HomeMy WebLinkAbout30936-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30783 Date: 02/22/05
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 370 FISHERMANS BEACH RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 111 Block 1 Lot 13 .1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 4, 2005 pursuant to which
Building Permit No. 30936-Z dated FEBRUARY 4, 2005
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 ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MARK SCHWARTZ AND LAUREN PRAUS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2043437 02/17/05
PLUMBERS CERTIFICATION DATED N/A
C'Afuthorized Signature
Rev. 1/81
_ -- Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
FEB I �i , �J I TOWN HALL
11 765-1802
. APPLICATI N FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 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- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00,Commercial$15.00
Date. !�Z��4 Ila s
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 37f f'l sff',E��t /J' Q(/� i2 r,? Cu
House No. Street Hamlet
Owner or Owners of Property: Lhiteen
Suffolk County Tax Map No 1000, Section 1f 1 Block Q 1 Lot
Subdivision Filed Map. Lot:
Permit No. j 01131,0 Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
&3
�� ��� Applicant Sign t e
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)
PERMIT NO. 30936 Z Date FEBRUARY 4 , 2005
Permission is hereby granted to :
LAUREN PRAUS
375 FISHERMAN' S BEACH RD
CUTCHOGUE,NY 11935
for
ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
THIS PERMIT REPLACES BP423759 .
at premises located at 370 FISHERMANS BEACH RD CUTCHOGUE
County Tax Map No. 473889 Section 111 Block 0001 Lot No. 013 . 001
pursuant to application dated FEBRUARY 4 , 2005 and approved by the
Building Inspector to expire on AUGUST 4 06 .
i
Fee $ 150 . 00
r
"hod ASi ature
ORIGINAL
Rev. 5/8/02
r�rJ�cJ'r�r�c fir C.l`e.lr r GI' �r.�r.Pr r�rJ'c1r.!rJC�r�[.1L1�J' r�tJ��r�C1�GJ� 1001 r LrL-i Pc0
BY THIS CEF TIFICATE' OF COMPLIAN_ ;CE THE
5 5,
5
NEW - 'RK C FAD, OF FURE UNDERWRITERS5
BUREAU O iELECTRIC ITY
40 FULT.,ON STREET '^ NEW YORK, Y' 100.38
CERTIFIES `I"HA"r �.
5wpon'the app,l'icatlori of `upon premises owned by,
MARK SCHWARTZ &_ = MARK SCHWARTZ& 5
LAUINE PERAUS LAUREN PRAUS 5.
3,75 FISHERMAN BEACH ROAD 375 FISHERMAN:BEACH ROAD
CU T CHOGUE, NY 1X35' CUTCHOGUE,,,NY •1,1935. 5
�5 Located at 375 FiSHEERMAN'BEAC,HiROAD CUTCH'OGUE, NY 11'935
7 App,Ioca$ianV,umbero2043437 Certificate Number: 2043437
Section': BlockLot: Bui'ld'ing Permit;: B'DC'., ns1'1
to `n' f �
Described as a sy
occupancy, whereinthe premises,�electrlcal s co
_ m _ _ sisting 6-
5 electrical devices anal wiring,,descr[bed:below, ocatedinion t`he premises at
First F1'oor,:
e m"ses ele ric ste ii ited to electrica devices and,. wirin to-the extent,detailed
5 P ct al sy rn� m _i pp g S
A visual ins ection� of the pre a
herel,, was, conducted
in accordance with the requirements of the a lic.able code a'ndlor standard
prorn:ulgated by the State of N',eW York, Departme,n`t of State Code Enforcement and Ad:r' nistratlo.n, or other
authority having j.urisdicti'on, and found to be 'in compliance therewith o.n the, 17th Day of February,'2005.,
Naine' 'Rate, Ratin ; Circuit Type 5
Miscellaneous,�
lining room-bath room addition
as bu8t 19-97
5 Appliances and Accessories
Exhaust Fan
Wiring and Devices
Outlet 4, 0' Fixture ;5
Fixture 4' 0` Incandescent
Outlet 6 0 General Purpose'
Receptacle 4 .0 General Purpose, 5
5 Switch 4 0' General Purpose
5 D'irnmers 1 0
5 Roceptaele 1 0 GFCI t
