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RODERICIS VAN .:P.o/.YL, P.C.
/G. Ve-.- '~
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
SUFFOLK COaALTH DEPT, A,"""OVAL
~s NO. 11- 50-10
STATEMENT OF INTENT
THE WATER SU~ Y AND SEWAGE DISPOSAL
SYSTEMS FOR THIIE RESIDENCES WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO. DEPT, OF HEALTH SERVICES.
(51
APPLICANT
D€PT. OF HEALTH
APPROV AL OF
SUFFOLK COUNTY
SER V ICES - FOR
CONSTRUCTION ONLY
DATE:
H. S. REF. NO.: I{-SO-/O
APPROVED:
SUFFOLK CO. TAX MAP D€SIGNAT10N:
DIST. SECT. BLOCK PeL.
:000 122 ..., PIG 8
OWNERS ADDRESS:
H/Ci<:.6Y
(::>a8ox tZ-46
....1... T'n n./ c 1', N. Y; //9S'Z
i-l!/... Z 98 - 8960
DEED: L.;22.of3 P.-4~ (tiNJiFI)
L A
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TO TI;:S ::u::y:y IS A 'r:;:-.U,T;'~ol-: ,:,r
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'~::'):L GUARANHts A,-" Nor TItANSfERA~L'
.' ,l.;);):TlONAL INSTITUTIONS OR. .sus&6OW'N.T
",'v:';EKi.
SEAL
.
Southold, N.Y. 11971
HENRY E. RAYNOR. Jr.. Chairman
rRE:I?i:R.I~K i <:;QRPQll
JAMES WALL
BENNETT ORLOWSKI. Jr.
GEORGE RJTCHIE LATHAM. Jr.
William F. MUllen,
TELEPHONE
765 - 1938
Jr.
March 10, 1982
John R. McNulty
Attorney at Law
130 Ostrander Avenue
Riverhead, New York 11901
Re: Marilyn C. Hickey
Dear Mr. McNulty:
The following actions were taken by the Southold Town Planning Board,
Monday, March 8, 1982:
RESOLVED that the Southold Town Planning Board declare itself lead
agency in regard to the State Environmental Quality Review Act-rn-
the matter of the minor subdivision of property entitled Marilyn C.
Hickey, located at Laurel. An initial determination of nonsignificance
has been made.
RESOLVED that the Southold Town Planning Board approve a set-off (106-13)
on the subdivision map entitled Marylin C. Hickey, located at Laurel,
subject to receipt of six (6) copies of the final map within six months
from date of resolution.
Yours very truly,
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
,
/
./
,
.
.
T
LD
Southold. N. Y. 11971
HENRY E. RAYNOR, Jr.. Chairman
FR13BERI8Ir E. GSRB8tJ
JAMES WALL
BENNETT ORLOWSKI. Jr.
GEORGE RITCHIE LATHAM, Jr.
William F. Mullen, Jr.
NEGATIVE DECLARATION
April 26, 1982
TELEPHONE
765 - 1938
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 Soufhold Town Planning Board as lead a~ency 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 Marilyn C. Hickey is a two-lot subdiv-
ision located at Laurel.
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 Environ-
mental Conservation it is assumed that there is no
objecti~o.ll.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, NYS DEC Commissioner
NYS DEC at stony Brook
Suffolk County Dept. of Health Services
Suffolk County Planning Commission
John R. McNulty, Esq.
William R. Pell, III, Supervisor
.
.
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.~
.
Southold. N.Y. 11971
HENRY E. RAYNOR. Jr.. Chairman
I'l..E.ISERIen fl. 88R1)8lf
JAMES WALL
BENNETT ORLOWSKI, Jr.
GEORGE RITCHIE LATHAM. Jr.
William F. Mullen, Jr.
TELEPHONE
765 - 1938
March 25, 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 Marilyn C. Hickey
located at Laurel
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 April 9,
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: Dept. of Health
.
.
