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Home My WebLink AboutTR-4605 Town Hall Annex Glenn Goldsmith,President ®� S®U��r ®� ®� 54375 Route 25 A. Nicholas Krupski,Vice President h ® P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples ec` ® a® Fax(631) 765-6641 100UNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: I eWr m 20 3 INSPECTED BY: 'Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1 st day of construction % constructed x Project complete, compliance inspection COMMENTS: CERTIFICATE OF COMPLIANCE: Glenn Goldsmith,President Vv�Of SOV, ® Town Hall Annex 54375 Route 25 A.Nicholas Krupski,Vice President �� ® P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly e/' Telephone(631) 765-1892 Elizabeth Peeples � iQ Fax(631) 765-6641 c®UNT`I,�► BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 2083C Date: October 1, 2023 THIS CERTIFIES that the Wetlands& CEHA Permit to construct a 1-fam.dwell., sanit. system, garage drive as per map dated 5/21/96 14'x39' porch 14'x14' to be screened in; haybales at crest of hill & 10' non-turf/non-fert.buffer landward of bulkhead, At 960 Willow Terrace Lane, Orient Suffolk County Tax Map#1000-26-2-21 Conforms to the application for a Trustees Permit heretofore filed in this office Dated June 13, 1996 pursuant to which Trustees Wetland Permit#4605 Dated June 27, 1996 and Coastal Erosion Permit#4605C Dated June 27, 1996,was issued and Amended on October 23, 1996 and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for Wetlands&CEHA Permit to construct a 1- fam dwell sanit system garage drive as per map dated 5/21/96 14'x39' porch 14'x14' to be screened in-, haybales at crest of hill& 10' non-turf/non-fert.buffer landward of bulkhead. The certificate is issued to William A.Hands,Jr. owner of the aforesaid property. 0 Authorized Signature . . Albert J. Krupski. President John Holzapfel. Vice President Jim King Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P.O. Box 1179 Southold. New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ·)ctober 24, 1996 william A. Hands, Jr. P.O. Box 134 Orient, NY 11957 RE: SCTM *26-2-21 Dear Mr. Hands: The following action was taken by the Southold Town Board of Trustees on Wed., October 23, 1996: RESOLVED that the Southold Town Board of Trustees grants an amendment to permit 146Q5 to add a 14' X 39' porch, 14' X 14' to be screened in as per survey dated September 28, 1996. This does not constitute any approvals for any other agencies. If you have any further questions, please do not hesitate to contact this office. Sincerely, tta,· ¡ r; /~. 9, Albert J. Krupski, Jr. President, Board of Trustee cc: Bldg. Dept. . . Telephone (016) 765-1801 Town Hall. 53095 Main Road P.O. Box 1179 Sonthold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL f1rT I 8 \996 The following recommendation was made at the OCTOBER 17, 1996 meeting of the Southold Town Conservation Advisory Council: A-75 Moved by Scott Hilary, seconded by Bruce Loucka, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Amendment to Permit request of WILLIAM A. HANDS JR. 26-2-21 to add a 14' x 39' porch, 14' x 14' to be screened-in. Willow Terrace Lane, Orient Vote of Council: Ayes: All Motion carried. ~ue I '),1- . ç~ ~, /99{, ~. ~~~ ~ ~~ Á ~ s. ¥bOS- P ¿!.~d: a:... I'fX1'I ~d -~ ~~ Þ1V 7 /UIÛ./ ¡f2a:ûé - ¡/~~ r-.' ~~ /J. M.·.~- ~. r -.----. ŒŒŒOWŒY . ~ ,---.---.-¡ r. n '; II ~~! ¡. II J. UU! OCT 2 1996 !L0: I i_u__J . '., ,., 'I' ....\; 'T' .r;, ",I ':~ :'.-/'_~) ~.t:;>~;.u.i CL- '. C,.