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TR-8475
11 ,lam iiii John M. Bredemeyer III,President l,gO.�� U�T40 Town Hall Annex Michael J.Domino,Vice-President h : 54375 Main Road jig mf; ,T� P.O. Box 1179 James F.King,Trustee ; Southold, New York 11971-0959 Dave Bergen,Trustee �, • � ,,'�� Telephone (631) 765-1892 Charles J. Sanders,Trustee ?��COUNT`1, °i� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1099C Date: March 26, 2015 THIS CERTIFIES that the removal of existing bulkhead and construction of anew 66' long vinyl bulkhead in-place of and up to 15"higher than existing; construction of(2) 15' long returns; backfill area with approx. 65 cy. of clean fill; new 4'x66' walk along landward edge of bulkhead;reconstruction of 4'x6' beach access stairs; a 10' wide non-turf buffer landward of bulkhead At 4365 Camp Mineola Road, Mattituck,New York Suffolk County Tax Map # 123-5-23 Conforms to the application for a Trustees Permit heretofore filed in this office Dated July 17, 2014 pursuant to which Trustees Wetland Permit#8475 Dated August 20, 2014,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal of existing bulkhead and construction of a new 66' long vinyl bulkhead in-place of and up to 15"higher than existing; construction of(2_.) 15' long returns; backfill area with approx. 65 cy. of clean fill;new 4'x66' walk along landward edge of bulkhead; reconstruction of 4'x6' beach access stairs; a 10' wide non-turf buffer landward of bulkhead. The certificate is issued to ROBERT A. CZENSZAK owner of the aforesaid property. eithN Authorized Signature . . . , , . '' 5, : E C E VIE n '. ', -ILI , , i Illi j ' :'. DEC 9 2015. .' i • yd ` j Southold Tern ' /. Q-Q� Boar¢of Trustees A , Lig e - . ' 6J)-k ke-00111 ' q 3''6-3r � p/h„ a{�4 12i a k. , e'/L i�y(/F,-z / • a _ , Fe0m �D.bele..." 4- rhPcesG (za ,s � ,C ) D3 '11r_.�3j3 '-' ' '' .'' ' ' ' 't-7"- 'rj'-'1' 'i)t" '''"' "`t '6u e e a �f�-f . )1,4. : ', i / ' Co-LH 09-4--1--L ' . 1, , "t2.,,, ! ' - ' , —x 13 'i - ' ' I jbL-L. ' `' ' ' ' . ,,,,-.),,,,— - ' c.„11.,,i..,..0:,,f.Ltti .,661.6-, ak.„....2.1 ,--k---a, L--3 , , . i .. , _ , , , _, ,, .. . . , , „ „ 1 ° _ 4:--' : ' A . , , - rYi_f .:Linc,-,s a e2.,..2,,), s_7_4 m.... - - l_0 u ni M��l i d J , L,e .,. . , . _ 0 01.4) 4,-:,, .,1) '71 ' „.i Pd ) , 3,3,,--L. 7:, 12.9a/,-paw ,, {{ CC# : C15-42983 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 10/26/2015 under Liber D00012838 and Page 025 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 affi �• s-��-.. • • . and Court this 10/26/2015 L;. ECOVF 1 E i Lj DEC - 92015 SGtIthcld Tt van Board of Trustees SUFFOLK COUNTY CLERK JUDITH A.PASCALE - SE'AL 11101111 Ilifi IIffl 11111 DIII DIII 1111 1111II ;r r 11 1111 11111 DIII Iffi IIII DEC - 9 2015 SUFFOLK COUNTY CLERK sou cul iasan RECORDS OFFICE Bear .f irus'ees RECORDING PAGE Type of Instrument: DECLARATION Recorded: 10/26/2015 Number of Pages: 6 At: 12 : 16 :07 PM Receipt Number : 15-0148543 LIBER: D00012838 PAGE : 025 District: Section: Block: Lot: 1000 123. 00 05 .00 023. 000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $30 . 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 $7 .50 NO RPT $60 . 00 NO Fees Paid $137 .50 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL - r JUDITH A. PASCALE County Clerk, Suffolk County • . . . .. , , , RFCORDED 26 6 Number of pages 2015 Oct ?._'o 16 OT PM •_ . - , .3UDI'I H P. PASCALE • - . CLERK OF . - . This .c meat will be public SUFFOLK COUNTY record. Please remove-Ai : . , , , L Doi i01211388 S®CaaE-SecaarAty [I�� ,l�errs. _ ,_ . F 025 - pri rr to recording. ' Deed/Mortgage Instrument Deed/Mortgage Tax Stamp - ' • Reco ding/Filing Stamps• ' FEES -. .----rri-sn.1 Page/Filing Fee iO -- v ? L _ _ _ .ageAmt.Handling 20. 00 DEC - 92015 A 2. •ditional Tax TP 584 Sub •tal • 1.-----z----,—.�-,oid-,;4 Spec. ' ssit. - Notation Boar if T u NSil or EA-52 17 (County) Sub Total Spec./Add. EA-5217 (State) TOT.MTG.TAX , A.- ,,,,e,..-- N Dual Town Dual County R.P.T.S.A. ` '6/ e, Held for Appointment Comm. of Ed. 5. 00 411 1K, ,1. Transfer Tax Affidavit - _ % 844.r Mansion Tax Cerifd;Copy; w :,.y�� The property covered by this mortgage is or will be;improved_ by a. one or two urc arge 15. 00 Ori D family dwelling only. Sub Total • / YES , .or NO- - Other Grand Total / r SO If NO,see appropriate-tax clause on yy , page# of this instrument. i Dist. ? 3026829 1000 12300 0500 023000 !--5-. Community Prestrvation Fund - 1- Real Property ( SA � Consideration Amunt $ II��I��IIIIIflhIIllhIIII !fflhIWI1IIIfl:I _ Agency 26-OCT-I CPF Tax Due _T$ Verification . - - — — _ _- __ - Improved Satisfactions/Discharges/Releases List-Property Owners Mailing Address REC S!!",1 ,& RETU,'N TO: Vacant Land M A;�= 2� ��j�J "C?e.n/s .7.-6-k-- : TD J 0 svMe-li l►`)-,)_ ,/Or, vs'e TD ,J 1-41‘Ai' /53 TD .1 u Mail to: Judith A. Pascale, Suffolk County Clerk 7 i 'nide Company TnWormatioinl 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk Title# ilf tOliKCounty This page forms part of the attached 'beC made by: y/_ ' " (SPECIFY TYPE OF INSTRUMENT), -P-s- ��-t 4- l hetS G. CZ 55 a. ,k The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of 5o rft'i e L ,N In the VILLAGE or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12-0104 10/08kk (over) If the document you've just recorded is your SATIISFACTIIORI OF MO,''IMAGE, please be aware of the following: If a portion of your monthly mortgage payment included your property taxes, *you will 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 10th and onor before May 31st. Failure to make payments in a timely fashion could result in a penalty. Please contact your local.