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HomeMy WebLinkAbout813 LEGAL NOTICE NQrICE OF HEARINGS Pursuant to Section 267 of iht Town Law and the provisioim the amended Building Zone Or- dinance of t~e Town of Southoid, Suffolk County, New York, public hearings will l~e held by the Southold Town Board of Appcals at the Town Office, Main Road, S~uthold, New York on November 10, 1965 on tdle follq~ving appeals 7:30 P.M. E.S.T.), Upon appli- cation of George W~etmore, Green- port, New York, a/c E. Lionel Pay- lo, 530 Fifth Avenue, New New York, for a variance in ac- cordance with the Zoning Ordin- ance, Article III, Section 303, Art- iele X, Section 1000A, /'or permis- sion to divide property. Location of property: west side Baysl~ore Road, lots No. 148, 14:9, 150, and North ~/2 of 151 in Peconic ~ay Estates, Greenpo.rt, New York. 7:45 P.M. (E.B.T.), Upon appli- cation of ~'erry Shulman, and Wife Belie .Terre l%oad, Port Jefferson New York, for a variance in ac. cordance with the Zoning Ordin- ance, Article IV, Section 410 (g), Article X, Section 1007 (e), for permission to erect an addition to a non-conf, prming building. LO- cation of property: south side Sound Avenue, Mattituck, New York, bounded North by Sou,nd Avenue, east and south by Long Island Railroad, west by Jefferson Stoval. Any person desiring to be heard on the above applications should appear at the time and place ab~ specified. DATED: October 28, 1965, BY OP, J)ER OF THeE SOUTHOLD TOW~'q BOa. RD OF APPEALS. 1tN5 COUNTY OF SUFFOLK, ~ s~,' STATE OF NEW YORK° j .... ~..'~...~: :~.~.~:~. ?~ .~e ~'.~-~ ....... ~ing duly Sworn, says that . ..~. i~ Printer and Publisher ,of ~e SUFFOLK WEEKLY TI~ES, a news~per publish~ ~t Greenport, in sai~ county; and that the noti~, of which the annexed is ~ printed copy, has been published in the ~aid Suffolk Weekly Times ~nce in e~ch week, ~or ........ ~F~ ........... week~ successiveiy commencing on the ... d~y of .. ~J~.~:-7~v... 19.~ S~orn to before me this .~ ..... day of .. ~.'~.~'~.. 19.~ FORM MO'. 3 · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CL~ERK'S OFFICE SOUTHOLD, N. Y, t;~OT~.CE OF D?SAPPBOVAL ~,e ~o .................................................................. ~,~e ........ ~/~ ~ ~ ~...~-- ...... ~. ~~ .~. ~~.... ............... ..................... ~......~.~" ............... ; ~.: ................... ~or permit ~o construct .~.L.~.f..C.{~. ....... at thc premises loc~ ................ ....... ~~~.~ ...... ~~ ....... Stree~ ~ ~~ returnea herewith and dmapproved on the followm7 grou~.d~', ..... ~._~: ......~..~.~.:~ .... .... ~~.~.:~ ..... &4~.~.~....~.....~..~z..c.~.~....~) ......... ~ ............ ........ ~..~.~..~..~ ........ ~...~...~.~..~....~..~.~ Building Inspector FORM ~0. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ , 19 ........ - Approved ........................................ , 19 ........ Permit No ............................. Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This applic;~tion must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or_public streets or areas, and giving a detailed descri priori of layout of property must be drawn on the diagram which is part Of this application. 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. SUcki permit shall be kept on the premises a~,aiJable for inspection throughout the progress of the work. e. No building shah be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 Ragu!arians, 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 cod~ .... ........ ~.~..~:.. ~ ....... ~..~ ............ State whether ap~!icant is owner, lessee, agent, architect~ engineer, general contractor, electrician, plumber or builder. ................ ~,~.. ............................ : ....................................................................................................................................... Name of owner of premises ..... ~ ...... ~-. ~e~_4.~*,.%C~9~ ....................... If applicant is a co~orate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done Mop No.: Lot No.: ........................ ~ ~. ~ ~. · · ~...,,~ ~ · · .~ ~...~ ~~ ........................................... Municip,ali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ~'~ ,~, ~ 3. Nature of work (check which apl-.,cable): New Building .................. Addk .n .~ .............. Alteration .. Repair .................. Removal .................. Demolition.' ................. Other Work (Describe) ........................................ 4. Estimated Cost ............................................................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~ ............... N tuber of dwelling units on each floor If garage, number of oars ..... .~ ........................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..,,.~;;~ .... 7. Dimensions of existing structures, if any: Front ........................... Rear ................................ Depth .................... Height ........................ Number of Stories Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ~'~ ................... Rear..~ ..................... Depth ...~t~ ............... Height ~. ............. Number of Stories ......... ~ .......................................................................................................... 9. Size of lot: Front~ ....................Rear ....... ~:~r. .............. Depth ...~}.~ ..........' ....... 10. Date of Purchase ~ ~tG~ .... N~ame of Former Owner 1 t. Zone or use district in which premises are s~tuated ..5:~~ ................................................................. ;: ........... ~ ... ~ .................................................. 12. Does proposed construction violate, any zoning law, ordinance or reaulation? 13. Name of Owner of premises ~.~.~:~.. ,.~ ,~ .. ~ . .......Addres~..~..¢/.~ .~¢. ~.¢,~.~J..~e Name of Architect ...................................................... Address ........................................... Phone Na ..................... Name of 'Cfnt-r~tor ................................................. ~Address .......... ~..~ ....................... ~ ...... Phone No ..................... PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set~ack dimensions from property lines. Give street and block number or eescription according to deed, and show street names and indicate ~ether interior or corner lot. STATE OF NE~YORK, .}S.S. C©U NTYmOF ~.~.~,,~-r~,~..~..~ ........ ............ ..'v' ....... (Name"r' ..... of "'"':"~md~wdua.~"'::f~':s~gnmg ............ app ~6at~on)";'": ..................... being duly sworn,,deposes and says that he is fhe applicant above named. He is the .~ ........................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner o~ owners, and is duly authorized to perform or have performed the said work and to make and file this application; that al statements conto.ined 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 b~re me this A%, ~ / ......................................... t~' .......................... ~'~-~, ,- ............. ......................... Notary Public,k~'~'...~... ......... :.~,.~~ ......... County ~/ (Sign/Cturf of applicant) ROBERT W. KIEPER ~otary Public State of ~w No. 52-21080~ 3 Suffo!k Cour't~ Term Expires Msrch 30. 19 TOWN OF $OUTHOLD, NEW YORK APPEAL FROM DECISION OF BUILDING INSPECTOR TO THE TON lNG BOARD OF APPEALS, TOWN OF SOUTHOLD, N. ¥. ....... E' .~.. ~c~ ...... ~ ~.~..J~ £~e.,. s~.. z~ Nome of Appellant Street a_pd Number ~P.:~..~....~.~.~;~e~5.0~,..~.[.~__~.~. ................................................. ~].~ .............. HEREBY APPEAL TO Municipality State THE ZONING BOARD OF APPEALS FROM THE DECISION OF THE BUILDING INSPECTOR ON APPLICATION FOR PERMIT NO ..................................... DATED-..~.%o.;e%.~&~...~9~z. .............. WHEREBY THE BUILDING INSPECTOR DENIED TO Name of Applicant for permit of .~,~C~ .~ *~ ~'"'"'"'"'"'"~''''~ ....... ~,e .~..n,, .~c~ .......... , ,~ ,~..'~ ~.. ....... ~b~,.~ .~. ,~ ~/,~ ~ c~.~ .~ ~.~ ~ ..... ,,~!~ .................................................... &~.~.