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Pagnozzi, Agnes
e1 n .r.Pw», , r , w - IT . r$� a..K»rt mm9�c-.w..r;..�,a..w w. .,.v.,,H..y�.w,r•aaaa.; Y �� � r TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, NEW YORK WETLANDS PERMIT This Wetlands Permit No. .....56.......... has been granted by the Southold Town Board according to information furnished in Application No. ..A ............ filed by Applicant .. Agnes PagnoCzi ............................. ........................................ on ...J Y..6............. 19.81.... A map of the proposed work will be kept on file in the Town Clerk's Office under the application number given. Permit granted to do the following workconstruct 50 ft of marine railway 25 ft on beach and 25 ft. in water to maximum of 2 ft . at M.H.W. ................................................................................................................................................................. .......:......................................................................................................................................................... Location of property on which work to be done ..south side of Jockey Creek Drive, ....................................................................... „Southold, New York .................................................................................................................... ........................................................................................................................... ................... .... Creek, Bay or Harbor frontingproperty ... Jockey Creek �\ �i.. ...�. ..:�7...:t. . .. ........................................................................................................................ .';..,. <..........1. . ..1. ... � � �\� ��� Sizeof work: Length ..5.0....f...t...........................................................................:r` li�.,(r �.. :I....... ft Width ................................................................................................................. Height Above High Water ....0-3...ft on beach Depth Below Low Water ... r...part...at...M...L.:W................................................ 'Yards to be Excavated ......none..................................................................................... Yardsto be Filled ......none.......................................................................................... Manner in which material, is to be removed or deposited .....--- ............................................................. ................................................................................................................................................................. Intended use of propertyResidential ......................................................................................................................... ................................................................................................................................................................. Conditionsif any ..................................................................................................................................... ................................................................................................................................................................. ExpirationDate ........................................................................................................................................ Number of Inspections Required ...---- ................................................................................................. Inspection Fees ...-.--.- ........................................................................................................................ Liability Policies in the Amount of ......---- ............................................................................................ The validity of this permit is or may be subject to the approval of other governmental or municipal authorities. The Town accepts no responsibility in applying for or obtaining such approval. In the event that such approval is necessary, the holder of this permit shall not commence operations here- under until such approval has been obtained in writing. The failure to obtain such other approval when required shall subject this permit to immediate revocation by the Town Clerk upon receipt by the Town Clerk of written notice from such other governmental or municipal authorities of its refusal or disapproval. The applicant does by the acceptance of this permit, assume all responsibility for operations under- taken pursuant to this permit, and shall take all precautions for the prevention of injuries to persons and property resulting from such operations. By such acceptance, the applicant also agrees to ind mni- fy and save harmless the Town, and its officers, agents and employees from any and all claims a ising from operations under this permit and any and all acts or omissions of applicant, his agent and employees. The applicant and the owner and occupants of the premises upon which the operations authoriz d by this permit are being conducted, do, by the acceptance of this permit, give consent to the Town and its officers and employees to enter upon the premises where such operations are being conduct3d to make such inspections as the Town may deem necessary to insure that such operations are being con- ducted in conformity with this permit. This operation will not substantially: A. Adversely affect the wetlands of the town. B. Cause damage from erosion, turbidity or siltation. C. Cause saltwater intrusion into the fresh water resources of the town. D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife and ege- tation or the natural habitat thereof. E. Increase the danger of flood and storm-tide damage. F. Adversely affect navigation on tidal waters or the tidal flow of the tidal waters of the town. G. Change the course of any channel or the natural movement or flow of any waters. H. 'Weaken or undermine the lateral support of other lands in the vicinity. I. Otherwise adversely affect the health, safety and general welfare of the people of the town. Signed . `..c.� �.. ' Town Clerk, Town of Southold (S(E AIS J/I Date.........September 1981 .......................2.3.,....19.8.1............. TEL. 765-1802 op ®may TOWN OF SOUTHOLD �c OFFICE OF-BUILDING INSPECTOR ,T P.O. BOX 728 C= TOWN HALL SOUTHOLD, N.Y. 11971 P-ECEI�1D Srl, 11 September 1 1 , 1981 TOM Clerdl outfiof� Judith T . Terry Southold Town Clerk Main Road , , Southold , New York Re : Agnes- Pagnozzi 1450 Jockey Creek Drive , Southold , New York Dear Judy : In reference to your letter dated September 10 , 1981 , George Fisher asked me to make and inspection of the subject premises , which I have done this date . I did not find any construction in the rear yard area , (water front) that violates Zoning Ordinance . Permits would be required , however, for the Marine railway that has been installed and the four pilings that provide hoist for boat . The construction of Marine railway is in the wetlands , partly on their property, and partly in the creek , Town waters . A permit is needed from Town Board and Trustees . The structure for hoist is completely in the creek , permit from Trustees is required . Very truly yours , EDWARD . HINDERMANN Building & Housing Inspector EFH : jd O�FI�E'0'� RK TOWN OF�' D JUDi rH T.TERRY SIUFFOLKz TELEPHONE Tmm CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 September 10, 1981 Mr . George Fisher Building Inspector Town of Southold Southold, New York 11971 Dear George: Please conduct an inspection -on the property of Agnes Pagnozzi, 1450 Jockey Creek Drive, Southold, and advise the Town Board by September 18th wheth-er or not the construction of the hoist, pilings, etc. is a violation of the Zoning Ordinance. All the construction you see at the waterfront has been installed without Trustee, Wetland or Building Department permits. Copies of Wetland Applications 6y and 71 by Agnes- Pagnozzi are attached hereto. Very truly yours, Judith T. Terry Southold Town Clerk- Attachments WETLAND APPLICATION OF AGNES PA'GNOZZI' #69 PUBLIC HEARING - 3: 40 P.M. , TUESDAY, AUGUST 25, 1981, SOUTHOLD TOWN BOARD Present: Supervisor William R. Pell, III Councilman Henry W. Drum Councilman John J. Nickles Councilman Lawrence Murdock, Jr. Councilman Francis J. Murphy Town Clerk Judith T. Terry Town Attorney Robert W. Tasker COUNCILMAN NICKLES: NOTICE IS HEREBY GIVEN that public hearings will be held by the Town Board of the Town of Southold at the Southold Town Hall, Main Road, Southold, New York, on August 25, 1981, as follows: 3: 40 P.M. o' clock in the matter of the application of Agnes Pagnozzi for apermit under the provisions of the Wetland Ordinance of the Town of Southold for permission to construct 50 feet of marine railway in front of her property located off south side of Jockey Creek Drive, on Jockey Creek, Southold, New York. I have notice of publication from- Pat Wood of- the 'Long-lIsland Traveler that occured on the 13th of August. Similar