HomeMy WebLinkAboutTR-4524Board Of $outhold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. (-/"~"~' ~/
DATE: .9/.28/95
ISSUED TO ..... ~LLiA~ .?~!~B~LL ........................................................
jkutlj r zation
Pursuan+ +o +he provisions of Chaplet 615 of +he Laws
+he S+a+e of New York, 1893; and Chap+er 404 of +he Laws of +he
Sfa+e of New York 1952; and '*he Sou+hold Town Ordinance
+i+led "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and +h.e
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS:" and in accordance wH'h +he
Resolu'*ion of The Board adop'*ed afa mee'*ing held on 9./28/95 .......
19 95. , and in consideration of +he sum of $200..00 paid by
En.-Con. s~ltants..%nc.., ..fo.r WILLLM~4. TUR~BULL .....................
o{ ..... Southotd ................................. N. Y. and subie¢'* +o $he
Terms and Condifions lisfed on '*he reverse side hereof,
of Soufhold Town Trus'*ees aufhorizes and permifs ,*he following:
To construct 160+,/- !.f. of scone revetment against eroded
and backfill with 85+/- c.y. of clean sand to be trucked in from
upland source, construct a 3' X 20' stairway to connect to exist.
:atfa~n and s~airs wf~ ~edes~rian access o.ver revetment ~ toe
the aeta~tea specmcat~ons as presentea ~n
accordance _
.ff .+he orlgina+ing appJicafion.
IN WtTNE~S WHEREOF, The said Board of Trus+ees h,ere-
by causes frs Corporafe Seat fo be affixed, and +hese presenfs
be subscribed by a majorif',/ of +he said Board as of +his
Trustees
Albert J. Krupski. President
John Holzapfel, Vice President
William G. Albertson
Martin H. Garrell
Peter Wenczel
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York t 197!
Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
COASTAL EROSION MANAGEMENT PERMIT
Permit Number: 52-1-1
Name of Applicant/Agent: En- Consultants
Name of Permittee: William Turnbull
Address of Permittee: 54005 North Road, Southold
Property Located: Same
DESCRIPTION OF ACTIVITY: to construct 160+/- 1.f. of stone
revetment against eroded bank and backfill with 85+/- c.y. of
clean sand to be trucked to be trucked in from upland source.
Construct a 3' X 20' stairway to connect to existing platform
and stairs for pedestrian access over revetment at toe of bluff.
Located 54005 North Road, Southold.
Date of permit issuance: September 28, 1995
This permit is valid for a period of two years from the date of
issuance.
SPECIAL CONDITIONS:
Bluff restoration through a re-vegetation agreement is
attached hereto and is a necessary special condition of this
permit.
A relocation agreement is attached hereto and is a
necessary special condition of this permit.
A maintenance agreement as attached with application and
is a necessary special condition of this permit.
Albert J. Krupski, Jr.
President, Board of Trustees
Albert J. Krupski, President
John Holzapfel, Vice President
William G. Albertson
Martin H. Garrell
Peter Wenczel
Town Hal!
53095 Main Road
P.O. Box [179
Southold. New York 11971
Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
October 2, 1995
En-Consultants
1329 North Sea Road
Southampton, NY 11968
Re: William Turnbuil
SCTM # 52-1-1
Dear Mr. Haje:
The following action was taken by the Board of Town Trustees
during its regular meeting held on September 28, 1995 regarding
the above matter:
WHEREAS, Eh-Consultants on behalf of William Turnbull applied
to the Southold Town Trustees for a permit under the provisions
of the Wetland Ordinance of the Town of Southold, application
dated June 22, 1995, 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 September 28, 1995, at which time
all interested persons were given an opportunity to be heard,
and,
WHEREAS, the Board members have personally viewed and are
famSJiar 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 structure complies with the standard set forth in
Chapter 37-18 of the Southold Town Code,
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,
RESOLVED, that the Board of Trustees approves the application of
En-Consukants on behalf of wILLIAM TURNBULL to construct
1.60+/- 1.f. of stone revetment against eroded bank and ba?kfill
o --n sa ' to be =ucked in from
withsource85+/-ConstructC-Y' of a%~o X 20%%~stairway to connect to ex~sting
platform and stairs for pedestrian access over revennent at toe
of bluff. Located 54005 North Road, Southold.
