The URL can be used to link to this page

Home My WebLink AboutTR-759 John Bredemeyer, President �osuFF014. Town Hall Annex Michael J. Domino, Vice-President mss° °may 54375 Route 25 James F. King ti P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Dave Bergen y�O1 ,� �a°! Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees, Field Inspection/Work Session Report Date/Time: fl i-, 7-i-) Ir GEORGE N. & DEBRA M. CORITSIDIS request a Transfer of Wetland Permit#759 from Raymond J. Akscin to George N. & Debra M. Coritsidis, as issued on September 12, 1972; and for an Amendment to Wetland Permit#759 for the as-built 2.7'x31.6' wood walk; 4.1'x17.4' wood ramp; and the two (2) wood floating docks in a "T" shape with one float measuring 4.1'x16.2' and second float measuring 4.1'x16.5'. Located: 1800 Cedar Beach Road, Southold. SCTM# 89-2-5.1 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-S bmission Violation Notice of Hearing card posted on property: Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: (v ` Present Were: ___I/Bredemeyer ' M. Domino .//J. King,4-e. Sanders�Bergen Bay Constable Other Form filled out in the field by i Mailed/Faxed to: Date: o� 7`: S , R 2 7 2015 600 R o.1,T,,�� 447 X00 0 N 88027'40" E 157.50 TAX LOT 003.000 �r P00oloDF l Y � Nftl 66°522 B9r °URk \\` zs qww 1 � (PO�N�RIP, Ap 0,35 `\ `\ �� TAX LOT 1 �" S'QjJ ir�� 005.001 lf� lJ ✓ANL 0ks8D Z08 C 0 00 2g \ FC04 00 \\� qo Hoop O• O 1 �0R9�1 'o 4�� 1fP FENCE / !V`cAgy ��\\ 20p 00� 0.21f ��\ ��\ \\\ !.e •� cv 2g W'W / cJ• // \\ \�� 1 j �� / 0 A'00D 0'0sTA'pS Co // {`�� 5�'� x3/HcyCk 2u� lOBpNrE�i�/ FENCE n- o FENCE 0.4E1p 0.4E010 SHED O 44�svDRn6g9Y \�._ ood�� SHE0. DS STIED 0. �+� 411 =�44'�ti\F' it l 1 cT 4w 1 ; FENCE \\ 0.2E FENCE `\ �!� 04 3.9N FENCE ��-- "'�" FENCE 2.oe cr 2.7S c 1.7r FENCE 6.3S k 00 �,� P R4�P � 20 s.BN xEU� *'(?,P � , O FENCE o� s JO O � 7.3S IRAEO '� f� AyR Fg CE 16'0 0.5E ' F (6 �� j .00 FENCE �Pt 0.5N py 3,�6 slEo 0.1M 0 v PROPERTY INFORMATION: DRAWING INFORMATION: aF NE�v T.L. 003.000: 20,000.00 Sq.FL 0.46 AC. SCALE: 1"=40' LISA Mc UII�KI SUR T.L. 005.001: 69,813.26 Sq.Ft. = 1.60 AC. DRAWN BY: R.K.H. 1> N VEY OF LOTS 25 & 28, TOTAL AREA: 89,813.26 Sq,Ft. = 2.06 AC. FILE No.: Q476-14 ��' ;i + LAND SURVEYING AS SHOWN ON SUBDIVISION MAP OF r. CEDAR BEACH PARK CERTIFIED T0: DATE: JANUARY 5, 2015 "' FILED: DECEMBER 20, 1927 — MAP No: 90 274 EAST MAIN STREET '. AT SOUTHOLD, TOWN OF SOUTHOLD GEORGE CORITSIDIS & DEBRA CORITSIDIS � �-�' EAST ISLIP N.Y. 11730 SUFFOLK COUNTY NEW YORK >. TEL: 631-277-3605 CORE TITLE SERVICES — CORE20896 `^.: •r r, .__ �? �, SCTM: 1000-089.00-02.00-003.000 & 005.001 FIDELITY NATIONAL TITLE INSURANCE CO. FAX: 631-277-3906 ` LAND ONdVYBORTZED ALTERATION OR AD➢R'fON TO THIS SURVEY IS A WOLAITON OF SECRON 7209 OF TBE NIX YORE CTAT$EDUCATION IAT.COPIES OF THIS SURVEY YAP NOT BEARING THE LAND SURVEYORS[NEED OR$VBOS=SEAL 1RE I7ANCES SHOTN FROM PROP®tTY LINES 70 IDSflNC STRUCTURffi 668 FOR A SPECIFIC PURPOSE AND US6,AND ARE NOT INTENDED 7'0 QUID$IN TBE ERECf10N OF FENCES OR Or=SISOLTURffi.CERT�IC1710N I1D[C18D NOT CONSIDERED 70 BE 1 TRUE Vd1ID COPY,D HEREON SHALL RUN ONLY TO THE PERSON FOR TROY THE SURVEY LS P$RPARED AND ON HIS BMW,TO THE COMPANY OR AGENCIES LISTED HEREON AND TO THE ASSIGNHR.S OF TBE LENDING INSIT"MON.CWMCATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTf=ONS OR SUBSEQUQTP OTNBRS. 1800 CEDAR BEACH ROAD, SOUTHOLD Q476- 14 George N.&Debra M.Cor'rtsidis 1800 Cedar Beach Road,Southold SCTM#89-2-5.1 4/15/15 MAA t ' 1 µ. I Y _ r y - y- ;-i- ! �.:��A- ... � .__ - .+ •�„ Tye: .r /, y,5t.'"' ��i. '',?�: •�`,.� q .•,e• a 1l- ' '+s"cN' ,y3- "„ l<' .. "�0 _._I>.,^, �;f f ? y w:, j• '•�- y a ; v? v3r'::. a,{ ` :; ,;y f T�s. r "? �•' f 'rf:" :S` ,f' �j,' ,: i-Jr!• n=,;s F,x� > >� 1`f' .;'t�,:�. �'• �s ,.�! ''ws.' '.F s'4'"R ;' 'i" :i ,� , S' +; - ';x.�,�r�^'6 x• ,a raaM�t�,wA . ,.�.,c�r}f a ar. I:• �." -.ms ;an,: z yea ' .J',y�•.V'y� `r a , i ,oyry 1 �v4 r ,z ::;, t.>Tf,•' h'a3+ = •ffi'€+ .,, s W -" '`,f,•%. �'ml- '� � � .%wa`;=':. {2 •c "�.-;i4' r,�,_ :,}s:k�- � ;� c�°u `,' �r�`.jar.. �a� y�°^'Tr't,•`''•�y .c;, ;>;'d, •J' .r`'�� t' i��'`r•`�' ' "' •, Ts?, `- -'�,°pis',. - ;:=}'r 1 ;�� ni,. ''t 5' -!'�;t•�Y's'F "_' '.�°_F,•fi` ^" .=Sss:.r `a'+ i � {'i'� `'-s`�` r ''':4�_ ''•� f'Itr�� , `� rT,i.l �:Y�a:��'S�r.'