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HomeMy WebLinkAboutTR-4986 Board Of Southold Town Trustees SOUTH OLD, NEW YORK PER~,1IT NO. 4q~(p DATE: 1\1',-;1 2~, I-¡<IY ISSUED TO .IOU C. KERBS ""~1ttl~ori lU tio 11 Pursuant to the provtslOns of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on f\jJ<"il .' 1, 19 '''', and in consideration of the sum of $ 1511. lI(I paid by ['II I\" I: l'¡- )~ of i.l.dtlluck N. Y. and subject to the T arms and Conditions listed on the reverse side hereof. of Southold Town Trustees authorizes and permits the following: V,'vtIdl!\! j\'!-IIHl to Ijuild <\ single-family /¡olìle '.'.'lth ,\ JLJ' ,\.ll),[,- I", ! r'''[11 tlli...: flTSIl'.valel' wetlands \..it/¡ the íUJ[d'.\Jlìl-! ",,,..1'1«""0: ISICr,: ATTt\CIIE:D¡... " all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The s.id Board of Trustees here- by c.uses its Corporate Se.1 to be .Hixed, .nd these presents to be subscribed by . m.jority of the s.id Bo.rd as of this d.t". tL¿¿~'l /-::'7~Lh:;/ ~ ~ ffþ)¿<,<~~¿ - --ø?:-æ:.. ( L ..!Ier:~-Y Smith - Absent Trus/as r TERMS and CONDITIONS The Permittee Jon C. Kerbs residing ae part of dlc lowing: 440 Riley Ave., Mattituck N. Y., .. consideration for die issuance of we Pennie does understand and prescribe to the £01- 1. Thai <he said Board of Tnmees a.od <he Town of Souwold ate released from a.oy a.od all damages, or claims for damages, of suits arising dltecdy or indirectly I!J a resulc of a.oy oper- ation performed punuanc Co chis pennie, a.od we said Permittee will, at his or her own expense, defend any a.od all such suits lniriat<:d by third pardes, a.od the oald Permittee assumes full Uabillcy wiw "'speer thereto. ro <he complete exclusion of the Board of TlUSCtes of the Town of Southold 2. That thi5 Permit is valid for a period of 24 mos. ..Web is considered Co be the estimated lime re< uired to complete che work involved, buc should circumstances warrane, request for an extension may be made (0 the Board at a latcr date. 3. 111at this Permit should be retained indefinitely, or as long.. the .aId Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that RUth· orization was originally obtained. 4. 1111t we work Involved wUl be subject to the .lnspecdon a.od approval of the Board or i<> agents. and non-œmpliane<: with the provisions of the oclginaclng appliadon, may be cause for revocation of this Pennit by resolution nf dIe said Board. 5. 111at fhere will be no unreasonable interference with oavigatioo as a result of the work herein au"tl1Orized. 6. That ,here ,hal\ be no interference wiw the right of the public to pass a.od repass aloog die beach between bigh and low water marks. 7. That If future operations of the Town of Sourhold require the ¡emoval a.od/or altetadons in d,e location of the work herein authorized, or U, in the opinion of the Board of Trustees, the work sbaU cause unreasonable obstrucuon Co free navigadon, the .ald Permittee wiU be required. upon due norie<:. to remove or alter <his work or project herein .rated without expenses to we Town of Sourhold. 8. 1111t dIe said Doard will be notified by the Permittee ot the completion of the work auth- orized. 9. 1111t the Permittee will obtain all otber permits and consents thac may be required sup- plemental to dlis permit wWch may be subject Co revoke upon fallute to obuin .ame. ii' , NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees grant a Wetland PermIt to JON KERBS to build a single-family nome with a 30' setback from the freshwater wetlands with the following conditions: - The applicant provides original authorization from all ownership interests within 120 days. Drywells must be installed to contain all roof run-off. Grade changes to conform to survey as per submitted and dated April 27, 1999. The front yard will have no turf within 30' of the ponds. Haybayles must be placed around the work area. There will be no turf on the side yard. There will be no turf in the rear yard. The only clearing in the rear yard will be for septic system installation only. All disturbed areas are to be naturalized with wood chips, and/or natural plantings. There is to be no bare soil remaining after construction. Permit must be amended if there are any changes in the landscaping. 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 and complete 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, ~0 /~.}h. Albert J. Krupski, Jr. President, Board of Trustees AJK/lms cc: DEC Hea 1 th Dept. Bldg. Dept. ¡ Alliel t <1. }<rupski, P¡'csident , rllnes King, Vice-President lIcl))")' Smith :\rlj(: FI),Stcl' ¡(en f'1I11\\'(ldiL fJ-7)Ll17,<~;-_ (ii ffO '<0.. ¡I '\)<¡,\I L.t-"è- (I ISS.G'~\\ g ~~), Q . I '" "", (~ ~(\I ,.~. '<'\,1 .:' +- '" I ':~_~O.¡ .. "+-~~JIII '<bq Vii Q7.Zro:fP 1'0\\!n I {all 53095 t<.fain Road P.O ßox 1179 SOllthold, New York 11 D71 TeJephune i !JllÌ) 7ti[")-} '6IJ'2 Fnx \516) 765-182:3 ßOAUD OF TOWN TnUSTEES TOWN OF SOUTHOLD CONDITIONS PAGE 1 OF 1 APRIL 28, 1999 - The applicant provides original authorization from ali ownership interests within 120 days. - Drywells must be installed to contain all roof run-off. - Grade changes to conform to survey as per submitted and dated April 27, 1999 - The front yard will have no turf within 30' of the ponds. - lIaybayles must be placed around the work area. - There wiil be no turf on the side yard. - There will be no turf in the rear yard. - The only clearing in the rear yard will be for septic system installation only. - All disturbed areas are to be naturalized with \~ood chips, and/or natural plantings. - There is to be no bare soil remaining after construction. - Permit must be amended if there are any changes in the landscaping. " '. --<IV York State Department of Environmental Conservation /-:;,ildillg 40- SUNY. SIOIIY Brook. NY 11790-2356 ¡elephone: (516) 4-14-0275 Facsimile: (516) 4-14-0297 ~ ...... ~ John P. Cahill 0'mÎtÙH:i.rIEc 22 October 1997 Jon Kerbs 440 Riley Avenue Mattituck. NY 11952 RE: DEC#: ) - t./ 7,3R - 017 R 3., J IH--ð-(J , Dedf Mr. Kerbs, [n response to your request for a freshwater wetlands determination for the property identified below, the New York State Department of Environmental Conservation has determined that the parcel is more than 100 feet from regulated freshwater wetlands. Therefore, no permit is required under the Freshwater Wetlands Act (Article 24 of the New York State Environmental Conservation Law). Location: Rene's Drive Town: Southold Tax Map Number: 1000-54-06-4.1, 4.2, 4.4, and 4.5 This determination may be considered permanent and should, therefore, be retained along with other documents related to this property. If future actions by this Department result in any change in jurisdiction, you or any subsequent owner will be so notified in writing. Please be advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, ~rlJ~ Permit Administrator cc: Bureau of Habitat . 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 TO: .;;thOrn!'} 0) ~(> h 11 r 'hv') /--::f-t, I, ( I ~, --!r!:X. c..'?~; C! Please be advised that your application dated /0 IdY'l 01( reviewed by this Board at the regular meeting of / / / /7 / Cf/ following action was taken: has been and the ( /) Application Approved (see below) L-) Application Denied (see below) L-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the South old Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: ..g :)"0. 00 ~ 6( I1cLJ (t1IJp-ecLl~ TOTAL FEES DUE: $ SlJ,OO SIGNED: Û/t4~-f (l ~.~. PRESIDENT. BOARD OF TRUSTEES . . Telephone (631)765·1892 TO\vn Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tues.. November 9. 2004. the following recommendation was made: TOM SCHLICHTER & FELICIA SCOCOZZA to Amend Permit #4986 to add an attached deck to the rear of the dwelling, 22' X 12'. Located: 400 Rene's Dr.. Southold. SCTM#54-6-4.4 The CAC did not make an inspection, therefore no recommendation was made. . . 