HomeMy WebLinkAboutSTRIPP, JOHN TRUSTEES
John M. Bredemeyer, III. President
Henry P. Smith, Vice President
Albert J. Kmpski. Jr.
John L. Bednoski. Jr.
John B. Tuthill
Telephone (516) 765-1892
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
SCOTF L. HARRIS
Supervisor
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone {516) 765-1800
May 25, 1990
Glen Just, President
J.M.O. Consulting
P.O. Box 447
Quogue, NY 11959
RE:
John & Judith Stripp Property/Fishers Island
SCTM ~1000-7-2-9
Dear Mr. Just:
Please be advised that the Trustees reviewed the
above-referenced project, and after an on site inspection, it
was determined that this project is out of Trustee jurisdiction.
All other approvals that may be applicable should be secured
prior to commencement of work to be done.
Very truly yours,
John M. Bredemeyer, III
President, Board of Trustees
JMB: jb
cc: CAC
Bldg. Dept.
File
Board Of $outhold Town Trustees
SOUTHOLD, NEW YORK
DATE: ... 5./.2.61.9.4 ...........
ISSUED TO .......... ZO.~....8~g.~P.:~ ....................................................................................
Au horizatio
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the Laws of the
State of New York 1952; and the Southold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
Resolution of The Board adopted at a meeting held on
19....9.~.., and in consideration of the sum of $..!.50_,.0.0 ..... paid by
.......... ~T.,.~.,.Q.,.....G~n~..U..!~i..n.g ...... ~: ....... 3~gF~...:S~.:~?.:~ .........................................
of ....... .~!~.b.~.~..s.....Z..~] .......................................... N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of South°Id Town Trus~'ees authorizes and permits the following:
To construct a single family dwelling, sanitary system &
pool as per plan dated August 27, 1993, a staked row of hay
bales will be maintained during consiruction, all sui~ject to
applicant following conditions of all approvals of any necessary
all in accordance with the detailed spec~ications as presented in .
the originating application, agencies. Fishers Island.
IN WITNESS WHEREOF, The said Board of Trustees hlere-
by causes its Corporate Seal to be affixed, and these presents +o
be subscribed by a majority of the said Board as of +his dat,e. ·
Trustees
Albert J. Krupski, President
John Holzapfel, Vice President
William G. Albertson
Martin H. Garrell
Peter Wenczel
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765-1892
Fax' (516) 765-1823
May 27, 1994
J.M.O. Consulting
P.O. Box 447
Quogue, NY 11959-0447
Re: JOHN STRIPP
SCTM ~7-2-9
Dear Mr. Just,
The following action was taken by the Board of Town Trustees
during its regular meeting held on May 26, 1994 regarding the
above matter:
WHEREAS, JOHN STRIPP applied to the Southold Town Trustees
for a permit under the provisions of the Wetland Ordinance of
the Town of Southold, application dated May 9, 1994,
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 April 26, 1994 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,
a/id,
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 I.T,,
RESOLVED, that the Board of Trustees approves the application of
JOHN STRIPP to construct~a single family dwelling, sanitary
system, & pool as per plan dated August 27, 1993. A staked row
af hay bales will be maintained during construction, subject to
applicant following conditions of all approvals of any necessary
agencies. Located Private Road, Fishers Island.
Permit will expire two years from the date it is signed. 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.
Fees: None
Very truly' yours,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/djh
cc. CAC
Bldg. Dept.
ZBA
Agenda
May 24, 1994
reconstruct existing deteriorated 12' x 285' fixed timber dock; reconstruct offshore 6' x
64' "L" section with the installation of a wave curtain to protect docked vessels from
North, Northeast and Northwest winds; reconstruct offshore 32' x 32' filled dock; replace
two 6' x 24' floats and add three additional 6' x 24' floats, with associated mooring
pilings, for island visitors/government officials, emergency vessels, caretakers, etc.;
install four 7-pile dolphins to safely berth ferry boar and/or supply barge.
Robins Island
Vote of Council: Ayes: All
Motion carried.
No. 1154
JOHN STRIP 7-2-9 to construct a single family dwelling, sanitary system, poot as per
plan dated August 27, 1993. A staked row of hay bales to be maintained during
construction.
