Loading...
HomeMy WebLinkAbout32459-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 11/02/06 No: Z-31979 THIS CERTIFIES that the building ALTERATION (STREET) Block 4 MATTITUCK (HAMLET) Location of Property: 11605 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 141 Lot 42 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 30, 2006 pursuant to which Building Permit No. 32459-Z dated OCTOBER 30, 2006 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 BILCO CELLAR ENTRANCE & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN F DEREEDER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMEIlT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~~ Au orized Signature- Rev. 1/81 ~ Form No.6 TOWN OF 80UTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 I \- ~ ., APPLICATION FOR CERTIFICATE OF OCCUPANCY N c.n This application must be filled in by typewriter or ink and submitted to the Building Department with the ~JlOfin~ ,:,.:) : ~~~~~~~~ j L . 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural Qr . topographic features. '-- - . 2. Final Approval from Health Dept. of water supply and sewerage-disposal (8-9 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 I % 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. _~:1 B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. 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 I. 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. Q<'.... -b1L( l../i,1...LJ:J ~ , New Construction: Old or Pre-existing Building: ~ ~~,~; S+ld House No. Street Owner or Owners of Property: :kt~ r de... ~ ( check one) ll-(~-i"v<-~ Hamlet Location of Property: L.f~O Suffolk County Tax Map No 1000, Section J L./ ( Subdivision ~~...r-eJ Permit No. 3;+~sq -2.. Date ofpermit. )0 '~D-6/f Block ~'-f Lot a y-z...- Filed Map. Lot: Applicant: --::r.:L.... ~ ~ Health Dept. Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ ~2.,'5\ dO ct.-u::--l t ~ 15 C 0--2- '-';1771 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. 32459 Z Date OCTOBER 30, 2006 Permission is hereby granted to: JOHN F DEREEDER PO BOX 1322 MATTITUCK,NY 11952 for : CONSTRUCT ALTERATION AND BILCO CELLAR ENTRANCE TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP 24557. at premises located at 11605 MAIN RD MATTI TUCK County Tax Map No. 473889 Section 141 Block 0004 Lot No. 042 pursuant to application dated OCTOBER 30, 2006 and approved by the Fee $ 75.00 Authorized Sign Building Inspector to expire on APRIL ORIGINAL Rev. 5/8/02 .,. --~- ;L'f S" S7 Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [)4., FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION ~~~ ~ REMARKS: ~k.. 10 - )0 r () h DATE INSPECTOR ~.~ ~ ~ r:o z &:2 N'" t- .e U ...C5 ,Z III !is ::!A. ilcn Z - . CI ID Z ~ 0 z 5 CI ::. -I ::. U) c o Z Z a: _ it ~ ~ ~ ~ ~ ~ ti Z ... e ! U) Z Z ,.. W U Z Z .. 52 52 IU !c !c CI ~ e e Ii ... Z Z :I a. g g ~ I u. u. u. u. --. --. ,........ --. ......., ......., ......., .......... = I ..~'li.;;~:'. .: "-~6.....-;t,. .......-....-....~.._. ,.. . .~ ,- I' 'l~I.1J IIIHI'I~\;1' I'HI 'U~nJ1rr ::...:.:' .... ..- ....... -.. -... -., .......... ...