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Home My WebLink AboutTR-5994 TERMS and CONDmONS 'Ole Permittee SlL6<1'l H. Je.¡)¡)e.Ue.6 røidiag at EMt End Rd., Fi6he.6 I~ûnd " N. Y.. as part DC the coasideratioo lor !he ¡';'._n.... oC the Permit does uødeøtIod and prescribe to the fol- lowing: 1. That the Aid JJoud of Trustees aad Ibe Town of Soud101d ate rdeNedfrœ> any IIØd aU damages. Of: cWms fOl: damages. DE lilies atWog. cIiRcdy or 1adirecd, as a result oC any opet"· adoa pedonuecl punulOHDëbis peø>It. aad the aid 11· 11'e.,wIII, lit Ids or her own expeoR. cIelend «oy IIØd aU JUCh lllies-¡nltl-œ-I br 1bI.td.,udes, ucI the aid .....,...1"'1< ......,..., Eu111i1h111tr wiIh reSpect thereto, ~ .!he .øp'''.rsdusIon DE cbe IIøud of TI\JSIèes of die Town of ~ 2. That Ihb Peöiút Is ftlid for a pedod DE 24 : _ ..m&ch Is tIGI'''''eoed Co be the e<f!moted time· required to '~"k cbe work Inwl~ but shOÚ1d ~ wartIDt, request lor III exœasioo ma, be made to the Bod lit a bier d-. . 3. That this PetlDÍt IhouId be retIIncd indeCinitd" or as loog as Ihe said Permittee 'Irishes to m_in..¡n !he lU\ICt1Ite or PrQjea involved, to provide erideaœ to an,one <:oo<:aned chat IDth- orizadon was odginaU, oWIne<I. 4. That cbe wodc ånolved will be subject to the iospcctioø IIØd apprOYd of the BoucI « ia agents, IIØd non-œmpUanoc wilb the provisions of the ortg;...tI..g applicatioa, may be øase E« mocaâon oC this Permit by RSOludoo of the said Boud. 5. That there will be no unreasonable interCetenœ wiIh nuigadon as . resa1t of the wodc bereIn aùthorizccI. . . . 6. That there sbaU be no Interletenœ wiIh the right of die public Co pass IIØd repas doag the beach Lenlccn túgb aad low water awb. . .< ,. 7. That If Mute oren"lJGf of the Towa oE Soo·d>øLI reqnIre cæ -.111Ød/0I: d1Jeøtlo- in the Iocft/tvo oflhe wock herein ..·ð·-¡"~. or If, In Ihe opinion of. Bod of n-. die, wade shall cause lI1Lte&SCJIIObIe obsttaœon to Eree ...~ cbe Aid ........,- will be nqaIred. upon due notice, Co RIIII"C or ~ Ihb wodc or PrQjea herein staled wIdIoIIt ezr !nICI to Ihe TowD . of Soucbolcl. . 8. That the said Board will be notified by the PermItœe ot die ~Of the wock aad1- otDecI. 9. That the PermIttee will Gbtain aU other pemûa and -.. 'dolt -r be reqaIrecI .p. ........"" to this peaøIt ~ _"be IIIbjea to revoIœ upon faIIan to obtain ame. - > . . Albert J, Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P,O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 22, 2004 Mr. Glenn E. Just J.M.O. Environmental Consulting Services P.O. Box 447 Quogue, NY 11959-0447 RE: SUSAN H. JEFFERIES EAST END RD., FISHERS ISLAND SCTM#1·2·11 Dear Mr. Just: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, September 22., 2004 regarding the above matter: WHEREAS, Glenn E. Just on behalf of SUSAN H, JEFFERIES applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated August 23, 2004, 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 22, 2004, 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, 2 . . WHEREAS, the structure complies with the standards set forth in Chapter 97 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 approve the application of SUSAN H. JEFFERIES to remove the existing concrete block wall and patio, to construct a screen porch, gates, sitting wall, open cabana, pool, enclosed cabana and pool equipment, and all as depicted on the plan prepared by Richard H. Strouse last dated January 28, 2004. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification, Inspections are required at a fee of $5000 per inspection. (See attached schedule.) Fees: None Very truly yours, P/t4·.Jl 'l ~. (j. . Albert J. Krupski, Jr. President, Board of Trustee~, AJK/lms . . Telephone (631) 765-1892 Town Hall 53095 Route 25 P,O, Box 1179 Southold. New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tuesday, September 14, 2004, the following recommendation was made: SUSAN H. JEFFERIES to remove the existing concrete block wall and patio, to construct a screen porch, gates, sitting wall, open cabana, pool, enclosed cabana and pool equipment Located: East End Rd., Fishers Island, SCTM#1-2-11 The CAC did not make an inspection, therefore no recommendation was made, Field Inspection 8/1 0/04 . . 1 (%,,0 J-€.('..{>.Q.> - Eo.>/-- EV"G ~aa, -.~c:. :::t~I(i..J -,- '~ _r.." ~ ~ i .... -4 . - -- ¡¡ ~ ~ ,,' j' .--" ...,-- ." ,,"-~ ~ \s..k. - 'r \ -' -. I" .. -- ,/ , s '" h ______--!". r ~.~ ""'- ,j " / .. "I, ,--' ;V' --/ I ; .. ; - ~ .... a ., - ;~ · 'I Siièets98 Omi 0.2' 0.4' 0.6' · ".. · 'II ~ 0.8 Copyright 0 1988-1997, MIaosoft Corporation andI'or its suppliers. AJI rights reMNed. Please visit our weD site 8t htlpJIm8p8.upeclia.oom. p...' '} JI!!'" , ! . > ~} '+ . .~ ¡ .. 5 i ~ > I' I ~ . or. -<>- Z .. .. I ·f " " , ; 8 i <> f _.:- --/ i ¡"J i. j. 0'1 \I :::~i t ! §~ t u ~( ~_. ~ 1: jl.' ~ ~- ; I-- l5!:- -c:: , ':2-: ~ ~- (' §. 1" r ~ ~ iì ".'. ~ !JIll'- ¡m . ~ , í , !Ii II .'. ~ . ',: , t .' '. , . ~ ; \ m . a , . . " ~, X <D --0 C 0.. 0 ~ p... f-_ >--. +- '- <D 0.. 0 '- 0- ! , , , , 0 <D 0::: . .e <>-~---=:::" , ~~~. ~~il!l ~ ã~; i ~ rei~ ~ §¡ "'"U . ii·¡ hh ~ ~ . " % ~ , ~ ~ d <i ~ \f\ e \ U 0: -" !< 0 '" z r + z M ~ 0 0 ~ ¡= w u 0 ~ w 0 ~ ~ ~ "~ "> -+-o.hi> .~ ,-.. . . "~ '" ìi .....:: :::::\ -...I co -' <=> '" ~ => <=> V> s <> . <> ' <> . - ~ / /";~ j' "\ '--, ,// " 'î! ~ , , <Í' if I:! ~ ...~ ;;¡~ " . . PII'\'~Tl AD. C.Stl - ¿;.'. . " . ; ~ I I ti """\.LI>- ::E-co... . ~ 9~ "'- ~~ . "" - -l 8 >- 0·- "- >z "- IE]' ~~~",M I..L..~~~ o ~ ~ >-t ilia .... ~- . :z o.! ~ ~ ~ 00-- u"'ð &¡ . e 9 ~h' '"Æ"~ h.~~ \:j i~ ~ ~ ~ 'õ ¡:::Ii.... ~ :z: :õI!:! :=~;:: ~~~~i ~HL :i¡g¡¡;;~1!:I ·'1 j ,', n ¡i, ~ . !.'.!E~ id;~'IH ;¡ ~j , ;d~Hi " , . II1II Ii Ti i I I II Ii n e' i I II 1" I I I § I I I I I "-..... Q. '" I I I I , , IIIIII I I I I I I linn ] d.. ie!!! " I ¡ I ! . ¡ I I I I ¡J I . ~ ~ ~ D-r:::: 1111.... ~ 0 ~ ~ . · f ~ ìdfd UJIH Ii r ,~ I :' " I I I " ,I I l I ~ j , ¡ nlii ...JUH.)WZ I~ ~ " ~~ ~ ~ ~ i! t ~ ~~ .. '~, ~ \, I '\ ·1 't' ~ (' ~ ~ I I " \ I ') ~ '~ ' is ,I / i " I tJ~, ( I ,~ '~, +oo ...JLLle,:)WZCJ ~UG-ll:2004 15:40 FROM:JMO CON1IIÞ1NG 6533348 n.6641 P.l I':, io1!! "~ì "hl·.\\'~ I, \' I' , 'r , - '( J.M.O. Environmental Consulting Services Phone (631) 653-0607 · Fax (631) 653-3348 121 Jessup Ave . 2nd Floor· P.O, Box 447 Quogue, New York 11959·0447 FAX COVER SHEET To:_L OO~t^ Date: ~4o'l Company Name ~ 1a...Y\ ï'rus.\.a,4 Attention -- Fax Number -::¡CoS;-I~~ Number of Pages Including Cover 5: FROM: GJ.c.......... :\u ~ ------ . RE: --:)'e-Ç...(tA: (,4.- - EQ~..E",). ?~( D-..L.D. c:. ":'n Is-' MESSAGE: -l.. ~r€f' - ~~L/ rv1 nt\ IJ J... l11!X.