~ ~. _ Street aha P~umDer mumc~pality 5tare PERMIT TO USE PERMIT FOR OCCUPANCY P'e~rlss!o~ to ~dd %a st:~ct~z.~e 1. LOCATION OF THE PROPERTY ..~L0e:~.~..f~¥..~.~....~....~..~..~?.~.~.~u.'..~..~...~..C.~ ...... Street ~ ~ Use District on Zoning Map Map No. Lot No. 2. P'ROVtSION (S) OF THE ZONING ORDINANCE APPEALED (Indicate the Article Section, Sub- section and Paragraph of the Zoning Ordinance by number. Do not quote the Ordi:n:ance.) 3. TYPE OF APPEAL Appeal is made herewith for ( ;~ A VARIANCE to the Zoning Ordin,a~nce or Zoning Map ( ) A VARIANCE due to lack of access (.State of New York Town Law Chap. 62 Cons. Laws Art. 16 Sec. 280A Subsection 3 4. PREVIOUS APPEAL A previous appeal (/~ (has not) been made with respect to this decision of the Building inspector or with respect to this property. Such appeal was ( ) request for a special permit ( ) request for a variance and was made in Appeal No ................................. Dated ...................................................................... REASON FOR APPEAL ) A Variance to Section 280A Subsection 3 ) A Variance to the Zoning Ordinance ) ~s requested for the reason that Form ZB1 (Continue on other side) REASON FOR APPEAL Continued i ~TRIC~- APPLICATION OF THE ORDINANCE would produce practical difficulties or unneces- sary'HARDS'HIP~because a~. ~'.-~.*~.¢~¢r~ ~,- ..... ~ ~ ~f~ ~ ~ ' ~ ?'-~--L:2, The. hardship created is UNIQUE and is: not shared by all properties alike in the immediate ':: vicinity of this property and i~'this use district bec. au-se i77~'~S &D ~ ~'~'::;z~¢¢~';; ::~ D¢'~[, 3, The Variance would'observe the spirit of the Ordinance and WOULD NOT CHANGE THE CHARACTER OF THE DISTRICT because~.:?~.~; ~'.,!' f; ~ ~",:~-~'*~?~ ........ '~', ¢ STATE OF NEW YORK ) ) ss COUNTY OF~'~.¢¢-~d¢ ) Sworn to this ..............................................dey o~ ................................................... ]9 Ph'one' I~R 3-3000 or 3-o3t3 SEED BOX 41 JERRY SHULMAN PRODUCE SHIPPER HR 3-o3x3 - 24 hour Answering Service OFFICE Hy 25 A and Davis Ave. FERTILIZER INSECTICIDE PORT JEFFERSON STATION, L. I., N. Y. A,.)DI~IOi~AL l~tt O..=~TION I 0,, FO~I #1 ON ,~2J,.IC,,IAON FO~ B~iLDL~G . 3 ~lte~ed St~Actu~o 79' ~aO' 91' Southoid Town Board of Appeals ACTION OF THE ZONING BOARD OF APPEALS App]. NO. ~ Application l~t. ed October 16, 1987 TO: Charles R. Cuddy, Esq. as Attorney for ~RGE S~.~ .INq~ 180 Old Country Road P.O. Box 1547 Riverhead, NY 11901 [Appellant(s)] At a Meeting of the Zoning Board of Appeals held on November 18~ 1987, the above appeal was considered, and the action indicated below was taken on your [ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a ~ ] Request for Special Exception under the Zoning Ordinance Article VI~I ~ Section IO0-80(B) [ ] Request for Variance to the Zoning Ordinance Article , Section Request for Application of GEORGE L. PENNY, INC./JERRY SHULMAN for a Special Exception to the Zon'T-~g--O¥~T~'eT~,'-AF~-~-Fe V~T~J~l-$'n ]O0-~O(B) for permission to use existing storage building for warehousing and stor'age of lumber and building materials and supplies, in conjunction with th(~ existing lumberyard opposite Sound Avenue. Zone Oistrict: "C-Light' industrial." Location of Property: South Side of Sound 2~venue (or Nerth Road), Mattituck, NY; County Tax Map .?arcel No. 10[}0-141-3-4t. WHEREAS, a public hearing was held and concluded on November 10, 1987 in the Matter of the Application of ~E~G_E_~. SHULMAN under Appl. No. 3682; and WHEREAS, at said hearing all those who desired t~ be beard were heard and their testimony recorded; and WHEREAS, the Board has carefully consioered all testimony and documentation submitted concerning] this application; and WHEREAS, the Board Members nave persenally v]..w, and are familiar with the premises in question, iCs p~esent zonin9~ and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. The property in question is identified on the Suffolk County Tax Maps as District 1000: Section 141, Block 03, Lot consists of a total area of I0,688:t sq. ~t. with approximately 200 ft. frontage along the south side of Sound Avenue (a/k/a Old North Road), Mattituck, and is located ir! the "C-Light Industrial" Zoning District. 