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HomeMy WebLinkAboutTR-4904 . . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1882 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 24, 1998 J.M.O. Consulting P.O. Box 447 Quogue, NY 11959 Re: Gerard H. Bellesheim SCTM #15-3-9 Dear Mr. Just The following action was taken by the Board of Town Trustees during its regular meeting held on April 22, 1998 regarding the above matter: WHEREAS, J.M.O. Consulting on behalf of GERARD BELLESHEIM applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated March 31, 1998, 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 April 22, 1998, 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 37-18 of the Southold Town Code, . . WHEREAS, the Board has determined that will not affect the health, safety and people of the town, the project as proposed general welfare of the NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees grant a Wetland Permit to construct 100+/-' timber bulkhead with a 10' return on the west property line. Armor with 1-2 ton stone. Backfill with 35+/- c.y. of clean sand from an upland source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to east and will follow toe of bluff. A new survey will be submitted showing same, and 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, ULtt.,If). /~ 9, Albert J. Krupski, Jr. President, Board of Trustees AJK/jmd · .. Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1882 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD COASTAL EROSION MANAGEMENT PERMIT Date: April 27, 1998 Permit Number: 15-3-9 Name of Applicant/Agent: J.M.O. Consulting, Inc. Name of Permittee: Gerard H. Bellesheim Address of Permittee: 74 Park Ave., Bronxville, NY 10708 Property Located: 122 Soundview Road, Orient. DESCRIPTION OF ACTIVITY: construct 100+/-' timber bulkhead with a 10' return on the west property line. Armor with 1-2 ton stone. Backfill with 35+/- c.y. of clean sand from an upland source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to east and will follow toe of bluff. A new survey will be submitted showing same. SPECIAL CONDITIONS: (apply if marked) Bluff restoration through a re-vegetation plan 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/jmd . . Telephone (516) 765·1801 Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL The following action was taken by the Southold Town Conservation Advisory Council at its meeting held Monday, April 20, 1998: No. 1553 Moved by Sharon Shine, seconded by Betty Wells, it was RESOLVED to recommend to the Southold Town Board of Trustees DIS""ROVAl... ,;·of the Wetland Permit Application of GERARD H. BEl.LESHEIM f!I-3-9 to construct 100 +/-' of timber bulkhead with a 10' return to the west property line; armor with 1-2 ton stone; backfill with 35 +/- c.y. of clean sand from an upland source; bulkhead to be in line with adjacent bulkhead to east. 122 Soundview Road, Orient The CAe;; r:._ç~... . . i~it,-r,)I~Ii!$ :O!1J!!1tI1t!tA"'im'~_... ust 24, 1995: The CAC (I reo C. fîI'I\tiK!.. .m.t~. s..êit1 ..... .:. "~:i¡j¡;¡' . ··..:ìtin '¡'''¡~~.'.'.'. .... .;. .. ..1.1. '..... ..·.k';;.,.......~t .~~~5 'öl< '.' 'erof jJ~ 14, 19t5 or;t1titÿttMd:,1f'" '\îÌ~r "fiti"esf policy for bulkheads on the Sound. Motion Carried ·' . 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 24'\ 2003 Catherine Mesiano, Inc. 12 Mill Pond Lane East Moriches, NY 11940 , {I RE: SCTM#15-3-9 735 Soundview Road Orient, New York Äo-þ", Vl...), I J . ,l , !, If' '- ¡..J,t 'i " (2ß'v " í -, ~\.t 1 ~ ~ Dear Ms. Mesiano The Southold Town Board of Trustees reviewed the survey prepared by Joseph A. Ingegno Land Surveyor dated May 20, 1999 and revised June 24th, 2003 to renovate proposed second story addition to be out ofthe Wetland Jurisdiction under Chapter 97 of the Town Wetland Code. Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97) and the Coastal Erosion Hazard Area (Chapter 37) no pennit is required. Please be advised however that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without a pennit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation of other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your projects. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale benn, However any activity within 100' ofthe Wetland line and/or seaward of the Coastal Erosion Hazard Line, would require action from this office. This detennination is not a detennination from any other agency. . If you have any further questions, please do not hesitate to call. Sincerely, ~ fJ. 1/ - ¿-fL. Albert J. Krufiski, ~ ;1'1 President, Board of Trustees AJK:cjc cc: Building Department . . . . y.... CATHERINE MESIANO, INC. 12 MILL POND LANE EAST MORICHES, NEW YORK 11940 631-878-8951 September 15, 2003 Town of Southold Board of Trustees Box 1179 Southold, NY 11971 Re: 735 Soundview Road, Orient SCTM # 1000-15-3-9 \ Gentlemen: Enclosed please find a copy of a survey of the above referenced property with proposed second story additions indicated. All proposed activity is >100' landward of AHW and is limited to the second story. Kindly provide me with a letter of jurisdictional determination. Thank you for your attention to this matter. ,-.'--. Very truly yours, -~ 1fB) œ (G ~ n WI œ lñJ IIlJi SEP 23 "'03 ~, atherine A. Mesiano Enclosure Southold Town Board 01 Trustees rö)~(cIE~wrerm lfù SEP 1 6 2003 lW Sauthold Town Board 01 Trustees . . Albert J. Krupski, President James King, Vice·President Henry Smith Artie Foster Ken Poliwoda 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 June 22, 2000 Mr. Glenn E. Just J.M.O. Environmental Consulting Services P.O. Box 447 Quogue, NY 11959-0447 Re: GERARD BELLESHEIM SCTMU5-3-9 Dear Mr. Just: The following action was taken at the Southold Town Board of Trustees Meeting held on Wednesday, June 21, 2000: RESOLVED, that the Southold Town Board of Trustees grant the request for an Amendment to Permit *4904 for the construction of a 6'X 6' platform and 3'X 15' stairs for beach access. This is not an approval from any other agency. If you have any questions, please call our office at 765-1892. Sincerely, ~0 /~~.~. Albert J. Krupski, Jr. President, Board of Trustees AJK: lms cc: DEC . ' . . ~~M 2: I 2000 >f-IOA MeN 'enßol1t) sea/illeS ßumt7SuoQ ¡eJuewuoJ/llu3 'UJ'V r ----.....-- ? -JU Z J]JHS 3; I « 3: ...J « z o '- I- U W U) , \ (j) N ~\ '¢ '\ / / ,j' \ ~l.L. wL1. °3 LIro \J) ~ " ~.2 ts It Q; I- 0.. :J ~5 0...J 0.. 0. f- Œl I f ! § E . ,p I )-"d -'C .... ,go~ 0._ Co<C~ ~<ñZ . '" \DC,)>: '" (..)- - g § (..) g-BG ~g;~ 0..00 u~æ o r.8 ;:: - if! '" '" I ).!::! .¿ ",ó3_ o t;; 0 ê'o -5 .... on ;:: p,.- 0 ....,xC/) æ ~I) 'õ (..) ~~ ~ ~~~ 2 ~ '1 -" " ;" J I / ,. .. ( . -._.-.----. -_.~--- - 5 'C o .¿ <:; "'0 .. ....I ) - .I )- ~ ~, ~c:r ~::: :>rI)~ I )I ) ?'oo - '- Cf. ~ 1('1") ->t:n;>tr) Q)"'C ~ o~" C!¡s::8...¡ ,g; "t:I5<:t:-8-:- ~VJ..c:50"," I )N (..) 1<1-0 C)N g; p,.O~ .. - C!¡ p,.Z· "Ei:i..<C"""~ '" 0 I ) ....". :&.~ ~ i b ~ ~j~oCl)j W ...J « u if) ~ o w U:: . -º~ x&::..J llJ<>:ro , N \,.. . 'If/U07:'---?~ ,:§ ~. ':::0 -::;;, o . "" "'= 'ð ", ~. ~ . EUZABETH A. NEVILLE TOWN CLERK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765~1823 Telephone (516) 765-1800 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR PUBLIC ACCESS TO RECORDS INSTRUCTIONS: Please complete Section I of this form and give to Town Clerk's Office (agency Freedom of Information Officer), One copy will be returned to you in response to your request, or as an interim response. -- - - SECTION I. To:_Tru&k.