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Home My WebLink AboutTR-5789 Albert J. Krupski, President James King, Vice-President Artie Foster Ken poliwoda Peggy A. Dickerson BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town nall . 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 ! 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. - RE STRONG INSPECTION SCHEDULE Pre-construction, hay bale line 101 day of construction Y2 constructed --X- Project complete. compliance inspection. .. "' Board Of Southold Town Trustees SOUTH OLD. NEW YORK PERMIT NO. ...5'111 DATE: .J\ll)"~~,~tlM ISSUED TO .........RE...STRO'NG .............................. 1\utqnrilutinu Pursuant to the provisions of Chapter 615 of the Laws of the State of New York. 1893; and Chapter 404 of the Laws of the . State of New York 1952; and the Southold Town Ordinanc:e 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. W A TERS;~.'. and in ac:c:ordanc:e with the Resolution of The Board adopted at a meeting held on .....J..l,llY...n.L 200.3....... and in c:onsideration of the sum. of $.....,!{){l..{l.Q-.. .... paid by En::-.Cons.ultan ts.,IrlcJ;;~_...()n...beh"lf.. .<>f...Re ..Stl'&llR...............,...........,......... of ..........p..9.11tbampton.... ............................. N. Y. and subjec:t to the . Terms and Conditions listed on the reverse slele hereof, 01 Southokl Town Trustees authorizes and permits the folowing: Wetland Permit for RE STRONG to remove and replace (in place) approximately 91 linear feet 1 of existing timber bulkhead and two returns (16' and 30') with vinyl bulkheading and backfill with approximately 70 cubic yards of clean sand fill to be trucked in from an upland source as per plans prepared by En-Consultants, Inc. last dated 8/8/03. aU in a. cordanc:e with the detailed specific:ations as presented in . the originating apprlCation. . IN WITNESS WHEREOF. The said Board of Trustees here- by c:auses its Corporate Seal to be affixed. and these presents to be subscribed by a. majority of the said Board as of .this dafoe. . . TERMS and CONOmONS ,\~ The Pennittee RE STRONG. "P -.~ ~, residing at l095Westview' Drive, Mattituck, N. Y.. as part' of the coosidentioo for the /sSo..~ of die Pdmlt does ..,.da,wad and prescribe to the fol- lowiog: 1. .' That the said Board of Trustees and me Towu. 01 Southold are releaed from 'D.f and all damages. or daims foe damages. of suits arlsiag ditecdy or Jaditecdy as a rauk of 'D.f opec- atloa pedocmed pinuaDt to this permit. and die said J'o. I.~.ee wi1I, at his or her own ~ defend 'D.f and aU such suits 'bIld.-l by tbltd patties, and the said p.. .111.... -- fall PahIlJty wilh reSpect Ibereto. to the compIdeea:lusion of die &ad oi Trusttes oi die Town 01 ~ 2. That this Permit is' valid fOe a .period of 24 IDOl. ..bkh is conslkl>ed to be the estimated time. required to complete the work invohed, butihoold ~ WattIJIt, request for an exIeII5ioo may be made to the Board at a later due. ~. That this permit should be rCtained indef"lDic:ely. or as loog as the said PeaDlttee ...u:&a to '....I....ln the sttuCtUte or project involved, to provide evidence to 'D.fO"" coocemed that aath- ,orization was originally obtained. 4. That die worklnvolved ..m be subject to the u.srecrJon and approval of the Board oc its agents, and flOIH:OIII(lliaoce' wilh, the provisions 01 the oMW-fl..g app1icatioa, tDA'f be ause for revoc:atiOll of this Permit by resolution of the said Board. S. That there ..m be no untelISOl'.ble interfereoce wilh aavigatioa as a rauk of the work hereia> aUthorized. ' 6. That there shall be 00 interference with the right of the pubIlc to pass and repass aloog the beach between high and low water marks. ' !. 7. That if ,future operations of the Town of Soutb9ld require the re.tDOftl andjoc alteradoas ' in the Ioaltlnn of the _rk hereia> ...cJ-l-f. or If; in the opiaioo of the Board oi Truscces, the. work shall ause ~Ie obstrucnon to free oavlgaMa. the said p.-I.- will be required, upoo. due ootice, to remove or. alter this work or project hereia> stated without ~~ to the Town . of Soutbold. ' , 8. That the said Board wl1l be notified by the p......I_ or 1he c:ompIetioo' oi ebe work aath- orized. 