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TR-9299
Michael J.Domino, President �,QF SU(/T Town Hall Annex John M.Bredemeyer III,Vice-President ,`O�' OHO 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �O �� Fax(631) 765-6641 cou BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1641 C i Date: October 6, 2019 a.� TCe �e_70P_5kJ G-noj THIS CERT, ��C� ulkhead; install 97 if of proposed rip rap stone armor alo, _T high water line;rip rap to consist of three courses varyi / [1 blish and perpetually maintain a S 6'I e. S ! ��i� G'UJY A&� p rap wall; 1, Laurel OAW -t� 119 Confori IN W(* VS"O Ou 0 OF 46971N6- lretofore filed in this office Date, PWO F144 CAA hla ,_ i Wetland Permit#9299 l /o 94 ed and conforms to all of the requirenl St�p 3` I icable provisions of law. The project j for which i 7R 7!' pfor the removal of existing remaining bulkhead; install 971f of prof O'VV'Lj lxisting line of erosion landward of the mean high water line;rip raptoi OXQ_A,�ZX Alk lin size of 2-5 tons placed in three courses; establish and perpetually-mamuai.,,,--.—....- --____If buffer landward of proposed rip rap wall. The certificate is issued to Ann T.Krom owner of the aforesaid property. 0 m Authorized Signature Michael J.Domino,President ��OF SO!/r�o Town Hall Annex John M.Bredemeyer III,Vice-President ,`O l0 54375 Route 25 P.O. Glenn Goldsmith l [ Southoldd,, x 1179 New York 11971 A.Nicholas Krupski G � O Telephone (631) 765-1892 Greg Williams O Fax(631) 765-6641 &OUNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 101411.1 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction Y2 constructed _4 Project complete, compliance inspection. INSPECTED BY: 1%1dsmi�"� COMMENTS: _ OK qc Co C. Su i i k ;n accardD,nGe 9+�. aecer►.r C1299 and J ooS OM -o,/ed 9/7548 CERTIFICATE OF COMPLIANCE: rr'YSUFFat Michael J. Domino, President , opo oo�t Town Hall Annex John M. Bredemeyer, III, Vice-President 54375 Route 25 Glenn Goldsmitho79 h Southold, NY 1 1971 Grehols illiams pski Greg Wti ti �a �X Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed When project complete, call for compliance inspection; _ .Y. A. ...� -,�` •.'i"•. " V-111 i V SSS r n ,7i•- r`. .-` � r� •i /16,..11 " ���.c"����—'� ' ,lam� SUV' if rt.,1 '`. 1 "�•.. � " _t�.,t `•J. •.'. .�, "��:.1 -1 ,�� \\�."Taves' g59.SGCR;d1Kx 'p%'97JS7AA?A.LQ:'Ir1.t2r�4/? ^'�A�'ECr2.gIt'MT.gnxrbD. `T�[.- 0cmX4:�F`.S!^bSRG3�@yT!R/JfG�..c'4;A7,cRR�:fwbL'A.11�JPry1�A7:�ni) 'sIIf�7JXIAA27�ADb7'+�3�55^ 'C:,YSU7:SSSh^!oAC.V,oF°4 t. , BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT NO. 9299, DATE: AUGUST 15, 2018 ISSUED TO: ANN T. KROM ` I PROPERTY ADDRESS: 1296 GREAT PECONIC BAY BOULEVARD, LAUREL . 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 August 15, 2018, and tt� 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: `r. Wetland Permit to remove existing remaining bulkhead; install 97 if of proposed rip rap stone z; armor along existing line of erosion landward of the mean high water line; rip rap to consist of 'f three courses varying in size of 2-5 tons placed in three courses; establish and perpetually } + maintain a 10' wide non-turf buffer landward of proposed rip rap wall; and as depicted on the site plan prepared by Jeffrey Patanjo dated July 17,2018, and stamped approved on August 15, 2018. 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. HIZ AW� cei ® yy Zs J W 4,- A Nicholas Krupski—Recused X01 �,ap* �:.• �`- F '� � e7�31'�i1fw1)Y\��uSk+?L)1v�A'DaiekwA.a'ru34;A'+ut5S.1P.Ra£��Ya,+�.J;aYfD�.xtaike�'iU9i�4.;ii5914a`,.uJ.YCPPiC�ow�ff`uiu.�DWifi;a��5u:.�SSYw�.A�'Q'7�a'�rcA>YtuxaaT"+i0,.w�r,3 nkSY[uu.'6',::�.a�uc.Soo,.�s9iiG�ASaDxa»rY9�,e`�rtG:aasaouu.4rcaxu `\ �� i'�C._/I,, �. � u`_ ; � � � fit_`�i � -� �l.`;�, Z __ `` ��• ���;,. •. ,` �;;r d•` •;\.��1 ,. ��i. _ -, _�al.,;, .„r:. �V �� �� '{� 0r4=:,1n,'s .`�'r- y :),v;`ti \,�;-J' <4>.p.,4 tip•' n.. TERMS AND COND-t SONS' The Permittee Ann T.Krom residing at 1296 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. 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. The Permittee is required to provide evidence that a copy of this 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. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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. 11. 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. \ t ��QF Ury� Michael J.Domino,President SOTown Hall Annex John M.Bredemeyer III,Vice-President l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski �p� Telephone (631) 765-1892 Greg Williams D��cou Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 15, 2018 Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 RE: ANN T. KROM 1296 GREAT PECONIC BAY BOULEVARD, LAUREL SCTM# 1000-145-2-19 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its Regular meeting held on Wednesday, August 15, 2018 regarding the above matter: WHEREAS, Jeffrey Patanjo 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 February 8, 2018, 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 LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: amended project description; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on August 15, 2018, 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, 2 _ �1 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of ANN T. KROM to remove existing remaining bulkhead; install 97 If of proposed rip rap stone armor along existing line of erosion landward of the mean high water line; rip rap to consist of three courses varying in size of 2-5 tons placed in three courses; establish and perpetually maintain a 10' wide non-turf buffer landward of proposed rip rap wall; and as depicted on the site plan prepared by Jeffrey Patanjo dated July 17, 2018, and stamped approved on August 15, 2018. 