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 SOUTH OLD T: Trustees, Southold Town F: Scott Hughes, Senior Environmental Planner D: II August 2003 R: Backyard grass planting. SCTM# 1000-54-6-4.4 I have reviewed the planting proposal, have visited the site, and offer the following comments and suggestions. The uncommon forested wetland systems found throughout this area have been greatly disturbed by the allowance of houses being constructed. However, the application site is not contributing to any further disruption primarily due to the use of environmentally responsible practices such as berming, native species plantings, and proper counter grading. Also, having visited the site the day after a 2-inch rainfall (when runoff patterns are readily distinguishable), I have concluded that the backyard in question does not anyway contribute a significant amount of direct runoff into the wetlands. The majority of which is collected, then absorbed in the natural and man-made swales and buffer zones. (Unlike the two neighboring houses being constructed that seem to be contributing a tremendous amount of silt laden runoff directly into the wetlands.) It is my opinion that the addition of the small proposed turf area will have a negligible (if any) effect on the neighboring wetlands. Furthermore, I recommend that the application be permitted with the following stipulations: I) the berm in the northwest comer of the yard be raised 6 to 8 inches, as discussed with the applicant; 2) the "fine leaf fescue" variety recommended by Cornell be planted; and 3) these stipulations be represented on a planting plan with "No Fertilization Zone" clearly shown over the backyard. cc: Mark Terry, S.E.P. ~ æ A~G ~ 3! w" æ ~ Soulhold Town Board of Trustees . . 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 July 25, 2003 Mr. Tom Schlichter PO Box 77 Southold, NY 11971 RE: 400 Rene Drive Southold, NY SCTM#54-6-4.4 Dear Mr. Schlichter: The following action was taken at the Southold Town Board of Trustees Regular Meeting on July 23.2003. RESOLVED, that the Southold Town Board of Trustees Approve the request for a Transfer of Permit #4985 from Manzi Homes, Inc. to Tom Schlichter. If you have any questions, please contact our office at 765-1892. ~9~·~. Albert J. Krupski, J r. President, Board of Trustees AJK:cjc , . Telephone (631) 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, July 15, 2003, the following recommendation was made: Moved by Bob Ghosio, seconded by William Cook, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Amendment application of THOMAS SCHLICHTER to Amend Permit #4986 to grow turf grass in the backyard, covering a 50 'X 40' section directly behind the house. Located: 400 Rene's Dr., Southold. SCTM#54-6-4.4 Vote of Council: Ayes: Bob Ghosio, Nicholas Dickerson, Madeline Brisotti, Donald Wilder, and William Cook. Abstained: Thomas Schlichter . . 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 July 17, 2003 Mr. Thomas Schlichter P.O. Box 77 Southold, NY 11971 Re: 400 Rene's Dr., Southold SCTM#54-6-4.4 Dear Mr. Schichlter: The Board of Trustees has received your application to amend Permit #4986. As the Board reviewed the file, we felt that an environmental analyst should review the file as well. The Board would like to request a postponement of the hearing until this review is made. If you have any questions, please don't hesitate to call the office. - Very truly yours, &k19~·~. Albert J. Krupski, Jr., President Board of Trustees , Albert J. Krupski, Plesident Jarr.es King, Vice-PreRident Artie Foster Ken Poìiwoda Peggy A. Dickerson \\,UHOL.t ~ #.'~_.;. ,... ~' ~ ~~. ~. ~ ~O./ . ~-..~ ""'. BOARD OF TOWN TRUfiTEES TOWN OF SOtTTHGJ D April 1 8, 2002 Ms. Michelle Gesseck Manzi Horne:;, Inc. P.O. Box '702 Rocky Point, NY 11778 Re: 400 Rene's Dr., Southold SCTM#54-6-4.4 Dear Ms. Ge'5seck: . Town Hall 53095 Route 25 P.O. Box 1179 S":lthold, New York 11971·0959 Telephone (631) 765·1892 Fax (631) 765-1366 This letter is to inform you that the Trustees inspected the a':Jove-referenced property and found the project to be in compliance with the W?\land Permit. If you have any questions, please don't hesitate to call our office. Very truly yours, aft L-I t1 /4.-Avß..' (2. ,. I " Albert J. Krupski, Jr. President, Board of Trustees AJK:lms 1. A.:¡('I'1(~ SDùìh. ..I-¡(,...."J I';a ? New York: State I 3 011.1 -aT<I ~ O"g INCIDENT REPORT I NY (;", r'j -I 0 lopp ':': I '~O,,; rll óf'1 I ~~' ~ I:" ~/:;~OD.lf 16 Il'1od~l'1tt~,) I ";"'1 ~ /'" þ:;;- ;>reon(t ,. ReportDaV 1/'7 [01 I ,;;p;';me -- 8 Date O<curred OnlFrom ""0 If .... 16 InClden! Tipe ~ -r;;... AI (!" 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Race o WhIte 0 Black 0 Other o Indian 0 ASian 0 Unk z o '" 0: w ... ...8 v... w", "'w "'0: =>0: "'« " z ¡;; '" 34 Type/No 3S. Name (last. FI....t. Middle) 31 Apparent CondItIon o ImpaIred Drugs 0 MeotalOis DUnk. o ImpaIred A'co 0 Inj / .11 0 App Norm 36. AhastNlcknamelMauden Name (last. FIrst. Middle) 38. Addreis (Street No. Street Name. Bldg No. Apt No. Citv. State. Zip) " DateotBlrth I " He'ght I 142 Age 143 Se~ OM 0 F Du 49 We'ght I SO Hair I SI EVes 1]9 Phone No o Home o Work 44. Race I 145. EthnIc I :46 ~k," 147. Occupation o WhIte 0 B'ack 0 Other 0 HIspanic 0 Unk 0 lIght 0 Dark 0 Unk. o Indian 0 Ailan 0 Unk 0 Non·Hi'\Pan,c 0 Med.um 0 Other S2 GliliSe-; ')3 BUild 1 ')-4 EmploverlSchool I')S Addre~~ o ve-;.O Contacts DSmall Olarge o No 0 MedIum 40. SOCIal Security No :! S6 ~car'\l Markirranoo~ (DeKrlb(o) Sl M,S( ~~.Victic:~ -"" Status Pr~y QUllntityf Me:a\~r~ r:.k~v~ OeKrlptioo Serial No. M_I V.I~ >- ... 0: w ... o 0: ... 59 Vehicle Status 162 e..-p Yr 16) 168 ~tyle 60 llcen~e Plate ~o 67 Model 164 Value 69 VIN FullO 61 Stale PartIal 0 PlateTVpe I w ~ v % w > 6S Veh Vr 66 Make 111 Towed6V 'p 70 Colorh) 1'2 VehIcle Note~ 'J. ;;;. S. #£7/ ¿""V E" 7;l~",.,. Á 'h -rl ...,... A- /ít?./77Z,..;-T- '> ~"'N a = ~.... ".$ R~~,w¿./ ~ A ~I77G~ /j~ U/o¿"_?'7,,., h,. /b..... ~ "r..æ.._ 7l>~ 4.1_ -,.oJ /rs....,.../. « Z {5,,//.,/.-, _ AI/or.. /Z4t:;e./ -'-- .-1- ¿¿ ~"'I. 2 .~ .4- w; -J.. ~_.. € rt:,,~c/ w~.-I ;v;tr "M____ JH¿>~, .,;!.7 #- ~Ef..<.L '/.--#-~ ~ i?ø'?'7( L? (//0 Ú'I-I,,,,,_ '-" ~/ e.-A>C4t: oS v"," _ I~r ~ 97-.1';> _t!_. J.. '" ~".- h,- 7Z", ~"'- .a 14. Inquiries (Check all that apply) o DMV 0 WantlWarrant o Crim History 0 ~tolen PrOperty w > ¡:: « ~ ï L v~1':t!;¡'"'1 I" 'Øl-r i ~ (If ClMed. check bo..- belOw) ~ 0 Ane-;! 0 Pro~ Dechned o Arre";! ·JU\l 0 Offender Dead 75 NYSPIN Me-;.sage No 76 Complainant Signature o ~cofflaw o Other ~ 19 ~upervl'>Or's SIgnature{lnclude Rank} 18010NO 07 I B3 NOllf,edfTOT 8 I. Status . _'! 0 Open o Vlct Refused to Coop o CBI 0 Juv. ·~o Cu->todv ~/"ï/?' o Unfouoded DWar<antAdvl\eC! DExtrad De<lln ~no...." DCJS-320S (2/97) *FALSE STA TEMENTS ARE PUNISHABLE AS A CRIME. PURSUANT TO THE NEW YORK STA TE PENAL LAW A ~ .-- c_ ~.5 '- '- G - H_ ,- ,- , - , - .,..- .- 8 [] [] 0 [J ŒJ D EJ 0 G [J GJ B .. ·m ...f ::.. ('f':_c-" " ...age of Pages . . A 1610 Town 01 Southold SUffolk County, NY The People of Ihe Slate of New Yark ... lAST NAMe /DEFENDANT) ARSr NAME Manzi HODles STREET AlXmESs PO Box 207 MIDDLE INITIAL 'CIN APT. NO POint N. Y. UCENse OR REGISTRATION NUMBER STATE 11778 "p PLATE NO DATEEXPtRES STATE """'TYPE ONY. ON' ON' o N.J. 0_ OPASS o COMM 0 VEHICLE MAKE 0 DOo,,, 0 '""', 0 CHEV 0 CAQlUAC 0 """'"'C 0 FORO 0 0U>s 0 Fl.'" 0 ToYOTA 0 vCUes 0 'DO, 0 'OR 0 "'R 0 'us 0 Mev 0 SW "'" 0 ",UCK 0 _e" 0 v,," 0 VJN NUMBER THe PERSON DESCRIBED ABOVE IS CHARGED AS FOllows PlACE OF OCCURRENCE Per 400 Renes Southold OAT" OF OFFENS' .... aN. 'OWN.""",,- OR _'" '~OU""'''m ~ o "¡,¡'ëJ''mt'1and Pel1Dit I.IISDeMEANQR 0 FACTuAL PART (NOT FOR TVB¡ -""""-EDDEFENOANTI>DON_STA""'''''''',"M',,"D'''-<Ce Did Construct = h~~:: ;n: :=;;: 0yo>øm nn> ~o pørmi»øn ~ hy ;~ClløA Pørm, ""-·-~-~'-""'--r_"',"",",,,,,,=-,,~,. t'hp np.pnnønt- dated /,,, P"'_NO SOH'DUCED FINE. CONT'CT COURT 0 I I THe PERSON DEScIt'8ED A80YE IS SUMMONED TO APPEAR AT SOU1lioLo TOWN JUSnœ COoRT, 5308$ ROUTe 25, &ouTHot..o. NY 11e71 ~TE()Ç~!NOrF()l J\1!¡ ON 01/12/02 9:30 ..... AT ~"""""""'" _N...."""''''"'-'", """, ~SC"M""'" ""'""" 'O'<cTIoN",.. OF >HE. eN" COM"" ~ ""ì/h,~ ...,.,. Donald M-1 COURT Copy ~ . NOTICE . Police Dept. - Bay Constable Town of Southold Peconic, New York 11958 NOTICE OF VIOLATION Date: 11/20/01 To: Manzi Homes (Owner or authorized agent of owner) Address: po Box 702, Rocky Point, N.Y, 11778 (Address of owner or authorized agent of owner) Please take notice there exists a violation of the Code of the Town of Southold, Chapter 97 Article II, Section 97-20 a premises hereinafter described in that A house was not built as per a Southold Town Trustees Permit' also a water suoolv line was olaced in a wetland area without trustee aooroval. You are therefore directed and ordered to comply with the following: Aoolv to the Board of Trustees to correct the above violations and reinstall all required hay bales on or before the 15th day of Dee ,20...QL.. The premises to which this Notice of Violation refers are situated at: 400 Rp.:ne~ nrivp.. ~ntltholñ Thwn of Southold, Suffolk County, NY (Suffolk County 1àx Map Designation: Dist. 1000 Section: ,4 Block: O¡; Lot: 4 04 ) Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine or imprisonment or both: NOTICE: You have the right to apply for a hearing before the Board of 1tustees of the Town of Southold, provided that you file a written request with the Clerk of the 1tustees within 10 days after service of the Notice of Violation. Such request shall have annexed thereto a copy of the Notice of Violation upon which a Hearing is requested and shall set forth the reasons why such notice of viola- tion should be modified or rescinded. /~t~£:.:So"Wold. 