McNULTY, GILMARTIN, DIPIETRO, NESCI Ii. HAEFELI
ATTORNEYS & COUNSEL.ORS AT LAW
130 OSTRANDER AVENUE
P. O. BOX 757
RIVERHEAD, NEW YORK 11901
516.727-8200
SOUTHAMPTON OFFICE
320 HAMPTON ROAD
SOUTHAMPTON. NEW YORK 11968
516 - 283-0200
.JOHN R. McNULTY
DAVID J. GILMARTIN
ARTHUR DIPIETRO
PAT FRANK NESCI
RICHARD T. HAEFELI
March 24, 1982
Henry E. Raynor, Jr., Chairman
Southold Town Planning Board
Town Hall
Southold, New York 11971
Re: Marilyn C. Hickey-Subdivision
Dear Mr. Raynor:
Pursuant to your letter
herewith six (6) copies
JRM:clp
Enclosures
cc: Mrs. Marilyn
9598 peconic Bay B
P.O. Box 1246
Mattituck, New York 11952
.
.
McNULTY, GILMARTIN, DIPIETRO. NESCI is. HAEFELI
ATTORNEYS ~ COUNSELORS AT LAW
130 OSTRANDER AVENUE
P. O. BOX 757
RIVERHEAD, NEW YORK 11901
JOHN ~. McNULTY
DAVID J. GILMARTIN
ARTHUR DIPIETRO
PAT FRANK NESCI
RICHARD T. HAEFELI
516 . 727-8200
SOUTHAMPTON OFFICE
320 HAMPTON ROAD
SOUTHAMPTON, NEW YORK 11958
516 - 263-0200
January 28, 1982
Southold Town Planning Board
Town Hall
Southold, New York 11971
RE: Marilyn C. Hickey - Subdivision
Gentlemen:
I enclose herewith the following items:
1. Six copies of map;
2. Photocopy of deed dated April 11, 1981 and
recorded in the Suffolk County Clerk's Office
in Liber 8998 cp 131;
3. Check in the amount of $50.00;
4. Letter regarding drainage, grading and road
construction;
5. Short Environmental Assessment orm;
6. Application for Approvial/of PIa
Thank you for your attention to this-matt r.
cy t,u
'---
John
JRM:phd
Enclosures
.
,0
.
.
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
MARILYN C. HICKEY SUBDIVISION
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
................................................................................,..............
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:
Liber . M.9.?..,..........,.. Page :).;n.,..,..,.,........ On ., M,U/?;L....,..,.,. ;
Liber ........................ Page
On
. . . . . . . . . . . . . . . . . . . . . . . ,
Liber ...........,............ Page
On
.......................,
Liber ......,.,.,............. Page
On
........................
Liber ........................ Page
On
.......................,
as devised under the Last Will and Testament of ...,......,.,........................"
or as distributee .......................................................................
............................................,...............................................
5, The area of the land is .~~.~! ~,~~.. ~.q:. .f.t.=~
6. All taxes which are liens on the land at the date hereof have been paid except ............
. . , , ,4n4. J'g(I,f..l, 9.1HJ. ?~. . . . . . . . . . . . . . . . . . .
7, The land is encumbered by .1;l.Q.........., , , , , . , . , , . , . , . . . . , . . . , . . . . , . . . . . . . . . . . . . . . , . . .
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 ........................
. . . . . . . . . .none. . . . . . . . . . . . . . . . . . . . . . . .
9. The land lies in the following :zoning use districts .......................................
........................................................................................
10. No part of the land lies under water whether tide water, stream, pond water or otherwise, eX4
cept ............... !l.<?l;le. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
II. 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 wi thin' a District, is ................ none. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Water mains will be laid by ................... .nf.f3;. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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.
n/a
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 "E" 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 Southald Highway system, annex Schedule "e" 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 app licant 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
$.. .r;t/f}.", as itemized in Schedule "E" hereto annexed and requests that the maturity of the
Performance Bond be fixed at . . . r:-J~, , , , , " years, The Performance Bond will be written by
a license~s rety company unless otherwise shown on Schedule "F".
DATE..,....1. .l?............., 19.~.. I1I11{?d~.y.II... .r.. ..j(;~/r:. ?l....
(Name of AP6licant)
BY:P/~~"C..~ ......