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: $50.00 Very truly yours, d Michael J. Domino President, Board of Trustees MJD/dd I i o7 c ..i CC ` O I �a 0 Y Y FpJO G�a G SURVEY OF PROPERTY SITUATE U, 0 No. `� d LAUREL Nom'\ TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000- 145-02- 19 - SCALE 1 "=30' \ FEBRUARY 13, 2017 \ \ AREA = 23,495 sq. ft. \ \ C' To WALL)LINE 0.539 cc. \ \ NOTES: 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM EXISTING ELEVATIONS ARE SHOWN THUS: F.FL. - FIRST FLOOR I G.FL. - GARAGE FLOOR (4 TB - TOP OF BULKHEAD \ BB - BOTTOM OF BULKHEAD TW - TOP OF WALL BW - BOTTOM OF WALL \ �S OP. \ 9 ` ` vim• \ \ x r r`x.12J Nei, ` a X12,4 �O'\• �� \ a. osy X\ �\ xlzb o h� ` nx xx b o J,� •y 9 'per`� �G `]d !L o �o 0- X IiLi xIiLi X 10.4x Hce SVFG°�� O S�ppO '� ° °F �•2 Sol:r.,v y 5 OD 0 5 Qj IPA << Xm SoA PREPARED IN ACCORDANCE WITH THE MINIMUM r X STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE L.I.A.L.S. AND APPROVED AND ADOPTED FOR SUCH USE BY THE NEW YORK STATE LAND TITLE ASSOCIATION. ;• \ �YGR x A,4X w pAR r Y`. X�u X$'-4 4 u ? WOdD W O Y.S. Lic. No. 50467 _LZ H`GH Wa 5 9•GJ�j x1W UNAUTHORIZED ALTERATION OR ADDITION SSE '0 TO THIS SURVEY IS A VIOLATION OF WppO SN S Nathan Taft Corwin III SECTION 7209 OF THE NEW YORK STATE P� p c EDUCATION LAW. 2 „W JJ C Land Surveyor COPIES OF THIS SURVEY MAP NOT BEARING cpNc ��Qom` ,•80' �1 0 THE LAND SURVEYOR'S INKED SEAL OR JQ�" EMBOSSED SEAL SHALL NOT BE CONSIDERED ��" �•1 ,l/ TO BE A VALID TRUE COPY. Successor To: Stanley J. Isaksen, Jr. L.S. CERTIFICATIONS INDICATED HEREON SHALL RUN Joseph In a ONLY TO THE PERSON FOR WHOM THE SURVEY p A. no L.S. r^ yJ�' 11Y 9 9 IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND Jc Title Surveys - Subdivisions Site Plans - Construction Layout LENDING INSTITUTION LISTED HEREON, AND / TO THE ASSIGNEES OF THE LENDING INSTI- -J PHONE (631)727-2090 Fax (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. OMCES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHT OF WAYS 1586 Main Road P.O. Box 16 AND/OR EASEMENTS OF RECORD, IF Jamespor't, New York 11947 Jamesport, New York 11947 ANY, NOT SHOWN ARE NOT GUARANTEED. Opti � �d 4 - •` • .APPROVED=BY: F BOARD-OF TRUSTE ES• TOWN -OF'SOUTHOLD :DATE Aws7; yzso� Is Zalg o, SCTM NO. 1000-145-02-19 \ VACANT LAND 4. too. moo\ y - G \ too, 3t - .mss LIMITS OF STORM EROSION PROPOSED 10' WIDE �. NON—TURF BUFFER E C E I V E JUL 1 8 2018 �,� MND �! 9.53 Southold Town REMAINS OF EXISTING BLOCK WALL Board-of Trustees g67-46'25 S�21g 85' BODUPROLDERS CONSISOSED 97 LFTNG OOCK FEL WERNCO RS TO CONSIST OF PROPERTY OWNER: �� 4-5 TON AND UPPER COURSES 2-3 TON SIZES AND PLACED IN AN INTERLOCKING MANNER ANN T. KROM �`Z`' ��' CONSISTENT WITH NYSDEC AND SOUTHOLD TOWN P.O. BOX 545 / SPECIFICATIONS AND REQUIREMENTS. LAUREL, NY 11948 / C $0,i PREPARED BY: vr,��1 JEFFREY PATANJO / P.O. BOX 582 BOHEMIA, NY 11716 631 -484-9332 BULKHEAD PERMIT PLANS SCALE: JJPATANJO@GMAIL.COM 1"=30' NOTES: PROPOSED PLAN DATE: 1-14-18 1 . PORTIONS OF SITE PLAN FROM SURVEY PREPARED BY: 7-17-18 NATHAN TAFT CORWIN III LAND SURVEYOR 1296 PECONIC BAY BOULEVARD 1586 MAIN ROAD, JAMESPORT, NY 11947 LAUREL, TOWN OF SOUTHOLD DATE SURVEYED: FEB. 13, 2017 SUFFOLK COUNTY, NY SHEET: TAX MAP N0. 1000-145-02-19 1 OF 2 PROJECT "a LOCATION <,,,p esy0• '$ i a de Brushs Point �'t�J °0D r 1296 Peconic Bay Boulevard' Q i i PROJECT LOCATION MAP N.T.S. EXIST. GRADE HEIGHT OF EXISTING BANK VARIES BETWEEN 4' & 8' ABOVE GRADE /.\//.\//.\//.\//.\//.\//.\//\//\//.\//\//,\//,\//\�/\\��\\/�\\//\\ AT EXISTING BEACH PROPOSED ROCK REVETMENT TO CONSIST OF •//\//\ BOULDERS CONSISTING OF LOWER COURSE �\/\ 4-5 TON AND UPPER COURSES 2-3 TON SIZES �\//\\/ CONSISTENT WITH NYSD C AND SOUTHOLD TOWN SPECIFICATIONS AND REQUIREMENTS. HEIGHT OF ROCK TO VARY BETWEEN 4' & 6' ABOVE \ \\ \\ GRADE AT EXISTING BEACH. NOT TO EXCEED 6' LIMITS OF EXCAVATION IS uMTTED TO AREA \ \\ REQUIRED TO INSTALL AND STACK ROCK. ANY EXCESS FILL WILL BE UTILIZED BETWEEN RBOULDERS EVETMENT SYSTEM TE A TIGHT COMPACTED APPROXIMATE M.H.W. EL 2.5t X,\\//�\/� APPROXIMATE M.LW EL O.O± DISTANCE TO M.H.W VARIES FROM 2'TO 6'TO BASE OF ROCK .TYPICAL SECTION A-A N.T.S. EGEIVE J U L 1 8 2018 Southold Town Board r BULKHEAD PERMIT PLANS SCALE: N.T.S. 1 0 TYPICAL SECTION & DATE: LOCATION MAP 1-14-18 7-17-18 1296 PECONIC BAY BOULEVARD LAUREL, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: TAX MAP N0. 