Private Road, Fishers Island
NO RECOMMENDATION. THE CAC WAS UNABLE TO MAKE AN INSPECTION.
No. 1155
Moved by Bruce Loucka, seconded by Allan Connell, it was
RESOLVED to recommend to the Southoid Town Board of Trustees APPROVAL WITH
STIPULATIONS of the Wetland Application of JOHN J. FIORE 91-1-5 to construct a 16'
x 32' swimming pool inground surrounded by wood decking and chain link fence; to
regrade, seed and landscape around pool area.
The CAC will recommend approval, provided the application remove the concrete ramp
and regrade existing shoreline away from the creek and provide a sand ,drain to allow
water to percolate into the ground.
5050 Sunset Way, Southold
Vote of Council: Ayes: Ali
Motion carried.
No. 1156
Moved by Allan Connell, seconded by Bruce Loucka, it was
RESOLVED to recommend to the Southold Town' Board of Trustees APPROVAL WITH
PROVISIONS of the Wetland Application of DONALD AND VlRGINA BAYLES 57-1-16.1
to resheath 220' bulkhead landward side, replace backing system, backfill 10 yards clean
fill, replace seven pilings in-kind, in-place.
The CAC recommends approval .provided the applicant create, along the affected
area. a berm effect with a sand drain landward to allow control runoff and allow water to
percolate into the ground.
785 Albacore Drive. Southold
Vote of Council: Ayes: Ail
Motion carried.
No. 1157
Moved by Allan Connell, seconded by Betty Wells, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the
Wetland Application of THERESA CASAMISINA 57-2-19 to obtain permit-for 37' long
bulkhead which is already built in 1978
The CAC'sees no need for the bulkhead but is concerned for the damage which
could occur if the present bulkhead is ripped out.
Page 2
DEC PERMIT
1
TYPE OF PERMIT · New
NEW ~',
STATE DEPARTMENT OF ENVIRONMENTAL CORSERV,
PE IT
Under the Enviramenta[
Core~ervat ion La~
Renewal
IEFFECTIVE DATE
Decent~r 29, 1993
EXPIILa, TION DATE(S)
Oecember 31, 1996
0 Modification 0 permit to Construct 0 Penait to Operate
0
0
0
0
0
[]
ArticLe 15, TitLe 5: Protection
of Waters
ArticLe I5, TitLe 15: Water
SuppLy
ArticLe 15, TitLe 15: Water
Transport
ArticLe 15, TitLe 15: Long
IsLand WeLts .
ArticLe 15, TitLe 27: WiLd,
Scenic and Recreational Rivers
O 6NYCRR 608: Water ~uaLity
Certification
0 Article 17, TitLes 7, 8: SPOES
0 Articte'19: Air PoLLution
Control
O ,ArticLe 2~, TitLe 27: Mined Land
RecLamation
· ArticLe 24: Freshwater Wet[ands
0 ArticLe 25: Tidal Wet[ands
Other:
PERMIT ISSUEO TO
John & Judith Strfpp
)RESS OF PERMITTEE
~ Scatacook TraiL, Weston, CT 0688~
CONTACT PERSON FOR PERMITTED gORE
John & Judith Stripp
NAME AND ADDRESS OF PROJECT/FACILITY
Stripp Property - Barrow Pond
0 ArticLe 27, TitLe 7; 6N¥CRR 360:
SoLid Waste Hanagement
ArticLe 27, TitLe 9; 6NYCRR 373:
Hazardous Waste Management
Articte'3~: Coastal Erosion
Management
O Article36: FLoodPLain
Managmaent
[] ArticLes 1, 3, 17, ~9, 27, 37;
6NYCRR 380: Radiation Control
TELEPHONE NUMBER
TELEPHONE NUMBER
OF PROJECT/FACILITY ~
BarLou Pond - SCTM #1000-?-2-9
COUNTY I TCR~N [ WATERCC~JRSE
SuffoLk Southo[d BarLow Pond
Construct single femity d~eLLing, pooL, septic system and regrade parcel adjacent to Bar[ow Pond.
accordance with the attached NYSOEC approved plan dated 12/29/93.
