Loading...
HomeMy WebLinkAbout37217-Z �o�SUFFp4co Town of Southold Annex 5/15/2012 Gym P.O.Box.1179 H 54375 Main Road o Southold,New York 11971 u CERTIFICATE OF OCCUPANCY No: 35601 Date: 5/15/2012 THIS CERTIFIES that the building DECK Location of Property: 32 (aka 860) SOUND ROAD, GREENPORT, SCTM#: 473889 Sec/Block/Lot: 35,141 Subdivision: Filed Map No. Lot-No. conforms substantially to the Application for Building Permit heretofore filed in this oificed dated 8/15/1989 pursuant to which Building Permit No. 37217 dated 5/15/2012 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: deck addition to an existing one family dwelling as applied for. The certificate is issued to JOSEPH&EILEEN VERITY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Autho ed Signature J TOWN OF SOUTHOLD BUILDING DEPARTMENT y TOWN CLERK'S OFFICE o . SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 37217 Date: 5/1 512 0 1 2 Permission is hereby granted to: JOSEPH & EILEEN VERITY 35 SOUND ROAD GREENPORT, NY 11944 To: CONSTRUCT DECK ADDITION. REPLACES EXPIRED B.P. # 18388 At premises located at: 35 SOUND ROAD, GREENPORT SCTM # 473889 Sec/Block/Lot# 35.-1-11 Pursuant to application dated 8/15/1989 and approved by the Building Inspector. To expire on 11/15/2013. Fees: PERMIT RENEWAL $25.00 Total: $25.00 Buildin pector FORM NO f 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) N 2 S Z Date ...... /z:�..................................... 19 Permission is hereby granted to: . ... ............ ..`..................................... ..... .... ..... . .. ....................... ....... ..:....�.. .� ......�.�- ...��.... to ..�� .... ..... ..... .. ....... .................. .... l .: ..... �...... .... : ........................... .. . ........ ........ ........ .-......... atpre ises located at ... lJ.®......... .... ....... .. . .......................................................... ............................................... [s- ........................................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section .......,, .�`........ Block ........... ........ Lot No. ...� pursuant to application dated .........- ..'-P................................. 19..F�, and approved by the Building Inspector. Fee r ... ....... .vfo..�.......... Buil actor Rev. 6/30/80 Form No.6 TOWN OF SOUTHOLD. BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This-application must be filled in by typewriter or ink and submitted to the Building Department with the following: & 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. *Sw-om statement from plumber certifying that the solder used in system contains less than 2110 of 1% lead. . S. 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool $50.00, Accessory building$50.00,Additions to accessory.building$50.00,Businesses$50.00. 2. Eertifcate 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 $1.5.00,Commercial$15.00 Date. 5 New Construction: Old or Pre-existing Building:" (check one) /. Location of Property: S ���� d ��P�l�PDT House No. Street V Hamlet Owner or Owners of Property: Suffolk County Tax Map No'1000, Section 3 S Block l Lot Z Subdivision Filed Map. Lot: Permit No. 3 1- 1 —7 Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: check one) Fee Submitted: $ Applicant Sign ure e 765-1802 �p V BUILDING DE". c,a,�,v K Po fz--l' INSPECTION [ ] FO D ION 1ST [ ] U PLBG. [ ] FOU TION 2ND [ ] IN TION [ ] F MING [ ] F NAL REMARKS: . G�` AID cc� 0 t'l Ef II DATE 7/,2,-o INSPECTOR t oF so�Tyolo G moo! • �� OWN TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLOG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: t-�-- © C ,. (� , DATE / INSPECTOR :1r:LD Ii:S:'ECTION UTE �� i;OaKMENTS ��o2J� -o F OU11DATION ( 13t ) ' c FOUNDATION ( 2nd ) 2 . z � ROUGH FRAME & ^� PLUMBING r cn H rri 3 x • 1 INSULATION PER N . Y. y STATE ENERGY CODE x 4 . FINAL I • •z ADDITIONAL COMMENTS : t x � H O % x a r� H rn H ti BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . SURVEY . . . . . , TOLVN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM . . • . . • . . • " " TOVIN HALL COUTHOLD. N.Y. 11971 NOTIFY � �S TELL..: 7G5•i-3b2 CALL . . . . . . . . • Examined • . . . . . . . . . . . .. 