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-1(. r j'„/'l P_NAUTHORILED ALTERATION OR ADDITIOPA
10 THIS SURVEY IS A VIOLATION OF
i �^, SECTION 7209 OF THE-NEW YORK STATE
f 1F '•�Y� .~ir SSE�i�f r C G! IDUCATION LAW. r..'�•s �a pC I
) POPIES OF THIS SURVEY MAP NOT BEARING
Cty y b'vfl(t+�' c(1:q--vor7( "1<t 't't,�THE LAND SURVEYOR'S iM(LD SEAL OR e
s
�-• L� ,-•, f EMBOSSED SEAL SHALL NOT BE CONSIDERED +
0 t j ''j _ ._Io. 'cla, 1t i
' , ) TO BE A VALID TRUE COP'!.
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GUARANTEES INDICATED :IEREON SHALL RUN •f 1
4 rL7! i rk :,�f;�J+;i v/✓ .�1�, �. ,A C1 1^iCb(j ONLY TO THE PERSON FOR WHOM THE SURVEY ,
IS PREPARED, AND ON HIS BEHALF TO THE H•''� �'�`i t , f~*�� J
i�yt'C $�F"(vC3r •' _ ��S f +�+;., TITLE COMPANY, GOVERNMENTAL AGENCY AND ;;7 ' /
f J LENDING INSTITUTIOPI LISTED HEREON,AND �✓
N-L - TO THE ASSIGNEES OF THE LENDING INSTt- ---------- ----•---_.._._..:__..__._____..__,__._ -._._,_
RABLE
+,. -t-tizi-T( 1-C,YK N1CY�a Li';ji I-r•..GI iC`l:' TUTION. ZONAL INSTITUTIONS
UTIONS OR SUPFEQUEW fc.E_'1- `i L_•:YttCi t"•�'C'c..(- +Yr
� FO ADDITIONAL INSTITUTIONS OR SUBSEOUENI ,
OWNERS. Hip l�,t✓'L ! v�
� EF�LK
P
ISILD
01 �
Southold, N.Y. 11971
HENRY E.RAYNOR,Jr., Chairman TELEPHONE
JAMES WALL 765-1938
BENNETT ORLOWSKI,Jr.
GEORGE RITCHIE LATHAM,Jr.
WILUAM F.MULLEN,Jr.
November 9 , 1982
Ms. Olga Lomaga
P.O. Box 386
Mattituck, New York 11952
Dear Ms . Lomaga:
The following actions were taken by the Southold Town Planning Board,
Monday, November 8 , 1982 .
RESOLVED that the Southold Town Planning Board declare itself lead
agency in regard to the State Environmental Quality Review Act in
the matter of the minor subdivision of Olga Lomaga, located at
Mattituck. An initial determination of nonsignificance has been made.
RESOLVED that the Southold Town Planning Board approve a set-off
( 106-13) as designated on the subdivision map of Olga Lomaga, dated
July 9 , 1982 and amended August 25 , 1982 , located at Mattituck, sub-
ject to completion of the State Environmental Quality Review Act and
receipt of the filing fee in the amount of $50.
Please forward six (6) copies of the above map to our office for neces-
sary referrals under the State Environmental Quality Review Act. When
the above conditions have been met, the Chairman will endorse approval;
two copies will be returned to you for your records .
If you have any questions concerning the above, please feel free to
contact our office.
Very truly yours ,
HENRY E. RAYNOR, JR. , CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Susan E. Long, Secretary
MINOR SUBDIVISION /
1. 6 copies sketch plan received
spot elevations
sent to Planning Board
2. Meet with Planning Board
3 . Required changes sent in writing
4 . New submission received
5 . Approval of sketch plan
6 . Sent letter with resolution approving
7 . Application and fee
If corporation, affidavit of ownership
6 copies of final map
Covenants and restrictions
Description of property
Note on plat that sanitation ans water facilities
meet County Board of Health specifications
Developer attend meeting (official submission)
8 . Public Hearing (within 45 days)
Advertised Affidavits of publication received
9 . Action by Planning Board (within 45 days)
10. Sent to County Planning Commission
Received County' s recommendations
11. Filed covenants and restrictions received
12 . Authorization and signing of map
1 �
EFO
TP
ID�+Yp!
