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Home My WebLink AboutTR-4461 Michael J.Domino,President �0f S0!/jyo Town Hall Annex John M.Bredemeyer III,Vice-President l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 CA A.Nicholas Krupski �pc Telephone(631) 765-1892 Greg Williams �ly`,ou Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 15, 2018 Thomas J. McCarthy McCarthy Management, Inc. 46520 C.R. 48 Southold, NY 11971 RE: PAUL & JOAN KUSTEK 1540 SMITH DRIVE SOUTH, SOUTHOLD SCTM# 1000-76-3-5 Dear Mr. McCarthy: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, August 15, 2018: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#4461 from Victor & Gail Ferrulli to Paul & Joan Kustek, as issued on May 25, 1995. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, ?rza�/ Michael J. Domino, President Board of Trustees MJ D/dd Micl-fael J..Domino, President *rif SO, Town Hall Annex, John M.Breden-idyer III,Vice-President 54375 Route-25 P.O.Box 1179 Glenn Goldsmith Southold,,New'York,11971 A.Nidholas'KnC-Sipski Telep-hone -1892 (631)765 Greg Williams Fax-(631) 165-66.41 e0UNV BOARD 01F TOWN TRUSTEES TOWN OF SOUTHOLD APPLICATION FOR A TRANSFER OF A WKFUIWT_ C _ E �11 D 2018 0, DATE 6/19/2018 JUN 2 6:j Southold Twun A Paul & Joan Kustek OWNER PHONE-- MAILING ADDRESS 743 Flowerdale Drive, Seaford, NY 11783 AGENT Thomas J. McCarthy PHONE 631-765-5815 ADDRESS 46520 County Road 48, Southold, NY 11971 PROPERT-'LOCATION 1540 Smith Drive South, Southold, NY 11971 TAX MAP NO. 1000-76-3-5 I/We Paul & Joan Kustek- xequest.a Transfer of Permit# 4461 from Victor J. Ferrulli Signed By:, s - a Board of Trustees, Application i I i s -AFFIDAVIT a I I Paul & Joan Kustek E £EING',1DULYY SWORN DEPOSES AND AFFIRI IIS THAT H /SHE'',1STI3E APPLICANT FOR THE'ABOVE DESCRIBED•PERMIT,(S)_AND THAT ALL,STATEIVIENTS'CONTAINED HEREIN ARE TRUE TO'THE BEST OF'HIS/HER KNOWLEDGE AND'BELIEF;AND THAT ALL WORK WILL BE DONE IN THE MANNER SET'FORTH1N THIS APPLICATION ANNAAS MAYBE APPROVED.BY TEIE�S.OUTHOLD'TOWN BOARD OF TRUSTEES_ . THE A.PPLI.CANTAGREES TO HOLD THE TOWN,OF SOUTHOLD AND'THR BOARD QF TRUSTEES 11AAM-USS-AND FREE FROM-ANY AND ALL DAMAGES; I AND CLA;IN$J ,A:RISING-UNDER OR,BY Vy -TUE OF SA:ID_PERMIT(S),,IF GRANTED. IN COlVIPLETJCNGTHIS APPLICATION;I HEREBY-AUTIIORIZE THE TRUSTEES,THEIR AGENT(S) OR RE PRESENTA:TIVES, INCLUDING THE ' CONSERVATIONADVISORY COUNCIL,TO ENTER:ONTO MY PROPERTY TO- l[NSPECT THE PREMISES:INf CON&NCTION WITH THIS AJPPLItkTION' INCLTIDINGA FINAL INSPECTION FURTHER AUTHORIZE THE 13 J A OF TRUSTEES`TO ENTER ONTO MY PROPERTY AND.AS,REQUIRED TO INSURE ? COMPLIA:NCE'WITHA:NY CONDITION OF ANY WETLAND OR-COASTAL ER^SIOl`I PERMIT ISSUED.B�`i'-Ti�E'BOARD OtTRUSTE-ES.DURIIVG THE'TERM � 'OF THE.PERI M i ! i =Sig re of Pro rty Owner Signa r of Property Owner ,S WORN TO BEFORE ME THIS' . DAY QF Z� WALTER J ALLEN Notary Public-State of New York N0.01 AL6202242 NNOtc1r 'I�UbI1C Qualified in Nassau County otary'Public Commission Expires Mar 1 G,2021 Michael J. Domino, President ,{ �Q CD Town Hall Annex John M. Bredemeyer III,Vice-President._- ��O G��' 54375 Route 25 Glenn Goldsmith C $ P.O.Box 1179 A.Nicholas Krupski �O � Southold,NY 11971 Greg Williams p! Telephone(631)765-1892 mol '�a Fax(631)765-6641 BOARD OF TOWN TRUSTEES ,) TOWN OF SOUTHOLD Date/Time: /0 it ?