HomeMy WebLinkAbout30875-ZFORM NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31078
THIS CERTIFIES that the building ADDITION
Date: 08/03/05
Location of Property:
180 SOUND
AVE
PECONIC
(HOUSE
NO.)
(STREET)
(HAMLET)
County Tax Map No. 473889
Section 67
Block 1
Lot 9
Subdivision
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 8, 2005 pursuant to which
Building Permit No. 30875-Z dated MARCH 8, 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 "AS BUILT" DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED
AS PER CONDITIONS OF ZBA #5608 DATED 11/18/04.
The certificate is issued to RISA LYNN ARIN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED
Au horized Signature
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD t —_
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY LnCC
This application must be filled in by typewriter or ink and submitted to the Building Department with thA. For new building or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unus
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
L Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool 525.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing.Building - S100.00
3. Copy of Certificate of Occupan4 - $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
D .1
Date. 7 / /9os-
New Construction: Old or Pre-existing Building: _ V/(check one)
Location of Property: 8(D a )C) L A - 6011g CC A 1r -
House
cHouse No. Street Hamlet
Owner or Owners of Property: r T 1,5A L ae 1 ho
Suffolk County Tax Map No 1000, Section (o Block 7 Lot q
Subdivision Filed Map. Lot:
Permit No. 3l7 S Date of Pzrniit.0p Applicant:
21SA (
Health Dept. Approval: ),J 14 Underwriters Approval: I V A
Planning Board Approval: _ 1011] , /
Request for: Temporary Certificate Final Certificate: " (check one)
Fee Submitted: S
Applicant Signature
ARG 31
CdT-k310n
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. 30875 Z
Permission is hereby granted to:
RISA LYNN ARIN
Date MARCH 8, 2005
145 EAST 16TH ST APT 4N
NEW YORK,NY 10003
for :
'AS BUILT" CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE
FAMILY DWELLING AS APPLIED FOR PER ZBA DEC 45608
at premises located at
'®�
SOUND AVE SOUTH/PEC
County Tax Map No. 473889 Section 067 Block 0001 Lot No. 009
pursuant to application dated MARCH 8, 2005 and approved by the
Building Inspector to expire on SEPTEMBER 8, 2006.
Fee $
0111291L1
Authorized Signature
ORIGINAL
Rev. 5/8/02
APPEALS BOARD MEMBERS
Ruth D. Oliva, Chairwoman
Gerard P. Goehringer
LN din A. Tortora
Vincent Orlando
Jarnes Dinizio, Jr.
�41
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http:/isouthoilv%� n.northfoik.rict
BOARD OF APPEALS
TOWN OF SOUTHOLD
FINDINGS, DELIBERATIONS AND DETERMINATION
MEETING OF DECEMBER 2,2004
ZBA Ref. 5608 - Risa Arin
STREET & LOCALITY: 180 Soundview Avenue, Peconic; CTM Parcel 67-1-9.
DATE OF PUBLIC HEARING: November 18,2004
FINDINGS OF FACT
Southold ToX%rn Hall
53095 Main Road
RO. Box 1179
Southold, NY 11971-09'�9
Tel. (631) 765-1809
Fax (631) 765,-9064
PROPERTY FACTS/IDESCRIPTION: The applicant's property is 21,636 sq. ft. with 50 ft. frontage
along Sound View Avenue in Peconic. The property is improved with an one-story, single-family
dwelling as shown on the July 26, 2004 survey prepared by Peconic Surveyors, P.C.
BASIS OF APPLICATION: Building Inspector's August 31, 2004 Notice of Disapproval amended
October 26, 2004, citing Sections 100-242A and 100-244 for the reason that the combined side yard
area is less than 25 feet.
AREA VARIANCE RELIEF REQUESTED: Applicant requests a setback variance concerning an as -
built deck addition, after removal of the former deck construction. The relief requested is for a
combined side yard area of 18.4 feet for the new construction area (or 17.2 feet from closest
measurements when measuring from the existing southwest corner of the dwelling) instead of the
code -required 25 feet.
REASONS FOR BOARD ACTION, DESCRIBED BELOW: Based on the testimony and record
before the Board and personal inspection, the Board makes the following findings:
1. Grant of the area variance will not produce an undesirable change in character of neighborhood
or a detriment to nearby properties. The as -built deck is 30.6 feet wide along the northerly
measurement and 28 feet deep along the west side measurement. This new construction is a
replacement of the pre-existing deck, maintaining all pre-existing side yard setbacks at 10 feet from
the southwesterly corner of the deck to the side lot line and 8.4 feet from the northeasterly corner,
measured at the closest points as shown on the August 27, 2004 amended survey prepared by
Peconic Surveyors, P.C.