•Towffi Tax E ecceiveir with any questions regarding property ,tate, 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 Independence Hill Shelter Island Town Hall Farmingville, N.Y. 11738 Shelter Island, N.Y. 11964 (631) 451-9009 - (631) 749-3338 East Hampton Town Receiver of Taxes > ; . Smithtown Town Receiver of Taxes 300 Pantigo Place 99 West Main Street_ East Hampton, N.Y: 119.37 - • Smithtown, N.Y. 11787 (631) 324-2770 5 (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 53095-1V1aiii-Street + Islip, N.Y. -11751 Southold, N.Y. 11971 - (631) 224-5580 (631) 765-1803 - - 'Sincerely,- „(;2 •• , Judith A: Pascale -° Suffolk County Clerk• ' Ll E C E E 1{ DEC - 9 2015 DECLARATION OF COVENANTS Soutoid Town Board of Trustees THIS DECLARATION made this 13 day of August , 2015 , by Robert A.Czenszak & Theresa M Czenszak , residing at 10 Summerhill Drive ,Downingtown,Pa 19335, hereinafter referred to as "DECLARANT(S) " : WITNESSETH : WHEREAS, DECLARANT (S) is/are the owner(s) of certain real property located on 4365 Camp Mineola Road, Mattituck_, Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 123, Block 5 , Lot 23 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 10 'wide, 66 ' long non-turf buffer adjacent and landward of the bulkhead be established and maintained. ' DEC - 92015 t � smt ok !oYJ{) Beard of Trustees NOW, THEREFORE, the DECLARANT(S) do/does hereby covenant and agree as follows: Upon the substantial completion of the aforementioned permitted activities there shall be established and__ subsequently maintained a 10 ' wide , 66' long non turf buffer-adjacent and landward to the bulkhead as defined by Chapter 275 of the Town Code; and as depicted on the site plan prepared by DKR Shores, Inc. , last dated August 25, 2014 and stamped approved on August 26, 2014 . , see Exhibit A attached; and 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 a public hearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owner(s) has/have duly executed this instrument this , -4 ay of StO ter , 20h7. Robert A Czenszak OWNER'S SIGNATURE Theresa M Czen ` ,_ / - OWNER'S SIGNATURE STATE OF �' /s leek ss: COUNTY OF‘J U F k On the ( r"j day of I , in the year 20/5', before me the undersigned, a Notary Public in and for said State, personally app .' Q ,CZ 5Z' ` I -. EsQ personally known to me or proved to me on — 'basis of satisfactory evidence to be the individual (s) whose name (s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed -the same in his/her/their capacity, and that by his/her/their signature(s) on the instrument, the individual or the persons on behalf of which the individual (s) acted, executed the instrument. \--f,k0E14,601 - -?1/145&k.: Notary Public Cr 11 tai Fn vt THERESA WR.MAU I Not6y Public State of Rev York DEC — 9 2015 `' R1o.®I 18329U R-EkOir J JaotisPy 3 ,OWilhb Southold Town Board of Tru tees as a t-a nt i -. mon. ( 51) k-,it 12>r bou>n r • -a it I ‘ '`6. Ll I , party of the second part, SC lihe WITNESSETH,that the party of the first part, in consideration of 8dtJt 't dollars and other valuable consideration paid by the party otfne second part, does hereby grant and release unto the party of the second part,-the heirs or successors and assigns of the party of the second part forever, ' ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the At Mattituck,Town of Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at an iron pipe on the southerly line of a 30 foot right of way distant 717.08 feet westerly along said line from the westerly line of a 25 foot right of way said point of beginning being the northwesterly corner of land of Milligan; RUNNING THENCE along last described land south 7 degrees 33 minutes 20 seconds west, 150 feet to the ordinary high water line of Great Peconic Bay; THENCE along the said ordinary high water line of Great Peconic Bay along a tie line course of south 75 degrees 22 minutes 30 seconds west, 61.82 feet to land of Cahill; THENCE north 6 degrees 05 minutes 40 seconds east, along said land of Cahill 150 feet to a monument in the southerly line of said 30 foot right of way; THENCE north 76 degrees 35 minutes 40 seconds east, along said 30 foot right of way 65.40 feet to the point or place of BEGINNING. Being the same premises conveyed to the party of the first part by deed dated September 5, 1989 and recorded in the Suffolk County Clerk's Office on October 5, 1989 in Liber 10943 page 419. Said premises known as and by 4365 Camp Mineola Road, Mattituck, New York 11952. TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and roads• ' abutting the above described premise3 to the center lines thereof- TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second part forever. _ __ AND the party of the first part covenants that the party of the firstparLhas;nopdone•Tor.suffered anything ' whereby the said premises have been encumbered in any way whatever, except as,aforesaid. AND the party of the first part,,in_compliance,,with Section 13 of-the-Lien-Law,-covenants that the party of the first,part will receive the consideration-for-this conveyance:and,will,hold the,;right.to,receive such consideration as a trust fund to be applied first for the purpose'Of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any`part of the total of the same for any other purpose. The word "party" shall be construed as if it read "parties" when:ever the sense of this indenture so requires. • IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: i 1/9". __,, ,_:. 12cA........„. ROBERT�CZENSZAK J THERES ZE • . 'K ��j.\ ' l ii V � 4�yy J r---------111 j 9� di DEC - 92015 \ L__________II . Suuthoid Tom - Boar If Trus ee • Standard N.Y.B.T.U.Form 8002-Bargain and Sale Deed,with Covenant against Grantor's Acts—Uniform Acknowledgment • OF EXISTING APPLICANT PROPOSES TO REMOVEF SECTIONS 66'BULKHEAD MI5"HIGHER \ ;; s; BULKHEAD,TO RECON(IN PLACE) r� �;�2 t1� THAN EXISTING,TO CONSTRUCT(2)NEW VINYL RETURNS,TO BACKFILL i FILL,TO CONSTRUCT A NEW 4'X 66' \ 65 CY OF CLEANyr-:, a;� ' STRUCTURE WITH k1' WALK LANDWARD OFAI BULKHEAD AND RECON/REINSTALL GREAT EXISTING 4 X 6' ` BEACH ACCESS STAIRS. AT CAMP MINEdLA ROAD, PECONIC BAY, \ c'',1�- - 9 2Q1�t 4! 