2. This is an application 'for a Special Exception to the Zoning Ordinance, Article VIII, Section lO0-80(B) for permission to establish and use a Iaajority of the existing storage building for warehousing, storage, loading and unloading of lumber and building materials and supplies, in conjunction with the lumber yard operated by Penny Lumber directly across Sound Avenue (a/k/a (CONTINUED ON PAGE TWO) DATED: November 18, 1987. Form ZB4 (re% ]_2/81) CHAIRI~N, SOUTHOLD TOWN OF APPEALS ZONING BOARD Page 2 Appl. No. 3682 Matter of GEORGE L. PENNY, INC. Decision Rendered November 18, 1987 Old North Road). 3. The subject premises is presently improved with the following structures, as shown by survey amended May 23, 1964 submitted with this application: (a) substantial frame storage building, partly encroaching along the front property line at its northeasterly corner, and (b) frame building situate at the northwesterly corner set back 3.5 Feet at its nearest point from the front property line along the south side of Sound Avenue. 4. For the record, it is noted that there are prior actions of record: (a) under Appl. No. 3482 for a Special Exception rendered April 16, 1986 permitting the warehousing of building materials and office area (for use by the insulation company presently occupying the premises) at the west end of the premises, and (b) under Appl. No~ 813 rendered November lO, 1965 to erect an addition to a nonconforming building to house trucks and loading and unloading of potatoes. 5. For the record, it is also noted that the Following permits have been issued to date concerning these premises: (a) Certificate of Occupancy i.Z-~6390 daled Novelnh~=r 13, 1987, (b) Certificate of Occupancy #Z-16385 dated November 10, 1987; (c) Certificate of Occupancy #Z-14,145 da!ed May 30~ 19~$6; (d) Certificate of Occupancy ~Z6774 daLed November IO~ 1975, (e) Building Permit #!4874Z dated May 12, 1986; (f) Builcling Permi~ #8119Z dated August 1, 1975; (g) Building Permit #2931Z dated November 16, 1965, (h) T~)wn Plaoning Board Site-Plan Approval rendered May 5, 1986, (i) Fown Planning. Board waiver of October 9, 1987; (j) Town Board adopted March li, 1986 determining the uses to be c~nsi.~tcn,~ witB those in the proposed "B-I" General Business Zoning District prepared by Raymond, Parish, Pine &..Weiner. 6. In considering this application, the Board has de~er- mined: (a) the uses proposed will hOC prevent tho orderly and reasonable use of adjacent properties or of properties in adjacent use districts; (b) the uses will not prevent the orderly and reasonable use of permitted or legally established uses in adjacent use districts; (c) the safety, health, wel- fare, comfort, convenience or order of th~ Town will not be adversely affected by the proposed use and its location~ (d) the use will be in harmony with and promote the ge~,eral purposes and intent of the zoning ordinance. The Board has also considered items (a) through (1) of Article XI~, Section 100-121(C)[2] of the Zoning Code. Accordingly, on motion by Mr. Sawicki, seconded by Mr. Douglass, it was RESOLVED, that the Application in the Matter of G_[-OR~GE L. PENNY, INC./JERRY SHULMAN, for a Special Exception as applied under File No. 3682 for permission to estabiish and use existing building for warehousing, storage, loading and unloading of lumber, building materials and supplies in conjunction with the luniber yard opposite Sound A~nue (a/k/a Old North Road) and in conjunction with those uses established and approved under Special Exception No. 3482 rendered Page 3 Appl. No. 3682 Matter of GEORGE L. PENNY, INC. Decision Rendered November 18, 1987 April 16, 1986, BE AND HEREBY IS GRANTED, SUBJECT TO THE FOLLOWING CONDITIONS: 1. No obstructions into the public street areas by vehicles loading, unloading, parl~in§, etc. which may block access (along Sound Avenue), 2. No storage of materials outside of building (~]ll materials must be contained inside of the existing building), 3. Any change of use (to other than that applied and granted hereunder) will require further application for consideration. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis~ Douglass and Sawicki. (Member Doyen of Fishers island was absent.) This resolution was duly adopted. lk GERARD P. GOEHRINGER, C~IRMAN November 19, 1987 FOI~M NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. ¥. Certificate Of Occupancy No. Z622~ ...... Date .............. [I.~*¢ .... lQ , 19.?~ 'Fills CERTIFIES that the building located at 8/~ .Sound. Ay~.e .......... Street Map No. XX ........ Block No..~: ...... Lot No..xx ..... Mattitnck. I~,Y ...... c, mforms substantially to the Application for Building Permit heretofore filed in this office dated .......... &qg .... l.., 197.~. pursuant to which Building Permit No. dated ........... AUg .... ~ ..., 19.'~., was issued, and conforms to alt of the require. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Iltdus.triai .bui/~ling..(potata .grading & .shi.l:ping.) ............. The certificate is issued to . Jerry..Schularm ........... 0mmr ................... (owner, lessee or tenant) ;,~' the aforesaid building. f;;~[rolk County Department of Health Approval l~..ito ...................... UNDERWRITERS CERTIFICATE No..E...Fta ....................................... ttOUSE NUMBER .. 1.1.9~'0 ..... Street..$ocad .;ye.,,. t~Iatti ~aek,. ~,.~, ........ TOWt~ OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 811§ Z Permlssion is hereby granted to: · [c~l~Y..... ~.c~te~. ...... ~/.,C., ~.e r.=y,,.S~.~.;.~ .................... ~¢~ttuck ................................... Build a~ a~dl.~c.~ .OB .~%~,~g c.c~..e, rcl,1 ~..o..~.~..o...p.~.c_k~..g..~.u...i.~..d.$~g at premises located at ....~9~...&~...~..~,~_,2,.~., ........................................................................ ~ttitu~ . . . .................. pursuant to application dated ............................... ~[ .......J ......... , 19..~., and approved by the Building Inspector. Fee $~,~-..~) .......... Building InsplffF, tor [ I~OB.M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~xomined ....................... , 19. ..1. ',opraved ............... '.: ............ ! .......... , 19.).,~.TPermJt No. ~..(...t...?.~,,~.~J. ............ APFLICATION FOR BOJLOI~G PERMIT INSTRUCTIONS ~ a. This application must be completely filled in by typewrit,~r or in ink and s~bmitted in h~plicate to the Building~ nspector, with 3 sets of plans, accurate plot plan to ~ale. Fee according to schedule. ,,/ b Plot plan showing location of lot and of buildings on premisus, rulationship to adjoihing p~emises or punic streets or teas, and giving a detail~ description of layout ofproperty rr,usJ be d~awn on the diagram which is pa~t of ~his applicatior,.~ c The work covered by this application may not be conm~enced I:)efore i::suance of Betiding Permit. d Upon approval of this application, the Building Inspectar wiJJ issue u Building Permit to the appiicorm Such permit f~ hall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa: f)r ~ny purp(se whatever until a Certificate of Occupancy ~all have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department l~or the issuance of a Building Permit pursuant to the L',udding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or qeguIations, for the construction of buildings, additions or aJterations, or for removal or demolition, as herein described i he applicant agrees to comply with al! applicable laws, ordinances, building code, housing code, end ragu!arians, and to admlt authorized inspectors on premises and in buildings for n~essa~ inspections. (Signature of oppl~bnL or nome, if o corpcroHon) (Addrem~ of applicant) i, ctpplicant is o corporate, signature of duty authorized officer (Name and title of corporate officer) Builder's License No. ~.~.~..*.,~.~....~.....~...*..~...~. ......... /../..~. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proj?gsed work will b~,done. Ma~p No ,~: ........ Let qo .~. ............ Stree't and Number~'~.~.'~..~...~.i~.'~..i~.'~.t~ .,~.:?.k. ~.. ~ '?l~. ~ !, ~fr~-~ L..