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HomeMy WebLinkAboutTR-5940A . . 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 Permit No.: 5940A Date of Receipt of Application: June 2, 2004 Applicant: John McFeely SCTM#: 128-2-9.1 Project Location: 5900 Peconic Bay Blvd., Laur~1 Date of Resolutionllssuance: June 24, 2004 Date of Expiration: June 24, 2006 Reviewed by: Trustee Jim King Project Description: To replace the existing 20'X 20' deck with a 24'X 23' deck. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. The issuance of the Administrative Permit allows for the operations as indicated on the attached survey prepared by Howard W. Young last dated March 11, 1983. Special Conditions: None If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the South old Town Code, a Wetland Permit will be required. This is not a determination from any other agency. m..1 tJ. ~ _L. /7. Albert J. Krups{i:Jr~,~ yn. Board of Trustees + I -<>- Z I ~ + .. + + + .." ..#4to.;o' + . ~ g:; "' M ~ . . 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) 765-1692 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD Office Use Only Coastal Erosion Pennit Application ~etland Pennit Application _ Major Minor QIt IIIJ,;' . Waiver/Amendn]l'nt!c.~g:J _~e.ceived Applicat~Q;.. flJl~/lIlJ ~ceived Fee:$ ..~ G'" ...-completed Application ., I. 1'\11 0 Ie C Ie I \VI IE _Incomplete _ SEQRA Classification: Type I_Type II_Vnlisted_ JUN - 2 2004 _ Coordination:( date sent) CAC Referral Sent: ~te ofInspection:~ Ilh/lj Southold Town _Receipt of CAC Report: Board of Trust..s _Lead Agency Deterrnination:_ Technical Review: ~lic Hearing Held: ~ '-'ll!lt Resolution: qt\Oo. 5 Name of Applicant ~ Ja J.I IV . , PEco /'J Ie F. (J1C I3?Y Address G / () 0 " Y) L( ffh t- /:::-EE /....-Y - , 13 t- v...i) Phone Number: ( )6 J/ J. 9t.? 5lf'l-D '-17 SJ'rF9 /;2 cf? -;) -1, I PE~O).) Ie- f3;J Y t5 l I/b Suffolk County Tax Map Number: 1000- Property Location: ?; 9 (J{) (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: . Board . of Trustees Application Land Area (in square feet): GENERAL DATA 3d' ~oo Area Zoning: Previous use of property: PR!v~rf- I/<J n7~ Intended use of property: il /1 Prior permits/approvals for site improvements: Agency 7- tJ f} Date I ~v /, _ 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): / / R13:/' I- (}c ! N ?- ;;0 l')Ec,L (.., I 'T /-I Jlj I Y <~ ~/ . Board . of Trustees Application WETLANDfrRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: I(fP'- 14 C I Iv c j)~cj.c fl-77 &ell!?/) rb do 1.1.s~ 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? ~ No Yes 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: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): . Board of Trustees . Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: f' is- P t- il c E ,FYI> 1/jV? j)EC/ 1J-7 1 &c /; b j) T,1 ;-jtJ '-1.1 r Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? V'. No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? ( 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) /yON€:- . . I 'PROJECT ID NUMBER 1. APPLICANT I SPONSOR 617,20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only (To be completed by Applicant Of Project Sponsor) 2, PROJECT NAME SEQR PART 1 - PROJECT INFORMATION (/ }f IV r-. WI V (7] ~ I?l'-f IDE i<f if .?,k:'- landmarks ete - or provide map 5. IS PROPOSED ACTION: }II) D New o Expansion ~ification I alteration 6. DESCRIBE PROJECT BRIEFLY: , Rer>/...y:}c.