Southold, N.Y. 11971
HENRY E.RAYNOR,Jr.,Chairman TELEPHONE
JAMES WALL NEGATIVE DECLARATION 765-1938
BENNETT ORLOWSKI,Jr.
GEORGE RITCHIE LATHAM,Jr. January 10, 1983
WILLIAM F.MULLEN,Jr.
Pursuant to Article 8 of the Environmental Conservation Law
State Environmental Quality Review Act and 6NYCRR Part 617 , Section
617 . 10 and Chapter 44 of the Code of the Town of Southold, notice is
hereby given that Southold Town Planning Board as lead agency for
the action described below has determined that the project will not
have a significant effect on the environment.
DESCRIPTION OF ACTION
The minor subdivision of Olga Lomaga is a two-lot subdivision
located at Mattituck.
The project has been determined not to have a significant
effect on the environment for the following reasons :
An environmental assessment has been submitted which
indicated that no significant adverse effects to the
environment were likely to occur should the project
be implemented as planned.
Because there has been no response in the allotted time
from the New York State Department of Environmental
Conservation it is assumed that there is no objection
nor comments by that agency.
Because there has been no response in the allotted time
from the Suffolk County Department of Health Services
it is assumed that there is no objection nor comments
by that agency.
The project will meet all the requirements of the Code
of the Town of Southold Subdivision of Land Regulations .
Further information can be obtained by contacting Mrs . Susan E . Long,
Secretary, Southold Town Planning Board, Main Road, Southold, New York
11971
Copies mailed to the following:
Robert Flack, DEC Commissioner
NYS, DEC at Stony Brook
Suffolk County Dept. Health Services
Suffolk County Planning Commission
William R. Pell, III
Olga Lomaga, applicant
raFO� „ -PNF U�L 4'
TCl�
O S0UT Q D
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rFO K sCs0 Ty
Southold, N.Y. 11971
HENRY E.RAYNOR,Jr.,Chairman TELEPHONE
JAMES WALL NEGATIVE DECLARATION 765-1938
BENNETT ORLOWSKI,Jr.
GEORGE RITCHIE LATHAM,Jr. January 10, 1983
WILLIAM F.MULLEN,Jr.
Pursuant to Article 8 of the Environmental Conservation Law
State Environmental Qualitv Review Act and 6NYCRR Part 617 , Section
617 . 10 and Chapter 44 of the Code of the Town of Southold, notice is
hereby given that Southold Town Planning Board as lead agency for
the action described below has determined that the project will not
have a significant effect on the environment.
DESCRIPTION OF ACTION
The minor subdivision of Olga Lomaga is a two-lot subdivision
located at Mattituck.
The project has been determined not to have a significant
effect on the environment for the following reasons :
An environmental assessment has been submitted which
indicated that no significant adverse effects to the
environment were likely to occur should the project
be implemented as planned.
Because there has been no response in the allotted time
from the New York State Department of Environmental
Conservation it is assumed that there is no objection
nor comments by that agency.
Because there has been no response in the allotted time
from the Suffolk County Department of Health Services
it is assumed that there is no objection nor comments
by that agency.
The project will meet all the requirements of the Code
of the Town of Southold Subdivision of Land Regulations .
Further information can he obtained by contacting Mrs . Susan E . Long,
Secretary, Southold Town Planning Board, Main Road, Southold, New York
11971
Ccpies mailed to the following:
Robert Flack, DEC Commissioner
NYS, DEC at Stony Brook
Suffolk County Dept. Health Services
Suffolk County Planning Ccmumission
William R. Pell, III
Olga Lomaga, applicant
o �
T D
Southold, N.Y. 1 1971
HENRY E.RAYNOR,Jr., Chairman TELEPHONE
JAMES WALL 765-1938
BE,NNETT ORLOWSKI,Jr.
