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HomeMy WebLinkAbout29096-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29190 Date: 01/10/03 THIS CERTIFIES that the building ADDITION Location of Property: 2105 OLD ORCHARD RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 37 Block 3 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 10, 2003 pursuant to which Building Permit No_ 29096-Z dated JANUARY 10, 2003 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITIONS AND OUTDOOR SHOWER ENCLOSURE "AS BUILT" ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ZBA #4210 DATED 2/2/94 . The certificate is issued to JAMES J & DALE P LEYDON JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 1 Aut orized Si nature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29096 Z Date JANUARY 10, 2003 Permission is hereby granted to: JAMES J & DALE P LEYDON JR 185 CEDAR AVENUE ISLIP,NY 11751 for CONSTRUCT DECKS AND SHOWER ENLCOSURE "AS BUILT" AS APPLIED FOR. THIS PERMIT REPLACES BP#21755 . ZBA #4210 DATED 2/2/94 . at premises located at 2105 OLD ORCHARD RD EAST MARION County Tax Map No. 473889 Section 037 Block 0003 Lot No. 006 pursuant to application dated JANUARY 10, 2003 and approved by the Building Inspector to expire on JULY 10, 2005 . Fee $ 150 . 00 Authori Signa re ORIGINAL Rev. 5/8/02 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date.....JI�........................................... 19..� NO 21755 Z Permission Is hereby granted o: / x&r................................ ... . ' :r.. ...'-j--?........................................ 19 , .. ..... .......... . ...Y,1l. �..,....�. 9 /0*�. .....A.A.IK A" ' ....................................................................................................................................I............................. .................................................................................................................................................................. ................................. ................................................................ at premises located at...`0'��4..r..t�.... .... .... ........................................ ............................................... 1...... ............ .................................................................... County Tax Map No. 1000 Section .......... .7... Block........... ,--7....... Lot No. ..... .................. pursuant to application dated .........lQ .9.............................. 19..`?„5..., and approved by the Building Inspector. Fee$...7's(..�... ............ a �%I!:..`................... ng Inspector Rev. 6/30/80 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY I This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957)non-conforming uses, or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00, Swimming pool$25.00,Accessory building$25.00, Additions to accessory building$25.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Date. January 10, 2003 New Construction: XX Old or Pre-existing Building: (check one),. Location of Property: 2105 Old Orchard Rd East Marion House No. Street Hamlet Owner or Owners of Property: T a m P.-, T Rt n a 1 P P 11 P v d o n, jr Suffolk County Tax Map No 1000, Section 37 Block 3 Lot 6 Subdivision Filed Map. Lot: Permit No. 29096 Date of Permit. 1/10/03 Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: - Request for: Temporary Certificate Final Certificate: XX (check one) Fee Submitted: $ 25. 00 Applicant Signature X PEALS BOARD MEMBERS �,�' ,,,�� Gerard P.Goehringer, Chairman a ; Serge Doyen,Jr. ; Town Hall, 53095 Main Road James Dinizio,Jr. �� �� P.O. Box 1179 Robert A.Villa Southold, New York 11971 Richard C.Wilton 1 `} Fax (516) 765-1823 Telephone (516)765-1809 BOARD OF APPEALS Te ePhone (516)765-1800 TOWN OF SOUTHOLD FINDINGS AND DETERMINATION Appeal No. 4210: Application for STEPHEN T. VESEY and CHERYL SCHLITT.' Variance to the Zoning Ordinance, Article IIIA, Section 100-30A.3 for the existing location of a deck addition "as built." A portion of the deck encroaches in the side yard. The accessory garage structure, which has existed, is also now partly in a side yard area. Location of Property: 2105 Old Orchard Road, East Marion, NY; County Tax Map Parcel No. 1000-37-3-6. Subject premises contains a lot area of 8,638+- sq. ft. and is located in the R-40 Low-Density Residential Zone District. WHEREAS, a public hearing was held on February 2, 1994, at which time those who desired to be heard were heard and their testimony recorded (no opposition was received) ; and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, Board Members have personally viewed and are familiar with the premises in question, the present use and building(s) , and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. The