HomeMy WebLinkAbout646
NOTICE OF HEARING
"'Pursuant to Section 267 of the ~
Law and tne Provisions of the Amellllea
Building Zone Ordinance of the Town
of Southold, Suffolk County, New York,
public hearings will be held ,by the
Zoning Board of Appeals of the Town
of Southold, at the Town Office, Main
Road, Southold, Newl York, on April 16.
1964, on tp.e following appeals:
7:30 P. M. (E.S.T.), upon application
of TredweIl Abrams, Sea Shell Marina,
Southold, New York, for a special ex-
ception in accordance with the Zoning
ordinance, ~icle IV. Section 408,
Subsection A, for permission to erect a
third ground sign at the Sea Shell
Marina, south side Main Road, Green _ I
port, New York.
7:45 P. M. (E.S.TJ, upon application
of Frank Milowski, Front Street, James-
port, New York; for recognition of ac-
cess in accordance wUh state of New
York Town Law, Section 280A. Location
of property: private right of way, south,
side Main Road, (Route 25), Mattituck,
New York, bounded north by private
road, east by Roy Schlein, south by J.
Boutcher Est,' west by J. Boutcher EAst.
8:00 P. M. (E.S.TJ, upon application
of Ann DeMaria, 5 We~n Road, Cam-
mack, New York, for . 'recognition of
access in accordance with State of New
York Town Law, Section 280A. Loca-
tion of property: private road known as
Park Place, east side South Harbor
Road, Southold, New York, bounded
north by M. Crane, east by E. H. Ford.
south by L. Ford, west by Park District.
8:15 P. M. (E.S.T.), upon application
of George W. smith & Sons, Southold,
New, York, ale Dai-Moy, 37 Mott Street,
New York 13, New York, for a variance
in accordance with the Zoning Ordin-
ance, Article III, Section 300, Sub-
section '1, for permission to erect a pri~
vate detached garage in the front yard
area. Location of property: south side
private right of way, Cedar Beach Park,
Lot No. 117, Southold, New York.
8:30 P. M. (E.S.T.), upon application
of Edna Brown, East Marion, New
York, ale Helen H. Lyons, 36 Ocean
Drive, St. Augustine, Florida, for a
variance in accordance w.ith the Zoning
Ordinance, Article In, Section 300, Sub-
section A, for permission to sell a lot
with 75 ft. frontage. Location of prop-
erty: west side Robinson Road, Green-
port, New York, bounded north by A.
Rosenberg, west by Robinson Road,
south by D. Bruckheimer and Sterling
creek, west by Sterling creek.
8:45 P. M. (E.S.T'), upon application
of George Moore, 152 Flanders Road,
Riverhead, New York, for a speCial
exception in accordance with the Zon-
ing Ordinance, Article IV, section 408,
Subsection A, for permission to erect a
COUNTY OF SUFFOLK
STATE OF NEW YORK
} 55:
C. Whitney Booth, Jr., being duly sworn, says
that he is the Editor, of THE LONG ISLAND
TRAVELER - MATTITUCK WATCHMAN, a public news-
paper printed at Southold, in Suffolk County; and that
the notice of which the annexed is a printed copy, has been
published in said Long Island Traveler-Mattituck Watch-
~ .
man once each week for ...................,;.-:...i~....-;........ weeks
successively, commencing on the ..............0'.:.......................
,/ // - (-
day of ........,...C.l....'.../....;1....' 19......... ,
mmmm<t((lf;Jj</C:;
Swprn to before me this ......."........... ... day of
/, /
......C,i,:!,:.,."...:..........., 19.J"...:.
r,
,
'i (..)/ ';',~',' I ",_ ',,' 'Ft,_ !__--
............i. .,.... ~... N~t~;r~bH~"""'( ',:' .~, ....."'.J~..~............
~,'I~.f':T..,-( f~ ~':i~":":
r.'"
I
1 'C.
c.
!
iLl
directional sign on the property of
Mary Phylko, south side Sound Avenue,
Mattituck, New York, bounded on the
north by Sound Avenue, east by F.
