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TR-6016
James F. King, President O~~QF S~U~yO Town Hall Annex Bob Ghosio, Jr., Vice-President ~ ~ 54375 Main Road P.O. Box 1179 Dave Bergen # ~ Southold, New York 11971-0959 John Bredemeyer G Michael J. Domino ~ ~ ~0 Telephone (631) 765-1892 Fax (631) 765-6641 ~y~0UNT1, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0907C Date: September 20, 2013 THIS CERTIFIES that the construction of 4'x24' stairwa lie to a 4'x8' platform, a_4'x16' stairway leadin8 to a 4'x8' platform, a 4'x16' stairway leadine to a 4'x8' platform to a 4'x18' stairway to a 4'x20' walkway at top of bulkhead, a 4'x4' cantilevered platform to a 4'x8' stairway ending at the beach At 5295 Nassau Point Road, Cutchogue, New York Suffolk County Tax Map # 111-9-13 Conforms to the application for a Trustees Permit heretofore filed in this office Dated September 3, 2004 pursuant to which Trustees Wetland Permit #6016 Dated October 20, 2004, was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of 4'x24' stairway leading to a 4'x8' platform, a 4'x16' stairway leadine to a 4'x8' platform, a 4'x16' stairway leadin@ to a 4'x8' platform to a 4'x18' stairway to a 4'x20' walkway at top of bulkhead a 4'x4' cantilevered platform to a 4'x8' stairway ending at the beach. The certiTcate is issued to ARNOLD BARYON owner of the aforesaid property. ar~.,~• o'er - ~thorized Signatd e i • lames F. King, Pce6ident ~FfO(,r Town Nd1, 53095 Man Rd. Bob Ghoaio, Jr., VieaPresidml P.O. Baa 1179 ave Sood~old, NY 11971 lohn 8rodnneyet ~ Tdcy6one (631)765-1892 Midud Domino ~ Fu (631) 7656641 BOARD OF TOWN TRUSTEES TOWN OF SOU'1'HOLD DATE OF INSPECTION: ~ 9 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt Goom/silt curtain 1 day of constriction constructed Project complete, compliance inspection. INSPECTED BY: `I 1 ~ s < COMMENTS: G (v ,b' o 'r1 P s ~ ~ ~ 60 ~ 6 - i ~ CERTIFICATE OF COMPLIANCE: Albert J. Krupeki, President. . Town Hall James King, Vice-President ppgpFFO(,~c 53095 Route 25 Artie Foster ~OV 0 P.O. Box 1179 Ken Poliwoda _ Southold, New York 11971-0959 Peggy A. Dic$eraon N Z Telephone (631) 765-1892 Oy Fax (631) 765-1366 col ~ Sao 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 APRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE _ Pre-construction, hay bale line 15i day of construction '/2 constructed I!/ Project complete, compliance inspection. _ ` y ` `r A Board Of Southold Town Trustees SOUTHOLD, NEW YORK ~a~ ~ ._x' PERMIT NO.._ DATE: ~~.....20.,....2Q.04 ARNOL1) BARTUN ISSUED TO ,~nt~a~r~~tt#ivn . Pursuant to the provisions of Chapter 615 of the Laws of the. State of New York, 1893; and Chapter 404 of,fhe Laws of the State of New York 1952; and the Southold Town Ordinance en- _fiFfed-,"R~C3UL-AiiNG-,4ND TME-.PLACING-r~QF OBS]It(tC1~N~_ IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOYAL OF SAND, GRAYEL OR OTHER MATERIALS.F~DM LANDS.UNDER TOWN WATERS,.'. and in accordance wit `the Resolution of The Board adopted at a meeting held on 2.4._..... 2004_,,.;1 and in consideration of the sum of =250.00,,.,_.._.. paid by Anno.Cd 8ahtan ~ ~ Ctt~cho ue of .........................d.............._............................................ N. Y. and. wbieet fo the Terms and Conditions Hsted on the reverse side hereof, of Southold Town Trustees authorizes end permits the following: Wetland Permit to consWct a 4' x 24' stairway leading fo a 4' x 8' platform, a 4' x 16' stairway leading to a 4' x 8' platform, a 4' x 18' stafrway leading to a 4' x 8' platform to a 4' x 18' stairway to a 4' x 20' walkway at top of existlng bulkhead, a 4' x 4' pntllevered plaBorm to a 4' x a' stairway ending at the s beach and all as depicted on the plans prepared by Costello Marine Contractlng Corp, last dated October 21, 2004. aM in accordance wifh the detailed speeificat'rons as presented in the originating application. IN WITNESS WHEREOF, The uid Board of Tnafees here- by causes its Corporate Seal to be affixed, ane! these presents to . be wliseribed by a majority of the said 6oar+d .as of fhh data. c~FFD(k en PaR,udo cr+ d ~ 1'.Krte« ~ Permitbee Ahno~d &tnton u Cutchapue ~ N. Y, a of dx cotuidauioa E« the 1laeoa of the 1?rrmit das updwpnd ind m dx [ol- i. Thu die eeid ,peed of Ttuuaes eod the Iowa of Soatkwid •ee releNed -from aay sod ~ duoages, « eht'~ee far dwges, of tmlte a T u o ueait of say opa- -~o1oa. {~afonwd..}~mwe~#~iiie. rettirly ~nd+~+e rY tare.tw..w~. ~c f~k. Qe ~r_ox~aue, defoad *07 .od .ri tach eo4e`ie+kleeed ~f d>ird.~eeet~t,.aa aye eeid ~eneeirtee .~wr« ,pq wide eeipoee theaeo, Re-~ eedsdaa of rite Beieed d 71erMeee of the Tewo of.fioolhoid t Thet thb EbaYtic 1E ~ for , ~ of 14 ~ aoc..eWrf, h tloYrWaad a be the admeced time~eegdccd ro ooiapieoe the wtxic io~t+lted, bu'r;Loidd detaei~taooes weetuu, cegaat f« w eameaioa mq fie arde a the Qoeed u • fetee dpe: 3. Thu this Fegroit ehotdd be eetdaed lode8efktj, « to bog a the sdd @ttidiroee wlthes toelauia the straoacb « pegjta hnolved, to pto~lde eddmoe a eoyase ooaoetned thu amh- 1 +t a wK ahtdoed. 4. Thu the wodc io*olted writ 6c tedtjaot w the loej+adoo ead eppto~d of the poud « by .eigeaa, .od aon•oorprieooe wkh the peatLisae e~f dee arilteeBeg opptbedoa etq 6e aae f« at:toadoa of this itmic hl srsoipdoa of ehe ald Bard. S. Thu ~ writ 6e oo tnraeooehle LKtferaooe with onigetioo s: a eswh of the work heeds trti. 6. Thet rhea tbeLL 6a m isea&awoe with the eight e~f the priiic a pea tmd etpea tip d,e beodi 6etweeo itTS1r ae?d bw wtmer nrda. 7. That >E [Dame apenaoos oc the Tows of SowhDid txgoioe the. eemoeai w~/oe tuteaaoro In the baidoa drys wodc Mnin.~adeef. or i4 h ate egitaloa of~e B..oi>:oE amt, the. wodc shell tmrwoaiAe obsttoatoa to fees a the raid >Qrt:elatee wig 6e etpm doe aeMiog a eroeare «olttr this wodc «peajeoeieteia eteeW wi/rtm e~gMtaMS to the Y1ewn' • . of $opt6oid. ~ . a That e6e aid Bard writ be ooelAed 6! the iwrekoee ee tie ooe~tleYao;:i d+e wtidc awh- oatxd. 9. Thor the ~teraYMe wLl s6eeia ou eNhee ~eu~tite as oe.eerti fibre aer be ewpdeed tetp: piamamd to drat ;sack wlii tag •be oei~eot to etsetloe ~ fa>htoa as tettil tatae. ,z OgUFFO(,~ Albert J. Krupski, President CQ Town Hall James King, Vice-President G'y~ 53095 Route 25 Artie Foster OVJ ~ - P.O. Box 1179 Ken Poliwoda ~ ~ Southold, New York 11971-0959 Peggy A. Dickerson ~ 'yi~ro ~Q~' Telephone (631) 765-1892 1 ~ Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 20, 2004 Costello Marine Contracting Corp. P.O. Box 2124 Greenport, NY 11944 RE: ARNOLD BARYON 5295 NASSAU POINT RD, CUTCHOGUE SCTM# 111-9-13 Dear Ms. Costello: The Board of Town Trustees took the following action during its regular meeting held on Wednesday October 20, 2004, regarding the above matter: WHEREAS, Jane Costello Walsh as agent for ARNOLD BARYON 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 September 3, 2004, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council fortheirfindings and recommendations, and, W HEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 20, 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, z * • 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, RESOLVED, that the Board of Trustees approve the application of Jane Costello Walsh as agent for ARNOLD BARYON to construct a 4' x 24' stairway leading to a 4' x 8' platform, a 4' x 16' stairway leading to a 4' x 8' platform, a 4' x 16' stairway leading to a 4' x 8' platform to a 4' x 18' stairway to a 4' x 20' walkway at top of existing bulkhead, a 4' x 4' cantilevered platform to a 4' x 8' stairway ending at the beach and all as depicted on the plans prepared by Costello Marine Contracting Corp. last dated October 21, 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.) This is not a determination from any other agency. Fees: $50.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/hct SufFOC,~ Albert J. Krupaki, President O~ CQ Town Hall James King, Vice-President 1~`t` Yf.~ 53095 Route 25 Artie Foster ~ P.O. Box 1179 Ken Poliwoda ~ Southold, New York 11971-0959 Peggy A. Dickerson ~.f.~ 0~~ Telephone (631) 765-1892 ~,a Fax (6311 765.1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: r i"~"'~o{ ~r'~~ Please be advised that your application dated Sep+' 3 r 2'Q' ~ has been reviewed by this Board at the regular meeting of ~ - 2c~~ 2«, and the following action was taken: )Application Approved (see below) Application Denied (see below) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the 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: -~j j-y, ( l n it c c-F, e~-, ~ S(~ • TOTAL FEES DUE: $ S~ ' p • SIGNED: ~ PRESIDENT, BOARD OF TRUSTEES ~o~gOfFO(,~c0 ~ ~ Telephone ~ ~ Town Hell (631) 765-1892 W ~ 53095 Route 25 O ~ P.O. Box 1179 'y Southold, New York 11971-0959 '~O! * ~a CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Monday, October 18, 2004, the following recommendation was made: Moved by Don Wilder, seconded by Nicholas Dickerson, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of ARNOLD BARYON to construct a 4'X 20' stairway leading to a 10'X 20' deck, a 4'X 16' stairway leading to a 6'X 8' deck, a 4'X 16' stairway to a 6'X 8' decking, then a 4'X 14' stairway to a 4'X 20' deck. A 4'X 4' platform to a 4'X 8' stairway ending at the beach. Located: 5295 Nassau Point Rd., Cutchogue. SCTM#111-9-13 The CAC recommends Approval of the application with the Condition the stairs are constructed with appropriate landings 4'X 4' or smaller, and there is no change to the bluff. Vote of Council: Ayes: All Motion Carried 8~ c / q Q ~g 6 9 an ~ a 9 ~ Pi a a~ \ \ y\? u s . a ~ +r a a ~ B ~ e ? n ' 4 a a \a ,a b a ~ ?a\ a~ z~® S~ ~ 'L .5 JR /e e~\ S y a ~ t a e\ y 1 A\~ t '~7 ?3 eve ~ C e ~ c ~Eq~ F b ' 4 \ ® e ; ~ ^ ~ 1 e \ \ y~ e 1 a A 7 4 ? v ev - ~ n yy 9 \ \ \ = G, ~ ~ Y a\\,3 399\ 4 ? ? e ' \ Q f~ ~e ? - ~ ebb ' 9 e e \ , e 49~ I ~~j~F~ \ e e \Y p^ ~ O ee6e f r e e e a e e C ? P e ~ f' ~ ~y($by¢{~+~{f~j~ ^ M\ e e ' ~ 9 y ^?"11P ~ je~~a y1 e e P 4 P` T ~ $1 l6dfll ? ~ o` e epee e ~ oe ` e , e e a a 'fe ' 7 y y ? e e 111 P 4 'e ti j( P ~ e e 9 f" ? e 8e a ,b e~• p+ \ ~gIII~ ? o e " e