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HomeMy WebLinkAboutTR-3792 Glenn Goldsmith,President *QF SO(/�yO Town Hall Annex A.Nicholas Krupski,Vice President ,`O l0 54375 Route 25 P.O. Box 1179 John M.Bredemeyer III Southold,New York 11971 Michael J.Domino c/30 �c G Q Telephone(631) 765-1892 Greg Williams � Fax(631) 765-6641 �yIUNTV,Nc� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 20, 2021 Dean C. Lennox .1604 Bryan Avenue Ocean, NJ- 07712 RE: LAGOON-LODGE LLC - 270 KNOLL CIRCLE, EAST MARION SCTM# 1000-37-5-14 Dear Mr. Lennox: The following action was taken by the Southold-Town Board of Trustees at their Regular Meeting held on Wednesday, May 19, 2021: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#3792 from Grant H. Lennox to Lagoon Lodge, LLC, as issued on January 26, 1990. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, Glenn Goldsmith, President Board of Trustees GG/dd Glenn Golds" 1, President Town Hall Annex A. Nicholas-,':rupski, Vice-President � �q 54375 Route 25 John M. Bredemeyer, III o P.O. Box 1179 Michael J. Domino o Southold, NY 11971 Greg Williams �,o� p�r t Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �-6 }1 9,.s� Completed in field by: LAGOON LODGE LLC requests a Transfer of Wetland Permit#3792 from Grant H. Lennox, as issued on January 26, 1990._ Located: 270 Knoll Circle, East Marion. SCTM#: 1000-37-5-14 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7, Placement,of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Surveys 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other Glenn Goldsmith,President Qv SQ(/��0=�, Town Hall Annex A.Nicholas Krupski,Vice President f�O �� V 54375 Route 25 John M. Bredemeyer III P.O.Box 1179 Southold,New York 11971 Michael J.Domino G Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 p F '!J BOARD OF TOWN TRUSTEES APR 2 2 2021 TC NVNI APPLICATION FOR TRANSFER OF WETLAND ERMIT so"'t(iiidi 1&in Board of i;"Stens DATE: q12-D 2-, C PROPERTY OWNER NAME: MAILING ADDRESS: 1664- ?rJ OIA 4v4 . Qce4,j AJV- D 77)Z. PHONE: 4' AGENT: PHONE : ,,ADDRESS: PROPERTY LOCATION: 27o knn1 orl&A /i TAX MAP NO.: 1000 a 37, 5- 14` UWe U;p!oh tvd a s44ror U 'LeKttae.1 , v, C. L&h_� j3�r�✓a.��l,. �ey�oo� request a Transfer of Permit# 37?2 from 6rix4 Oeeecte-40 Signed by: e April 19, 20211E C_E LIVE `_ Board of Southold Town Trustees APR 2 ,2 2021 ,Town of Southold =�� Suffolk County, New York Loanof i'uS220- Dear Trustees: Our property at 270 Knoll Circle in East Marion was deeded over from Grant H. Lennox to Lagoon Lodge LLC in 2016. During a telephone discussion with your office I was informed we must provide ownership change forms of current LLC members to the Trustees office since the 1990 Bulkhead Permit(#3792) contains the name Grant H. Lennox, not the name.of the LLC. In 2016 the property was deeded to Lagoon Lodge LLC and at that deed is on file at the Suffolk County Records Office. At the inception of Lagoon Lodge LLC, the following were all members of the LLC: Grant H. Lennox Dean C. Lennox Arthur H. Lennox II Barbara L.Westwood Grant H. Lennox died in 2017. Enclosed are notarized Trustee ownership change forms for each of the 3 remaining members of.Lagoon Lodge LLC. Also enclosed is the Application for Transfer of Wetland Permit. We are requesting this information to be recorded correctly as such. Thank you, /} Dean,C. Lennox, Organizer and member Lagoon Lodge LLC 1604 Bryan,Ave. Ocean NJ 07712 - hoard of Trustees Ap*ca'-4 on AFFIDAVIT BEING DULY SWORN DEPOSES AND AFFIRMS 