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HomeMy WebLinkAboutTR-5596Albert J. Krupski, President James King, Vice-President Artie Foster Ken Peliwoda Pegg~ A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 October 22, 2003 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. & Mrs. Richard Jahncke 5050 Stillwater Ave. P.O. Box 798 Cutchogue, NY 11935-0798 1450 GLENN RD., SOUTHOLD SCTM#78-2-32 Dear Mr. & Mrs. Jahncke: Thc following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, October 22, 2003: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Permit #5596 from Charles Rehwinkel to Richard & Joann Jahncke. Permit was granted on July 24, 2002 to construct a 4'X 34' fixed dock leading to a 32"X 12' aluminum ramp, and a 6'X 20' float in a "T" configuration, and secured by a single pile dolphin on each end. If you have any questions, please contact our office at (631) 765 -1892. Sincerely, President, Board of Trustees AJK:lms Albert J. Krupski, President James I~ing, Vice-President Artie Foster Ken Poli~voda 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 May 26, 2004 Mr. & Mrs. Richard Jahncke P.O. Box 798 Cutchogue, NY 11935 RE: 1450 GLENN RD., SOUTHOLD SCTM#78-2-32 Dear Mr. & Mrs. Jahncke: The Southold Town Board of Trustees reviewed the survey prepared by John T. Metzger last dated March 5, 2004 and determined the proposed deck to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town Code. Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97) and the Coastal Erosion Hazard Area (Chapter 37) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. However, any activity within 100' of a Wetland line or seaward of the Coastal Erosion Hazard Area would require permits from this office. This determination is not a determination from any other agency. 2 If you have any fur[her questions, please do not hesitate to call. Sincerely, Albert J. Krupski, Jr., President Board of Trustees AJK:lms N~w ?ork State Department of Environmental Conservation 'Division of Environmental Permits Rm 121, Building 40-SUNY Stony Brook, New York 11790-2356 Telephone (631) ~.~?.~0365 Facsimile (63~1) ~?.~.-0360 LETTER OF NON-JURISDICTION Mr. Richard L. Jahncke P.O. Box 798 Cutchogue NY 11935 May 13, 2004 NYSDEC # 1-4738-03043/00002 Jahncke Property 1450 Glenn Road Southold NY SCTM #1000-78-2-32 Dear Mr. Jahncke: Based on the information you have submitted, the New York State Depamnent of Environmental Conservation CNYSDEC) has made the following determination. The portion of the property landward of the 10-foot elevation contour interval, as shown on the survey prepared by John T. Metzger last revised on 3/23/04, is beyond the jurisdiction of Article 25 (Tidal Wetlands). Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6 NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsib~ing any necessary permits or approvals from other agencies. /~ /~ - ) ¢ ~?ly your~/~. / ¢ au~' pWe ieldtnAddministrator cc: Marine Habitat Protection file ~of-tA_P oF oF ~ /~ /?;,,.; ~/7 I¢,'¢'/~/" /?',,~'/Z /~ ~'o/I LDT ~7 256.90' 07'30'00' ~/ ~ L[~T 15 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 29May 2003 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Charles Rehwinkel 59 Warren Street New York, New York 10007 Phragrnites curing request. SCTM# 1000-78-2-32 Mr. Rehwinkel: The Trustees have asked me to relate to you why the Phragmites on your property should not be cut. In most cases Phragmites is an aggressive invader that out competes native species. However, sometimes it can provide important benefits such as acting as a buffer between marsh and upland and as a filter of runoff from the upland, particularly when lawns are involved. Lawns