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Home My WebLink About19801-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPAN~f No Z-20739 Date MAY 19~ 1992 THIS CERTIFIES that the building. ACCESSORY Location of Property 1673 ROW OFF ROCKY POINT RO. EAST MARION, N.Y. House No. Street Hamlet County Tax Map No, 1000 Section 31 Block 2 Lot 10.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Building Permit No. APRIL 15~ 1991 pursuant to which dated APRIL 23~ 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificat~ is issued is ACCESSORY NON-HABITABLE GARAGE (FARM TRACTOR SHED) AS BUILT AND TO CONDITIONS OF ZBA #4004. The certificate is issued ho DAVID J. VERITY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A // ~uil ding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20740 Date MAY 19, 1992 THIS CERTIFIES that the building ACCESSORY Location of Property 1673 ROW OFF ROCKY pOINT ROAD House No. Street County Tax Map No. 1000 Section 31 Block 2 Subdivision Filed Map No. EAST MARION, N.Y. , Hamlet Lot 10.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 15, 1991 pursuant to which Buildin§ Permit No..1980]-~ dated APRIL 23~ 199% was issued, and conforms to all of the requirements of ~he applicable provisions of the law. The occupancy for which this certificate is issued J.s ACCESSORY STO~AGE TRUCK BODY AS BUILY & AS TO CONDITIONS OF ZBA #4004. The certificate is issued to DAVID J. VERITY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEAI,THAPPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ~'~~/~u~ldi~inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 19801 Z Permission is hereby granted to: , · ..~-~..~ ..................... , *~.~7.~ ...... ~_~..~....~ ......... ~~~_~...~... ....... ....................................... ~ ~"' ............................................. ~.~ ........ ~~ ............................................................... co,,~ T., ~o, No. ~000 Sec~o, ........ ~ ....... ,,~* ........... .~. .... ~o~,o....~....~.... to d -~ ~'~ ot.d ...~ .................... pursuant application ,~ ~-~, ~/'//~/~'/ Building Inspector. Fee and approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept, of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industriai building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual 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 shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.OO 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ......... ........ New Construction ........... O*d Or Pre-exist%ng Building ................. ...... ....... Location of Property.' .................... House No. Street Hamlet o ,,r o, o, er .......... . ................................... .. County Tax Hap ~o 1000, Section ..... .~.~ ..... Block ................ Lot ................ Subdivision .................................... Filed Map ............ Lot~'. .................... ............. Permit N~ /~) / . .Date Of Permit ......... Applicant .............. ~.~ ....... Health Dept. Approval..i...~.~..~. ................ Underwriters Approval ...... .~..~. .............. Planning Board Approval ...... ~//.~. .......... Request for: Temporary Certificate... !i'Final Certicate... Fee Submitted: $ ...... Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~ALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual 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 shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, C~mm~rcial iiiiii Date ........... -~./../~ ./..?./ .............. New Construction .... ¥...... Old Or Pre e isting Build ....... House No. Street Hamlet Onwer or Owners of Property .......... b ?.>,,. 5. ..................................... IO County Tax Map No 1000, Section ..... ~..! ...... Block...~.. .......... Lot ......... '.g .......... Subdivision .................................... Filled Map ............ Lot ...................... Permit No. Aff.~. / ...... Date Of Permit...~,l~..~?.'/. .... Applicant...~.~.~..~..~.: .~?.~.t.~. ......... .~../.~. ....... Underwriters Approval... /~. ~. ~. ............. Health Dept. Approval .......... io~ iii ..... Request for: Temporary Certificate ........... Final Certicate.~v-~. Fee Submitted: $ ..........