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HomeMy WebLinkAboutPWIB North LLC Glenn Goldsmith,President �OF S0(/jy Town Hall Annex A.Nicholas Krupski,Vice President ��� ��� 54375 Route 25 P.O. Box 1179 John M.Bredemeyer III l Southold,New York 11971 Michael J.Domino G Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 OOUNTY ---=- ------- --��AR�O��OWN T.KUSTEES- TOWN OF SOUTHOLD February 10, 2021 John J. Condon, PE Condon Engineering, P.C.• 1755 Sigsbee Road Mattituck, NY 11952 RE: PWIB NORTH LLC 1230 CLEARVIEW AVENUE, SOUTHOLD SCTM#: 1000-70-x-56 Dear Mr. Condon: The Southold Town'Board of Trustees reviewed your letter received in-this office on February 10, 2020 and the sanitary plan prepared by Condon Engineering, P.C., dated January 7, 2021, and determined that the proposed activities including the abandonment of the old sanitary system are out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no clearing, no removal of vegetati cut or fill of land-or removal of-sod;-no-construction, sedimentation, or distu"—b"Ce of any kind may take place within 100' landward from the top of the bluffer`seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without further application,to, and written authorization from, the Southold Town Board of Trustees -pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area 2 between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm, This determination is not a determination from any other agency: If you have any further questions, please do not hesitate to call. Sincerely, Glenn Goldsmith, President Board of Trustees GG:dd K MODEL NO. SINGLE FAMILY RESIDENCE487 PUMP COMPRESSER POWER CIRCUIT 120105 PINE NECK ROAD CONNECTED TO PUBLIC WATER 091 a- G II CB1w w 070 067 ° -��. euc M1 Buc SPI SPRAY PAGE L1 z \ 067 I PUMP 1 > \ ° > N `"'T ""T N MOTOR PUMP RATINGS: CUSTERAVENUE a SOUTH \ SINGLE FAMILY RESIDENCE �O • LO 3/4HP ® 115V S CONNECTED TO PUBLIC WATER o CB2 M2 CSR 6 LOOPS II G 15.0 F.L.A. A 9 0 0-B1f �"` RP RECIRC UMP RATINGS: ® PUMP 3/4HP 0 115V w g n ""T '""T W CLEARVIEW AVENUE m y PROPOSED 5PYs EXPANSION 8.5 X 435'X N MOTOR 15.0 F.L.A. z V DEEP LEACHING GALLEY M.OF 3) •!�\ \ ° 1 5 Ila > CB3 11 G a z = \ ,B3 M 3 f- �s0• BU( Buc N BIC 'PMIXER UMP RATINGS: g 4HP 0 115V = TEST HOLE MOTOR 15.0 F.L.A. o Z 0 \M -Z l��l\ \ SINGLE FAMILY RESIDENCE ° ° e II G PROJECT 4Q PROPOSED RELOCATED WATER SERVICE / \ •. EX WATER SERVICE CONNECTED TO PUBLIC WATER CB4 LOCATION GOOSE CREEK o/Q ��yeNr \ ° ° ° car --�� cRr Cl COMP COMP. RATINGS: 8Q \ PROPOSED \ ° - / •"�? 1/4HP 0 115V LOCATION MAP PROPOSED 8S X 4.75 X 4'DEEP � ,aM� a �\v��'� 0�0 oto\�DISTRIBUTION BOX \ ° � N MOTOR 5.4 F.L.A. LEACHING GALLEY(TYP.OF 6) b94� '. \ 064 " \ NOTE: ALL MOTORS GENERAL NOTES \ � \\ 0e3 In MUST HAVE INTERNAL 651'1150'MIN) L' / .