Walgo, south by C. Price, west by H. R.
Reeves & Sons.
9:00 P. M. (E.S.TJ, upon application
of Long Island Lighting Company, 175
E. Old Country Road, Hicksville, New
York, for a special exception in accord-
ance with the Zoning Ordinance, Ar-
ticle III, Bection 300, SUbsection 6a, for
permission to install an area protection
generator on property of Long Island
Lighting Company, north west side of
Main Road, (Route 25), Greenport,
(Arshamomaque), New York, .bounded
north hy Stepnoski, east hy S. Ciacia
Est., south by Main Road, west by
Drossos and Rempe.
9:30 P. M. (E.S.T'), upon application
of Constantine King, 69 Further Lane,
Riverhead, New York, for a special ex.
ceptton in accordance with the Zoning ;
Ordinance, ArtiCle In, Section 300,
Subsection 11, for permission to erect a
directional sign on the property of John
G. Poliwoda, south west corner of North
Road and Albertson Lane, Greenport,
New York.
9:35 P. M. (E.S.T.), upon application
of Constantine King, 69 Further Lane,
Riverhead, New York, for a special ex-
ception in- accordance with the Zoning I
Ordinance, Article III, Su_ion 300,
SUbsection 11, for permission to erect a
directional sign on the p<operty of
Marie Cassidy, east of Fleet Lumber
Company, south side Main Road,
i Greenport, New York.
! 9:40 P. M. (E.S.TJ, upon application
of Constantine King, 69 Further Lane,
I Riverhead, New York, for a special ex-
! ception in accordance with the Zoning
Ordinance, Article nr, Section 300, Sub.
section 11, for permission to erect a
directional sign on property of Martin
Nelson, south east corner of North
Road, and -Moore's Lane, Greenport,
I New York. ---
9:45 P. M. (E.S.TJ, upon application
of Constantine KIng, 69 Further Lane,
Riverhead, Newl York, for a special ex.
ception in accordance with the Zoning
Ordinance, Article IV, section 408,
Subsection C, for parmlssion to paint
words flBowl" and "Restaurant" on the
southerly roof of King's Lanes, east
side Moore's Lane, Greenport, New
York.
I-~-
I
-n
---T~--
UilGAL lifO'1'XCB
Notice of Hearing
Pursuant to Section 267 of the Town Law and the provisions i
of the All\ended Building Zone Ordinance of the Town of Southold.
Suffolk County. New York. public hearings will be held by the
Zoning Board of Appeals of the Town of louthold. aththe Town
Office. Main Road. Southold. New York. on April 16. 1964. on
the following appeal..
7.30 P.M. (E.S.T.). upon application of Tredwell Abrams.
Sea Shell Marina. Southold. New York. for a special exception
in accordance with the Zoning ordinance. Article XV. Section
408. Subsection A. for permisSion to erect a third ground sign
at the Sea Shell Marina. south side Main Road. Greenport, New
York.
7.45 P.M. (E.S.T.), upon application of Frank Milewski.
Front street, Jamesport, New York, for recognition of access
in accordance with State of New York Town Law. Section 280A.
Location of property. private right of way, south side Main
Road, (Route 25), Mattituck. New York, bounded north by private
road, ..st by ROy Schlein. south by J. Boutcher Est. west by
J. Boutcher Est.
8.00 P.M. (E.S.T.). upon application of Ann DeMaria,
5 Weldon Road, Commack, New York, for recognition of acces. in
~ ;
:;
!: accordance with State of New York '1'OWn Law. Section 2S0A.
Location of property. private road known as Park Place, east
side South Harbor Road, Southold. New York. bounded north by
M. Crane, east by E. H. Pord. south by L. Pord. west by Park
District.
l
...,.... .. .,- -- __.,_._. '_"~._._" ._..,_ ,'_. "__,'___'._. ,_ _"__,""~"______'_W n'_ '_"_"',__,'_.""'.._ ,._,____._~_.__...__,..._ "._" _,_..._ ,.__',._,_ _'_._. .,' '___~'_..~_,.~.___.,_._"_ ....,__,___._. ..-...-,..-...-.......-..