-i'\¿" i rr 3--% , . . Albert J. Krupski. Presiden1 John Holzapfel, Vice Presiden1 Jim King Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P,O, Box 1179 Southold. New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD .ïl[le 28.. 1996 William A. Hands. Jr. P.O. Box 334 willow Terrace Orient, NY 11957 Re: SCTM t26-2-21 Dear Mr. Hands, The following action was taken by the Board of Town Trustees during its regular meeting held on June 27, 1996, regarding the above matter: WHEREAS, WILLIAM A. HANDS, JR., applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 13, 1996, 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 Juen 27, 1996, 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 structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code, WHEREAS, the Board tlas 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 WILLIAM A. HANDS, JR., to construct a single family dwelling, garage, driveway, well and sanitary system as per map dated May 21, 1996, and that hay bales be placed at the seaward crest of the hill and a 10' non-turf/non-fertilized buffer be placed at landward side of bulkhead. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency which may also have an application pending for the same or similar project. Permit to construct project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. FEES: None Very truly yours, ~ ~ /~- --ßl'9 Albert J. ~~pski~~~ , President, Board of Trustees AJK/djh cc. CAC Bldg. Dept. D£C-. f(€/ftÆff ð e Pr. . . Albert J. Krupski, President John Holzapfel, Vice President Jim King Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P,O, Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD ~nAST~L EROSION MANAGEMENT PERMIT Permit Number: 4605 SCTM i26-2-21 Name of Applicant/Agent: Wiliarn A. Hands, Jr. Name of Permittee: WILLIAM A. HANDS, JR. Address of Permittee: 960 Willow Terrace Lane, Orient, POB 334 Property Located: 960 Willow Terrace Lane, Orient NY 11957 DESCRIPTION OF ACTIVITY: To construct a single family dwelling, garage, driveway, well and sanitary system as per map dated May 21, 1996, and that haybales be placed at the crest of hill and a 10' non-turf/non-fertilized buffer placed at the landward side of bulkhead. Date of permit issuance: June 27, 1996 This permit is valid for a period of two years from the date of issuance. SPEeIAL 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 AJK/djh cc. CAC DEC Bldg. Dept. f(€/ft-Tff tJ f'r'r.. . . Telephone (516) 765-1801 Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisorý Council held MONDAY, JUNE 24, 1996 the following recommendation was made: No. 1364 Moved by Allan Connell, seconded by Robert Keith, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH PROVISIONS of the Wetland Application of WILLIAM A. HANDS JR. 26-2-21 to construct a single family dwelling with garage, driveway, well, and septic system. The Council recommends approval provided there is a 20' non-turf buffer back from the edge of the bulkhead and the gutters and downspouts go into drywells. Willow Terrace, Orient Vote of Council: Ayes: All Motion carried. . . r ~ /f9ç, j)&t/ k, /l~..d.¿ ~ 7 ~ ~~d- I J~./U CL-~ . ~/~~, ~ ./Ú~ ~æ/~ r --di AZ¿~ ~ ~~ ~~/7,/Þ~~' 3z..3-2<rS'"S:- &-rM .