9 MATn TUCK,TOWN OF SOUTHOLD,SUFFOLK COUNTY.NEW YORK SHE® >`,i j t QEC EX�NCRETE WALL(seaward section to r •e removed)and 15'vinyl return to be • I \ \10�f constructed in its place - GARAGE () \� \ "r� \ 1� CO l' �G 11\74 � 40 \Sp- \ate '� \ C. Y,_. �o %.,,. N V. ® \ •� � �0°°���o\i. Ts". . vs T��� ®ECK 1 STY COTTAGE � 61. m 0. 1J0.% 4X6 beach accesS - A. Oi _ \ \ \ steps to be recon as �````� ,. necessary . - �+-ROP.le \\ \ EOOB 7ET1Y '�C.��NCR€ \\ WALL(to remain • i . . , tt undisturbed) \ •-1-.7-----'7'1;•,"•-:E":;'", •••-;,-i•-,-::,..,:::: ,::::::•:--:-.--,777:-.,. \ \ )( ,i e\ , A BD \ ,:=� , s` c U _ Oa *revised to shoal buffer 8-25-14 _ r � . . a •_ = / --- Applicant: Robert A. Czenszak �� - D. 2-�e ' -� r--frif ii --�-�- Location: 4365 Camp Mineola Road, Mattituck •inf Purpose: Bulkhead reconstruction IA��} '/ Apparent Low Water ss ; 'r {1IDatum: , � � \�)��•ti+li f 1�y/���r, S.C.T.Ill1.1�10. 1000-123-5-23 _= AUG 2 6 2014 ,�'Mli,d ! LOCUS: 40°58'48" 72°31'35" DKR SHORES INC, P.O. BOX 488 1 July'14 � :,��;�������� �/�� SHEET 1 OF 2 _ Souttio,u Town - ` t (ii HAMPTON BAYS, N.Y. 1946 - N 1 DiSalvo, Diane From: DiSalvo, Diane Sent: Wednesday, September 02, 2015 2:28 PM To: Bob Czenszak Subject: FW: Covenants & Restrictions document for review Attachments: PDI_0232.JPG; Covenants Restrictions Template-Aug 13.doc; PDI_0229.JPG; PDI_ 0230.JPG; Exhibit A.pdf Mr. Czenszak: Below you will see that Town Attorney Lori Hulse has reviewed your attached Covenants and Restrictions for your filing at the Suffolk County Clerk's Office. You will see that I have also attached herewith Exhibit"A"which is to be attached to the Covenants. I believe you were also sent our list of instructions on how to file. Should you have any questions, please do not hesitate to contact me. Once you have a recorded copy of the Covenants and Restrictions, please send same on to me and I will issue you your Certificate of Compliance. Thanks Diane From: Hulse, Lori Sent: Wednesday, September 02, 2015 11:07 AM To: DiSalvo, Diane Subject: FW: Covenants & Restrictions document for review Diane, These look good. I am sending them back to you,as I didn't get a name/address as to who was requesting the review. Lori ._ ._ .. From: Duffy, Bill . .. ., . Sent: Friday, August 14, 2015 2:08 PM To: Hulse, Lori Subject: FW: Covenants & Restrictions document for review Hi Lori, Diane sent these to me. She called and said she was not sure of the procedure, so I said to send them to me and we would figure it out. Just let me know if they usually go to you or what the procedure is. Thanks, Bill From: DiSalvo, Diane Sent: Friday, August 14, 2015 11:05 AM To: Duffy, Bill Subject: FW: Covenants & Restrictions document for review 1 Attached are the covenants and restrictions we just spoke of. Thank You • DLO VV.,Di.SOL o Southold Town Trustees Town Hall Annex/First Floor 54375 Route 25 P.U. Box 1179 Southold,NY 11971-0959 (631) 765-1892 Fax: (631) 765-6641 From: Bob Czenszak [mailto:rczenszak(@comcast.net] Sent: Thursday, August 13, 2015 12:14 PM To: DiSalvo, Diane Cc: Bob Czenszak Subject: Re: Covenants & Restrictions document for review Diane -can you have this reviewed by the town attorney ( Lorrie Hulse ). Included is the completed document , my most recent deed and the approved bulkhead authorization labeled "Exhibit A". If I was supposed to send it directly to her please provide her email to me . I assume I have to have the document notarized. I would appreciate confirmation that you received this correspondence. Thank you, Bob Czenszak From: "Diane DiSalvo" <diane.disalvoctown.southold.ny us> To: "RCzenszakAcomcast.net" <RCzenszakacomcast.net> Sent: Thursday, August 6, 2015 8:17:47 AM Subject: Covenants & Restrictions Attached is an additional copy of the "blank" Covenants and Restrictions. Dia Ike D%Siatvo Southold Town Trustees Town Hall Annex/First Floor 54375 Route 25 P.O. Box 1179 Southold, NY 11971-0959 - (6 31) 765-1892 Fax: (631) 765-6641 2 John M. Bredemeyer 111, President ,• g>SFFD(,� Town Hall,53095 Main Rd Michael J. Domino,Vice-President eg Gy P.O.Box i 179 James F. King 1 • ; Southold,NY (1971 Dave Bergen `t -t. '+�� Telephone(631)765-1892 Charles J.Sanders = 111, I John M. Bredemeyer 111, President ,'' ,g1}FFflL - Town Hall,53095 Main Rd. Michael J. Domino, Vice-President ;�l,• cOG�� P.O. Box 1179 James F. King ; y Southold,NY 11971 Charles J. Sanders `:�y�J► 0).. ,itis Telephone(631)765-1892 41 Dave Bergen ' Ol ,,,**of 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 1st day of construction '/2 constructed Project complete, compliance inspection t \v 1' 11 ! � v 4 \ / �,g�z tv l� �i If ti ' ' i BOARD OF SOUTHOLD TOWN TRUSTEES `= 1' SOUTHOLD, NEW YORK 1 I �;:;t PERMIT NO. DATE: AUGUST 20,2014 :-_ ISSUED TO: ROBERT A. CZENSZAK - �C PROPERTY ADDRESS: 4365 CAMP MINEOLA ROAD, MATTITUCK f, - - _,,.\:_:7_, ((_ SCTM# 123-5-23 � 1 ' / AUTHORIZATION \ "' Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in 1+5, / ' accordance with the Resolution of the Board of Trustees adopted at the meeting held on August 20,2014,and �-, r in consideration of application fee in the sum of$250.00 paid by Robert&Theresa Czenszak and subject to the ! -- w ' Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits ( -: t ! the following: t7� t I Wetland Permit to remove existing damaged bulkhead; construct in-place new I } ' 4�= 66' long vinyl bulkhead up to 15" higher than existing; construct(2) 15' long vinyl j ` f . ,,,, returns; backfill area with approximately 65 cubic yards of clean fill; construct new j --- 4'x66' walk along the landward edge of bulkhead using untreated material; and =. .