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HomeMy WebLinkAboutKrom, Ann r 1 BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 9122 DATE: NOVEMBER 15, 2017 ISSUED TO: ANN T. KROM PROPERTY ADDRESS: 1296 GREAT PECONIC BAY BOULEVARD, LAUREL MOP 40%.19V Ift N Ar SCTM# 1000-145-2-19 1TAIFO.Utl Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and accordance with the Resolution of the Board of Trustees adopted at the meeting held on November 15. 2017, and in consideration of application fee in the sum of$250.00 paid by Ann T. Krom and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: i Wetland Permit to repair the existing±98 foot long cement bulkhead with±30 foot long westerly cement ~ return as needed in-kind and in-place; install a 39' long by 4' wide vinyl return along the easterly property line; backfill void areas with approximately 80 cubic yards of clean sand; and plant approximately 300 plugs of Cape American beach grass in disturbed and void,areas; subject to the approval of New York State DEC; and with the condition that no further work is done seaward of existing wall; and as depicted on the site plan prepared by Derek N. Bossen, received on September 20, 2017,and stamped approved on November 15,2017. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. r oguFFoc�-�o Gyp17 V t, QCIO Glenn o dsmith-Ab �- 1 JV f ri sozv Michael J. Domino,President,,— `��""' y�lO h Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 Charles J. Sanders P.O.Box 1179 c/� QSouthold,New York 11971 Glenn Goldsmith � a® Telephone(631) 765-1892 A. Nicholas Krupski ��yO'OUN 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 t Pre-construction, hay bale line/silt boom/silt curtain y • O 1 st day of construction Y2 constructed ' Project complete, compliance inspection Wf� l BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT NO. 9122 DATE: NOVEMBER 15,2017 ISSUED TO: ANN T. KROM PROPERTY ADDRESS: 1296 GREAT PECONIC BAY BOULEVARD, LAUREL i r I T SCTM# 1000-145-2-19 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on November 15. 2017, and in consideration of application fee in the sum of$250.00 paid by Ann T. Krom and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to repair the existing±98 foot long cement bulkhead with±30 foot long westerly cement return as needed in-kind and in-place; install a 39' long by 4'wide vinyl return along the easterly property line; backfill,void areas with approximately 80 cubic yards of clean sand; and plant approximately 300 plugs of Cape American beach grass in disturbed and void areas; subject to the approval of New York State DEC; and with the condition that no further work is done seaward of existing wall; and as depicted on the site plan prepared by Derek N. Bossen,received on September 20, 2017,and stamped approved on November 15,2017. � Jr IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. OgUEFOZIr fly' � o4e.. , f' COD dsmrth beTr— ip r ew I� a. TERMS AND CONDITIONS The Permittee Ann T Krom residing at 1269 Great Peconic Bay Boulevard,Laurel,New York, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 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 operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability 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 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. I 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 the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice,to remove or alter this work 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 authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Michael J.Domino,President o��OF S0(/jyOl Town Hall Annex John M.Bredemeyer III,Vice-President O 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith G • Telephone(631) 765-1892 A.Nicholas Krupski 'O Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 15, 2017 Chris Mohr P.O. Box 48 Cutchogue, NY 11935 RE: ANN T. KROM 1296 GREAT PECONIC BAY BOULEVARD, LAUREL SCTM# 1000-145-2-19 Dear Mr. Mohr: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, November 15, 2017 regarding the above matter: WHEREAS, Chris Mohr on behalf of ANN T. KROM applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated September 20, 2017, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LW-RP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on November 15, 2017, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ANN T. KROM to repair the existing ±98 foot long cement bulkhead with ±30 foot long westerly cement return as needed in-kind and in-place; install a 39' long by 4' wide vinyl return along the easterly property line; backfill void areas with approximately 80 cubic yards of clean sand; and plant approximately 300 plugs of Cape American beach grass in disturbed and void areas; subject to the approval of New York State DEC; and with the condition that no further work is done seaward of existing wall; and as depicted on the site plan prepared by Derek N. Bossen, received on September 20, 2017, and stamped approved on November 15, 2017. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, a e Michael J. Domino, President, Board of Trustees MJD/dd i ECECVE SEP 2 0 2017 Southold town Board f Trustees X6-1'SJ�AMA i I NOT'�� �'zh` �^f -. `. �. WLPu`e-+J§ C_rY� J �j 11 .7711) ._� y,YL SHAD Skf=14)144 lilt ( rP3 13 ��.` �! S�;'`''D3; _ = _ ; ;=,APPROVED BY,- 'BOARD OF TRUSTEES 0'"'v B"-K'WAD -r°fr-. IEfD'jN 14j°4D TOWN OF SOUTHOLD Sra'rl ZtV 1.6o, ;DATE l cu6te P`'is Zol-7 Al r 15-W15%t®"!