e e 5 e, a ~ y. „ 'a s M ~~e1~t~ ? s e 9 ,yg o- r t a s ye i? e .o e e e\~ 9 0 ~ e° e y aQ ff1'f6f ie o ~ e Y~i\ y 1 ea a ~I I + e r ~ ~ o 111 ~ 'v .I ~i3 i a U iyS% ~ e~ ey~ 1 ~ 1~~~~ sH •7 ; ~a~l w .a X11111 1 ^ a 4 p ~ ' y g i a .a ' ~ ~ 111111 ^ b. ;titii e\. ~ ~ !a A v ' ~ a a~ gga~~ Q ~ ~ 1 ~ ql ~ro..3 ~ ~ °b ~ f { S f~f • + ~ sH.se '*f ' 9 M - ~ ' ' ~a ~ ~ ~~ifi~ • B t I 1 ~ , ~ a, r1, ~ : u . f ' Y e ~ ~ :jif 3 ~ l ~ _ - I COSTELLO MARINE CONTRACTING CORPORATION DOCK BUILDING • JETTIES • BULKHEADING • STEEL & WOOD PILING • FLOATS 423 FIFTH STREET • P.O. BOX 2124 • GREENPORT, NEW YORK 11944 • (631) 477-1199 / 477-1393 / 477-0682 • FAX (631) 477-0005 October 25, 2004 Southold Town Trustees ~ ~ P. 0. Box 1179 Southold, NY 11971 ~ ° - Attention: Lauren Southold Town Board of Trustees RE: Arnold Barton 5295 Nassau Point Road Cutchogue, NY Dear Lauren: It is my understanding that the Trustees required the originally proposed platforms to be smaller. Enclosed please find copies of the revised plans showing 4'x8' platforms. Sincerely yours, Jane Costello Walsh Permit Manager Enclosures ~ ~Nnv«w~~\ f ~ ~ a e~ 4 U Ne~4~G ~ s J~ may., / ~ V , / V ~ / t ~Alt~ ~Ire«vIa / ,e.y t\ w"''y M1 ~ P~E a i~ / ~1R.I!/ Tr"n`r yic /n~iT)' ic•~st p L xATio~/ MAP ,,.arre~v,• oeca..as Q bc./•xre~n.,rsevrra~cs /O W/lG/e1M GAXTCR /O$O 7pUTw/AM AY6. G.Q~.vwrlf/./, CT• CYiBlO ® GeNNtRT, .~RRief~¢T Y--/a~ON d~K/G.OVRN Ro. Gsj.~Cl~v. crTY, N•Y• /Y69Ca S4,~6/v.Ax3da//~T. XLO. 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Nt' . , . , . sr.~.,rwaly ~ . jr(i~ a$O . 1~ll~po3'6D ~ ~ ~ ' ' . ~~~y (N7~16'QwCN~3+~^'~' 3T.n~R~ ~ ~ ~ , ~~LiftllKa gO~w.wA /~//~tf - , t'f'~ ~rro - R7"O~hlRB910icNCfs- Q s ; -pr ,.r.x.. ~raas~O '~,r nJC.y~"' _ ocr r i~ n:~aPj` ~ suF~T ~ of 2 t~yr)¢ri y I ~,~,,g1RT~ON RL3/~I~AC+li' d ~ ~ aO ~1I/'.13421oQ~[T.RLUtZ2 11 . i ~a~ $ ~ 3 ' ~ oc ~ ~ ° n _ n 0 a a o h _ ~ ( W ` ~ I ~ ~;W ~ ~i ~ ~ ~ . t a= ~ 'O~ „ ` b . ~ ~ ~ 2 * 4 , 7wRE~Reo ~`ss ,k ' ~ ~ u oesr+~c.co ~?tA,R~ u~..Tandr~vA~Geap, ~ ~ ~ ~ , to. sex arses ~~~vaoaT, MY• ihN• w sN~'Er ~ 2 ~OgUFFO(,~~o Town Hall Albert J. Krupaki, President ~Q~ ~ b309b Main Road James King, Vice-President G ~ P.O. Box 1179 Henry Smith ~ . : Southold, New York 11971 Artie Foster Oy ~ Ken Poliwoda Telephone (618) 766-1892 ~ .~`S~ Fex (616) 766-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application wetland Permit Application Grandfather Permit Application waiver/Amendment/Ch nges moved Application: 3 ,Received Fee: $ O•C~ e~ ~ [ ~mpleted Application D ~ ~ Q Incomplete D SEQRA Classification: Type I Type II Unlisted SEP - J 2QQ4 Coordination:(date see C Referral Sent• ¢ -Hate of Inspection: 3 Southold Town Receipt of CAC Report: Board of Trustees Lead Agency Determination: Technical Review: blic Hearing Held: / Resolution• q Name of Applic~a'nt l,}~Y{~Q~//~~~ I~Y1~1~.V(f'I^^IJ{II~ r Address t'Y(~nL~l;{~ lIlllf~t YVP7~ 6'Cu~dP.~ t,~ Nq~., I~'/~~ Phone Number : ( rJI(P ) ~ ~ Z zg ~ I Suffolk County Tax Map Number~~:// 1000 - ~ ~ ~ 'q~ Property Location: /Va ~ u fC ~ (provide LILCfO Pole dist nce tLo cross streets, and location) ~ AGENT : D~C.I It7 Mia.r(V YI.~ C'i ~ ~ AL.R (If applicable) ~ ~ Address o. ~c 14 . ~reeVlDOi'~' . ~[Y I ~Q4`~' ,1 Phone • ' ~ FAX#: 1 ~ard of Trustees Applicat~ GENERAL ,D(AT``A~ Land Area ( in square feet) : ~ ~ ~ 4~p V Area Zoning: `71~YL~LQ.I Previous use of property: ~~~,y.1Q""""IP I~y ~'L~(~_V~~'~ Intended use of property: -~y~[~ 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? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): ('~~ruc-~ n~ ~4'x2a' Gi~filrNUlI1 lear~u~tn ~o a ID' x217' ~I r;~~ ~lpey? ano y' ~}'x Ilu' ~rEa.?v~v~lu~.~~nd(,~n -b Q ~'x e' r~<~t 4'x I(a' ~i~aiYrJou,? to ~ (a'x 8' dec,~.i.(n~ f ~`x i4' ~kttv~?~(a~,f ~ a q x Zp'~er.~.. 4'X4' .pla~F~OrvVl ~'xS' ~Fal~?nla.(1 LVLcd~Tl~'~' ~1efL~, Z Bo~ of Trustees Apglicatioa+ WETLAND/TRUSTEE LANDS APnnP__LICATION RATAI'_. Purpose of the proposed operations:~~~/~~ Q. ~'ifllY I.~ ~V~Il.-~ btu -b GtC'C~ ~-rhP. (~GI/1 ny~ lid X22 Area of wetlands on lot: ~ square feet Percent coverage of lot: ~ $ Closest distance between nearest existing structure and upland edge of wetlands: ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated3_~q .cubic yards How much material will be filled7,' A cubic yards Depth of which material will be removed or deposited: a~ feet Proposed slope throughout the area of operations: ~J~14 r- Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason. of such proposed operations (use attachments if appropriate): QUIT( n~Y_i~ INI ~(h, y1D.,_F _~p ~'~Q h ~4 QI 3 • •ard of Trustees Applicat~ COASTAL ffi20SION APPLICATION DATA Purposes of proposed activity: t Are wetlands present within 75 feet of the proposed activity? No__~ Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated? N h (cubic yards) How much material will be filled? ~ (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting ;from implementation of the project as proposed. (Use attachments if necessary) ~Hete tnltll gym. PX}~ ey~y~rowtPVtf~[ ~~~ar~-1~ or 'Ze 4 ~oard of Trustees Applica~n County of Suffolk State of New York DEPO~~SES AND HE~~~~~~ PP BFORGTHELABOVE~ DESCRIBED PERMIT(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), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH IEW OF THIS APPLICATION. Signa(~ture " ~ SWORN TO BEFORE ME THIS ~,rJ~ DAY OF JC/>>~~9f~$L-~, , ~ 000 ~1 No y Public tINR.Y T. MuM/i~f ~r~ e~:p.~.pa°~0.aro~ 1A•16•% (2/877- ie%t 12 • • PROJECT LD. NUMBEA 611.21 SEQ ..Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM . For UNt.tSTEI) ACTIONS Only PART' I-PROJECT lNFORMATlON (fo be completed by Applicant or Project sponsor) 1. APPLICANT IS NSO Z. PROJ C7 NAM 0 J. PROJECT LOCATION: Municlpallly Courtly PRECISE LOCATION (Street addreaa and road Inlerssctlona, romin nl landmarks, elc., or provipa mapl 5Z 95 Nam ~~f ~aa~, ~'utcho9ue, ~lY /193.~j S.C.T. M. Iroo ~9 -i3 5. I PRO OSEO ACTION: New ? Eapanslon ? Modlflcatlon/altaratlon 6. DE CAIBE PROJECT BRIEFLY; ~a ~h~,~~LY ^ f, ` I ~?~uc-~ 0. ~+a~YfA~e ~wvt oun e~c?~~c~ 1.r4.~e W II co,~s~ !)'i''XLOI 5ktlv'w~Q.t~ ~2) 4`x Ib' Slatrt~l~-~S Ct~ `I x t'~ y~0.?PW1ax•~ 4'x8 ` 5.1+aArW 4.ri I 10'KZA' (~2C~ Z) 4'~8' k, (t) 4''nZD'C~eGk (I) 4'x4' }{o?wl 7. AMOUNT OF l,ANO AFFECTED; lnitlally apfee Ultlmetaly r- acres 6. WIL AOPOSED ACTION COMPLY WITH 'eXISTING ZONING OR OTHER EXISTING LAND US'e RESTRICTIONS? Yes ? Nd If Np, desCride bite@y 9. V!H IS PRESENT LAID USE IN VICtNtTYff^^O~~F PROJECT? I Residential []dndustrial L.i Commercial ? Agriculture L ;Park/FOrasVOden space L.J Olner DescriEe: , ' ~rlvufe ?'e~extta.l w~~eY~'o~.