5 An aslbuilt visual inspection;.of the delineated electrical inaaflation,determined that an Obvious hazard is not present and the instal1xJ,6v
' believed to Abe;n comformdnce with cbe applicable reference Stan-lard for the estimated period of construction of preniises,wiring syjgtortt
Iseal
1 of
This cer.i.f te.may not be,altered'in;an way and is validated onl by the;presence of a'raised seal at the location;in, 5
Y Y Y 5
5` 5
to r.J�cJ�r.�r.�ci c1c.l[.Ic1�c1[�G1�r�Jr�rlc�rJr [J`cPr�[Ji�P�cJ"[.I c!atJ'cl�c�Gl�cTrJ�r�[l7r�tt.Pf� rJrlcPGlc l�r�r [1�rnr�r�r�c�c rfl[�EE f
c� [��PJ�J?C.ff�f"r��J',cll�l�c�[�.1�PCJ�[17Gf[.t'i�C1`rJ?G.CCf'3�rJ'�r.1�enCJ'3[��rc�tnrJ�t�e.fCl7tn[.nel�efC1'cPrJ�r�r�r�rl[.f�[J�r�r��rJ�irJC.tr,�ir�[.!'rJ�[14J�JrJC.IGf[.r][P[J� Cl
5 BY 'TH'IS CERTIFICATE OF COMPLIANCE THE
5
,NEW YORK, BOARD OF FIRE U DERV!V 'TER5
5'
BUREAU ca�
ELECTRICITI ,
5
S40 FULTON STREET - NEW YORK, NY 100313
CERTIFIES THAT S
5 Upon,the application of upon premises owned•by
SL!UAGI RERINUZZ'I LUIGI PERINUZZI S
S
20-62,48TH,
H
ASTORIA, NY 11'05- ASTORIA, NY 111105 5
5
Located at 740 BAYBERRY LANE SOUTHOLD, NY 11971
'S 5
Applications Number:, 2.042421 Certificate Number: 2042421
5 Section: Block: Lot: Build'i`ng Permit= B'DC'c nsl1
Described as a occupancy, wherein,th.e premises electrical system consisting of
[�? electrical devices sand wiring, described below,, located inion the premises at; c�
5 Basement,Outside,P'oOSpa, 5
5 A .visual inspection of the premises electrical 'system„ limited to. electrica devices and wiring to the. extent detailed �
herelin,, was conducted ib accordance with the re,uirernents of the .applicable code anal/or standardi
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 Day of 1.Oth February,2005.
5 Name QTX Rate Ra, tine CircttiE Type
�! Miscellaneous
AS BUILT INSPECTIONPOOL-1987 7
Appliances and Accessories ,
Tirne Clock/Switch 1 0 "
Pool/Spa Bonding i 0 5
5 Panels 5
51 3`0, 4
Wiring and Devices
Receptacle 1 0 General Putpos-e nR-y
��L]] Receptacle, 1 6 20 amp Pooll Spa
fre irnmitest and or ro slcertificate covers compliance•at the date of inspection only. Because of unusual environments it is advisable to have S
5 Swunmin Pool Thi
q` pairs niade by a qualified person.,
55 seal'
5 of 5
5; This,certificate may not be altered i,n anyuvayand is validated only by the presence,of a ra sed'seal at the locations indicated:.
r�r�e11c1�c.��c lLPCJC3r�r_fcJcJ""cfhPrJr�cPcJrJr�c.frJ'c.I�i�fr.Pr�r�r�rJ�rJ�r1r�tf'r l�r.J�[l��J�[1�r1cfir�cl�tJ�rJrJcPcJ��r�r.PrJ'r?I�cltPr.fr?Pc 9cPtJ�r�[J7
76s-ieox
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ J FIREPLACE 8 CHIMNEY
REMARKS:
DATE ID �fI INSPECTOR
71,
30�3�0 �en�we D
T65-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS:
a
G
DATE 5t7 INSPECTOR.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS:
DATE -INSPECTOR,,��/%��
�-33o93b��
M-iso2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ 7INS
GH PLBG.
FOUNDATION 2ND [ LATION
[ V1] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE 2 Z7 � INSPECTOR
J
z 7e5.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:---7 1�5L
DATE INSPECTOR
P 11:1.I) I rIS1,1:c:I I Ura itr1,0It 1. 1)ATI-. (;UMr11sN:1'i
II _ .
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Mate K 1c. Sc HW 44 Z-
10-4 2
10-42 -9 6r,
PROVIDE OPENINGS FOR
EMERGENCY ESCAPE AS
REQUIRED BY PART. 114 OF
N.Y. STATE BUILDING CODE.
�--.--
BOARD OF III•:nL'I'll . . . . . . . . . . . . . . .
FOMI iaO- I I SETS OF PLANS . . . . . . . . . . . . . . .
TOWN UP SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . .
ISU LI,i)I NC Ill VARTP11'".N1• CIIECK . . . . . . . . . . . . . . . . . . . . . . . . .