GEORGE RITCHIE LATHAM,Jr.
WILLIAM F.MULLEN,Jr.
November 23 , 1982
Environmental Analysis Unit
DEC, Building 40, Room 219
SUNY
Stony Brook, New York 11794
Gentlemen:
Enclosed find a completed Short Environmental Assessment Form
and a copy of the map of the minor subdivision of Olga Lomaga,
located at Mattituck.
This project is unlisted and an initial determination of
non-significance has been made . We wish to coordinate this
action to confirm our initial determination in our role as lead
agency.
May we have your views on this matter . Written comments
on this project will be received at this office until December 8,
1982 . We shall interpret lack of response to mean there is no
objection by your agency in regard to the State Environmental
Quality Review Act.
Yours truly,
HENRY E. RAYNOR, JR. , CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Susan E. Long, Secretary
Enc .
cc: Department of Health Services
1� 4Yn�S0.�hwYw�wIMwW�+:MY`lY�N�YM1�FiM.. 4 � i .
iTOWN CLERK • •.•.•.•.•.•.•.�.•.•.•.•.•.•.•.•
TOWN OF SOUTHOLD
i Suffolk Cauuty, New York 516 . 765.1801 8 8 51
� N°
19
Southold, N. Y. 11971 �
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iFo ` _ ollars 3
Cash Ju 'th T. Terry, Town Clerk
❑ Check 7' .20 7�
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Southold, N.Y. 11971
HENRY E.RAYNOR,Jr., Chairman TELEPHONE -
JAMES WALL 765-1938
BENNETT ORLOWSKI,Jr.
GEORGE RITCHIE LATHAM,Jr.
WILLIAM F.MULLEN,Jr.
October 13 , 1982
Ms . Olga Lomoga
P.O. Box 386
Sound Avenue
Mattituck, New York 11952
Dear Ms . Lomoga:
After an on site field inspection and discussion at our
meeting held October 8, 1982 it was the concensus of our
Board that you apply for a set-off, Section 106-13 , Code
of the Town of Southold. This procedure does not require
a public hearing nor does it require referral to the
Suffolk County Department of Planning.
If the above procedure is agreeable to you, please submit
your request to our Board so that we might place this
matter on the next available Planning Board agenda.
If you have any questions concerning the above , please feel
free to contact our office .
Very truly yours
HENRY E. RAYNOR, JR. , CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Susan E. Long, Secretary
`✓�:�... I C� � �'[i'i lilt_ it.' =55�•� _ . I 'V;:id
ItJSTpuCTI IS .-
o In order to ans`;ar the questions in this short EAF it is assumed
that the preparer will use currently available infornotion concerning the
project and the lil:ely impc* cts of the action . It is not expected that
additional studies, research or other investigations will be undertaken .
(b ) If cny question has been onseered Yes the project may be
significant and a completed Environmental Assessment Form is necessary .
(e ) If all questions have been answered Flo it is likely that this
project is not significant .
