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HomeMy WebLinkAboutTR-4203 James F. King, President o~~oF so~ryo Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road P.O. Box 1179 Dave Bergen Southold, New York 11971-0959 John Bredemeyer H Q ~O Telephone (631) 765-1892 Michael J. Domino Fax (631) 765-6641 ~'~oouKr+,~' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0905C Date: September 18, 2013 THIS CERTIFIES that the installation of batter piles to reinforce 100' of existing bulkhead: and installation of ±100'x6' of vinyl skin onto existing sheathing of bulkhead At 7225 Nassau Point Road, Cutchoaue, New York Suffolk County Tax Map # 111-15-12 Conforms to the application for a Trustees Permit heretofore filed in this office Dated July 22, 1993 pursuant to which Trustees Wetland Permit #4203 Dated July 29, 1993, was issued and Amended on February 20, 2013 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the installation of batter piles to reinforce 100' of existing bulkhead; and installation of ±100'x6' of vinyl skin onto existing sheathing of bulkhead. The certificate is issued to RJJ PROPERTIES LLC owner of the aforesaid property. Authorized Signature 0 i James F. King, President o~gpfFfl(,~co Town Hall, 53095 Main Rd. Bob Ghosio, Jr., Vice-President P.O. Box 1179 0 Dave Bergen } Southold, NY 11971 John Bredemeyer Telephone (631) 765-1892 Michael J. Domino Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: q l 17 I U V Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction _ % constructed Project complete, compliance inspection. INSPECTED BY: IJ • 3 G f COMMENTS: r drl r CERTIFICATE OF COMPLIANCE: James F. King, President • QF so Town Hall Annex Bob Ghosio, Jr., Vice-President Q~~ UryO 54375 Main Road 'l P.O. Box 1179 Dave Bergen # lr Southold, New York 11971-0959 John Bredemeyer CA ac Michael J. Domino • ~O Telephone (631) 765-1892 ~~yCOU'~Aa Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 20, 2013 Mr. John N. Blakely PO Box 432 Southold, NY 11971 RE: RJJ PROPERTIES LLC 7225 NASSAU POINT ROAD, CUTCHOGUE SCTM# 111-15-12 Dear Mr. Blakely: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, February 20, 2013: RESOLVED, that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit #4203 to install +/-100' x 6' of vinyl skin onto existing sheathing of bulkhead; and as depicted on the revised site plan prepared by John N. Blakely, last dated January 10, 2013 and stamped approved on February 20, 2013. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, James F. King President, Board of Trustees JFK:amn James F. King, President • QF soy Town Hall Annex Bob Ghosio, Jr., Vice-President O~~ TyOI 54375 Main Road h O P.O. Box 1179 Dave Bergen # Southold, New York 11971-0959 John Bredemeyer Na ]c Telephone (631) 765-1892 Michael J. Domino Fax (631) 765-6641 ~y00U0,~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 20, 2013 Mr. John N. Blakely PO Box 432 Southold, NY 11971 RE: 7225 NASSAU POINT ROAD, CUTCHOGUE SCTM# 111-15-12 Dear Mr. Blakely: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, February 20, 2013: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit #4203 from Warren Augenthaler to RJJ Properties LLC, as issued on July 29, 1993. If you have any questions, please contact our office at (631) 765-1892. Sincerely, James F. King President, Board of Trustees JFK/amn 0 Fo1M lames F. Kine. President s CpG P.O. Boa 1179 Bob Ghosio, Jr_ Vice-President j f Southold, NY 11971 Dave Bergen H ? Telephone (631 765-1892 lobo Bredemeyer Fax (631) 765-6641 Michael.1. Domino Southold Town Board of Trustees Field InspectionMorksession Report Date/Time: _ •'Zi17143 John N. Blakely on behalf of RJJ PROPERTIES LLC requests a Transfer of Wetland Permit #4203 from Warren Augenthaler to RJJ Properties