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HomeMy WebLinkAboutTR-6031Albert 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 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction % constructed Project complete, compliance inspection. Board Of $outhold Town Trustees SOUTHOLD;. NEW YORK PERMIT NO.. ~l ...... DATE: ...t~?.... ! ~... ~.g04 ISSUED TO PATRICE & JOHN KF._ITT Pursuant to the provisions of Chapter 615 of fha I-~ws of the State of New Yo~ 1893~ and Chapter 404 of the ~ws of the State of New York 19521 and the Southeld To~n Ordinance en- titled · "REGULATING AND THE PLACING OF OBSTRUC~ONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAYEL' OR OTHER MATERIALS.FJJJ3M LANDS UNDER TOWN WATERSj..?. and in aocotdance wi{h the Resoltrfion of The Board adopted at · meeting held on Nou. 1'7, 2004 and in consideration of the sum of $ 250.00 paid by Pat~ice & John Ke~b~t of ............. §._o...~...h.~. ............................. i ................. N. Y. and. subject to the Terms end Conditions listed on the reverse side hereof, of SouthoJd Town Trustees authorizes and permlfs the folJowlng: Wetland Permit to remove/replace (in-place) approx. 152 linear ft. of existing timber bulkhead with vinyl bulkha;'d; remove (2} existing timber retaining walls and construct (1) approx, t 59 linear i~. timber retaining wall. and backfill with approx. 125 cy. of dean sand fill to be mJcked in from an upland source. Remeve existing swimming pool, patio, decks lan~ngs and steirs; and construcl new swimming pool. terrace, deck, stone landscape wall. walks, landings, and stairs. Including 4'X 15' ptaffm3'ntetai~s to beach, with the condition a dh/watt is installed to contain the pool backwash, and all as dap cted on the plan prepared by En~onsultents, Inc. dated IJ,~ ~l~ · all in a~.ordance wi~ the dete~d sl~ificafions as pre~en~ed in · fhe originating appllcafioa. ,' IN WITNESS WHEREOF, The ~aid Board bf Trudees here- by oauses Ifs C, erporate. Seal to be affixed, and these pres_~ts to Joe suBsa-ibed by ~'malorlfy of the sald Board .as of this darn. TERMs ncl CONDITIONS ~a~ .. ?a.~ce ~ John. Keitt 280 Basin Rd., Southold .~..~ flor an ex,~_~,4oe ~}, b~ mack to ~ Boa~ at a !w~. ~ 5. That this ~' sl~xdd be retained iade~inl~y, or as long Lsthe said Petmigtee Msiw to ,~*~,~ d~e mucu~ o~ project involved, to provide evt4e~ to anyone co~--~l dar amh- 4. That t~e wodc imrol'~ed frill be subject to the Jm~tloa iacl ~roral (fi(be lk)~d oc Albert J. Krupski, President James King, Vice-President Art[e Fester 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 November 17, 2004 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Robert E. Herrmann En-Consultants, Inc. 1319 North Sea Rd. Southampton, NY 11968 RE: PATRICE & JOHN KEITT 280 BASIN RD., SOUTHOLD SCTM#81-1-19 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on November 17, 2004 regarding the above matter: WHEREAS, En-Consultants, Inc. on behalf of PATRICE & JOHN KEITT applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated October 25, 2004, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on November 17, 2004, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that tl~ project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of PATRICE & JOHN KEITT to remove/replace (in-place) approx. 