-...-- t;Utllll;trlll ' n__..._..._.. -- _.- ._- ..... -.. -- - ---....___., __ ..... n_ .....__......_......_____ _ ___.... FUIIIII1AT 11111 l'UIItIlMTlI1Il (2IW) .."-~..~~~."-~-----~------- ....~-- ...----...-........ ...... IIIIIIWI Jfn^,lI~ ,. "l.lUlU l'lt: ~--------------......_..._~--~- ....-............. r _n___~__"_.....___._...~_....__._______~____________________.__' III:illl.^'I"OIl 1"If.n II. T. ,- .--..-- WrhTI'. 1'.Hlt.ltIIV f:l1Im -...--.............---.....--.....-...........--- ......-----... ... .......-.......-...-...............-......-------...-- .... - 'e--tJ I l'tll^l. ,c :::'-~'~~f:;'~_:j~ .........-----................---......------ :.,.-~,~-:t~:~~5". --....-----......------...---------......------------------------...-. -, , ^ ., , !( '. tt:;r:, " ~,'~*:>.l;;':<.......:-;': ..'';',:-'' '"<.. . ~,:, -:~Si~:t~~*:;~-"-. ?-'.< . .'~?;!X'-,~. ~ >'- '0" , .' .. ~ 5 ~ '~~~ ffi~'A\ -u !~ !:l ""T.1 .':'.. ~ """"';',~ 5 ~;(r~ :,:,,:.~ 'll ~ \ ~ tl ~ -".1 ;." -"f; "I~:- _,\;~~~ :r ;"-'~ ~frl". -: -1;1, :. ~. ''''l.1 ~I" o " " .~,. E ~.\~ (" ' . -I "'.;',1-'_"" ..., 525 tfeUl)uffoll<FveQue post Offiee Box 1322 fI\attituel<, tf eUl Vorl< I 1952 ~ ovell\ber 7. I 997 Southold Building Department Town Hall Main Road Southold, New York 11971 Dear Building Department: Enclosed please fmd a completed application for a building permit together with I) a recent survey, 2) the first page of the deed which describes the property in metes and bounds, and 3) a sketch showing possible required alteration to cellar opening. I plan to repair and renovate the northerly building over the next several months as follows: Replace existing well system with municipal water. Replace existing electric baseboard heat with direct-vent propane-fired hot water baseboard heat. Installation of heating unit may require enlargement of cellarway opening per sketch. Insulate ceilings and outside walls as needed. Replace exterior doors and windows in place without alteration to openings. Remodel kitchen, including relocation of existing electric range. Remodel bath, without changing the location of plumbing fixtures. Replace rotten sofftts and trim. Treat termite and powder post beetle infestation. Replace broken shingles Repaint interior and exterior. I realize that you are absolutely swamped with permit applications, and I am perfectly happy to wait for the required permits before proceeding. I am hoping that in the meantime you can indicate to me which of the above alterations and repairs may be undertaken without a building permit. If you need to contact me, I can best be reached during the day at my offtce, 298-8000, but feel free to call me at home if required, 298-9755. Of course, I'm in Town Hall six times a week, too. Thanks as always for your help and consideration. -"""~I'" -- ,;.' -:;',.' . s: D6R SEAS. LAND IMP. 00 I ;;}.. 00 00 00 3.:LD 0 do r. . .3 0 (l; ~:3-_ 2300 Zoo AGE NEW FARM NORMAL Acre Tillable Woodland Meadowland House Plot ,.,.