notice from Troy Gustayson of the Suffolk Times, same date, August 13th. An affidavit from the Town Clerk that it was published on the Bulletin Board. I have a letter from the President of the Southold Town Trustees, Anna T. Hataier to the Town Clerk: "Dear Mrs. Terry: The following action was taken by the Board of Southold Town Trustees at a regular meeting held August 5, 1981: RESOLVED to recommend to the Southold town Board approval of the wetland application of A. Pagnozzi, #69, for a permit to construct a 50' x 5' marine railway alongside of existing dock. " I have notice of a Negative Declaration relative to this project . SUPERVISOR PELL: You have heard the reading of the public notice. Does anybody wish to speak in favor of the applicant? In favor of the application before the Town Board? (No response. ) Does anybody wish to speak in opposition? (No response. ) Does anybody wish to be heard at all? (No response. ) If not , I declare the hearing closed. vel" Judith T. Terrr Southold Town Clerk SOUTHOLD TOWN r P.ICEIVED CONSERVATION ADVISORY COUNCIL Southold, N. Y. AUG t G '1981 Town C,RrK Southold 25 August 1981 Mrs. Judith T. Terry, Town Clerk Town Hall Southold, NY 11971 Dear Mrs. Terry: The following action has been taken by the Southold Town Conservation Advisory Council at a regular meeting held August 25, 1981. RESOLVED to recommend to the Southold Town Board approval of Wetland Application #69 of Agnes Pagnozzi to construct 50' of marine railway, 25' on beach and 25' in water area to max- imum of 2' at M.H.W. RESOLVED to reoommend to the Southold Town Board approval of Wetland Application #70 of R. M. Kammerer, Commissioner, Suffolk County Department of Public Works to reconstruct bridge carrying New Suffolk Avenue over West Creek at New Suffolk on the condition that the board see the complete plans of construc- tion and see it staked out before the job starts so that they will know the construction limites of the project. Any wetlands that are damaged must be put back in their natural state after construction is completed. RESOLVED to recommend to the Southold Town Board approval of Wetland Application #71 of Agnes Pagnozzi to attach existing dock to two new wood pilings and add two additional pilings for a hoist for permanent use. Yours truly, FRANK CICHANOWICZ' III CHAIRMAN CONSERVATION ADVISORY COUNCIL ByJane Moffatt, Secretary LEGAL NOTICE NOTICE OF HEARINGS COUNTY OF -SUFFOLK NOTICE IS HEREBY GIV- STATE OF NEW YORK ss. EN that public hearings will be'! held by the Town Board of the', Town of Southold ,at the Southold Town Hall, Main Road, Southold,New York, on Patricia Wood, being duly sworn, says that she is the August 25, 1981 as follows:, Editor, of THE LONG ISLAND TRAVELER-WATCHMAN, 3:30 P.M. o'clock in the matter of the -application of a public newspaper printed of Southold, in, Suffolk County; Fred Melin for a permit under the provisions of the Wetland and that the notice of which the annexed is a printed copy, Ordinance of the Town of has been published in said Long Island Traveler-Watch- Southold for permission to install an aluminum bulkhead, man once each Week for ......................................weeks extend existing-float and in- stall four pilings at his pro- successively, commencing'on the .....N.—)....................... perty on Mud Creek at Skunk ' Lane, Cutchogue, New York. I day ..... .. . ..... ............... 19.% 3:35 P.M. o'clock in the I ` matter of the application of Enconsultants, Inc.,for' How- and Petersen for. a permit under the provisions of the Wetland Ordinance ,of the Town of Southold for permis- sion to construct retaining wall, catwalk, timber ramp Sworn to before me this ....... .................. day of extension,steel ramps,and fill' c� for ramp approach at property ...... ........ ..... �..... 19...aJ��• off Naugles Drive on Mattituck Creek, Mattituck, New York. e3:40 P.M. o'clock in the matter of the application of Agnes Pagnozzi for a permit under the provisions of the Notary ubliC Wetland Ordinance of the Town of Southold for permis- sion to construct 50 feet of marine railway in front of her ! CLEMENT J.TJOMPSOfd property located off south side NOTARY PUBLIC,State of Now York No.52-9321725 of Jockey Creek Drive, on Residing in Suffolli CouaV Jockey Creek, Southold, New Coananissian Upkes Riarch 30,J&a York. / 3:45 P.M. 