HomeMy WebLinkAbout32531-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33259
Date: 09/05/08
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: 2850 ROCKY POINT RD EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 2 Lot 2
Subdivision
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 20, 2006 pursuant to which
Building Permit No. 32531-Z dated NOVEMBER 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 ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
The certificate is issued to KIRIAKITSA PANTELIAS
(OWNER)
of the aforesaid building.
SIIFFOLR CODNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 3023127 06/06/07
PLDIYBHRS CERTIFICATION DATBD 07/25/08 HI TECH PLUMBING
tl} riz Signature
Rev. 1/81
• ~/ ~ Form No. 6
TOWN OF SOUTHOLD
' ~~ ~G ~ BUILDING DEPARTMENT
Q.L ~~ t.~ /l~.r ~ TowN 80 L ;,; 18
APPLICATION FOR CERTIFICATE OF OCCUPANC ~__ - - ' r
-, ; i.
1C~' JiiiOLD !
This application must be filled in by typewriter or ink and submitted to the Building Depart wt t e~`ollowing:
A. For new building or new use:
] . 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 elechical 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. Submil Planning Board Approval of completed site plan requirements.
' I3. 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
l . Certificate of Occupancy -New dwelling $25.00, Additions to d~a~elling $25.00, Alterations to dwelling $25.00,
S~~~imming 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 ofOccupancy - $50.00
5. "Temporary Certificate of Occupancy -Residential $15.00, Coum~crcial $15.00
Date. '$'l y--O~
New Construction: Old or Pre-existing Building: [/ (check one)
Location of Property: 2'8~1Q ~~ ~~~~ ~~-~
House No. S reef
Owner or Owners of Property:. ~ /j~~'Qt/~~-(
Suffolk Cowrty Tax Map No 1000, Section
Subdivision
Permit No. 3~~
Block_ Q~~ Lot 002 ~ ,Z
Filed Map. Lot:
Date of Permit ~~-30 -U G _ Applicant: ~~~A'~~tl~~2C~i~t~
Health Dept Approval: ~~-- Underwriters Approval: /oo' G ' ~~ !~
~lr~~_
Plamung Board Approval: ~l~ l ~JrU~' ~~ ft'"GG 70~~
Request for: Temporary Certificate
Fee Submitted: $ ~~[_,S
arc, ~ ~/~~~
Final Certificate: (check one)
~e
A plic Signature
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. 32531 Z Date NOVEMBER 30, 2006
Permission is hereby granted to:
KIRIAKITSA PANTELIAS
5 E HIGH POINT RD
STUART FL, 34996
for
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at 2850 ROCKY POINT RD EAST MARION
County Tax Map No. 473889 Section 031 Block 0002 Lot No. 002
pursuant to application dated NOVEMBER 20, 2006 and approved by the
Building Inspector to expire on MAY 30, 2008.
Fee $
288.60
ure
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
work will be done:
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 //~~ h '~( '~ Survey
www. northfork.net/Southold/ PERMIT NO. J~ Check
Examined '~ ,20
Approved ~ 0~
Disapproved a/c
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Phone: -~ -S 3- ~-~~ ~O
Expiration , 20
__-. _ ~ tsutlttmgms e r
r
~ APPLICATION FOR BUILDIN IT
2o~~s
- Date /V -~ ~ , 20~~
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 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 part 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 not 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. /j~ Li ec~ ~ ~,[~ Pjt,s
/zhH2c~ /~-e~lla ~
(Signature of applicant or name, if a corporation)
~~• /3ax 36Y O~(teyT W`F 119x7
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, eneral contractor, ectrician, plumber or builder
(~v.v rf i0Y9tTc~ 2
Name of owner of premises ~ /1 1 •¢ Kt1'SA P ~e ~ i //S
(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. ~o ~G~ f7~
Plumbers License No.
Electricians License No.