premises in question: (a) is a parcel of land shown on the Map of Gardiners Bay Estates as Lot Nos. 13 and 13A (Combined as one) with a total lot area of 8,638 square feet, and two street frontages of 40.0 feet; (b) is improved with 'a single-family, one-story frame dwelling structure with attachments as more particularly shown on the survey amended December 23, 1993, prepared by Roderick VanTuyl, P.C. , which dwelling is shown to be set back six feet from the northerly property line, 13 feet from the southerly property line, 34 feet (exclusive of porch and step area) from the front property line along Old Orchard Lane, and 110+- feet from the easterly front property line along Sylvan Drive; Page 2 - Appl. No. 4210 Matter of STEPHEN T. VESEY and CHERYL SCHLITT Decision Rendered February 2, 1994 �i (c) is also improved with a garage building, built as an accessory structure in the rear yard with a setback at 1+- feet from the southerly side property line. The deck area, now extends "as built" into the side yard, which places a portion of this accessory building in the side yard as well; (d) is improved with a new deck area which is the subject of this variance which extends "as built" into the side yard with a setback at 11 feet from the side property line. The new sideyards are 11 feet and 6 feet, rather than 13 feet and 6 feet, for a reduction of two feet. 2. By this application, appellants have requested approval for a reduction in the southerly yard setback by two feet, for an 11-foot setback for the new deck area (instead of the principal setback of 13 feet) . The total setbacks, as built with the new deck, are now 17 feet, rather than the 19 feet previously existing. 3. The code requirement for a nonconforming parcel in this R-40 Zone District is regulated by §100-244 of the Zoning Code as it pertains to less having less than 20,000 sq. ft. enacted in January 1989 for minimum sideyards at 10 feet and 15 feet. 4. It is the position of the Board that the amount of relief requested is not substantial in relation to the requirement, being a variance of two feet for the new deck. No other side yard would be reduced, and the garage has not been moved and will remain in the present location. 5. In considering this application, the Board also finds: (a) there is no valid public purpose which outweighs the applicant's difficulties for a two-foot variance for the southerly side, and two-foot variance for the total sideyards; the size of the deviation is de minimus; (b) a substantial change will not be produced in the character of the neighborhood; (c) the difficulty cannot be obviated by some method feasible for the applicant to pursue other than another variance; (d) in view of the manner in which the difficulty arose and the fact that additional land area is not available, the interest of justice will be served by allowing the three-foot side yard reduction. • Pace 3 - Appl. No. 4210 Matter of STEPHEN T. VESEY and CHERYL SCHLITT Decision Rendered February 2, 1994 (e) the applicant' s difficulties are self-created since the deck was not built exactly to plans issued under the Building Permit <#21755 dated 11/3/93>; (f) the difficulties claimed are uniquely related to the layout and general character, shape and size of this parcel and are not unreasonable; (g) in considering all of the above factors, the interests of justice will be served by granting the reduction in the sideyard, as requested. Accordingly, on motion by Chairman Goehringer, seconded by Member Wilton, it was RESOLVED, to GRANT the requested reduction of two feet from the southerly property line for the deck extension, "as built," with a setback at 11 feet, SUBJECT TO THE FOLLOWING CONDITIONS : 1) There be no adverse lighting - all lighting must be shielded to the ground to prevent annoyance or glare onto neighboring properties. 2) That it remain unroofed , as applied . Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Dinizio, Wilton and Villa. This resolution was duly adopted. lk Z4 GERARD P. GOEHRINGER, CHA� r i FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL Date . . . . . . . l. .(. . . . . . . . . . . 19 .!:3. To7i� . . . . . : . . . . . . . . . . . PLEASE TAKE NOTICE that your application dated . . ... . . . � . . . •, 19 / for permit to �✓` /�t,/�r, , G/�, ���lT7cs�/ • . . Location of Property �5N , , , • •QG • , • •�Jj�'/, _ f�--�j�,�jv�/ House o. Street • • • • Hamlet County Tax Map No. 1000 Section . . 3� . • . . . . . Block .4 .- . .. . . . • . , . Lot . . ... . . • , • , , , Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . . Lot No. . . . . . • . . . . . . . . . . . is returned herewith and disc pproved on the following grounds . .,����G,ii�/• . . . . . . . . . . . . . . . . . . . . . . . . . .? . . . • . .ar. . . . . . . . . . . . . , • . . . . • GST= • �c ; o . . . . . `.