~' '~'~' ~' ..... ~p~C~ ......... .................. APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman Charles Gfigonis, Jr. Serge Doyen, Jr. James Dinizio, Jr. Robert A. Villa Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF $OUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 DELIBERATIONS/DECISION: ACTION OF THE BOARD OF APPEALS Appeal No. 4004: Application of DAVID J. VERITY. Variance to the Zoning Ordinance, Article IIIA, Section 100-30A.4 for permission to locate accessory (garage and shed) buildings in areas other than the required rear yard. Location of Property: 1673 Right-of- Way located off the easterly side of Rocky Point Road, East Marion, NY; County Tax Map Parcel No. 1000-31-02-010.002. WHEREAS, a public hearing was held on February 22, 1991, at which time all those who desired to be heard were heard, and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, Board Members have personally viewed and are familiar with the premises in question, its present zoning, the surrounding areas; and and WHEREAS, the Board made the following findings of fact: 1. The premises in question is located along the easterly side of-R~0cky Point Road, East Marion, Town of Southold, and is referred to as Lot 3 on the Minor Subdivision Map for Kimon and Woodene Retzos. 2. The subject premises contains a total lot area of 40,000 square feet and is improved with a 16.6 ft x 29 ft. nonhabitable garage structure and unhabitable 8.2 ft. x 16.2 ft. storage shed. At the present time, no dwelling exists on this lot, although a previous building permit (~15834) was issued for a new dwelling but has since expired. Page 2 - Appl. No.14004 Matter of DAVID J.!VERITY Decision Rendered March 8, 1991 3. The accessory storage buildings, which are both the subject of this ap~eat application, are located 7.1 feet and 35.3 feet respectively from the westerly property line, and more particularly shownion the survey updated March 28, 1990 prepared by Peconic Surveyors. 4. Article III-A, Section 100-30A.4 from the R-40 District provision~ of the Zoning Code allows accessory buildinqs to be located in the required rear yard area, but does not provide for accessory buildings to be located in any other yard area. This provision also did require accessory buildings to be set back notlless than 20 feet from any lot line at the time of the filing,of this application; however, this provision was amended by Local Law #2-1991 (effective 3/2/91) requiring not less than 10 feet from any lot line, for lots containing from 40,000 to 79,999 sq. ft. in area. 5. It is thelposition of the board that the location requested is not unreasonable and it that area which would normally be deemed~.a rear yard if a new principal dwelling structure were located as required by code (similar to that applied for under permit No. 15834Z, which has since expired). Also, there is no alternative location to place the accessory building in any ot~er yard area at this time without a variance. 6. In considering this application, the Board finds and determines: : (a) tha~ the circumstances of this application are uniquely related tQ the land and are not personal to the landowner; ~ (b) that there is no other method feasible for appellants to purs6e other than a variance; (c) tha~ the area chosen for the accessory structure is not unreasonably located; (d) tha~ the variance will not in turn cause a substantial effect!on the safety, health, welfare, comfort, convenience and/orlorder of the Town; (e) that in carefully considering the record and all the above factors, ithe interests of justice will be served by granting the variance, as applied and conditionally noted below. Page 3 -Appl. No. 4004 Matter of DAVID J. VERITY Decision Rendered March 8, 1991 Accordingly, on motion by Mr. Grigonis, seconded by Mr. Doyen, it was RESOLVED, to GRANT a Variance in the Matter of the Application of DAVID J. VERITY as applied under Appeal No. 4004 for the placement of the accessory buildings, as applied and SUBJECT TO THE FOLLOWING CONDITIONS: i. That the accessory buildings remain in their present position~ 2. That the subject accessory buildings not be relocated (except in the required rear yard), converted or increased in size and as an accessory building not be used for habitable, sleeping or business purposes; That there be no plumbing and no electrical facilitie 4. That the accessory buildings be used for accessory storage purposes only. Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Grigonis, Dinizio and Villa, consisting of the entire board. This resolution was duly adopted . lk ~ZGERARD P. GOEHRINGERJCHAIP/4AN FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDIT!Oi COMMENTS: I° VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD March 12, 1990 Mr. David Verity Shipyard Lane East Marion, N.Y. 11939 Re: Building Permits 15834-Z, 16528Z, & 16762Z i672 Rocky Point ~oad, East Marion, N.Y. Suffolk County Tax Map ~1000-31-02-10.2 Dear Mr. Verity: According to our records the above permits have expired. Construction for permit ~15834Z was never started. In order to construct a new dwelling a new permit and Suffolk County Health approval will be needed before construction is started. Permit ~16528Z for the shed is in need of a survey showing the exact location of the shed to determine if the setbacks are met for a principal building. A Certificate of Occupancy cannot be issued until the location is verified to meet the setbacks. Permit ~16762Z must be reapplied for before any work can be done on the garage. In order to avoid legal action you must contact the Building Department to resolve these matters. Thank you for your cooperation. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Vincent R. Wieczorek, Ordinance Inspector FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date ~IARCH 12 19...9...0.. MR. DAVID VERITY SltlPYARD LANE (owner or authorized agent of owner) EAST I~IARION~. N.Y. I ]939 (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation ar: Zoning Ordinance CltAP. 100 Other Applicable Laws, Ordinances-'ar Regulations ............................................ at premises hereinafter described in that A (state character af violation) ,iobtio, of ......... 00-28 (State section or paragraph ofapplicable ................................................................................... law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED ta Comply with the law and ta remedy the conditions above mentioned The premises to which this ORDER TO REMEDY VIOLATION refers are situated at 1672 ROCKY POINT RD., EAST ~iARION... ................................................................................. t..ounty of Suffolk, New 'fork. SUFFOLK COUNTY TAX HAP # 1000-31-02-10.2 Failure to remedy the conditions aforesaid and to comply wilh the applicable provisions of Iow may constitute an offense punishable by fine or imprisonment or both. VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 12, 1990 Mr. David Verity Shipyard Lane East Marion, N.Y. 11939 Re: Building Permits %15834-Z,16528-Z & 1672 Rocky Point Road, East Marion, N.Y. Suff. Co. Tax Map ~1000-31-02-10.2 16762-Z Dear Mr. Verity: Please contact the building department at once for suggested method of resolving your zoning violation. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. TJF:gar Thomas J. Fisher Building Inspector FORM NO. 3 TOWN OF SOUTItOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL ? ·..~..~., PLEASE TAKE NO~TICE that your application dated .~. ~..~.~O..~.O~.40~4~'. ~19 ~ County Tax Map No. I000 Section ... ~...' .... Block ...~. ........ rot ... JOx..~... Subdivision ................. Filed Map No ................. Lot No... ' ......... is returned Imrewith and disapproYed on the following ,,rounds.. ~/~.~.~. ~~~. -,~ , .-- ~- ° ~ .... /- ....... , ~ ."~, .. . X~ ~ /o~ ~.. ~~ ......... . .~, .~... ~ ....... ~J... ~. ~..,.~. .... ...... .~~..~ ........................................ ............ ~~... ~..~. ~..~~.. :: RV 1/80 KIMON RETzo$ Et WOODENE RETZo$ ; 0.4* ~/o/~ GEoRGE i, tlETR OPOULOS [ dwethi~CJ) CERTIFIED TO : TITLE U.S.A. INSURANCE CORPORATION OF NEW YORK DAVID d. VERITY N/O/F KIMON RETzos El WOOOENE RETZos LOT 2 LoT 14. 64' AREA = 40, 158 SO, FT. (5~6) R 0 . BOX 909 MAIN ROAD SOUTHOLD , N.Y. 11971 $. 85° 3:5 0 · ~o.?__.~ ~* 40_~°24' RIGHT OF wAY._%~ ~ ~ ESTATE N/O/ F G.S. NowELL LOT NUM~RS REFER SUBDIVISION FOR KIMON WOODENE RETZOS SURVEY FOR DAVID d. VERITY AT EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY , N.Y I000 31 02 ' P / O lO SCALE I" ~ 50" JULY 17, NOV. 6, 1986 March ~8, 1990 (u,c,) NO, 49668 TO MINOR TEST HOLE .0 /o O.r'o 2.' 4' 5 ~8' BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : /OWN HALL $OUTHOLD, N.Y. 11971 NOTIFY CALL ................ MAIL TO: , ~/ TEL.: 765-1803 Examined...~.'./. ~.~..D ...... , 19 Approved.. .. /' ~ ~ X (Building ~nspecto~ ~-[~ ~- ,-~'~ ~ ~ APPLICATION FOR BUILDINGPER~IT / a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall b~ 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 oia Southold, Suffolk County, New York, and other applicable Laws, 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 all applicable laws, ordinances, building co,~e, housing cod/e, and regulations, and to admit authorized inspectors on premises and in building fm~necessary inspectionffr./__~ /? Z/~/,~ .......... .L~. ~.