HomeMy WebLinkAboutTR-6454
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
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
1 st day of construction
Y, constructed
/ Project complete, compliance inspection.
.
.
TERMS AND CONDITIONS
The Permittee Gladvs Milne, residing at 240 Knoll Circle, East Marion, NY, as part of the
consideration for the issuance of the Permit does understand and prescribe to the following:
I. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit, and the said Permittee will, at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto, to the complete exclusion of the Board of
Trustees of the Town of South old.
2. That this Permit is valid for a period of 24 months, which is considered to be the estimated
time required to complete the work involved, but should circumstances warrant, request for
an extension may be made to the Board at a later date.
3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to
maintain the structure or project involved, to provide evidence to anyone concerned that
authorization was originally obtained.
4. That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
for revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work
herein authorized.
6. That there shall be no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of South old require the removal and/or alterations in
the location of the work herein authorized, or if, in the opinion of the Board of Trustees,
the work shall cause unreasonable obstruction to free navigation, the said Permittee will be
required, upon due notice, to remove or alter this work project herein stated without
expenses to the Town of Southold.
8. The Permittee is required to provide evidence that a copy of this Trustee permit has been
recorded with the Suffolk County Department of Real Properties Office as a notice
covenant and deed restriction to the deed of the subject parcel. Such evidence shall be
provided within ninety (90) calendar days of issuance of this permit.
9. That the said Board will be notified by the Permittee of the completion of the work
authorized.
10. That the Permittee will obtain all other permits and consents that may be required
supplemental to this permit, which may be subject to revoke upon failure to obtain same,
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
September 20,2006
Mr. John Costello
Costello Marine Contracting Corp.
P.O. Box 2124
Greenport, NY 11944
RE: GLADYS MILNE
240 KNOLL CIRCLE, EAST MARION
SCTM#37 -5-15
Dear Mr. Costello:
The Board of Town Trustees took the following action during its regular meeting held on
Wed., September 20, 2006 regarding the above matter:
WHEREAS, Costello Marine Contracting Corp. on behalf of GLADYS MILNE applied to
the South old Town Trustees for a permit under the provisions of Chapter 275 of the
South old Town Code, the Wetland Ordinance of the Town of Southold, application
dated August 15, 2006, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory
Council and to the Local Waterfront Revitalization Program Coordinator for their findings
and recommendations, and,
WHEREAS, in accordance with Chapter 268, said application was found to be Exempt
from the Local Waterfront Revitalization Program policy standards, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on September 20, 2006, 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,
2
.
.
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 275 of the
Southold Town Code,
WHEREAS, the Board has determined that the project as proposed will not affect the
health, safety and general welfare of the people of the town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of GLADYS MILNE to
remove 106' +/- of existing bulkhead and 96'+/- of 4' wide wooden boardwalk and
replace same in-like/in-place, with C-Loc vinyl sheathing, and with the condition of an
additional 5' non-turf buffer landward of the boardwalk, or a 10' non-turf buffer landward
of the bulkhead, if the boardwalk is not replaced, and as depicted on the plan prepared
by Costello Marine Contracting Corp. last dated July 28, 2006.
Permit to construct and complete project will expire two years from the date the permit
is signed. Fees must be paid, if applicable, and permit issued within six months of the
date of this notification.
Inspections are required at a fee of $50.00 per inspection. (See attached schedule.)
Fees: $50.00
Very truly yours,
~07~
Jam~F.Ki~g ~ ;/
President, Board of Trustees
JFKllms
1'; .
((
,lu"
P~<<:r c.Oc..drIO,,",
C::UV4ilS-'~
V/C/NIT.." MAP
o
- -
- -
.I
. 2_Fr.
PIlZQ.PDSt!!O :
~e"",oV6 /0'" ';t DF eW'TIHc-. aV'~Ut!!EAr.>
_.AND "It;,':t .. .,. ,,,.,,Ot!l WooDeN .a-...cow...uc
...ANI> R~...tr6 SA"" /1V-~/IICt!!!. /N- P'AC..
I,: '
i
l..'~' '.-'''
.-A c:cess ;
By ""AT~ U5/1o/(;,.
2>.<lRE'06 J CPl.A~ ANO
P.N' ~ANb ,1-4R.OI.IQ,H
A P~/C"'NT'S PRop_7IIT'I
~1fIJ'7N-~~.... ~_
.PS;I! .~_ -., ~C'---.
~ft4 ..- .Tr.,...."AAI' ..""
,..,,<I>W-NH--
~ --~
c:5".4D""~ Il.,f/(.AJc
p. O. '&P>C ;:z..,,~
<<!!.A.V" MAfCIDM, N.Y. 1/"3~
~4Q /tCwo,"" t::/,cc,t!!!.
:5<=7"_/000-1$':1_$-/5
-'~r~a,:t/.__~
S/o/6I!:T ! .': 5
~/:II'--"N p..'OO"W
1""
I
/,,< <4T,c;'t . ^4~Jt:>
~JOJ:
r.--T't'
.
r~.-""
If:
I{\ ~P""" ....." C"4:coe "He.
~ ~.o...." 4-
1S.,6r ~NII"_. tN.,/- /"1""
@
H~ 11"'., I$A....".,
~-+~u_HC6
P.o.,s"", 114-
EA~ Nf~OIV, /11.)1. II~"
-::Vo A::M:>>~c:. CIII"':~t!I
'2' ~.NeIC, "R"''''7"~.