✓ '13;85 „'; ' r 'Pim IZE61m-we By VOU �5 Michael J. Domino, Prest _ A t � rte* Town Hall Annex ty�f5o��gUFFQ(k�o� �r � .5 John M. Bredemeyer, III, Vice-President P. ay'., 5437Route 25 Charles J. Sanders P.O. Box 1179 Glenn Goldsmiths T Southold, NY 11971 A. Nicholas Kru ski �y ���,f Telephone (631) 765-1892 p 01 Fax (631) 765-6641 -1, CIT, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Il.alp 1' To: Please be advised that your application dated Sxpr 2012417 has been reviewed by this Board at the regular meeting of JVOV 15 001and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1" Day of Construction ($50.00) '/z Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30-Year Maintenance Agreement(complete original form enclosed and submit to Board of Trustees Office) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ ` laD BY: Michael J. Domino, President Board of Trustees Michael J. Domino, Preside ;) �Q �'� { I Town Hall Annex John M. Bredemeyer III,Vice-Pi-siaent ��� Gym 54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski 4 p! Telephone(631)765-1892 ��� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 161)-2A= � Completed in field by: /615-m ' Chris Mohr on behalf of ANN T. KROM requests a Wetland Permit to repair the existing ±98 foot long cement bulkhead with ±30 foot long westerly cement return as needed in-kind and in-place; install a 39' long by 4' wide vinyl return along the easterly property line; backfill void areas with approximately 80 cubic yards of clean sand; and plant approximately 300 plugs of Cape American beach grass in disturbed and void areas. Located: 1296 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-145-2- 19 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 +,// 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: / no mGOLi ee L �G Ta9- Presentwere: '� J. Bredemeyer ✓M. Domino ✓G. Goldsmith V N. Krupski t'11C. Sanders Other Page 1 of 2 Michael J. Domino,Presides, o�";_Of (�coG \ ~ Town Hall Annex John M. Bredemeyer III,Vice-President ti� yJ, 54375 Route 25 Charles J. Sandersy z P.O.Box 1179 Glenn Goldsmith ® Southold,NY 11971 A.Nicholas Krupski y p! Telephone(631)765-1892 �Od �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Chris Mohr on behalf of ANN T. KROM requests a Wetland Permit to repair the existing ±98 foot long cement bulkhead with ±30 foot long westerly cement return as needed in-kind and in-place; install a 39' long by 4' wide vinyl return along the easterly property line; backfill void areas with approximately 80 cubic yards of clean sand; and plant approximately 300 plugs of Cape American beach grass in disturbed and void areas. Located: 1296 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-145-2- 19 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 _ r Ann ,. 1150 Great ` Peconic 1296 Great Peconic Bay Blvd.,Laurel(Lot 19) z�' SCTM#: 1000-145-2- 11-8-17 pip "r nrir - �{ rt _ • S �) r� n e l -Z v ti _ y rr ' s • .F y �AV, �� Y r v , s- - r Ilk' Al ' �• �' '`. +� �' wa'^`�,s � � tri,, ATm T.KroTn/loanneKtaebel 96GreatPecomic Bay Blvd., 1 . 1150 Great Peconic / 1 000 M . as low— r.1. ■l �. -fes s'•Y. T low , ,V 1� :a,�;ar• MAY~~S� y.,; - - - - k T.Krom/Joanne Kraebel 1296 Great Peconic Bay Blvd.,Laurel(Lot 19) 1150 Great Peconic Bay Blvd.,Laurel(Lot 11) SCTM: 1000-145-2 11-8-17 r pp- .., r l • v i of e i t s? i r• i1Ni j ' Ann T.Krom/Joanne Kraebel 1296 Great Peconic Bay Blvd.,Laurel(Lot 19) 1150 Great Peconic Bay Blvd.,Laurel(Lot 1 1) CTM#: 1000-145-2 11-8-17 4 , F Y . ' Lr�i• kk '" ire"' "�. y"�11f ■ LAW A-LAM.M6 ._ w �, r ,. • w s „ p • .00! r s f {tea M,� �� � '� •� -E r . ' s �. 1� s s ,�. �r �'i � a � �., e f F '*' � � _. � -.� F@� ��. �!. 4+�' i a _- �; y� 04/06/2017 11:1176641 SOUTHOLD S PAGE 01/07 .BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD FAG$IMIL73 TR,ANSMJTTA], SHEET fc7 P110M• Doreen, Elizabeth Cantrell COMPANY; DATE, Chaffs Mohr Landscape 4/6/209.7 FAX NUMBNi: '1'fyl'AI NQ Or PAC};ti 1Nf;I,UI)1N( f,;l,1VE;RI 631-765-9026 6 IIIIONI..NUMBPR: SI':NUICK'S P}IONP.NUNIIVIII: 631-765-4.617 (631) 765-1892 It R1 SrNV8,11%FAX NUMtk%1k: Emergency nennit (631)765-66¢1 ❑ UR(:P;N-1' ❑roR imvnlm ❑IIl.AASI&COMMT31,1'(' ❑P),1iASl w-'my Cl II.I.L:AS1.:Ii.l'iC:YC:I.Ii .FIi Dorccn, I Rm so sorry, I completely forgot to fax you the emergency permit the other day. Attached is the emergency peanut application. The directions_arc on,the first page. The llfhdavit page and the Authorization page both need to be.nQf,1.ti7ed when,the l,oaneowncr(s) sign,them. The last two pages are the same page,the homeowners need to- complete 6he'and Chris needs to complete the second one as the"agene., f<1a; the property owners. If there is anyway this can get to us by Monday, the Board will go look at it Tuesday to autho-luc you), teguest. If they approve it, you should have your perl.Tait to do what is needed within a day or two after Tuesday. I cru fax that to you as well. Please cal] lane if you have any questions. Sincerely, Elizabcth Cantrell Seniox Ocxlz Typist Board of Trustees 7(65-1.892 wwwww-ten ...r�.+.r-..may 54375 MAIN ROAD P,O BOX 1179 SOUTHOLD, NY 11971 Po.x.�.u.. u.. � ,,,, ___—__ oxen. — �_ _ __ - - _- -,._r. : '_. _' � . .-_'r y:..•x".,::.w� .r -.. 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A .�_... .. '•-- -�--..-..a —�.,...,_` _ —���" _ lwi,.rnxsErxcv.- �. `�i�{ p—� p a�sraect'no 1�q PR6QERTYM7M P h T3 / `M1+ u Z03R E / O 4 a o $ 0, '1 `F 6 IPNiltl 0'0 G 0 �0 0G� foo 4 y0 ^m ;L ,d+ "' "^" ------ °iO1` --64'-- °�"'^ --"-- NOTICE aIDln COUNTY OF SUFFOLK © E c� SOUTHOLD SECTION NO ,E —�-- - (z+) ,. 2 - _ --_'—_—_ _"—_—_ �� a+ Real Property Tax Service Agency Y �E� Ns.,�.� -•'- o.�m, a v. —O m.rou. — o.a,..--pf_— p®S cP""�Ycem..a.�m.,a.xri�sm 1. A 145 V w 1000 PROPERTY AIl,P 4 tov so OFFICE LOCATION: ®� F ��- ®� MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) fr_r Southold, NY 11971 Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TO VN OF,SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: November 14, 2017 Re: LWRP Coastal Consistency Review for NN T: KROM SCTM# 1000-145-2-19 Chris Mohr on behalf of ANN T. KROM requests a Wetland Permit to repair the existing ±98 foot long cement bulkhead with ±30 foot long westerly cement return as needed in-kind and in-place; install a 39' long by 4' wide vinyl return along the easterly property line; backfill void areas with approximately 80 cubic yards of clean sand; and plant approximately 300 plugs of Cape American beach grass in disturbed and void areas. 