19 0y 1�--�� MAIL TO : . . . . . . . . • . Approved . . . . . 15 . . . . . . 19LV . Permit No. . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . Ai �O AS'Np . .. . .. . . . . . . . . . . . . . . DATE: t5 FEE: Blf ui no Inspector) NOTIFYI AT 765-1802 9. AM'70-4 PM R THE APPLICATION FOR BUILDING PERMIT FOLLOWING INSPECTIONS: 1. FOUNDATION: TWO REQUIRED • Date .Q , , , , • • 1.9 FOR POURED CONCRETE INSTRUCTIONS 2: ROUGH - FRAMING & PLUMBING ' •I �l�Ncation mus etely filled in by typewriter or in ink and submitted to the Building Inspector,witl setAof��'a-c 4f;. Fee according to schedule. b.BFI� io of and of buildings on remises or -4s, iQl premises, relationship to adjoining premises or public stree :atiiE REQ O iqion of layout of property must be drawn on the diagram which is 7 ENE Y part of this aPF �on.may not be commenced before issuance of Building Permit. ° n, the Building Inspector will issued a Building Permit to the applicant. Such perm. sh1{� I F AT inspection throughout the work. hall.7 °i k8 d4nAO*bif F1I9FfIJRdT"Eused in whole or in part for any purpose whatever until a Certificate of Occupanc E OEbr6wPuildingg Inspector. A$PLFM 0 &j 1�}R'Dpto the Building Department for the issuance of a Building Permit u 3uildingF �Q Q�i Southold, Suffolk County, Ne�v Yor- P rsuant to th �e;ul�ti -t li dif�i k, and other applicable Laws, Ordinances c i ite a�pINY , tg,, �1yO u dins, additions or alterations, or for removal or demolition, as herein descrbec =dmit�u�lted [ , 4v1 japplicable laws, ordinances, buildin; code, ousi cod , and regulations and t BE COMP�LE�I''E F((''jj C. nd in building for necessary inspections. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. •(Signature. . . plicant . . • ' ' ' ' ' ' STATE CONSTRUCTION & FIERGY , o am ,if c rporation) CODES. NOT RESPONSIBLE FOR 7 DESIGN OR CONSTRUCTION ERRORS . . . • • • (Mailing address of a• ... . ••. PPlicant) Mate whether applicant is owner, lessee, agent, architect. engineer, general contractor; electrician, plumber or builder- `same of owner of premises . . . . ..T/" "ti, / • . . •. . . . . . . . ... . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . (as onthc tax roIIo " " " " • • • • • • r latest deed) :f applicant is a corporation, signature of duly authorized officer. . . (l;ame and title of corporate officer)• • . . Builder's Liccnsc No. ,za QG,�. • . • . Plumber's License No. . . . . . . . . . . . . . . .. . . . . . . . . E!ectrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . Location of land on which proposed work will be do�.c. House Number . . . . Street.. - 'k�6 . . . . . . . . . . . . . . .�at • - Hamlet . • . . County Tax Map No. 1000 Section . . .���'�. • .��. . • ; Block . . . . . . . . . .C Lot . Subdivision . . . • . . • . . . . . . • • - . . . . . . . . . . . . . State (N. le j . . . . . . . . . . . . . . . Filed Ala 1) NO. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . existing rise and occupancy of premises and intended use alld occupancy of proposed construction: a. Existing c . use and occupancy . . . . . .. . b. Intended use and occupancy . . . . .. . . . . .. . . . . . . . . . . . c, !'c • ' . . . . . . . • ::`'�: . .. . . . .. .. ..... . . ... . .. V I 3,! Nature of Nvork (check %which applicable): INC . -...