HomeMy WebLinkAboutTR-7884 James F. King, President ~OF SOUj~, Town Hall Annex
Bob Ghosio, Jr., Vice-President ~O~ 54375 Main Road
P.O. Box 1179
Dave Bergen l~[ l~ Southold, New York 11971-0959
John Bredemeyer G • O Telephone (631) 765-1892
Michael J. Domino ~O ~ Fax (631) 765-6641
~~OOUNiY,~`
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 0838C Date: February 13, 2013
THIS CERTIFIES that the replacement of the existing 60' of bulkhead in-place with an
8' return; replace 4'x4' landing and stairs to beach: a 6' wide non-turf buffer along the landward
side of the bulkhead which is to be subsequently maintained.
At 3825 Camp Mineola Road, Mattituck, New York
Suffolk County Tax Map # 123-5-32
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated June 29, 2012 pursuant to which Trustees Wetland Permit #7884 Dated
August 22, 2012 was issued and conforms to all of the requirements and
conditions of the applicable provisions of Iaw. The project for which this certificate is
being issued is for the replacement of the existing 60' of bulkhead in-place with an 8' return;
r~lace 4'x4' landing and stairs to beach: a 6' wide non-turf buffer alont; the landward side of
the bulkhead which is to be subsequently maintained.
The certificate is issued to ICATHARINA SCHEIDELER owner of the
aforesaid property.
Authorized Signature
Jill M. Doherty, President ~OF ~~Vly Town Hall Annex
James F. King, Vice-President ,`O~ 54375 Main Road
P.O. Box 1179
Dave Bergen l~t ~ Southold, New York 11971-0959
Bob Ghosio, Jr. H Q
John Bredemeyer ~ Telephone (631) 765-1892
Fax (631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: lI'°:U t 3
Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
151 day of construction
'h constructed
Project complete, compliance inspection.
~ 1 -
INSPECTED BY: `J , 7 ti
COMMENTS:
-
J
CERTIFICATE OF COMPLIANCE:
i.
CC # : C1338666
COUNTY CLERK'S OFFICE
STATE OF NEW YORK
COUNTY OF SUFFOLK
I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court
of Record thereof do hereby certify that I have compared the annexed with the original
DECLARATION
recorded in my office on 09/05/2013 under Liber D00012743 and Page 063 and,
that the same is a true copy thereof, and of the whole of such original.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County
and Court this 09/05/2013
~ECEI~E
D SUFFOLK COUNTY CLERK
SEP - 5 2013 ~~-d~- Q. ~~-e-~-
JUDITH A. PASCALE
outholtl Tawn
e
SEAL
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DECLARATION Recorded: 09/05/2013
Number of Pages: 4 At: 12:29:27 PM
Receipt Number 13-0111633
LIBER: D00012743
PAGE: 063
District: Section: Block: Lot:
1000 123.00 05.00 032.000
EXAMINED AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $20.00 NO Handling $20.00 NO
COE $5.00 NO NYS SRCHG $15.00 NO
TP-584 $0.00 NO Notation $0.00 NO
Cert.Copies $5.00 NO RPT $60.00 NO
Fees Paid $125.00
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
?i~
a
Number of pages = - _
_ L 4. 'r C.
t:
This document will be public ~
record. Please remove all
Social Security Numbers
prior to recording.
Deed /Mortgage Instrument Deed /Mortgage Tax Stamp Recording /Filing Stamps
3 FEES
Page /Filing Fee ~ Mortgage Amt.
1. Basic Tax
Handling 20. 00
2. Additional Tax
TP-584 Sub Total
Spec./Assn.
Notation
or
EA-52 17 (County) Sub Total ~ 0 Spec. /Add. _
EA-5217 (State) TOT. MTG. TAX
Dual Town Dual County
R.P.T.S.A.
Held for Appointment
Comm. of Ed. 5. 00 ~i~ ~ Transfer Tax
Affidavit ~ ~ Mansion Tax
r ~ The property covered by this mortgage is
Certified Copy ~ or will be improved by a one or two
NYS Surcharge 15. 00 ' family dwelling only.
Sub Total YES or NO
Other
Grand Total ~ ~ ~ If NO, see appropriate tax clause on
page # of this instrument.
4 Dist. 2565174 1000 12300 0500 032000 5 Community Preservation Fuad
Real Property R DHO A IIIIIIII~~III~IN~INI~II~I~I~ Consideration Amount $
Tax Service 05SEP-13
Agency CPF Tax Due $
Verification
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
/ RECO/RD & RETURN TO: Vacant Land
('/I~GG ! ~ ~~f TD
Cf/Oe~1 n~5.. ~ TD
~j~S~~NG /Lti6!/yt N~ ~C, v ~ TD
Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Com an Information
310 Center Drive, Riverhead, NY 11901 Co. Name
www.suffolkcountyny.gov/clerk Title #
g Suffolk Count Recordin 7~& EndoLrsement Pa e
This page forms part of the attached J~=~G~~i~-1 1. [)1/( made by:
(SPECIFY TYPE OF INSTRUMENT)
~~a Cory'/` .~/e/~e ~/1 ~Q The premises herein is situated in
/~lQ...f.-T~ yid l~~ ~ti SUFFOLK COUNTY, NEW YORK.
7 TO In the TOWN of ~~T~(~f~/®'~
~fi? SD r I y c~ 1~ In the VILLAGE
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
~z-oioa..~a~oakk
(over)
IMPORTANT NOTICE
If the document you've just recorded is your SATISFACTION OF MORTGAGE, please be aware of
the following:
If a portion of your monthly mortgage payment included your property taxes, *you wlll now need to
contact your local Town Tax Receiver so that you may be billed directly for all future property tax
statements.
Local property taxes are payable twice a year: on or before January 10~' and on or before May 31".
Failure to make payments in a timely fashion could result in a penalty.
Please contact your local Town Tax Receiver with any questions regarding property tax
payment.
Babylon Town Receiver of Taxes Riverhead Town Receiver of Taxes
200 East Sunrise Highway 200 Howell Avenue
North Lindenhurst, N.Y. 11757 Riverhead, N.Y. 11901
(631) 957-3004 (631) 727-3200
Brookhaven Town Receiver of Taxes Shelter Island Town Receiver of Taxes
One Indepe~adence Hill Shelter Island Town Hall
Farmingville, N.Y. 11738 Shelter Island, N'.Y. 11964
(631) 451-9009 (631) 749-3338
East Hampl:on Town Receiver of Taxes Smithtown Town Receiver of Taxes
300 Pantigo Place 99 West Main Street
East Hampi:on, N.Y. 11937 Smithtown, N.Y. 11787
(631) 324-2770 (631) 360-7610
Huntington Town Receiver of Taxes Southampton Town Receiver of Taxes
100 Main Street 116 Hampton Road
Huntington, N.Y. 11743 Southampton, N.Y. 11968
(631) 351-3217 (631) 283-6514
Islip Town Receiver of Taxes Southold Town Receiver of Taxes
40 Nassau Avenue 53095 Main Street
Islip, N.Y. 11751 Southold, N.Y. 11971
(631) 224-5580 (631) 765-1803
Sincerely,
~.~.d.,:~. a. ~o.~
Judith A. Pascale
Suffolk County Clerk
12-0104..06/06kd
DECLARATION OF COVENANTS
TH[S DECLARATION made this S~ it, day of ~i'~a"`~- . 20 3 by Philip G.
Milot, Trustee for the Katharina G. Scheideler Trust, (attached) residing at
PO Box 552, 3825 Camp Mineola Rd. Mattituck, NY, hereinafter referred to as
"DECLARANT (S)":
WITNESSETH:
WHEREAS, DECLARANT (S) is/are the owner(s) of certain real property located
on 3825 Camp Mineola Rd, Mattituck, Town of Southold, County of Suffolk, State
of Newyork, described in the Suffolk County Tax Map as District 1000, Section 123,
Block 5, Lot 32 which is more particularly bounded and described as set forth in
Schedule "A"annexed hereto, hereinafter referred to as the Property;
WHEREAS, the Property is situated on lands within the jurisdiction of the Board
of Trustees of the Town of Southold (hereinafter the ('"Trustees") pursuant to
Chapter 275 of the Town Code of the Town of Southold or its successor, and
various activities conducted upon the property may thus be subject to the
regulation and approval of the Trustees prior to being conducted;
WHEREAS, the DECLARANT (S) therefore made application to the Trustees for a
permit pursuant to the Wetlands Law of the Town of Southold to undertake certain
regulated activities; and
WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such
regulated activities, the Trustees required that a 6' wide or wider "non-turf buffer"
adjacent to and landward of the 60' Bulkhead
NOW, THEREFORE, the DECLARANT (S) do/ does hereby consent and agree as
Follows:
(1) Upon the substantial completion of the aforementioned permitted activities
there shall be established and subsequently maintained a 6' wide by 60' long along
the landward edge of the bulkhead a "non turf buffer" as defined by chapter 275 of
the Town Code; and as depicted on the survey/site plan last dated and stamp
approved on 05/22/2012; and
(Z) These covenants shall run with the land and shall be binding on the
DECLARANT (S), his/her, their heirs, assigns, purchasers, or successors in
interest and may only be modified after the public hearing and upon resolution of
the Trustees.