�t,.t�;�'��+,.�v�'��zX�2r�r��.ai__z.�3Y:.•�;�5�� ,!•1y'.., Y,�,,�.�. sss.'c. O� - w` '"Tri -.s^�qv M+'=-�•.,,�- ,s,, r. _-.wr,v. rywg^,.,,,_,��p,n,;`, �:•t;1,.., s.'- ✓v' _ �, - = ,bii%9i i_4 .i-:.;r .$'`;moi +'r:`e? �„ ''.�. ''R,� ,,�'+'_: _g_ ). .�z„ c-: f;-.,' tv, 1._n_:.�••�s!z"`- ;+._:",F r,._. J _ '• "°:,�: "51— " Board Of Southold - Town Trustee iPti� ��V°�' r ✓, - . �'=1i1.{� � -4� � :.nidi i itis„,,,y 5: ' - `ro t SOUTHOLD, NEW YORK ; =r. ' N 1, .� Y.;,�• ya-,�''`ilr�}vY f�� - � ! , '#4�h�` 'L 4�'%n. �t� � �` t, ' '' �•_`�r-'_pry^ '1v':,''Aa•'•in. - .�� PERMIT NO. 759 DATE: .Sept., ilk„ 19?2';K':as "�.r �; + ';• Stake No. 331 ISSUED TO Rymonc7...J. Akscin ,...... �- � •r i{” ye• '��e�";'A'�?'��:.° , , .. - 1+■ Q��.y/a�p� .�}�>y ggr y■`■p�N •- "Pp ,;�/� .Y.3 '• 1 :Tk,A �'"'>4r.r.R,'�'a`;:'i' ' 4'! ♦PY �/� 4 A•Y 4b r `''• •,lY fr -'LJ•�,• ,i�>`S`` rY 'r_ie�`•� %z _ - .. _ 1/ 't'g;>i� '" 6�� 4. "±�',�t,.i•.�<i �4 , Kt Pursuant to the provisions of" Chapter b 15 of the L"aws;`t� ;`' y�y- '` ` Y _ ;.Y 's-.! • �, t, the Sfafe of New York, 1,893; and-Chapter 404 of the Laws of, he. State ,of New York 1952• and the Southold Town Ordinance '' •,;,`r'.� 'i$ titled "REGULATING AND THE PLACING OF OBSTRUCTIONi;s; IN AND ON TOWN WATERS AND PUBLIC LANDS and they, REMOVAL OF SAND GRAVEL �' t _•�,r:. ':� OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS', in accordance with the' P, 1, j _;. ' �, '.: � • Resolution of The Board adopted at a meeting heIJ on p' .. � _ •�"�`'�":-`��:x��'�€ :i' p � _ •}'i 19 7?....:,' and in'consideration of t e sum of $J4 0.. ; paid$y' ME. ;r:, ` . i :3 x5Y4• r;:* . . 'Ra rmond J.1,A�,sciri .. ..... z,• ;.:.,. ,,,, . TFn_.,. 'IM1 ,' ,,a , i rii � Oichard Lane Southold �.,. 7; of , ..Southold, . ._ N. Y. and' _ subject to # eT y° ,, p, . Terms and CondMohs' listed. 10n, 'the reverse side hereof; „,�, � ''; '' r of Southold Town Trusteet aufhoriaes and permits the following: j ='z , replace floating dock 5 It. by 16 ft. , andariip ` 5 f by 8 -ft: {.1?0 sq: ft. ) , and 2 pilings. atF.!;`, -,t s::,r; r.n, �.. ' ,,, ,, applicant's property ,on Cedar Seach Creek ';Lat28" Map bf Cedar Beach Park Southold, New York, all in accordance with, the defaijed specificationt as presented •in` ,; .„ ;,,• ; -' 'r''a` the originating applcation. : ,M1Y' '.,;•.:_,' - - '`{ IN WITNESS WHEREOF The said Board:of Trustees here-' by causes its Corporate Seal to be affixed, and these presents t® 'be subscribed by amajority of the said Board 'ds of this 'date.1pun • 'I�� 'y`i,''n'y-'``~ i�'�'ice_`'�M �•'s ,: `�' Sn"• ..��!"•_.' - t t��j�'^��-�,^`t?'-r' � !:y,�q ' �rirr•'_ _ '=qty� ,1• e�iS .,,,iri x"•.>�: _ _ -'� a ^��' )�$p ;y,_.:''. �,-;,f-�C011 . .. `'1T ' ^J+'�.Itr l,.r�^ S' J D yq �'I� _ _ "ss A2::�,,. -'3.,4f+'j,'J.n•.,�� . ^'iA •S,. ..�4., - 'tom (p''i, yqC7=..itj�r Z e`•4' "``' r �j'-�J l,+lr�� '- �((`tt.�,.r'� f.�'S' AI' , •r'^.- ,•! k;-,',�,•r"Ar'.a 1'j" ,a.,',.^ �,J�yn ��JJ Y ' - 6 '` s:! ¢=�'.�- ' r,a. `� - •--- -, ;It fp7,,s','�y':ikh,;ei�r �`y ` 33' ,.�?� _ '„•, .atria's�t,> �7�,�„. ��' � L4�%i"1, c.� .,{� ,' ifft,, r;,�,.} �r,• ' , - l ',,• .'�'^ T.'J'S titA3,, x-k -a .tT ... �... ie'U'r�`�:�',- 's'';,Ca.•, - '.,.4'�' ..� tz: ggi' :Su,w _147'011 i, >�t"s: a;`?:-`o�',7y'^>.: .� k• z..�...-'S 5`' "`».n. ak n �r ,.q•s. %'T fp ,. •ii,„ .E' ;{'i,-S. .-, t-i'':el;9i=t,- S'eJ,,,a``rd7�tC.'LY,s ,."'�7,M%y�`1,. •y - ?--`� ;t , J •4.:=1,i.5.e „a +l<F rv,.,�,r _ a;�},y;> *,_ ..t.k cam•* ;`4.'.'> :s:,>.Yi"%",,;., >t;y*.";; "s"sN •?.,, 'i�%tp;:�? w, C0 •,"`x;' >«, .'�.. 'w_ .n�.� G.,. � " •.•..nom,'r ` 1, .� _'`�4f ,- _ •'t°i `'`i.+.r�r. •�ky'riz_-r bl.te 3L .r A` Id{ i� �n� '�.Y'^: ?;�y +I�t 9�•"'�YY`i„y,Y,-:+`F' 'C?” rk/.ot',fM:v` d'vim`"'�'tG,x Y•,4'. _y�' rds7Y' .. - 'I=b`>uyC'� ? ':•f ,; J�7:- .;,<t ts'`'' 'y;,�! :i=' Y,ve't.h,:i.- ::�:.' ✓Y,.n"{T r.i '.-•'�ti'.-?��a-'as�t'e•r, ;,,vt' Sr'. 0 •y.�-„�7''-�. j,:,;'.•�.c._ Q,�., m 'i .,�,b1.••- a;�t r-,: ' I ,} '�� "��c��/l�`�".vy�� "�- �:y'+✓'`�t��''�`_A.!— i- �'`-'` -”" ;�'`�`"�� - �- - �•--'-4 "'— - --�-y� - ^ - f, s€i. _- ;�k�Sz=C• ;x>`J'%\ Fl 1'.y„ _ i�}":f,..,� '°�f_`r+'-t arc ' ., , � ' ' _ t ,--' .,.� /. '•., ,,,,.,' - - •,- - '"' ?'= ' � .•rte C -;'� +.eo •rbo� e,f ; +f.� t !�:-�^r,�>4' /qSf,-: • - -,� - � r' , '.