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 MANNER SET FORTH IN THIS APPLICATION AND AS MAYBE APPROVED BY THE SOUTHOLD 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 COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. �r ?Sig&n[n1aatAur'_ ro erty Ow er Signature of Property Owner SWORN TO BEFORE ME THIS 2,( DAY OF-�A ou) c,4 _ _,20L-I 6SNRY Kimberly A.Walker Q o� NOTARY PUBLIC STATE OF FLORIDA Y i Comm#GG207964 Notary Public INCE ts�� Expires 4/16/2022 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM -1 he Tounl of Sd'ti Code of Ethics ?tohibits conflicts of inlerq t(in Elie Hart ofyi ofligers and t nmplovices.The ur se of Ellis tirrm i5 to provide infnrnration,�hit h can alert the tmyat of sot ssibic Conflict~of interest and allow it to ta4:c,�hatcver action ie necessan,to avoid same. YOURNAME: � -�= (Last n e fust name, iddle initial,unle you are applyi a name of someone else or other entity,such as a company.If so,indicat a other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building _ Variance Trustee Change of Zone Coastal Erosion _- Approval of plat _ Mooring — Exemption from plat or official map _ _ _ Planning _ Other ' (If"Other',name the activity.) Do you licrsonally(or through your cotnpa113•,sP0uSC.sibling,pawnt,or child have a relation zhip,+ith any ollicer or employee rl•the Town oi'Southold? '9Lelalionshi[; includes b% blood.nlarriare.or hnsines-interest "l;usulcs5 inteiest'mean,a hu,iness, including a partnership.in which the town officer of eniplo)ee h.i,even partial ownr: ltip nl(or cnthluyutent bpi a corporation in which the town olTicer or enlplo%ec owns more than 5',N,of Ehc shares. YES _ NOy _ If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold_ Title or position of that person_ — Describe the relationship betwcen}•ourself(the apl)hcxit/,icnt/representative)and the town officer or employee.Either check the appr%,priate line A)through D)and'or descrilx in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 51-of the shares of the co,p oruc stock of lite applicant (when the applieutt is a corporation): B)the legal or beneficial owner of any interest in a non-corporate entit} (when the applicant is not a corpolation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP �tpRy ss Kimberly A Walker Submitted this 2b d y yf CAICA- 20;?� Q ¢�NOTARY PUBLIC 5imiature o — 221 —STATE OF FLORIDA _� �m� ,—� _ 0 Print Name - '�` Comm#GG207964` Form TS 1 s/NCE 19�® Expires 4/16/2022 Board of Trustees Ap icy on AFFIDAVIT a PPR ;E)V/v d�& BEING DULY SWORN DEPOSES AND AFFIRMS 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 DOME IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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 COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGEIQ T(S).OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARll OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES,DURING THE TERM OF THE PERMIT. Signa £Property Owner Signature of Property Owner / SWORN TO BEFORE ME THIS I DAY OF rV 14 iC '202-1 - 4-Notary J. � 0 vy,� Notary Public State or Florida KPAlic . Jessica Milner M'?oiap��� Expiirres 11/04/2024 060347 APPLICANT/AGEl\NUREPRESENTATIVE TRANSACTIONAL DISCLOSU"FORM The Tgwn of Southold's Code of Ethics prrobibits conflicts of interest on the part oftown officers and cmp o ees.The purpose of this form is to provide information which can alert the wn of passible conflicts of interest and allow it ter take whatever actions gecessm to avioid YOURNAME: (Last name,first name,ipiddle