HomeMy WebLinkAbout26053-Z FOI[H NO.
TO~N OF .qOUTIlOI.I)
BUll, i)! Iq(; I)F. FARTtlF. tI'F
TOWR Il^IA,
SOUTIIOI.IJ, R.¥. 11971
TEl.: 765- lB02
Di nnppr~r~ed n/c ..................................
Oll BIIII.II]NC FERHI'F
I N.qTlilICT I
BO^ltl) OF IIE^I,TII ...............
3 SETS OF 1FL^blS ...............
Cliff. CE .........................
SEPTIC FOEH ...................
' Dute ...... , 19 ....
u. 'lhi. nlqfiicnti(m -~..t Im conpletely filled |n Iry tyl~.TrJter or in bdt m.1 mfl~[ttml to tim ~m{ldlng ln.~cLor with
;et. of plmm, nco~rnte plot: pl~ to .cnle. Ieee ecconllng I:o nch~kde.
b. I'lot plnn rJ~irg l~.ti~ of lot m*l of I~Hdlngn ~ pronlse., iel~tim~bip to Mjolnlug p~i~e, or ~bl ic
Al'lq,l(~'rl(~ iS IIi~illY }~lli t:o tl~ l~fihllng l~l~rtn~nl: for the J~mm~e o[ n ItlJldl.g Pennlt ~tmmnt to the
ihlil~ 7x.m O~dhm~K:e o[ tl~ 'i~ o[ ~Rhold, ~ffrolk (~x~nty, ~ York, m.I off,er nl~lJc.ble I~., OnlJum~en or
ncr]l~l. ~I~ n~llcnnt u~u to ~fly .ith uti ~l. icnble I~., onli~m~., l~dldlng ~, Im~lng c~l~, m~l
(~qll lng ,xklren~ o[ nl~l. lcnot)
/.
I~'~i~li ~' . ............ II.ii,aa J, ............
I~I.OT I) I A(|IIAI'I
J:lcXJl lill)lx~ll'y Ijl~ll. gJ~(~ ol:r~el: m~l I)h'x:k ip, llJ),et" ¢)f d~Fm~'lptJ(~) ill[:c()lilJnlJ [6) iJ~/.~(l) lll~.J i~l¢.v,,~ fJI i'~(~[ lililll~,*i llJKi h~li(:lil'l:
LINDA J. COOPER
Notary Public, State of New Yor~
Ne. 48225(~3~ Su~o k County ~.~