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HomeMy WebLinkAboutTR-5599Albert J. Krupski, President James King, Vice-President Attic Foster Ken Poliwoda Peggy A. Diekerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWNTRUSTEES TOWN OFSOUTHOLD June 2,2003 Mr. John H. Hu~ado P.O. Box1925 Southold, NY 11971 RE: 10995 North Bayview Rd., Southold SCTM#79-5-20.13 Permit #5599 Dear Mr. Hurtado: The Code Enforcement Officer for the Southold Town Board of Trustees has inspected your property and has determined that the work performed on your property is in compliance with your Wetlands Permit. This is not a determination from any other agency. If you have any questions, please don't hesitate to contact our office. Very truly yours, Lauren M. Standish, Senior Clerk Board of Trustees 05,'05/2003 02;04 FAX ~]0Z uAy 20 8o~rd of Alber~ J. Krupski, President James King, Vice-President Artie Foster Ken Pol/woda Pe~y A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0969 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD 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 JOHN L. HURTADO . . Pre-construction, hay bale [ine 1st clay of construct/on Y~ constructed Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson 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 Fax (631) 765-1366 August 8, 2002 Catherine Mesiano 12 Mill Pond Lane East Modches, NY 11944 RE: SCTM#79-05-20.13 John L. Hunado 10995 North Bayview Road Southold, NY Dear Ms. Mesiano: The following action was taken by the Board of Town Trustees during a Regular Meeting, held on July 24, 2002, regarding the above matter. WHEREAS, Catherine Mesiauo on behalf of John L. Hurtado applied to the Southold Town Trustees for a penuit under the provisions of the Wetland Ordinance of the Town of Southold, application dated July 2, 2002. 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 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 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 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 John L. Hurtado for a Wetland Permit to construct wood stairs and 4'x4' platform at top and bottom as per drawing. dated September 11, 2002. 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: $5.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/oc cc DEC Building Department Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. ISSUED TO ...... ~TQH~ ..L...:.HU~T,A_DO ................................. DATE:--July 24~-2002 Pursuant to the provisions of Chapter 6IS of the Laws of the State of New York, 1893; and C.~pter 404 of the I~w~ of the State of New Yore 1952; and the Southeld Town Ordinance en- titled ."REOULATINC~ AND THE PLACINCo OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS end the REMOVAL OF SAND, CoRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;'~. and in accordance with the Resolution of The Board adopted et a meeting held on ..J.uly...7.4-~ .... 2002 ..... and in consideration of the sum of $. Z00..00. . paid by · .Catherine. Mesiano on behalf of'John 'L':' H'i/i~'~idi5 ................ of .....E~st. I~r~c.h~s., ...... N. Y. and subject to the Terms end Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to construct Wood stairs and 4'x4' platform at top and bottom as per drawing.,dated September 11,2002 all in eccordance with the detailed spe~ificetion$ as presented in the originating appJ;cafion. IN WITNESS WHEREOF, The said Board of Trustees Ixere- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. Ttwstees TERMS and CONDmONS pa~ of the coesldetatma for the r~suaace of the Pem~t does aade~-taad ami pemcribe to tee roi- 2. That d~ Petmlt J~ vaHd ~ot ~ ~etiod of . 