on the water's edge are notorious for impairing water quality and disrupting natural growth. (As testament to this, look at the photo you've submitted and compare the stunted sickly vegetation on the near side of the creek against the healthy marsh grasses on the opposite side.) In this case, the Phragmites is being helpful in taking up some of the excess fertilizer and other la~"n maintenance chemicals before they can runoffinto and further impair the creek. Anyway, cutting has not been proven to be effective at controlling Phragmites and in fact, cutting may actually spur the regrowth and vigor of Phragmites. Since Phragmites will thrive near freshwater inputs, in nutrient-rich waters, and in areas of sedimentation, a good way to abate its spread is to limit watering and fertilization on the adjoining laxxm. If you are serious about stemming the tide (so to speak) of Phragmites altogether the best defense is to plant a non-disturbance buffer zone of native species in its place. Senior Environmental Planner Trustees Mark Terry, SEP Eastern Permits Section DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOB K. JAVITS FEDERAL BUILDING NEW YORK, N.Y. 10278-0090 December 12, 2002 SUBJECT: Application No. 2002-00867-L2 by Charles Rehwinkel The New York District, U.S. Army Corps of Engineers, has received a request for Department of the Army authorization for the following activity: APPLICANT: Charles Rehwinkel 59 Warren Street New York, NY 10007 ACTIVITY Construct a pier assembly consisting of a 4' by 34' fixed timber pier, elevated a minimum of 1:1 over the grade of tidal wetlands, a 2.8' by 12' aluminum ramp, and a 6' by 20' float in a "T" configuration secured by two (2} guide pilings. The purpose of this project is to provide recreational mooring for applicant's vessel(s). WATERWAY West Creek, Shelter Island Sound LOCATION: Town of Southold, Suffolk County, New York As this is minor in nature, authorization may be by Letter of Permission. This is in accordance with current Federal Regulations governing work in navigable waters of the United States. To accomplish the coordination required, prier to the issuance of a Letter of Permission, your review of the enclosed drawings is requested. Pursuant to Section 30'7 (c) of the Coastal Zone Management Act of 1972 as amended (16 U.S.C. 1465 (c} (3} (A)), the applicant has certified that the activity complies with and will be conducted in a manner that is consistent with the approved state coastal zone management program. To allow for the timely processing of the subject application, your comments are requested within 15 days of date of this letter. the Sincerely, Marc Helman Acting Chief Eastern Permits Section Enclosure Map Title JO Landing Park 25 Hog Neck Mag 14 00 Fn Dec 06 16:21 2002 Scale 1:31,250 (at center) 2000 Feet 1000 Meters ' Secondary SR. Road. Hwy Ramp ~ Primary State Route Railroad · Pomt of Interest · Town, Small · Geographic Fea~dre · ~L Park or Reservation C05'TI:::LbO M/,,,I~Ii..IF__. C. ON-FF.,^C.2'rlF,,I(~ ~0. bO~. ~-IP-,.~ ~?'~NPOI~,.-F., NY II~J'~-"~- ...~NEET ~. OF 4- I~-O~+- 'TO OPP. ~HORE · / I X ,~' I' ~ ._ ~o~o~ ~'~ ~eu~ ~ ; /; ~.M. .~ILE DOLPHIN (~ OF~)~ ~ ~ ~. ~oeo,~ / , ~o~o~ ~-~' ~oc~ / ~ PLAN INDICATE5 WATEI~,. Or-I"' IN FEET WHEN AMLW ,= k t' AMHW CRo~5 o .~' ,,~ ~OTTO M / ALL LUMDEP- TO J~- ¢¢A TP.E^TI.