LLC, as issued on July 29, 1993; and an Administrative Amendment to Wetland Permit #4203 to install ±100' x 6' of vinyl skin onto existing sheathing of bulkhead. Located: 7225 Nassau Point Road, Cutchogue. SCTM# 111-15- 12 Type of area to be impacted: -Saltwater Wetland -Freshwater Wetland -Sound A-Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt. 111 -other Type of Application: _ Wetland -Coastal Erosion -Amendment _Administrative_Emergency Pre-Submission Violation Info needed: o I- T., ITJ~1 e_ Modifications: X lT f v r h-1 ~~r T [ ri a s Conditions: Present Were: /J. King _,ffB. Ghosio ~D. Bergen, ~-_J. Bredemeyer / Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: i _ 4 Board Of Southold Town Trustees \1 SOUTHOLD, NEW YORK PERMIT NO. 4203 DATE:...7/29/93 v ISSUED TO WARREN.AUGENTHALEl3 Aut4arization 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 1 i State of New York 1952; and the Southold Town Ordinance en- i titled "REGULATING AND THE PLACING OF OBSTRUCTIONS ~t IN AND ON TOWN WATERS AND PUBLIC LANDS and the 'y REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the 7/29/93.. Resolution of The Board adopted at a meeting held on 19 93 , and in consideration of the sum of $ 100,00 . paid by Costello Marine Corp. for Warren Augenthaler } of Cutchoguc N. Y. and subject to the Y Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: / Grandfather Permit to install 16 batter piles to reinforce .R 100' of existing bulkhead. Little Peconic Bay. i, tt all in accordance with the detailed specifications as presented in the originating application. / IN WITNESS WHEREOF, The said Board of Trustees hare- by causes its Corporate Seal to be affixed, and these presents to tr \ + be subscribed by a majority of said Board as of this date. OS FP LM 1 \ / l 4f , ~r ~ s xs ,rxisr~+s ors vx mrod q .IALIk3N .9PAWx~YO r tee rcanraeso Pwns Aawsw av&*o , 2K Si esHo a. s' ar ~ sJar.cit! N7.Fi 2 ff'Wr .?y. 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Box 1179 54375 State Route 25 Southold, NY 11971 (con Main Rd. & Youngs Ave.) T Southold, NY 11971 A Q Telephone: 631 765-1935 • ~O Fax: 631765-3136 Colvin LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM DE--- To: Jim King, President Town of Southold Board of Trustees FEB 1 5 2013 From: Mark Terry, Principal Planner LWRP Coordinator Southoldlown Board of hustces Date: February 13, 2013 Re: Proposed Wetland Permit for RJJ PROPERTIES LLC SCTM#1000-111-15-12 John N. Blakely on behalf of RJJ PROPERTIES LLC requests a Transfer of Wetland Permit #4203 from Warren Augenthaler to RJJ Properties LLC, as issued on July 29, 1993; and an Administrative Amendment to Wetland Permit #4203 to install ±100' x 6' of vinyl skin onto existing sheathing of bulkhead. Located: 7225 Nassau Point Road, Cutchogue. SCTM# 111-15-12 The proposed actions have been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that above actions are CONSISTENT with the LWRP. Note that the Board issued a permit for the bulkhead (in-part) in 1993. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F. King, President aQF SO(/jy Town Hall Annex Bob Ghosio, Jr., Vice-President ~Ie 54375 Main Road P.O. Box 1179 Dave Bergen lx[ # Southold, New York 11971-0959 John Bredemeyer G Q Michael J. Domino Telephone (631) 765-1892 Fax (631) 765-6641 o~yUMY Co BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD APPLICATION FOR AN AMENDMENT TO A~ JAN 1 52013 DATE JAN 1S 2013 hold own OWNER l2J3 prZOPr-rZYtr-S J1L PHONE 90u k19 3639 ADDRESS jo7 13014(4112C }.Nof3otiam SPRi)y6b 'k34--sa2 AGENT JOHN N. RLAKEO PHONE 6 51 -G S 1 95 9' ADDRESS PO 80X 1+32 S©UI'KDti0 X-1, 10.71 PROPERTY LOCATION ~22~/?RSShtU Pl- P42 CUr,1H6 jVe N 111935 TAXMAPNO. X060- lit- IS-I2 I/We 1?3) PR6PCI2'r1C S CLC request an Amendment to Permit #-V203 to ?NSrgLL * w'y 1, 'ap ViNyL SKiy dsr0 r=,Xtsriiv!, S*-197 {INS OF QU!