HomeMy WebLinkAbout22332-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23416 Date DECEMBER 19, 1994
THIS CERTIFIES that the building NEW DWELLING
100 DONNA DRIVE &
Location of Property 6700 NEW SUFFOLK AVENUE MATTITUCK NY
House No. Street Hamlet
County Tax Map No. 1000 Section 115 Block 15 Lot 26
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 26, 1994 pursuant to which
Building Permit No. 22332-Z dated SEPTEMBER 16, 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 A ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MICHAEL & CARMELA KOHLER
(owner, lessee or tenant)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0064 12/09/94 1
UNDERWRITERS CERTIFICATE NO. N335461 DECEMBER 6, 1994
PLUMBERS CERTIFICATION DATED 12/14/94 BERTSAND PLUMBING & HEATING INC.
/X"
Building/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)
Date................SEPTEMf3ER...1�..... .�.................... 19...94...
.
N2 22332 Z
Permission is hereby granted to;
EAST ISLE CUSTOM BUILDERS - A/C LINDMI;R, FRED
..........................................................................................
278 JANIAICA AVENUE
..........................................................................................
MEDFORD, NY 11763
....................................................................„.„.................
to ,,,,CONSTRUCT.. ...A ONE.. ...FAMILY DWELLING. . . . ..AS. ....A.PPL. . ...IED FOR.
.........................................................
. .. ...... ............ . . . . ........ .. . . . . ..............
..................................................................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
100 bonn2 ' iVIL -4-
at premises located at.....5700..NE;R..5UPYOU.AVE ..............MTTIMCK........................................
..........................I.................;..................................................................................................,................
County Tax Map No, 1000 Section ..........1.15.......... Block.........1.5....I........ Lot No. ..........ZS..............
pursuant to application dated ,,,,,,,,,,,,,AUGUST 26, ,,,,, 199�........... and approved by the
Building Inspector.
Fee$.3... .�.. ..�
ding Ins for
Rev. 6/30/80
FORM NO.6
TOWN OF SOUTHOLD ,
Building Department
Town Hall
Southold, N.Y. 11971 .
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted n a■ iii to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
' 5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p.mperty showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $2 5 . 0 0 -- BUSINESS $5 0 . 0 0
2. Certificate of occupancy on pre-existing dwelling $ 50 . 00
3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ 10 .0 0
4 .Vacant Land C.O. $ 20 : 00
5.Updated C.O. $ 50 . 00 Date . . . . . . . . . . . . . . . . . . . . . . . . . .
NewConstruction. . . . . . Old or Pre-existing Building . Vacant Land . . . . . . . . . . . . .
Location of Property .
. . . . . . . . . . . . . .. r5 ,Qv . .. . . . . . . . . . .
r.r
House No. Str et Ham/et
Owner or Owners of Property .
County Tax Map No. 1000 Section . . . /1 S. . . . . Block . . . . S. . . . . . . . Lot . . . . . . . . . .
Subdivision�G .�? GLc --�,� � Filed Map No.0�:' . . . .Lot No. . . .... . . . . . . .
Permit No. . . . . . . . . . . Date of Permit . . . . . . . . . .AppIicant� .k�- a5 L
Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .
Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval ... . . . . . . . . . . . . . . . . . . . .
Request for Temporary Certificate . . . . . . . . . . . . .. . . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . . . . .
Fee Submitted $ 2:5. . . . . . . . . . . . . . . . . . . .
Construction on above described building an er it m II ap icable code and regulations.
Applicant . -
s
�O TOWN OF SOUTHOLD.
0 �c QFFICL OF BUILDING INSP=OR
P.O. BOX 728
.,/ •� TOWN BALL }
p� SOUTHOLD,N.Y. 11971 ,
C E R T I. F I C A .T I O N
Date December 14, 1994
Building Permit :Wo. 22332
.Owner Kohler
(please print) °
z DEC. I 51994 �pp
Plumber Bertsand Plumbing & Heating, Inc. li
(please print) ___._ BLDG.DEPT.
TOWN OF SOUTHOLD
I certify that the #older used in the water
contains less than .2/10 of 1% .lead. PFYe
�� � 'X. (A
plu 4er's signdt"O) ..