\ � \ \ 493 Cn a �� , \' �� 4C, /j►`%� \ / E PLC CONTROL PANEL 488 OVERLOAD PROTECTION. s �� �`� // o R /•p�O �, W/ HP120 COMPRESSOR o, LR1-Ql „m MHr 1. ALL MATERIALS AND METHODS OF CONSTRUCTION SHALL CONFORM TO THE STANDARDS AND / O s REMOTE c� / j F Ml SPECIFICATIONS OF THE LOCAL TOWN OR VILLAGE AND THE SUFFOLK COUNTY DEPARTMENT OF g Mill�i'�' Si//, +�' \ \ / TO REMOTE OPS ow LR1-Q2 PINx M2 " r HEALTH SERVICES AS REQUIRED. L)BEABANDONEDS�' Q t�dC 1 Q e / VACANT 2. BOUNDARY INFORMATION FROM SURVEY BY PROVIDED BY SCALICE LAND SURVEYING,PC DATED � ° s� / RF NO?S / Pay / C A ECIRC RUNNING 411/2019. ELEVATIONS FROM SUFFOLK COUNTY GIS VIEWER AND ARE REFERENCED TO THE NAV 88 ��° 'cFOFA'CTpRY / X40 \ \ _ 8,,, LR1-Q3 M3 � DATUM. \ 3. THE CONTRACTOR SHALL FIELD VERIFY THE LOCATION AND DEPTH OF ALL UTILITIES PRIOR TO THE PROPOSED HYDRO-ACTION OqO\ \ G IXER RUNNING COMMENCEMENT OF WORK. THE CONTRACTOR IS ADVISED ALL SUBSURFACE INFORMATION SHOWN FM LOT 7 °M o �a AN-800 IIA OWTS \ ow LRT ON THESE PLANS IS CONCEPTUAL AND MUST BE CONFORMED ACCORDINGLY IN THE FIELD. TAX LOT 57 °Nc ARgCE / o Fti ELECTRIC LINE TO BELR1-Q4 SINGLE FAMILY RESIDENCE _� yz• \ ,� 4. A MINIMUM SEPARATION OF TEN(10)FEET HORIZONTAL AND EIGHTEEN(18)INCHES VERTICAL IS TO RESIDENCE TO BE CONNECTED gs �o .� PLACED IN CONDUIT 16 PLC INPUT BE MAINTAINED BETWEEN WATER LINES,STORM DRAINAGE AND/OR SANITARY LINES OR � R bN ° TO PUBLIC WATER �2 '4' ° \ AC ��� �s PROPOSED HYDRO-ACTION CONTROL eLu AS-1 pNK STRUCTURES. PANEL AND AIR PUMP ON A 36"X 36"X RUN 5. THE CONTRACTOR SHALL BE RESPONSIBLE FOR SECURING ALL NECESSARY PERMITS BEFORE ,( oR 6"P.C.SLAB WITH 6X6 WIAXIN1A WWM eLrr 5 RED AUD. << _ 7 ALARM COMMENCING WORK. _ PROPOSED VENT TO BE TERMINATED M U TE °� a" 6. ALL UNSUITABLE MATERIAL AND DEBRIS SHALL BE DISPOSED OF IN ACCORDANCE WITH TOWN, 7 HWA THROUGH ROOF WITH A CHARCOAL FILTER COUNTY,STATE AND FEDERAL LAWS,CODES AND ORDINANCES.CONTRACTOR SHALL BE BW TEST RESPONSIBLE FOR DISPOSING OF ALL UNSUITABLE MATERIALS OFFSITE. DEBRIS SHALL NOT BE / ALARM BURIED ON-SITE. EXISTING CESSPOOL TO BE PUMPED DRY AND 69 / O LIGHT 7, ALL PRECAST STRUCTURES SHALL INCLUDE SUFFICIENT STEEL REINFORCEMENT FOR TEMPERATURE ABANDONED OR REMOVED IN ACCORDANCE /(' ��1 64 s3 Rn NX RED NHT AND SHRINKAGE,TRANSPORT,AND TO ALLOW THE STRUCTURE TO WITHSTAND AASHTO H-20 WITH THE SCDHS STANDARDS LOADING AT THE COVER CONDITIONS SHOWN ON THE PLANS. p ENABLE FM LOT 5 35 8. ALL PRECAST STRUCTURES SHALL BE MANUFACTURED WITH 4000 PSI/28 DAY STRENGTH CONCRETE. TAX LOT 55 /h� 0 � BL" 1 2 14 11 PLC INPUT Q Yl 4c? ��� SINGLE FAMILY RESIDENCE 9. SANITARY PIPE TO BE SDR-35 PVC OR AS SPECIFIED ON PLANS. CONNECTED TO PUBLIC WATER �u OVERRIDE 10. DURING CONSTRUCTION,EROSION AND SEDIMENT CONTROL MEASURES TO BE UTILIZED AS y� y 3 4 CSR 12 PLCINPUT NECESSARY TO PREVENT THE TRANSPORT OF SEDIMENT TO OFF-SITE AREAS,PONDS,DRAINAGE F ow wI1 INLETS,ETC. THE METHODS AND MATERIALS EMPLOYED IN THE