initial,unless you are applying to the name of someone else or other entity,such as a company.If so,indicate the other person's or eomgany�s name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town,of Southold? `-`Relationship"includes by blood,marriage,or business interest"Business interest';means a business, including a partnership,in which the'town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO D. 11''" .1. If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicantlagentlrepresentative)and the town officer or employee.Either check the,appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicm.t (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitte t sk"' f� 2®Signatur PrintName � Form TS 1 �-JAI op#, Notary Public State of Florida Jessica Milner w- My Commission HH 060341 '�oi_pa Expires 11/0412024 Board of Trustees Ap4jicr1- ,`on AFFIDAVIT BEING DULY SWORN DEPOSES ANO AFFiRms THAT HE/SHE,IS.THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAInD HEREIN ARE TRUE TO THE BEST OF HIS/TIER]KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SO1�THOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES-TO HOLT)THE TOWN OF SOUTHOLID AND THE -BOARD OF TRUSTEES HARWLESSAND FREE FROM ANY AND .ALL_DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), =GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AI7THORIZE THE TRUSTEES,THEIR AGENTM OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO;ENTER ONTO IMS'PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. -T FURTHER.AUTHORIZE THE BOARD OF TRUSTEES TO ENTER'ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PER UT ISSUED HV THE.HOARD OF TRUSTEES DAG THETEM OTHE 1 HE PERLlWa Signature of Frroperty,Owner Signature of Property Owner SWORN TO BEFORE ME THIS b -DAY OF, ����,� , - ,, 0-2 Ido I'ubDic coPh;"i s) e X f) v`ej �v �i 141���, APPLICANVAGENT RRPR.ESENTA'TT TRANSACTIONAL DISCLOSURE FORM 7#te Ttivi=tf of sr�t olc#'s bode of 3 r?c s{rohWts gat ltic�Ps a interest tl a f' 9 s#ia c anti em'toy f t i 1tal s�mr idP iitforh: €ic�h avhich cau pl rt r#cru n ofRgssil�le ersnel ,ot'ihi ics3 and 8116ry itto tAe ry e rtev T4_cg�is recess i o avoid"sisrie, YOUR NAME: AL (Last name,fust ndme,.zpiddle initial,unless you are appl3(ing1fi the name of < someono else or other entity,such as a company.if so,indicatey the other person's or company's name.) NAME OFAPPLIOATIf . (Check allthatapply4 Tax grievance Building Variance _ - Trustee Change of Zone _, Coastal Erosion Approval of plat _ Mooring, Exemption f om plat-or official map _ __ Planning Other (if-Other',name the activity.) rop°yat pe ndfly,(or through your_cenapany,spoouse;'sibluta,, parertt;_oi�child)-hayv a"relafionship,with anyaff qqr or employee of die Town-of Southold?."Relationship"includes by bloddi-marriage,pr bttsittess'interesL"Busing interc&'mean"basiness, lstcluiiing a pmrtnarsl:tp,let which the-town officer oremplpym has eves a partiai'ownerslii{for(of empltiy)itcbrik,a.ton in v;lticl:tli tot+ s1 attic r,dr cmplo c e owns ` tt tha�'o of floc sharp s. YES NO if you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold r Title for position of that person D=tibe,the aeiationship btween yoursetf{the applicanUagc'tttlrepresentative)and the#own officer or employee.Either check the aagsptt>pr ntc,line A)through,D)-ar ordescril c in;tW 0&*proVlded. The town officer or employee or his or her spouse,sibling;parent,or child is(check all that apply): A)the owner of greater than 5%of the sharps of the corporate:,stock of the applicant (whe4 the applicagtt is a t orporutionX [i}the Icgal or henccr l owner of any intcrest in a ti0ft''c0rpt €ecnti€y(cairn the applicant is rat u axrrtiga}; C)an officer,di=. Wr,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP \ Submitted this / dav of t print.Nadtme Form'1CS 1 ARTICLES OF ORGANIZATION OF Lagoon Lodge LLC Under Section 203 of the Limited Liability Company Law FIRST: The name of the limited liability company is: Lagoon Lodge LLC SECOND: The county,within this state, in which the office of the limited liability company is to be located is SUFFOLK. ,THIRD: The Secretary of State is designated as agent of the limited liability company upon whom process against it may be served. The address within or without this state to which the Secretary of State shall mail a copy of any process against the limited liability company served upon him or her is: Lagoon Lodge LLC 270 Knoll Circle East Marion,NY 11939 I certify that I have read the above statements, I am authorized to sign these Articles of Organization, that the above statements are true and correct to the best of my knowledge and belief and that my signature typed below constitutes my signature. Dean Lennox, Organizer (signature) Dean Lennox , ORGANIZER 4 Pine Street Chatham,NJ 07928 Filed by: Dean Lennox 4 Pine Street Chatham,NJ 07928 FILED WITH THE NYS DEPARTMENT OF STATE ON: 02/09/2015 FILE NUMBER: 150209010343; DOS ID: 4707460 DOS-12394-11(Rev.02/12) Page 1 of 1 Board Of $outhold Town Trustees SOUTHOLD, NEW YORK Mooring # N/A PERMIT NO .... 379Z ............... DATE: .Jan....Z6,..1990 ISSUED TO ....... G'.~A~.T....~,,....LE Ni~.Q X ............................... Pursuanf fo fha provisions of Chapfer 615 o{ fha Laws of {'he Sfafe of New York, 1893; and Chaplet 404 of fhe Laws of fhe Sfafe o{ New York 1952; and {'he Soufhold Town Ordinance en- filled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF 5AND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance wifh fhe Resoiufion o~ The Board adopfed a{' a meeting held on .~.,.....Z.5. ....... 19 ~.~...., and in consideration of {.he sum of $ ................. paid by of .................................................................................. N. Y. and subjecf fo fhe Terms and Conditions llsfed on fhe reverse side hereof, of Sou+hold Town Trusfees au{.horlzes and permifs {.he following: Gonstruc~ a 65' b~lkhead ~e~ (10) feet back f~om existing, adjacent bulkheads (as e~plainec] in Alternative #2 Property fronts Spring Pond at 296 Knoll Gircle,East Marion all in accordance wifh {.he defaiJed specificaflons as presenfed in NY fhe originafing applicaflon. IN WITNESS WHEREOF, The said Board of Trusfees here- by causes ifs Corporafe Seal fo be affixed and {.hese presenfs be subscribed by a majority o,f~fhe ~smd Board as of fhis daf,e. TERMS and OONDmONS The Pern:6ttce Grant H. Lennox residing at 305 Garret Rd., Mountainside~ NJ 07092 N. ¥., as part of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: 1. That the said Board of Trustees and the Town of Southold axe released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any opex- afion performed pursuant to this permig mad the said Permittee wi~ ar his or her own ~e, defend an), and all such suits initiated by third parties, and the said Permittee assumes ~ liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for a period of 24 . mos. which is considered to be the estimated me required m complete the work involved, but should circttmstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to ma[main the structure or project involved, to provide evidence to anyone concerned that auth- orization was originally obtaine~. 