9. That the permittee wl1l obtain all other permits and coaset'tf d1at tDA'f be required ~ plemeolal to this permit whlcb lD1l1 be subject to revoke upon fUlare to obtain -. .... . ~, ? . . 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 September 9, 2003 Mr. Robert Herrmann En-Consultants, Inc. 1329 North Sea Road Southampton, NY 11968 RE: SCTM#139-1-2 Re Strong 1095 Westview Drive Mattituck, NY Dear Mr. Herrmann: The Board of Town Trustees took the following action during a Regular Meeting, held on July 23, 2003 regarding the above matter. WHEREAS, En-Consultants, Inc. on behalf of Re Strong applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of South old, application dated June 30'h, 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 July 23, 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 . 2 . Town Code. WHEREAS, the Board has determined that the project as proposed will not affect the health, Safety and general welfare of the people of the town. NOW, THEREFORE BE IT, RESOLVED, that the Board of Trustees approved a Wetland Permit for RE STRONG to remove and replace (in place) approximately 91 linear feet of existing timber bulkhead and two returns (16' and 30') with vinyl bulkheading and backfill with approximately 70 cubic yards of clean sand fill to be trucked in from an upland source as per plans prepared by En-Consultants, Inc. last dated 8/8/03. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency, which may also have an application pending for the same or similar project. Fee must be paid, if applicable and permit issued within six months of the date ofthis notification. If inspections are required, at a fee of$5.00 per inspection (See attached schedule). FEES: $5.00 Very truly yours, b~-j 9- ~.t}. Albert J. Krupski, Jr. President, Board of Trustees AJKIcjc cc: DEC . '" h =~ B~ $~ 1Il1.:! , .: O!llll " ~~ . WfSfVlEW 17R1'vt: , ' ',':. ' , , .::.....:,.,'.:.. " ' ~I '" ~ co '" (\j .~ ....: . ~ ',: ;>~~ . . ,3 ,,, k1 ;~<:~ '~:'''i ::':.'~ ':: :~.' S ,.' , .' ." : ......... . {".z' ~ " .~ 12.,IG' <t '" co '" 5uff~k ~ Haq5lrom Mop 20 I" ~ :,:-?ooo' en 0 w ~O w 'CiSI NTS c, 29;2:)R EA U~M Nl, H~-6(5 " o Z 1'/ ~ .......... ",( ~ ,0.- -<>0 CO I- W I- <( o r " " '. I sroR..Y FL'll'-lE.. HovS.a 0 &' o.--.ltAc.t:, ,.. 7.S 12..'1' ~ .. '" 25'.,,5"'~ I, I" = :70' ~ ~1I?' :':.J~' LfMfr CF 0i511J1iJJN-.te 'r /~-'OrFLL " ,/.~~-~- ..:!:20', - . . ""'W/"LW -~ .....- -... .:t..91' " -... " , .' '" t ~ ..... e~1lI1cE """":."'-w & (fit R~~ -_ k:e/:J(fp) '4tritrOI3/'(f;;:'::- VUViteii.~""/:J Kit:"", MAI1l1llCK CRE:EK ~ , \> o . ~ ... ~ Z Il:' L..-",_ ~ -' ~ ...I '" ~ ~ 0 N ~ 11 '" '" + is i::; ib < ib ~ . (O)IIE C IE Q W IE ;\ru AUG 2 1 2003 Note.: I) Purpose: Maintain "'1%1"1 "" 2) DabJn: N-W ?) New ,;heallll"1lo I" VI"4I; "I 1; 'I) !l>rr"", 70 OJbk: Ll'f"J.; 5a1d approved '4'1m:l "","ce m:l "",d .. backfill 0) PrG\'erlq k>:ation: 1090 W~ Drive, Mattllock. 5CfM IOOO-I?9-QI-02 6) Macent """"., 1 - Mol"" 2 - P~acek PROP05t:D r?UL-KHEAD I(f:MOVAL- AND I(f:PL-ACEMENi (IP) fOR I(f: SIRONCi ON MAi11iUCK CRfEK, SUffOL-K COUNiY, NY SHEEII Of I 6/ 2'?/ O'?, 8/8/ O'? """ I:L '../ ~ ~ \D ~ ~ ~ o<l ~- ~o ~.I\ ~ .,- \DID 2Z~ ~0-\ \:G <;:::,. ~ C) ~ ~ I:L \S2 ~ z C) " ~~ ~~ Sl~ $~ lllS! - .: "'lll x """ , we5NIf;W t7RIVf; lO ~l a:> t() (\j , :','- ,'," " .~ ...... .~..: ;:....~ ~ , ,5 ," f(l :.,~',::~ .:'.....: ".-' ... ~'..:'.'~": : ::.-8," .,' ." : ,,' ....., ~ 12,.16' ';., ''',2' '.. ;t ~ ... . " '. I ST"oR.Y F~!....d'o(E. Hov.5.s.. 0 f{ G-'lR.ACr.l!.. ,.. 7.5 IZ.'1 r G: . 25.38' 2.,..",.' ~ '<t t() a:> '" (\J I. I" = :?O' ~ .!.1I?' ~I~' 1 ~ ilMJrOF0/51li1J> ,~ Wvcc/~"CKrLi "- ,'j -----:--._-~- .2':20'" . . , !:.9!' ',I" ex.~ '<"'::::'/.W &/:fPl. R~ --_ "CetJ(lP) ::;rOfJE /:f~- Vuvltf1fJ.KifJ:, 1M1111l1CK CI<f;f;K 5uffdk CaJnt!j Ha,5\rom Ma;> 2:; I" ~ :,:-:?OOO' '<> , .,.. ~ C? o I ~ r-; s:c.. '-' :z ~ ID ~ ~ :z l:\2 1--~_ o<l N-CONSULTANTS INC, 329 NORTH SEA RD, 1,0UTHAMPTON, NY 11966 ~ 1 31-283-6360 -' - ~~ ~\ 6 ;0 ~ 2 '-'x ~. N ~ '" " ~ u e '" I ~ -l ~ ...I '" ~ ~ ~ ~ I ~ ~1 + is G <<: ~ co >< '<> ~ '" co co lR ~ - DfE~fE~WfE mre Notes: I) PUfJ'05l': Maintain el15tl"1 ffoslOn 2) I/atun: N-W :?) Ne.v 4eath1n::l to k vI~l; "I tl 4) .Appro< 10 OJble 4'l'd. :>aid to approved ~aid ",,"ce aid u5ed back :;) Pr'l""'lillocation: 109:; We9l>>lfNI rIVe, Ma/;t/luck, 5CfM 1000-1:'>9-01- 6) ,AJja;ent"""""., 1- 11',,1'" 2- Pdacei< CA-b~d 2 1 2003 In from a1 Southold Towa ~ x ~o l:\2 _" ~ -.. IDID s:z~ ~0-\ ~ s::, \:R ~ ~ s:c.. 2 ~ z C) <;::: \..) \:R Q ~ PROPOSftl BU~KHf;AD riMOVPJ, ANti riP~.ACf;ME:N-r (IP) FOR ri 5WONCi ON MAI1lIUCK CriEK, 5UFFOL.K COUNfY, NY SHEEn OF I 6/ 2'?