The URL can be used to link to this page

Home My WebLink AboutTR-5700Albert J. Krupski, President James King, Vice-President .~rtie Foster Ken Poliwoda Peg~[y A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line lSt day of construction H{d~lIg ~V-.?~ ¼ constructed Project complete, compliance inspection. Albert J. Krupski, President James King, Vice-President /~rtie Foster Ken Poliwoda Peg~5~ A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York JL1971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 January 19, 2005 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Robert E. Herrmann Eh-Consultants, Inc. 1319 North Sea Rd. Southampton, NY 11968 RE: ROBERT & HELEN KEITH 995 WILLIS CREEK DR., MATTITUCK SCTM#123 -10-2 Dear Mr. Herrmann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., January 19, 2005: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Permit #5700 as issued on January 22, 2003 and amended on October 20, 2004. This is not an approval from any other agency. If you h'ave any questions, please do not hesitate to contact this office. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK:lms ,lbert J. K~upski, President James King, Vice-President -~wtie Fester Ken Poliwoda Peggy A. Dickersen Town Hall 53095 Route 25 PD. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 October 20, 2004 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Mr. Robed E. Herrmann En-C:onsultants, Inc. 1319 North Sea Rd. Southampton, NY 11968 RE: ROBERT & HELEN KEITH 995 WILLIS CREEK DR., MA'I-rITUCK SCTM#123-10-2 Dear Mr. Herrmann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 20, 2004: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5700 to construct approx. 58 linear ft. of rip-rap on filter cloth and construct approx. 208 linear ft. of vinyl Iow-sill bulkhead to backfill with approx. 100 cy. clean sand fill to be planted with spartina alterniflora (12" on center), and as depicted on the plan prepared by Eh~Consultants, Inc. last dated September 14, 2004. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK:lms Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southoid Town Conservation Advisory Council held Monday, October 18, 2004, the following recommendation was made: Moved by Doris McGreevy, seconded by Don Wilder, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Amendment application of ROBERT & HELEN KEITH to Amend Permit #5700 to construct approx. 58 linear ft. of dp-rap on filter cloth and construct approx. 208 linear ff. of vinyl Iow-sill bulkhead to backfill with approx. 100 cy. clean sand fill to be planted with spartina alterniflora (12" on center). Located: 995 Willis Creek Dr., Mattituck. SCTM#123-10-2 Vote of Council: Ayes: All Motion Carried 10/13/04 Field InspectionO Albert J. Krupski, President James B2[ng, Vice-President .gxtie Pester 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 4, 2003 Mr. Robert. E. Henmann En-Consultants, Inc. 1329 North Sea Road South~mapton, NY 11968 $CTM#123-10-2 Robrtt & Helen Keith 995 Willis Creek Drive Mattituck, NY Dear Mr. Herrmann:: The Southold Town Board of Trustees at their Regular Meeting held on Wednesday, July 23, 2003 look the following action. RESOLVED, that the Southold Town Board of Trustees Approve an Amendment to Permit #5700 to construct (in lieu of previously approved proposed bulkhead) approximately 210 linear feet of rip rap on filter cloth along toe of embankment as per plans dated June 30, 2003 prepared by En-Consultants, Inc. If you have any questions, please call our office at 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees cc: DEC AJK:cjc AUG - 4\ Southold Towfl Board ~lf¢ ( tcc~ v~ 5it Jr-Cf PROf~I(1Y) f" .... "'""'~:~ INC. c :~;i L Y Ill 'I- 1-- ~o, ~ 1. I ~W", RIP-~P ADJACENT SEPA~TE 'J:59 LINEAR FEET OF 50-100 LB. RIP-RAP TO BE ~ PLACED ON FILTER CLOTH ON GRADE, I ALONG TOE OF EMBANKMENT AND TWB FLAGGED 'IDENTIFIED BY . ~,,, ) IN FRONT OF EX. BULKHEAD RETURN EN-CO.~U~?/.%. ,NC.. ~-~--o~Z.~.~. ,~ / '-'C'?t~¢ ~ --"~ EDGE v 8) A~jac¢~ ¢/r~r~,, h ~ 2, BaqvlcW ~ (631) 765-1892 Tovat H',~ll. 53095 ~ Road P.O. Box 1179 Southold, New Ym'k 11971 SOUTHOLD TOWN COi~ISEllVATIO~I ADVISORY COUNCIL At the meeting of the Southold Town ConserVation Advisory Council held Tuesday, July 15, 2003, the following recommendation was made: Moved by Donald Wilder, seconded by Thomas Schlichter, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A STIPULATION of the Amendment application of HELEN & ROBERT KEITH to Amend Permit #5700 to construct (in lieu of previously approved proposed bulkhead) approx. 210 linear ft. of rip-rap on filter cloth along toe of embankment. Located: 995 Willis Creek Dr., Mattituck. SCTM#123-10-2 The CAC recommends Approval of the application with the Stipulation that there are no alterations to the shoreline or existing vegetation. Vote of Council: Ayes: All Motion Carried Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 5~~j~ DATE: .Januar¥..2Z,. ZO0~ ISSUED TO ............ I~]~i~....~.~...~,..HE.L.EN..~/, KE~TH ............................ Pursuant to the provisions of Chapter 615 of the Laws of the State of New YorE, 1893; and Chapter ~0~ of the Laws of the State of New York 19521 and the Southold ToWn Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS end the REMOVAL OF SAND, GRAVEL OR OTHER tdATERIALS FROM LANDS UNDER TOWN WATERS;!~. and in accordance with the Resolution of The Board adopted at · meeting held on ~00.