-- ....-........-.-.-- __......_. ___._,__.~... ..__.._.__,..._._._,_..,..~_..__.__. ___._....._._._._ ,__,._____,.. _' _ ,__~.. ,__ .._____.________,..__.__.___..__.__.._~,__._.,__ '_'___m__n.__.._ __"'_ ._..
I I I I I .. I )If . & 2 >' i I i ,. ~ i ll<
I . i I 0
.... I tt . .. I
I lit I I i ,. i I
( . r .. ... ,. 01 i ... "
.t :I - 8 ... i . a I w . ..
"< t " ! toot . ...
. ... ... . . 0 I Vi
n 0 I i I .. . I 0 . .. .
. I "' .. ... .. . "' t "ll
,. IE . , ~ .. . '2 )0 .
:7 ! . ... :It .. i i lI: i I lot :II
, . . n ,. . ;- ,. i .
i ! i I . IE t;' I;' ...
'< ,. - I ... ... .... 'It III .... ....
i i "" , r; t .. '" r ... .. PI
. ! . ,. .. . ... a . . .
I 1 I';l . . .. III I';l ... I III
I I . .f ... .... ~ . .., t .... ! .
i I .. of ! I "" .... ! of . .. ... ~
. i I . ... . I .... .
,. - ,. :: .. ... I . . I -
.. .i .. . ,. I i .. , .. ..
( . .. . I .. !II
l I i t " i i t f . ! i
I f ! 3 ..
tl: fl .. ..
. f .. f't i . i i
g f: r .. f ... .. ... ~
...
,. i i i . i . t i f
. of . I '" I I
i . ... w 1 I \of i
.. i ... .i 8 1 0
I .. .. ... . i 0 ~ i i
I = .. i .. fi i ;- ..
I .. r i
,. n I i to .. f't 01 I i
. .. ~ i I I I i r f t
.. lot ..
,. J i III f .. .
I ,. .. w
I i t 0 . i I 0 i i I .., 0
... "' of r ... ...
. i i I
I liII ,. I
. .. I ! :a ;- t:J 0 t
. Q. "' 0
I .. .. ... )0 " "' 'I .., C
at ~ I .. c .. .. ... III
. J III I i .. i . ! It ,; i
,. I r , i .. r
:; . I ~
( i .. . .. i f .
... i f n It
I .f 1 110 . 1 . !
'II i i "< ... f
. I . - I i . t'I! . ! to I
, ... = I
.. i ... ..
f ;- "" I · L It: i ..~
... . Io.l .
-1........ ,. ... +
__...~~_~_".____ __,_... ,_...,._". _,"..,m_,__ .-..----.--j--- .. ..... . -~.. ..'."--.,
..
I
i
i
I
i
_c:=":c.=-~- "_'.c ,',- -"'-'"'" ~-"""'=--""'-""==-=:;;--="'-''---'.'=~=~-'::'=-"",,"_ ~_ -,--,-"".;""",,^"'''''-~-'''--='''='''~'''';;;=''-.~7==_''''o,,,:=~-'''',,"=-,'=''-''''"':_~,"'O"_;~.--"-""";,.~_c:.""-,;':';;;..=~..~"."-''''.;:'~'.,;;."."",,,"~;~'.-<"~_="'__'-'<_'..=~_.-_
( . w Ii .. i I w Ii .. i f I Ii .. of fA 1tool k lr fl i t"'
i (;I III 8 III III I "" .. ...
0 - I I ,
.. i I f .. .. '" I .. i .. r;
.. i I a .. i
I III III III III I "" 2 . oe
I I .. . I ~ f " r r w
t t I w i w I I ... 0
J f III )0 0 ... t ... 0
" .. " .. ... .. n
I .. .., i .., III I "
i . I i . ... I . I I ft C > .
i :I: 4 i :lII ... . i :l j 3:
. Ii . . .. . . ..