} ' reconstruct existing 4'x6' beach access stairs; with the condition to establish and , t. i/ subsequently maintain a 10' wide non-turf buffer landward of bulkhead; and as � `\` c depicted on the site plan prepared by DKR Shores, Inc., last dated August 25, 2014 and Aff ), l . stamped approved on August 26,2014. 1. = IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, �4 and these presents to be subscribed by a majority of the said Boar. .s of this date....,----(": . ....-(i , , -,\:7_,,,. ',‘ a ,,j'-^ .:,.... ,..) / .r a i ( ... _. ..—(01,,,,,,,,, ,,t,,..„,,, 4.,,,„,,, i&.____....// spa y ,,, q{�, J L U 1 �i ``^ V V `' / i1 V V s ,'- �! �� �. =�' h moi gar,� ,-° .,,rxs rcs' �'�� • S TERMS AND CONDITIONS The Permittee Robert A. Czenszak,residing at 4365 Camp Mineola Road, Mattituck,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages,or claims for damages,of suits arising directly or indirectly as a result of any operation performed pursuant to this permit,and the said Permittee will,at his or her own expense,defend any and all such suits initiated by third parties,and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of 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 Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 11. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title,or interest in real or personal property held or vested in a person not a party to the permit. • • John M.Bredemeyer III,Presidentii,01 � rye - Town Hall Annex Michael J.Domino,Vice-President �� '` l0 `� 54375 Main Road P.O. Box 1179 James F. King,Trustee ; Southold,New York 11971-0959 Dave Bergen,Trustee G ` - Telephone(631) 765-1892 Charles J.Sanders,Trustee IyC�U ��� Fax(631) 765-6641 %BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 20, 2014 Ms. Agena Rigdon DKR Shores, Inc. PO Box 488 Hampton Bays, NY 11946 RE: ROBERT A. CZENSZAK 4365 CAMP MINEOLA ROAD, MATTITUCK SCTM# 123-5-23 Dear Ms. Rigdon: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 20, 2014 regarding the above matter: WHEREAS, DKR Shores, Inc. on behalf of ROBERT A..CZENSZAK 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 July 17, 2014, 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 20, 2014, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 • • WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ROBERT A. CZENSZAK to remove existing damaged bulkhead; construct in-place new 66' long vinyl bulkhead up to 15" higher than existing; construct (2) 15' long vinyl returns; backfill area with approximately 65 cubic yards of clean fill; construct new 4'x66' walk along the landward edge of bulkhead using untreated material; and reconstruct existing 4'x6' beach access stairs; with the condition to establish and subsequently maintain a 10' wide non-turf buffer landward of bulkhead; and as depicted on the site plan prepared by DKR Shores, Inc., last dated August 25, 2014 and stamped approved on August 26, 2014. 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: $0.00 Very truly yours, dot- 4, John M. Bredemeyer III President, Board of Trustees JMB/amn Robert A. Czenszak 4365 Camp Mineola Road, Mattituck SCTM#123-5-23 8/13/14 � f ► 11 - , 4,44 Arlo _ a Robert A. Czenszak 365 Camp Mineola Road, Mattituck 6CTM#123-5-23 :/13/14 • hAh . a • '*i* •••.- • John Bredemeyer, President Town Hall Annex Michael J. Domino, Vice-President ��°� e 54375 Route 25 James F. King ;S ? P.O. Box 1179 Charles J. Sanders ,� Southold, NY 11971 �� a° Dave Bergen ' ' l � '�'' Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: azi /3 7sdl}"' DKR Shores, Inc. on behalf of ROBERT A. CZENSZAK requests a Wetland Permit to remove existing damaged bulkhead; construct in-place new 66' long vinyl bulkhead up to 12" higher than existing; construct (2) 15' long vinyl returns; backfill area with approximately 65 cubic yards of clean fill; construct new 4'x66' walk along the landward edge of bulkhead using untreated material; and reconstruct existing 4'x6' beach access stairs. Located: 4365 Camp Mineola Road, Mattituck. SCTM# 123-5-23 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound {Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: V Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Congition ; `/��,.rs'� ., ; ,�.�-p l S � .�.. 174V ' Present Were: J. Brede eyer wfi. DominoKing +-C. Sanders (--4:). Bergen Bay Constable Other Form filled out in the field by 45- Mailed/Faxed to: Date: T 4 _ CI 't ;�4 . _ _ . - • = ;mss w t i i n-wan_ ,- \J 0 :ems r®- .L. 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"` r....r 1 a .`.0 ____ .....u. __._— .1•••••••••111. •.... [[x Nne[.wrrAPERM...OFTHEENCV :✓� x n.!!�� P mruerw 1M0 PROPERTY NAP 00WERWN WU.NO t•MI 0 ,,„ .i.� II OFFICE LOCATION: �. 0••/ ��� SOti MAILING ADDRESS: Town Hall Annex 1�' ' O : P.O. Box 1179 54375 State Route 25 iNg * , Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) vkco Southold, NY 11971 % O �p,��c Telephone: 631 765-1938 Fax: 631 765-3136 �yeouNTI��,•e'�, %•... , 1'° LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM rC� i1 qty fes . . .- 3 To: John Bredemeyer, President STown of Southold Board of Trustees II AUG 1 9 2014 ,;!- J,/ From: Mark Terry, Principal Planner LWRP Coordinator ,.,' Boa';:..._..,,, ,<:. . _.-.— Date: .Date: August 19, 2014 Re: Proposed Administrative Permit for ROBERT A. CZENSZAK SCTM# 1000-123-5-23 DKR Shores, Inc. on behalf of ROBERT A. CZENSZAK requests a Wetland Permit to remove existing damaged bulkhead; construct in-place new 66' long vinyl bulkhead up to 12" higher than existing; construct (2) 15' long vinyl returns; backfill area with approximately 65 cubic yards of clean fill; construct new 4'x66' walk along the landward edge of bulkhead using untreated material; and reconstruct existing 4'x6' beach access stairs. Located: 4365 Camp Mineola Road, Mattituck. SCTM# 123-5-23 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 actions are CONSISTENT with the Policy Standards and therefore are 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 410 ,,,,,,,---_____ 110 1+\ %V Peter Young,Chairman ; , Town Hall,53095 Main Rd. Lauren Standish, Secretary ,` tri4 P.O.Box 1179 .0 Southold,NY 11971 \f* .