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Home My WebLink About13697-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zl&152 Date January 1.4 .19.8.6 THIS CERTIFIES that the building .O.n.e...f.a.m..~.1.7.. d..w.e.l.~. ~..n.g ......................... Location of Property ...~J.7.qi. Middle Rd. (CR #48) Southold h3dso No. ' ................. 's'~i~i ....................... hk~iel County Tax Map No. 1000 Section .... 0.5. 9 ..... Block ....... .0.3 ...... Lot 023 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Apt.±1..q B ........ ,19 ~.4. pursuant to which Building Permit No..1.369.7.Z. ............. dated . F. eb ,..6 .................... 19.8.5. , 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 ......... 0~ fgmil.y duelling with home occupation fac±lities for opthalmologkst. The certificate is issued to DR. J. P. HUBERMAN ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval & 2 J an. 07 ~ 1986 ..... J..-.~gr..~Q ......................... UNDERWRITERS CERTIFICATE NO ............. {~.N. 7. 2. 7.7.7.3. ..... D...e .c .. . . 2. .3 . fi. 9. .8 .5 ....... Plumbers Certificate Jan. 6, 1986 Building Inspector Rev. 1/81 ~ow~r NO. ~ TOWH 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) No_ County Tax Map No. 1000 Section .~..~... ........ Block ....~..~.... .......... Lot No. ~.....~....-~.... .......... ..~/.Z,.~..~... ........................ , 1~.....'~.., and approved by the pursuant to application dated Building Inspector. Fee .............. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ~ ~s.~,-~? ~ A. This application must be filled in typewriter OR ink, and submitted in duplicate 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pa~operty showing all propertv 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. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $ 1.00 4.Vacant Land C.O. $5.00 $15.00 New Building .... .V'/.. ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. House No. Street Hamlet Owner or Owners of Property ...t/~..~,. ,~i-'../.~.. County Tax ~ap No. ~000 Section ............ Bloc~ ............... lot .... ~ ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. J. 3~.qT.~.. Date of Permit .i?.~/~.~...Applicant .{I¢'}~f.). Approval v' Labor Dept Approval Health Dept .................................................. v' Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Construction on above described building and per, mit meets all applicable codes and regu~ns. Applicant,...~.-{./../t.Q/~...,.--.)... i .~.~.,r~.~..~.~t~,...~.? .............. ,I, ls FIELD I~SFEC~lION FOUNDATION FOUNDATION 2. (2nd) ROUGN FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE 4. O~ ~c~ COMMENTS FINAL ADDITIONAL COMMENTS: THE .Ew Yo.K .OA.D Or rmE BUREAU OF ELECTRIGITY ~00~{)'/1 8~ JOHN STREET, NEW YORK NEW *ORK 10038 THIS CERTIFIES THAT Dr. P. ~uberman, ~It. 4~ n/s Kennys Rd.~ ~ Jacobs Lane~ wasexaminedon D~c~]~e~ ~].~J~ andfoundtobeincompliancewiththerequirementsofthlsBoard. EXHAUST 66 ~S 42 37 ?9 t 13.0 i 1.2 3 SERVICE. DISCONNECT NO. OF S E R V I C E 2 ~0~ cb ~ 2 4/0 P 4/0 ' ~/0 G.F.C.t~-.!~ ~n~oke Detec.tors~. 2 Track Lighttng~.;.A ~ ) 0 b.ttek~ Box 215 must not be altered in any manner; return to the office of the Board if incorrect Ins e ' · '" -~ · Th~s COPY ~ IN ANY MANNER. HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765--3690 Inc. BLDG, DEPT, TOWN OF SOUTHOLD CERTIFICATION Building Permit No.__~ ...... Owner Plumber__~B~Z_~_~!~_~_~_~ 11971 I certify that the solder used in the water supply 2/10 of 1~ ~lead. ...... ~ y ~ Sm' ~ - Sworn to before me this _~h_day of ~[ .... , ~9 86 Notary Public Notary Public, Suffolk County State of New York, Commission Expires March 30, 1986 76s-xsoz BUILDING DEPT. INSPECTION', FOUNDATION '~ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [/FINAL (EXiSTiNG SMOULDER) TO ROAD OR ,'"-,'""" 2:"G5~ RE'V;SED: Z-lO-G7 TOWN I-IF- SOUTHQLD r'll~FIr.