~- tq. DOES ACTION INVOLVE A PERM17 APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVEANM ENTAL AGENCY (F EO EAA L, STAR LOCAL)? Yes11 ,1? No Ir yes, Ifst ege~ndyj(s) and permHlaPprovels ~bki~~ ON~VI vu~cG~ F 71. DOES ANY AS CT OF THE ACitON HAVE A CURRENTLY VALID PERMti OR APPROVAL? ? Yes No If yes, Ilst agenoy name and permit/approval t2. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE .MOOIfICAi ION? ?Yes o I CERTIFY THAT THE INFOPMATION PROVIDED ABOVE IS TRUE TO THE 3E5~ OF My KyN///'''~~'OWLECOE /y~' Appllcan VSponsor nam ~ ~ Dam: v ~O Signature: If the action is rn the CGGSta! Area, and you are a state acency, complete the Coastal Assessment Form before proceeding with this a~,;essment OVER PART II-~NVIRDNMENTAL SSMENT (fo be completed by Agency) •A. DOES ACTION ErrX~~CIEED ANY TYPE I THRESHOLD IN 8 NYCRR, PART 617.127 If yes, woroinate me review process one use the FULL en:. ~ ? Ya! lJ NO B. WILL ACTION RECEIVE COORDINATED REVIBN AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617.6? II No, a nag atlva acct araur may be lupersetleb by another involveo agency. Yes ? No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may pe nanowritten, if legible) Cl. Existing air quUlty, surface or'groundwatsr quality or quantity, noise Ievela, exishnq tralllc patterns, sotto waste proouc;ion or alsoosa potential for erasion, oramags or flooding problems? Explain briefly: j C2. Aesthetic, agricultural, arbheeological, hlstorlc, or other natural or cultural resources; ar community or neignbornootl character? Explain betel CJ. Vegelallon or fauna, Rsh, shellflah or wllEllte species, slgnilleam habitats, or Nrealened or endangered species? Explain brlelly: C4. A community's existing plane or goals as oltlClally adopted. or a change in use or Intensity of ass of land or other natural rasourcesl Explain betel C6. Growth, subsequent davelopmant. or relatetl aCtlvltlas likely to be induced by Inc proposatl action? Expialn briefly. C6. Long term, short term. cumulative, or other effects not Itlentlfled in Ct~C61 Explain brlelly. C7. Other impacu Qncluding changes in use of either quantity or type of energy)? Explain brlelly. ti O. IS ]HERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ? Yas ? No If Yes, a%plain brlelly PART III-DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUC?IONS: Far each adverse effect Identlfled above, determine whether it Is substantial, large, important or otherwise significar Each effect should be assessed In connection with its (a) setting (I.e, urban or rural); (b) probability of occlkring; (c) duration; irreversibillly; (e) geographic scope; and (tJ magnitude. If necessary, add attachments or reference supporting materials. Ensure ;h. explanations contain sufficient detail to snow that all relevant adverse impacts have been Identlfleo and adequately addressed. Q Check this box if you have Identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF andlor prepare a positive•declaration. ~ Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in~3,ny significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: .~nme m Le+J agency Yam or IyPe Name OI xc>pensmle Ulficer m Lead Agvn<Y title of Resoonsmle n¢er jigna mre Or Hespom,ble lacer m Lead Agtn<Y S,gnature os YreVarer of din erns nom rerponupie ahcen alc 2 - ~ ~ ~g~1FF0(,r Albert J. Krupski, President O C Town Hall James King, Vice-President ~Z` ~ 53095 Route 25 Artie Foster ~ ~ P.O. Box 1179 Ken Poliwoda W ~ Southold, New York 11971-0959 Peggy A. Dickerson ~,j, ~ Telephone (631) 765-1892 ~0,( .1?,`a~ Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of --~r_cu~ld.