~ ... ' ...... ...... Sldte existing use and occupancy of pre,geraLd.in.ended uso and at,policy u! propo:rd co,~slrucdcri: o Exisitinn use and occunanc~ ~/.,/~'~)--("(2~/'/~'~'~' ~..:~ (', ~.,~_ b. Intended use ond occupancy .............................................................. ../...~ ......... 3. Nature of 'work (check which applicable): New Building .................. Addition .....~?. ........... Alteration ........ Repair .................. Removal .................. Demolitior ..................... Other Work .................................................. (Description) 4. Estimated Cost .L.~.?.~ ................................................. Fee ................. (to be paid on filing this application) ,5. If dwelling, number of dwelling units ............................ Numbcr of dwelling units on each floor ........... ................ ~.Mdeni~g--additiorl to: ;~rr c , ~ : , If garage, number of cars ................................................................. 1 ............. [ ................ ~ .............. ' ........................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...................... 7 Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ................. Height ........................ Number of Stories ........................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ................ Depth ................................ Height ........................... Number of Sto~ies .............................. 8. Dimensions of entire new construction: Front .................. , ................ Rear ............................ Depth ................. Height .................... Number of Stories ........................................................................................................... ~ Size of lot: Front ........................................................ Rear .......................................... Depth ........................... 0. Date of Purchase ........................................................ N~me of Former Owner ...................................................... 1. Zone or use district in which premises are situated ...................................................................................... /. ( ) No Will lot be regraded ..~,,,~ .................... Will excesst, flthbe removedrf~o~3 pr~'qr;!ses: ( ) Yes h ~..4..~._¢ [~'[t)~ (~dles~...~ ,.-~/z~,~ -Z:~. Phone N~. ...................... ,ame of Owner of pre .......... ..~:...~..,,,..~; ....... A :.~..~: ...... !,~.. I~) O~?~ ¢ Name of Architect .............................................................. Address ................................ Phone No ...................... Nom~ of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or p~oposed, and indicate all set-bock dimensions fr,~rx :perry lines. Give street and block number or description according to deed, arid show street names and indice[c (Name of indlw' 'dual signFng contrac0 .Dve named. is the ............................................... .(~. ~' '~'"~.. ......................................................................................... (Contractor, agent, corporate officer, etc.) sc~id owner or owners, and is duly authorized to perform or have performed the said work and to make and file application; that all stctements contained in this application are true to the best of his knowledge and belief; and .ar the work will be performed in the manner set forth in the application filed ?herewith. /orn to before me this . ..,~, ........ day of .. t.,~L-~-"~-,. ~, , 19 ,/ ' .... ?" ";,"f" :";i .................... )c-", I . , . _ Xorv Public ........................ .,~.t~i,~,.<.~, ....... County ./....~. ................................... .: ....... ;~ ....... '/'~' ". ' , ~'" i '~" "~I'~ · ,. -- / ' (Sigimture of applicant) ....... -J [ilZA!)ETII ANr~ !I[VILL[ sUrVEY FOR :TOWN OF SOUTHOLD ~.TER-COU.TY ~TLE GUARA.TY ~ SCALE; !''= ;50' ~ORT(~A~E CO MAY P:5, 1964 · . '. PROFESSIO~J~. EHC~IEER.AND ....... ' - LAND SURVEYOR, N.Y.S.LIC:NO. 12845 '*: ' - RIVERHF-AD, N,Y.