INSTALLATION AND MAINTENANCE OF ,ry 14 PLC INPUT EROSION CONTROL MEASURES SHALL CONFORM TO'ME NEW YORK GUIDELINES FOR EROSION AND so 83 m TIME DOSE TAN 17 PLC INPUT SEDIMENT CONTROL•. COSTING INFORMATION E 11. ALL BACKFILL SHALL BE SELECT GRANULAR MATERIAL COMPACTED TO 95%MAXIMUM DENSITY AT " LABOR RATES (=PER/1R) Pens eaaouan tmr P9,/NI.an roiiwy BLu DEM AND THE OPTIMUM MOISTURE CONTENT,AS DETERMINED BY STANDARD PROCTOR TEST. V 4gRSy\ SPRq y o�' UNF\ yfpF ?s;Y PERSON 1 =14.50 - \ \\\ 4` Rte° ' 1�FR - _ FR TEST HOLE DATA QTS - - SPRAYTM/VMC@PLC INPUT 12. LOT AREA:21,734 S.F. _ NOTES: FLOAT SWITCH TO BE RATED 2 AMP AT 120V MINIMUM. 5 a tom \ °as WEIGHT RANGE vama MAIN PANEL DISCONNECT MUST BE PROVIDED BY INSTALLER. loTsr \ EL 10.0 NOTES: - W1 B1 1p DASHED LINES INDICATE ITEMS NOT CONTAIN IN THE PANEL. W1 BROWN LOAM(OL) REQUIRED TORQUE FOR TERMINAL BLOCK SCREWS IS 16 in-lbs. 1.0' BILL OF MATERIALS FIELD WIRING MUST BE A MINIMUM OF 60'C COPPER WIRE. BROWN CLAY(CH) CHANGES TOLERANCES DRAWN BY DATE LjL �O 3.0' ITEM P/N DESCRIPTION QTY: F DECIMALS C. BAMICK 11/3/16 SCHEMATIC, ELECTRICAL Lro .xxx- t.00s 4- , �� HA-AN800-R TANK, AN800 245 NITROGEN REDUCTION REMOTE 1 93F� D xx-t.mo MATERIAL SPECIFICATION: 4'04� cS� 25 PALE BROWN FINE TO MEDUIM SAND(SP) A - TANK, AN800 245 PRETREATMENT 1 C FRACTIONAL SCALE: PART NO. ll SEPTICPRODUCTS INC x/x-1.1/64 AS NOTED \ B 130002 SNG STANDARD 2 TANK CONNECTING KIT 1 B ANGLES FULL 120105 \ C - ASSEMBLY, RE-CIRCULATION 245 COMPLETE AN800 1 A x•-f1/r 8.5'(EL 1.5 HIGHEST EXPECTED GROUNDWATER ELEV.) D AN800-P AN800 W PLATFORM COMPLETE 1 SITE PLAN 8.V(GW EL1.2) E EC50-30-L15O-PLC EC50-30-L-150-PLC 1 022.45 SCALE:V=30'-0' WATER IN PALE BROWN FINE TO MEDIUM SAND(SP) [057.0m] 021.65 17.0' [055.Ocm] TESTHOLE BY McDONALD ° GEOSCIENCEDATED 302020. •. AN800 245 NITROGEN REDUCTION SYSTEM DRAWN Br: ADAws 136cm] • [33. I GROUNDWATER ENCOUNTERED • APPROVED BY: SIGNATURE DATE REV. PART# , • • 8.8'BELOWGRADE hydr Ct10A 08/02/17 0 HA-AN800 A°"R�A•°• '• i 11j • • CUTAWAYMEW m 15.60 020.65 Notes: * _ [052.5cm] BOTTOM MEW TOP MEW 13.74 EX. ' All wiring and equipment are to be be provided and installed by the Electrical [34.9cm] ELEC contractor(EC)in accordance with the National Electric Code(NEC)and Local POLYLOK 20"D-BOX INSIDE BOX Box ACCEPTS: PANEL Electrical Codes. PART NO.3017-20 UGHT COVER PART NO.-3009C MATERIAL-HDPE HEAVY COVER PART NO.-3017•C20 GRATE- PART NO-3017-(320 •The EC will file all necessary forms and pay all fees for the electrical work DATE; 8/12104 6•TALL RISER PART NO.3009 shown on these drawings.The contractor will arrange for all inspections and 12'TALL RISER PART NO.3009-R12 secure a Fire Underwriters certificate which is to be turned over to the owner at EXTERIOR RATED JUNCTION the completion of the work. 22.45[57.Ocm] BOX BELOW GARDE IN A 20 AMP BREAKER SPRINKLER BOX 'All foundation penetrations