(f\JC / r) 7- , Y / ;70 / '"/ ql j)~ C~ h-1711 / J) 6C ft- 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 6. WIll PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? G3Yes D No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY 0R'eSidential D Industrial D Commercial OF PROJECT? (Choose as many as apply.) DAgricu,ture D Park I Forest I Open Space D Other (describe) 10, DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, Stale or local) DYes D No If yes, list agency name and panni! I approval: 11, DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? DYes DNa If yes, list agency name and pennit I approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? []ves D No If the action is a Costal ea, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment I CERTIFY THAT ABOVE IS TRUE TO THE BEST OF P I?F.t. Y MY KNOWLEDGE Date o/J Jj' (J If Applicant Signature . . PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes. coordinate the review process and use the FULL EAF. DYes DNO B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. DYes DNo C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers 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 ftooding problems? Explain briefly: I I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: I I C3. Vegetation or fauna. fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: I I C5. Growth, subsequent development, Of related activities likely to be induced by the proposed action? Explain briefly: I I C6. Long term, short term, cumulative, Of other effects not identified in C1-GS? Explain brieny: I I C7. Other imoacts (includinQ changes in use of either uantity or type of energy? Explain briefly: I I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)7 (If yes, explain briefly: I DYes 0 No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: DYes DNo I I PART III- DETERMINATION OF SIGNIACANCE (To be completed by Agency) INSTRUCTIONS: For each advllfSeeffect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in oonnection with its Ca) setting (Le. urban or rural); Cb) probability of occurring; (c) duration; Cd) irreversibility; Ce) geographic scope; and (f) magnitude, If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination 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 mOfe potentially large or significant adverse impacts which MAYoccur. Then proceed direcUy to the FUL EAF andlor 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 actio WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Pnnt or Type Name of ResponSible OftK:8r In Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Pre parer (If different from responsible officer) . . ~.x NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: JO/1/V F y1JC f~~l. V SCTM# / J r -;1 -1 . I , , YOU ARE HEREBY GNEN NOTICE: 1. That it is the intention ofthe undersigned to request a Permit from the Board of Trustees to: If f ? l Y1 c ~ () C/ ;I- J 0 / j} €- C ,k- vv (7/-/ )3/""f. d Y- / Y~C,k 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: tlOrflf.:. 01- TO}lf'-l F ~ () c 14- T f.--.V 47 C3 'j 06 vP c t:et- t y r'f-c Q/'oJ Ie, B 4Y /11 roO . 3. 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 ofthe Board of Trustees of the Town of South old and does not reference any other agency that might have to review same proposal. OWNERS NAME: ::To /-IllI MAILING ADDRESS: t;'C}OO t-- )4 '-1 r? (3; J- IV Y PHONE #: 6 ~ / ,.) y,p F. yne F~EI-Y P~CO/VIc... A!?Y II 7\1 P ~ 1.1 Y () f31r'!/:) Ene: Copy of sketch or plan showing proposal for your convenience. ~r-&I" . . 