HomeMy WebLinkAboutTR-7944A James F. Kiag, President
Bob Ghosio, Jr., Vien-President
Dave Bergen
John Bredemeyer
Michael J. Domino
Town Hall, 53095 Main Rd.
P.O. Box 1179
Southold, NY 11971
Telephone (631 ) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
__ Pre-construction, hay bale line
__ Ist day of construction
~ constructed
Project complete, compliance inspection
James F. King, President
Bob Ghosio, Jr., Vice-President
Dave Bergen
John Brederaeyer
Michael J. Domino
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 7944A
Date of Receipt of Application: November 1, 2012
Applicant: William C. & Donna M. Goggins
SCTM#: 117-10-14.1
Project Location: 1780 Jackson Street, New Suffolk
Date of Resolution/Issuance: November 14, 2012
Date of Expiration: November 14, 2014
Reviewed by: Board of Trustees
Project Description: To replace the wood fence on west side of property,
outdoor shower and portion of southwest property adjacent to the fence that was
damaged in the storm.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
project plan prepared by William C. & Donna M. Goggins, received on November
1,2012, and stamped approved on November 14, 2012.
Special Conditions: None
Inspections: Final Inspection.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
James F. King, President
Board of Trustees
James F. King, President
Bob Ghosio, Jr., Vice-President
Dave Bergen
John Brederaeyer
Michael J. Domino
Town Hall Annex
54375 Route 25, P.O. Box 1179
Southold, NY 11971
Telephone (631 ) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Please be advised that your application dated ![/! !!.~. , . has been
reviewed by this Board at the regular meeting of /////¥/./2- and
your application has been approved pending the completion of the following items
checked off below,
__ Revised Plans for proposed project
__ Pre-Construction Hay Bale Line Inspection Fee ($50.00)
__ Ist Day of Construction ($50.00)
__ ¼ 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:
TOTAL FEES DUE: $ ,~0, OD
BY: James F. King, President
Board of Trustees
.lames F King. Presidcnl
Bob Ghosio..Ir, Vice-Presidcnt
Dave Bergen
John Bredemeyer
Michael .I. Domino
Box 1179
Southold, NY 11971
Telephone(631 765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection/Worksession Report
Date/Time: AJ¢¢ 7 / 7_.- /1"0°
WILLIAM C. GOGGINS, ESQ. request and Administrative Permit to replace
the wood fence on west side of property, outdoor shower and portion of
southwest property adjacent to the fence that was damaged in the storm.
Located: 1780 Jackson Street, New Suffolk. SCTM# 117-10-14.1
Type of area to be impacted:
~.,oS'altwater Wetland Freshwater Wetland __
Sound ~B~y
Distance of proposed work to edge of wetland
Part of Town Code proposed work falls under:
~-~hapt.275 Chapt. 111 other
T,~AAd of Application: Wetland Coastal Erosion Amendment
ministrative__Emergency --Pre-Submission -- Violation
Info needed:
Modifications:
Conditions:
Present Were: ~ J. King ¢""B. Ghosio /-'//D. Bergen,
~..,~. Bredemeyer.__ Michael Domino D. Dzenkowski __
Form filled out in the field by j
,
Mailed/Faxed to:
Date:
other
(1 ~ tmread) - xv~lhamgoggmsyt!yahoo co ~ - Yahoo! Mail Page 1 of 2
l~tlp:.'"~ls-mg4.mail.yahoo.com/l~eo, tat.tncl~?.~-a~d=Ognqpt:k I oa6up J 0/31/20t2
N
_ _~j~~', ,
OFFICE LOCATION:
Town Hall Annex
54375 State Route 25
(cot. Main Rd. & Youngs Ave.)