for entry of directly buried feeders are to be equipped with galvanized steel sleeves. RMC is to be used at an other foundation and floor 2.00[5.08cm 12 AWG OF WIRE IN penetrations. [409 m] CL.TO CL SIDE CUT OUT TYP.40 PLCS.] TO ACCEPT 3/4"PVC SCH 80 P°LYLOKSEAL `Furnish and install new service equipment and circuit breakers as shown in PRT.NO.3001 CONDUIT these drawings. All panels and breakers are to be labeled.The electric panels TYP.40 PLCS. are to be installed and grounded in accordance with the NEC and Local Electric 13.91 6.00[20.32cm Codes [35.3cm] s CL TO CL] PLC CONTROL PANEL W/HP80 COMPRESSOR AIR PUMP `All switch and outlet boxes,junction boxes,and pun boxes installed on the 306„ exterior are to be galvanized steel and rated for exterior use. (a ] ELECTRICRISER DIAGRAM •All exterior outlets are to be housed in weather proof enclosures. FRONT/SIDE MEW NOT TO SCALE POLYLOK 3017-20H6 20" ROUND SEPTIC DISTRIBUTION BOX DETAIL NOT TO SCALE HEALTH DEPARTMENT APPROVAL STAMP WATERTIGHT PLASTIC FRAME&COVER W/APPROVED 2"VENT LOCKING DEVICE TO WEIGH 60 LBS.MIN.OR SECONDARY THE VENT TO BE TERMINATED SAFETY LIDS 1 DEVICES TO BE PROVIDED 117/21 SCDHS COMMENTS CONCRETE C01/ER CONCRETE COVER CONCRETE COVER r, 18"MIN.ABOVE GRADE D I� REVISIONS 18'MIN. BELOW GRADE BELOW GRADE BELOW GRADE t� CARBON FILTER PROVIDE END CAP TYPE LEVELING 24Y0 PLAS11C RISER RINGS (' DEVICE 2"VENT TO UA UN DEVICES AT OUTLETS (12'MAX.HEIGHT) `F-6 F ���✓f- 2•MAX F E B 1 0 2021 o' F.F.EL.12.0 LOW LINE 11MIN TRAFFIC Lj� �pSEP/l C BEARING SLAB TRAFFIC TRAFFIC TRAFFIC CLEANOUT EL 10.3 E 11.1 L 11.1 EL 10. FINISHED GRADE BEARING SLAB BEARING SLAB EL 10.1 BEARING SLAB �k p� .--- ---- IN EL 8.5 MIN. INV EL 8A NV EL.8.25 TM 2'MAX T MAX Southold Town r ____ INV.EL 8.1 INV.EL 8.9 - - - _ - - - ALL LEACHING POOLS SHALL BE PLACED IN Board Of Trustees C-) c'. IN EL 8. ®®®IM a 53®®®® 39®ca ACCEPTABLE LEACHING SOILS AS APPROVED BY 4'PVC WASTE 4"PVC WASTE ®®®lk 0®®® ®® 4"SANITARY WASTE PIPE r MIN, 4' THE SCDHS. IN THE EVENT POOR LEACHING F� `v c7 LINE " LINE PITCH 1I8 8'EQUALIZATION 8"EQUALIZATION 59 PITCH 114 INCH PER FOOT co co 20 Q 2•-0• 7-0• MATERIAL IS ENCOUNTERED,EXCAVATION IS TO /O PITCH Ys INCH INCH PER ®� PIPE PIPE ® EL.4.5 'Ell PER FOOT FOOT MIN. MIN. BE CONTINUED TO SUITABLE MATERIAL AND OF 1 ���' 13'(10'MIN.) 25 rM1N. �I� (6)4 FEET DEEP GALLEYS = BACKFILLEDAS DETAILED. CUTTING RINGS MAY ESS:fl II _ S.C.T.M.: DIST. 1000 SEC. 70 BLK.9 LOT.56 F�--S MIN. 14'(T MIN.) `= 3'MIN. [ BE REQUIRED. PROPOSED HYDRO-ACTION POLYLOK 3017-20H6 [ WATER EL.1.5 NOTE: AN-800 VA OWTS 20"ROUND SEPTIC _, GROUND WATER _, LEACHING GALLEYS TO BE Condon Engineering P.C. B E N I C RE S I D N E C E DISTRIBUTION BOX OR (HIGHEST EXPECTED Plans are prepared c Condon Engineering,P.C. It is a violation of the Scale:AS SHOWN ����� II���������III� (N ) III�II ���� I IE���� ���� I