IN WITRNESS WHEREOF, the owner (s) has/have duly executed this instrument
this day of Dt 'e .2013.
_ TRUSTEE' SIGNATURE
STATE OF ~ r tJ ~ >r ~.5 E~f P~r ~ (ijv G• ~/i~oT
ss:
COUNTY OF ~w,~2St i
On the ~ day of 5 ~P ~
~57ER- . in the year 2013, before me the
undersigned, a Notary Public in and for said State, personally
appeared Pw~L~ iP YZ'1, ,,_o z- ,personally known to me or proved to me on the
basis of satisfactory evidence to be the individual whose name is subscribed to the
within instrument and acknowledged to me that he executed the same in his
capacity and that by his signature on the instrument, the individual or the persons
on behalf of which the individual acted, executed the instrument.
I~bq„~_
.Notary Public
\ JOHN A. CUTTING
NOTAR7 PUBLIC OF NEW JERSEY
W COMIAMSSION El~B APRI.2B, ZOt 8
L
I .
A
ALL that cataitt plot pieaa ~ parcel aI land. with the buildutgt sold
inrproveraasUa tltweoo etececd, situate, lyiag and beiag i6 the Taws of '
~ Satdtaid, Cauttq otSnt>*blk std Spate of New York itamded and described ~
es fattaws:
BEGINNING et ¦ point at the Southerly aide of a txutain right-of-+~Y thirty
fret wide, distant South 74°00' West, 182 ket fran the Nord~erly poorer
of cetmin Ymd conveyed by I.cone D. Howell acrd l.rns F. Etowoil, ttie wi&,
to t3ryan S. Catrktirt by decd dated April 15,1426 and racaeded is the
Suffatk Courtgr Clerk's Qffioe ht t.~ar 1 I8T of ~ at page 88;
rwnittg thence Sault 4.24' 20" ~ atottg read now ax fonnctiy of R.G.
lltandel,194.4 fat b the br>fidrad stoat Gtrats Pacaaia Bay: thotrce along
said bulkhead South 74° S t' bleat. 59.68 !ka to land new or fomterly of
Ptter Gray; thentx iYacth 4° Oi' 20' x,154.4 feet to the saudterty side of
said righaof
way ehencc North 74r 4' ~ atoog the SatWrctfx able of said
riglu-af-way 60 feet oa the poinrc or pine of be8'untis~.
TpGE'1'Et6ti with aright-of-wq owr a sMp of Wd 34 fat wee. tht
Southerly tine of which begire at the Nlacfbwest ootttar of cite tend har+dn
described and rune an a cause tJardt 74' 00' fat t?a8 to the Nartheaetaly
comer of dre read baatoforo mentioned as conveyed to Bryant S. Caaklin,
and tlKrtce Nott#twaN ovpranother dsht-of-way 25 Poet wide acterdhtg
t'ratr the Southerly aide of the lust meaiarrcd ag~tt-of-rray W taw Suf~6t
Avenuc.'ilja itst reanieaed right-of-way a+as eataWished by s~wttntt
E3earge a. tieove, Elo,+etxe 8. Reeve and Phebe M. Hollister acrd
recorded Sepxntber 5,144? in the tJfi'~e of the f2eek affix Cautrty of
Suffolk in l.iber 629 of Heeds et page 168. it is wtderstood and t~aeti that
the rtgMs hasht gives vttder the fat raetrtiatod riyyit4~wtpr atttril net
extend Soudt of the Sarah tip of the finK dcsaibed dghcryf-+vay.
gUFFO(,~
James F. King, President ~p9 ~OG~ Town Hall, 53095 Main Rd.
Bob Ghosia, Jr., Vice-President P.O. Box 1179
Dave Bergen W ~ Southold, NY 11971
John Bredemeyer ~ • ~ Telephone (631) 765-1892
Michael J. Domino ~'IOj ~ .~D~~ 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 APRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
Pre-construction, hay bale line
15` day of construction
Yz constructed
Project complete, compliance inspection
BOARD OF SOUTIIOLD TOWN TRUSTEES
SOUTHOLD, NEW YORK
PERMIT N0.7$84 DATE: AUGUST 22, 2012
ISSUEi) TO KAr,TIIARINA SCHELDELER
PROPERTY ADDRESS: 3825 CAMP MINEOLA RD. MATTITUCK
SCTM# 123-5-32
AUTHORIZATION
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold'and in
accordance with the Resolution of the Board of Trustees adopted at the meeting held on August 22! 2012, and
in consideration of application fee in the sum of $250.00 paid by Katherina Scheideler and subject to the Terms
and Conditions as stated in the Resolution, the Southold' Town Board of Trustees authorizes and permits the
following:
Wetland Permit to replace existing 60' of bulkhead in-place using vinyl
sheathing with an 8' return and backfill with 140 cubic yards clean sand; replace
existing landing with a 4' x 4' landing; replace existing stairs to beach; with the
condition of establishing and subsequently maintaining a 6' wide non-turf buffer; and
as depicted on the project plan prepared by Philip G. Milot, received on June 29, 2012
and stamped approved on August 22, 2012.
i IN WITNESS: WHEREOF, the said Board of Trustees hereby causes its Corpprate Seal to be affixed,
and these presents to be subscribed by a majority of the said Boazd as of this date.
t~
~FF~,~Z,~ b Ghosio, Jr. - A sent
'
~ ~
vit~~ i
i
TERMS AND CONDITIONS
The Permittee Katharina Scheideler residino at 3825 Camn Mineola Road Mattituck, New
York as part of the consideration for the issuance of the Permit does understand and prescnbe
to the following:
1. That the said Board of Trustees and the Town of Southold aze 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 Southold.
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 Pennittee 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 umeasonable 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 Southold require the removal and/or alterations in
the location of the work herein authorized, or if, in the opinion of the Boazd 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 pertrrit has been
recorded with the SufYolk Countk Clerk's Office as a notice co~rc8irtt and deed restriction
to the deed of the Subject parcel. Such evidence shall be providelhvi~tiin rtinety (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 alt 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 ~~OF SO(/j~o Town Hall Annex
Bab Ghosio, Jr., Vice-President 54375 Main Road
P.O. Box 1179
Dave Bergen l~i * Southold, New York 11971-0959
John Bredemeyer G Q
Michael J. Domino ~ ~0 Telephone (631) 765-1892
~~~.COU~'~~ Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
August 22, 2012
Mr. Philip G. Milot
140 Woods End Drive
Basking Ridge, NJ 07920
RE: KATHARINA SCHEIDELER
3825 CAMP MINEOLA ROAD, MATTITUCK
SCTM# 123-5-32
Dear Mr. Milot:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, August 22, 2012 regarding the above matter:
WHEREAS, Philip G. Milot on behalf of KATHARINA SCHEIDELER applied to the
Southold Town Trustees for a permit under the provisions of Chapter 275 of the
Southold Town Code, the Wetland Ordinance of the Town of Southold, application
dated June 29, 2012, 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, the LWRP Coordinator issued a recommendation that the application be
found Consistent with the Local Waterfront Revitalization Program policy standards,
and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on August 22, 2012, 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,
z ~ .
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 have found the application to be Consistent
with the Local Waterfront Revitalization Program, and,
RESOLVED, that the Board of Trustees approve the application of KATHARINA
SCHEIDELER to replace existing 60' of bulkhead in-place using vinyl sheathing with an
8' return and backfill with 140 cubic yards clean sand; replace existing landing with a 4'
x 4' landing; replace existing stairs to beach; with the condition of establishing and
subsequently maintaining a 6' wide non-turf buffer; and as depicted on the project plan
prepared by Philip G. Milot, received on June 29, 2012 and stamped approved on
August 22, 2012.
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,
r
Ja es F. King
President, Board of Trustees
JFK/amn
~o~,a~Fwc~-~~~
James F. King, President y ~ Town Hall Annex
Bob Ghosio, Jr., Vice-President p ~ 54375 Route 25, P.O. Box 1179 '
Dave Bergen .y ~ Southold, NY 11971
John Bredemeyer ~d
1 ~ ~ Telephone (631)765-1892
MichaeU. Domino Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
To: Ph~`lir~ G. MI`Icrl- ~h~ll.-~' o-F ~~~~,y~a~.Jeler
Please be advised that your application dated 2 D has been
reviewed by this Board at the regular meeting of 2 D and
your application has been approved pending the cor aletion of the following items
checked off below.