1000-145-02-19 2 of 2 Michael J. Domtg%_; President ��o. ���; Town Hall Annex John M. Bredemeyer, III, Vice-President54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A Nicholas Krupski Southold, NY 11971 Greg Williams Od ` Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: ANN T. KROM c/o JEFFREY PATANJO Please be advised that your application dated February 8, 2018 has been reviewed by this Board at the regular meeting of August 15, 2018 and 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) 1St Day of Construction ($50.00) '/z Constructed ($50.00) xx 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) xx 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: $ 50.00 .vi$ q BY: Michael J. Domino, President 141:r- Board of Trustees Michael J. DominoIe7 QS �'� Town Hall Annex John M. Bredemeyer III, eresident 54375 Route 25 .A Glenn Goldsmith o P.O.Box 1179 rn z A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES �/ TOWN OF SOUTHOLD Date/Time: IS Completed infield by: !"[. Jeffrey Patanjo on behalf of ANN T. KROM requests a Wetland Permit to remove existing cement bulkhead and replace with 97 linear feet of new vinyl bulkhead in-place with one 35 linear foot bulkhead return and one 6 linear foot bulkhead return; raise existing height to 42" above existing top cap elevation to match neighboring bulkhead to west; install 225 cubic yards of clean sand fill from upland sources behind bulkhead to replenish sand lost during storms; install 4' wide by 10' long platform and stairs to beach supported with 3-10" diameter cca piles; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead. Located: 1296 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-145-2-19 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q 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 f Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: r r � Present were: . Bredemeyer i//M. Domino G. Goldsmith N. Krupski _�/Williams Other Michael J. Domino, P t O�QSUFFO(� Town Hall Annex John M. Bredeme er III Vice- resident Gy 54375 Route 25 Glenn Goldsmith � P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 7�1 JZ: y® Completed in''field by: Jeffrey"Patanjo on behalf,of ANN T. KROM requests a Wetland Permit to remove existing cement bulkhead and replace with 97-linear feet of new vinyl bulkhead in-place with one 35 linear foot bulkhead return and one 6 linear foot bulkhead return; raise existing height to 42" above existing top cap elevation to match neighboring bulkhead to west; install 225r cubic yards of clean sand fill from upland sources behind bulkhead to replenish sand lost during storms; install 4' wide by 10' long platform and stairs to beach supported with 3-10" diameter cca piles; install and perpetually maintain' a 10' wide non-turf buffer along the landward edge of the bulkhead. 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: �u l 1.�,� �o.G cta�d o,✓o c�l 10yele� <:�o5n ccs \rjo,;� I)C C Gm,�-oyal I have read & acknowledged thin foregoing Trustees comments: Ag ent/Owner: G/ � l Present were: J. Bredemeyer /M. Domino ✓ G. Goldsmith, N. Krupski v G:Williams Other T.Krom 1296 Great Peconic Bay Blvd.,Laurel CTM#: 1000-145-2-19 7111118 i JPF m tk Ifr i T, AIR. .154ig: a UV T AM U1001 .v m, 1. - r -•. , _ Y r- . a fix; Ann T.Krom 1296 Great Pcconic Bay Blvd.,Laurel 3CTM#: 1000-145-2-19 /11118 AIX y C f � � rt s 1 r" , r . r � y , } .41. k 1 'tel-" ati LAS r 10-1 Moo 44 gIn � v Michael J. Domino, Pr� O�Q tFFD4 Town Hall Annex John M. Bredemeyer III,Vice-President �� �� 54375 Route 25 Glenn Goldsmith a P.O.Box 1179 A.Nicholas Krupski 0 Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 i BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: /3 //f' Completed in field by: �u-- Jeffrey Patanjo on behalf of ANN T. KROM requests a Wetland Permit to remove existing cement bulkhead and replace with 97 linear feet of new vinyl bulkhead in-place with one 35 linear foot bulkhead return and one 6 linear foot bulkhead return; raise existing height to 42" above existing top ' cap elevation to match neighboring bulkhead to west; install 225 cubic yards of clean sand fill from upland sources behind bulkhead to replenish sand lost during storms; install 4' wide by 10' long platform and stairs to beach supported with 3-10" diameter cca piles; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead. 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 Noticeo 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 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: / J. Bredem /e er /M. Domino ✓ Gpski. Goldsmith N. Kru YY G. Williams Other }�rr • Photo 1 (1/20/18) H M' f Photo 2 (1/20/18) y r i _ r Photo 3 (1/20/18) 7 F x Photo 4 (1/20/18) r .I•' w '7lhat r Photo 5 (1/20/18) Fn / 1 y Ul o e � // `•M1` 3 oao'04 � ® N �` N °R M1 /�O• "6 a 'm Ems.. / tP C Q'0 • `� � �`�� 0 'c / a • Ivu«o / 2 �� epi a • / / t M1 •/ Or, ` / r v O £p r G � o NOTICE COUNTY OF SUFFOLK © E SOUTHOLD SEC710N N0 Real Property Tax Service Agency r 145 P xic,xo 1000 PROPERWMAP Ann T. Krom 1296 Peconic Bay Boulevard Laurel, NY 11948 SCTM No.: 1000-145-02-19 PROJECT DESCRIPTION (Revised 7-17-18): The project includes removal of existing