2011-403 ii411110oPki TOWN OFQ UEENSBURY
Woo742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110403 Date Issued: Friday, February 22, 2013
This is to certify that work requested to be done as shown by Permit Number P20110403
has been completed.
Tax Map Number: 523400-239-017-0001-010-000-0000
Location: 33 ANTIGUA Rd
Owner: MARTIN & SUSAN FARBER
Applicant: MARTIN & SUSAN FARBER
This structure may be occupied as a:
Deck
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
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property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
FIZTO
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110403 Application Number: A20110403
Tax Map No: 523400-239-017-0001-010-000-0000
Permission is hereby granted to: MARTIN& SUSAN FARBER
For property located at: 33 ANTIGUA Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: MARTIN& SUSAN FARBER
1229 SANDRA Ln Deck $45,000.00
NISKAYUNA,NY 12309 Total Value $45,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
STEVEN TURNER
209-6930 885-3847
145 PAISLEY Rd
BALLSTON SPA NY 12020-0000
Plans&Specifications
2011-403 HOLD needs Area Variance see C. Brown,ZA letter dated Aug. 12, 2011
1357 sq ft deck
$135.70 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday, September 30,2012
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To Queens1ry;�„ ,F is y, September 30,2011
SIGNED BY ( ; :y'� for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY Y-2-C-E-1}.WE
TAX P NO. PERMIT NO. // j >
/ 2U% ; ti '. - �p�9,3
Pi
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FEE AID 135,r BLDG.&CODES APPROVAL
, I
ACCESSORY STRUCTURE BUILDING PERMIT APPLICATION
Use this application for any structure other than the Principal Structure (house) to include, but not limited to:
garage, shed, greenhouse, dock, deck, etc. Refer to Informational Brochure No. 3 entitled Accessory Structures-
Sheds/Fences.
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE
ISSUANCE OF A VALID PERMIT. NO INSPECTIONS WILL BE MADE UNTIL THE APPLICANT HAS RECEIVED
A VALID BUILDING PERMIT. may^ l^7
OWNER: ?xf` K5i ?� 54 �`��`--'� I����, ,,//�� j11=9INSTALLER/BUILDER:� V&N/ 1ZI1 Ne
ADDRESS/22954M arkE d ISI `.t%IVA AP( ADDRESS: 45 F
INE"(leo (3' .- NY (2420
PHONE NOS.511 4z3 44-ii PHONE NOS.2-(4-4/3C) 8S5 'J'/
a
LOCATION OF PROPERTY: 33 Ai4774uk 0040 SUBDIVISION NAME:
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION:
HAS THERE BEEN A SITE PLAN REVIEW:VARIANCE OR SUBDIVISION APPROVAL? ❑YES 1$ NO
IF SO,INDICATE APPLICATION NO.AND DATE OF APPROVAL:
ESTIMATED COST OF CONSTRUCTION_$11.6-10a,—ANY OTHER ACCESSORY STRUCTURES ON PROPERTY? `1t5
IF YES,PLEASE LIST: 1:2 74'Tdcose D IL
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: `J Tui M8 PHONE:5/1 207 693o
ST No PROPOSED
PROPOSED CONSTRUCTION 1 FLOOR 2 FLOOR TOTAL HEIGHT
SQ.FT. SQ.FT. SQ.FT. FT.&IN.
OPEN PORCH
DECK // 35, 1/357 !!L w
3 SEASON,COVERED OR ENCLOSED PORCH*
• BOATHOUSE
BOATHOUSE WITH.SUNDECK
DOCK
SHED
POLE BARN
DETACHED GARAGE(NO.OF CARS: )
OTHER ACCESSORY STRUCTURE:
*CONSIDERED FLOOR AREA & MUST COMPLY WITH FAR [FLOOR AREA RATIO] REQUIREMENTS IF THE
STRUCTURE IS LOCATED IN THE WATERFRONT RESIDENTIAL ZONE.
To the best of my knowledge, the statements contained in the application, together with the plans
and specifications submitted, are a true and complete statement of all proposed work to be done
on the described premises and that all provisions of the Building Codes, the Zoning Ordinance,
and all other laws pertaining to the proposed work shall be complied with, whether specified or
noted, and that such work is authorized by the owner. Further, it is understood that I/we shall
submit prior to a Certificate of Occupancy or Certificate of Compliance being issued, as requested
by the Zoning Administrator or Director of Building and Codes, an As-Built Survey by a licensed
surveyor, drawn to scale, showing actual location of all new
construction.
