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HomeMy WebLinkAboutTR-5218 Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 'Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 21,2011 Ms. Averil Wertz P.O. Box 1413 Southold, NY 11971 RE: 1080 WEST LANE, SOUTHOLD SCTM#88-6-14&15 Dear Ms. Wertz: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., September 21,2011: RESOLVED, that the Southold Town Board of Trustees APPROVES the Amendment to Wetland Permit #5218 to restore the soil level and beach grass near the bulkhead with approx. 250 cy. of fill in the highlighted area indicated on the site plan received on September 12,2011. This is not a determination from any other agency. Sincerely, Jill ~1. Doherty, Presid(~ht BoaVcd of Trustees ' JMD:lms V_mn m~-< 4-24' ~') Applicant: Peter F. Wertz Location: 1080 West Lane Road Purpose: Bulkhead reconstruction Datum: Apparent Low Water Locus: 72°24, 41'02' S.C.T.M.No. 1000-88-6-14 & 15 F F Applicant proposes to reconstruct in kind in Place +208.5' of timber bulkhead and a 24' Remm in kind in place and backfill structure With +15 c.y. of clean sand to be mmked In from an u land source At Peconic Bay, p . Southold, Town of Southoid, Suffolk County, New York. r~o:r: ,, ,~,,,~, J.M.O. Environmental Consulting Services Ouogue, New York / '0 {9 0 ,T ' ¥--.4 t L-'_ ~ ~. L_. L, DC)'='," Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King John Bredemeyer PO Box 1179 Southold, NY 11971 Telephone (631 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ~ AVERIL WERTZ requests an Amendment to Wetland Permit #5218 to restore the soil level and beach grass near the bulkhead with approx. 250 cy. of fill. Located: 1080 West Lane, Southold. SCTM#88-6-14&15 T,,y_~,e of area to be impacted: __Saltwater Wetland Freshwater Wetland Sound ~'Bay Distance of proposed work to edge of wetland Pa~ of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Type of Application: __ Wetland ~Ad ministrative__Emergency __Coastal Erosion ___Amendment Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: ~v~JJ/ ~B. ~D · Doherty . Ghosio J/~l. King . ~' J. Bredemeyer_ D. Dzenkowski other Form filled out in the field by Bergen, Mailed/Faxed to: Date: James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 SEP ] 2 2Oil ;~I _1 Southho!d Town Bnard of Trnstees APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT O , R/kaa -b0 zrz- AGENT PROPERTY LOCATION TAX MAP NO. [~900 ¢4x ~mll I/We /~V~)._I L.- ~0 ~-'12-~-'~_-- request an Amendment to Permit Si~ed By: &~Z Board of TrUstees Application County of Suffolk State of New York }k/~-4/.. t~, ~bYz.wT-~ ~nmo Dtm¥ SWO~ D~OSES ~ ~F~S ~T ~S~ IS ~ ~PLIC~ FOR ~ ~O~ ~scmm v~(s) ~ ~x ~ s~m~s com~ m~m ~ ~m ~o ~ ~sTov m~ ~o~ ~ ~mmv, ~ ~x ~ wo~ ~L BE DO~ ~ T~ ~ SET FORUm ~S ~PLICATION ~ AS ~V BE ~PRO~ BY ~ SO--OLD TO~ BO~ OF TRUSSES. ~ ~PLIC~ AG~ES 'TO HOLD ~ TO~ OF SO--OLD ~ ~ TO~ ~US~S ~ESS ~ ~E ~OM ~ ~ ~L D~GES ~ CL~S ~S~G '~ER OR BY ~ OF S~ PE~(S), ~ G~D. ~ CO~G ~S ~PLICATION, I ~BY A~O~ ~ ~US~ES, ~ AG~(S) OR ~P~SE~ATI~S(S), TO E~R O~O ~ PROPERTY TO ~SPECT ~ 'P~SES ~'CON~CTION ~ ~W OF ~S ~PLICATION Signature SWORN TO BEFORE ME THIS /c~ DAY OF~~,,20/1 'l~r6taofliublic {fl-.-: No..0 .ll~Sga't'~ - APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of ~;0uthold's Code of Ethics nrohibits conflicts of interest on the vart of town officers and emelovces. The nuranse of this form i~ to nrovide information which can alert the town of nossible conflicts of interest and allow it te take whatever action is necessary to avoid same. F;:' - ........ · (Last name, first name, gaiddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so. indicate the other e .z ~ person's or company's name.) - '- NAME OF APPLICATION: (Check all that apply.) i l Sc, '-- Iai, n Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) /~.