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Home My WebLink AboutTR-5943 . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE Date: April 24, 2007 # 0193C THIS CERTIFIES that the construction of an addition to the existing dwelling At 915 Lakeside Drive, North, Southold, New York Suffolk County Tax Map # 90-4-6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 06/02/04 pursuant to which Trustees Permit # 5943 Dated 06/24/04. Was issued, and conforms to all of the requirements and conditions ofthe applicable provisions of law. The project for which this certificate is being issued is for the construction of an addition to the existing dwelling. The certificate is issued to Anthonv Graziano owner of the aforesaid property. ~o<~ Authorized Signature AlbertJ. Krupski, president. James King, Vice-President Artie Foste~ ,,'~ ., .-.- . Ken Poliwoda Peggy A. Dickerson . Town Hall 53095 Route 25 P.O. Box 1179 Southold, N;wYork 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-GONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. c:- r-~ ~ ~ q 1'\ 0 INSPECTION SCHEDULE Pre-construction, hay bale line 151 day of construction Yo constructed /' Project complete, compliance inspection.l/Jq/o1 O.~.~ Albert J. Krupski, President James King, Vice-Presiden~. Artie Foster * Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.~. Box 1179 Southold, NewYork 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE __ Pre-construction, hay bale line __ Ist day of construction ¼ constructed __ Project complete, compliance inspection. Board Of $outhold Town Trustees SOUTHOLD, NEW YORK June 24, 2004 DATE: ........................... ISSUED TO ANTHONY GRAZIANO Ant'lfari atian Pursuent to the provisions of Chapter 61~i of Se I-~ws of the State of New York, 1893; and Chapter 404 of fl~e L~ws of the State of New Yo~ 19~2~ end the Sodhold ToWn Ordinen~ ~1~ ."R~U~N~ AND ~E P~CIN~OF OBSTRUC~S IN AND ON TOWN WATERS AND PUBLIC ~DS end REMOVAL OF SAND, G~VEL. OR O~ER ~ATERIA~.~M ~NDS UNDER TOWN WA~RS;~. end in ~ccmden~ w"h 'the Red.ion of ~e Boerd adopted et a meeting held ~ ..~.,.~.~ .... Anthony Graziano Te~s ~nd ~ndlti~s listed on the reve~ slde ~f, of ~uth~d To~' T~es a~horlzes and permi~ ~ fo~o~ng: Wetland Permit to construct an ~ddition ~o the existing dwellin with the condition gutter~ a drywells are.installed to contain ~e roofrun-off, and~ll as deuicted on the plan prepared by chael Macaluso last dated ~uCpst 2.. 20¢~. al in a~dan~ ~ the dete~8~p~cMma~ ~s IN W~S WHERe, %e ~id ~rd ef T~s ~e- by ~s ~ ~afe ~al ~o be a~xed, a~ ~e~.~senh to ~ sub~ by ~'~j~ of ~ ~id ~d as of ~h date. TERMS end CONOITIOHS P~mt _~ee Anthony Graziano 915 Lakeside Dr., North, Southold, ,- - N. Y~ ~ .&]bert J. Krupski, President. James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 June 24,2004 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Mr. Anthony Graziano 915 Lakeside Dr. North Southold, NY 11971 RE: 915 LAKESIDE DR. NORTH, SOUTHOLD SCTM#90-4-6 Dear Mr. Graziano: The Board of Town Trustees took the following action during its regular meeting held on Thursday, June 24, 2004 regarding the above matter: WHEREAS, ANTHONY GRAZIANO applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated June 2, 2004, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 24, 2004, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of ANTHONY GRAZIANO to construct an addition to the existing dwelling, with the condition gutters & drywells are installed to contain the roof run-off, and all as depicted on the plan prepared by Michael Macaluso last dated August 2, 2004. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/Ims . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765.1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: (lft\h,Ort4 0m"2I(lM Please be advised that your application dated 0~~~ reviewed by this Board at the regular meeting of -/d:lIIill. following action was taken: has been and the ~PPlication Approved (see below) L-) Application Denied (see below) L-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: o ~f\Q\ m~pec-\\l)r) - ~ SD ,00 @ reul'~d plo.n-dYLjUJQllS "\-5u+tQ.t5 TOTAL FEES DUE: $ 5/),CD SIGNED: dt~$ 9. ~. t).e PRESIDENT, BOARD OF TRUSTEES I Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tuesday, June 15, 2004, the following recommendation was made: Moved by Don Wilder, seconded by Doris McGreevy, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit application of ANTHONY GRAZlANO to renovate and construct an addition to the existing dwelling. Located: 915 Lakeside Dr. North, Southold. SCTM#90-4-5&6 Vote of Council: Ayes: All Motion Carried Date: August 2, 2004 305 East 46th Street New York, NY 10017-3058 212-355-6555 212-355-6919 ~x email: mjmacaluso@mindspring.com LETTER OF TRANSMITTAL To: From: Re: Mr. Tony Graziano 915 Lakeside Drive North Southold, NY 11971 P: 631.765.9393 Ryan Scipione, Project Manager Graziano Residence 915 Lakeside Drive North Southold, NY 11971 We are sending you: Enclosed X Drawings X Letter Other For Approval As Requested X For Your Use Comments: Project No.: 03086-00 Under Separate Cover X For ReviewAnd Comment Please find enclosed three copies of the revised drawing A-0.1 (dated 8/2/04, "Revised and Reissued to Trustees"). Please call with any questions. k Albert J. Krupski, President James King, Vice-President Artie Fester Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~Coastal Erosion Permit Apptica~ edand Permit Application Major Waiver/Amendracnt/_Cltange s ~-~--~Received Application:..,d~ ~] O~ .__~eceived Fee:$~ ~ ,,.~o'mpleted Applicaffffff- ~,/~-] ~ __Incomplete __SEQRA Classification: Type I Type H Unlisted__ __Coordination:(date sent).~...~.~ ~'~AC Referral Sent: ~]~t g~t. .,-Date of Inspection:~f/ti/_0[~ Receipt of CAC Report: Lead Agency Determination:__ Teeth/cai Review: /'ffublic Hearing Held:~/~ Resolution: JUN - 2 2C)4" Baard o! Ttuste~ s Name of Applicant /t) P/~--~ d> ~-/? Address q/~- /xCLJ~-.~ldg._. 4~1C- ~ /lq '7 / Phone Number:(b,'~/ Suffolk County Tax Map Number: 1000- 02C)--t~4 Cg~'~ ~'~ (provide LILC0 Pole #, dista[ace to cross streets, ant~location)t] AGENT: (If applicable) Address: Phone: OBoard of Trustees Applicat~lon GENERAL DATA Land Area (in square feet): Area Zoning: Previous use of property: Prior permits/approvals for site improvements: Agency Date [/"No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ,./'No Yes If yes, provide explanation: Project Description (use attachments if necessary): ~'h..x~ ~ ~,.I%t~x.~ Board of Trustees Applica~on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~tO~ ~ /2CFT;pd~_/, j,~[ Area of wetlands on lot: [{o,,~'~___ square feet Percent coverage of lot: -'~-"~--[ % Closest distance between nearest existing structure and upland edge of wetlands:~feet Closest distance between nearest proposed structure and upland edge of wetlands:~feet Does the project involve excavation or filling? If yes, how much material will be excavated?~ ~-'-'~--~) cubic yards How much material will be filled? ~ cubic yards Depth of which material will be removed or deposited: % feet Proposed slope throughout the area of operations~-F:~ ~',g., ~--'~.-~ Manner in which material will be removed or deposited: (~'~°--~rQ~'V~ Statement of the effect, if any, on the wetlands and ttdal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): Board of Trustees Applica n COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? Does the project involve excavation or filling? If Yes, how much material will be excavated? ~ (cubic yards) How much material will be filled? ~,t~. (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) PROJECT ID NUMBER PART 1 - PROJECT INFORMATION I1. APPLICANT / SPONSOR (~PROJECT LOCATION: u nicipality 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEVV SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed b ! Applicant or Project Sponsor) 2. PROJECT NAME SEQR 4. PRECISE LOCATION: Street Addess and Road IntersectJo* Prominent landmarks etc -or omvide mad 5. IS PROPOSED ACTION: [~] New ~ Expansion ~)~;~Modh3caflon / alteration 6. DESCRIBE PROJECT BRIEFLY: Initially ~.(}{~"~ acres Uttimataly 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~Yes [] No If no, descdbe bdefly: 9. WHAT IS PRESENT LAND USE IN ViCiNiTY OF PROJECT? (Choose as manyas apply.) ~_ Residential [] Industrial r--] Commercial r-']Agriculture r~ Park / Forest / Open Space [~ Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ]Yes [~No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes r~No ff yes, list agency name and permit / approval: I/' CERTIFY THAT THE INFORMATION PROVIDED .ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE / Sponsor~,~,¥' /'~ .~/t ,'9 2 ~ '~'~) Date: Applicant If t n ostal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART 11 - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY 'tYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. [~Yes r'~No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answem may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aestheticl agricult~ral,';~cl~e~iogical, histmtc, or other natural or cultural ~sources; or community or neighborhood character? Explain bdefly: C3. Vegotetio~ Er fauna, fish. shelifish or wildltta apocles, sign~,'icant habltets, or threstened or andang&md ap~iss? Explain C4. A commune's existing ~ian$ or goals as offmlall¥ adopted, or a ~l~ange in use or intensiht of u~e of I~nd or other n~t~ml r~'o~r~? ~xpl~in DS. Grow~. subsequent d~velopment, or related activities Ii,ely to bo Induced by the preposod action? Explain b~fly: C6. Long tem~. shod t~rm. cumulative, or other sffect~ not iden~d In C~4957 E~lain br~fly: C7'. Other impacts (includin~ ~han~les in use of either quantity or t~e of ene~l~'? Ex~lain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. IS THERE, OR IS THERE LIKELY TO BEI CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ~'es ex~31ain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified a pove, determine whether it is substantial, large, imporlant or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) reagnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse i repacts have been identified and adequately addressed. If question d of part ii was checked yes, the detarreination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially la~ga or significant adverse Impacts which MAY occur. Then proceed directly te the FULl EAF and/~r prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actior WiLL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons suppo~ng thi! determination. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, ~-~ z'z//~, residing at r /1571 being duly sworn, depose and say: That on th~ ~a.y of .~j~, 200 , I pe,rsonally posted the property known as by placin~of T~~~ster-where it can e~ily be seen, ~d that I have checked to be sure the poster has remained in place for ei~t days prior to the date of the public he~ng. Date ofhemng noted thereon to be held ' ,. ~ . Dated: (si~7{ature) ~/ Sworn to 1;}.efore me this day of~ 200¢ N~rY l~blic ' JOYCE M. WILKIN$ Noterv Public, State of Now York No. 4952246, Suffolk County Term ~ir~ Jun~ 1~.7L O O'~ NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: SCTM# YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trastees /Go S 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: . You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. ~L/9/ 5'373 Enc: Copy of sketch or plan showing proposal for your convenience. Board of Trustees Appli~ion County of Suffolk State of New York TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD ~ TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. j SWORN TO BEFORE ME THIS DAY OF ~ JOYCE M. WILKINS Notew Public, State of New Yo~ No. 4952246, Suffolk County Term Expires June 12, 0~0 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics Drohthit~ conflicts of interest on the tort of town officem and anlolove~. Tho ouroo~ of this form is to orovide in forination which can alert the town of oossible conflicts of interazt and allow it to lake whatever action is (Lost n a~e, fi~ hame, ~iddle initial,'unless y6u ar* applying in the name of someone else or other entity, such az a company. If so, in dic~/e, the other person's or company's name.) NAME OF APPLICATION: (Chack all that apply.) Tax grievance Building Variance Trus~ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent' or child) have a r~l~onship with any officer or employee of the Town of Soathold? ~Relafionship" includes by blood, marriage, or business int~res~ "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5%.of~haraz. YES NO If you answered "YES", complete the balance of this form and da~ and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(thc applicant/agent/represc ntative) and thc town officer or employee. Either check the appropriate line A) through D) and/or describe in thc space provided. The town officer or employee or his or her spouse, sibling, parent, or ~hild is (check all that apply): A) the owner of greator than 5% oftha shares of the corporate stock of the applic4mt (when tho applicant is a corporation); __B) the legal or ~en~ficial own~ of any interc~ in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, partner, or employee of the applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted this ~~f~ ~ 200 ~ SignaU_,r~.