~' OI~ BLIILDINr~ TOWN OLEI~K'E~ OF'rI[~P' SOLJTHOLD, N, Y, FEB 2 6 1985 TOWN OF $OUTHOLD Commissioner of Public Works Suffolk County Yaphank Ave., Yaphank, N. Y. Dear Sir: In accordance with Section 239K of the General Municipal Law of the consolidated Lows of the State of New York, this Is to notify the Commis- sioner of Public.Works of the County of Suffolk that ..~..~....,'~...~,..~..~.....~..;....,~.?'~ /~f,~ ,,,, .(~r;¢.~ ......... N~, ~. ~, · · ,'~,~ ;,,; ...... ~, I,¢, ~.¢m, ~"J~ ............... ....... ................... £ ........................... has applied to tho Town of Southold for on .~--..~. ........ ~'/.:.....¢.Z ................... ~.~...o.r~.~=.~...~.. ........... ' as shown o~the attachecl plot plan. subj:ni,tted in ~,plicgte. dc~; ...~-./~-~/ .................... We shall withhold further action on this appfieation for ten deys or as otherwise provided in the aforementioned Section 230K. 2/22/85-A~?ROVED-to the Town of Southold Very~truly yours, 239K of the General f/ '/ pursuant to Section Municipal Law subject to the stated conditions: As per revisions & comments in red. A Permit /~ //.// to Section 136 of the is required pursuant Highway Law. / ' 'Bui I~'ng ' Inspector Town of Southold, N. Y. A. BARTON CASS, COMMISSIONER S UF~F, 0LK COUNTY D E~.~ViENT OF PUBLIC WORKS C. ROaR ~KER CHIEF ENGINEER TOWN OF' SOUTHOLD ElF"FIDE OF' BUILDIN[2 IN~PEE)TOR TEIWN I~LEEK'S Commissioner of Public Works Suffolk County Yaphank Ave,, Yaphonk, N. Y. Dear Sir: In accordance with Section 239K of the General Municipal Low of the consolidated Laws of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ..~..,'~,,,~'./~,..~..~.,;..~...:.o.~,~,,.~ ~'¢'~'_ -,- _-~'~'~'~"""//"" ........ .~:,~ '¢' ~~' .~ ......... ~,r..,..,z...P.... ;'....../~......~.~.~c~..,.z~.,..~. ................... Z ............................ J~as applied to the Town of Southold for a permit to construct a building -..¢., .................. ¢~ ..-:..,,,/¢.... · o. ................. ~q.~ ............ We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 239K, ruly yours, / Town of 5outhoid, N. Y. FORM NO, 3 TOWN OF 8OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTItOLD, N.Y. NOTICE' OF DISAPPROVAL File No ................................ ~..¢...e.~...~~ ~ ............. ..~.~.....~.~~ ........... ............ Location of Property h.otq, s}.^~:Q .~. ....... .,..r~..~..6i"~. .... '8't/obi' '~' ~..ex,~. ......... 313t~[oi County Tax Map No. 1000 Section .... C)..~.~g ..... Block .... .c~.~ ...... Lot ...'~..~.:..~'~. .... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds .~ .t~..' .~....~...~,g~ .x~..I. ~O~..~.~0. ~ t~ ) ~..~.~.. ~..~¢~...~.. Building Inspector RVI~O FORM NO. 3 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To ..¢....~..s....¥~ ............... ~.~ '~,i~: ~.~,:~.:,:,.~.~.,. ...... ....... ~( ~.~ .... ¢.~¢.~ ...... PLEASE TAKE NOTICE that your application dated ..... ~...[.~ ........ ,19 .~ ~.. for pe~it to const~ct · .~ .~ ~~ ~;~. ~. k~. ~..~.~ ........ at Location of Property ..... House No. Street County Tax Map No, 1000 Section .... ~ ¢~ ~ ..... Block .... ~ ~ ...... Lot . .~ ~ e ~ .... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds .(~...' .~.. · .~.....~. · .~?'.: ./.~. ?.~.*...~.~) ~. ~ ~.. ~.~.~4~. ~. ~.~.~.,. ~:~..~ ~,~.. ~.~ :~.~.~. ~.4~ ~..~.~: ~.~,...~."~ ~ .~ .~¢ ...........