~1fHr--(~ Signed By: JCHN X 1340 ff-~:& James F. King, President ~Of SOUj~, Town Hall Annex Bob Ghosio, Jr., Vice-President ~O~ 54 Main Road P.O. Box 1179 Dave Bergen Southold, New York 11971-0959 John Bredemeyer Telephone (631) 765-1892 Michael J. Domino O Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD APPLICATION FOR A TRANSFER OF A L~1O SWIE JAN 15 2013 DATE JAN IS 161 u old own Board of Trustees OWNER R33 P20PTRTlr5 LLC PHONE gad *19 3639 MAILINGADDRESS 107 130NAfl2F LAUI 13oN1TA SPR?tiSS FL31.13k -8502 AGENT 30,4k N. 131.AKFHL-l PHONE 6331 WS- 1038 ADDRESS PO ilOX 432 600i401,0 N.I. H971 PROPERTY LOCATION 14630' 7225 N966t711 P01AIT im / uTCNoc~DE hl.i19315- TAX MAP NO. 1000 - i l l - IC- 12 I/We RJJ P2001:2T1kC4 INC request a Transfer of Permit# lt203 from 1VR2Y26N AU~FNTH4LEl2 Signed By: JMAI N. C3L.nilfl?d7 Board of Trustees Application County of Suffolk State of New York )0J(AU AV y~ 219 161-T.4BEING DULY SWORN DEPOSES AND -AFFIRMS THAT HEISHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S). AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HISMER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE.FROM ANY AND ALL DAMAGES AND CLAIMS ARISING ,UNDER OR BY VIRTM OF SAIDPERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGI NT(S) OR REPRESENTATIVES(S) TO ENTER ONTO MY PROPERTY TO INSPECT THE PRENUSES IN' CONJUNCTION WITH REVIEW OF THIS APP. LICAT40N" Signature SWORN TO BEFORE ME THIS DAY OF cJd ,20 / otary Pullin \ JOAN 7 LAXHAM - NotaryPuNic; State of New York io 4R`302) ..Qualified in Nassau county - - Ccitmiss on Expires aly= Boar* Trusteeg Application AUMORIZAY`CK (where the applicant is.not the owner) - 107 130kV71AM LAAM- . . RJJ .P2dnK/[at- JLU residing at IL -(Print owner of property) (eetfTT;n= address} PoRTA6PQIAi5 R D44-9,02 ? G Ace- C " do hereby authorize ~I A r L y .(Agent) Al, / to apply for permit(s1 from the Southold Board of Town Trustees'oa my behalf. (Owner's'signat e) Board of Trustees Application County of Suffolk State of New York )r9kN /V 119r!3'1 BEING DULY SWORN DEPOSES AND AFFIRMS THAT IMSHE 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 APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING SUNDER OR BY VIRTUE OF SAID PERMIT(S); IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S) TO'ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN' CONJUNCTION WITH REVIEW OF THIS APPL TRW ill 50~w Signature SWORN TO BEFORE ME THIS DAY OF Ac)e l ,20 otaty Public ftk County Cc zir , .,z; t.peesaWiy~ - Z,2,S G~ ' / !J Boar•f Trustees Application AUTHDRIZATICK (where the applicant is.not the owner) )Z37 136l VQ~ LAAP7 i, . PjJ P/ZOPfrI rtES . jU residing at 7 /L (print owner of propertx) (mailing address) PO)vi- q yPnIN 5 R 315 f 34-- $15 02 ~f L do hereby authorize V G f I- L y (Agent) All to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (owner's sigaat e) Town of Southold . • LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold 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 sigficant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listind both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.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# t [ I -I - 12, PROJECT NAME EJJ h201"?_ -rft1 kl.f The Application has been submitted to (check appropriate response): Town Board ? Planning Board ? Building Dept. ? Board of Trustees 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ? construction, planning activity, agency regulation, land transaction) ? (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: b1VStA-1,L t i6© f d 'BF VIMYL SKIN dlure AX'(67 IuL, s 14 6.4 T-4r N6 ®r gu4.KNr,6A>. Location of action: ~22591554V !'0rnti 26(4D CU1'Ck606 /VV' (1435^ Site acreage: a 752 Present land use: R r' 51 Df=N FI A 1. Present zoning classification: )2 r 6 i p rN n A t. 