~ Total w'. '" ' . . / ,;;.i'> '. ~' t.... /'1!!D.F._:;:~--:',:,';:'-;' ':~"'<""""""-'::'- .' i:"~?c,.: ., .. ;,:: ~;:, :':- ,~:' ~~i~~;t..lk:" ,;k:':,:::') ';' ..; -..:, )~i:!Uf. ;:->._:;,~\~" ~-,-'- , ". .,M E ~ 'j \ It",'.; '~~'. - .' ~ADl=oi<:.cb:"... ,.' ".....: . i. '!~L . ',T'(PEOFl.!~I~}.~~~C(~0"'~ . "L:T. ;.~ " '" .'_' ~' :~-~ ' - ~~'? :~~r"~~~~~ ~ ';. 'r,~-:~, . . " I COMM.. CB. MICS. Mitt. Value.:.:..., ,li ',' .~'-...........:...i ./' ,.i.;,,;;..;.:rr-- ' ........" . < . ( (/ :e-L ~. VL. FARM '.". l" ,;, C TOTAL DATE REMARKS /'3:''.S'Oi::J:.(!., . -/- ~ . 'S'$, RlloF,,1l'1J (iI/of B.Lb,! G'.c...,.v~ / -, ./I' T" ().B. q./}/~e'"E e. 3j-"" .,' ~ ..,c, .3 ~ co '-~~ BUILDING CONDITION I BELOW ABOVE' Value Value Per Acre FRONTAGE ON WATER . . FRONTAGE ON ROAD 6/.. 97 DEPTH 2CJ.~ BULKHEAD ~OOO. 1:20...;. 0/ - DOCK ~,~ . .. ""-i:'~'\:~'f~~:;~~~;:~~~~'1~:I,:' ;' '1'2:' ':: :;,=. .::- '~:tl ), M. Bldg. .2<1;( I~:" L./?,Y'/ " l,^iJ"'~ JSI_)y I.l.. 1. W '- 4f.~ % 'I J_ .2, t> 0 , f.oo . Extension Extension Extension Porch Porch ;2. ,~" \ L Breezet..W'7 %;( I~ -= j / ;... ~. p.o~ ~~ Garage Patio , o. 8.C.\.t-J. ~/ 2- rf.MHe ;11..11 !J ? Total j: 7: -. "'('-.... ..'\oi: :..' COLOR :l.1C.'O~ , LIar ~v -- ~ .( (, ~ Foundation .Q' I ~ Basement ~ ~'" !r Ext. Walls '. 2 YO Fire Place. Type Roof I ~~~ Recreation Room ~/p ,.~ Dol'\li'~r L';pic. " . 'I I ~. .. . ',' 'f~O~ Ibftl$- ,-J ,.' ."Y - ,~'- ,-. _'~-" . '.:, -.Vt',rZArf"( -/900" . . ",' ';'. \:'~;,,," :..;.::,. ..' .r- . . ,.~ '-<_'o_~;i':;"';''to-''i~-~ ," "" '.', ,'!n<'nil:~;:Zs3C?'~;(i_;_' 7 ,:'...,:,' ..."..."~~.'",,. *",.., ".t,..ct..l.",,1.4 ~. TRIM WIj,'l~ . -..~:". " I - it y ':'l ). I 1.'1 } .1, 11"'1. /3 'Y I (./< Bath ~ h~n qinelle Floors ;~,' i K. a~b St.. Interior Finish I/~ i lR. V1l\ . Heat - d 1/' I DR. r. . . '" Rooms 1 st Floor BR. Rooms 2nd Floor FIN. B Driveway . ~ . ;~~~'~~;':~~~::~_~~:S~~:~~;~~:~~:~1:'I.;_ . "~"A~\ .., ... /" . -- ......."'-..~" ;; i;~: ' " !'_-i'_ N III N .... N fr. shed =Q. ;.. III N o N NI F HALLOCK N. 51.40' 20. E. , A> ..- 64.90 Cl.r.'r4 . ~ 1o..,.:.\J,;'"'\ . -\"1--'.5'.1 V 3. Cl <( o a:: 11.1' 1 sty fro "' dWell. : - 22.4'- U lL. \ - U iii ~ . 0 ~ C"I . -0 ,... 0 iii III III III . ., \ III 0 t'l . iii ______ .... C"I Z 'R> 6\.97 ;;....& . O' \0.1H. 5.42 2 ! cr I&l ~ ..J ii: III U. - Z \'AAIN RoAO The existence of right of ways and or ease'"e1lb of record, jf any, not shown are not guaranteed. nt' OHVrS c- OIMENStONll 'SHOWN HElEON fROM THE 'iT'RUCTURES TO TH4! PROPERTY UNI!$ ARE fOR A SPECU'IC PUR- QOSE AND US! AND THEReFORE 4,RE NOT IN1lhtlEO TO GUIDE THE =RfCTIQN Of f!NCES, RfTAINING NAllS, i'OCU. PA11O&, P'lANnNl:; -\fI:~. ADDt110N TO BUilDINGS ~"'Nf'tone c.t:JNSIIOCfJON JH:A.UTHOfl:llf:D Alnl:AlION 01: <\DOnlON TO 11tiS SURVEY tS /II. 1QlAnoN OF SI!C11ON 7209 a= .. NIW ~ SMlf ElJUCAlICIN ~w. !" GUARANTIES INDICATIiD HlAiON aw.L RUN CN..Y ro 1ME PWIKlN POR WHOM 1tfE 5URV!Y IS PM- PARED, il.NO ON HIS M'HALf TO THE ,nTLE CJ:>Mf'ANY, GO\I8tNMfN- TAl AOENCV AM) lENOING INSTJ.. ruTlON LISTED HEREON, AND TO 1'}ft ASSIGNEES Of THE lENOlNG INSTITUTION. GUARANTEES AIr NOT ~lf TO ADDnlONAl INSTITUTIONS 01 c;U8SEQUENT 0W>0llS. OOPES Of .... II.IMY MM NOr IEARING THE LAf'8) SuavE _ 5fAl 00 _NOr. JOB NO. 91-480 SURVEYED FOR FILENO.67aF t. &; SITUATED AT MATTI TUCK TOWN OF SOUTHOLD SUFFOLK CO. NY SCALE ,'. = 30' DATE 10-11- 11il91 FILED MAP NO. DATE TAX MAP NO. 1000 -141- 4 - 42 (REF. ONLY) DISK 1 HAROLD F. TRANCMoN JR. P.C. LAND SURVEYOR . SUCCESSOR TO WILLIAM G. MEIER 1866 WADING RIVER-MANOR RD. WADING RIVER, NEW YORK, 11792 516-929-.695 j .. .... J..L fiil WN~~~O:;O~D NaV -7 . ~ DING DEPARTMENT TOWN HALL ~. mOLD, N.Y. 11971 L44, L: 765- 1802 .