( -(~fI- ~,~ -- .- ~ If you do not receive the correct number of pages, please call our office as soon as possible AUG-11-2004 15:40 FROM:JMO CON~ING 6533348 T.6641 P.2 Albert J, Krupald, PJeaident James KIng, Vice-President Artie Foster Ken Poliwoda Pea:Y A. DIcIœrøon Town Hall &3096 lIoute 25 P,O. Bœ 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Faz (631) 785-1368 BOAl\D..OF TOWN TRUSTEES TOWN OF SOUTHOLD orne< u.. Only _Collllll1l!nJsion Pcmlit Appli""tion _Wetland Permit AppHcation _ Major Minor _ WaiverJA.............tJCbanges _Received Application: Received Fee:S Comp1eœd~ _lŒompletr: SI!QRA Classification: Type I_Type n_Unliated_ _CoordiDation:(cIate ....t} CAC Referral Sent: DIIe of 1Dspecti0n: _Receipt nfCAC lIoporI: _LeId Apør:y Determinatinn:_ Technical Review: Public HeariDg Held: _Resolution: Name of Applicant Susan H. Jefferies Address 7623 Fenwav Road. New AlhAny, OH 4~O~4 Phone Number:() 631-788- . "1 ('<1<ò Suffolk County Tax: Map Number: 1000 - 001- 2 -II Property Location: East End Road, no H, Fishers Island (provide LILCO Pole #. distance to cross streets. and location) AGENT: (If applicable) Glenn E. .TtlR~- .TMO ~nuirnnmon~~' ~Q"OultiRg Addrc6S: P.O. Box 447, Qungue, NY 11959-0447 Phone: 653-0607 AUG-11-2004 15:41 FROM:JMO C~TING .55541 5533348 Board of Trustees Application GENERAL DATA Land Area (in square feet): 117.612 Area Zoning: R-120 Previous use of property: Single family dwelling Intended use of property: Single family dwelUnp; Prior permits/approvals for site improvements: Agency Date -L No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suapended by a governmental agency? ----2LNo_ Yes If yes, provide explanation: Project Description (use attachment. ifnecessary): Apl)'.i ..,," t prnpM"q . to remove existing concrete block wall and Datio. to construct a screen nor~h PRtp~ ~;t~;ng ~~11. QP'~~ cabana. pool, enclos~ cabana and pool equipment. P.5 AUG-11-2004 15:41 FROM:JMO CO~TING 6533348 .56641 P.4 Board of' Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: add it ions to an exis ting single rAmi Iy dwelllnl! Area ofwetlaDds on lot: o IICII8I'e feet Perceot coverage oflot: % Closest distance between nearest existing structure and upland edge of wetlands; greater feet than 100 feet Closest distance between nearest proposed structure and upland edge ofwetlands: 80 feet Does the project involve excavation or tilling? x No Yes If yes, how much matcrial will be excavated? 0 cubic yards How much material will be filled? 0 cubic yards Depth of which materia1 will be removed or deposited: o feet Proposed slope throughout the area of operations: 1 . 1 Manner in which material will be removed or deposited: n I a <- Statement of the effect, i( any, on the wetlands and tidal waters of the towu that may resuh by reuon of such proposed opel'81ions (use attachments ifappropriate); AR nroDosed the Droiect shall have no negative impacts un on the wetlands or~waters of the Town of Southold ,RUG~11-2ØØ4 1~:4Ø _FROM:JMO CO~ING 5533348 T.55641 P.3 Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Addi t ions to an exis ting single family dwellinR, Are wet1ands present within 100 feet of the proposed activity? No X Yes Does the project involve excavation or filling? X No Yes If Yes, how much material will be excavated? 