. J"JOV/OV i 1 .STREET 9 G AN A ww IM w -o u N N ( 0 rn Lot 2O 0~ 150.0 w pFE -job 4 ~IY23 m Cb m W u' ,u QI - , ~T t ~ E q N V1 ~ Q~ tO~ a 0131 Q~s ~ a+ G 1 'I Map' g o rn ~W o O v p 150.00 •J O 1 3 # - 0 0 W ~g ~I'Y340 s N Lot r E,11 J J, I MOTE a z NONUNENT SUED/VISION NAP FILED /N THE OFF/CE OF THE Clew aFSUFFOLK cwNTY ON bWAFC 8, /970 AS NAP NO. 5 498. N RICVIYION9 YOUNG & YOUNG I XPR.YE197Z 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK II MAY 1 , 1972 ALDEN W. YOUNG HOWARD W. YOUNG JUNE 19,1972 PR0?YY810NAL BNOIN881E AND LAND ¦URVYYOR UNAUTHORIZED ALTERATION OR ADDITION LAND 9URV8YOR, N.Y.Y. LIC. NO, I1648 N.Y.Y. LIC. NO. 40890 EO THIS SURVEY R A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE SURVEY FOR: EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT NAVING S.P.A. ENTERPRISES, INC. THE LAND SURVEYOR'S INKED SEAL OI TIAN A AUD SHALL ro)1 N GL;NSIptREp LOT NO. 19, "LAUREL COUNTRY *TE4TE " TO R A VALID TRUE CLAY / OE NEW \ GUARANTEES WGICATEp HEREON SHALL .UN ONLY TO THE PERSON FOR WHOM In, su.vr AT GUARA E O• L. i= R TI PWAUD. AND ON RH IN'll E I U THL LAUREL SOUT Y'SA AS"BANK H'S TITLE LF COMPANY. GO VkRN/AENAI wG,. C. SECU 1 ~•ou~u7 CO. LENDING INS1ITUTION LISIEU N.uu... ANL TOWN Or SOUTH OLD ~7 • . TAN ^ TO THE ASS,GNEES 01 THE U,,j,mJ .1,11. n 71 1S i 1 NTION. GUARANTEES ARE Nui I A: ffLtr TO ADLI?OnAI N%i'W ~ i. eY SUFFOLK CO., N. Y. SCALE: / E/ c 40 E DATE: FEB. 18,197Z S/~h°' Ili .p~_• i ' I , U I i II ~ I t.`Jrwyy~J ~ 41G`£Fy,B~t ~ }11Sed a"s , pS 0 J ~1J( 1 A ' - e~~l a o! MiL I i n re r 1n ~,q L C-- T Vl I ' Lam,. I O GO, Jam= -or-- J V 5 X f N Q A - y ~ ~ M r x ~ x ooo o a 0 M -10 - l 1 u a ' ~ J u° JW W s= fl _ _ _ .N Z LL ~lJu f W LrJW . O w::) - a. In X000 m Z a C3 4 i- M w II oz 1 a. W O \ q p y. 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