.. c r ... c ... .. i ~
.. ... .. ii ... .. - r ... .. ,.. .. -
. ... ; I 0 ... J; w I I J; .. I of ,.. r\ ... r .. !II#
0 ... llf . ... ... lli! .. llf . '" I . ..
i ... .. I IQ .. I !Ill i . .. ... ... VII
f . I i . i 'I f . tI\ I ... .... .
! r ... .. r ... ... . . tot I "" ...
. " . Cl I i . ... .
.. - I f - . -- n: .. lit -
ft I .. i .. .. i .. i .. . .
i Ii I t'l 'I . ! lit
.. j .. t t I ! ~ j
i .. i I .i .. f i .. r i f
I 1 I i J ..
i = I ... I '" -- i t'l
i I .t . i i , I I . .. 1 Ii I f
i .. i ... I
r I .. r I .. r I . I w
.. .. I . .. 8 I
I I i .. I i >> i
I I r , I ..
.. .. I .. i . !
i It It f ... i i It
I i .. r i 0 i .. r i 11II .. r i J; t I i
... I I .. I ..
e ~ . r: i t' .f 0 .
11II 0 .. It 11II 0 . 11II 0 I ... 0
. ~ ... i It ... It i ... ) i "'
It 11II t 11II :; t . . I I i c
n t'l i 1 n i i
I I I It f tt I i tt I Ii Ii
r: I r; E i fIo r
... i ... .... i l f z:
... ... ... ... III ... I .. ~
.. ... .... .... It
i . I It i .. I ... 0 .. I ft .. . I (
. f i ... . i . J; ... i ..
"' III .. i III f
I n . I ! I I I
I I ... .f I i
It >: ... ~ ~ .
i .f . i i i I i i i It C
B i
. .. .
.. Ioi .
,_..'"". ..~_. ..._,_.M'".,' .,_ ._'."'~""H~"'_~__.~__.__.."'_'~__' _,,_,_ '. _.- .._--_.,_._-^_._-_._.._...._-",._.~.._--._._._'_.- ,...~._-_.. -_.--,-. . - .-...-.--- ..._.. ..... -8--....- .-..--. ...-j- .._-----
.
nJi!~il:. I
1=-1" ..!....!
!!lli~fii l
Ii . ,~"II. f
It s.... of
i ill i f
n i.' ~ ~
J ~~~ t I
IiI ~ i
.. It
JI I I
It ,t
~ f;
...
!
..
i 5
fC
" ~ e.
~ ~ E
. ,
J ! I
!; Q
. I ... PI
. a!"
· a 3 )0
. ~ I
· S (::
I i
Ii ..
~ 5
~ I
I
s I
.. -
III ...
.. N
....
~ I
.. ,Ii:!
If. !
f: .. I
Q." It
i i i!
i f
I r
II> r
i f
f i
. f
! I
i
,. I
...
i
f
..
: I It
. A 0
..
· · t
i ;
.
~ I Ii: ~
5; i it f ~
~~~!t'~
. c:.
i f r i ~ F
· JJlfi~
: "Iiil~
· '~if.l
i I r fl I I
. l I f J I
i I 1 r i
.. t r " I>>
. It ....
· i ! i i
J i ~ E I
I .. r i i
ii I i
a ..
..
1
I
i
i
-1_: i -
,j...,'
TOWN OF SOUTHOLD, NEW YORK
APPEAL FROM DECISION OF BUILDING INSPECTOR
APPEAL NO. C, J {,
DATE .;J/i!..f/I.y...
TO THE ZONING BOARD OF APPEALS, TOWN OF SOUTHOLD, N. Y.
-~(We) f~,{~~~'0"}:;~~:f..<-,Jt..A,.. .;~" of ._....At.$./t;;~~I.~.~d..N~;;;b~.;-........._........_......
......................".sQ..~1~~.i~~i~....................... ............ ......../lt~.......HEREBY APPEAL TO
:::L~:A~I:: BF~:R:E::I~P::LS..~~~.~.~.~E...D.E~I~IO: ~:D T~Ll~.~.~~;~~~...~~
WHEREBY THE BUILDING INSPECTOR DENIED TO
(X)
( )
( )
?~,...I.%:/~f.:AP"';.I~~:t.~~1~~;~;y<!.f\:..~. .....