� Building Repair . . Removal . . . . . . . . . ,• . • ' • .Demolition • • .Addition . . . . . . . . . .Vteratron /� Demolition Other Work 4- Estimated Cost . . .�Dd. . . .e . . . . . . . . . . . . . . . (D_ 5. If\ . . . . . . Fee . . . . . . . . . . . . . . . . . . . ...^r;ro d�vcilin„ nutnbcr - • . . . . . . . .. . . of dwcllinb units . • • , , . (10 be Paid on filing this application) If,.,.a,.c, number of cars ' ' Pplication) . Number of dWellirr 6• If business, coin • • • ' ' ' ' ' ' ' ' ' • • • • • • . .. . , , , g units on each floor.mercral or mixed occupanc}•, specify nature extent of eactr•t • • . • • • • • 7, Dimensions of existing structures, ' ' ' • • •- Iici_lrt if any: front . , type of use Dimensions' . . . . . . . . . . . . . . Number of Storie • . . . . . . . . . . . Rear • . . . . . of same structure ith aft' s • . ' ' ' ' ' • • • • • • ' • • • Depth . Depth . . . . . a w' erations or ad • . . . . . . . . . . , , ' ' lIci`Irt additions: Front ' '' ' ' • S. Dimensions of entire . . . . . . . . . . Rea '-.. . . . . . . . new construction: F Number "`' ''S ':��Hei;ht rout • . . . . . . . . . oS'ttfrz;r ": • • . . . . . 9. Size of lot:•Fr • • • . . . . . . . Number of Stories , , . . Rear . :. . . u• Front . . . • . • ....N-,.......:_-_.. .: .,Depth....,. 10. Date of Purchase • . . . . . . . . . Rear ' . . . . . . . . . . . . . . . . . . . . . . . . . •..,. . • . . , 11. Zone or use district • . . . . . . . . . . . . . . . . c .th ,..y.'.^ •.,•.: • • . . . . . - rict in %vhiclr . Name of Former O�'vnei� 12. Does proposed Premises arc situated , i - :e • • • - construct.on violate an :,.:I.13. Will lot be regraded }' zoning law, ordinance 14. N -.• . . . . . . . . . . race or regulation:; •.��'-� ' . . . . irnc of 0��•ner of Prcznises • • • ' ' ' • • • Will excess fill b Marne of,architect • . . .Add e removed ftorri:premises: 'Yes .• . . . . . Name of Contras . . . . Phone No.- tor. . . • • . Address • IS - Is this • . .ocat . - ess . Phony o:j. • • . . ilI i..(. * property located • • . . . . .Address . . . ... - ,.., �N •• . . . . . . . If yes , Southold Town Trustees lnPeo mi a e t of� a tidal •wetL:zIId?n PLOT may be required rots •210- • - Locate clearly d DIAGRA,%f ;. , 1 ,_,.,-,;..,.:• distirictl y property 1i;;,s, } all buildings, whether Give street and block number or descriptionxaccordingto d ed irate^or or corner lot. s or no osed, ,and:.ind. catc.,.all set-b-ck­dirn^rsions fro: and.show$treeCnairies and indicate whcthc Af 42X/v - s' S� W6 416 '•1Tr Op PORK, )UNT1' OF . . . . . . . . . . . . . . . . S.S • • • •(:!:,c of individual si-n bciri" dul)vc na„ cd, irro contract) sw orn, deposes and says that he ' - - 1s the applicant is tile ;aid (Contractor, agent, corporate officer. etc.)• . • . • • . ' owner or otvncrs, and is duly authorized to Perform . • - • • � • ,,ration; t;':at all statctncnts contained in or lr:rvc performed tlrc said work an• • • • • - will be � this application arc tare to tllc best of his kno�vled�• d to make and Per.orrrcd in the manner set forth in the a file this m to b�for� nine t!ris pplication filed therewith. d� and belief;and ilia[ the • . . . . . ..:; . . . . . . .day of. . . \. t/ - 9 t-7 • County HELEN K DE VOE NOTARY PUBLIC,State of New Yak • - • . . . . . No.4707878,Suffolk Co�untyc� • ' ' - ' ' • - • - - • - - - • • - Term Expires March 30,19� i;naturc of applicant) �o��oF so�ryol 0 Town Hall,53095 Main Road Fax(631)765-9502 P.O.Box 1179 G • Q Telephone(631)765-1802 Southold,New York 11971-0959 '0 BUILDING DEPARTMENT TOWN OF SOUTHOLD July 27th, 2007 Joseph Verity 32 Sound Road Greenport,N.Y. 11944 RE: 860 Sound Rd. (Deck addition) SCTM#35 1 11 Dear Mr. Verity, Please be advised that your Building Permit# 18388 issued August 15th, 1989 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit,please submit a fee of $200.00; at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions,please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. BOARD OF HEALTH . . FORh1 NO. 1 3 SETS OF PLANS . . . . . . . . . . SURVEY . . TOWN OF SOUTHOLD CHECK . • - BU.ILDING DEPARTMENT SEFTIC •F011,11 . . . • � . � � � � � TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY �' /S �7TEL.. 7G5.1302 CALL . . . . . Examined . 