\!:) .~_tC'-f'cl..C44
4"'" ~~,N',/, ",.,
A~'-~~
-..._ ;~ '...rJII'W"\
""'.P->-&'t- .~r. lFd.ill"N"~
t-. 4077-,,".
GI<=AO'7"'.:5 M/l..~e
~C. &~ 2~4
EAST MA~'OM, MY. //"f~"f
'24D /C:::NC(:'- c:::'/Ac:'c.e
:5<=nw /OtlO-~;1_~/'!!S
-'v(..,..~,1oI~
-S1Il!eT 2 -F 5
~u. c.,,-Cc.4I.
V) Q
>- w .....
c:a w 0
I- ::E:
C V) I-
::> ::>
w a:: 0
> l- V)
LL.
0 0 LL.
0
er::: Q
0.. a:: Z
0.. <e( ~
<( 0 0 I
<0 I- w
l- ."
<e( I-
L__ Q
'-... 4a6O' ./
" ~ ...1' .-f'
\
. \
\~
1'4 \\
ti~ \
It~\ ~
\\ \ ~- l~ ~N6S
~~ \ -I; I'l /S'.~:i ,,;,., ,10./?'
1.\ :z. .s aG".tfc,' 4Z'"" /,#.43'
,. 50,oU'$5"""n.OS'
r"'\ 4.5""6&'/20" 21......
MT__",,'" ~ \ '.\ ,.... c_ ,.S....
S7'-.s \ \\ /'
't \ \v--- ~17-'____
.....-..__c.o . \. t:'lleG.~
/ ~W4~ t ~ ~4\ \,\ --- .,..~C#'/
@'-@ ~
.::s~1Q.''''''C'", 7::>0,"",,0
"'-II1CJ1.,,..,., G..._ op .__....
.......... c=...ue '",C.- \
PROpo5eC>: .QC!!;I.Ht"'I'I!I~'~ o"EY'.Jr'~
"'-~"'-.o""'N" ,...1'.
tf.IUSr_ 4' ,.,_. ._'flll "'I(
~ q-.-~,.. .-1.,.,1N-UN/II
"I,.,.. ",.... ACe. .
llo
I
~
""
')
~
"
I
olo
:)
\\
':r.
, ll.
....
[
4d,.,_I'J-.rlltlNl> ~ '''"
"'-..
CD
"'-
.
.
'sITE.
- -
- -
. t. HR
~~CI"l .~ -'IL~W'i~
"'.~~ -"1' ..... ...."N.. ...,.,
,..,) "'''''NH-
~JIIIl1DLI~'" ..rr_
Gt::..d O'1'"S MIl. Ale
1'?o..8o~ 2?4-
EJlST'MAR,N:J"', N.Y. 1Il/~.,
24D ,It:,.,ccc. C::,.AtC'c.e::
:ScTNf "'.--3~- tS"~'5
J~'", za, ~Ooco.
slIeer .3 .': 5
.
:ll
.1
..
!
b6l:~
AUL nr,-
~
aMJ1JI... ~.tf I"
'-,-W= .'.1(I.t.
\
\
~
\l.
'Ill \t
. .
~ \~
it! \
~ \
\C\ \
,'1\ \
(' ,\ CAOU.o"
""-~ ~'.
\{....,.
\. -eN
\ \
\.\ //
. \ ~'-~.-,
\.........0
\ \
\ \
. \
\
. .-.NQU 5.6
I
.~
<<
.
~
.
(I
~ '
C'~""..' .
At_I' - p.r'F.. WA""
...,.".,,,,,,.,
I.~
-
~-'
I.. ._-'V'~
II8'FN 'Pq' n ~ - -:M
...t .
:.e-_
tI'!~~,..U--l~OVC /tIf.':t f/P
~. ........-.. - ~':!
-",--",.""",... weH/I1. ...--~",.........~
--.."'-~"'_...." IW.~'II&'
nv-.,.,..~;
$PIIVJlJtis 'POND
.
-f..11 .TiWt~.,:: ~ ....-..... ~ 4'~-.H
PL.A ^"
- -
- -
D
o
'-
'l
.
\
-
..
':l
,
~':t.
~
\
Mol
J,PI'!JI..Itf::..~ a".
C;;'..dDY.s MI'-Ale
1II:!o. -->C 2 ~
SASr ~A.A/lbD"'. 1\1. y. //"3"
240 '+::N~C. C/If'CC.E
:s-=rM /otJo- S7-.- /'5
-I~ Z&.~"
.$.II" 4- -/l-~..
#0
~R:
15<<6'_~ .;tr tUtfT -
.. .....~?"A~..,.,..
".- ."...,..",--
."+".S'~
n
1 ,
l],( ~:--.-..
/'" ---
eJic.AVArtI! AS
4...../4.0 .JI"'~
,Ile-MSS.A$ ,....c:c. ~/".
_~ove .........coj(.1t>'i
- 4l1tiSr. WOt1~
",-...,....~...N.
.......~ IfIII._
._---
-.~~.-
--...,-...
El...,.~'-t.
~..~~M_
..NA-.,.......
:Jt'TAL,." --5
",'
AMIiJN "'..'5
- r---
~.6
A.A.u..WQ.O
/Q~jf#, .
HR.-FlA.