~C)[~,~3 "~2~P~l~ ~/[~,~/~'-"'~ Pi ~P~/'~L}"" Do you personally (or through your company, spouse, sibling, parenk or child) have a relationship with any officer or employee of thc Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of{or employment by) a coq~orution in which thc town officer or employee owns mort than 5% of the shares. YES NO X If you answered "YES", complete the balance of 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/agent/reprtsentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space prox~ided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of grtater than 5% oftbe shares of the corporate stock of the applicont (when the applicant is a co~ooratiun); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); ___C) an officer, director, partner, or employee of the applicant; or ___D) the actual applicant.. DESCRIPTION OF RELATIONSHIP Form TS 1 Board Of Southold Totem Trustees SOUTHOLD, NEW YORK ISSUED TO ....... '~ E,T ~R... E.~....~?~ i :,.~.' ............... Authartzatt Pu~uant ~ the provision~ of the Sta~ of New York, 1893; State of New Yo~ 1952: e~ the Town en- titled "RE~U~TIN~ AND THE PLACIN~ OF OBSTRU~IONS IN AND ON TOWN WATERS AND PUBLIC ~DS and REMOVAL OF SAND. ~VEL OR OTHER MATERIALS LANDS UNDER TOWN WA~RS;~. and in acc~e~e with the Resolution of ~e Board adopted at a meeting held on .~.~ Z0 . z000 , end in consideration of the sum d $.~50..0.0 .... pa~d by P~te~ ~....~e~tz .................................................... of..Q~P.~.~.~ ............................ N. Y. and subject fo the Te~s end Condlflons Ii,ed on fha revere sl~ ~m~, o~ Southold To~ TruSses e~hodzes and~mi~ ~ ~tland Permit to ~econst~uct ~n ~nd in p]ace +/- 208.5: o[ t~mber bul~he~d ~nd a Z4~ ~et~n Jn ~nd in place and baC~J~] St~OCtU~e +/- ~ C.~. O~ clea~ s~nd to be t~ucked ~z: [~om ~ ~pl~n~ source, 10~ non-~istu:b~nce bu[[e~ be ell in accordance with the detai~d specifications as pm~nted in the odglnetln9 application. ma~nt~ned. IN WITNESS WHEREOF, The said Board of Trustees ~re- by c~uses lb Cor~rate S~d to be a~xed, end ~e ~ to be sub~ribed by a major:~ of the said ~ard as ~ th:s date. Board Of $outhold Town Trustees SOUTHOLD. NEW YORK PERMIT NO. ~' ~ I ~I~ DATE: .Sept. 20,2000 ISSUED TO ......... ~.E.T.?,... [5.,....~.~, g T.g ........................ 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 1982: 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 ..~.~P.~: 2~.. 2000 , and in consideration of the sum of $.l.50..0.0 .... pald by P~ter F....l~ertz .................................................... ...... ~qe.Y. and subiect to the Terms°f ..0~.~f!.~.~end Conditions ...................... I;sfed on f reverse side hereof, of Soufhold Town Trustees authorizes and permlh fha following: W*~tland Permit to reconstruct in kind in place +/- 208.5' of timber bulkhead and a 24' return in kind in place and backfill structure +/- 15 c.y. of clean sand to be trucked in from ~i'n upland source, 10' non-disturbance buffer be all in accordance with the detai~ed specifications as presented in the originating application. maintained. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, end these presents to be subscribed by a majodfy of the said Board as of thls date. - · f Tn~stees Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, Neon· York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 27, 2000 Glenn E. Just J.M.O. Environmental Consulting PO Box 447 Quogue, NY 11959-0447 RE: PETER F. WERTZ 1080 West Lane Southold, NY SCTM# 88-6-15 Dear Glenn: The following action was taken by the Board of Town Trustees during a Regular Meeting, held on September 20, 2000, regarding. the above matter. WHEREAS, J.M.O. Environmental Consulting on behalf of PETER F. WERTZ applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated August 28, 2000, 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 September 20, 2000 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 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 PETER F. WERTZ to reconstruct in kind in place +/- 208.5' of timber bulkhead and a 24' return in kind in place and backfill structure with +/- 15 c.y. of clean sand to be trucked in from an upland source, 10' non-disturbance buffer be maintained. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency which may also have an application pending for the same or similar project. Permit to construct project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued witin six months of the date of this notification. 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 when project is started and on completion of said project. FEES: NONE Albert J. Krupski, Jr. President, Board of Trustees AJK/cjc cc: DEC ACE Dept. of State TERMS and CONDITIONS' The Permit-tee .PI~TRP ~ WPPT?' residing at 1080 West Lane, Southold N.Y. ~ part of the coaslderatinu for the issuance of the Pennlt does undersumd and prescribe to the fol- lowing: 1. That the said Board of Trustees and the Town of Southold ave released from any and aU damages, or ,-lo~,~, for d~,~gas, of suits arising directly or indicectty as · resuh of any ope~- · tlon pedonned pursuant to this permit, and the said Pennleme will ·t his ot her o,v,~ expense, defend any and aU such suits initiated by thud panics, and the said eermittee amines full HnbtHty with respect thereto, to the complete exclusion of the Board of Tnutees of the Tv,,a of Sonthokl 2. That this Permit is valid for · period of 24 mos. which is comtdeted to be the estimated time requi~d to complete the work involved, but ~ould cito,m~ances wax'mn% request for an extension may be made to the Board at a later dat~ 3. That this Permit should be fetal,ed indefinitely, or as long as the said Permittee withe· to maintain the strucntte or project involved, to provide evidence to anyone concerned that auth- orization was otiginaUy obtained. 4. That the work involved will be subject to the inspection and approval of the Board ot its agents, and non-compliance with the ptovlslom of the oti~-nfing appHcaelon, may be cause revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as · result of the work herein au'thotized. 6. That there shall be no interference with the tight of the public to pass and tepas~ along the beach between high and low water mazke. 7. That if futt~re operations of the Town of Southold ceclui~e the ~ and/or alterations in the location of the work herein anthorlzed, or if, in the opinion of the Board of Tmste~ the work shall cause unreasonable obstrucoon to free navigation, the said Perm~ee will be requited, upon due notice, to remove or alter this work or project herein stated without ex-peases to the Town of Southold. 8. That the said Board will be notLfied by the Petmittee ot the completion of the work auth- otized. 9. That the Permittre wiU obtain aH other permits and consents that may be tequlred sup- pie. mental to this permit which may be subject to revoke upon faUuce to obe~. same. Telephone (516) 765-18q;~ Town Hall. 53095 Main Ro~d P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Consen,'ation Advisory. Council held Tuesday, September 12, 2000, the following recommendation was made: Moved by Bob Ghosio, seconded by Scott Hilary, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITtI A, CONDITION of the Wetland Permit Application of PETER F. WERTZ 88-6-15 to reconstruct inkind/inplace +/-208.5' of timber bulkhead and a 24' return inkind/inplace and backfill structure with +/-15 cy. of clean sand to be trucked in from an upland source. 1080 West Lane Rd., Southold The CAC recommends App, roy.a[.~ll:ka q~pditjpn ora non-turf buffer. Vote of Council: Ayes: All Motion Carried J.M.O. Environmental Consulting Services tf;~,.