Southold, NY 11971
MAILING ADDRESS:
P.O. Box 1179
Southold, NY 11971
Telephone: 631 765-1938
Fax: 631 765-3136
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF $OUTHOLD
MEMORANDUM
To:
Jim King, President
Town of Southold Board of Trustees
From: Mark Terry, Principal Planner
LWRP Coordinator
NOV 1 4 20!2
Date: November 13, 2012
Re:
Proposed Wetland Permit for WILLIAM C. GOGGINS, ESQ
SCTM# 1000-117-10-14.1
WILLIAM C. GOGGINS, ESQ. request and Administrative Permit to replace the wood fence on
west side of property, outdoor shower and portion of southwest property adjacent to the fence
that was damaged in the storm. Located: 1780 Jackson Street, New Suffolk. SCTM# 117-10-
14.1
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 Policy Standards and
therefore is CONSISTENT with the LWRP.
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
Jill M. Doher~, President
James F. King, Vice-President
Dave Bergen
Bob Ghosio, Jr.
John Bredemeyer
Town Hall, 53095 Main Rd.
P.O. Box 1179
Southold, NY 11971
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
Coastal Erosion Permit Application
Wetland Permit Application y Adrninislrative Pennit
AmendraenffTrans let/Extension
~_Received Application: la
V Completed Application
Incomplete
SEQRA Classification:
Type I Type II Unlisted
Coordination:(date sent)
'LWRP Consistency Assessment Form /f~/~-.
fi/i~I~_CAC Referral Sent:
/~Date ofinsp~otion: n I
Receipt of CAC Report:t
Lead Agency Determination:
Technical Review:
~--~'~blie .~-~.e~d: ~ / t~/ t 2..
Resolution:
~0'¢ - 1 2012
Name of Applicant wt 11 tam c. goggins a~ld Donna M. Goggins
Address 1780 Jackson Street, New Suffolk, New York
Phone Number:( ) (631) 298-4200
Suffolk Cotmty Tax Map Number: 1000- 117.00-10.00-014.001
Property Location: 1780 Jackson Street, New Suffolk, New York
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone:
Bwd of Trustees Applicatio~
Land Area (in square feet):
Area Zoning: I~- 4 0
GENERAL DATA
41,510
Previous use ofpropc~y: residence
Intended use of property:, residence
Covenants and Restrictions: Yes No
If "Yes", please provide copy.
Does this project require a variance from the Zoning Board of Appeals __
If"Yes", please provide copy of decision.
Prior permits/approvals for site improvements:
Agency ' Date
Yes xx No
__ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency.9
xx No Yes
If yes, provide explanation:
Project Description (use attachments if necessary):.
repair fence, outdoor shower, and area depicted in attached photos caused by
of Trustees Applicat:
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity: repair damage caused by hurricane
Are wetlands present within 100 feet of the proposed activity?
xx No Yes
Does the project involve excavation or filling?
No xx Yes
If Yes, how much material will be excavated?
How much material will be filled? 5
Manner in which material will be removed or deposited:
(cubic yards)
(cubic yards)
wheel barrel
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
fi.om implementation of the project as proposed. (Use attachments if necessary)
none
' I PROJECT ID NUMBER
617.20
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 / SPONSOR
12. PROJECT NAME
William C. Goggins ~ Goggins
3.PROJECT LOCATION:
Municipality Southold ICounty Suffolk
4, PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide mai)
1780 Jackson Street, New Suffolk, New York
5. IS PROPOSED ACTION: [] New [~]Expension r~Modification/alteration Repairs
6, DESCRIBE PROJECT BRIEFLY:
Repair damage cause by hurricane
SEQR
7 AMOUNT OF LAND AFFECTED:
20 square feet
Initially acres Ultimately acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
~XL~Yes [] No ]f no, describe briefly:
9. WHAT I~ PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.)
p Re ,d ntia, [],.al.sM., E3comms. , E3^ r,cu,tur E3Pe ,Fo st,OpenSpaca E30,her d.or,be
10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
[]Yes []No If yes, list agency name and permit / approval: pal-mit to replace jetty expired, wattin~
Board of Trustees of the Town pf Southold. response from DEC to amend length
11. uo~ ANY AMPEGI OF IHI= A~JIION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
E~Yes if yes, list name arid /
agency
permit
approval:
.I 12.[~YesAS A RESULT~No OF PROPOSED ACTION WILL E~ISTING PERMIT/ APPROVAL REQUIRE MOOIFICATION?