'Located: 1296 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-145-2-19 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 CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. o.15F F04 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 Ton of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., November 8, 2017 the following recommendation was made: Moved by John Stein, seconded by Caroline Burghardt, it was RESOLVED to NOT SUPPORT the application of ANN T. KROM to install 36'X 4' of vinyl bulkhead sheathing; backfill with approx. 80 cy. of clean sand; install Cape American Beachgrass; and fix two areas in existing concrete bulkhead with cement. Located: 1280/1296 Peconic Bay Blvd., Peconic. SCTM#145-2-12 Inspected by: John Stein, Caroline Burghardt The CAC does Not Support the application and questions the feasibility of the plan. The plan appears to be inadequate for proper protection of the shoreline. Vote of Council: Ayes: All Motion Carried Michael J. Domino,President QF S®(/T�® Town Hall Annex John M.Bredemeyer III,Vice-President �O lO 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith ® Q Telephone(631) 765-1892 A.Nicholas Krupski O Fax(631) 765-6641 co BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD EMERGENCY WETLANDS PERMIT Permit No.: 9112E Date of Receipt of Application: November 9, 2017 Applicant: Ann T. Krom SCTM#: 1000-145-2-19 Project Location: 1296 Great Peconic Bay Boulevard, Laurel Date of Issuance: November 9, 2017 Date of Expiration: 30 Days From Date of Issuance Reviewed by: Board of Trustees Project Description: Stabilize section of cement bulkhead that cracked and fell down; dig behind cement bulkhead and stabilize with boulders in assorted sizes ranging from 2' to 5' in diameter; land backfill wall with sand. 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 received on November 9, 2017. Special Conditions: A full Wetland Permit must be obtained within 90 days in order to conduct any further activity on the bulkhead. This is not a determination from ny other agency. 7&� Michael J. Domino, President Board of Trustees Am Adak STEE oo�UmTHOLD TRU No* E UP 3o7p�,y &narync Issued 7'0 Jnr, T. Kram Dade // ? / 7 Address la .1 THIS, NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE TOWN .OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-1892 114i116i2017 11:11 6317656641 S4UTHOLD TRUSTEES PAGE 03/07 Michael J. Domino, PM.�?dent ,Jahn M.Brodemeyer 111.Vice.President �+���StlFF01�-CD4_ Charlcs J.Sanders o D Town Hall Annex 54375 Rout®25 Glenn Goldstoith A.Nicholas Kntpski P,O.Box 1.179 Southoid,Ny 11971 29.1 � Telephone(631)769.1992 - - F TOWN TRUSTEES TV E TOWN OpSOUTHOLD EMERGEf�Cy PERMIT flD NOV e 9 2017 APPLIC,qTI No Southold Town Property owner Name: A( f 1 le.f� f21i a r Mala Mailing Address: • � L4S Phone Numb "lam Property Address: Suffolk County Tax Map Number, 1000- 14S 2 - Agent(if applicable) n r � ��'' Address: 2.2-f`��� f. ly, ra +! e Phone Number(s); Board of Trustee pe, it Nclmber(s) if any: W111 any part of this project require a Rr rilriin„ f rY} STABILIZE SECTION OF CEMENT BULKHEAD THAT CRACKED AND FELL DOWN. BULKHEAD,STAiWITH DIG BEHIND CEMENT BACKFILLED WITHH SAND. BOULDERS,ASSORTED SIZEZ FROM 2-5' IN DIAMETER.WALL WILL BE SA I,•d dg l•:ZO L 1,60 AoN • �p� oar John M.Bredemeyer III';President S O� Town Hall Annex Michael J.Domino,Vice-President ~ 54375 Route 25 Glenn Goldsmith P.O.Box 1179 us Southold,New York 11971 A.Nicholas Krupski % YOQ Telephone(631)765-1892 Charles J.Sanders �� COUNVI y Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN'OF SOUTHOLD Office Use Only oastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Tran��'er/Exte ion Received Application: CJ,Zp�joj Received Fee:$2$_ 0'�0 Compted Application .,Z7z Incom lete , _SEQRA Classificatio Type I Type ' Ustenlid oordination:(date sent) SEP 2 0 2011 WRP Consistency Assessment Form 11 3.17 CAC Referral Sent: i"S'17 Date of Inspection:_ /j=Q�( Southold Town Receipt of CAC Report: a f Trus e _Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: Name of Property Owners) f-a f� / n n � ��. Address JA / P� 4 4 U r e-/ Phone Number:(�,�QSuffolk County Tax Map Number: 1000 Property Location: ZJ r-,- roved (p e LILCO Pole#, distance to cross streets, and location) AGENT: G Met f 4 6 (If applicable) Address: Chris Mohr Landscaping — PO Box 48 3 — Phone: Cutchogue, NY 11948• Board of Trustees Appl_�..tioti GENERAL DATA Land Area(in square feet):- '�j Area Zoning: Previous use of property: Intended use of property: "` + Covenants and Restrictions on property? Yes If"Yes",please provide a copy. No Will this project require a Building Permit as per Town Code? If"Yes",be advised this,application will be reviewed by the Building Dept.prior to a Board of Trustee re and Elevation Plans will be required. view Does this project require a variance from the Zoning Board of Appeals? yes If"Yes",please provide copy of decision. —,&_No Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes _4_140 Does the structure(s)on property have a valid Certificate of Occupancy?.