/ 0''5,8/8/ O'? . . h llSi Sl~ ~~ ~~ ~~ i:l~ ~ Wf.5fV1f;W DRI\Ir: . '. . " ,', ',,' ,,' . . . ."" . t() co t() N ~I ~ '~ .':~. ~ ',: ::-:.~ ~ . . 3 ." ~ :~.~'.::~ .7......: '.". . . '.:':.'~ .': .. 0 ' ...'v" . ," ." .. .,' ..... ~ 1,-,,;:' ... " " .25.2' .!:; 11.16' ;, ,; N ." I SiOR.Y FRJ.HE. HovS.E,. 0 V c;AlU,o.~ ,... 7., 12.'1' !Q G 2"'."'-' ..... 25.38' .,' . '. 1l ...... 1 ~\ rt 'Cc~G " '. .~"~: I. ;...... I" = ~O' ~ 2:.IW LIMJr OF O/5TIJI?BNva .--r /8k:xFLL ~ . :----.. . .--- ~20'" . . ~ :!:.9t, " :,:-l~' EN-CONSULTANTS INC. 1329 NORTH SEA RD. SOUTHAMPTON, NY 631-283-6360 <I' t() co '" '" " . ~ v e " t ~ "- EX -....- "'-II' g 1e~~8tLI'J.E~ ,,_ k:i'O(I') U'!:.rOlJE/if --_ ''''11 VffifrL "J.L'Mcveo IJfI'/:) MAI1l1lk:l CRf:f;K 2. l~ ~~ is -~ ~~ id~ SlfTdk CoJ~ rla:i9tr<>T1 M.p 2'7 I" - -I-:?OOO' 1196~ -' ~~ 6~ '-'x N~ '" , ..- ~ 9 b , ;:;: z ro, >L '-' :z ~ ID ~ ~ ~ <XI ~- ~O '^ ~ _II ~. ;;> ~ -.- "- IDID b S'Z~ ~ ::l (r\ ~ ~ ~ C) ~ >L iSZ ~ z C) \= ~ ~ ::Z ll:: 1--",_ I ~ ~ ~ ~ ~ ~ 0 ~lN ~ ~ ; ~ t is is -< ~ b ~ ~ '" '" i'b i'b D[I!::[~IHI tUG 2 1 2003 No\e,;: I) Purpose: Maintain ""1%1"'1 eros", conI:rd 2) t:'ab.m: N-W :?) Ne,y sheall1l"'1to be vl~l; "I j;mber-to be "I) .Aj:>prO<. 10 llJbk; Lja-d. 5a1d to be true In rc aJ approved ",laid _ce aid used as back II '7) Pr~ location: 109'7 W~ t:'r;ve. Mat.tJlud. 5CfM 1000-IW-0I-02 6) AdJacenl; """"": I - Mol... 2 - Pdacek Southold Town Rn~rd nt Trndooll!_ PROP05f1? BU'-KH~AD r?f;MOV/ii. Mil? r?f;P'-AC~Mt;Nf (IP) fOR r?f; 5fRONCi ON !v\Af1lfUCK Cr?f;~K, 5UffO'-K COUNfY, NY Sl--It::t::f1 Of I 6/2'5/0'5,8/8/0'5 TO: En-Consultants. Inc. on behalf of RE STRONG Please be advised that your application, dat!9q,. J1J.ne 30. 2003 has been reviewed by this Board, at the regu1ar meeting of Tn1,' ?~. ?oo~ and the following actton was taken: Albert J. Krupski, President Jsmes King, Vice-President Henry Smith Artie Foster Ken Poliwods ", BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD (~) Application Approved (see below) (____) Application Denied (see below) (____) Application Tabled (see below) . Town Hall 63095 Main Road P.O. Box 1179 Southold. New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 D ~ AUG 2 0 2003 Soulhold Town Board of Trustees If your application is approved as noted above, a perm ee now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. "- ~~ COMPUTATION OF PERMIT FEES: One Inspection Fee @$5.00 TOTAL FEES DUE: $ 5.00 I . tllt.c.-I ~ t&~ ,;".-1.: 9, PRESIDENT, BOARD OF TRUSTEES SIGNED: BY: C~ ~~ C ERK, BOARD OF~S .1./0\< . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD \ . Town Hall 53095 Main Road. P.O. Box1.179 SouthoJd, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 TO: En-Consultants, Inc. on behalf of RE STRONG Please be advised that your application, dated June 30. 2003 has been reviewed by this Board, at the regular meeting of Tnl:, 7<. 7nn< and the following action was taken: .. C.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 accordi~g to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: One Inspection Fee @$5. 00 TOTAL FEES DUE: $ 5. 00 SIGNED: all.... I ~ ~,.,1"4.1..- 9. PRESIDENT, BOARD OF TRUSTEES l!.liJMb. ~ # CLERK, BOARD OF TRUST S BY: 4/QR Cc: Mr. A1bertKrup'-' · Pres. Southold Town Truslees Office "ltc: -l'l'tlS1ee'NewuTircrermes----- - - -- .---- .---~ From: Jeffery L. Strong Strong's Marine Date: July 9th, 2003 n________n __._,~__- .-.------..--- I appreciate the Trustees requesting input on the new guidelines to try and make it as realistic as possible. As discussed at the gathering, my primary concerns are: I. A distinction to be made in the guidelines between residential and commercial. 2. C.C.A - to be allowed for pilings, bulkhead walers and dock structure. The use of C.c.A. for decking and sheathing would be eliminated. 