~ D. PEEPARED CO.STELLO MAI~IN~:. CONTI~AC. TIN~ ~O.'l~OX P_.I~_...4,- ~EENPI:31~T~ NY II~J~ APPLI CANT: CHAJ~LE~ I~EHWIN KEL ~J~J WA~P. EN ~T. NEW YO~K~ NY I ~l~O ~IENN APE. ~7, SHEET 3 OF .4- .W. ABETH A. NEVILLE TOWN cLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fa~ (516) 765-1823 Telephone (516) 765-1800 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD. APPLICATION FOR PUI~LIC ACCESS TO RECORDS INSTRUCTIONS: Please complete Section I of thi~ form and give Office (agency Freedom of Information Officer). ORe copy will be in response to your request, or as an interim response. to Town Clerk's returned to you SECTION I. (Department or Officer, if known, that has the information you are requesting.) RECORD YOU WISH TO INSPECT: (Describe the record sought. If possible, date, file title, tax map number, and any other pertinent information.) supply Mailing Address (if different from above): [ ] APPROVED [ ]' APPROVED WITtt DELAY* [ ] DENIED* ,JUL 7 2003 Freedom of Information Officer 0.0 I~OTTO M j I I I I I' I I I I I I I I I I I I I ._¥_ _ I I [ I I I ¥ +8.5 _-- '?,." DECFd i"JC~ .Al'v'l HW w INglDE PILE Ok/L¥ AT O F:F.~ H 0 I~.E E[NP AMLW VAI~I [ OCK ECTION CO~TrSL. LO IVlAffE. INP_ COI',I'TIL,',C, TII,,h:~ (~O[ff, 6~['~ .4-7'7- I ["~ (-,HAI~.LE.~ RP-,: HWl N F~E L 5~ WA I~.F-E N NIEw ¥OP,.F~ I',1'¥ 10007 0C7~. I~ ~00~ SHEET 4 OF 4- Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERIdIT NO. ,~,~jl~ DATE: July 24, 2002 ISSUED TO ....................... GHAt~LES...RE H~/INK E.L ............................... 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 OBSTRUC:T1ONS 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 ...~X. 2.~ .... 20(~.~ , and in consideration of the sum of $...2.0l]..00 .. paid by Costello...Ma~,ine on-behalf' of 'Ch~le¢' RelS~iiil~'~] ........................... of .... Gr. eenport~...;; ...... N. Y. and subject to the Terms and Condff~ons tided on the reverseside hereof, of Southold Town Trustees authorizes and permits fha following: Wetland Permit to construct a 4'/c34' fixed dock leading to a 32"x12' aluminum ramp, ending with a 61x20' float in a "T" configuration secured by a single pile dolphin on each end. ' all' in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- b~ causes its C:oroorate Seal to be affixed, and these presents to be subscribed by a malor,ty of the sa,d Board as of th,s date. TER~S and CONDmONS ~ of d~e coas~lem~oa fo~ ~be Ls~mce of ~e P~-~e aees ~a~ ~m~ ~ m ~e fo~- 1. That the said Board of Tm~o~e~_ and the Town o~ Somhold tre ~ f~ ~ ~ ~ ~,~~ of~T~T~~ 24 for ~ ~on ~y ~ ~ to ~ ~ at a ~ ~ 3. Tl~t ~ Penn~t should be t~-talned inde~mltely, or as long as the said Pe~z~ttee wishes to maintain the s~'uct~e or project involved, to pro.de e~ia,.~e to anyone mn~-rned that amh- c~za~ion wt~ originally ob~i~'d. 4. That d~e work involved will be subject to d~e in~ and approval of the Board i~s agents, *nd non-compliance with the ptovi.~on~ of the o~--~-~ ~oa, may be _~ tevo~a~o~t of thi~: Pe~mlt by te~dufion of the said Board. 5. That ti~re w/Il be no untea..mmtble interfere~:e with navlgatkm a~ · reml~ of the w~k herein ~thotized. 6. That there shah be no interference ~i~h the right of the pui~c to pass and rep~ along the beach between high and low water m~'ks. 7. That if fmute opetatiom of the Town of 5outhold te~ the ~ and/or altetatiom ia the loottion of the work herein authorized, or if, in the opi~on ~ the Bo~d o~ Tmstze~ the work ~hnll cause unre~.~ble obstt'u~uon to free navigation, the sa~d Porm~tee ~O1 be tequtted~ upon due notice, to remove or tlter d~ work ot project herein sttted without exTenses to the Town 8. That the said Board will be notified by the Permictee ot ~he c0mpleti0n of the work aud~ orb:ed. 9. That the Permittee will obtain all other pex'mlcs and co~s~t~ tt~t may be required sup- plemental to this permit which may be subject to revoke upon failure to obtn~ same. 