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Home My WebLink About22074-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. (~TIFICATE OF O~Ju~ANCY No Z-23707 Date J~NE 14, 1995 THIS CERTIFIES that the buildin~ Location of Property 1010 MAPLE LANE House No. Street County Tax Map No. 1000 Section 35 Block 5 Subdivision Filed Map No. ADDITION GI~NPORT NY Hamlet Lot 27 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 6, 1993 pursuant to which Building Permit No. 22074-Z dated MAY 20~ 1994 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 A DECK ADDITIONTOANONE FAMILY Dg~?~.INGA~ APPLIED FOR AND TO THE CONDITIONS OF '£~u~ ZBA APPEAL ~4223. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Building~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. N£ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTHORIZED] Date. ~...~.... ............................................19~-'~... ?2074 Z ........ ....... ..~.'....~.~.~.~...~~.~..~~...~~~..~..~.~. ................ ..... ~....~ ............................. ~ ....... ,.....~....../..~ ............................................... ........ ~~.~...... ~..~.~..... ......... ~~.~..~ .................. at premises located at,....~'..~../..~.......~.." .~/.....~--~_~... .................................................................... ................................................. ~.;,~.~.~ ............. .,.~.~.~ ........................ Couniy Tax Map No. 1000 Section ....... '~..~... ....... Block ....... ~.~ ........ Lot No ........ ,~....?.. ........... pursuant to application dated ....~.~.. .................................. 19 ................ Building Inspector. ~ ~--'~-~' Fee $...~..~ ..... and approved bythe Rev. 6/30/80 '['OUil IIALI. 765- I 8U2 API'I.ICtVflON FOR CEIUI'[F[CATI'~ 01" OL;CIIPAUCY Thin application must be filled in by typcwritcr OR i.k and submitted to the b. ildlng inspector with the following;: for new buildLnK or new I. Final survey of properly with accurate JocaLion of all buildiags, properly lines, 2. Firml Approval from tlehlth Dept. oE waLer supj, ly n.d sewerage-dLsposal(S-9 form). 3. Approval of electricz~t installation from Board of Fire Underwriters. Sworn statement' from iplumber certifying that the so[der used in sy~;tem cnntairs le~;s than 2/10 of l% lead. 5. Co,mmrcial building, indnstrial building, multiple resldence~ and similar buildings and installations,~,a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Flaoning Board Approval of completed site plan requirements. For existing buildiogs (prior to April 9, 1957) non-conformiog uses, or buildings and "pre-existing" land uses: 1. Accurate survey of propcrty showing ali property lines, streets, building and nnnsuai natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building inspector si,ail state the reasons therefor in writing to the applicant. [. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swi~mning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existin~ Bui]dine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Co~ercial $15.00 ~ u~ .............. > /~ ~LL ~.C~ Ne~ Cons~r~c~on ........... Old Or Pre-exis~in~ ~uildia~ ................. House No. S~ree~ Ha~le~ co,,,,~ ~ ,~p ,~ ~000. S~ion..~.~ ........ ~i~,~ .... ~.Z ........ ~...~? ................ / ~ . ~ ............... 3ubdivisio..~4~i 7 ........ Filed bi:,p.~7, r~f?..Lot...¢... Ileal~h Dept. Approval. - . ............... Underwriters lpprov'lt ?lanni.g Board Approval ........................ · '.equest for: Temporary Certific3te ........... Final Certicatn ........... .................... '" . . . ' t~c.t~ .ir tlq~r.-;~,, ... ... ×... ........ ~. OUI;DA'T!O:; ( ls t) OU~'$DATIO:! (2nd) ,0UGH FRAHE .PLUI,iBI~IG -'I;SULATIO~'; FER H. Y. STATE E~JERGY CODE FI;;AL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INitiATION [ ] FRAMING [~/] FINAL [ ] FIREPLACE & CHIMNEY DATE 765-3.802 BUILDING DEPT. INSPECTION ( ~] FRAMING (/_~INAL REMARKS: ~.~ DAT~INSPECI'Q~ APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Richard C. Wilton Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 April 12. 199q Mr. and Mrs. John Bertani John Bertani Builder. Inc. 1380 Oakwood Drive Southold. NY 11971 Re: Appl. No. ~223 - Donald Brehm 1000-35-2-27 Dear John and Linda: Enclosed please find. a copy of the Board's Findings and DeterminatioR rendered at our .April 6. 