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code ( ) (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes A No Rf If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold 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 LWRP Section III - Policies; Page 2 for evaluation criteria. ? Yes ? No Not Applicable i Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ? Yes ? No MNot Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ? Yes[:] No Q 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 LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ? Yes ? No VNot Applicable Attach additional sheets if necessary i Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria ? Yes El No aNot 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. ? ? M Yes No Not Applica~ . Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ? Yes E] No [VNot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ? Yes 11 No te u 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 Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. j ? WE] No i "i 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. ? Yes ? No [O 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 LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ? Yes ? No 9Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. ? Yes 1:1 No ev u Not Applicable i Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. i ? Yes ? No [9 Not Applicable PREPARED BY JOHN N. wRvf7~ TITLE A- tly7 DATE N 1 0/3 D ECEIV~ D PARTIAL P12000-IF OF DETAILS. REINFORCE E~c1S?INC, fHEATNINS 100 JAN 1 520 ! wztaw I 1 1 1 r i 1 r ' r i t , r t 1 ' t 1 , ~ t t t 1 r ! ' t ~ 1 t • • iY~ 1 f r , _ I' - t 1 t 1 1 ' I t 1, 1. r t 1 ~ 1 t i t{ t 1 , 1 1 t 1 1 1 ' • 1 ' , ' t I 1 i , t , r t , 1 SaRa~ Lr . vv' sue. puRP05&, nelpir0RC>c l;7UM95 SNERT11,N5 u1TH R SXIQOF 1 RULKNCAD nemi 1! lkfrt • YINYL MKINC~ INSY4M, NMIZaNTALLY rftfJ * 100 1 _ 4bPOF [iCISYtAS SHKA'DJ11Jlt YO trs~D~ • ON RfAfH SIDE OfFX1StfNySNfR^NlN4 UX Al AYYA[MEY 74+bbc Ir'r+owagp jtgEplND Ip toEXtsrlrJS SHERTHINS F¢AtlL~b unx V4" TRL<RtEO P.F. AWACBNT P1160 RTY Ou/UC-45 IVICH46L CATAPANO 7225 M4Jf4V.Af•RD CM)(04VO Ny 1193 NC-IL 9-P4741CIR STROWW1 2G YANSuEUy> DP AW 4R Or? A40NXVILLF N.Y. 1040$-3)14 p TI65 LLC iiR IRE LiAN[- ~RCP~S f P S Ct N 2 KQ9M f- APPROV M-r D2 wN ti s~' BOARD QFd RWSNf66; s F . 3h 134' SSOZ TOWN OF SOWWMM 10 2013 DATE Z 2 0 L j 'Ai Till ill Board Of Southold Town Trustees SOUTHOLD, NEW YORK s PERMIT NO. 4203 DATE: ._7/29/93 ' c @u ISSUED TO WARREN_ AUGENTHALER tl io l 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 I„ State of New York 1952; and the Southold Town Ordinance en- p ` ba titled "REGULATING AND THE PLACING OF OBSTRUCTIONS R IN AND ON TOWN WATERS AND PUBLIC LANDS and the \ REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM t~ LANDS UNDER TOWN WATERS;" and in accordance with the 1 > y° Resolution of The Board adopted at a meeting held on 7/29/93 „ it 19 93 , and in consideration of the sum of $ 100.00 paid by Costello Marine Corp. for Warren Augenthaler , of Cutchogue N. Y. and subject to the " Terms and Conditions listed on the reverse side hereof, I Lill t' of Southold Town Trustees authorizes and permits the following: h. @€& Grandfather Permit to install 16 batter piles to reinforce s 100' of existing bulkhead. Little Peconic Bay. all in accordance with the detailed specifications as resented in \ the originating application. p 4 'til IN WITNESS WHEREOF, The said Board of Trustees here- i ~ by causes its Corporate Seal to be affixed, and these presents to e ['a; be subscribed by a majority of a said Board as of this date, \ > ' , Lr) t i > y v Trustees ra fr is i -+;:~rA~ 'y,.