4, That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application, may be cause for revocation of this Permit by resolution of the said B~rrd. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the fight of the public to pass and repass along the beach between high and low water marks. 7. That if furore operations of the Tqwn of Southold require the removal and/or alterations iff the location of the work herelrt authorlzed~ or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstmmon to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work or project herein stated without expenses to the'Town of Southold. 8. That the said Board will be notified by the Permit'tee or the completion of the work auth- orized. 9. That the Permittee will obtain ali other permits and consents ,that may be required sup-. plemental to this permit which may be subject to revoke upon failure to obtain same. TRUSTEES John M. Bredemeyer, III, President Henry P. Smith. Vice President Alber~ J. KrupskL Jr. John L. Bednoski. Jr. John B. Tuthil] Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTt L. HARRIS Supawisor Town Hall, 53095 Main Road P.O. Box 1179 Sm~thokl, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 January 30, 1990 John H. Geidemann Box 416 East Marion, NY 11939 Re: App. No. 10-6-89-37-5-14 /Lennox Dear Mr. Geideman: Tke following action was taken by the Board of Town Trustees during ~its regular meeting held on January 25, 1990 regarding the above matter: WHEREAS, John H. Geideman on behalf of Grant H. Lennox applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated December 4, 198'9 and, WHEREAS said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a public hearing was held by the Town Trustees with respect to said application on January 25,1990 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, -WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW, THEREFORE BE IT RESOLVRb that John H. Geideman ON BEHALF OF Grant H. Lennox BE AND HEREBY'IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: Construct a 65' bulkhead ten (10) feet back from existing, adjacent bulkheads (as explained in Alternative $2). Property fronts Spring Pond at 296 Knoll Circle, East Marion, NY. This permit will expire two years from the date it is signed if work has not eormuenced by said date. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the TrUstees are to be notified upon completion of said project. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Permit will be issued upon payment of the following fees for work to be done below Mean High Water Mark: This permit could be reconsidered as a Type I action should you request to amend your permit to AJternative #4. Very truly yours, M. Bredemeyer, III President Board of Town Trustees JMB: jb CC: Bldg. Dept. Conservation Advisory Council file BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hall, 53095 Main [toad P.O. Box 728 Southold, New York 11971 OCT 3 1 1989 TOW~ OF SOUTHY, OLD (516) 755-1892 APPL,CATION NO/¢"_~=~..y--3~'~'--_../_~_ATE oF APPLICATION______Z¢ - s/ ADDRESS OF APPLICANT LOCATION OF PROPERTY FOR WHICH PERMIT WANTED ........ PHONE NO o 7o~ PHONE NO. HOME ADDRESS OF PERMIT APPLICANT IF DIFFERENT FROM AFORESAID LOCATION WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY DEPTH AT LOW TIDE DISTANCE TO THE NEAREST OF PROPERTY KNOWN PRIOR OPERATIONS CONDUCTED ON IN THE AREA REMOVED OR DEPOSITED THE PREMISE AND WHETHER ANY PRIOR LICENSE OR PERMITS HAVE BEEN ISSUED TO ERRECT ANY PERMITS OR LICENSES WERE EVER SUSPENDED OR REVOKED BY A GOVERNMENTAL AGENCY ~'~_~'~f.