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HomeMy WebLinkAboutTR-6100 Albert J. Krupski,President Town Hall James King,Vice-President �OSUFFO(�C 53095 Route 25 Artie Foster �� �rj P.O.Box 1179 Ken Poliwoda C y� Southold, New York 11971-0959 Peggy A. Dickerson y = Telephone(631) 765-1892 Oyu �yC Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction Y2 constructed ,Z Project complete, compliance inspection. Board Of Southold Town Trustees ' �• SOUTHOLD, NEW YORK . trr • April..20...._ 2005 ..... DATE• .� PERMIT NO. ..�...�..--. --. ,� • ISSUED TO JO ELLEN & WILL.1AM AIMTY 1" _.... ........._..........._.................................................................................... Pursuant to the provisions of Chapter 615 of the Laws of the.State of New York, 18934 and Chapter 404 of the Laws of the .� r State of New York 1952; and the Southold Town Ordinance en- • titled ."REGULATING "AND THE PLACING..OF:..OBSTRUC .IQNS. ti IN AND ON .TOWN WATERS AND PUBLIC" LANDS al the REMOVAL OF SAND, GRAVEL-OR OTHER MATERIALS--FROM LANDS UNDER TOWN'WATERS;:•..'. and" in. accordance with'the Resolution of The Board adopted at a meeting held on Apr1:20, 250 00 2005..,..:., and in consideration of the sum of $..............�.........._.. paid by. s� Jo Elle ................_..........-..-........... ...................._-............. of ....._... .................................I.............. N. Y. aill subject to:"the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to remove add replace(in-place)approx.67 linear ft,of existing timber bulkhead with t vinyl bulkhead and backfill with approx.25 cy.of clean sand to be trucked in from an upland source; remove and replace existing 3.5'X 5.5'timber beach steps to beach,with condition of a 10'non-turf buffer landward of the bulkhead,and all as depicted on the plan prepared by En-Consultants,Inc.last . dated April 26,2005. all in accordance with the detailed specifications as presented in •the originating application. I IN WITNESS WHEREOF, The said Board of Trustees here- t i by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board .as of this date, clin O Ar ie Poster rli i . TERMS and CONDMQNS Ptttit Jo Ellen & William Ahmuty 3405 Bay.. Shore Rd. , Greenport r �_•�,_ -_ N. yy as pan-of the coad&ration for the Issuuloe of the Permit does uOdecat"d and prescribe to the fol= 1. That the said,Board of Trustees and the Town of Southold are released -from any and all damages, or Halms for-damages, of snits arising.dite4 or Indirectly'as a result of any oper- *d�oa'performed_pwrssiaat�:: h:*�.:��odd Pa�tdee.srIll, at �s or lut own .. defend any and all such suite idated:by dlird patdes, and the saki Vermittee aswtnes full liability l with respect thereto,-t*Ah&WM e etdusloa of die.board of Trustees of the Town of Southold. 2. 11w-this Pedah is valid fors . of . :24- rues. �vhidr is dOrpsideracd to be the emoted dine-required to complete the work involved,but should drdttiastancts warrant, request: � for an e:teo_sion may be made to the board at a .iaM *tr_ - i 3. That this Permit should be retalned indefinitely, or as long as the said Permlaft wishes tro'taaintain the structure or project involved, to provide evidence to anyone concerned that era& motion 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 odgitiating applicatioa, may be cause for revocation of this Permit by resolution of the said Board. S. That there will be no unreasonable interference with navigation as a result of the work herela authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between NO•sad low water marks. 7. That if future operations of the Town of Southold require rhw removal and/or alteradoas in the location of the wotk-herein outhodal, or 14 is the opinloa of the.Board of Tmstees, tbe.- Wa&.." cause unreasonable. obstrucuoa to free pavigadon, the raid 8emattee will be tbqulmk ".due aodoe, to remove or alter this work or project herein stated without Ocpens" to the Town` S. That the said Boatd will be notified by the Permitter of the oompledon.•cf the work anth- odzed. 9. 