-!-OWN NALL SEPTIC FOlifl . . . . . . . . . - . -
SU11•LI OLD," N.Y. 1 197 1
TEL: 761- 1007. NOTIFY:
r. -
C o. . I
x:.rrirx:d .".a. , 9. ..- r1n:r1.- to: . . . . . . ... . . . : . . . . . .
At if ,/ .-., 19./.(J 1'ennil fkr. . . . . . .. . . . . . . . . . . .. . .. . . . . ... .. . . . . . . . . . . . . . . .
Di r nII)rw(yl a/(. . . ............. •• . . . . ... .. . .
. . .-. . . . .W! . . . . - - -- -- -
Ikrildinl; In::tri>raor')
nl'1' .ICATION IOIt 111)1LDINU PFAMIT
INSTRUCTIONS
N. •IIIin aplil ical.icrl nou(t be coilildtely "f.illc(I in Iry typ(rwriler or in iuk :rill n(deni1ted to III(! Ikrildiol, lus.pcc-lor will
:1 rr'Is of plmrl, accorate plot: lila" to reale. Lee nccnrdi"g to nclredule.-
1). floc plan r:lx!wing local:icxl of lot: ;rill of building!; oo pr""inen, relatioonllip to ckljoinin►; prrrniren or I>,Ilrlis
n0c•cfn or Arens, :rxl giving a detailed Uncriptirnr of Inpolt: of protwrl:y nual. Ire drrxo(I on LIIe dings" whirh in lr:n"1 of
Ilrir. .Ilgr(ic:r,lion- �. � .
c. 'Ill! (.x)rk co-C21-ed I,y Llrin alrl)I ic.rCi.inr rxty Ont: Ire aarlxQIrc:ed before inrwaoce of. ►k)ildiog Perinii-.
d. Illxnr approval" of (leis nppl ication, Ole ItiAldillp I,nnper.l-or "rill irmre a lkri ldirrp, 1'eln)it to Ow applicant. Such
tx:rmit shall 1)e kept: oil lire pre(nisen available for' inrlrectill Llo-rxiorxrt: Ole mirk.
r- i•k) Wilding sludI lilt (wcupied or lined in whole or in hall: for ;Illy lxo-lx)re w11at:ever until a (ktrl.ifii:al(: nr
(k:cuparx:y 01:111. IYIVe befell l,r:anterl by the lklildin(, In!rl.rector.
nl'1'Ll(WHON IS III.ItI.ISY MAIK;.lo Ill. Iklildiol; I)el+:rrinrol: for Llre i!mmwe of: n Iwilding fermi( lr.wmm"t In Ole
Ikrilding 7A)u(� OrdiunnC-e'o1 1.11e Ttxnr of Southold, Suffolk Lrxinty, New Yolk, and other nirplic:ll)le Isnan, Oldinalx:en or
Vvpplaliolln, for the courl.r(I 0011 of Ixlildinhr(, a(1dil.ioon or alteratioun, or for" roL.rval or drnxrlitioo, an liewio
do rcrilx•d. IIIc applicant al,rces to c.1,40Y.willr al I. .1110 ical)le I:n7n, orclin:nu'en, buildio); code, Irnlri lg (:(xlr, arxl
regulatioun, aril to :xlric anrtalorizecl inslicctorh rnr Inuniren but.1 "io lr(II I lin, -for, 9 . . . .. . . . . . . .
nrfx�c�?ggp�
i,j,layrwwoof app , o Harr, if a cut Jul;rtin")
30
Cit(1�4`+I ifi"; .xlilrens of alq)l leant.)
Stale: (.Aletller alrlrl(:aIAI--- in"ic)wrrer, architect, e"girx>er, l;e"err)) conlracl:or, electrician, pluiix-tv or Inri161r.
. . .. . . .. .. . .. . ... . ... .... ..... .. . . ... ... . . .. .... . . . . .. ... . . .... .. . .. . . . .. . . . . . . . ... ..... . . . .. . . .. ... . . . . . .. . .. . .. .. . . . .
.-- . - -.Vil:II of urlxt - . . �s
- . ..
(an CA 111e Lax roll or larc:r:l: dc(>(I)
It :Ippl icaut in a corlxn":Ititnr', niln ot.ore url duly notintrized officer.
(1l:nxr :rill LW( of c:oil x)Iit:e offi(:er)
Iklild(:rn I.ic:euse ia). . .,-..-. .... .... .. .. . . .. .
PlIsibern I,ia?n!:n No. ... . . ... . . . . . .. .