Sworn to before me this
14th day of December , oo
19 94 ��—
Notary Public
Notary Publ iC, Suffolk County EILEEN M.IROACHE
Notary Public,State of Newyork
No.482G942
Qualified in Suffolk County
Commission Expires January 31,19-9—is,
ti
Date November 28, 1994
Building Department
Town of Southold
Town Hall '
Southold, New York 11971
Re: Building Permit
Owner: Y—p R(.�GZ
Gentlemen:
I hereby certify that the solder used in the water supply system
for the captioned job contains less than 2110 of 1% lead.
Very truly yours,
BERTSAND PLUMBING AND HEATING
By
Sworn to before me this
2_8th_ day of Nov embP> P 1994
r �---
` - DEC 1 3 1994
o ary Public t..
EILEEN M.ROACHE BLDG.DEPT,
Notary Public,State of New York TOWN OF SQUTHOLD___
No.4826942 --
oualified in Suffolk County
Commlmion Frpire9 Janunry 31,19�v
r
THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1
BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date DEC:EMBER ®G e 1994 Application No.on file 85948494I/94 N 335461
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
KOHLER, S/T11 C'. DONNA DR. & NEW SU FOLK A'VE, MA.TTITUCK,, N.Y.
inthefollowinglocation., yi Basement ® lstFl. ❑ 2nd Fl. ATTIC/OUT Sertion Block Lot
was examined on NOVEMBER 28 r 1994 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES S FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS WITCHES INCANDESCENTI.FLUORESCENT I OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
9 28 15 3
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL'REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
1 F 3
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER �,4W 3W 3,0'3W 3,0'4W NO.OF CC.COND. A.W.G. NO.Of HI-LEG A.W.G. NO.OF NEUTRALS A.W.G.
EQUIP. PER.0' OF CC.COND. OF HIAEG Of NEUTRAL
1 1092 CIS 1, x 1 44 1 4
OTHER APPARATUS:
r.F.C',.1:-2
SMOKE DETECTOR.-1
PETER CI-iARLBONNEAU Lic'#2G97—E
35 SHEPPARD LANE
SMITHTOWN, NY, 1.1788 GENERAL MANAGER
11
Per
This certificate must not be altered in,any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
1 fry 7 ^Rf 97�� /'�r:7 i1G i]i "'�� �'C''��•� �'.i� �C�dr.. L�,. D��J La:�n1T
®PV ® ��9��DC(� ���aG3 �t���u. ��� 1, ti7�. t s � _ �� r�,
BUILDING DEPT.
INSPECTION
( ] FOUNDATION 1ST [XFIONAL
GH PLBG.
FOUNDATIQN 2ND [ LATION
FRAMING [
RE II ARKS: -�L?,
DATE /L ��' ` INSPECTOR �-�
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST JINSLULATION
CH PLBG.FOUNDATION 2ND
[ ] FRAMING [ ] FINAL
REMARKS:
�b
DATE INSPECTO '
M-isoz
BUILDING DEFT.
INSPECTION
[` ] FOUNDATION 1ST [ -'ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
REMARKS �✓ d�'i L
0 12,
001,
0-4
DATE. : INSPECTOR__7
pus-ieoz
BUILDING DEFT.
INSPECTION
[ /FOUNDATION 1ST [ ) ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE � INSPECTOR
D�I::Si 2 C T10 JJDAT COt1-VI'l1E:NTS
1� =0 (4
C c
H
OUNDATION ( 1st ) zz
cn
FOUNDATION ( 2nd )
2 .
cy n o
ROUGH FRAME &
G
'PLUMBING
C^
3 .
fi
INSULATION PER N . Y. / y
STATE ENERGY _
G
CODE
4 .
FINAL /
ADDITIONAL COMMENTS :
x
• x �
H
O
.r
x�
d.Ak
m
APPENDIX B
SECTION 155.3 OF THE REGULATIONS OF THE
COMMISSIONER OF EDUCATION(8 NYCRR, 155.3)
HEALTH AND SAFETY IN unless immediately adjacent to an approved exit.