24 mos. wbith b ~ to be dae es~m~ted ~.,,e_ requb~J *o complete dae wodc iavolved, but ~ho.~--d ch~mstm~ win'mt, requ~ for aa e~,~on may be m~de to the Bo~d at · I~r datr~ 5. That this Permit should be reeained indefinitely, or as long as the said p,-~mi~ee to mail~a;n the structure or project involved, to provide ev~ence to anyone cooc~ued that orizttion was originally 4. That d~e work involved will be subject to dae inspection and approv~l of d*e Be~d ot agents, amd non-compliance with the provisions of d~e o~4~.g application, may be _~-~ for ~vocatio~ of this Pennit by resolution of the said Beard. 5. That there will be no unreasonable interference with txsvlg~t-~ as · result o~ the wm:k hexe~n a~thor/zed. 6. That d~ere r. haH be no interference with the right of the public to pass the beach b~tween high and low water 7. That if future opecatiom of the Town of 5outhold zequite the v~moval and/o~ akemtom ia the location of the s~ herein tmdsotized, or E, in the oplukm of the Bo~d o~ Trm~ee% the. work ~,1! cause uttreasonabie obsmacnon to free navigation, the said Pennlttee will be Vequtted~ upon due notice, to remove or alter this work ot project heteln stated without expenses to the To~n 8. That the said Board will be not/fled by the Petmktee ot the c.~ of the work aud~- orlzed. 9. That the Permittee wiU obOtln aH otl~er perm~ and co.sends ~at may b~ izquh'ed mp- plemental to chis permit which may be subject to revoke upon failure to obtain same~ Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dicker:son Tmvn Hall 53095 Route 25 P.O. Box 1179 Sou timid, New York 11971-0959 Telephone 1631) 765- [892 Fax (6310 765-1.366 BOARD OF TOWN TRU,q.'VEES TOWN OF SOUTHOY,D August 28, 2002 Ms. Catherine Mesiano Catherine Mesiano, Inc. 12 Mill Pond Lane East Moriches, NY 119,10 JOHN L. HURl'ADO 10995 NORTH BAYVIEW RD., SOUTHOLD SCTM#79-5-20.13 Dear Ms. Mesiano: The following action was taken by the Board of Towu Trustees during a Regular Meeting held on Wednesday, August 21, 2002: RESOLVED, that the Board of Trustees accept the request of JOHN H. HURTADO to WITHDRAW WITHOUT PREJUDICE the application to construct a wood dock into Southold Bay. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. IQups~i, Jr. President, Board of Trustees AJK:lms F~OM ~C MESIAND INC. FAX NO. ~651-878-8951 Rug, 20 2002 ll:O?AM Pi CATHERINE ME$IANO, INC. Licen'~d Real Estate Broker Real Estate Consultant August 19, 2002 Albert J. Krupski, President Board of Town Trustees Town of Southold Box 1179 Southold, NY 11971 BY FAX: 765-1366 Re: John Hurtado - Proposed Dock 10995 N. Bayview Road, Southold SCTM # 1000-79-5-20.13 Dear Mr. Krupski: I am in receipt of your letter dated August 19, 2002 requesting postponment of the scheduled hearing of August 21, 2002. [ have discussed the matter with Mr. Hurtado and we wish to proceed with the previously scheduled hearing. All required documentation has been provided to your office. The proposed plan is consistent with many previously approved by the Trustees and meets the standards set forth by the New York State Department of Environmental Conservation. The