~----"77-...t,"7~.~......t.d.,c--t . , lr ['- ['- ['- t:l Ul Ul <0 U.S. Postal Service"" CERTIFIED MAIL" RECEIPT. (Domestic Mail Only; No Insurance Coverage ~ided) Postage $ ..... o Certified Fee t:l o Return Reclept Fee (Endorsement Required) o Restricted Delivery Fee M (Endorsement Required) ..... rn 2.30 1. 75 )F MAILING OF NOTICE ERTIFIED MAIL RECEIPTS Address: .... /-7;-80--- ()4w~ c..+ ~~JcL ))'1 II 'J t 1 ~ ~R:lYes~-rriJel~ pO /OcJ/.CJIS: l'li ~ M-)0<'/S'a w1-h l) <'L. AY Y I J 9"7 I ~ QE,,'.-l~ ^' t.1l'-{ / i7 / - U5C4.. -f/ot'~ ~ (lcJ.h.:~ Urlfer; tJ'j /0.5/( STATE OF NEW YORK COUNTY OF SUFFOLK ~ ~aJ'1Jz-z.J~eSidingat q/0 ha.J:1;;8/cf; -6,L N . 0 0 I -' Yj, being duly sworn, deposes and says that on the day of ,20_, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southo1d; that said Notices were mailed at the United States Post Office at , that said Notices were ~ to each of said persons by (certified) (registered) mail. /,,/- C,/.-'/" ~ JOYCE M. WILKINS NotMy Public. State of New Vellt No, 4962246. Suffolk Countv Term ElcpirelJune 12. .;tOO / rT1 .:r- .-'l ..n ['- .:r- Ll1 '" U.S. Postal Service"" CERTIFIED MAIL", RECEIP. (Domestic Mail Only; No Insurance Coverage Provided) u. .-'l o o o Retum Recfept Fee (Endorsement RequIred) o Resbicted Delivery Fee M (Endorsement Required) .-'l rT1 Postage $ Certified Fee 2.30 1.75 IF MAILING OF NOTICE ERTIFIED MAIL RECEIPTS Total Postage & Fees $ 4.42 rT1 ~ ___" ^-'l~rj v(.ww ['- ~1:J:i}~~:;m. '7JJ-'(Ji;IJ~-Cl''''..---------''h--- CitY.'siB..::tip."-- -mm..------------i/m .{(""f:.:,.,-------.--.------. :11 II Address: u ~ f) 0 tJcdtaJ (Tt) cL c.+- s~/L JJY/lq7/ ----- ..---- --- fh~ ~esl ~~j{)e-/~ .--' ------- -----' j2r~-;$.-- /I1EC(1 ,/0 ~CJ;t q 1S & u:::::J--h {) L cL. /J Y II q -0 / 0 I -"2c2C. I!vrfow IlL (J?>+~ t/.,ffeH ~ (// (jJ . { STATE OF NEW YORK COUNTY OF SUFFOLK 1l,N~ ~ r<:l-u.:nf\:siding at 910 Aa..& .s, J .lL. JJ~l'f_ lS6 IL~ ~ . y /lcnI , being duly sworn, deposes and says that on the day of ,20_, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment ro)l,ofthe Town of S<}Ithold; that said Notices ~ailed at the United States Post Office at '::::6 ~ t-+ ~ that said Notice,s.-were mailed to each of said persons by (certified)(registered) mail. ,,/ -,,/- L "- L/ ( J ~~ Sworn to ~r~~e ~s ~ D~of 20~ ik~ Notary Public JOYCE M. WILKINS" Notary Public, State of New YOIle No, 4952246, Suffolk County Term Expir88 June 12. ::l 00 7 ..D '" I'- I'- U.S. Postal Service," CERTIFIED MAli ~" RECEIPT.. (Domestic Mail Only; No Insurance Coverage vided) I~ :'" I,., 10 10 ;1 0 Return Reciept Fee :1 (Endorsement RequIred) il 0 Aestrlcted Delivery Fee II r-=t (Endorsement Required) ,''' 11m if Tota! Postage & Fees $ 1m ! 0 entTo A7 il 0 ---V~ A>c:1U<->-" Ii r'- ~!.~~~~;~~~~~""16"""""""""""-----------'------ I: C""State,ZI m~~iln~m nnin(flnmnnmnnnm- !I 'I I " I :1 Postage $ O.J7 Certified Fee 2.30 1. 75 IF MAILING OF NOTICE mTIFlED MAIL RECEIPTS 4.42 () Address: 014 j) cT DIet. IJ'/ //971 (Yo 100;< q IS 00 LV+hO) cL fi} I 101 73<:2<.. ~ ~-;;/4-(lef (Vi /" Jrn ~ E,eN e..8 T S Ch 11 eJ -clu.J ( Pt\cI'C"t'-ry 70 Se>J~) 11<::;71 ~ et/NQ., fJ1 (p~, p M/',d) . .- (e'; 71 STATE OF NEW YORK COUNTY OF SUFFOLK 11/'1';' of'/- (b)'1Q "7-JCL-nbresiding fit c;i 6 Aa..}:..e:s "lL ,6;(>> 8()~hlJ 1'-- JJ Y / I 9 '7 J , being duly sworn. deposes and says that on the . },.-- day of ~\v l0e , 20rt. deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southo1d; that said Notices were mailed at the United States Post Office at ~JU.iA fJ J . that said Notices were mailed to each of said persons by (certified) (registered) m 1. _____--- ~ ! JOYCE M. WILKINS Notary Public. SIBte of Naw York No_ 4952246. Suffolk County Tarm Expir.. June 12, d.-O 0)