'o'clock in the matter of the application of R.M. Kammerer, Commis- sioner, Suffolk County Depart- ment of Public Works for a permit under the provisions of the Wetland'Ordinance of the Town of Southold for permis- sion to reconstruct bridge carrying New Suffolk Avenue I over West Creek at New Suffolk in the Town of South- old. All persons interested in said matters shall appear at the time and place above specified and will be given an opportunity to be heard. Dated: August 4, 1981 i -- .,,BY,;ORDER OF THE SOUTH'OLI)TOWN'BOAA ' l JUDITH T.TERRY TOWN CLERK 1T-8/13/81(2) Legal Notices -Wetland Ordinance rof the Town of Southold for permis- i LEGAL NOTICE sion to construct•50 feet of NOTICE OF HEARINGS marine railway in front)f her i NOTICE IS HEREBY property located off soiMi side GIVEN that public hearings of Jockey 'Creek Drive, on will be held by the Town Board Jockey Creek, Southold New of the Town of Southold at the York. SUFFOLK, I Southold Town Hall, Main 3:45 P.M. o'clock in the EW YORK, ss: Road,Southold,New York, on matter of the application of R. August 25, 1981, as follows: M. Kammerer, Commission- Stays On 3:30 P.M. o'clock in the er, Suffolk County Depart- , . , ° , , , • , , , , . being duly Sworn. matter of the application of ment of Public Works for a I . . . . . . . . ° ° Fred Melin for a permit under permit under the provisions ofis is Printer and Publisher of the SUFFOLK the provisions of the Wetland the Wetland Ordinance of the Ordinance of the Town of Town of Southold for permis- S. a newspaper published at Greenport. in Said Southold for permission to sion to reconstruct bridge car- install an aluminum bulkhead, rying New Suffolk Avenue at the notice. of which the annexed is aprinted extend existing float and in- over West Creek at New Suf- stall four pilings at his proper- folk in the Town of Southold. a published in the said Suffolk Weekly Times ty on Mud Creek at Skunk All persons interested in Lane, Cutchogue, New York. said matters shall appear at i eek, for , one . . . . , . . . . . . . . , , • , weeks 3:35 P.M: o'clock in the the time and place above matter of the application of specified and will be given an ammencing on the . . . .13. �a. Enconsultants, Inc. for How- opportunity to be heard. ° ° • • • ° ° ° . • . • ° and Petersen for a permit DATED: August 4, 1981 0-1under the provisions of the BY ORDER OF S t �" Wetland Ordinance of the THE SOUTHOLD Town of Southold for permis- TOWN BOARD • • • • • • . . . . . . . . . . . . . . . • • • • sion to construct retaining JUDITH T.TERRYl wall, catwalk, timber ramp TOWN CLERK are me this 3:t.. , extension, steel ramps, and 1TA13-3744 rRs 81 fill for ramp approach at. ' - ____? 19. . . . J property off Naugles Drive on i` , �. . .(S.•. . Mattituck Creek,- Mattituck, • • • • • • • • New York. 3:40 P.M. o'clock in the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . matter of-the application of Agnes Pagnozzi for a permit under the provisions.of-the - -- - - NOTARYHELEN K DE VOE No 4 07878 Std Suffrykof New York Terra Expire s MCDUN arch 30 1 I ' 1 I I I. I i -- j STATE OF NEW YORK: II SS: • COUNTY OF SUFFOLK: JUDITH T. TERRY, Town Clerk of the Town of Southold, New York, being duly sworn, says that she is over the age of twenty-one years; that on the 4th day of August 19 81 i• she affixed a notice of which the annexed printed notice is a true copy, in a proper and substantial manner, in a most public f �1 place in the Town of Southold, Suffolk County, New York, to wit : - '' � i, Town Clerk Bulletin Board, Town Clerk Office, Main Road, Southold, New York 11971 r Notice of Hearings - August 25, 1981 - Wetland Applications of :j 3: 30 P.M. - Fred Melin i 3: 35 P.M. - Enconsultants, Inc. for Howard Petersen �? 3 : 40 P.M. - Agnes Pagnozzi l• 3: 45 P.M. - R. M. Kammerer , Commissioner , Suffolk County 11 Department of Public Works li ! ! I Judith T. Terry !; Southold Town Clerk , I? I� fi ;i Sworn to be before me this LINDA F. KOWALSKI NOTARY PUBLIC, State of New Yodf j 4th day of August 19 81 No. 52-4524771 Qualified in Suffolk County Commission Expires March 30, 198.2. �! Notary Public I f 7 e 1� 1 I I i 1 1 i LEGAL NOTICE ii NOTICE OF HEARINGS .i I ii NOTICE IS HEREBY GIVEN that public hearings will be held by t �I he Town Board of the Town of Southold at the Southold Town Hall, Main Road, Southold New York on August 25 1981 as follows: 11 3: 30 P.M. o 'clock in the matter of the application of Fred �Melin for a permit under the provisions of the Wetland Ordinance i of the Town of Southold for permission to install an aluminum bulkhead, extend existingfloat and install four pilings at his , property on Mud Creek at Skunk Lane, Cutchogue, New York. 3: 35 P.M. o ' clock in the matter of the application of i� 'Enconsultants, Inc . for Howard Petersen