� -1,�'s f� ? /� -foD of .. ,r ''II � r ai` C � - / - ' \'�/. •ta;..n'?IYjVM/�.y.,' _ .` - '� ///J.�FOe`4' y ... �,4 �: &��•k -.7 'Alt,j\\ /s3 t` . c �\"L` '� 'e/•':;�\a° �/e�3- - rs- - t: 'te ''e,,:'; W ./��,y��f.5 jL.'y}pt+,s. ' _ - Io, . 'RLSC'NV,Cr✓- !"- :��^' i' ,\ ',y .. ,- - TG„�'•,J:. •L- .•—,...�.a„• - - ,..,o..'"a-�`.•ta�'�^,;�+....•;; - ��fff��.ff~```"` �np r:- - •�f.• .rn�M1_ \ - -- a�+a��\,\\�.$c..- t• .�' _;�.;f�i,;�ri� "'C4.r u>3i.>'u '�.��p`'._f-LrT�:'�.�,' -. .U.>dS ,. •"""VI�:/�', -,��.YJ-'�� //','•� ,',, • ^,�j,"''•V`p, � \•„ : _J _ ' _ ^ .tom - 4:: .• '':r;. ;r-: ' �" ae' z6�g '" (I �9:' ,\O :C �J }ryJj 3 ,la j;\a ��•, ' y - "_ sh, 151 ?WK f cS•rl / J3' sy S,,,. -a7 .r T �6 Y'E L �a J?S�y, ,l'$ - 'o rL�,�•`5..;��1J`,�5� "_i'' T•��.Y ti�L;. � - - �- 6s" 4 ",9 �. 'mss de ;�'"•C,f' y.—' �.�.'.r-n1��''si'f'' A�iii. .YS^i,'","•.i-' :i-^',''F's �, _ ^ � I 1t��- ad- ;°i� _ y �7x`.,• /P SS�t;^:f3.!'�,~- M1`��•D�a�. ,�_ ::A.t oe s�,(. __� _ !`� aV _ __•�•,q- /�;f ,sSaz V;V-'` ,I�_o�,p>'' ..�_r rJJ'-�:��\1r'��{ _• { ., '='c`=5��j�fy 81 '/! ` ,S t �. 4e..VI 2 "�` `` 'ar,`:.- �_ '\. ...',I.��-`•\'i:;;j /` w� .Q S - - .•. `l++Ni � 1 M .�1.'(L�"'/Z;yf�lJ T*V t '.�',�'"'� > 'S '�' f ;/ ',�- ( 'O:y M - €, '�°J-C?�.r: ��a�:&=�"i.'.1�:.i:jS3,� im :.;. +ii �z• -:'r`�,''S,:•1� may AW �/ {' l °f. •� r :'fir, ``�1. lei r C''"-'..i",'i' toy 7 .':�.yk�.'.:•''i�,{r,',•`,:�:. xt \t,,, ;. :F'", i.ti e.l'�`,� / 8 V,�S.-i~}: ✓' y,. t,^t i =Y .1- ' /6 t - •��" -Q. A ...;r Pop tli.;,r�i�• ,'.�,�"`!'rI - ;lei .li`•1-`-:a,` '�.';�:e \` •r .1..-� `W 4�:., is '��.i• fr "(1" <j '•" v a' ' �` i Ao�,I �•, '.` , ,2�..- f".if., i,Ati„� ?`?„ - _ 1 ;, •Y .0'r�r��,CS t•' ��.,� � -_ f,. e rJ'� x AS < y ,lL lr':�,r. '{j .,r:"�� y' ie`O , W offj lit uti • 'Kms'"• �' h*•'t,•ri1., ,i-� "'-x Y\L��'� � ;fit-�;� _ ' - - - r'•,t'� s�'r,u,t �L,i•'ait;.�t'•.:`,....h',�;_,?F,'p:� - fy �l - ;i,-;:;;��^:,`�p;.�!`�•'a;:�?.,�- t.n tF ems,..{5' i:,, p6�'c.. ,• -_ } 'f .. '.i"yAP''�t. ':(�f� a.Yi•a`''Jf kk4yY•1.';F'i,:i." - .t i,- a.!♦ .:J _ - IE i�1[.,- - . ., :,, - t ., -rt, i?",�'�. .�.., ,-'I,F•'„- 1 .,,�,+.r,-, ,l^•u,}i•_ .n�71'e -� ,.:f`_.^..l>,. :..'i. F :r "245x, Mf r►ti • R MAP PROPE uN suwwc F�pli lw xn Haj -------------- RD .....11SA CH2 3 rald Haan 70—OF SonOLD ------------ 7 ORCHARI) LA M) SoUr" BAYVIEW RD it 14 IS L COUNTY OF SUFFOLK K SO—Ow SECTION NO E NOTICE --- ,, Real Property Tax Samoa Agency a Ey G ------- —P -:-q��— E m ® ems t00a 8 A P 12-1 rjf S OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 LOP Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 Telephone: 631 765-1938 U L WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD P[ac�S - soup, d�"�yf '' k k MEMORANDUM To: John Bredemey'er, President Town of Southold Board of Trustees APR 14 201 From: Mark Terry, Principal Planner LWRP Coordinator Date: April 13, 2015 Re: Proposed Wetland Permit for GEORGE N. & DEBRA M. CORITSIDIS SCTM# 1000-89-2-5.1 GEORGE N. & DEBRA M. CORITSIDIS request a Transfer of Wetland Permit#759 from Raymond J. Akscin to George N. & Debra M. Coritsidis, as issued on September 12, 1972; and for an Amendment to Wetland Permit#759 for the as-built 2.7'x31.6' wood walk; 4.1'x17.4' wood ramp; and the two (2) wood floating docks in a "T" shape with one float measuring 4.1'x16.2' and second float measuring 4.1'x16.5'. Located: 1800 Cedar Beach Road, Southold. SCTM# 89-2-5.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is INCONSISTENT with the Policy Standards (Policy 6.3) and therefore is INCONSISTENT with LWRP. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all,Andros Patent and other lands under their jurisdiction. The application cannot be fully assessed to the LWRP. Water depths and a cross section of the proposed dock have not been submitted. 