0 (c:ubic yards) How much material will be filled? o (cubic yards) Manner in which material will be removed or deposited: n I" Desaibe the nature and extent of the environmental impacts reasonably anticipated resulting ftom implementation of the project as proposed, (Use attachments if necessary) Since there is no excavation or fill invnlvørl yith the project and that the project is:~ located landward of an existing bluff there are no negative environmental impacts anticipated. r i1t r:r:~ "OJ t-I-§~ ~ð¡f> Õ (1)-0 Z ..... ~ ¡g-ow I&. o:õ O~,5~ N QE~.g ~ ~ ~ u 0 g I:D 10 AMT PAID a2lJ BALANCE DuE J.M.O. Environmental Consulting Services September 1, 2004 Board of Town Trustees Town of Southold P.O. Box 1179 Southold, N.Y. 11971-1179 Attn: Lauren Re: Jefferies Application, East End Road, Fishers Island Dear Lauren: lease find is a check for the application fees for this project. 0, lJð&1J¡; . " Dollars B~.r¡ J.M..r . AJherI; J. Kr\IpBki, Preaidmt Jamllll KID& Vice-President Artie Foster Ken Po1iwode peay A. DicIœrIon BOAlU).OF TOWN TBtJ&"l1!JJ§S TOWN OF SOUTHOLD 0IIIce Use 00Iy _ Coutal BrosiIIII PemIit Applica1ion ~~ð&jor ~~~ ~~c~u~~ 0 -~ _SBQRAn..~ AUG 0 ~ 2004 Type I_Type U_UDlisted_ ~'~1;'~::r.n-m- ~oft I[~:~ _Receipt ofCAC Report: _ LeId Atf:1øI::Y 0.' ...:.~tinn: T-.n..., Review: . ~BariD¡H~ _RaoluIioI>' MiDor Soutl1old Town Board 01 Trustees Name of AppJicant Su~an H. Jefferies . Town ø.n 69085 Røute 25 P.O.Bcmll79 SauthoId. NewYorIt 11971-0959 Telephmuo (881) 786-1892 Fa (631) 765-1366 Address 7623 Fenwav Road New Albany, OR ¿~o~¿ PhoncNumber:() 631 788 7608 SuffolkCountyTaxMapNumber: 1000- 001-2-11 Property Location: East End Road. no 8, Fishers Island (provide L1LCO Pole #, di5tanœ to croas stroeIB, and location) AGENl': (If applicable) Address: Glenn E. JURt- .IMO RnvirnnmAn~~1 ("nncuJltiRg c1x ~V<'f>\'I;} ./ P.o. Box 447, Quogue, NY 11959-0447 Phone: 653-0607 .rd of Trustees ApplicatiO. GENERAL DATA Land Area (in square feet): 117.612 Area Zoning: R-120 Previous use of property: Single family dwelling Intended use of property: Single family dwelling 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 ünecessary): App Ii ""n t prnpnq" q to remove existing concrete block wall and Datio. tn construct a screen Dorch. ~Rtp~, qitting u~ll, nr9R cabana, pool, enclos~ cabana and pool equipment. ard of Trustees ApPlicatio. WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: additions to an existing single family dwelling Area ofwetlands on lot: o square feet Percent coverage oflot: % Closest distance between nearest existing structure and upland edge of wetlands: greater feet than 100 feet Closest distance between nearest proposed structure and upland edge of wetlands: 80 feet Does the project involve excavation or filling? x No Yes If yes, how much material will be excavated? 0 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: 1 : 1 o feet Manner in which material will be removed or deposited: n I a . Statement of the effect, i( any, on the wetlands and tidal wåters of the town that may result by reason of such proposed operations (use attachments ifappropriate): As DroDos~d the Droiect shall have no negative impacts liD on the wetlands or,waters of the Town of Southold Ard of Trustees ApPlicaticf COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Additions to an exis t ing single family dwelling Are wetlands present within 100 feet of the proposed activity? No X Yes Does the project involve excavation or tilling? x No Yes If Yes, how much material will be excavated? 