HomeMy WebLinkAboutTR-4109Board Of Southdd Town Trustees
SOUTHOLD, NEW 'fORK
PERMIT NO. =:."'°, DATE: .¢=.~,* g~,. i993
ISSUED TO ........ ~ _ ~.~u vRa!e
Pursuanf fO the provisions 0¢ CHaplet
+he Sfa+e of New York, 189~; and Chapter 4~ of fke L~ws of fhe
Sfafe ~f New York t952; ~nd fhe Soufhald Town Ordinance en-
f(f{ed "REGULATfNG AND THE PLACING OF OBSTRUCTIONS
iN AND ON TOWN WATERS AND PUBLIC LANDS
RE~OVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN
WATERS and in accordance wffh fhe
R~soJuf~on of The goard aBop~e~ afa meef~ ~e~d
93 and in .... of ~ p~id by
0¢ . N.Y. a~d subjec~
Terms ~nd Condff~ons iisfed an fhe reverse side hereof,
of Soufhold Town Trus+ees ~ufhorizes .nd permi+s fhe
.... dated 12/2'%/
be subsc6bed by ~ ma[or~+y of +hs.~ald Board as of fhb daf,e.
lobn M. Bredemeyer. III, President SUPERVISOR
lien. P. Smith, Vice Presitlent e'~t~~--_:~ tf S COTF L. IIARRIS
AI~. I. K~ki, Ir. ~ '
Zob~ L. Bedno~M, It. Town
~o~ B. Tulhill ~~ 53095 Mai. Road
P.O. Box 1179
Teleph~e (516) 765-1892 BOARD'OF TOWN TRIJ~TEE~ 8outbid. New York
Fax (516~ 765-1823 TOWN OF 8OU~tOLD
COASTAL EROSION MANAGEMENT PERMIT APPLICATION
TOWN WETLANDS PERMIT APPLICATION
TRUSTEE LANDS PERMIT APPLICATION
Office Use Only:
?~Coastal Erosion Permit Application
7Wetland Permit Application . --- ,
~zTrustee Lands Pe, rmit Applicqtion~O~c~/vf/
~Grandfather Dm~K-- ~
~omp].e~ed Apps. Dat~:
~Variance Reguired,
'~ Neighbors notified Date:
~Type . ~
~p. comp./dake. ~
~QRA Dekermln./date.
Publ~ Hearing/date:
-- Findings: ~.~[~
Permit Vot~' ~/N):
[also see file)
Application Number; SC1~4 ~1000- q~ - I - ~
Project Name Jif any) ~r~i ~r-.'~,0)~
Date Prepared:
Interest: (owner9 conaultan%,lessee,etc.).
Owner of Property: ~& +~OAQ.
. ~ Phone
(Provide LILCO Pole ~, Distance to cross Streets if not on
location map)
THIS IS NOT A PE~IT
~Ydsl t~ibe excavated: O Yds. to be filled: ~
Manner in which material will be removed or deposited:
width of canal, creek ornery fronting property: ~0'
Depth at low tide: Aver° rise in tide:
Distance to nearest channel: p/~ Distance project
extends beyond similar projects in area:
Is project for private or busingss use:
Intended use of property: ~~7Lu~ij~L~O
Describe known prior operatioHs con~u~ted on pr~mises:
Has any prior license or permit been issued to erect structures~
dredge,, or deposit fill on said premises: %ln~ .~.~
~as any lieense or pe~Lt ever been revoked or suspended b~ a
Governmental Agency: ~
Project Description
The project description must also include plans for reclamation
of land disturbed during construction of the principle and
accessory structures and underground structures (i.eo~ 'pipeline
and septic system; make additional attaclm~ents if nece. ssary)~
Authorization (Where the applicant is not the owner)
i residing at
' IPrint-owner of subject property) (Mailing address-phone)
do hereby authorize to apply for
Coastal Erosion permit(s) from the Southold Town Trustees
S[gnatur~
THIS IS NOT A PERMIT
COUNTY OF SUFFOLK
STATE OF NEW YORK
AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND
THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF }{IS KNOWLEDGE
AND BELIE~ AND ~{AT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS
APPLICATi~ ~D A~ ~Y BE APPROVED BY THE TO~ ~O~D OF THE TOWN OF
SOUTHOL~ ~ ~C~T AGREES TO HOLD THE TO~ OF SOUTHOLD ~D THE T~WN
TRUSTEES ~5~ ~D FREE FROM ~ ~D ~h D~GES ~D CLAIMS ARISING
UNDER OK ~ VIRT~ OF SAiD PE~IT, IF G~ED.
IN COMPLETING T~I~ APPLICATION, I NEREBY AUTHORIZE THE TRUSTEES, THEIR
AGENT OR REPR~SENTATIVE~ TO ENTER ONTO ~ PROPERTY TO INSPECT THE PREMISES
f Apptican
SWORN TO BEFORE ME THIS ~ h~ DAY OF ~'~ 3~l/'e_~L)~.3~- , 19 q Q_7
NOTARY PUBLIC 0 Not.~ P~lic, State of New Y~
NO, 01 L04958343
Qualified in Suffolk Coun~
Comm~oa Expires Novem~ ~, 1~
EX~INED BY.~
APPROVED . :
DISAPPROVED ~,
CONDITIONS (if any)
sIGNATURE O~ e~Al~
COMPUTATION 0~ ~EBS
Approved. 2/~7/85
617.20
Appendix C
Slate Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS ODly
PART I Project Information (To be completed by Applicant or Protect sponsor}
ICERTIFY ~'HAT THE INFORhlAIION PROVIDED ABOVE IS TRL~E TO THE BESI OF ~,l'~ K~,OWLEDCE
II the action Is In the Coastal Area. and you are a state agency, complele the
Coastal AssSssment Form before proceeding with this assessment
OVER
1
PART Ill Determination of Significance (To be completed by Agency)
iNSTRUCTIONS: I~or each adverse effect identified above, determine whether it is substantial, large, important or other~lse
signiflcant, Each effect s~ould he assessed in c6nnection with its [a) settin8 [ie. urban or rural): (b} probability of occurring;
(c) duration; (dj itteversibili~y; (e] geographic scope; and (f) magnitude. If necessary, add attachments or re~erence supporting
materials, ~ns~r~ that explanadon~ contain sufficient detail to show that all relevant adverse impacts have been identified
and adequately addressed,
~ Check th~s bo~ if you have identified one or more potentmatly large or sigmficant adverse impacts ~hich MAY occur Then
proceed directly lo the ~ULL EAF and, or prepare a positive declaration.
~ Check this box if you have determined, based on the information and analysis above and any Supporting dOCumenla[mn.
that ~he propd~ aCtlbh WiLL NOT result in any significant adverse environmental impacts AND p~ovide he~e, and o-
JABES H. P BO, INC.
BISHOPS LANE
SOUTHAMPTON, N.Y. 11968
PHONE: (516) 283-1254
(516) 734-5859
FAX: (516) 283-7018
December 11, 1997
A1 Krupski
Southold Town Trustees
Town Hall
Main Road
Southold, N.Y. 11971
Re: Vitale Permit 94109
Amendment dated February 29, 1993
Dear chairman Krupski,
Please inform us if this amendment to
install armor stone, as per letter, is still
in effect. If it is, in fact, still valid,
please let us know. If not, please consider
amendment or extension of that letter.