~ ...... and in consideration of the sum of $.20.0..00 .... paid by . ~?b.~r.~..]~z ~ .I~3.. ~,..}~i~h~ ...................................... : ................... o{ ....~?~!~ N.Y. and s~biect to the Terms and Conditions listed on the reverse ~lde hereof, of Southold Town Trustees authorizes and permits the fo~owlng: Wetland Permit to construct bulkhead with C-Loc Vinyl protect bog with rock with the stipulation that the contractor contact the Trustee's Office when the project is to start - two ins first .day and when .t. he project, is co e . all in accordance w,th tl~e ~dteaed sp~c~/~,~ns as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees h~re- by causes, its Corporate. Se. al to be a~xed, and these ~.resents to be subscribed by a 'rnalority of the sa,d Board as of thls date. , (/,52. Trustees TERMS and CONDmONS The permittee 1. That che said Board o~ Trustees and the Town c~ 5oud~old aze released fr0m any and all damage~ oc ,'1-~,~ for ~l-m%oer~ o~ mJt~ Lri~g dl-~fly oe lndh'ectly as ,, remit of my ~. ation perfov~d_ purmaat to d~s pea~ and thea~cl PeanieeeewRI, ~ebiso~be~ownezpem~ 2. That this Pennk is' valld f0t a period of 24 ma~ wlfich is c0mMemi to be t~e es~nated dme'requlred to comlgeee the wodc involved, but should ~'es win'mt, nequest for sa ex~_ ~on may be made to the Bo~d at a later ,!.~ ~. That this Permit should be rer'Im'xl imleflaitely, or as long as the said ps.rmtt~e ~hes to ,~1,w.i. the structure or project involved, to ptovlde evidence to anyone concerned that od-~tion was originally obtained. 4. That &e wodc involved will be subject to the ~ and approval of the Board m its agents, and noa-comp~i-~ce with the provisions of the o~--~-g ~pac~ioa, may be ~-.~ fo~ revocation of this Petmlt by ~esolullo~ o~ the s~ki Board. 5. That thexe will be no um'easotxable inte~fexmce with ntvi~ as · resuR of the wo~ hetdn au'thodzed. 6. That there shall be no interference with the right of the pub/lc to ~ and ~ alaag the beach between high tad low water marks. 7. That if /mute operations of the Town of .%uthold reClUiVe the removal mgl/ae aleeratioos inthe location o~ cbc w~-k bead~ -,,~ or i~ i~ d~e ola~aga~ a~ Ihe Board o~ Tnmees, d~e upon due notice, to remove or alter this work or project be~in rated ~vflho~t ex1~se~ to the Town 8. Tha~ the said Board will be notified by the Pet~txee m ~he ~Of the wadi ~ orized. That the Permktee ~ obtain ~dl ml~r l~ ~d comea~ plemental to this permit which may be subject to t~voke upon failure to 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 January 30, 2003 Robert W. & Helen W. Keith 995 Willis Creek Drive Mattituck, NY 11952 RE: SCTM#12340-2 995 Willis Creek Drive Mattituck, NY Dear Mr. & Mrs. Keith: The Board of Town Trustees took the following action during a Regular Meeting, held on January 22, 2003 regarding the above matter. WHEREAS, Robert W. & Helen W. Keith applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated January 2. 2003. 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 January 22, 2003 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. 2 NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approved the application of Robert W. & Helen W. Keith for s Wetland Permit to construct bulkhead with C-Loc Vinyl protect bog with rock with the stipulation that the contractor contact the Trustee's Office when the project is to start - two inspections first day and when the project is complete. 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 san~e 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: $10.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/cjc cc DEC Albert J. IZ~upskl, President James King, Vice-President Henry Smith Artie Foster lien Po]iwoda 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: ROBERT W. & HELEN W. KEITH Please be advised that your application, dated 3anuary 2, 2004 has been reviewed by this Board, at the regular meeting of and the following action was taken: January 22, 2003 ( X ) 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: Two Inspection ~$5.00 each TOTAL FEES DUE: $ 10.00 BY: PRESIDENT, BOARD OF TRUSTEES CLERK, BOARI~'O~F TR~JS'-TE'E~ 4/98 Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster 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: ROBERT W. & HELEN W, ~ETTH Please be advised that your application, dated January 2, 2004 has been reviewed by this Board, at the regular meeting of and the following action, was taken: ( X ) 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: Two Inspection @$5.00 each TOTAL FEES DUE: $. 10.00 BY: PRESIDENT, BOARD OF TRUSTEES BOAar;"Og 4/98 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 ROBERT W. & HELEN W. KEITH 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 x lStdayof construction ¼ constructed X Project complete, compliance inspection. 1/30/03 Field Inspection 1/20/03 Field Inspection 1/20/03 Field Inspection 1/20/03 Field Inspection 1/20/03 Field Inspection 1t20/03 Telephone (631) 765-1892 Tovm Hall. 53095 Main Road P.O. Box 1179 Southold, New Y~xk 11971 $OITI'HOLD TOWi~I CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conse~ation Advisory Council held Wednesday, January 15, 2003, the following recommendation was made: Moved by Melvyn Morris, seconded by Tom Schlichter, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Wetland Permit application of ROBERT W. & HELEN W. KEITH to protect the bog at the mouth of Deep Hole Creek with 95' of granite rocks west from property line set to the height of the bog (with filter cloth behind). Protect the sand fill atop the bog with a 3' retaining wall for 38' west from the property line and then 10' sheathing driven through the bog (with an average of 16" showing) west from the 179' to the fixed dock. Located: 995 Willis Creek Dr., Mattituck. SCTM#123-10-2 The CAC recommends Disapproval of the application and to allow the natural process to occur. Hardening of the shoreline will exasperate the problem down the creek. Vote of Council: Ayes: All Motion Carried ROBEI{T W. KEITH 995 WILl_IS CREEK ~A[ ~ ~ C~. YORK Mr..kibe,:! J. Krupski, President OC'~LF(i Of ]'OYV~ ~[FOSIeeS P.