152 linear ft. of existing timber bulkhead with vinyl bulkhead; remove (2) existing timber retaining walls and construct (1) approx. 159 linear ft. timber retaining wall; and backfill with approx. 125 cy. of clean sand fill to be trucked in from an upland source. Remove existing swimming pool, patio, decks, landing and stairs; and construct new swimming pool, terrace, deck, stone landscape wall, walks, landings, and stairs, including 4'X 15' platform/stairs to beach, with the condition a drywell is installed to contain the pool backwash, and all as depicted on the plan prepared by En-Consultants, Inc. last dated December 8, 2004. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/Ims 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 (6311 765-1366 TO: BOARD OF TO~fN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated reviewed by this Board at the regular meetin~ of following action was taken: 101 % I.c' has been { / IIr)l L_XI and the (~/") Application Approved (see below) (__.) Application Denied (see below) )Application Tabled (see below) If your application is approved as noted abo~ money order payable to the Southold Town '1 according to the schedule of rates as set fort ~, a permit fee is now due. Make check or rustees. The fee is computed below in the instruction sheet. The following fee must be paid within 90 day~ or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ SIGNED: PRESIDENT, BOARD OF TR~ JSTEES Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tues., November 9, 2004, the following recommendation was made: Moved by Don Wilder, seconded by Jack McGreevy, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of PATRICE & JOHN KEITT to remove/replace (in-place) approx. 152 linear ft. of existing timber bulkhead with vinyl bulkhead; remove (2) existing timber retaining walls and construct (1) approx. 159 linear ft. timber retaining wall; and backfill with approx. 125 cy. of clean sand fill to be trucked in from an upland source. Remove existing swimming pool, patio, decks, landings and stairs; and construct new swimming pool, terrace, deck, stone landscape wall, walks, landings, and stairs, including 4'X 15' platform/stairs to beach. Located: 280 Basin Rd., Southold. SCTM#81-1-19 The CAC recommends Approval of the application with the Condition the bluff is re- planted with native species and a 5' vegetated buffer is installed. Vote of Council: Ayes: All Motion Carried EN-CONSULTANTS, INC. 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com ENVIRONMENTAL SERVICES December 8, 2004 Albert Krupski, Chairman Board of Trustees Town of Southold P.O Box 1179 Southold, NY 11971 Re: Patrice and John Keitt, 280 Basin Road, Southoid Dear Mr. Kmpski: Pursuant to our discussion during the Keitts' 17 November 2004 public hearing, please find attached (3) copies of a project plan revised to include 1) a notation that the embankment will be planted with native vegetation upon project completion; and 2) a depiction of a proposed swimming pool d .rywell. As the plan scale had accidentally been omitted from the originally submitted plans, a scale has also been added to Sheet I of 2. By copy of this letter and revised plans, I am similarly advising the New York State Department of Environmental Conservation of these changes. Resp~.