EXISTING EDUCATIONAL FACILITIES The primary exit is commonly the opening to the
corridor.The second means of egress may be a door
Facilities in school districts other than city school dis- opening into a separate smoke zone, or a door di-
tricts in cities having 125,000 inhabitants or more,shall rectly to the exterior,or a window of such size and
meet the following requirements and, in particular in- design that will facilitate egress, or a door provid-
stances,such other requirements as may be deemed nec- ing egress through adjacent spaces where specifi-
essary by the commissioner to insure the health and cally approved.
safety and accident protection of occupants. (i) Any point in a space of pupil occupancy shall
(a) Exits not exceed a maximum of 50 feet straight-line
(1) There shall be at least two means of egress re- distance to an exit, unless otherwise approved
mote from each other,leading from each floor occu- by the commissioner. Any additional exit nece-
pied by pupils,including basements. sary to satisfy this requirement shall be remote
(i) When pupils enter into a corridor,there shall and may be required to be directly to the exte-
rior.
be a choice of two unobstructed means of egress
in different directions. (ii) When spaces of pupil occupancy are defined
in an open area by wardrobes, cabinetry and
(ii) Handrails shall be provided on at least one other furniture which does not present obstruc-
side of stairways,and on both sides of stairways tions to egress and which allows students to cir-
88 inches or more in width. culate freely from one space to another,the total
(iii) There shall'be no storage under any stairs open space is considered, for exiting purposes,
or landings unless the enclosure is approved as a single space.Exits from such open-planned
fire-resistant construction. space shall meet requirements determined by
(iv) Provision of fire escapes.of approved design the commissioner.
may be required where other.exits are deter-
mined to be inadequate for fire safety. (6) Required emergency egress windows shall be of
a size and design, including hardware and, in ap-
maximum depth of one and one-half times the
(2) Dead-end corridor pockets shall not exceed a propriate instances, steps or ladder to high sills,width of the pocket or one and one-half times the that will permit and facilitate emergency egress.uch windows shall be free of obstructing screens
width of the corridor,whichever is less,unless oth- S storm sash.
erwise approved by the commissioner.
(i) The minimum clear opening area for such
(3) Corridors and exitways shall be kept clear and windows shall be six square feet, with a mini-
free of obstructions at all times. mum dimension of 24 inches, unless otherwise
(4) Fixed and portable security gates shall not be approved by the commissioner.
located or used where they will obstruct exits or (ii) At least one such window in each space of
create dead-end conditions for occupied spaces. pupil occupancy shall be marked with an appro-
(5) Every space of pupil occupancy over 500 square priate sign identifying it as an emergency
feet in area. shall have two separate means of egress window.
egress from such space.A space of pupil occupancy (7) Places of assembly. A place of assembly is any
is any room or self-contained space housing pupils area used for the assembly of 100 or more persons,
on a regular basis,other than a place of assembly and spaces over 1800 square feet in area used for
or small rooms where no more than 10 pupils are the assembling of persons. A place of assembly
under direct,responsible, adult supervision. Each shall have at least two exits remote from each
means of egress shall be in a separate smoke zone, other.
14
t Y 10 516 727 3411 PO1
EAST ISLE CUSTOM BUILDERS, INC.
278 JAMAICA AVE
MEDFORD, N.Y. 11763
(516)727 6023
November 7, 1994
Mr. Gary Fish
Southold Building Department
Re: Building Permit No. 22332
Dear Mr. Fish:
with regard to the-bracing you questioned on the captioned
job, attached please find bracing as done according to engineering
notes circled at top of page.
cerely,
O
resident
Enclosures
Ll
PinU - 9 1994
.lame uiE—car DOLL MC EAST =6 i fir• a1�u FFa 1oi1r aD•os c o by p
R
TOP cmm 2n4 SP R W M 93 MEN-FIR OR ISO I CONTUMM L.ATERM.
ROT CHM 294 SP N! ' BZ 2a4 SP 02 BE EDUALLY SPACED. ATT&M WITH EM eo NAILS. ti
WEBS 2t4 SFF 0 S 'W6 2x4 SP #2 14ATERIAL TO BE SUPPLIED AND ATT�D
SUITABLE S1OPP43TT BY ERECTION pQ�1Al�rIbR.