(d ) Environmental Assessment
1 . v.ill project result in a large physical change
to the project site or physically alter more
thrill 10 acres of lunc!? . . . . . . . . . . . . . . . . . . . . . . . Yes /No
2 . Will there be a major change to any unique or
-urusuol land form found on the site? . . . . . . . . . . Yes r/ N0
3 . Will project alter or have a large effect on �/
existing body of water^: . . . . . . . . . . . . . . . _Yes I/ No
r 4. Will poject have a potentially large impact /
on groundwater quality? . . . . . . . . . . . . . . . . . . . . . . ._Yes �! No
5 . I'lill project significantly effect drainage
flow on adjacent sites? . . . . . . . . . . . . . . . . . . . . . . Yes VINo
6 . k'ill project affect any threatened or jNo
endangered
ngred plant or animal species? . . . . . . . . . . . Yes �/
7 . Will project result in a major adverse effect
on air quality? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes t/Na
E . I'lill project have a major cffcct on visual
character of the eommunil ,v or scenic views or //
vistas known to be important to the community? Yes ✓ No
Y . Will project adversely impact any site or
structure of historic, prehistoric or
paleontological importance or any site
du signated as a critical environmental area
bya local agency? . . . . . . . . . . . . . . . . . . . . . . . V Yes l/ No
10 . Will project have a major effect on existing — /
OF future recrcati.onpl opportunities? . . . . . . . . ._Yes ✓ No
11 . Will project result in major traffic problems
or. cause o major effect to existing /
transportation systems? . . . . . . . . . . . . . . . . . . . . . . . Yes V No
12 . I'lill project re:,ularly cause objectionable
odors, noise, glare, vibration, or electrical
disturbonee as a result of the project ' s /
operation? . . . Yes ✓ No
13 . Will project have any inpuct on public health �— /
or . safcty? . . . . . . . . . . . Yes ✓ No
14 . Will project affect the existing community by
directly causing o growth in permanent
population of more thon 5 percent over a one
year period or have a nojor negative effect
on the character of the eornmuni.ty or
neighborProod? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes ✓No
15 . Is there public controversy concerning the
project? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes ✓ No
PREPAkEf? ' S SIGt4,1TU!:E 167esrG� r-lzg-CL-�,�,�
REfP.ESEtJTING_ —'—� --� DATE K-10- �2
APPLICATION FOR APPROVAL OF PLAT
To the Planning Board of the Town of Southold:
The undersigned applicant hereby applies for (tentative) (final) approval of a subdivision plat in
accordance with Article 16 of the Town Law and the Rules and Regulations of the Southold Town
Planning Board, and represents and states as follows:
1. The applicant is the owner of record of the land under application. (If the applicant is not the
owner of record of the land under application, the applicant shall state his interest in said
land under application.)
2. The name of the subdivision is to be . . . .. . .Q���. �O✓N IgC-4
. . . . . . . . . .. . . . . . . . . . . . I . . . . . . . . . .
.
. . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . .. .. . . . . . .
3. The entire land under application is described in Schedule "A" hereto annexed. (Copy of deed
suggested.)
4. The land is held by the applicant under deeds recorded in Suffolk County Clerk's office as
follows: pp
Liber . . .P.S7.. . . . . . . . . . . . Page . . . . . . . . . . . .. . . . . . On .4?.. .?�.C, J.1. . . . . . ;
Liber . . . . . . . . . . . .. .. .. . . . . .. . Page On . . . . . . . . . . . . . . . . . .. . . . . ;
Liber . . . . . . . . . . . . . . . .. .. . . .. . Page . . . .. . . . . . . . . .. . . . . . . . On . . . . . . . . . . . . . . . . . .. . . . . ;
Liber . . . . . . . . . . . .. .. . . . . . . .. . Page . . . . . . . . . . . . . . . . . .. . . . On . . . . . . . .. . . . . . . . . .. . . . . ;
Liber . . . . . .. . . . . .. . . . . .... ... Page . . . .. . . . . .. . . . . . . . . . . . On . . . . . .. . . . . . . . . . . . . . . . . ;
as devised under the Last Will and Testament of . .. . . . . . . . . .. .. .. . . .. .. . . . . . . . . .. . . . . . .
oras distributee . .. .. .. .. .. .. . . . . ... . .. .. . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . .. .. . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . .. .......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . .. . . . . . .
5. The area of the land is 2 S
.. . . . . . . . . . acres.
6. All taxes which are liens on the land at the date hereof have been paid except . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .
7. The land is encumbered by . .. . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . .
mortgage (s) as follows:
(a) Mortgage recorded in Liber . .. . . . . . . . . . . . Page . . . .. . . . . . . . . . . . . . in original amount
of $. . . . . . . . . . . . . . unpaid amount $ . . . .. . . . . . . . . . . . . . . . . held by . . . .. . . . . . . . . . . . . . . . . .
. .. . . . . .. . . . . . address . . . . . .. . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . .. .. . . . . .. . . . . . . . . . . . . . . . .