~-~' ~ ..... ,, ~ .... , Building Inspector RV 1/80 ATTORNEY AT LAW 828 FRONT STREET GREENPORT, N.Y. 11944 PHONE {516} 477-1016 June 11~ 1984 Building Department Town of Southold Main Road Southold, New York 11971 Attention: Mr. Victor Lessard Re: J. P~. ~ ,H~u~b~rma,n , Dear Mr. Lessard: Enclosed herewith please find copy of your notice of disapproval in respect to the above captioned matter. As we have discussed, I believe a revised notice of disapproval will be in order. The reason is as follows: The property is zoned A-Residential. A physician's office is a permitted home occupation as an accessory use (Section 100-30(c)). The amount of parking is not discretionary and needs no approval from either the Planning Board or .the Zoning Board of Appeals (Section 100-112(a), page 10044). It is my opinion tha% the only variance which is necessary is that required because the home occupancy will exceed 30% of the floor area. Your early attention to this matter is respectfully requested in that a contract of sale is subject to obtaining the necessary approvals. Very truly yours, ~ William H. Price, Jr. WHP:kk Enclosure cc : Mr. Garrett A. Strang Permit No. 48-12 PERMIT, UNDER SECTION 136 of ARTICLE VI of HIGHWAY LAW WHEREAS, a certain highway known as the ~dl~ has been improved and is on the Suffolk County Road System and requests permission to as per sketch or map attached, NOW, THEREFORE, permission Js hereby granted to said CONDITIONS AND RESTRICTIONS 1. When concrete Js removed, cut concrete with concrete saw two feet outside the limits of the proposed excavation and for the full panel width, When the cut is ma~e in pavement within 10 feet of the panel joint, the pavement shall be removed for fuji panel width from the cut on the far side of the excavation to the panel joint. 2. Backfill and thoroughly compact fill using POWER TAMPER, placing soils so that various types of soil are in 3. Replace pavement, sidewalk or surface same as existing; if concrete, replace using 1:1 3/4:3 1/2 mix stone mix concrete If bituminous material, replace using same type as removed. 4. If concrete curb is removed, replace with sJmi ar curb 1:1 3/4:3 1/2 mix. 5. Edge of Jacking Pits or any other excavation shall be not less than 5 feet from Edge of Pavement. No undercutting allowed in Pit. 6. Notify the Department at Yaphank 924-3451when the work is to begin so that an inspection can be made of the operation. P~brtc during the progress of the work authorized by thts permit or by reason thereo~. and the State, County and Town sha]~ be held harmless on account thereof. with the terms and conditions upon which it is granted. is Form P-136 42-107:1/83 MAIN RE)AD- ~TATE F~AD 25 To. . Board APPeals SEIUTHC~LD, L.I., N.Y. TELEPHONE (516) 765-180,9 ACTION OF THE ZONING BOARD OF APPEALS Appeal No.3262 Application ~ated ~une 22, TO: Irving L. P~ice, Jr., for DR. J.P. HUB£RMAN _828 Front.Street Greesport,'NY 11944, 1984 (Public Hearing September 13, 1984) Esq. as Attorney -[Appellant(s)] At a Meeting of the Zonin¢$ Board of Appeals held on S~e~tember 13, 1984., 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 [ I Article , Section Ix ] Request for Variance to the Zoning Ordinance Article III ~ Section 100-30(C) [ ] Request for Upon application of J.P. HUBERMAN, 2 Linde Lane; Setauket, 'NY (b~?, ~. Price, Jr.