2. The benefit sought by the applicant cannot be achieved by some method, feasible for applicant to
pursue, other than an area variance. This is simply a replacement of the construction that was
existing.
3. The requested area variance is minor with a 6.6 ft. reduction from the code required 25 ft.
combined side yard area.
Page 2 — December 2, 2004
Appl. No. 5608 — R. Arin
CTbt 67-1-9
4. The difficulty was self-created when the applicant purchased the property with preexisting,
nonconforming construction, and the deck was replaced without a building permit.
5. No evidence has been submitted to show that this minor variance will have an adverse impact on
the physical or environmental condition in the neighborhood.
RESOLUTION/ACTION: In considering all of the above factors and applying the balancing test
under New York Town Law 267-13, motion was offered by Member Goehringer Member Orlando
(Vice Chairman), seconded by Chairwoman Oliva and duly carried, to
GRANT the variance, as applied for, as shown on the August 27, 2004 amended survey
prepared by Peconic Surveyors, P.0 (and Condon Engineering, P.C. Plan S-1 dated
6/24/04), SUBJECT TO THE CONDITION that the deck remain unroofed and open to the
sky.
This action does not authorize or condone any current or future use,
subject property that violates the Zoning Code, other than such uses
are expressly addressed in this action.
Vote of the Board: Ayes: Members Oliva
was: Member Orlando.) This Resolution
setback or other features of the
setbacks and other features as
12v2X -04
(Absent
3d g 7�7
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [%FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
0
DATE 6 INSPECTOR ��
,> , n TOWN OF SOUTHOLD
�OPERTY RECORD CARD 0
/006 — (0
OWNER
STREET l
VILLAGE
DISTRICT
SUB.
LOT 3
ISC� L
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FORMER OW7-
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TYPE OF
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COMM. IND.
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I MISC.
Est. Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS ete
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BUILDING CONDITION
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NORMAL
BELOW
ABOVE
FRONTAGE ON WATER
Farm
Acre
Value Per Acre
Value
FRONTAGE ON ROAD /
Tillable 1
BULKHEADl� '
Tillable 2
DOCK r
Tillable 3
Woodland
Swampland
Brushland
House Plot
Total
Is■
- - --......... .----
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Foundation � at
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Basement Floors ✓I41
Ext. Walls Interior Finish
-
kFire Place
Porch Roof Type
Porch I� Rooms l st Floor
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Ext. Walls Interior Finish
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Porch I� Rooms l st Floor
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FIELD INSPECTION REPORT DATE
COMMENTS
OC
FOUNDATION (IST)
---------------------------------
--------------------------------------
FOUNDATION
FOUNDATION (2ND)
-
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P
ROUGH FRAMING &
-
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PLUMBING
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INSULATION PER N. Y.
STATE ENERGY CODE
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FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD
BUILDINGirEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
BUILDING PERMIT APPLICATION CHECKLIST
PERMIT NO. S�
Approved
Disapproved a1c'/31 o.r '
Expiration_ 1046 -
&JAS
Building Inspector
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Septic
N.Y.S
Contact:
1' Mail to:
Phone - OS C 1
APPLICATION FOR BUILDING PERMIT
(91'7)SBto-OS01
Date SV h e Ir 20_Q
INSTRUCTIONS
♦ a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
.V's 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 waterways.
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 issue a Building Permit to the applicant. Such a 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 par, for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has riot commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
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.
(Signature of applicant or name, if a corporation)
IMS
61 JA s, NX NY (000 44ertg
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises R isA (, . A R 1 N
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No. _
Electricians License No.
Other Trade's License
Location of land on which proposed work will be done:
IVO A-VEWO N\C
House Number Street Hamlet
,)unty Tax Map No. 1000 Section d 6'
'-)division
(Name)
Map No.
Lot
2. State existing use and occupancy of premises and intepded use and 6t;cu0mcy of proposed construAon:
a. Existing use and occupancy ng a k
b. Intended use and
3. Nature of work (check which applicable): New Building_ Addition Alteration
Repair Removal Demolition Other Work R,, l
usrrf(r F—U T/S& F o}�r;�} (Description)
4. Estimated Cost Fee
�''
4'oepaid on filing this a plication)
5. If dwelling, number of dwelling units `, Number of dwellinon eaIf garage, number of cars loth
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 I Number of Stories_ C rl
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories CI)
Dimensions of entire new construction: Front Rear Depth
Height Number of Stories (I )
9. Size of lot: Front Rear Depth
10. Date of Purchase >4r* Zg r aOoo Name of Former Owner Pa+ r; c'i n- –_ Abrli 1p
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO %(
13. Will lot be re -graded? YES` NO Will excess fill be removed from premises? YES_ NO_X__
14. Names of Owner of premises RlsA 4a i N- Address 1%0 Smr b 414: ramc Phone No0So9
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO iC
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NOS
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY
!OF�[N811 yp-
I <
–T—
At? I N being duly sworn, deposes and says that (s)he is the applicant
(Narrc of individual signing contrart) above named, '�
(S)He is the
Agent, k,Orpmate Utticer, 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 befpre me this
/ter day of 20g
Notary Pu lige Signature of Applicant
YOUNH. LEE
Notary Public, State of New York
No.O1LE50757?4
Qualilied Queens CotlAX
Comm ssior Expires Ford 1 /017 7
Appticant/ Date.