-~.ri~_r_Z---------------------------- COUNTY OF SUFFOLK) STATE OF NEW YORK) p AFFIDAVIT OF POSTING I J~w.t A~ C°S'r'ts~,residingat l2/o nlO~GT/t /2oA.D ~P.2~cr/11Po.2T' t /Vacw ~(ot~t lI95~~ being duly sworn, depose and say: That onOthe $ day of , 200`' I personally posted the property known as ~ ~Z / S /VR 35A{.a.. Ao~NT f~~O~ CKTCr+og ..~.6t ~ ~ 35 by placing the Boazd 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 of the public hearing. Date of heazing noted thereon to be held C - or` ab o~lLt 'l~.lb IM. Dated: ~ ~ ~ 'gnature) Sworn to before me s l,p day ofp 200 Notary Pu i EMILY HE gotery Public, State Ot New tib~lt No.O1HE6059270 Op ~ dsaion IExpir®s July 23.~ } + 1 1 ~ i i R ~ ~ ~ ~c~ o~ ~~ARf~IG ~'~'I IS HEREBY GtYEh! thal o ppi6~ic hearing wili ba hefd br 1he * -i ' „~~~DARR OF TRUSTEES al this Tewq Nafl, 53095 Man Road. ~ccming Rlsv. prppnrlr. 4WN~~~S~ pF RECORD: Qrr~ltQ aA+1on S~KT OF Pti6tlC HEARING: ~1M~I+r+• S~a~swaul d~orJn bV~i4. ~ GATE QF Pl)8t)C HEARING: "~~flbar~lo,,~q,~1 -^onart~bq.R+~YAD ~ ' art ~ ~ m ~hts prgM, you arv irr.tirod 1o vWw Iha Tow! his '''`-t, w tlw dey of the heoti++9 ~t"3-"O'fi~~ iquy3Ef S • SU~vnt QF 5QllfFlOlA ' )d~ 1) 765.184= to . i i,!^ r ~ J i 1 + !7i~ j l E. !~I ~ 1 k) T 1 /NI Y e. ~ a ` hh.` ~1 ~ r ~'1 ~r g• ':tip ~ `r - ' r ...de-. J..: ,~~~IITb int Road, Cutchogue, NY 11935 595 Nassau Po Amo1d Barton 10!5!04 Public Hearing Postln9 • PROOF OF MAILING OF NOTICE 70D1 2y~510 OODO 1247 9478 1 2510 DODD 1247 941 2510 0000 1247 9~ S " ~a m ~ y 1~a ~ ~ ~ '~y ~ 8... o o°~ 3 0~ oa ry ~n~ oa ~ pp~~ Y ! 6$: b m u y ~ . a.,. a 3$ 3, ~ ~ 33 3~ 8( o° 3~ a: oz 3 r $z' 8~ ~ ~ n~ n~i n~ a$ $ T T T .y ~ ~s ~s s ~ ~ ~ t ag ~a f ~ t ~g ~i ~ S 1~ T ~ ly icy' ~ ~ ,;p ~ - ~al ~ ~ t~ z ~ ~ ~ ° , ~b~dN33do ti ~ ~l yl~d~ ~Tl COUN/T~Y OF SUIFnF~, r _ - ,,JtUM l 1~P.~IU V ,residing at 7b O C~(OS~L ~Vt I ~ y ~ I ~Z. being duly sworn, deposes and says that on the day of 0~ f0 h• ~ , 20~¢ 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 addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shovsm on the can ent assessmen roll of the Town of So thold; that said Notices were mailed at the United States Post Office at ( that said Notices were mailed to each of said persons by (certified) (regis eredj mar Sworn t o me this 3~' Day of~~~~ , 2~ o ]i CYNTHIA M. MANWA NG NOTARY PUBLIC, STATE OF NEW YORK N0:01 MA8100507 QUALIFIED IN SUFFOLK COUN COMMISSION EXPIRES OCT. 20 08/18!20].7 01:04 F.4R ~ 002 FROM iASTEL~D MRRINE COhIT, • PHOhE N0. :516 477 0605 • Sep. 02 2604 12:52PM P2 COSTELLO MARINE CONTRACTING CORPORATIC~r ~ddK 6U{LOWO • JtTTtEB • 6ULKHEADlNO • STEEL & WOOD PILINQ • FLOATS 42iPIFTN6TIILlT • P0.!lOk719i • OIIgtNN01M'f,NfWYCRK11044 • {pt)4T7.1I01/477.1iW/4T1'.pal~ • FAk(Oi~Ja».000 t. ,~riw ld ~ r fa?t owaar of ~+>oataa at hz 9 5 f~&~c ~ k f mod, u U~r %/93.