INYTM COORDINATES
ALL work shaLL be in
'= By acceptance of this permit, the permittee agrees that the permit is contingent upon Strict c°mPLianCe with the
ECL, aLL appLicabLe regulations, the General Conditions specified (see page 2) and any Special Conditions included as pert of
this ~rnit.
REGIONAL PERMIT ADMINISTRATOR: ADDRESS c ..
~e~eq~ ~j. /L/~m~.~L~ BLdg. 40, SUNY, Room 219, Stony Brook, NY 11790'2~56 :~
AUTHORIZED SIGNATURE DATE '.
· ~-~ · Page I of 6' -.'
Inspect ions
1.
' ~ CE:tOITICN3 ~
The permitted site or facility, including relevant records, is subject to in-
inspection at reasonable hours and intervals by an authorized representative of
the Deparl~rent of Envirorrrental Conservation (the Departrrent) to determine
v~ether the permittee is caTplying with this permit and the ECL. Such represen-
tat ive n-ay order the work suspended pursuant to ECL 71-0301 and SAPA 401(3).
copy of this permit, including all referenced maps, drawings and special
conditions, rrust be available for inspection by the Departrrent at all tirres at
the project site. Failure to produce a copy of the permit upon request by a
Department representative is a violation of this permit.
Permit Changes and Rene~ i s '
2. The Deparl~rent reserves the right to rrodify, suspend or revoke this permit v~hen:
a) the scope of the,.permitted activity is exceeded or a violation of any
condition of the permit or provisions of the ECL and pertinent regula-
t ions i s found;
b) the permit wes ol~tained by misrepresentation or failure to disclose
relevant facts;
c) nevvmateriai inforrration is discovered; or
d) envi rorrrental conditions, relevant technology, or appiicable lan .or
regulation have material ly changed since the permit v~as issued.
3. The permittee rrust sub"nit a separate written application to the Departrrent for
renewal, rredification or transfer of this permit. Such application trust include
any forms, fees or suppleTental inforrration the DeparlzTent requires /Nqy
renewal, rmdification or transfer granted by the Deparl~Tent rrust be in writing.
4. The permittee rrust sub"nit a renewal application at least:
a) 180 days. before expiration of permits for State Pollutant Discharge
El iminat ion System (SFOES), Fazardous V~ste ~lVl~nagm-ent Facilities
(Fi/I~), rrajor Air Poi iution Control (APC) and 'Sol id V~ste Manage'rent
Facilities (~VF); and
b) 30 days before expiration of all other permit types.
5. Lhless expressly provided for by the Departrrent, issuance of this permit'-does
not rmdif, y, supersede or rescind any order or determination previously issued by
the Departrrent or any of the tents, conditions or requireTents contained i.n such
order or determination.
Other Legal Cbl igations of Pen~ittee
6. The permittee has accepted expressly, by the execution of .the application, the
full legal responsibility for al I .daTages, direct or indirect, '.of V~hatever
nature and by v~rmver suffered, arising out of the project described in this
permit and has agreed to indeTnify and save harmless the State fr~n suits,
actions, da'rages' and costs of every na~e and description resulting fr~m this
, project.
7. This permit does not convey to the permittee any right to .trespass upon the
lands or interfere with the riparian rights of others ~n.order to perform the
permitted york nor does it authorize the irrpairrrent of .any rights, title, or
interest in real.-or personal property held or vested in a person not a party to
the permit. ·
8. The permittee is responsible for obtaining any other permits, approvals, lands,
ease'rents and rights-of-way that may be required for this project.