-Yes No Prior permits/approvals for site improvements: Agency Date ZNo prior permits/approvals for site improvements. p meets. Has any permit/approval ever been revoked or suspended by a governmental agency?X--No Yes If yes,provide explanation: Project Description(use attachments if necessary): a M6 LI �Z4 c U Ili (UA- q0 ' 36 </ r Board of Trustees Applic' on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: j::,-j* S� O'y Area of wetlands on lot: �� square feet Percent coverage of lot: Closest distance between pearest existing structure and upland edge of wetlands: feet Closest distance between,nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: �� �;,� Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): 4� 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 Name of Action or Project: 4 Project Location(describe,and attach a location map): P. Brief Description of Proposed Action: V' vi b U i kiTA-d wily e-eme"P'1-� 2� Ire Name of Applicant or Sponsor: Telephone: t Any A T-. L E-Mail: ���_ �•� � Address: City/PO: State: 'fpCo e: eve* I d y— Q 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, ES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that El F1 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,list agency(s)name and permit or approval: NA ❑ 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? O r acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 311 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban E3 Rural(non-agriculture) ❑Industrial ❑Commercial J§Residential(suburban) ❑Forest ❑Agriculture El Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. is the proposed action, NO YES NIA a.A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ ®0' 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ UN 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? N9 1:1 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: ;4 M 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 14, ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 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? ❑ 3,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. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: , oreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑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? ❑ 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 I YES If Yes, a.Will storm water discharges flow to adjacent properties? �NO ❑YES ❑ ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ;!&NO DYES Page 2 of 4 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: K ❑ 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: ❑ 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: ❑ I AFFIRM THAT THE INFO ATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: .1. 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 I. 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? n ❑ 3. Will the proposed action impair the character or quality of the existing community? LC=1 ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the n ❑ establishment of a Critical Environmental Area(CEA)? Lam! 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 E]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? L� 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 1 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? 1 l. Will the proposed action create a hazard to environmental resources or human health? 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. EJCheck this box if you have determined,based on the information and analysis above,and any supporting documentation, that 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 imp cts... Town of Southold-Board of Trustees it �1 r 1 Name of Lead Agency Date Mt~� �� � President Print or T p�,Name of s onsibl Officer in Lead Agency Title of Responsible Officer v Signature of Resp Bible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 04/06/2017 11:11 6a;- _ ',56641 SOUTHOLD TF EES avesi.ti ui r umr6uev yIPP11C"...01L PAGE 05/07 AUTH0RI,7,A TION (Where the applicant is riot the owner) I/We, A, owners of the property identified as SCTM# 1000. 14 2— in the town of New York, hereby autliollm [.tet I r i s Unh r to act as my agent and handle all necessary work involved with the application process tit pemut(s)from the Southold Town Board of Trustees for this property. Property Owner's Signature Pro gn perty 0vmex s S� ature. SWORN TO BEFORE ME THIS t DAY Op , 20 t Notary Public CARMEN D HUMN Y PuMc.State of Near hide No.01HU5=19 &W ied in Suffolk CM* CWW"m Exg"s mber go,at U-1 04/06/2017 11:11 7656641 SOUTHOLD w'STEES PAGE 06/07 Aki'LICANT/A GENTAM#rpr,SLPNTATrn TROSA,CTIONAL AISCLOSUIt,I,OR T of Srn�hoid's Codc�rt:a„w t to rev de ` m ° tO S1.11l�_tirt fawn of tx:cstblc cenAicts of• e -And att+nteve The „,.e -d-- -- / -tLllow tt�2tako whetem r aotion i YOUR NAME: (Lest name,first natno,,g)iddle initial.unless ' som�wne else or other onto you m°applying in tha name of person's or con:tpnny's AMC.) ucit os a company,If$o,indicato Ntt'.other NAME OI,APPI..ICATION; (Cltcck all that apply.) Tax grievance -- Variance. _ _-_ _ Building - Change orzone ---== Trustee Approval of plat Coostal Erosion - Exemption fMm plat or ofliclai map ` Mooring — -- Other Planning (If 110thce,nnrtto the activity.) Do you personally(or through your com aM� oFthe To of Southold? "Rclationshi h n lads 1) sltiling,pnronh or child)have a rolndonshlp.widt any officer or omploy� ' including t1 partnerattlp,in which the towniofileaf or�employco hes age, a pa nni s Toler st of(or ess io in which the town offer or employee owns more than gob of the sem,or business interest"Bustncss intorest't moans a business, • p ymont hy)a corporation Yt3S NO lrydu answered"YPS-,,complete the balance of this toand and a►gn where indicotCd, Name orporson employed by dtc Town oFSouthold Title br position of.that person -- Nseribe the relationship hetween yourself(the applicant/a en!