199q Recjula~ Meeting. Please be sure to return to the Building Department .for a building permit; after obtaining other agency approvals-that may be applicable.for this project. For your convenience, we have-furnished the Building Department Office with a copy of this date~mination for their permanent recordkeeping and update. Also, we have transmitted copies of-your .file to the Suffolk. County Department of Plannin~j in. accordance with Suffolk. CountySs Administ~ ative Code rules and regulations pertaining to projects located within, 500 feet of a waterway. Once we have received their written response, we will forward a copy to you for your permanent file. Please do not hesitate to call our office or the Building Department if you have any questions, Very truly yours. Linda Kowalski. Clerk Board of Appeals Enclosure Copies of Decision to: Town Building Department Suffolk County Department of- Planning APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairnmn Serge Doyen, Jr. James Dinizio, Jr. Robert A. Vill~ Richard C. Wil~nn Telephone (516) 765-1809 ¢~O~ ~ [~~, New York 11971 ~"~ ~- F~ (516) 765-1823 ~lephone (516) 765-1800 BO~ OF ~P~ TO~ OF SO.HOLD ACT I0~ 0~ T~ BOA~ Appl. No. 4223: IJpon Application of DONALD BREHM. This is a request for a variance based upon the Building Inspector's March 4, 1994 Notice of Disapproval concerning a building permit application for a deck addition proposed within 75 feet of the bulkhead along Dawn Lagoon; ref. Article XXIII, Section 100-239.4B of the Zoning Code. Location of Property: 1010 Maple Lane, Greenport, NY; Lot No. 60 at Cleaves Point, Section Ill; 1010 Maple Lane, Greenport, NY; County Parcel 1000-35-5-27. The subject premises is substandard and is located in the R-40 Zone District. ID WHEREAS, a public hearing was held on April 6, 1994, at which time all persons who desired to be heard were heard and their testimony recorded; WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; WHEREAS, Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; .and WHEREAS, the Board made the following findings of fact: 1. By this application, appellants seek a variance under Article XXIll, Section 1OO-239.4B of the Zoning Code for a proposed 450+- square foot deck addition. The addition, including a new step area, is proposed at a setback of 43'8" from the existing wooden bulkhead at its closest point and 48'4" from the bench/deck area (although the survey map prepared December 7, 1993 shows a proposed setback from the step area at 45+- Feet). 2. The premises in question is identified on the Suffolk County Tax Maps as District 1OOO, Section 35, Block 5, Lot 27, and is known and referred to as Lot 60 on the Map of Cleaves Point, Section Ill." This parcel is substandard in size containing a total lot area of 13,247 sq. ft. and frontage alon9 Maple Lane of 100.O feet. 3. This parcel is improved with an one- story frame dwellin9 · built in 1983 under Permit No. 12291 and is presently shown on the ~acje ~ - AppI. No. 4223 Matter of DONALD BREHM Decision Rendered April 6, 1¢J94 survey dated December 7, 1993 with an existin~-~etback from the bulkhead at its closest point at 52+- feet. 4. During March 1985, the Town of Southold enacted "Local Law #4-1985" pertaining to building setbacks from water bodies, and on May 17, 1988, enacted Local law #15-1988 pertaining to setbacks from bulkheads (prey. Section 1OO-119.2B). 5. Article XXlil, Section 100-239.4B, as re-numbered on danuary 10, 1989, provides that all buildings and structures located on lots upon which a bulkhead, concrete wall, rip-rap or similar structure exists and which is adjacent to tidal water bodies other than the Long Island Sound to be set back not less than seventy-five (75) feet. 6. It is the position of the Board that the amount of relief requested for the proposed setback between the bulkhead and the existing building is not substantial, although when considering the proposed setback in relation to the 75-ft. requirement, the setback substantial. The percentage of relief requested for the deck is substantial at 1004 from the required standards. 