�fi�`�'l' Telephone(631)765-1892 4 14%, ,,, Fax(631)765-6641 ., Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., August 13, 2014 the following recommendation was made: ROBERT A. CZENSZAK to remove all sections of timber bulkheads, reconstruct in-place of seaward bulkhead 66' new vinyl bulkhead "up to 12" higher", (2) new 15' vinyl returns and backfill with 65 cy. clean fill as necessary. Construct a 4'X 66' walk (untreated material) landward of new bulkhead. Located: 4365 Camp Mineola Rd., Mattituck. SCTM#123-5-23 The CAC did not make an inspection, therefore no recommendation was made. D i; 7J2oMi7p1 • • John M.Bredemeyer III,President 4*4 mo,„ ' Town Hall Annex Michael J.Domino,Vice-President 14.4;t) (4:9 '?; 54375 Main Road James F.King,Trustee sras ail .f d Southold,New York 11971-09591 Dave Bergen,Trustee 111 a Telephone(631)765-1892 Charles J.Sanders,Trustee COMM � �Et Fax(831)765-6641 <... t BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD D Office Use Only ` Li _Coastal Erosion Permit Application JUL 1 7 2014 V Wetland Permit Application Administrative Permit Amendment/Transfer/extension ,..,. Received Application: 7//7/� • T Received Fee:$ �b v- • Completed Application 7707/'1 _ _Incomplete _SEQRA Classification: Type I Type II Unlisted _Coordination:(date sent) X1 LWRP Consistency Ass ssmept Form I> / CAC Referral Sent: _ J / 10 Date of Inspection: 3/7-"r" _Receipt of CAC Report. _Lead Agency Determination: Technical Review: Public Hearing Held: SpeAct Resolution: Name of Applicant gO ...- Cz c_rn 5 ZG-u_ Mailing Address 10 St rner h(' I ( O riv E , ADO W ADA. n , 1"iq_._e 1 Ci 33 5 Phone Number:( ) 1 10 - 6 t!a Suffolk County Tax Map Number: 1000- a 3 — 05 - 3 3 to 5 Corn.p )'Yl i ne o f o.. PotPropertyLocation: 1-1 1 _. (provide LILCO Pole#, distance to cross streets,and location) _n c 1 ' - ��' AGENT:____...._...� I, � ,1 � 1 � I, ,.• I 6. _. _ SIS(' ) � (If applicable) Address: P . O. IJ Q erg+) fi n ,,{ \ \CL4lam Phone: (n.7)k 5t.p �. -LatDU.Q (Y,1\03` �5t�` 4oard of Trustees Application GENERAL DATA Land Area(in square feet):_ i O, 169 S - -C Area Zoning:______AL i0LAn Previous use of property: e%`1-i5 /('e-52 Intended use of property:__ 30.111¢ Covenants and Restrictions on property? Yes )( No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes [` No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes 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 x No Does the structure(s)on property have a valid Certificate of Occupancy? / Yes No Prior permits/approvals for site improvements: Agency Date tla-Yub. n • 1 D L. .9- - t\l‘\5'N C 6 e ra l Periss e- bOlkl2s . - Lig _ 09) L /ooOo e,,6p I-►Lc- 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): Arocaraforasec 4U rein ov QI� SCC- o __ timber--h I Ind (s re, bul _c - n place ) of Seaward (v ,h �Wer; ka �� t � I � 2t hew 15' Urn y re-urns . _ ClEa44 ./I4 akt To �ons4 runt- 611X C ' &to' wed k (U� trea e d l�(a. tc�a.l) 04(460(4 P -x ,w b ) LAA . •rd of Trustees Application • WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Ero 5;DYl GOY) 1 — Area of wetlands on lot: square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: (feet Closest distance between n t proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No r/ Yes If yes,how much material will be excavated? cubic yards How much material will be filled? 9 5 cubic yards Depth of which material will be removed or deposited: 1 feet Proposed slope throughout the area of operations: 11- Manner in which material will be removed or deposited: .i)&, ._ $t-te r and /o r 5rnod I bu lot 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): 11-s rrfcstci 41f\e �ra���— SlYtA have_.no £,•_1 i :V 1 et s /Del4-6 ) Cs f t Qvtc51/J Som • • 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Ober — A . C z en s za Name of Action or Project: -_-__ 311°"(k°-aj re.c0n (� plate e..) w/vin. . Project Location(describe,and attach a location map): Brief Description of Proposed Action: )Z t h 1 k z — Pecon C�n ace)bce Is�ii2 &a l bad d u) vrh ( ' * fuit, 4/Uri/I 5 I -h).bAda II Lt.)/ C . c ovt vuck a "-&-- 4 t ? (a(0 Name of Applicant 6r onsor: Telephone: 56 L —620 tt.12, �V'ZnY' _ E-Mail �rre �r Add s: 7_ )��-,_ 9, b . god 4bg act. __ City/PO: State: 0 _ LC��i 10 1.Does the p oposed action only invol the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that n may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? _NO YES if Yes,list agency(s)name and permit or approval: N`, •in _ Et! 3.a.Total acreage of the site of the proposed action? 10 1 toy -wares 5 F. b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action, ❑Urban 0 Rural(non-agriculture) ❑Industrial El Commercial OResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 ! ! 