0 (cubic yards) How much material will be filled? o (cubic yards) Manner in which material will be removed or deposited: n I" Describe the nature and extent of the environmental impacts reasonably anticipated resulting ftom implementation of the project as proposed, (Use attachments if necessary) Since there is no excavation or fill involvpn yith the project and that the project is_ J located landward of an existing bluff there are no negative environmental impacts anticipated. 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 Sponsorl 1. APPLICANT/SPONSOR 2, PROJECT NAME SU3Ðn J Jqfferies i't'onoserJ ;JoDI sC'tcl caban8s H, 3, PROJECT LOCATION: Municipllily ,'isaers Is1anrl County ,~l1ffo1k 4. PRECISE LOCATION (Street Iddress Ind road inlerædions, prominent Ilndmlrks, etc., or provide mop) .L:Jst ¿;¡d .. , '. Location e;¡c1osed 1~02.G. . no i,-, me.D S . C . ~; . ~1 . t¡o. 1000"001-2-11 5. PR~IED ACTION IS: New D Expansion o Modificationlatteration 6. DESCRIBE PROJECT BRIEFLY: i'lease s.ee attacheð 7, AMOUNT OF ~FECTED: U_imately Ô leres Inilillly aeres S, WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? DYes D No If No, describe briefly 9, WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? EiJ Residential D Industrial o Commercial D Agriculture D Par1<lForesVOpen Space o Other Describe: Single family d've11i;¡gs 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR UL TlMATEL Y FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? eJ Yes D No tf Yes. list agency(s) name and permit/approvals: Southo1d TO';o1n Trustees 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Dyes EiI No If Yes, list agency(s) nome Ind penniVapprovals: 12, AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? DYes ~NO ~ I CERTIFY THAT ~;-'TlON PÃV1DED ABOVE IS TRUE TO THE BEST OF MY KNOWlE~ ApplicenVsponsor name: G 1 iii n... J u ~ t a s a a e r¡ t Date: Signeture: / lA, J.L), f If the action is in the..l /tal Area, and you are a state a~ency, complete the Coastal Assessment Form before proceeding with IS assessment OVER 1 lard of Trustees ApPlicati! County of Suffolk State of New York -.if (j/t IJ Q nne.¡(¡¡- BEING DULY SWORN DEPOSES AND AFFIRMS T HFJSHE IS mE APPLICANT FOR TIlE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO mE BEST OF HISIHER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN TIlE MANNER SET FORm IN THIS APPLICATION AND AS MAY BE APPROVED BY TIlE SOUTIlOLD TOWN BOARD OF TRUSTEES. mE APPLICANT AGREES TO HOLD TIlE TOWN OF SOUIHOLD AND mE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING TInS APPLICATION, I HEREBY AUTIlORIZE mE 1RUSTEES, TIIEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER PROPERTY TO INSPECT TIlE PREMISES IN CONJUNCTION WITH F THIS APPLICATION. SWORN TO BEFORE ME TInS 6L ~ \l.L4 . .200~ I'ERONICA HAMILTON NOTARY PUBLIC STATE OF NEW YORK NO.01HA8087785 QUALIFIED IN 8U~C07U"1:Y ,,-- TERM EXPIREL{ V ¡RI U \ "- þ. . . . APPLICANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town ofSoutbold's Code ofBlhies mohibits eonfIicts of interest on the DIrt of town n':..t~~::""~ nu:Of this form is to nrovide information which can aJert the town ofoossible cnnflj~ ~f~~ ow' to . is _-.u to avoid same. YOUR NAME: _(I'DN~~lL'-I \ \(~"\Ñ .