(.). Bo>: !!79 Southokl. NY, 11971 De;. Al. 63!' 298 - 8508 (_),.,tot ~.1 ] 8,.zt,O.z'wx ~ 123 -10-2, Kc:th ! 23-!0-3, Sco!!:.'d During tl~e Trustees' inspections of Februao' 13. 2002, the Board Iookccl ;it thc ' e,.'os~on ,,f ....... h. v,...= underlying th~-- .... ~J] on both om' Hole ,_ tek.,~' *, that finktilt'k" Board recommended that ;.,c iii; nc ] rcu :m&:,~ and.,a~ Both made essentially thc same recommcmdations which we pkm to submil v~hcn .\Icssrs..knders and Tanski bdie'\,'¢ lhat excessive boal wakes arc a significant the bog al thc creek mouth (il fell hire thc water about a month ago duc to thc erosion m )cast 75 yards fi'om thc mouth of thc . ~¢¢.. tis is now done al thc eBll'/mc¢ lo olhcr surest:rig fbr Dccp Hok Creek. \Vt uun~ i, x.Jdk,, c hdpm~ also to have a si~ remind:ha boaters lcaxSn~ "' ' crock mq)e h,a, l.c~c steps will be [mplcm~cnted next sphng at the ~, o[ ~' ~ ,.,.. ucd...~dcrs, Departmcmt of State ~123 ~'- I~1, '1 .- ~ ' SUR VE Y OF "VIEW A Z MA TTITUCK FILED AUGUST 21, 1987 FILE NO. 8377 A T MA TTITUCK TOWN OF SOUTHOLD .1000 - 123 - 10 - Scale 1" = 40' Feb. 16, 1990 Doc. 3, 2002 AREA = 42,596 sq. ft. to tie lino O3 , .. . 5,¢0,.., - ~ PA ?FUCK .$'d'O&LARD ANY AL TERA T/ON OR ADD/I-ION FO TftlS SUf?VEY IS A VIOLA rlON SAID MAP Of¢ CO~f'IfS~_~:~H_ THE IMPRESSED SEAL OF THE SURVEYOR 'm LOT DEEP CERTIFIED f O: H ..... · i.e. K£-f77! ' CREEK SUR VE Y OF LOT ~&::' MA P OF ". 'HARBOR VIEW A T MA TTITUCK" FILEO AUGUSr 21, 7987 FILE NO. 8377 A T MA TTITUCK TO WN OF SOUTHOLD i ..S £ C 7'1~' ff LOT~,! R/60.OO' ~. KEY ~.~ SCALE, 0 DEEp LOT N. 87o~3,20. H/. HOLE 267.85' or WILLIS CREEK CERTIFIED TO, ROBERT H/. KEtTH HELEN W, KEITH AREA = 43,274 sqft. to tie line ANY AL TERA TION OR AODtTION TO ')'HIS SLA~VE¥ I~ ~ ~C~ 7209 ~ T~ ~ y~ STAT~ ~D~ATI~ LAW. ~X~T A~ ~R ~CT~ X~09 - S~VI~ ~, ALL CERTIF~A T~S ~ A~ VA~ F~ T~ ~AP A~ C~S ~RE~ ~4~ ~P ~ C~S ~ ~ ~,~ SEAL ~ -~ S~VEY~ ~ ~ T~ ~EARS ~TI~LL y TO C~ y ~ITH SAID L~W TERM ' AL TERED BY MUST ~ U~D BY 4NY ~ ALL ~f~9 UT~IZ~ ~HT - TO - D~T~ ' A~ NOT ~ C~L~E SURVEY OF LOT16 MAP OF "HARBOR VIEW A T MA TTITUCK" F~.E~ ALli3LIST 2~ 1~SX F~E NO. 8377 A T MA TTITUCK TO WN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000- 123- 10- 02 Sca/e: 1"= 40' Dec. 30, 2002 02-~6~ Albert J. Krupski, President James King. Vice-President llenry Smith Artie Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 FAx (631) 765-1366 DATE OWNER ADDRESS AGENT SEPTEMBER 24, 2004 ROBERT & HELEN KEITH LETTER OF REQUEST FOR AN AMENDMENT 995 WILLIS CREEK DRIVE, MATrITUCK, NY 11952 EN-CONSULTANTS, [NC. PHONE 631-283-6360 ADDRESS 1319 NORTH SEA ROAD, SOUTHAMlYi~N, NY 11968 PROPERTY LOCATION 995 WILLIS CREEK DRIVE, MATT1TUCK TAX MAP NO. 1000-123-10-2 I/We EN-CONSULTANTS, INC. request an Amendment to PemR# 5700 TO CONSTRUCT APPROXIMATELY 58 LINEAR FEET OF RIP-RAP ON FILTER CLOTH & CONSTRUCT APPROXIMATELY 208 LINEAR FEET OF VINYL LOW-SILL BULKHEAD TO BACKFILL WITH APPROXIMATELY 100 CUBIC YAKDS CLEAN SAND FILL TO BE PLANTED WITH SPARTINA AL TERNIFLORA (12" ON CENTER), ALL AD DEPICTED ON PROJECT PLANS PREPARED BY EN-CONSULTANTS, INC. LAST DATED 9/14/04. Siglted By: ~,/'x~.~,. ~,, ~ ROBERT E. HE~, COASTAL MGMT. SPECIALIST Boar~ o~ Trustees App/-~catlon AUTHORIZATION (where the applicant is not the owner) (print owner of property) (mailing address) (Agent) to apply for permit(s) from the S~~Board of'Town Trustees on my behalf. (Owner s szgnat~) - 8 Board of Trustees Application County of Suffolk State of New York ~>~t-03 .~;¢~ ~ [~LO. 1~,'444 BE~GD~YSWO~ DEPOSES ~ ~F~S THAT ~/S~ IS T~ ~PLIC~T FOR T~ ~O~ DESC~ED PE~T(S) ~ T~T ~L STATE~NTS CONT~D ~ ~ TR~ TO ~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ T~T ~L WO~ ~]L BE DO~ ~ ~ ~R SET FORTH ~ T~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SO.HOLD TO~ BO~ OF TRUSSES. T~ ~PLIC~ AGREES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ TRUSSES ~ESS ~ F~E FROM ~ ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~T~ OF S~ PE~T(S), ~ G~TED. ~ CO~LET~G ~S ~PLICATION, I ~BY A~HO~ T~ ~US~ES, T~ AGENT(S) OR ~P~SENTATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT T~ P~3~SES ~ CON~CTION ~~W OF T~S ~PLICATION SWORN TO BEFORE IV[E THIS ~ DAY OF ~47 '200--~ No.