` o . . o /. .0 .lc •��ltr��r,L . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 - 00 . . . . . . . . . . . 00 . . . . . . . . . . 00 - . . . . . . . . . . i • • . . . . ` B i gInspector oo µ RV 1/80 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTi`tENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date . , , ,DECEMBER 6,. . . . . . . I9 93 . To . .$ireY�$.Y�ssey. . . . . . . . . . . . . P.O. Boa 53 East Marion, N.Y. 11939 4 PLEASE TAKE NOTICE that your application dated . . . . .NOVEMBER 3, . . . . . . . . . . . . . . . .. 14 ,93 , folpermit17 FOR DECK,ADDITION "AS BUILT" . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at Location of Property . . .z lU5 ,QI;D,ORCHARD LANE EAST MARION, NEW YORK HouseNo. . . . . . 8t�eet ' . . . . . . . . . . . . . . . . . . . . . Hamlet County Tax bfap No. 1000 Section . . . . .37 . , . . . .... Block . 03. . . . , . . , , . . Lot 06. . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . Filed hlap No. . . . . . . . . . . . . . . . . Lot No. . . . . . . . . . . . . . . . . is returned herewith and disapproved on the following grounds . . . . . . . Building Permit. #21755-Z.was issued, but upon .inspection• it•was•noted• that:. . .1;The above grade. deck. . . • • "AsBuilt" put the accessory garage• in. the. side•yard,. and ..2:-.The_deck encroached in. . • • . • .therequiredside yard setback on anR-40Zone. • : . . • ' ' 1. Chapt.. 100-33 and 2. Bulk Schedule R-40 Zone. • . . ACTION REQUIRED BY THE ZONING BOARD OF APPEALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . B ding Inspector ry J. Fish RV 1/80 t� BOARD OF APPEALS.TOWN OF SOUTHOLD In the Matter or the Petition of I ' 5P a n 2 GI�1 Cheri xh)177 NOTICE TO to the Board of Appeals of the Town of Southold ADJACENT 11-1 TO: , jDIVV"'13Ui �� e5) . PROPERTY OWNER 53095 MG4 c� .5orU+i-)C)), , y ,)q r7 - »"79 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to petition the Board of Appeals of the Town of Southold to request a ariance (Special Exception) (Special Permit) (Other) . . [circle choice] 2. That the property which is the subject of the Petition is located adjacent to your property and is des- cribed as follows: n�1f7�l�oa� ,l/ rr 139 s� rM *e i000 - 3`)- 3-6, 3. That th property which,is the subject of such Petition is located in the following zoning district: 7D 4 That by such Petition, the undersigned will request the following relief:'-/&- o ley QI" c 2550 L r cI ' Q rd Gn �1 ro �ecl In l+v- re df- rd -40 ane.. 5. That the provisions of the Southold Town Zoning Code app icable to the relief, ought by the under- signed are Article I[0 Section .:3� rll�C�� &)/C- I- du l-e— K-41) ;Z0f)e_ j ] Section 280-A, New York .Town Law for approval of access over rights)-of-way. 6. That within five days from the date hereof, a written Petition requesting the relief specified above will be filed in the Southold Town Clerk's Office at Main Road Southold, New York and you may then and there examine the same during regular office hours. (516) 76'5-1809. -7. That before the relief sought may be granted, a public hearing must be held on the matter by the Board of Appeats; that a notice of such hearing must be published at least five days prior to the date of such hearing in the Suffolk Times and in the Long Island Traveler-Mattituck Watchman, newspapers published in the Town of Southold and designated for the publication of such notices;that you or your representative have the right to appear and be heard at such hearing. , Dated: etition r Owner ' Names :�eyj_n% �Q:�c�l G��� l zhlill Post Office Address 50x 53 rrt 144rjon /pry I1Cf3o1--60�;3 Tel . No . (silo [Copy of sketch or plan showing proposal to be attached for convenience purposes . ] J . 7 ?f 5-1802 BUILDING DEPT. INSPECTION [ J FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND INSULATION ] [ � SOLATION [ ] FRAMING [ INAL REMARKS: DATE �S 3 INSPECTOR C)q Lo suaciNc DE". INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1N CATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ��� /Leq,ccr� DATE div INSPECTO ! cl 7r� 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: O�af rp DATE 0 /I" INSPECTOR �/�'1 I::LD I::S:'?cN U_ ATT.,�� LOMMENTS r3 7OU11DATION ( 1st ) 6 J F OUNDATION ( 2nd ) 2 . . � z o � ROUGH FRAME & U •PLUMBING t ti 3 . ►3 rxl INSULATION PER N . Y. „ y STATE ENERGY CODE l 4 . y FINAL ite C I � � DDITIONAL COMMENTS : x ZZ S H 9 y H �U tv ^0 H BOARD OF HEALTH . . . . . . . FORM NO. 1 3 SETS OF PLANS , . . . , . . . . TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CHECK . . . . . . _ _ _ • . • • . . . . . TOWN HALL SEPTIC FORK • . . SOUTHOLD, N.Y. 11971 c�-, ^^S�TEL.: 765-1802 t:oi I FY 0 • 1 77' Examined ,�� . . 19�:� r>1�)C 'c� ��' MAIL TOT . •_• PP / /y A roved . .