Z>4N.>M;N
V~1fI"
/Q'" ~:Zeu.PHc-.
.t.:",,-.:s ~'....G.
&"t6x&' /.eI",..
Al.4C-/Il<A'ofCi'> PIC'
~'...C.
". '",
. .
~"M
.. ,,~
C:;."elC 'r~lIt:I
VI...,V", 6#'/1r1(INC.,
"d.' ""."'th.
.v~: ~1i'$TM6t:JuclUleAO
Tel e. .~_o
I!!:"'r'lle.c..,...
c.~ 0::5--:5
:::5 e.C 'T /0"-1
- -
- -
.
+11'T.
eI
,,~- .~_ .~ ~C~~.
,..,." ....- "~r. --.,MIC .....~,
. "."o#~,r.tH-: -
- .. -----
....~~",.,...~
<7 GAZ>"'5 "'" / (. IV is
Po. 2!l>C>,)C' 2..,4-
e AST Nt~/D"". N.y. 11"13.,
'240 /<Nt:I(.C. C:-/A'C:C.E.
Sc7"M /atllO_ ~- 5-/5
JUi.T 2~.UIJ"
.s.IIMT ~ .~ 5 .
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTH OLD
TO: ,.1JJ.atf ~ rnl ( nL
Please be advised that your application dated-.-Kl (~7o(,
reviewed by this Board at the regular meeting of ---3 /.J-()/~
following action was taken:
has been
and the
( v") Application Approved (see below)
L-) Application Denied (see below)
L-) 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 Chapter 97 of the Southold Town
Code.
The following fee must be paid within 90 days or re-application fees will be necessary.
COMPUT~TION O~ PERMIT FEES: ~
L1t t'\O...f (I\.D~ (' ~ .4 S- 0 . DO 1.0 G
\0\10\
TOTAL FEES DUE: $ S"O,OO
BY: James F. King, President
Board of Trustees
.
.
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 Southold Town Conservation Advisory Council held Wed.,
September 13, 2006, the following recommendation was made:
Moved by Jack McGreevy, seconded by Don Wilder, it was
RESOVLED to recommend to the Southold Town Board of Trustees APPROVAL WITH
CONDITIONS of the Wetland Permit application of GLADYS MILNE to remove 106' of
existing bulkhead and 96' wide wooden boardwalk and replace inkind/inplace.
Located: 240 Knoll Circle, East Marion. SCTM#37-5-15
Inspected by: Jack McGreevy, Don Wilder
The CAC recommends Approval of the application with the Condition the entire lower
area is non-turf and grated vinyl is used for the boardwalk.
Vote of Council: Ayes: All
Motion Carried
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
,
)
i I
.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
Name of AppliC311t:
vYl...., r--
Type of Application: J Wetl311d _Coastal E psi on _Amendment _Administrative
_Emergency
Info needed: C~<:'L~ is- ~
is 0 j?er",,:\
,
t:/ h,o/l 1vr ~ ~'-1 ~ i
Modifications:
.
Conditions: I
i
!
! I
Present Were: vI.King v:t.Doherty '"iCDickekok~. Bergen~.Ho1zapfel
Other: I I
--- I I
I i
! I
Mailed/Faxed to: . I Date:
I '
!
i
,
"
.
"">V1'1# fAr.
Gladys Milne
240 K.-101l Circle
East Marion
.
.
April 2006
I~
I
VIIEW ~-""11J $.-m-""fIIT
OlimC ,.,.,.,.... P. 1 f1-WiA~
I
V,~ ~o_,,.,., HMIIf.4mf'1"
,
O~ W_O.,I :i3___c.C
~"T
VIItrM l...,,.,., (,ufJISr
~.., B.a,lOfiIte
I
V,ec.u '-0 o #Iff: ".'" weft1'i
.j>'J . ._ Bo&4IQf_
G1l!dys Milne
240 Kn;)lI Circle
East Marion
.
.
April 2006
1//1lkI t.ON:''''" iVOIC1N
~ W-,..".,,,. S"N.~.
I
V';'6~ ~o.,~.~ Nt1ttMI.lIMS1'
;r:,u,,., ''-~''''' ~~~
I
V/6~ .t.ooc:".,~ HOArH-t!!1I$r'
I
791....., t>p,-,s'Rr SNo~
I
.
.
-1-
I
-z~----
I -----;::-""
+.,~
--
;
I
+
I
-,1-"
~
.
.
Omce Use Only
Coastal Erosion Permit Application
...-wet1and Permit Application ~ Administrative Permit
Amendrnent!T~ferlExtension
--=:::Received Applicllion: '(; 11 !>l 0 l.