¿s (Department or Officer, if known, that has the information you are requesting.) RECORD YOU WISH TO INSPECT: (Describe the record sought. If possible, supply date, file title, tax map number, and any other pertinent information.) . Mwv-l-r ñ éc ~ '''- k[ ?,¿rc~cc y; v~ unci"" ~nn' mö~ / .:+rc-<. fY)oThræv . D6Y¡~b t- -Hc::r rr ;¿r=r=do-..n2.~~ C~'jb'<lJ i=bulos, + (.,-c::..-aY'cI Ii. B...rle....he;/h Sign'ature of Applicant: ø~~.A-- ' Pri nted Name: ::P A--r12-lC r"'\ C. fY) DO r2..E Address: fJ¡02-0 m4//V /2.0 / 60t./T7-r'rX..:> Mailing Address (if different from above): Telephone Number: 7(p 5'- </330 Date: /1 / Ý /7' f{ - - [ ] APPROVED [ ] APPROVED WITH DELAY" ~~idlt2 r)e¡~~U Elizabeth A. Neville Freedom of Information, Officer [ ] DENIED" q~C~IVI :''' NOV 4 1998 (U~~I k ::RIuthúld " If delayed or denied see reverse side for explanation. . . Telephone (516) 765-1892 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 Advisory Council held Tuesday, June 13, 2000, the following recommendation was made: Moved by Abby Cochran, seconded by Jaclyn VanBourgondien, it was RESOLVED to recommend to the Southold Town Board of Trustees AFPROV AL of the Amendment Request of GERARD H. BELLESHEIM 15-3-9 to Amend Permit #4904 for the construction of a 6'X 6' platform and 3'X 15' stairs for beach access, 122 Soundview Rd., Orient Vote of Council: Ayes: All Motion Carried · ,.t.:':':3/99 , 12:19 FAX 518 485 7714 ~YSDEC 1ßJ UUl -í^,L.tSTé:ES ~IŒ.I~':ÌJI ~ -.. ~ John P. Cahill COmrni5Eiioner New York State Department of Environmental Conservation Office of Hearings and Mediation Services. Room 423 50 Wolf Road, Albany, New York 12233-1550 Phone: (518) 457-3468 FAX: (518) 485-7714 ,n" 2 ~ ','"Q'v9n ",.:;..: '~j J iJ June 23. 1999 Town Clerk lTown of Southold P.O. Box 1179 Southold. New York 11971 Re: Gerard Bellesheim DEC Application No. 1-4738-00704/D0004 Dear Sir or Madam: Enclosed please find a notice about the cancellation of the hearing on the Tidal Wetlands permit application submitted by Gerard Bellesheim. Please post this at the Town Hall for the information of anyone who might be looking for the hearing in response to the hearing notice which was published in the newspaper several weeks ago. Thank you for your help with this. Yours truly, s..ð~ ð' ~ Susan J. DuBois Administrative Law Judge Encl. Web Sile: http://www.dec.sroze.rry.us/ohms E-Mail: sjdubou@gw.dec.slalv.Y.us r:6/2J/99 12:19 FAX 518 485 7714 "YSDEC i4I 002 .. ' -, . NOTICE The hearing on the application of Gerard H Bellesheim, for a Tidal Wetlands Pemùt fÌ'om the NYS Department ofEnviroIlII\ental Conservation, is canceled. The hearing was scheduled for June 24, 1999 at 10:00 A-M at the Soutb.old Town Hall. Mr. Bellesheím had requested a hearing on the Department's denial of his permit application. Following further discussion between the Department Staff and representatives of the Applicant, a permit was issued and Mr, Bellesheirn's anomey withdrew the request for a hearing. For additional infOlmation, please contact Margaret Rorke, NYS DEC Region 1, Building 40, SUNY Campus, Stony Brook, NY 11790-2356 (516-444-0362) or Susan J. DuBois, Administrative Law Judge, NYS DEC Office of Hearings and Mediation Services, 50 Wolf Road, Albany, NY 12233-1550 (518-457-3468). The application is DEC Project No. 1-4738-00704/00004. ...----- c?G">- ~ f=>,.:g ~ ==: o v> ð ...., o§ CJ)X.... g ....'0 S-~a 0"''0 ........0 po e. ~ CJ)~'" s::: Õ' g :;¡....ð 00-0 ¡;¡::~~ (')ð!:t O::r~ s::: '" ð ::s ð .... ~ð '" " ~ 0\ Z'" 0 . X r1> ~>-~ ~....'O 0°.... ~~. g, . ::s 0 .r+ª Ç)'- OVlo cs: ::þ'n ~ ~ OO('H~!'! ~ (J'1 cc' N .. C f71(J) ~ '- - ::þ'Ur fTI Z~.~Z C n' -i0- < ... n ~ _ -...¡::þ0 2 N -VI):> 2 .XI N'U . r1 0 01'1 Z ~ 0 ~'U- ~ ,2 -i . 2 ::ÞO ù> .. 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H10IM o N (J ()\ (') (J í) 0 1.:J ---" '-' ,Nvl\' 7 _, 9NOl ~ ·' . ~ ..... ...". New Yor!< State Department of Environmental Conservation Building 40 - SUNY, Stony Brook, New York 11790·2356 Phone (516) 444-0270 Fax # (516) 444-0297 rr~, r, Œ ((~-~. W rn 1 rñì II [\" JUL 2 0 I9'l> æJ : '¡ , ; '''~:-;:'F 9QUT~O~J2, uly 14, 1995 Michael D .Zagata Commissioner NOTICE OF PERI\HT DENIAL Mr. Gerard Bellesheim ì":;' Park A'v'è. Bromville, NY 10708 RE: Application # 1-4'738-00704/00003-0 Dear Mr. Bellesheim: We have carefully reviewed your proposal to construct 100 linear feet of timber bulkhead incorporating into the design the large natural boulder located on the beach. The following is our determination. BaseJ upon our analysis ar:d a recent field investigation, we have found thar the timber bulkhead does not meet the standards for permit issuance pursuant to 6NYCRR Part 6ó1.9(c)(3). Specifically. your proposal will have an undue adverse impact on the present and potential value of the adjacent tidal wetlands and will also adversely impact your neighbor's properties to the east and west. It was our recommendation to you to either go forward with the bluff toe protecÜon authorized under permit # 1-4738-00704/00001-0 which was issued to you on May 10, 1994, or [0 re::iesigll your current propo:;oil to construct a reck rcvet.~ent. Eith~r of ~hes~ t\V0 alternatives wculd provide the needed toe protection to your bluff and would not adversely effect the tidal wetlands or your neighbor's properties. During a recent phone conversaricn you said you would nor accepr either alternative. Since you propcsal does not conform to the requirements of 6NYCRR Part 661 (Tidal Wetland Land Use Regulations), the permit is hereby denied. This permit denial is made without prejudice and is based upon the current configuration of your proposal and the current conditions at your site. You may resubmit your application for the construction of a rock revetment and it will be reconsidered. " ... . Please be advised. 6NYCRR Section 621.7(f) provides"t an applicammay request a public hearing if the permit is denied or contains conditions which are unacceptable to them. Any such request must be made within 30 calendar days of the date of the mailing of the notice of denial and should be addressed to the Regional Permit Administrator at the above address. Please direct any questions to myself at (516) 444-0270. Sincerely. ("71"--· _ {", --¡:- ~....----.", µ',-,,-~~, -- Charles T. Hamilton Deputy Regional Permit Administrator cc: I.H. Geideman Legal Affairs DRS BMHP Southold Trustees . . , I AUt; 2 5 19:)5 . ! I ...._, tIJ)wprO¡:·~VJMJil·I-:..J , ~ 'VI IJ I LD' Town Hall. <>;:S:U;;J.) '~::!j P.O. Box 1179 Southold. New York 11971 Telephone (516) 765-1801 - SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Thursday, August 2~, 1995 the following action was taken: No. 1291 Moved by Bruce Loucka, seconded by Stephen Angell, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Wetland Application of GERARD H. BEllESHEIM 15-3-9 to construct 100' of bulkhead (as per plan). The CAC recommends disapproval as submitted. The Council suggests a rock revetment as per the DEC letter of July 1~, 1995 or bury the bulkhead as per Trustees' policy for bulkheads on the Sound. 122 Sound View Drive, Orient Vote of Council: Ayes: All Motion carried. T\.;::-:::1J;_X:~C~.Y l. ~ . ~:TAT:: 1J:.\L Ll'..~ìTY or: :'TE\':"l YORK t"r:~;., \' T3:l(~::')';,:, ~';:\'l ·~·i-;·:':T( 11790-2356 . L:~.