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MANZI HOMES, INC P.O BOX 702 ROCKYPOINT, NY 11778 744-1039 FAX: 744-0032 Town Trustees P.O Box 1179 Southold, NY 11971 March 21, 2002, Regarding permit # 4986 Property, 400 Rene drive, Southold. ¡WIM::. ¿ 5 , l' To whom it may conceru This letter is to notify you that the house on 400 Rene Drive. in Southold permit # 4986 has been completed and is ready for a final inspection. If you have any questions please contact me @ (631) 744-1039. ';;;:1) led MicheUe Gesseck Manzi Homes, Inc Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson 1- . 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 January 25,2002 Manzi Homes, Inc. PO Box 702 Rocky Point, NY 11778 RE: SCTM#54-6-4.4 400 Rene Drive Southold, NY Gentlemen: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, January 23,2002. RESOLVED, that the Southold Town Board of Trustees grant an Amendment to Permit #4986 for the change in the side yard from 30' to 27.7' southwest side only, well and well water line screened through wetland area, and cesspool in front of house instead of rear as per the Health Dept. with the condition that the stone for the retaining wall has to be brought in from an outside source. If you have any questions, please call our office at 765-1892. ~nCereIY'l 9 ~. .. Albert 1. Krupski, Jr. President, Board of Trustees /~Ly AJK/cjc CC Building Department 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) 763-1366 BOARD OF TOWN TRUSTEES TOWN CJF SOT.."THOLD TO: Michael Verity Building Dept. FROM: Albert J. Krupski, Jr., President Board of Tru stees DATE: January 17, 20G2 RE: :vIAHZI HOMES, INe. -ICO Relle's Dr., Somhoid SCTM#54-6-4,4 The SOlllhuld '·J'.\'Il Board o[ [n;stees inspected the above-referenced property on January i -;, 2002 and found that the applicant has satisfied an the concerns of our Board at this time. We it",:= '1(, ,h.:~:::io~ t;J ::i!c''ing the appiicant to rontinue with the project. We ""cui.;: ;;k.e :c' r~ql!~:·;t to,,: ce[.~æ a Cenificate ufCccupancy is issued, we have the ùppOr:1llllrv '" '.1ske a tinal in:;pection of Oltf ow':! !n orrier \(I make sure that an restoration work has been completed. Tl1arL~ you fa:.- Y(;'~r l~()·)~J·~:-aô.oa. . . ~ EN-CONSULTANTS, INC. 1329 North Sea Road Southampton. New York 11968 631-283·6360 Fax: 631·283-6136 E·mail: encon@peconic.net www.enconsultants.com ENVIRONMENTAL SERVICES December 12,2001 Manzi Homes, Inc. c/o Richard Manzi P.O. Box 702 Rocky Point, NY 11778 Re: 400 Renee's Drive, Southold, SCTM No. 1000-54-6-4.4 Dear Mr. Manzi: As you requested, I visited the captioned property with you on 11 December 2001 to inspect the validity of the wetland boundary that was delineated before you purchased the property, as well as its location relative to that of the recently constructed house. I do agree with the location of the wetland boundary, which was apparently flagged by the New York State Department of Environmental Conservation and reflects the limits of the forested palustrine wetland characterized predominantly by red maple, Acer rubrum; black gum, Nyssa sylvatica; and sweet pepperbush, Clethra alnifolia. The shortest distance between the wetland boundary and the southwest side of the dwelling is not 27.7 feet as stated in your violation, however, but rather 31.0 feet. I measured this distance by stretching a measuring tape between the southwesterlymost comer of the porch, which is the point of the dwelling nearest the wetland boundary, and the point of the wetland boundary nearest the house, which is represented by an orange flag hanging from a sweet pepperbush shrub adjacent to a large oak tree. The distance &om this wetland flag to the southwesterlymost comer of the concrete foundation is 32.5 feet. In another matter, the well-water line has indeed been trenched through this wetland, which could be the result of the original permittee changing the well location for the Suffolk County Department of Health Services after having already received a Town wetland permit, which he fuiled to subsequently amend. Regardless of the cause of the problem, its best and perhaps only practicable resolution is the restoration of the disturbed wetland area through minimal regrading and subsequent planting of native wetland vegetation. I would be happy to prepare a wetland restoration plantings plan if this is indeed what you are directed to do by the Board of Trustees. Please let me know ifI can assist you in this regard. Sincerely yours, ).., I " Robert E. errmann Coastal Management Specialist . . Telephone (631) 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 Thursday, December 13, 2001, the following recommendation was made: Moved by Scott Hilary, seconded by Drew Dillingham, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Amendment Request of MANZI HOMES, INC, to Amend Permit #4986 for thë change in the side-yard from 30' to 27.7', southwest side only, well and well water line trenched through wetland area, and cesspool in front of house instead of rear, as per the Health Dept. Located: 400 Rene's Dr., Southold. SCTM#54-6-4.4 The CAC recommends Disapproval of the application and that the Trustees refer to the previous comments submitted by the CAC on the original application. The wetlands should be restored and all fill removed from the wetlands. The extent of the fill at ground level is within the wetland boundary. The CAC recommends that the applicant receive the full extent taken by the Town and the State. Vote of Council: Ayes: All Motion Carried . . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Faste!' Ken Poiiwoda ~ (t " '.l+ ~_ ~. Telephone (631! 7 Fax (631) 765-1 Town 1 53095 Roc P.O. Box, Southold, New York BOA..'ID OF TOWN TRUSTEES TOYI'N OF SOUTHOLD August 30, 2001 Ms. Michelle Gesseck Manzj Homes, Inc. P.O. Box 702 Rocky Point, NY 11778 RE: 400 Rene's Dr., Southold SCTM#54-6-4.4 Dear Ms. Gess,=c!<: The following action was taken at the Southold Town Bsard of Trustees regular meeting held on Wedne::;day. Augus~ 29, 2001: RESOLVED, that ê:-Je 2,')uthold Tawr: Soard of Trustees APPROVE ¡he :'equest for a Transfer of Permit 149136 from ·Jon (; ;~e¡,bs to Manzi Home", Inc. in accord:mce with ai' terms and conditicns stated ;n !tle original p,~rmit. If yet.! have any q:~estions. alease cont3ct our office at (631) 765-1892. Sincerely, t2!tt.-¡ ç /4.-(~~'~. Albert J. Krupski, Jr. President, Board of Trustees AJK:lms -..... 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 April 26, 2001 Mr. Jon C. Kerbs 440 Riley Ave. Mattituck, NY 11952 i i . f RE: 400 Rene's Dr., Southold SCTM#54-6-4.4 Dear Mr. Kerbs: , The following action was taken by the Southold Town Board of Trustees on Wednesday, April 26,2001: RESOLVED that the Southold Town Board of Trustees grants a One- Y ear Extension to Permit #491: 6 to construct a single-family dwelling with a 30' setback from the freshwater wetlands with listp.d ccnditions. Permit to expire April 27, 2002. Ihis is not. an approval from any other agency. rfyou h~vc any qllcstJODS, please do not hesitate LO contact this omce. Sincerely, a,¿~·1 9. /~. ~ Albert J. 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(',.J -_. 1 ;: (.; @:§) ~ 'C. ~ ~::>' -. ~ ~'. po ----. ;:.:. . ...¡ oi ~ ~ ~ ~ ~ ~~ IS ~~ "). ~ ð~ ~" h \I ~~ \I ~" It'" \J '>'.~ .... ~\j ~~ ~ ~ ~ ð~ ~ ~~ ~o\ H ~ ~~ ~~ ~ e" 1 ~~ ~ ~;\ ~ ~~ ~ ~~ ~~ ~ ~ ~t ~ ~~ ~~ \) ~I¡, -ì.,1I;) , ~~ ' ~ ' ! ~ ~ ~ ~~ ì1 ~ ~ I OJ ,. "~ t ~ ~ ~ ~ ~ '~ I!I' ~ },. t): \ ~ ~ ~ ~ ~ ~ ~I{ ~ ~ ",. ~~. ~\1 ~ ": V ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~ ~ ~ ~ ~ ~ ~ r,¡ ~ Ii. ~ ~ ~ Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. ISSUED TO l/ q gG, DA TE:i\pril 28, 1999 JON C. KERBS .