Page 2.of 6
ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Ti'tie .51, 24. 25, 34 and 6 NYCRR Part 608 ( C"~'- ~',
lO
11
12
That if future operations by the State o~ New York require an al-
teration m tl~e position of the structure or work herein authorized, ar
if; in the ol)inio,~ of the Depdrlment ot Lnviromnental Conservation
it ~h,dl cause unreasonable obstruction to the free nawgalion ot said
waters or flood flows or' t,n(langer tl~e health, safety or welfare o~
the peol)le ot the Slate, or < ,ruse It}nh or dt,ntruction of the natural
resources ol the St,itt', the ownt~r may be ordt,rt'd [)y the Department lO
ren~ove or alter the structural work, ~}bhlfLlt tit)ns, or h,~ zar(ls caused
thereby without expense to the State. and if. upon the exl)iration or
revocation of this permit, the structure, fill. excavation, or other
modificatio~ of the watercourse hereby authorized shall nor be com-
pleted, the owners, shall, without expense to the S{ate, and t~ ~uch
extent ,md ill such time and nlallner as the Department of Ellvirollnlellt,lJ
Conservation maytequire, remove all or any portion of the uncompleted
structure or fill and restore Jo its JOrlller condition the navigable
and flood capacity of the watercourse. No claim shall be made against
tile Slate oJ N~w York on ~C('oLInJ Of any such removal or ajj~ratJOll,
That the SJ,Jte of N~w York ~hall in no ca~e be liable for any damage
or injury to the structure or work herein1 authorized which may be caused
by or result from future operations ulldertakell by the State for the
coflservaJJon or Jllll)rovemeat oJ navigation, or for other purposes, and
no claim or right to compensation shall accrue from any such damage.
Granting of this permit does not relieve Ihe applicant o~ the responsi-
bility (}f obtaining ally othi'f pefllllssjoll, tOllSeflt of approval from
the U.S. Army Coq)s oi ~'n~ineers. U.S. Coast Guard, New York State
Office o~ General Se[vi('es or local ~ovemmenl which may be required.
All necessary precautions shall be taken to i)reclude contamination
oi any wetland or waterway by suspended solids, sediments, fuels.
solvents, lubricants, epoxy coatings, paints, concrete, leachate or any
oth(,r m.tvironnlentaJJY deJL, tertou', rnal('ri,tJ>, a~ociati'd with
prolect
13. Any nlaLerJal dredgect in the l)roseculiOn ol the ~ ork hereto pern~
shall be removed eveaJy, without leavin~ la[~e [(~JLI~(~ piJe~, ri(J~e~ ac
Ihe [~ed oJ ~1 walefw~Y or jJoo(Jplall~ (ti deep hoh'~ lhal illay h,tvt.
JtHIden('Y to cruise (Jallla~e Jo IhiVi~dhJe (h,lllneJs o[ to the J)dllkS
d wa Jel'Wdy.
14 There ~JlalJ be I10 Lin[easolldble interfe[elll e.wJth navJgatlOll b~ the work
herein authorized.
JJ upon the expiration or revocation of d~is t)ermit, the prolect hereby
authorized ha~ not been coml)le~ed, the applic ant shall, without expense
~o the 5tare. and to such ex[em and i~ such [line. and manl3ef ,~
Del)a rtment of Environm~nt'al Consurwttion may re(luke, r~move aJJ or
an~ portion of the uncompleted structure or fill and re,tore th~ site
~o its former condition. No claim shall ~e made asainst the State
New York on account of any such r~moval or alteration.
16. If 8ranted under 6 NYCRR Part b08, the NY5 Department of Env~ron-
mentaJ Conservation hereby certities that the ~ubject'proje( t will
contravene uffluenL Jim.i[ation5 or other JimitaJioi)~ or st,mdard~ under
Sections 301. 30~, 303, ]0b and 307 of the Clean Water Act of 1977
(PL 95-~17) provided that all of the conditions listed Eerein are met
17 Ail activities autl~ori~ed by this I)erm~t musl be in ~tri( t coniormance
wilh the approw'd I)J~ns submitted by the al)pli( mil or hi~ asm)t a.~ part
of the permit application.
Such al)proved plans were prepared by
amd
SPECIALCONDITIONS-
1. Any work,disturbance, and storage of
shall be confined to: within the
Disturbance" as shown on the approved plan.
2. Heavy equipment, including bulldozers, backhoes,
etc., shall not be operated beyond the limits of
the approved plan.
construction materials
,,Limit~of Clearing and
payloa, ders ,
clearing on
A snow fence or.other temporary, project-limiting fence shall
be erected prior to the commencement of any construction
activities: along the ,,limits of clearing" on the approved
plan.