Revised Plans for proposed project
Pre-Construction Hay Bale Line Inspection Fee ($50.00)
15` Day of Construction ($50.00)
Constructed ($50.00)
Final Inspection Fee ($50.00)
Dock Fees ($3.00 per sq. ft.)
Permit fees are now due. Please make check or money order payable to Town of
Southold. The fee is computed below according to the schedule of rates as set forth in
Chapter 275 of the Southold Town Code.
The following fee must be paid within 90 days or re-application fees will be necessary.
You will receive your permit upon completion of the above.
COMPUTATION OF PERMIT FEES:
Final TnSpec-h'on -~SD.bD
TOTAL FEES DUE: $ SD . D ~ ~ ~
q~~3(~z
BY: James F. King, President
Board of Trustees
Katherina Scheideler
3825 Camp Mineola Rd., Mattituck
SCTM# 123-5-32
817 512012
~
~ ~ `
ur
_ p
i
_ -
- r ~
_ i ~ ~
wti A ~
_ ~
- - l _ f.- - ~ -
,1:i . r 1 's, "fem.;--a~~~~ t
~'.y~ ~
_ a
~
,7~~'?F1 ~l1 b~.d
W.. ~ L f•
• ~o~gpPFD(,~c •
Peter Young, Chairman ~ ~ Town Hall, 53095 Main Rd.
Lauren Standish, Secretary ~ ~ P.O. Box 1179
Southold, NY 11971
~~l ~ Telephone (631) 765-1892
Fax (631)765-6641
Conservation Advisory Council
Town of Southold
At the meeting of the Southold Town Conservation Advisory Council held Wed., August
15, 2012 the following recommendation was made:
Moved by Doug Hardy, seconded by William McDermott, it was
RESOLVED to SUPPORT the Wetland Permit application of KATHARINA SCHEIDELER
to replace existing 60' of bulkhead in-place using vinyl sheathing and backfill with 140 cy.
clean sand.
Located: 3825 Camp Mineola Rd., Mattituck. SCTM#123-5-32
Inspected by: Audrey Horton, Doug Hardy
The CAC Supports the application with the Conditon of a 15' non-turf vegetated buffer.
Vote of Council: Ayes: All
Motion Carried
6
~gU4~FFpt~'
lames E King, President ~'QV C~, P.O- Box 1179
Bob Ghusin. Jr., Vice-Pres'idenl ~ Oy Southold, NY 11971
Dave Bergen y ? Telephone (631 765-1892
John Bredemeycr ~ ~ Fax (631) 765-6641
Michael J. Domino
y~o~ ~ Sao
Southold Town Board of Trustees
Field Inspection/Worksession Report
KATHARINA SCHEIDELER requests a Wetland Permit to replace existing 60' of
bulkhead in-place using vinyl sheathing and backfill with 140 cy. clean sand.
Located: 3825 Camp Mineola Rd., Mattituck. SCTM#123-5-32
Tyge-of area to be impacted:
-Saltwater Wetland -Freshwater Wetland -Sound -Bay
Distance of proposed work to edge of wetland
~f Town Code propose work falls under:
_Chapt.275 Chapt. 1 -other
Type of Application: Wetland -Coastal Erosion -Amendment
_Administrative_Emergency Pre-Submission Violation
Info needed: ~
nec~ -~1~,~ f ~U C ti ~~~C'
Modifications:
Conditions: ~7 ~~r/~ T ~y /J`~L~~nr~'1 r f~,,,l„1 ~
Pre~erR"Were: ~ Kin~6. Ghosio ~D. Bergen,
J. Bredemeyer Michael Domino D. Dzenkowski other
Form fille.¢.out jp~~~~
Mailed/Faxed to:
Date:
•
i Y k r ~
Y J~
~ i '7 Y
~ ~
r . ~ ' ~r
= _
-r~_ q
1~
i
~
'Y - ,1
~ ~ ~ l'~
Y ~ , w
d ;i
.#x~ J 1 ~y pis: + ~ :ii ~1 t a "y~ ,~r,
~ - fir ~ ,
L ' t'r` r r
. J.
X`.•~e
1
- -
j
e. ~
r'
jt i
i 1 I"
~1 ) a ;f
_ ~I ~ I I, ~
,y~ 1
, _ I _ ~ N 1t( ~ /
i S.
sF' ( gy`, .ITS`. .
1
7 '
~ ~ ~1
` 1
~ 1
~ ~ ~f
] l 1
~I f
~~l, .
d~,~ ti
~i~
' ,1 a,.aCa. ~
~
1 ~
,
. c- i ,T
y efw
74. _
~e ~ r « ~ LY x a,
/ + r ~
r
~r,.,_ - ~ _ - - _ -
-
r ~
i yy
1 ! u. _ 04 a~~a ~ S
, ~ ` , , ~ ` f
~ , sir.. ; ~ ~
_ ,
r
- Y
_
•
Higgins Marine Construction, Inc.
docks bulkheads floats stairs
P.O. Box 748 Greenport, NY 11944
631-655-5595
June 8, 2012
Mr. Phillip Milot
3825 Camp Mineola Road
Mattituck, New York ~ ,
Re: Bulkhead Proposal
Dear Phil,
Thank you for the opportunity :o bid on this project. Higgins Marine Construction, Inc. proposes
removing and disposing of the existing 60'of bulkhead. In its place construct a new 60' vinyl bulkhead
and 12' return using C-Loc 9900, 10" butt CCA piles 6' on center and three tiers of 6" x 6" CCA whalers.
The backing system will consist of 10" butt CCA lay logs, 8" butt CCA deadmen and 1" tie rods. The
bulkhead will be capped using 5/4" x 6" cedar. All hardware will be hot dipped galvanized steel. The
following are the specifications of the material to be used on the new bulkhead.
14' C-Loc 9900 vinyl sheets
16' 10" butt CCA piles
6" x 6" CCA whalers
8" butt CCA deadmen
10" butt CCA lay log
6/4" x 6" cedar cap
i" galvanized tie rods
galvanized bolts
The cost to remove existing bulkhead and construct a new CCA and vinyl bulkhead is $372.00 a linear
foot for a total of $22,320.00 and 12' return at $300.00 linear foot for a total of $3,600.00. The total
cost for bulkhead and return is $25,920.00.
Higgins Marine Construction, Inc. proposes constructing a new cantilevered 4' x 4' platform with
handrails for the cost of $945.00.
There is no planting of any kind included in this estimate. Permits are the responsibility of home owner.
Please call with any questions.
Respectfully,
Dan Higgins
Higgins Marine Construction, Inc.
Suffolk County Contractor License #46908-H
Town 13a11
Albert J. Krupski. President ti~~~o~ TyO~ 53095 Route 25
James King, Vice-President ~Sp p,p, Bo~c 1179
Artie Foster ~ ~ Southold, New York 11971-0969
Ken Poliwoda
Peggy A. Dickerson • Telephonel831)786-1892
Faz(9311796-6641
~
BOARD OF TOWN TItU3TEEt3
TOWN OF SOUTHOI.D
E
~ -
Date Sept. 20, 2005
# 0061C -
THIS CERTIFIES that the first and second floor additions to dwelling
At 3825 Camp Mineola Rd., Mattituck
Suffolk Counn• Tax Map # 123-5-32
Conforms to the application for a'Frusdees. Permit heretofore flied in this office
5872 Dated 2/25/04
Dated 2/4/04 Pursuant to which Trustees Permit #
Vas issued, and conforms to all of ttre requirements and conditions of the applicable
provisions of law. The project for which this certificate is being issued
is for a first and second floor additions to the existing dwelling
The certificate is issued to _ Clans scheideler owner of the
aforesaid property.
Authorized Signature
• FORM N0. 4 .
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
No: Z-31259 Date• 11 04 OS
THIS CHRTIPSBS that the building ADDITIONS ~ ALTERATIONS
Location of Property: 3825 CAMP MINEOLA RD MATTITVCK
(HOUSE N0.) (STREET) (HAMLET)
County Tax Nap No. 473669 Section 123 Block 5 Lot 32
SY~bdivision Filed Nap No. Lot No. ,
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DUNS e, 2004 pursuant to which
Building Permit No. 30400-Z dated JUNE 15, 2004
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to HANS & BRIDGET SCHEIDSLER
(OWNER)
of the aforesaid building.
SQPPOLK CODHTY DSPARTMD~PP OP HEALTH APPROVAL N/A
rxr.arraTCAL CSRTIFICATH NO. 2038019 06 13 OS
PLDl~BSRS CgRTIFICATION DATED 10 18 05 WILLIAM GREMLSR
Au horized Signature
Rev. 1J81
~aw
~ ~.~e.......xe.... xort6E COUNTY OF SUFFOLK ~ ~ ~a sau ~xw.