Î\ut11nrÜ!utintt Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952: and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;". and in accordance with the Resolution of The Board adopted at a meeting held on i\pJ::!L 21.L 19 99 d ' 'd t' f th f $150 00 'd b . ., an In conSI era Ion 0 e sum 0 ... .' ..... .. pal y Jon C. Kerbs of Mattituck .. N. y, and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to build a single-family home with a 3D' setback from the freshwater wetlands with the following conditions: (SEE ATTACHED)". all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees I¥!re- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this datI!, &¿d/4r~ß ~. ...,. fflJ&c~ . '(/1~~' .... w . -. .~f.?/.LL.¿... . ... . .......... ...._H.'è~r.x E;[lJi~J:1....:..'-'I:>.se.,,:~ Trust... . . TERMS and CONDITIONS The Permittee Jon C, Kerbs residing at palt of the lowing: 440 Riley Ave., Mattituck N. y~ OJ consideration for <he issuance of the Permit does understand and prescribe to the fol- 1. That <he said Board of Trostees and the Town of Southold are released from any and aU damages, or claims for damages, of sui,. arising directly or Indirecdy OJ a result of any oper- ation performed pursuant to this permit, and the said Permittee will, at his or her own expeose, defend any and all such suits initiated by third parties, and the said Permittee assumes foil Iiahillty with re<pecc thereto, to the complete exclusion of the Board of Trostees of the Town of Southold 2. That this Permit is valid for a period of 24 mos. which is coasideJed to be the estimated time required to complete the work Involved, but should årcumsraoces wUraot, request for an extension may be made to the Board at a larer date. 3. 11"t this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that auth~ orization was originally obtained. 4. That the work Involved will be subject to the Inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application, may be cause for revocation of this Pennit by resolution of the said Board. 5. Thai rhere will be no unreasonahle interference with navigation as a result of the work herein au'dlorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or It, In the opinion of the Board of Trustees, the work shall cause unreasonable obstruCbon to free navigation, the said Peanlttee will be required, upon due notice, to remove or alter this work or project berein stated without up<!D5eS to the Town of Sou<hold. 8. That <he said Board will be notified by the Permittee Ot the completion of the work auth- orized. 9. That the Permittee will obtaJn all other permits and consents dJat may be required sup- plemental ro <his permit which may be subject to revoke upon fallure to obtain WDe. . . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda . 'z7J7xzxr~ ll~ ~\!fFOlk ¿-c ;/',~~.~'\ 1/ !;; ~ \\, N C . ~ r¡ en == ,I,' \\ "Õ ~ if \!., ~ · ~ ,)' '~'ò~' Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765·18'12 Fax (516) 765·1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD CONDITIONS PAGE 1 OF 1 APRIL 28, 1999 - The applicant provides original authorization from all ownership interests within 120 days. - Drywells must be installed to contain all roof run-off. - Grade changes to conform to survey as per submitted and dated April 27, 1999 - The front yard will have no turf within 30' of the ponds. - Haybayles must be placed around the work area. - There will be no turf on the side yard. - There will be no turf in the rear yard. - The only clearing in the rear yard will be for septic system installation only, - All disturbed areas are to be naturalized with wood chips, and/or natural plantings, - There is to be no bare soil remaining after construction. - Permit must be amended if there are any changes in the landscaping, . . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda ,¡!~~~~ )Y,&".~ 'OK ,9L~ =¡e, '; 'I ~ :;..\~' , ==> .... ".' ',Q . " \i V, a:: N t!, 'ð;. ~. h ~\ +. . ~ }, ":Oè~O./ + i-~~ijtr ""'~Q";zn____~f."I- Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone í516) 765·18'12 Fax (516) 765·1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 28, 1999 Mr. Jon C. Kerbs 440 Riley Ave, Mattituck, NY 11952 Re: 400 Rene's Drive, Southold SCTM#54-6-4.4 Dear Mr. Kerbs: The following action was taken by the Board of Town Trustees during a special meeting held on April 27, 1999 regarding the above matter: WHEREAS, JON KERBS applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated March 3, 1999 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 21, 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 the project as proposed will not affect the health, safety and general welfare of the people of the town, . . NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees grant a Wetland Permit to JON KERBS to build a single-family home with a 30' setback from the freshwater wetlands with the following conditions: - The applicant provides original authorization from all ownership interests within 120 days. - Drywells must be installed to contain all roof run-off. - Grade changes to conform to survey as per submitted and dated April 27, 1999, - The front yard will have no turf within 30' of the ponds, - Haybayles must be placed around the work area. - There will be no turf on the side yard. - There will be no turf in the rear yard. - The only clearing in the rear yard will be for septic system installation only. - All disturbed areas are to be naturalized with wood chips, and/or natural plantings. - There is to be no bare soil remaining after construction, - Permit must be amended if there are any changes in the landscaping. 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 and complete 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, tktL-1 ÇJ. /~ !h. Albert J. Krupski, Jr. President, Board of Trustees AJK/lms cc: DEC Health Dept, Bldg. Dept. · .\ l-.arch 12, 1999 Su.bf pß MS ;:Jouthold. ~2o'.,:~ }lanninõ' ibarJ. Lou-~Ì'_olo.it ....t·w i'Öl:K Gentlemen: 1 respectfully request that the application submitted by Jor< "erbs to develop the property e¿"st vr :Ückory _,oad, just off ;;3oW1uview ..;:t..~.re. .in douthold, be u.eniea. ,I':;: have lived. e.t 1.1.645 SoundV:i.e-vi for 30 years- jus t ea. s t of trh.: p~oposed Jevel- opment, on "the opposite side oi tÜL street. :rhe r'lood.eci street in this aJ..'¿a nas always beeú a p.r·oblem. .30 much so, that the '¡lawn ÚibllWay had even erected a siõn- r'.;autioll-lc¿lI, as in the winter) it b~came hazardous. fhis all JUç, of CO~3e, to tne fac~. oî the water table ill that arEa; \\'hi::h no\, is bein¿' tilreatenel1 to h¿,vE: llouses bu.i¥t upon.. ~'n2 v~~:./ ti-!oubl1t 01."" cess-pools,8t~. belnf; placeci. in trüs fi'a.j:ile, u.':'îsts.ble area, is at trlt;. -'lel'::~ le2.st, IT¡os-c ¿¡,la:!..~rnln(.;.. ~ú ti1ese ,:l..~~\s Ol..~ ¿,nv.:c-l'O.íJlll¿l1tal a'tlal.~aness, thes0 ::..~'.:; T;Ù2 VGT~'~ tlÙll-.jS tl1E. t :i;ü3 t be 2:vol.deJ. Jev.¿l:.2..1 ;-/3-Z;.i.S c:...:;o, t~1~ ~'Qwn approye.J 2. :coad -co b¿- CL:..t in t';:l-::: ¡lüO\...i.S, u..l.:c·ectl;i a~:J..::JS3 l1-',j,,1 -LlB t cd'~ ""Gilt: ou.iLliü.:j of 3svEral horr.es. ~'vê.L·;1 i..'Cl...l.rl finds ',·.'2.te:...· cascé..c.:.in¿ dO-.in .30-clrÛVi. 3'.. n"\~-';';. t.:J -;::f1ç ,,<'81:, ¿~iij -;:'11":' ",:oad l·er:.a..l~lS d¿''''; ':C)1: ¿.~-.rc'-.,.:S.J.. J..:.:.:-,s. _-'--,___.......; _.",.',,,:; tit::...;:; t:,-"cJ,:·:..;<',-:.-'--. .;,::_ ..:'~.....: -":::::~_2_.l.__,____·_~ laGt~_.s lGS'L .fo~'8ve:c. . r~L... ...._"" -~ -,_~~,~~___J..... , f?¿,u b.te. ill:1'j<!:,(~ä~7q] "" ".-.- ~ r.-':\_~'~ '., ~ ! r~. "<. APR 1 4 1999 Mrs. Theodore A. Stoll 11645 Soundview Ave. Southold, NY 11971-2747 South old Town Planning Board Io)Œ©I~r ilir ~~9~~ TOWN OF SOUTHG1·!:' >- fQb ...J ~ BS ~. iii '" t saOOM NVIONI .10 dVW ~ NOlsl~lOens <fONIW 'ý 107 0:: ,J ~~. .<!J~ t( " ~ 0:: "0 ;<ô ~.~ [bß!J 0 ~o: !:! " j ~j i ,Lq-6 ~ M"Ot,F}OlfrS ~ ~ , ~ '" ~ = " ~ 1¡&~ .. 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'oJ ~ 0- J '~ C~ [b!bI] (ë3e . .' ~~ ...::::=. =- ~"S ~= <55ª '" ., :g ~ SaOOM NÞ1aNI ..fa d"W ~é: NOlswaens <fONiW 'I> .L07 ~~~. .~~ · .Lç·~·-./M.O,.Bòl·s <ri I ~~ I "'" I : \ hi \ ~ \ I I II i 'cg~~, ~~~~ 0 oc \ , ~ \1 "'\. -z. I,. ~ .~~ 0 \0'6.~,. "-.. ".-1 ~\!)t-\ "-.... r- I \ \ ~\ \\ './ : I \ \ cc.