7-~ / //_-- PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK , residing at , 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 South old; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this Day of ,20_ Notary Public . . Board of Trustees Application County of Suffolk State of New York BEING DULY SWORN DEPOSES AND AFFIRMS TIIAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND TIIAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND TIIAT 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 THE 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. ? SWORN TO BEFORE ME THIS :::l. DAY OF ublic JOYCE M. WILKINS Notary Public, State of New YOlk No. 4952246, Suffolk County Term Expires June 12, ..1.0 0 '7 -:.j t" ,20~ . . APPLICANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of SouthoJd's Code of Ethics orohibits conflicts of interest on the Dart arroW" officers and emolovees. 1be oumose of this fonn is to orovide information which can alert the town of DOssibJe conflicts of interest and allow it to take whatever action is necessary to avoid same. . YOUR NAME: (Last name, first name, J11iddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) . NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity,) Building Trustee Coastal Erosion Mooring Planning Do you personally (or through your company, spouse, sibling, paren~ or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or bus'iness interest "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 the shares. /' YES NO If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town ofSouthold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee, Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, paren~ or child is (check all that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the appliC\ll1t (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the - applicant is not a corporation); _ C) an officer, director, partner, or employee of the applican~ or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi Signature PrintNam P. VYI Form TS I . .. :-l,t <<J"Y- ~ ... "'t, . .....v. ::t:;,,' 1.0.- CO ~.. 1--.. ~ :r~ ...,;:;: :1:... f-.~ Q:: ~ :E1 Q ,,~. <::> .",0 ...\\G o~'b b ,\~ ~'o ~b GO. ",. q ~~/ // >- :i &.r.> CO . '" o ... ~ - ~ ~ .. ::;;: '" o ... . \ o ~ o ~ '!, ::;;: -,:.. .. -:; M .,., o ... -:; \ . . T4.s'T HOLE. -- 0.0 / ,..~ ...il ..~ 106'" Z.O SAnti '.' ""At." \ ~L& OItlln IIBUIII 1lD'..:r_ ".:r.l~ B. D. RU. #1.3.5tJ-..3.5 the sewase d1ll,,08a1 and 1I'8ter SUPply ~aci1ities tor thi8 100atioD have been J.l1spected by this de~tmeDt and found '.0 It. satistaotory. Sf Oh1et otGer&na~~.~:-" PE, 1I....,,1"... HEALTH DEPARTMENT -DATA FOR APPROIAlL TO CONSTRUC T * NE'REST WAI'Ift .AIN_M'. ~ .. SOURCE OJF WATtft I flftl..n LItUIILIC _ .. ......, co. TAX ..AIt DIll I.WUl IE: C TlON ..nL ILDCK .J2.L LOT .2AL It THEN: AM f<<) DWE.LLI'" WITHI-' 100 FEET 0' n.. '''OPE"n OTHE" THAN THOIr: SHOWN HllltEON. If THE WATlft IU",,"V AM) SE__ OISIIOIAl SVITbI fOft THIS ftOIDENCE WILL CONFO.... TO THI nANDUtOI 0' THE SutrtrQLK COUNTY DE'...TNINT OF HUL TM SERVICES. NPLICAHT. AOOIU SS nL. .a MONUMENT FOUND Dc STAKE AREA TO TIE LINE II 37,310 S. f. * 1ME: LOCATION (II' WlLL(W). SEPTIC TANKeST). CESIPOOLS(CP) IttOWN ""ION ME P1tOII fiELD ~RW.TIClNS AND 0" DATA o.r....D'ffOM OTHE'" , BRA.NOIS & SONS, INC. 1618 o ~. .' , . ~ ffi en ffi c... = :z o ... ~ '0 ~ '!, ...... .,., o M .. '" ... ... - ... - ~ .. Co ... '" .,.. .. ~ .. .. '" "" <:> .. .. "'I\. \ \ , SURVEY FOR JOHN F. Mc FEELY AT LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY. NEW YORK tflJNA,UTHORIZED