P,leclriciaon I.ic(>nse No. . .... . . . .. .... .. .. . ..
00wr Trxh!'r Licence No, ..... . . . . . . . .... ....
I. l(.x•:Il:lorl of land cm w11iCII prolioned wrnk will be done. . . . . . . .. .. . . .. . . .. . . . . .. . .. .. . . .. . .. . .... . .. . . . . . . .. .. . . .... .
- - . . . . . . . 3.7. 5. . .-. . . . . .. . . . .. . . . . . . . .("�uri3Oli4100i... .. . . .. . . . . . ... . . .. . .
Ikxlr:(! flrrlrr?r: Street /lbsMeC
(:cnnll,y •fax Fhp No. I(XX) rictcticrl . . . .. .�1.�. :.... . ISlcx:k .. . . . . .. .... . . Lot ... ..... ..
SN11xlIV InlOrl fU�tiic. .V. .. . . . . . . . .
7- SInUe r,rcintinl; orae nxl u(:,(-uJVnx:y of I)FOniner. .110 interxied Ise aril rx:cupatwy of prolx)red cut ualucl.ioo:
n, Exintinl, lire aIXI oc:cull:ux:y . - • �5�n�f - . -. . . . .
Ir- Inlr:Ixk(1 use rnxl rxxrltrux:y .. . :=.'!!o LC� '!l//^ . .-- .... . . .. . ... .. . . .. ..... . ...
I. 1'IIIII e of tA)fk (r.IH:t:l( tlliclt fil;l,lir.fillli:): Pk,i 14tIIlllinli . ... . :- • . - . . . . . Allcrnl.iofI
II:lklir
. . . . . .. . . . . . . . . . .. . . . . . . . Ik'altlllLinn . . . . . . . . . . ..
l)Ilter lkul[ ��!� Ql!!Kc.QF- 3. WlNbdtvS 7U
(Ilnwvil,ljoo)
W/NOaw
�I L•:;il LIIiII eIl G,aC : .. ... . . . . . . .- - �U .
, 3 Nutt/
5.
. ... . ... . . . . . . . . . . . I . . . t'N��e.[. . . . . . . . . . . . . . - - - -. . . . . . . . . . . .
(lo Ix: IHii11 on fi 1 inl, IIIia i1ppl icill.iof1)
AA:I l illy. IJI.IIH:r t,1` A—I l Inl, unll:: . . . . . . . . . . . . 11.•u1H:r of Ihx:i I fill, uuil':; oil r:oral fl()or. . . . . . . . : . . . . . . . .
(�. II' Ixlallu:;rn, croui:rt_ifil or. Mixed occolwncy, olx:r:il:y oilhile I'M l:xleo(. of t:ocli lylx! of fuse.. . . . . . . . . . . .. . .
/. I1i11K:n:Ihm1:i of c:xitil'ilig 111.1lu:luleil, if: filly: hool.. .. . . . . . . . . . . . . . . RI:ar . . . . . . . . . . . .
lit!iI)tl. . . . . . . . . . . . . . . . : . . . . . .. . . FhnlHi of Slorir::; . . . . . ... . . . . . . . . .
Diltr:n:ciotu; of -ilvle tit ItuAlife Milli ollerol.ilxl:; or iuhli1:ion:;: hrool . . . . . . . . . . . . . . . HeitI. . . . . . . .
IA 1,111 . . . . . . . . . . . . . . . . .. .. II 11;111: .- - . . . . . . .- . . . . . . . ... h1.Ilici ill` lil'oI-ieti . . . . . . . . . . . .. . . "
I1. Mlig uiilxel ol` clII ilc tu1w cofInI1111:1:it,11: Nlool :. . . . . . . . . . . .. . . IL:itr . . . - - - .. . Ik ,l 11
l;lll. . .. . . . . . . . . . . .... . . ... . .. . IJ,nIH:r 01' 'it-oriea . . . . . . . . . . . . . - . . - . . . .
Slze of lnl : I"rtxtl' . :. .. . . .. . . . . . . . . . . . ILlfiI' . . . . . ... . . . . . . . ... . . . . I> 1,111 . . .. - . . . - . - . . . . . .. . .
I0. 14il c 411` ILI clul:H: . . . ... . . . . . . . . . . . . . . . Milli! of I olnt:r lltlH':i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .- .
11. IIN4:: of uue 411 t;l:1.1et: in LAlldl liruuisetr circ ifilualerl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .•. . . . . . - . . . . . . . . . . . . . . . . .