Applicant I CERTIFY ~HAT THE INFOR~,ATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Date: 11/01/12
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 completed by Lead A~lency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coo~:linafe the review process and use the FULL EAF.
[] W.a [] No
S. WILL ~.CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative
declaration may be supemeded by another involved agency.
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be haodwri[ten, if legibte)
C1. Existing air quality, surface or gmundwafer quality or quantity, noise levels, existthg traffic pattern, solid waste production or disposal,
potenfial for erosion, drainage or flooding problems? Explain bdefly:
I ,I
C2. Aesthetic. agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly:
I
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habifals, or threatened or endangered species? Explain briefly:
I I
C4. A community's existing plans or goals as officially adopted, or a chang~"~"~ or intensily of use of land o~ other natura{ resources? Explain"l~efly? "'
C5. Growth, subsequent development, or related activities iikeiy io'~nduced by lt~e proposed action? Explain b~fiy~
I
C6. Long term, short term, cumulativel or other effects not ideniified in Cl -C57 Explain brieflyi
C7. ither impacts pnciodi~
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
IRONMEN~TAL AREA ICEA~? III )'es. explain briefly:
Yes ~L~jNo
E. IS THERE, OR IS THERE LIKELy TO BE~ CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If~es explain:
PART II1 - DETERMINATION OF SIGNIFICANCE (To be completed by .N:jency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large~ important or othen~ise significanL Each
effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibiltiy; (e)
geographic scope; and (0 magnitude. If necessary, add attachments or reference supporting reateriats. 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 significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
Check this box If you have identified one or more potentially la rge or significant adverse impacts which MAY occur. Then proceed dimc~y to the FULl
EAF and/or prepare a positive declaration.
Check this box If you have determined, based on the information and analysLs above and any suppoAing documentation, that lhe proposed aclt~
WILL NOT result in any significant adveme environmental impacts AND pro~le, on attachments as necassary, the reasons supporting th[
deten*ninaflon.
Board of Trustees
Name of Lead Agency
vdnt or/ypo Name of Responsible Officer in Lead Agency
Si~tore of Responsible Officer in Lead
Title of Responsible Officer
Signature of Preparer (If different from responsible officer)
of Trustees Applicat~
County of Suffolk
State of New York
William C. Goggin$ 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, THEm AGENT(S) OR
REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES 1N CONIUNCTION WlTH~F ] ~LI£ A~2T] ON
Signat~e /
SWORN TO BEFORE ME TInS DAY OF l ~-
Anthony H. Palumbo
Notary Public, State of New York
No. 02PA6114032, Suffolk County
Commission Expires Aug. 9, ~t'~
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
Thc Town of Southold's Code of Ethics nrohibits conflicts of interest on the oat of~own Officem and emnlovces, The ouroose of
~hi~ form is to orovide information which can alert lh~ town of nos~ible conflicts ofintcm~t and allow it to tal~a whatever action is
~ec~ssarv to avoid same.
YOUR NAME:
William C. Goggins
(Lust nam~ first name, gniddin initial, unless you are applying in the name of
someonc els~ or other entity, such as a company. If so, indicate th~: oth~'
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Varianco Tmslce
Change of Zone Coastal Erosion
Approval of pint Mooring
Exemption from plat or official map Planning
Other
(If"Other", name the activRy.)
Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee
of the Town cd:Southgld? "Relationship" includes by blo~d, nlarriage, o? burliness interest. "Bnsir}ess interest'~ means a business,
including a paanership, in which the town off~cer or employee h~ even a partial ownership of (or employment by) a corporation
in which the town officer or employee owns more than 5% of the shams.
YES NO xx
If you answered "YES", complete the balance of this form and dam ~md sign where indicated.
Name of person employed by the Town of Southold
Title br position of that person
Describe the rolationship between you~if (the applicant/agent/representative) and the town officer or employee. Either check
the appropriate line A) through D) and/or describe in the space provided.