~y Public ^~V,¥ F. WIPPERT Qualified In Suffolk Cou, nt~, Comml$$!on F. xpire~ ~ 13, The Town of Southold'a Code of Ethics prolibi~s conflicts in~erSS~ on the pa~ of town o~ftcers and e~ployees. The purpose of this form is to provide ingorme~ion which can alert the town of possible conflicts of in~ereet and, allow it to take whatever action is ~ecessar¥ to avoid same. (Lae~ ndme, girst name, middle initial, unless you are applying in the name of someone else or other entity, such aa a company. If so, indicate tile other person's or company's name.) NATURE OF APPLICATION~ (Check all that apply.) Tax grievance Variance Cha~ge of zone App{~val of pla~ , Exemption from plat or official m~p Other (If .Other,. name the ac~lvity.) employee of the Town Of Southold? "Relat~onehip# includes ~hich the ~owo officer or employee has eYe~ a partial ownership of (or employment by) a corporation in which ~he town officer or employee OSha more titan SX el the YES NO ~ If you answered "YES," complete the balance of this form and Name of parson employed by tho Town of Southold Title or position of that person Describe the relationship between yourself (the applicant) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. Tile town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply). A) the owner of greater than 5% of the shares of the is a corporation); corporation)~ applicant! or D) the actual applicant. DESCRIPTION OF RELATIONSHIP NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEESr TOWN OF SOUTHOLD Tn the matter of applicant:ROBERT&H~LEN~ITH SCTM~1000- 123-10-2 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request Permit from the Board of Trustees to: TO CONSTRUCT APPROXIMATELY 58 LINEAR FEET OF RIP-RAP ON FILTER CLOTH & CONSTRUCT APPROXIMATELY 208 LINEAR FEET OF VINYL LOW-SILL BULKHEAD TO BACKFILL WITH APPROXIMATELY 100 CUBIC YARDS CLEAN SAND FILL TO BE PLANTED WITH SPARTINA ALTERNIFLORA (12" ON CENTER), ALL AD DEPICTED ON PROJECT PLANS PREPARED BY EN-CONSULTANTS, INC. LAST DATED 9/14/04. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: 995WILLISCREEK DRIVE, MATTITUCK 3. That the project which is suDJect to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public con%ment on:OCT. 20,2004~7P.M. 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: ROBERT & HELENKEFFH MAILING ADDRESS: 995 ~qLLIS CREEK DPJVE NL%T~TUCF~ NY 11952 PHONE ~: 631-2~-8508 Enc.: Copy of sketch or plan showing proposal for your convenience. 5 2) P~m: ~W ~ ~ ~ emb~k~/~ wl~ vlnql ~he~i~; ~m~r ~ ~ ~pr~, ~00 cH de~ *~ Fill ~ in fr~ ~ upl~ ~rce ~ u~d ~ fiji ~ ~ pl~ wl~ 5, ~m~a (I'QC,) Pr~r~ ~: ~ WIIh~ Cr~k M~K; ~TM ~l~d~-IO-2 ~j~ ~r~: I, ~l~a~ 2, OONTI~UOUS RIP-~P · LOW-SILL BULKH~D PROPOSED ON ADdAOENT PAROEL BY SEPARATE APPLIOATION EX. B~HD. TWB FLAGGED %~ 148' ~ V~l -- ~X HOU~ PROPOSED +5~ LINEAR FEET OF' 7) 50-100 LB, RIP-RAP TO BE PL~.CED-O.N FILTER CLOTH ON GRADE, .. ....... .A~ONG TO~"OF~ EMBANKMENT AREAS TO BE "-: BACKFILLED AND PLANTED WITH S. ALTERNIFLORA (INDICATED ;, ?.,- } ~ 'C- '? PROPOSED +208 LINEAR FEET OF LOW-SILL VINYL (MN,) OF EN-CONSULTANTSlNC. 1319 NORTH SEA RD. SOUTHAMPTON, N.~ 11968 631-283-6360 PRQPO~ RIP-PAP AN~ LOW6tL ELILKH~A~ FOP, H~LUN AN~ RQi~IET I~ITH ON IZ~P HOLU C~K, MAF11TLICK, SUffOLK COUNT'/, NY 5HBBT I OF I 6/50/05, 9/Id/04 Name: PATRICK SCOLLARD PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: 129 STRATFORD AVENUE GARDEN CI15', NY 11530 PATRICIA GAZOULEAS 960 WILLIS CREEK DRIVE MATTITUCK, NY 11952 BAY%qEW AT MATTITUCK HOMEOWNERS ASSOCIATION P.O. BOX 871 MATTITUCK, NY 11952 STATE OF NEW YORK COUNTY OF SUFFOLK ROBERTE. HERRMANN 1319 NORTH SEA ROAD . UmAMPTON, NY .doing business atE~ONSULTANTS,INC- · being duly sworn· deposes and says Sworn to before me this27TH day o f SEPTEMBER ,20 04 Notary/ Public that on the 27TH day of SEPTEMBER ,20_04. , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addressesset opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office atSO~N , that said Notices were mailed to each of said perso~ by (certified) ~~X~) mail. COASTAL MANAGEMENTSPECIALIST rn ~;~ (~x~orsemem Required) ,I OFFICIAL USE ~ ls~r° Patrick Scollard r~ ~0~:'~:x~ 129 Stratford Avenue o~o~ Garden City, NY 11530 m OFFICIAL USE ~ $ m= ls''` r° Patdcia~--, ,. Oazouleas NY r'- ~:'~"~or~o~~, 960 Willis Creek 11952 -' ............. ~ twammc~., SEP 2 Seutho Town Board FLAGGED '~ 14e' S V~, -- bX. ,¢" 1" -- 40' PROPOSED _+51~ LINEAR FEET OF 50-1OO LIB. RIp-RAP TO 8E AREAS TO BACKFILLED AND PLANTED WiTH S. ALTERNIFLORA (INDICATED:: }-?C-I*;':' :') PROPOSED +208 UNEAR FEET OF LOW-SILL VINYL BULKHEAD FROPOC:~P ~0 -I00 LC 51-ONB RIF-P.4¢ TO D~ PLAC¢~2 ON ~IL~R CL~ 6" Xe" I' - -¢ ~000' o 2) P~m: ~W 4) L~-slII ~lkhe~ ~ ~ ~) Prm~ed w~ ~ ~ u~er~ In cmj~ti~ wi~ ~ ~ed i~ siml~q prod w~ ~ ~J~ p~cel ~ 6) ~prox, I~ ~q cle~ s~ fill ~ ~ ~ked In fr~ ~ upl~d ~rce ~ u~d ~ fill ~ ~ pl~d wJ~ ~, d~mlfl~a (PO,CO 7) Pr~r~/~m: ¢9¢ Willis Creek Pr., ; %tM RIP-RAP BULKH~D ON PARCEL BY *PPLI~TION EX. BLKMD. EDGE OF ~/ALW -6" (MIN,) -O'-O" EN-CONSULTANTSINC. 1319 NORTH SEA RD. SOUTHAMPTON, N.~ 11968 631-283-6360 PROFOSeP RIP-RAP AN~ LQW-51LL ¢L/I.~A~ FOR H~L~N ~II'H ON P~P HOL~ C~K, MA'Flq~CK, 5IJPPOLK COL~NTY, NY Cf'II, BT' I Ol~ I 6/~0/0~, 9/14/04 EN-CONSULTANTS, INC. 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com ENVIRONMENTAL SERVICES January3,2005 PERMIT EXTENSION REQUI~ Town of Southold Board of Trustees Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Robert W. & Helen W. Keith 995 Willis Creek Drive, Maltituck SCTM # 1000-123-10-2 Permit #5700 Dear Board of Trustees: The above referenced permit is due to expire January 22, 2005. As the approved work has not been completed, would you kindly extend your permit for a period of one year. The permit fee of $50.00 and a copy of the permit are attached. Thank you in advance for your attention to this matter. You~truly, Coastal Management Specialist /khs Enc. Board Of Southold Town Trustees ISSUED TO ........... ~g~%~....w.,:. ~ HEL.~I~ 1N KEIT. H ............................. Pursuant fo the provisions of Chapter 6l$ of fha Laws of the State of New YorE, 1893; and C~apfer 404 of fha Laws of fha State of New. Yor~ 1952; and fha Soufhold ToWn Ordinance eh- rifled ."