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 August 1, 2002 Mr. John Costello Costello Marine Contracting Corp. PO Box 2124 Greenport, NY 11944 RE: SCTM#78-2-32 Charles Rehxvinkel 1450 Glenn Road Southold, NY Dear Mr. Costello: The following action as taken by the Board of Town Trustees during a Regular Meeting, held on July 24, 2002, regarding the above matter. WHEREAS, Costello Marine Contracting Corp. on behalf of Charles Rehwinkel applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 18, 2002. WHEREAS, said application xvas referred to the Southold Toxvn 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 July 24, 2002 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar xvith the premises in question and the sun'ounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold 2 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 approved the application of Charles Rehwinkel for a Wetland Permit to construct a 4'x34' fixed dock leading to a 32"xl2' aluminum ramp, and ending with a 6'x20' float in a "T" configuration secured by a single pile dolphin on each end. 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. Fee must be paid, if applicable and permit issued within six months of the date of this notification. If inspections are required, at a fee of $5.00 per inspection (See attached schedule). FEES: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/cjc cc DEC Building Department Telephone (631) 765-1892 Town Hall, 53095 ~ Road P.O. Box 1179 Southold, Ne~v Yo~k I19'71 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Wednesday, July 17, 2002, the following recommendation was made: Moved by Drew Dillingham, seconded by Jason Petrucci, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAl of the Wetland Permit Application of CHARLES REI4WINKEL to construct a 4'X 34' fixed dock leading to a 32"X 12' aluminum ramp and ending with a 6'× 20' float in a "T" configuration and secured by a single pile dolphin on each end. Located: 1450 Glenn Rd., Southold. SCTM#78-2~32 The CAC recommends Disapproval of the application based on the concern that construction would jeopardize the health of the surrounding ecology/habitat and that the structure would not conform to the other docks in the area. Vote of Council: Ayes: All Motion Carried VICINITY LOGATIONJ MAP o ~-oo' AOdACeNT PI~OPEK-rY OWNI~I~: (~) ~.AMUP--L ~ ANJ~ I~=LUCA I~O ~L~N~ PP. ~OUTHOLJ~ IkJ¥ II~T| ® ~l=Ol~J~l:: 1~ MUI~II=L ~JOHN~Okl ~OUTHOLD~ NY II,TI P~OPO~EOl ACCE~: CONSTRUCTIN~ A ~ ~ FIY,.EI~ I~0¢1'~- LEAI~ING TO ~.11~ i~,.~ ALUMII~UM RAMP ANI[~ F--NI~II~I~ W~H A FLOAT IN A u'T~ CONFI~UI~ATION ANI~ ~EC. UI~ED ,~IN~I-Im PILE I~OLPHIN ON P-..AC.N ENid. APR. ~% ~OOE SHEET A PPL. I GAl4-1' ~ C H AK L. EL% ~.F-.HWl N K~ L ~,~. ~'~ ~00~ ...~HEET ~. OF 4- I.. / ~.~. ~! ,~ ~, :.1 ~ @ INDIC, ATE5 WATEI~.. I::)E.F'rn-l-Jn~ IN FEET WHEN AMI-W O.O F c~o~5 ,.%ECT t o ~J ~0TTO M / NOTE' ALL LUMJ~IE. TO (;CA TIR. EATE D, ¢O~TELLO MAR, I N E CONTEAC. TI N~ ~OI~R ~.O. ~OX ~E~ ~NPOI~'r, N~' 11~4-4- ('~) 4-77- I lOJOj APPLICANT: CHAIItL E,~ I~.EHWI N KEL- 5~ WA R.I~E N ~EW YO~ N~ APE. ~T, SHEET 3 OF 4-. TP,.P,_AT ~ D ...-_.__~ PILE +~.5 0.0 I~0TT0 Irt/- I l I i I I i I I I +'7.5 PILE ONLY AT AMLW VAR, I E.~ PODIA 5 ECT I 0 Ikl C06TEL. LO I',AAI~.IINE C,ONTII. AC. TINO COI~.P. P.O. ~OX. ~,e~. ~I~.mJ=NP'oR.'"r,, N'"Y 11~,4.,a~ APPLICANT: CHAP..LE5 R. EHWI N F',E L 5~ WAR, RE N NEW ¥OR.V,,~ Iq"'( 10007 ( 1,4-50 (~,LENN K.I~,t ,~0UTHOL[~ Af~. 2.7, ~00~ SHEET ~' OF ~- AMLW / LOT 17 ~ LDT ;~5 Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box [179 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/ Wetland Permit Application t/Major Waiver/Amendmen~Ch. an~s Keceived Application: ~,! Received Fee:$ ~ '" Completed Application ./ Incomplete SEQKA Classification: Type I Type II Unlisted Coordination:(date CAC Referral Sent: ~ [~.