......tee
^-'1. E ~~a.. m-, s -t g. rte.
qww - SFt xo. ns E sc ru
mOIO SFE YL xO ux
,61DW mW xNrGx~ _ uME ~ Y~ W.KA ' ~ _ ~ ,aa xS
ao: sEa~~xo. x ° E OP. 4 \
ai
i s rm
° e v _
x,a 1 y~ m. ~ .x.Wq ~ ~1Wq vWq ~
„ M m ~ xWq N
as rgxPq~xq
=EE~ x~ ~ _ ,,E ~ o .
s
~ Hamm. 4 x mw~ r I
' ,a m r w ro .o..~.~. _ cM~Ex 9 a
~ ,M
vn. Q vx 85 R x ~ 'n1 s o ,Yr ,x?/' ~
y` p ` i/ 4
!D, 'y Q2 xa x ,r ~ ~ p.
u ,M y typ ; n .y4 Q.
y s H . Otx m Yp
s ~~{q y p `y NP vJlq : 9a i ? M1~ 9 i. /
g p J p ~ xV
~ , ~ ~e ~ •
a i.
!w ~ " fix. , °~Y,~ a^ m
a
sar n v v~~ °
p+` ~pµcl
e
W
VmHO ,9Mq
a m
n ~ n
~,M~
e ~
1M ~ ~
~ /i
PEA! Y~`9,P ~wv
ex!xq 6 ,iM° 6 a P m J /
.Q~° y iiMq l.M\ J. j..
II, M, P ~
p m
Yy mm1 ye s
a f ° i
V -
n ~
OO / ?x
,c° / ' • q
:a,! 'n% ~ ~ s ~9. ~ MY/ GREAt ~L~IC ~Y ~ •
rob j
° . ~1
j.
s
O secrxw xo
xoricE COUNTY OF SUFFOLK C i °
, ._x. ~xii O ~ m ReaI Pn ~M1y
T.~ aServ;~~RrtcY + ,oxM 123
E asu~.. a.. _ a__ w~~--n~_- ewn ...~.Maer x M
ry...~~.~. ti= s.~ Y v.eu . o.. . ~ e CTS P iv x~ru ,°°0 P0.0PEPtt NAP
OFFICE LOCATION: ~~OF SOUjyO MAILING ADDRESS:
Town Hall Annex h0 l~ P.O. Box 1179
54375 State Route 25 .IL Southold, NY 11971
(cor. Main Rd. & Youngs AveJ T T
Southold, NY 11971 G Q Telephone: 631 765-1938
'.2 ~ ~0 Fax: 631765-3136
~~y00UNT'1
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
~ f~ 7
MEMORANDUM ~1-- ~I
1~~~~
~'s AUG - 9 2012
To: Jim King, President ~;h;;,;;a
i;,~~ ~
Town of Southold Board of Trustees so~~d m irustaes
From: Mark Terry, Principal Planner
LWRP Coordinator
Date: August 9, 2012
Re: Proposed Wetland Permit for KATHARINA SCHEIDELER
SCTM# 1000-123-5-32
Philip G. Milot on behalf of KATHARINA SCHEIDELER requests a Wetland Permit to replace
existing 60' of bulkhead in-place using vinyl sheathing and backfill with 140 cubic yards clean
sand. Located: 3825 Camp Mineola Road, Mattituck. SCTM#123-5-32
The proposed action has 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 the proposed action is CONSISTENT with the LWRP review provided
the following best management practices are required if the action is approved:
To further Policy 5: Protect and Improve Water Quality in the Town of Southold and Policy 6;
Protect and Restore the Quality and Function of the Town of Southold Ecosystem it is
recommended that the Board;
Require that the applicant establish a 15' wide landscaped buffer landward of the
bulkhead (excluding the paver patio area).
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
i
James F. King, President ~~Of S~UTyO Town Hall Annex
Bob Ghosio, Jr., Vice-President ,`O l~ 54375 Main Road
P.O. Box 1179
Dave Bergen 1xI # Southold, New York 11971-0959
John Bredemeyer
Michael J. Domino ~ ~ ~0 Telephone (631) 765-1592
~yCOU~'~~ Fax (631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
_Coastal Erosion Permit Application
_?Wetland Permit Application AdminisVative Permit
_Amendment/Tran fer/Extension
?'Received Applicationf ~
Received Fee:$ ~ $ O . ~
Completed Application
Incomplete
_SEQRA Classification:
Type IType IIUnlisted
Coordination:(date sent) ~ 2Q~Z
?LWRP Consistency Assessment Form ~ I3f '1 ~~~eJ 2
,/CAC Referral Sent-=-~~
,,Hate of Inspection: 1 _ -
Receipt of CAC Report:
Lead Agency Determination:
_Technical Review:
.Public Hearing Held: ~ 1
Resolution:
Name of Applicant Th !a' R i ~?A ~ k ~ ~ l~ iy 12
Address ~O ~e-.. /1~~ rli j-?clf ~J ~ I 1 ~ !'L
Phone Number:( ) r: 2 ~t F 7 .3 7
Suffolk County Tax Map Number: 1000 - ~ ~ j - - 3 L
Property Location: 3 ~ J~ N+/" /1i~'.~LO lI~ n J ~h /`!'7 T~C'y
~o/g rs2 /Dan' r'u K2/4~f 7oy ' 7'u vlt T? 1L r..c,cw
(provide LILCO Po/le distance to/~cross streets, and location)
AGENT: ~~:I /I~ G. i~/. ~e~ - V~Y~'~L ~dW~~c.- h~~'~c1tA..t~~
(If applicable)
Address: /~d Gt>vDA!' ,C=.~ I~ /'2 /3/~ tftia/ G r1~ J~ t
N/%t.J ,]-iji~Le. f O 7 ~ 2 p Phone: O S ` ~ T" ~ - / 17
cam) sug - 3i3 d/ T ~
~ 1
So~ of Trustees Application •
GENERAL DATA
Land Area (in square feet): 9' C 0 0
Area Zoning: 2~.T/ ~Jlfi~/ T/ I3 C
Previous use of property: ~ Q ri d ~ ~ 1l A C
Intended use ofproperty: /Z/L ~ 7/~~a+ T!/~'~
Covenants and Restrictions: Yes No
If "Yes", please provide copy.
Does this project require a variance from the Zoning Board of Appeals Yes !i No
If "Yes", please provide copy of decision.
Will this project require any demolition as per Town Code or as determined by the Building
Dept. Yes ~No
Does the structure (s) on property have a valid Certificate of Occupancy Yes No
Prior permits/approvals for site improvements:
Agency D e
17rz~i,r) ~3C~r/Nyc ~H
~~~,nr-
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 if necessary): R,rip~ e„~J G
Bo~ of Trustees Application •
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:?
`p//fG I £x irTiN ~ /.TyGK` t¢~
Area of wetlands on lot: ~~/a square feet
Percent coverage of lot: /I/~/a
Closest distance between nearest existing structure and upland
edge of wetlands: /y~i5~ feet
Closest distance between nearest proposed structure and upland
edge of wetlands: N~I'~ feet
Does the project involve excavation or filling?
No Yes
If yes, how much material will be excavated? cubic yards
How much material will be filled? ~'J'`~ cubic yards
Depth of which material will be removed or deposited: feet
Proposed slope throughout the area of operations:
Mann!e~r in which material will be removed or deposited:
U ~ 1i.9?~
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):
N~A
Bo~ of Trustees Application •
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity: ! ~ l~~s'~c z /1~Gcl~c~-r- ~ /i~fi~/~~-~~~~
Are wetlands present within 100 feet of the proposed activity?
No Yes
Does the project involve excavation or filling?
No Yes
If Yes, how much material will be excavated? (cubic yards)
How much material will be filled? rya (cubic yazds)
Manner in which material will be removed or deposited:
Describe the nature and extent of the environmental impacts to the subject property or
neighboring properties reasonably anticipated resulting from implementation of the project as
proposed, including erosion increase or adverse effects on natural protective features. (Use
attachments if necessary)
~t//iv~
James F. King, President ~OF SO(/jy Town Hall Annex
Bob Ghosio, Jr., Vice-President O~ ~l 54375 Main Road
~ ~ P.O. Box 1179
Dave Bergen ~ J~f Southold, New York 11971-0959
John Bredemeyer N ~
Michael J. Domino ~ ~ ~O Telephone (631) 765-1892
p~yCOU~'~a Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
30-YEAR MAINTENANCE AGREEMENT
EROSION PROTECTION STRUCTURES
CHAPTER 111-15 OF THE SOUTHOLD TOWN CODE
The owners of record of property at: 3 fi ~ ~ G
c~fi.-~ ~Ti~~/~" /`'0.
SCTM#1000- i~ 3 ~ 1 3'L~
in applying for a Coastal Erosion Permit for an erosion protection structure do hereby
agree to a 30-Year Maintenance program for a structure as described:
Cc(GJ ~,~~j
as shown on the attached licensed survey and/or site plan for the approved structure.