QUESTIONS? CALL 761-8256 OR EMAIL
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Queensbury Building & Code Enforcement - Residential Final Inspectidn
Office No. (518) 761-8256 Arrive: am! m Depart:Lam/p
Fn[-bet-
m
Date Inspection request received:7Inspector's Initials:
NAME: r b E t- PERMIT#: //- O 3
LOCATION: -A-ey4- (.4(10, { r n Q, DATE: -- �-/ 2
TYPE OF STRUCTURE: L e ( 1
Comments:
Yes No N/A
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more ✓
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access,1 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110 Y�
Enclosed Stairs Sheetrock Underside minimum h"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door loser
Gas Logs in Sealed or Glass Enclosure
Final Electrical;Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System I Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/0[Temporary/Permanent] tv/
L:\Building&Codes Forms\Building&Codes\Inspection FonnssResidential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart:. Dam/pm
Date Inspection request received: Inspector's Initials: f /
NAME: ft r €t PERMIT#: j y 3
LOCATION: 3.3 " rr-I-i cc�� u4f�'cs( DATE: it
TYPE OF STRUCTURE: J (C f<
Comments:
Yes No N/A P O!-30 (\
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors I Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup: _�
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area t►yVy ►�
Crawl Spaces 18 inch x 24 inch access,1 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Fumace/Hot Water Heater operating —
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrodc Underside minimum W Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/'/,hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical;Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/0[Temporary/Permanent
L:1Building&Codes Forms\Building&Codes\Inspection Forms Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date! '7 / (2
Queensbury Building&Code Enforcement Arrive: request
Depart.
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:6A,g9
NAME: 1 ?i + 1 1
1 U��N`P PERMIT#:
LOCATION: 3 ', /1A4- , L,cR INSPECT ON: v;,t Z
TYPE OF STRUCTURE:
l
gaming y NA COMMENTS:
`Attic Access 22' x 30'minimum
Jack Studs/Headers li.
Bracing/Bridging I"
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed property \( '12.-N,c
12"O.C.
Headroom 6 ft. 8 in.
Stairwens 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 'A(w) 16 gage (8) 16D nails each side
Draft stopping 1,000 sq. ft.floor trusses
Anchor Bolts 6 ft. or lesson center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in ca ' min.
Garage Fire Separation
House side'A inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:1Buikikng&Codes Fortes-OLIMuliding&CodesUrgpedion Fo,mslFmming Firestopping I Repotdoc Revised January 7,2008
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BUILDING ®.'=P,'.RTMENTLI
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. Based on our limited exariation,compliance
with our comments shad not be construed as ,.»�k
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Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received: 1 i-1 y 1
Queensbury Building&Code Enforcement Arrive: am/ - am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's In'
NAME: 4/9e & PERMIT#: i )-
LOCATION: 33 i96 9-16-on INSPECT ON:
TYPE OF STRUCTURE:
dr) N NAA COMMENTS:
Attic Access 22"x 30" minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers --41(
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 16(w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq.ft.floor trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side"A inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:1Bufdl g&Codes Fortes-OLD Building&Codee\Inspsctbn Fam s1FramIng Firestopping Inspection Rsportdoc Revised January 7,2008
ZA t-af. 47
Framing / Firestopping Inspection Keport •
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/ : 1i r am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:,
NAME: r/.1e rPERMIT#: /f- <'c ;
LOCATION. Ani fry ' L-C INSPECT ON: jA:L71175C-4
TYPE OF STRUCTURE:
Y !r `IVA COMMENTS:
Framing
s 22'x30" minimum l�
Jack Studs/Headers _cm
Bracing/Bridging
Joist hangers • Z.� t
Jack Posts/Main Beams
Exterior sheeting nailed properly ��
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 'A(w) 16 gauge(8) 16D nabs each skis :1 )‘)
;I
Draft stopping 1,000 sq. ft. floor trusses ,I
Anchor Bolts 6 ft. or less on center �7
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour I
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side'A inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceilinglwall
Windows Habitable Space 1 Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0sf�rade
L:1Buiidi g&Codes Forms-OLDDBuilding&Code&Jnspsdion FonnsTruning Firestopping Inspection Repatdoc Revised January 7,2006
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Community Development Office
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Town of Queensbury . 742 Bay Rd.