Thomas E. Samuels
cc: Ted Dowd
F~bruary 29, 1993
Costelio ~arine con~r&¢ting Cozp-
P.O. Box 2124
~reenDort. NY 11944
i.:
92-1-g ....
Pear.~. Long,
re~ meeting of Feb~a~ 25,
sec~o~~ ~ bu~ead r~t~
exist~g bu~ with rock reverent. ~ ~ock ~h~l ~t be
~e~e~.. LoCat~ inlet Way,
I~ you ~ve~ ~y ~ations, pleaae ~i1 o~ offi~.
yours
JMB:djh
Albert J. Kmpski, President Town Hall
John Holzapfel, Vice President 53095 Main Road
Jim King P.O. Box 1179
Martin H. Garrell Southold, New York t 1971
Peter Wenczel Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 19~ 1997
The following action was taken at the Southold Town Board of
Trustees Regular Meeting on Tuesday~ November 18, 1997:
RESOLVED, that the Southold Town Board of Trustees grant a quit
claim deed, as indicated on survey by shaded area, to Anthony
Vitale for the Purchase of this property at the cost of
$1,000, Property located on Fairhaven Inlet, Cedar Beach,
Cutchogueo - SCTM ~92-1-8
Albert J. Kmpski, President ~.,~ Town Hall
John Holzapfel, Vice President ~'il~ 53095 Main Road
Jim King ~l~ P.O. Box 1179
Martin H. Garrell ~'~4'~'~ Southold, New York 11971
Peter Wenczel Telephone (516) 765-1892
~ Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 19r 1997
The following action was taken at the Southold Town Board of
Trustees Regular Meeting on Tuesday, November 18, 1997:
RESOLVED, that the Southold Town Board of Trustees grant a quit
claim deed, as indicated on survey by shaded area, to Anthony
Vitale for the purchase of this property at the cost of
$1,000, Property located on Fairhaven Inlet, Cedar Beach,
Cutchogue. - SCTM ~92-1-8
Albert J. Ktupski, President ff-,~x,~ Town Hail
John Holzapfel. Vice President ~'l 53095 Main Road
Jim King P.O. Box 1179
Martin H. Garrell ~ Southold, New York 11971
Peter Wenczel ~ Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 19~ 1997
The following action was taken at the Southold Town Board of
Trustees Regular Meeting on Tuesday, November 18, 1997:
RESOLVED, that the Southold Town Board of Trustees grant a quit
claim deed, as indicated on survey by shaded area, to Anthony
Vitale for the purchase of this property at the cost of
$1,000, Property located on Fairhaven Inlet, Cedar Beach,
Cutchogueo SCTM 992-I-8
CONSULT YOUR LAWYER BEFORE SIGNE4G THIS INSTRUMENT--THIS INSTRUMENT SHOiH.D BE USI~ BY LAWYERS GNLY.
~fll~iNDEN~umde the day of December · inn~eenhundredamdninety_seven
THE BOARD OF SOUTHOLD TOWN TRUSTEES, Town Hall,
Southold, New York 11971,
par~ ofthe first part, and ANTHONY VITALE and MARIE VITALE~ residing at
One Hoaglands Lane, Old Brookville, NY 11545,
par~ of the second part,
WrfNF.,SSETH, that the party of the first pa~, in consideration of ten dolors paid by the party of ~he s~ond
part, does hereby rem~, release and q~tcl~m unto the par~ of the s~ond part, the heirs or successors and
~signs of the par~ of the s~ond pa~ forever,
~- that certain plot, pi~e or pared of land, with the buildings and hnprovemen~ thereon er~ted, situa~,
lying andheing~the at Bayview, in the Town of Southold, County of Suffolk and State
of New York, being particularly bounded and described as follows:
BEGINNING at a point at the Northeasterly corner of the premises hereafter described
said being the following thirteen coarses and distances from the corner iformed by th
intersection of the southwesterly side of Inlet Way with the Southerly siide of Cedar
Point Drive East;
1. South 39° 18' 30" East, 121.04 feet
2. South 41° 05' 40" East, 151.05 feet;
3. South 49° 00' East, 54.99 feet;
4. North 88° 00' East, 90.00 feet;
5. North 69° 30' East, 180 feet;
6. North O0~ 30' West, 51.33 feet;
7. North 56° 46' 50" East 51.33 feet;
8. North 01° 31' 48" East, 28.96 feet;
9. South 78~ 15' 00" East, 25 feet;
10. South 30° 22' 34" East, 43.11 feet;
11. South 28° 08' 37" East, 50.00 feet;
12. South 57~ 08' 57" East, 15.00 feet;
13. South 22° 45' 12" East 57.95 feet to the true point or place of beginning;
RUNNING THENCE South 22° 45' 12" East, 50.63 feet;
THENCE South 71° 14' 55" West, 110.15 feet;
THENCE North ll° 18' 20" East, 26.26 feet;
THENCE North 79° 38' 40" East, 47.30 feet;
THENCE North 50° 52' 30" East, 36.53 feet;
THENCE North i0° 35' 10" East, 25.19 feet to the point or place of BEGINNING.
TOGETHER with all right, title and interest, if any, of the l~rty of the first part in and to any streets and
roads abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances
and all the estate and rights of the pa-~'y of the first part in and to said premises; TO HAVE AND TO
HOLD the premises herein gTanted unto the party of the second parr, the heirs or successors and assigns of
the party of the second part forever.
AND the party of the first part, in compliance with Section 13 of the Lien Law, hereby covenants that ~che party
of the first part will receive the consideration for this conveyance and will hold the right to receive suc~ cormid-
eration as a trmt fund to be applied first for the purpose of paying the cost of the improvement and x~ill apply
the same first to the payment of the cost of the improvement before using any part of the total of the ~me for
any other purpose~
The word "party" shah be construed as if it read "panics" whenever the sense of t~s indenture so ~eqinres.
warm , the fire pa. ddy the and bove
BOARD OF SOUTHOLD TOWN TRUSTEES
By:
Albert J. Krupski, ~Jr., as~resident of Board of
Southold Town Trustees
~lzo~ OZaN /O
[iuvduwD aouvznsuI ali~.£ uvo~zou~v ~sa,M
jo~sanba~¥ p~p~oa~l ~'~V,I~A ~;IMVR pujeI S[~IA
O.L
TP-584 (10196) Recording Office Time Stamp
~ New Yolk State Department of Taxalion and Finance
Combined Real Estate
Transfer Tax Return and
Credit Line Mortgage Certificate
See instructions (TP-584-1) before completing this form. Please print or type.