~' a~~5q r~ Exanined.l;ifs1~....., 19.... . ~fL '7L Approved../~ .~..., 19.... Permit lb. J,--!:.0... Disapproved alc ............................... . BOARD'OFBEALTH : /. . .. . . . . . 3~SETSO~~S ............... SURVEy.,...................... . CHECK .::tl.. ~n~................. SEPTIC FORM ................... 00 ~li> BLDG. DE"'. NOTIFY: CALL .................. .MAIL TO:.. ................... .................................... ............................................ ..................................... ... .!t~. ildi~ Inspector) ATION FOR BUILDING PERMIT ,. N~-..lG....b",;- '17 Date................, 19.... INSTRUCTIONS a. 'This applicatioo DllSt be.".,.,letely filled in by typi!writer or in ink and 8Ubnitted to the aJildi~ Inspector witl 3 sets of plans, llCOJI"ate plot plan to scale. Fee accordi~ to sche01le. b. Flot plan ehowi~ locatioo of lot and of buildi~ 00 preaises, relationship to adjoini~ preaises or Jd>lic ,streets or areas, and givi~ a detailed descriptioo of layout of property IIIJSt be dram 00 the diagran .mich is part of this applicatioo. c. n.e loIOrk CO\I'l!red by this applicatioo may rot be ro,ue,ICed before issuance of fuiidi~ Permit. d. Upoo approval of this applicatioo, the fuildi~ Inspector will issue a fuildi~ Permit to the applicant. Such permit shall be l<ept on the premises available for inspection throughout the work. e. lb buildi~ shall be occupied or used io .mole or in part for any purpose .matever Until a Certificate of Occupancy shall have been granted by the Iluildi~ Inspector. APPLICATICIl IS IEBEIlY MNJt to tbe llui1di~ Department for the issuance of a fuildi~ Permit pursuant to the Iluildi~ Zone Ordinance of the Towo of Soutbold, &1ffolk County, New York, and other applicable~, Ordinances'or Regulations, for the aJOStructioo of bui1di~, additions or alterations, or for n...xwalo.. deIIOlition, as herein described. n.e applicant agrees to .".,.,ly with all applicable laws, ordinances, liuildi~ code, housi~ code, and regulations, and to lIlbit altborized inspectors 00 preaises and in bui i v~ inspections. lTAJlllTll:lI=lIWlIJoItu :. ..... ................................. (Signa f applicant, or naDe, if a corporatioo) 1:<;>:.. .J . ;~..M~>>A~~....I)~~~.......... (Maili~ address of applicant) 1 St__..~t1...f.~'fiellM-i.,._I'; l~.lsee, agent, architect, engineer,' general contractor, electrician, plmber or builder. .. ~~..~~~;~~~~~:~,;:I~;:':................................................................................... .cIolO1TJ3'l.~"'1 V~!r:," r,- de.. ~( .. .. 1lafel6~ ~TAOIIG.~1r..;...... ........... .................................................................. mllJMO:) 031lUOCl r:<as on the tax roll or latest deed) O"'I!l"'UJOl . OMIMAIA ..IWI.'