(Signature and Title)
. .9.-?1.8. .;g~{JIt!I.C;. .l$.8~.. .P(t(l:J
(Address) ? .:;> . ~/ I
/.0, ",-,0;< /~'7''t,
-??IRT7IT,-,<-I~ It/.y /1Y'.s-;;J."
STATE OF NEW YORK, COUNTY OF . ,StJ.ft:~~.!~"..,.. ,......, ss:
On the....,./ f~~..... day of., ,J/7(1(~1:I?.'I..."",..." 19.f'.?-.., before me personalty came
,1.11 ~ ~ ~ )'f.... . . ~ . '. . \\ .'.<c ~~ .f, 'f' . , . . . . . . . . , .. to me known to be the individual described in and who
executed the foregoing instrument, and acknowledged that ecuted the same.
...rJ.
JOHN R. McNULTY
N~ta'?'., P~bHc, Sial, of New Ycrlil'
ho. ':J""'d;~; '~;l'~r-_I% CC;UI~~
COiTnnL;~':;n r-::'~'I"L"~'" ~"., ,'- 3^ 1.... 1'1
--.."'",,', "!.V,-.!j -J, ':J-:;;,J
STATE OF NEW YORK, COUNTY OF........,................... 55:
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. ..............,.'........,.,.......,'.........,.....
. . . . . . . . . . . . . . , . , . . . . . . . . . . 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
, , ' , " '" I . I' ')" II r' , 'T . I ! " S t' S ' "'1 ' . \J' I
, ::.::.."..:.'-,-~~,,-,,.; 1\. \~'..': """'." ,. :..., .
J:lSrr:!JCTlOtlS: .
--(0)1,1' order to (JnS\i"r th" qu"stions in this short EAF it is assumed
thot the preporcr uill use currer,tly avoiloble information concerning the
project (Jnd t!w lii:ely impocts of th" action. It is not expected that
additional studic~, rc~eurch or other investigotions will be undertaken.
(b) If any quc~ti0n has been onswcred Yes the project may be
:;igni f icc:nl CIne} 0 co,";>l" led [Clvirol1fOl"nlol Assessment Form is necessary.
(c) If all qu~:;lions hove been unswcred No it is likely that this
project i~ not si9nificont.
(d) Envil-ont~~ntul Assc~;~m~llt
J. 1'/iIT f,,'ojFcct resurt--in 0 lorge physicol change
to the p;:ojecl site or physicelly alter more
U""1 10 acres of lanel?....................... YesXNo
2. llill tl,er<, be 0 mojor chonrle to ony unique or - .
,u,.usuol land fOlfn found on the site?......... Yes V No
3. l'/ill project alter or heve 0 large effect on - -
existing body of water?................. ..... Yps X No
4. \'Iill p;'oject hove 0 potentinlly lars" impact -:-. ~
on ')roundwClter quality?................... ',' ._YesLNo
5. Will project significontly effect drainage -
fluw on 9djocent sites?...,.........:......... Yes X No
6. \'Iill project affect a:1Y threatened or - -'
enJon;jered plant or onimol species?.......... Yes ')<No
7. l'lill project result in 0 major adverse cffeel ~ '~
. 1'" " ' 'Y V'N
on (J 1. r Cj U (J. 1. L..)' : .. .. .. .. ,; .. .. .. .. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ........ c s -A:.. 0
C. \'/ill project hove a major effect on vi'sual .-
chOToctcr of the community or scenic views or
v~ c.[os kr;o\'ln ..to' be impo:-tant to the. communitY?_Yesj(_I~o
9. 1'1111 JiJ'oJ'C,ct adversely ~,"pact any s:de or "
structure of hist.oric, prehistoric or
paleontological importance or any site
d(;~iSln(d.c:d os a criticCJl environmental crcCl
by 0 local agency?.............,..".'.'.,'.'....."..... YesXNo
10. \'/il1 project hove 0 major effect on exisU.hg -
or fu lure recreational opportunities?........ Yes-ANo
11. 11il1 project result in .,"ajor traffic problems -
Or couse 0 major effect to existing
tronspc>rtation 5)'stcms?...................... YesXNo
12. I'/ill project r'p'rJularly couse objectionable -
odors, noise, glore, vibration, or electrical
Jisturbo~ce os 0 result of the project's ,
. l' ? Y V
opera ~on... .,.... .............................. es.-a.No
13. \'Iill project have any irepoct on public health -
c..r ,safety?................................... Yes--X.-No
I/;. \'Iil1 project offect the existinD community by -
directly causing 0 growth in permanent
population of more than 5 percent over 0 one
ye(Jr period E.!- hove 0 ",ojor negoU.ve effect
On the character of the community or V
neishborhood?... . .. . . .. . . . ...... ., ... . . . . ... ._Yes...t::...No
15. Is there public controversy concernin') the '
project?.... . ... ... . .. .. . ........ ... ... .. .... ._'YesLNo
DATE~R;:L.