Permit to construct project will expire two years from the date
it is signed if not starred. Fees must be paid, if applicable,
and permit issued within six months of the date of this
notification-
Two inspections are reci~ired 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/jmd
cc: CAC
Telephone
(516) 765-1801
Town Hail. 5309,5 Main ROad
P.O. Box 1179
Sou£hold. New York 11971
- SOUTi~OLD TOWM
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southoid Town Conservation Advisory Council held
Thursday,. August 24, 1995 the following action was taken:
No. 1279 - TABLED 7/19/95
Moved by Stephen Angeil, seconded by Bruce Loucka, it was
RESOLVED to recommend to the Southoid Town Board of Trustees APPROVAL
WITH PROVISIONS of the Wetland Application of WILLIAM TURNBULL 52-1-1
to construct 160 +/- l.f. of stone revetment against eroded bank and backfill
with 85 +/- c.y. of clean .sand to be trucked in form upland source. Construct
a 4' x 30' stairway to connect to existing platform and stairs for pedestrian
access over revetment.
The CAC recommends approval provided that after reburying the revetment, all
fill be planted with beachgrass. Also the Trustees should require the
applicant to keep structure maintained and buried.
54005 North Road, Southoid
Vote of Council: Ayes: All
Motion carried.
<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 Ma~n Road
P.O. Box 1179
Southold, New York 11971~
Telephone (516) 765-1892
Fax (516) 765-1823
Office
Use
Only
~--C°astal Er°si°n Permit Applicati°n ti~l~~
~ Wetland Permit Application
Grandfather Permit Application
Trustee Lands Permit Application
Waiver
~ Received Applicati. o~:
~ Clerical Review: ~/~,t/9~ ·
__Completed Applicafion !
( Incomplete~~ A~F -~ ~/.~/~'
SEQRA_ Classlfi~ation:
~e I ~ Type II Unliste
Coordination: (date se~lt) , ~/~J/~"
~CAC Referral Sent:~
~ Date of Inspection:
~ Receipt of CAC Repor6
~-Lead Agency Deter~ination~
I ~Technical Review: (date) _.7/~~'-~ ~ 4~
[ ~-Public Hearing: (date)
~ Decision: Approved
I~ Application Fee:$~.
Name of Applicant William Turnbull
Address 54005 North Road, Southold, NY 11971
Phone Number:(516~765-5092
Suffolk County Tax Map Number: 1000 . 52-1-1
Property Location: 54005 North Road, Southold
(provide LILCO Pole 9, distance to cross streets, and location)
Agent: En-Consultants, Inc.
(If applicable)
Address: 1329 North Sea Road
Southampton NY 11968
Phone:(5i6)283-6360
86-22-1995 02:BiP'- FROM EN-CONSULTRNTS, INC TO 765&823 P.02
PROJ3~CT DESCRIP~TION
Construct 160± l~f. of stone revetment agai~s~ eroded
bank and backfill with 85± c.y. of clean sand to be
trucked in from upland source. Construct a 4t x 30~
stairway to connect to existing platform and stairs for
pedes=rian access over revetment.
TOTRL P. 02
Board of Trustees Application
GENERAL DATA
Land Area (in square feet): 35,088+/-
Area Zoning: R-40
Previous use of property:
Intended use of property:
one one family dwelling
no change
Prior permits/approvals for site improvements:
Agency Date
No prior permits/approvals for site improvements.
Has 'any permit/approval ever been revoked or suspended by a
governmental agency?
x No Yes
If yes, provide explanation:
Project Description (use attachments if necessary):
SEE ATTACHED
'oard of Trustees Applicat?
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity: to prevent further scouring of presently
eroding bank & provide access to beach.
Are wetlands present within 75 feet of the proposed activity?
x No Yes
Does the project involve excavation or filling?