~]n"J ET);}.;);:::G 40 e ~ New York State Department of Environmental ConselVatlon S~(Ç Id Îou.", ()cavJl ;:;f,"i' rv,,'\-e'<'" J 1c<'-c)f\ \-Iu(!!; po ,2,(,(-))171 5::,u'-\'\., 0 f IL· ¡I'-J '1 1,17 ( A-+¡,,\, S\:C<f<~ (O(Q~l"'~(\)' rn "( J,/f13 Œ&ŒUWœFñ) - 8 '9931~1 Thom.. C. Jorllng Commla.loner Dear S'ç: G-lè CQX9"c'L~r: RE: TOWN OF SOUTHOl 0 LEAD AGENCY COORDINATION REQUES I ' ' . The purpose of this request is to determine under Article 8 (State Environ- mental Quality Review - SEQR) of the Environmental Conservation Law and 6 NYCRR Part 617 the following: 1. Your agency's interest in acting as lead agency; 2. Your agency's jurisdiction in the action described below; and 3. Issues of concern which your agency believes should be evaluated. Enclosed is a copy of the permit application and a completed Part 1 of the Environmental Assessment Form to assist you in responding. Project Name: Ger'aJ'd ¡{ ße JI es¡'(',,,~ Project . c· d < o,,~A ¿Y,¿d ¡/9I7 Locatlon: (22 -'Dc/I Vlrl..'- /Lt/(fI(Y, , T~ 50v'-(/..o lei, Jf...1 Uäk (01.."·' Jé7 SctVlt1 IOCC"- ¡J-' 3'1 DEC Project Number: 1- 4 7.~J'·-()()70'l/()O(.'C, j-Ù DEC Permits:-ltJo! cvr/flo'1c/¡' SEQR Classification: [] Type I IX1 Unlis DEC Contact Person: 1/ A 1I'1'UJI ' no)' I"n ft(....,dr \ ,/ / _/-01 I / '- L! DEC Position: [] DEC has no objection to your agency or another agency assuming lead agency status for this action, but reserves the right to comment on this action if a positive determination of significance is made. ~T 1-PROJECT INFORMATlO~ Prepared by Project Sponsor NOTICE This document is designed to assist in determining whether the action proposed may have a significant effect on the environment, Please complete the entire form, Parts A through E, Answers to these questions will be considered as part of the application for approval and may be subject to further verification and public review, Provide any additional information you believe will be needed to complete Parts 2 and 3, It is expected that completion of the full EAF will be dependent on information currently available and will not involve new studies, research or investigation. If information requiring such additional work is unavailable, so indicate and specify each instance NAME OF ACTION 'Rc Ë 'ß)..,L.\FF LOCATION OF ACTION (Include Street Address, Municipality and County) J...~ 50'-""1'-\1':> V \-==- \ ^ NAME OF APPLlCA~T¡SPONSOR 2..A-Tt+A:'^" SAN y(.A-vEL T N'- :):'N <-- SL"F',= BUSINESS TELEPHONE (;"/") 3:2..;)-'J.~ ADDRESS 0· r?:. ù'x 'ìì" <,£, Ì) "Z'L-L-eS ADDRESS 'i y,ctv~ K Av E CITY/PO '6/l...ôNY-. ulL.L¡-== DESCRIPTION OF ACTION '«-,,-\,00-"" 5~ ~ do-~c.\.d<L ~ b! lA.-G-Ç. -¡>kL€_ Ltc<:) c....~ "Ids cÆe.o-..~ ~II -%0'''''' '-'-fi",-~~ :So,"^-.ne --(&,¡- s-+CC.b11''''-0-'t-",,", Y\.e-f/<AL(L., Y'^15SINC- %"'t-",-,r-" ~""'" 1",-""",, ¿¡¿clk.. "'" bQOo-~L.. Cð...f>f"-O,,", )0'). A-)'~"" yo :J.'~\ 5~~ Ð~ ..ç,tt4..,/' c:/,,~ OcIO""~d bc...s"'- ð-il- 101,,,,--ÇÇ ,,^,"\ ZIP CODE /0)ð !S""' Please Complete Each Question-Indicate N.A. if not applicable A. Site Description Physical setting of overall project, both developed and undeveloped areas.~ 1 Present land use: DUrban Dlndustrial DCommercial Œ!1<esidential (suburban) DForest DAgriculture DOther 2. Total acreage of project area: Lis,S "''''' '/"1 acres. , APPROXIMATE ACREAGE Meadow or Brushland (Non·agricultural) Forested Agricultural (Includes orchards, cropland, pasture, etc.) Wetland (Freshwater or tidal as per Articles 24, 25 of ECL) Water Surface Area Unvegetated (Rock, earth or fill) Roads, buildings and other paved surfaces Other (Indicate type) DRural (non-farm) PRESENTL Y Û acres o ð AFTER COMPLETION o acres o D acres acres acres acres acres acres o acres !...<:.~-> ........,.... ' ·'!gv €odc- T"i'''9-acres / Ò acres é) !.->2."'$ ì>--.<--_ 'Ie o acres acres acres acres acres 3 What is predominant soil type(s) on project site? L. c """"Î 1. 5' A- N " a Soil drainage: ,eWel1 drained % of site DModerately well drained % of site ':":~oorly drainèd ¡ f'R.j % of site b, If any agricultural land is involved, how many acres of soil are classified within soil group 1 through 4 of the NYS Land Classification System? N /.0. acres, (See 1 NYCRR 370), I 4. Are there bedrock outcroppings on project site? DYes ~o a What is depth to bedrock? (in feet) 2 ~. How'much natural material (ie, roc~arth, etc.) will be removed from the site' 1'\0_ <!.. tons/cubic yar~:; 3, Will disturbed areas be reclaimed? DYes DNo o.N1A a If yes. for what intended purpose is the site being reclaimed? b, Will topsoil be stockpiled for reclamation? DYes DNo c. Will upper subsoil be stockpiled for reclamation? DYes DNo 4, How many acres of vegetation (trees, shrubs, ground covers) will be removed from site' D acres, 5, Will any. mature f~st (over 100 years old) or other locally-important vegetation be removed by this project' DYes i31'40 6, If single phase project: Anticipated period of construction 7, If multi-phased: a. Total number of phases anticipated ,'J- (number). b. Anticipated date of commencement phase 1 J ~\~ month c. Approximate completion date of final phase ~ 1 month or d. Is phase 1 functionally dependent on subsequent phases' 8, Will blasting occur during construction? DYes ~o 9, Number of jobs generated, during construction :J.... months. (including demolition), 1"1"\.3 19 '\ ~ DNo year, (including demolition). year. 12!Yes ; after project is complete 10, Number of jobs eliminated by this project 11, Will project require relocation of any projects or facilities' DYes ~o If yes. explain 12. Is surface liquid waste disposal involved? DYes ~o a, If yes, indicate type of waste (sewage. industrial, etc.) and amount b. Name of water body into which effluent will be discharged 13. Is subsurface liquid waste disposal involved? DYes }3(No Type 14, Will surface area of an existing water body increase or decrease by proposal? DYes ØNo Explain 15. Is project or any portion of project located in a 100 year flood plain? E(Yes DNo 16. Will the project generate solid waste? DYes ~o a. If yes, what is the amount per month tons b, If yes, will an existing solid waste facility be used? DYes DNo c. If yes, give name location d. Will any wastes not go into a sewage disposal system or into a sanitary landfill? e, If Yes, explain DYes DNo 17, Will the project involve the disposal of solid waste? a, If yes. what is the anticipated rate of disposal? b, If yes. what is the anticipated site life? DYes *0 tons/month. years. 18, Will project use herbicides or pesticides' DYes ~o ~o 19, Will project routinely produce odors (more than one hour per day)' DYes 20, Will project produce operating noise exceeding the local ambient noise levels? }00 DYes ~o 21. Will project result in an If yes. indicate typeCs) increase in energy use? DYes . .... 22, If water supply is from wells, indicate pumping capacity gallons/minute. 23. Total anticipate.d water usage per day Does project involve Local, State or Federal funding? If Yes, explain gallons/day, DYes þ 24. 