~ .ember 13, 2000 SEP I 42008 Board of Town Trustees P.O. Box 1179 Southold, N.Y. 11971-1179 RE: Property of Peter Wertz, 1080 West Lane Road S.C.T.M.No. 1000-88-6 14 & 15 Dear Sirs: Enclosed for your review and fries please fred a copy of the U.S. Dept of Army Corps of Engineers approval recently issued for this project. Should you have any questions please feel fi-ee to contact our office. Most sincerely, Glenn E.(J~st arh F~none L6._ ~; ~;DJ-0o07 *, Fax (c -..... ,3-jj48 '121 JessuF.; Ave * 2nd Floor * ~.C" Fo.-. 447 Q~JO.C'iU,:; .. [',Jew York ) "0~:1:~, ~ ~'..,-''i ~', Eastern DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOE~ K. JAVITS FEDERAL BUILDING NEW YORK. N.Y. 10278-0090 September 6, 2000 Permits Section SUBJECT: Application No. 2000-01116-L2 by Peter F. Wertz Peter P. Wertz c/o J.M.O. Consulting P.O. Box 447 Qnogue, New York 11959-0447 Dear Mr. Wertz: On A,,gust 29, 2000, the New York District Corps of Engineers received a request for Department of the Army author]?ation to replace, in-kind and in-place, approximately 208 linear feet of timber bulkhead, install a 24-foot return and place approximately ~5 cubic yards of clean fill to be trucked in from a~ up]and location. The site ls in Little Peconic Bay located in the Town of Southold, Suffolk County, New York. Based on information submitted t© this office, and accomplishment of notification in accordance with the a~plicable federal requirements, our review of the project indicates that an i~div[dual permit is not required. It appears that the activities within the jurisdiction of this office could be accomplished under Department of the Army Nationwide General Fermit Number 3. This nationwide permit is p~escribed in the Final Notice of Issuance and Modification of Nationwide Permits in the Federal Registers of March 9, 2000 (65 FR 12818). The work may b~ performed without further authorJ, zatio~l fr~ln this offic~~_ prnvJded the activity complies with the telm~ co~d[tions of this nstionwide permit, and Section C of the March 9, 2000 Federal Register, cop~es enclosed. ~pe~_~a_~ Conditi__9~ (A) The permittee understands and agrees that, if future operations by the United States require the removal, relocation, or other alteration, of the structure or work here~n authorized or if, in the opinion of the Secretary of the Army or his authorized representative, said structure or work shall cause unreasonable obstruction to the free navigation of the navigable waters, the permittee will be required, upon due notice from the Corps of Engineers, to remove, relocate, or alter the structural work or obstructions caused thereby, without expense to the United States. No clalm shall be made against the United States on account of any such removal or alteratlon. This determination covers only the work described in the submitted material. Any major changes in the project may require additional authorizations from the New York District. Care should be t,3ken so that construction materials, including debris, do not enter any waterway to become drift or pollution hazards. Yon are to contact the appropriate state and local government officials ho ensure that the subject work is performed in compliance with their requirements. This verification is valid for a period of two years from the date of this letter, nnless tile nationwide permit is me~d~fied, suspended or revoked. This verification wJ )l remain va] id for two years from the date of this letter if the activity complies with the terms of any subsequent modifications of the nationwide permit authorization. If the nationwide ~ermits are suspended, ~evoked, or modified in such a way that the a~tivity would no longer comply wi. th the te~ms and conditions of a nationwide permit, and the proposed activity has c¢~mmen¢'ed, or is under contract to commence, the permittee shall have ]2 months from the date of such action Lo complete the activity. Within 30 daye of the compl~tlon of the activity authorized