(b) Mortgage recorded in Liber . . . . . .. . . Page . . . . . . . . . . . .. . . . . . . . . . . in original amount
of . . . .. . . . . . . . . . unpaid amount $. . . .. . . . . . . . . . . . . . . .. . held by . . . .. . . . . .. . . . . . . . . . . .
. .. . . . . . . . . . . . address . . . . . ... . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . .
• (c) Mortgage recorded in Liber . . . . . . . . . . . . . . Page . . . . . . . . . . . .. . . . in original amount
of . . . . . . . . . . . . . . unpaid amount $. . . . . . . . . . . . . . . . . . . . . . held by . . . .. . . . . . . . . .. .. . . . ..
. . . .. .. .. . . .. .. . . . . . . . address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . .
8. There are no other encumbrances or liens against the land except . . . . . . . . . . . . . .. . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . .. . . . .
9. The land lies in the following zoning use districts . . . . . . . . .
. . . . . . . .. . . . . . . . . . . . .
. . . . . . . . . .. .. . !.;�L!. . . .-. . 3. .- . . . . . . . . . . . . . . . . . .. . . .. .... . .. . . . . . . . . . ..
.
M. No part of the land lies under water whether tide water, stream, pond water or otherwise, ex-
cept . . . .. .. . . . . . . . . ... . .. .. . . .. . . . . . . ... . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . .
11. The applicant shall at his expense install all required public improvements.
12. The land (does) (does not) lie in a Water District or Water Supply District. Name of Dis-
trict, if within a District, is . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .
13. Water mains will be laid by . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .
and (a) (no) charge will be made for installing said mains.
14. Electric lines and standards will be installed by . . . . . . . .. . . . . .. . . . . . . . . . . .. . . . . . . .. . . . . . .
. . . . . . .. .. . . . . . . . . . . . . . • . . . . . . . . . . . . and (a) (no) charge will be made for installing said
lines.
15. Gas mains will be installed by . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . .
and (a) (no) charge will be made for installing said mains.
16. If streets shown on the plat are claimed by the applicant to be existing public streets in the
Suffolk County Highway system, annex Schedule "B" hereto, to show same.
17. If streets shown on the plat are claimed by the applicant to be existing public streets in the
Town of Southold Highway system, annex Schedule "C" hereto to show same.
18. There are no existing buildings or structures on the land which are not located and shown
on the plat.
19. Where the plat shows proposed streets which are extensions of streets on adjoining sub-
division maps heretofore filed, there are no reserve strips at the end of the streets on said
existing maps at their conjunctions with the proposed streets.
20. In the course of these proceedings, the applicant will offer proof of title as required by Sec.
335 of the Real Property Law.
21. Submit a copy of proposed deed for lots showing all restrictions, covenants, etc. Annex
Schedule "D".
22. The applicant estimates that the cost of grading and required public improvements will be
$. . . . . .. .. . as itemized in Schedule "E" hereto annexed and requests that the maturity of the
Performance Bond be fixed at . .. . . . . . . . . . . . years. The Performance Bond will be written by
a licensed surety company unless otherwise shown on Schedule "F".
DATE Q. .�.. P. :"-, 19. K.?-' . . . .. . .(u.,A.'
(Name of pplicant)
By . .. �T �?. .. . . . . .. . . . . . . . . . .
(Signature d Title
3aviub . . 11�:E. . .,. . )11 RT.Tf.1 u, c�. . . . . .
(Address)
STATE OF NEW YORK, COUNTY O . : . . . . . . . . .. . . . . .I ss:
On thee. . . . . . . . day of. . . . . . OGL . . . . .. 19�. ., before me personally came
. . . . V . . . ..FJ>-!vY'• -/�'t�l...-• . . to me known to be the individual described in and who
executed the foregoing instrument, and acknowledged that . N �,/_.. . . executed the same.