7. In viewing the history of permits and existing buildings in neighborhood, the following information was found (preexisting of the subject code provision unless otherwise noted below): a) Lot #38.1 - setback 59+- feet from the closest bulkhead; b) Lot #34 - 50+- ft. to outside edge of bulkhead; c) Lot #33 - 60+- ft. to bulkhead/Dawn lagoon d) Lot #28 - 50 ft. to bulkhead (variance obtained in 1986) 'e) Lot #26 - 64 ft. to house now; 50+- ft. to deck f) Lot #20 - 50+- ft. to bulkhead g) Lot #17 - 42 ft. to bulkhead (1977) h) Lot #16 - 40 ft. to swimming pool; 30 ft. to deck. i) Lots #26 and #37 are also under consideration this evening for similar relief. 8. It is also the position of this Board that in considering this application: 'Page '3 - Appl. No. u~23 Matter of DONAL0 BREflH Decision Rendered (a) the relief requested for a setback at 43'8" is not the minimum necessary to afford relief, and there is an alternative to reduce the deck or relocate the step area to gain a greater setback; (b) the relief, as alternatively granted, is similar to those generally existing in the neighborhood, as noted above; (c) the difficulties claimed are uniquely related to ~he property and are personal in nature to the landowners; (d) the relief, as alternatively granted and noted below, would not in turn be adverse to the safety, health, welfare, comfort, convenience or order of the town and neighboring properties; (e) in view of all the above, the interests of justice will be served by denying the relief as requested and granting alternative relief', noted below. Accordingly, on motion by Chairman Goehringer, seconded by Member Dinizio, it was RESOLVED, to DENY the relief, as requested, and to GRANT ALTERNATIVE RELIEF for an unroofed, open deck addition, including all steps, at a setbacks not closer than 45 feet from the bulkhead. Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Dinizio, Wilton and Villa. This resolution was duly adopted. lk · GERARD P GOT~HR I NGC-ER, CHA.,K~MAN DONALD AND JOAN BREHM 1010 Maple Lane, P. O. Box 585 East Ma~on, N. Y. 11939*0585 DONALD AND JOAN BREHM 1010 Maple Lane. P. O. Box 5{35 East Marion, N. Y. 11939-0585 / C?-L~ARAMc,~. ..... L DONALD AND JOAN BREHM 1010 Maple Lane, P. O. Box 585 East Marion, N. Y. 11939-0585 DONALD AND JOAN BREHM 1010 Maple Lane, P. O. Box 585 East Marion, N. Y. 11939-0585 New York State Department of Environmental Conservation Bulldincz ~0---_ SLJbLY. Stony.Brook, New York 11790-2356 Thomas C. Jorllng Commissioner Date: Re: /-~$~'- Based on the information you have submitted, the New York State Department of Environmental Conservation ha% .~etermined that: Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary p'er~its or approvals from other agencies. Very truly yours, Deputy Regional Permit Administrator FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL .... /..el/..~.,..~...~... ~...~.. .......... ...... ~~~.,~...~,.~: PLEASE TAKE NOTICE that your application dated ....~.//-..~. ................... 19 ?,~... ~o~a~o~o~ro~e,~ ~:~:~... ~.~..C~... ~,~; ............... County Tax Map No. 1000 Section ..... ~ ..... Block ....... .,~..... Lot ....~....~ ....... Subdivision ................. Filed Map No ................. Lot No .................. is~et~rRe'',ere~ith a~d di~..provedon the ~ollo~in~ ~ro,nd, . ~.~. . ~I~:.~. .~ . . ~ .: ~. . .~ . . ,., ~,. ~~ ~~~. .~ . . ~ · ..... .... ~.~. ~.~ ...... ~ ........... . .... : . . ~. . .~ ........ ...... : ....... ~ .... ~ . . .~ ~. ~ . ~ :~ ~ · ~.:.~_ .... :~~...~.~::.~..~~,, :._,_. ~, . ........ ~ ~. ,~~~ . . . ~x~~ ........... · ............... RV 1180 BOARD OF APPEALS, TOWN OF SOUTHO~_D In the Matter or the Petition of to the Board of Appeah of the Town nf Sou~hold TO: YOU ARE HEREBY GIVEN NOTICE: NOTICE TO ADJACEI'IT PROPERTY O%PNER 1. That it is the intention of the t~ndersigned to petition the Board of Appeals of the Town of Southold torequest a ~(S,peclal Exception) (Special Permit) (Or_he:) [¢~.£¢].e tho.ice] 2. That the .property which is the subject of the Petition is located adjacent to your pr6perty and is des- That the property which is the subiect of such Petition is located in the following zoning district: $. That the provisions of the Southold Town Zoning Code applicable to the relief sought by the under- signe~l are A~r.i¢].e '~. ~' Eec'c3.on / d O ~.3~', L//~ .... [] Section 280-A, New York To~n Law for approval of access over right(s)-of-way: 6. That within five days from the daze hereof, a written Petition requesting the relief specified above will be flied in the Southold Town Clerk's Office at Main Road Southold, New York and you may then and there examine the same during regular office hours. (5].6) 7~5-1809. 