3. Add language addressing the possibility of installation oflow sill bulkheads. In addition, after re-reading the guidelines I have the following suggestions: I. Dredging as suggested in 5b. should address the possibility that some dredging in close proximity to eelgrass could be allowed if it were determined that it would benefit the production of eelgrass. 'J would appreciatereceh~ng a revlsedeopy of the d.tafi prior to'~ public-he;:~g.s~ I-c~'- review it. Email ieff@1strongsma.,rine.com or fax 631-29&.3&01. If you have any questions at all please call me at 298-4770. Thank you. Sincerely, Jc~&-' Strong's Marine - r. 0. BOX 1409 . CAMP "I!'IBOIA ROAD. PIATl'ITUCK., !'lB. YORK 119Ii2-0998 PIIONE (631) 298...\770 . FAX (631) 298-J801 e-lDaU: lnfo@stroDgslDulne.CODl . www.stroDgsDluIDe.coDl 810# :IN .L1ilSall 0 .LNas 'S:Jd 00.00 .L a:JVSil S~:ZZ ~Z/ LO lIIU.L '.LS <II NO I.L:J1INNO:l Z99SZ9S 111.L NO I.L:J1INNO:l H~Z ON XlI/X.L U1I.L1I1dWO:l .LON SVM NOI.L:lWllI X.L *************************** ... .LlIOdall X.L lIolllla ... *************************** .....~....................u TTunT nTnTl'lnnC" OO~T co/ aTe YV~ QP.:7.7. aHM to/tZ/LO . . Board of Trustees Town of Southold, Regarding applicant Re Strong, SCTM 000-139-1-2 This permit request includes dredging a trench 4 feet deep 10 feet wide along the 91- foot bulkhead. My property borders the Strongs property to the north with our bulkheads connected. My concern is the trench would cause the rising and falling tide along with the current to undermine my bulkhead. The request also states that sand spoil would be trucked off site. Please note vehicle access is not available. I ask the Board to please address these concerns. Sincerely: Joseph Moisa Jr. P.O.Box. 1239 Mattituck, N.Y. 11952 ., , Board of Trustees, Town of Southold July 23, 2003 The matter of STRONG SCTM 000-139-1-2 The applicant is reqesting permission to dredge in front of his 91 foot bulkhead for a width of 10 feet, a trench 4 feet deep. Current flow caused by tidal action could cause erosion of the soil in front of my bulkhead, which is adjacent to the STRONG property on the south side. The replacement bulkhead calls for 16 foot sheatthing. My bulkhead has 14 foot sheathing. My sheathing has been in place for about 20 years. Any erosion of the soil in front of my bulkhead could possibly cause washout of soil from behind it. I wish to ask that the Board question the necessity for the requested dredging in light of the possible effect such dredging might have on adjacent bulkheads. Thank you for your consideration in this matter. ID)IIE eEl \ru JUL 2 2 2003 o ~l~y ~:t::L Frank J .~polacek P.O. Box 177 1085 Westview Drive Mattituck, N.Y. 11952-0177 Solllbold Tow1I Soan! of TnIsl111 - . Telephone (631) 765-1892 Town Hall. 53095 Main Road P.O. Box 1179 Southold. New. York 11971 SOUTHOID TOWN CONSERVATION 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 William Cook, it was RESOLVED to recommend to the Southold Town Board ofTrustees APPROVAL WITH A STIPULATION of the Wetland Permit application of RE STRONG to remove and replace (in-place) approx. 91 linear ft. of existing timber bulkhead and 16' and 30' returns with vinyl bulkheading. Dredge an area up to 10' off bulkhead to a maximum depth of -4' ALW; use approx. 70 cy. sand spoil as backfill and truck remaining spoil off- site to an approved upland source. Located: 1095 Westview Dr., Mattituck. SCTM#139-1-2 The CAC recommends Approval of the application with the Stipulation that there is no dredging and backfilling because the council feels that the dredging is unnecessary. Vote of Council: Ayes: All Motion Carried , , 1329 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 E-mail: encon@peconic.net www.enconsultants.com ~ EN-CONSULTANTS, INC. ENVIRONMENTAL SERVICES June 25, 2003 ~~t~U~\Em\ ,.\ ,) '. f\r,,'\-~ \' .J J\JN 3 u tJW \~ j Soutbo1d lown Board olllustees Town of Southold Board of Trustees Post Office Box 1179 Southoll!, New York 11971 Re: Re Strong 1095 Westview Drive, Mattituck SCfM #1000-139-1-2 Dear Board Members: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: , , 1329 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 E-mail: encon@peconic.net www.enconsultants.com ~ EN-CONSULTANTS, INC. ENVIRONMENTAL SERVICES Town of South old Board of Trustees Post Office Box 1179 Southold, New York 11971 ~~t~U~\Em\ ,'I 'j ",r,(\ t\-..i JU\'l 3 U Luv} \.:.