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 � t Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish, Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., April 15, 2015 the following recommendation was made: Moved by GEORGE NICHOLAS CORITSIDIS to Amend Wetland Permit #759 to include the existing wood walk 2.7'X 31.6', wood ramp 4.1'X 17.4', and the "T" shaped 2 floating wood docks, 134 sf. 4.1'X 16.2' and 4.1'X 16.5'. Located: 1800 Cedar Beach Rd., Southold. SCTM#89-2-5.1&3 Inspected by: Keith McCamy, Peter Young The CAC Supports the application with the Condition appropriate materials are used for reconstruction. Vote of Council: Ayes: All Motion Carried Fir.) APR 1 7 2015 C March 23, 2015 10 Marions Lane E Fort Salonga, NY 11768 MAR 2 7 2015 631757-5964 To the Board of Southold Town Trustees, We have recently purchased the former Raymond J.Akscin property at 1800 Cedar Beach Rd in Southold (Tax lot number 1000-089.00-02.00-005.001 & 003.000). It has come to our attention when attempting to apply to transfer the wetland permit#759 that the dimensions of the existing floating dock and ramp differ from what is stated in the permit dated 09/12/1972. Therefore, George Nicholas Coritsidis and Debra Messina Coritsidis,as the new owners of the stated property are respectfully requesting an amendment to permit#759 to include the existing wood walk(2.7'X 31.6'),wood ramp (4.1'X 17.4') and the "T"shaped 2 floating wood docks, 134 sq. ft. (4.1'X 16.2' &4.1'X 16.5'). Attached are the following: (original and 3 copies of each) 1. Application for a Transfer of a Wetland Property 2. Applicant Transactional Disclosure Form 3. Board of Southold Town Trustees Authorization Permit dated 1972 4. Signed and Notarized Board of Trustees Application 5. Property Survey dated January 5, 2015 6. Appendix B Short Environmental Assessment Form 7. LWRP Consistency Assessment Form 8. $100 check made payable to Town of Southold 9. Photographs of dock Please do not hesitate to contact us,should any piece of information is missing. Thank you for your attention to this matter. Sincerely, COVUC_.- GeorAe Nicholas Coritsidis /j, c'� Debra Messina Coritsidis CO I� �dl �1 rtsfS ®�Ir John.M.Bredemeyer III,President Town Hall Annex �� /�®/ Michael J.Domino,Vice-President *® 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,TrusteeFax(631)765-6641 F:�' M BOARD OF TOWN TRUSTEESTOWN OF SOUTHOLD 2 7 2015 4 APPLICATION FOR A TRANSFER OF A WETLAND PERM- 1 IT " 1 DATE -rQ �� D�, 75 ', S PHONE �3I. OWNER �� MAILING ADDRESS /29d Gc&a 4� S �� AGENT ig&L7 o!t r r f �1 s PHONE j ADDRESS PROPERTY LOCATION - 7 TAX MAP NO:J 0 0o O S. 0 0 _ (12, 00 00400n Q' 6th 3 , ='Wei � G ,L �!c� request a Transfer of - � �-Qn�,� l.(��' 'l� � Permit# � from -- Signed By: 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 VD Am"at Name oV Action or Project: Lvn10 U Son a l 9� Project Location(describe,and attach a location map): Brief Description of Proposed Action: _I C� 46 incka',Q 'Arnerl sf ooc� WO-1k TW 310 G > WEI0 d-Pt7�o C Lf, / 'A;t1/0CL&)5 Woo'( doc& J -39 Name of Applicant or Sponsor:� ('PIA ,, 'Telephone: �3 -L al +S) 4S' E-Mail: 4 me ss 0, r"db i�►�f'.c_t Address: I City/PO: State: Zip Code: NO 1,1 fv1 —44 (? 1.Does the proposed actiog only involve the legislative adoption of a plan,local law,ordina ce, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that 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,lit agency(s)name and permit or approval: ❑ �� rM (A.,S m %c o l>Jv LX 3.a.Total acreage of the site of the proposed action? acres 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 0 J 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban EJ Rural(non-agriculture) [—]Industrial ❑Commercial ZResidential (suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ IJ ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ B7- 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 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? ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? FA ❑ 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? NO YES If No,describe method for providing potable water: ® ❑ G S 11.Will the proposed action connect to existing wastewater utilities? nn NO YES If No,describe method for providing wastewater treatment G /T� eS r� e ® ❑ W G 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ b.Is the proposed action located in an archeological sensitive area? ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Iden ify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: horeline El Forest ❑Agricultural/grasslands ❑Early mid-successional EglVetland ❑Urban ❑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? Rr ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, YES ❑ a.Will storm water discharges flow to adjacent properties? ❑NO b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: NO AYES Page 2 of 4 J 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES 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: (m ❑ 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: M-1 ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AppIicant/spons nme: Ot b(e, S 4, Co114Date: /s 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? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? �j ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 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? 7. Will the proposed action impact existing: ❑ 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, � ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 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 1:1problems? 11. Will the proposed action create a hazard to environmental resources or human health? 1:1 El 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. ElCheck this box if you have determined,based on the information and analysis above,and any supporting documentation, W hat 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 7 _ /�_ Name of Lead Ag cy Date e Y President Print or Type me ofespo Bible Officer inlLead Agency Title of Responsible Officer Sign e fRespo s e Officer m Lead&gency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS e Q Name: C—nd `�vr �- -� J UNS Address: ��c Si�[e�✓�. LJ�; q9 • a �f L= fir",°n, G. G� sa�,,��-�,^�.a-P/t. M,�-� 0 � J�� /esfl-�-r �c.rk,-•�� ,��lJ�.�-c.yo�, �s�g, �'� • a• 6 STATE OF NEW YORK COUNTY OF SUFFOLK DI -- - ------ - - - - -- -- - - - - - - - - - ---- - ------- - - - - LI, !� S S�`n✓�s [9 2r 'rs i , residing at d a Ce 4 e--1 12,� being duly sworn, deposes and says that on the 2—day of , 20_LC, deponent mailed a-true copy of the Notice set forth in the Board of rustees 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 Notices were mailed at the United States Post Office at rif that said No 'ces were mailed to each of said persons by CERTIFIED MAILIRETURN CEIPT. Sworn t0 efbre me this j DEBRA ROWE Day of , 20 Notary Public-State of New York NO.01R06304558 Qualified in Suffolk County My Commission Expires May 27,2018 i Notary Pub is ■ •stal Service-r. Postal ServiceTM ■ , MAIL. RECEIPT CERTIFIED ! ■ ■ Er i (Domestic Maft I No Insurance I• I No Insurance Coverage Ir delivery43 For •n visit our websiteis fr . • • • ,. M �,'' r, m ria• r.... C • 8"• ' p Posta e $ ry yI� -00 Postage $ u..�i g ®�.t z' Ln `p T-/Vk Certified Fee / Q Q Certified Fee / Postmyrk p Return Receipt Fee p P 'p Return Receipt Fee Here p (Endorsement Required) ! pQP " p (Endorsement Required) o Her C3 P` / I p Restricted Delivery Fee U APR U J Restricted Delivery Fee ` (Endorsement Required) I C3 (Endorsement Required) ) f C3 Ln Total Postage&Fees $ lr J \ Ln Total Postage&Fees $ 0 GJ� O / p Sent To � J S Sent To `^��p_ (�� -//►► p ----- ---------� N--------- oC � C w3�!+V- -------------- Street,I Street Apt No.: Street Apt No.; n f C3 or PO Box No. '�y�^, �d� or PO Box No. f�� CQ aQ(p7 w ` ---$ e- P-- ----------------------------------------- --- --- City,State,ZlP+4Q p� City,State,ZIP+4ICy- ,k, ' n l I `(,{/SOL PS Form 3800,August 2006 ':gee Reverse for Instructions PS Form 3800,August 2006 See'Reverse for Instructions co ,. (Domestic Mail Only, Ln (Domestic Mail Only; D• o Er' For delivery information visit our website at www.L--,P I i�.qqlno Er For delivery information visit our website at www.usps.C.Ornb C3 C3 0 F 1�M 114. -0 Postage $ 1 O�'J M' Postage $ G r— Q UN Certified Fee (� p�'D Certified FeeC3 0 Y� Postmark p p Retum Receipt Fee f Retum Recei t Fee p (EndorsementRequred) Here �• 0 (Endorsement Required) H L7 Restricted Delivery Fee U•S, C3- Restricted Delivery Fee (/ j Q C-3 (Endorsement Required) p (Endorsement Required) Ljj Total Postage&Fees. Total Postage&Fees 0 8 %.3/. / 0 9• a j Sent To Sent To 14 Street,Apt No.; n /� / \ ^� // / Street Apt.No.; ! or PO Box No. // _ C ��( /d 7 Gi r fl�4 � or PO Box No. ��e u,�,Q- - 0�J� -------------------= ------------- --------------- - Ciry, --)-------------- ----------- --------------------------- (z� cS5 City,State,ZlP+4 O K :11 II•• Em .