Other Trade's License N
1. Location of land on
House Number
County Tax Map No. 1000 Section
Subdivision i/ A
(Name)
ivy
Hamlet
Block 2. Lot_
_ Filed Map No. ~/ 73 ~ 8 q' 3/.-R-2L,ot
Z
2. State existing use and occupancy of premises and
a. Existing use and occupancy ~ /1;
b. Intended use and occupancy
use and occupancy of proposed construction:
3. Nature of work (check which applicable): New Building Addition (/ Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost 1) U
Fee
' (To be paid on filing this application)
5. If dwelling, number of dwelling units t Number of dwelling units on each floor /~ /9
If garage, number of cars ! un,a..r H~~S-~
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front 3Z , J Rear 3~ • y Depth 2 q. it
Height 2 2- Number of Stories o rut
Dimensions of same structure with alterations or additions: Front 3,Z.S~ Rear 3'Z- ~~
Depth .~.(~0-`lEneG~~.,1. Height 2~/ Number of Stories o~u~P,
8. Dimensions of entire new construction: Front 3R-`/ Rear Zz' ~o Depth 31. }/~*/x
Height 2 Y Number of Stories 1
9. Size of lot: Front /VO.oO Rear 9,38 Depth ~//•~~ t7,/0-~~
10. Date of Purchase olLj", /%J ~/ Name of Former Owner ~ ~"
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning ]aw, ordinance or regulation? YES NO L/
13. Will lot be re-graded? YES NO (/Will excess fill be removed from premises? YES NO v
s'J'u,d~cf1'L/} ~Y94G 2G
14. Names of Owner of premises~Au~~t95~'~g~, Address~E~yzT/~~~~d PhoneNo.7?.2',ZBf;'~y
Name of Architect Address Phone No
Name of Contractor ~ ,hiu[C ,GGL, Address .Cl a Phone No. 3R3-~ 8-r'G
. • ~n~.~
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO C/
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? *YES NO ~
* 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)
S: _. _ _
COUNTY O ~
[L /'7A2r~ ~e e h.9~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S~Ie is the
(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 met
S~ day of 20
9---
Notary Public
Signat re of Applicant
BARD bRo, gNate of New York
Notary No.4@65895
l]ualifiad in Suffolk Couniya0 0
Commission Explrea April 14, ...J
3~3 ~~-
TOWN OF SOUTNOLD BUILDING DEPT.
765.1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING /STRAPPING
[ ]FIREPLACE 8~ CHIMNEY
REMARKS:
[ ]ROUGH PLBG.
[ ] 1 ATI
[ FIN
[ ]FIRE INSPECTION
DATE D ~ INSPECTOR
[ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION
~ z~ l~
TOWN OF SOUTFIOLD BUILDING DEPT.
765-1802
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] IN TION
[ ]FRAMING /STRAPPING [ FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ] FlRE RESISTA~CONSTRUCTION [ ] FlRE RESISTANT PENETRATION
REMARKSe~~) -~ ~~
. ~ _
/~cd'~S
Ems, /~ ~ ~~~.5 ~~ .
DATE Y INSPECTOR '`~
~~
TOWN OF SOUTNOLD BUILDING DEPT.
765.1802
1 NSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING /STRAPPING
[ ] FIREPLACE ~ CHIMNEY
[ ] RRE RESISTANT CONSTRUCT
[ ] RO, GN PLBG.
[ NSULATION
[ ]FINAL
[ ]FIRE SAFETY INSPECTION
[ ] FlRE RESISTANT PENETRATION
REMARKS:
~ /S
DATE ~ INSPECTOR
3z~31~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
1 NSPECTION
] FOUNDATION 1ST [ UGH PLBG.
] FOUNDATION 2ND
] FRAMING /STRAPPING
] FIREPLACE 8~ CHIMNEY
] FIRE RESISTANT CONSTRUCT
REMARKS:
`~-
[ ]INSULATION
[ ]FINAL
[ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT PENETRATION
DATE ~ ~ 0 INSPECTOR
3 ~. ~~ l ~-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ]FOUNDATION 1ST [
[ ] F NDATION 2ND [
FRAMING /STRAPPING
[ ]FIREPLACE 8~ CNIMNEY [
] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
REMARKS:
3~-~3 ~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
( OUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [ ]FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
( ]FIRE RESISTANT CONSTRl1CTI0N [ ]FIRE RESISTANT PENETRATION
REMARKS:
DATE / ~~ 0 INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
~J y
~ ~
FOUNDATION (1ST)
~ ~
------------------------------------ ,,I
1~
FOUNDATION (2ND) ~~
-f
O
ROUGH FRAMING &
-
` ~
-- -
-
--- ~~ ~
G
----
_ - ~~
----
--- - ~ .