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;~J. end in accordance w{fh fha Reso{uflon of The B6ard adopted afa meeting held on ...3...a...n-.u..~T. YL..~2, ' 20.D3...L, and {n consideration of the sum of $.2.0Q...0.0 ........ paid by _ ~.e~.L..w...~_..~..., ~..e.~..n....,~....-.K..~l~~ .................................................. ., ........... : ......... of ....~.~.i.~.~.~.......:_: ....................' ................... N. Y. end subject to the Terms and Condd~ons listed on ~e reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to construct bulkhead with C-Loc Vinyl prot~{ bog with rock with the stipulation that the contractor contact the Trustee's Office when the project is to start - two ins :first .day and when .t, he prnlect, is sp~n~l~6ns as presented Jn at{ {n e¢¢ordance w~th the ~{'6failed ~o e . · {he oHginaf{ng application. . IN WITNESS WHEREOF, The said Board of Trustees here- ~ oauses {is Corporate Seal to be affixed, and these [:.resen~ fo subscr~ed by a 'majority of the sald Board es of this daf~. Albe~t J. Krupski, Presidei JameJ King, Vice-Presiden~ Henry Smith Artie Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1892 FAx (631) 765 - 1366 DATE OWNER ADDRESS SEPTEMBER 24, 2004 ROBERT & HELEN KEITH LETTER OF REQUEST FOR AN AMENDMENT ,S,EP 2 9 2O.i Southold Town Beard of Trustees PHO ;E wi-2b&-o~w 995 WILLIS CREEK DRIVE, MATTITUCK, NY 11952 AGENT EN-CONSULTANTS, INC. PHONE 631-283-6360 ADDRESS 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 PROPERTY LOCATION 995 WILLIS CREEK DRIVE, MATTITUCK TAX MAP NO. 1000-123-10-2 I/We EN-CONSULTANTS, INC. requat an Amendmeat to Permit # 5700 TO CONSTRUCT APPROXIMATELY 58 LINEAR FEET OF RIP-RAP ON FILTER CLOTH & CONSTRUCT APPROXIMATELY 208 LINEAR FEET OF VINYL LOW-SILL BULKHEAD TO BACKFILL WH'H APPROXIMATELY 100 CUBIC YARDS CLEAN SAND FILL TO BE PLAN~I~D WITH SPART1NA ALIERNIFLORA ( 12' ON CENTER), ALL AD DEPICTED ON PROJECT PLANS PREPARED BY EN-CONSULTANTS, INC. LAST DATED 9/14/04. ROBERT E. HER~R~NN, COASTAL MGMT. SPECIALIST 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn, depose and sa~,: ~ That on the/F:~ day of &~7,, 200 ~I personally~posted tlW property known as 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 cL hearing. Date of hearing noted thereon to be held~[~ 0 ~.~ Dated: (signature) - [ys prior to the date of the public Sworn to before me this day of ~c/ 200 ~? No~ar~ Public / · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: A. Sight,re = ~) f ~. ~ [~ Agent. B. ~ei~d by {Printed Name) C~e o~ve~ D. Is delive~ address diffem~ lmm item 1. ~ ~s If YES, enter delive~ add~s below: ~ 3. Service Type []~ertified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Deliver~? (Extra Fee) [] Yes PS Form 3811, February 2004 7003 3110 0000 3106 0182 Domestic Return Receipt 102595-02-M-1540 · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Patricia Gazouleas 960 Willis Creek Mattituck, NY 11952 (Transfer from service label) PS Form 3811, February 2004 A. Signature [] Addressee B. Received by (Pdnted Name) lC. Date of Deliver7 ,, D._I8 de~ive~j address d~em~ ~m ~em 17 ~ Y~ ~~er delive~ addr~s below: ~ No~ ~. ~ y ~ ~istemd 0 Return R~aipt for Merchandise 7003 3110 0000 3106 0113 Domestic Return Receipt 102595-02-M-1540 · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. Agent [] Addressee D. Is delivery address different from item 1~' [] Yes If YES, enter delivery address below: [] No Patrick Scollard 129 Stratford Avenue Garden City, NY 11530 3. Service Type [] Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 2. Attiole Number (Transferfromsem/ce/abe ~,,[i7~D[~ 3110 [3000 '3106 PS Form 3811, February 2004 D~lc R~urn Receipt 0175 I02595-02-M-1540 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) (print owner of property) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the S~thold Board of Town Trustees on my behalf. ~ · (Owner's signat~) - - 8 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) (print owner of property) (mailing address) (Agent) to apply for permit(s) from the S~thold Board of Town Trustees on my behalf. ( owner ' s signat~ - - OBoard of Trustees Applica~n County of Suffolk State of New York SErSO SWO DEPOSES AND AFFIKMS THAT HE/SHE IS THE APPLICANT FOR ~ ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF H/S/I-[ER KNOWLEDGE AND BELI]EF, 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 TI-I~ TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), ~ GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PKOPEKTY TO INSPECT THE Signature - (' SWORN TO BEFORE ME THIS ~ DAYOF /~F'~a~7 ,20 0_2 Not~ Public ,~J AIV,¥ F. WIPPER7 Nolm'y Public, State of Ne~ Y~ No. 0t WI4~84083 Qualified in Suffolk Coun~ ~_.., 10,20,2004 17:06 FA_'( 6412836136 EN-CONSULTANT$,INC. ~0t)2 3dbe~ J Fmupslc, President Jm-tues King, Vice-President ~&rtie Foster Peg~' A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 outhold, New York l 1971-0959 Telephone (631) 765-1892 Fax (681) 765-1366 BOARD OF TOV(N TRUSTEES TOV~N OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In lhe Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTiNG __, berg duly swom~ ~ose ~d sa~: ~ ' t z~ o~ ~,~y of ~,, 2~ q~ p~o~nyvo,,~ m p~o~ ~ a~ by pbcmg ~e Bored ofT~t~s o~ci~ post~ w~e i¢c~ ~ily be seen, ~d ~t ~ have choked to be s~e ~e ~ster has rem~M m pl~q ~r~ight ~ he~g. Date of herons noted ~eon to be held~. ~ Dated: tys prior to the date of the public Sworn to before me day of ~r/200 q' 1 - N~t ary-l:,tlbtic / 15:53 RECEIVED FROM:6312~361~8 P.D2 d / use 1 Patrick Scollard ! 