~ Date of Inspection: 2! Receipt of CAC Report: Lead Agency Determination: __ Technical Review: Public Hearing Held: Q]~qt~_n Resolution: Minor Phone Number:( ((Ik~[) C~a)q-Ht[']5 Suffolk County Tax Map Number: 1000- -"/g - ~ - ~),~ Prope y ocation: 14% NY IlqTI (provide LIDCO Pole ~, aist~ce to cross streets, ~nd log~tion) (If applicable)- I ' Address: ~.O.~( ~l~r~. Phone: Board of Trustees Application GENERAL DATA Land Area (in square feet): c~)i ,~"~ Area Zoning: "~l~R'~6[.I !AJ~.(~VlJI- Previous useofprope~y: ~[e a~'l~ [~q~d~[t Intended use ofprope~: ~ __ Prior permits/approvals for site improvements: Agency Date ~ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): "t'~ 34' ~ed ~ ~adina I I I -- Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations'.--"l-~'t~'--~>Eoi/de, tl dt~t~h ,fac't t;~// Area of wetlands on lot: IIZ~ square feet Percent coverage of lot: ~, 5 % Closest distance between nearest existing structure and upland edge of wetlands: ~ ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: C) feet Does the project involve excavation or filling? /x~ No Yes how much material will be excavated? ~1~, cubic yards If yes, How much material will be filled? ~4/~, cubic yards Depth of which material will be removed or deposited: ~1 ~' feet Proposed slope throughout the area of operations: iq/~, · 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 re.ason of such proposed operations (use attachments if app)'oprlate): Board of Trustees ~pplication COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present, within 100 feet of the proposed activity? No Yes Does the project involve ¢ No If Yes, how much material How Manner in excavated? (cubic yards) (cubic yards) or deposited: reasonably anticipated resulting Describe the nature and extent of the from implementation of the project as proposed. Albert J. Krupski, President James King, Vice-President Hern-y Smith Artie Fester Ken Poliweda 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, ~ ~) ~ , residing at ~ ~ being duly ~worn, depose and say: That on the %~ day o~ ~ , 20~ I~persona~ly posted th~ property known as ~c~ ~ ~J~ ~-~M4~dJ . ~ [{9~] by placing the Board 6f-T~stees official pester'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 ~e pDblic hearing. Date of hearing noted thereon to be held~~, Dated: natu'r e ary Publi~k-~' _ ¥0r.o..Dica ~. Cido~ Notary P,u. Dlic. Stme of N~,w York ~o: 52-,4~81406 Qualified in Suffolk County Commission Expires Dec.31 Board of Trustees Application County of Suffolk State of New York ~ ~/-/~ ;¢~..e.~ BErG Ot~V SWO~ DEPOSES AND ~F~S ~AT ~/S~ IS T~ ~PLIC~T FOR T~ ~OVE DESC~BED PE~T(S) ~ *~V ~L STAIE~NTS CONT~NED ~ ARE *R~ TO Tm BEST OF mS~R ~O~EDGE ~ BELmF, ~ T~T ~L WORK WILL BE DO~ ~ T~ ~R SET FORTH ~ T~S ~PLICATION ~ AS MAY B~ ~p~o~= ~Y ~m SOUmOL~ ~0~ BO~ O~ ~US=~S. T~ ~mCaNT AO=~S TO .0~ ~ TO~ O~ SO~.O~ ~ ~ TO~ ~UST~S H~ESS ~ F~E FROM ~Y ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY V~T~ OF S~ PE~T(S), · G~D. ~ CO~LET~G THIS APPLICATION, I ~BY AUTHO~E T~ ~US~ES, T~ AGENT(S) OR REP~SENTATI~S(S), TO EN~R ONTO MY PROPERTY TO ~SPECT T~ P~MISES ~ CON~CTION ~TH ~W OF T~S ~PLICATION. SWORN TO BEFORE ME THIS ture tz+L- OA¥OF ~ ,200_2.. Oualified In Suffolk County ~#nml~ion Expires July 23,~0~i NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: 2. That the property which is the subject of Environmental Review~s located adjacent to your property and is described as follows: 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public cogent on: 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. MAILING ADDRESS: 5~ ~U~-vt ~r. PHONE # :; ' ' Enc.: Copy of sketch or plan showing proposal for your convenience.