~eivedFee:$ Cl"S\:l~
_k:ornpleted Application-.XJ ~I ex.,
_Incomplete
_SEQRA Classification:
Type I_Type II_Unlisted_
Coordination:(date sent)
~AC Referral sent~:f/;f
~ate of InspectIOn: 0
_Receipt of CAC Report:
_Lead Agency Determination:_
Technical Review:
----..J'ublic Hearing Held: '1. ld-Ul O.ln
_Resolution:
,.
fI(\,,,r
~UG \ S L'/dD
LLVIZ.-f _
Name of Applicant
Address--PO P1jx .7q~ I ~a.'7L.Ma.non I NY UCJ3Q
Phone Number:( ) ~~0 417 -0108
Suffolk County Tax Map Number: 1000 - 31 - 5 - {&:J
Property Location: ,J 40 tMU ewe Ie I 8LSt Mar-lllvlj Ny llq~9'
C\'^ ~ 0-
c;p~ 1> \ff-\~
4laoard of Trustees Applicati~
GENERAL DATA
Land Area (in square feet): 1, ~til
AreaZoning:-Jj()_ 'SW\{IJe. FUM'\I{-~'7t.de..l'lc.e
Previous use of Property:_~LdP..vIh J
Intended use of property: :sa.mL
Prior permits/approvals for site improvements:
Agency
Date
_ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
~No_ Yes
If yes, provide explanation:
Project Description (use attachments ifnecessary)~MOye 1010' O+-
board ~r
tlWLt.e...?'f1('f ~ vw~ Iy'\'-lilu I m-piaCR
-
4Itoard of Trustees Applicatio~
WETLANDITRUSTEE LANDS APPLICATION DATA
. .......r
Purpose of the proposed operatIOns:
~d~9~ .
Percent coverage oflot:
o
D
square feet
Area of wetlands on lot:
%
Closest distance between nearest existing structure and upland
edge of wetlands: 0 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: C) feet
Does the project involve excavation or filling?
No
'f
Yes
If yes, how much material will be excavated? 97 ~ cubic yards
How much material will be filled?
3<10
cubic yards
Depth of which material will be removed or deposited:
Proposed slope throughout the area of operations: ()
(p
feet
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):
,
~re wW b( MlM.l~ l1'tVII'OV\wtLVt/J ~och tk
-to ("O....-r: . e.
~uwh1l1Aq ILYtt1 17 P/XI~~1'
4Itoard of Trustees Applicati~
COASTAL EROSION APPLICATION DATA
Purposes of proposed activi~ t({tlYI c:Jrztrf (1,/1 I!XI'SfJt79
. ~i/Ut1 hu f[itllld
Are wetlands present within 100 feet of the proposed activity?
No
')d
Yes
Does the project involve excavation or filling?
No y.. Yes
If Yes, how much material will be excavated? 31'5 (cubic yards)
How much material will be filled? 3 '/0 (cubic yards)
Manner in which material will be removed or deposited:
trOt11 !.and WIlli tt baC!JWf, ~ '?tYfal/ t',xCaVll.fcr
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
~rf. wi/Lbl 't'vtIM"IVlflf ~/I1Vlrt1nWQJtiJ L~illll<,.
, I
~ O-rpfJ btl1ilid-ffi( 'l'xflIM1 fMlthf4ti WLlUf ~
~co.vaffd Mid CfMftwttd 00 fhaf #Ie, MaJ,noJ
~t7 ~of fJt~-fYlt ~oAtvwa.l.( du.YtVl1 -/1,te.
.
.
. .",< . 811.20
,,, .... ...:::".'.Appendlx C
State EnvlronmentSlQu.antY Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
.' /F.<.ju.... .:.
PART I . PROJECT INFORMAl10N 0 be com I.ted b
1. APPLlCANTISPONSOR
C"".;.,~o ~A.AIZN". ~At':rAt.A ~p.
3. PROJECT LOCATION:
Municipality cAST" MNZ,ol'/ County S",,.'Of..I'-
4. PRECISE LOCA nON (Slr8eladdl888 and road Inillrsecllons, pI\lf11lnent landmar1<s, etc., or provide map)
:2.4-0 KNOe.c. C/teCt.tl"
E~"'r .,tAAlZ/D~, N.'/'.
//93
Iicant or Pr ect s
2; PROJECT NAME
&;G,qr.>~ MIe.N=
~crM. /000-37-5-/5
5. PRO~~ACTlON IS:
Ik?" Now 0 Expansion 0 ModlfIcationlo'*-tion
6. DESCRIBE PROJECT BRIEFLY: :;I?_O".../OG'~ lIP ewsr/~#o Buc.JCH.<ilC ..<IN":>
"a.'Zo~ c;~S7"lw"" 4' IAhOt!J e_r.>""AC./' .AN":> 7<~4t'.
~,.,...,... /N-c..IN:16, h.,_ 7"='I'At:IIl.
7. AMOUNT OF lAND AFFECTIED:
Inillally c:> a""" UlUmetaly c::1 a"""
6. WILL ~OydSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
~es 0 No IfNo,desatbobr1efty
.", ,~
-< :;.'"J. h,'i)."i.... ",~~.,\...". '".
9. WHA ,!,!,5,?ESENT lAND USE IN VICINITY OF PROJECl?
l$.:fRosldontial 0 Indusb1a1 0 Cornmarclal 0 Agrlcul1u... 0 PlII1<IForeslIOpon Spaca
Describa.
?P,c/V.A.,.- 7i?_-.~tt". - W"'~ ~"",r
o Othar
10.
DOES ACTION INVOLVEj\PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM AN'( OTHER GOVERNMENTAL AGENCY
(~ STATED~~)1nY"1,~';;~.)ne~;.~~;v.~:.
,: ", ..':~ ;<.~ ::.{ r /: ::, : (j f :, 'L', _ . ... .
,4/'1$:Z::OC:,1 .. N'f$"DOS ;.Aeo..'~"iw..., o,i.1,,soc:.w,U::I
. ""~ . i.''', '" '. ' ',l 'If;. ;, ", ,. .
11.