remaining bulkhead. Install 97 LF of proposed rip-rap stone armor along existing line of erosion landward of the mean high water line. Rip-rap to consist of three courses varying in size of 2-5 tons placed in three courses. Provide 10' wide non-turf buffer landward of proposed rip-rap wall. p EGEQVE 1 JUL 1 8 2018 Southold Town Boar� OFFICE LOCATION: ®��q ®ur�®� MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Pw Southold, NY 11971 ® aQ Telephone: 631765-1938 ® Fax: 631765-3136 U01 LOCAL LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: June 13, 2018 Re: Local Waterfront Coastal Consistency Review for ANN T. KROM SCTM# 1000-145-2-19 Jeffrey Patanjo on behalf of ANN T. KROM requests a Wetland Permit to remove existing cement bulkhead and replace with 97 linear feet of new vinyl bulkhead in-place with one 35 linear foot bulkhead return and one 6 linear foot bulkhead return; raise existing height to 42" above existing top cap elevation to match neighboring bulkhead to west; install 225 cubic yards of clean sand fill from upland sources behind bulkhead to replenish sand lost during storms; install 4' wide by 10' long platform and stairs to beach supported with 3-10" diameter cca piles; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead. 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 INCONSISTENT with the Policy Standard 9 and therefore is INCONSISTENT with the LWRP. 1. It is recommended that the bulkhead be re-aligned to coincide with the angle of the M.H.W line to improve public access along the foreshore. See Bulkhead Permit Plans. 2. A vegetated buffer comprised on native, salt tolerant plants should be required landward of the bulkhead. 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: Damon Hagan, Assistant Town Attorney Peter Young,Chairman y Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 y�►� fl� 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., June 13, 2018 the following recommendation was made: Moved by James Abbott, seconded by Peter Meeker, it was RESOLVED to SUPPORT the application of ANN T. KROM for the removal and replacement of existing bulkhead with 97 If. of new vinyl bulkhead and one 35 If. bulkhead return and one 6 If. bulkhead return. Raise existing height 42" above existing top cap elevation to match neighboring bulkhead to west. Install 225 cy. of clean sand fill from upland sources behind bulkhead to replenish sand lost during storms. Install 4' wide X 10' long platform and stairs to beach supported with 3-10" dia. CCA piles to replace stairs lost during storms. Provide a 10' wide non-turf buffer landward of proposed bulkhead. Located: 1296 Peconic Bay Blvd., Laurel (Vacant Land) SCTM#145-2-19 Inspected by: James Abbott, Peter Meeker Vote of Council: Ayes: All Motion Carried so Michael J.Domino,President off® 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 ® ® y� Telephone(631) 765-1392 A.Nicholas Krupski l�c+®UN.il Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit n c, 3 Amendment/Transfer/Extension !� �� ` a �' IFF Received Application: Received Fee: —Completed Application: 54,19 FEB — 8 2018 F Incomplete: t SEQRA Classification: Type I_ Type II Unlisted Lead Agency Determination: L Board of iii+sfus. --.i �Coordination:(date sent): 6�pa LWRP Consistency Assessment Form Sent: CAC Referral Sent: 5• ),18 Date of Inspection: 6 tp-t Receipt of CAC Report: Technical Review: 74_Public Hearing held: Resolution: Legal Name of Property Owner(s): kn o T 11 r®m Mailing Address: L a s t et N 1( 9 y 8 Phone Number: b 3j' ; q %_ 9`l b S Suffolk County Tax Map Number: 1000- 1 `� 5 - "19 Property Location: 1x96 P•Ceoni'e Q-a,N alvd— — tavre-L ( "CaK-- Lu„od) ®:re oke iveH,ntt } Oo P- 9-42. (If necessary,provide LILCO Poe#, distance to cross streets, and location) AGENT(If applicable): �e 4 re� Parra a1 a Mailing Address: D . Ga X .5'9 7- 13 o Ae M A N Y 11-7/ /. 9 3 3 Phone Number: 6 31 ' q $ y � �y I Board of Trustees Appl: Ann T. Krom 1296 Peconic Bay Boulevard Laurel, NY 11948 SCTM No.: 1000-145-02-19 PROJECT DESCRIPTION: The project includes removal and replacement of existing bulkhead with 97 LF of new vinyl bulkhead and one 35 LF bulkhead return and one 6 LF bulkhead return. Raise existing height 42" above existing top cap elevation to match neighboring bulkhead to west. Install 225 CY of clean sand fill from upland sources behind bulkhead to replenish sand lost during storms. Install 4'wide x 10' long platform and stairs to beach supported with 3—10" diameter cca piles to replace stairs lost during storms. Provide 10' wide non-turf buffer landward of proposed bulkhead. Board of Trustees Appl: 0. l"Itioa 1 v WETLAND/'TRUS'TEE LANDS APPLICATION DATA Purpose of the proposed operations: 5{c- 'qt t-a c 6-e- CL Area of wetlands on lot: square feet Percent coverage of lot: N A % Closest distance between nearest existing structure and upland edge of wetlands: "JI A feet Closest distance between nearest proposed structure and upland edge of wetlands: t4 A 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? 