proposed dock is the most minimal structure that could be designed to meet the generally recognized standards. We are prepared to move forward and believe this matter should be heard and a decision be rendered on the merits of this project. However, if the postponment is being requested for a specific reason, that specific reason can be stated on the record at the upcoming hearing and we will address it. If the Trustees need additional information to aid them in making a decision, we would be more than willing to Provide specific expert testimony as to your specific concerns. We respectfully request that we have the opportunity to discuss these issues at the August 21~ hearing. Very truly yours, Catherine Mesiano, President Cc: John Hurtado 12 Mill Pond Lane * East Moriches, New York 11940 * 631.878.8951 Albert J. Krupski, President James King, Vice-President Artie Foster Ken Po]iwoda Peggy A. Dicke~-son 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 Fax (631) 765.1366 August 19, 2002 Ms. Catherine Mesiano Catherine Mesiano, Inc 12 Mill Pond Lane East Mofiches, NY ! 1940 RE: JOHN HURTADO 10995 North Bayview Rd., Southold SCTM#79-5~20.13 Dear Ms. Mesiano: The Board of Trustees request the above~captioned hearing scheduled for Wednesday, August 21, 2002 be postponed. The Board will not be taking action this month, as this environmentally sensitive project deserves continued special ~eview. Thank you for your cooperation in this matter. Very truly yours, Albert J. Kmpski, Jr., President Board o f Trustees AJK:lms DM :C MESIANO INC. FAX NO. :651-878-8951 15 2002 10:52RM P2 J, Krups]d, President King, Vis. President Henry Smi[h Artie FOYer Ken Poliwoda Town Hall ~8095 Ma~ Road P.O. Rvx 1179 8outh01d, New York 11971 'f'~eph~ne (516) 76~1892 Fax (516) 765-1828 BOARD OF TOWN TRUSTEES TOWN OF SOIITIIOLD Catherine Mas!ano on behalf of John L, Hurtado Please be advised that your application, dated July 2, 2002 has been reviewed by this Board. at the regular meeting 'of July 24. 2tiff2 and the ~ollowing action wa~ taken:' ( X ) Application Approved (___) Application Denied (__) Application Tabled (see below) (see below) (see below) If your appltcation is approved aa noted above, a pemlt fee la now due. Make check or money order payable to th% Southold Town Trustees. Tbs lee ia computed below according 'to the schedule of rates as set [orth in the inst~vct~on sheet, The following fee must b% paid wit.bin 9() days or re-application fees will be necessary. COMPUTATION, 0F PKRMIT FEES= One In~pect/on @$5.00 TOTAL FEE8 DUE: SIGNED: BY: PRESID~.~T, BOAR~ OF TRUSTEES 4/98 Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(631) 765-1366 August 8, 2002 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Catherine Mesiano 12 Mill Pond Lane East Moriches, NY 11934 RE: SCTM#79-05-20.13 John L. Hurtado 10995 North Bayview Road Southold, NY Dear Ms. Mesiano: The Southold Town Board of Trustees reviewed the survey dated May 31, 2002 at their meeting on July 24, 2002 and determined that the tennis court and in-g~ound pool - to be out of the Wetland .iurisdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town Code, Coastal Erosion. · ' ' Coastal Eroston How¢,'er any activity within 100' of the Wehand hne and/or seaward of the Hazmd Line, would require action from this office. This dete.,.mination iz not a determination fi:om any other agency. if you have any further questions, please do not hesitate to call. Sincerely, Albert J. Krupski, Jr. President, Board o f Trustees AJK:cjc cc: Building Department Albert J. Krupski, President James King, Vice-President Henry Smith Artie FoYer Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Catherine Mes!a._n9 on behal£ of John L. Hurtado Please be advised that your application, dated July 2, 2002 has been reviewed by this Board, at the regular meeting of July 24. 