# ~-~-~ ~ I~ cl',' Y I" . þ\ ,J' ,?L~ ,. ---- , ~1-042 ~ . . ~ (Re\', 1 /9~UFFOLK COUNTY DEP ARThfENT OF HEALTH SERVICES """ ;.":"':' ~ -. ""'-_:. " BUREAU OF WASTEWATER MANAGEMENT SUFFOLK COUNTY CENTER RIVERHEAD, NEW YORK 11901 516-852-2100 NOTICE OF INCOMPLETE APPLICATION _ RESIDENTIAL TO, ...... H.S, REFERENCE NO.: PROPERTY LOCATION: Ct c,1 llC¡;- The rlans for your proposed sewage disposal and water supply systems have been reviewed and the following will be requIred prior to further processing of the application for arproval to construct. PLEASE RETURN A COpy OF THIS FORM WITH ANY RESUBMISSION, NOTE: CHANGES TO P ANS MUST BE MADE BY A LICENSED DESIGN PROFESSIONAL (I.E" SURVEYOR, ARCHITECT 0R ENGINEER). I. PRELIMINARY APPROVALS - OTHER AGENCIES l){ N,Y.5. Dept. of Env. Cons, [ J Sewer District Approval [ J SEQRA Determination I'I<f 'Town Wetlands/9re.iI ag'il./7...........g [ I S.CD.H,S, Vector Control [ J Other U, PLAN DATA AND INFORMATION REOUlRED [ ] 3 prints of r.,.lan :!Juired with [ ] Indicate on plan the specific [ ] Indicate any surface waters within design pro sion 's original location(s) [with measurements] 300' of plot; show wetlands limit stamp and signature of all water suppl~ wells & septic as flagged by NYSDEC and/or systems (within I of all Town [ ] Application Fee-.$ property lines) or state if dwell- Ings are connected to public water [ ] Show area for 50% expansion of [ ] Name, address, phone no. required sewage disposal system [ ] Show proposed housel driveway [ J Statement signed by applicant location on plan [ ] Show test boring & location [ ] Indicate area of lot (sq, ft.) [ ] Show proposed sewaged~ on plans system/water supply well water [ J Test boring inadequate, See [ ] Comer elevations service line on plan Remarks below, [ ] S.C Tax Map Number required [ J Test well required on your lot as [ J Grading plan ShoWin! invert [ ] per attached bulletin elevations of sewage isf¡osal Surrounding properta: - vacant or srvtem, foundation and inal grade improved (within 15 of all [ J Submit letter from water district ( y licensed design professional) property lines) indicating d ¡stance to nearest public water main and availability [ ] Public sewer stub location from [ ] Retaining wall must be designed sewer district shown on plans by r.E. or R,A. III, OTHER/REMARKS Date Prepared 5 - 2..c¡ --9£ By No' 18-1146.. 12/91 1- ...1..,~,.... "=>'"' .=o..........n :;:r,q. t'1o.!=lsible; hOwev~.L, 0............ .......___ -' ,... f'I TOWN OF SOUTHOLD PROPERTY REI;ORD CARD '""" )1-1. .2- / VILLAGE OWNER \A11LLIAlV\ ,I-tAI\.l~S-.:rR.., fORMER OWNER /, ~.- ..- . Dm. e - r t~ Y1 ( SUB. WI/low LOT S ii a r,-rr:. ---- leYYCLoe- . E S W- i I ';/0 w ~ ' ~(..,yac.e,/ RES. SEAS. IMP. VL. J/j . TOTAL FARM LAND DATE REMARKS '60D 7nD / 'J 0 I : I ! I_ , , NORMAL BELOW ABOVE Value &:l~ '0 8'0 GJ..tA~ .... oS elf ~Gs%e~ '2D.81!l i Tillable FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH' BULKHEAD /30 (J '-S 2,lJIHJ ~. 10 tl~C'f ....~.-.. ~~'-I - ::S~4o rifE) I L AGE NEW FARM BUILDING CONDITION Acre Value Per Acre I Woodland ) Meadowland f Hause Plat l f'~'9ta' ;1 ,) .1 . .1lI \:!l ~ DOCK ,.. -0:,1 . ~~~ . {l$'''D%\ a :-< \1 , en '2:& ,~ ~'i '.0. ~:j ~~ ~~'t-{( ~ '0./ + i'"~p" ~~~ Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 Albert J. Krupski, President John Holzapfel, Vice President Jim King Martin H. Garrell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD uffice Use Only Vcoastal Eros~on per~it ~PPlicati01/;;)O ~ @ ~ 0 WI ~ m -VWetland Perm~t Appl~cat~on I~~r'-"~ ~ =Grandfather Permit Application IJII _waiver/Amendment/Changes L J, JUN' J 1996 Vl<.eceived Application: ",'~-'r~ I ...-'Received Fee: $ ~. i-..:-;:-.:'~'::":~-:-;-::- -V-Completed Application t.-I'!J."b I . ", ~.,j!j I HOLD Incomplete SEQRA Classificat~n: Type I Type II~ Unlisted Coordination: (date sent) ---- CAC Referral Se~t: ~~1~; ate of Inspect~on: . , Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: '--8.1-"" Resolution: ~ 0 .... 13- """""'''</,,,,'':'''7.~'':'i'j,,,~,,''''<>:*~t:'rdY;. ..: Name of Applicant Address u)/LLOu) OILIE1J7 , AI_l/ , , I./JII...!..IIJU /l h?w/JS .J/L ' Tazlt/leE jJt) /?;r.