It is my/our understanding that we are to maintain this structure with materials designed
to endure 30 years and/or equivalent to the original approved structure. Any
maintenance which involves more than 50% of the length of this structure requires
approval of the Board of Trustees. We further understand that failure to maintain the
structure could result in a requirement to post a bond and/or have the repairs ordered as
alien against the property upon a finding by the Board of Trustees that said lack of
maintenance would risk life, property or important natural resource features.
/ - /)/~oA~_
-
Notarized signature of owner of record
No ary
CAR INE RITZER
NOTARY PUBLIC ~ NEW JERSEY
MY Commis~;nn Expires June 15, 2015
This maintenance agreement shall only be valid upon the attachment of a licensed land
survey/and or site plan made within one year of the original construction and validated to
show the final approval of the administrator.
• sizzo • SEAR
PROJECT ID NUMBER APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor)
1. APPLICANT f SPONSOR r ~ 1/J r1i O ~ 2. PROJECT NAME
Fo /i
ji?~1/r~a p .(1 s~ Bs/ rn- ~ 6 ! r/.~-~ O~c p/.o~ c/~ H.E
3.PROJECT LOCATION: r^
Municipality ~ /~?v~ County / ~ F~~/
4. PRECISE LOCATION: SVeet Addess and Road Intersections, Prominent ,landmarks etc -or provide maD /
3fr?s' Q/?M~/Jfiw/~orc~0 2~~ A7r~rTi9'~~ /od/C /ued ?+r
KtiA?r R~} ; 1 v e' ~ aL t S?~c ~ ra .v rl.,/ r? r~'Cv~-~t ~
5. IS PROPOSED ACTION : New ~ Expansion ~ Modification /alteration
6. DESCRIBE PROJECT BRIEFLY:
~PI~~, o,¢T/~ 7`b+ hy/b/,pct /fzc,.vG ,JvLrl ~s.r~tJ
7. AMOUNT OF LAND AFFECTED:
Initially acres Ultimately acres S x I/~ J?LL(~
S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
Yes ? No If no, describe bdeFly:
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.)
Residential ~ Industrial ~ CommercialAgriculture ~ Park /Forest /Open Space ~ Other (describe)
I
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL ~
A,G-E,N~CY (Fetleral, Slate or Local)
~ iTres ~ No If yes, list agency name and permit /approval:
CJ / G
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
Yes 1-1116 If yes, list agency name and permit /approval:
1f2'. ~A"S AR_E,I,SIUQ~ OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
LJres L~'I~FJO
I CERTIFY THAT THE INFORMATION PROVInDED ABOVE IS TRUE TO /THE BEST OF MY KNOWLEDGE
Applicant /Sponsor Name ~/~~'~//jT ~ ~v/4" ~dA- ~//-Tir /~nr{./A/~ Date: `/3~ ,L
Signature SG~ S /t7 r/r~
If the action is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment
PART II -IMPACT ASSESSMENT To be tom leted b Lead A enc
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL FAF.
Ves ~ No
6. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative
tleGaration may be supersetletl by another involved agency.
Yes ~ No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwrttten, if legible)
C1. Existing air quality, surface or grountlwaler quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
C2. Aesthetic, agrtcultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain brefly:
C3. Vegetation or fauna, fish, shellfish or wiltllife species, significant habitats, or threatened or endangered species? Explain briefly:
C4. A community's existing plans or goals as oRCially adopted, or a change in use or intensity of use of land or other natural resources? Explain Driefly~.
C6. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:
C6. Long tens, short term, cumulative, or other effects not idenfifietl in Ct-C5? Explain briefly:
C7. Other im acts inclutlin than es in use of either uantit or t of ener ? Ex lain briefl
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA CEA ? If es, ex lain briefl
Yes ~ No
E. IS THERE, OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? It es ex lain:
Yes ~ No
PART III -DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: Foreach adverse effeclidentified above, determine whe[herit is subslantial,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 identified and adequately addressed. If question d of part ii was checked
yes, the determination of sign~cance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
Check this box if you have identifietl one or more potentially large orsignificent adverse impacts which MAY OCCUr. Then proceetl tlirectly to the FUL
EAF antl/or prepare a posifive declaration.
Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actin
WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi
determination.
Board of Trustees p /91/(r / D ~-a/
Name of Lea/tl 'Agency J Dale
J ~ ~ r- s F 1 \ / ~f President p
Pri or Type Name of Responsible Offi in Lead Agency Title of Responsible Officer
ignature of Responsible Officer in L Agenq Signature of Preparer (If different Trom responsible officer)
e~k Town of Sout old
~ ~ Erosion, Sedimentation 8 Storm-Water Run-off ASSESSMENT FORM
~ PRDPERTY LocArloN: s.c.r.M. s: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
~4( ~ STORM•WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN
u-6
trio saMTon 'g1Ti -
o~ CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
SCOPE OF WORK -PROPOSED CONSTRUCTION ITEM # /WORK ASSESSMENT Yes No
a. What is the Total Area of the Project Parcels? t~0 ~ a f
(Include Total Area of all Parcels /opted within ~ Will this Project Retain All Stone-Water Run-Off
the Scepe of Work for Proposed ConsWction) ~ I Generated by a Two (2") Inch Rainfall on Sfte? - ?
(s F / Aces) (This item will include all runoff created by site
b. What is the Total Area of Land Clearing clearing and/or constmdion activities as well as all
and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of
construction activity'? impervious surfaces)
(S.F./Aces)
2 Does the Site Plan and/or Survey Show All Proposed a
PROVIDE BRIEF PRO]ECI' DFSCRD'710N (Predd. AadlnNw Page. asNwtletl) DreinageSWctures lrMicating Slze&Locetion7 This
Item shall include all Proposed Grade Changes and
n' tP~.9 GtA~i L~ t S r/a?G Slopes Conholling Surface Water Flow.
* 3 Does the Site Plan and/or Survey describe the erosion
~t/ Gr/~ ~i s.~ ~ L/ P~/j' G£' and sediment control practices that will be used to ? ?
control site erosion and storm water discharges. This
G-2iay` /,I,Z ~ (~!(J C ~ item must be maintained throughout the Entire
a Construction Period.
i i
i) ~ t 4 Will this Project Require any Land Filling, Grading or ? -
Ezcavation where there is a change to the NaNral
Existing Grade Involving more than 200 Cubic Yards
of Material within any Parcel?
rj Will this Applicetion Require Land Disturbing Activities
Encompassing an Area in Excess of Five Thousand ? f?
(5,000 S.F.) Square Feet of Ground Surface?
s Is there a Natural Water Course Running through the ? -
Site? Is this Project within the Trustees jurisdiction
General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or
Submission of a SWPPP is required for all Constmclion aclivides involving soA Beach?
disturbances of one (t) or more acres; inGUding disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes ? -
arepan of alarger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to t~
inWdirg Conslmclbn activities involving sod disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance?
the DEC has determined the/ a SPDES Demut is required far storm water discharyes.
( SWPPP's Shall meet tM Minimum Requirements of the SPDES General Permit $ Will Driveways, Parking Afeas or Other Impervious ~
for Storm Water Discharges from ConsbuMion aetivly • Permit No. GP-0.10-0Ot.l Surfaces be Sloped to Direct Storrs-Water Run-Off
1. The SWPPP shall ba prepared prior to the submittal of the NOI. The NOI shall be into and/Of in the direction of a Town right-of-Way?
submitted to the Department prior to the commencement of construction activity.
z. The SWPPP shall describe the erosion and sediment conud pmdices and where 9 Will this Project Require the Placement of Material, ~
requiretl, postconslmction storm water management practices that vnll be used andmr Removal of Vegetation and/or the Construction of any
constructed to reduce Me pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder
compliance with the terms and conditions of this permit. In addkion, the SWPPP shall Area? (this Item will NOT Irrcluda Ne Insbllapon W Ddvswry Apror,a.)
identify potential sources of poAulion which may reasonabty be expected to affect the '
quality of stone water discharges. NOTE: If Any Answer to Ouestlons Ona Nrough Nitre h Answered with a Check Mad
3. All SW PPPS that require Me poslconslroclion storm water management practice to a Box and me mnsWCtlon site disturbance is between 5,000. S.F. A 1 Acre in area,
component shall be prepared by a qualified Design Professional Licensed in New Vod a Sbrm-Water, Grading, Drainage 8 Erosion Control Plan la Required by the Town of
that is knowledgeable in Me principles and practices of Storm Water Management. Southold and Must be Submitted for Revtew Prior to bauanee of Arry BulWing Pemrk
(NOTE: A Cheri Mark and/or Amwer for each puestion is Required for a Complete Application) '
SPATE OF NEW YORK, ~
`COUNTY OF SS
That I, ..~^C /~....~~~~r being duly sworn, deposes and says that he/she is the applicant for Pemtit, I~
(Name of intlivitlual signing Document)
And that he/she is the t
(O.vner, Conbaclw, , Coryorete Officer, etc)
Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to I'
make and file this application; that al( statements contained in this application are true to the best of his lutowledge and belief; and
that the work will be performed in the manner set forth in the application filed herewith.