2 2 5- cubic yards Depth of which material will be removed or deposited: (o feet Proposed slope throughout the area of operations: i - 2 % Manner in which material will be removed or deposited: Cxc-a�a1'"� SFr o/V% yanZ� ,p ^JCS 6.✓LX-4as.A . 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): 7ktre wild 10-c .t g+ S, +tve a f4ee+ o,i + e- 44a( w�c1"ct1 ole �'. No '�U(_tlkeA aro SI oa _FPi.-L 6-ek c vtJL baLle-114A A . Short Environmental Assessment Form Part I -Project Information Instructions for Comnletins 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 1 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: Proposed bulkhead at 1296 Peconic Bay Blvd.Laurel Project Location(describe,and attach a location map): See Location Map Brief Description of Proposed Action: Remove and replace 97 If of existing concrete bulkhead with new vinyl bulkhead in same location and raised height of 42"above existing. Install new 35 If&6 If vinyl bulkhead returns and install 225 CY of clean sand fill behind bulkhead to replenish sand lost due to storm erosion. Install 4'wide x 10'steps to beach, Name of Applicant or Sponsor: _Telephone: 631-298-9465 Ann T.Krom E-Mail: Address: P.O Box 545 City/PO: State: Zip Code: Laurel NY 11948 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, 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,list agency(s)name and permit or approval: ❑ ❑ NYSDEC/NYSDOS/Town of Southold Trustees 3.a.Total acreage of the site of the proposed action? 0.539 acres b.Total acreage to be physically disturbed? 0 01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.539 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban [:]Rural(non-agriculture) ❑Industrial [—]Commercial ®Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Pagel of 3 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑✓ ❑ b.Consistent with the adopted comprehensive plan? ❑ W1 ❑ 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:Name.Peconic Bay and Environs,Reason-Protect public health,water,vegetation,&scenic beauty, ❑ gency u o County, a e' - - 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? ❑ 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: W1 ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: W1 ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? W1 ❑ 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? El 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: ❑Shoreline El Forest ❑Agricultural/grasslands El Early mid-successional ❑ Wetland []Urban m 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 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 AYES Page 2 of 3 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:closedTNOYES 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 INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Ann T.Krom Date: Signature: PRINT FORM Page 3 of 3 i 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: ❑ ❑ 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 INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: 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 El ❑ 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? 4. Will the proposed action have an impact on the environmental characteristics that caused the El 1:1establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ F-1affect 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: EJ 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, ❑ El or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ Elwaterbodies,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 ❑ ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? El 1:1 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. EICheck 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 impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 EAF Mapper Sum', ry Report Tuesday,January 23,2018 6:06 PM Disclaimer: The EAF Mapper is a screening tool intended to assist project sponsors and('2700=7 00:r1 D00,` 1 00=100--[400 \ ,1 �1 F500�a�0 14402 t assessment form(EAF)vIN t'all questions asked encies in an the EAF are ring an nmental 145Q004 2001 '12900100-9000"��\r; ti < <- 14500-400-5900 ChiIli, answered by the EAF Mapper.Additional information on any EAF - ' 1'4500-100T2000 .�`A .- uestion can be obtained b consultor the EAF Workbooks. Although 12900-900�a000 �, v,Y- [- 14,_00 400=•14001-`, q Y 9 9 �' 14500=t00-6000 5 `� the EAF Mapper provides the most up-to-date digital data available to 12900-'100-'70 0,-/ r,✓ ,fir ' v ' ¢,r-,•r� •. \ c f '' i - , DEC,you may also need to contact local or other data sources in order 12 96 1 00�6000c�i1'F5�00'113�Q=1ti3L•01500, 104,15 0,00 to obtain data not provided by the Mapper.Digital data is not a 12900-'100_=50i91A " I'4500=200-15,09100=300 '1'1400 ,f substitute for agency determinations 12900=100=50021••4500-260`170 3 X14500=''400'12001 12940•140-9444(j --c 12900'140-4-044 Q0=244�I2444' ti.�_ '. 04500400-10'000)„ ; 1'4500'300-7001 _ t filantC6p1' t 14500'=20 — Otlarra / 700 f450'0 300 900, -✓ 1450072 T11 00` \ ti-- r.r.� it yc, ;� ! 9�• 'r {•..41114 N AI O ,4500`200413000` I v 14560=246 4666 - 1:�• 12900=100=3©62`1'4500=200=1'0045. 