4 e - 9')-193 fS189J~7e NEW YORK STATE D£PARTMENT OF [NY D[e APPUCATlON NUMBER !MENTA' CONSERVATION JOINT APPLICATION FOR PERMIT II S ARMY CORn Of fNCINfERS APPlICATION NO Please read All instructions on back before completing Ihis application Please typ~ or print de,lilv in íllk. AHillh ildditional information as needed DARIIClE 9, TITlE 1, ARTiClE 4] 6NYCRR 646 (lAKE GEORGE RECREATION lONE) DARTlCLI: 15, TITLE] {AQUATIC PESTICIOES CONTROl} 06NYCRR 327 (AQUATIC VEGETATION) Dt.NYCRR 328 (1"1511) []6NYCRR 32'J(IN$EC1S¡ DARTlCL( 15, TITLE S bNY(RR 608 (PROHCTION OF WATERS) o For the construction, reconstruction, or repair of a DAM or other impoundment structure Drar the distu;bance of a STREAM BED OR BANKS or ex<:avc1tion in or fill of NAVIGABLE WATERS 0401 WATER QUALIfY CERTIFICATION OARTICU 15, TI....IE 15 06NYCRR 601 (WATER SUprlY) D6NYCRR 602 (lONG ISlAND WHI) OARTlCLE n, TITLE 27 6NYCRR 666 (WilD, SUNIC AND RfCRFATlONAl RIVERS) DARTlClf 24 6NYCRR C¿2, 66] (fRESHWMER WETlANDS) fJiARTlCLE 25 6NYCRR b61 (!lOAl WETlANDS) OARTlCU J4 6NYCRR 50S (COASTAl EROSION) ------------------------------ ------------ ---------------------------------------- OSECTlON 10 (RIVER AND HARBOR ACT OF 1699) for sllUclures and work in navigable waters of Ihe U,S DCOASTAt CONSISTENCY CERTIFICATION DSECTlON 40", {ClEAN WAlER ACT or 1977} lor disposal of dredged or Iillmaterial in walers of tlll~ lJ_S DSECTlON 10) (MARINE PROTECTION, RESEARCH AND SANCTUARIES ACT) lor the trarnportalion of dred"ed materials for dumping into ocean walers LIST PREVIOUS PERMIT/APPLICATION NUMBERS AND DATES (If any) 2 ArrUCANT IS AlAN [llOwner DOper ator Olessee o Municipality/Governmental Agency (Check as many as apply) NAME Of APrtlCANT (Use rull Name) Gerard H. Bel1esheim .. NAME OF DOwner Latham Sand I!J Agl.'nl/Col1lact PerSon & Gravel, Inc, MAILING ADDRESS 74 Park Avenue POST OFFICE BronxviIle, (Check one) MAiliNG ADOIHSS P.O. Box 776 POST OFFICE Orient . 5 PROJECT/FACILITY tPCATION (Mark location on map, see Number 1a on reverse side) County Suffolk I Town or cily Southold STREET ADDRESS ((f different from applicant) 122 Soundview Road po~ T OFF ICE Orient I Village Orient b N^ME OF STREAM OR BODY Of WATER ZIP CODE 11957 Long Island Sound HAS WORK BEGUN ON PRO/Fcn Dy" ŒJNo If YES, attach eXIJlanation on starling work without permit, include dates Show work on map andlor drawings 8 WIU PROJECT UTIUZE STATE lANDl DYes [;a No <) PROPOSED USE: o Public kJ Private D Commercial 10 PROPOSED STARTING DATE: 11 APPROXIMATE COMPLETION DATE: 12. FEE OF (NYS Permit Only) March 1993 A ril 1993 s Endosed 13 PROJECT DESCRIPTION: (e.g. quantity and type of material to be excavated, dredged or used for fill or rip rap, location of disposal sites; type of stfucture 10 be installed; height of dam; size of impoundenl; capacities 01 proposed water sources; exlent of distribution system; ete) Requesting Emergency Permit for Repair of Storm Damage to Bluff. Property in danger of cesspools being exposed or destroyed in another storm. Request permissio to ring n 400 cds. of cl an fi 1 ro land source 0 tabi i buff. Also 14 kJ Yes 0 No If yes, please list: Southold Town Trustees bIt 15. CERTIfiCATION: I hereby affirmlhat under penali1y of perjury that information provided on Il1is form and all attachments submitted herewith is true 10 the best of my knowledlJ[e and belief False stalemenls'Í~ade herein are punishable as a Class A misdemeanor pursuailtto Section 21045 of the Penal Law Further, Ihe applicant accepts full responsibility for all damage, direct or indirect, of whåtever nature, and by whomever suffered. arising out of the projNt described herein and agrees 10 indemnify and save harmless the Slate from suits, actions. damages and costs of every name and descriplion resulting from said projec.!. In addition. Federal law. 18 Us.e. Section 1001 provides for a fine of not more Ihan S10,OOO or imprisonrl1ent for not more Ihdn five yeArs, or bOlh, where an applicant knowingly and willfully falsifies, conceals. or covers up a malerial fact; or knowingly makes or uses a false, ficlilous or fraudulent stdlemenl ~ I hereby aulhorize Ihe agenl named in Number 4. above to ~ubmil this application on my behalf. ~~7~rqi;;~ion form attache~_~, y_~~ -r-----oA'TT ~~ ~._.l""ìk"..,"\S:"..ó-", G«"'I }-4 TITlE PLEASE READ At l. INSTRUCTIONS ON REVERSE SIDE Dr:-QUIT ð.nMII\.II~TRA TnR LONG ISLAND SOUND ~FLOOD E.aO~ WIDTH>I MILE .,. "," BEACH , PROP. AR~ORED BOO· PROP FILL EJ z z a 2. SI'( ~ sro z N 'J IE'll ROAD SO\J~D ~ \ .¿; ct: HI Z C§ ~ o ã: ,. . ¡ \..w VI REC'f.NTLY APffiOVED BULKHEAD OE OF LoCAT ION I3LUFJ; Suffolk County H'agstrom Map 32 Scale 1 "=3,000' i B~~tIU\"I\T OF DISTURBANCE Applicant proposes to construct L 100' of timber bulkhead with a 10'return on the west property line. Armor with 1-2 ton stone. Backfill with ~ 35 c.y. of clean sand from an upland Source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to the east. At Long Island Sound. Orient, Town of Southold, Suffolk County, New York. Applicant: Gerard Bellesheim Location: 122 SoundView Road, Orient Purpose: Erosion Control Locus: ~·15' 41·09' 30. S.C.T.M.No. 1000-18-3.9 SC'*LE, " I~'.' ~:'_i, ;~~~;,¡ ,!', . ' 5 E." .Y .' · " ,.-, SE I NO SCALE ,/ " POOP FILL :!35C:f. CLEAN SAND FROM UPLAND SOURCe:. ~ A RMQR . ) 2.0' AHWH' A 0 TOP OF BWFF PItCP BlKO TOE CF BLUFF Applicant proposes to construct 100' of timber bulkhead with a 10' return on the west property line. Armor with 1-2 ton stone. Backfill with 35 c.y. of clean sand from an upland source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to the east. At Long Island Sound, Orient, Town of Southo1d, Suffolk County, New York. Applicant: Gerard Bellesheim Purpose: Erosion Control Location: 122 Soundview Road, Orient Locus: ~2~ IS' 41° 09' 30" S.C.T.M.No. 1000-15-3-9 \ f Sf-lEEr ] OF 3 J MO CONSULTING QUOGUE) NY 653-0YJl ..., '-~"._'-' '".,."", ,·"·"1·· "L" CA'N'··D'5DÚl'IO , -- '-"" ",',' ,''',', .".. s" _--- -". .,-- ~-",...",.~ __ LON G.___ .1-¡;-'.-UJnfe.t" L,f1t' >¡ _-- - ~ ;; ir?t1ÝV - /11, ' ,n. /00.0 ~ N-1<"OZ ~,()f. ðøach --'00 . ,,_ :sfo(1'ey , ." ,r .~ ".' ~" .- ,-/Þ GVDwfj¡ I;) ------~- ... -.. -- /"'1 ~ \1' IJtv:!!7 VI ~ ~ 1: <Sirass ~ ç.,; l PL A/\/T/NC'¡ ~ 0- "' . ~" . , " ! 20,< 40 , evIl: POOL \ If"Ms ( . '" . ", <:::I "- '"" '<::!- . t\J . I/) J 18' I·I-~ , <;:: L4~n :J.-r. z ' N1."t %.~.'6,. . ~o'DD.vJ1 '_ s·-n ' ,2._ 54!'..'" l·7~.~f s.aUND VTEW {so'l .J2òAD aronfee-d il? oc-cordonce ¿,j/fj¡ -li,t" '?WH, .5lcmc/ora'::: For hf/'p sv,-v....y ~-N.v. 5-f.aN Ù;no' -r;lIe .4ss h 7õ~ c.{ ~!cpe .¡I¡:-...... Top of) trt~rJ.nr /8 .. (;q 11 r" N/f /'.5. Qumn ,) Sea J e " 1"- 40' , . \ .\ ~.-- .MAP of PROPERTY SURVEYED fö" G'fRARb ßELLESHEIJYl af 0F21fNT Soutbojd Town /I 1\1,'1(, Juf{o IK (1" ¡(Jl)()~.Ifi - 3- '? Th¡'s "$ fo ct?"¡i{V Ihaf the c;,boye s(/rv~y Was comp/",fetl ón 1/7/$ /OJ'/¡d", ,p IVJ4 1995,. J. H. GEIDEMAN' E. MiH2 /0 r\J., L. T. ........¡.A.. .....~~Li~:~!.i~:;~ ~. Y State Lie. L.:Jnd šüï:v~·ÿo¡::......·· 'if2284Ð Date lolrj<¡J¡ -. -. ~. t1.~ I "--~'i . . ~ Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-18! 2 Fax (516) 765-1823 BOARD OF TRUSTEES: BOARD OF TOWr", TRUSTEES TOWN OF SOUTH OLD T~~ OF SOUTHOLD ----------------------------------- JUL bL. . ._" I, In the Matter of the Application of -6ero.r.ct .b\-"._ß~l\.Q..sh~.Jm. __ _____ ~~CUNT'( 0;;'" SUFFOLK) STATE OF NEW YORK) :,Gìen...... E. -:JU::'+ AFFIDAVIT OF POSTING residi~g at IJ.\ -:Séss<\e_Äve0dc./-_ __QJ-tg)~.N ,~(. bei¡¡g J.u sW0Ln, depose and say: ~W:' fv-- That ,)n the 13¡~day of ~-:M ne...,·_ ; q personally posted th.e ~·'·o·pe,·t·~· known !is 1;J.d- Sou,-:-d vieJo /2d ~Li£L2-L-_____ jy ?lacing the Beard of Trustees official poster where i~ can e:6'cly be se;,n, and that I have checked to be SllTe the pO,c,,-er '1a:.: :-eméÜned in place far seven days prÜ,r 1:0. t.he date '~f the Fciblic hearing. ~date of hear.ing no':edthereon to be hel'i.Jl.nc!.~I,~ ~...o:c.!\b ()J:t- '7 ~OO ø", . ~_.__."