Schedule A -- Information Relating to Conveyance
Grantor Name (ff ~ivldual; last, first, middle i~i§al) Social Security Num6er
[] individual THE BOARD OF SOUTHOLD TOWN TRUSTEES
[] Corporation Mailing address Social Security Number
Town Hall
I-- Partnership
City State ZiP code Federal employe~ taent number
[] Other Southold New York 11971
Granlee Name iii individual; last. first, midd/e inS/al) Social Security Number
[] Individual ANTHONY VITALE and MARIE VITALE
[~] CorporaI~on Ma(ling address Social Security Number
One Hoaglands Lane
E] Partnershla
City State ZIP code Federal empioye~ ident, number
[] Other Old Brookville New York 11545
Location and descdptiorl ol property conveyed
Tax map designation Address City/Village Town County
Section Block Lot
Type of property conveyed (chec~ applicable box)
I [] I -3 lamily house 5 [] Commercial/Industrial
2 [] Residential cooperative 6 [] Apartment building Date of conveyance Percentage of real property
3 [] Residential condominium 7 [] Office building conveyed which i~s residential
4 [] Vacant land 8 [] Other I 12 I ~ 97 I real property ~ %
month day yeal (see instructions)
Condition of conveyance (check all that apply)
a. ~ Conveyance of fee interest f. - Conveyance which consists of a mere k - Contract assignmem
~. - Acquisition of a controlling interest (state change of identity or form of ownership or L - Option assignment or surrender
percentage acquired %) organization la,ach Form TP~584.t. Schedule F) m. - Leasehold assignment or surrender
c. - Transfer of a controliiag interest (state g. - Conveyance for which credit for tax n. - Leasehold grant
percentage translerred %) previously paid will be claimed o. - Conveyance of an easemera
d. - Conveyance to cooperative housing lattach Form TP-5~4 t. Schedule G) p. -- Conveyance for which exemption
from
corporation h. - Conveyance of cooperative apartment(si transfer tax is claimed (complete Schedule B,
Part lid
e. - Conveyance pursuant to or in lieu al L - Syndication
q. - Conveyance of property partly within and
foreclosure or entorcemeof of security j. - Conveyance of air rights or eevelopment partly without the state
interest (attach Form TP,584. [, Schedule E) rights r. - Other (describe)
Schedule B -- Real Estate Transfer Tax Return (Article 31 of the Tax Law)
Part ! - Computation ~f Tax Due
I Enter amount of consideration for the conveyance (if you are claiming a total exemption from tax, chec~ the exemption
claimed box, enter cor~ideration and proceed to PartllJ,~ ................................ [~Exemption claimed I 1,000 00
2 Continuing lien deduction (see instructions il property is taken subject to mortgage or lien) ............................. 2 { -0- )
3 Taxable consideration (subtract line 2 from line ;~ .................................................................. 3 I, 000 30
4 Tax: $2 for each $50(]. or fractional part thereof, of consideration on tine 3 ..................................... 4 .4 30
5 Amount of credit claimed (see instructions and attach Form TP-584.1, Schedule G) .................................... 5
6 Total tax due* (subtract line 5 from line 4, .......................................................................... 6 ~ DO
Part H - Computation of Additional Tax Due on the Conveyance of Residential Real Property for $1 Million or More
I Enter amount of consideration for conveyance (from Part 1, line 1) .............................................. [
2 Taxable consideration (multiply tine 1 by the percentage ct the premises which is residential real property; see instructions) ......
3 Total additional transfer tax due* (1% of line 2) ...................................................................
*Please make check(s) payable to the county clerk where the recording is 1o take place or if the recording is to take place in New York
City, make check(s) payable to the NYC Department of Finance. If no recording is required, send this return and your cne~k(s) made
payable to the Department of Taxation and Finance. direofly to the NYS Tax Department, I t I B-Transfer Tax, PO Box 50~5, Albany NY
12205-5045.
For recording officer's use Amounl Da{e received Transaction number
TP-584 (t0/96) (back)
Schedule B -- (continued)
Part I[~ - Explanation of ExemptiOn Claimed in Part ][, line 1 (check any boxes that apply)
The conveyance of real property is exempt from the real estate transfer tax for the following reason:
a. Conveyance is to the United Nations, the United States of America, the state of New York or any of their instrumentalities,
agencies or political subdivisions (or any public corporation, incleding a poblic corporation created pursuant to agreement or
compact with another state or Canada) ...................................................................................... a []
b. Conveyance is to secure a debt or other obligatibn .......................................................................... b []
c Conveyance is without additional consideration to confirm, correct, modify or supplement a prior conveyance ................ c []
d. Conveyance of real property is without consideration and not in connection with a sale, including conveyances conveying
realty as bona fide gifts ..................................................................................................... d []
e. Conveyance is given in connection with a tax sale ........................................................................... e []
f. Conveyance is a mere change of identity or form of ownership or organization where there is no change in beneficial
ownership. (This exemption cannot be claimed for a conveyance to a cooperative housing corporation of real property
comprisir,3 the cooperative dwelling or dwellings.) Attach Form TP-584.1, Schedule F ....................................... f []
g. Conveyance consists of deed of partition .................................................................................... g []
h. Conveyance is given pursuant to the federal bankruptcy act ................................................................. h
i. Conveyance consists of the execution of a contract to sell real property without the use or occppancy of such property or
the granting of an option to purchase real property without the use or occupancy of such property .......................... []
j. Conveyance of an option or contract to purchase real property with the use or occupancy of such property where the
consideration is less than $200,000 and such property was used solely by the grantor as the grantor's personal residence
and consists of a 1-, 2-, or 3-family house, an individual residential condominium unit, or the sale of stock in a cooperative
housing corporation in connection with the grant or transfer of a proprietary leasehold covering an individual residential
cooperative apartment .......................................................................................................
k. Conveyance is not a conveyance within the meaning of section 1401 (e) of Article 31 of the Tax Law [attach documents
supporting such claim) ......................................................................................................... k
i. Other (attach explanation) ................................................................................................... ~ []
Schedule C -- Credit Line Mort(lacle Certificate (Article 11 of the Tax Law)
Complete the following only if the interest being transferred ia a fee simple interest.
I (we) certify that: (check the appropriate box)
1 [] The real property being sold or transferred is not subject to an outstanding credit line mortgage.
2 [] The real property being sold or transferred is subject to an outstanding credit line mortgage. However, an exemption from the tax
is claimed for the following reason:
[] The transfer of real property is a transfer of a fee simple interest to a person or persons who held a fee simple interest in the
real property (whether as a joint tenant, a tenant in common or othe~vise) immediately before the transfer.
[] The transfer of real property is (A) to a person or persons related by blood, marriage or adoption to the odginel obligor or to
one or more of the original obligors or (B) to a person or entity where 50% or more of the beneficial interest in such real
property after the transfer is held by the transferor or such related person or persons ~'as in the case of a transfer to a trustee
for the benefit of a minor or the transfer to a trust for the benefit of the transferor).
[] The transfer of real property is a transfer to a trustee in bankruptcy, a receiver, assignee or other officer of a court.
[] The maximum principal amount secured by the credit line mortgage is $3,000,000 or more and the real property being sotd
or transferred is not principally improved nor will it be improved by a one- to sixJamily owner-occupied residence or dwelling.
Please note: for purposes of determining whether the maximum principal amount secured is $3,000,000 or more as
described above, the amounts secured by two or more credit line mortgages may be aggregated under certain
circumstances. See TSB-M-96(6)-R for more information regarding these aggregation requirements.