/ the apProprtnte line A)through D)and/or dose jbe in the space p� �a a dv®)and the town otFcor or omployae Either check The town officer or employeo or his or her spouse,sibling,parent,of child is(ohook ell tilos apply): pp y); the owner of greater than 5%of the shares of the • (whoa the applicant is a corporation) corporate stock ofthe applicant B)the logit or beneficial ownar of any interest in a (wh�fl•the non•corporato applicant is nop a corporation); Cncit}� C)an officer,director,partner,or employee of the applicant;dr ,D)the octual applicant. DESCRIPTION OP RELAr10iVSltIP Submitted this :3 clay of Signature Corm TS 1 Print Name 04/06/2017 11:11 6391• 6641 SOUTHOLD TRI' JES • PAGE 06/07 i A.P.I'LICAiNT/AGENT/Mir PC,SErfWIVE TRANSACTIONAL DISCLOSURE rIORM Tho of Southotd's Codc of Ethics nrnhihire,.w •rt a � vtcac oa[_hC DaS3 0*t0 n b "'"` ind'tmEloyees ?Ile bniTM+c�n of thi�fenn is to provide information whio_h�n91ert the town Df Dossiblt:contlicls of tw to avoid same. �lgllllew it to take whatever acdon Is YOUR NAME L f L 4�IrL7 W� (Last name,first nerne,ipiddle initial,unlcss ydu are applying I11 tie nine of someone else or other ontiiy,such as a company.If so,indicate tfia.other parson's or company's name.) NAME Or'APPLICATION: (Check all that apply.) Tax grievance VarianceBuilding - . ._ � _ Tntstee Change of Zone —�'�'"– Coastal Erosion Approval of plat Mooring _ Exemption from plat or official map Other Planning (If"Other',name the activity.) Do you porsonally(or through your company,spouse,sibling,parent,or child.)have a teladonship with any officer or employee ' of the Town of Southold? "Relationship"Includes by blood,marriage,or business Interest"Business including a partnership,In which the town Officer or employee has oven marts a business, s pettinl ownership of(or cinterest"est"by)n corporation In which the towp officer or cmployco owns more than 5°h of the Yr;S NO Ifydu Answered"YES",complete the balance of this form and data and sign where Indicetcd. Name Of pdt.Vn employed by die Town of Southold Title br position o('that person Describe the relationship between yourself(the applicant/agcnt/ropncsentative)and the town officer or employee.Either check the appropriate line A)through D)and/or deselbe in the space provided. The town officer or employee or his or her spouse,sibling,paregt,a1r child is(cheek all that apply): � A)the owner of greater than S%of the shares of the corporate stock of rho applicant (whch the applicant is•a corporation); B)the legal or beneflcial'owncr of any Interest in a non-corporato entity(wh6n.the applicant Is not a corporation); C)an officar.director,partner,or employae of the applicant;dr D)The actual applicant. DESCRIPTION Op RELATIONSHIP Submitted this 3 day cf 20'f 7 Signature—' Print Name ,L Form T5 I ~' ' 04/06/2017 11111 6i 56641 SOUTHOLD T , FEES PAGE 07/07 APF LICANT/AGENT/RB-PRES ENTATI VE TRA NSACTION'AL,DISCLOSURE FORM The town ot:3octhold'a GodQ,q ka nmw is conAisra af t tis fo bmvide intotination whi h cen ale tic town of � fhe o rt eftnwn�•• • IFC� dJomelo�eaThc,-�ei� , �r necessary t0 avoid ama, bins � nfliYOUR NAME: NiL h r ([.ast nam*,>yist name,Middle initial,un!,-- U55 YOU aro applying id the came of someone cis*or other amity,such as a company.If so,indicigg thb.other person's or company's name.) NAME OF APPLICAT,•iON: (Check all that apply.) Tax grievance Variance Building '.'' • , �• Chariof$.one Trustee "- Approva(of plot Coastal Erosion -- Exemption from plat or official map Mooring Other Planning Of"Other",name the activity,) ��— Do 1rou personally(or through your corttpatty,spouse,sibling. rvn or child)have a relationship with arty officer or employee of the Town of Southold? "Relationship"includes by bloodg' t' " Including a pertncrship,in which the town officer or employee has seven part al ownt hid of or oma tommsf:means a business, in which the town officer or employee owns more than 5%of the shares, � p ( . p yment by)a corporation YES NO ____—�. . , • ifydu answered"Y O,complete the balance orchis form and date and sign where indicated, ?lame of 1>cr8.011•omployed by the Town of Southold Title br position of that person Describe the relationship between yourself(thc applicant/agggt/repmscntativo)and th*town gMcer or emplai Either Check the appropriAtc line A)tltrougll�)end/or describe in the space prvttidcd. The town officer or omployco or his or her spouse,sibling,parent,of child(s(check all that apply); _A)the owner Otg'r eater 11111115%of the shams of the corporate stock of the applicant (when the applicant is n corporation); _w8)the legal or beneficial owner ot'eny interest in a non-corporate entity(wh6in the' ttpplicont is not a corporation): _,-Q an officer,director,partner,or employee or the applicant;or D)the actual appliCanL DESCRIPTION OC 98LATIONSHIP Submitted Otis •3 day of MGL 200! / Signature Form TS 1 Print Name Board of Trustees Appli , :tion AUTHORIZATION (where the applicant is not the owner) residing at PO P,5o (print name of owner of property) (mailing address) r&/ qJ do hereby authorize -- ----- (Agent) - toa apply y for permit(s) from the Southold Board of Town Trustees on my behalf. �(Owner'ssignature) 04/06/2017 11:11 6, ` 556641 ,soa"t oz 1.runteegOU APP PP liaaeD 1 'TEES PAGE 04/07 • - sen AFFIDAVIT k4v v),jDEPOSES AND AFFIRMS THAT kIE/SHE IS T BEING DULY SWORN DESCRIBED PE HE APPLICANT FOR TIBC RMIT(S)AND THAT ALL STATEMENTS CONTAINED i,IEREIN ARE TRUE TO THE BEST OF HIS/ITER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL DE DONE IN THE MANNER SET FORTH IN THIS APPLICATION. AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOAUSTEES THE APPLICANT AGREERD OF TIt S TO HOLD THE'TOWN OF SOUTROLD AND THE OF'TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING-UNDER OR BY VIRTUE OF-SAID PERM. T(S),Iy GRANTED. IN COMPILE TING THIS APPLICATION, I HEREBY AUTHORIZE THE - TRUSTEESt THEIR AGENTS)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL, TO ENTER ONTO INSPECT THE PREMISES IN CONJUNCTION WITH RISA pL�APPLICATION PROPERTY TO 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 RY THE BOARD OF TIRE PERMIT.' OF TRUSTEES DURING THE TERM Si�t�atwejo�fprop��tywncr Signature of Property owner SWORN TO BEFORE Mp_THIS DAY OF ,� , 207 lug. ICS �r. ��.Nota�ry Publi / CARMEN D NUMN Noby Pul tc,State of NmvVXk QUalMed InHSufrollkk County Cammisslon Expires September 28. Board of Trustees Appli,- _ :ion AFFIDAVIT An n '�°m 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 TRUSTEE'S 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. --4�Signature of Property Owner SWORN TO BEFORE ME THIS q Ftp. DAY OF_ j e, o_r 20i�, P:�!