Quansbury, New York .12804 PLOT PLAN
Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines.
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Lands of Craig F. Brown
(1129/235)
\ METAL FENCE POST
AT CORNER OF CHAIN
♦ LINK FENCE AS LOCATED N 50056'13' E
♦ 8Y SURVEY 1N 2007 9.50'
N 50056'13" E l CORNER OF
UTILITY POLE ff�I,filf�ififff�fff�fff�ffi!•fff!•ffff•fif�fff!•fff�ffi!•fff!•ffffllf�fdfflf�ff�Ifi!•ff�fff�ffineamfi�ff�iff!•tffllMff•Ff�M�i�ff�Mf1•ftfNff�.ff�Ffii•f•R�f\i ��SEAWALL
472 - NYT 6 -� - BOARD FENCE 206.50'
f c C CHAIN LINK FENCE
206. SO r END OF
- 1 I CHAIN LINK l
\ FENCE
320.3'
/ \\ 324.5' —.► /,
/ \LU
ILL i� Iol 13 1
I LL,
TENNIS COURT z
2 2; I IMI I� ATOPMOE STONE 9. CAP I
• I Q ATOP STONE &MASONRY 1
RETAINING WALL 320.4' j
324.9'
POURED
SEAWALL , l
N'
/ RO — - — — — — — - CHAIN LINK FENCE 1 I - LAKE
/ ----------------------
p - I T /
/ A 1 1 4' DIAM. METAL 325.4' �� h �
DRIVEWAY CIRCULAR STAIR - - - /`' /
fff I I e 1
REMOVED) Og OF 2ND
CASE (To BE s7aRV G,OK — I - - - - - - - - - B7 O' ' G I
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I 'CS)— - — — Eo33 g (EX�S?IN , 2ND STORY DECK, • r _♦ 320.4' !
DEED REFERENCE• �, `— — — — — — — — 1,� TO BE REPLACED. I Y - -- - !1
Phili I v II \ �-tl 0� EXIST. ELEV. = 347.0 GAP IN
I ' SEAWALL 44 1 GEORGE
p S Caponera Danny C William '
47.1 = 4'DIAM METAL s"s' W : 1
as Co -Executors of the Estate of James K. Meisner, ! I Z I! \ \ \ L \ CIRCULAR STAIR y I V Q 1
deceased ` - \ / TORY CASEREMOVED) I ,0 ,' WATER SURFACE ELEVATION ON AUG. 11, 2011 = 319.3'
t0 II / 2 RAMS 1.0' ± i h I
M rt. I UTILITYPOCE �: / F i,, 0 21 t7 N /I MEAN HIGH WATER ELEVATION= 320.2'
a m S. Farber and Susan M. Farber 113'5 472 \ m I O
��� / ,o
D: June 28, 2000 I I \ 6. 6'
R: 117 I (� \ -�l W I.00'
2/155 I i- I o o v
- \ 1 R l 2 ro Q POURED 1
(Note: Deed refers to map referenced hereon) I I 1 \ "� o� �� m 2ND STORY DECK, I ° o
CONC.
EA WALL W
I p m; w wti,
TO BE REPLACED.
MAP REFERENCE: I j \\ 1.9' m • EXIST. ELEV. = 347.7 ° I a y ; , \
1/2 Y v T �:
I w' -
"Map of lands to be conveyed by The Estate of James K. I V' I W \ 44
2 AME o 1
5-5' FR n; 4-
91
Meisner to Martin S. & Susan M. Farber," dated June 19, I 0 I 49.2' N 19,'
\
2000 and made by Coulter &McCormack, Licensed Land I I1 U.S. 4.60' :. 320.3' / 014�
Surveyors, Y z l'// \\ o�c �P5 \PS \\ \\
y Glens Falls, NY. A copy of this map, ata I - N GARAGE z FRAME 0 50' 19.3' � Q 4a3_ _ _ - - - -
reduced scale, is made a portion of the deed referenced = I ! _-- /I/ / / \ \
above at 1172/155. I I; N 23.3'
- o IgtING1
I I - 19.2' R;.5' A ( Si YOEGK i 326.2'
ZONING INFORMATION: I I 1 E,
STEPS
Parcel is zoned "Waterfront Residential" (WR),
subject to a 75' waterfront setback overlay area.