INSULATION PER N
Y - - - - - ~
.
.
STATE ENERGY CODE
_ y
'~
~ ~ n
a,
c
~,~~ 3
~
FINAL .~ ~~~~~
tKoo._
ADDITIONAL COMMENTS
- - ~-- _
/ -_
- -~ ~ -
O
_
W
G
y
G c
z
_ x
~
H
__
__ x
c
_ ~
b
.~
................................................................................................................
FROM SOUTHOIJ) TOWN Pl_RNNING H' 'D FWC N0. : 631 765 3136
Town Hall, 63095 Msln flood
P. 0. Box 1179.
Southold, Newt York 11971
May. 18 2001 02:19PM PS
Fax (618) 765-1823
Telephone (518) 785-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOID
C S R T I F I CAT I O N
Building Permit No. 3 ~6~ t
(please print)
Plumber: ~ I /'~L° 11 7 Lv/'10~'~ ~//"'1
pl•ass pr nt)
DATSs b "~/ '~
NI-TECMPLUAABINO 6 tIEATINCi ENTINQ
700 MAIN RD. .
RIVERFIEAD, NY 11901
831-722818
S certify that the solder ussod in the water supply eyetem
contains lase than 2/1D of L>t lead.
i
umbers 91g 'at
6worn to before me this
~~' day o! Qv(a~ST a®o8
Notary Public, ~lT-~C'o» County
~, ~~-~
~~,~~
Ie sltnea~ c~~~r
Coef~BpyKApui u,20,~
.-~. ~-
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
HUBBARD ELECTRIC KIRIAKITSA PANTELIAS
178 HUBBARD AVE 2890 ROCKY POINT RD
RIVERHEAD, NY 11901, EAST MARION, NY 11939
Located at 2890 ROCKY POINT RD EAST MARION, NY 11939
Application Number: 3023127 Certificate Number: 3023127
Section: Block: Lot: Building Permit: BDC: ns11
3x531
Described as a occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises. at:
First Floor, service + addition, Attached Garage, Outside,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 6th Day of June, 2007.
Name ~ Rate Ratine Circuit Tvoe
Miscellaneous
addition-bed room-bath-kitchen
and living room
Alarm and Emergency Equipment
Sensor 1 0 Carbon Monoxide
Sensor 1 0 Smoke
Appliances and Accessories
Dish Washer 1 0 1.2 KW
Exhaust Fan 1 0 F.H.P.
Wiring and Devices
Outlet 12 0 Fixture
Fixture 12 0 Incandescent
Outlet 23 0 General Purpose
Receptacle 17 0 General Purpose
Switch 11 0 General Purpose
Paddle Fan 1 0
Receptacle 1 0 30a Laundry sea/
Receptacle 2 0 GFCI
Continued on Next Page 1 of 2
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
_2- 2
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
HUBBARD ELECTRIC KIRIAKITSA PANTELIAS
178 HUBBARD AVE 2890 ROCKY POINT RD
RIVERHEAD, NY 11901, EAST MARION, NY 11939
Located at 2890 ROCKY POINT RD EAST MARION, NY 11939
Application Number: 3023127 Certificate Number: 3023127
Section: Block: Lot: Building Permit: BDC: ns11
3~53~
Described as a occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
First Floor, service + addition, Attached Gazage, Outside,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 6th Day of June, 2007.
Name TY Rate Ratine Circuit Tvoe
Service
1 Phase 3 W Service Rating 200 Amperes
Service Disconnect: 1 200 cb
Meters: 1
seal
2 of 2
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
Penm a
PemYt Date
REScheck Software Version 3.7.3
Compliance Certificate
Project Tithe: PANTELIAS KIRIAKITSA
Report Date: 10/20/08
Date i8erterne: C:1DOarxrente end 3etf9galEDWARD CEBUL1My DoctanentaVlCAD PROJECTSIRESCHECK ENERGY
CALCSWANTELIAS.rck
Energy Cade: 2000 tECC
Location: Southold, Nws York
Canstnktlon Type: SInDh Famlly
Glenng Area Peroentega: 1
HeaBng Degree Days: 5372
CanehrK3lon Ske: Owner/Agent: Desigrrer/Condactor:
2890 ROCKY POINT RD. RICH FEEHAN
EAST MARION, NY ALLIED BUILDERS
MAIN ROAD
ORIENT, NY 11957
831 883.2388
_ ,.