7. Thal before the relief sought may be granted, a public hearing must be held on the matter by the* ~3oard of Appeals; that a notice of such hearing must be published at least five days prior to ,the date of such hearing in the Suffolk Times and in the Long Island Traveler-Matt[tuck Watchman, ne'wspapers published in the Town of Southold and designated for the publication of such notices; that you or your representative have the right to appear and be heard at such hearing· Petitioner Post Office Address [Copy of sketch or plan showing proposal to be attached for convenience purposes~,] PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS ADDRESS STATE OF NEW YORK ) COUNTY OFSUFFOLK) SS.: , residing at , being duly sworn, deposes and say's that on the __ day of .. ,19 , deponent mailed a true copy of the Notice set forth on the re- verse side hereof, directed to each of the above-named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the addresse~ ot' said persons as shown on the current assessment roll of the Town of Soulhold; that said Notices were mailed at the United States Post Of- fice at ; that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this day of ,19 Notary Public (This side does not have to be ~ompleted on form transmitted to adjoining property owners.) Ih,.'~ :ri 1" IIl:;,.I.'l'll ...... 3 SETS OF ?LANS ....... 'FORM NO. 1 SURVEY .......... TOWN OF SOUTFIOLD CIIECK .......... BUILDING DEPARTMENT SE?TlC FO[tN ............. : TOWN HALL TEL.: 765-1802 CALl .......... ',' HALT, TO: · ': .... '-,~,7-~ I:xanlmml . . .~/~ ............ 19 .~'"..~ ^,,,,rove,, ......... , ............ ............................... .... APPLICATION FOR BUILDING PERMIT ~ Date .................. , 19. INSTRUCTIONS a. This application mnst be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit' sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre or areas, and giving a detailed description of layout of property must he drawn on the diagram which is part of this ap cation. c. The work covered by this application may not be commenced before issnance of Building Permit. d. Upon approval of this application, the Bnilding Inspector will issued a Building Permit to the applicant. Such peri shall be kept on the premises available for inspection throughout the work· e. No btfilding shall be occupied or nsed in whole or in part for any purpose whatever until a Certificate of Occupar shall have been granted by the Building Inspector. APPLICATION IS HERI/By MADE to'the Building Departmeut for the issuauce of a Building Permit pnrsuant to i Building Zone Ordinance of the Town of Sou(hold, Suffolk County, New York, and other applicable Laws, Ordinances Regnlations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describt The applicant agrees to comply with all applicable laws, ordinances, buihling code, housing code, and regnlations, and admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) · !~.o?.. ~. ~..9.3,...~t?.{z.49:.~.~.,. pg... ~. ~..9.5¢ ......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bnildc Bu.L.l de.t Name o['owner of pren]ises Dona,Ld Z., B~_ehr~ and 7non Ill. B~eh~ (as on thc tax roll or latest deed) If al)plicant is a corporation, signatnre of duly authorized officer. (Name and title of corporate officer) . ALI, COUTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Ph d~cr s Dcensc No ......................... I:lcctr c an s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work w. ill be done~ ...................................... llnuse Num her Street I [amlet County 'Fax Map No. 1000 Section J.5 Block 05 ....... 27 Sul)tlivJsion ~eat~e~ Po&~ - Se~Zo~ 3 Filed MaI) No. 83-349 Lot 60 (Name) State existing use and occupancy of premises and intended use ami occupancy of proposed construction: a. Existing use and occupancy ~e~d.d~n~&aL/~ne~ Occtt~anc~l .................................. b. Intended use and occnpancy ~*~&de~&o~/Omne~. Occupant(t.'' ~;" ~* ~' · ' *. (;% ct' ) 3. Nature of work (check v/hich applicable): New Building . . .)