- /f Wis.. ~ .,I~~,. - ~ ~SUFfOI~-~ TRUSTEES ~G John M. Btedemeyet, III, President y~ SUPERVISOR Henry P. Smith, Vice President co Z SCOTT L. HARRIS Albert J. Krupski, Jr. John L. Bednoski, Jr. Town Hall John B. Tuthill tt 53095 Main Road P.O. Box 1 l79 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (516) 765-1823 TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT PERMIT APPLICATION TOWN WETLANDS PERMIT APPLICATION TRUSTEE LANDS PERMIT APPLICATION Office Use Only: Coastal Erosion Permit Application Wetland Permit Application D 0 Trustee Lands Permit Application Grandfather JUL 2 2 M Completed Apps. Date: Variance Required, Tu t~ Neighbors notified Date: TOWN OF-SO UTHOLD SEQRA Type Coord. Review-opt.,mand. Date Rec. by Office Insp. comp./date: SEQRA Determin./date: Public Hearing/date: Findings: Permit Vote: (Y/N): Special Conditions: y^r (also see file) V Application Fee: Application Number; SCT14 #1000- l I I 1 S- / c21/ Project Name (If any) 110 142fk++AA~ Date Prepared: a 0 Applicant Address: J•O. R l11414 Phone ~t (51L) Interest: (owner, c sultant,lessee,etc.) lA Owner of Property: Address 01 Phone ( ) Subject Pro erty Location. -O S- ~AlA. IA.) QUtM ~ (Provide LILCO Pole Distance to cross Streets if not on location map) THIS IS NOT A PERMIT Yds. to be excavated: D Yds. to be filled: - D Manner in which material will be removed or deposited: Hhg Width of canal, creek or bay ronting property: Depth at low tide: Aver. rise in tide: Distance to nearest ch nnel: Distance project extends beyond simil}ar'rprojects in area: N 4 Area zoning: VkA &-f V Land area in acres: •SO Is project for private or business use: Intended use of property: ~FIAA ~Ti ~ a 4.0.1 A0 Describe known prior operations condu ted on premises: /VM UV-Q. Has any prior license or permit been issued to erect structures, dredge, or deposit fill on said premises: / m p Has a~-e-=or t ever been revoked or suspended by a Gover "ehtal Agency: Project Description The p Z~jec_f"description must also include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures (i.e., pipeline and septic system; make additional attachments if necessary). Authorization (Where the applicant is not the owner) I residing at (Print-owner of subject property) (Mailing address-phone) do hereby authorize to apply for Coastal Erosion permit(s) from the Southold Town Trustees Signature THIS IS NOT A PERMIT County of Suffolk ) State of New York ) C ED'KGE -h. UVELL0 A BEING DULY SWORN 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 WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD Or TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(s) OR REPRESENTATIVE(s), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. S NATURE Till SWORN TO BEFORE ME THIS : o DAY OF -70D4 '1993 C SUSAN E. LONG C Nopry Public. State of New York N0.01L04958343 Cua ifiW in Suffolk Coun NOTARY PUBLIC 2, n 4 Pommabokn Expires Naven ber 19.W Suggested space for location Map THIS IS NOT A PERMIT Appendix C Slate Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I Project Information (To be completed by Applicant or Project sponsor) 1 A,Dlicanbfponta, I 1 Pfolecl Nam= VS C O MhpIWE TR CTI E 1 Protect location. Municipality p PL )j SL) FEAU; J 1, ,,,Posed action. 13 New ? Expansion El Modificationialteral.on REPPrI r RE I N Fo P-C E M r-Q -F S Describe protect briefly. -bo lOOr -sa" b Precise location Iroad intersections, pionninnennt landmarks, etc or provide map) v 7 Amount of land anected: O acres -.