No ¥ Yes
If Yes, how much material will be excavated? n/a (cubic yards)
85+
How much material will be filled? - (cubic yards)
Manner in which.material will be ~em~wed or deposited:
Clean sand will be trucked in & spread by payloader.
Describe the nature and extent of the environmental impacts
reasonably anticipated resulting from implementation of the
project as proposed. (Use attachments if necessary)
As the presently unprotected subject bank is being severely
scoured by wave actions it can be reasonably anticipated that the
proposed revetment will dissipate wave· energy & effectively prevent
further erosion of the owner's upland.
hoard of Trustees Applicat~ n
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: To prevent further scouring
of presently eroding bank and provide access to beach.
Area of wetlands on lot: -0- square feet
Percent coverage of lot: -0- %
Closest distance between nearest existing structure and upland
edge of wetlands: n/a feet
Closest distance between nearest proposed structure and upland
edge of wetlands: n/a feet
Does the project involve ~or filling?
No x Yes
If yes, how much material will be excavated?
How much material will be filled? 85
Depth of which material will be ~or deposited: 2~ '
feet
Proposed slope throughout the area of operations: 1 : 1.5
Manner in which material will be removed or deposited:
Clean sand will be trucked in & spread by payloader
n/a cubic yards
cubic yards
Statement of the effect, if any, on the wetlands and tidal
waters of the town that may result by reason os such proposed
operations (use attachments if appropriate):
There are no wetlands on site and the revetment will be a minimum
of 45+' from the waters of Long Island Sound Therefore, there will
be no effect on Town wetlands or tidal waters.
6
14-16-4 {2/87~--Tex! 12 ·
IPROJ~ECT I.D. NUMBER 1 617,21
. Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNL~-~TED ACTIONS Only
PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
SEQR
1. APPLICANT ~'SPONSOR
William Turnbull by En-Consultants,
3. PROJECT LOCATION:
Municipality South'old
TI 2. PROJECT NAME
T
County
Suffolk
4. PRECISE LOCATION (Street address and road inters~tions, prominent landmarks, etc., or provide map)
54005 North Road
SCTM #1000-52-1-1
5. iS PROPOSED ACTION:
[~ New [] Expansion [] Modification/alteration
6. DESCRIBE PROJECT BRIEFLY:
SEE ATTACHED
7. AMOUNT OF LANDAFFECTI=D:
· 80¥' .80+
Initially --
acres Ultimately -- acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
[~ Yes [] No If No, describe briefly
9. WHAT IS PRESENT LAND USE tN VICINITY OF PROJECT?
~.. Residential [] Industrial [] Commercial
Describe:
[] Agriculture
[] ParklForest/Ol~en space [] Other
10.
DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL.
STATE OR LOCAL)?
~ Yes [] No ' If yes, list agency(s) and permit/approvals
DEC, COE Request for letter of "No Jurisdiction"
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
[] Yes [] No If yes, list agency name and permit/approval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APpROVAL REQUIRE MODIFICATION?
[] Yes [] No
I CERTIFY THAT THE iNFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Appiicant/sl;onsor name:
Signature:
- ~, .~.,
If the action is in the Coastal Area, and you are a state agency, complete the
Coastal Assessment Form before proceeding with this assessmea~
OVER
1
PART 1--PROJECT INFORMATION
· /' Prepared by Project Sponsor-
. ~
NOT'ICE: This document is des,gned to assist in determining whether the action proposed may have a significant effect
on the enwronment. Please complete the entire form, Parts A through E. Answers to these questions will be considered
as par't of the application for approval and may be subject to further verification and public review. Provide any additional
information you believe will be needed to complete Parts 2 and 3.
It is expected that completion of the full EAr will be dependent on information currently available and Will not involve
new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specify
each instance.