PREPIII~Ef~' S
DIST 1000
::;EC. l2~. 0
ILK. 07.00
p/~
~OT DC S. 001
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CONSULT YOUR LAWYER BEFOR~NING TH S INSTRUMENT. THIS INSTRUMEN?rHOULD BE USED IT LAWYERS ONLY
THIS INDENTURE, made .he ~
BElWEEN
day of APRIL
,nineteen hundred and EIGHTY -ONE
MARTHA HUSING, residing at (no #) Old Main Road,
Mattituck, New York,
party of the lirst part, and
MARILYN HICKEY, residing at 25 Barnaby Lane,
Hartsdale, New York,
party of the second part,
WITNESSETH, that the party of the lirst part, in consideration of ten dollars and other valuable consideration
paid by the party of the second part, does hereby grant and release unto the party of the second part, the heirs
or successOrs and assigns of the party of the second part forever,
ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate,
lying and being ~ in Laurel, in the Town of. Southold, County of Suffolk
and State of New York, being more particularly bounded and
described as follows:
BEGINNING at a monument set on the northerly line of Peconic Bay
Boulevard at the southeasterly corner of land of Nature Conservancy
and being the southwesterly corner of the premises herein
described;
RUNNING THENCE along said land of Nature Conservancy, North 58
degrees 12 minutes 10 seconds West 325.73 feet;
THENCE along other land of the party of the first part, two courses:
(1) North 55 degrees 39 minutes 50 seconds East 425.58 feet;
THENCE
(2) South 34 degrees 20 minutes 10 seconds East 306.28 feet to said
northerly line of Peconic Bay Boulevard;
THENCE along said northerly line, two courses:
(1) South 62 degrees 39 minutes 50 seconds West 245.27 feet;
THENCE
(2) South 32 degrees 32 minutes 50 seconds West 54.73 feet to the
point or place of BEGINNING.
Containing 105,000 square feet.
01, \,odlo;, "'-{.
BEING AND INTENDED TO BE~the same premises
herein by deed dated 6/18/1942 recorded in
on 7/24/1942 in the Suffolk County Clerk's
conveyed to the
Liber 2243 page
Office.
seller
499
't
TOGETHER with ..11 right, title and interest, if any, of the party of the first part in and to any streets and
roads abutting the abo\.e de5criJx.d premises to the centt.'T Jines Ih<:reof; TOGETH ER with the appurtenances
and all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO
HOLD the premises JJ{'rein granted unto the party of tht' ~t'(f)nd part, the ht'irs or suc{'cssors and assigns of
the party of the serond part forever.
A:\'D the party of the first part covenants that the p~rly of the first part ha~ nut done or ~Ilf{tft'd anything
whertby the ~aid pr<::mises have D(-('n encumbered in any way whatever, t"xn'pt as afon'said.
A~D the part} of the first part, in rompliance with St:ction 13 of the Lien Law, t'ovenants that the party of
the first part will n-ceive the consideration for this conveyance and will hold the right to receive such consid.
<ration as a trust fund to be applied first for the purpose of paying the cost of the impron-ment and will apply
thl' same first to the pa)'Olc'nt of the cost of the impron'Jnt'nt before using any part of the total of the same for
any other purpose.
The word "party" shall be con~trl1ed as if it read "parties" Whl"'H:n'r the sellse of this inden1pre so requirt's.
IN \'{ITNESS "tHEREOF, the party of the lirst part has duly executed this deed the day and year lirst above
written.