5. Is the proposed action, NO YES N/A a. a. A permitted use under the zoning regulations? ED b.Consistent with the adopted comprehensive plan? n 0 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? n 0 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? (E ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? EI n 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply? ,�y NO YES If No,describe method for providing potable water: �' rl 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: I-- 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES P aces? � n �1 yin b. Is the proposed action located in an archeological sensitive area? Jv 1'I ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain O YES wetlands or other waterbodies regulated by a federal,state or local agency? n b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? �(�` If Yes,identify the wetland or waterbod and extent of alterations in square feet or acres: ' I 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline 0 Forest 0 Agricultural/grasslands ❑Early mid-successional Wetland 0 Urban 0 Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? n 16.Is the project site located in the 100 year flood plain? NO YES 171 17.Will the proposed action create storm water discharge,either from point or non-point sources? ,„ NO YES If Yes, E E a.Will storm water discharges flow to adjacent properties? NO EYES b.Will storm water discharges be directed to established conveyance systems(r _off and storm drains)? If Yes,briefly describe: Fr. EYES Page 2 of 4 S 18. Does the proposed action include construction or other activities that result in the impoundment of I NO YES I water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: l l 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: /41 (] I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE A licant/s onso me: i P` /D�..e S'v 2rg/— – Z Pp p 1 Date: /-7 7 —Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? y� 2. Will the proposed action result in a change in the use or intensity of use of land? I i 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the (� establishment of a Critical Environmental Area(CEA)? l 1 5. Will the proposed action result in an adverse change in the existing level of traffic or I V• ,f ri affect existing infrastructure for mass transit,biking or walkway? I 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? I 1 7. Will the proposed action impact existing: - r n a.public/private water supplies? _ b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, d I C architectural or aesthetic resources? L- 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, I waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 • I No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage El problems? 11. Will the proposed action create a hazard to environmental resources or human health? IIM Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. iiCheck this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees (I Zv / 7 Name of Lead Agricy Date (c_' e 1 J- Ern / President Print or Type Name of Respo sibl fficer in Lead Agency Title of Responsible Officer ignature of Respo s' le Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 • PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK t , residing at MOO tJ}� ey-� A e ,(L L 4lta_bOscut , being duly sworn,deposes and says that on the g' day of 414.4. , 20 l`1, deponent mailed a true copy of the Notice set forth in the Board of'trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said No ' - were mailed at the United States Post Office at ,�o • , that said No =° ere mailed to ea. •f said persons by CERTIFIE)JMAIL ' TURN RECEIPT. • , Sworn to before me this 20 Day of US� , 20 i1 { Notary Public JOYCE M.CAMPBELL Notary Public,State of New Yat No.01CA4972051 Qualified in Suffolk County Commission Expires Sept.17.20 1110 • John Bredemeyer, President "suFFoc� Town Hall Annex Michael J. Domino, Vice-President 14- 0'- --co.. °,�; 54375 Route 25 James F. King ,h z P.O. Box 1179 Dave Bergen i �,/ Southold, NY 11971 Charles J. Sanders -y4foi ,F ya°0.'' Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ROBERT A. CZENSZAK COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS I, L K, �9-e14L /ejq , residing at/dba d i 4C Ito"A/D--c.aiceer Z.cV 33-- 77-,ou 1--- 6-4-4,-crle— adk-a-- 0-at,..a. s_L ert_sz.,,_, being duly sworn, depose and say: That on the Cr day of ash , 201 , I personally posted he pro ert own as de kr Ab�D/� /�G'( /6".. by placing the Board of Trustees ficial 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 Wednesday,August 20,2014. Dated: II AAI / 7._ re UPY/ Sworn to before me this a° day of,1 ai/20/i Notary Public JOYCE M.CAMPBELL Notary Public,State of New Volt No.01CA4972051 Qualified in Suffolk County Commission Expires Sept.17,20 > NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be held by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. • OWNER(S) OF RECORD• Roberf R. z ens 2-01c. C SUBJECT OF PUBLIC HEARINGS R ;A existing bulkhead; *, s �, ..a , . bulkhead up to 12" higher than existing; construct (2) 15' 16 vinyl returns; backfill area . .a ,-ly 65 cubic y . of 4, y;n fill; construct new 41'x66' walk along the landward edge of bulkhead using untreated material; and reconstruct existing4'x6' beach access stairs. TIME & DATE OF PUBLIC HEARING: Piv? 1 kktic7/ c.X'19 -of-or odoo►d S'•'.30 r� . flu c�5 , If you have an interest int is project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of8 a.m and 4 p.m. Y BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 Bo. of Trustees Application 40 County of Suffolk State of New York /` (Z,2ItJs Z./1 ,k 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. Signature of Prop wne SWORN TO BEFORE ME THISt;144-k. DAY OF ,2014A Notary Public THERESA M.KATTAU Notary Public,State of New both No.011%4832984 Qualified E inesJanuary nta 31,Je Commisssion ii By of Trustees Application • AUTHORIZATION (where the applicant is not the owner) I, Ila QT 4 ( JZ9'1. residing at d 5ummerhi L (print owner of property) (mailing address) 19335 Or) OD w i n /Don Pl3 do hereby authorize 1 / i , dint — 'Agent) ' 1q 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 Part of town officers and employees,The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: -R • (Last name first name,piddle initi ,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Taievance Buildingrust Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse.sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"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 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,or child is(check all that apply): A)the