Sworn to before me this;
N~tatyPttblie : ~ ~d
CAROCECA(NEi217Z€R
ERSEY (Signature of Applignt)
FORM - 06/10 ~,E~~;DnFzpires.hxtel5,
o~suFFa~~.~,
James F. King, President Town Hall, 53095 Main Rd.
Bob Ghosio, Jr. ,Vice-President ~ P.O. Box 1179
Dave Bergen Oy Southold, NY 11971
John Bredemeycr 0 Y Telephone (631)765-1892
Michael J. Domino ~1T Fax (631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application of
KATHARINA SCHEIDELER
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
~h ~ ~ ~ ~~~gAFFIDAVIT OF POSTING
F L~/"L ~
l~;rirhrtnjivl~l~c~~/t/cn,residingat/dba 3 8~5' ~"'~i-,~ ~Ji-v/?i3 ~-o<
1~l/~~i T./ -c, N ~/91'L
being duly sworn, depose and say:
That on the Oday of , 20I~.I personally posted the property known as
by placing the Boar of Trustees official poster where it can easily be seen, and that I have checked
to be sure the poster has remained in place for eight days prior to the date of the public hearing.
Date of hearing noted thereon to be held Wed., August 22, 2012.
Dated: •y/3 0//2. '
`
(signature)
Sworn to before me this
~p dayof~,6i 20/~
Notary Public
PATRICIA RICHERT
Notary Public State of New York
No.3~-4141154
Cualified in Nassau / Suffo Cou ties
Commission Expires ~p~3/~/~Y
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAII, RECEIPTS
Name: Address:
~3o~s ~ti~~nitirri ~~7~2~' Pv ~~z Gvu ,,lry~a.urtr[//L If9~F6
/~C ~L~'~j-I ~n c ~t- 3 ~ ~ f' ~rz'-~-/~ /A'~~ Ec%a tid ~~f'~f'/7~'l-~/'/ ^'Y
,EJti~ ~ ~C dvvn~`!r j /Zvc~/u/l( r!5'~''z
jd s,.Vr.. r « r.....
^'7 ~~s_ jo
/VD~Yrc .r~-- fi~Y1'k/fG~}-uG/ .17i ~J~r C ~ P. L.~rn(. r7,' fwGi ~.y H 9 ~i
~X... /ZCr L4. /~~~[~'r G /~(L/SuT" S /KT l~ G P'[ k G~~..i .cy il7yls
T6i~.v /JOiw,(~~ / d Crf ~~.-01/wor,~9 ,F]n, W h'.S~ /~-j-l-,~ s:..j'
`/f-i y
STATE OF NEW YORK
COY OF SUFFOLK
(JAG C. ~+r./rr~ ~Ao/1 f~K- ~p
l/n~4i .~-n.:c. ry /'~4 ®~G~- ,residing at ~ Y ~ ti e.•o y a r ~E.-r ~ ~w ~~rlfi~,' ~
~'.__L o 74 Z ~ ,being duly sworn, deposes and says that on the
3 , .-c day of „20~ deponent mailed. a tme copy of the Notice
set forth in the Board of rustees 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 ol'the Town of Southold; that said Notices were mailed at.the.United States Post.
Office athr/tv/7Y"r.~J . ti~ ,that said Notices were mailed to each of
said persons by -
(certified) (registered) mail.
j
Sworn to before me this ' U
?ay of 20
(A-~-t~t/
t//l~c-~~C~C-c-~~GLt
Notary Public
PATRICIA RICNERT .
No!:.,ry Puhlic State of New York
No.3b-4741154
llualifie { in Nassau / Suffo Co ties
Camp ~sion Expires
Bo~ of Trustees Application •
County of Suffolk
State of New York
/ ~U~~~ d'~ltn-
C fll,~r ~`j-TFili•,,vi~?- 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 ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR
REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
ignature
SWORN TO BEFORE ME THIS~_DAY OF ~y~ ,20~
Nota 1'
CAROL ELAINE RITZER
NOTARY PUBLIC OF NEW JERSEY
My Commis~inn E'xneres June 15, 2015
Bo~ of Trustees Application •
AUTHORIZATION
(where the applicant is not the owner)
I, ~t~~Aj~.~,v/i ~~i5 4~~Qs rzti residing at o /f d x S" .l~Z
(print owner of property) (mailing address)
/h!g-~
T,/~ ~ //9~'`~ do hereby authorize ~ ~ ~ - rh ~ / 6 / ~
' (Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
(Owner's signature)
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the Dart of town officers and emrlovees. The ourpQSb of - it
this form is to provide information which can alert the town of possible confltcts of mteres[ and allow rt to take whatever actwn is
necessary to avoid soma / r /
YOUR NAME: ~~i I/A /O/ ~I K/j Tw /'!'/L r •yj4 J C~ fit ®!~C/L
(Last name, fits[ name, rpiddle initial, unless you are applying m the name of
someone else or other enfity, such as a company. if so, indicate the other
person's or company's name.) 'I
NAME OF APPLICATION: {Check all that apply.)
Tax grievance Building
Variance Trustee ? ~
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
~
(~fhOther',nametheactivity.) $~'r'r~ cAA Rem//tc6 ~1Lri%y ~~N~~~'c t
Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship wiih any officer or employee
of the Town of Southold? "Relationship" includes by blood, marriage, or business interest "Business in[erest° means a business,
including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation
in which the town officer or employee owns more than 5%of the shares.
YES NO
If you answered "YES", complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself (the applicant/agent/representative) and the [own officer or employee. Either check
the appropriate line A) through D) and/or describe in the space provided.
The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply):
_A) the owner of greater than s% of the shares of the corporate stock of the applicant
(when the applicant is a corporation);
B) the legal or beneficial owner of any interest in anon-corporate entity (when the
applicant is not a corporation);
C) an officer, director, paratet, or employee of the applicant; or
D) the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted th' d day of Jr t?G 20~~ L
Signatu
Print Name h~ ~lf7 /fli/e r
Form TS 1
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 aze subject to the Town of Southold Waterfront Consistency Review Law. This
assessment is intended to supplement other infonnation 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 prepazer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local i
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 Southold Town).
3. If any question in Section C on this form is answered "yes" or `ho", then the proposed action will
affect the achievement of the LWRP policy standazds and conditions contained in the consistency
review law. Thus, each answer must be explained in detail, listin¢ both supportin¢ and non- j
supporting facts. If an action cannot be certified as consistent with the LWRP policy standazds 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 Boazd of Trustees Office, the Planning Department, all
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# ~T3 _ ~ _ J 2
PROJECT NAME ~ ~!/~.f ~ R s~/A tI`wY.c~iv %
The Application has been submitted to (check appropriate response):
Town Board ? Planning Board ? Building Dept. ? Board of Trustees
II
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) I
(c) Permit, approval, license, certification:
Nature and extent of action: I
~'~ioc/aAT/Oh rJ ~S~/~Gt ~~t ~ JT~~G ~i~ G~II
P~~GC o ~ ~y/NG ~.c. /.fd G Y
Location of action: ~ ~y' C ~c~/~ .y~d ~i9 ~ /1'~~T~/~
Site acreage: q O o /
Present land use: ~ T' i ~ Tl i9~
Present zoning classification: ~s Pi .~,L~~/3 I
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: I
~~i /'13 C ~ ~ ~d~- .r.Y9~ ~~c /(~s~r/t.
(b) Mailing address: ~~U ~Jao~9 J ~.r~ ~n.
~i~J'~i.t/G rL~~~-- ~ d '7 4 ~ o
(c) Telephone number: Area Code ( ) 9 0 ~ ~~/>r3 ~ y 7 ~ E ~ 0 ~ 3 ~ 3 e ~ ~
(d) Application number, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes ? No ~ 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 beneficia? use of a coastal location, and
minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation
criteria.
? Yes ? No ?'fVot Applicable
i
I
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LWRP Section III -~Po~
li/cies Pages 3 through 6 for evaluation criteria
? Yes ? No I~ Not 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 Not Applicable
Attach additional sheets if necessary
NATURAL COAST POLICIES I
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 u Not Applicable
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III
-Policies Pages 16 thr~~oug~h
21 for evaluation criteria
? Yes ~ No U Not Applicable
Attach additional sheets if necessary i
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.
? ?