for a permit under the provisions of the Wetland Ordinance of the Town of Southold for I permission to construct retaining wall, catwalk, timber ramp ,extension, steel ramps, and .fill for ramp approach at property i Of Naugles Drive on Mattituck Creek, Mattituck, New York. s: 3: 40 P.M. o' clock in the matter of the application of gAgnes Pagnozzi for a permit under the provisions of the Wetland { jQrdinance of the Town of Southold for permission to construct l� 150 feet of marine railway in front of her property located off Ij outh side of Jockey Creek Drive, on Jockey Creek, Southold, New i �Yo r k. i; 3:45 P.M. o' clock in the matter of the application of iR. M. Kammerer, Commissioner, Suffolk County Department of Public N Works for a permit under the provisions of the Wetland Ordinance �I ! sof the Town of Southold for permission to reconstruct bridge t carrying New Suffolk Avenue over West Creek at Nese Suffolk in the iTown of Southold. All persons interested in said matters shall appear at the ltime and place above specified and will be given an opportunity to 1 e heard. , ATED: August 4 , 1981 j BY ORDER OF THE SOUTHOLD TOWN BOARD f JUDITH T. TERRY I �! TOWN CLERK I 1 if 1' Page 2 - Legal Notice - Wetland Hearings I , jjPLEASE PUBLISH ONCE, AUGUST 13, 1981, AND FORWARD FOUR (4 ) iiAFFIDAVITS OF PUBLICATION TO JUDITH T. TERRY, TOWN CLERK, TOWN ;;HALL, MAIN ROAD, SOUTHOLD, NET YORK 11971. ii 'Copies to the following on August 6, 1981: IThe Suffolk Times IThe Long Island Traveler-Watchman (Town Boai+d Members ,,TowTown Clerk' s Bulletin Board Fred Melin n Clerk' s a/c Howard Petersen ( Agnes Pagnossi ISR. M. Kammerer, Suffolk County DPW IIl1 II i i I, I i 1 i� Ij i 1. it C i 1 I Is i i i RECEIVED AUUG 619x1 BOAR STEES OUT TOM MEW bUftld FO UOU° Telephone 516-765-1938 Southo . 11971 August 6, 1981 Mrs. Judith T. Terry, Town Clerk Town Hall Southold, 1Vew York Dear Mrs. Terry: The following action was taken by the Board of Southold Town Trustees at a regular meeting held August 5, 1981: RESOLVED to recommend to the Southold Town Board approval of the wet- land application of A. Pagnozzi, #69, for a permit to construct a 50 ' x 5 ' marine railway alongside of existing dock. Yours truly, W'zi Anna T. Hataier, President Southold Town Trustees OF K 0 SOUT JUDITH T.TERRY L = TELEPHONE TowN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT Dated: August 5, 1981 Pursuant to Article 8 of the Environmental Conservation Law State Environmental Quality Review and 6 NYCRR Part 617, Section 617 . 10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Board, as lead agency for the action described below, has determined that the project, which is unlisted, will not have a significant effect on the environment. DESCRIPTION OF ACTION Application, of Agnes pRgnozzi no: 69 for a Wetland Permt to construct 50 feet of marine railway �n front of her property located off south side of J6ckey Creek Drive, on Jockey Creek, Southold, New York. The project has been determined not to have a significant effect on the environment for the following reasons : An environmental assessment has been submitted which indicated that no significant adverse effects to the environment are likely to occur should the project be implemented as planned. Because there has been no response in the allotted time from the New York State Department of Environmental Conservation, it is assumed that there is no objection nor comments by that agency. Further information can be obtained by contacting Mrs. Judith T. Terry, Town Clerk, Town of Southold, Town Hall, Main Road, Southold, New York 11971. Copies to : David DeRidder, DEC Stony Brook Commissioner Flacke, Albany Southold Town Building Department Agnes Pagnozzi Town Clerk Bulletin Board OFFICE OF�TOWNCLERK TOWN,OFA SSOUTHOLD JUDITH T."KERRY SUFFOLK-COUNT TELEPHONE "_ TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS "- } Southold, L. I., N. Y. 11971 1 July 8 , 1981 - i Mr. David DeRidder Environmental Analysis Unit N.Y.S . Dept . of Environmental Conservation Building 40 , SUNY - Room 219 Stony Brook, New York 11794 Dear Mr. DeRidder: Enclosed is application of Agnes Pagnozzi no, 69 for Agnes Pagnozzi for a Wetland Permit to construct 50 feet of marine railway in front of her property located off south side of Jackey Creek Drive, on Jockey Creek, Southold, New York, This project is unlisted and our initial determination of non-significance has been made and we wish to coordinate this action to conform our initial determination in our role as lead agency . May we have your views on this