Prior to commencement of any construction activities, a
continuos row of straw bales shall be staked end to end:
along the base of the snow fence ( or other temporary, project
limiting fence).on the upslope or project side of the fence.
~-bales shall be maintained, repaired and replaced as'often
as necessary to ensure proper function, until all disturbed
areas are permanently vegetated. The average useful life of
a bale is approximately 3-4 months- sediments traPPed by the
bales shall be removed to an approved upland location before
the bales themselves are removed.
I~t (' t'l RMII NUMI{I R
1-4738-00102/00002-0
PRO¢;RA,%t I At'II IIY NLIMllJt R
t P'~g~ _3__- of _6_-_
95-20-bf (7/87)--25c
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Sm
J
e
10.
11.
12.
SPECIAL CONDITIONS
For Article 24 (. Freshwater Wetlands .)
Ail disturbed areas where soil is temporarily
exposed/stockpiled for longer than one (1) day shall be
covered with a tarp .or contained by a continuous line of
staked straw bales placed on the downslope or wetland side.
.Any demolition debris/excess construction materials/excess
excavated materials shall be immediately and completely
~isposed of on an approved upland site more than 100 feet from
any regulated freshwater wetland.. These materials shall be
suitably stabilized so as not to re-enter any water body,
wetland, or wetalnd alaacent area.
Excavated materials/fill materials shall be stockpiled more
than 100 feet landward of the wetland or water body and shall
be contained by straw bales or silt fencing to prevent
erosion.
Ail fill shall consist of clean soil, sand and/or gravel that
is free of the following substances: asphalt, slag, flyash,
'broken concrete, demolition debris, garbage, household refuse,
tires', woody materials including tree or landscape debris, and
met~I objects. The introduction of materials toxic to aquatic
life is expressly prohibited.
During the grading or sloping operation s0~l shall not be
placed in or graded toward the wetland.
The work area shall be graded to conform with the elevation
and contours of the undisturbed land immediately adjacent to
the work area.
Ail roof runoff and pool discharge shall be directed to
drywells located according to the approved plan.
Ail equipment and machinery shall be stored and safely
contained greater than 100 feet landward of the regulated
wetland or water body at the end of each work day. This will
serve to avoid the inadvertent leakage of deleterious
substances into the regulated area. Fuel or other~chemical
storage tanks shall be contained and located at all times in
an area greater than 100 feet landward of the regulated.
wetland or water body. If the above requirement cannot be met
by the permittee, then the storage.areas must be designed to
completely contain any and all potential leakage. Such a
contaminant system must be approved by NYSDEC staff Prior to
equipment, machinery or tank storage within 100 feet .of the
regulated wetland or water body.
DEC PERMIT NUMBER
1-4738-00102/00001-0
FACILITY ID NUMBER J PROGRAM NUMBER
I
Page 4' ' of
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
SPECIAL CONDITIONS
For Article. 24 ( Freshwater Wetlands )
13.
All areas of soil disturbance resulting from this project
shall be -- seeded with an appropriate perennial grass; and:
mulohed with straw immediately upon completion of the project,'
within.two (2) days of final grading, or by the expiration of
the permit, whichever ,is first. Mulch shall be maintained
until a suitable vegetative cover is established. If seeaing
is ~mpracticable due to the time of year, 'a temporary
'~et/mulch shall ~e applied and final seeding shall be
'p~rformed as sonn as weather conditions favor germination and
growth.
14.
The permittee shall incorporate the following langugage as a
notice covenant to the deed:
"Regulated freshwater wetlands associated wi~h MY-9
are located on or near the properties of John & Judith Stripp
and his/her/their heirs, assigns or successors. This property
is -subject to the provisions of ECL .Article '24, and the
conduct of regulated activities may occur only pursuant to ECL
Article 24 if prior approval is given by the New York State
Department of Environmental Conservation (NYSDEC). Regulated
activities include, but are not limited to clearing of
vegetation; application of chemicals; excavation; grading and
filling; and erection of any structure(s).,
This deed covenant shall be recorded with the Clerk of Suffolk
County within 90 days of the issuance of this'permit. A copy
of the covenanted deed or other acceptable proof of record,
along with the number assigned to this permit, shall be sent
within one calendar year of the issuance of this permit to:
NYSDEC, Regional Manager BEP, SUNY Bldg. 40, Stony Brook, New
York 11790-2356.