~ Esq.) for a '~6'-t-6'-~'he Zoning Ordinance, Article II Section 100-30(C1 for permission to establish hom~ occupancy, to wi~t: physician ~ffice, within a one-family residential building exceeding 3 of the maximum-permitted first 'floor area, at 41505 C.R. 48, Southold, NY; County Tax Map Parcel No. 1000-059-03-023.. ~J~x The board made the following findi~ngs and determination: This is an appeal from the June 20, 1984 Notice of Disapproval from the building inspector concerning an application to construct a new, one-~family dwelling with phyisician's office on the entire first floor of 2,300 sq. ft. in area. The premises in question is located in the '~A-Residential and Agricultural" Zoning District at the north side of County Road 48, Southold, is vacant and contains an area of approximately 42,900 sq. fro with 132.17' frontage along the County Road. The subject parcel 'is bounded on all sides by residentially- agriculturally zoned properties° Approx%mately 200 feet to the west of this pa.'cel is a parcel of land zoned "B-1 General Business"; and further ~west of Kenney's Road are premises zoned "B-.Light Business." Article III, Section lO0-30(C)[1](c) of the Zoning Code provides that a home occupation shall not exceed 30% of the area of one floor of the main building, and the home occupation shall be incidental to the residential use of the premises and shall be carried on in the main building by the resident therein with not more than one nonresident assistant. Article III, Section lO0-112(A) requires a minimum of five parking spaces per each physician. Thirty percent of the greater floor area (first floor) is 690 sqo ft., the maximum permitted by the zoning ordinance without Board of Appeals approval. Applicant is requesting 2,300 sq. ft., the entire first floor of this proposed one-family residence structure, which is substantially more than 100% of a variance of these regulations. Applicant has assured the board that this structure will be used at least 50% of the time as a resi.- dence by himself, and that the structure will not be occupied or leased to others for residential purposes. Applicant has also indicated that the design of the dwelling may be changed. I~ should be understood that a change in the square footage or percentage of use of the home occupation and residence should be resubmitted for reconsideration if the home occupancy is more than the percentage of that one floor a]lowed by this decision, or 1,500 is less. (CONTINUED ON PAGE TWOI 1984. CHAIRMAN, SOUTHOLD TOWN OF APPEALS DATED: September 17, Form ZB4 (rev. 12/81) fto, whichever ZONING BOARD Pa~e 2 - Appeal No. 3262 Matter of DR. J.P. HUBERMAN Decision Rendered September 13, 1984 The board members are familiar with the site in question as well as the. surrounding neighborhood. Also, the board members have taken into~.consideration the testimony and documentation both in support and'in opposition to this application. For the recorfl, it is noted that a 28-name petition has been submitted in opposition to the application. Although this parcel is vacant and the difficulties or hardship claimed by the applicant are self-~imposed and "significant economic injury" has not been proven, the board does agree that 690 sq. ft, of area, 30% of this first floor area, is minimal. The board also agrees that some relief should be granted, t'hat relief would not produce a change on the character of the immediate neighborhood since there are businesses nearby, that the principal use of this structure is one-family residence, with this home occupation as an accessory use, and therefore the public health, safety and welfare will be served by allowing certain relief, as noted below. Accordingly, on motion by Mr. Douglass, seconded by Mr. Doyen~ ~i'~ it was RESOLVEP, that Appeal No. 3262, in the matter for J.P. HUBERMAN~i~ BE AND HEREBY IS GRANTED, SUBJECT TO THE FOLLOWING CONDITIONS~ U,J 1. That the home occupation use shall not exceed 65.2% of ..... the first floor area (in no event more than 65.2% of the requested 2,300 sq. ft., or 1,500 sq. ft. maximum); unless further authorized by this board; 2. That the home occupation is limited (and his