2002 and the ( X ) Application Approved (__) Application Denied (__) Application Tabled following action was taken: (see below) (see below) (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold 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: One Inspection @$5.00 TOTAL FEES DUE: SIGNED: BY: PRESIDENT, BOARD OF TRUSTEES ERK, BOAR~ OF TRUSTEES Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095Route 25 P.O. Box 1179 $outhold, New York 11971-0959 Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line __ Ist day of construction Y2 constructed Project complete, compliance inspection. Telephone (631) 765-1892 Town H',~II. 53095 Ma,in Road P.O. Box 1179 Sour, hold. New Y~xk 11971 SOUTHOLD TO~N CO~ISERVA.'rIO~ ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Wednesday, July 17, 2002, the following recommendation was made: Moved by Drew Dillingham, seconded by Jason Petrucci, it was RESOLVED to recommend to the Southold Town Board of Trustee~i~iOVAL of the Wetland Permit Application of JOHN Lt .HURT~::IO to .construct a pool with a 4' high fence approx 75' from the bluff, corl~truct wood stairs and platforms on the bluff, and construct a wood dock into Southold Bay. Located: 10995 North Bayvie~v Rd., Southold. SCTM#79-5-20.13 Vote of Council: Ayes: All Motion Carried Albert J. Krupski, President~ James King, Vice-President Henry Smith Avtie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Applicati9ff~'--~ .Wetland Permit Application ___(_Major_,/ Waiver/Amendment/lTh~ges Received Application: Received Fee:$ ~:~,~'t ' Completed Application Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ~ CAC Referral Sent: f]/~'7/[O _._Date of Inspection: ~/[~,[0 "~ Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: ~/or[ Resolution: ' ' Minor Name of Applicant ~r)/./~t/ l. ~t,//_t~e~O0 Phone Number:( Suffolk County T= Map Number: lO00- Property Location: (provide LILCO Pole ~, distance to ~ streets, //,9 7/ /._3 (If applicable) Address: Board of Trustees Application GENERAL DATA Land Area(in square feet): J f— p K 3 � C a &-S Area Zoning:_ R qO + AC- CRV/ 5t l) OJVC� It/C -LYou)f Previous use of property: 6-S[ 0&nA'L Intended use of property: K (.'S [0 pawag L Prior permits/approvals for site improvements: Agency Date Qf�'TIiuS�rrtS �/i�OG , e2avo /% S/uG[& No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspend3xi by a governmental agency? No Yes If yes, provide explanation: Project Description(use attachments if necessary):_ Tn C o reS TAOCC f'Cx)c -� / F C-A/G C�-25�-15 , FAM &C1Ff �r✓�oD JjA/�f, Nn P�t�AXS cw 61-OFF 3 r A1- /tOU' woo D Doc& /urd Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA purpose of the proposed operations: ~(~ ~ Area of wetlands on lot: ~(.~S/'~At./ quare feet Percent coverage oflot:{-g~;5 f'ff/12 / % Closest distance between nearest existing structure and upland edge of wetlands: /~000 ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: /Dr_30 ~ feet Does the project involve excavation or filling? No u(/ Yes If yes, how much material will be excavated? ~) cubic yards .How much material will be filled? ~(,{.