owner of greater than 5%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 a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner.or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP 1D OV1e.iaVatQe. LA)/ prose CV Submitted this (, day of 1_ I 200L/-91Signature Fes_ Print Name Alra _ ,if Form TSI s • ,oro --....v , __ Town of Southold i1 Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM s-�' ;. PROPERTY LOCATION: S.C.T.M.0: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A C4 y ,,'' 1 looD G3 0 5 a 3 STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN District Section "WocJ oo CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION TTEM# / WORK ASSESSMENT YesNo a. Whet is the Total Area of the Project Parcels? Q 1 Will this Project Retain MI Storm-Water Run-Off 6(Include Total Area of all Parcels located within (C> f I \ Generated by a Two(2')Inch Rainfall on Site? / the Scope of Work for Proposed Construction) (This item will Include all run-off created by site / b. Whet is the Total Area of Land Clearing ()Acres) clearingand/or construction activities as well as all ✓✓ and/or Ground Disturbance for the proposed 13 ZQ Site Improvements and the permanent creation of construction activity? / impervious surfaces.) (s_tor Acrel PROVIDE BRIEF PROJECT DESCRIPTION IRONS'Additional Pages ore eded) 2 Does the Site Plan and/or Survey Show All Proposed NejDrainage Structures Indicating Size&Location?This ' item shall Include all Proposed Grade Changes and — `n a c.�,n . ' h� J ('fl t o r.e ) Slopes Controlling Surface Water Flow. e. 11 P 3 Does the Site Plan and/or Survey describe the erosion C/ (CU v p 4-o t -t'/Us l,t and sediment control practices that will be used to ❑ � control site erosion and storm water discharges. This — LS C' l 1 item must be maintained throughout the Entire f Construction Period. -(z ) ,) 1. U t Ai I ' 'k)r i S 4 Will this Project Require any Land Filling,Grading or 4 (( ''// JQl L Excavation where there is a change to the Natural ❑ J �L0 LP(ht? . Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities e — Encompassing art Area In Excess of Five Thousand (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the / " Site? Is this Project within the Trustees jurisdiction t/ General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP Is required for all Construction activities involving soli Beach? disturbances of one(1)or more acres; Including disturbances of lose than one acre that 7 With there be Site preparation on Existing Grade Slopes / ere part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to ✓ Including Construction activities I woMng sot disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? — — the DEC has determined that a SPOES permit Is required for storm water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDEB General Permit 8 Will Driveways,Parking Areas or other Impervious IN / for Storm Water Discharges from Construction activity-Permit No.0P-010401.) Surfaces be Sloped to Direct Storm-Water Run-Off c/ 1.The SWPPP shell be prepared prior to the submittal of the NOI.The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. / 2.The SWPPP shell describe the erosion and sedknent control practices and where 9 Will this Project Require the Placement of Material, ✓// required,post-oonetnwdon storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any ❑ constructed to reduce the 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 addition,the SWPPP shall Are8?(Tlhle Item will NOT InoW6 the hertalletlon of ONvewey Aprons.) Identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 3.AN SWPPPs that require the post-construction storm water management practice in a Box and the construction els disturbance Is between CON a.F.31 Awe M area, component shall be prepared by a qualified Design Professional Licensed In New York a Sterni-Water,Grading,Dralnags&Erosion Control Plan ie Required by the Town of that is knowledgeable In the principles and practices of Storm Water Management Southold and Must to Submitted for r for each Prior to Issuance of Any Complete Permit. (NOTE: A Check Mark(.1)and/or Answer for each Question h Required fore Complete Appilceeon) STATE OF NEW YORK, , ,r n COUNTY OF.S .Tri?' ss That I,.1101-et.k <'4 11. r lq.'� being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of MrYvid signing Document) And that he/she is the QG>j,�( j 00 (Owner,Contractor,\ y�St orporete 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 make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; 15-44- day of... (-)\1/4- 20j4 r Notary Publi � 1 64,-'' e... / (SI, -lureof/ scant) FORM - 06/10 LAUKIt rv+Lr1ORN NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 KA6205483 Qualified in SUFFOLK COUNTY Commission Expires MAY 11,2017 • • Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluatedas 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- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION 1000 — SCTM# 13,3 - 65 - a 3 �I PROJECT NAME C Z e n S zp.Y- v -8Lu I kt 02r-on The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees ig Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital ❑ construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit,approval,license,certification: Nature an. extent of action: .t i. n . 0 __4 Ji 1 �J I f))Oce DC-e i5-hi (á&) n� b I�p(v� vl,� I u 1211 kdkso 5 ��. . z , . s b , ) Esc /'t1 -iv rt si-a l l -� ' > I i3€ access _ , i&S ' q ' X 4262 re -� cu(c ► � 1ct,�.d w�� v b Ilc�l� w • Location of action: LI 3 Co 5 Came J i n e 010. 12c! ' ) u ,64- - Site acreage: (D 16'S 5 . 1 Present land use: I 1 Citi - I,Ute_renD C1\--- Present zoning classification: r ,6j6 -H-j cd 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 l Db of f /�A A . CMZ 2_n5 Z0..k C /O D K k Silo re S (b) Mailing address: P,(7 . box 1 -t`tp Q �n c._, . NN. `.c\LA-1Q (c) Telephone number: Area Code( ) (pal-51D.