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wsw wpm wa. oas m TC LL 30.0 PSf
a o o m o as T1PO�lT811�4 �r Ewa w�r V�I�i yi wo�. .w
cma ao cm 886"r HL w ww ft - TC OL 10.0 pw
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a�wis�■ra.�w a■ wiw.wsra wan mw•pow, rn�w�... OC LL 20-0 P�9f
r wws ww w s s+.��aw,� o�warmws�trw wa a—�a 10T 1.0. OS-0
O O wiwir�swrsv P r V m a M.M Ma!1 am worm was aIw f�wawa
a w w M own love MM w1R�M Ar•��.MaM a aw w am
ao e a a� o o m'e"'m sa►w s was wr m w�m. wsw�w ws uat�r,aw.era. OWA.f 1rL. 1.15
EAST ISLE CUSTOM BUILDERS, INC.
278 JAMAICA AVE.
MEDFORD, N.Y. 11763
(516)727-6023
October 21, 1994
Building Department
Town of Southold
Main Street
Southold, New York 11971
Re: Permit No. 22332
Gentlemen:
Enclosed for your files is the under construction survey
you requested.
3Ri
,
I
isano
RO:eac
Enclosure
2�199.E
;z 0fi
i
�uRUEyED �oR Incl-/gEL ¢ CA,PMELA /to�/LER �Sc.Tn�. o. 1oo0�-//5- /5-26 -
_.10R0PER7-Y Z0CATEO AT /V�RT717UC)1<
/Y,Qp of .OEE,0 9cZ6 C.4EEK E57.47E5 AA ,, The water supply and sewage disposal systems for
ZoT ?,vT Q this residence will conform to the standards of
22
the Suff County Department of Health Services,
TON/N 6F $DUTNoLO �o•p �1 0
SuFFo Lf; co L11V T/, NE
AREA = 2/, 76 7 !F n
o "
6cALE / _ 4O• I; t o
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l na,dhnnn4l.ilh•ratinn or.Iidihun In Ihro.;in , n a nlannn 1 4) -L N
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TOWN OF SOUTHOLD
La
L.E!'ttiq&0i„ •� ..il.nanlcceorcertih,,�unn. uv hcated by"'O.'.Hall rnnnl, Io TEST{�D 1-6 •D � 1 n t-„hum Ih• u�,`�'��`r,P,lr�•rI ,ndon 1.)L„h�,l+� L T I�1,.,y,ai0p aft,tespo61 My to5. F"o
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SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES W/KECLCE 1P1� 2 W p ¢5' r �C G
�R�[1YEL
FOR APPROVAL OF CONSTRUCTION ONLY
:-DAJ " HS REF. NO. 6 No
I� iVATER /p,°R°R�
f AREA °
�K
5 S l
APPROVEDZIP
_� � � 2¢0• ,�T C�. aj $. gh
LY WILY
`EXPIRES THREE Y S FROM DATE OF APPROVAL
WIRE 0 �r-•�: -•:'
FE,vcE
03
CER7/F/Eo 7b: /(/
0 3 s
/YI/cN4EL Ko�LER 9 �� oP E I YsF® LAND s%3�
--A
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vs D A �A2M�25 t1oM£ Dr�IN�S r�ATIc L02-�Z Z
2 � I-RgNK BAR yL sx/
DES, N� IVy.5 Zl f MO.
/62Bg V/uNE 2z, /994
r�URVEyEp �oR /1�/C%-/AEL ¢ L'AR�'1ELA KofyLER SC.r•n'I. do. /000 -//5-15-26
PROPERTY LD C,QTEO AT MRTT/T U C/<
%Y710/0 of A9'eE,o No L E CReEAY E57A7E5 ,I
LoT 22 4pv /��['�+
F/LED �ANuARy 28, /965: F/LE /S/o. �256 �vO
7o wN aF So uTNo z o �•,� L/'k-
'5�clFFo LK CO vIv r l, NEW IORX lyi4'P W/OTrrJ�r C/�
ARCA = 24 76 7 45 6S57-
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Unauthorised alteration or addition to this surnev r a violation VJ /
`d N
of Section 7209 of the New York State Education L.ns. /
Copies of this survey map riot bearing the land Surrevor's inke<f
seal or embossed seal shall not be considerM ut be a valid true \�
copy.