12. Ikx::; I,rIII Kl:H:tl clxtSI k-1m:l iof vioIitll: oily zrnllnl, 1iA4 orrlililt u t: or rcl,uIiIlJo l:
17. IJF 1 1 Iol. Ix: rta;riu4:ll . . . -.-. .. . . . . .-. . . .7.^. 1�1p1 1 1 tnweti:i f f l l IH: r[SlrwctJ 1:1-4111 fit Old lieu:
nr",40
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Ih. IIrI.::i o(' () u r' o[ l,rr�ule;e:i ./"!�12/qN-�,/c.I Je!iV.S A,kliena�St/�tLMM!�.r7(�!7 r"'40-
tLur- ill' Arclli l itch . . ... .. . . C"f9rl�r.F'�.-. .s!�i��✓��r�. 11i61reua ��5. .�-�=�9f2V j�✓. ./4(/f1-.-. Motu: tdl. 7�as -'��./ 8
I/xllror.lor . .. . .. .. .. . . . .... . . .. . . .. . .... . . . . . . . . . . ... . . . . . . ... . . . . . . . . . . . . . . . . .112otx: P1,. . . . . . .
I'i. I:I IIIIa plolx:tly willtin NX) feel: (lf` it I iilitl wel:lotulT YES .. . . . . .
Alli YES, :i(AIIIC)I D 'IfAM '11111";Iwifi W14,11•f NAY IV 'Ill lillllfl'I1.
PLOT 111 ACIIAH
locule cicorly tHxl di81:iIV:t:Iy fill IKIIIIIill- " lel u:r exl?Y-io(,_or piolxltiell, olul itwlicol:e ill( :u:C I,oca< tllur.ln;;lt,lla
(I lilt l,iolx:rl y I ilu:n. Give eLreel: iloil bl[x: ItAII)er 'ot 11e;il:Yllll il,ll ncc'o inn to deed;•filul t;I1rA4 til reel: nivIV21i Ind il,Ilicill e
,dil:lltl:I inler'inr ni ln1'Ix:r ►oL. PROVIDEOPENINGSFOR
EMERGENCY ESCAPE AS
REQUIRED BY PART. 714 0E APPROVED AS NOTED
N.Y. STATE BUILDING COD . ATE: s.P# �3 7S
r , FEE:
NOTIFY QlI1LDiNG DEP
7fiS-1802 g AM TAT
r �'� % TO 4 PM FOR THE
VCYFOL-LOWING INSPECTIONS:
OI
Fes", �� N i• '9 9 FOUNDATION
.v�? �p FOR F' TWO REQUIRED
l� aOURED CONCRETE
�,,. 2. BOUGH _ FRAMING
-_u 3. ItVSULATION ` a PLl+M611�G
i11r� ' ?` 4•. FINAL. - CONSTRUCTION MUST
13.E COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
REQUIREMENTS OF THE N-Y.
g7ATE CONSTRUCTION & ENERGY
:warn:
(mi, w.11 Y 11 CODES. NOT RESPONSIBLE FOR
/
DESIGN pR CONSTRUCTION ERRORS
. . . . . . . . . . . . . . . . . . . .IH:inl; duly tirilio, th:lxt:H:l; olid »nyti lltnL.lu: in llto nly,licilill
(Ilinr: of i„ilividoill :;igitiol, cinll I'ncf)
:IIx Ivo Initial,
. . . . . . .
(ld)l II rllc�r", nl,ll corliolillc officer, elc.) . . - . . . . .. .. .. . . . . . . . . . . .. . . . . ..
A41x:r or IAil un':i, nlul 1n 41ulY itulltnriretl I:o IK:rfulnl ul Ilitve lx:rfulilr:tl'- IIIe fill id in,rlt firxl lu Hrllcr nlxl file IIIi:;
nly,l it;nt'ion; Ihill ;III 1;1olutrallif c.olilifhK l in Ihiif nl,l,l icol ion ort: I IIx! Io IfH: I,efil: of I,it; IouA"Iclll,l: ;IIuI Ix!l iel iHul
Ihill IIH! %All It till Ixi,lic:l'1olHr:il i1 Ilit! Hvullu:r fel: fill Iit ill IIt(:! olildicill.iorl Ill(.-(I IllereiiIIt .
i1 to I,l'tllle IY! Illia
p
�/ . . flay of
. . I'1. . .
G
Ikil;try 111 ,tic . . . . - . . .. . . . . .. .. . .. . .. . . . . .
. . . . . . . . . . . . .
CLAIRE L.GL.EW ' (:iil,nnl to e of Appl iconl.
Notary Public, State of New York
No.4879545
oualified in Suffolk County
Commission Expires December 8,19`1'70
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