by this permit and any mitigation required by this permit, you are to sign and suhmlt the attached compliance certification form to this office. If any qnestions should ar~se concerning this matter, please contact Denise Butts, of my staff, at (2]2) 264-3913. Enclosures Sincerely, QC~J. ef, Eastern Permits Section 2 '4O PI:CONIC 11958 NASSAU PO NT -? O b~ O Applicant: Peier F. Wenz Location: 10g0 West Lane Road Purpose: Bulld[ead reconstruction DaRnn: Apparent Low Water Locus: 72'24' 4 S.C.T.M.No. 1000-88-6-14 & 15 Applicaol proposes lo rcconstruct in I~ind in Place ~-208.5' of limber balkhead and a 24' Relum in kind Jo place and backfill st~uctore W/th +15 c.y. of clean sm~d Io be tn~ckcd In flora ao uplaod soarce. At Peconic liny, Soutbold, 'Fo~,'~n of Soulhold, Suffolk Couoty, t~'ew York. J.M.O. £nvironmental Consulting Services Ouogue, New York SECTION SFD I __ '20' DIST.' pILL · .15 CY OF C L[,N'4 5NID FP, OM Uf)I_AHD SITE E~, I~ ODEADHAN SCALE I1'" -----AHW~2' J. M.O. Enviro~mental Consulting Services Quogue, New SHFET 2OF z HOG NECK AH,err J. l{rupski, President · lames King, Vice-President llenry Smith Artie Foster Ken Poliwoda T. wn ttall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Teleph~,ne (516) 765-18~2 Fax (516) 765-1823 BOARD OF TOWN TRUSTEE~ ToWN OF SOUTIIOLD Office Use only ~Coastal Erosion Permit Application Wetland Permit Application --Grandfather Permit Application Waiver/Amendment/~nq~ · Received Application: Received Fee:$ ;~u ~ Completed Appli~tion ~./~_A~ Incomplete SEQRA Classification: -~pe I__.Type II Unlisted Coordination:(date CAC Referral Sent: ,Date.of Inspection: Receipt of CAC Report: Lead Agency Determination:__ Technical Review: ~ / / Public Hearin~ Held: h-O ~-~ ..Resolution: Name of Applicant Peter F. Wertz Address 524 Silver Lane~ Oceanside, N.Y. 11572 Phone Number:(516)764-8591 Suffolk County Tax Map Number: 1000~8-6-15 Property Location: 1080 West Lan~oad,~Southold (provide LILCO Pole #, distance to cross streets, and location) Glenn E. Just/ J.M.O. Environmental Consulting AGENT: (If applicable) Address: P.O. Box 447, Quogue, N.Y. 11959-0447 653-0607 / Phone:  FAX#: / 653-3348 Board of Trustees Application ~KNE~AL DATA Land Area (in square feet): ~40,000 s.f. Area Zoning: unknown Previous use of property:. Intended use of property: single family dwelling and vacant parcel Prior permits/approvals for site improvements: Agency Date X No prior permits/approval~ 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): Applicant proposes to reconstruct in kind in place ~20~$'0f timber bulkhead and a 24' return in kind in place and backfill structure with ~15 c.y. of clean sand to be trucked in from an upland source. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Bulkhead reconstruction Area of wetlands on lot: 0 .square feet Percent coverage of lot: n/a % Closest distance between nearest existing structure and upland edge of wetlands: 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? , How much material will be filled? ~15c.y. Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: I:1 Manner in which material will be removed or deposited: Payloader 0 cubic yards cubic yards 4'-6' Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): As proposed, the project should have no negative impacts upon the waters or wetlands of the Town of South01d Qoard of Trustees Applicat~n AUTHORIZATION (where the applicant is net the owner) (print owner of broperty) (mailing address)' ~ i {L)'fA,.. ~6',"~(', O~on~,-e~,~-~. do hereby authorize ( Agent ) C~e~ ~-~ J'~-~,(~,('?~'~C'~.