matter. Written comments on this project will be received at this office until July 27 1981 We shall interpret your lack of response to mean there is no objection by your agency. Very truly yours, ��2' Judith T. Terry Town Clerk Enclosures cc: Commissioner Flacke Southold Town Building Department .t J 4: OFFid,bR,TOWN.'CLERK TOWN, OF'SOUTHOT,D JUDITH T.TERRY SUFFOLK COUNTY TELEPHONE TOWN CLERK f'= '3. L1` (516) 765-1801 REGISTRAR OF VITAL STATISTICS er Southold, L. I., N. Y. 11971 July 6, 1981 To Whom It May Concern : Attached hereto is Environmental Assessment Form completed by Agnes Pagnozzi in connection with her wetland application no. 69 for a wetland permit . Permission is requested to construct 50 feet of marine railway in front of her property located offsouth side of Jockey Creek Drive, on Jockey Creek, Southold, New York. Judith T, Terry�G�%G JTT/bn Town Clerk Posted on Town Clerk Bulletin Board on 76/81 `;ee r" ,. 'y'."., - _ .. ,;'PS`-- i _. i:,`..s -a�;r�;i..-.�,;:c3s�``_" }4,r.,`.c�.,;`?,.€..:,nli-+'Y,s;:4fi,K?M.r,�:irk';r:`Gax^,•�,,w:'�,LSSs�'�jg4wYi"n3;ti^kA''3`?�,r',Y:.i Y• iT•,':,1�t'._ i�''L;`(Kr,�^z}ta1R�i'si'}y'4.v, •. , I —e4 ®jFF 1 ,'0F;=TOWN:CLERK TQ 'OF,SOUTHOLD- JUDITH T.TERRY SLJFFOI K'FCQ ' NTY TELEPHONE x TowN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 Southold Town Board Southold Town Hall Southold, New York 11971 Gentlemen : Transmitted herewith is application no . 69 for a wetland permit submitted by - Agnes PR gnozzi„ Copies of this application have been forwarded to the Board of Town Trustees and Conservation Adv-sory Council on this date for their report of findings and recommendations . Very truly yours, Judith T. Terry Town Clerk JTT/bn Enclosures • OFF.iCE�OF'TO �C"',�;EI2K Q,ITT>IQD JUDITH T.TERRY UFF0L COL7NTY TELEPHONE TOWN CLERK (516)fns �; (516) 765-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 Mrs. Anna Hataier, President Board of Southold Town Trustees Southold Town Hall Southold, New York 11971 Dear Mrs. Hataier : Transmitted herewith is application no. 69 for a wetland permit submitted by Agnes, Pagnozzi,, Please prepare a written report of findings and recommendations with respect to this application and submit said report to me within 20 days of receipt of this letter. Very truly yours, �✓/rte Judith T. Terry Town Clerk JTT Enclosures ,j'N ® F.ICE F'TOWN 'CLERK TOWIOF- pSOOTHOLD JUDITH T.TERRY OUNT19 TELEPHONE TOWN CLERK (516) 76S-1801 REGISTRAR OF VITAL STATISTICS Southold, L. I., N. Y. 11971 Mr . Frank Cichanowicz III , Chairman Conservation Advisory Council Southold Town Hall Southold, New York 11971 Dear Mr. Cichanowicz : Transmitted herewith is application no . 69 for a wetland permit submitted by Agnes Pagaozz�, Please prepare a written report of findings and recommendations with respect to this application and submit said report to me within 20 days of receipt of this letter. Very truly yours, Judith T. Terry Town Clerk JTT Enclosures r t Town Of Southold Town Clerk's Office Southold, N. Y. APPLICATION FOR WETLANDS PERMIT Application No. ............ ... ............. Date of Application ..................... .......... .............. Identityof Applicant ...... :.�aLZJ........................................................................ Address of Applicant ............... . `ro..... ©. c ...... 'GJ ......' :�.............................. INSTRUCTIONS FOR PERMIT A. This application is to be completely filled in by typewriter or ink and submitted to the Town Clerk in quadruplicate, accompanied by writter permission from the owner of the property if not the some as the applicant. B. Pilot Plan must be drawn to scale on the reverse side of this application showing the location of property, the names and locations of owners of adjoining properties, and a detailed description of proposed project. (Note: Copies of the Pilot Plan may be made by a copy machine and attached to the Permit Application.') C. No operation shall be initiated by the applicant until all permits that are required are issued. D. A detailed statement of the rehabilitation and proposed condition of the premises after the work is completed must be given, including a survey if required. E. If permit is being sought for a more sizeable excavation than the construction of a private single dock or jetty, then this application must be accompanied by a survey and topographical map certified by a registered land survey or Professional Engineer. The horizontal control of survey shall be based upon an approval local coordinate system. The vertical control for elevation and