~j do hereby give Ccatella IvLrlae Cotnracting Corp. the authority to set si agent in my L+rohalPin applying i~br sit oPthe neoeataty permtte Por vrork to ba wrapleted at my above • ~ rcfenonced plaperty. \ Dstc oe%1s~zots o1:us FAx • ~ ooa FR4M CG6TELL0 MRRINE CGNT. • PHONE NG. 53b 477 8805 Sep, 02 288+{ 12:52P"I P3 I` AP~'LICANT~AG$NTARF.YR~BE~'ATIV ~ 'rRANSACl'iONAL DI6CLOS4JRE I~'O81YI v~cm Nom: ~ r nr,_(~~ a®q ~ name, mid, m1a.7oM re~pyl~n~ of aotaeooe sloe ea• aiha aaelq. sucb aft a eampaoy. t!w tdkee the omar pmem~'e or wtgfo~'s aaaa.) NAI~ffiOFAYPIICAI'COR1: (Cbadtelltbet~plyj 't9aa itrleaaaae Wii~aoe C'hai~ ofZana hfpro~~P~ ~ flam p1a a olLawt aap nr"Clamt+', ams the eativiry.) ~~Il in/f S ° L~lrrzs,: ~5+aY1 ~In ~ I Q f1lYt~ no roa pa+oaeAq~ role aeayrx tpara awl Ewa a taLaimehip «ea.w a~ or a artae~tewnarsea~ewa ~saumon~mv"~a~awtir~am.e+w.a<rrreaammxa~~..~.m~rr~,~a.~r~, raioa>u~ ajwnbmrebiµ lawhieb tberoara aHiaar ar agyo~eenu am. ~t o~..w~ oftar tD».oar~on raa~smnunat>faaroraaeployesawaemnamm at+~. xss x0 ___..Z___ ttYeu satwe[ed ow~faa the bateaee of ibis lbttn wd dw sod +itya whaa iadiwea0. ..r Naas afpaeon aaeptoyed by Eu'fowa oY 9oamwld 75tleaapaeNaaa{IhetDwma Dswibe thenMivaabip botwam rwitaeiECa~e ) and tba aoaru a~oa ar ea~iayoa 81~eraLeot daa'aVP'~iem Vmo N e~dlordeeoiibo in tte ~ pieuWod. lbstorm arcs ar aaptq~m R 6ia or hee yAtlq sl6Tmp, ppenr, a afilld k (ohear Ml flat RiVl~t ~y tbo away olerowaAr~ 7%a[tIr oboes otPoo vatpo~eae meat artbe amplWatt (whmtba w t $eiytl arbmeddd awaa oC fwtia amo~ao~paab aMy(wLm dw eppliarR it sot a esrpaaatoa); q at ot8see,ditaalae, perfaer, eemplo)re a41ha sppilamt or ~ arsaat gtPlMaan- ua~emaori a~ a81~?a» x SiQrbua • ~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southokl•s Code of Ethics prohibits conflicts of ioteres<ao the Dart of town offices and emobvees. Tla tantrose of tlrk fotm is m ntovide information which un slat the town of oossrbk conflicts of interest snd allow it to take whatever actin is nar~arv to avoid same. YOUxNAI~: ~~ei~o ~r me, (~a~?}rac~r<<i l o~~ . name, fvst name, middle wtial, unless you appl ' m the name of someone else or other entity, such as a company. Ifso, indicate the other person's or cempwy's name.) NAMB OF APPLICATION: (Chxk all that apply.) Tae grievmce Varimce Chwge of Zone Approval of plat Bxemption from plat or official map ' (OIf~''erOdter•,nametheaetivity.> Vde~undS ~!.t~iEit~P~vo~~OYI Do you personally (or through your company, spouse, sibling, pereM, or child) have a relationship with any officer or employee of the Town of SoutholdT "Rchuionship" includes by blood, macriagy or busiaeu intereat'Busmese iderest" rtteaos a business, including a parmaehip, m which the town officer ~ anployce has evert a partial ownership of (or m~ployment by) a cerporatiao in which the town officer or employee owns mere than 5% of the shares. YBS NO If you answered "Yl~', complete the balance ofthis form and date and sign where indicated. Name of person argrloyed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicmNagenNrepresentstive) and the town officer or empkryee. Hither check the appropriate line A) through D) and/or deacrtbe m the space provided. The town officer or employce or his or her spouse, sibling, parent, or child is (chxk all that apply): ,_A) the owner of greater thm 5% of the shares of the corporate stock of the applitmt (when the applicant is a corporation): _B) the legal a beaeficisl owar of any mtaeat iu a tton-corpaate entity (whm the applicmt is not a rnrporation); _C) ao officer, director, perber, or employee of the appliaot; or D) the actual applicant. ' DESCRIP710N OF RBLATIONS1flP Submitted der of200~ Signature PrintN .lane loaf'/Io~Q