�� , 7, , . , . . . 19,:.�. Permit No.' -3� ' • ' ' ���� - Disapproved.a/c . . . . . . . . . . . . uildi Spector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .119 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3 sets of plans,accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets s or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. C. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building,eode, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in ecti ns. �. . . . . . . . . . . (Signature of applicant, me, if a corporation) Pb,dax 53. . . _5f. . . . . . . . . . ... . . . . .I�IGritrl ,/1,� it 9 39 . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . U�!i��r. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:. . . . . . . Name of owner of premises SC�I.0 y 1,fhe 5el-a1i . . . . . . . . . . . ... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Plumber's License No. . . . . . ... . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . , , , , . , „ , 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . House Number Street Hamlet County Tax Map No. 1000,Section . : . :. . . . . . . . . . . Block . . 2. . . . . . . , . , ; . Lot . . Subdivision.. C�/Y�//7�r5 p�/ atC� t'S. . . Filed slap No. `�� ^. . . . . . Lot /.3 /3A. . . . . 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancyr:. . . . • . . . b. Intended use and occupancy � . . � . . , , W?t^��� (��c, � �S� . 3. Nature of work (check which applicable): New Building . : . . . . . . . . Addition . . . . . . . . . . Alteratio ' Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . 1b Z DCO . ' • e� (Description) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . ... . . . . . . . . . . . . Number of dwelling units on each floor. . . . . . . . . . . . . . . . If garage,number of cars . . , 6. If business, commercial or mixed occupancy, specify nature.and extent of each type of use • . • • • • . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear Depth . • fleight . . . . . . . . . . . . . . . Number of . . . . . . . . . . . . . . . . . . . . . . . . . Stories _ Dimensions of same structure with alterations or additions: Front Rear • • • . . . • . . • • Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . Number of Stories . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . , . • • • • • • • • • • • • • • ' • ' Height Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Number of Stories . . . , ci. Size of lot: Front . . Rear. . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . .: . , . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . r�:�:'. :7 . . . . p th . . . . . . . . . . . . . Name of Former Owner 11. Zone or use district in which premises are situated , _ • • •. ' 12. Does proposed construction violate an zoning law, • • • • • • • • _• . . . • ' • x g , ordinance or regulation: /�� . 13. Will lot be regraded . , , , , , • , , ,N, 0 , , , , . , Will excess �} a removed from premises• • • • •Yes • . 14. Name of Owner of premises �f'�-'.1! n. Y�./ , , , , Address X45�`� �h''y� �7?:Phone No�•����,' ';7;�;�5 ;�5, Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . .Address 1�9b 4e',. . Phone No. Name of Contractor . . . . Address .Phone No. • • • • • . • • 15. Is this property within 300 feet of a tidal wetland? *Yes. . .. � � • � • . . . . . . . No. 211• *if yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. k E, of •. T - ilil: l"N '±Y.,y i„J d•• /i-l;c 2'..,.. q,'E ENERGY C'717ES, 140rl RESPONSIBLE - FOR ,:z :'r-.1-i l;ONSTRUCTIf. N ERM)PS STATE OF F • . LOVip .� s.s COUf_Y . 0 • • : • . . . . being duly sworn, deposes and says that he is the applicant • • •�. •(Name of individual signing contract) above named. fieis the . . . . . . . . . .� � .✓ . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent,corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this-application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . .`. . . . .day of: . . . . ., 19 : Votary . . . . . . r Pu lie .\ . . . . . County CLAIRE L GLEW Notary Public,State of New York No.4879505 . . . . . . . . . . . . . . . . . . . . . Qualified in Suffolk County (,!� (Signature of applicant) Commission E*ires December.8,19._ - ---- ----- - __ — - — f f ov f 1 MAP OF. PROPERTY this Law. dy0tt Law. oMIS It.Mveyrzodc stela ., IChMj not been al eum TEV EN, tmalft 1,�EY, o pat-g d he►eon s 317 rJn F Ntla ed Onwhotr Lia sun©y CHEQYL � hb behz f to the 3 5,QAJTT ggbn. the tends ency ef and �►gnee of arsMIZon end AT rs Ls:iwnort tr2ri fnse►tlable 1 EAST . MA 10-N uenc TOWN OP SOUTHOA-0v N.Y. t _ 4 �► N.58 5B �, ZG5.�5 ,? fir- E•�0°� � t �aY � Ott.No _ _ FA F/w 30"t++!,lJ. f i v U 00 CIQ 30 A _r`JD CW,.25 JDS S of NEy, 4 Rf ER AS S(. t t p p T it � .�.. QoO EQIC V VAN, TU PC A 1 t . 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