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HomeMy WebLinkAboutTR-8951E SOF soul Michael J. Domino,President ��� y�lO Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith ® �O Telephone(631) 765-1892 A.Nicholas Krupski �ycou�� Fax(631) 765-6641 e BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD EMERGENCY WETLANDS PERMIT Permit No.: 8951E Date of Receipt of Application: February 6, 2017 Applicant: Frost Road Associates, LP, c/o John Nickles, Jr. SCTM#: 1000-66-3-15 Project Location: 1840 Frost Road, Southold Date of Issuance: February 7, 2017 Date of Expiration: 90 Days Reviewed by: Michael J. Domino, President & Board of Trustees Project Description: For the restoration of the storm damaged bluff barrier consisting of the re-installation of Coir Logs to be staked in same location as previously installed after Superstorm Sandy; add approximately 20 cubic yards of clean sandy loam where needed; and to plant beach grass in the filled in areas. 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 on the project plan prepared by Creative Environmental Design, received on February 6, 2017. Special Conditions: None. This is not a determination from any other agency. '. �",.,-v Michael J. Domino, President Board of Trustees so John M.Bredemeyer III,President Town Hall Annex�� y�lO 54375 Route 25 Michael J.Domino,Vice-President _W_ . P.O.Box 1179 1� Glenn Goldsmith v 'i` Southold,New York 11971 A.Nicholas Krupski G ® �@ Telephone(631) 765-1892 Charles J. Sanders �� Fax(631) 765-6641 ��COUNTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Z -2�-e 1`1 /Ch. 275 Ch. 111 INSPECTION SCHEDULE Ennt5 l 1St day of construction % constructed Project complete, compliance,inspection. 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P z+HU 4 Michael J.Domino,PresidentSu� 01 TCS Town Hall Annex John M.Bredemeyer III,Vice-President „ G�� 54375 Route 25 Charles J.Sanders y =4 P.O.Box 1179 Glenn Goldsmith t Southold,NY 11971 A.Nicholas Krupski Telenhone(631)765-1892 X E61-61 1 BOARD OF TOWN TRUSTEES F E B _ 6 2011 TOWN OF SOUTHOLD Southold Town EMERGENCY PERMIT APPLICATI T Property Owner Name: �0 N-i'j N91soMain Mailing Address: 87-7 Phone Number(s): D "' 3 C,i Property Addres8 —Y a✓ 0 c��l�� Suffolk County Tax Map Number: 1000 - {C —(• IS— Agent S— A ent if a licable _1i�� g pp ) l,•i G i-h3•�f r]lAJ i GZ, 12 ..5 Cite%. I Address: QQ. 1(�O Ic Phone Number(s): �, �- �� -I Z Board of Trustee Permit Number(s) if any: Will any part of this project require a Building Permit? � Project Description: �,�STU�2 c�''�I �v vQ Q>LQ F 12 1—e—✓ r 0IA?:- Lon 5S Tl�-IG = nJ 6 La.ne__ SGC 511TJ iSv ' Gvwm awv� gwdl l 6ed.y6 1/" of Trustees Appli.cati AUTHORIZATION (where the applicant is not the owner) I, :::�p AW I d 'Tel residing at (print name of owner of property) (mailing address) �6 Iko Ak, � do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Idwner's"S'ignature) of Trustees Appli.cati AFFIDAVIT 16 t+ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/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 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.. ignatu of Property Own SWORN TO BEFORE ME THISDAY OF fY 20) Notary Public SABRINA M BORN notary Public,State of New York No.01B06317038 , Qualified in Suffolk County Commission,, Expires Dec.22,2018 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics rohibits 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,.ipiddle initial,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 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 ifyou 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 applic4at (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 t -t-� �2o 1-7 Submitted this of 29e-- ' Signature Print Name Form TS 1 A At , t 4tl r h rt c y, IXAGO%. ' , NO r r r � v r :S d S „ s- w „ "oa, r ' AWL It, �► �. 44It IMW ;. 791t ij ----FL--L— EL lop%,t*. , � Ar: I, 1 k z. 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