- June 25, 2003 Soutbo1d lowR Board 0' lrustees Re: Re Strong 1095 Westview Drive, Mattituck SCfM #1000-139-1-2 Dear Board Members: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 1. Three (3) Wetland Permit Applications, ( including Notice and Proof of Mailing to adjacent owners). 2. Three (3) Short Environmental Assessment Forms. 3. Three (3) copies of authorization & disclosure forms. 4. Three (3) work plans. 5. Three (3) copies of survey. 6. One (I) set of site photographs. 7. Application fee 0[$200.00. I trust this information shall allow you to process our permit request. Sbould any additional information be required, please do not hesitate to contact our office. s~L' Roberl . Herrmann Coastal Management Specialist /khs Ene. . , ... , ,---- RE STRONG, 1095 WESTVIEW DRIVE, MATIITUCK ~. -~ .~~~ "--ii/:! ... ~ ~'.!.:l " , ..." . . . IilI II III ." .. Figure I. Looking north al face of exi..ling bulkhead IlJ be removed and replaced with vinyl bulkhead , .. r:II -'l<'"" Figure 2. Looking soulh along /tJp lJf exisling bulkhead 10 be removed and K'~~~'.~""" 'I;' .... .' '''-. ~- .,..... ~ . ~ .. -- """"--- " ""l:;' ''; Southold ",wn Board of Trustees * , : .. (1;1 ail\;. - Figure 3. Looking easl al norlherly par/ion offace of exisling bulkhead 10 be removed and replaced wilh vinyl bulkhead. I' ~~_ ." r ~- -ifiJ ~m \ Figure 4. Looking easl al soulherly par/ion of face of exisling bu 10 be removed and replaced wilh vinyl bulkhead. Southold Town Board of 1rustees \. '. 1---- \ t<\'- o.J "'~. "ft!:--- I \ 0.". ~ o'w. 50.0 .780424 S. - <Jl ~ - \ ~ "'"" ~ - ~ SURVEY OF PROPERTY AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000 - 139 - 01 - O~ SCALE : I" = 30 I DATE : DEe 15. 1986 ~ t.u t.u ~ (,) f,\OISr. CO~S1'r.\IICe. ,^. 6. f,\OISr. a. , 215.85 Jose.?\1 .' - ~ \IIIOlf to, _- 0.'" .:......,' . " ~ ~ . l'I ...., '40 to. 18042 \II. ~ (,) .;:) I- - l- I- ~ ~ SLT NAIL,: 4 t'> '0 O. JO::' .W I' N ,I ~- -- ,.., NN o ,.., to " o to ~ r Z I ~ I II ~ o 5'k7' . . . .. . ". . .. \ ",:" .....: ':' f. . ~ WOOD ~ ^~... "....oc.." 0'" . '" r. E.~\l\.Se.\II \..OUISe. , G\..r.o~S e.\'l.\l\.SE\II a. EUS1'r.CE \IIIOlf CERTIFIED TO CHICAGO TITLE INSURANCE CO JEFFERY L. STRONG RE A. STRONG ENGINEERS I p. C. 11971 / aRO'f4ER. RO~o. ( I \ o ::D 2- ff\ 86 - 766 " ~ \\\ \ \ , '. \. I 1 L / f \ . . ! \ ~~---- \ \ \'" ---- .~! " ./ ' \' I , . ~ , ." ," '\' ~~ ~~/ 0. " I r i ! \ \ \ \ ( \ .....". / /' / / // / // / ~/ , / I / I ) ,tP'" /~ // ^\ \ \ '..------- ". ----- + "---- . 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" " i "'<>00 -... 11971 / ' II I '!l_o's. , SLr NAIl.:. =~Ji~ <t_ "- I<l NN o ' I<l Q) Q o Q) ~ r Z i I ~ I . , '1l,,!-i t Q ~~J f ,".: 1:''< '- '"' '" I tI ~ ~ , ~ d'll' I J I 1'~' ,. No/O/f JOSE.P\'\ WlOISt>- COt-lS1't>-NCE. WI. B. WlOISt>- e. '2.15.85' ~'-- - - '" ~ ,or '40 <-. 1804'2. N. ~ o '. J--- '\ ",,- 0:1 "'~. "1"1!:--- I 0... ~ "w 50.0 '78042'40 ' S. (/l \ - \ 59:,1' . ..::.:<.....~:.~.:: . . .' '" . . . . . ,". . " ",. ,". .:: >: . ~ , ~ ~'f'ocrt.J>. f'e,....c.5- -'" '" - ~ '..'" -j. , . ~~ r, E.F.\~SE.N ,-O\.l\SE. :?",. \. 0"1\ ( . . '" \\..... \ i r '00 ... f-" 150 30 S. i ~ , L1C. NO. 496'8 ENGINEERS I P. C. ,lI.o"<S &G~ E.~\~SE.N E.\.lS1't>-CE. t-I/0/f CERTIFIED TO : CHICAGO TITLE INSURANCE CO JEFFERY L. STRONG RE A, STRONG - .. ~. ~. rn . ;- ~ ~ "'"' .e:..' - ~ eRO'ffER RO ~ 1) -l '" '<6. o ." - .e:.. t1\ ( \ \ SURVEY OF PROPERTY AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY IN. Y. 1000 - 139 - 01 - O~ SCALE . I" = 30' DATE . DEC 15, /986 86 - 766 VVf;5fV1rW tJRIvt: to OJ to N ~l ~ ;, . N I S""OR..Y 7., 12.'1'?o: 2'5"b5".~ " , : ........., . .' . . :.... .::....':..,... .. ' . ': >-. . ~,' 'i',"", 0".' iJ ," U1 :..~'.:"~ '~:'.'.: ~~':.'~ . : : :>8." ..- ." :..' ...... "!; 12.IG' ~ 1",2' ). " . '. FLAtoME. HovS.E, 05 " V GoAu,C.~ <t to OJ '" C\J 2!!.38' t ,," " " ," 'c:owC' , " .~'no . " " " ~\ ...... tl. 2. . . ~ u e ... I. I"=~' ~ 2:.11~' <:> h ll:!> I!;~ 8~ U "'~ x ~~ ~I~B' LiMlr~ Pi~ ,----,... "'u/8It:KfLL / ,:-- ---,-~,- .!:'.20" . .i:..9t, "- --- ---'---. ... . 