�r 0
Guarantees or certifications indicated hereon shall run onlv to
the person for whom the survey is prepared,and on his behalf to I07 N
the title Company,governmental agency and lending inswuuon Z� \
lisled hereon, and to the assignees of the lending inswutinn,
Guarantees or rertifications are not transtetable to addiuenal iENCF i
institutions or subsequent owners. LbT
W4h !�
Wh O 10 a I W
53 itl � 3
O a c�u� ��D¢ NEW yOft
N "® it �I 0 , BARy �-
w�RE
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CER7/ -160 TO _ n /V 87, �3
/1,91CYOEL /<oNLER /9 20°� E d%= �� ItS
/ C+� 442 JkA
0o c z�m,,,, ' s/URYE yE L7 LAND
CAR/►�/EL A KD NL ER 2 S sv�
VS D A i:&kM-Ea5 -HOME zo
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T 23. /RANK c/ /JARyLS/c/
iVyS Lic. lVo. ��22
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J�URVEyED �oR /1�/CygEL ¢ C4RIY7ELA rSC.T/Y1. Alo. /000-//6- /5-26
PRooERTy LOCATED AT /✓I,4T7/7UCK
1W,,QP OF OEE,d NaLE CREED 1557A7E5 /V�� V V The water supply and sewage disposal systems for
ZoT 22 n /7- u this residence will conform to the standards of
F/CEO �,1, 1VUQRy 28, /965: F/LE Alo. ¢256 �(/� �° the Suffolk County Department of Health Services.
Tow,A/ OF 90UTNo1-o
eo
$UFFb LK CO tl/V T y IV---lN
AR t A = °
2/, 7 6 7
AFeAx
Un.wlhorized alteration or addition to thn �� WELL
sun(` i5 d UGldbnn CV
or Section 7209 of the Ness Nod,State Idur auun I a 'nss ^
Copies of this aunrs ntap not I,eanng the land sue.es or's inked VO
seal or ernbo,ed seal shall not he ronsvlr•rerl to he,; sa6d tan• ,
ropv.
.mint• /j7gn,
her 2.¢0, �� T'QzN
Guarantees or certifications indicated hereon shall run nnh TE T{ [to S �OE 3 C)
the person for shorn the sun Ov is prepamd and on hts behalf br O n 107 Er Cio
the Idle company.Cuvernmentai agents and Irndinw mshtut„,n 5. ToP50/L O y o .o
hsl(-d hercon. .tnd to the aai nrr,of rhr h ndus ...tnutrn n zc)41,7
Guarantees or rerrrtualurns,i r••not transn•r.thle to I FE/v�F �Rr✓Et.vq
ind rtuhnns or xdnsrtuent rns ner. L07- r 9w
2/
RE 5 DOE °
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 91 S w/�yEL��E 1�1pt� ttj
RQYEL D
FOR APPROVAL OF CONSTRUCTION ONLY Q �� 3 Q I
Qj
DATE HS REF. NO. No
SaN/7aR / � v
APPROVED �\S�� Q 2�a• s,� r< o; NEW
fll i(; 2 61994
CE/RT/F/Eo To y /I/
/ 9/Cf/�1EL /<of�LER BLDG.DEPT 7 /9 �_ O
TOWN OF SGUrHOLD _ o$
CARMf-z14 ,<1oNLEll? �3 z moo m° SuRVEyEo �y
OS t> N ARM-LaS i1on�£ ��MINIS'TQA'T1��1 [07 �Z z �RgNK cl
z � �ARyLsx/
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`�/wE� ,8R/OCEf/A/hPTON, ¢
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�uRVEyED �oR /l�/C�IAEL CAiP/►'1ELA /tOf/LER ,SC.r/Y7. do. /000 -//,5- /5-26
loRO,oERTy LOCATED AT /✓IgTT/TUC/c
/Y1AP of ,OEEp 9OZ E CREEX 557.47E5 Al�:v V
ZoT 22
F/LED 1,0A1UOlg1 28, /965 f/LE A/o. 4256 (��� New �Q�
TowN aF 5ourl/ol-o �o.p �0�� ti~A �. ®
$uFFo LK Co uN T� NEyv yoR/t s, R w. ti Y � ��
(Vq w w
AREA = 2/, 76 7 5F. 8u`oo8 o,J �x,sMv v� iz
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ALL Np HAS BEEN APPRO\IEn nio F BL W G DEPART AT '65-1802 9 AM TO h PM FOR THE
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