ELIZA,B1, AfiN NEVILLE
NOW
NOAIRY PUBLIC, State of New YorM
No. 52.8t25850, Suffolk Co Notary tblic
term Expires March 30. 19,ly
STATE. OF NEW YORK, COUNTY OF . . . ./. . . . . . . . . . . . . . . . . . . . . .. . ss:
On the . . . . . . . . . . . . . . . . day . . . . . . . . . . . . of . . . . . . . . . .. . . .. 19. .. . . ., before me personally came
. . . . . . . . . . . . . . . . . . . . . to me known, who being by me duly sworn did de-
pose and say that . . . . . . . .. . . . resides at No. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .
. . . . . . . . . I . . . . . . . . . . . . . . . . . . . . that . .. . . . . . . . . . . . . . . . . . . .. . . . is the . . . .. . . . . .
. . . . . . . . . . . . . . . . . . of . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .
the corporation described in and which executed the foregoing instrument; that . .. . . . . . . .. . knows
the seal of said corporation; that the seal affixed by order of the board of directors of said corporation.
and that . . . . . . . . . . . . signed . . . . . . . .. . . .. . name thereto by like order.
. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . .
Notary Public
A • •
APPLICATION FOR APPROVAL OF PLAT
To the Planning Board of the Town of Southold:
The undersigned applicant hereby applies for (tentative) (final) approval of a subdivision plat in
accordance with Article 16 of the Town Law and the Rules and Regulations of the Southold Town
Planning Board, and represents and states as follows:
1. The applicant is the owner of record of the land under application. (If the applicant is not the
owner of record of the land under application, the applicant shall state his interest in said
land under application.)
2. The name of the subdivision is to be . . F 0 rY1 N 6�+
. . . . . . . .. . . . . .. . . . . . . . . . . . . . . .. .
. . . .. .. . . . . . . . . . . . . . . . . .. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .
3. The entire land under application is described in Schedule "A" hereto annexed. (Copy of deed
suggested.)
4. The land is held by the applicant under deeds recorded in Suffolk County Clerk's office as
follows: //� 4
Liber . . . .Qs.... . . .. .. . . . . . Page . . . .,:4 . . . . . . . . . . . . . On 2. -. Q. . .7/. . . . . ;
Liber . .. . . .. . . . . . . . . .. .... ... Page . . . . . . . . . . . . . . . . . . . . . . On . . . . . .. . . . . . . . . . . . . . . . . ;
Liber . . . . . . . .. .. .. . . . . . . . . . . . Page . . . . . .. .. . . . . . . . . .. . . . On . .. . . . . . . .. . . . . . . .. . . . . ;
Liber . . . . . . . . . . . .. . . . . . . . . . . . Page
Liber . .. .. .. . . . . .. .. . . .... . .. Page . . . . . . . .. .. . . . . . . . . .. . On . . . .. . . . . . . . . .. . . . . . . .. ;
as devised under the Last Will and Testament of . . . . . . . . . . . . . .. .. . . .. . . . . . . .. . . . . . . . . . .
or as distributee . . . . . .. . . . . .. .. .. .. . . .. .. . . . . . . . . . . . . . . . . . . .. . . . . . . .. .. . . . . . . . .. . . . . . . . .
. . . . . . . . . . . . . . . . . . . .. . . .. .. .. . . . ... .. .......... . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . .. . . . .. . . . . . . . . . . . .
5. The area of the land is . . . . . acres.
6. All taxes which are liens on the land at the date hereof have been paid except . . . .. . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7. The land is encumbered by . . . . . .. . . .. .. .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . .
mortgage (s) as follows:
(a) Mortgage recorded in Liber . . . . . . . . . . . . . . Page . . . . . . . . . . . . . . . . . . in original amount
of $. . . . . . . . . . . . . . unpaid amount $ . . . . . . . . . . . . . . . . . . . . . held by . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . .. .. .. . address . .. .. .. . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(b) Mortgage recorded in Liber . . . . . .. . . Page . . . . . . . . . . . . . .. . . . . . . . . in original amount
of . . . . . . . . . . . . . . unpaid amount $. . . . . . . . . . . . . . . . . .. . . . held by . . . .. . . . . . . . . . . . . . . . . .
. .. . . .. .. . . . . . address . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .
(c) Mortgage recorded in Liber . . . .. . . . . . . . . . Page . . . . . . . .. . . . . . . . in original amount
of unpaid amount $. . . . . . . . . . . . . . . . . . . . . . held by . . . .. . . . . . . .. . . . . . . . . .
. .. .. .. . . . . . . . . . . .. . . . address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .
8. There are no other encumbrances or liens against the land except . . . .. . . . . . . .. . . . . . . . . . . .
. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . .. . .. . . . .
9. The land lies in the following zoning use districts 2oA/E
. . . . . . . . . . . .. . . .. . . . . . . .. . . . . . . . . . . . . . .
(rig. . ..-. . . !.? !.-. . . . 3. .-
10. No part of the land lies under water whether tide water, stream, pond water or otherwise, ex-
cept . . . . . . . . . . . .. . . .. . . .. . . . . . . .. . . . . . .. . . . . . . . . . . .. . . . . . . .. . . .. . . . . . . .. . . . . . . . . . . . . . . .
11. The applicant shall at his expense install all required public improvements.
12. The land (does) (does not) lie in a Water District or Water Supply District. Name of Dis-
trict, if within a District, is . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .
1.3. Water mains will be laid by . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. .
and (a) (no) charge will be made for installing said mains.
14. Electric lines and standards will be installed by . . . . . . . .. . . . . .. . . . . . . . . .. .. . . . . . . .. . . . . . .
• • • • • •. • • • . . . . . . . . . I . . . . . . . . . . I . . . . and (a) (no) charge will be made for installing said
lines.
15. Gas mains will be installed by . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
and (a) (no) charge will be made for installing said mains.
16. If streets shown on the plat are claimed by the applicant to be existing public streets in the
Suffolk County Highway system, annex Schedule "B" hereto, to show same.
17. If streets shown on the plat are claimed by the applicant to be existing public streets in the
Town of Southold Highway system, annex Schedule "C" hereto to show same.
18. There are no existing buildings or structures on the land which are not located and shown
on the plat.
19. Where the plat shows proposed streets w hich are extensions of streets on adjoining sub-
division maps heretofore filed, there are no reserve strips at the end of the streets on said
existing maps at their conjunctions with the proposed streets.
20. In the course of these proceedings, the applicant will offer proof of title as required by Sec.
335 of the Real Property Law.
21. Submit a copy of proposed deed for lots showing all restrictions, covenants, etc. Annex
Schedule "D".
• 22. The applicant estimates that the cost of grading and required public improvements will he
$. . . . . . . . . . as itemized in Schedule "E" hereto annexed and requests that the maturity of the
Performance Bond be fixed at . . . .. . . . . . . . . . years. The Performance Bond will be written by
a licensed surety company unless otherwise shown on Schedule "F".
DATE . . . . . .. . . . . .. .. . . .�P. ..- ., 19. S:Z CX I rac Gc r
�. � ... . . . . . . . . . . . . . .
(Name ofplicant) i. . . ..
By . .. .. 4 r: �—. . .
(Signature and itle)
(Address)
STATE OF NEW YORK, COUNTY OF . . . . . . .. . . . . . . . . .. ss:
On the . . .4 . . . . day of. . . .. . . . . . .. . . ., before me personally came
/'
O . . . �07X1' to me known to be the individual described in and who
executed the foregoing instrument, and acknowledged that �ute._�. executed the same.
ELIZAB9'ff ANN NEWLLw
NOTARY PUBLIC, State of Now (�
No. 52-8125850, Suffolk
Tare Eeolres Mach 30. 19 L Notar ublic
STATE. OF NEW YORK, COUNTY OF . . . . . ./. . . . . . . . . . . . . . . . . . . . . . ss:
On the . . . . . . . . . . . . . . . . day . . . . . . . .. . . . of . . . . . . . . . . . . . .. 19. . . . . ., before me personally came
. . . . . . . . . . . . . . . . . . . . . . . to me known, who being by me duly sworn did de-
pose and say that . . . . . . . . . . . . resides at No. . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. 1 . . . I . . . . . . . . . . . . . . . . . . . . . . that . . . . . . . . . .. . . . . . . . . . . . . . . . is the . . . . . . . . . .