'f ---. --:-.J , "- E~ 17Ml!s '<'--'1'.11' 81fEFt Rf3tL~ '--_ -'cePr,,) ~ro8E1iE -_ VfNltf3tL~P ~IVJ MAf1l1UCK CRr;rK l~ ~~ i~ ~~ ' \i<~ id~ Outlo" Lruntli M"15trom Nlap L'7 I" - ~?OOO' ~ -' (s~ <= ,-,,,, '-'x ~~ '1' ..- ~ <:0. ~~ <:0.... 32 {l2C:> ..:: <:o.s-, ;,- liS>' ~ c:)G ::E "'-0 I..,,.,.g ~~ . ." ....1..:) '-' ~:t';':I~ >:La: ..'...:.:~~ ~~ ~ ", ......:....~ l.:L,-/ o;:~....J"- ' -.--..r. ::z -....,. ;, ~ '". __L----~- Q b , '$: ..:: ~ '" '" + CD x b '" N ~ S! x '" ~ Q (3 ~ = ~ I~~.'I~..I w If) I . '" JUM 3 0 lXi- Soutllokl 1\08'" a1111111111 j '"' I:L '--' :z ~ ID ~ ss:= lSZ 00 ~- ~O lSZ _II ~ --- IDID 2Z~ 5~ \:G s:::" (}; C) es "" I:L ~ ~ Z C) 1;:= \..) (J.; ~: I) Purpose: Maintain ",,'.t'rq er0510n ccrieeA 5I:ruclure & reaNef loot ""'KfllI 2) I?atun: liW . ~ . ?) New .heatlllrq to be ~I; ..I timber to be CCA-treated 4) ""prO!(, 120 cubic 'l""ds!a1d to be dredqed fran a-ea '4' to 10 feel; seawa-d of bulkhead to reaNef loot bacKfill; ""prO!(, 70 C4 'l""ds spoil to be used as ""'Kfill & 'W"", !:i0 C4 5pOilto be trucked offstle !:i) Prq=hj Ioca!.lon: 109!:i We<ioJlfNIl?rtve, MattttucK, 5crM 1000-1:79-01-02 6) AdJacenl;~, I - Mol'" 2 - PeAacek EN-CONSUlTANTS INC. 1329 NDPTH e:':,1\ ~j} SOl ITH/,I\!, , I~Y 11968 631-283-6360 PROP05W i?UL.KhfAD '((i.MOVIi ANtJ RrPL.ACrMWr (IP) fOR Rr 5fRONiA ON MA1TI11JCK CRrrK, 5UffOt..K COUNfY, NY 5H'(r-r1 Of I 6/ 2'? / O'? ~ EN-CONSULTANTS, 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 August 13, 2003 Albert Krupski, Chairman Board of Trustees Town of South old P.O. Box 1179 Southold, NY 11971 DECEIU~ AUG 2 0 2003 Sou\llOld Town Board of Truste", Re: Re StrODI!, 1000-139-1-2 Dear Mr. Krupski: As agreed during the 23 July 2003 public hearing on the referenced application, please fmd enclosed (3) copies of a project plan revised to eliminate, without prejudice, the proposal to dredge a lO-foot wide area adjacent to the bulkhead. Respectfully yours, f1- Robert E. Herrmann Coastal Management Specialist Enclosures 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 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. S -+'C> '"'-J INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction % constructed v Project complete, compliance inspection. ---~-- . Albert J. Krupski, President "James King, Vice-President Henry Smith Artie Foster Ken Poliwoda . . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fex (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicat~ _Wetland Permit Application ~ Major Waiver/ Amendmen~Cha~ges _Received Application: I. ~O, b ~ _Received Fee:$ m "it I ~ Completed Application b rJf D - f , _Incomplete SEQRA Classification: Type I_Type II_Unlisted _ Coordination:(date sent) j I _ CAC Referral Sent: ~I ~ () f ~~ Date ofInspection: lit. ~ -Receipt of CAC Report: I Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: 1 0 " :;"Ofbj I . Minor Name of ApplicantRE STRONG Address P.O. BOX 1409, MA TIlTUCK, NY 11952 Phone Number: 631-298-4770 Suffolk County Tax Map Number: 1000 - 139- 1-2 Property Location: 1095 WESTVIEW DRIVE, MATIlTUCK (provide LILCO Pole #, distance to cross streets, and location) AGENT: EN-CONSULTANTS, INC. (If applicable) Address: 1329 NORTH SEA ROAD, SOU1HAMPTON, NY 11968 Phone: 631-283-63 .oard of Trustees APP:LiCaenJ GENERAL DATA Land Area (in square feet): +/-18.300 Area Zoning: Previous use of property: RESIDENTIAL Intended use of property: NO CHANGE. Prior permits/approvals for site improvements: Agency Date X 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): REMOVE AND REPLACE (IN-PLACE) APPROXIMA TEL Y 91 LINEAR FEET OF EXISTING TIMBER BULKHEAD AND 16' AND 30' RETURNS WITH VINYL BULKHEADING. DREDGE AN AREA UP TO 10' OFF BULKHEAD TO A MAXIMUM DEPTH OF -4' ALW; USE APPROXIMATELY 70 CUBIC YARDS SAND SPOIL AS BACKFILL AND TRUCK REMAINING SPOIL OFF-SITE TO AN APPROVED UPLAND SOURCE. 4IJoard of Trustees APPlica~n WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: TO MAINTAIN EXISTING EROSION CONTROL STRUCTURE AND RECOVER LOST BACKFILL. Area of wetlands on lot: 0 square feet Percent coverage oflot: N/A 0/0 Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? NO X Yes If yes, how much material will be excavated? +/-120 cubic yards (DREDGE SPOIL) How much material will be filled? +/-70 cubic yards (BACKFILL) Depth of which material will be removed or deposited: -4 feet AL W Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: APPROXIMATELY 120 CUBIC YARDS OF SAND WILL BE DREDGED VIA CLAMSHELL BUCKET CRANE, 70 CUBIC YARDS OF WHICH WILL BE DEPOSITED LANDWARD OF NEW BULKHEAD AS BACKFILL. 