-®1d /.,Wa, Completed in field by: QQ'Y�' Thomas McCarthy on behalf of PAUL & JOAN KUSTEK requests a Transfer of Wetland Permit #4461 from Victor & Gail Ferrulli to Paul & Joan Kustek, as issued on May 25, 1995. Located: 1540 Smith Dive South, Southold. SCTM# 1000-76-3-5 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 d Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: k1d,7E a" � , I- A"LW W"84 A�v 710 1 Aae=� I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer J M. Domino G. Goldsmith N. Krupski G. Williams Other MCCARTHY ' MWENT9 ]NC. awn 6-1 46520 COUNTY ROAD ? - SOUTHOLD, NY, 11971 I p DAT JOB NO (631)-7,65-5815 FAX (631) 765`5016, -° ATTENTION I TO 44 RE WE ARE SENDING.YOU ❑ Attached. ❑ Under separate cover via the following.items: ❑ Shop drawings ❑ Prints ° ,,, 0 Plans. ❑, Samples ❑ .Specifications. ' P,.Copy'of•lette'r ❑,Change order ❑ •• • • 0 l tJA � I ,8 a O VU THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted - ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: If enclosures are not as noted,kindly notify us at once. Michael J.Domino,President S0 Town Hall Annex�0� John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders C'm 4tr Southold,New York 11971 Glenn Goldsmith Q Telephone(631) 765-1892 A.Nicholas Krupski lif'COU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1307C Date:January 30,2017 THIS CERTIFIES that the existing 5'x20' floating dock with two pilings; At 1540 Smith Drive South, Southold Suffolk County Tax Map#1000-76.-3-5 Conforms to the application for a Trustees Permit heretofore filed in this office Dated August 16, 1993,pursuant to which Trustees Wetland Permit#4461 Dated May25, 1995,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 existing 5'x20' floating dock with two pilings. The certificate is issued to VICTOR FERRULLI owner of the aforesaid property. Authorized Signature QF SU(/r John M.Bredemeyer III,President �� y�lTown Hall AnnexO 54375 Route 25 Michael J.Domino,Vice-President .S P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G ® �Q Telephone(631) 765-1892 Charles J.SandersFax(631) 765-6641 OWN,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 3-0 . 17 Y Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction '/z constructed Project complete �com liance'ins ection. p P P INSPECTED BY: "Yv,, COMMENTS: CERTIFICATE OF COMPLIANCE: Irtvr 1:errulh 1919 Ruccancer Drive # log S1-erasuta, F1 34231 1a.-sw=,` 26, -lo i' Tin of southO4. T fu%tL-c% F r �rxc P.U. HOX F 179 ld, NY 11971 RE: 1540 5auth Driv-c, Sourbojej. 1971 Fit the, {c'".rr W rvr :ta w!ltacre �h� at�i»� rn�ntx,n,c� �� for YOU k.)an��a �:•--rst or VR4461 �4x�'�r �c�k rati€at, Psi. inxped Kin rquol is ,j�a.i:n A CCr,:f�tc of 'C` p�3aarc�. t dux S{+te s� � l+ ,cd k*r the cc' I'cnr tJ r art_ Ft ycue r ld has a sr�w axe roc „ car ccWco-t.. P]c,I%c � ' �! 1 lr,�m +► lrt'9rth e � F irarc. F sz 631-765--" S Shy, y��.,. Ecraulri �'V '9. . °, `tiro �av�•✓�, �a� k6Ab 1z h�'ti'�:.. � � "<:c S� -� f a as CC - i Board Of Southold Town Trustees SOUTHOLD; NEW YORK y ` p ay -4 PERMIT NO. .._ DATE: _..25./95. y ISSUED TO ...VECTOR. &..GAIL.FERR.IILLL Au#4nr zation Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS i 3 . IN AND ON TOWN WATERS AND PUBLIC LANDS and the , REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM 1 LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on 5125.19.5 .... ` u 19 95..::, and in consideration of the sum of $ 100.,.00 paid by VI.C.TOR & ..GAIL F'ERRULLI l of ._.Southold__ N. Y. and subject to the "t 5` Terms and Conditions listed on the reverse side hereof, 3' `s r of Southold Town Trustees authorizes and permits the following: Grandfather Permit for a 5' X 20' floating dock with 2 pilings. Canal to Goose Creek -t3 all in accordance with the detailed specifications as presented in it the originating application. a IN WITNESS WHEREOF, The said Board of Trustees Mere- z by causes its Corporate Seal to be affixed, and these presents to - ' ai be subscribed by a majority of the said Board as of this date. cn z O _ �ypl .a0 u 1 T e h i wp\ l3\ rl i � � \ K . �ro mow ✓y ,3+�' .� � Yr .�. n.