�—�No�tar�pu�blic CARMEN D HUD90N Sony pwft&tate d,,NMY*k Nsu k t" Michael J.Domino,r,,-,„dent O�QSVfFQ��`1 Town Hall Annex John M.Bredemeyer III,Vice-President �� yam, 54375 Route 25 Charles J. Sanders y = P.O.Box 1179 Glenn Goldsmith y Southold,NY 11971 A.Nicholas Krupski 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 ANN T. KROM COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, tha �w ris W Y I r , residing at/dba 61h r 221515 ft &a 000Q Uj5 //173.5 being duly sworn, depose and say:." 6 That on the ff day of U_5_ fr 7`6, 201-,I personally posted the property known as 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, November 15, 2017. Dated: 1A �k nature) Sworn to before me thi's 8 day of NOV.201? Notary Publi ALLISON L.STARON Notary Public,State of New York No.01ST6239228 Qualified In Suffolk County Commission Expires April 18,20L4 n� 4 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: m — • ."'.."r'® 'a5: - .qua +;� aj $- y, -�' I lLn I ..A Certified Mall Fee N Extra Services&Fees(checkbox,add fee as r p eJ ! v/ 4 ❑Return Receipt(hardcopy) $ ) ) I a ❑Return Receipt(electr-onlc) $ ../ Postmark 0 ❑Certified Mail Restricted Delivery $ JL I 4 L]Adult Signature Required $ 11_• [�1-1•ere 01, El Adult Signature Restricted Delivery$ • i Z®" ®� �i � OPostage ,� 1-3 $ .$1.49 \� OTotal Postage and Fee $ $ .59 —� Sent To r-1L-w re.( N Vq:;yrPOBcys AIFj S City St.ZC%� --- 4a�C y ------- ta STATE OF N ►-r I h / /9 of COUNTY OF SUFFOLK i rVY' residing at 2.2-1 �lYl dayof , being duly sworn, deposes and says that on the �a,1�1 20i-deponent mailed a true co set forth in the Board of Trustees Application, directed to each of the above named Demons at the addresses set opposite there respective copy of the Notice addresses set opposite the names of said persons are the address of said person's as Shown on the c �A assessment r 110 thoym Southold; that said Noiices were mailed at the anent Office at United States Post CERTIFIED that said Notices e e mailed to each of said persons by RETURN RECEIPT. I Sworn to before me this a,-.N Day of NOV�11A��� 20 t CA M Not Public l ALUSCYN L�UARGO 4 i Notary Ptibin,State of Rjav JrQe; No.OI ST6239223 Qualiiicd in au#+alx Cou* Commission Expires April 18,201q � s PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL. RECEIP'T'S g Name: ru 19 µt11+°' - a s '�, , •. 1 'u%j .-D Certified Mad Fee Ln $ $3.35 ra t Ln Extra Services 8 Fees(checkbox,add ree te) I ❑Retum Receipt(hardcopy) $ M11- a ❑Return Receipt(electronic) $ tkl�l 00 �� 1421b rk 3 ❑Certmed Mail Restdcted Delivery $ $9 09 I G7� ��aI `{ I] []Adult SignatureRegwred $ leg 1j ❑Adult Signature Restneted Delivery$ ' •yt _ O®� C! C3 Postage $ $0.49Er O Total Postage and Fees 1 J ji $ $6.59 Sent To d h A-le, `,Q e— ak— 0 �tieet No.,,,eo��PO Boz No'--------------------`-" -- STATE OF NEW yOR COUNTY OF SUFFOLK residing at 7z,-LI Vn � being duly sworn, deposes and says that on the_day of YLLV'>✓1 set forth in the B20�deponent mailed a-true copy of the Notice oard of Trustees 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 r Il o the Town of Southold; that said Notices were mailed at the United States Post CERTIFIED MAII,/RET that said Notices e e mailed to each of said persons by URN RECEIPT. i Sworn to before me this gvH Day of NoVEMgEr 20 T stvwt No Public i ����Bg Rq��aaFF++,,.,pp,��pp �a p i MP.t.6SON L STARON Notary Public,State of New York: No.615'6238228 Qualified in Suffolk county Commission Expires April 18,20 t9 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS k 0T Name: f ® . © Y u ru 1 y LIP ...D Certified Mall Fee i Ln $ $3.35 Ln Extra Services&Fees(cbeckboxadd/esa e) �U+�f�4 ❑Return Receipt(hardcopy) ❑Return Receipt(electmnlc) $ $ 00 P4ark , C3 ❑Certified Mail Restricted Delivery $_ .t^ r. `Were r3 ❑Adult Signature Required $ PV VtJ ❑Adult Signature Restricted Delivery$ 9 Posta a $l7:49 C3 Total Postage and Fees $6.59 -o s rr C3 -- V) Z �- ✓� -- - - -- - Stlee - t. r PD,ox IVo. .. ------.y--�-- u ----�-- — V �/� City, tate. IP+4a �-------- - - ---------- STATE OF NEW YORE ��' _ ��� COUNTY OF SUFFOLK— „ residin at Z�l ��� Nivin &tW'wfflkL--'- day g� , being duly sworn, deposes and says that on the of � t,�, 20j-deponent mailed a•true copy of the Notice set forth in the Board of Trustees 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 �A assessment r Il Otho Southold; that said Notices ttvere mailed at the United nt Office at �, ed States Post CERTIFIEDthat said Notices were mailed to each of said persons by M �RETURN RECEIPT. Sworn to before me this Day of MOVEMBE 20 17 Willi Not Public i ALUS i l ARON Notary Public, tar StateOf New York No.01 STS239228 Qualified in Suffolk County commission Expires April 18,2019 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS - Name: yoi `® © �'� , iN1 - 0 001 o —a Certified Mad Fee / Z j Ln $3.35 �n��o_ t19��_ I Extra Services&Fe (check box,add fee a ❑Retum garsipt(hanlcopy) $ 111 N U� I C3 ❑Return RecelPt(electronic) $ $0 00 C-3 El Certified Mail Restricted Delivery $ — Pos�m$rk r-3 ❑Adult Signature R,Uired $ �V'— w.�S1 Hire +� ❑Adult Signature Restricted Delivery$ "�-•'•" !� I / O Postage $ $0.49 \,YJ-i{I�j` CEr3 Total Postage and Fees 11,/1 U/2011 7 $ $6.59 Street an o., O ox ------------------------------------ ------------ --------------------------------- ---- -- '--- �� STATE OF NEW YO i crry,st ---- --- ------- ----- COUNTY OF SUFFOLK--- residing at day o being duly sworn, deposes and says thapy t on the set forth in card�63 20i '-deponent mailed a-true co Trustees Application, directed to each of theabove named Notice 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 r 11 o ;t�he�To of Southold; that said No were mailed at the Unit nt Office at ed States Post CERTIFIED MAIL/RET that said Noti URN RECEIPT. ces mailed to each of said persons by i Sworn to before me this 8TW Day of NOYEM E'er 20 1-t 4 S tary Public i ( ALLISON L STARON I Not'(ry Public,State of New Y'otk No.01ST6239228 Qualified in Suffolk county Commission Expires April 18,20M NUTILt: U1 HLAKING1 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 : ANN T. KROM SUBJECT