~ / I \ 9\ \~\ \ \ u¡S;:'. I W I <:'" .... \ Õ c:¡ ~ "'------ '" \~\ ~u \ I \ \\' ,~ ,I \ "" '- l '\ v ~ " 0. ~ ~ ß ! ..J C) co, lei co, a 3:: (¡) " lJ..¡ < lJ.J Q: ;þ. a ,a ;; . ~ ':t- ~ ~ " ~ ¡:; ¡j , " ~ ß ">: ¡;:. '" c; ,3"OUjO.LÞN i 3/L O'8e" A WJW<fO..f1 <f0 MON aN.".., 8 ~ ..... '). "\ -'S -oS _ -'0-- V -> T .. -" "'L _...\, ~ <' '+ ~o-J > <ð -~ -<;¡. ~~ ~¿; =-- ~ <ò 0) - VIEW so~~gNUE " -".. .~ "'> !:! " '" , ~ ~ ':t- "J k ~'" ~ §i!~ :5 >- '" 85 ~ 6:", '" ~~ ~u a '" §i! :5 <11 85 2: a >- ctJ ~ ß ~ ~ . S(..)U C)" .g: '" "- -Vj ~"'1 ~-~ ~ If r: ~,,-::: :::, Vj '. æ",~ ~~'<:( )... r--....ç.:;. Q:'0", ~ ". õ: ~~è3 ù'i"d >- '" ~ ~ 6: ~ Q:'" aQ: 3::~ a '" §i! :5 ._.~- ~... -- .... >- is:! ~ Q: 6:", Q:1§ a¡;¡ 3::ctJ ~ §i! :5 @1 ~.' tti -J ~ ""u «0: tti -J ~ ~ ~.s-g ~ ~ ~o: ~ t1 Õ ~ '3~ ~trib Lù g-J § e <I) ~l5 ~ ~~ ð<'5 ©: ~ '-' '5 ~ ..,. C) a a C) C\¡ ,,: a ~ - C) lc. Q:: C\¡ .... 0 §=: a >- -..J Q 0 Q: <0 ~V) -...J3i:: § C) 0L..J ¡¡¡ ;S ~~ô8 ..... r::<: " C):::J t:' Qj -£ -...J 0 . ..,. ~§!v)~ kj lC) ~ !2 ¡..:: <: '" C) SI-._:<: :§:::Jlc.:::J (§ f¡j ~a§~ f...:.OOÇ) cnV);;::'-J Vj V)-....Jv)<: C) ::s::~ a ~ C) Q:: 2<3 C) Ç) <0 t I[ '" :;;; , ~ :¿; :::J '" (n \'\ kj ~ -..J Ù '" 0 Co r..rj 0) -.;- ..... 0 ~ ci <: Q) '" <: Q) :,g <; -" g~:Q- ~~~~ C) tJ_Q~~ lr) .J- "_0 ""f- c-.rcn~oC'\¡C\ "'"' ¡j'nt'.¡C'\¡ ¡Sa ¡.J ~3::~-~~a ..... '.", ., "'~'" C/) Cr}o.:G:~~a~ ·<:~o _~_ a a 89::CI' c:¡a::::;~ <: _ o.::~¡:j~Q'"") ~e¡!:!:5C: ",0 f!5~~~~~~~~ -::'Q::.:::JV) --.J ·12 I 12 ~~ ;:f~ji~l~ f;:; " g §~ ~~~ï~~I>II:f~ '" ~~ ~"o~~ ~ '-' ~~ ~e~ ~~~~~ "'~ ~~ e~lf~~~e 8 ~ ~~)..!tí f!s ~ II¡ 8~<: ~ê ~~~ liæ~i "'¡:so " " ~~ hr ~~ GC:¡~ ~I ~~~!~!~:~ ->:" ~ao.. "'" -\!~8 u i\~ ~,=~u~ ".... §~ .~~~~ ~~e~. è eJ&ÇJ ~o~~~ ~~G ~ h:,,~ ~(J¡..;: ~1~¡h~e~~~Ê] -",'" ~ ~S~I~~~~:~ ß :ï! '" ,,'-' " i:<: v ~~ ~ ~-~~ ~j~~c ;::: lI) ~ ~ ~~~I~~~~~ ~~~ e:¡ ~",,,, hi! e 0. 0 <::i '" ~~~ ~h~~d¡~ (j iE~", . . 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 Office Use Only _Coastal Erosion Permit Application WetlandPe' ·cation _Major Minor ..........-vIaiverl ndmen Changes _.-Received Applica . 0 ", _~cei\'ed Fee:$ ðlY "'-pmpleted Application /O/¡ ~ t:)'1 _Incomplete _SEQRA Classification: Type I_Type lI_Unlisted_ _ Coordination:( date sent) ~CReferraISent: IQ/œ~. _ 8Irtf oflnspection: /J II \, I OJ _Receipt of CAC Report: _Lead Agency Detennination:_ Technical Review: = P!!'5!ic Hearing Held: 1I1I '7/ ¡y.¡ Resolution: Name of Applicant Address ;: o. V'-:!y. /19'7/ 0w, ,<Ç;. /, l!' lk ¡r /) /}/ kAli ¡foý ç,/ tli) l' /èJZí.c<.... »a¿.2z.<:e- ¿!" .5"a4c// I 'Ii Phone Number:(¿$/) 7~ r - sa? 0 Suffolk County Tax Map Number: 1000- Property Location: t/-v D 1&.-fL ~ ý..... ö'} 'f f3L/ç· a tlt,¡-< SQ~ ~ Ie( 4/- oe4.-tJo ~ ..f;:1/ , (f 9 ) ( AGENT: --- (If applicable) ~ ~5~m; ýj \0\ (provide LILCO Pole #, distance to cross streets, and location) Address: Phone: 4I!ard of Trustees ApPlicati~ GENERAL DATA Land Area (in square feet): :J..(.,t.f sr- /L¿<; I-£,J~ ~Ú7,mÁ Intended use of property: If PI d /' v( tit ( t' J4--. Area Zoning: Previous use of property: Prior permits/approvals for site improvements: Agency Date ~ prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? Y"No Yes If yes, provide explanation: Project Description (use attachments if necessary): ~µ á-~r¿// kl- z$' ik£·k &.v.'11 i., 'L. / ~ <' " \l ~ ædß. ¿-/'cU.c.r<'. , ?-/ ;J-rt... re~ 2Jl / VI-r ; / Ý /'Z . Board . of Trustees Application WETLANDrrRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: dck-- ~ ~ 4/~d/<.I 4~/¿// ~ 4d4',K /'7'" ~ Area of wetlands on lot: square feet Percent coverage oflot: % Closest distance between nearest existing structure and upland edge of wetlands: *1 ð feet Closest distance between nearest proposed structure and upland edge of wetlands: >Z' feet Does the project involve excavation or filling? /' No Yes If yes, how much material will be excavated? -- cubic yards How much material will be filled? - cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 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): ~ 5~ué/¿{ ¿ /A.-o ¿,rk-,L ~ 4/~/Þ4A ¿~ ¿LI tÅ-" II? J~-J/ A.. ~qf, (!h<-A~ or? J,~.y. #(1 ¿t'Æ- dvt/1fÞ ~,II k d'~ ~ ¡V\... "..£ /-lad ~4!' >/ 4I!ard of Trustees ApPlicati~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: tÆJ~ &-Ct(, Are wetlands present within 100 feet of the proposed activity? No V Yes Does the project involve excavation or filling? ./ No Yes If Yes, how much material will be excavated? - ( cubic yards) How much material will be filled? - (cubic yards) Manner in which material will be removed or deposited: --- Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) ,lvi:> e ; (/>If"7""^,,l'j (p ,~:O'ic. -& ~~c.k//. I PROJECT 10 NUMBER I- 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only (To be completed by Applicant or Project Sponsor) - SEQR PART 1 - PROJECT INFORMATION 1 APPLICANT I SPONSOR / I /, .:> /V? .5'c t, l c h 'f"'('",'-- 3.PROJECT LOCATION: /l;4/" of ",.u~ Municipality q¿)¿J þ/?.¿'s ~ ¡t,. ~ 2P:47¿;~ ;{- ack- ~alk- County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc· or Drovide map ,Þ~ Ú>tLS1 ,11 Þ1?C tfcM. r-s ¿;.., ;fh- 5. IS PROPOSED ACTION: D New ~panSion D Modification I alteration 6 DESCRIBE PROJECT BRIEFLY: /1M /'-- ~~k- d 0?;52 (;kck /v'/! t ú/¿d 'k ¿;v, þ> I-- f(æf, 2. 5ÞZ 5Þ¿~' /Y~ ~~.I~ 7 AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres U 8. W1LL PROPOSED ACTION COMPLY W1TH EXISTING ZONING OR OTHER DYes [a'Ño If no, describe briefly: / tJt-lir.'1/~ ~-;f- ~/fld~ ~ rr~.[ Ä f' 9 WHAT IS PRESENT LAND USE IN VICINITY ~Sldential D Industrial D Commercial OF PROJECT? (Choose as many as apply.) DAgriculture D Park I Forest I Open Space D Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANV OTHER GOVERNMENTAL AGENCY (Federal. State or Local) D Yes ~ If yes, list agency name and permit I approval: 11. DOES A~A~ OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR D Yes ~o If yes. list agency name and permit I approval: APPROVAL? A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? ONo I CERTlFV THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Signature Date: ~)/ø/ Applicant If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment . . PART II - IMPACT ASSESSMENT fTo be comDleted by Lead Aaeney) A. DOES ACTIO~EX~EED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.41 If yes, coordinate the review process and use the FULL EAF. DYes LlfNo B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NVCRR. PART 617.6? II No, a negative declaration m~~perseded by another involved agency. c=J Yes ~NO C. Ct. Existing air quality, surface or groundwater quality or quantity, noise levels. existing traffic pattern, solid waste production or disposal, rtential lo;:;::.~rainage or nooding problems? Explain brieny: I C2. rsthetic~;ral. archaeological. historic. or other natural or cultural resources: or community or neighbomood character? Explain brieny: I C3. Vegetation or fauna, fish, shellfish or wildlife species. significant habitats. or threatened or endangered species? Explain briefly: I f/V I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly· I ~/C I CS. rowth. -;~ue;development, or related activities likely to be induced by the proposed action? Explain briefly: I C6. rng teÄ-~rt:~. cumulative. or other effects not identified in C1-GS? Explain briefly: I C7. Other imoacts (includina chances in use of either auantitv or tvae of enerav? Exalain briefly: I ~/O I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL DI~~~M~IEA (CEA)? (II ye.. explain brieny I E. IS THERE. O~E LlKEL V TO BE. CONTROVERSV RElATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? II yes explain: D Ves ~ NO I I PART III . DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (Le. urban or rural); (b) probability of occurring; (c) duratk>n; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY oca.Jr. Then proceed direcUy to the FUL EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actio WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date pnnt or Type Name of Responsible Officer In Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) 4Itard of Trustees ApPlicati~ County of Suffolk State of New York 74 ú~4' S S; ¡ I ( I, -J.r- BEING DULY SWORN DEPOSES AND AFFIRMS THAT milSHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HISfHER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ,-;:% A ?"~ Signature SWORN TO BEFORE ME THIS .:>zJ DAY OF () cI-- ,20 (!) L/ &4~ Notary Pub¡¡t I'ATRICIA CORWIN NoIaIJ PIibIic. Stall 0/ New M Q J~IC05017852 ~ ...