[] Other (attach detailed explanation).
3 [] The real property being transferred is presedtly subject to an outstanding credit line mortgage, However. no tax is due for the
following reason:
[] A certificate of discharge of the credit line mortgage is being offered at tire time of recording the deed,
[] A check has been drawn payable for transmission to the credit line mortgagee or his agent for the balance due, and a
satisfaction of such mortgage will be recorded as soon as it is available.
4 [] The real property being transferred is subject to an outstanding credit line mortgage recorded in
(insert liber and page or reet or other identification of the mortgage), The maximum principal amount of debt or obligation secured
by the mortgage is . No exemption from tax is claimed an(; the tax of is
being paid herewith, (Make check payable to county clerk where deed will be recorded or. if the recording ia to take place in New
York City, make check payable to the NYC Department of Finance.)
Sklnature (both the (lrantor(s) and (Irantee(s) must sicln).
The undersigned certify that the above return, ibcluding any certification, schedule or attachment, is to the best of his/her knowledge, true
and complete.
THE BOARD OF SOUTIJOLD TOWN, TRUSTEES
Gren ee Title
Title Anthony Vlta{e
Marie Vitale
Reminder: Did you complete atl of the required information in Schedules A end B? Were you required to complete Schedule C? If you checked e,
f or g tn Schedule A, did you complete TP-584.17 Have you attached your check(s) made payable to the county clerk where recording will take
place or, if the recording is tn New York City, to the NYC Department of Finance? tf no recording is required, send your check(s), made payable to
the Department of Taxation and Finance, directt¥ to the NYS Tax Department, 3Tt*B~Transfer Tax, PO Box 5045, Albany NY 12205-5045.
FOR COUNTY USE ONLY
Cl. SWIS Code I · ' ~ , , , I ~ REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
/ / I STATE BOARD OF REAL PROPERTY SERVICES
C~. Date Deed Recorded [ Month Day Year
RP - 5217
C3. Book I ~ , I I C4. Page ~ , ,
PROPERTY INFORMATION I
I I I
z Buy., I Vitale Anthony
I Vitale Marie
3. Tax Indicate where future Tax Biffs are to be sent
Billing if sfber tha~ buyer address lat bottom of form) I
4. Indicate file number of Assessment 1~ (Only if Pa~t of a parcel) C~k as they
Roll parcels t~ansferred on the deed I # of Panels OR. . part of a Parcel 4~L P~annlng Board with Subdivision Authority E~sts []
S. Deed 4B. SubcEvis;on Approva~ was Bequked for TranSfer []
~op".v I I x I I o. I . . I ~ Pa~.~*p~d fur Be~r~is~o. with M~ ~o~ded []
IsoBar I The Board o£ Southold Town ~rustee$
I
8. Ownership Type is Condominium []
! ~ One Family Resiclentiat !~ Agdcu~ural ~ CommunRy Servise 9. New Construction on Vacant Land []
2 or 3 Family Residengal Commercial Industrial 10A. Properb/Locsfed within an Agricultural D~stfict []
Residential Vacant Land Apartment Public Service I0~. Beyer received a disclosure notice indicating []
Non-Besidential Vacant Land Entertainment ! Amusement Forest 'd~at the property is in an Agricultural Districl
~ SALE INFORMATION ~ lS. Che~k one or more of these ~ondltfuns as applicable to transfer:.
Monfh Day Year ~ Sale Between Related Companies or Partners in Business
C ~ One of the Bayers is idso a Seller
12. Date of Sale ! Transfer ~L ~7 / .~ / ~ 7 D -- Bayer or Seller is Government Agency or Lending Institution
Month Day" Year ~ ~ Deed Type not Warranty or Bargain and Sale [SPecify Below)
[~ -- Sale of Prectlonel or Less than Fee Interest [Specifl/Below)
O ~ Significant Change in Property Between Taxable Status and Sale Dates
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill ~
tli. Prop.nv ~ I , , f-IItg. Behont s~iat.~me ~
I
I I I
CERTIFICATION
I
I I ~
SELLER [N,TJ~W ~J~'ORK~ STAT~,
The Board of Southold Town Trustees COPY
By: I 17/~ /97 k.
CO§TELLO [VIARINE CONTRACTING CORPORATION
DOCK BUILDING - JETTIES o BULKHEAD~NG ~ STEEL & WOOD P~LING o FLOATS
423 FIFTH STREET, P.O. BOX 2124 · GREENPORT, NEW YORK 119~ o (51~ 477-1199/~7-1393/47%0682
November 5, 1996
Board of Trustees ~ NOV
P.O. Box 1179
Southold, NY 11971 ~
thony vitals
Permit #4109
Pursuant to the enclosed permit, please be advised that
Costello Marine would like to undertake reconstruction of the 35'
offshore section of the easterly jetty. The reconstruction is
necessary due to the October 19, 1996 nor'easter.
It is my understanding that this notice of commencement is
all that is required of your board for us to undertake this
activity. I have enclosed project plans and photographs of the
area for your files. Please advise if you require additional
information.
Thank you for your attention in this matter.
Very truly yours,
Permit Manager
Enc.
J
Albe~t J. Kmpski, Presidem Town Hall
John Holzapfel, Vice President 53095 Main Road
Jim King P.O. Box 1179
Martin H. Garrell ~ ~,~ Southol. d, :New York 11971~
Peter W enczel ~-~ Telephone (516) 76 $- 1892
'~ F~i,x 765-11~23
(516)
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 19, 1997
The following action was taken at the Southold Town Board
Trustees Regular Meeting on Tuesday, November 18, 1997:
RESOLVED, that the $outhold Town Board of Trustees grant a quit
claim deed, as indicated on survey by shaded area, to Anthony
¥itale for the purchase of this property at the cost of
$i,000, Property located on Fairhaven Inlet, Cedar Beach,
Cutchogue. - SCTM 992-1-8
TRUSTEES t ~..~ SUPERVISOR
John M. Bredemeyer, IlL President ~'~ SCOTT L. HARRIS
Albert J. Krupski, Jr., Vice President
Town Hall
Henry P. Smith ~,/d~/.~
John B. Tuthill 53095 Main Road
William G. Albertson '~-x~t~ / P.O. Box 1179
Telephone (516) 765-1892 ~ Southold, New York 11971
Fax (516) 765-1823 BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
February 29, 1993
Costello Marine Contracting Corp.