~ .................... DESCRIBE FULLY THE REHABILITATION AND PROPOSED CONDITION OF THE PREMISES AFTER THE WORK IS COMPLETED INCLUDE AN ADDITIONAL SURVEY OF THE PROJECT SITE IF NECESSARY ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED THAT WOULD PROHIBI~ THIS PROJECT? ~9 COUNTY OF SUFFOLK ) STATE OF NEW YORK )SS: in Completing this aPpli:cation I hereby autho~uJ~z_e the Trusteesj age~t'hr representa~%e to enter~%o my p~pert~ to inspect the premises in conjunction ~ith r~f~~cation. SWORN TO SEFORE ME T~IS ~/ COMPUTATION OF FEES Approved 2/27/85 i d I> Ravi siOme, T�ckep, f North Road (Rou+e 25) Tor,rnf I L EC�END o GENERA, _ NOTES p1I f3�F-I - BuIkS-I¢acl H.W,M. High Water 1✓IarK 1. pro d o arae, nai'on. +1 6"� 6' S-Frin ar � I � = EI 9 xRe-CtDiatric+ 1a00, 5ect 3`]7, .C31K M.L.W. = Mcar, Low Watar ! 0 Ta5, Lof 14 N H pit• = Alt.¢rnat¢ G YG' S x 4 .C�aly bo0:7 Pile v ," Address: 296 Knot( Clyde , I mooed S - Slap¢ S I Ea3t gariorl , >J.`C 1(939 I \ sh¢ath(r,q ! --6"X6" strlo cr Q, Qwncr•. M rant M,Lanr,ox s Prty, = Proper t) ---- - _._'' s^=� calms ao t /rq G ` t FF = First Floor _ 15I o. o r+,W" ) P O. Hox l4-5O 1 A / fi r East Mariov-1 , KY. 11939 °k �o� �t I 3. Elavatlon Vatumt Arbitrary - use a�f>:1r¢rrt ct y ( a� Nigh U/atcr N'`tdr'IC ese El, O.00 1 \ Ba p S -z.o 4 Qwners A9art : \ Qw o > ry ro Vfl John H. C7aldernan, P. E. . P.O. (3ox 4-16N n 'o L Coon+¢roinV, all bolt hTads .lush L ' East Marlon , hlY 119�j9 U 1 SPRING{ u OwkC with surFhce o-r plle . Tel. 51G 477-2421- i 5. Alternatao ire Plan 4 Cross Secrag tions 1� I�Isl.f Y V r¢{¢r to I¢t+ar -to D.E C. dated j Bulkheads 00 Jen. 9> 1990 r� $ulL haadS r' 0- -TYPIfo. Qroposcd PiI I rnquir¢d up 1'o EI. I.O ''C 1 � � z 0- Ty P i Cis 57cY. Fill to be obtained by Sczle I " = 2' excavafiorn of collar under ¢Kist. / W 2z I i Pr'i O'7ECT �JITE D z'dwE I I i v1q � O LU .� Ex�e,+ Bulk hc+d l (_7? -20'- 10 E W Q \ Alt n Z Alt 4 tW iL ^-T1l-EI' n —..,�. _.,- ------- --.0 k' paid qQ\ O O _ EI 0,0 _( H < -.._.�\ �- - C I O,O �H W M ) — �� MAP , V X O , i A,1 ', o ,Oo ioo DOD oho SOD beO Source - Town of Soafi,old Pro ar+\ Map Sheet 037 I - ll/Z St DWI �\I O C FE el. 14.7 Q SEcTS . -_ ECT F= (Alo, ;k f Fr+L 11 )a) gcala i „ Z m 9 Exlstln bul head 0 I I IG' 'Fatu r) )�) —1 W F/H I U' (To - 15/H. E1.3.0 r-- PI{a2 -I 4l+ *4 -- Alt?+2 — A(t_,W4 PI` �Xi�t Ground ^\ ( SECT F 11 ` \ �, /'1 J ' I ! (Plvperty I;na) LY W \ Il J L-K.. C" / SECT. E O EI. 0. C) C w w raL---------- -----= ` ..� -...---- EI 0.0 r o P P�eP. F;u — Tax CS','�. N - c OT 14 /L Story �amr Dwl�. S � � / / 1 11 �� // Alt �+ ?_ - 13ultnl�ar iOr �Q L� 00 - �c� I I , bnccl5 �rov ;, ax letin hulk- �w Z i sic D / Q SECT C JECT. Dcz -1:11 3rJx'i- to EI. I=0 at- Q f i b 0 Q �Qr1� "sF - 1 O cr c EX� s _ of her i ,3 IT Alt:'4- - ulk.haa d G] LL Q) e130 GrOur, � � j j e1jo 1, e��� 2 g fir¢- ¢�tablisn¢d but tWac lir'!m. Lal Exit ualead \ ` ° -` EI 1.o Lirr�i-t 1�ine .�or prop. ft ----- 0��'\ Lancth = GS' 't . Top CI . 3.0 [Y a I— EI o.o i' w al i F - EL O.O ( w v ) Exist. 10' 'Q¢tcjrn DataJan,9,% Exist- Bulkhead �� Top d/N� n � Sca12' /`� Shore Ima/prope( h, lin¢ as per MaP -A-3 Shown - J� (_�' A (A,lon9 wa�'4arly Pity, lire) (.� �/ Sa<tior, � � CTardinerSYi'ay E'5 V5, rn�xp c _ SECT, V Piled 9/73/ 1927 a5 Map # 275 . Drawn Thie info, ;rorn survey bf thrs property by 10 I