CORNER OF 2 -FT. Rafts, I - _ '\ . \4, \ \ \
Minimum lot size: 2 acres SQUARE STONE & f V
MASONRYPILLAR.I I�11_f \ /i O \ \ y,# Fr.K..,
Minimum lot width: 150' I +/- 15"HIGH. $4'WIDE CONC. CAP
as B2 35ps w I �I , Oic I ATOP STONE & MASONRY \ 4
I ,. ,. a .
Minimum road frontage: 150' /M� .� RETAINING WALL , \ \
•+t/ ,\ rT\ I = DECK
Minimum water frontage: 150' ,y I END OF ,
�1F PICKET
Minimum front setback: 30' Bd+° \ FENCE 0 2011
ts� s�. ��� — PICKET FENCE I �• 03 ,
Minimum side setback 25' (Lot width I _ � - _ PICKET FENCE MEANDERS —
NOTES,
1)
2)
3)
4)
5)
6)
7)
00.Iff,flf>•IIf>•Ifalf�iNewfff♦ffaill�Ifirfl�f�fSiff�fl�Ifff.flf>•Iff�flf•IfIfK����60'
greated than 150) '
S 51052100" W 5°52-00" W
S3
' Lands of Gilles Chapaalos
Parcel tax map number: 239.17-1-10 I (1487/1)
Parcel area: 0.705 acre +/-, per map reference. MA P
Parcel address: 33 Antigua Road"
Elevations shown hereon are referenced to the
elevation of the surface of Lake George as
determined on August 11, 2011.
The purpose of this survey is to demonstrate the
present location of the existing residence, garage,
seawall and lake -front retaining wall.
Parcel boundary is related to the deed and map
referenced hereon.
Dashed map features are as shown on the referenced
2000 survey map.
I
Approved X
MOTION TO APPROVE AREA VARIANCE NO. 59-2011 MARTIN & SUSAN FARiER. Introduced by Brian
Clements who moved for its adoption, seconded by John Koskinas:
33 Antigua Road. The applicant proposes to re -build and replace an existing 1578 square foot second
story deck patio roof with a smaller, 1357 square foot deck. The applicant requests 26.7 feet of relief from
the minimum 75 foot shoreline setback requirement of the Waterfront setback overlay district as per
Section 179-3-040. In making the determination, the Board shall consider, Number One, whether an
undesirable change will be produced in the character of the neighborhood. A desirable change should
be produced. Number Two, whether benefit sought by the applicant can be achieved by some method
feasible for the applicant to pursue other than an Area Variance? Feasible altematives appear limited.
Number Three, whether the requested Area Variance is substantial? Actually it's going to be a smaller
deck so it would be better. Number Four, whether the proposed variance will have an adverse effect or
impact on the physical or environmental conditions in the neighborhood or district. Minor impacts can
be anticipated, and whether the difficulty was self-created. It may be considered self-created.
Duly adopted this 21 st day of September, 2011, by the following vote:
AYES: Mr. Kuhl, Mrs. Hunt, Mr. Urrico, Mr. Garrand, Mr. Clements, Mr. Koskinas, Mr. Jackoski
NOES: NONE
of a re -survey of lands of
Martin S. & Susan
M. Farber
situated in
Town of Queensbury , Warren County , New York
Scale: 1 " = 20,
1made /nom fhe w Nh althla
"MYY MW mep which are marked wAh an
orgtnd o/the sad surveyors embussed
y saalandbsaring the A-Wo's Orgkul
RVI"" in red ink 8W considered
Veld and &n -PA...
Survey and Map by
CHARLES T. NACY
Licensed Land Surveyor
32 John Street
Queensbury, NY 12804
August 12, 2011
Unauthorized alt mWn or addlion to s wrvey
map b"eaV a Ncea wd bnd sunroyors not is
a viobeon Of Sddbn ?^. wbdivision 2, o/ the
New York Stele Education Law.
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information hereon is confidential and may not be used in Sheet 2 of 2
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