Yes No Not Appli.ee •
Attach additional sheets if necessary j
~I
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III -Policies
Pages 32 through 34 for evaluation criteria. ~
~I
? Yes ? No Not Applicable
~I
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 ? No ~ 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.
nn r
? Ye9-1 No ~XNot Applicable
I
I.
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 ~ Not Applicable
i
I
i
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 ~NOt Applicable i
I
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 ? No 'L-f' Not Applicable
Ii
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III - Polici~es~;/Pages 65 through 68 for evaluation criteria.
? Yes ? No LJ Not Applicable
PREPARED BY~Gfa///J G.. ~j~~ TITLE ~lGti~ DATEo~ ~'~'~y
•
Itconlcr form No. AIIR I - Stxtmory shod Ibnn of (icncral I'nwcr of Annrncy:
(:OI_ ` 5-1501: 12 pl. lyre, I-97
DURABLE GENERAL POWER OF AT'T'ORNEY
NEW YORK STATUTORY SHORT FORM
17/li /'ON'7:'H.S 1'OU GRANT liGL011' CONT/NU/i TO lJG•t Fl7iCT/Pf:
5'/lOU/,D 1'OU 11/iCOAI/i UIS,1/7/,GOOX /NC'OA//'/i77iNT
Caution: This is :m important document. It gives the person whmn you designate (yom• "Agent") broad
powers to hmtdle your property dm•ing yom• lifetime, which may include powers to nwr[gage, sell, m•
otherwise dispose of any real or personal property without advance notice to you m• :glprov:d by you. These
powers will continue to exist even after you become disabled m' incompetent.'1'hcse powers arc explained
more folly in New York Ccucrul Obligations L:»v, Article 5, Title I5, Sections 5-IS02A Through 5-1503, which
expressly permit the use of au}' other or different form of power of attorney.
This document does not authorize anyone to make medical m' other health care decisions. You mu,y
execute a heult6 ru-e proxy to du this.
If there is anything about this form that you do not understand, you should asl< a lawyer to explain it to
you.
`fl-ITS is intended to constitute a DURABLE GENIiRAL POWER Op AI"I'ORNIiY pursuant to Article .5, 'T'itle
i 5 uF the New York General Obligations Law:
I RATHARINA G. SCHEIDELER, residing at 3825 Camp Mineola Road,
' Mattituck, New York 7(I[x95~3C~)&i~Xfr7~tk
PHILIP MILOT, Noll Camp Mineola Road, Mattituck, New York ll~i~2rcl`t'y nlpioint:
~u`k*x>&~xxmxustm~t+nnrr~r+rr~txar~~cstiar~;tAL~~tca~~x~'~~'Ro,~7~'~lr~'y:~~XX
(lJ Z or more pers'unr ore !u be uppninled agents' hl' port insert Ibeir nunres' and uddrerses' above)
my atorney(s)-in-Get TO AC'f
(ll'rnore Brun one agent i.r designcned, CHOOSE ONE of dre Jollaa~ing ova choicer hr pulling
pour initials in ONE o/ the blcudc spacer to the leJl q/dour c•Irnice: )
[ ] Hach agent may SH['ARATHLY act.
[ ] All agents must act'fOGLTHHR.
(ll~neidrer G/nnh syure i.r inilin/eel, Ure agents still Ge reyuire~l to nc! TOUFTI/F. R)
IN MY NAME, PLACE AND STEAD in any way which 1 myself could do, if I were personally present, with
respect to the following matters as each of them is defined in Title 15 of Article 5 of the New York General
Obligations Law to the extent that 1 am permitted by law to act through an agenL•
(DIRECTIONS: luitial in the black space to the left of your ciwice any one or more of the following lettered
subdivisions as to which you WANT to give yom• agent authority. If the blank space to the IeR of any
particular lettered subdivision is NO'P initisded, NO AUTHORITY WILL [3E GRANTED fm• matters that
are included in that subdivision. Alternatively, the letter corresponding to each power you wish to grant may
be written m• typed on the blank line in subdivision "(Q)", and you may then put your initials in the blank
space to the left of subdivision "(Q)" in order to grant each of the powers so indicated.)
[L' ~ ] (A) real estate transactions, [ ~ S ] (M) making giFls to my spouse, children and
[ ~6 S ] (B) chattel and goods transactions; more remote descendants, and parents,
nut to exceed in the aggregate $10,000 to
[ ~ G $ ] (C) bond, share and commodity transactions; each of such persons in any year;
[ ~~5 ] (D) banking h•ansactions;
[%S f ] (N) lax matters;
~ S ] (E) business operating transactions, [ ] (O) all other matters;
6S ] (F) insurance transactions; [ ~,C~ ] (P) full and unqualified authority to my
6 S ] (G) estate transactions; attorney(s)-in-fact to delegate any or all
6 f J (H) claims and litigation; oFlhc foregoing powets to any person or
~ ] 0) personal relationships and affairs; persons whom my attomey(s)-in-fact
shall select;
[ J (,I) benefits from military service;
k [ ] (Q) each of the above masters identified by
[~~S ] (K) records, reports and statements; the following letters:
(,f ] (L) retirement 6enefil hnnsactions;
S) (R) Perform Estate Planning to Benefit
(Sj~eciu/ provisions and lnnilolions nnrh Ge included in dre statutory short /br~rPah)t~Sh• /~i]I~rlF}/ripTlSrh~~~nhjxandchildren
i/~/6rr crnrfrn'm or the regnircmenGr r j,ceclinn 5-1503 of the Neu' Yn k Genera! Ohli,r,'alioas LmrJ
•
't'his Durable Puwcr of A(Unney shall nut be ulTeraerl by my subseyuenl disability ur incungreleuce.
If every agent named abme is unable or unwilling lu serve. I appoint
(in.aa9 nrrmr unrl arldrr.rs n(sur'rrs.vnr)
lu be ury ;Igem fur all purposes hereunder.
"1'o induce smy third party br act hereunder, 1 hereby agree that any third party receiving a duly executed copy or facsimile of
this instrument may act heleundeq m:d that revocation m• termination hereof shall be ineffective as to such third party
unless trod until actual notice or knowledge of such revocation or termination shall have been received by such third party,
and 1 for myself and for my heirs, executors, legal representatives and assigns, hereby agree br indemnify and hold harmless
any such third party from and against any aad all claims that may arise against such third party by reason of such third
party having relied on the provisions of this instrument.
'I'bis Durable General Power of Attorney may he revoked by me at any time.
lu Witness Whercol', I have hcrcunw signed my name This 4th(~~J day of July 2Qp
(YOU SIGN IiLRG:) l ;ter C .(~W
11 Signunux• nJ' lb inri/rnl )
Katharina c~~. Scheideler
Acluuncledgnxnl tnlren in New York SL•de Acl:nnn•Icdgnu•ul lakrn outside New York tilale
Slate of New York, County u( SllffOik • t5 "`St:uc of ,County of , .cs
'r)!! !hc 'I^•• m iue uu' he'111R: OIL`, nle'
i4t[1°°~ Jllly y 21)t)5 *(nr inwrl Uislricl nl' Culunlhia.'ICrrilur)•. Pusscsyiun m' Fvrcign C'uunlg9
tlr~1"ersigncd, personally appeared known to me or proved to me on dm One the day of , in the year .before
basis ul s;nis Llelory evidence In be the inrlividu:d(cl whose name(s) iz nte, the undersigned. personally appenrcil known to ntc ur proved u, nle
tare) subscribed to the within instruntem mld acknuwledgal to Inc thnl 00 IIIC bayls OI yi111510e1U1'y l.'V ldl•0Cl` Ill bl IIIL' Inrll Vld llOlly) wdlUtil'
he/sheAhcy cxcculcd Utc same in his/her/dtcir capacily(ics), and Thal by OaInC(y) IS (art`) snhxl'llherl hr the within inytruntcnl :Ind acknowlcrlgcd
his/her/Ihcir signature(s) on the instrument. the individual(s) or the per- to me Utal he/she/Ihcy cxcnned the scone in his/herhhcir capaeity(ies),
son upon bchall' of which the individual(s) acted, cxcculcd the inslru- and that by his/her/Ihcir xignauoc(s) on the inslnuncnl, the individually)
01101' or the person upon bchnl(of which the individual(s) acted, cxcculcd the
insu'unten4 and Ihat such individu:d made such appearance before ate
unrlcrsigncrl in the
~j (add the city or politico) subdivision ;uul the slnlc ur cnunu'y or other
pIOCI; II1C al'kI1l1WICllglitl•Ill WOy takCll
Notary Signutnre:_~Nv/L'/V~ C~ 4 Nuhrry Signature:
Sl:unp:
SL•Imp:
NotaryPubllc, S to of
INNeSw Pork
No. 4963689, Suffolk Cowlly /
fommission Expires March 12, a~
AhRIUAVI'1"I'h1A'1' POWER OI' A'1"I'OI(NEY IS IN pllLl, RORC14
(,Sign helirre n natm_r public)
S'PA'I'H OF COUNII' OF . ss
being duly sworn, deposes coal says:
I. 'fhc Principal within did, in writing, appoim me as the Principal's frcr- and lelvl'ul A'!`pORNEY(S)-IN-FP,C'I' in tltc within Puwcr of Anurncy,
2. 1 have no acUlal knowledge ur actual notice of revocation rn' termination of the Power of Attorney by demh or olherwisq or knowledge ul' any
Gtc)s indicating the same. 1 further rcprescm Thal the Principal is alive, has not revoked or repudiated the Puwcr of Aunrncy and the Puwcr of
Auontcy still is in full force and cl'fccl.