NAME OF ACTION
LOGATION OF AGTION dnctude Street Address, Municipality and County)
54005 North Road, Southold, NY 11971
NAME OF APPLICANT/SPONSOR. BUSINESS TELEPHONE
En-Consultants, Inc. 516 )283-6360
ADDRESS
1329 North Sea Road
: CITY/PO '~ i STATE [ ZiPCODE
. - Southampton , NY 11968
NAME OF OWNER (If different) BUSINESS TELEPHONE
William Turnbull 7~8 )639-8233
ADDRESS
54005 North Road
CI~/PO STATE I ZiP CODE
Southold NY 111971
DESCRIPTtONOFACTION
Construct 160+ l.f. of stone revetment against eroded bank
and backfill with 85 c.y. of clean sand to be trucked in from
upland source. Construct a 4' x 30' stairway to connect to existing
platform and stairs for pedestrian access over revetment.
Please Complete Each Question-Indicate N.A. if not applicable
A. Site Description
Physical setting of overall project, both developed and undeveloped areas.
1. Present land use: ~Urban ~Industrial
~Forest ~Agriculture
2. Total acreage of project area: .80+
-- acres.
APPROXIMATE ACREAGE
Meadow or Brushland (Non-agricultural)
F~Ie×1:IE Beach
Agricultural (includes orchards, cropland, pasture, etc.)
YVetiand (Freshwater or tidal as per Articles 24, 25 of ECL)
Water Surface Area
Unvegetated (Rock, earth or fill)Revetment
Roads. buildings and other paved surfaces
Other {Indicate type). Lawned/Landscaped
3. ",3/hat is predominant soil type(s) on project site?
~-xResidential (suburban) ~Rural (non-farm)
~Commercial
E-lOther
PRESENTLY
acres
.28+
-- acres
-0-
.06+
acres
.46+
Haven loam
acres
acres
acres
acres
acres
AFTER COMPLETION
acres
.21+
-- acres
acres
acres
acres
.07+/- acres
.06+
-- acres
46+
-- acres
a. Soil drainage: ~&'etl drained 10f]% % of site ~Moderately welt drained % of site
~Poorly drained % of site
b ]f any agricultural [and is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS
Land Classification System? n/a acres. (See 1 NYCRR 370).
-',re tner: ~edrock outcroppings on project site? ~Yes
~ 3, ,~ ?deDth to bedrock? 700+ (in feet)
J. ~,pp,ux,,n~e percentage ct proposed project site with slopes: ~0'10% ~ % ~10-15% %
I-I15%., ~ ~,reater %
'~. Is Project substantially con,,~Uous to, or contain a building, :site, or mstri~:t listed on the State or the I~ational
'Registers of Historic Places? fi'lYes ~blo
7. Is project substantially contiguous to a site listed on the Register of National Natural Landmarks? []Yes
2+ at work site
8. What is the depth of the water table? -- (in feet)
9. Is site located over a'primary, principal, or sole source aquifer? ]~es
10. Do hunting, fishing or shell fishing opportunities presently exist in the project area? XR1Yes F-INo
11. Does project site contain any species of plant or animal life that is identified as threatened or endangered?
~Yes ~z[',lo According to !~ny T,.
Identify each species
12. A~e there any unique 0~ unusual land forms on the project site? (i.e., cliffs, dunes, other geological formations)
I-Wes ~ ' Describe
13. Is the project site presently used by the community or neighborhood as an open space or recreation area?
Res [~o If yes, explain site is adjacent to Town beach
14. Does the present site include scenic views known to be important to the community?
[No '
15. Streams within or contiguous to project area: n/a
a. Name of Stream and name of River to which it is tributary
16. Lakes, ponds, wetland areas within or contiguous to project area:
a. Name Lonq Island Sound b. Size (In acres)
17. Is the site served by existing public utilities? 12~s [-INo
a) If Yes, does sufficient capacity exist to allow connection? [l-lYes F-INo n/a
b) If Yes, will improvements be necessary to allow connection? f-lYes [-]No n/a
18. Is the site located in an agricultural district certified pursuant to Agriculture and Markets Law, Article 25-AA,
Section 303 and 304? [l-lYes
19. Is the site located in or substantially contiguous to a Critical Environmental Area designated pursuant to Article 8
of the ECL, and 6 NYCRR 6177 [~Xes
20. Has the site ever been used for the disposal of solid or hazardous wastes? [l-lYes ~ztNo
B. Project Description
1. Physical dimensions and scale of project (fill in dimensions as appropriate)
a. Total contiguous acreage owned or controlled by project sponsor .80+
b. Project acreage to be developed: ' 06+ no
-- acres initially;
c. Project acreage to remain undeveloped .7 4 +/- acres.