..r.:.'.IA..{.Ix:. ...;~.r.................. .,-;':0, ~f..f.. lI...e.J!.................:.!:..:;/.:........................
Street and Number Municipality State
PERMIT TO USE
PERMIT FOR OCCUPANCY
of
LOCATION OF THE PROPERTy...j').6?I.I.:./fI.~.......1/~~.d;P'..............................................
Street Use District on Zoning Map
1.
/'t./fl.!.:E..Lt..()/uf./:!..Uf.c./f..lAR/t... ....
Map No. Lot No. /7
2. PROVI ION (S) OF THE ZONING ORDINANCE APPEl\LED
3 TYPE OA,PPEAL Appeal is made herewith for
()l) A VA CE to the Zoning Ordinance or Zoning Map
( ) A V NCE due to lack of occess (State of New Yark Town
Art. 16 Sec. 280A Subsection 3
Sub-
section and
0.
o
Law Chap. 62 Cans. Laws
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
( )
is requested for the reason that tv<' <"" \ // /. /:1,< /' L. (J ;//1///1 Y ""--- ,. >{., /"/C" , ,h
j/+ fC' ;'>
/ /:.) (~/~ 1.( 1,1 ;"A) (1(.7-' /.;... ?-.
Form ZBl
(Continue on other side)
REASON FOR APPEAL
Continued
1. STRlCT APPLICATION OF THE ORDINANCE would produce proctical difficulties or unneces-
_sa;~ AARDSHIPbecause 1/ /-i/</<< A. d ?/-A'c <':.- ~ /#0'4-j?<!:..- //Y -4.L. ()LA-T/",;'v
"; /h4-/!~ out j) Sf:>,); L. TN ,.t, (lU//(, elf:. S U,'-e w ,:;("":C 1/1 e. t23 -4/ AII/.o /,fl,.>,"
TN-e. lit E' CJ <?F T/f<: AtJY<-,,:,;,A/j ?RCi/>eR77 C'JU'Ale~
"
2, The hardship created is UNIQUE and is not shared by all properties alike in the immediate
vicinity of this property and in this use district because 7#/j I" A ,./iTeRI'''''?",. 7 /..C'r-
3, The Variance would observe the spirit of the Ordinance and WOULD NOT CHANGE THE
CHARACTER OF THE DISTRICT because 7>'f r'S /,/-.. R /I fe. tll tI" L d .B~ ,P/- t9' <C',r;J
}i/vtJj(,f ,,,'//) e or T#e kCIf'/fBH~5.h' )<C/5T'ivf' /A/E'Aft:..
STATE OF NEw YORK )
0, . I. ~/~Jd)
COUNTY OF~)
ss
.A/f~W~4~~~_fk-,
.~ 4J;A~~~~/4:----.A?#
y......:.....................................................................;......
Signature
Sworn to this ...................'!1.I..~........... day Of..............~~........ 19& /
...............~.~~...
Notary Publ ic
JUDITH T. BOKEN
Pu:-'lic, State of New '(or\<.
N~~ar\2.(;3.,4S63, Suffolk CO;jnty~ <'
cQminill\On Expires March 30, 1
, FOBM NO.1
TOWN OF SOUTHOLD
'- BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTH OLD, N. Y.
Examined ",.""ou..""ou.ou".....".",,,,, 19"".."
Application No. ........................"..
Approved """""'''''''''''''''''''''''''''''', 19"".",Permit No. "......""...............ou..
Disappraved a/c..........."..... .... ..... "..... .... ........... .." .." .... ..... ... ........ .................
..........................................................................................'...............................
.................................................................................................
(Building, Inspector)
APPLICATION FOR BUILDING PERMIT
Date ...,,;?4.0"7....................., 19...."......
INSTRUCTIONS
a. This application 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 ta adjoining premises or public streets or
areas, and giving a detailed description of layout of propertymust 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 II')SPector will .issue 0 Building Permit to the applicant. Such
permit shall be kept on the premises available for inspeCtion throughout the progress of the work.
e. No building shall 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 opplicoble Lows, 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 011 ap~licable laws, or_A;~~~~n~:t;~~ .h-c-
..:. . """""(S'i9~:;i'~ppii~t:'~';'~~':':;~:"if'~'~~;p~;~ti~~j"""'"
~.~
".~ .