OF PUBLIC HEARING : For a Wetland Permit to repair the existing ±98 foot long cement bulkhead with ±30 foot long westerly cement return as needed in-kind and in- place; install a 39' long by 4' wide vinyl return along the easterly property line; backfill void areas with approximately 80 cubic yards of clean sand; and plant approximately 300 plugs of Cape American beach grass in disturbed and void areas. Located: 1296 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-145-2-19 TIME & DATE OF PUBLIC HEARING : Wednesday, November 15, 2017 — 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 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 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 si ficant 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- supportink 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: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# ' DD 0 - 1(f<_- 2.. _ 2-- PROJECT NAME - 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: -,-_ x rP * n Location of action: Site acreage: Present land use: Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code( } (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No❑ If yes,which state or federal agency? 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. ❑Yes ❑ No Not Applicable 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 0 No Not Applicable 1 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 R 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 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. Yes No Not Applicable 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 P,Not 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. ❑ Yes ❑ No 1)kNot 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. ❑ YeO No Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No rRNot 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 ❑ No Not Applicable Attach additional sheets-ifnecessary 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?�\Not Applicable PREPARED BY �h,t3 f C eY( ! TITLE DATE 04/06/2017 11:11 6317FF",41 SOUTHOLD TRUS_r-',vPAGE 03/07 , y- Michael.i. Domino, President �QS�fF01,�-C�G� Town Hall Annex John M. Bredemeyer 111,Vice-President ��`Z y 54375 Route 25 Charles J Sanders c P.O. Box 1179 Glenn Goldsinith - ^�+ Southold,NY 11971 A.Nicholas Krupski , y� w pl Telephone(631)765.1892 Fax(631)765-6641 - BOARD OF TOWN TRUSTEES (� L MAY 1 1 2017 T (�c I e�� OWN Off'SOUTHOLD � EMERGENCY PERMIT APPLICATION ep(,Ai Property Owner Name: sU AJ T �'� M4 „_• Main Mailing Address: rill X 54S Laur I ) f) �_ lq4p Phone Number(s): (-osl- Z- 9 9--- '--74k Property Address: ( 2- 02 • 0,000 66 L-ka 1-C k, if Suffolk County Tax Map Number: 1000 - ( 4S- 2-- ( 2— Agent 4S - 2- 12— Agent (if applicable) Ch r1s rtDh r Address: 22-1 5�- �D OYl � � ) 11113 Phone Number(s): U31 Board of Trustee Permit Number(s) ii any: Will any part of this project require a Building Permit' Project Description: I n S " :3 mW s ®-� r VD 31 � 7T) N Q v-e-o( i R�QIr�7�� 04/06/2017 11:11 6' ")56641 SOUTHOLD TP EES PAGE 06/07 A.PPLICANT/AGENT/REI'PX,SLfN'rATIVE TRANSACTIONAL DISCLOSURE roRm Thc�own of Southoid's Code of Ethics orohi '• this form is to provide information whioh en ►s�onttfcts of interest on the Hari o town titliQ�r employees.The ouivose of tt Ierl the town of uossibic conflicts of'nw A��Itow it to take whatever action is n c ncv to avoid same, ,, YOUR NAME- AAW (Last name,first namc, iiddle initial,unless you at>;applying in the name of someone else or other entity,such as a company,If so,indicatt:tfia,other person's or company'$name.) NAME OP APPLICATION: (Check all that apply.) Tax grievance Building / Variance —•"'�— • Change of ZoneTrustee �^ _ Approval of plat Coastal Erosion MooringExemption from plat or official map Other Planning (If 1,0dicel,nagtc the activity.) Do you personally(or through your company,spouse,sibling,parent,or child,)have a neiadonship with any officer or employee of the Town of Soudtold? "Relationship"includes by blood,marriage,or business interest."Business intcrost'•means a business, Including a partnershfp,in which the town officer or employco has even i partial ownership of(or'cmployment by)a corporation In which the town officer or employee owns more than 5%of the shares, Yr;B NO —T •, tfydu answered"Yir5",complete the balance of this form and Slate and sign where indicattd, Name Of paten employed by die Tom of Southold Title br position of,that person "— Describe the relationship between yourself(the applicant/agcntImprosent'ative)and the town officer or employee.E die r ebeck the appropriate line A)through D)and/or descObe in the space prodded, The town officer or employee or his or her spouse,sibling,parept,o1'child is(cheek all that apply): A)the owner of greater than 5%of the shares of the corporate stock of die applicant (when the applicant is a corporation); .• II)the legal or beneficial owner of any interest in a non-cotporato entity(when the WHOM is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this :3 clay of ZO' Signature,. Form TS i Print Name "• . 