ALn"ATIOH Oft ADDITION TO THIS SU"V(V . A VIOLATION OIF I(CTIOH 7201 OF THE NEW YO"K 'TAT( (OUCATIOH LAW M cO~ln OF THIS ""'''EY HOT .A..... THE. LAND SUftV(l'OlII'S INKED SEAL 0" [IItIOSSEO SEAL SHALL NOT IE CONSIDEIItlD TO IE: A "ALl D T"U E COpy MGUARANTEEI INDICAT(D HEREON SHALL RUN ONLY 10 THf ~RSOH FOR WHOM THE SU~EY IS P"EPAIUD AND (J\I HIS I(HALF TO THE TITLE CONNNY, GOY(ltN- MENTAL AGENCY AND LtNDIN& INSTITUTION LISTED HDtEOH, "'NO TO THE ASSI8NUS OF THE LENDING INSTITUTION. GUAfIlANT[[S AftE HOT TMNSFER....LE TO "'COITIONAL INSTITUTIONS OR SUIIS[QUfNT OWNERS .. DISTANCES SHOWN HE"EON FROM ~IIIOPERTY LINES TO EXISTIN' ST"UCruftES AftE FOR ... S~[CI'IC ~Ufll~OSE AND ARE HOT TO If USED TO EST....LISH ~ftOPEPtTY LINES OR FOR THE E"[CTIOH r:1f '[HCES ~ ...........~-- = ~ ffi , \ '. t; "'OOq ie~J':J- ~ \G I; O~ / I ~CJ ~ - = = ill ~ ~::&7 <- ~ ~ ~ ~ co DATE' SCALE' NO. !Nt '.~ . - APR..2.a, 198 5 ~ MARrlJ, 1983 I" = 50. 83-119 , " YOUNG 8 YOUNG 400 OSTRANDER AVEMJE RIVERHEAD. NEW YORK ALDEN W. YOUNG, PROFESSIONAL ENGINE ER AND LAND SURVEYOR N.Y..S. UCENSE NO. 12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE NO.45893 \ ~ ~ . lFii1I ~. e... , fi " c:: . z I lFii1I N = --~-- N ~ = = .". lFii1I / . . ~{ ~~ I I , / / / \V 0\4 I,G.'" ~'V. .~.. ..... fl' . J 'eO . ". / ~ " .. <; 1, .. - <; ~ . -::. - <; \ '" " .,.. 0_ ~ ~ ~ ~ ... ~ .. ... .. 'So .. ~ ." " ~ ~ .. \ \ '\ '" //\.// (' Ili~O \ \ \ J-4I8 \ \ (J / ~/\-/ rrSTHtH,E o.D .., ~.:J D.$ IOc4rrt 2.. SAnd '.S ..v 4tet" ~" / \ \ \ ~ \ :;;: ~ C> . '" ... \ . - , , <:> .~ a ~ ~ - '" ~ -::.:. .~ -: ~o ~ _0 .. ~O'l~ .~~, \ o ~\) \/// ~ ~ /; -'~~{)O('/ ./ett.r I; \G --.. Ij Cj~ / / I,\.J Q.V SURVEY FOR JOHN F. Me FEELY s. AT LAUREL TOWN OF SOUTHOLD SUFFOLI< COUNTY I NEW lOfIlI( DATE SC ALE NO. APR. 29, 19E1 5 MAR. II, 1983 I" = 50' 83-119 IfIJNAUTHORIZst> "1....n. 0" AGOITION TO THIS SUltVU a A .,.,...... ,. tECTION 7Z0. <<W TMI HEW yo". 1'Ill'JIit: ~a'l~ 1...... M COt'IU .. .US ~... NOT ...lNt ntl LAND SUAVEYO'''S ~ 0 -.. OJt[MIOSSf:O SEAL SHALL. NOT It: CONI..,.,,1O BE. " YAllO TJtUE COPy NGUAltA-NUES eKll~TEO H[It(ON SMALL AUN ONLY T'O THE Pf]lI$OH FO" ..lItO.. THE SUIINE't' 15 PREPAIHD AND ON HIS ISEHAL'TO THE TITLE CONJlWrr,jy, GOVE,AN- MENTAL AGENCY AND LEHOIHG INSTITUTION LISTED HE..EOfoI, "'NO TO TliE "'SSIGNEEs O~ THE LENDING INSTITUTIQfil GU........NTEES "'RE NOT TRANSFER"'BLE TO "'DO/TlOH"'L INSTITuTIONS OR SUBSEQUENT OWNERS W OIST"'NCES SHOWN HEREON FROM ~ROPERTV LHiffS TOfl(ISTlNG STRUCTIJ"U ...,n,OIIt ... S~[CI'IC PURPOSE "'NO ..."'E filOT TO IE USED TO ESTAILiSH P~PfllltT" LINES OR FO" THE ERECTION OIF ,rENCES HEALTH DEPARTMENT -DATA FOR APPROVAL TO CONSTRUC T N NfAREST WAT'E" ...."\1_..1 ~ N SOURCE OF WAnR ,.,......TE LpU8l.IC_ N Sl.F, CO. TAX iliA,. Dill !..Q.QQ.. SEC TION.B!L 8I..OCf( ....Q.L LOT 09.1 .. THEN: "'M NO DWELL".. WITHIN 100 FEET OF T....' 'ROPfRTV OTHER THAN THOSE SHOWN HItREON .. THE W"'HIIl suP....." AICl Sf""'aE OlSPOl"'L SYSTEM ~ THIS R" I DE He!: Wlt..~> CON'OIlUII TO THE STAHOrAItOI OF THt: SUI"'OI.,J( COVHTl" DfPARHIENT OF H[AL TH IflNlCES ""'LICAHT. AOOlltE IS Tn .= MONUMENT FOUND 0= STAKE AREATO TIE LINE;: 37,310 S.F, . TMf LOCATIQfil OIF WR.L(W),SEPTlC rANK{ST). CfSSl'OOLS(CJI') SHOWH HEIIlOH ME .....ON FIELO oe5ERW,TlQNI AM) Oil OArA O.T.....O I"llrOIII OTHER S 'iRAN[)I., ,<., "'.;'N'" Ir,i' : ',j I' YOUNG a YOUNG 400 OSTRANDER AVENUE RIVER HEAD, NEW YORI< ALDEN W. YOUNG, PROFESSIONAL ENGINE ER ANOLAND SURVEYOR NY.SUCEHSE NO.IZ84~ HOWARD W, YOUNG, LAND SURVEYOR N.Y. S. LICENSE NO. 4~893