------- Da~Ç:d: l"i!J1J:,'~<~ Sworn to before me this 3c> day of ~ù,,,,t ~ ;;¿ó1f'O N~'C~ MARY E. MAKI Notary Public, State of New Yo k No. 4982813 r Qua/ifie,d in Suffolk CouQty Expires June 10, 20<2L- · .. J.M.O. Environmental Consulting Services May 23, 2000 Mr. Albert 1. Krupski, President Southold Town Trustees P.O. Box I 179 Southold, NY 11971-1179 p~-~, ¡: ~---r - ¡; It¡; l:;,:; iii' I ".:r c" ' I" 1 i IT~ t MAY ~_I 3m RE: Permit ID No. 4904 Bellesheim, 122 Soundview Road, Orient S.C.T.M.No. 1000-15-03-09 Dear Mr. Krupski: At this time, we are reqllesting to modify this permit (copy enclosed) which was issued on 4/27/98. The requested modification is to allow for the construction of a 6'x 6' platform and a 3'x 15' stairs for beach access. For your review, we have enclosed copies of the modified plans and a cross section. As always, should YOll have any questions regarding this matter, please feel free to contact our office. ()L::"£11~ 'chenn E. £si GEJ;arh L f\.Jr-ec Cori r)\. I (1,Ttk,à_ Phone (631:> 653-0607 . Fax (6:3 ]) 653-3348 121 Jessup Ave. 2nd Fioor . P,O Box 447 QuoDcJe, New York 11959-0447 . 'ì--:;:t::'.:::-:.--,:-~~'-. 'fi' ,II~ ~", ,I"'-c: ~.\ .=> .-<. 'I Q . ~ ", "" ::!: ,I, 'i....... ~l' :\ (:::'.. ~~,: ""~ ~'t-,., ~Q./ ... i-~ ,elr '~":I" .,;ù- _'~.., .....,_":.1,- ............,.... . Albert J. Kmpski. President John Holzapfel. Vice President Jim King Martin II. Garrell Peter Wenezel Town Hall 53095 Main Road P.O, Bm 1179 SOllthold. New York 1197\ Telephone (516) 765·1892 Fax (.5\6) 76.5-1823 .' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use only ~oastal Erosion Permit Applicati Wetland Permit Application =:=Grandfather Permit Application Waiver/Amendment/Changes ~eceived Application: 3 -'M~ __~ceived Fee:$ I~Ð. ~ompleted Application Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ---- CAC Referral Sent: q -I-"'W Date of Inspection: ~~!tf Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: 4~~~ Resolution: D rn © JL!l W ._Œ ,I ~ì ¡ L~3 1 œ< :! IQVGi OF ::;,i_, i).', ~a MAR 3 I 1998 Name of Applicant Gerard II. Be11esheim Address 74 Park Avenue, Bronxvi11e, N.Y. 10708 Phone Number: (914 ) 337-3686 Suffolk County Tax Map Number: 1000 _ 15-3-9 Property Location: 122 SoundView Road, Orient , (provide LILCO Pole *, distance to cross streets, and location) AGENT: J.M.O. Consulting (If applicable) Address: P.O. Box 447, QuoSUe, N.Y. 11959-0447 Phone: 653-0607 FAX': b)j-j,j4ð I, I' 1 " ~ \J '. ~il"";' ttard of Trustees APPlicatiJIÞ . ".'-^ .;.. ~ C..\' . " ',(. Land Area (in square feet): GENERAL DATA + 26,000 Area Zoning: R-? Previous use of property: Existing single family dwelling Intended use of property: same ,> Prior permits/approvals for site improvements: Agency Date x No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): ApplicanF proposes to construct +100' of timber bulkhead with a 10' return on the west property line. Armor with 1-2 ton stone. Backfill with +35 c.y. of clean sand from an upland source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to the east. 2 4Ibrd of Trustees APplicati~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Erosion control Area of wetlands on lot: o square feet Percent coverage of lot: nla ~ o Closest distance between nearest existing structure and upland edge of wetlands: +82 feet Closest distance between nearest proposed structure and upland edge of wetlands: +42 feet Does the project involve excavation or filling? No x Yes If yes, how much material will be excavated? o cubic yards How much material will be filled? +35 cubic yards Depth of which material will be removed or deposited: 4 feet Proposed slope throughout the area of operations: 1:3 Manner in which material will be removed or deposited: Payloader 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): 3 :r 'f /. ../. ,', ¡ -..",.".., .:.::,,:~, ',,-,, BO~d of Trustees Application 4IÞ '¡' COASTAL EROSION APPLICATION DATA Purposes of propos"'" "ctivity: Erosiòn control Are wetlands present within 75 feet of the proposed activity? No x Yes " Does the project involve excavation or filling? No x Yes If Yes, how much material will be excavated? o (cubic yards) (cubic yards) How much material will be filled? +35 Manner in which material will be removed or deposited: Pay loader Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attacl~ents if necessary) Should be no environmental impacts '" / 4 -,--- . . . - ^:""..-~-:' ;.... 14.16.'4 (1ii9!5)-.:reh 12 I PROJECT I.D, NUMBER :;. " ~. .,',"'" -," 617.20 Appendix C State Envlronment.1 Quality Review SHORTEN~RONMENTALASSESSMENTFORM For UNLISTED ACTIONS Only PART I-PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEQR 1. APPLICANT ISPONSOR ~ Þ 2. PROJECT NAME J.M.O. Consulting for Gerard H. Bell sheiml/ Bulkhead construction 3, PROJECT tOeA nON: Municipality Orient County Suffolk 4. PRECISE lOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) 122 Soundview Road, Orient Location map & survey enclosed S.C.T.M,No. 1000-15-3-9 5. 15 fG:~ED ACTION: w 0 Expansion o ModiflcationlalteratJon 6. DESCRIBE PROJECT BRIEFLY: Please see attached 7. AMOUNT OF LAND AFFECTED: Initially _ 0 acres Ultimately 0 acres 8, WfJ PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes D No If No, describe briefly 9. ~T IS PRESENT LAND USE IN VICINITY OF PROJECT? Resldenlial 0 Industrial 0 Commercial o Agriculture o ParklForestlOpen space DOlh., Describe: 10, DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ~es 0 No If yes, list agency(s) and permlllapprova s Southold Town Trustees 11, DOES ANY:tfi..ECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? o Yes No ~f yes, Jlsl agency name and permit/approval 12, AS A RESULT ~ROPOSEO ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? DYes 0 I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE App lcantfsponsor name: _7J};n ;J /~0-~ agent Dale: ~/::u/~i Signature: ¿;/ " 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 . . PROJECT DESCRIPTION Applicant proposes to construct i 100' of timber bulkhead with a 10' return on the west property line. Armor with 1-2 ton stone. Backfill with i 35 c.y. of clean sand from an upland source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to the east. . . .---/ APPLtCANT TRANSACTIONAL ÐISCLOSURE FORM The Town of Soubhold's Code of Ebhics prohibibs contlicbs of interesb on the part of town officers and employees. The Qur ose of bhis form is bo rovide informabion which can alert the town of poss ble conflicbs of interest and allow It to take whatever action is necessary to avoid same. , , ," TOUR NAHE. (j knn E . J liSt (Last name, first name, midd~e i~itial, unless you are applying in the name of someone elee or other entity, such as a company, If so, indicate the other person's or company's name.) NATURE OF APPL1CAT10NI (Check all that apply.) 'tax grievance Vàrhncé Chaltgg of Itong ^p.p~Gval of plat Exe~ption from p other (If ·other,· name . r ufficial map no you personally (or I:hrough your cU*'panr, npout..!, ttl.blin!J. parent, or child) hnve a relatlonnhlp with nny officer or employee of the 1'own of Southold? -Relntlonship- includes by blood, marriage, or businens in"erent·. -business interee"- Rleano a business, Including a par"nernhip, in which "he town officer or employee has even a par"ial ownership of (or employmen" by) a corpora"lon In which "he "own officer or employee owno more "han 5% of "he ohares. NO -+- YES If you ann_ered -IES," comp1ebe .he bälaltce bt bhtø lorm and da"e and sign where indica"ed. Name of person employed by the Town of SoUl:ltold ~ Title or position of I:hat person Describe tlte relationship between yoursell (bhe applicant) and the town officer or employee. Either check I:ha appropriate line A) through D) and/or describe in the npace provided. The town officer or employee ot hin or her spoune, sibling, parent. or child is (check all thaI: apply). A) I:he owner of greater than 5% of the shares of the corporate stock of the applic~nt (when the applicant is a corporation), B) the legal or b~neficial owner of any interesl: in a noncorporabe'en"ity (when the applicant ie nol: a corporation) , C) an officer, director, partner, or empluyee ot bhe applicant, or D) the actual applicsnt. ~~ : J.m9 CONSUlTING ¡,¡....,... "ó' . PHONE NO. : 653 0607 . Oct. 22 1997 10:4~ PØ3 .. , Board of TrU$tees Application County of ~:f~~ State ot Rew York ~¡¿4I(.