DOES ANY ASPECT...2?E AC11Q~ ~Yl1.:A CORREI'ITL... Y VALID PERMIT OR APPROVAL?
DYe. lkfNo.. Ify...lIologency(')Iltl!T1.~PI!'T1lltlol'!""""lI:
12.
ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
Signature:
THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEOGEh
.. . U""1. . 0,..: 7 ~c.
..~"U/ _....< '
.
". , .,' -,".,;~'1;:, '., -''''.. ,. ",: '_. :'" . .
If the action Is In the..C.oastarArea, and you are a state agency, complete the
Coastal Assessment Form before proceeding with this assessment
OVER
1
'~et
-'_.-._---~---
.
.
PART 1/. IMPACT ASSESSMENT lTd be comDlel8d bv Lead Aaen""}
A. DOES ACTION EXCEED ANV TYPE I THRESHOLD IN 8 NVCRR,PART 81r.4? If yes, coordilate the review process and use the FULL EAF
OY.s 0 No If No. a negative
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 8 NYCRR. PART 81 r.8?
dOClarallon may be ..._ by anoll1er Involved agenoy.
DV.s 0 No
C. COULD ACTION RESULT IN ANV ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (An....rs may be h.ndwritten, n Iegibl.)
C1. Existing air quality, surface or groundwalter qUluty or qUlntIty, noJH 'Ivell, exlsUng tratnc pattern, lOUd waste production or dISposal,
potondal for erosion. drainage orftoodlhg p(O/)I!'fl1s? Explain bl1ol1y:
C2. Aesthetic. agricuttural, a~ical, hl8to11c. or other natural or cuttural resources; or community or neigfltK>rtlood character? Explain bliefty:
C3. Vegetation or fauna, fish, shellfish or wildlifelP9de8, ~ntf'lCIInt habit8ts, or threatened Oil endangered species? Explain briefty:
.
C4. A community's existing plans or goaf, - otIicl8iNy adopted, or. c:hangeln UH or Inlenalty of ute of land or other natural resources? ~l8in briefly:
C5. Growth, subsequent devolopment, or -tad actlvjtlos Ilkoly 10 be IndUOOd by Ih. PfOl)OSOd _? Explain bri.fly:
.'
eft. Long term, short tooo, cumulative, or oIher __ not Idontlftod In C1-C5? Exptoln bl1ol1y:
cr. Other Impacts (inCluding changes In use of olIhor quantity or type of .nergy)? E>cpIain briolly:
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA (CEA)?
o Yes 0 No IfV....xplllnbl1ol1y:
.'
E. IS THERE, OR IS THERE LIKEL V TO BE. CONTROVERSY RELATED TO POTENTIAl ADVERSE ENVIRONMENTAL IMPACTS?
oVes DNo If Yes. explain bl1ol1y:
PART III - DETERMINATION OF SIGNIFICANCE (To be oolllPlel8d by AGency)
INSTRUCTIONS: For each adverM efI'ect ldenlilled lIbove. detwmine Whether ilia aubal8ntlal. large. important 0' olherwis. significant. Each
effect should be a_ In oonnecaon with IIa (a) 88III~.(i... utben or NIBI); (1)) P/ObebllltyofOOCUrrjng; (c) duration; (d) irrav.rsibility; (eJ
geographic aoope; and (f) magnitude. If n_/y. 8dd 8lI8chments or ref8renoa supportlng lIlIlle~aJs. Enaure that .xpianatlons contain
sufficient detail to sbow that all relevenl advelll8lmpacts he... been ldentlfiad and lIdequalllly addl'll88ad. If quoatlon 0 of Part" was cheCked
yes, Ihe determination of signlflcanca must evaluate the potential imptlot of the propoaed aCtion on the enVironmental charact.ristics of tho CEA.
o ChoCk this box n you hove id.nllftad one or more poI8ntially !erga orllgnltlcant ad_lmpocta whloh MAVoccur. Then Proceed dirocUy to the FUL
EAF and/or prepare 8 positive declaration.
o Chock Ihis box f you havedatennlnad. based on Iho Informallon Ind analyllaabovelnd II1Y~ng dooumontallon. that tho PfOl)OSOd action WILL
NOT ,..uk In any significant advarae anvfronmonlallm_ AND provida. on at1aclunenllaa~. Ih. ....sons supporting this d.tOlT11inallon
Name Of Lead Agency
Dato
Pnnt or Type Name of ~ orncer In Lead AQentY
TIlle or 1'(8apOOd)je omcer
Slgnalure of ,,_ otIloor In Load Agency
Slgnatuno of PJapa,w (If diffanlnt from _nsible otlioer)
Reset
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
----------~----------------------------------------------------
In the Matter ofthe Application
of
------><'-~~~~---~~-~~---------------------
COUNTY OF SUhOLK)
STATE OF NEW YORK)
I, L.ynnE-Sltven"
SEP 1 4 2JCS
AFFIDAVIT OF POSTING
,residing at /03:.[ 11/1/ti.A 's/ArJe, C"J/ch-Ove
being duly sworn, depose and say:
That on the /().#ctay or)erfem~ 200111 I personally posted the prgperty known as
aio /<!no/I ~'rc./e t;C/.dr mar/~, AJ'I /1'1Y1
by placing the Board of Trustees official poster where it call easily be seen, and that I have
checked to be sure the poster has remained in place for eight days prior to the date of the public
hearing. Date of hearing noted thereon to be held Wa,I'l $.rri..20. ,.;2DO(, ~
On (VI Ct 00rt (e ,'3C PlY) ,
Dated:
Sworn to before me this
J;;;" day of5€('t200b
~2S~
#cM~
Notary Public
ROBERT CURTIN
NOTARY PUBLIC, Slate of New York
01 CU4604511
Q~a"fied In Suffolk Countyn::> lJ ~'[)
Commission Expires March 30
Gladys Milne
240 Knoll Circle
East Marion
Posting - 9/12/06
.
