HomeMy WebLinkAboutTR-8783E saFOor-
John M. Bredemeyer Ill, President ;�o�ax , coG;` Town Hall Annex
Michael J. Domino, Vice-President _ kaa,. 1', 54375 Route 25
Glenn Goldsmith t;;N 1çP.O. Box 1179
A. Nicholas Krupski � =w 24.0%.c' �,� Southold, NY 11971
Charles J. Sanders `°; oxltl ;� Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
Pre-construction, hay bale line
1St day of construction
V-Project
1/ constructed
complete, compliance inspection
'1 ®F SO(j
John M.Bredemeyer III,President ,i0 ®�� tit :-� y®l Town Hall Annex
Michael J.Domino,Vice-President `` 54375 Route 25
-d P.O.Box 1179
Glenn Goldsmith ; V. Southold,New York 11971
sc
A.Nicholas Krupski G , 1, Telephone(631) 765-1892
Charles J.Sanders ��irCOUNTOC0i, Fax(631) 765-6641
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BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
EMERGENCY WETLANDS PERMIT
Permit No.: 8783E
Date of Receipt of Application: May 5, 2016
Applicant: Carolyn lannone
SCTM#: 1000-126-3-10
Project Location: 955 Albo Drive, Laurel
Date of Issuance: May 6, 2016
Date of Expiration: 90 days from Date of Issuance
Reviewed by: President John M. Bredemeyer, Ill, Board of Trustees
Project Description: Pump out and fill in existing failed septic system; install
new 1,000 gallon septic tank and one (1) 8'x8' leaching cesspool.
Findings: The project meets the requirements for issuance of an Emergency
Wetlands Permit as determined by the'•Board of Trustees. The issuance of an
Emergency Wetlands Permit allows for the operations as indicated in the
application and project plans received on May 5, 2016, and stamped approved
on May 6, 2016.
Special Conditions: The bottom of the proposed 8'x8' leaching cesspool must
be at least 2' above ground water when installed.
This is not a determination from any other agency.
derOlev-- 4wk 6,4447€01.ML-
John M. Bredemeyer, Ill, President
Board of Trustees
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THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD
SOUTHOLD; N.Y. 11971
'TEL.: 765.1892
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OFFO(it �a
John M. Bredemeyer III, President ''�� eon s Town Hall Annex
Michael J. Domino, Vice-President et $�'a, 54375 Route 25
Glenn Goldsmith ify P.O. Box 1179
A. Nicholas Krupski ,�,p� : ,,',}� Southold, NY 11971
�.Gharles " rs ?dal �afr Telephone (631) 765-1892
r :ii, ;, I%` i "i e ( 7 ,,,,__„.0.,,,,_ Fax (631) 765-6641
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d MAY 5 2016 $ d BOARD OF TOWN TRUSTEES
iTOWN OF SOUTHOLD
south id;asqa
L...._.____T,:a1. 1:E .x _ _....._.__,_...iMERGENCY PERMIT APPLICATION
Property Owner Name: C'akro0�i v, M,vvin eve
Main Mailing Address: 955 A\bt Dr. L acre I ►)`I 11 qi1 CC
Phone Number(s): (, 1 W-45 �ZZ?
Property Address: 5oa -
Suffolk County Tax Map Number: 1000 - l - 3- (0
Agent (if applicable) ��5/A,,, -- � s ,. ,,,, ry �r�
Address: /40.17,5"--.677-.4,19e- 4, - _��X'�®,,ds�, �� .7//7 -
Phone Number(s): 73V6 �`^E35 /x/69403/5 7
Board of Trustee Permit Number(s) if any:
Will any part of this project require a Building Permit?
Project Description: I/fief ���Ie .���"r",;
��272 J�4/� .://.�sv 7/4 ®/I/ .61-,# ��.5�
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E rd of Trustees Applicatiol
AFFIDAVIT
L(x.n �(�^ �a`'� `� d yk-S 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
BOARD OF 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, INCLUDING THE
CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO
INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION,
INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF
TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE
COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL
EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM
OF THE PERMIT.