—a Postage $Ln CPostm9ark .;1 Certified Fee ;O p Retum Receipt Feep (EndorsementRequired)� Restncted Delivery Fee r'(Endorsement Required) �r9Total Postage&Fees P.S Sent To [r' ------ ,--- � Street,Apt.No.; ---- - p or PO Box No. ti -- ------------------------- ------------ -3 ------------°`� --��,.-�------------ PS Form City, /I i :rr August 2006 See Reverse for Instructions John Bredemeyer, Presidents�FF �oocxc Town Hall Annex Michael J. Domino, Vice-President hoo °ay 54375 Route 25 James F. King ? P.O. Box 1179 Dave Bergen o • Southold, NY 11971 Charles J. Sanders y�or , �a°� 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 GEORGE N. & DEBRA M. CORITSIDIS COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS I, hvo S:C"'jYkCp 2; i ,xesiding at/dba O-D Ctz-a( gni-t-4 d' a, I I � -4 being duly sworn, depose and say: That on the y day of , 2011, I personally posted the property known as Q� Ce S �— by placing the Board of Trustees official 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,April 22, 2015. Dated: /)j it�) S-- r — (si nature) Sworn to before me thissY t_4 Rl-ay of AfA 20 15 DEBRA ROWE FNO. Public-State of New York 01806304558 lified in Suffolk Countyission Expires May 27, 2018 Notary Public NUTIL- t Ulm Ht: AKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: GEORGE N. & DEBRA M. CORITSIDIS SUBJECT OF PUBLIC HEARING : A Transfer of Wetland Permit #759 from Raymond J. Akscin to George N. & Debra M. Coritsidis, as issued on September 12, 1972; and for an Amendment to Wetland Permit #759 for the as-built 2.7'x31 .6' wood walk; 4.1 'x17.4' wood ramp; and the two (2) wood floating docks in a L6T" shape with one float measuring 4.1 'x16.2' and second float measuring 4.1 'x16.5'. TIME & DATE OF PUBLIC HEARING : Wednesday, April 22, 2015 — at or about 5 :30P. M . If you have an interest in this 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 of B a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 yard of Trustees Applicat_,-__ County of Suffolk State of New York �l RS D +�rS 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, INLUDING 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. Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF HOA Lti` _,20 15 DEBRA ROWE FNotary Public-State of New York N0.01806304558 + alified in Suffolk County mission Expires May 27,2018 Notary Public 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: (Last name,first name,middle initifil,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.) Tax grievance Building 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 igterest."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 X _ . 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 orbenefrcial 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 Subm'i'tted this �3 day of mC1,c-t 20 Signature Print Name 0ee2,2A /1d Ce 2;/Sj r Form TS 1 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 evaluated. as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- 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: o a Own;,of,Sou ld's website (southoldtown.northfork.net), the Board of Truste t0f ce, h6 P anning Dep t, all local libraries and the Town Clerk's office. MAR__2 7 t, r B. —-DESCRIPTION-DESCRIPTION OF SITE AND PROPOSED ACTION— 201 SCTM# I�d d� p°� + Dl�_ aw :,:,+:;,'4 PROJECT NAME -A 4, The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. 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 and extent of action: �� oCa f /r 6 t W®� 1 �1 lA l Ia I , T �/ �lr►C� -r.SAU-Q CQ 4-1 wj�,ru� Woo ck 4606 s, /3 Y s ( L/'a I �� (a, l 0,11 �l. 1 `X /(�. C - P Location of action: Site acreage: )9 v Present land use: iel-►1 a4. o v� -t- Present tPresent zoning classification: )" a 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: L (a) Name of applicant: C OS ►I(S (b) Mailing address: (r1t21.o y1S (ell— (c) Telephone number: Area Code(0) `��'- � e/ J � ) 9-/ 7-0 (d) Application number,if any: o S 6 v law), /rug Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes N No❑ If yes,which state or federal agency? '0 . 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. LZJ Yes ❑ No ❑ Not Applicable C�0S 6C nn Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No R" Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No FLV14 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No EX"i 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 evaluation criteria. ❑ ❑ M Yes No Not A cable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes [:] No VNot 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. 