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): THE PROJECT ENTAILS THE ORDINARY AND ROUTINE MAINTENANCE OF AN EXISTING BULKHEAD WITH MINOR, INCIDENTAL DREDGING TO RECOVER BACKFILL THAT HAS LEACHED THROUGH BULKHEAD. AS SUCH, THE PROJECT WILL HAVE NO SIGNIFICANT ADVERSE IMPACT ON THE ADJACENT TIDAL WATERS OF THE TOWN. 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) .~ SEQR 14-16-4 (2IB7)-Texl t2 PROJECT I.D. NUMBER 617.21 1 APPLICANT/SPONSOR: I 2. PROJECT NAME RE STRONG BY EN-CONSULTANTS, INe. 3 PROJECT lOCATION: Municipality MATTlTUCK County SUFFOLK 4 PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc, or provide map) 1095 WESTVIEW DRIVE, MATTlTUCK, TOWN OF SOUTHOLD, SCTM #1000-139-1-2; MAP PROVIDED. 5. IS PROPOSED ACTON ~ _ Expansion D Modificationlaheration 6 DESCRIBE PROJECT BRIEFLY: REMOVE AND REPLACE (IN-PLACE) APPROXIMA TEL Y 91 LINEAR FEET OF EXISTING TIMBER BULKHEAD AND 16' AND 30' RETURNS WITH VINYL BULKHEADING. DREDGE AN AREA UP TO 10' OFF BULKHEAD TO A MAXIMUM DEPTH OF -4' ALW; USE APPROXIMATELY 70 CUBIC YARDS SAND SPOIL AS BACKFILL AND TRUCK REMAINING SPOIL OFF-SITE TO AN APPROVED UPLAND SOURCE. 7. AMOUNT OF LAND AFFECTED Initially +/-0.42 acres Ultimately +/-0.42 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? IZIv es DNO If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ~ Residential D Industrial D Commercial o Agricutture o Park Forest/Open space o Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDNG, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ~Yes DNa If yes, list agency(s) and permit/approvals DEC, COE, DOS 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? DYes ~NO If yes, list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAl REQUIRE MODIFICATION? DYes ~NO I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWlEDGE Applicant/sponsor name R ell ERT E. HERRMANN, COASTAL MANAGEMENT SPECIALIST DATE JUNE 25, 2003 1 :; ~ l^~ Signature: , "rr' n \\11 \" \D If the action is in the Coastal Area. and you are a state ag C ~r Iln IS u '\ Coastal Assessment Form before proceeding with t~\~?ssment , ':., OVER U ~ J'u".""~ - SOo\hoId loti' 6"~ oI11U-,\e<l!i -;- '" . . . NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant:RESTRONG SCTM#1000- 139-1-2 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: REMOVE AND REPLACE (IN-PLACE) APPROXIMA TEL Y 91 LINEAR FEET OF EXISTING TIMBER BULKHEAD AND 16' AND 30' RETURNS WITH VINYL BULKHEADING. DREDGE AN AREA UP TO 10' OFF BULKHEAD TO A MAXIMUM DEPTH OF -4' AL W; USE APPROXIMATELY 70 CUBIC YARDS SAND SPOIL AS BACKFILL AND TRUCK REMAINING SPOIL OFF-SITE TO AN APPROVED UPLAND SOURCE. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: 1095 WESTVIEW 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 comment on: JULY 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: RESTRONG MAILING ADDRESS: P.O. BOX 1409 MATTITUCK, NY 11952 PHONE #: 631-298-4770 Ene.: Copy of sketch or plan showing proposal for your convenience. 5 _______ ",-e,. 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 --------------------------------------------------------------- ;:~~~~~""~----~----~~~---- STATE OF NEW YORK) I, AFFIDAVIT OF POSTING () I f I _ . . ~ EN-CONSULTANTS INC. KIX1f,ot'f j-t.0tVV4.U lilY' . Ksiding lit 1329 NORTH SEA RD. SOUTHAMPTON, N.V. 11968 631-283-6360 being duly sworn, depose and say: That on the ~t'--daY of9 Jv1-'1 , OO~ I personally Xed~e property known as by placing the Board of Trustees official oster where it can easily be seen, and that I have checked to be sure the poster has remained in Pla~ eight days prior to the date of the public hearing. Date of hearing noted thereon to be held ~ 1.1? m ~ 1;. (d> . ~ h-.t t-- '7D~~ _ {V' v Dated: Sworn to before me this r:>8M.. day oqu.