~lly yours, Robert E. Henmann Coastal Management Specialist Enclosures cc: Mark Can:ara, NYSDEC, # 1-4738-00177/000 l 1 SO UTHOLD EXISTING +152' TIMBER E1U/KHEAD TO BE /:~EMOVED AND REPLACED (IN-PLACE') WITH VINYL BULKHEAD ~ 1." -- 30' BASIN ROAD WOOD TRELUS SO UTHOLD EXISTING +152' TIMBER BULKHEAD TO REMOVED AND REPLACED ON_PLAcE) BE WITH VINYL BULKHEAD PROPOSED R~NNING WALL ~& ~ ~ ~ ~ ~)~. R~NNING W~LS BE REMOVED 1" 30' BASIN ROAD ED WOOD TEELLIS FROFO~P PLILKt-f. Ag g P~fAININfi WALl. ~MOV~ ANP ~FLACI~MP-N1' POlL ?AI~ICP- ANP JOHN I~.lff OIq 50LffHOt-P PAY, 5(2LII'HOL. O, %IPFOLK COLNI'Y, NY Of ~ 10/1~/04, 12/~/04 ,S'O UTHOLD EXISTING +152' TIMBER ~ULKH BE R£MOVED WITH VINYLANDBuLKHREPLACED (iN_~0 NECK /,n "7 ,'~,I ' ' . ~ .~1~ ,~ ,~ ~. PROPOsEo R~NN~NC WALL (2) EX. R~NNING WALLS TO BE REMOVED :1' . 1" = 50' BASIN ROAD WOOD TRELUS FROPOSP. P PLLIffCAP s t~.I'AININ6 W4gb ~MOVAb ANP f~-FLACEMI~N1' FOR FAfRICg ANP JOHN iq. iff ON 50LffHOI-P [~AY, 50LilklOLP, 5UPPObK COUNTY, NY ~f-TI Of 2 10/1<5/04, 12/~/04 REMOVED AND REPLACED (IN-PLACE) WITH VINYL BULKHEAD SOUTHAMPTON, N.Y. 11968 ~,', EXISTING +152' TIMBER BULKHEAD TO BE PROPOSED RETAINING ~20) EX. RETAINING WALLS 4' BE REMOVED WOOD TRELLIS ~PPROVED BY !A[{D OF TTM mTEES T~',. ,: '. ////7/~ ~/ BASIN ~OAD EN-CONSULTANTS INC. 1319 NORTH SEA RD. SOUTHAMPTON, N.Y. 11968 631-283-6360 'EXiSTiNG · EN-CONSULTANTS lNG. 1~19 NORTH SEA RD, $OUTHAUPTON, N.Y. 631-283-6360 SO UTHOLD REMOVED AND REPLACED (IN-PLAcE) +152' TIMBER BULKHEAD TO BE WITH VINYL BULKHEAD PROPOSED R~AINiNC WALL ~flk ~ ~ ~ ~9 I"- +D~' ~2) EX. R~AINING WALLS -- TO BE REMOVED BASIN ROAD WOOD TRELLIS :} PRQPQ~12 BLILKHBAI2 g RBTAININ~ WALL I~MQVAL ANI2 F~PLACUMBNI' FOR PA11qC~ ANI2 JQHN ~ITT ON 50LITHOLI2 PAY, 5QUTHOLO, SLIFFOLK COUNTY, NY SHBBfl OF 2 I0/Id~/04 7 BI.CON~I~I~I~ INC. 1319 NORTH SEA RD. SOUTHAMPTON, N.Y. 11968 631-283-6360 Albert J. KrupskL President · Jfimes King. Vice-President Henry Smith Artie Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fex (631 ) 765-1366 Office Use Only Coastal Erosion Permit Application ,,.'~Tetland Permit Application ~'~ Major Waiver/Amendment/Changes ~" Received Application: .,...Received Fee:$ ..Completed Application Incomplete SEQRA Classification: Type I Type I1 Unlisted Coordination:(date sent) ,~CAC Referral Sent: ~,Oate ofL. spection: I! Receipt of CAC Report: Lead Agency Determination: Technical Review: .~ublic Hearing Held: I I It Resolution: Minor Sm~thold 10~vn Board of Irustee~ Name of Applicant PATRICE & JOHN KEITT Address200 EAST 56TH STREET, #29G, NEW YORK, NY 10022 Phone Number: 212-759-9795 Suffolk County Tax Map Number: 1000 - 81-1-19 Property Location: 280 BASIN ROAD, SOUTHOLD (provide LILCO Pole #, distance to cross streets, and location) AGENT: EN-CONSULTANTS, INC. (If applicable) Address: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 Phone: 631-283-6360 ~oard of Trustees ;n Land Area (in square feet): 29,986.88 Area Zoning: R-40 GENERAL DATA Previous use of property: RESIDENTIAL. Intended use of property: NO CHANGE. Prior permits/approvals for site improvements: Agency SOUTHOLD WETLANDS #5853 3/24/04 Date NYS DEC #1-4738-00177/00010 3-25-04 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): REMOVE & REPLACE (IN-PLACE) APPROXIMATELY 152 LINEAR FEET OF EXISTING TIMBER BULKHEAD WITH VINYL BULKHEAD; REMOVE (2) EXISTING TIMBER RETAINING WALLS AND CONSTRUCT (1) APPROXIMATELY 159 LINEAR FOOT TIMBER RETAINING WALL; AND BACKFILL WITH APPROXIMATELY 125 CUBIC YARDS OF CLEAN SAND FILL TO BE TRUCKED IN FROM AN UPLAND SOURCE. REMOVE EXISTING SWIMMING POOL, PATIO, DECKS, LANDINGS AND STAIRS; AND CONSTRUCT NEW SWIMMING POOL, TERRACE, DECK, STONE LANDSCAPE WALL, WALKS, LANDINGS, AND STAIRS, INCLUDING 4' X 15' PLATFORM/STAIRS TO BEACH, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY JOSEPH A. INGEGNO, LAST DATED OCTOBER 18, 2004 AND/OR PROJECT PLAN PREPARED BY EN-CONSULTANTS, INC. DATED 10/I 8/04. of Trustees Applica~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: MAINTAIN EXISTING EROSION CONTROL STRUCTURES AND INTEGRITY OF EMBANKMENT; UPLAND IMPROVEMENTS. Area of wetlands on lot: 0 square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: 0 feet (BULKHEAD) Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet (BULKHEAD) Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated.'? N/A cubic yards How much material will be filled? +/-125 cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: APPROXIMATELY 125 CUBIC YARDS CLEAN SAND FILL WILL BE TRUCKED IN FROM AN UPLAND SOURCE AND DUMPED AND GRADED AS BACKFILL LANDWARD OF NEW BULKHEAD AND RETAINING WALL. 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): THE PROJECT CONSISTS OF THE ORDINARY AND ROUTINE MAINTENANCE OF AN EXISTING TIMBER BULKHEAD AND WILL HAVE NO SIGNIFICANT IMPACT ON THE ADJACENT TIDAL WATERS. THE UPLAND PORTION OF THE PROPOSAL ENTAILS THE REPLACEMENT AND RELOCATION/RECONFIGURATION OF EXISTING ACCESSORY STRUCTURES. · 14-1~-4 (~BT)--Texl t2 PROJECT I.D. NUMBER 617.2t Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) FORM SEQR I ,~PPLICANT/SPONSOR: I 2 PROJECT NAME I PATRICE & JOHN KEITT BY EN-CONSULTANTS, INC. 3 PROJECT LOCATION: Mun~cipa#ty SOUTHOLD County SUFFOLK 4 PRECISE LOCATION (Street addre~a~ and ro~d intersections, prominent landmarks, etc, or provide map) 280 BASIN ROAD, SOUTHOLD, SCTM # 1000-81 - l - 19 5. IS PROPOSED ACT 6 DESCRIBE PROJECT BRIEFLY: REMOVE & REPLACE (IN-PLACE) APPROXIMATELY 152 LINEAR FEET OF EXISTING TIMBER BULKHEAD WITH VINYL BULKHEAD; REMOVE (2) EXISTING TIMBER RETAINING WALLS AND CONSTRUCT (1) APPROXIMATELY 159 LINEAR FOOT TIMBER RETAINING WALL; AND BACKFILL WITH APPROXIMATELY 125 CUBIC YARDS OF CLEAN SAND FILL TO BE TRUCKED IN FROM AN UPLAND SOURCE. REMOVE EXISTING SWIMMING POOL, PATIO, DECKS, LANDINGS AND STAIRS; AND CONSTRUCT NEW SWIMMING POOL, TERRACE, DECK, STONE LANDSCAPE WALL, WALKS, LANDINGS, AND STAIRS, INCLUDING 4' X 15' PLATFORM/STAIRS TO BEACH, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY JOSEPH A. INGEGNO, LAST DATED OCTOBER 18, 2004 AND/OR PROJECT PLAN PREPARED BY EN-CONSULTANTS, INC. DATED 10/18/04. 7. AMOUNT OF LAND AFFECTED Initially 0.688 ~ Ultimately 0.688 ~ 8. W~LL PROPOSED ACTION COMPLY VVlTH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ~Yes [] NO If NO, clescdbe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commercial []/~riculture [] Park Forest/Open space [] Other Describe: t o. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL}? [] Yes LJ No If yes. list agency(s) and permit/approvels COE, DOS, TOWN OF SOUTHOLD 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? DEC #1-4738-00177/00010 - TIDAL WETLANDS LETTER OF NON-JURISDICTION t2. AS A RESULT OF PROPOSED ACTION ~VlLL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? I-]Y,, []-o I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOVVLEDGE ~.pptic~nU.~on~or narr~ ~. HERRMANN, COASTAL MANAGEMENT SPECIP~L[ST D^'r fi OCTOBER 20, 2004 Signature / J~ l,I I I If the action is in the Coastal Area, and you are a state agency, complete the I Coastal Assessment Form before proceeding with this assessment I OVER Boar~ of Trustees App]_~cation AUTHOP~I ZATION (where the applicant is not the owner) (print owner of property) residing at 5~ =--~-~4-u'%W- (mailing address) do hereby authorize (Agent) to apply for pezmit(s) from the Southold Board of Town Trustees on my behalf. (Owner s ~ignature) / ~rd of Trustees Applicati County of Suffolk State of New York K~i'.~i ~J-'~..3t0/q-7'~,C~' C- BE~GD~YSWO~ S ~F~S THAT ~S~ IS T~ ~PLIC~T FOR T~ ~0~ DESC~ED PE~T(S)~ T~T ~L STA~NTS CO~D ~ ~ ~ T0 T~ BEST 0F ~S~R ~0~EDGE ~ BEL~F, ~ T~T ~L W0~ ~L BE DO~ ~ T~ ~R SET FORTH ~ T~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SO--OLD TO~ BO~ OF TRUSSES. ~ ~PLIC~T AO~=S TO HOLD ~ T0~ OF SOU~OLD ~ ~ TO~ ~US~ES ~ESS ~ ~E ~OM ~ ~ ~L D~AGES ~ CL~S ~S~G ~EK OR BY ~ OF S~ PE~T(S), ~ G~D. ~ CO~LET~G ~S ~PLICATION, I ~BY AU~O~ T~ ~US~ES, ~ AGENT(S) OR ~P~SENTATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT T~ P~SES ~ CON~CTION ~TH ~W OF ~S ~PLICATION. .~ ~ ~ Sigha~/ ~.~ IIMINY M, NOTARY PUBLIC - STATE OF NEW YORK NO. 01-PE8056607 QUALIFIED IN NEW YORK COUNTY,,.-f"'7 MY COMMISSION EXPIRES 03-26-20 "'" / NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEESe TOWN OF SOUTHOLD In the matter of applicant:PATRICE&30}{NKEITT SCTM#1000- g1-1-19 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: REMOVE & REPLACE ON-PLACE) APPROXIMATELY 152 LINEAR FEET OF EXISTING TIMBER BULKHEAD W/TH VINYL BULKHEAD; REMOVE (2) EXISTING TIMBER RETAINING WALLS AND CONSTRUCT (1) APPROXIMATELY 1:59 LINEAR FOOT TIMBER RETAINING WALL; AND BACKFILL IllTH APPROXIMATELY 125 CUBIC YARDS OF CLEAN SAND FILL TO BE TRUCKED IN FROM AN UPLAND SOURCE. REMOVE EXISTING SWIMMING POOL, PATIO, DECKS, LANDINGS AND STAIRS; AND CONSTRUCT NEW SWIMMING POOL, ~CE, DECK, STONE LANDSCAPE WALL WALKS, LANDINGS, AND STAIRS, INCLUDING 4' X 15' PLATFORM/STAIRS TO BEACH, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY JOSEPH A. INOEGNO, LAST DATED OCTOBER lg, 2004 AND/OR PROJECT PLAN PREPARED BY EN..CONSULTANTS, INC. DATED I 0/18/04. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: 280 BASIN ROAD, SOUTHOLD 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on:NOV. 17,20~ ~7:00pm You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: PATRICE & JOHN KEITr MAILING ADDRESS: 300 EAST 56TH STREET, #29G NEW YORK, NY 10022 PHONE #: 212-759-9795 Eric. : Copy of sketch or plan showing proposal for your convenience. Name: DOREEN & KEVIN BARR PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: I 1 DIRKSEN DRIVE WILTON, CT 06897 BASIN ROAD REALTY TRUST 4311 GULF OF MEXICO DRIVE, #301 LONGBOAT KEY, FL 34228 VICTOR & MARY ZUPA 4564 PARADISE POINT ROAD SOUTHOLD, NY 11971 