P.O. Box 2124
Greenport, NY 11944
Re: Anthony & Marine Vitale
SCTM 9 92-1-8
Dear Ms. Long,
The following action was taken by the Board of Trustees at their
regula~ meeting of February 25, 1993:
Resolved that the Southoid Town Board of Trustees approved the
request for an amendment to permit 9 4109 to state the
following: Resheath 332' face of existing bulkhead with
plywood, replace 85-90 yards lost fill, install 5 new pilings on
easterly section of bulkhead and 4 support batter piles on north
section, extend bulkhead return 16~, armor 1504 section of
existing bulkhead with rock revetment. The dock shall not be
amended. Located Inlet Way, Southold.
tf you have any questions, please call our office.
o~hY~Mtruly yours,
President, Board of Trustees
~ JMB:djh
TRUSTEES · SUPERVISOR
John M. Bredemeyer, III, President SCOTT L. HARRIS
Albert J. Krupski~ Jr., Vice President
Henry E Smith -Town Hall
John B. Tuthill 53095 Main Road
William G. Albertson EO. Box 1179
TelephDne (516) 765-1892 Southc/ld, New York 11971
Fax (516) 765-1823 BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
February'9~ 1993
Costeilo Marine
Sue Long
P.O. Box 2124
Greenport, NY 11944
Re: Anthony & Marie Vitale
SCTM ~1000-92-1-8
Dear Ms. Long:
The following action was taken by the Board of Town Trustees durLng
its regular meeting held on January 28, 1993 regarding the above
matter:
WHEREAS, Costello Marine on behalf of Anthony & Marie Vitale
applied to the Southold Town Trustees for a permit under the
provisions of the Wetland Ordinance of the Town of Southold,
application dated and, ~J~ I~,~
· 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 28, 1993 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
RESOLVED that the Board of Trustees approves the application of
Costello Marine on behalf of Anthony & Marie Vitale to resheath
17' on east jetty (South end), resheath 5' on west jetty (south
end) and install 32" X 8' ramp with pipe support pilings attached to
existing 12' X 14' fixed dock with 6' X 20' float as per revised
plans dated December 28, 1992.
permit will expire two years f~om'the date it is signed. Fees mus~
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 pro3ect.
Permit will be issued upon payment of the following fees for work to
be. done below'Mean High Water Mark:
Very truly yours, ~
John M. Bredemeyer, III
President, Board of Trustee
JMB: 3d
TRUSTEES
John M. Bredemeyer, III, President SUPERVISOR
Henry P. Smith, Vice President SCOTT L. HARRIS
Albert I. Kmpski, Ir.
]olm L. Bednoski, Jt Town Hall
John B. Tuthill 53095 Main Road
P.O. Box 1179
Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 1197l
Fax (516) 765-1823 TOWN OF SOUTHOLD
COASTAL EROSION MANAGEMENT PERMIT APPLICATION
TOWN WETLANDS PERMIT APPLICATION
TRUSTEE LANDS PERMIT APPLICATION
Office Use Only:
__Coastal Erosion Permit Application
Wetland Permit Application ~
__Trustee Lands Permit Application -
Grandfather t~7 _~
__Completed Apps. Date: ~]~]
Variance Required,
--_ Neighbors notified Date: L~__
coord. Review-opt.,mand. Date Rec. by Office
II,ap. comp./date: -
SEQRA Determin./date:
__Public Hearing/date:
Findings:
Permi~ Vote: (Y/N):
Special Conditions:
(also see f-i-le) Application Fee:
Application Number; SCTM %1000- q;[~ _ ~
Project Nffme (If any)
Date Prepared:
Applicant: O~e&TF UhC3 ~¢ k%E C-O~37~,%CTIkJ&
Aaaress: P.O. O
Interest: (owner, consultant,lessee,etc.)
Owner of Property: ~k3T~bg\l \~ IT3k F~
Address - ~. - I ~6>h ~ k ~ kJ~b.~ kP~ kJ ~.
Subject Property Location: ~Ei~JLFT ~jA~
(Provide LILCO Pole #, Distance to cross Streets if not on
location map)
THIS IS NOT A PERMIT
Yds. to be excavated: ~l~ Yds. to be filled: ~-q~ ~
Manner in which material Will be removed or deposited:
Depth at low tide: ~]/~ Aver. ~ise in tide: k~l~
Distance to nearest ch~nel: ~!/~ Distance project
extends beyond, similar. .projects ~n area-. ~.
Area zoning: ~e~%4~{~ ~ Land area in acres: ~
Is project for private or busigess Use: ~%~
Intended use of property: ~x~Q'% '
Describe known prior operations conducted on premises:
Has any prior license or permit been issued to erect structures,
dredge, or deposit fill on said premises:
Has any license or permit ever been revoked or suspended by a
Governmental Agency: ,j'V~O
Project Description
The project description must also include plans for reclamation
of land disturbed during construction of the principle and
accessory structures and underground structures (i.e., 'pipeline
and septic system; make additional attachments if necess, ary).
Authorization (Where the applicant is not the owner)
T residing at
(Print-owner of subject property) (Mailing address-phone)
do hereby authorize to apply for
Coastal Erosion permit(s) from the Southold Town Trustees
Signature
THIS IS NOT A PERMIT
TRUSTEES - SUPERVI/SO//
Jol~ M. Brcdemeyer, HI President SCOTT L. HARRIS
Albert J. Krupski, Jr.. Vice President
Henry E Smith Town Hail
John B. Tuthill 53095 Main Road
W/Il/am G. Albenson P.O. Box 1179
Telephone (516) 765-1892 Southolfl. New York 11971
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
NEGATIVE DECLARATION
NOTICE OF NO SIGNIFICaNT EFFECT O~t THE EArVIRORI~E~T
APPLICATION NO. 1000-92-1-8 Chapt. 97 - Wetlands
NkwxE: Marie Vitaie Chapro 37 - Coastal Erosicn
DATE: December 17, 1992
RESOL¥~D that pursuant to Article 8 of the Environmental Consezvation
Law, State Environmental Quality Review and 6NYCP~R Part 617t
Section fii7.10 and Chapter 44 of the Code of the Town of Southold~
notice is hereby given that the Southold Town Trusteesr as Lead
Agency for the action described below~ has determined that the
project will not have a significant effect on the environment~
~lease take further notice that this declara%ien should not be
considered a determination made for apj other department or a~ency
which may also have an application pending for the s~me or s~milar
project.
A planting survey shall be submitted prior to final approval~
TY~E CF ACTION: T~e I!
DESCRIPTION OF ACTION: to resheath 17~ on east jetty (south end),
resheath 5' on west jetty {south end) and attach to a 28" X 16~
ftoat~ r~m to be 32~ X 8~' and pipe support pilings~
NOT~: Revised survey must be received prior to the January 28~ 1993
public hearing.
LOCATiON:SC~
REASONS S~PPORTING THIS DETE~INATSON:
1o An on site inspection has been conducted by the Beard of
Trustees.
2. An environmental assessment~ submitted by the applicant and
reviewed and completed by the Board of Trustees~ hes indicated ~hat
no significant adverse effects to the environment are likely toloccur
should the project be implemented as planned.
Town Hall, 53095 Main Road
Telephone P.O. Box 1179
(516) 765-1801 Southold. New York 1197~[
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
TO: Southold Town Board of Trustees
FROM: Southold Town Conservation Advisory Council
DATED: December 16, 1992
RE: Recommendation of Wetland Application
At its meeting held Thursday, December 10, 1992, the Southold Town Conservation
Advisory Council made the following recommendation:
On a motion by John Holzapfel, seconded by Bruce l-oucka, it was
RESOLVED to recommend to the Southold Town Trustees approval with
conditions of Wetland Application No. 92-I-8 of Anthony and Marie Vitale to
resheath 17' on east jetty (south end), resheath 5' on wetst jetty (south end).