19 �� /� �� . . . . . . . . . . . . . . •+ MAIL TO Approved . . /S� . . lg •t/ 0. Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . DATE aR• �c�3 - E NOTIFY ° �Y; ri ng•Inspector) FUUMOLOM OE 766-1602 8 AM TO 4 PM A 1HE APPLICATION FOR BUILDING PERMIT FOLLOWING INSPECTIONS: 1. FOUNDATION - TWOK*UME0 s Date FOR POURED CONCRE INSTRUCTIONS • . . . • • .2: ROUGI4 - FRAMING i PLUMBING •IN "catio s g'`tD� at"' �etely filled in by typewriter or in ink and submitted to the Building Inspector with ' t ^4 e. Fee according to on to schedule. b.g�'1 io of and of buildi or s,C, i O premises, relationship to adjoining premises or public stree -ati R ion of layout of property must be drawn on the diagram which is part of this app �T •r 'on may not be commenced before issuance of Building Pe o n, the Building I o Permit. shal4 b_Inspector will issued a Building Permit to the applicant. Such perm I y AT inspection throughout the work. 4 shall.7 °I9 A jb bf kgfIjRdTfjEused in whole or in part for any purpose whatever until a Certificate O& of Occupanc �L111-I�Q6puilding Inspector. APPfRN BuiIding 0 'the Building Department for the issuance of a Building Permit pursuant to th Re,u191iAMU Southold, Suffolk County, New York, and other applicable Laws, Ordinances c rite apj4 t ° u dings, additions or alterations• or for removal or demolition, as herein describec 'dmit4•u�� e�;,, rC I Qv1 j�applicable laws, ordinances, building g code, ousi cod , and regulations, and tc 6E COM r' and in building for necessary inspectionsJ' P� ALL CONSTRUCTION SHAH MEET _ THE REQUIR9MENM OF V4 N.Y. = STATE CONSTIMXWN (Signaturelicant,, o• am ;if .c rporation - ERM ) CODES. NOT IIEBPiONSMM,+s N011 .�dL DESIGN ON . . . . . .... . . .. .. . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician; Plumber or buil der. ame of owner of premises .. . . . . U . . . • •. . . . . . . . .•. . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax . . . . . roll or latest deed). . . . . . . . . . . . . . . . . . . . . . . . . . :f applicant is a corporation, signature of duly authorized officer. • • (1\3mc and title of corporate officer). . . . . . Builder's Liccnsc No. , , ,�•3, Q�.�, • . , , Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . EIcctrician's License No. . . . . . . , , , • • • • _ , . . Othcr Trade's License No. . Location of land on which proposed work will be done. .BL2.0. . . . . . . . . . . .,. .�'. ..9. . .�.��, • . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . ... . (louse Number Strect. . . . . . . . . . . . . . . . . . . . . . . . . . �- Mtx _. . �' Hamlet ' ' ' County Tax ,Map No. 1000 Section . . . .JJ , • : Block . . . . . _ • . . .� Lot Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1N;. . .j . . . . . . . . . . . . . . . Filed ,41a1� No. . . . . . . . . . . . . . . Lot .l�»e . . . . . . . . . . . State existing use and occupancy of premises and irttend�--cl use acid occupancy of proposed constriction: c a• Existing use and occupancy b. Intendcd use and occupancy . . . . . . . . . . . . . . . . . . . . . . � . . . .. . . . . . . . . .. . . . . . . . 