STATE OF NEW YORK COUNTY OF SUFFOLK doing business atEN~ONSULTANTS,INC- ROBERT E. HERRMAJqN 1319NORTHSEA ROAD SOUTHA ,N~TON, NY 11~8 , being duly sworn, deposes and says that on the 21st day of OCTOBER ,2o ~ , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addressesset opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at SOUTHAMFION , that said Notices were mailed to each of said persoqs by (certified) ~) mail. Sworn to before me this 21st day of OCTOBER ,2o~ ~ ~/ Notary Public 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 i1971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of .............. COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, Robert E. Herrmann residing at doing business as En-Consultants, Inc., 1319 North Sea Road, Southampton~ New York 11968 being duly sworn, depose and say: That on the qiC'day of J~' , 2006 1 personally posted the property known as by placing the Board of Trustees o£ficia[ poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held ~/J_t~]: c~ OD ~ fl)/oTOLV" . On o-t ato..tt- Dated: ~ (signa ure % ~wom to b~f2re me this J7 '~'day ofJ[/~ 200~ - Ner{ary~Pubiic The Town of Southold's Code of ~thic.s prohibits conflicts interest on the part of town officers and employees. The purpose of this form is to provide information which can alsrt tile town cf possible co~flicts o~ interest and alio~ i= to t~e whatever ~ction is necessary to avoid same. you are ~pplylng In the name og someone else or o~l~er enmity, such aea company. If so, Indicate El~e o~her person~s or company's name.) NATURE OF APPLICATIONs (Checl¢ all thst apply.) Tax grievance Variance Change of zone ARp~ova'l off plat . . , Exs~ption from plat.or official map (If "Other," name the activity.) which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town o~ftcer or employee o~ns more than 5~ of tile NO If you answered "YES,'. complete the balance oE this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant) end the town officer or employee. Either chec~ the appropriate line A) through D) and/or describe in the space provided. Tile town officer or employee or his or her spouse, sibling, parent, or Child ia (check all that apply}l A) the owner o~ greater titan 5% of the shares of the B) the legal or beneficial owner of any Interest in a ccrporation); · C) an officer, director, partner, or employee of the D) the actual applicant. DESCRIPTION OF RELATIONSIIIP EN-CONSULTANTS, INC. 1319 North Sea Roa~ Southampton, New York 11961 631-283-636(~ Fax: 631-283-6136 www. enconsultants.com ENVIRONMENTAL SERVICES October 21, 2004 Town of Southold Board of Trustees Post Office Box 1179 Soutbold, New York 11971 Attn.: Lauren Standish Re: Patrice & John Keitt 280 Basin Road, Southold SCTM #1000-$1-1-19 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 3. 4. 5. 6. 7. Three 1.3) Wetland Permit Applications, ( including Notice and Proof of Mailing to adjacent owners). Three (3) Short Environmental Assessment Forms. Three (3) copies of authorization & disclosure forms. Three (3) work plans. Three (3) copies of survey. One (1) set of site photographs. Application fee of $250.00 wetlands. 1 trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. ? Sinc~ Rot/ertl. Herrmann Coastal Management Specialist /kbs Enc.