Owners Name:,. Reviewed:
Architect/ 007 Date -
1 nimeer: Submitted: f` G_
SCT'M #:
[)istritt: l,QQQ Section:Block:
Project I Subdivision
Location: C-h� �— Name:
i
Single & separate Required i
ccrtt6cauon: '
Req. >
Zoning Distriel:.(141 size: FT Aaual: I lW covcage : Nrutx►sec�"_: i
Req. Req R J,�
(from Yaurd�iL — Proposod: Lk (Side Yard / roposed: �: J (Rear Yud Proposed' _SIa —)
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Project Description:/ �d A�"
gGEI CIARIS Permit
RH rrrnft FOR REVIEW Et/
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Suffolk County Health Dept-
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Town Thwtecs
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Appticant/ Date.
Owners Name:,. Reviewed:
Architect/ 007 Date -
1 nimeer: Submitted: f` G_
SCT'M #:
[)istritt: l,QQQ Section:Block:
Project I Subdivision
Location: C-h� �— Name:
i
Single & separate Required i
ccrtt6cauon: '
Req. >
Zoning Distriel:.(141 size: FT Aaual: I lW covcage : Nrutx►sec�"_: i
Req. Req R J,�
(from Yaurd�iL — Proposod: Lk (Side Yard / roposed: �: J (Rear Yud Proposed' _SIa —)
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Project Description:/ �d A�"
gGEI CIARIS Permit
RH rrrnft FOR REVIEW Et/
Number
Suffolk County Health Dept-
New
eptNew York State. D. R C.
Town Thwtecs
Town Zoning Board approval:
Town Planaln Board approval: ----�
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SURVEY OF PROPERTY
AT PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY
1000-67-01-09
SCALE: 1'=30'
JULY 26, 2004
Aug. 27, 2004 (additions)
COASTAL EROSION HAZARL' 1NE FROM
COASTAI EROSIC'n. H4ZAF< MAF 0?,T' x
19 6?
ELEVATIONS ARE REFF_RENL:EP TO Nu, V.D.
AREA=2 SO. FT.
TO E-77 LINE
"I'- :h 'Hr..
-0ASTAL EROSION HAZAF. 4 /�_ L - , IIJ24 1':. 2V41- Vi ."
— L INE
4Nr ALTERATION OR 400/170N TO THIS SURVEr iS 4 VIOLAIION
O6 ;EC TION '209 OF THE NL W ✓ORK S14 IF EDUC.A TION I AW
E,(CEPT 4> PEP SECTION '209 -SUBDIVISION 2 ALL CER TIFIC4 TIONS
HEREON ARE VALID FOR THIS MAP ANO COPIES THEREOF ONLY IF
5410 M4P OR COPIES BEAR ThE IMPRESSED 3[-4L OF THE SURVEYOR
WHOSE SIGNATURE APPEARS HEREON.
ECONIC VEYORS.
(631) 765-5020 FAX (t
P.O. BOX 909
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SURVEY OF PROPERTY
AT PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY
1000-67-01-09
SCALE: 1'=30'
JULY 26, 2004
Aug. 27, 2004 (additions)
COASTAL EROSION HAZARL' 1NE FROM
COASTAI EROSIC'n. H4ZAF< MAF 0?,T' x
19 6?
ELEVATIONS ARE REFF_RENL:EP TO Nu, V.D.
AREA=2 SO. FT.
TO E-77 LINE
"I'- :h 'Hr..
-0ASTAL EROSION HAZAF. 4 /�_ L - , IIJ24 1':. 2V41- Vi ."
— L INE
4Nr ALTERATION OR 400/170N TO THIS SURVEr iS 4 VIOLAIION
O6 ;EC TION '209 OF THE NL W ✓ORK S14 IF EDUC.A TION I AW
E,(CEPT 4> PEP SECTION '209 -SUBDIVISION 2 ALL CER TIFIC4 TIONS
HEREON ARE VALID FOR THIS MAP ANO COPIES THEREOF ONLY IF
5410 M4P OR COPIES BEAR ThE IMPRESSED 3[-4L OF THE SURVEYOR
WHOSE SIGNATURE APPEARS HEREON.