4,'-20iYc1,a460 , 4 '1 f• !a a y ,: I Tora�itb f 1 Jia4L;.r?t, , 4 14,500;200-7000' j rids fuhyr) c•Roche7ra� ) ' f • 1--15,0'02.Ob=8000 �1,. 1`� - pl / ' '� � `44 "f' Detroit . ..�''' '12900100-300.1 1'45'00=200.60Q0- ' gc�c�,:;IsrP'{Imd�_ gnGS Ce,;3 500114 :200-5001” r,, Ihternap,,INCRE MiJT '- f 4@pap,1u1ETl'„EsriG in ' i; t nl�eltrtiit•T:i11s,� c' 11�ew, 145 00 200 2000 pa h' a (Hong.Konglt,Esrl' i 5�urcE�i G �btrrtiiirgfi' - +- ��1/A, \ ?�/ Kcr�a„E��i;{Tfisilend�h,tul trt India„IIGCG,•_, Columbur'..;�'P �'U _—,delp�,Intermap, '1,000-200'3000 IS -6-7--r. 3500-2,00 1'005 ®,,Ovr� tr ttvlap�xs7ttiitwt_o's` 1�h�Ci )© lo• -r, I,; _ y -- UJEtu1F�lTP,1JRGsn„tri Us.=i p alu ” T�1ETI,Esri China{ticng, •.\� 't� ,ti ti 3 j Comm riitj,• ! nnaL i:Sai� y- r�Wa�PPro,� Part 1 /Question 7 [Critical Environmental Yes Area] Part 1 /Question 7 [Critical Environmental Name:Peconic Bay and Environs, Reason:Protect public health,water, Area- Identify] vegetation, &scenic beauty,Agency:Suffolk County, Date:7-12-88 Part 1 /Question 12a [National Register of No Historic Places] _ Part 1 /Question 12b [Archeological Sites] Yes Part 1 /Question 13a [Wetlands or Other Yes-Digital mapping information on local and federal wetlands and Regulated Waterbodies] waterbodies is know_ n to be incomplete. Refer to EAF Workbook. Part 1 /Question 15 [Threatened or No Endangered Animal] Part 1 /Question 16 [100 Year Flood Plain] Yes Part 1 /Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report 1 Board of Trustees Application AFFIDAVIT H� `► • ��r ons. 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 ITIS/TIER KNOWLEDGE AND BELIEF,AND THAT ALL WORD 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 SOUTHOL D 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 REPRESIENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICA'T'ION, 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 Owner Signature of Prope ` Owner r�'g�,+ - 0 wa.y 0 U h Z/1 SWORN TO BEFORE ME THIS _ DAY OF _ , 20 Notary Public CONJTANCE LISOVYY NOTARY PUBLIC-STATE OF NEW YORK N0,011.16110900 QUALIFIED IN SUeFOLK COUNTY MY COMMISSION EXPIRES 06.01-2020- Board of Trustees Application AtUTHOMATRON (Where the applicant is not the owner) I/We, An n lL r®,n owners of the property identified as SCTM# 1000- 1 k S -0 a ' q in the town of GL New York,hereby authorizes __J_e f+P -r°`^� & to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner' Signature r t e- W aI 0 w-N h SWORN TO BEFORE ME THIS DAY OF 0 _ _ V Notary Public CONSTANCE LISOWY NOTARY PUBLIC-STATE OF NEW YORK NO.01 L16110900 QUALIFIED IN SUFFOLK COUNTY MY COMMISSION EXPIRES 06-01-2020 AiP1PlLICANT/AGICNT/REI PR ESE+NPATIIV+ TRANSACTIONAL DISCILOSUnj FORM The Town of Southold's Code of Ethics nrnhibits conflicts of interest an thepart of town officer;and employces ' ro pu os 0 this form Is to provide inforination which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. I n,/1 YOUR NAME: !��/"M , (Last name,fust name,itiddle Initial,unless you are applying in the mune 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 mlalionship with any officer or employee of the Town of Southold? "Relationship"includes by blood,nlarringe,or business interest."Business hitcrest"means u business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which ilia town officer or employee owns more than S: Pc shares. YES NO If you answered"YES",complete the balance ofthis 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)nnd/or describe in(lie 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 S%of the shares of the corporate stock of the applicont (when the applicant is a-corporation); B)the legal orbenclicial 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 thisday of 20—/fSignature Print Name_A sn A - e-r ra te• _ Form TS 1 TRANSACTIONAL DRSCLOSURE FORM The'Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town afiicers and employees.T7le purpose of this form is to provide information which can alert the town of possible conflicts of intetrst and abort it to take whatever action is necessary to avoid same, D YOURNAME: I a 'C•. \ v, J @�'F l c..f T. (Last name,first name,Middle 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,njarriage,or busiucss 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 otl icer or employee owns more than 5%o/ffltc shares. YES — NO ✓ 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 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 th' 3 J A n 20 �1�a Signature Print Name •u�t Foran TS I PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: SCTM#1000-145-2-12 SCTM#1000-145-2-11 Krom, Laurie A Kraebel,Joanne Krom,Ann 1150 Peconic Bay Blvd. I P.O.Box 545 Laurel, NY 11948 Laurel, NY 11948 SCTM#1000-145-2-18 SCTM#1000-145-2-17.4 Laurelwood Ests POA Perillo,Thomas V Jr P.O.Box 505 Perillo,Christopher Laurel, NY 11948 87 Old Country Road Melville, NY 11747 i STATE OF NEW YORK COUNTY OF SUFFOLK Jeffrey Patanjo residing at P.O.Box 582,Bohemia,NY 11716 being duly sworn,deposes and says that on the l day of June , 20 18 ,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 �r 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 ;3,h�M,,a, ,that said Notices