Install 28' × 16' folat attached to 6j x 20' float.
The CAC approves the project provided that it does not block navigation
(tie-up must not block navigation up the creek) and the floats must not go
out further than the fixed dock.
Inlet Way, Southold.
Vo~e of Council: Ayes: All
Motion carried.
~'- ~ q ~ ~ [~'c~zr ~, 1992
Under the Envlronmef ~l~gonse_~.~tion~L)i~ ~ ~
, ~r~ ~ ~--, -~~]~~~ D~r 4, 1995
~n of ~ L , ~ SPDES , ~ Haza~us ~s~ Management
~ A~cle 15, Title 15: ~ A~le lg:
A~cle
34:
Water Supply Alt Pollu~0n Control ~,, ~
~ ~tAI Erosion Management
~ A~e t~ ~[i~ ~5: ~ A~cle 23, ~tle 27: -- AdJcle 36:
I ~ Water T~ns~ I - t Mined ~nd R~lama~ ~ R~plain Management
~ A~le 15 mia 15: ~ A~cle 24: ~ Aaicles 1. 3. ,7. ~9. 27. 37:
Long Isl~ W~li~* Freshwater Wetlands __ 6NYCRR 380: Radiation Coatrol
~ Adi~e 15~, Ti~e 27: ~ A~icle 25:
Wild, S~dib ~ R~e~ional I ~ I Tidal WetlAnds -- Other:
Rivers ~ Adicle 27. Title 7; 6NYCRR 360:
I 1
Solid Waste Management
~ 6NYC~R 608:
Water Q~ality Ce~fi:tion
P~T ~SSUEO TO , ]
~o~ ~ ~e Vi~e r~,o~
1 ~agsl~ ~e~ Old B~ille, ~ 11545
Cost'lo ~ TELEPHONE NUMBER
(516~ 477--11S9
Inlet W~
Sou%~ld
couN,,S~fo~ iTOWN/~~u~Old IWATERCOURsE~ET~ND NO' j NYTM COORD,NATE$E: . __ N:4
~hea~ a ~o~ o~ ~ jet~e~ 17' o~ ~e ~t ~ett% ~ 5' o~ ~e ~t ~ett%.
I~ll a 32" X 8' r~ ~ x ~float held wi~ pi~ s~ pil~gs. ~1 work
shall ~ ~ ac~ wi~ ~ attach~ ~SD~ ~rov~ pl~.
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance
with the ECL. all applicable regulations, the General Conditions specified (See Reverse Side) and any Special
D~Cponditions [nclu~ed as part of this permit.
PERMIT ADMINISTRATOR J ADORES/
David ~dd~ ~Slon ~- ~!~. 4o S~Y
GENERAL CONDITIONS
Inspecfions
1. The permitted site or facility, ~n~dmg relevant records, is subiect to inspection at reasonable ho
and intervals by an authorized reeresentative of the Deoartment of Environmental Conservation ~ e
Department) to determine whether the permittee is complying with this r~ermit and the ECL.
representative may order the work suspended pursuant lo ECL- 71-0301 an~ SAPA 401(3)~ A cop~
this ~ermit. including a~l referenced maps, drawings anc~ special conditlons, must be avaJlabi~
inspection by the Department at all times at the project site. Failure to produce a copy of the pa' --;it
upon request by a Department reoresentative is e violation of this permit.
Permit Changes and Renewals
2. The DeDartmen~ reserves the'right to modify, suspend oF revoke this 3ermit when:
a) the scope of the permitted activity is exceeded or a violation of any condition of the pe~
or btovisions of the ECl_ and pertinent regulations is found;
b) the permit was obtained by misrepresentation or failure to disclose relevant facts;
c) new material information is discovered: or
d) environmental conditions, relevant technology, or applicable law or regulation have mate~tly
changed since the permit was issued.
3. The permittee must submit a separate written application to the Department for renewal.
tion or transfer of this permit. Such application must include any forms, fees or suoplemental i- or-
motion the Department requires. Any renewal, modification, or transfer granted by the Depart~-gnt
must be in writing.
4. The permittee must submit a renewal application at least:
a) 180 days before expiration of permits for State Pollutant Discharge Elimination System tSPC~iS),
HazardoUS Waste Management Facilities (HWMF), major Air Pollution Control (APC) and
Waste Management Facilities (SWMF); and
b) 30 days before expiration of all other permit types.
5. Unless expressly provided for by the Department, issuance of this permit does not modify, supersede
or rescind any order or determination previously issued by the Department or any of the terms ;on-
ditione or re~3utrements contained in such order or detel'mination.
Other Legal Obligations of Permittee
6. THe permittee has accepted expressly, by the execution of the application, the full legal respon~ bill-
ty for ali damages, direct or indirect, of whatever nature and by whomever suffered, arising c t of
the project described in this permit and has agreed to indemnify and save harmless the Stat~ ~rom
suits, actions, damages and costs of every name and description resulting from this projec';
7. This permit does no[ convey ~o the permit~:~e any right to trespass upon the lands or interfere ~ith
the riparian rights of others in order to perform the permitted work nor does it authorize the irt :~air-
ment of any rights, title, or ~nterest in real or personal property held or vested in a person not ~ ;arty
to the permit.
8. The permittee is resp~nsibie f~r ~btaining any other perm~ts~ appr~vais~ ~ands~ easements and ~i~hts-
of-way that may be required for this project.
Peele 2 of
by or result frown future OperafJon~ uJ~de~aken by th~ S~a~e for t~
~ da ~ Or HS~ ~ c~J~n shaU ~c~e from any such damage, con~avene effluent limitations ~r o~he~ limitations or s~n~rds under
the U.S. At~ Cb~s of ~ihee~, U.~. Coast Cua~, N~ Yo~ State wi~ t~ approv~ p}ans ~bmitted by the applicant or his a~ent as ~art
Offic& of Cen~tal S&~c&~ or t6cat ~emment which may ~ ~mr~. of t~ permit application.
of a~ wetland dr w~te~ay by sBgpend~ solids, sediments, ~els, Such approved plans were prepared ~y COS~iO ~e
solvents, lubricant, e~coafings, ~lnts, co~rete, leachateor any sh~ts 3, 4, 5 of 5
SPECIAl CONDITIONS
1. ~y deb:is o~ excess ~ate~&al
p~ojec~ shall be completely ~e~oved ~:o~ the ad~acen~ a~ea
(upla~d~ a~d ~e~oved to an approved upland a~ea ~o~ d&sposal.
~o deb:zs &s pe~ed &n ~idal ~e~lands.
2. ~loats and ~a~ps ~ay no~ :est on vegetated t&dal ~etlands.
3. DocAs ~ay no~ extend laterally beyond p:ope:ty l~nes, be
~laced so ~ba~ doeAed boats e~e~d ove~ ad~acen~ p:ope~y
4. No pe~anen~ st:ue~u~es may be bu< on docA
ob~alning Depa:t~e~ app:oval.
~eplaee~e~ o~ exzs~ng s~:uc~u:al elements
de~!gn:' dimension, o~ ~ate:ials, unless
au~o~z~ed Ae~e~n.