assistant); 3. That the principal building must be residence (no rental or occupancy for residence by others); 4. No expansion of the home occupation use, or the building without the express written consent of the Zoning Appeals after formal application. Location of Property: 41505 C.R. Tax Map Parcel No. 1000-022-02-01. Vote of the Board: Ayes: Messrs. Douglass and Doyen. to one practitioner practitioner's principal Board of 48, Southold, NY; County Goehringer, Doyen, Grigonis, lk ff~RARD Po~IiOF~H~RINGER/ CHAIRMAN September 17, 1984J ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL,: 765-1802 Examined~. ~ .Z'./.0~...., 19 :d~ff.' ApproveS .~..~.~.....~. ..... ,l~.~.~ermit No.. /..ff.~..~.? Disapproved a/c ~...C'~...~..~.~z~...~.,/tX. :~./~ .... / ~ O_~_,/~-~ ' ~<,~ ...... (Buildi~'I~;dt;;i ........ a.-~7 ,~r /~g¢,~ APPLICATION FOR BUILDING PERMIT t'< ~,~ ~ Date .~f~... ~.~.., 19 ~ ~~~~ -- '~V 'INSTRUCTIONS ; T~s applicati~ m~t be complete y fil ' y ~p ...... g P , ' sets of plans, accurate plo~ plan to scale. Fee according to schedule. b. Plot plan showing location of lo~ and of bulldogs on premises, relationship to adjoining premises or pubic streets or areas, and giv~g a det~led description of layou~ of property mus~ be drawn on the diagram which is pa~ of this appli- cation. c. The work covered by t~s application may not be commenced before issu~ce of Bu~d~g Permit. d. Upon approval of this application, the Building Inspector will issued a Bulldog Pe~it to the applicant. Such pe~it shall be kept on the premises available for ~spection ~rou~out the work. e. No bulldog shall be occupied or used in whole or in p~t for any purpose whatever until a Ce~ificate of Occupancy shall have been grated by the Bulldog Inspector. APPLICATION IS HEREBY MADE to the Building Dep~tment for ~he issuance of a B~lding Pe~it pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Co~ty, New York, ~d other applicable Laws, Ord~ces or Regulations, for the construction of build,as, additions or ~terations, or for removal or demolition, as hem~ described. The applicant agrees to comply with all applicable laws, ordin~ces, building code, housing code, ~ regulations, and to admit authorized ~spectors on premises and ~ b~ld~g for necessa~.insp~~~.__ ~.~..~ ~. ~v (Signature of applicant, or name, if a corporation) .. r, er. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................... .~.~( .~/.~,/77..~.~..TY:.~ ........................................... Name of owner of premises...~..~.,.....~.,...~.~... ~..o..~. ~ .~..~.4..,~...-.....'~.,q..,~..'~.~..,e.~..)z'y...~/~..,~. ~ ~ ...... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..../~..,'..TT...~./{c. ff?.~.~..~...~.~7~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No. ~ / 1. Location of land on which proposed work will be done .................................................. ...... .... ....... ............... House Ni~mber Street Hamlet County Tax Map No. 1000 Section ....... CP..~..~ ..... Block ...... .c?.,~. ....... Lot ..... .~..~. .......... ~ Filed Map No -- Lot Subdivision ................................................................... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............. ~ ?..a..~..-cfi. .............................................. b. Intended use and occupancy . .~. ~?..'F./P~.....~. ~c..q .~./.~..~,..~.~... ~.~.~...~C~?.~. ¢.~,~.~.... 3. Nature of work (check which applicable): New Building ../e~..'. .... 'Addition .......... Alteration ......... Repair .............. Remlovai .............. Demolition .............. Other Work ............... 4. Estimated Cost ...................... Fee ...................................... ~ q' (to be paid on filing this application) 5. If dwelling, number of dwelling units ....c~. · .