Ce51ng t: Flat CeSkq or QuGSaor Tnws: 470 19.0 0.0 24
CeNing 2: CeBbdral CeWrq (no at9c); 380 19.0 0.0 20
Wall 1: Wood Frame, 18' o.c.: 848 11.0 1.8 59
Wirdow 1: Wood Freme:DOUde Pane: 70 0.320 22
poor 1: Glace: 87 0.350 23
Floor 1: AS-Nbod JofaNTnms:Over UnoonrABOned BPaoa: 827 19.0 0.0 39
Biller t: Other (Except OeaFlred Steam): 85 AFUE
ComWlance Statement The proposed dulldn9 deggn deecrlbed bare M cartdsteM wtth the buiWin9 Wane, apecHkatfone, and oMer
calculatlona submitted with the penult apWlcauar. The propoeed dYldinp here been designed b meet the 20001ECC re~kerrrents in
REScheck Version 3.7,3 erM to mmply whh the nlarxMtory requlrementa Ibtad in der RESc/reok Irrapeceat Cheddst.
BWlder/Designer
Gate
PANTELIAS KIRWCITSA Pepe 1 oT4
i,; h~ _ :~, _ 2 _ ~ TOWN OF SOUTHOLD PROPERTY RECORD CARD ~ - d 3
-, -
OWNER
STREET ~O
VILLAGE
DIST.
SUB. LOT
r'',~K,T s o Po~nf Rd ~'. ~ 3 ~rs~.
FORMER OWNER N
~ - /~
((` ACR. i
S~
VV I ~ (SUFI L-l5 y~/r~ ,I ~ ,/~.
~ ( TYPE OF BUILDING /
~~ ~
2ES. a ~~ SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
(~
.~ .~ `.? ~ s ,.~~-,y
Gi>~7'k4 C4= ~-7~ YYI(~R.IGO Tv 1G i~P,1'G~'C~5 3- 14-P>3
.~ J~o o i3 (,'
;3v2 o c~ ~ ~ ~-. ..
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per
Acre Value
Tillable 1
Tillable 2
Tillable 3
JJoodland
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD ~ ~ ' ~ 9, ~ ° ~ ~0 Q
House Plot DEPTH L ~ ~ ~ p. ~~,~_
rte..-F
~. ~.
BULKHEAD
Total DOCK
=,,N,
STREET ADDRESS• 2890 ROCKY POINT ROAD
N
SURVEY OF PROPERTY
A T EAST MARION
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1000-31-02-02
I SCALE.• 1'=30'
OCTOBER 2, 2006
ANGLE N/ ~ M~~{AEL CONyyAY
POINT O
210.35
p
Ng1'30'00"E cfi
~ J
/•~ O
~ ~ c. w~u ~NCe C, m
rN via~E n
~ z ~ ~,..
> °° !~
~ ~ Wo ,na+ ~/
O • ~/
C~ ~ o seo ~
29.E ~
r ~
336 ~~_.
Q~
Q A~y " ~-
~ %~
u O yi~ uNK ONCE
y ~ ~, ~~x+
O wµi5 .29.4 9. _
~1 0 ~ ~ ` 'e--- .~CRE7E 2t1.28~
0
b ~ S79'09,'w~W S~~ KALTSAS
' ~ N~O~ MICHAEL HARTOFlUS &
I
~pF ~
0~'~ at. b
~~
^ =MONUMENT ~
ANY ALTERATION OR ADDITION TO THIS SURI~£Y lS A NOLATION ECONI
A~ SECTIQN 720901 THE NEW YORK STATE fDUC~7lAN LAW. (631) 7
EXCEPT AS PER SECAON 7?09-SUBO/NS/ON 2 ALL CERTIfICA7lANS p, 0. BOX ~'
HEREON AR£ VAUD FOR 7HlS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURI•EYOQ 1230 TRAVE
A~~~~~7 ~• ~• NHOSf SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y.
1