... . .. If apphcant 18 a ct>LI"~;8.1Pture of wly althor1zed off1cer. . e' '1\1 fI0IT'l"QT;>'M'.) - ........................ ~&~~~rr!i'~:-.~'.""""""..""""""..".. ........... (NlIne .....titl.e I,OI\I~~ officer) "\ i \ .____"__.__ .3TMJ lluilders License lb. Plmbers License No. Electricians License No. ..................... Other Trade's License lb. .................... I. Location of land 00 Which proposed work will be dooe.............................................................. ... !l6.9.~. t!~!~.K~;:?.. (~J!<.(..... ~ ~.<? ~~if.:~. .,S}!.~t)./. ..I.'j.-rlt.:t~~. ................................... IhJse IUd>er Street . . . Homlei: . /'11 4 '11... . County Tax Map lb. 1lXX). Sect100 ................ Block ................ lDt .....;.......; .'. Subdivisioo ........... .......... .......... ....... Filed Map lb. ............... lDt,............... (NlIne) . ':,'-'-".-, 2. State existi~ use and occupaocy of preaises and intended use and occupaocy of pro[ioaedaJOStruction:' . . S-FR ... .....'. ... a. ExistlIlg \I8e ard. ~l"'I.~ ............................................................................... ......... ~.~ .............. .'............ ~........ . S-ff: ... ... ,. b. Intellded. \ISe ard .~~ .. ."........... ..................................................... ._.... .... ...... ........ ..............;,....... ....... lflii .... __'_,_:~:..\t','....!j!~Il:.r:fJiL_ . .,.-.,' '......"- 'M"!;;':. . ,- ':' .~~~;:r::'~~~5.~,': .: 3. .... . . : ..' 51 )7 t211 ~J: ~ ""1- Mature ~rk (check Mild. apphcable). New IknldlOg .......... .......... Alterauon .......... llepair. ......;.. Reaova. ..}....~....... ....i..,....... Dem>lition............: ~. ;.." .,......; '~::FJ,.............:..... .c,..;..,,~. r e4+,,,,,,1-, f'... "...,~.<J 1-.,....... ~Descrlj~jij) . ., .6/C:it> <':>0 ....~""n~, . IlS~I:~~Q>sa:;~;';:;~:;;~''::~:4'j:'' fee "(~~';;";';' d';'" ". '. ti;.J"" If <koelling. ...mer of dwelling mits ....1.,...... fumer of dwelhng mits on eadl floor................ If garage. ...mer of cars...,................................... ii-.;r ir 1"4. f"-<'+ ("(0-") If husiness. comerdal o~milll!d occupsncy. specify nature snd extent of eadl type of use.....f...~/~..'l~~f:-f.+."j.. .. . . '. '. -z.,g 3 I t..f 3 I "l." 'i ' OUllenSlOOS of. exJStlng structures. 1 f any: Front.. .. .. L .. .. .... Resr .... t. .. . .. .... Depth .....:........... lleight .......,.,......:......: ~ Ilmher of Stories .... \. .. .. .. .. .. .. . ., . O' . f twi hI' -~~. . Froo .r..."",- .r....~ lmensloos 0 ~ s ructure t a teratloos or QUUltlOOS: t ............... Rear .v~............ Depth .., .(~l":"l'.....,. ~.. :'Height ; .(~l":~............ Ib1ber of Stories ..r~.":'~........ ','^". I ~ ~. 5. 6. 7. 8. O. i f t' .. t' Froo VlO"'e.. Re "'0"1':' th 6"'.... lmens OOS 0 en Ire new CQ08truc Ion: t ........,....... ar............... Dep .. .Y.I.......... lleigllt .......Vl~r."':.......,.... Ib1ber of Stories ..~~~.-:-............. d ..t.L . ..,.... -L"""''''''-- .iT Size of lot: ~t ...~.1...!.7.......... Rear ..<;.