-IoSutIGIII - commi"ion~Sept~ C.) . . APPLICANT/AGENTIREPRESENT ATIVE TRANSACTIONAL DISCLOSURE FORM o ssible nflie YOUR NAME: NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance ~ Change of Zone Approval of plat Exemption from plat or official map Other ((f"Other". name the activity.) v/ - ee.The 0 e whatev r action i Do you personally (or through your company, spouse, . ling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by lood, marriage. or business interest "Business interest" means a business, including a partnership, in which the town officer or mployee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more an 5% of the shares. YES NO IFyou answered "YES", complete the balan of this form and date and sign where indicated. Name of person employed by the Town of Title or position of that person Describe the relationship between you If (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) an or describe in the space provided. The town officer or employee or hi or her spouse, sibling, parent, or child is (check all that apply): 5% of the shares of the corporate stock of the applicant (when Ihe applicant i a corporation); _8) the legal or benefici owner of any interest in a non-<:orporate entity (when the applicant is not a ration); _ C) an officer, directo partner, or employee of the applican~ or _D) the actual applic t. ~~:.::~;: this n ~ ~&,:/ 20olt- PrintNam~~ ~,¿, t. frr- Form 1'$ I . ~ Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Albert J. Krupski, President J ames King, Vice-Presidènt Henry Smith Artie Foster Ken Poliwoda Telephone (516) 765·18<r.l Fax (516) 765·1823 BOARD OF TOWN TRUSTEES , , TOWN OF SOUTHOLD LETTER OF REQUEST FOR AN AMENDMENT \.",:\,'J (, ,\ .' L- DATE 1/ at. 0; '" L OWNER]Y\CLr'\c,i I-bmt'.f, It'll' PHONE b31 7'-1'1' 1039 ADDRESS P n i? (") k- to,), 1'\ DC./'«(j Po i,,~ l N Y II -, 7 f' AGENT 5~f'ùe", E LOSNo...fJ..ro PHONE '7,-/'-1 - 9070 (63/) ¿; ADDRESS 101 "" Röu..\e 2,S A Rc:;)(~'<..'1 Poi..,~: .AJ'III'Ot' PROPERTY LOCATION LIOO f2.erìC?. Drì.;e" Sov...,P'lOlc.l , TAX MAP NO IÜQo - 5'-1 - . nb ' Lf· DLf IfWe ..fv\()..(\t: i Ho{YJp ç '1'1 é. request an Amendment to Permit # if? ¡. b , ¡::'/?,J,Þ( :;/7 / T~ 27,7/ .J(NfTH It/EI'T~/'þE .5liH VAd (¡ / k,I'£LI. + W/;'l.L W'IIT~'¿ ~/;t/E T¡(,::,.."..a~E() TII¡(v~~ II ~"'ß/J) A,,(¡Ç/4. CcfJs¡4ppL /µ rdv_r p¡C ApMt'5F /Þ--rrrEHZ ~€-M· A..f';¡:¡:Z' >/6<tLrtf "'-;/r. oD'-'~ Signed By . _ .#'1' t?- "\ Q(þv<!-- I ~ ¡ ~ ¡lc' , , . .¡ . . MANZI HOMES, Inc P.O Box 702 Rocky Point, NY 11778 631-744-1039 August 9th, 2001 Regarding: Transferring Town Trustees permit into out name, To whom it may concern, On the property of 400 Rene's drive SCTM# 54-6-4.4. We are requesting that the permit # 4986 be transferred out of the name of Mr. Jon C. Kerbs and Into the name of Manzi Homes, Inc Thank you for your attention on this Matter, If you have any questions, I can be reached at 744-1039 /m:!lJh It~ Michelle Gesseck ~ r i -------.- !. r: f"-' JIíJ.1 I 3 . ~- . \1·' ;: ' ,r ,¡ ·~.1 ......, - - - --- -. - -, '-]\1 1., if I, J. I' .:J ~ t . 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,'12 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD office Use Only Coastal Erosion Permit App1icatio œ ~Wet1and Permit Application ___Grandfather Permit Application ___Waiver/Amendment/Changes Received APp1ication:~ Rece i ved Fee: $/ S-d Completed APplication...3-J-Œ Incomplete SEQRA Classification: Type I Type II Unlisted coordination: (date sent) ---- CAC Referral sent:~ -~~ Date of Inspection: 3 - ~ Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing He1d:~-,,-a= Resolution: Œ©Œ~WŒIñ1 MAR 3 91) æJ TOWN OF SOUTHOLD ~D MAR 3 - 1999 Name of APP1icant~ D"'- C.- e.. 5 AddreSs~O ~( to ( ~ A.¡~ fvt,~·\J\l{. ) ~k:, lJ Lf' (~ z.. Phone Number: (9'0) 76 r -;;)0 ~- G suffolk County Tax Map .N~ 1000 - C:;C¡ -~ - Y. i ,,' Property Locat"t:.: ~ev."" 's Dy"\íe s.,,~<Ac9 Sc,,- =-~Lfl (provide LILCO Pole *, distance to cross streets, and location) I' AGENT: (If applicable) Phone: FAX*: Address: 1 BO~ of Trustees Application IÞ GENERAL DATA Sl'f57 'S·I.Çt- lJúc r. ~ -\- lç.,L.-JÎ \ ç "^\ l,- ~~':> \ Land Area (in square feet) : Area Zoning: ~-~ Previous use of property: Intended use of property: Prior permits/approvals for site improvements: -s"u\LI(~~~\~~~~~-J7 ~ I.).. 78 No prior permits/approvals for site improvements. Has any permit/approval ever been governmental agency? revoked '/. No or suspended by a Yes If yes, provide explanation: Project Description (us~ attachments 'f nec~ssary): ÙuJJ S'\",- . -=ç<.W\\ ~( 'Se--\ c..cK ClAA. fw II Ie-\- \c~~<, 2 Wi sö' Boa.of Trustees Application . WETLAND/TRUSTEE LANDS APPLICATION DATA ~"~ the propo.ed operation., '"Bu:lre š'~J< ~...J, ~SI&".C't" Area of wetlands on lot: Percent coverage of lot: Closest distance between edge of wetlands: Closest distance between edge of wetlands: 1, C, ðO 0 Square feet ) to 7,- % nearest existing struJ:~re a~d upland feet "\0 e_ ),~ '5"Wv<-\ur< "- nearest proposed structure and upland "30 feet Does the project involve excavation or filling? >C Yes -é'K.cC'~v<~-\\~......ç:: C"""Q.~'--\-S('~\IL .'? s.,,\'>~ If yes, how much material will be excavated? ::.0 Ocubic yards C-> No How much material will be filled? cubic yards 6'- Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Vtù c~~~ Manner in which material will be removed or deposited: .~C-~ 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): V\. U'vv 3 14-16-.4 ¡2fS71- Text 12 I PROJECT '-D. NUMBE" . . 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only SEC PART I-PROJECT INFORMATION (To be completed 1. T/SPONpoR j,J\. ~ J. PROJECT LOCATION;/' Municipality 7ù County 4. PREC:SE LOCATION (Street aadress .ana ] Intersections. promInent lanamarKs. ~[c.. or ~rovlae :TIap) w\ ':> ~1t(A.() 'r.~~. \l \11 5. IS PR POSED ACTION: New 0 Expansion o MoaificalionlalteraUon 6. DES R<BEPRo~c~~:rç~~t ~~'JJ ~~ wi S-(~h( SI> .w.. 7. AMOUNT OF LAND AFre:CTEt: Inillally ~ acres Ultimatelv acres 3. w~ ?ROPIJSEiJ ACTION COMPL':' 'NITH EXiSTING ZONING OA OTHER EXISTING I...AND USE .~ESTn CTIONS? ~Yes 0 No If ~o. describe brle/ly g. VJHAT IS PRESENT LANiJ U::ê: IN VICINITY OF ?AOJECT? ¡¡fì Residential [J.~ndustr1al [J C~mmerclal Ò:Sctlbe: Q Agrlcuuure --.,; ParK/Forest/Ooen space U Other 10. DOES ACTION INVOLVE A PSRMIT APPROVAL OR FUNDING. ,'lOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (F=iJERAL, STATE o¡::¡ LOCALI? ~Ye.s DNa if yes. lis~¡afenct~and ~aoDrovals ~V0~W \<.JW"'-. 'TVUS\et"> - 11. DOES ANY ASPSCT OF THE Acnor., HAVE A CURRENTLY VALID PERMIT OR APPROVAL? o Yes· ~ No If yes. JIsl agency name and permIt/approval 12. AS A RESULT 0 PROPOSED ACTION WILL S<LSTlNG PERMIT{APPAOVAL MEQUIRE \.10QIFICAï¡ON? o Yes No Applicant/sponsor ,1ame: HE INF01'ON PRê:~ ~~o THo 3ES7 OF MY KNCWL2DGE . L-, D.le 1:ß7('f9 SIgnature: If the action is in the Co"stal Area. and fOU are a state agency, complete the Coastal Assessment Form before proceeding with this a~~essment OVER PART 11-:NVIRONMENTAl ASS- MENT (To be comoleted oy AgencYI ~. DOES AC710N E~EED ~NY TYP!:: I ï DYes jUNO a WILL ACTION RECEIVE COORDINATED REVIEW AS ?ROV'OE~ ¡::OR UNLISTED ,l.cnONS IN ô NVCAA. PART 3; i.57 may be superseded by anOlher ¡nvolved agency. DVes DNo C. COULD ACTION RESULT [N ANY AOVERSE EFFECTS ASSOCIATED WITH THE FOllOWING: (Answers may ce r'landwnnen. If !eglblel C1. EXlsllng air quality, surface or grounawater Quality Of Quantity. nOise levels, eXisting ~rafflc patterns, sOlia waste produc:Jon or dlscOS2 potential for erosion. drainage or flooding problems? Explain briefly: ·SHOLO IN 6 NYCr:1A. !='.;AT â17.12" If yes. COQrOln",C8 the review :rocess ana use the FULL ~'=-. II NO. 3. neqallve oec:araUc V\() C2. Aesthetic, agricultural. arcnaeoloqical. hlstonc, or other natural or cultural resources: or community or neighborhood cnaracter? :xplaln orte! ~1ù CJ_ Vegetation or fauna. fish, shellfish or wliallfe species, significant habItats. or threatened or enaangerea specIes? :xolam brlefty: \ \W <:4. A community's existing plans or goals as officially adopted. or a change in use or intensity of use of land or other natural resources? Explain orle \'\0 C5. Growlh. suoseQuent aeveJopment. or related activities likely to be Induced oy Ihe proposea action? Explain one/ly. ",Ò C6. long term, snort term. cumulative. or other effects not Identified in Cl·CS? Splam orietly_ \J\u 1:.7. Other impacts (inClueing cha(1ges In use of eIther Quantity or type at energy¡? explain briefly. \J\D I, o. IS ~ERE. OR I~HEAE LIKELY TO BE. CONTROVERSY AELATE0 TO POTENTIAL ADVERSE :'!'