� ,� n BOARD OF TOWN TRUSTEES ` TOWN OF"SOUTHOLD SUFFOLK COUNTY Telephone SIC - 765-3783 Southold, L.S., N. Y. 1197t July 13, 1976 Mr. Thomas O'Neill & Mr. Arthur O'Neill Smith Drive South Southold, ' N.Y. 11971 Gentlemen: The Board of Trustees of the Town of Southold have examined the survey, maps, and deeds of your properties in the Goose Creek area. In our opinion, the areas covered by these deeds indicate your ownership as of the dates shown. This ownership includes the marsh land and the bottoms of the man-made canals included therein. Therefore, in the opinion of the Town Trustees, the Town of Southold does not have ownership of these lands and lands under water and consequently does not have jurisdiction over them. t f We suggest that you stakeout the boundaries of your marsh lands and canals that are covered by these deeds in order that your rights thereto may be known by anyoneconcerned. Yours truly, Alvah B. Goldsmith, Chairman Board of Southold Town Trustees ABG/bn cc: Southold Town Board Chief of Police, Carl Cataldo TRUSTEES SUPERVISOR John M. Bredemever, III, President SCOTT L. HARRIS ;Albert J. Krupski, Jr., Vice President Henry P. Smith Town Hall John B. Tuthill 53095 Main Road William G.Albertson banj `t EO. Box 1179 Telephone (516) 765-1892 Southold, New York 11971 Fax (516)765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30 year Maintenance Agreement Erosion Protection Structures Chapter 37 Southold Town Code Southold Trustees as Administrator I (we) Victor J. & Gail A. Ferrulli type or print name(s) 1540 Smith Drive South the owners of record of property at: Southold` NY (type or print street address) SCTM #1000- in applying for a Coastal Erosion permit for an Erosion Protection Structure do 'hereby agree to a 30 ,year maintenance program for a structure commonly known as a 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 years and or equivalent to the original approved structure and that for any 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 to 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. Notarized Signature(o,f owner of record lb SWORN TO BEFORE ME THIS 0 DAY OF (J U S+ ,199 NOTARY PUBLIC ELEANOR A. SORR£NTINO Notary Public, State of New York No. 4624646 Qualified in westc!,ester Cou Please submit three °OEE3 10�!ix9S� "'laic sed land survey made within one year of the original 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 ) BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD 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 REPRESENTATIVE(S) , TO ENTER ONTOMY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. i 7 it lti.� /�C M-,rvLtiL SIGNATURE SWORN TO BEFORE ME THIS DAY OF ,19 NOTARY PUBLIC ELEANOR A. SORRENTINO i tate of New York ' Notary Public, S : No. 462.4646 . - Qu-alified inwestct,er Cou1n9ty S Commssi n Expires ,an. 31, Suggested space for location Map THIS IS NOT A PERMIT TRUSTEES J� > ; SUPERVISOR John M.Bredemeyer, IIt, President' SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President Town Hall Henry P Smith r?, John B. Tuthill �' - ,N 53095 Main Road ,✓ . ,v William G. Albertson P.O. Box 1179 Telephone (516) 765-1892 U Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only: DATE REC.: Coastal Erosion Permit Application kACoastal Erosion Variance Application ' s etland Permit Application aiver from Chapter 97(Application/per . I ustee Lands Permit Application - AM to, so C:randfather ;Permit Application, Completed Apps. Date: -jyIk-l Z> TF1lArA, n 1 I n Inspection date: g- tom!