J. I nmkc Ihls allidavil lift the purpose of inducing to accept delivery nl the lidlowing htslruntcnt(x),
os cxcculttl by ntc in my eapncity as the A'I"I'ORNEY(S)-IN-FAC'T', with full knowledge that this al'lidavil will be Iclicd upon in aacpling the
execution and delivery of the Instrument(s) and in paying good trod valuable nntsidcralinn Ibercl'or:
Sworn In before ntc on:
P:Blld I
Uistribulcrl by
Chicago Title Insurmue Company
Philip G. Milot
140 Woods End Dr.
Basking Ridge, NJ
07920
Board of Trustees
Town of Southold _
Town Hall Annex
54375 Main Road o ~
PO Box 1179 ~ ~ ; ; 2 ~ 2"'
Southold NY 1 1 97 1-0959
June 29, 2012 _
Tothe Trustees,
Mrs. Katherina Scheideler resides at 3825 Camp Mineola Rd in Mattituck. She suffers
from progressive dementia. While she is unable to speak or express herself in any other
way, she had always indicated to me that her home is where she would want to live for as
long and as comfortably as possible.
In 2005, Mrs. Scheideler had a Durable Power of Attorney drawn naming me as her
Agent. A copy is enclosed. I have been acting as her agent in numerous capacities since
the onset of her illness.
Mrs. Scheideler's bulkhead is showing the wear and tear that a storm could greatly
impact. An "In Place" bulkhead replacement will be needed.
Accordingly, I am filing the attached application as her Agent. I will also file an
application with the DEC. If there are any questions, please do not hesitate to call me at
908-953-9117 or cetl 908-313-0134.
Thank/you for your time and consideration.
~ C
Philip G. Milot
wRr6R ?iF~ _ scti4ar ~b ~rs/t- I~R oI~/~/Zf
' ~o ~
d /a I~OSi
~t/aGE ~ ~
~ ~ ~ s ~ j
_
f ~ € ! [
A ~ t~ _ i% ~ ~i ii ~ ~L r4 ~ iii
tt j ' ~ f ~ ~
3 ~ t e
~ ~ i 1 f
t ' i ~ ~ ~ ~ 1
! ~ e i
~ ~ ~ i ~ i .
j a ~ ~
i {
~ ~ ~ ~
4, ~ ~ f
1 ~ ~ ~ I
i
~14D0 j cA 'C. ///NYC S'~~ p 7'~ ~N (i
APPROVED BY -
BOARD OF TRUSTEES ~ ~ . ' ~
TOWN OF SOUTHOLD ~ ;
BATE ~ 2 Z ~ Z ~ i J,PJN 2 ~ 2012 SC !31 rf~ / :
o ~ ~ _ -
F2,R~. v, EN/ I
w~-r-E R,
/d" AaSf is"/~os'
_ _
_
? _ _ U
tio~ r~Rr: c3?FFi~n. _ _ . Nv~ r.~.ti/- R~ G/~~'~-
z
1 ~kU,~~~
`1~- ~ ~'R o PF~t T't~
~~Grl~iyG vic~i..~ 2 ,~v ~ f/`R
7 X /o'~ cavF2,niG SIiF/-1-T3~~%G 2x,o covFa.~vG
~rz~~<.1/ o~ o a 0 0 ~ b d r~~rE2,
_
' ~ i
C ~ (~~~Q \ ~
1
~R/o~
Go vs.n~
S c ~ ' = ~
SURVEY OF ARE THE RESULT OF ACT
UAL HELDMEASUREMEN SUM AND
1wEelEmx°E°Gm µr`
H
~
a~`m,
°xw:
evum viii
DESCRIBED PROPERTY LOTAREA:11,983S0.FT=0.275ACRE(AREATOMEANHIGHWATERMARK ^~;E~E~;°~;.a,~°°~^~Ea,°°•„~
SITUATE AT 12-,6.03, tea..°~`
LOT AREA TO BULKHEAD :9,151 SQ.FT. = 0.210 ACRE w,>E~ o
w°...mxEx c°xe~MCUw,.
~~~aM.:~.~.,
MATTITUCK ALLOWABLE LOT COVERAGE.'2,397SQ.FL=20%(AREATO '°°"°°"""""°'"°E"
TOWN OFSOUTHOLD M.H.W.12-16-03) ~~E;~u~~~,~
SUFFOLK COUNTY, NEW YORK EXISTING LOT L'OVERAGE: 2,008 SOFT. = 16.8 % ;~,WE~~ KYMVI~MTM=pWRNE°
EIUE°uDMMBY
illlEttYME W.{IN[oiµbExLYM9
S.C.T.M. DIST. 1000 SEC. 123 BLK. 05 LOT 32 ~(S, T:'o,:
N~w~~~°,
fJIFFe Ei IxF,FXPx61W11~
1° NIAMYiM1ilVMy pl9RHq£Xi
10 5 0 f0 20 30 40 50 60 70 80 90
SCALE: 1" = 20' DATE: DECEMBER 11, 2003 -cc~r
Q
FLOOD ZONE BOUNDARIES AS DEPICTED ON THE F.E.M.A. 1 0ti6~ mZ
o~pm~Z
FLOOD INSURANCE RATE MAP, MAP NO. 36103C 0482 H V ~ ~ZO v
EFFECTIVE DATE: SEPTEMBER 25, 2009 ~ o
~
o ~~O i
~ a° Z v -
p m
O Zo2~m orv
` ~ 5 ~ ~i`L
V ~~oP~6
0o J/ o oZ~GO vo 0
J ~
-`0 \°P°~~~~ J fNOb ~z
` `\v` ~1 ~ / No2o
G~°~QP~ ~ ti 6 m9
?O v / / A
F,° ~ e
z° n0 4'
r rjF1 z~ FNS 6.t~
w~
r~5 ~ Z MEE Az N ~ Z
~~~oa ZS ~ ~ ~ap° a vo
~ ~b ~"Z ~ oNpZO
/ oSJ~ ~°~t Cn / 'y ~
~ 2 O
/ ti~~~P~ 4 ~m~~
0 ~pT
e~ ~ ~ F`°~ / tio~~~``19 ~N
~Z y m ~p Q~ a
0 0
O °n, 4 I \Q 3
~ a , `
P /
O
Amp `o \~,\\°"o=ONO ~ \ ~pm ,b^ 'u``°r''w
L ~ ,'4' ~ ~ .
T 5. ~
a?' U1', ~mm°~
~FF,, S' IE'1~ y
~ 9~
~ ~
o~ ~ p
e7 °RJ
I x/25( M,E
y./ F~"~~N° /
5 0~
~~P°~~
~
~mm pm I z PS ~M1
P~~~~ ,?~~9aEL~2 ~ 991/. a
l~`1~O~~0o~~ ~gY~ ~pLL/ m ePp~ ~j . ` /
CERTIFIED TO: KATHARINA SCHEIDLER P~\~y ~ ~ .
Y1P~~ 6'~J~~~ /
Oti0 ~ p2 '1~,~0.~°e ~ . .
0
O FN ~ ~ ~ ~~~S~EP / `E-
JOB N0. 2003-532 ~Q-
MAP N0. /e ,;c~' ~ A
FILED: / ~O ~l+ND gU9 :r>~~ ~ '+~"o°`~ r
REVISIONS: ADDEXISLELEVHSE. ' ~anONA<p GF~ o$o~ °F ~P~~
CORNERS & FIN.FLOOR 5/18/04 ti O ~a,3m ~ ''J- ~ ,Z. o, ,
UPDATE, FINAL, ADD TOPO IN NAVD a 92 GtF~zy ~ ,r~ 6oP
ADD FLOOD ZONE DATA, REV. CERTS .,y4 ~ 2i 5m ~y /
\ iP G5 m C~ .b
'S ~ ii 50`363 Q~F- / F,f,LF~9 g O~ eb^'
F OF NE`N
LICENS ~~~c-9,s, ~ Q
~
HANDS ON SURVEYING ~Q'
46 NORTH ROAD
HAMPTON BAYS, NEW YORK
11946 ~"w
TEL: (631)-723-1954 - FAX•(631)-723-1329 \J
MARTIN D. HAND L.S