3. Nature of work; (check which applicable): New Building Repair . . . . . Removal . . . . . . . . • . . n . . . . . . . . . . Addition . . . . . . . . . . .Vtcratron - 4• Estirna;�d Cos 4 re Demolition . . . . . . . . . . . . . . Other Work .�. t • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . (D.:scriiptto S. If divcllin„ nurnbcr . . . . . . . . . . . . . . . . . . . . . . • • . . . . . of dwelling units . . • , , , (to be paid on filing this application) 1f^ara;c, number of cars g tr Numb • • • er of dwellin • � • • � nits on each floor. 6• If business, commercial or mixed.occupanc•�• • • . . . • . . . ' ' ' ' ' • • ' 7. Dimensions of existing structures, if a y ' specify nature and extent of each•type•of use. • • • • . • . • - Flei;lit structu any: Front . • . . •. . . • • . . . . . . . Number of StoriesRear Depth . ' . • Dirnensionsofsamcst " • • • • • • . . • � � • � • • � • • • • • - Depth . , • • • structure with alterations or additions: Front • . • • • • • •. • • • • ' • ' ' ' • ' • • • . - 8. Dimensions • . . . . . . . . . . . . . . IIci__^ht . . , . . . . . . . . . . • ' ' • • . . ons of entire nc%v constructio • • ' ' ' ' . Number ' 1Fei;ht n: Front , . ' • • . . . . • .Num ber of • . . . Rear.. . . . . . . . . . • ... .`4�. ': T'9. Size of lot: Front • • • • • Stones . . , �• ••.Ip;h •s .• • � i: ' ' . . . . . . . 10. Date of Purchase Rear . . . . . . . . . . . . ... . . . . - �?.... . . . . . . • ,,,, • . . - 1 1. Zone or use district • . .` . . . . . . . . . . . . . . . `r r.ire 4bf � e:?;Lt ,• . . in t hick premises ar* c situated. . . , . Name of Form er.Q�� G •�e 1 �:�• .`� '.�I-F"r� - 12. Does proposed construction 13. 1j'iI[ lot be regraded n violate any zoning law, . . . . . . . . . . . . . . . . . . . . . . . . •= ii�^.^i.;-t4 . . . . . raded ordinance or regulatior 4`t� 14. Name of Owner i:- .,�.��.. ,'.'" . . . . f of premises . • • , • , • • ��ill excess Crll be removed �a .0/1.�. O i� • . . . . nl• Architect . Address . . . *4" :1r1q �� .'� Name oI •• • . . . . . . . . . i Plioric�No.`. ' t'- Ih Contractor . . . . . . . . . . . . ' ' • . Address . . - . • ":SYb�=B_'`:. ii . . . . 5 I s this s property r t " . • • . . . . . . Address r, Phon.r1j\?o• :,.:.: . . . *If es p y located within 30 - . . . . . . . ?:.� artf' ,rt�p"htone`No..:.:• . . . y Southold To Tr 0 feet of a tidal wetly "' T`•l `�" ' " • • • Town Trustees I'LO mit may be requi?re5d, 4s" d?.r �..yF Locate clearh� and T DIACRA111 v. ': T_'�t tgr `vi�l: +f`sslfr>'•� distinctly all build' property Lines. m�s, whether ~rx ri.?ytA� ; tf"`I"rtZtt.r" ,,.,f.d�. .;1 ',>•. Giti e street and block number or description to d ed s or proAoscd,_,�aiad�ini�tacr ! lt•:sir�0-back` " �ns fr©r. interior or corner lot. ^ ' hp�SRtedfa7iams and"iri�icaie whcthc ///��j/�6�r/�/--� ,�'7'IO.IY l/��.R� Mix ;ts: t;.P Ffir:P•� 7, S -t:��.�a-''_Y*'. r« r•� �.,�-j'S':,_,F�.r1Rt y°-!� :1��" • ✓ ��.,�'� ;i �'f`'Ct�;,`!1'�lt���� St.3�A' :L°�'3�4Ye._3 � X6 1%TE OF NEV OUNTY OF . . . . . . . . . . < . . . . . S.S �ovc named(�'y:n" of indi�:idual signing•contract) • • ' ' ' • being duly sworn, deposes and say t h s that a is the applicant is tile • . . . . . . . . . . . . said (Contractor, abent, corporate officer, etc.)• . • • • • • • • . • ' owner or owners• and is duly authorized to Perform or have performed the said work • • • • ' - • • ' 'liration: that all statements contained in this application are - '^ wrll be Pertormcd in the manner set forth in the application filed tttcrecv�tlt of Itts l.no�vl �and to make and file this 0m to beforo me this d� and belief;and that the . . . . . - . . . . . . .day of. . . 7 . . . . . ., 19t County _ C HELEN IC OE 110E . . . . NOTARY PUBLIC,State of New York • • • • . No.4707878,SuffolkCou��Term Expires March 30,1 ety • • •i,narurc ofapplicant) 9 � 1