-7✓ IdJY tV OF _HOLD getermin./date: ments-Date: Sent Rec, :r e Required: (Y/N)rs notified-Date:TypeDate sent Public Hearing/date: "Findings: Approved(YIN) Special Conditions: (YIN) (see file) Application Fee: �Permit(s) issued-date: Application Number;SCTM#1000-�71�6 3-5- Date: Applicant: Victor J. & Gail A. Ferrulli Address: 1540 Smith Drive South Southold, NY Phone '(51 765-640 Interest: (owner, consultant,lessee,etc. ) Owner Owner of Property: Victor J. & Gail A. Ferrulli Address 1540 Smith Drive South Southold, NY Phone { ) 765-61 Subject Property Location: SAv+Xc `Aa fR\yXiYF. (Provide LILCO Pole #, Distance to cross Streets if not on location map) THIS IS NOT A PERIMIT Page 1 '?ds. to be excavated: Inds. to be filled: -- Manner. in which material will be removed or deposited: Width of canal, creek or bay fronting property: 3 0 Depth at low tide: Aver. rise in tide: Distance to nearest channel: N - Distance project extends beyond similar projects in area: o.J Area zoning: Land area in acres: Is project for 'private or business use: 1tLaVviTe intended use of property: Describe known prior operations conducted on premises: N - n Has any prior license or permit been issued to erect structures, dredge, or deposit fill on said premises: U riti hhJW*) Has any license or permit ever been revoked or suspended by a Governmental Agency: O 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) . V e THIS IS NOT A PERMIT Page 2 Authorization (Where the applicant is not the owner) Victor J. Ferrulli &- I Gail A. Ferrulli residing at 1540 Smith Drive South (Print-owner of subject property) (Mailing address.-phone) Southold, NY 516-765-6146 do hereby authorize to apply for , Coastal Erosion permit(s). from the Southold Town Trustees Signature THIS IS NOT A PERMIT Page 3 W-',64(2/87)-Teat 12 �:/`"�+J� PROJECT I.O.NUMBER `�.,.. - 617( ,SEO Appendix C State Environmental Quality Review . -' SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART [—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. PLI�yaN-T./SPONSOR.. ?.. PROJECT NAME J. PROJECT LOCATION:. p Municipality .County 4. PRECISE LOCATION(Street address and road intersections,prominentlandmarks,etc.,or provide:map) _ 5. IS PROPOSED ACTION:' `cam ❑New C1 Expansion ❑Moditicationialteration C.Q �Ve VtI �Nr0y_M_. 6. DESCRIBE PROJECT BRIEFLY: h 7. AMOUNT OF LAND AFFECTED: Initially ' acres- Ultimately acres 8. WILL FROPOSED ACTION COMPLY WITH EXISTING ZONING.OR OTHER EXISTING.LAND USE RESTRICTIONS? '{ Yes ONO If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ""RResidentldi ❑!ndusinal ❑Commercial ❑Agriculture ❑Park/Forest/Open space ❑other Describe: 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(s)and Permit/aPProvals 11• DOES ANY ASPECT OF THE ACTION HAVE ACURRENTLY VALID PERMIT OR APPROVAL? j C3 Yes ❑No If yes, list agency name and permit/approval IS 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REOUIRE MODIFICATION? Cl Yes El No 1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE may, Applicantlsporlsor name: '" �t � v Dale: `a \\ Signature: 1✓.7/ + �� Idl�, If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment _� OVER __. ..�.+� i o co �.orno 'I^d 0,; Ayenc,") _ A. DOCS ACTION EXCEED ANY TYPE y RESHOLD IN 6 NYCnR, PART GITi it yes,c.r to the review process and use tern FULL EA ;�!' ❑Yes � � No J H. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR;PART 617.67 It No,a negative declaration a may be superseded by another involved agency. 13 Yes 13 No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten, if legible) 01. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns; solid waste production or disposal, potential for erosion,drainage or flooding problems?Explain briefly. - C2. Aesthetic,agricultural,_archaeOlOgica4 historic,or other natural or cultural resources:or.community or neighborhood characters Explain briefly* C3. Vegetation or fauna,fish,:shellfish or wildlife species,significant habitats,or threatened or endangered species?Explain briefly: C4. A c`o-mp munity's existing plans orgoals as officially adopted,or a change in use or intensityof useof land or other natural resources?Explain briefly C5. Growth, subsequent development,or related activities likely to be induced by the proposed action? Explain briefly. W C6. Long term,short term,cumulative.Or other effects not identified in CLOS? Explain briefly. C7. Other