ECONIC VEYORS.
(631) 765-5020 FAX (t
P.O. BOX 909
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Building Located in VE -13 Zone
(2) %2 Bolts Through Girder and
4x4 ACQ Posts
Simpson Post Anchor
2x10 ACQ Ledger Board
%Z' Anchor Bolts 12" OC
New 2x6 Joists 16" OC
and 5/a x 6 inch Decking
Grade
B SCALE
36" Min. 1." 'I 1 t—(2) 2x6
B110 Sonotuhe
Concrete Footing
A SCALE: 112"=1'A"
New 2x6 Joists 16" OC
Simpson Post Cap—\ and % x 6 inch Decking
Grade
Existing
Do Not Attach Framing to
Simpson Post
Nailed to Concrete
Every Joist
Galv. Hanger I 4x4 ACQ Posts,
4x4 ACQ Posts Simpson Post Anchor
SlmpsonPost Anchor 36" in.
610 Sonotuhe
Concrete Footing
, L
MAR
�F
L CONSTRUCTION SHALL
---� CERTIFICATION OF ME tLTHE REQUIREMENTS OF
NEWAob NAILING & CONNECTIONS CODES OF NEW YORK STAT'
—coti �Y REQUIRED.
oo, Plans are prepared by Condon Engineering. P.C.Ilefsonviolation
unless soling under rhe
2 •r Education Law, Article 145, Section 7209, for any p
r direction of a licensed Professional Engineer, Architect, or Land Surveyor, to alter any
item in any wayJf anitembeanngthe seal of an Engineer, Architect, or Land sur,ayorii
'' t altered, the altedng Engineer, Architect, or Land surveyor shall affix to the item hisfner
alteand aspecific oof the altera0o
,at
rations. notation
rdescriptiln n signature and the date of such
7rc,ondon Engineering, P.C. Orin ResidenceS1755 Sigsbee Road 180 Sound View AvenueMattituck,New York 11952 Peconic, New York
(631)298-1986
PURSUANT TO SECTION 4;
OF THE TOWN CODE.
FLOOD ZONE xJf 1�
COMPLY WITH CHAPTER "46"
FLOOD DAMAGE PREVENTION
SOUTHOLD TOWN CODE.
f ROr
� Q7^r"✓ APPr�..1 CD AS NOTED
DATE:,LiS BP.9 30k75_Z—_
FEE: --31 J4 BY EL",
OCCUPANCY
L",-
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPA NJCY
NOTIFY BUILDING DEPARTMENT AT
765-1802 8 A TO 4 P FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
New Wood Deck on Existing
Raised Concrete Patio
and Replacement of Existing
Wood Deck
Site Plan Prepared from
Survey by Peconic
Surveying Dated
September 3, 2004
SCTM# 1000-67-1-9
Scale 1" =10'
FF El. =13.5 Y
I FF El. =13' I
Building Located in VE -13 Zone
K
(2) % Bolts Through Girder and Post New 2x6 Joists 16" OC
and % x 6 inch Decking
4x4 ACQ Posts
Simpson PostAnchor--�,
Existing Single \ \
Story Dwelling Grade
FF EI=13.1'
Pie
36" )Nin.
200 ACQ Ledger Board
%" Anchor Bolts 112" OC
2x8 Simpson Galv. Hanger
are Ties
\-8"O Sonotube
Concrete Footing
B SCALE: 1l2" = 1'-0"
Nailed to Concrete
Every Joist
A 1
SCALE: 112"= 1'-0"
New 2x6 Joists 16" OC
Simpson Post Cap g andY4 g x 6 inch DeckinExisting
Do Not Attach Framing to[
2 " Simpson Post Cap
Grade
urricane Ties
44 ACQ Posts 4x4 ACQ Posts
Simpson Post Anchor 36" Min. Simpson Post Anchor
"O Sonotube
Concrete Footing
OSCALE: 112"=l,-0„
SCALE 1l4"=t,-g„ I Condon Engineering, P.0
Drawn by: JJC 1755 Sigsbee Road
Maltituck, New York 11952
Date: 11 -6 -2004 (631) 298-1986
OW
Plans are prepared by Condon Engineering, P.C. It is a Nolahon of the New York State
Education Law, Article 145, Section 7209, for any person unless soling under the
direction of a I Icensed Professional Engineer, Architect, or Land Surveyor, to alter any
item in any way. If an Item bearing the seal of an Engineer, Architect, or Land Surveyor is
altered, the altering Engl near, Architect, or Land Surveyor shall affix to the Item his/her
seal and the notation "Altered by" followed by hlslher signature and the data of such
alterations, and A specific description of the alteration
Arin Residence S_,�
180 Sound View Avenue
Peconic, New York