~..'~'... .... Number of dwelling units on each floor ................ If garage number of cars 6. If buslness, 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.~toxies/ ............. ,.,. ~., / · 8. D~mensmns .... of entire new constructmn.~ Front .... ~.'"._.~.~.~.~,... Re, ~,/ ..... ,.,,~..~/~J... Depth ... o~1~.. ~...~.'. Height ........ .~.'~.... Nurob, er of Stories ...... ~..~.....t. ?Z,: .................... , ............. 9. Sizeoflot: Front...{~.~.:.t.7 ........... Rear . I~5~' Depth 2,t~.~ .~ 10. DateofPurchase ; $~? ~.o~.-r~n ~ . Nam ., ........ , .................. te.q}f Former O. ncr ............................. Zone or use district 'n which remises are situa - ,,,, z,r~-- ,~ I1.. 1 P, ted.. ~'~.. ~.<'~/~.,~.. 77.'... z .~d,,~t~,,,~.t.~:~.¢.T. ~..~. .......... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~,~.~...../)(.c~. .............. 13. Will lot be regraded' . ...... l~l.o ................. Will excess fill be removed from premises: ~ Yes No ~14. Name of Owner of premises . .d.~ ~:. ~. ~P?. ~.;g. q .~.. Address ./~.,q..r..~/~.~.,~.*f.~.-q Phone No. ~.~ ! .'.~. Name of Architect .~,~.~.'( ?.~...~t.:. :~..~'.,~.~ .~..~' .... Address . ,-~.,~.~..~.,'~..~ .~?....'~.: Phone No...7.4 ........... ~'~'~"~ Nameof Contractor . .~.~.2~..~..~.~.,~.~..Z~.~..~. ..... Address ................... Phone No.'- PLOT DIAGRAM Locate clearly and distinctly al1 buildings, whether existing or proposed, and, indicate ail set-back dimensions from property lines. Give street and blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. He is the ...................... of said owner or owners, and is du applicationi that all statements cent STATE OF NEW YORK, COUNTY Or..~,~.~.~.~.,~.q.~-r.... S.S ..... · .~.~..~dt~. ~.,...~. ;"~..4 ~ .............. being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contract) above named. (Contractor, agent, corporate officer, etc.) y authorized to perform or have performed the said work and to make and file this dried in this application are true to the best of his knowledge and belief; and that the work will b~ performed in the manner set forth in the application filed therewith. Sworn to before me this ' , .............. '.day ol £Ui NOTRRY No. 52, ABE'rH ANN NEVILLE ' (Signature of applicant) ~IJIILI0, 8late ef N~w Yed~ "I Main Road P.O. Box 1412 Southo~d N.Y. 11971 516-765-5455 II,~ R~-F. N~ T 5O~FJL.~-. 6OL~N'~'f ~TATF.-/A [/N-F Of- I 2' GARRETT A. STRANG architect Main Road P.O. Box 1412.Southold N.Y. 11971 516- 765 - 5455 ~/F o5~ .5o" GARREETT A. ~TRANG architect Main Road P.O. Box 1412 Southold N.Y. 11971 516 - 765 - 5455 TITLE Pi::(, d, R H 'LOCATION ?? STRAN:G ,archi tect Box 2 SoUthold N,Y, 11971 516- - 5455 H,5, ~'F, N= T H.$, .-%TA.T F../A f.., 1'~ -F OF t m Z GARRETT A. STRANG architect Main Road P.O. Box 1412 Southold N.Y. 11971 516 - 765 - 5455 TITLE SCALE /*l , REVISED *o% -- ~OM$OII 74' · 'C MAP OF DESCRIBED PROPERTY A T SOUTHOLD TO kVN OF SOUTHOLD~ SUFFOLK CO., AREA ~ ~12, ?$Z SO. FT. OR 0.95 2,~ ACRE SUFFOLK COUNTY DEi~A~TMENT OF HEALTH SERVICES FOR APP[~OVAL 0{: CONS~'RUCTION ONLY DATE.__ _HiS REF. NO .... APPROVED to the standards of the Suffolk Bept, ol Health Servl~ces.. CERTIFIED TO: U, P HUBERM,4~ donack associates land surveyors and consulting engineers '313west main street riverhead,new york 11901 MAP OF DESCHIBED PROP,'fiErY LOCATED AT SOUTHOL. D TOWN OF SOUTHOLD SUFFOLK CO., IV. Y. A~KA: ?~,~'e7 SO. Pr (0.9e~£ ACRE) 74' CKRTIFIKD TO: SOUTHOLD SAVINGS COMMONWEALTH LAND T/ELK INSURANCE N£ 60611861,~ FOR: -~',.'~//'~'' Il/--~-- engineering p.c. AND~' II riverheod, new york 11901