The town officer or employee or his or her spouse~ sibling, parent, o~- ~hild is (check all that apply):
A) the oymer of greater than 5% of the shares of the corporate stock of the applicanl
(when the applicant is a corporation);
__B) the legal or beneficial own.er of any interest in a non-cerporate entity (when the
applicant is not a corporatiun);
__C) an officer, director, parmei', or employee of the applicant; or
__D) ti~ actual applicant.
DESCRIPTION OF KELATIONSHIP
Form TS l
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
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.
Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated, as to its significant
beneficial and adverse effects upon the coastal area (which includes all of 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~ listing both supporting and non-
suooortin~ facts. If an action earmot 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. DESCRIeTION OF SITE AND PROPOSED ACTION
scm#/000 -. /__0 - 0/q, i
PROJECT J
NOV - 1 2012
The Application has been submitted to (check appropriate response):
TownBoard ~ Planning Board ~ Building Dept. ~ BoardofTrustees
Category of Town of Southold agency action (check appropriate response):
(a) Action undertaken directly by Town agency (e.g. capital
(b)
(c)
Nature and extent of action:
construction, planning activity, agency regulation, land transaction)
Financial assistance (e.g. grant, loan, subsidy)
Permit, approval, license, certification:
Location of action: /7
Site acreage: ]~/, ,~-/0
Present land use:
Present zoning classification:
If an application for the proposed action has been filed with the Town of Southold agency, the following
information shall be pro~id:
(a) Name of applicant:
(b) Mailing address:
(c) Telephone number: Area Code ( ) (~?~t))~?-
(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 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
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 ~'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
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 ~ 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 through 21 for evaluation criteria
Yes ~ No [~ Not Applicable
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section IH - Policies; Pages 22
through 32 for evaluation criteria.
Yes No Not Apph~ble
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 ~ No ~ Not 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 ~ 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.
~] YeJ--] No]~ 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.
F~ Yes F~ No F-~ 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 F~ No L~ Not 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 ~ No~Z~ Not Applicable
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section HI - Policies; Pages 65 through 68 for evaluation criteria.
F~ Yes ~ No F~ Not Applicable
PREPARED BY
TITLE DATE /{/~1 /! ~
GOGGINS & PALUMBO
ATTORNEYS AND COUNSELORS AT LAW
P.O. Box 65
13235 Main Road
Mattituck, New York 11952
Phone: (631) 2984200
Fax: (631) 298-4214
November 1, 2012
Board of Trustees of the Town of Southold
P.O. Box 1179
Southold, New York 11971
Re: 1780 Jackson Street, New Suffolk, New York
Dear Sir/Madam:
Enclosed please find the following:
WILLIAM C. GOGGINS, ESQ.
ANTHONY H. PALUMBO, ESQ.
TRACY L. KARSCH, ESQ.
DONALD A. MATES, ESQ.
Of Counsel
DONNA M. PALMER
Paralegal
1. Emergency Permit Application;
2. Application Fee of $50.00;
3. Copy of survey from prior permit; and
4. Photographs.
We seek to make repairs from Hurricane damage.
Thank you.
WCG/bh
08/15/2087 12:32 51841
II i
I' -- 50'
COASTAL
PROVED BY
PAGE 83/04
NOV - 1 2012
2) I~:/'CW
7) Pr~b4 ~ 1700
5C'rM #lO(X),-JlT-tOd4J
EN-CONSULTANTS lNG.
1319 NORTH SEA RD.
SOUTHAMPTON, N.Y. 11968
631-283-6360
(~l~lT P~.CONIC
PP-.OP~p Pi,LICJ. r:~ AhiP (mPlN
I~PI.,,N:Z:~NF5 FOR WILLIAM AklP PONNA
K.-,O,C.~IN5 ON 6:I~AI' I~¢ONIC PAY,
I~W .%PPOLK, .,6U~PC~K ~. hlY
.5F~1'1 01~2 2/2l/C)'7.8/6/07'