0 Yes ❑ No ffNot 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. ❑ YesW No❑ Not Applicable —Its y;& dl Attach additional sheets if necessary Y ' WORKING COAST POLICI] Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LVVRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No [K Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ 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- evaluation criteria.- Yes Q No® Not Applicable _ - ._---- Attach _-Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No L&-j Not Applicable PREPARED BY {,,h a p91 r� TITLE � �/t • �, DATE S eg. -°', ,.- v :� "OK nE,y'�l n'> .Fia"} e fifr,,,a�Yr'+. 3Ka b l Y ,dmJ + c 5 u i w+ K r x {sy. � '# 99L�, � cbmlhb '�i `s tX�e�� ,�i`u:✓}' ` `+T �'fM4,"�' �•vrq , ji S 4 n'i, sv.�`� � .,� t w IYr s n a #Y 0 - ml ' r a`w'.r ' 1 Board Of Southold Town Trustees k SOUTHOLD, NEW YORKs PERMIT NO. 759 ' DATE: Sept. 1 .1972 m Stake No. 331 6, 9 + ISSUED TO . Raymond J Akscin r ", c�1Itl�DrtMttD11 t " Pursuant to the provisions of Chapter 615 of the Laws of. the State of New York, 1,893; and Chapter 404 of the Laws of;the � s ' 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 Sept,. 11, , 1972 ; and in consideration of the sum of $ 14 00. paid, by >s . ., 4 Raymond J.i A$scin. , of Orchard Lane, out Shold,_ N. Y. and' subject to the �1 1 Terms and Conditiohs listed on the reverse side heretjf, 1, ; a<, of Southold Town Trustees authorizes and permits the following: s =gs Y replace floating dock 5 ',ft. by 16 ft. ,' and ramp ft t. an 2pilings, at sY` 5 by 8 ft. (120 sq, f ) , d _ 4 4 applicant ' s property onCedar 'Beach Creek Lot 28, F I Mp of CedarBeach Park Southold, New York, all in accordance with the defaijed specifications as presented in !Al the originating applcation. IN WITNESS WHEREOF, The said Board i of Trustees here- . by causes its Corporate Seal to be affixed and these presents to,: be subscribed by a majority of the said Board as of this date. k ,IV s s + < 0 v { t * �±*'Y k' t w y -... Jr Trust � *.L� q i .4 s 3 i`^iyY"w"�" ,{ � fir%/ +yf�c"+.'�i�r�,'S �'� � ,`,.. ""� '�': � �• �m;y�,p"�'�4� ,:.9, � - �-, s t .�;. �,-^�--�"- -�'..;..;*'•-'T"----,,, �,.'r e-n':�-.-ems?-*..�-.,= -s« - TERMS and, CONDITIONS I The Permittee Raymond J. Akscin residing at Orchard Lane Cedar Beach 'Southold " N. Y., as I part of the consideration for, the issuance of the Permit does understand and prescribe to the fol- lowing: 1. 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 oper- ation performed pursuant to this permit, and the said Pennittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability II ^' 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 12 mos, which is considered to be the "i estimated time required to.complete the work involved, but should circumstances warrant, request . for an extension may be made to the Board at alater date. 3. That this Permit should be retained indefinitely, or as long! as the said Permittee wishes j` to maintain the structure or;project involved, to provide evidence to anyone coneern cj that autb- orr ation was originally obtained, iK 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and r}on-compliance with the provisions of the originating application, may bei cause for " revocation of this Permit by resolution'of the said Board. j 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 EEEE '; the beach between high and low water marks. I IC ( 7. That if future operations of the Town of Southold require the removal and/or alterations f �r in the location of the work herein authorized, or if, in the opinion of the Boatel of Trustees,the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, j upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work auth- orized. 