MANUFACTURED BY LONG ISLAND HYDRO-ACTION AN-800 DETAIL APPROVED EQUAL ���I�Illlgll L�IIIEdb_ IIIQIII II���II PRECAST OR AN APPROVED EQUAL New York State Education Law,Article 145,Section 7209,for any LOT6MAPOFSMITHFIELDPARKFILENO.4770 person unless actin under the direction of a licensed Professional 1755 Si sbee Road LEACHING GALLE ETAIL p g DATED DECEMBER 27,1966 OF Engineer,Architect,or Land Surveyor,to alter any item in any way.If an Drawn by:JJC g f item bearing the seal of an Engineer,Architect,or Land Surveyor is Mattituck, New York 11952 1230 CLEARVIEW AVEN U E altSANITARY SEPTIC SYSTEM PROFILE the rRemhe h eriealanng ither,Architectftered rfollo edor by IlMeaffix o 631 298-1986 631 298-2651 fax SOUTHOLD, NY the item his/her seal and the notation'Altered by'followed by hislher Date:5/26/2020 NOT TO SCALE signature and the date of such alterations,and a specific description of www.condonengineedng.com the alteration. SANITARY PLAN f f f Glenn Goldsmith, President �QF SOUrTown Hall Annex A. Nicholas Krupski,Vice President ,`O �0-� 54375 Route 25 P.O.Box 1179 John M. Bredemeyer III Southold,New York 11971 Michael J.Domino G Q Telephone(631) 765-1892 Greg Williams �� �� Fax(631) 765-6641 �yCOUNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD NON-JURISDICTION INSPECTION DATE OF INSPECTION: " 1/2 INSPECTED BY: i�Z`9 y Ll Ch. 275 Ch.--1 11 COMMENTS: .. - _ -1 SEE sM Na as A gat CK 11E Q" ♦ is _ vtMd �. T— CMM WEST lIel RD. isot � aB 78 � { Hu ty o a a z! m '•zyq 17 •t � TOWR oP samtotD Omt x a.a , 7• b '3 o b '� � tAA(d tic) n-awll _ „ sm m3 a r , ,�. r a .� � a ,. • n � �,yvEs � � ..w>a w+ 3 2&2 33 463 n95lOA.q S.UHOLDSptOo'L.'D"jFTTwTN03 - b w•�Yj.�'.-eit�,�•C.e��4t,*'�f�l• _'��,D^OrTg'�•�9', b!,,NpP,1�•,4?�b�,w► �w�i/rye-..�-�B a u HO1V��. NOAo -�,\Yy+ /.9.Jf., •,�A\(\-—.\1y�\0v:�\'I/lii�/i s�t•1A / ../j tan tato rata tan taa ms m ` •2, a f /` tsa t]A(q 1.1h(c) t.ao(d T71. 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TtiB-y-�- !.]w ! 5 ° ! ] � � A Tr o _ s 59 se � � 6t s° ^, A a j d aow FOR PCL NO.% -•, `i.. ii�6 6 m w O m n aEARUEw AVE. �� A w � sr t z� -�.�' --�..-3'`�.1L�__—INE MATCH r M u w A u t1A r TOWNSOUTHMD aP ttntNo.en+tN�n P.p,� S u am towtaP SOUTHOLD SEGTpN NO NOTICE COUNTY OF SUFFOLK © E Real Property Tax Service Agency Y p,. aB as vauoEOP X70 E e..,..�..,>. _�— ,,..r...►,. Rt) .. O o,.,.W --.-- ,..,.u---.r-- twna�xr roBria+ar t.• cc�.�,tr c.m.r w.N,oa.a,xrnw, w ,>� ,nv>wt wtweu •+ uB,r "�•' nr/tAAtwu,tt'TN�,e>vm nm.e*]a � av+t �c ,m A O•rr.uu. ____�; r,tr. ' - ___ _ „r,r.•w,r--•-- ,,,nom m a m DBrtee/ 000 PROPERTY MAP _ ansae, wm.er,w,wssiu+^�r*� ym P On s+s N ^�r � >0 r u,NT•,yM W —--- u..u^ --t-- uru.