Ò ;1. f.JiM. A ,¿E(L£,f///Z...t'^ BEING r¡ULY 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 '1'0 HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES ~~LESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING TIllS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJ~CTION ,,WITH REVI~ OF THIS APPLICATION. ¡ ~~â. d~ :,q~~,'" ~ Signature SWORN TO BEFORE ME THIS ó2 -:r ~ DAY OF 0 <:.h bo.A4.. ~ ,19'-" e!J , " OAneMA ftlTTr~ftG Nollry p~. tIMe 0' New VOIII /0/(1. 01RI4e70444 , J ""~1Ieð In lIk.i.,..", CO!IJIIJ ^, " eonvni'lion Cx¡¡k.. Aug. 31, ~ ", ,~, 7 FROM : JmO CONSULTING "ì;" ...-.-., " /: . PHONE NO. : 653 0607 . ~oard of Trustees Application , Oct. 22 1997 10:4ØAM P04 ,. ^UTHO~IZATION (where the applic.nt is not the owner) I, (;p:~R../) }-/, .ßeLLEJ.HéfA (pr nt owner of property) J"JYW. CDnSI1 Lh'J~ at~~¡(¿/~{jrc- ߯.DN)(Ù¡'L(L , (ma 1 ng a ress) ;Or )0)0/' G (ent) Ë ,J/.fS t / residing ¡ , i ¡do hereby authorize ! to apply for permit(s) from the (,Agent) Southold Board of Town Trustees on my behalf. '- " o . . . LONG ISLAND SOUND ~FLOOD EFð~~ WIDTH).I MILE . ~ :ßløl'lð 5C\.\....ø. '1~"IS' ~"O" ------^LW ...:.----- BEACH EJ z z a 2. 51'< ..!¿:, 5yD z N "IE'll ROAD sou~D J 'q~ ONME CONSU VI REC~NTLY APAROVED ./ BULKHEAD ~ OE OF LOCAT ION I3LUFI= Suffolk County H'agstrom Map 32 Scale 1"=3,000' OP OF BLUFF <t: HJ Z (§ ::f o Q:' Applicant proposes to construct ±. 100' of timber bulkhead with a 10'return on the west property line. Armor with 1-2 ton stone. Backfill with ~ 35 c.y. of clean sand from an upland source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to the east. At Long Island Sound, Orient, Town of Southold, Suffolk County, New York. Applicant: Gerard Bellesheim Location: 122 SoundView Road, Orient Purpose: Erosion Control Locus: ~·15' 41°09' 30" S,C.T.M.No. 1000-15-3-9 .Y . LONG ISLAND 50UND ~FLOOD E.B04t WIDTH>' MILE .... "r; BEACH , PROP. AR~ORED BU<D· ~ PROP FILL \ ~ .... . I LW VI REC1.NTLY APPROVE.D BULKHEAD OE OF LOcAT ION 6LUH: Suffolk County H'agstrom Map 32 Scale 1....3.000.' I I 1 8~~;IU~\T OF DISTURBANCE EJ z z a Z. 51'/' 5YO < I'U Z ;:§ ~ .Q. a. ...b:!:. z. , "IE'll ROAD SOUNO Applicant proposes to conltruct ~ 100' of timber bulkhead with a 10'return on the west property line. Armor with 1-2 ton stone. Backfill with ~ 35 c.y. of clean sand from an upland source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to the east. At Long Island Sound, Orient, Town of Southold, Suffolk County, New York. Applicant: Gerard Bellesheim Location: 122 SoundView Road, Orient Purpose: Erosion Control Locus: ~·15' 41·09' 30. S.C.T.H.No. 1000-18-3-9 i I I. . .;.;;<t}· ';¡~J:':,;f ":""I¥ISCl1l.E ,'. " ':0(..·,'i1i.' ..~., , 1;40 , , I"-",:~-,_:\,>~,, O,.;w.;~'t!' ,~~\ -.,: ¡ .,' '.'~.,. -, , '.l· , 5 E." .Y , .."j i',iÍJ':iJ"i ','I"'~ .,'., . i~;~ i_¡J:.J"·'>; JI<....~~' ,--,,, ¡ :';..,;' . . . . . " M SE I NO SCA L E / " ProP FILL :!35 C.Y. CLEAN SAND FROM UPLAND SOURCE TOE Cf BLUFF Zo' L. ./1 AH~n/ 3Z~ -------¿A 0 BE C TOP OF BWr-F Applicant proposes to construct 100' of timber bulkhead with a la' return on the west property line. Armor with 1-2 ton stone. Backfill with 35 c.y. of clean sand from an upland source. Bulkhead shall be in line with recently approved bulkhead on adjacent property to the east. At Long Island Sound, Orient, Town of Southold, Suffolk County, New York. Applicant: Gerard Bel1esheim Purpose: Erosion Control Location: 122 Soundview Road, Orient Locus: ~2° IS' 410 09' 30" S.C.T.M.No. 1000-15-3-9 ~. , $1-1 [T ] OF 3 JMO CONSULTING QUOGUE) NY 653-ŒJ)f ...., . . ---__e_ . I S LAN 0 5D~.['J ;:,. ._~_~;: ...---_ LONG.___. .,-;-'.-lj,J>..f.t.( L,nt'''">04 ..-- --- ~.. t'v.. f1/ ¡OO.D 0'(/011J0 I 'f' C'-.. h ::::::=---- 1'1-1'/' () z' ~,O , I...løac --"- ~- 5tone'( . ;;.' r ..I ,.. r-/Þ 0Y'Þ/() fA I:) ---~~ ... -.. /'" - , · "t. <Sir-asS ~ ,\I': ( (Jrv,11 11\ ~ ~ ~ Pl AhlTINCr (I(i: S,10danjc1 . , , 20'< 40 , t3ufi pOOL '\ II"Þt!J ( , "-J . 0' <::I '" '"" ":t , . I , ,-;:;?l \',J , !.!.! \I) , ( J , ".,-.J8~ ... '" . ~" ~ L4øn ;¡"'f.z· 1>'1.,,~ ~~.,&.. '30·00·w-1 " s:77 '?_ 548.1(" l·1~.~f s.ou NO VIEW {S6'} J?ÒAD 6uar-Clnfee'd in oC'cordonce ¿J/fh fI,t" '?J/nII?J{/}?1 5lanctord!!: For f¡fle svrvt"Y {)f' ¡he-N,y: 5-1:aN LtJno' íill~ /ìss h .--...-.-. 7é~ ,01 slePt? .,4:-........... Top of.} frr~t1.nr /8 .. 8(1('" N/f /' S. QUinn () Sea Ie " 1"- 40/ , ' \ , --\,..-- MAp of PROPERTY SU12VEYE-O föR. GfRARfJ ßELLESHEIJYl af o RTf NT Southo}d Town Il N.Y. So.Jf{o(KC." /IJ/JO.-jÞ-3-t:{ Th¡'s /s 10 ct?'-¡ify Ihaf t/1e c;,boye .5vrVf>y' WaS' cOn?pJfÞfeo' ðn fl1/S /OJ'/¡d~ ,p IV)q /995 J. H. GEl DE MAN . !:,MiJ.elorv. L. T. .........A.. ...{~L~~:~ li~:;~ N. Y State Lie. Liii~d" Šür¡;:~yõ¡::"""" "'22840 Date /o/$'/rri ... --, -. tI).~ f --:-.¡ ,. " " ,'1:.: ':'~~:., ')¡, """"".' , '~1"~' '~:~':i~,;' : ~,,' ,,;,:~; {:\ t~~t:: ':"~"i' f ,~: i " " :l; ( 8 >, .; , ~t,: a .PLUM, ISLAND ROCK' ^,. ,~,~ ,'-:é;4 ~)!~:.~:^";~; . 't¡"."~'; "J:~; ~~' . K" ~\;j~, "",, .' ,! ( ~' 'Í,.' " . TRUSTEES John M. Bredemeyer, III. President' Albert J. Krupski. Jr., Vice President Henry P. Smith John B. Tuthill William G. Albertson Telephone (516) 765-1892 Fax (516) 765·1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only: Erosion Permit Application Erosion Variance Application Wetland Permit Application Waiver from Chapter 97(Application/permit) Trustee Lands Permit Application Grandfather Permit Application complet~d Apps. Da~e~ _ __ -;sJl.-" Inspectlon date: ~ o<{' f~~ ~. CAC comments-Date: sent6. ec. ~i;l rr'" ariance Required: (Y/N Neighbors no\~f~~~ale: SEQRA Type ~ __ÇPord.: Date sent ~SEQRA Determin./date: ~~Ylr~ i Public Hearing/date: /1 ¡- Findings: Approved (Y/N) Special Conditions: (Y/N) (see file) Permit(s) issued-date: . SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold. New York 11971 lfõ) œ UŒ JUN-6~ n WI œ ~ =Q':~N nF SOI.,'THot ' ." .,--.....: ,._,~.: .~"..1 JUN 6. Aþplieat:i:on,..Fee: I' , Application Number;SCTMJ!1000- /5- 3-<f Date: Applicant: J)/. ¡:5',?/deI??Cln r'.¿.5' Address: PO BD V t.,L/ ¿ , E. fi1ar/oJ? 1\,," 'f. II '73 9' Phone (f) ¿') 1/-7 7- 'U,C z/ , , Interest: (owner, consultant,lessee,etc.) (. /"!J I ú¿>rard II ßpl/e,'"'jJ,eÚn 7 <,? /:, r j;-f1vr Owner of Property: Address I3ronK¡/;jle NY' /07oÇ? Phone (91)£) 3'>73iJ?t. '" '" Subject Property Location: ..,¡o /.?Z ~I.)nd ¿/,e¿v /)" Ooén I. ,);,.u!h old. ^/ Y. C~) F~]7; J,~~;~~{(~~ (Provide LILCO Pole #, Distance to cross Streets if not on location map) THIS IS NOT A PERMIT Pag e 1 jþ. . . "'ds. to be excavated: NOh(? Yds. to be filled: ISo CU, ¡viS' Manner in which material will be removed or deposited: {o)'ll t?1'If,1 /t1cJder Width of canal, creek or bay fronting property: L, I. ~"4wr1d Depth at low tide: Aver. rise in tide: Distance to nearest channel: Distance project extends beyond similar projects in area: Area zoning: ~. Is project for private or business Land area in acres: tcJá~ f~~ I ~éi use: tf~~dß. Intended use of property: 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: k ~ Has any license or permit ever been revoked or suspended by a Governmental Agency: ,/ n...v Proiect 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 necessary). c.