~'~'(.ff cubic yards ; · Depth of which material will be removed or deposited:__~_~ feet ?Ot~/- C)~' ¢ ~" Proposed slope throughout the area of operations: ~C<~ ~ .~'q'~¢/¥(///) ~CdA t/ir>" Manner in which material will be removed or deposited: ."f-~ 0 C R"(cD dYv-/'2 .5' / ~6" 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): Albert.J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hail · 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 ~ ~ /~ o,f ~OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, ~Off*/ L. /~//tT~Q residing at being duly sworn, depose and say: ,~/,,/, That on the /f--day of~ , 200~, I persgnally posted ,t/h~ property known as /O~ X/o ~,A?'V'/~¢¢o' /~/3. ~OC/~/{O~.f'.~... //~/ 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 eight days prior to the date ~f_ Xhe ~ublic hearing_. D~te of hearing noted thereon to be he~! Dated: ~s~i-g nat u r e ) Sworn to before me this /f~_~A day of ~Oc)/ 200 "-'~'o ~' Public ' ELIZABETH A STATHIS NOTARY PUBLIC, State of New York No. 01 ST6008173, Suffolk County Term Expires June 8, 20~ 2602 Albert ~J. Krupsld, 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 TOV~N TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application ...... ............ ~OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, ~0~~ ~, ~/~7~O~ residing at /0~ /~o ~/<~t~ ~, being duly sworn, depose' and say: That on the 11~ day of~U~f , 2002, I personally posted the property known as /O~- X/o ~f/6~ ~, ,~GO~d=~. /c/.~ //~/ 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 eight days prior to the date~f the ~l~ublic hearing~ D~te ~f hearing noted thereon to be he~! Dated: Sworn to before me this /~_~A day of ~C~¢~ 20/0~%-- '-No~' Public' ' ELIZABETH A STATHIS NOTARY PUBLIC, S~ate of New York No, 01 ST6008173, Suffolk Cognty Term Expires June 8, 20~ NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEESt TOWN OF SOUTHOLD In the matter of applicant: sCTM#~O00- 07 F YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: ~ ~0 co~5~Aac; ,~0o~ OoCK /P~O 50u~o~D BA? ~. That the property which is the subject of Environmental Review--is located adjacent to your property and is described as follows: /O9~C WO~ ~AYJ/f~ ROAD 3ouT'/to~D/ ,,~ Yo~K 11~71 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Cede is open to public comment on: 7~~ You may contact the Trustees Office at 765-1892 or in wri[i~g. 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: ~ILING ADDRESS: / Enc.: Copy of sketch or plan showing proposal for your convenience. JOHN L. HURTADO P.O. BO,~ 1925 SOUTHOLD. NY 11971 ~o oo 0,,,_.0% (-4 MLW) SOUTHOLD BAY 5 F 4' "°°'- :erly Trust .\ 800.30' .\ 20. O' - ///t II / ,/~/ / / ,/////' /// / ' // PARCEL 2 0 0 --~ 0 q) c-..~ © © L~ //rp /' Board of Trustees Application JOHN L. HURTADO /' RO. BOX 1925 /' $OUTHOLD, NY 11971 COASTAL EROSION APPLICATION DATA (~O 7'0 co,.,3/-leuc T' ffoo~_ ~, ¢ ' /--(-,vcc-' 75 /-,¢o,~ ~LU?F oses of proposed activity: ~ I~O CowJ'7,~o~ 7 woo/) ~.G/~/,~$ AuD/9(XTf-~ Are wetlands present within lO0 feet of the proposed activity? h/ No Yes Does the project involve excavation or filling7 No / Yes If Yes, how much material will be excavated? o~9c-3 (cubic yards) How much material will be filled? fro wC (cubic yards) Manner in which material will be removed or deposited: '7~/'~C/<'~ 0 Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEESt TOWN OF SOUTHOLD In the matter of applicant: sc~#~ooo- O7 9 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: ~ Fo ¢owjr,~uc;r ~oo~ ,~r-,,~t,~3 (~) 7-0 co~jF~o<? ,woo~ Dock /~'~'o 5ou~//o~O 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as folZows: /O?