.
~,,-ti.,'
.~~,:...:
~t:J:~~.:i.,.,..,,~.,.~I'I~.Jv.=::.
~-.--",;~~">"\
~::~Jil~~''''~'-' \
" i-;:::=-;::~~
~~~~+F~~I
1.ffiill1&"''''''i'OTi.O .rn~lJtl.:f,,~~flt:.:2f.11
~~~~~",---L";'t'lJ.~
- ~~~[t'.(.,c:"QF<;'J~,';:;;~~d:-t,=oi":!'1 I
~'S:~."~'::-:-_i\J: ~ .r.:;}, ....r.::-fi,:)l ;'""'. ,r:_'7,:,;;I_j:J}~i:l~'1':G-~'i.""""~'~I~~~
'l.r-f'.~ "'.r.~_.n:vo,,__i/"_~"l~ J."n(......,,_.:..JiT.<:l__, I
~~~_~~:._~~,~..:_~~J_~~~
~~~.8.~Jl&7~~~.;:'};'-?7s?:d.il:.:;~:E)';:'~r;:!I;,
,
';~~
-,
.
.
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
Address:
lYt<4S!17IJne PO, evy;;L9~ l'a::>r~~; A.Jy 1/939
O/Jct7eis 8(Jt he- k'noll C'rJk Za..sflJJWl-e~AJY 1/93'1
'IM1,' LaJrCl1Cl / Is..6el/e !/ouI/.:;,eelue.. .P' (), &:or lie;; !b,;,1)?JWLI~ )()YI/CJ37
Gr~ II UIJI1l/)C () 70~tJoll Cr/-Je.1 but /1JtW~ AJylfise;
??~J
Notary Public
ROBERT CURTIN
NOTARY PUBLIC, State of New York
01 CU4604511
Qualified in Suffolk Counly"'-;>Q' ;0,
Commission Expires March 30 ! U
.
COSTELLO MARINE CONTRACTING CORPORATION
DOCK BUILDING. JETTIES. BULKHEADING . STEEL & WOOD PILl~G . FLOATS
423 FIFTH STREET . P.O. BOX 2124 . GREENPORT,NEWYORK11944. (631)<177-1199/477-1393/477-0682. FAX (631) 477-0005
AUTHORIZATION FORM
I,
~
jl/jl/.--. ,'U t:::
C 13 c:
owner of J-. or ? (
(BusinessIProperty Name)
/' A ~
r. fA /) y.::,
(Name)
located at cJ.'io 1\ iV C j, L
L/f<(LF
do hereby give Costello MarIne Contracting Corp. the authority to act as agent in my
behalf in applying for all the necessary permits for work to be completed at my above
referenced property.
7 /is /lJ~'
D~te .
'-.. .
AI' /' ~ II 7/u /I '
~(;t1 /r'U.-I>'^-_C/
(f Signature
4Itoard of Trustees ApplicatiO'"
County of Suffolk
State of New York
JOJ\f_ ask\lo WQ.l'sh BEING DULY SWORN
DEPOSES AND AFFIRMS lHA T HE/SHE IS THE APPLICANT FOR lHE 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 lHE SOUlHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUlHOLD 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 lHIS
APPLICATION, I HEREBY AUlHORIZE lHE TRUSTEES, THEIR AGENT(S) OR
REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT lHE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
SWORN TO BEFORE ME THIS
fA-
/a DAY OF I-L!J,{,~L- ,20~
Puolic ~
CYN IA M. MANWARING K U
NOTARY PUBLIC, STATE OF NEW YORK
NO:01 MA61 00507
QUALIFIED IN SUFFOLK COUN:;( /.,.
COMMISSION EXPIRES OCT. 20 l:;f-1f
Town of South old
.
.
L WRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
I., All applicants for pennits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of South old Waterfront Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
making a determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area (which includes all of South old Town). .
3. If any question in Section C on this form is answered "yes", then the proposed action may affect the
achievement of the LWRP policy standards and conditions contained in the consistency review law.
Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a
determination that it is consistent to the maximum extent practicable with the L WRP policy
standards and conditions. If an action cannot be certified as consistent with the L WRP policy
standards and conditions, it shall not be undertaken.
A copy of the LWRP is available in the following places: online at the Town ofStlllthold's website
(solltholdtown.northfork.net), the Board of Trustees Office, the Planning Department, all local
libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# 31
:5
IF)
The Application has been submitted to (check appropriate response):
Town Board 0 Planning Dept. 0 Building Dept. 0 Board of Trustees N
1. Category of Town of South old agency action (check appropriate response):
(a)
Action undertaken directly by Town agency (e.g. capital
construction, planning activity, agency regulation, land transaction)
o
o
(b) Financial assistance (e.g. grant; loan, subsidy)
(c)
Permit, approval, license, certification:
:gr
N'rure~:~~~~~~~ q~:i,~::I~u
~'-,
Location of action: nl40 &/( Cycle. &71- AN~
I
Site acreage: . I q
Present land use: /f!e7tC1tYlitJ
Pr~sent zoning classification: ~ 1 () ~ <7t ~ iI' n>>IIIt./ 1J5Idenfr d
I.