Supplementary Special Conditions (A) through (F) attached.
DEC PERMIT NUMBER
1-4738-00102/00001-0
FACIt. ITY ID NUMBER
PROGRAM NUMBER
Page 5 of fi
SUPPLEMENTARY SPECIAL CONDITIONS
The following conditions apply to all permits:
A copy of this permit, including all conditions and approved
plans, shall be available at the project site whenever authorized
work is in progress. The permit sign enclosed with the permit
shall be protected from the weather and posted in a conspicuous
location at the work site.until all authorized work has been
completed.
The permittee shall require that any contractor, project engineer,
or other person responsible for the overall supervision of this
project reads, understands, and complies with this permit and all
its general, special, and supplementary special conditionsi Any
failure to comply precisely with all of the terms and conditions
of this permit, unless authorized in writing, shall be treated as
a violation of the Environmental Conservation Law. If any of the
permit conditions are unclear, the permittee must contact the
Division of Regulatory Affairs at the address on page one or
telephone (516) 444-0365.
Ce
If project design modifications become necessary after permit
issuance, the permittee shall submit the appropriate plan changes
for approval by the Regional Permit Administrator prior to
undertaking any such modifications. The permittee is advised that
substantial modification may require submission of a new
application for permit.
At least two days prior to commencement of the pro~ct, the
permittee and contractor shall sign and return the top portion of
the enclosed notification form certifying that they are fully
aware of and understand all terms and conditions of this permit.
Within 30 days of completion of the authorized work, the bottom
portion of that form shall also be signed and returned, along with
photographs of the completed work and, if required, a survey.
For projects involving activities to be undertaken in phases over
a period of more than one year, the permittee shall notify the
Regional Permit Administrator in writing at least 48 'hours prior
to recommencing work in subsequent years.
Fe
The granting of this permit does not relieve the permittee of the
responsibility of obtaining a grant, easement, or other necessary
approval from the Division of Land Utilization, Office of General
Services, Tower Building, Empire State Plaza, Albany, NY 12242
(518) 474-2195, which may be required for any encroachment upon
State-owned lands underwater.
DEC Permit No. 1-4738-00102/00001-0 Page6 of 6
;YSDEC
~ureau of Environmental Protection
~ldg. 40, SUNY
]tony Brook, New York 11790-2356
Issued To:u ~~h ~!'.- .~/~., -~.
Contractor' s Name
Contractor's Address
ContractOr' s Phone No.
lo whom it may concern:
~ursuant to General condition Number I of the above referenced permit you are hereby notified
:hat the authorized activity shall commence on '
Chis notice is to be sent at least two days and in advance of permit of co~encementwill be available of the project, at
~he permit sign will be posted at the site copy site for.
=nspection.
Submitted by: -
~ailure to notify or post sign will leave owner and/or contractor subject to applicable
:enalties for non-compliance with permit conditions.
~YSDEC
~ureau of Envi=onmental Protection
{ldg. 40, SUNY
~tony Brook, New York 11790-2356
Issued To: ~1~)~.~ 4_,.~ !
Contractor' s Name
Contractor' s Address
Contractor's PhOne No.
?o whom it ~a~'concern:
,ursua~t to~ ' General Condition Number i of the above referenced permit you are hereby notified
~hat the authorized activity was completed on ·
Submitted by:
· his notice, with photos of completed work and/or completed survey, is to be .sent tO above
.ddress promptly upon complettion of project. Failure to notify will leave owner and/or
~ontractor subject to applicable penalities for non-compliance ~ith permit conditions-
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12:2 ~."'LIQJID LE,EL ~ ri' '
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ASPttALT SEAL J,~ Lt
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:[ Y.P..!.~ 6.! ...... S.. :.¢ Z LO.~.
APPRovED BY
BOARD OF TRUSTEES
TOWN OF SOUTHoLD
DATE