{ 33<1 Phone Number: ( Sl') .:3 23 - 2V..s-r Suffolk County Tax Map Number: 1000 - /1,16 9t./J I (provide 96() 5/0 t/Al6- ST. LltiCO Pole *, distance t(/IM.()I(/ ~tU. tJ~ .(.,4. ()~/ Property Location: to cross streets, and location) AGENT: (If applicable) ...., Address: Phone: FAX*: 1 tjard of Trustees APPlicatiil V" Land Area (in square GENERAL ~1>fA feet) : /2- ./I{!lZtF Area Zoning: R C'$ I Dc~7/ /f'- Previous use of property: 1/ ,q.e A1J 7 Intended use of property: I PIJMILY /)WEU-l'u G- o Prior permits/approvals for site improvements: f!tJ,e. i3<<(../C~ Agency DEe -rotllV T./UtS TeeS ~9~9 /9t"9 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): / rffMl(..Y .7JWELU-VG- 8 M.1-t-~ ./J1l1 !/EWAf ' W&t...<- 5(;;17 ,<!...- SYS 7e n 2 B'lfd of Trustees Application . J WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: I . P/H-1IL i ]JuJcc..LIIJG-. Area of wetlands on lot: square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No ./ Yes (t5~ JI1 f!',.;/ t? cubic yards If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: ~~~. feet (1) cubic yards proposed slope throughout the area of operations: Manner in which material will be removed or deposited: ,Vfl#P 1/U1t!-L -t- fJA-'ILoM~/L statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): AI~A/~ 3 4IJrd of Trustees APPlicatio~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: I F/1UILY 'j)WCf:-Ll~G- , Are wetlands present within 75 feet of the proposed activity? No x Yes Does the project involve excavation or filling? No )( Yes 'i).. nc.t;I-t~' . excavated? ~fFJ (cubic yards) If Yes, how much material will be How much material will be filled? ('J (cubic yards) DtU11 -r/U(tL T removed or deposited: 1M L oAtJe.1l.. Manner in which material will be Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) A/~ A/tf "'". 4 .< '....t6.4 (2187)- Text 12 I PROJECT 1.0. NUMBER . . / 617.21 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) SEa 1. APPLICANT ISPONSOR /t-t.. 19M ,4- t4wP$.::T-t.. J. PROJECT LOCATION: I 2. PROJECT NAME Municipality County Pt:fJ '- 1< 4. PRECISE LOCATION (Street address and road intersections. prominent landmarKs, etc., or provide map) 'lGO WIU{)eV 7bUIJ(.E LMll? O/ZICIII7, /Y. 'I. 1/9S7 5. IS PROPOSED ACTION: R'New 0 Expansion 6. DESCRIBE PROJEC1' BRIEFLY: o Modification/alteration SIAJ~t.t: /74M /(-'1 j)UJCl-UAJ G- . 7. AMOUNT OF LAND FFECTED: Initially ( acres Ultimately :5 ~ ~ acres a. W~PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Kl. Ves 0 No If No. describe briefly 9. w~ IS, PRESENT LAND USe. iN VICINITY OF PROJECT? ~ Residential O.!ndustrral 0 C<Jmmercial Describe: o Agriculture o Park/Forest/Ooen space UOtner 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEOERAL, STATE OR LOCAU? bC'Yes D No 11 yes. list agency(s) and permit/approvals pee.. I-IcA'-~7/1- Jc-Ilr. BLj) '- j)efJ"T. .~ 11. DOES ANY ASPECT OF THE ACTIQU HAve A CURRENTLY VAllO PERMIT OR APPROVAL? o Yes ~ No II y~s. list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION WILL S<ISTING PERMIT/APPROVAL REOUIRE MODIFICATION? DYes DNo I CERTIFY THAT THE INFORMATION PROVIDED .-4.BOVe IS TRUE TO THE BEST OF MY KNQWLSDGE Applicant/sponsor name; JL Dale: ~ /'3/91 < Slgnalure: If the action is in the Coastal Area, and 'Iou are a state agency, complete the Coastal Assessment Form before proceeding with this a?~essment OVER 1 PART II-ENVIRONMENTAL AS SMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE ESHOLD IN 6 NYCRR, PART 617.12? If yes, coo ate the review proces3 and use the FULL E>AF. DYes DNo 6. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.61 If No. a negative deelatatlor may be superseded by another involved agency. DYes DNo C. COULD ACTION RESULT IN ANY ADVERSe EFFECTS ASSOCIATED WITH THE FOLLOWING; (Answers may be handwritten, if legible) C1. Existing air quality, surface 0(" groundwater Quality or Quantity, noise levels, existing traffic patterns, solid waste productIon or dlsposa: potential for erosion, drainage or flooding prOblems? exPlain brietly: _ C2. Aesthetic, agricultural. arChaeological, historic, or other natural or cultural resources; or community or neighborhood character? ixplain brfeti C3. Vegelatlon or fauna, fish, shellfish or wildlife species, significant habilats, or threatened or endangered species? exPlain brletly: C4. A community's existing plans or goals u officially adopted. or a change in use or Intensity of use 0' land or other natural resources? ExplaIn brlet CS. GrOwth, subseQuent development. or related activities likely to be induced by the proposed action? Explain briefly. CG. Long term, shOrt term, cumulalive. or other effects not identified in C1-CS? ExClain briefly. C7. Other impacts (inCluding changes in use of either quantity or type of energy)? Explain briefly. Q. IS THERE, OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? DYes 0 No If Yes. explain briefly PART III-DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial. large, important or otherwise signifiean' Eaeh effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occ~g; (e) duration; (c irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure thz explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. o Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF andlor prepare a positive' declaration. . o Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the propo~!,d action WILL NOT result in.",ny significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: .'.j,U1"~ or ~...~tJ Ag~ncy PrInt Of I vp~ N~mt' 01 i<('~"onsloi~ Ufilcer '" Lc~d A~t:nC'1 rjcJ~ Of J(l."ioonSlol~ VUlcer Sll:n.;alure 01 fo(esoonSIOle Ortl(('r '" Leold ^!;ency Sl~nacure Of Prep.lrer (If dutert!'nl Irom teSoonSIOIl! orflce" Q,He 2 . . Albert 1. Krupski, President lohn Holzapfel, Vice President Jim King Martin H. Garrell Peter Wenczel Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------- In the Matter of the Application of __ _W~_ll~~___I::t~~_I\:.:._______ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, l..J~\\:LUv"I ~T\, residing at il)~\\DLJ \e~t. L~ Dt"Gr\.+- being duly sworn, depose and say: That on the I~ day of3~ 1996, I personally posted the property known as S ~ ~vL- by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for seven days prior to the date of the public hearing. (date of hearing noted thereon to be held 1a-d-.7-"1f=. Dated: (p v3hb J/dtla'#f /J- ~- (signatur~) . J~~ to before me this -::S - . liay ofT~ 1996 ~Lf~ Notary Public CLAIRE L. GLEW NotSlV Public. Slate of N_ York No. 4879505 () b Qualified in Suffolk Cou119 '7 ' Commission Expires December - yd of Trustees Application . ~. County of Suffolk State of New York /j)/JJ..//'1~ /7. ~,tJS o//L. BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS 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 UNDER. OR BY VIRTUE OF SAID PERMIT ( S), IF GRANTED. 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. SWORN TO BEFORE ME THIS /L/.dd~ /J.~.k->>r. Signature ~ (~K DAY OF Tc.{.~ 19 CZ (.. '- Notary Public CLAIRE L GLEW NotarY Public. State of New York No. 4879506 q} Qualified in Suffolk CountY Commission Expires December 8. 19 ~ 7 . . J PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS y...