2. Iran application for the proposed action has been filed with the Town of Southold agency, the following
information shall be provided:
(a) Name of applicant: 6/or/t(> A.At....
(b) Mailing address:-FO ~() '!:. 02114
ftf;f- ftian/JY\ I biUl9M
(c) Telephone number: Area Code ( #-471- 0 1D ~
(d) Application number, if any:
.,
Will the action be directly imdertaken, require funding, or approval by a state or federal agency?
Yes 0 No ~ If yes, which state or federal agency?
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of South old that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and
minimizes adverse effects of development. See L WRP Section III - Policies; Page 2 for evaluation
criteria.
f'
o No 0 Not Applicable
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See L WRP
Section III - Policilils Pages 3 through 6 for evaluation criteria
DYes 0 NO~ Not Applicable
'.
.
Attach additional sheets if neeessa.
.
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of South old. See
L WRP Section III - Policies Pages 6 through 7 for evaluation criteria
o Y~s 0 No ~ Not Applicable
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See L WRP
Section III - Policies Pages 8 through 16 for evaluation criteria
l)2f Yes 0 No .0 Not Applicable
Attach additional sheets ifnecessary
Policy 5. Protect and improve water quality and supply in the Town of South old. See L WRP Section III
- Policies Pages 16 through 21 for evaluation criteria
o Yes D No JJ"Not Applicable
.
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III _ Policies; Pages 22
through 32 for evaluation criteria.
"ijJ Yes 0 No 0 Not Applicable
.
"
Attach additional sheets if negessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies
Pages 32 through 34 for evaluation criteria.
D Y ~s D No Cj3' Not Applicable
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and h-azardous
substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
DYes D No Q( Not Applicable
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public
resources of the Town of South old. See LWRP Section III - Policies; Pages 38 through 46 for evaluation
criteria.
~ YesD NoD Not Applicable
Attach additional sheets if necessary
WORKING COAST POLICIES
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria.
'i<1 Yes D No 0 Not Applicable '
.
.
Attach additIOnal sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, .the Peconic Estuary
and Town waters. See L WRP Sectiou III - Policies; Pages 57 through 62 for evaluation criteria.
DYes 0 No ~Not Applicable
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of South old. See L WRP Section III _ Policies; Pages 62
through 65 for evaluation criteria.
o Yes 0 No ~ Not Applicable
Attach additional sheets ifnecessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III - Policies; Pages 65 through 68 for evaluation criteria.
DYes 0 No Iff Not Applicable
Created on 5/25/05 11:20 AM
Date:
To:
Proposal:
.
.
August 4, 2006
Southold Town Trustees and Mark Terry
Remove 106' of existing bulkhead and 96' of existing 4' wide boardwalk. Replace same in-like, in-
place.
DEVELOPED COAST POUOES
Policy 1 Foster a pattern of development in the Town of Southold that enhances community
character, preselVes open space, makes efficient use of Infrastructure, makes beneficial
use of a coastal location, and minimizes adverse effects of development.
This is a waterfront piece of property that is presently bulkheaded. The bulkhead is failing and needs
to be reconstructed. The boardwalk is a buffer area for the property to walk. All structures are
existing. There will be no increased development and our proposal is an effort to maintain existing
structures.
Policy 2
Policy 3
PreselVe historic resources of the Town of Southold.
This property has no significant historic resources.
Enhance visual quality and pi otect scenic resources throughout the Town of Southold.
The bulkhead at this location is existing. The present condition of this bulkhead is showing its age by
presenting holes in the sheathing and leaking of backfill. A new bulkhead is just an attempt of the
upland property owner to maintain her property. All structures are existing so the visual quality and
scenic resources will remain the same.
NATURAL COAST POUClES
Policy 4 Minimize loss of life, structures, and natural resources from flooding and erosion.
The existing bulkhead is needed to protect the upland property. This shoreline is mostly reinforced
with erosion control structures. The new bulkhead will not increase flooding or erosion in this area.
Policy 5
Policy 6
Policy 7
Policy 8
Ploted: and improve water quality and supply in the Town of Southold.
This proposal will not have any impact on the water quality and supply of the Town of Southold.
Plotect and restore the quality and function of the Town of Southold's ecosystem.
This proposal will not have any impact on the Town of Southold's ecosystem.
PIOtec.t and improve air quality in the Town of Southold.
This proposal will not have any impact on the air quality of the Town of Southold.
Minimize environmental degradation in the Town of Southold from solid waste and
hazardous substances and wastes.
This proposal will not degrade the environment with solid waste or hazardous substances.
PUBUC COAST POUClES
Policy 9 Provide for public access to, and recreational use of, coastal waters, public lands, and
public resources of the Town of Southold.
Our proposal will not limit public access to the coastal waters or public resources of the Town of
Southold. There is a bulkhead presently existing and we are proposing for in-place construction. All
structures are landward of the AHWM.
WORKING COAST POUCIES
Policy 10 Protec.t the Town of Southold's water-dependent uses and promote siting of new water-
dependent uses In suitable locations.