~D= ,,VoKTA ~AY~/~ ROA~ 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: '~(~ 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: MAILING ADDRESS: / Enc.: Copy of sketch or plan showing proposal for your convenience. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS /'f ,5ax 7 STATE OF NEW YORK COUNTY OF SUFFOLK [~f OH lt/ L, ,/dL/ ~-'('P, O 0 ,residingat //0¢f.-5-- ,//, /'3 A Y u / · 5'007'htOo9. AY, Y, l[ ? ? / , being duly sworn, deposes and says that on the -/f4_~ da3~of ..'I-c~LY~ ,20dl-,deponentmailedatruecopyoftheNotice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set 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 (certified) (r,~i~m~l) mail. Sworn to before me this Day of ~u~ ,~' ,20 Notary Public ELIZABETH A STATHI$ NOTARY PUBLIC. State of New Yo~k No. 0 lST6008173, Suffolk County Term Expires June 8, 20 ~..~ Board of Trustees Application County of Suffolk State of New York ~)0~[1./ ~._, ~d/t-~/kDO BEINGDULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERaMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES 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), Il: 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 / ] ~ DAY OF :~CJ~ ~' ,20 t') L- Pu61ic/- ELIZABETH A STATHIS NOTARY PUBLIC, State of New York NO. 01ST6008173. Suffolk Cq.upty Term Expires June 8, 20.(.~:;, ~ard of Trustees Applicat~ AO'rUORIZATION (where the applicant is not the owner) (print owner of property) residing at (mailing address) do hereby authorize C~/~/~/~ (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) 8 · ,". ' PR~,JECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by AopHcant or Project sponsor) SEQ 1. APPLICANTISPONSCR i2. PROJECT NAME ~oHi/~-, Hu~T/~DO /o0o o79; 3. PROJECT LOCATION: M.,.i~I0...,, .SOL) TFo~ ¢2o, /D 5.IS PR~NewOSED ACTION:[] Expansion ~ Modification/alteration $. DESCRIBE PROJECT BRIEFLY; To c'o~..s'r~ucT ?oo~ ~ ¢/-GWce ~ CowSf~acf ~oo~. DOC~ /wFo WtH~']' iS PRESENT LAi'40 US~ iN '/IC[N[T¥ OF PROJECT? STATE R LOCAL)? If the action is in the Coastal Area, and you are a state agency, complete the Coastsl Assessment Form before proceeding with this a~s, essment OVER ! PART II--ENVIRO,'qM be ccm2ie!ec 2y PART III--OETE.U, MINATICN OF SIGNIFICANCE (To ;e completed by AGency) INSTRUCTIONS; For e3c.q adverse e;fect idem~fied ~ove. determine wnettter it is substantial, large. !m~or~nt or otherwise skJn~ fic =3c.q =,ffec*, snou;d ~e assessed in c=nnection with ,ts (a} setting [i.e. urban or rural); (b) ~rooaDHit¥ of OCC~.'"