sound- ings shall be based upon United States Coast and Geodetic Survey and/or United States Geological Survey datum. F. A statement must accompany the application describing any known prior operations conducted on the premises in question and whether any prior licenses or permits have been issued to erect structures or to dredge or deposit fill on said premises and whether any such permits or licenses were ever revoked or suspended by a governmental agency. G. A filing fee of $25.00 shall accompany the application. This filing fee includes one inspection, there is a $5.00 fee for each additional inspection. H. The Town Board upon reque of the applicant f r a per ,it, may waive in whole or in part, the provisions of Article II, Sect oAIIV, subdivisions (M and -where it finds that nature of the proposed operations are such, that -the requirements of such provisions are not necessary for a proper consideration of a permit application. I. Upon approval of this application the Town Clerk will issue a permit to the applicant. Such permit shall be available for inspection at any time, upon request. Examined .................................................. 19....... Approved ................................................................ Disapproved ........................................................... Conditions, if any ................................................,................................................................................ .................................................................................................................................................................. .................................................................................,................................................................................ ExaminingBody ....................................................,................................................................................ Signatureof Chairman ......................................................................................................................... APPLICATION IS HEREBY MADE to the Town Board of the Town of Southold, Suffolk County, New York, for the issuance of a permit pursuant to the Laws, Ordinances and Regulations govern- ing the Coastal and Interior Wetlands, Flood Plains andDrainageAreas of the Town of Southold: Permit requested to ...... r Is this for private or business use? ...............®r , ..... �./..®��l...:60 :.......... AreaZoning ......................... .6p� ...................................................................................... Manner in which material will be removed or deposited .................................................................. . .................................................................................................................................................................. Intendeduse of property ............ .�.�.. ...,................................................................................ .... ........................................................................................... .............................................................. Written consent of owner of property, if not the some as the applicant ........................................ .................................................................................................................................................................. .........4................................................................................•....................................................................... COUNTY OF SUFFOLK ) STATE OF NEW YORK ) SS: ..................................................................................................................... being duly sworn deposes and says that he is the applicant for the above described permit, and that all statements contained herein are true to the best of his knowledge and belief; that the work will be done in the manner set forth in this application and as may be approved by the Town Board of the Town of 'Southold. The applicant agrees to hold the Town of Southold and the T pard harmless and free from any and all damages and claims arising under y virtu of said ermit, if granted. Si nature of Applicant Sworn to before a this .....�.9................... CJ day of .... ...... 