-IVIAONMENT;'L :MPACTS? ~ Yes ~ No If Yes. explaIn briefly PART III-DETERMINATION OF SIGNIFICANCE (To be comoleted by Agency) INSTRUCTIONS: For eactl adverse effect identified above. determine whettler it is substantial. large. important or otherwise significa Each effect should be assessed in connection with its (a) setting (I.e. urban or rural); (b) probacility at occ~g; (CI duration: irreverSibility; (e) geograpnic scope; ana (f) magnitude. If necessary, add aUachments or reference supporting materials. Ensure U' explanations contain sufficient detail to snow that all relevant adverse impacts have been identifiea and adequately addressee. o Check this box if you have identified one or more potentially large or significant adverse Impacts which MAY occur. Then proceec directly to tne FUll EAF and/or prepare a positive' declaration. ::=J Check this box if you have determined, based on the information and analysis above and any supporting documenratlon, that ~he proposed action WILL NOT result in""µ'f1Y significant adverse environmental impac!s AND provide on attachments as necessary, the reasons supporting this determination: .....,,"~ () Leouj .....~nCy r'ron( 01 I yp", ....m@ 01 r<1:'~Don~.ol~ ulllcer 01'1 L~..o A¡,:t.'ncy r'l ~ 01 Kc~oon~IOIt: ÙII,cer :),.;n..HUf!:' 01 K,,"soanUOle vll'Cl:'r ,n L<:dC ^"ency ). (nõ(ure 01 r'r",p.uer III <JUI",r..nt trom (esoonUOh~ orllc..rI D.ne 2 ~ard of Trustees Applicat~ P~L.r-r- ;Q\2:'C.Q1-\ (ùunty of D11ffellt State of ~eu YQFk F LÖ!:l..1 i::) P. l''';J-'' )'1 -G - L.I, 51 ì (} (J Li U I ç: loLL Ç::.. ~ P E2Q.- BEING DULY SWORN DEPOSES AND AFFIRMS THAT æ/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF -æ-&/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS JI..ND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS --I q +-1\ (L;)ti~ Signát DAY OF ~J\ ~ '-J ~~tJl.~'<1t~"dO«-- Nary P ~c OFFICIAL NafARY SEAL SHIRLEY A DOWSWEIL NafARY PUBllC STATE OF FLORIDA COMMISSiON NO. CC7464û'2 MY COMMISSION EXP. ñ TN!';:zi.-?m? ,19..Q9 œrn©rnOWi;<;~ r-=-: 1:1.11 ~~Y_.2 519~ i~1 T.'':' .,:. , 7 .ard of Trustees APPlicatW- ... I, AUTHORIZATION _ (wher~ I the applicant is not the owner) \v..... f.,\,UrV2l,-\ l"\C~~{ K residing at ø L) (print owner of property) (mailing ~D&-A- Ç?G..~,-^- ~(f1. do hereby authorize Sc. OCP""'~ address) ~\.IJÝ 0 f\v+- llo \ \ ~ \) ( 00", ~. '\\,e'v\o "'":;;> (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. 6,~f~~&.f -:Çr ~\L'J~~ \:~::t~y\eo~ x œll ~~r;_:C-~i:\1 TOWN OF S~;'jï: 8 I-~~'", .,.,., . .~.,.,.". """'"1r' . ,I 'r " 'PI'I ~., P - . ~..? ,:/ I") , \1 'V ) ',h '" I.:~ ." :.F:("TJPf : ( ~'J.(,{ J¡)~ _ '/7" .~~ (' r:. PC t:J. 11 (Lf,l .n ntfi:K: or,.(I(I 11)1': p.'o "0.1,1'1111 l' ~·J,P/~ .'.;.---""'--: ~:.,.;.,- ~v( r ,,) , I . ....... ., .. , 'I"p,j --. .~--~--. 't1.' 'Or'W..rrrrJ : ·eightY.' :'¡f~ :'11 !,II,! Avenue, Southold. I<ew YOrli:ì ;,¡r ~lCl;.'VU! . ' ~~ 'f. "¡ð I' .'/ $..... .... ........., 11 II"AI. ESTATE, : " JAN 8 I~BI ! ~' ;.\ Tt~"I~S.Ff.R 1.,1l , "i( 1'-111,. øl tt,~ fir" (Qrt. ..n.J . St:f fULl<. :' DEDOfWl r _ ED~ON. rcsiding at (no numbp.r) wells A IH. CP.;~t~~~·, , d ':0"" YOlk 11971 and HURRAY KLAPPER. residing at (no nUlmer) Digman I ' Road, Cutchog .c, t4cw York 11935, as tenants in common !. ~ I .. I .~. ..' ....... ..·.1·..·.·.,.......· eo"~."n y"n UWT.I!1I{"O" 'I. MI.. TN" IMcTlV"'"f.nu11"nl t·,~!H!I,..· 5/. .... ., .-... -.- nlt~ IHDEN'"RJRE. rTUl.1r Ihr JOt h da"ðl. ()nccmhf!r . n;rwlh'n hundre-1 ud BETWEEN RENE· G!::NDP.ON, t~,idinq at 620 Youngs 11971 ¡.: 11;:I~J.1 rart)' of the sccon.J part, WlnES!ETtI. th.u Iht r:r.rt)· t)f tht fir.1 p..n. in c.....,.idtnli"'l1 01 '. Ten ($10. 00) --------------------------_______________.._______ doll.. .;. '.' 101....'"1 n,nnt'y tlr .hl Pnil...I.";IUU. >Old, ,,~. Iht ran)' Of Iht 't\'On, rart. don htrrÞ=, grant anoi rt'lt,,~t unln the party .llht '«OrId r-rt. the hdrs or '.' , ALL 111..t «fllin plo'. I'lece rlr 4rcri nf bnll. ~ith II.e Iouil,ling' and ¡n:.pro nnr.,tJ·;thcl'C'On eftt'lcd. 'Iru~'e/ ..Ic.·r·...'n ~IIII ....ir·' III ,ht' ·.¡rrr lor lilt' ,"("(oJI' r.,,1 fOl'rvt" I}in¡: an.! l~inR in Ihr Town of Soulhold, County of SUff?I'k and Sti,te YOI~, mora rartjcu1ør~y boundud ~nd dcscribed 81 follows. , . of New , . . . I" . Of:t'iINNJNG ¡1t. .1 point 0., thr. southwcsterly side )f 1\ private road known \ .):; Rf~ne'9 Drivo cUut;mt J4b.70 f~ct southerly f.~om the intersection of ~ lIw southwcst.el'ly si;)c of Rúnc's Drive with the 8uut~ea8terly øide of...1 ~;uul d'/il'''' ^I.·'HHI~. ~hich point i.s also the Bouthnastcrly corner of 1.nd,~ r..}'.. cr L...r~(!rlr' ...f ,'h~'ltO: "'. ".'~ n.:nnl.:'IJ U".enc(' fn..m &aid point of beginninq along the southwesterly '~ :i)J... of n~n~'B DrIve South 42 dcqrecs 51 mlnutf:!CJ SO sccanclø East lSq.67 f'··:l t!) .) v.ir.l.: I t,'·n··r- ;,Jr.n'l t".~ .In· 0" .) rllrvn ho.lrillc to ttH! II:ft:: hnvlnq a radio. f'. {/( f ~.lIU I'·t:l cI dJ!il~lnct:' o( 7i.4'J feel: ','. lhcncr. dlonq tho. arc o£ a curVL bcarin9 to the right having a radlu.fft of 170.CJO feet a distance of 142.9R feet to land no..... or lOL"'IIIerly of 1.;':- Klapper and Edson: t.hence along la:1d now or formerly of Icapper and Ed80n South 47 degree 00 mi.nutetl 10 Ru,,:oJ"lds WCRt 219.5, feut to land now or formerly of H 'I'~;' n~rqani: I ' thulCC o1lonrr l<'1nd now or formerly of Dergani, Spicar, aroach and ,I :<";' Cilr':"ol UOtth '¡4 dp-cJrcer. 12 minutc:,> on Beconds West 348.92 feet. to lend:, nf.l.... or formnrly of hhbatø.: I " run,1. C thnncC" alr,nq land no'W or forrrcrly of Abbate North 47 de~lr... ~ (If! millu cs 10 St:conJ£ I:;ast 142.70 f .:ot to the f:Jlnt 0.::' place of m-:c:aNNING. ALL ttlat c@rt~~n plot, ~tQce or p~rc~l t·~ land, 'It. S."1I.U,ol ~ l~ t..~(! T"....:1 of SOUt~1Dlt.l, CLunty of ~ ~W \'..I["Ic, b,.,wndcd ilnd d<;8cribuú liS foll.,W81 1· 8i~uatQ, IY1ng and beln Sulfolk and State of , Î. ,.~ rU:(;HmUI(; .'\t. a p("..lnt cm tlu~ "ßRtcrly .:.Lda of Rane's Drive (Private ROad) ....hieh poan::. iN ]r'O~8" fnf".t l'Iollth~rly from the interaoction formC'ld ·by.. I lhr. r"!anlorly RLfJn of Rene! I. DrivQ with t.he southeasterly side of SOt "d"".' Vif!W Avan\.(!, 8.'JLd point baing the sout.herly point of land now OL forMe or H·,r.rhiarr.llt: 1 ,.:.~ runnln.) th~nc(' fro:'ll Rrttt1 poirot. of hrqinnlnq North 47 degred& 08' I '~Ø\¡ ml.r~lllr.n 10 :u~..~r.mtl~ f.,19l 120.110 lant. t.o .t polrlt. And land no..... or fOl'1l'l.r~y~¡-~ or 1I."l.hn: :¡ ~.:'~ ~.:/\ .. -!"c,ntlnll,'d- '; .-¡::.~ : " ¡ I. , . .' , I", .- ¡.¡,;.. :~~;d;j¡)~.~·~;i '" 11-,1 . t-b ~r¡¡ ,j;iJ ¡~ . , I, il~ . , , , I.. .1:; ¡:.¡ L " ! I d.1 ;......: . ',1 : ~::' I· .U,: ('n~n 1:7" "'·r~J.1 :'I'I~ t.... r,tHlcrif.llon c:ont'nu~ci1 rU""in'J Lln:!net~ .llun'J land ~ow or torm~r__}y o! Hahn South 42 dngree. ~,L ndnutcs 50 M:cond5 East 4')5.0~ fcet t, nonc's Drivol runnjnc, :;hrncr~ alon<) hcnc'!'I Drive tho following fivo (5) course. ."\nd .JILl....ncp..:' . :' I, l) South 47 d.~qrQt1s OR mlnutns 10 scconds w(!st 35.00 'feet ·t·o a polnf:,' 2) .,krt.h 42 dC'J'!:ocr. ~l minutQIi 50 8cC'undn W "Ht 55.00 [cetl J) alonq tho lIn: of " curve bf'li\rinq to Lho left having a radius 200.00 fcut, a distance o( 1M·.:7.1 fl ":!t: .'. .1) lhllCI, i:Io1on'J tho lire uf n curvu iJ,.,nring to the rl,..ht h4v1nq a ra~iu8 of 55.00 (cot, n diAtnncc of 46.2~ fnet. 5) North 42 dCljrCoH 5J minutGR 50 sQconds Wust 210.0ú feet to the point or place of DEGIA'NING. ,,, nr.ING ANn INTENDED TO or. part of the name prem!... conv'!yed to the .'. qr,a,.ltor horoin by deed dtltQd April 11. 1977. rpcordod in the SuttoU.. CQunty Clflrk's OC'ico on I ril 11. ~977:i~ Ltb~~ 8219 page 363. .' ".~ ,I 'I I 'I I " I ., I :1 ¡ ,: :j I "'. ~'\ . .'''Í¡, , . '.: " .'f~ 'f .:(,.:. f '.'nl.. 'to , i··t 1''-'1,.., . of ~ '~-\,' ~ ~.~ 'H' . "~' . .t~. II .[ .." .1 J :~. " ., , I. ..' . I , I' " :., :". " i :1: ,ø··· ¡~!!;¡~f~r 'li', I,") I. ¡ .' "j "I ';~;it··· t, ,i I I II; '.' .: .8f11Q;,¡ 5ï:J TOcC11.r.R '" ,Ih all '¡~hl. 1\ n,1 illlrtr.'. if .20"'-, or 11If' (\':-t~ (·f It,.. foral (Url In "'1.1 '" ,u.,- t1ft'YtI &nd I.....r. ..I un,"£, II t' "I~ ,.. . -,.-:.!.o,f rrr!1õ1't. 