impacts(including changes in use of either quantity or type of energy)?'Explain prietly. D. IS THERE:ORISTHERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? uM ❑Yes No If Yes,explain briefly PART fit--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial;large,important or otherwise significant. Each effect should be assessed in connection with its (A) setting (Le, urban or rural), (b)probability of occurring; (c) duration; (d) irreversibility; (e)geographic scope;and(f)magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain'sufficient detail to show that all relevant adverse impact$have been identified and adequately addressed. ❑ Check this box it you have identified one Or more potentially large or significant adverse impacts Which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ❑ Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments asnecessary, the reasons supporting this determination: - NJmr ni Lejul AKeriCy Print VI IYVe Name pl Ketpun UU{B Vtlgef,n lc.W AFa'IKY (nip p! Ka•tPOnLUIa•UtbCH SiAneYure ul KeSpam,U1¢Utl¢i'r,n lead Ax<ncy SIXnJfUlC of 1'r¢pater Ilf dniercnl from IcrVumaole ollq Pr 1 Y s . r a ` �.� �'4 A [ tri ..i' "``� /s � :i �vr •A{ �• P pr.r} i3 fib.. s7iN r ap .ww �•�- rr 7 y y YL ,) we—�,-.....yam `� •�:r �'a: at � r v •. 3 rlt .y4 !..° ✓,'.o„ is ^A County. of Suffolk ) State of New York ) BEING DULY SWORN, DEPOSES AND AFFIRMSTHA /SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED ; PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND. BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD 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 REPRESENTATIVE('s) , TO 'ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.- . r li SIGNATURE SWORN TO BEFORE ME THIS DAY OF ,19 NOTARY PUBLIC -ELEANOR A. SORRENTINO Notary Fmblic, State of New York No. 4624646 Qualified in NJestct,esier county cbn5nisswen Expires.Jan.. 31, 19 Suggested space for location Map THIS IS NOT A PERMIT TRUSTEES SUPERVISOR John M.Bredemeyer, III, President i, SCOTT L.HARRIS Albert J.'Krupski, Jr., Vice President , Henry P. Smith Town Hall John B. Tuthill Y /?� -„ 53095 Main Road William G.Albertson 9 P.O. Box 1179 Telephone (516) 765-1892 Southold;New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30 year Maintenance Agreement Erosion Protection Structures Chapter 37 Southold Town Code Southold Trustees as Administrator I '(we) Victor J. & Gail A. Ferrulli type or print 'name(s) 1540 Smith Drive south the owners of record of property at: Southold, NY (type or print street address) SCTM #1000 in applying for a Coastal Erosion permit for an Erosion Protection Structure `:do hereby agree to a 30 year maintenance program for a structure commonly known as a 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 years and or equivalent to the original approved structure and that for any 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 to 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. Notarized Signature(o_.f owner of record SWORN TO BEFORE ME THIS 0 DAY OF (Q 0!Z+ , 19 NOTARY PUBLIC ELEANOR A.,$ORKNTINO Notary Public,,State of-New York No. 462464E Oualfied in westc`)ester Ooun Please submit threEP128 0&s-",8 � 'lice ed land survey made within one year of the original 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. qpul ez / > a� APR, 2 6 OLV TO 4 InrSznoli i Tj HIM Vo! - ,o / f2 v 5/417'�9 PRs ir= tee. r71 L-" 5,14 '1 d c-A7 �I 14TH f1 : lIIiS;Y Si I��i �l III is Tf. ;x t sof E - 3 +3 it Q.o eF II F aaif' f\ g j / F to 11 � a e F a .fi rl l :: . F fw / • C o n - ,/ iii ,t•. - < :. \ i ate_{-- -Ytl I 1 11 `� •Q O NoY 'Z6 7HunYberrs rc fcr;16 "'W4'7 4>711 45"--Pv NB k" t '_ --- f i/eco :n Sulk C arunl"y Cle�rA s elle as � Q Piga yt bfN p° off' h �+ 19"agb °xR 2 �e AUG 4 1993 * . 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