. . . . . . . . . . . . . . . . . . of . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
the corporation described in and which executed the foregoing instrument; that . .. . . . . . . . . . knows
the seal of said corporation; that the seal affixed by order of the board of directors of said corporation.
and that . . . . . . . . . . . . signed . . . . . . . . . . . .. . name thereto by like order.
. . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . .. . .. . .
Notary Public
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
� . . . .� .Z
FileNo. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . .U.Vr �. . . . ., 19
To . . . . . . .I. . . . . . . . . . . (� M G .
x 3s61 MA - T i 761CK
. . . . . . . . . . . . . . . . . . .I. . . . . . . . . . . . . . . . . . .
( f -'�r52
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
l r ��� l
PLEASE TAKE NOTICE that your application dated . . . . . . . . . . . . ... . . . . . . . . .. 19 ... . .
for permit to c6nStrucv . . I V( �fi t'K'0-F'E r� t T / . . . . . . . . . . . . . . . . . . . at
. . . . . . . . . . . . . . . . . . . . . . . .
Location of Property . . . �q ��.:�.�. . . . .`S 0 U t-'1� . . . .� L� E. . . . . . . . (1.1 /�i i i Tl/( /<
Nouse No. Street Hamlet
County Tax Map No. 1000 Section . . . .1 . . . . . Block . . . . . . ��. . . . . . Lot . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . Lot No. . . . . . . . . . . . . . . . . .
is returned herewith and disapproved on the following grounds . . �l .?. .r. l.0 1\ . . . . . . .
. . . . . . . . . ' frlC SEcTI _
-r. �. . . . . . l.J, l r f I�- I l . . . . L. ... .-. �. . . . . . . . . . . . . ..:.U. . . . . ta/t�. 'T. . . . . . .
�!EE :� . . . . . PL n/riu .r : '.�:. . . . 0a �'D �. . . . /),F� ,Incv/. �--. . . QF . . . . , .
7NF G Sir V! L=0 N
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
� 0VL7 C--7
. . . . . . . . . .. . . . . . . . . . . . . . . . . .
Building Inspector
_ �f3tl!SO/�1
RV 1/80
— � i
Southold Town Planning Board
Town Hall
Southold, New York 11971
Re:
Gentlemen:
The following statements are offered for your consideration
in the review of the above-mentioned minor subdivision and its
referral to the Suffolk County Planning Commission:
(1) No grading, other than foundation excavation for a
residential building is proposed.
(2) No new roads are proposed and no changes will be made in
the grades of the existing roads.
(3) No new drainage structures or alteration of existing
structures are proposed.
Yours truly,
M(Noi2 50001VISION
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AORILED ALTERAIION OR ADDITIOIN fC L11S SURVEY 15 A VIOLATION OF
m -F!Jf"`r'I fEY' �Rf.Jf !'v'if 1:, F '.ILO'-17209 OF THE NEW YORK STATE
%J,CATION LAW_ F''r/'f•(E3.1.;,�ET V�}'_):4 _ i.' i. 1
Stil Yrel y/�Ffi7/ ; x Wet �/,�((�A ,/ �yL� CON'S OF THIS SURVEY MAP NOT UARRTO
r �`' �f-' ( -{e"TT9I14$ THE LAND SU:,Y'OR'S INKED SEAL OE
J s.I I TO 81 ED SEA I E NOT■ CON71ISiW ` ( � ._...Ur,j
NT ��> t ���F fT ��•� O RE SE VALID TLLI L NO ) �C
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l ONLY TO IEIE � FOR WHOM SlRve.
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Area zoned - �c:ES. s Y?Y.; TINE COMPANY i OVEi"mLENTAL AGENCY ANT
1 l -DOG InSTITU11ON LISTED HEREON, AND
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nik l CJt v Rj C ] '. i G J 1 CY F IG(!: N. GUARANTEES ARE NOT TkAP4FNf Aai L_ ' l e,:7 .'YF7' L)t i4�C 1
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