( .' ..... Addition .......... Alteration .......... Repair .............. Removal .............. Dcmolitioo .............. Other Work ............... (Description) 4. Estimated Cost ...................................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling milts Sdtt~.Le Number of dwelling units on each floor If garage, hum bet of cars Two 6. If business, commercial or alixed occupancy specify nature and extent of each type of usg ..................... 7. D,me,smns al ex,sting structures ifa,y: Fro,~t ... 7.1...5 ...... Rear ...5~.. P ...... Depth .. fi.{..~ ....... lleiglt . . ~ ..... Nm ~ber of Stories .... 5)9~ ............... ; ................... Dimensions of same structure with alteratio,s or additions: Front ... ~.q~qg ......... Rear . . $~qt.~ ........... ' " I ' ' Same Depth. 7~. ~.,.. {q{. 59~.-..A{gOlteieht ..... 0~5. ............ Number of Stories ...................... 8. Dmmnsmns of entire new construction: Front . .* ~ ...... · ..... Rear .... ~ ......... Depth .. ~.{ . .~ ....... Height/if... 24':~3~. ~u,nb*~ or Stories ......................................... . ............... 9. Size or~ot: Front .... .l.q~xqO~ .......... Rear ........ ~, ~.7.' ........ Depth .. ~7~, PT.'/~5~,OO: .... '0. Date of Purchase .... ~{~A. ~7 ................ Nmnc of Former Owner . . . ~Aq4.7r/~ ¢~ .............. : I. Zone or use district in which premises are situated ..................................................... 2. Does proposed constructiou violate any zoniHg law, ordinance or regulation: ~ ..................... 3. Will lot be regraded ....... ~o ................... Will excess fill be removed from premises: Yes No 4. NameofOwnerofpremises I~onadd ,~ ~oan B,teh~ddress 1070 Illa~e Zaae PhoneNo. 477-221~ ..................... ~b~' ~I~6~; ' Ill/ .................. Name of Architect ........................... Address ...... Phone No ......... ~ ~o~ Bo~ r4'~j ........... }'d,~d,~SZ7 ..... Nmne of Contractor .... : ...................... Address ~/at¢~.~eg ...... Phone No. L5. Is this property located within 300 feet of a tidal wetland? *Yes .~.. No ..... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAG--{ Locate clearly and distinctly ~1 boildb]gs, ~vhetber existing or proposed, and. indicate all set-back dimensions from Jroperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or comer lot. '~: FE i,,¢)T',FY ~U~L;.:.!i';:G OEPal]ThfiENT AT., :~5-tF;07 ~T..,':t:l TO 4 F%l FOR TNF_ F,.". ~.! Pr',U,:;F:D ,.~ ' f-."'.'JGi-i - '-,qe, p:~;;\!G 8: ::. f ~ M. '-"::,:?,'F:!tCThn[\~ ~;:: ('Or, F: ?T'F ~'r:~!~ ."' i- 7tF)/,'9,'T',~:it.;TU,.".L~ $i4ALL ;'. ,iET :- :~'?:'"'~qT~:')/Y;';',rs OF TN:.; ,'.!',' ~ ." F'C-$. ,~!QT aESPORSlgLE FOF~ :' :,!.'~t : ,%'; t.:C: t.~::' FRUCTIOt, t 5.t:~_u.c..~;u.¢e. ~:o --.~cre,"-'n. ex4',-o~,/-nq c~n.,/tra.,/- a.,~-'t, c_ortd,.L4:ioner. Said ~truc~t*ae ~o i,¢ 8' urd. dex 6' dee~. x 6~' h.~qh cor~,i,.o.Ci..n.cI o~,, CC_Il ok cedar l(z,t,f_~.c_e. attach, ed to 4 x 4 CC~ ut~ctht 1~o~t4 ar~d hor,i_~ot~.t, ai ATE OF NEW YORK ,UN'fY Ol: .... ..... S.S ......... .~. ?..~. )~ .~...~.~..N~.?.~,~ ................. b~ing duly sworn, deposes and says that Ilo ]~ []lO applicant (Name of individual sig,i,g contract) JVC llalllgd. i, ................ . ....... (Contractor, agent, corporate officer, etc.) ;aid owner or owners, a~d is duly authorized to perform or have performed the said work aod to make arid file this lication; that all statements contaiHed D~ this application are true to the best orhis knowledge and belief; and that the k w/Il be performed in the manner set forth in the application ~lcd tltemwith. rn lo before nit this ~ ............. '5' I'ublic, . ~~unty ~ Y ...... ................. ~L~ ~ ' Si,.alu eof ' ~ARY ~BU~ ~ d K~ ' ' ( g r apphcanO ~. -s. S~dG SURVEY FOR Jx~I~ES IL~_ER ~OT 60, "C~EAVE~ POI~T- SEC~IO~ AT EAST ~WN ~ SO~THOLD SUFFOLK COUNTY, NEW ~RK SURVEY ~ A VI~&TION ~ SECTION TZO9 ~ THE HGUARANT[E~ INDICTED HEREON ~AL~ RUN~LY m H[AL~ DEPARTMENT-OATA F~ APPRO~L TO C~5TRUCT ~ ~R~ ~R WHOM THE 5U~T IS PREPARED YOUNG YOUNG c~wrr o~ ~u~ /~,/st~ as FILE ~0. 4*50 AND ~ND SURVEYOR N.Y.S. UC/NS[ N0.1~84~ SSS xoig '0 'd 'euel ®ldeiltl OTOT I~1H3~8 NVOf OhlV GIVNOG ; I I£./