-n.d;~ J I (TV . c!/ I3~U ",-eI (""" J:'1-r ~-><. ,J , f / fn?ù"- ~-='";tt" d h-v..z ~F a·u' k,µ4t7..--k"i" ~.)tfÎ ~d ~.~ a2,-r<' ¿ ¿:¿'-n .r,h<..r~ C~ cdJz::i,... Íz {/ h ~.?t-d ..«"·~4 ' THIS IS NOT A PERMIT Page 2 .' \ \ I u . '....,···\&-4/2/871- Text 12 . .. I PROJECT I.D. NUMBER . 6.1 .'. SEQF - 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) 1. APPLICANT {SPONSOR Gerar¡;/ t-f 3. PROJECT lOCATION: MunicIpality (]2~.. ~ -c;i'¿tJ'-~ County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks. elc., or provide map) C-(J~J ChA, a--Ý / t>-V' 'l z:.-~ /u2.r tf-c<.-t'../c.--d¿a d - A":-;zf. ~.v."""', . h ,f~.d.. ~~ t'0ðt L 1f:' 1 rv h·~ ð-1<~. ~~cL ~~-<., #&UtM~ ~kQ.,.. ~¡~ ~¿.' ,~:n ~t/M.~- fh... 64-u~ 2. PROJECT NAME (')...-i.&.d" [l)~,,J t:.:/ '5 hr!?lrŸ? " v 5. IS PROPOSED ACTION: ~New 0 Expansion 6. DESCRIBE PROJECT BRIEFLY: o Modifica1Jonfartef3tion 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres a. WILL FRO?OSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ~Yes 0 No It No. describe briefly 'H-avv- 9. VJHAT IS PRESENT LANO USe; IN VICINITY OF PROJECT? C'5r R~srdential 0 !ndu:>trial 0 Commercial Ó;;CrLbe: o Agriculture o Park/Forest/Open space DOtMer 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVEANMENTALAGENCY (FEDERAL STATE 0" LOCAL)? 'I\/',y. )', ;) £,C' } . ~ Yes 0 No If yes, 1i.1 agency!.) and pe,millappro,"" . '., ß.., ~ a~ (}~.1c!:~, :/ 11. DOES ANY ASPECT OF THE ACnOU HAVE A CURRENTLY VALID PERMIT OR APPROVAL? o Yes fiNO If Y'::5, list agency name and permit/approval t2. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? DYe. ONo I Cel1TIFY THAT THE INFORMATION PROVIDED ABOVE IS TnUE TO THE BEST OF MY KNOWLEDGE AppJicanllsPonsor name,~~lJ.j Be / / P.s), p ,,:"-' , -~~--~ /:~ (' æ(.,/"h""v D.lIe: c.,/ -3 / '7' r: / I Signature: " the action is in the Co~stal Area. and you are a state agency. completo tho Coastal Assessmen! Form before proceeding with this assessment OVER 1 . . --.--.---.-.... .....--.._---- --- ¿.<:'.... ,----.,ffi,.._~·-Ud.-... _,...---__._________.__~_ ___~, ,J,'7 i-/ 1,1 I'~ A.O"'¥' t(20<..< < ',' I ' {}i<f'IJ t -h /~ _.d'?nCI ' (;'Ir-·I ¡..Joy:S(l c "."- JYI1.J¡) t ~--,-,,-' ..; 63 - '-....¿_ - ~ .._....LUI.f-T. ¿,;J. _--~-~_./~..--.-.- -- - ._. \(j. -. .-. ~""""-""- I<J p(~ n'~I/""'1 ¿ , Eì< t:'v :Je-'tj W/~", l¡')e'~ ¡-Irqh lor) ((qt~ V ßoukÙ,' I Ib", _()r~~~~,g¡..J ':-~~:>-, /-t>N Á ",....... .1 LONG Is. StJLJNfJ JO()'j Te . -' Sc.v[)d 5fOf1t"'S , ' Sea Ie " 1"~4o' ~ L..->~ Lv ! ~ , ¡ l') \~ ! ~ ! IE··: r--·-tJo""] ¡i, 1.(,o]J ,/,/ .. /p".::l " ~..c________._" ,_____ 'i_~ 7' , /.7.1 /_ IC}.! /'1), '2- :57'-\/ \ > "-- '\..T~:..·~,¡ 18' (' . ,! _ ')()n;\ '-:J Lonq I, (,T~f.I~ -S~~:;:);;·- 50:;ND~I" ~::e~1~o N,,,,,,,, Or Fa~rn .J ,~ lèd :-. 0 ~\ L;r;. ,; j;!~ rJ ()i I rr>¡i!/) , .-----=~-cc. "to v) '.9 '" ()RIf'N T VICINI TV Nlap ¡;~o,,' ¡.¡ é/ 9 $ Troln A f /a S I _ c IOOó 7Þoc> 3<1'00, r= "..-. I tons/ruelo fm)lìer hulk- " .,.. 'I' h?ad ¿,./dh lo'reiLlrY)'J. - Sfa/r!; 10 6('och- 7é, f'é'pILO/'Jt:s"l1 ÍlOJlk i er05;{)/l t7/'Jd correcf CI ¡ c/'y!¿¡erotJs CDn c//fÙ:J,r. .4dd , 1-1 . b ,.."'''C''C~¡I /5û- )Ids of ó':7nk n./n f/I/ ehind ý)ew I:wlkh,'od, ..SuffDlk ~~,i#.~oo{), /5-j-q __ Owner. (/pf'âr¿;/ BFILo5!¡ciY)¡ 74 Por fí /I¡/e, Br'onx'v'I//!' NY'- 10708 Cjl</. 33 7· .'" 0B (~. Suff:?lk(ò, lail "ïiJNi-/S.. 3, \ . .----...... -··...-.--l--;L. ~ r"J1 i'j i) _.~_ _ y.!...: VIEW Rd, !_~D' -.--- ..-- -- - -'- ~-_.-_..~. ... -. -_.,.,--,-------_._,._-,---"-_._.~--.,.._-,_.-,-,- f7,c~PoSC'd. :5f61>_' to "~~,I ~"\ _) I µ h 1-'-;:1 ~J: IlðPfJ;H'fI Lj(tlk fOod E.ri5 tIn r¡/ ' ~\;~·:1'\. S /.00' x' 6' (-¡¡,'..JOt ),.:;-1\¡,\ '''''',' ~",,'" / I 8 - /", ,,\"'_ ", ...L .. tit!1 (, J".-" Ïf u ~uo I 1Vi. 1-1. tv, 60")< Run '<:-" 5' t. rd ""-, W' :;' 17;t.t'ï¡)77 ?'\;'-V7~ ./ ,'. r"'\\~ 30 _. ----'>-I ----- 5ä,.,d ~ 6t'c;r;fe/ No 6,o",þH., Q¡>\TlnN ~_::"'J _ l_ _ .J J. H. GEIDEMAr~ beðcJ, a".....eô NEW YOR ( and ßul/(head 01 foe tJf 18' bank.. 3"~/D' Ti (7' frt¡h,i- -shNrll"h? 3f¡'/' he rod$ fa d¿>QcX ",o"n In éúnk, r?e-r;-'Dv",blc' Slef'1 f. bE7úch frQ,," 8. H. -~ ------ ----------- - , ._--_._.,~._-_...- N. Y Stðte Lie. LIVId ~,urveyor, D¡¡tc ) \ " .' ..--.-...-.........--.--.,-.-- ':5~, b,I"-1"'1f:,- _··_·-,··I--~-~··_--·_-_· -----~~--- ~ ~ ....-..--..-......- ,. --...'-....-'.--..--------.-.--- ,. ----..--.., .. l' "~ 1 S LAN D .s£J¡}rl_~ ~___...'--- _.' L 0 \I U ---- J. let Lint ~.._ ~--_..-_.-. ,I h ,II /l'" ~.-~--- ..~.. .. (/ H,a ," =-- ¡OD.D ~. ¿;I t10 ) J.. 0/1,1__-- "-02'(0£, Bea<:h _~ _---.. ~1-11 " ------ ~, :5fon ey ~,~7Y~""'-: ._....~ .- ¡JD (iroi<Jfh -~'" of slopt? ~~ ;:--.---.....-......4:'-----, -~- ~._.---------- /~.-:-. lop of) ~ C,ra'?5 '~, I,?~:/ ",Ii 'J: ['y¡r,{mq () l' ,-, t)¡1Jjl \1\ /~f:: 1 \. . " ~ ¡;:; Bal)'; ~ P L r,/\I T If., L, '" ~ {' ',: ~" / \-~. :;0'0< 4,' e,~/l (, WAL~~ P{)()L '\', ~;'ð~, .s, lodan;l.a~/_,' _......' I, j ~,\..,._-~ ":( 't-... .....OPI'pY - 22' y '" D^rt° ~ --- - ~, ) r ¡..-, , <J ~ ~ \r) I ",1111' "'I ~ -} "',for'( \ rq ~ '-..... Ff'Qltì(' ~ ,- ",I '" .... '" "1- , '" , t,,) , .. '-:/'l I~ , Ifì <.': I } I 18' F /1'/"--- L4 t(/ /? I I , I ! I n/)br1~ ~o' oo·vi-1. S_77d ;J J-'1 z ' \ ,2' 54 p.:ïio'- L·7.· >,z tljðt) 2.ô.¡;Iò' _ SOUND VIEW J20AD {50') Gl.1on:¡nfeed In occordance L,)¡fh f/,,~ '-)11171 /]JUI?, 5!cmc!arcrs Tor hf/p ;jvrv<",y-s ()f Ihc,·NY Sfalt' Lt1nd idle .4ss h -~~-~------_. NI- /> 1 S, Qu 11)17 J [; 5co/e ,. 1"-10' MAP o!PROPERTY SU/2VEYf:O fOR GeRARD BELLESHEJY1 a+ ORlfNT Sovthojd ]oum 1\)."'(, j'uf{o IK C" /flOOD -15 - 3- '1 Th¡"s 1$ fo ct"J'¡'-fy Ihaf 'the äbOYé: 3urvpy /.1/05' comp/I"ft'r/ ón II)/s /ol/¡drA ; '" . IV)t;¡ /9C¡5 1. H. GEIDEMAN F..IV1/.1 Q 10 f\J, L. T. ~~EW YQBK, - 1I'l..?JC¡ , po. ðd..... 41b ), /.~/4' ., r'~y St~¡~~\.ic: ~;'~dÇ~~;~~~, \....."'2284D Date Jo/!:'h!;; r~----:t~ -----.--.-...--.-. ---_..~-.-.- · ~""",-"",,"_(. ........... '\00'-~:"'Î.1t,'\Ji 110 CC' (;OIT1~)II.:lf~(j b'( )\I¡enC'IJ ~ A. Ooes ACTION EXCEED ANY Typ THRESHOLD IN 6 NYCnR, PARr fil7.12? If Y", '"aro Iho '."ow .'0,-." ano u'o '0. FULL ""'. DYes oNo 8. Will ACTION RECEIVE COORDINATED REVIEW AS PROVIOEO FOR UNLISTED ACTiONS IN 6 NYCRR. PARr 617,67 If No, a nog..". oecla..lIon may be superseded by another involved agency. DYes DNa c. COULD ACTiON RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOllOWING: (Answe<S may Oe hanow,"IIen. it leQ'Olel C1. Exlsllng air qualily. Surface or grounowat.r QuaHty 0' Quan'ily. noiso lo,els. exosHng tralllc pall.,ns, soHo wasle P'OOu~I'on or disposal. polential for erosion, drainage or flooding problems? Explain briefly: . C2. Aesthehc, agricultural. archaeolog,cal, hlslOric, or olher natu,al 0' cultu'al resou,c,,: or cOmmunily 0' nelghbo'hood cha,acter? EXPlain brlefty: CJ. Vegelahon or fauna, fish. shellfish or witdHfe spec'es. sigmflcan' habilalS. or thr.a'ened or endange'eo spec'es? Explain b".IIy: C4. A commun,ty's exishng plans or goais as Olticlally adop'.d. or a Change in us. or intensily of us. ot land 0' other nalurai '.SOu,ce.? Exptain brlefty cs. Growth, subsequent development, or related aclivifies likely to be mduced by the proposed action? E:O<Platn bnetty. .:'::-..-..