~g; (C) dursdon' irre,/erslbdi[y; ',e) geograon~c ~ccce; and {t) magmtude, if necessa~, a~d attachments or reference supposing m~er~als. ~2sure eXplAnations ccn[ain sufficient de~Ad (o s~ow (hal ail relevant adverse impacts have been identifie~ and adequA[ely acCressec. TRAN~ACTf, ONA[, DISCLOSURE FORH ~nte~s~ on the par~ o~ ~ow~ o~fic~rs and empkoy~es. The ' purpose o~ this form is to provide informabio~ which can al~r~ ~he ~own of possib~._~onflfc%s o~ inter,st a~d ib bo bake whatever action.is necessary to avoid same. you ar~ 'applying in %he name of someon~ ~ls~ or other ~ntity, such 9s a company. the o~her p~rso~'s or company's name.) NATURE OF APPLI~ATION~ ('Cheek ail that apply.) Tax grievance Variance Change of zone, · .. ~Ex~ption from pl~t or o~lcial map Do you personally (or through your uompany~ epou~e, parent, or child) have a relationship with any o~giuer or employee of the Town of Southold7 "Relationeh~p" by blood, marria~e, or bueineea ~ntereet. interest" m~ans a business, inuluding a partnership~ which Ehe to~n o~fieer er employee has even a partial ownership'or (or emplDrment by) a corpgration in ~hich the town officer or emplbyee owns more than 5% of the shares. YES NO If you answered "YES,". ~omplete the balanu~ o~.thi~ ~orm and date and sign ,here' indicated. Name og person empZoyed by th~ ToWn o~ Sou%h01d Ti~le or pos~%~on OE that person ~. and the %own offic~r ~r employee. Either check %he appropr[a~e lin~ 5) ~hrough D) and/or d,scr[be ~m th, spac~ provided. The town officer or ~mploye~ 0~ h~8 or her ~pous~t' s~bl~ng, parent, or child ~s (check .all %ha~ apply)t A) %h~ own~ cE greater than 5% of the shar~s cE the corporate stock'o~ the applic~nt (when %he appl~uant' is a uorporatfon); __B) the legal or b~neEicial owner of any inter,st in a noncorporate"entity (when the applicant is not a corporation)~ .... C) an offiuert d~rector~'p~t~sr~ or' ~mploy0e. o~ tho applica~t~ or D) the a~tual.spplicant. p rJ v ,V- cgi . NEW BALING TO CODE GRADE a .4 0' 4'-0' - PLATFORM PLATFORM 6" X 6" CCA POST v z , LLJ IJ,-0' �• i rTr '� I • I a ly P.C. FOOTING 1 PLAN OF STAIRS 14!La LO" , • STEEL REBARS (SPIKES) • ALL O TREATED CCA 0 18^ SUP ' ALL SUPPORT POSTS 6`%6" .- ALL HARDWARE CALAVANIZEO 12" TREAD n FOOTING DETAIL 6*RISERS _ 0io 7 6`TO 7"STEP UP NEW RALNG TO CODE II II yid CD 6'RISER R 19 Lill,' P.C.FOOTING OfSECTION OF STAIRS 1 /4" = 1 -0 > O I 6' %6'CCA POST f-- A-1 Cn Q m . . ,� 0. iyG ,r . as 1`•"�� r q.; a x r SYI G�oHinos �O ` b> d0 Gado 3{ , s3 sn ai ' _ IdS YJ4p4}gMl �� �1 q h9 1 {a.E I -- I l LOCATION MAP SCALE:1"=600' (-6 MLW) I 4_ 1J , ILII SOUTHOLD BAT (-6 MLW) (-4 MLW) SOUTHOLD BAY IT (-3 MLW) „�PR WOOD WOOD (-2 MLW) II (-1 MLW) 1p jI S76'13'28°E 156.86' IT TEL iNv°°I"M ,i' — PROPOSED— — I STEPS 1 �IQ ZONING OBE OIBIRICT UNE - LDIq ' y PROPOSED C.) A_C o `V 15.0' - If POOLUD L _ _ �O- 0 4 GO p0 L LL DWELLING �o 0 0 0 N U U OF 2°P 3O 5 my El N.wA C U /—DuNEIIaurn p EADEMENT NORTH BAYVIEW ROAD - CE ..D- 3�nT1 �P je 3 0 o a - om � TEST HOLE DATA rn D I r o 0 In I. C L 7-11E] HOUSE —D 20 D' v = T- o l �. o c E _ - U O I PROPOSED1 ' O E.xo laixl, _ Q,n`v _ C "- U I WURI :il ' GO Pu"iin - O O U I I / O V� 0 00 J -o r I o 170O N E so.ao C i 5 / ` 3 a _- O O I C nx[To -.isnni, emu r.un. 0 / O C O U) I ya ( PARCEL 2 UJ LIEF a/ (348,209 SF OR I HEAD IIIIMEF 8 00 ACRES) I GSMPIT / 0 _C On o N ( 3 v Zo 0 0 LD v / m a � now Or formerly C, A, N O I PeCOnIC Land Trust L°NDWARD unuT DE Z " I LAImwaRD uMIT IF U owSiWn 1ER wCr'L`C As ERESHwa 1ER VerawOs as CarEO ev LMID use _ I DWNEa L, 11'L111 C \ I CO IN SCP 1, 1999 CO IN SEPT 199EUSE O \ _ I 5 Jo - — 800.30' I pD'D 740.30' .00' / I \ I TD _ i d PARCEL 1 rn I � I (16,04 ACRES) o I I 1\ N7020'0 I % 0°W I z R3''`o \ GO o kOK�'L�O Y. oo I LV N IN O O 5 I260.00' N N t\Os, -\e\ GJt qq O 1, ry I N85'19'00"W w 0 or