198.... �7 ? If4 ................... .il- ................. yIIC ANTHONY DeT i �R• E. � Notary Public, Stat of New York No 52-4657619 of Now yo* Qualified in Suffolk County No.62-"W843 Tenn Expires Mari 30, 19.8- Qualified In Suffolk County r`nmrteiaginn Fxniroa March $0, 19 ZA Aa 14�fr ` ® / `16 „ 7 . f w0 a > } a cr cn U J JLLI J J C Z B Z G,L N m G _ CD jwwclon �aNARPFR � , • c m d� cred-ur Ile bof 0u i a f Q 0 3 n f z z � m i O 5uUTHU I r Aq I� / r �i i • I' I( P� B I l , i• �t f ey} o Fj 0NV :j ii i--`-,- I",t,� , , , ," ,,,,.,,,I � �,,", "I , i��,11 - , , 111-W1-,1_',�3,1•.,7,6,_�I'll,, I,, ; `-, 11 11, 114��r � , , , ", t i,� ,�, . - ,, , ,�,, ,,, 1. , I I ........ �fi , - ,tA _ " I "' . .. I . , 1,Q,I,,I,I ji,��, 4 ;0, I I'll, j,0 , r,. - � ,,11`Feld,, � -�q " '. , j . �', ,I All ,,;,V�z � - , 1'�� ';:j! ,, - _� I " 11, 'I LLL=L� IWW"`B�� LL 1� -L It,,,--:--,_L_' ��.:-.-tj�-.-4-_i6_! _!�,, ,";,��4t,;�____,__ ," . 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I ,.11 - --lo - � 1 I , _i;7, ,�w-"�11';,-"e ,, e.� i c",N,�, C_ 4 -�, -_ 11 11, , , ��,�1 lt �",;:�h'W", -, �. ,""i, I A Jt,4 I b , I, , "I ,"' 1111� . ` ,- ��: 1, I .;�,j,,,,��,'' ,, , - �" �, ': ii 1,,,I �il,l,,'I I I Ad, , %', 11� I I llt�l�� 1�._, i , ,, , :,7 ) i�*',v�,'Iv-'!"s�,�,,,, �,; ,,.,�l- -;.,,' ,- W1 -, ,�, - A----------- - � ' ' : ��=,C'';1: w """," 4 J�rA%-"", I, 1Y � , , , t -, .1 " I I , , --' '"' - -t- • , �' � �'., , - �,-�1,.,T- � ,�,� , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,�� , , , , , , ' ' ' ' ' ' ' ' , , , , , , , , , , ,, " ,, " - , ,"!! , " " " " " " " " " " " " " " " 6,'�,, ,, .�,� �,.� , , , , , , , , , , , , , , , , , , , , ., i!: , , i i i i i i i i i i i i i i i i i i i i i i i i i i i i i !'- -, ' , , L r , - 9 - 0091191, i � " � I , , ,f L, ,, I, " .p e .. , :A AT I A A vi k�31,11te�, - - - -:504 11.swe " ",,,,� � , , ......... , , - ,:14S on x. , ie I _ A, . ki .- i � TOWN OF SOUTHOLD SHORT ENVIRONMENTAL ASSESSMENT FORM INSTRUCTIONS : a In order to answer the questions in this short EAF it is assumed that the preparer will use currently available information concerning the project' and the likely impacts of the action . It is not expected that additional studies, research or other investigations will be undertaken . (b) If any question has been answered Yes the project may be significant and a completed Environmental Assessment Form is necessary . (c) If all questions have been answered No it is likely that this project. is not significant . ` (d) Environmental Assessment 1 . Will project result in a large physical change to the project site or physically alter more than 10 acres of land? . . . . . . . . . . . . . . . . . . . . . . . • YesNo 2 . Will there be a major change to any unique or unusual land form found on the site? . . . . . . . . . . Yes No 3 . Will project alter or have a large effect on existing body of water? . . . . . . . . . . . . . . . . . . . . . . . Yes No 4. Will project have a potentiallylarge impact , on groundwater quality? Yes 9 No 5 . Will project significantly effect drainage flow on adjacent sites? . . . . . . . . .. : . . . . . . . . . . . . . . YesNo 6 ._ Will project affect any threatened or endangered plant or animal species? . . . . . . . . . . . Yes ► No 7. Will project result in a major adverse effect on air quality? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YesNo 8 . Will -'project have a major effect on visual character of the community or scenic views or vistas known to be important to the community? Yes_X_No 9 . Will project adversely impact any site or structure of historic, prehistoric or paleontological importance or any site designated, s a critical environmental area by a local •agency? . . Yes _No 10 . Will project have a 'Major effect on existing or future recreational opportunities? . . . . . . . . . YesVNo 11 . Will project result in major traffic problems or cause a major effect to existing transportation systems? . . . . . . . . . . . . . . . . . . . . . . Yes_ )( _No 12 . Will project regularly cause objectionable odors, noise, glare, vibration, or electrical disturbance as a result of the project ' s operation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YesYNo 13 . Will project have any impact on public health or -safety? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • YesNo 14. Will project affect the existing community by directly causing a growth in permanent population of more than 5 percent over a one year period or have a major negative effect on the character of the community or neighborhood? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . —Yes No 15 . Is there public controversy concerning the project? . . . . . . . . . . . . . . . . . . . . . . . . . . . . YesNo PREPARER ' S SIGNATURE REPRESENTING DATE 1-2, `