, .""'"'' .""~.:.......".(Addre~.~t~p~*.............."...........
. .~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
/") _ J
.........................l....:~~~-:k............................................................................"............................................".....
f. //~q / - m~~
Name of owner 0 premIses ."..".~;:"'-"-........""."..7 ""......"......................"............................................................"...
,1.~..~~~:4?;::2Z~~~.~.~~i.~.~~..~.~~icer.
(Nome and title of cofporate officer) .
1. Location of land on which proposed work will be done. Map NO/~{#1".~c.r.4 Lot No: <.-::.2...........
S d N b ~~ -~~~...-..Y. , . '..' . .
treat an urn er ........ ........':...~~.......................-;:~..............................-.............................................,..........
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
. o. Existing use and occupancy :.Ut5f:.(.:9.:y.~~....................................................................................................
b. Intended use and occupancy .................................................................................................................................
"
Nature of work (check which aPr.cable): New Building ..K............ Add.. .In .................. Alteration ..................
Repair .................... Removal.................... Demolition.................... Other Work (Describe) ......................................
-T.' ~.- p-.)
Estimated Cost ......~:e.f?a.... ......... .... ... .... ........ ..... ..Fee .. ....2....:=:::-........ ................ ............. ............ ........... ..... ....
(to be paid on filing this application)
If dwelling, number of dwelling units ............................Number of dwelling units on each floor ............................
If garage, number of cars ..........;b,.(AR.................................................................................................................
If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................
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 ........................................
.., . <j ., I "J "? I 02...2 '
DimenSions of entire new construction: Front ....."",,.,7.-............... Rear ..~.".,................. Depth ............................
Height ..../ff..:............... Number of Stories ....aN.e..............
Size of lot: Front .........f...~..'!.......... Rear ..../...07..1:............. Depth ....L.?::.5.:...::t":........
Date of Purchase ........................................................Name of Former Owner ...I.:I.~.A!&.y....~j.l.:.1:..l.l.:lf..........
Zone or use district in which premises are situated....rf.?e..5.'./..A.~.!\.!..T.;Ak................................................
Does proposed construction violate any zoning law, ordinance or regulation? ....y.,;>..?........................................
~^ ' It or
Name of Owner of premises ..k:.I:-K..t::MP..1..............Address ...~~i!.irP.&/:(...[,I.....y... Phone No. ....................
Name of Architect ......................................................Address ............................................ Phone No. ....................
Name of Contract~~A1F.!f...k:J;...(.i7.:"::l9..:-.J{I....(Address ..:~.~.,.r.-I.l7I?f....j............... Phone No. ....................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
3.
4.
5.
6.
7.
8.
9.
10.
ll.
12.
13.
P e. c 0 lJ ~ ( tJ iJ.. "{
. t(3",>-K He A 0
!- aT fir. /17
LoT .oJ flf
rt II/'
t
\
~4t\iilv'1-\
t-+o" 5 ~-
v
~
i j; f,." mil?
. '7 PrRI'r'/!..'
'\ ?R(}f>.<;.."
,..-. 'I A- J? 1+1 t,
~u
2-"Z- .
. ~~
"
tJ
'"
...
t
Ri
-~---
or
Leo<' A.\.
\
-"~
STATE OF N . "5.5. J
COUNTY OF . ..... . ..... ...j"7 _ /'
................~~....~~z:::..........being duly sworn, deposes and says that he is the applicant
(Name of individual signing application) .
above named. He 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 filedZh.
swo:':~~:~:;.:~..;~;;~..., 19..r;.Z:..kc~~~......................
Notary Public,,~. ,. .y~~... un (Signature of applicant)
Nij. 52.0344963, Suffolk ~o~nll' 1. <
tom~I'Sslon Expires March .,u, l.il,)"
-
--
t:-
l~
,
~..
t',
~,