forrneOYJr. o o nOW JI Berry, a o r George i 3 1 o Z 3 O \ C W \ Uto 1 01 - - - � _ _ — C n ED LET U0 3 1 i L a� J N U O y O CL h "� Of L Q / o O Q `✓ /\h O U I 3 o o in I � �6�ry6 I OP <L I O OR / E 0— O 's I 0 07 m zt O p / V\ E / z P Q ti / CERTIFIED TO: W 10 I . / CHRISTINE C. HURTADO, JOHN L. HURTADO, SR., '2� 598.12' Is DEBRA J. HURTADO & JOHN L. HURTADO, JR. FIRST AMERICAN TITLE INSURANCE COMPANY i OF NEW YORK �wAIER MAINZ OWNER NORTH CHRISTINE C. HURTADO, JOHN L. HURTADO, SR., DEBRA J. HURTADO & JOHN L. HURTADO, JR. P.O. BOX 1925 SOUTHOLD. N.Y. 11971 NOTE 1. TOPOGRAPHICAL DATA SHOWN HEREON IS FROM SURVEY PREPARED BY ANTHONY LEWANDOWSKI, L.S. LAST DATED NOV. 09, 2000 AND IS REFERENCED TO TOPOGRAPHICAL MAPS "5 EASTERN TOWNS" 2. WETLANDS LINE SHOWN HEREON IS FROM SURVEY PREPARED BY ANTHONY LEWANDOWSKI, L.S. LAST DATED NOV. 09, 2000. 3. PARCEL 2 NOT TO BE FURTHER SUBDIVIDED THIS IS TO CERTIFY THAT THIS SUBDIVISION PLAN HAS BEEN APPROVED BY ARTICLE 16 OF THE TOWN LAW. SITE DATA H -II II p'II, TOTAL AREA 24.043 ACRES ` l JUL 3 tl9 ZONING USE DISTRICT R-40 & A-C CHAIRMAN DATE OF APPROVAL DATE OF CERTIFICATION SCHOOL DISTRICT SOUTHOLD FIRE DISTRICT SOUTHOLD G.W.M.Z. IV SUFFOLK COUNTY DEPARTMENT CP HEALTH SERVICES I HEREBY CERTIFY THAT THIS MAP WAS MADE BY ACTUAL SURVEYS COMPLETED UTILITIES NYNE%, LIPA HAUPPAUGE, N.Y. APRIL 04, 2002 AND THAT ALL CONCRETE MONUMENTS SHOWN THUS: ■ ACTUALLY (ALL UTILITIES EXIST AND THEIR POSITIONS ARE CORRECTLY SHOWN AND ALL DIMENSIONAL AND WITH THE PUBLIC SERVICE COMMI SIGN REGULATIONS) TO BE INSTALLED UNDERGROUND IN ACCORDANCE DATE GEODETIC DETAILS-ARE CORRECT. THE DIMENSIONAL REQUIREMENTS FOR ALL LOTS SHALL.O (9FBRMgTFK-RE51DENCE "R-40 & A-C" ZONING USE DISTRICT. SCALE: 1"=100' JOB NO:2D02-os1 Set Off Prepared For: DATE: REVISION: "CHRISTINE C. HURTADO, ' JULY 03, 2002 rLnx rerPArsm i THIS IS TO CERTIFY THAT THE PROPOSED REALTY SUBDIVISION OR DEVELOPMENT 4 iw JULY 09, 2002 AMEINDED PLOT=uw A7'14' �� *I JDLY 29, 2002 R➢ ooCl< JOHN L. HURTADO, SR., FOR IN THE1n"P �'} WITH ATOTAL OF LOTS WAS DAVID H. FOX DATE DEBRA J. HURTADO OL APPROVED ON THE ABOVE GATE. WATER SUPPLIES AND SEWAGE DISPOSAL FACILITIES MUST CONFORM TO CONSTRUCTION STANDARDS IN EFFECT AT THE ��6 �L>>SO'2N.Y.S.LS. If 50234 JOHN L. HURTADO, JR. " TIME OF CONSTRUCTION AND ARE SUBJECT TO SEPARATE PERMITS PURSUANT TOS/_FI ITIf'P`�% THOSE STANDARDS. THIS APPROVAL SHALL BE VALID ONLY IF THE REALTY "I HEREBY CERTIFY THAT THE WATER SUPPLIES AND/OR SEWAGE DISPOSAL SYSTEMS FOR At 1 SUBDIVISION/DEVELOPMENT MAP IS DULY FILED WITH THE COUNTY CLERK WITHIN THIS PROJECT WERE DESIGNED BY ME OR UNDER MY DIRECTION. BASED ON A CAREFUL Bayview ONE YEAR OF THIS DATE. CONSENT IS HEREBY GIVEN FOR THE FILING OF THIS AND THOROUGH STUDY OF THE SOIL, SITE AND GROUNDWATER CONDITIONS, ALL LOTS, MAP ON WHICH THIS ENDORSEMENT APPEARS IN THE OFFICE THE COUNTY Town of CLERK IN ACCORDANCE WITH PROVISIONS OF THE PUBLIC HEALTH H LAW AND THE AS PROPOSED, CONFORM TO THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Southold SUFFOLK COUNTY SANITARY CODE. CONSTRUCTION STANDARDS IN EFFECT AS OF THIS DATE." I.... _ -- Suffolk County, New York SCALE:1"=100' FOX LAND SURVEYING Suffolk County Tax Map: VIM T L QUAL" P.E. Dlst. 1000 Sect. 079.00 Block 05.00 Lot 020.013 - DIRECTOR, DIVISION OF ENVIRONMENTAL QUALITY JOSEPH FISCH ETTI, PE DATE PO , N.YOX . 11 f; SPEONK, N.Y. 11972 (631) 325-2902