8Upple~en~a:y Special cond&tions (Al
DEC PERMIT NUMBER
1-~738-00628/00001-0
PROGRAM/FACILITY NUMBER
I Page , 3 of 4
SUPPLEhnNTARY SPECIAL CONDITIONS
The following conditions apply to all permits:
A. If any of the permit conditions are unclear,the permittee shall con-
tact the Division of Regulatory Affairs at the address and telephone
noted beloW.
A copy of this permit with supple,ientary conditions and .approved
plans ~hatl be avail:-able at the project site whenever authorized
.work iS il{ progress.
C. The permit Sign enclosed.with the permit or a copy ~f letter of
approval shall be protected from the weather and posted in a con-
spicuott~ lOCation at the work site until completion of authorized woflk.
D. At.lO~t 48 ~bO~ks prior to commencement Dr..the pro3ect, the permittee
~hal~ c~mpl~te and return the top portion of tl~e e{]closed receipt form
cert~y{,g ~hat 9e' is fully aware of ahd understands all provisions and
co~dltiOns of this permit. Withi, one week of completion of the
permitted ~Ork, the bottom portion of that form shall also be com-
pleted a~d returned,
E. For project~ i~vO~ving activities to b~ accomplished over a period of
mor~ ~han One year~, tge permittee shall notify the Regional Permit
A~mlnlSf~rator i, Writing at least 48 hours pri~r to the commencement
of Ye~u~ption Of Work each year.
F. If project deslg~ modifi.catious take place after permit issuance, the
p~rm[tt~ shall submit the appropriate plan changes for approval by
the RegioNal P~rm~t Administrator prlof to undertaking any such modi-
fIc~[~o~, "~h~ p~rmittee is advised that substantial modification
ma~ r~g~ire submission of a new application for permit.
G..All necessary precautious shall be taken to preclude contamination of
any wetlands or Waterway by suspended sol~ds, sediment, fuels,
solg~tS~ lubricants, epoxy coatings, paints, concrete, leachate or
a~y other efivi~o~me~tally deleterious materials associated with the
project work, '
H. Any'f~ilBr~ to comply precisely with all of the terms and conditions
o~ ~hls permit, unless authorized ~n writing, sial be treated as a
vioiatiO~ O~ the Environmental Conservation haw.
I. The pe~mittee is advised to obtain any permits or approvals that may
b~ regui~ed from the U.S. Department of Army Corps of Engineers, NY
Di~tfiet, 26 Federal Plaza, New York, NY 10278, (Attention: Regulatory
Fu~Ctlons. Bra~ch}, prior to commencement of work authorized herein.
J. The g~a~ting of this p~r~it does not relieve the permittee of the
respo,$lblizty of o~f~l?lng a grant, ~a~eme~t, or o~ber necessa y
approval f~om the Division of Land Ut{llzatzon, Off~ce of General
Serv~s, ~ow~r Building, Empire state Plaza, Albany, NY 12242, which
may be reqOired for~ any encroachment upon State-owned lands underwater.
Regional Permit Admil]istrator
NYS Dept. of Environmental Conservatio~i
Bldg. 40, SUNY-Room 219
Stony Brook, NY 11790-2356
(516) 751-~89
TRUSTEES
~hn M. Bredemeyen III. Presiden! SUPERVISOR
bert J. Krupski, Jr., Vice President SCOTT L. HARRIS
Henry P. Smith
John B. Tuthill Town Hall
William G. Albertson 53095 Main Road
P.O. Box 1179
Telephone (516) 765-1892 Southold. New York 111971
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
December 7, 1992
John Holzapfel
P.O. Box 210
Southold, NY 11971
Dear Mr. Holzapfel:
Enclosed are the application recently received in the Trustee
Office.
Please review the following and send your comments back as soon
as possible.
Eugene Bolter 111-14-36.1 & 36.3
Tony Helies 123-8-13
Anthony Vitale 92-1-8
TRUSTEES
John M. Bredemeyer, III, President SUPERVISOR
Henry P. Smith, Vice President SCOTT L. HARRIS
Albert I. Kmpaki.
lohn L. Bednoski, I~. Town Hall
Iolm B. Tuthill 53095 Main Road
P.O. Box 1179
Telephone (516) 765-1892 BOARD'OF TOWN TRUSTEES Southold, New York 11971
Fax (516) 765-1823 TOWN OF SOUTHOLD
COASTAL EROSION MAi~AGEMENT PERMIT APPLICATION
TOWN WETLANDS PERMIT APPLICATION
TRUSTEE LANDS PERMIT APPLICATION
Office Use Only:
Coastal E~osion Permit' Application
---Wetland Permit Application
Trustee Lands Permit Application
Grandfather
__Completed Apps. Date:
Variance Required,
Neighbors notified Date:
SEQRA Type
Coord. Review-opt., sand.
--Insp. comp. /date : !~ ~ ~ ~ ~ ~ ~'~
__PublicFindings: Hearing/date:
Per. i% Vote, (Y/N):
Special Conditions:
(also see file)
Application Number; SC224 ~1000-
Date Prepared:
Interest: ( ~ons t,lessee,etc.)
Owner of P~operty:
(Provide LILCO Pole ~, Distance to cross Streets if not on
location map)
THIS IS NOT A PE~IT
Yds. to be excavated: O Yds. to be filled:
Manner in which material will be removed or deposited:
Width of canal, creek or y fronting property: ~'
Depth at low tide: Aver. rise in tide:
Distance to nearest channel: ~/~ Distance project
extends beyond similar projects in area:
Area zoning.° ~ Land area in acres: ~3~
Is project for'private or business use:
Intended use of property:
Describe known prior operations conducted on pr~mises:
Has any prior license or permit been issued to erect structures,
dredge,, or deposit fill on said premises:
Has any license or per~it ever been revoked or suspended by a
Governmental Agency:
Project Description
The project description must also include plans for reclamation
of land disturbed during construction of the principle and
accessory structures and underground structures (i.eo, 'pipeline
and Septic system; make additional attachments if necessary).
Authorization (Where the applicant is not the owner)
I . residing at
(Print-owner of subject property) (Mailing address-phone)
do hereby authorize to apply for
Coastal Erosion permit(s) from the Southold Town Trustees
lgna ur~
THIS IS NOT A PERMIT
COUNTY OF SUFFOLK
STATE OF NEW YORK
BEING DULY SWOAN DEPOSES
AND SAYS THAT Hg IS THE APPLICANT FOR THE ABOVE DESCRIBED pERMiTS, AND
THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE
AND BE WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS
APPLI£ BE APPROVED BY THE TOWN BOARD OF THE TOWN OF
SOUTHOLD~ ~CANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN
TRUSTEES HARMLESs AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
MFbETIN~ THI~ APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIE
AGENT OR REPRESENTATIVE, TO ENTER ONTo MY PROPERTY TO INSPECT THE PREMISES
IN CONJt~CTioN WITH REVIEW'OF THIS APPLICATION,
~lgnatur~ bf Applicant
SWORN TO BEFORE ME THIS ~ h~
- DAY OF .~t~er- , 19 q ~_~
NOTARy PUBLIC 0
SUSAN E.