d. Length of project, in miles: n/a (If appropriate)
e. If the project is an expansion, indicate percent of expansion proposed
f. Number of off-street parking spaces existing · n/a ; proposed
g. Maximum vehicular trips generated per hour ~/a
h. If residential: Number and type of housing units:
One Family Two Family
acres.
change
acres ultimately.
n/a %;
(upon completion of project)?
Multiple Family
Initially 1
Ultimately 1
i. Dimensions (in feet) of'largest proposed structure __ height; ~ width;Z60 '
j. Linear feet of frontage along a public thoroughfare project will occupy is? ...16Z ft.
Condominium
length.
-. ,,~ ......... ~ ;~ :~,~cu~d~ material tlc., rock, earth, etc.) will be removed from the site? -0-
'~! 4i,;turh,,,d areas be recJa;-ed? ~3Yes GNo ,_~N/A
a. ir yc~,. ~or what inten6~d purpose is the site being reclaimed? '
b Will topsoil be stockpiled for reclamation? ~Yes ~No
c. ',Viii upper subsoil be stockpiled for reclamation? ~Yes ~No
4. How many acres of vegetation (trees, shrubs, ground covers) will be removed from site? -0- acres.
5. Wilt any mature forest {over 100 years old) or other locally-important vegetation be removed by this project~
~Yes ~No
6. if single phase project: Anticipated period of construction 1
7. If multi-phased: zl/a.
a. Total number of phases anticipated (number).
b. Anticipated date of commencement phase 1
c. Approximate completion date of final phase
d. Is phase 1 functionally dependent on subsequent phases?
8. Will blasting occur during construction? iqYes [~o
9. Number of jobs generated: during construction 6
10. Number of jobs eliminated by this project 0
11. Will project require relocation of any projects or facilities?
months, (including demolition).
tons/cubic yards
month year, (including demolition).
month year.
~Yes ~No
' after project is complete 0
L~Yes :x~::No If yes, explain
12. ts surface liquid waste disposal involved? ~Yes
a. If yes, indicate type of waste (sewage, industrial, etc.) and amount
b. Name of water body into which effluent will be discharged
13. Is subsurface liquid waste disposal involved? ~Yes ~o Type
14. Will surface area of an existing water body increase or decrease by proposal?
Explain
~Yes ~_~No
15.
16.
Is project or any portion of project located in a 100 year flood plain?
Will the project generate solid waste? lq, Yes ~No
a. If yes, what is the amount per month tons
b.
c.
d.
~Yes I-]No
If yes, witl an existing solid waste facility be used? I~Yes ~No
If yes, give name ; location
Will any wastes not go into a sewage disposal system or into a sanitary landfill?
If Yes, explain
~Yes
~No
17. Will the proiect involve the disposal of solid waste?
a. If ,/'es, what is the anticipated rate of disposal?
b. If ',,'es, what is the anticipated site life?
18. Wilt
19. Will
20.
21. Will proiect resuit in an increase in energy use?
If yes , indicate type(s)
~Yes ~No
tons/month.
years.
pro?ct use herbicides or pest c des? ~Yes ~No
project routinely produce odors (more than one hour per day)? ~Yes ~]No
proiect produce operating noise exceeding the local ambient noise levels? ~-Yes
~Yes
~0
22. If water supply is from wells, indicate pumping capacity
23. Total &nt;cipated water usage per day 300 gallons/day.
2z Doe~ ~)rc,,ec: in~oive Local,~State or Federal funding? ~
. . ~_Yes
5 gallons/minute.