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MARTHA HUSING V
,.~;;;l:; .:~;::;L~
,sor~ame
MARTHA HUSING
SUF~
1!{11 . ""fore me
described in and who
and acknowledged that
JOHN R. 1,~cNULrr
Notary Public, S;ct. of New YorIJ
No.. 5~-2637425. Suffolk Coun~'2.
Comm....on ~r.. Marcbao. YJSiiS
STATE OF NEW YORK. COUNTY OF
On the day of 19 . before me
pt'rsonally came
to me known. who, being by me duly sworn, did depose and
say that he resides at No.
that he is the
of
. the corporation described
in and which executed the foregoing instrument; that he
knows the seal of said corporation; that the seal affixed
to said instrument is such, corporate seal; that it was so
affixed by order of the board of directors of said corpora-
tion, and that he signed h name thereto by like order.
margaiu au!'J {}ale ?:l~~!'J
\VlTH COVE;-.;'ANT AGAINST GRA:";TOR'S ACTS
TITLE NO.
MARTHA HUSING
TO
MARILYN HICKEY
-
STArWARD FORM Of NEW YORK BOARD OF TITlE UNDERWRITERS
Distributed by
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On the day of
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STATE OF NEW YOU, COUNTY OF
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On the day of 19 , before l1]e
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at the same time subscribed h name as witness thereto.
SECTION
BLOCK
LOT
COUNTY OR TOWN
Recorded al Request of
CHtCAGO TITLE INSURANCE COMPANY
Rdum by Hail to
McNULTY, GIL~ARTIN, DiPIETRO,
NESCI & HAEFELI
130 Ostrander Avenue, Box 757
Riverhead. N.Y. 11901
Zip No.
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RECEIVED
f '0
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REAL ESTATE
MAY 5 1961
TRANSFER y,.J.
SUFFOLK
COUNTY
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Southold Town Planning Board
Town Hall
Southold, New York 11971
Re: MARILYN C. HICKEY SUBDIVISION
Gentlemen:
The following statements are offered for your consideration
in the review of the aqove-mentioned minor ,subdivision and its
referral to the Suffolk County Planning Commission:
(1) No grading, other than foundation excavation for ~
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,
7fc~uL;~ ~,~
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RECEIVED BY
SOUTHGLO TOWN PlANNING BOARD
F
DATE
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Hall. 3,198/
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LICENSED LAND SURVEYORs
GREENPORT NEW YORK
SUFFOLK CO. WLTH DEPT. ....PPROVAL
.S. NO. 11- 50-/0
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STATEMENT OF INTENT
THE WATER SUPPL Y AND SEWAGE DISPOSAL
SYSTEMS FOft THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUI"FOLK CO. DEPT. OF HEALTH SERVICES.
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DEPT. OF HEALTH
APPROVAL OF
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SUFFOLK COUNTY
SERVICES - FOR
CONSTRUCTION ONLY
DATE:
H. S. REF. NO. 11- 50-10
APPROVED:
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT BLOCK PeL.
(COO 122 7 ~/c:. 8 _
OWNERS AODRESS:-p.O. 13<>)< /~.;th
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STAMP
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JI'lAUTH01UUO ALTERATION Oil; ADDlTJO"
ro THIS $UIWEY IS A VIOLATION OF
SECTION 7209 Of Hlf NEW YORK STAll
EOUCATlON LAW.
COPltS OF Tt-l!S S'J;!.v~y I.,A? NOT BEARING
fHE L."".o su::vaO;;'5 !N~.:D ~cAt OR
IMIossm SeAL SH.~,U I~:T D: CO~,SID.ReD
TO at A VALiD UJ, C':;?'t.
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GUARANnzs ::-,:DI:::ALC !.:t\G1:~ S!~ALL RUN
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IS PRfPA!:EO. A:~;:) o~" H.~ i>-.:ii....U TO 1'tlf
TITLE COMrAN'f, C:)V~;::..'.',3ij'\L AGiNO .liNe
UNOING I>SnTUTIOr1 LS~c:) IU!;0d, AND
10 THE. ASS:GNHS OF T;:r LG'-10i;'o'(.; IHSH.
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