29 Stratford Avenue Garden City, NY 11530 OFFiCiAL US~ Patricia Oazouleas 960 Willis Creek --- Mattitucl~ NY 1195_~ .................... NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEE$~ TOWN OF SOUTBOLD In the matter Of applicant:ROBERT&}{~LEN~T~ SCTM#1000- YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: TO CONSTRUCT APPROXIMATELY 58 LINEAR FEET OF RIP-RAP ON FILTER CLOTH & CONSTRUCT APPROXIMATELY 208 L~ FEET OF VINYL LOW-SILL BULKHEAD TO BACKFILL WITH APPROXIMATELY 100 CUBIC YARDS CLEAN SAND FILL TO BE PLANTED WITH SPARTINA ALTERNIFLORA (12" ON CENTER), ALL AD DEPICTED ON PROJECT PLANS PREPARED BY EN-CONSULTANTS, INC. LAST DATED 9/14~4. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: 995 WILL~S CREEK DRIVE, MATT1TUCK 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on:OCT-20,~7~M. You may contact the Trustees Office at 765-1892 or in writing. The .above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: ROBERT & HELEN K~rFH MAILING ADDRESS: 995WILf/$CREBKD~JVE MAT~TJC~ NY 11952 PHONE ~: 631-298-gSOg Eric. : Copy of sketch or plan showing proposal for your convenience. Name: PATI~CK SCOLLAPJ) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: 129 STRATFORD AVENUE GARDEN CITY, NY 11530 PATRICIA GAZOULEA$ 960 WILLIS CREEK DRIVE MATTITUCK, NY 11952 BAYVIEW AT MATTITUCK HOMEOWNERS ASSOCIATION P.O. BOX 871 MATrlTUCK, NY 11952 STATE OF NEW YORK COUNTY OF SUFFOLK ROBERT E. HERRMANN 1319 NOR'I~I SEA ROAD SOUTHAMPTON, NY 11968 doing business atEN~ONSULTANTS,~NC- · being duly sworn, deposes and says Sworn to before me this 27TH day o f SEPTEMBER ,2o04 ~ ~ Notary/Public that on the 27TH day of SEPTEMBER ,20 04 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addressesset opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at SOUT~u~MPTON , that said Notices were mailed to each of said persor~ by (certified) ~) mail. COASTAL MANAGEMENTSPECIALIST The Town o~ Sou~hoid'a Code of ~thic,s prohibits conflicts of interest on the park of town officers and employees. The p~rPO~e o~ this form is to provide information which can alert the town of possible conflicts o~ interest.and allow it to ta~e whatever action is necessary to avoid same. (Last ngme, first name, middle initial, unless you are applying in the name of someone else or other entity~ such aa a company. If an, indicate the other person's or company's name.) NATURE OF APPLICATION~ (Check all that apply.) Tax grievance Variance Change of zone A~p~oval of plat -- ~xe~ption from plat o~ oSficial map Other (If 'Otter," name the activity.) -'"r~w~.~,- interest" means a business, including a partnership, which the town officer or employee has even a partial ownership of (or employmen~ by) a uorporation in which ~he ~ovn officer Or s~ployee dyne more than 5~ o~ ~he YES NO )< you answered "YES," complete the balance of this fform and Name of person employed by the Town o~ SouMiold Title or position of that person Describe the relationship between yourself (the applicant) and the town officer or employee. Either cheek the appropriate line A) through D) and/or describe in the space provtde~. Tile town officer or employee or hie or her spouse, sibling, parent, or c~lld is (cheo~ all that apply)l A} the owner of greater than 5% of the shares of the is a corporation)~ corporation)l C) an o~ficer, director, pa~tner, or employee of the D) the actual applicant. DESCRIPTION OF RELATIONSHIP .~hle ~ day ' ~5 ~ _/ Submi bred o '~ EN-CONSULTANTS, INC. 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com ENVIRONMENTAL SERVICES September 27, 2004 REOUEST FOR AMENDMENT Town of Southold Board of Trustees Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Re: Robert & Helen Kcith 995 Willis Creek Drive, Mattituck SCTM #1000-123-10-2 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: Three (3) Request for an Amendment Applications, (including Notice and Proof of Mailing to adjacent owners). Three (3) copies of authorization & disclosure forms. Three (3) work plans. Application fee of $50.00. 1 trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. Rober't'EOHerrmann Coastal Management Specialist /khs Enc. Alb¢:rt J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1892 FAx (631) 765-1366 LE'iiER OF REQUEST FOR AN AMENDMENT DATE JUNE 30, 2003 OWNER HELEN & ROBERT KEITH PHONE 631-298-8508 ADDRESS 995 WILLIS CREEK DRIVE, MATI1TUCK, NY 11952 AGENT EN-CONSULTANTS, INC. PHONE 631~283-6360 ADDRESS 1329 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 PROPERTY LOCATION 995 WILLIS CREEK DRIVE, MATT1TUCK TAX MAP NO. 1000-123-10-2 I/We EN-CONSULTANTS, INC. request aa Amendment to Permit # 5700 TO CONSTRUCT (IN LIEU OF PREVIOUSLY APPROVED PROPOSED BULKHEAD) APPROXIMATELY 210 LINEAR FEET OF RIP-RAP ON FILTER CLOTH ALONG TOE OF EMBANKMENT. Signed By:_ ~ ROBERT E~ HERRMANN, COASTAL MGMT. SPECIALIST 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application COUNTY OF SUFFOLK) STATE OF NEW YORK) bUL~IHt,~N1Ull)Iq, I~.Y. 11968 631-283-6360 being duly sworn, depose and say: That on the (~- day of ~-~ , 200~, I personally po,s~e~ the property known as by pla~ing the Board of Tn~tees offidial post'~r &here it em easily be seen, and that I have checked to be sure the poster has remained in pla~for eight d.a~s prior to the dat~ o.f the public l~aring. Date of hearing noted~th~reon to he heldk,4~W'~ ~, ~ 3 ~ e~'~%,~- '7~ Cr~. ~' / Dated: (signat Sworn to before me this ,,2;'/~day o~ce~200-g NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant:HELEN&ROBERTKEITH SCTM#1000- 123-10-2 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned Permit from the Board of Trustees to: to request a TO CONSTRUCT (IN LIEU OF PREVIOUSLY APPROVED PROPOSED BULKHEAD) APPROXIMATELY 210 LINEAR PEET OF RlP-RAP ON FILTER CLOTH ALONG TOE OF EMBANKMENT. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: 995 WILLIS CREEK DRIVE, MATTITUCK 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public coherent on: ~UL¥23,2003 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: HELEN& ROBERTKEITH MAILING ADDRESS: 995 W~LIS CREEK DFdVE MATTITUCK, NY 11952 PHONE #: 631-298-8508 Eric. : Copy of sketch or plan showing proposal for your COnvenience. Name: PATRICIA GAZOULEAS PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: 960 WILLIS CREEK MATTITUCK, NY 11952 PATRICK SCOLLARD 129 STRATFORD AVENUE GARDEN CITY, NY 11530 STATE OF NEW YORK COUNTY OF SUFFOLK ROBERT E. HERRMANN 1329 NORTH SEA ROAD SOUTHAMPTON, NY 11968 doing business atEN-CONSULTANTS,~NC- · being duly sworn, deposes and says that on the day ofJUNE .2o 03_~___, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addressesset opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at SOUTHAMPTON f , that said Notices were mailed to each of said persons by (certified) ~) mail. Sworn to before me this day of, .2o ROB COASTAL MANAGEMENT SPECIALIST mm I $orn ro Patrick Scollard r,- [ ................. 129 Stratford Avenue O ~, .~ lilml A L U $ E $ 0.3'/ 2,30 /( V r~ [,~.,ro ' Patricia Oazouleas / r,- ta~':ibi: 960 Willis Creek Drive .... { [o,.o~,; Mattituck, NY 11952 -I of Trustees Applicat~ County of Suffolk State of New York DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE 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 APPLICAN~r 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 Signature [ SWORN TO BEFORE ME THIS DAYOF ~:~'~'~7 ,200_~ Not~y Public AI~,¥ F. WIPPERI' Qualified in Suffolk Countw _ APPLICANT ~jhs Town of Southold's Code of Ethics pro!libits conflicts of ingerssg on tile parL of town officers and employees, The p_~poee of this form is to provide ~nformation which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same~ (Last nWme, first name, middle initial, unless you are applying in ~he name of eomeoee else Or other entity, aucll as a company. If so, indicate the other person's or company's name.) NATURB OF APPLICATION, (Check all that apply.) Variance A~p~val of plat _ (If "Other," name the activity.) interest" means e business, isclsdisg a partnership, in which the town officer or employee has even a partial ownership o~ (or employment by) a corporation in which the toYn officer or employee owes more than 5~ of tile Yg$ NO If you answered "YES," complete the balance of ~his form and Name of person employed by the Town of Southold Title or position of that parson Describe the relationship between yourself (the applicant) and the town officer or employee. Either check the appropriate line A} through D) and/or describe in the space provided. The town officer or employee or hie or her apouse, sibling, parent, or child is (check all that apply), A) the owner of greater than 5% of the shares of the __C) an officer, director, partner, or employee Of the D~SCRIPTION OF R~LATIONSHIP 5~fTdk +_3000' FLAGGED {t~" 40' PROPOSED "t'2115 LINEAR FEET 50-100 LB, RIP-RAP TO BE PLACED.ON FILMER CLOTH ON ...' ....... AE~NG TOg"OF~ EMBANKMENT GRADE, DEEP HOLE CREEK o 5~CTION THRU PROP05~ RIP-PAP - HM F~LCONSULTM, IT8 INC. 1329 NORTH SEA RD. '~ "~THfi~,,PTON, N.Y. 11968 831-283-6360 EX. BLKH RIP-RAp PROPOSED ON ADJACENT PARCEL BY SEPARATE APPLICATION '"-/'---SEAWARD EDGE OF IM/ALW 4) ProF~ rip-rap In~all~lm ~, be u~¢~n tied I~ parcel ~ ea~, 9) Pr~ I~lm: 999 Willis Creek Pr,, PROPO~P DP-~ ~0~ H~L~N ~fflTCK, SUFFOLK COUN~ NY OF I ~/~O/O~ EN-CONSU LTANTS, INC. 1329 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 E-mail: encon@peconic,net www. enconsultants.com ENVIRONMENTAL SERVICES June30, 2003 REQUEST FOR AN 3JMENI}MENT Town of Southold Board of Trustees Post Office Box 1179 Southold, New York 11971 ' Attn.: Lauren Standish Re: Helen & Robert Keith 995 Willis Creek Drive, Mattituck SCTM #1000-123-10-2 Dear Ms. Standish: In regard to the above referenced property, enclosed am the following for the Board of Trustees review: 3. 4. 5. 6. Three (3) Request for an Amendment Applications, ( including Notice and Proof of Mailing to adjacent owners). Three (3) copies of authorization & disclosure forms. Three (3) work plans. Three (3) copies of survey. One (I) set of site photographs, Application fee of $40.00 wetlands. I trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. Coastal Management Specialist /khs Enc. Albert d. Bh'upski, President James ]King, Vice President Henry Smith Artie Po~er Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone ~631) 765-1892 Fax {631~ 765-1366 Office Use Only ~/_Coastal Erosion Permit Application I~Wetland Permit Application Major Waiver/Amendmen~/Cllanges Received Application l/~o .... Received Fees Completed _ Incomplete SEQRA Classification Type I Type 11 Unlisted Coordination:(date sent),_ CAC Referral Sent ~Date oF Inspection Receipt oFCAC Report:/t I,ead Agency Determination; Fechnical Re~ie~ ' Public Hearing Held Minor JAN- 2 ! esolution '_ ' Suitblk County Tax Map Number I000-_i.