Notery Pub;~c, State of Ne~ ¥orl[
No. O~ LO49s8343
~ Qualified ~n Suffol~ County
~OramLssion E×~ires NOVember
EXAMINED BY
APPROVED
DI SAPPROV~.D
CONDITIONS (If any)
SIGNATURE Oi~ C~AIRMAN
COMPUTATION OF FEES
Approved. 2/27/85
617,20
Appendix C
Stale Environmental Ouality Review
SHORT ENVIRONMENTAL ASSESSMENT'FORM
For UNLISTED ACTIONS Only
PART I [Project hl~ormatlon (To be completed by Applicant or Project sponsor)
Initially ~ ........ acres -'-ultimately- --. ~ ..... acres ......
~Ye5 No II NO. ciesctibe br~eily
If the action is in the CoaStal Area, and you are a state agency, complete the
Coastal Assessment Form before proceeding with this assessment
OVER
1
PART I~ EnvirOnmental Assessment (To_~e~cpmpieted by Agency}
PART UI D;terminatton ol Significance (To be completed by Agency) ,.
iNSTRUCTIONS: For each adverse effect identlfied above, determine whether it is substantial, large, important or otherwise
significant. Each effect should be assessed in cbnnection with its (al setting [ia, urban or rural); (b) probabihtY o( occurring;
(c) duration; id) irreversibility; (e) geographic scope; and (fi magnitude. If necessary, add attachments or reference supporting
materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identiiied
and adequately addressed.
[] Check this. box if you have identified one or more potentially large or signliicant adverse impacts ~,hich MAY occur Then
proceed directly to the FULL E^F and/or prepare a positive declaration.
[] Check this box if you have determined, based on the information and analysis above and ~ny supporting documentation.
that the proposed actloh WILL NOT result in any significant adverse environmental impacts AND provide here. and on
attachments as necessary, the reasons supportng this determinahon:
2
lolm M. Bredemeyer, III, President SUPERVISOR ~
lien' P' 'mith' Vice ~esidentAl~, ,. K~pski, Jr.~~; SCO'.' L. ItARRIS
lohn B. Tuthill ~~ 53095 Main Rind
P.O. Box 1179
Telephone (516) 765-1892 BOARD'OF TOWN TRUSTEEs Souihold, New York 11971
Fax 1516) 765-1823 TOWN OF SOU~tOLD
COASTAL EROSION MANAGEMENT PERMIT APPLICATION
TOWN WETLANDs PERMIT APPLICATION
TRUSTEE LANDS PERMIT APPLICATION
Office Use Only:
Coastal Erosion Permit Application
Wetland Permit Application
Trustee Lands Permit Application
Grandfather
~Completed Apps. Date:
V
arlance Required,
__ Neighbors notified Date:
SEQRA Type
Coord. Revi~w-opt. ,mand.
Illsp. comp./date: Rec. :e
Determin./date:
Public Hearing/date:
Findings: N~V
Permit Vote: (Y/N):
Special Conditions: L
(also see file) ~'~a
ApPlication Number; SCTM ~1000- q~ - I - ~
Date Prewred:
~ ~ llq'-/c/ ' · ~hone (,fi/&} uJ7q_ ilO~C~
Interest: (owner, consultant,lessee,etc.)
' ¥ Phone
Subject Property 5ocation: ~4~Qj_X¢ [4)~
(Provide LILCo Pole #, Distance to cross Streets if not on
location map)
THIS IS NOT A PERMIT
Yds. to be excavated: ~) Yds. to be filled:
Manner in which material will be removed or deposited:
Width of canal, creek orN~ fronting property:
Depth at low tide: Aver. rise in tide:
Distance to nearest channel: ~/~ Distance project
extends beyond similar projects in area:
Area zoning: ]~%~ Land area in acres: ~5'~OaO
Is project for pri~ate or busingss use:
Intended use of property:
Describe known prior operatioHs con~ted on pr~mises:
Has any prior license or permit been issued to erect seructures,
dredger, or deposit, fill on said premises:
ttas any license or per~it ever been revoked or suspended by
Gover~ental Agency:
Project Description
Tile project description must also include plans for reclamation
of land disturbed during construction of the principle and
accessory structures and underground structures (ice., 'pipeline
and septic system; make additional attact~ments if necessary}°
Authorization {Where the applicant is not the owner)
I residing at
(Print-owner of subject property) {Mailing address-phone)
do hereby authorize to apply for
Coastal Erosion permit{s) from the Southold Town Trustees
~gnatur~
THIS IS NOT A PERMIT
COUNTY OF SUFFOLK
STATE OF NEW YORK
A~D SAYS T.~T .E IS T~,E APPLICANT FOR T~ ABOVE DESCRIBED PERMITS. A~
THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE
AND BELIE~ AND THAT WORK WILL BE DONE IN THE MANNER SET FORT[! IN THIS
APPLiCATIoN eD A~ MY BE APPROVED BY THE TOWN BOARD OF THE TO%~ OF
SOUT[{OLD~ T~ APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND TNE T~WN
TRUSTEES ~L~SS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR' ~ VIRTUE OF SAiD PERMIT, IF GRANTED.
IN COMPLETING T~IE APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR
AGENT O~ REPRE~ENTATIVE~ TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES
IN CONJUNCTION WIT~ REVIEW'OF THIS APPLICATION.
~lgnatur~ of Applicant
SWORN TO SEFORE ME THIS ~h&
I DAY OF -~m~ , 19
NOTARY PUS~I ~' ~ SUSAN ~.
Nots~ Public. S~ate of Ne~
No, O]L04958343
C- Ou?~f~ed in SuffolE Ceun~
vmm~ssmn Expires November ~
EXAMINED BY
APPROVED
DISAPPROVED
co.~T~ONS (i~ any;
SIGNATURE O~
COMPUTATION OF FEES
Approved. 2/~7/85
617.20
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I Project Information (To be completed by Applicant or Project sponsor)
~"O×'g'~,~ o~ ~1~ ~
~,,~,.~ ~ 0~t~.,~1 ~. ~,,,
the action ts In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form betore proceeding wtth this assessment
OVER
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PART III Determination Of Significance (To be completed by Agency)
INSTRUCTIONS,* Fol each adverse effect identified above, determine whether it is substantial, large, important or other~l~e
signiflcant. [ach ~i(~ct s~ould be assessed in c~nnection with its Ca) Settin~ [ie. urban or rural); (b} probability, of occurring:
{c) duration; (d) irtever~ibility; [e) geographic scope; and {f) magnitude tf necessary, add attachments or reference suppordn8
materials. ~nSure th,~l explanations contain sufficient detail to show that all relevant adverse impact~ have been identified
a.d adequately addlres~ed
U Check thls box if ~,ou have identified one or more potentially larEe or significant adverse impacts ~hich MAY occur ]her~
proceed girectty h) lh~ CULL [AF and, or prepare a positive declaration.
~ Check this box ff ?ou have determined, ba~ed on the information and analysis above and ~ny ~upporllng documentation.
that the prop~s~ ~c{~Oh WIlL NOT result in any significant adverse environmemal impacts AND provide here. and on
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