were mailed to each of said persons by CERTIFIED MAHJRETURN RECEIPT. s igria ure Sworn to before me this_ /I Day of June 12018 MARILYN S.HICKS NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 HI6365489 i ftotPublic Qualified in Suffolk County Commission Expires October 10,2021 ,t r Michael J. Domino,President o�QSvaffal,(eoG Town Hall Annex John M. Bredemeyer I11,Vice-President ��� y�F� 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 ze A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(63 1)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 DA YS PRIOR TO THE PUBLIC HEARING DATE- I, Jeffrey Patanjo , residing at/dba P.O. Box 582,Bohemia,NY 11716 being duly sworn, depose and say: That on the 10 day of June , 2018 , I personally posted the property known as 1296 Peconic Bay Boulevard,Laurel,NY 11948 SCTM#1000-145-2-19 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, June 20,2018. Dated: to ' (sig/to ) Sworn to before me this - i I day of June 2018 MARILYN S. HICKS NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 HIS365489 Notar Publi Qusimed in Suffolk County Commission Expires October 10,2021 L 46 Postal t Postal CERTIFIED MAIL@-R D�6m4tib MaiPOnlym Dom,I stic Mail • nly LAUDE >'�NY[[441,194 • • LAU E1.:?Y TI94 � , - ' rr Certified Mad Fee 4 =_ U Certified Mad Fee X3.45 0� I�-Er $ ■ efri $ `S 1 Extra Services&Fees copy) kbox,-add lee,�pp pppggq���C , 20 �� bra Services&Fees(checkbox,add fee p ate) %i y ❑ Return Receipt(hardcopy) $ p V O ❑Retum Receipt(hanicopy) $ �' a` ❑Return Receipt(electronic) $ E=1 [I Return Receipt(electronic) $ PostttPc3tjt� C3 Stmark l C3 E]Certified Mail Restricted Delivery $ �,(� � �'" �, ❑Certified Mail Restricted Delivery $ ' ' O ❑Adult Signature Required $ Her` ❑Adult Signature Required $ A AA _ d ' ❑Adult Signature Restncted Delivery$ �- ❑Adult Signature Restricted Delivery$ E:3 Postage / O Postage u, $ ��NOS$0.50 - � $ $0.50 Total Postage andosta —_0trF111 Total Pge and — — $ 6'70 SCTM#1000-145-2-11 1 r- $ ent To—,I` fi'70 SCTM#1000-145-2-12 I r--1 sent Too Kraebel,Joanne '� I Krom, Laurie A stN StreefanifApFNo.; reet andA;A 1150 Peconic Bay Blvd. ilt Krom,Ann llyli� statil,WI;d®; Laurel, NY 11948 P.O. Box 545 lid Laurel,-NY 11948 i I _ • • I Postal CERTIFIED ® . . ■T 'CIERTIFIED MAILP . ■ .D Dr Only Ln 1—1 !rq �' .-� ' . i MELS U� 1� MJ Er ' �, . Er p" Certified Mad Fee `3 45 - i r- Certified Mail Fee � ear $.�.4�.! ^ �y Er Extra Services&Fees(check box,add fee p Cate) >� 20 Ir Extra Services&Fees(check box;add lees,�ppfgppate) �6 0 ❑Return Receipt(hardcopy) $— XV /� ` I Q ❑Return Receipt(hardcopy) $ 1t!!•UUYAUU ❑ Return Receipt(electronic) $ TU.UU 4"' Po i�� 0 [I Return Receipt(electronic) $ �tL{ ue,1 Po rk C3 }A n �' ❑Certified Mail Restricted Delivery $ $0.j0 Hie' ❑Certified Mall Restricted Delivery $ ` G-00 , Here°. z r _ �, []Adult Signature Required $- m Ifi�?!1 ❑Adult Signature Restri3 []Adult Signature cted Delivery$ �v t_ (a M Postage ��• � ' �j P' �r ❑Adult Signature Restricted Delivery$ d- o Postage $0.50 /y�13 H 0 L $ $0.50Ln �- $ ——.0$/111-2 - ---- - 1= Tgtal Postage and 1 - 06 �' M8 -- -- Total Postage and ,$6.70 SCTM#1000-145-2-18 $ 6.70 SCTM#1000-145-2-17.4 N $ ent TO � Sent To Perillo,Thomas V Jr Laurelwood Ests POA p SffeelandApf.IVo.I Perillo,Christopher C SfieetandApf.No P.O. Box 505 N • 87 Old Count Road crry 8�ate;ziP+aa Laurel, NY 11948 crry'staie;ziP+d, Melville, NY 11747 M. j :.. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS _ Name: >i :,__- :i• s::' ,t, R=;,<; .s w; m;:FA;:; .._ - - 'q M:�`- �`y'-,'xJ�„'-":tib" ;�:. •`J4', •ter r:,'.:. Si 4r- ,>"stir= --'t,,;.•"�`" ... =rr;,_";,t.+t • �+I(��t�,. .aY,;�:• > - =M1S;.y;y:z,�}'=jn:": _.' -':iia %- STATE OF NEW YORK - COUNTY OF SUFFOLK , residing at , being duly sworn, deposes and says that on the day of , 20 , 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 assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. i Sworn to before me this Day of ,20 Notary Public r, �a June 11, 2018 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 1296 PECONIC BAY BLVD. - LAUREL, NY SCTM No. 1000-145-2-19 AFFIDAVITS Dear Trustees: Attached please find affidavit of mailing and posting for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Je ey Patanjo P.O. Box 582 Bohemia, NY 11716 Qr JUN 1 4 2018 ! Southold Town Board of Trust � ees _1 H 't-- - ARING NUTILI: Ulm 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 remove existing cement bulkhead and replace with 97 linear feet of new vinyl bulkhead in-place with one 35 linear foot bulkhead return and one 6 linear foot bulkhead return; raise existing height to 42" above existing top cap elevation to match neighboring bulkhead to west; install 225 cubic yards of clean sand fill from upland sources behind bulkhead to replenish sand lost during storms; install 4' wide by 10' long platform and stairs to beach supported with 3-10" diameter cca piles; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead. Located: 1296 Great Peconic Bay Boulevard, Laurel. SCTM## 1000-145-2- 19 TIME & DATE OF PUBLIC HEARING : Wednesday, June 20, 2018 — 