'n Ihr Ir"! ~r I,nn '''rr... i, TOcEnI£R """f¡ d... J!' otH1'"t1Jn":rt 11111 311 tI:r cOlale an.1 ri¡;hh (., Ihe r.any of Ih.. linl f'an in and 10 ""¡'I pJ('Mju." TO flAVE AND -... . ".J) the prrmi!.f" hernn rln!d l.OIO I,.. pIny.., 1!1C ~rontj part, .he hritt or Ulrrh"lr, .n,I., ,ny to' Ihr o«r.nd part forr\'~r. , AND flu' pour,. of th~ tint pHI (,nC'nani, ILu Ihe- p.1rty of Ihr fin: ¡.art h,¡\ ntll rJon~ nr IUfl"rrN In,vainc \\/Irrchy Ihe "lie! flr-lIIist .'I.:nc Iwm incumtlt'rerf in any "ïl' whaltnt. u('tp~ .S af!~rt'said. AND 'h~ I""Y (I' Ihe tiul part, in ('Inf!plianrc ,..llb ~r(lion JJ or the J.i~n I..aw, CO"rnanlllhallh~ party of 111_ fi'lI ~rl .-111 rt,~iYr Ihe ('(lnsidrn.lion 1.1, I~i. C'tIn"c~"nC'~ ",n.1 will hr' .1 the right to rraivt IUd¡ ton.rd. rf.lllnn as .t Irml lun,' t.) '.-: apr1ir,I fint 'Of lI,e r\lf1"'Jle ..f p'rillR lhe ,'on <)f Ihe impro\'rmC'nl and will appl, '}or "-<Imo: (ir~: t.... the JI:!.)Tlfn! (~dl(' en,1 of If:e Imprrn'C'mtTII bfofr'te J'in: an.III'.u1 tll Ihe .otal 01 .he alnt lOt :LIIV "'IhRJ 'I:'I""~~, "II,.. ""·".1 "1"11\'" ~h.IIII..· ···".Iru.., "'~ if ¡11f'.ul "....",...,.. "..Iu·nr\rr Ihe "'I'~r "' Ih¡~ in.lnnute 10 ,.,.qulrrL IN WITN£5S WflERI.:oF. thr loan,. flf n,r fint I.ut h"" dill)" UlC'culrd Ihi\ dred . r day anel ynr fir1t atxwe _riti'ffI. ," JIf ""''''~I),: , ~ .. ~.... ',1'· ' . /r,,·' .!.6..i.-;,{ L-......'" 1 ,,(I . "- RClle'Ocndr"n I,; T,,\,'''''''-~I'''' .1" ,...1.. .. I !' '11';'" ,. . I! : J, I II: r , ~I ,i" I "loTI 0' '11""' 'fe-U. COli""'" 0" Su r t h 110: ~'~ ... "1".' I . ,. ¥ ,"'r........;.I;'~. 1,1-:" to m. ...... ,. '" I.. i.di...... d.....W In In<! ..... '.: .(~ nmnrd d1: forrxninl inltnunral, and .dcnowIed~.... :'I~~l ~Jtl"nnN Ih,. QI"lC. . '..l dT~1 . I~';: n, IUT. o. Hrflf 'OU, COU,"" 0' ('\nIl,.· !IIthll\ of O':Cf. r.)'C'r. prr."f,.lh fI"" 1""I"...rM"m" On thO' (h"nf f'tnl'nall."um, . 19 -, "':11" I (;I!ItJ"OIl In mC' ! .TI"" n I," IIf' I~'~ intfi,..du31 rJ~c-i~ in and ""hD C' t("Ulj'l Ihr turl"mint in",umrnl. arId .clmo...· rtftrd thai hI! ~ (~d II~ ume. t I . . ::1 -.' / / 1'7'-' t.../ 'I' r1'~};/ ø'1.,~'X L ;~;nOl Ph ÞOi UH" It »...."",..."..". '.'.1...'"'''' ,..a "'.. ~;. {-I',','. 1'1 ...-~::~~..~.... :~};.;'~;:,~.; ";;',"1 Jill ,. . lTAn 0' ',"" YO". COU,," ", II, STAn 0' tiN ro.... CO; ,0 r o. .. ("tn 1""1 ,Iw n' II) . Mfnr ' mr On Ihr day nl 19 . bdou me 1",,···...:Ih- :"111' J'l'f'''n.n'''um.. I,' II>r 1. , no II. ,..t..., I...i..~ '.\ nlf .1,,1\ "'"m ,I, I ,1"¡ø\4" \n,1 ,10.. ,"t'O"I'!''''': ""In"" f.. II'f fl"r~I"¡n( in'lnlmfr.1. with '.. I' ~"', ,:,.. ,,' ~( ... I,"'n I 111\ J'l"r'"II.t!h· .....¡uainlr,l. '" h(t. I't'in t' h}' m~ dul, I HH,m. ,Ii I ,ttpo',e- ,\n.1 ~:t}. thai lie- r~~idu at So. :!;., .,.,,!!.. . 111.1.1 ~ he Im~s . . . Ihe t"nr¡tI"lr'I:illfl rt,.~cril't"11 ' In .1.n·1 .. h. h n",III,.·1 !I.,. f",t¡:'"ntt illolr":"!ltlll; "'If he- ' In tIIC" lhe h..f¡.ld.., .."..". I~.r \"11 .·f u,, "'.r"',al",": Ihal Ih,. "':11 allix...1 ,!"'criNoII in allet ",ht) C'xK'UIl'd .h" fOle-lOinr i:utl'1lmnll; In r..\i,I·,n,lnJ"'rnl I' .u.-h mrpnnt, ~': It.al iI wu M Ihat he-. "irl .uh.cril.inr wilntS!, "... prt'Sftll,.nd _w. ,d!in.I', M·I"r .,f tht 1....lIrI of rfirmon of ....i.1 rnrp.r;¡· . C'J'r('UIC' Ih~ same; and that he-1uid _;"""" lann. Iml ,ha' hI' ,ip".! h nan~ Ih""'lo to, Idre- OI'der. al ,hI:' sam" time .ubtcribtd h name.. _una. IltcMo. I I Bargain nnil !!oa'r Drr/l ""IIH (""1"'''1 \r,u".r (......,t...·, .\rn I UCTION' rrnl NO r....--....__~~-==_=- auK.. Rer.e' Gcndr.on LOT CIOIl"Jr.n:xøa Tm"II' of ~ut:101Cl CG~nty of Suff~lk .~.I""""" Ctlle "r,l' nTLI. IN'SU."NQ ""'NY "0 Dcbor~h D. Edsjn & Murray ''.lapper ';"';-----,.. -I : IJlJlrl6ulf'tI ~ C:..r..A'Do TWTa". , I"'.V...",.,.. .,.......#111' .__ ."......, N,II.. Edson & 8~uer, Esq.. p. O. Pox 1047 Southold, Haw Yo~k 11971 ....... ;¡ 5 i ~ o ~ ~ = , ~ "-- ~ .,. , ~ <::> o ,., ......., u· ," ,.. .' ..~ ~. - , ~ ¡ - : - --------- ---~ .J , .. 'r7, '""""""'. ,i '1,: . ":' , , ~. ~~...j"f'''''''~ '. :1: , . 'I. ¡.~ ;., i'f~"', t "f'i! ·~[~.~i" , ;1' . '1' 'I 1:I.i. . .' 809 of Trustees Application . AUTHORIZATION i O\JV -u t, If L1 (where the applicant is not the owner) - ~ '\ - -. ì .. I, LevJ~~ USÓiA- (print owner of property) residing at MPrllV ~V VO ß;" \ V£' (mailing address) authorize Jdv\ ~_ \(l.L~ (Agent) ~OiJ~\J~ ~- do hereby to apply for permit(s) from the Southold BO~ of Town Trustees on my behalf. ~/ ø ~ -?-~~ /JØI~ --- (owner's'signature) 8 BO~ of Trustees Application 4IÞ ~ounty of Suffolk State of New York ------ Jon C . tí rb 5 BEING DULY SWORN DEPOSES AND AFFIRMS THAT éW/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERM¡T ( S) ~ THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF Q!!S1HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT ( S) OR REPRESENTATIVES ( S), TO ENTER ONTO MY' PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. C(y.i~g h ,19~ DAY OF AJCi rc~ SWORN TO BEFORE ME THIS 3 J~ry~ Notary Public MElANIE V. BROWN Natary NIle:, SIIIt 01 New York No. 49D1712 Qded In MIll Coudy (] ~ CammIllllanEJpheOd.II,19'] / 7 ........ , Telephone (516) 765-1Bft2 Fax (516) 765-1823 Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda BOARD OF TRUSTEES: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TOWN OF SOUTHOLD ----------------------------------- In the Matter of the Application of -0 N 1/ ED f) C" ~-------~--~----------------- COUNTY OF SUFFOLK) STATE OF NEW YORK) evL,) . 1/ {,/ . .{" <... bing u y sworn, dep se and say: That on the /1 day of I1pL, 1997, I personall¥- pOP/t«;q, the property known as /V~ - 5' f-O 6 - '7"'...s I .,. y by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for seven days prior to the date of the public hearing. (date of hearing noted thereon to be held (IN fY/l/tlrH 021{ fJltJ fJ~ I4ßOtl.., ?: (~r IJ1t . I AFFIDAVIT OF POSTING ') / . , residing at c¡ 3d d '; ~ rj¿ \ Dated: --'-........ Sworn to before me this d,j~ay of /}ÿ¡cLA..¿¿\..1997' ~¿()~ Notary Public HELENE D. HORNE Notary Public, Slale of New York No, 4951364 Qualified In Suffolk County ;?Ç Commission Expiraa May 22. 19 ~ APPLt~ANT TRANSACTIONAL DISCLOSURB FORM . . The Town of Sou~hold's Code of E~hics prohibi~s contlic~s ot in~eres~ on ~he par~ of town officers and employees. The purpose of this form is to provide informa~ion which can alert the town of possible conflic~s of interest and allow it to take wha~ever action is necessary ~o avoid same. YOUR NAHBt . '. r" .;:...,~, I .' '.:'t" ~]!" '1'. ;rJ!,.fo-1I:t- , . .~." ", ,,,~~. . (Last name, first name. middle initiai;'~nless you are applying in the name of someone else or other entity, such as a company. If so. indicate the other person's or company's name.) ..~..i·,,·<··."I',:'··"" "," ......G-. '''''.,-,- ,. ." . " -." - ~ NATURB OF APPLI~ATIONt (Check all tha~ apply.) Tax grievance Variance Change of zone Ap'pJ¡poval of plat . . Exe~ption from plat or official map \ other f \ ~ ' t (1 f "other." name the act! vi ~y.) =C\,ù~\L..t'7 yo{" """ \ Do you personally (or through your company, spouSe, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? -Relationship- includes by blood, marriage, or business interest. -Business interes~- means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YBS NO~ If you answered ·YBS,N. complete the balance of ~hl. fora and date and sign where indicated. ....).". Name of person employed by the Town of SouUtold Title or position of that person Describe the relationship between yourself (the applicant) and the town officer or employee. Ei~her check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse. sibling, parent, or child is (check all that apply). A) the owner of grsa~er than 5% of the shares of the corporate stock of the applicånt (when the applicant is a corporation), B) the legal or beneficial owner Of any in~erest in a noncorporate'entity (when the applicant is not a corporation), C) an officer, director, partner. or employee ot the applicant, or D) the actual applicant. . ,. , " .¡\':".. : ." DESCRIPTION OF IŒLATIONSIIIP . ',. .. ,_ . "j L ~ .. ¡¡". ow.',v ..... ,.... ", '-.L,-~""""~" -, ·'.rA ~_.~~~.:;.!~:' . '. , _ .: r', _ ,tI.,!.~., .... .:~, ;.,.,1 :'/ '. ,. ' .~..~"f. ..\~:, '.:. "~ . :....'.. "';V·''.~)7.~lí,t'¡;'IiL.;i>~...... ?"', 'f.';; . "M"',&": .' " ., r ' .1'". '," '. -.'. .~"\f!·. s....".. ,~.... ..~.~'..~.' 19.97·...'.)..:'· Signatur~C.. '. ","'\" :. ~; f' .,'. "J,:·~~"r ·Prtnh ~ame .LI.:..:~.,~~ ~v~'·< ...~:-".::-'.-..~:.:..,:_ . ,...".~,.. .~ . . ·':f.\f~···'ì·"" . ¡:; ~ '" ',' . . 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