4
'City, Town, Village Board ]~)~'es [:]No
City, Town, Village Planning Board I-lYes E:]No
City, Town Zoning Board I-lYes [:]No
City, County Health Department I-lYes []No
Other Local Agencies I-lYes I'-lNo
Other Regional Agencies []:]Yes E:]No
State Agencies ,~__J~es l-INo
Federal Agencies [:]Yes I-INo
Type
Southold rustees Coastal
Erosion a Wetlands
NYDEC Art. 25
Submittal
Date
6/95
C. Zoning and Planning Information
1. Does proposed action involve a planning or zoning decision? []-]Yes X[]No
If Yes, indic'ate decision required:
I-izoning amendm~ent [:]zoning variance L-lspecial use permit []subdivision i-lsite plan
I-inew/revision of master plan [-lresource management plan [other
2. What is the zoning classification(s)of the site? R-40
3. What is the maximum potential development of the site if developed as permitted by the present zoning?
One one-family dwelling
4. What is the proposed zoning of the site? n/a
5. What is the maximum potential development of the site if developed as permitted by the proposed zoning?
n/a
6. Is the proposed action consistent with the recommended uses in adopted local land use plans? :x~Yes
7. What are the predominant land use(s) and zoning classifications within a '~ mile radius of proposed action?
R-40
~No
8. Is the proposed action compatible with adjoining/surrounding land uses within a '~ mile? ~Yes I-1No
9. If the proposed action is the subdivision of land, how many lots are proposed? ~./a
a. What is the minimum lot size proposed?
10. Will proposed action require any authorization(s) for the formation of sewer or water districts? []-lYes X~No
11. Will the proposed action create a demand for any community provided services (recreation, education, police,
fire protection)? I-lYes :k~No
a. If yes, is existing capacity sufficient to handle projected demand? FqYes []No
12. Will the proposed action result in the generation of traffic significantly above present levels? []-lYes
a. If y~s, is the existing road network adequate to handle the additional traffic? [l-lYes I-iNo
D. Informational Details
Attach any additional information as may be needed to clarify your project. If there are or may be any adverse
impacts associated with your proposal, please discuss such impacts and the measures which you propose to mitigate or
avoid them.
E. Verification
I certify that the informa¢~ provide~d above is true to th~ best of my knowledge. _ .
Applicant/Sponsor Name L / ~"~) ~'~ ~ Date ~/~
Signature . g~' ,4/~~' Title ___ __//~ .......
If the action is in the Coastal Area, and you ar~ a state asency, complete the Coastal Assessment Form before Proceedi.~
with this assessment.
5
AUTHORIZATION
(where the applicant is not the owner)
William Turnbull
(print owner of property)
residing at
(mailing address)
Rn-Consn]tan~s~ Tqm.
do hereby authorize
(Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
(Owner s signature)
County of Suffolk
State of New York
moara oz Trustees App±lcation.
William Turnbull BEING DULY SWORN
DEPOSES AND AFEIRMS THAT HE/SHE tS 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 MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES.
THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN
TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS
ARISING O7~ER ORBY VIR~JE OF SAID P~fIT(S), IF GI.~%/{TED. IN
COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,
THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY
TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS
APPLICATION.
Public
~. H~,$M,~MO~.UcK ~E~,C
~N.CONSULTANTS
~29 NORTH SEA RD,
~OUTHA~PTON N.Y. ~96~
~ ~~ /S~O ~o~0
o ~.o 4~
I Oj.~>
EN.CONSULTANTS
1329 NORTH SEA RD,
~OUTHAMPTON N.Y. 11968
~10-283'6360
PRo ~o =z~ O ,~,~- V~'"T",'~,E,',/"7"
/5
EdlJCi~on I,Illy.
to~ a vafld ~,
only ~.0 the peg$Oll Io~,llllh~ ~ ~
is prepared; and on I~I ~ I~ I~t
rifle company govenlmeall lll~Itll
lending Institution ~isted hMe~e ~
t~ the assignees of~h® I~~
Guarantees am not tramfemtl~
EN-CONSULTANTS
I329 NORTH SEA RD,
SOUTHAI~PTON N.% l !
516-2,83-6360