CAA4-4x
Signate of Property Owner
SWORN TO BEFORE ME THIS `j DAY OF �7Z - , 20 /-t
/6114-
Notary Public
PATRICIA RICHERT
(votary Public' State of New York
No.-30-4741154
Qualified in Nassau/Suffojk Cou ies
Commission Expires / //,3/ /7
B 7d of Trustees Applicatior,
AUTHORIZATION
(where the applicant is not the owner)
I, Ca‘r°1 i a.i" rt-'5v1 C.— residing at i�S All'
(print name of owner of property) (mailing address)
Lxxxrt.A ► '`I 109 do hereby authorize 417/
(Agent)
�iIA , P./Af,,..C:42ve to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
jcuttAkft(_
Owner's 4;gnature)
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art. _ 1� ,
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MAY 2016 E' p
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\OL�Py,:, �� / �� .\ ,.#. &'A�2� E04°C •-,-0 F `'ems\ SECTION 7209EOFSTHE VR
Fy / rye% °Z �`� r:1 EDUCATION LAW
,0� �p J ��� \\o ,r. . _ I COPIES OF THIS SURVEY',
LLa THE LAND SURVEYOR'S II
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rL' >� J EMBOSSED SEAL SHALL I
9L�y ;„ �� �,,.{' -w, co. .-.-?,,T,-
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C. `2� \ lSs. ��� ✓� '' CERTIFICATIONS INDICATE[
a �� O ONLY TO THE PERSON R
O o �r131:,
IS PREPARED, AND ON h
° p \ f`Q p 301' Dc� TITLE COMPANY. GOVERNI
\ / -' r V LENDING INSTITUTION LIST
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\ - TUTION CERTIFICATIONS r
�e 11
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e T`•- FY OF PROPERTY
\ r �I I CK
k-.. TOWN OF SOUTFOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1 000- 1 26-03- 1 0
SCALE 1 "=30'
10AO - JULY 15, 2014
,JEE: 27, 2%21=` '..C.C.-,TE ;LAGGED WETLANDS
0 AREA = 37,700 sq. ft.
(TO TIE INE) 0.865 ac.
\
Tj�` \
(
�'a2\ �� CERTIFIED TO:
°�\ CAROLYN IANNONE
;s \ BRENDAN FIDELL
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
\ 13- THE FEDERAL SAVINGS BANK
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y PREPARED IN ACCORDANCE WITH THE MINIMUM
( STANDARDS FOR TITLE SURVEYS AS ESTABLISHED
'IN i BY THE L I A L.S. AND APPROVED_AND ADOPTED
4 ,4` ,II SII' FOR SUCH USE BY THE'"h'I'EW YORK STATE LAND
i��c� `" TITLE ASSOCIATIOyN''1r r ? , '"Tzy„
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_,.._____— N Y.S. Lic. No. 50467
UNAUTHORIZED ALTERATION OR ADDITION .
TO THIS SURVEY IS A VIOLATION OF
E IL EDUCATION LAW Nathan
7209 OF THE NEW YORK STATE Nathan Toft Corwin Hil
COPIES OF THIS SURVEY MAP NOT BEARING ti
THE LAND SURVEYOR'S INKED SEAL OR Land Surveyor u r v e y o r
EMBOSSED SEAL SHALL NOT BE CONSIDERED I Q
TO BEA VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN '
ONLY TO THE PERSON FOR WHOM THE SURVEY 4
ISPREPARED, AND ON HIS BEHALF TO THE
COMPANY, GOVERNMENTAL AGENCY AND ; Title Surveys — Subdivisions — Site Plans — Construction Layout
TITLE
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI— ;
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. ., PHONE (631)727-2090 Fax (631)727-1727
` OFFICES LOCATED AT MAILING ADDRESS
THE EXISTENCE OF RIGHTS OF WAY 1586 Main Road P.O. Box 16
AND/OR EASEMENTS OF RECORD, IF Jomesport, New York 11947 Jomesport, New York 11947
ANY, NOT SHOWN ARE NOT GUARANTEED. t