Our proposal is to reconstruct a failing bulkhead. The present condition of the bulkhead is poor and
is unsafe. The construction of a new bulkhead in its place will allow the property owners to safely
.
approach this waterfront.
property.
.
All structures are in need of reconstruction to maintain the integrity of this
Polley 11 Promote sustainable use of living marine resources In the Town of Southold.
This proposal will have no impact on the marine resources in the Town of Southold.
Polley 12 Plot:ect agricultural lands in the Town of Southold.
This proposal has no impact on the agricultural lands in the Town of Southold.
Polley 13 Promote approprlatll use and development of energy and minerai resources.
This proposal has no influence on the development of energy and mineral resources.
KNOLL
CIRCLE
R= 50.0'
L= 26.1'
t,O
C',")
I.'~
Lei
,--
~1
~i
~.
"
~.
~
CD
=.J
<l:
~
~~\
Vl~
g:\
~
~\
\0
'r-\
\
is. \
~
~
\
~\
\:::)
~\
l\
~\
>-
~
~
<l?
Cj
~
C:l
II
~
~
~
~
~
~
~ ~
11/2
t 12.9' STORY
1i/
MOOD FRAME
.. DECK
~ fI()(T No. 240
OIf"Ii'
STOfY'
0
~ J<#.<#'
LOT 30 ~ TIMBER WALL
I
~
.......
_ BOX
. MNOOW
29.S'
AIR
COND. BOX
",/10011' 8'
- 10,
12.1'
.....
5.0'
,
10.3
~
;.,
N
"i
<#. TlM8&
COHCRE.,. It STONE
RETAINING WALL
RETAINING
-
~
8?~
Q ~
~"
~
--
LOT 31
5
.-,
\, \\
, ,
\ \\
' ,
, 4l '
, ",'
\....... ,
'=' ,
\ Cr::. \\
, <n ,
,
\ Q \
.1.1 (;) ,
'J1'\~\
, ,
, ,
, ,
, ,
, ,
, ,
, ,
, ,
, \
,
,
oS' t~o
1f6"1f<.
7 "-1f,7, ""
<#' BOARDWALK
TIMBER 8/)LKHEAD
S 65022'56" W
59.03'
SPRING POND
ISSUING OF A NO( nn.E' POUC'f OR RmA TIHG Of AN fXlS71NG
POC,JCY fttFrRfNCIHG 1Nf5 SUR\oFr IIl'lHOUT BCHCFlT or AN UPOA Tt
OF" THIS SUff\lE''I' BY l'HOIIAS AfATNfAZlO, LANa SURK"I'tW SHALL
TE'RIIINAl't ANY LlAKlTY EXPRf'ssm OR INPt.IED HEREON.
THe 0FJ"5!7! OR OIWEHaoHS 5H01IN I'JItOW lJK SmJCWI'CS TO '/Hf' ~rr UH!S
ARE F'OIf A IP(QFIC PtJRlIl'OS(' AND USE' NCI:I JHE1tf.,. 'C.ll!E' ARE' NOT /H'Il'HOfO 10 Gl.ltDf
THE EM'CQON OF FDfCD. ,,"ANNO IMlLS POtU. l'A lJOLt PlM'l\Ha AREAS, ADOflJOH
ro SJRUCnIIfn NCI NfY OlHlll cc:wmIUC1JCW.
THE EXISTENCE OF RIGHT OF WAYS AND/OR EASEMENTS
OF RECORD, IF ANY, NOT SHOWN ARE NOT CERTIFIED
UNAUTHORQED At.lERAnoH 0It AOt7naN TO 1MS SUIIl€Y IS A 'ltCUDtW OF 5r'C7JOH
1201 OF H' H[W lawt' STArr fDtA':Ancw LA*
ctW'Ca aF ntl 5UR"'" *" HOT IJi[MWO n,r LAM) SIJR'~'S IM<ED SEAt. CIR
(WIOSI!D ,seAl SIWJ. HOT lit ~ TO 8E A VALID 1I9UC CCPY.
ClJmFJCAncws MlfCAD HfRrCW SHAlL RUN OM.., TO THE' PER~ F'OR' IIHClW TH!
~ IS MO'Mm. NIO ON HIS IafAV TO lH[ "'IE COWlI'AH'(, GCM"IWKHTAL
AGEHCY AND I.!HDWc: MnlUlJCIN US1tD HE1ffGW, AND 'ItI JHC ASIIl:Htt$ OF 1HE
LENDlNC MmunoN, CDt1L'JCAm:ws ARE HOT 1RAH5nltAaC TO ADlJInONAl
JNsm1JJIGYS QIII SlJISE'QlJt'HT 0lIH(ft
SCALE: 1'= 20'
@ 2006
THOMAS MATARAZZO
LAND SURVEYOR
32 SEQUOIA WAY, HOLBROOK, NY 11741
rAX/PHONE: 1-631-472-0968
SURVEY OF: LOT J1
FILED MAP: SECTION TWO GI4f'WNER'S BA Y ESTA TrS
FILED SEPT 2.3, ) 927 No. 275
LoeA TED A T: EAST MARION. roWN OF SOUTHOLD
SUrrOLK COUNTY, NEW YORK
TAX DES/G.: D/ST 1000; SEr:; ,'1; BLK 5; LOT 15
CERTIFIED TO: C.O. SURVEY
TITLE NO.:
---