04/06/2017 11:11 631'«5641 SOUTHOLD TRUF--11;S PAGE 06/07 APS'LICANT/AGENT/RUI-PR-U4SENrATIVE TRANSACTIONAL DISCLOSURE><'7pR1V� Ire Town of Southold's Codc of Ethic"rAbbAs_Rtl$licts of interest on the Part-of-town cUSd p�loyecs_The putvose of this farm,is to provide inforination Thicl�9fl��ri the town of uossiblc conflicts oCitttc gy lytul flew it to take whatever action is necessary to avoid same. YOUR NAJvIE: L.at,c,r� (Last name,first nates,ipiddle initial,unless you aro applying in the name of someone clsc or other entity,such as a company.If so,indicate tfia.other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance 'Trustee Change of Zone Coostal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Othce',narttc the activity.) Do you personally(or through your company,spouse,sibling,pamnl,or child,)have a relationship with any officer or employee ' of the Town of Southold? "Rclationship"includes by blood,marriage,or business imerest"Business intcrest"means a business, including a partnership,in which the town officer or employcc has even a partial ownership of(or'amployment by)a corporal ion in which the town offlcer or employee owns more than 5%of the shares, Yrs � NO Ifydtt answered"YES",complctc the balance of this form and date and sign where indicated. Namc of person employed by die Town of Southold r Title br position of,that person Describe the relationship between yourself(the applicant/agcnt/trpt'esent'ative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space prodided. The town officer or cmployce or his or Ther spouse,sibling,parent,of child is(check all that apply): A)the owner of greater than 5%of the shales of the corporate stock of the applicant (when the applicant is a corporalton); B)the legal or beneficial owner of any interest in a non-corporute entity(when the applicant is not a corporation); C)an officer.director,partnei,or employee of the applicant;dr D)the actual applicant. DESCRIPTION OF RELATIONSHIP Su""it this day >: 2o--L7 Signature Print Name ,L Foran TS 1 04/06/2017 11:11 631—`641 SOUTHOLD TRUE, ' -zN'6 PAGE 07/07 APPLICANT/AGENT/R)CPRESENTATTVT TRANSACTIONAL DISCLOSURE FORM The Town of_Soudiold'.s Q%lto, thics prohibits conflicts of interest on the Dart of town glFlEe�s and-cat1tZ14yec ,, o�u this form-i"gptMJef inf2rinAtion which can alert the town of ssi�¢�„a contligLQL' cl and allow it to take whatever action is necessary Kk D h r . YOUR NAME: (Last name,fiist name,ipiddle initial,unless you arc applying id the name of someone also or other entity,such as a company.If so,indicate thc,other parson's or company's name.) NAME OF APPLICATION: (Clhcck all that apply.) 'fax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plot Mooring Exemption from plat or official map Planning Other (If"Otho",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or chilcl)have a relationship with any officer or employee of I he Town of Southold? "Relationship"includes by blood,marringe,or business ihtcrest."Business interest"means a business, including a porhhcrsh;p,in which the town officer or employee has even it partial owngrsbip of(or'employmcnt by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of parson•employed by the Town of Southold Title or position of that person Describe the relationship between yoursoif(thc applicant/agcnt/represcntativc)and the town officer or employee.Either cheek the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or hot 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 applieanl:is it corporation); $)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 Submitted this—,Z—day of_44,1 200 Signature , Print Name /h 4 Form TS 1 04/06/2017 11:11 6317«5641 SOUTHOLD TRU - ---S PAGE 05/07 airtirct c�i i1;UUr-v ry app.L3.ca n AUTHORI,7ATION (Wherc the applicant is not the owncr) I/We, Lau P1 e- k-(9 owners of the properly identified as SCTM## 1000- I W�--2—12— in the town of New York, hereby authorizes M(�-s Ubh r to act as my agent and handle all necessary work involved with the application process for perm. it(s) .from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORN TO BEl~OREMC THIS �'I DAY OF. l , 20 11 Notary Public CARMEN D HUDSON MINY Pubfic,Slate Of Newllbdl NO.01HU5002313 Qualified in Suffolk Canrftslon Expires September 28,MO 04/06/2017 11:11 6317f;r-6641 SOUTHOLD TRU;,:'s PAGE 04/07 150arCI Or TrU9CeeB Appllcal n AFFIDAVIT �&Vlrllt V"W M BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINEDH,EREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTIS 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,THEREBY 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. Signature of Property dwncr Signature of Property Owner SWORN TO BEFORE ME THIS `� DAY OF &,41 201 7 Notary Public CARMEN D HUDSM Nomry Public,State of New Vb* No.OIHUS002313 Qualified in Suffolk County - Commission Expires Septenber 28, PD,r- SEP 2 0 2017 O Sou!hold Town 9 O� 7 110 SURVEY OF PROPERTY O SITUATE Na d LAUREL TOWN OF SOUTHOLD O� SUFFOLK COUNTY, NEW YORK \\ \ 1000- 145-02- 19 S.C. TAX No. \ SCALE 1 "=30' \ \ FEBRUARY 13, 2017 \ \ o AREA = 23,495 sq. ft. (TOJTIL)LINE 0.539 ac. \ \ NOTES: \ w\ 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM -'- EXISTING ELEVATIONS ARE SHOWN THUS: F.FL. — FIRST FLOOR G.FL. — GARAGE FLOOR TB — TOP OF BULKHEAD \ BB — BOTTOM OF BULKHEAD N TW — TOP OF WALL BW — BOTTOM OF WALL so \ F \ GOr,G \ CT \ \ �4Z \ 9 \ \ 13.5 Q \ X X__ X1214 �O�• O O� \ X 13.0\ x� O x 12.0 o 2 �x"0o d9xb� O� 12.0 01 y '\ X 10.1 Lx SVFEO\•� o Opo OF \.Xo. E �1 X 19 PREPARED IN ACCORDANCE WITH THE MINIMUM x ON STANDARDS FOR TITLE SURVEYS AS ESTABLISHED $2 BY THE L.I.A.L.S. AND APPROVED AND ADOPTED TFOR ITLE SUCH USE BY THE NEW YORK STATE LANDASS \N. a LAGgYpUND x iz\ is gF p X .4 a \ AgK /..' � \ •�� p MPRK � ,NptER 04 x 3 x 5.4 TN 2 8.6x 'v x 5.5 1W b COG N �� A-ONG ' O N SER�NR� e GJ7j o s . N.Y.S. Lic. No. 50467 6� Al �4x x Nathan Taft Corwin III SECTION;20 OFSTHE NEW YO ALTERATION OR STATE mfr+ � s 67' 46�2 YYY EDUCATION LAW. G �1Pu j so' ,• S Land S u r v e o r COPIES OF THIS SURVEY MAP NOT BEARING CON �P�P 8Q' 1 V Y THE LAND SURVEYOR'S INKED SEAL ORJ�P� EMBOSSED SEAL SHALL NOT BE CONSIDERED 4 y� J{�. ' TO BE A VALID TRUE COPY. V� O Successor To: Stanley J. Isaksen, Jr. L.S. CERTIFICATIONS INDICATED HEREON SHALL RUN �( 0 Joseph A. Ingegno L.S. IS PREPARED, ANDLY TO THES ON ON HIS B HAFOR LIFTHE TO THEV� eta Title Surveys — Subdivisions — Site Plans — Construction Layout TITLE COMPANY, GOVERNMENTAL AGENCY AND pc� '�J. / Y Y LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI— r PHONE (631)727-2090 Fax (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. OFFICES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHT OF WAYS 1586 Main Road P.O. Box 16 AND/OR EASEMENTS OF RECORD, IF Jamesport, New York 11947 Jamesport, New York 11947 ANY, NOT SHOWN ARE NOT GUARANTEED.