~ tO apply for permit(s) , · stees on my behalf. from the ..i-,~6..4 t'c~;')--q SEQR PROJECT ID NUMBER APPENDIX C STATE EI'~n~eONMENTAL OUALITV REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME Peter F. Wertz Bulkhead reconstruction 3 PROJECT LOCATION: Municipality Southold county Suffolk 1080 West Lane Road S,C.T,M..NO. 1000-88-6-15 S. IS ROPOEED ACTION: e. DESCRIBE PROJECT BRIEFLY: Applicant proposes to reconstruct in kind in place +208,$'of timber bulkhead and a 24' return in kind in place and backfill stru~-ture with +15 c,y, of clean sand to be trucked in from an upland source, Inltiall~ -~ acres Dltimatety .'~ acres 8. WlI.J,. PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER E~-ISTING LAND USE REETRICTIONE? Single family dwellings 10. DOES ACTION INVOLVE A pE-~rai/APPROVAL. OR FUNDING, NOW OR UI.TIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FodMII, Stale Southold Town Trustees, N.¥.S.D.0.S., U.$.D.O.A. & N.¥.S.D.E.C. 1 f. DOES ANY ASPECT OF THE ACnON HAVE A CURRENTly VALID PERMIT OR APPROVAL? I CERTIFY AT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE eEST OF MY KNOWLEDGE If the action Is In tho Coastal Area, end you ere a state agency, complete the Coastal Assessment Form befdre proceeding with this assessment OVER THE FOLLOWING ARE A LIST OF ADJACENT NEIGHBORS FOR THE BELOW NOTED PROPERTY AS PER THE TAX ASSESSORS OFFICE OF THE TOWN TAX ASSESSORS OFFICE OR THE DEPARTMENT OF REAL PROPERTY Owner: Peter F. Wertz S.C.T.M.No. 1000-88-6-15 Adjacant Owner: Averil Wertz Mailing Address: 524 Silver Lane, Oceanside, N.Y. S.C.T.M.No. 1000-88-6-14 11572 Adjacent Owner: Carol Ann Stancs Mailing Address: 40 Kenwood Road, Garden City, N.Y. S.C.T.M.No. 1000-88-6-16 11530 Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Potiwoda 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 Mat~.r of th~ Application. COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING i~. ~C~-~--~-- , residing at ~ ~-~%C~ ~ being duly s~n, ~epose and say: That or. the~day ~f~,., 200 , ~ personally posta~ the property kn~n as ~ ~F N~ ' by placing the Board o~ Trustees official post~ where it can easily be seen~ and that I have checked to be sur~, %.~_~ post%:r has remained in place for seven days prior to the dale of~,~=/ ~~D~e o~ ~ear~ng ~oted thereon T.o.. ~ald Sword to befo2~e me this 5_.,day Tem~ ~pires~ ' ( s ~.gnat~uFe ) , /~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: U.S. Postal Serwce CERTIFIED MAIL RECEIPT STATE OF NEW YORK COUNTY OF SUFFOLK _//~/~ ~/~ ~ ~ ~, ~ . . ~f /~'/~ ' , ~eing duly sworn, Geposes aha say that ~n the ~ day of ~ __,~, deponent mailed a true copy of the N~e set forth Jn 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 sa~ Notices were mailed at the United States Post Office at ~~ ~ ., that said Notices were mailed to each of sa~/persons by (certified) (registered) mall. Sworn to before me this day of ,19 Notary Public Name: PROOF OF MAILING OF NOTICE ATTACH cERTIFIED MAIL RECEIPTS AddresS: CERTIFIED MAIL RECEIPT STATE OF NEW yORK coUNTY OF suFFOLK named mailed a true ~uFx nameS; Trustees ApplicatiOn, directed to each of the above es of said persons are persOnS at the addreSseS set opposite there respective _~ o.~osite the nam L~ .,,trent assessment ~h~ ~he addresses s~u F~_ o~ ~hown on u.~ ~- - . . sa~d Notices were mailed at ~-addreSS of said perSOn~ ~ - ~ ~uthold, that . , , that roll of the Town o~_~ office at ~~certified) -~- ,,~ited states ~u~ _ ~ ~ach of sa~°JF~ ..... said Notices were mail (registered) mail. sworn to before me this ,19~ day of °II Applicant: Peter F. Wertz Location: 1080 West Lane Road Purpose: Bulkhead reconstruction Datum: Apparent Low Water Locus: 72'24' 41'02' S.C.T.M.No. 1000-88-6-14 & 15 I-- Applicant proposes to reconstruct in kind in Place +208.5' of timber bulkhead and a 24' Return in kind in place and backfill structure With +15 c.y. of clean sand to be trucked In from an upland source. At Peconic Bay, Southold, Town of Southold, Suffolk County, New York. J.M.O. Environmental Consulting Services Ouogue, New York J.M.O, Environmental Consulting Services Quogue, New York 'T ISS. G 'l - fSO.. ..¢ · -'S c.,q:;L S:. 5 O' *, I"' · . 'ptp~'.