~:~~.......... Depth .1=~:z:.:~:.:~.?!~.5'l IMte of Purd18se ., ..IV. r/.i'J.~.,..... HIm! of Former Omer ..~l~/:,,;. :F:~~~. J .:':.~~~:': .-r.:~:1... Zone d'" .Lieb". . ed 'i-O or 1.18e Istrlct In 1l1li1 prBnl&eS are ssttJat .. .,................................................................ , Does proposed CQ08truction viorate any zoning 1..... ordinance or regulstion: . .~~................... Will lot be regraded .., ~ .. ~~ . : ., ., ., ... Will excess fill be remved fron pmni!"i": YES @ .~... -t. ~"'~ 1'.0. IH't. t\...*:-t;.....1. Vff-1"~W Names of Owner of premises ........................... Address .............................. Fhone No. .............. 'Z-1~-f<l6(10) HIm! of Architect .................................... Address .............................. I'hone No. .............. 9. 10. II. 12. 13. I~. 15. HIm! of Contractor .......;......,..................... Address .............................. .I'hone No. Is Ulis property within 3lXI feet of a tidal wetlsnd1 * YES .......... m:+...... *IF YES. !UJI1IID 'RHl '11lIlS111E.'l I'IlmfIT Mo\Y JlIl IlElplRllD. , ................ . 'PLOT DIAGRAM locate clearly snd distinctly all buildings. Wether existing or proposed. snd indicate sll set-back dimensions fron property lines. Give street: snd block ...mer or description according to deed. and show street DmlI!S snd indicate ...heUler interior or comer lot. X ' 'P1<ASc. f"'... s ......v<-'/ ....^ ~ Gh+ r""'J'" .(' w ..Jt- A...\..~ "",~""l1I5 CER1lf1CA1t 1lQU1JI" ~~~ASNmED f DATE: B.P. # ;tfrfS7 T' FEE: 7~BY:~ NOTIFY BUILDING DE~ 765-1802 I AM TO 4 PM FOR THE FOLlOWING INSPECTIONS: . 1 FOUNDATION. TWOftEOUIRED FOR POUftB) CONCftI1I 2 ROUGH. FItAMINCI . PWMIING 3. INSU~TION 4 FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. SrNIE OF IUI YpHt. Cf)~ c' . ,'ONSTRUCTION & ENERGY .:::::::... ~TI<:r 5,<; F ",)T RESPONSIBLE FOR WJlny OF ................. .. Li ~"~.,, :ONSTRUCTION ERRORS ......J~.~~..J.~...~.~.. .~................being duly sworn, deposes snd says lI18t lie is UIe applicant ~ ,.",..... I'\f"';,(">",r\,;,""'''''''';, 1;)\"",:,,1,., ~; ',' I; . 'f.r ","['IIP;'\1F;Y ~'r v'Vvu~ r'\, I, (HIm! of individual signing contract) above 11lI1Ed. .J . \\/1 (J / . lie is the ....... .... 0.~.L~............................................ ......... .................. (Contractor. agent, corporal'!! officer, etc.) of said owner or owners. snd is duly authorized to perfOOD or have perfotnEd UIe ssid work mid to...ke snd file this applicstion; that sl1 statenentscootained in this spplication sre true to the best of his knowledge and .belief; and thst the work will be perfotnEd in tile ...nner set f'Orth in the application filed therewith. ~rn to 0 ~ this mov q" ". . .......... ,of ........... ....19 ... Notary :J;~c, ~ oc-1Z~~<?J\ /0., ----r.'\ /, 'Q ~ ~\, \0 vi' r / y~, , +. 'Kcc~(" e.Jc-.) ",,-. ~ to h I---------r--'J---- -1--------------------------- \ I'" ..1 " .,,-.-..--, .~ .' 117iLL~c .=~-===_ / ! K~VV'6')<.t ~\o<l~ -piA....... IJ Lc........) l" 1...- 1-T - ----T i-J .,__J,..._, _:~ , ! A,d) G'I'7F-+ toy 6Cu(f' '/., {;it 1> I L.W 'D()() 1Z. $ \ '1$ 0