-- Address: Z 760 491 7&6 Receipt for , It if, d Mal' Cert Ie ogo Pro.id.d ." No \nsuranc; C~~:'natiOn8\ Mail ~ 00 not use or _~ \50. 1I0.or.ol I postage certified Fee Special Oelivery fee Restricted Oeliver't Fee I' to '" 0> 0> ~ k '" 0> 0> ~ " u lo ~ TOTAL postage o ""FeeS o postmark 0 ell tt l'l 0 E 5 u. rJ> "" " u lo. ::;; o o ell l'l E o u. rJ> "" residing at W/LLOtV /e;V{. i../?i1VC , being duly sworn deposes and says tha on the ~ ay of ,~~AYc- ,19~, deponent mailed a true copy of' ~e Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that ~~d Notices were mailed at the United States Post Office at (,?gje:nIT, AI. ~. ,that said Notices were mailed to each of said persons y (certified) (registered) mail. ,//Pd~ d-~r' Sworn t9f';efore me this. (3 ~ Vq~ A~ Notary PublJ.c CLAIRE L GLEW Notary Public, State of New York No. 4879505 Quelified in Suffolk County (y I . Commission Expires December 8. 1lJ(..Jf 1 ,'- 6 ~/f~ LOuc..,c::: ;-! 4&-i:?r'(' !-f Ic--~ .&~ ~, /99' ~. .J anv./lL~ ~ ~~ A ~ d "'6~, ~ e~ a... /<t X If ~d-~ ~~eL PJV 7'/utU/ fla:t2C. tI~~ r' ~~ /l ~c7--' Ll' <:;/ I" Y (il eQ r L h. I \)../ v ( LI ' :-)" .fL' ened '>1 . In) rn@ rn U~!l \nil \ ,UU OCT 2 ~~I ,TOWN_OF SOUTHOLD I ~ /o/1~ Ct-'. (.-1"1'-- io-3"qb .,., ~~N to ~ " lie: ~(\' iif UJ z :5, lUi~! ~f~ ~l C!!.i"'i ~i~1 i...., I: () Z a j ~ ~ ~. ~ .~ 0 III ei z ~ o ~ [( -i J: ..J ::u. a m r 1 Q ...J ~ I~~ ~ I :r:: ..... ~ => 0 ~ N '(1) @) g u... 0 ~ z r =T==: 3: f2 t "'-,-.' . ~.t ~' xi .. .;J . Ii R; l'- C'J , :I X o(~ o .l<!l u lie: ..J o Ia. ' It;~ Vi 0- ..: Cj; . ',~' , . ~ i , '. r " II.... r TI' r" k.' ~"" ;::f: '>~, ~ vi .." .-1 -, . Q L. _.. 0,1.41 ":~I[. m"J ~1?!~J,! -1 . ......1.1l ..-,!~~XJn.: \;~j..'!"l I;J::.:I~II.:"'1 .,,-,.,. ~ ,.' 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'!O ;;;J..... '. t. 'W<J. ',;I";' ,.t' ~ , \ \ \ . \ \ , ~ . .. ,) ..,..,. C'-~ >~ .~ .--\ .-; ~ ~ !\ m --s. 'Y P \9. .0 tc\ \ \. /..-".\ fP . \ \ \ -"f' ,.. ~.I$'i, _ "'." '4'-' .- . ;y(~},l) MAP or. vr<OPHZTY _.""-_._.--.-......~-_.. -- .-.----,. -- -...-- . SU;ZVifVfJ) fCf~ --'-'-'--".--"~~--' .~._.~~.- ,. ......- \ Il.Ll! A' '.~J1 w......' " ^ ~ 1 fo. f\ rr, r- z'" t 1 i. 1',1 : , ~.\ J~... ,.'.' ...... \....,..I 'r-"-' .t ) \.,...' \ c.... .L ---.-....-..-'...--. ......... .-..;.-.,.- A'T . ''')i''>I.'''N.-:- ...... .<, &i"., \ . TOWN QF ~;;OU THOU) ,"V . __.,.~.......__.IL-."~__'__'____'_"" ~,.:___._._,._ . AWlOOcO JUNE fl'. 1996 .........--..... '--"'-'- --- TELEDYNt POST NtI,J2$ I I i , I ! \ \ . \ '; ';-} ... ""' ~ ri > Z -1 "'-"'" ... '~lti~s.:"~:_:io::,-,~~~~:}:."::\'?i ~:-~j ',' '\:~!l; -,:;(:~~ .' ,': ',_7""?_''''P"' ,:':-, 1~':""}_,,'-~ < ... .0', , -." ..._~ 11 . II .. / r / /' i ! ,. ! I~ , , / r: W.~~~::~ ill TOWN OF SOUTHOL SUf'FOU< CO. TAX MAP AlN~ DI$T. _.'T. 81.00< IQO:J 2i. z OW IfS AD WILLOW T~ t..ANE ~-~...--,..~~......._-.- ,"",' .-._- ORt5N:t'tN,V,. fIgS.., . TEl,. 323 -Z729 ~:t.:. P. ~_ J ' .' -~ .-, / I I ~rA.jC .;1',,4..0.. . ,"j "~..' 4Z,SOOt :$.;, ------.-_"'-- r~ ,HONUMEhlT ____-_.._ _m"'~"~' ____ Q ~ PlPE. ----.-',---- \ --"b..d..... .'~- ............... vIIIIitIiit"'F:" --"'.._"'*- _t.. ~",...._.......... ltellndlllrVllW'e........ ---......- tobea__ow CluI:rantNI.............. .,.. It., crlylolhe ptfIOn b'wbam....,., isptOpaNd, and on hII...llo...e litle(;ompany.~aQInCJ'''' 1eo:.M9i1stitutlonlisledhereonal1d 10 the essignees eftlle Iendinlil in8Io tutiQl1.G~"raMee$arenot~ to addiVQr;~1 rnc;li!<ltivns or aublllqueAl .....~ t)..1 <- ~. ~t w1 ..J' u.1 w! Wi In. P6 SUfNEYED HAYZ),I<)% .--.-..-..- -.._-,-- .-.__.,.--._-~.--.- RODEft~. ~~U'9-~ LICENSED LANe SURVeyORS GRaNl"ORT NEW YORK