--.r— _ mweuu/nt,E.»n.s+ Condon Enganee6ng, Poco New York State Licensed Professional Engineers 1755 Sigsbee Road 631-298-1986 Mattituck, New York 11952 Fax 631-298-2651 www.condonengineering.com February 9, 2021 Board of Town Trustees Town Hall Annex Building 54375 Route 25 Southold NY 11971 Re: Trustees Wetlands Permit— I/A OWTS— 1230 Clearview Avenue, Southold, NY SCTM: 1000-70-1-56 Dear Board of Trustees: Attached please find the following for your review and approval- Two sets of the proposed sanitary plans • Check for$50 for the application fee • Authorization form • Owner permission form The Suffolk Country Department of Health services is requesting a letter of non jurisdiction from the Board of Trustees for the proposed sewage disposal system installation. The owner proposes to install a new I/A unit with leaching galleys in the front yard of the property in accordance with the Suffolk County Department of Health Services requirements. The existing cesspools in the rear yard will be abandoned in place. The existing cesspools and proposed sewage disposal system are more than 100' to wetlands. It is my understanding that the proposed project is exempt under Code Section 275-4.A(1)(k) since we are moving the septic to the front yard away from the wetland and all work is greater than 100' from the wetland. Thank you for your assistance. Please call me if you have any questions. Yours truly, JV Condon, P E. E102 E thold Town d of Trustees Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) UWe, owners of the property identified as SCTM# 1000-_7 b ,�_�,� in the town of — �av -New York,hereby authorizes 576111 J to act as my agent and handle all necessary work involved with the application process for permits)from the Southold Town Board of Trustees for this property. I Properly Owner's Signature Properly Owner's Signature SWORN TO BEFORE.M E THIS_ S`k-- DAY OF UM ,20- -- Notary Pu z BRITTANYA.GENOINO otary Public,State of New York No.01 GE6245154 oualified in Suffolk Coun mmission Expires July 18,20?r Board of Trustees Application AFFIDAVIT M i e POUF P �� rt v DEPOSES AND AFFIRMS ULY SWORN THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNERSET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED-BY THESOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE`TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETINGTH ,IS APPLICATIONI HEREBY AUTHORISE THE PRESEN TRUSTEES,THEIR AGNT(S)OR RETATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TQE�TERONTO MY PROPERTY TO INSPECT THE PREMISES IN-CONJUNCTION.WITHTHIS APPLICATION, INCLUDING A FINAL INSPECTION. I FUR 'HER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONT O MY PROPER TX AND AS,REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION DF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. 4Sigggnature Property Owner Signature-'of Property Owner SWORN TO BEFORE ME THIS 54 DAY OF , 200-4 _n n PUbI gRITTANYA.GENOINO Notary Public,State of New York No.01 GE6245154 Qualified in Suffolk County Commission Expires July 18.201-,2)