¡,.,~ (LIst........ lint name, middle initill, unless you .... . in the name of someone else or other entity, such as a company. If so, indicalt the other person's or company's name.) NAME OF APPUCATION: (Check.U that IIpply.) Tax gritvllllce Variance Change of Zone Approval of plat Exemption ftom pl.t or official map Other (If"Other", name the activity.) Do )'Ou personally (or Ihrousl> )'Our company. spouse, a'bling, plrCDt, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, 1IIII1'riage, or business interest. "Business interest" means . business, including a partner>hip, in which the town officer or employee has even . partial ownership of (or employment by) . corporation in which the town officer or employee owns more than 5% of the shares. YES NO ~ lf)'Ou IIIlSWerCd "YES", complete the balance of this fonn and date and sign where indicated, Name of person employed by the Town of South old Title or position of that person Describe the relationship between )'Ourself (the IIppliCIIDtlagentlrepresenllltive) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided, The town officer or employee or his or her apouse, SI'bling, plrCDt, or child is (check all that Ipply): _A) the owner of greater than 5% of the shares of the corporate stock of the IppIiCIIDt (when the IppIiCIIDt is . corporation); _B) the legal or beneficial owner of any interest in. non-corporllte entity (when the Ipplicant is not a COIIOIation); _q an officer, director, partner, or employee of the IppliCIIDt; or _D) the IICtuII\ IppliCIIDt DESCRIPTION OF RELATIONSHIP Subnù~daYOf~200-1 Signature Print Name ~FJI ('o~~"Ç"( (1 ' APPROXIMATE LOCATION OF COASTAL EROSION HAZARD LINE PER COASTAL EROSION HAZARD AREA MAP, TOWN OF SOlJTHOLD, SUFFOLK COUNTY, NEW YORK, PHOTO NO, 38-879-83, SHEET 42-FI OF 49 \ \ \ \ \ \ \ \ \ \ \ \ N8B'~10"E 395,37' N/F SUSAN H, JEFFRIES BLOCK 1 -LOT 4B (VACANT LAND) POLE ~ #692 \ , I I / N 1201.26 E 1156,36 GUY /' MANHOLV (C~f'ÔOL) --------~ ~---- ~~~ / / ,/ / // / ---- ~ /- / .._\ß---- .______7:. ./'" _____./'" -- -- ___ ~-16" --- --- --- --- ------- ---- ---- -------- ---- "----- ------- - ----20--- POLE ~ #693 \ TEL, ¡;\ \ BOX o ELEC, \ METEf)) ___ - ELEC') D rv /- ./'" --- /' VAULT /~.,. / ì ,c/ / / ,ç, II I /~ i I: ,I 1 / / /::,1 &:2 1 \ .!',j /Í \ì I I l;;ftF;i, I /\)PIC () / 1 I ~ '-- 124~ ~ I I OAK I I I / I i I i / TREES ---- '-- '-- " ~- '"-- ---- '" '" '" --- ( \ \ \ ) / PROPOs$> SITTING rNJ. / / a 1 I I c d Q: 6" \ CHERRY " ? '" \ \ ) / 1 1 / I / / 1 / 1 TREE \ \ \ ';;, I I I /],'ò '" ME~L PdST / I. // r ( -' ---- / / / Ie ____ r 1// / Ir // ~ / /7 / Iy.¡,,,, ! /3:l / ;f? i I/" é( -.I~ I /1 d) I I I I I I , , l ) ~ ," '" ___'\2- ---- ---- ---- -------- ____:~'2.--- " ú ~ . / - -, 4- , , , / LP. (FND) / I 732,09' N83'l£!0"W ~ I . PROPOSED ENCLOSEO CABANA .' - i I ;' PROPOSED POOL EQUIPMENT .. ACCESSORIES - / / / / PROPOSED OPEN CABANA I / I / , I . . , , I . . ,. I , J . , . J I I ¡ I " I . / . . . . I I I . . , . POLE ~ #691 N/F PETER H, STRIFE BLOCK 1 - LOT 6 (SINGLE FAMILY RESIDENCE MUNICIPAL WATER/ON SITE SEWAGE DISPOSAL SYSTEM) PROPOSEO UMITS OF CLEARING QUALITY CONTROL CERTIFICATION GROUP PROJECT MANAGER SURVEY ENVIRONMENTAL CIVIL STRUCTURAL ARCHITECTURAL REVIEW D . DATE ,t ropy' /.2¿{,O:> P "7 1"/ ,1- J< ""~ FILE J4805 . , / ! ¡ / , . . I ;' . . ! .. i / \ \ \ \ \ \ \ \ \ VI o 0>'" VI "'\ ' '" '" . 