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 CONSI6STCNCY 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 •icant 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- sunportiBng 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 AMON SCTM# 145- - 09 - 19 PROJECT NAMF, OvLK-4er.k &1 ucemcv%-r at tz9tv P«on,c 6^!1 Elv Q . The Application has been submitted to (check appropriate response). �-�/ Town Board El Planning Board❑ Building Dept. ❑ Board of Trustees E 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: S-e rA-t-Ta Location of action: I a 9 Rt co- C� &y 81 vcQSite acreage: o • S 39 Present land use: VAC 4A T Present zoning classification: e-e S 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: A h et -v% (b) Mailing address: P• y ` 13m X 5- `{ S k-LVr'cL , Nti l 0, �00 (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 PT'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, snakes 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. 16Yes ❑ No ❑ Not Applicable ervle J Pro-ret TS -+k-e — risr, S pore I -fn& ,e. h be ri prop-erfii4s 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 1:1 No IJ N t Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LVVRP Section III—Policies Pages 6 through 9 for evaluation criteria PfYes ❑ No ❑ Not Applicable Pro,ee'l p-lo..dde5 k 5-r'ab(r sA®,rcI, ae- wr-th fe'r4meX L,s.lA . Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See Lvak? Section III—Policies Pages S through 16 for evaluation criteria Ef Yes ❑ leo ❑ Not Applicable Pr®,<o[ roTee is a A4,i s r tors v F wti A .evz Zj trv,ir#..r #.^A Mpr^Ls Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of,Southold. See lLWRP Section III —1Policies Pages 16 through 21 for evaluation criteria 2/Y os 1:1 No ❑Not Applicable n/orse ^i n, m t e-e1 e�osron 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 L,WRP Section III—Policies; Pages 22 through 32 for evaluation criteria. i Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWWRP Section III{ — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No[? 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 LRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes 11 No U Not 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 ILWWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. a Ye�] No❑ Not Applicable Pr,1,eer-w -ro lJta6C- r Aet,-SS .Fo -a--t-eeLi- Attach additional sheets if necessary _ WORM TG 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 ❑ leo [2"Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of Paving marine resources in Long Island Sound, the Pecoanic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. 1:1 Yes El Into A loot 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 forevaluation criteria. ❑ Yes 1:1No I-.-J 1�1ot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWU Section Ill—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ❑ <ot Applicable PREPARED BY J Pet 'tA v) z, TITLE ,C n DATE Cantrell, Elizabeth From: Cantrell, Elizabeth Sent: Tuesday, May 1, 2018 9:24 AM To: 'Jeffrey Patanjo' Subject: RE: Krom 1296 Peconic Bay Blvd - Laurel Hi Jeff, Unfortunately, it is too late for the May agenda. If you would like to proceed,your application will be placed on the June 20, 2018 agenda with a field inspection on June 13, 2018. Elizabeth From:Jeffrey Patanjo<jjpatanjo@gmail.com> Sent: Monday,April 30, 2018 10:08 AM To: Cantrell, Elizabeth<elizabethc@town.southold.ny.us> Subject: RE: Krom 1296 Peconic Bay Blvd - Laurel Good morning Elizabeth, Hope you had a nice weekend.At this point, since I've yet to hear back from the NYSDEC I'd like to go ahead and proceed with getting this agenda on the May hearings if possible. Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 631-484-9332 From: Cantrell, Elizabeth Sent: Monday, March 19, 2018 9:07 AM To: Ilpatanio@�mail.com Subject: FW: Krom Hi Jeff, Below is an email you sent to Diane,on Feb. 121'' requesting that we hold this application until you receive DEC permits in case the project plans change. We have an application, but as you requested we have not slated it for a public hearing. Elizabeth From: Jeffrey Patanjo [mailto:jjpatanjo@gmail.com] Sent: Monday, February 12, 2018 10:23 AM To: DiSalvo, Diane Subject: Krom Good morning, Per our conversation I would recommend you hold the application I made for Krom. Once I receive the NYSDEC permit I will make an amended submission for the revised plan.Sorry for any inconvenience. 1 DiSalvo, Diane From: Jeffrey Patanjo <jjpatanjo@gmail.com> Sent: Monday, February 12, 2018 10:23 AM To: DiSalvo, Diane Subject: Krom Good morning, Per our conversation I would recommend you hold the application I made for Krom. Once I receive the NYSDEC permit I will make an amended submission for the revised plan. Sorry for any inconvenience. Thanks, Jeff Sent from Mail for Windows 10 1 February 6, 2018 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 EEC V E P.O. Box 1179 Southold, New York 11971 RE: 1296 PECONIC BAY BLVD. - LAUREL, NY SCTM No. 1000-145-2-19 wn APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, ell J re, Patanjo P.O. Box 582 Bohemia, NY 11716