Loading...
HomeMy WebLinkAboutTR-4144 GFBoard Of $outhold Town Trustees S.OUTHOLD, NEW YORK PERMIT NO. 4~44 DATE: ..,4./39/.93 ISSUED TO .......... -TQ $.~;?~ . .C H ~.~,g~A .............................. Au horiza o Pursuant to the provisions of Chapter 6t5 of the Laws of {'he State of New York, 1893; and Chapter 404 of the Laws of {'he State of New York 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on 4/29 19 93 . and i~ consideration of {'he sum of $ paid by of ................................ N.Y. and subject fo the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits +he following: Grandfather Perr~it to reconstruc: bulkhead, deck & sunroof all in accordance with the detailed specificaflons as presented in +he originating applicaflon. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these p?senfs +o bi subscribed by a majority of.thesaid Board as of th,s date. ...................................... ................................... TRUSTEES ' John M. Bredemeyer,.jr. ILl, President Albeit J~ Kr~psk5 Vide P~'esid~n( -Henr'~p.s~ith ~ John B. Tuthill William G. Albertson _,. Te_leplmae .(516) -765,1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD 30 year Maintenance Agreement Erosion Protection Structures Chapter 37 Southold Town Code SUPERVISOR SCOTT L.HARRIS -~ 'T{~ii -Hall 53095 Main Road P.O. Box 1179 $o. uthold,: New York 11971 Southold Trustees as Administrator type.or print nale(s) the owners o~ record of property at: .(type or print sffreet address) SCTM ~t000- zn applying for a Coastal Erosion permit for an Erosion Pro~ection Structure do hereby agree to a 30year maintenance program for a structure commonly known as a j~//~ of ~ as shown on the attached feet of length licensed survey of the as-built Structure. It is my/our understanding that we are to maintain this structure with materials designed to endure 30 .... e.quivalen~. . ~ ~ ~ . to~he.~ ~°rigin~l~p-P~dV~d~';s~'~r~ ~nd :that. :...~ .... . - fo~- a~- -_ maintenance which involves more than 5% in length-of this- structure we are to give prior written notice to the administrator, waiting for their approval in all but true emergency situation's which would seriously endanger life, property and important coastal natural resource features such as bluffs or wetlands. We further understand that failure to maintain the structure could result in a requirement ~o post a bond and or have the repairs ordered as a lien against the property upon a-finding by the Trustees that said lack of maintenance would risk life, property or important natural resources features including protected, rare or threatened animals and plants. T~.r~l'ork Please submit three copiJ~~at~n~'~su~ve, made within one year of the originat construction. This maintenance agreement shall only be valid upon the final approval of the administrator. Subsequent owners may apply to the Southold Town Trustees to re-authorize this maintenance agreement. County of Suffolk ) State of New York ) ~ ~ ¢~ o.~. BEING DULY SWORN DEPOSES AATD 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/HERKNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MA~ BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO. HOLD THE TOWN OF SOUTBOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER ER ORaY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE TP~ ~USTEES, THEIR AGENT(s) ORREPRESENTATIVE(s), TO ENTER~T© MY PROPERTY TO INSPECT THE PREMIERS IN CONJU~CTIONWITH REVI~EW OF THIS APPLICATION. / SIGNATURE SWORN TO BEFORE ME THIS /~7~ .DAY OF ~_~ ,19{2~J NOTAR~ PUBLIC Suggested space for location Map THIS IS NOT A PERMIT Page 3 Yds. to be excavated: ~ Yds. to be filled: ~ Manner in which material will be removed or deposited: Widtk of canal, creek or bay fronting property: · ~ Depth at low tide: . ~ A~er. rise in tide: '~ Distance to nearest chann~-~i Distance project extends beyond similar projects in area: Area zoning: ~-~r Land area in acres: Is project for private or business use: ~;v~ Intended use of. property: Describe known prior, operations conducted on premises: Has any prior license or permit been issued u%~erect structures, dredge, or ~eposit fill on said premises: Has any license or permit ever been revoked or suspended by a Governmental Agency: Project Description The project description must also include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures (i.e., pipeline and septic system; make additional attachments if necessary). Authorization (Where the applicant is I residing at (Print-owner o~ subject property) do hereby authorize not the o~ner) (Mailing address-phone) to apply for Coastal Erosion permit(s) from the Southold Town Trustees Signature THIS IS NOT A PERMIT Page 2 TRUSTEES John M. Bmdemeyer, III. President Albert J. Krupski. Jr.. Vice President Henry E Smith John B. Tuthill William G; Albenson Telephone (516) 765-1892 Fax (516) 765-1823 SUPERVISOR SCOTT L. HARRIS BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Main Road P.O. Box 1179 Southold. New York 11971 COASTAL EROSION M3LNAGEME2qT PERMIT APPLICATION TOWN'WETLANDS PERMIT APPLICATION TRUSTEE L~lqDS PERMIT APPLICATION Office Use Only: asual Erosion Permit Application etland Permit ADplication~-D~Do,~ ~aiver from Chap%er 97 rustee Lands Permit Application randfather , Wcompleted Apps. D?te: ~CAC comments-Date. Sent Rec. ~Variance Required, ~ Neighbors notified Date: / SEQRA Type ~/~ - Coord. Review-?pt.,mand. ~Insp. comp./date. SEQRA Determin./date: Public Hearing/date: Findings: Permit Vote: {Y/N): Special Conditions: (also see fil~) Application Fee: Application Number; SCTM $1000- Project Name (If any) Date Prepared: -~/~c~/c~ 3 ~ zn~eres~: [owner, consultant,lessee,etc.) ~Owner of Property: ~ Phone S ' ub3ect Property Location: (Provide LILCO Pole $, Distance to cross Streets if not on location map) Consultant Project Name SCTM ~1000- ~ The Southold Town Trustee office has determined that your application for a coastal ero=~nn/~=-~-l~ ~=~.~ non 3urzsd!ctzonaI/lncomplete, please consider the following informatlon zn thid regard for any required re<urn submission: rustee R~present~tive ~ cc: B~i-l~-~.~ Deutr~. ~ ~'-"' ''- -'_, eal_ e~=~r-v =_ t ion A~c'i ~1 This notice makes no claim with respect to other jurisdictions within or outside the Town of Southold with respect to permits, permission required. 4/92 ,Appendix C State Environmenta Quality Review .~ SHORT ENVIRON MENTAL ASSESSM ENI' FOR M For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION ('Fo be completed by Aeelicant or Project Sponsor) ~. PROJECT LOGAT ON: SEQF 5. iS PROPOSED ACTION: 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT~AN/pOF LA AFFECTED: Initially ~/1)/7-- acres Ultimately -- acres B. WILL~F OPOSED ACTION COMPLY WITH EX[STING L~.Yes [] No Jf No, describe briefly ZONING OR O~HER EXISTING LAND eSE RESTRICT ONS? g. WHAT. IS PRESENT LAN'~ USE iN VICINITy OF PROJECT? [~R~srdentlal [] !nOustrial [] Cornmercfal [] Agriculture [] park/Forest/Open s~ace [] Other 10. DOESsTATEACTiONoR .OCAL]?INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANy OTHER GOVERNMENTAL AGENCY IFEDERA~-.J If yes, list agency(s) and Permlt/approva~s 11, DOES AN'~ ASPECT OF THE ACTIOt~ HAVE A CURRENTLy VALID PERMIT OR APPROVAL? AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAP~RROVAL R~UIRE M'ODIFICATION? I--)Yes ~No ' ! CERTIFy THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE "-"--If actior~ is in the Co,sial Area. and you are a state agency, complete the L_~ Coastal Assessmen. Form before proceeding with this assessment the OVER 1 ~0. ~.4~7 ~ADE iN U.$,A.