-Ultimately auef. Initially - a will p "Posed action comply with existing toning or other existing land use tewrctionft Yes ? No If No. describe briefly 9 what relent land use to vicinity of protect Residential ? Industrial ? Commercial- ? Agriculture ? Pafkland,open space ? Other Desusbe.vi 10 Does acti involve a permit. approval, or funding, now or ultimately. Nom any other governmental agency (federal, slate or local)' 9es ? No if Yes, list agencv(s) and pe,mrt,appfovals 11 Does any aspect ofrytp~ action have a currently valid permit or approvals ? Yes J No If %es. list agency name and pamn.apptoval type 11 As . of proposed action will existing permit approval require moddicatwd Yes ? No 1 CERTIFY THAT ~Tr.HE~INFORMATION a PROVIDED ABOVE IS TRUE 100 THE BEST OF An KKNOwLEOCE 7J/;~.a,~~J1~(o~QL ' Applicant sponso, name. A'A IJ I x 1 Date -"J / - Signature. J ' I 41 It the action Is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form belore proceeding with this assessment OVER 1 PART 11 Enylfonmenial AssfisaTnYnl 6.,_,e completed by Agency) A Does action exceed any Type I threshold m b N)CRR. Part 617 11? 11 yet. coordnsare the rev.ew process ano use the ELgt EA7 , ? yet ? No e will action receive coordinated rlvievir U Provided for Unlisted Acluml in 6 NY(RR. Pill 617 77 It No. a negative declaration may be Wperceded by another involved action ? Yes ? No C. Could Action result an ANY adverse effects on, to. or ansing from the following (Answers may, be hand.vnt(en, d legible) Cl Existing it, oualdv, surface o, groundwater Quality or quantity. noose levels, tunm[ traltic pallemS. Solid "sit production or dnpoul, polemist for ommn drainage or flooding woblemd Explain briefly C. Aesthetic, agricultural, archeological, historic, or other natural or cultural resources. or community or neighborhood chara<terl Explain briefly. U. Vegetation or launa.;moverneni of lish or wddide species. sgndreani habitats. or threatened or endangered species? f+Vbrn Irnruv CA. A commumtvl existing plans or goals as officially adopted. or a change in use or intensity of use of land or other natural resources' Exolam briefly C5 Crowth, subsequent development. or related activities likely to be induced by the proposed actiont Explain briefly' C6. Secondarv. cumulative. or other effects nor identified in Cl C61 Explain briefly. C A change in use of either quantity or type of energy? Explain briefly PART III Determinatlon of Significance (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identiiied and adequately addressed. ? Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur Then proceed directly to the FULL EAF and;or prepare a positive declaration. ? Check this box if you have determined. based on the information and analysis above and any supporting documentation. that the proposed action WILL NOT result in any significant adverse environmental Impacts AND provide here, and on attachments as necessary, the reasons supportng this determination, Agency Name ' AlenR PrepLN'a Name Preparers synature. 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S' air rsGy vj! /r9r/ 8 s' ~,srar~N'. i-~sEx B .ai,~oylwE lv~nisueV.?y. //T9o ~rznssrr~d o~.r~.ay 7zzs .t/~ss~v~,vr,~~ ,947715C l°/C?K6S CUTE "Cd", 70Gfi DP OFl`G~'//3Y/.~' To OXMYV6 ~arx.s/ Cry a- 5r~~x Jiff-E~ Z qc Z ?UL~/B-~3 4 E rb `rg- I a ~t~~) 4Z3 ° 8 a t4 02, o ^ 444 5 ale R=G nc i S4 wG 4 OD ~~D~F gp eq N l; Irk q o y ~ Q`~ ~ y ~ ~ 0 4 ~ ~ I~ ~f. ~ ' 4 ~ n U? q Z n IC 4 +~I~ 1 oh o A ; SaoQ I~x~~~1 o~~-q E ` N I C "'j~~'1 1: "w JG ~s I ~m 4~C~it tit ca t: D~ N la ai~ c b 4 ,n q i y i zo i O Q Z t\ 7 T M Ik r a O Lam. tA 4,ik Wet~~.n~~k QC S.d•~o -lou.oo ~o~ jm h { y ~ 1R ul X C ip L11'Tf.25 PFCONJC: uAY - 4 y' AUTHORIZATION FORM bate. a3 ~3 I ~i~APt~,~+d AIXry~,tlrloAt ~2 owner ofS /1//j~SAU /b/A)r Rib Bus ness/proper y name ibcated at dV cHo(;vE' MQ) Yoie/c-- »9~~ do herby give costelio Marine contracting torp& the authority to act ad agent in my behalf in applying for all of the hecessary permits in order for work to be done on my property described above. s gna ure