(,D -C4 01 Cy (d) Application number,if any: )(\\ 3-{ , (LA-44 lS 4.me . Will the action be directly undertaken,require funding, pproval y a state or federal agency? Yes EJ No❑ If yes,which state or federal agency? n yS Dry _ e! 1-hat been rem - 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 n 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— ' ies Pages 3 through 6 for evaluation criteria Pol 0 Yes C 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 r Yes n No Ui 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 Secti n III—Policies Pages 8 through 16 for evaluation criteria Yes n No 0 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 thro 21 for evaluation criteria Yes El 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 III—Policies; Pages 22 through 32 for evalua ' criteria. n n 1,a 4IP • Yes No Not Applicab 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. n Yes n No Ed 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. n Yes n 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. YeEl No❑ Not Applicable Attach additional sheets if necessary IP S WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in sui ble locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. r. Yes No ❑ 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 w ers. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. Yes ❑ No 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 eva nation criteria. n Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; ages 65 through 68 for evaluation criteria. I I Yes n No Not Applicable PREPARED BYD KE S D(� z—1 RA UY�- .-1()& TITLE A- (, DATE T Of U.CAN--, APPLICANT PROPOSES TO REMOVE SECTIONS OF EXISTING TIMBER \ • BULKHEAD,TO RECON(IN PLACE)OF EXISTING 66'BULKHEAD 15"HIGHER THAN EXISTING,TO CONSTRUCT(2)NEW VINYL RETURNS,TO BACKFILL \ STRUCTURE WITH 65 CY OF CLEAN FILL,TO CONSTRUCT A NEW 4'X 66' WALK LANDWARD OF BULKHEAD AND RECON/REINSTALL EXISTING 4'X 6' \ y BEACH ACCESS STAIRS. AT CAMP MINEOLA,ROAD,GREAT PECONIC BAY, MATTITUCK,TOWN OF SOUTHOLD,SUFFOLK COUNTY,NEW YORK. ol SHEDI \ \ EX.CONCRETE WALL(seaward section tom \ -'� •=removed)and 15'vinyl return to be \ constructed in it's place � � � GARAGE C \ �'< 11G 1/\$ Vtt \ �3. INN p \ °�i t�S ?O �i•` �a z �a � � \ \� — walkway / V. 0 0 xt,,% 1.4 % -z \ �'� i. \' DECK \ �� \� �� 1 STY COTTAGE �� \ \ 4x6 beach access \ \ i — I steps to be recon as necessary � \ `` / 'ROP\15'RETURN Ek—woo. --EX.CONCRZ —PL \\ \ WALL(to remain undisturbed) \\ \ '''APPROVED BY \ \ BOARD OF TRUSTEES: �- -'C -- • 'TOWN OF SOUTH. --- \ \to show buffer 8-25-14 ' 210 9_ D (a' D.) Applicant: Robert A. Czenszak - `� Location: 4365 Camp Mineola Road, Mattituck !'i1I AI/ Purpose: Bulkhead reconstruction AUG 2 6 2014 _p'4,',�.1' / Datum: Apparent Low Water IP, \�`,1 ,11) (/'/`, ' LOCUS: 40°58'48"172°31' 35" Southold Town . 23-5-23 � , rl d/,' y, i 11�,fp,/ DKR SHORES INC, P.O. BOX 488 1 July'14 SCALE 20' ;i`rt rf •S., HAMPTON BAYS, N.Y. 11946 SHEET 1 OF 2 10'NON-TURF BUFFER AREA REQUIRED I-574"x 6" CAP 2"X6"FOLLOWER ______ Z, ii PROP.4'x 66'walk , PROP. GRADE EX. GRADE — / 3/4"HCG HARDWARE )1)1 lite 1"X 12'LONG HDG TIE ROD de / %VI ; :I - 10"0 CONTINUOUS LAYLOG / 5 X 5 CCA WALES(2 ELEVATIONS) BEACH GRADE C WEEP HOLE IN VSP©9'O.C. i 8"CCA PILE- 16'LONG@6'O.C. 1 I 1 1 / I EVERLAST ESP 4.5 VINYL SHEET PILE(TYP)- 12'LONG Constructed 15"higher than existing timber bulkhead 8"X 8'LONG ANCHOR PILE @ 6 O.C. 1 I i APPLICANT PROPOSES TO REMOVE SECTIONS OF EXISTING TIMBER BULKHEAD,TO RECON(IN PLACE)OF EXISTING 66'BULKHEAD 15"HIGHER THAN EXISTING,TO CONSTRUCT(2)NEW VINYL RETURNS,TO BACKFILL STRUCTURE WITH 65 CY OF CLEAN FILL,TO CONSTRUCT A NEW 4'X 66' WALK LANDWARD OF BULKHEAD AND RECON/REINSTALL EXISTING 4'X 6' BEACH ACCESS STAIRS. AT CAMP MINEOLA,ROAD,GREAT PECONIC BAY, MATTITUCK,TOWN OF SOUTHOLD,SUFFOLK COUNTY,NEW YORK. *revised to show buffer 8-25-14 I N. --- Applicant: Robert A. Czenszak I:\ `-a Location: 4365 Camp Mineola Road, Mattituck Q .i ii ,� << I .�/ Purpose: Bulkhead reconstruction V _��,�,11� i / ' Datum: Apparent Low Water AUG 2 6 2014 ���\ ,,1 �,/4//' LOCUS: 40°58'48"123-5-23 72 31' 35" �� -; � P�����"1/' DKR SHORES INC, P.O. BOX 488 1 July '14 SCALE 3/8"= 1' of Trust es HAMPTON BAYS, N.Y. 11946 SHEET 2 OF 2 ELEVATIONS REFERENCED TO N.A.V.D. SURVEY OF PROPERTY x = SPOT ELEVATION AT MA TTIT UCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000-123-05-23 SCALE: 1'=20' NOVEMBER 28 2013 X DEC. 2, 2013 (CORNERS SET) JUNE 16, 2014 (REVISION) 4 KT of �ITA1 TIMBER CURB RjQ �"� 30 I 0.6.E• 717.08 O 65.40 W Ds j IC `� N76.35+40 `�K 'l4-- a 9R `.< / PR SET-' 0 c WALL o W NZ ME R A$-1 NPT �s N ♦ Qo CONC. No 2 4.9' 14.3 � � 1�1W N ' Lct4 \.i / N w< NU I cisMN 0.8' 25.3 ANT 10.9' �� V i 1 1l� Wcl cc OUT.SI.wR. i Li z 3.7' '� tL N W o Q 2 * �U E Q Q ®aa N o Q .. , o Z3 X' 25.3' lit 4.2' Z EL6.1' w - /0.8' x U EL4.1' II DECK ' .1 EL 5.4' O / Z ),- X X EL4.1' 1_ c x ` N . EL4.6' EL4.5' otd C 46 � O EL4.5' g � ♦�• 14 EL.4.8'- X EL 5.0' CO AEL 5.1' l Cl) 2 X EL.5.1' oFLAG POLE BEL4.9' xEL4.8' 1Op WPV --L1:- �, r i; .i`' Q 4.5 xE�3 1 EL4,7'X W�gENCN EL4.5 it 5.4 JUL 1 7 2014 EL4.3 EL4. .80:000...-0.1..• V0 _,T.-. , 4.5' E� / Eat-1,7:,i,:,:=,:.:.:'id? WALL O 9'E g.3 A� W000 g��H 66.32✓ ,�. y• E3-.3.'i'X ` Si MUNE) • PW 1� .800* •512 �� of -:\-‘`X.01-1057 0�G lot_ Wp ,.4.,,,,..o.,G Y BA psCONIC % • AREA = 10,169 sq. ft. ; : to tie line , t I � h. � %` e.,.#<' . Y.S. LIC. NO. 49618 ANY AL TERA 770N OR ADDI770N TO THIS SURVEY IS A VIOLA 770N '' Co v ► 4i%='1_ ORS, P.C. OF SEC770N 72090F 7HE NEW YORK STATE EDUCA770N LAW. (631) 765-5020 FAX (631) 765-1797 EXCEPT AS PER SEC770N 7209-SUBDIVISION 2. ALL CER77F/CATIONS P.O. BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET /3 272 WHOSE SIGNA TURE APPEARS HEREON. SOUTHOLD, N. Y. 11971