~_ZL9_'_~ (providc LILCO [ ole ~, distance to cross streets, and location) AGENT ~ (IFapplicable) Ad&ess ...... Phone: Board of Trustees Application Land Area (in square feet): Area Zoning: / al, c..4c. GENERAL DATA Previous use of property: ~¢~, &J,~ t'.~0 Intended use of property: i¢e$, id Prior permits/approvals for site improvements: Agency Date __. No prior permits/approvals for site improvements. provide Has any permit/approval ever been revoked or suspended by a governmental agency? ~, No Yes explanation: Project Description (use tach~n%nts if necessary): go4-e6~C ~ ~ O ~ ~Ou~ 0~ Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: Ip;-Jr~D square feet Percent coverage of lot: ~' % Closest distance between nearest existing structure and upland edge of wetlands:_ Dr~ ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: O' feet ~.d~ DO,.. 5G~" aat ~ c~lo~ Does the project involve excavation or filling? No ~ Yes If yes, how much material will be excavated? cubic yards How much material will be filled? ~oD cubic yards Depth of which material will be removed or deposited: ,~ feet Proposed slope throughout the ~ea of operations: 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); Albert J. Krupski, President James K/ng, Vice-President Henry Smith Artie Pester 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 OFSOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD I~the Matter of the Application f ~COUNTY OF SUFFOLK) STATE OF NEW YORK) ~ AFFIDAVIT OF POSTING I,~, ~Oi~ , residing at being d~ly s~orn, depose and say: That on the~O~ day offS. 20~, I perso~allv posted the property known as~ ~],~'~,~ by placing the Boa?h of TrusSes offici~ pbs~er 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 or.he ~'~ ~ublic~h~aring' ~0 ~~Date of hearing, noted thereon to be held~~ Dated: ~ [0, (signature) Sworn to before me this day of~-~ 200 / Notary~u-bl ic F ~ ^~v;¥ F. WIPPERT Notery Public, State of New No. 01Wl4884083 Qualified in Suffolk County Commission Expires April 13, PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK · COUNTY OF SUFFOLK .~o~}-~>qat"LI3 ~.e,q4A , residing at qq.~i' Od,'t[i[{(_.~tec~. ~vl~-t M~q~,,d-qc.~(. ^IV' [~.t:kj'L-,bemgdulyswom, deposes and says that on the __~_.~___ day o5"~, 20~, deponent mailed a tree copy of the Notice set forth in the Board of Trustt*es 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 Office at ~,~, lr.Sc.~: ^~x/ , that said Notices were mailed to each of said persons by (certified) (~zg:.zt.zrzd) mail. ~ ~'~ Sworn to befm;e me this c~ Day of :~'t~ ,200_~ Notary public t~, , UELANIE V. BROWN ,~, No. 4906/12 · Complete items 1, 2, and 3. Aisc complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we,can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: [] Agent Date of E tem 1 ? [] Yes ,r delivery address below: [] No [~ Express Mail [] Registered [~ Return Receipt for Merchandise [] insured Mail [~ C.O.D. 4. Restricted Delivery? (Exfra Fee) [] Yes 2. Article Number PS Form 3811, August 2001 Domestic Return Receipt · CSmplete items 1, 2, and 3. Aisc complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card or on the front if space permits. [] Agent [] Addressee C. Date of Delivery address different from item 1 ? [] Yes enter delivery address below: [] No [~i~Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2, Article Number PS Form 3811, August 2001 Domestic Return Receipt 102595-01 M-0381 · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. PS Form 3811, August 2001 [] Agent [] Addressee 0. Is delivery address different from item 1 ? If YES, enter delivery address below: [] No 3. Service Type [;~,~ ertl fied Mail [] Mail Express [] Registered [] Return Receipt for Merchandise [] Insured Maff [] C.O.D. 4. Restricted Delivery? (Extra Fee) E] Yes Domestic Return Receipt 102595-01-M-0381 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--.PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEC If the actio.n is in the Coa*;tal Area, and you are a state age.ncy, complete the Coastal Assessm.n, Form before proceeding with this assessmem OVER I County of Suffolk State of New York ~o~0~41~ W. ~ ~.f/Vl U3~ .~ig'tJclq BEING D~Y SWO~ DEPOSES ~ ~F~S ~T ~/S~ IS T~ ~PLIC~T FOR ~ ~0~ DESC~ED PE~T(S) ~ T~T ~L STA~m~S CONT~D ~m ~ ~1~ TO ~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ ~t ~L WO~ W~L BE DO~ ~ t~ ~R SET FORTH ~ T~S ~PLICATION ~ AS MAY BE ~PRO~D BY t~ SO'HOLD tO~ BO~ OF TRUSTEES. t~ ~PLIC~T AG~ES TO HOLD T~ WO~ OF SOU~OLD ~ T~ tO~ TRUSTEES H~ESS ~ F~E ~OM ~ ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY mT~ OF S~ PE~T(S), · G~TED. ~ CO~LET~G TinS ~PLICATION, I ~BY AUTHO~E T~ ~US~ES, T~ AGENT(S) OR ~P~SENTATI~S(S), TO E~R O~O ~ PROPERTY TO ~SPECT t~ P~SES ~ CON~CTION ~,~~ 0F T~S; 3~PLICATION Signa[ure SURVEY OF LOTS 16 & 17 MAP OF HARBOR VIEW AT MATTITUCK FILE No. 8377 FILED AUGUST 21, 1987 S.C. TAX $ITUA TED A T MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK 1000-123-10-02 No, 1000-123-10-03 SCALE 1"=30' MARCH 51, 2005 R=60.O0' S.C. TAX 100D-123-10-02 W AREA DATA DEEP HOLE 1. ELEVATIONS ARE REFERENCED TO N,G,V.D. 1929 DATUM EXISTING £1~EVATIONS ARE SHOWN THUS:~ EXISTING CONTOUR LINES ARE SHOWN THUS: ..... W WILLIS S.C. TAX No. 40,555.21 sq. ff. 0 TIE LINE 0. g31 S.C. TAX No. 1000-123-10-13 46,082,86 mq. fl, (TO ~E LIN£) 1.058 TOTAL 88.636.07 sq. ft. CREEK CERTIFIED TO: PATRICK SCOLLARD Joseph{A. Ingegno