~. . Z/~.<~.X¢l ............... (Signature of applica~nt, or namel~f a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .. .................................................................. ~ ~ . , ...................................... Name of owner of premises ...... .~ ........... .~.....~..q-.~..1 .~.7. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ....... t~.t4.)...~..~.) .~. ....... Electrician s License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done'. .... /..~.. ~ .~. .... ~ .O.. '.o~. .... .~..o.~..k..x[. ~..~...~...~... ..... ...... ..... /../..?.3..?, ...................................... House Number Street Hamlet County Tax Map No. 1000 Section ...... ~...]. ........ Block ...... .O. 2 ....... Lot... ?/o.... ].0. ...... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Ex~stmg' ' use and occupancy ........ .~.~.~ .~.~..' ' .¢.~.~. ~ b Intended t se and occupancy [Oc~oc~~'S 'it~t~..~X.~ .~. ,~ ................................... '~./ttqefr'o~-"St~tecO~: qcf~A~r~ z///'~F~//~ '~l~,'" 3. Nature of work 'check which a-'qicable" New Bufldin t vP J. g .......... Addition .......... Alteration ....... ,~.. Repmr .............. ~m~v~l .............. D~molifio~ ............. O~ Wo~ d..' 4. Estimated Cost ...... ~ ~ ................... Fee .................................... ~.: ~ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage, number of c~s .... ~ ........................................... ..................... 6. If business, commercial or mixed occupancy, specify natuze and extent of each ty~e of use ........... ~ ......... 7. Dimensionsofex~sti~gstmcture~s if any Front .... ~4J~ .... Rear .~. ...... De~th ~ ..... Height ...... /.*r ..... Number of Stories ..... '. ................................ '. ..... ~. ~.. ~. ~.. D~ensions'of same structure w~th alterations or additions: Front ................. Rear .................. Depth .................... j.. HeiSt .............. y ........ Number o~/S$ofies ............. ~ ........ Dimensions of en[~new const~ction: Front .... ~. .... Rear...~.~. ...... Depth ...~ .......... Height ..... /.4 ~ ...... Number of Stories ................. . .................................. Sizeoflot Front ~a~ .......... Rear ..... ~.~?~ ..... J2 D~pth ...~/Y~ ........ 10. Date of Purchase ............ dO~ ......... '. Name of Fomer Owner .... ~/~. 11. Zone or use district in which pr~mises are situated ................................................ 12. Does proposed construction violate ~ny zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... !..~ 0 .............. Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises . ,~.~9)¢. ~,~.{~JJ... Address .~*~.~. ~!~p~g.t.~Phone No.. 97.~ ..... Name of Architect .......... : ................. Address ................... Phone No ................ Nme of Contractor ........ ~ ................. Address .... : .............. Phone No ................ 15. Is this property loeatedlwithin 300 feet of a tidal wegland? *Yes ..... *If yes, Southold To~ TrUstees Permit maybe required.' PLOT DIAG~M Locate clearly ~d distinctly ~1~ bu~d~gs, whether existing or proposed, an& indicate ~1 set-back d~ensions from property ~nes. Give street and blockinumber or desc~ption accord~g to deed, ~d show street names and indicate whether. inte~or or~ , O ,OUPA CY! USE UNLAWFUL WffHOUT C RTIF]CAT£ OF OCCUPA CY STATE OF NEW YORK, ' S.S COUNTY OF ................. 765-~802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION '~0 REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL CONSTRUCTION MUST ~E COMPLETE FOR C,O. ALL CONSTRUCTION SHALL THE REQUIREMENTS OF THE N.~ STATE CONSTRU~ION & ENERGY CODES. N~ RESPONSIBLE FOR ~ESIGN 0R CONSTRUCTION ERRORS ............................ i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigping contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dqly 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 mannler set forth in the application filed therewith. Sworn to before me this ............... · ~. day~f...~ ....... ............ 19'~''. · .~..4~..~..~ Notary Public ...... ~ff,.~.... ~.... ~).t.....~.~..Coun HELEN IL DE; WE .... ............... NOTARY PUBLIC, Stat~ of New Ymk ' ' ' ~ .... (Signature of applicant) No. 4707878. Suff01k Ceunty~,, Term Expires hc~uch