} 2019 ~d:f- '" --Jf.":A _4" o lic I , IIKSlIAlII !lnyPlb't.Il8It~lIIlIl ClmilIIan1ll.!IIlIl llilIieIi*. illIiIliI - . . > PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: JOSEPH MOISA, JR. Address: P.O. BOX 815 MA TTITUCK, NY 11952 FRANK POLACEK, JR. P.O. BOX 177 MATTITUCK, NY 11952 STATE OF NEW YORK COUNTY OF SUFFOLK ROBERT E. HERRMANN doing business atEN-CONSULTANTS, INC. 1329 NORTH SEA ROAD SOUTHAMPTON, NY 11968 , being duly sworn, deposes and says that on the 25TH day of JUNE .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 shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~ ' that said Notices were mailed to each of said perl ons by (certified) _......", mon. A ...1- '{'~ Sworn to before me this day of 8AJ1~ .20 03 C- ~.- N.:2!~~ ~'- DlRSIEI'IERS NilllyPn:jt.SIaII~lIeIliII Co"",,"No.~I5931 lW"~m~CoiilJ 1:.iI~~~ ~ ..-- LI'I ru Cl .,... ~ '" ~ ~ =r- Cl Cl Cl U.S. Postal ServIce CERTIFIED MAIL RECEIPT (DomestIc Mall Only N I , 0 nsurance Coverage ProvIded) CMufinlf. Nt artl A 0.37 Certified Fee 2.30 1.'15 L U S ..,.=-- .. / ..' /.~ ' i,-' )' .~ J.-..; ,':'-> ii~':t ~=~ Postage . o Retum Receipt Fee ...[] (Endorsement RequIred) '" _edllelive<yFee o (Endorsement Requlllld) Total Postage A ea.. * ".~ ru Cl Cl ~ nt 0 Frank Polacek, Jr. P.O. Box 177 Mattituck, NY . 11952 Si;;e;,"Aj'-CNt. or PO Boll No. c;,;o"s;,;;w;"z;, :.. '" ... Cl .,... ~ '" ~ ~ =r- Cl Cl Cl U.S. Pustdl S~IVI(.:e CERTIFIED MAIL RECEIPT (Domestic Mail Only No fnsurance Coverage Provided) Certlfled Fee 2.30 1.'15 OtATfimf. HI &i21 A 0.37 Postage $ Return Receipt Fee ~ (ElldOlsementRequlred) '" _,,",-Fee D ([ndo.8eI,18Itt ReqWed) ru _,_&_ !II Cl Cl ~ ".~ ent 0 Joseph Moisa, Jr. P.O. Box 815 Mattituck, NY 11952 s;;e,;i;i;;i:iiO:, or PO Box No. Ciii"s;,;;w;"~ :.. . . . OWNER'S ENDORSEMENT (TO BE SIGNED IF APPLICANT IS NOT OWNER) STATE OF NEW YORK) COUNTY OF SUFFOLK) SS: -~e... .4 , S~o"'~ . being duly sworn, deposes and says; I reside at \ 0 9 S lAJ ~ ~ d-~: IQ..W 't>t-J V l- ~b1. r IIJd II? s d.- In the County of 5'^-.c-~""\L- and the State of r\J "''''Al ~ ~ , and I am the (owner in fee) (officer of the Corporation which is the owner in fee) of the premises described in the foregoing application and that I have authorized En-Consultants, Inc. to make the foregoing application as described herein. ~~ G-S~ Of\9 Signature Signature If Corporation, name of corporation and Officers Title Officers Title Before me, this '1 day of &~~? . Notary Public __ .... -'.1ii / _~"=' <-/ fB))~ ~ ~ ~ WJ ~_~ U] c ijJ , I j I Southold Town Board of Trustges ... - ~ .DISCLOSURE AFFIDAVIT . READ THIS DOCUMENT CAREFULLY. YOU MAY CONSULT AN A'lTORNEY BEFORE COMPLETING THIS FORM. STATE OF NEW YORK) COUNTY OF SUFFOLK) SS: I,Je- ,(J., 5-\..\'-0"-'7 the following relief: duly sworn, deposes and says: , an applicant for and being That I make and complete this affidavit under the penalty of perjury and swear to the tIuth thereof. That I understand that this affidavit is required by Section 809 of the General Municipal Law and that a knowing failure to provide true information is punishable as misdemeanor. Being so warned I state: That neither I/We nor any member of my/our family is a State Officer; is an officer or employee of Southampton Town, and That this person has an interest in the person, partnership, or association requesting the above stated relief. That for the purpose of this section an officer or employee shall be deemed to have an interest in the applicant where he, his spouse, or their brothers, sisters, parents, children, grandchildren or the spouse of any of them is the applicant, is an officer, director, partner or employee of the applicant, legally or beneficially owns or controls stock of a corporate applicant or is a member of a partnership or association applicant, or is a party to an agreement with such an applicant express or implied, whereby he may receive any payment or other benefit, whether or not for services rendered, dependent or contingent upon the favorable approval of such application, petition or request. That ownership of less than 5% of the stock of a corporation whose stock is listed in the New York or American Stock Exchanges shall not constitute an interest for the purposes of this section. (a) (b) (c) (d) (0 tlQ Sf1&Ul7 Signature this '1 day of ,~dLH .3 Notary Public ....IICHEIIT -,.......S1aterf",..'Yorlr NO.30"7~'~oki~ /' =:=~~