- "- CG. long term, short term, Cumulative, or other effects nOI identified in C1.C5? Explain briefly. C7. Other impacts (inCluding changes in Use at either quantity or type at energy)? Explain briefly. O. IS TriERE. OR IS THERE LIKELY TO DE. CONTROVERSY RELATED TO POTENTIAL AOVERSE ENVIRONMENTAL IMPACTS? DYes 0 No If Yes. e)(pl;:¡in briefty ," PART Il'-DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, delermlne whelher II is substantial. large, important or otherwise significant. Each ellect should be assessed in connection wllh its (a) Selting (i.e. urban or rural); Ib) probablllly 01 OCcurring; Ic) duration; (d) irreverS'b'"ty; Ie, geographic scope; and (t) magmtude. II necessary. Odd attachments or relerence sUPporting materials. Ensure that explanal'ons con lain sulticienl deta,llo show that all relevant adverse impacts have been identified and adeqUaleiy addressed. o o , Check this box if you have identified one or more potentially large or significant adyerse impacts which MAY occur. Then proceed dircclly to the FULL EAF and/or prepare a Positive declaration. Check this box if you have determined, based On the information and analysis above and any SUPPOrting docur.>enlatlon. that the proposed action WILL NOT result in any significant adverse enVIronmental impacts AND provide on attachments as necessary, the reasons supporting this determination; , N.ln,,· o. l~·,Io.J ^¡';CJ1cy """nIOI IV¡H.· N.HI1t" 01 I<n :)ons,( Jt" Ult'cer m lc,lú A!-:Cf1(y , 1!lIe ul 1<"Spon\,ùl~' Utl,(~, -- )'l;n,lIU((' 01 ¡(.t'Spons,ol(> Utl,(<'( m le.uJ A~"fI(y "_1. StKfI,Ilurt.' 01 1'lt·P.lH·' (II Ut ~It"fll I(om rt'IVUflUQI(" urr'{~r¡ ~~ - O.ltt!' 2 .. . . Authorization (Where the applicant is not the owner) I residing at (Prin~ owner of subject property) (Mailing address-phone) do hereby authorize to apply for Coastal Erosion permit(s) from the Southold Town Trustees Signature .£u ß;z{;~ f &N4Þn/? / - ¿J--h.J,-uz./< I¡ THIS IS NOT A PERMIT Page 3 . County of Suffolk ) State of New York ) . 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 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 REPRESENTATIVE(s), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS NOTARY P , ,;I ROBERT I. sc..4. JR. NOTARY PUBLI~;:;e of N.Y. No. 4725089, Suffolk CounJ.Yr Term Expires May 31, 19~(P ~.J. þ 7~5:1 SIGNATURE ..J v \\I-L Suggested space for location Map THIS IS NOT A PERMIT -----..... ,19<fS: P,L.:5, ,\ . . Civil Marine JOHN H. GEIDEMAN Consulting Engineer (516) 477·2421 P.O. Box 416 E. Marlon, L. I. New York 11939 '1'(> I:hom It Hay C:onccr>n, I , (; E..,<:'JJtf?t:. J-/ I ß¡:u.S' fI.E. ( /'1. l1uthori.:>:c ;¡John H. Gei.deyn,m to act aR my agent in appJying fop permits to construct Ii on my property at Sign'~~~ Including: N.Y.S Dept. of EnvIronmental Conservation U. S. Armv Corps of Engineers Town of 5fu-t.l....",t!.d . ",'. ."<~..-..'..'_.__.._,.- )# N.Y. S-kde Lie. LO/1o Svry,eyoY" . . . COASTAL EROSION MANAGEMENT PERMIT APPLICATION TOWN WETLANDS PERMIT APPLICATION TRUSTEE LANDS PERMIT APPLICATION Office Use Onl : .... Coastal Erosion Permit Application Wetland Permit Application Trustee Lands Permit Application Grandfather Completed Apps. Date: Variance Required, Neighbors notified Date: SEQRA Type Coord. Review opt.,mand. -Insp. comp./date: SEQRA Determin./date: Public Hearing/date: Findings: Permit Vote: (Y/N): Special Conditions: (also see file) {õ)Œ@ŒUWŒfñ un APR 2 7 1993 æJ TOWN OF SOUTHOLD Date Rec. by Office Sto''''' ~~<- Application Fee: Application Number; SCTM nooe ~1Ji/2A. /,,~,l v,(,p ,,~ -fa h" CA,- (" f r Project Name (If any) Renouris, ,'111, /} - . 1'-'Llj..U-J(I2v-,,~ ~ :::i::~ed;",",~;::, ':' ,::::" ÞJt:;; J; 'l(!) í ,/', , ,/ Gf' {' ''i:;:: 'j'JÌ.(Y(' / .·"~/<"~'r . - / t- , Address: P.O. Box 776 Orient, NY Interest: (owner, consultant,lE OWner of Property: Address Gerard H. B 122 Soundvi Orient, NY Subject Property Location: 122 Sou Orient, PýG "l (Provide LILCO Pole #, Distance to c location map) on THIS IS NOT A PERMIT . . . Yds. to be excavated: 0 Yds. to be filled: 400 Manner in which material will be removed or deposited: Trucked in from upland source Width of canal, creek or bay fronting property: Lor. Sound - 7 mi. Depth at low tide: Beach 1eveJAver. rise in tide: Distance to nearest channel: NIA Distance project extends beyond similar projects in area: 0 Area zoning: Res. Land area in acres: 1/2 Is project for private or business use: Private Intended use of property: Private residence Describe known prior operations conducted on premises: Construction of in-ground pool, retaining wall, stairs to beach Has any prior license or permit been issued to erect structures, dredge, or deposit fill on said premises: Army Corps - NIA, DEC pending - 1-4738-00704/000001-0 Has any license or permit ever been revoked or suspended by a Governmental Agency: No 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 necessary). Requesting Emergeny Storm Damage permit to restore bluff. Property in danger of cesspools being exposed or destroyed in another storm. Permission requested to bring in 400 cu. yds. of clean fill from upland source to stabilize bluff. Also to replace stairs and align 40 2-3Ton stone on filter cloth along base of bluff. 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 See Attached Form Signature THIS IS NOT A PERMIT . . AUTIIORIUTION fORM ,,,. 1';:¿;/9 > I. (! ERflR.JJ Ii .$rà /t:S'ff Ô ^ , owner o~ property at the following ,.. II (')(Z, 6.' NT t-- \. J I do 11ereby give l attl~m Sand & Gravel, rllC. authority to act in my behalf location, I) /. c; C't \..., N :Þ \.' ~ ~ ",} '1'" ,~ as petitioJler/agent in aPIJlying for suell permits as necessary in order [or work to be done at my property. ~~;M~u/l~ Signature . . County of Suffolk ) State of New York ) . c. 1 ~ oR. ~ ii1E L A- TJi 1'\ "'" BEING DULY SWORN DEPOSES AND AFFIRMS THAT /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 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 REPRESENTATIVE(s), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. C:,~~ ... SWORN TO BEFORE ME THIS ~3 ..." DAY OF ¥,\.,p -R., \ L. ,19~ ~~~~J~Í?~~-' MARION G. LATHAM Notary Public, State Of New York No. 52-4649732, Suffolk County Term Expires Suggested space for location Map THIS IS NOT A PERMIT ~ ~1 _, ^ c... I'" <> - :, . . S!O - I ~. 0\,..0.-,....-""'\ ,l" \ < '\ 'M, \\, A~, f'.......+,..,~,.\ \'\ \-I D..,1-:)') J;,O'-J\ \:.,,,~'^, ,~ . LT SOCA,o'\¿' V^-";"~'j) \ \'\ '0'1 ~J "---_....\.. /'-- -- J.-. D~""""') v)",f f'" ~\~~', ",J >(, fK1"fl,t ~ Jøj"......~ I I -" .\ I ~~\':;'~ I'\FTf''(~ I t1.GSTDI'l.'1ì'.:'_"V-·\_TJI' r.1o:-'\1 ,\(--6- - ~ - --~1~"" .-\.. ICO' t I~<;:.' .í. (~!~"j ¡ 'G-) 4- (~)... U>,~-.'S! \,' r,,-' ;- ~ \.",fo,I~~ .. (' 'I; ,.. " ," [~ ~¡\",,\,,\\·,'l 1\ ___ ,-,::::;1, r \"'-.......... "\\ .(' o~ \.. \\ '\' "i----"'Ë: \ o 'f' ''.J \, ,\~ ¡:-~~ '\ ,\<-. . -'1:"(~_,() c.' '. t 'It~1 C 1Itt'\E'1J.1 H"'Nrt-::;I \ ....;¡")..~ \-,\D~Sf \\L \ r' . '!. \ J \ Y\" :Ø- \"J.. =-__ .5 D \.À \'.\ ",> V \ ¡'Ç \~) ~,~"\ ------- -- ~---~----"'-'---- ""', ~ IHI';Sft'--0"'"' (1TL>'\5 ~"ìf'''J,L N. - õ' 1\, I \ (1¡)O - t ~ . 5 PI\..vAì"C'~r: :!A,uA\-\'1A '6:l;')~ c.t~ I'\e-t-', l.t ,,'1 Ave.. . N'1 :-r~ \, / Te ("{ i., (.""--' \ \ ì" ... - ,.._,._~.- .,--.---~_..- -~----- - -- Property of Gerard H. Bellesheim 122 Soundview Road Orient-By-The-Sea Orient, NY 11957 SCTM #1000-15-3-9 Prepared by Marion Latham Latham Sand & Gravel, Inc. January 29, 1993 'I1,£VIS£'b Pof'I'I.-\1- :<".3, < '1) ----.-----.- - .~. ---------..--..--- -... -.." --. ..~_._---.-._..__.._-_..... - ...,-. .:5 .:> <.( I-I L) . .., I.- ;tU'¡ D I -.. .. __. 1'-1 ð ...... .. ,--n",...1< -. - ~ a . ' w,,~I~~ . -,: .~<J ~"~-""""--¡'<' -~...ð""~""--;-?Ò''Îð'. ¡C'ð. ::;:-.' , .~. ..,0"0<: ~."_. tlf-'''''' ¡---....:. ..." C) ~ \ > h ~ -\j 1".: \) ,\) ~. <:'I V¡ \) <: ...... o '\I t . t ~ I.) t¡ . 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