0>0 '0 , "" , i , i , , . . ! i · · .~ - 0 "' .0, cO'" '" ,", -", - VI , , · / · i , i I · I · ~ · · i i ::::, . . ~ , i ! I . ! I !i , i J . · , · ¡ , " . ð . , . , 0 . iif ¡ , ¡ ¡ ! , ; I I . . , ! , I , - , . , - , ! , . . . I / I I / . I / I / ! ,. / I I · ,. .. / . . I I . . . LEGEND FF ELEV SF - -22-- rYYYYYYY'> ~ ,." 0<3 ,... E ~ ~ bJj , '" ~ c '" ,- ·§U '" ' , . '" . <:J co .5 o~ "'''' ~ . c o~ c . o . .S¡:l, '<I .c E a. ~ bJj ~ ~ ~ ¡::¡bJj ~.S oo~ ~ ~ '" 00 '" "' .~ ~ 0 ~ Of-- ¡gu gCZJ "' . OiS t5~ 00"0 t .'0 oo¡::¡ ~ 0 <r:ro u 0 'F ~~ <S o - Z ~ >,rn rn-' 3 . Ü 1ijE eD ,. <D ~ ou ~'" -'" ~ ~ U \-JC 1-2B '-N 0-;0" .æ. ~ ~O'" l':/Ø" 1~~A ~ '1: If/r. -~ ~& (j(f) ¡¡j 1-"8 ,-, J,,, H "\'Il', """, -, ,., -, ,-, ,-, (;) ,-, SCALE 1 "=400' LOCATION MAP . '.' MAP REFERENCES 1.) SURVEY MAP PREPARED FOR SUSAN JEFFRIES; BLOCK 1 -- LOT 5; FISHERS ISLAND, NEW YORK; CME/CPK DESIGN GROUP; NORWICH, CT.; DATE: 11/19/01; SCALE: 1"~2D'; SHEET 1 OF 1 IJIQIES , I J 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED HEREON. ANY EXTENSION OF THE USE BEYOND THE PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE ENGAGEviENT. 2.) IT IS A VIOLATION OF THE STATE EDUCATION IÞ.W FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY. J.) ONLY COPIES OF THIS SURVEY MARKED WITH THE IÞ.ND SURVEYOR'S SIGNATURE AND t\N ORIGINAL EMBOSSED OR INK SEAL ARE - THE PRODUCT OF THE LAND SURVEYOR. ,4.) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC SURVEY TRIANGULATION STATION "EAST END 2" (f) W '" - a:: '" 0 lL. "'>- '" lL. g~ 0 W Zu. z :50 ""') I . "-w 10 w'" . z ...00: I ~:5 -"- ",(f) (f)W '" ü(f) a. Z 0", « ..Jw "'I (f) (f) => u. (f) 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX MAP 1000, SECTION 001, BLOCK 2, LOT 11. 6,} TOTAL AREA " 2,20± ACRES, 7,) SITE IS LOCATED IN R-120 20NE, . ß,} APF'LlCANT: SUSAN H, JEFFRIES 7623 FENWAY ROAD NEW ALBANY, OH 43054 9,) SITE IS SERVICED BY MUNICIPAL WATER AND ON SITE SEWAGE DISPOSAL SYSTEM. 10.) BASE FOR LEVELS: NGVD 1929. ~ , , " " " " (f) z a m Z " z '- 0 APPROVED !;IY " ~ ~" I 0 L> ~ "' ~ w " D m '- BOARD OF 1 itU"Ti:[S m (f) 8 z 0 m " TOWN OF SOUTHOLD ~ õ > 0 " ~ DATE , /0 W n ~ 'f/':¿,J 0 0 0:: 0 0 W N N < '- '- . . D N '¿¿' y' ./,J__""" '- '- ",_,:..c:~_L. N ~ 0 Ó N Z FIRST FLOOR ELEVATION SQUARE FEET EXISTING CONTOURS EXISTING TREELINE PROPOSED LIMITS OF CLEARING 00: 0 ... " D 00: ~ Q 0 0 ~ ~ 00 vi 00 ~~ ~ ~ ij '\iJ ~ ~ ~ oi m ~ 0 I I 0 0 ~ 0 <D N ~ ~ ~ N 0 0 D "J ~ D AUG ï " 2004 I L> Z W W ¡;: -" w z z .,. ~ .,. 0 " L> 0 0 0 EJ ¡:I w 0 "J ~ 0 I 0 "- 00 0 D L> L> [L SQuthold Town 11/04/2003 Board of Trustees DATE: SCALE: 1" - 20' 20 10 0 SHEET 1 OF 1 20 --- - - GRAPHIC SCALE IN FEET - ~ - - -~-~, - -~ ---~-~-,----_.- - ---~---_._'- -~- --~ -.---. -~- ---~_._-'"--~---"--~-~-----.----~-- - -~--,--~~-- -~-~------ ,~------~----~,---- ,-- --~-~~~~---- _________._.~__ ____,______.._ ___~___~~_ _ __,__~ _____~_u ,___~~__~___ ___,__, ,_.._ _~ ~_ _,~____ - -- - - , ~ - ,- -~-----~-~-~-- --- -- _._,-- - -~-- ~~- ., -"--~-~_. ,~- ------- ---~-- ----