9. That the Permittee will obtain all other permits and consents that maybe required sup- plemental -to this permit which may be subject to revoke upon failure to obtain same6 E I jI I 1938 M y 31 1978 Mr. Raymond J. Aksc r Cedar Beach Rood So thold o New York 11971 Dear Mx. Akscina Please excuse the delay in answering your letter requesting permission to repair the ice damage to your floating dock and retain �1.. at DryandIs Basin. � k There is no permit necessary from the Town of Southold to do this qork. Yours truly, Muriel Brushy Clerk R c y' ��iYi �u e- s 7 ,w &ClEi . OF SOUTHOLD TOTZ' TRUSTEES A .._ , rev 6j72 APPLICATION FOP, FIXED and/or FLOATING DOCKS / / 1 . Applicant ' s name & address : Vrn cmc✓ �/ SG I /V��/ ��AJ .��a/ �f3JyP✓ C G-'c�✓�G� � ��co� �srur�d�s�'_�C.;/ ' 2 . Contractor ' s name & address : _46QX �c i'/ , 3> Briefly explain/ thepurpose of this application : 4- e e 94s�ec 1}`-�7c�:�--_�dc.�s �E , ci •�y ✓` f.�._ 11) Af 47 4. After issuance of a Permit ,' I expect to: (mark by an X) (a) Conmence work--®®-AT ONCE; ASAP_; UNKNOWN (b) Complete work in--IDAY—; IMO._,;, IYR.`; FUTURE_. 5 . Secure the correct, Area Map from the Secretary of this Board ,and ,by using an X WITHIM A''CIRCLE indicate as closely as possible the ,location' of this dock. On the reverse side of this map, provide a SCALE DRAWING which will show Ordinary High `Fater Mark, the shape and size of the dock and any supplemental pilings which are needed x to hold a floating dock or tie-up a boat . Give ail dimensions necessary to determine the area of the dock surface which extends offshore from the O.H.W.M. 6. Will any portion of this construction extend offshore: into Town Waters beyond an' imaginary line or boundary formed by other similar structures along the area ' s shoreline? YES or NO. If it does extend beyond this so-called dp ck line indicate by how far,approximately, ft . Ju 0 y 7. Provide the following documents: (a) A Licensed Engineer 's Survey of the property involved. (b) A copy of the Contractor 's Plans & Specifications . Will this construction require the Filling of any land offshore of the Ordinary High Water Mark or the Dredging of any material from Town Lands under water? YES or NO. If it does , Form A/4 (Application for Dredging/Filling) must be completed and attached "as part of this application . O In requesting approval of this application, I submit that : the information presented herein is true and correct to the best of my knowledge and belief; I am the person accountable for the performance of the work in accordance with the plans and spec- ifications attached pec_ifications' attached ; , I have read or am familiar with the pro- visions of any Southold Town Ordinance pertinent to the work involved; and further,I intend to adhere',to and abide by the Terms and Conditions of the Permit , when and if issued to me. L.S . XXXXY,XXY.XXXXXXXXXXXXXXXXXXX.K,vx-xxXXXX XXXX XXXXXXK-'XYXX:KXXt,-x3a Accepted by: 7 Dated: >; D od t P d d P Oj ,d 0 ao \ r h. Y N '+y/y� � Mrry 10� ° OF S9UTHLAA, rk)�;N T[2UST£ES P rev/5/72 To: Raymond J. Akscin�parchard Lane Cedar 'Beach, Southold" N-Y_ _ __ 1197: 1 . Your application , dated August 15, . 1972 has been reviewed by t ; .s ' I - f !,card ata meeting of -the Trustees held on September 11, ' 1972 and. resulfing in' the action , as ' indieated below: i" (X) Application approved. ' Application d,2nied,, ' Application tabled`. Y �,= 2 , -omments and remarks : p .1 ja 3. If your application, is approved above, A Permit Fee 1s now due, hl , and should be made payable to the order of the ;Board of. Southold ;? Town Trustees . This fee is computed below according to the, Schedule of Rates as set forth in the Instruction Sheet (Form I/1) ' If the Permit Fee'" isaid in person to the Secretar of the ' Eoard, The, Permit willrbe obtainable at the same time. If the €ee, is paid by mail, the permit will be mailed in reply. Computation of Permit Fee: { J Floating dock - ' 5 ft. by .I6 ft. sq, ft,, C ramp-:i_ 5 ft. by '$ fit. (51 's ft: , � 0 'sq. ft2� sq fti:` $12�.0tl 2 pilings @I.00ea3' 2.00 $14.00 ` 12:00 ,paid : 2r :DO du e , G , _ $Total Fee £or this' aPPlicationi ----- --- -$1400 2. 00 due -- Signed >Gf �in2i . Chm., Board of Southol Town Trustees , i, Secretary. '' a i a�ll a Y seo :o r P 5„ GARrysE I � f _ d , roe F- ` 70LL) 10 e �L °T3 hl f c D1 �fiSlN .ZZ 0, 15 .30' F V.,° �. l 5 , o Sf' 41738 � s L/ Y SO � a pR �s , ° a 4 GS 6.> � Q� v (r� Y IV If d k V 6/ Sb1 f� ¢ N Jy> r 6Fr 6 �' 7 : <'77�80 49 � � 5 tJtT all- T s r �.3z 4 ,I i 1 Al G•r � � x ; )k11 �+ _i � r �i d 6 �} < s tR-. 1 'f