'That the 'Petinktiec will obtain all other permits and consents that may be required tap: plemeatd to this permit whuh may be subject to re coke Upon (allure to obtain same. Albert J.Krupski,President 0� f S O�ry� Town Hall James King,Vice-President O l0 53095 Route 25 Artie Foster P.O.Box 1179 Ken Poliwoda N Southold,New York 11971-0959 Peggy A. Dickerson � �� Telephone(631)765-1892 coUM`I,� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 20, 2005 Mr. Robert E. Herrmann En-Consultants, Inc. 1319 North Sea Rd. Southampton, NY 11968 RE: JO ELLEN &WILLIAM AHMUTY 3405 BAY SHORE RD., GREENPORT SCTM#53-6-10 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wed., April 20, 2005 regarding the above matter: WHEREAS, En-Consultants, Inc. on behalf of JO ELLEN &WILLIAM AHMUTY applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 23, 2005 and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 20, 2005, 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, 2 WHEREAS, the structure complies with.the standards set forth in Chapter 97 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 approve the application of JO ELLEN & WILLIAM AHMUTY to remove and replace (in-place) approx. 67 linear ft. of existing timber bulkhead with vinyl bulkhead and.backfill with approx. 25 cy. of clean sand to be trucked in from an upland source; remove and replace existing 3.5'X 5.5' timber beach steps to beach, with condition of a 10' non-turf buffer landward of the bulkhead, and all as depicted on the plan prepared by En-Consultants, Inc. last dated April 26, 2005. 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, Albert J. Krupski, Jr., President Board of Trustees AJK/Ims $ul Fot� Albert J.Krupski, President ��0 C'0 Town Hall James King,Vice-President !�'Z` Gy 53095 Route 25 Artie Foster p� P.O.Box 1179 Ken Poliwoda 4 Southold,New York 11971-0959 Peggy A. Dickerson � Telephone(631) 765-1892 .( `t► Fax(631) 765-"66- BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Please be advised that your application dated 3 1 3 110V has been reviewed by this Board at the regular meeting of b and the following action was taken: (_!---'Application Approved (see below) �) Application Denied (see below) �) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days o -applicatio -fees will be necessary. COMPUTATION OF PERMIT FEES: p - a SDI OU Opp v ft lrs\ - R(Z PU�Sp� OCwFN (�� IO' tA0CA--tuc4 �u TOTAL FEES DUE: $ (�,(� SIGNED: 4 '0_ PRESIDENT, BOARD OF TRUSTEES o��g�FfO�,�co Gyp Telephone p Town Hall (631)765-1892 _ 4 T 53095 Route 25 Q P.O.Box 1179 y • 0� Southold,New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Mon., April 11, . 2005, the following recommendation was made: Moved by Jack McGreevy, seconded by Alicia Marin, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of JO ELLEN &WILLIAM AHMUTY to remove and replace (in-place) approx. 67 linear ft. of existing timber bulkhead with vinyl bulkhead and backfill with approx. 25 cy. of clean sand to be trucked in from an upland source. Remove and replace existing 3.5'X 5.5' timber steps to beach. Located: 3405 Bay Shore Rd., Greenport. SCTM#53-6-10 The CAC recommends Approval of the application with the Condition of a 20' non-turf buffer landward of the bulkhead. Vote of Council: Ayes: All Motion Carried JOELLEN AND WILLIAM AHMUTY,3405 BAY SHORE ROA1), G.REENPORT s ; 7 MAR Lj � 1J (' 2 3 2005 - _ -; Town ' IVA&- A o Figure 1. Looking northwest at existing bulkhead to be removed and replaced(in-place) with vinyl bulkhead. OF I i Figure 2. I,00kiug southwest aI hwrtherll lernhinhrs of subiect bulkhead to he replaced. JOELLEN AND WILLUM AHMUTY,3405 BAY SHORE ROAD,GREENPORT s t tw- - _= _--- - - - -- - Figure 3. Looking east from upland over top of bulkhead to be replaced. S. 4 3 AkD. .... ... Lk AL f 14 2 Muld H.1 70. SW-S — CREEK -P11peb ED LTA 41 ft.&, MS EU-1 % PCL.NO. SEC... W-ft-OX3 Z- 7 SEC. OS, SEE SEC.NO.O,, L N- COUNTY OF THOLD SECTION NO V,IS.— A SUFFOLK E E NOTICE @ x SOU G ————-- Red Property Tax Service Agency y E Q\- IN T. 053 C—ty COOter Fr—teAN Y IHOI A D 1000 —T 11. PROPERTY MAP R � , _P•IPE•S G ao 0'!E ;1 �'',! l Suffolk Cot*Hag4xorn Map 28 Fc SOU A� sUoS :1 �� y 3 3 do.. ALW — — — — — _ ` °a �5���� SITS CAGCE55 VIA, PROPOSED jff s TO BE CON TRUCTED IN PLACE 4 is N VIEW 6A OF EXISTING TIMBER BULKHEAD AHW +12' Con Zing Pt '��•• it ADJ. BULKHEAD 3.5' x 5.5' STEPS - W 3 +16' TO BE REMOVED & REPLACED EN-CONSUM So INC. w : . 1319 NO 8� +39 SOUIHAM W 11968 ADJ. BULKHEAD 631.2834► _ Notes; p A'P P R O?C.�LI Nt�T• b F BAC KF I L ' 1) Purpa5e: Maintain existinq erosion control 1 ———— —— structure p $ 2) Patum;ALW # 3) New sheathmq to be vingl - 1 = 2 0' 4) Approximately 25 cubic ga'd5 clean sand to `9 I be tracked in from an upland sourrce for backfill N 57 property location,5405 Pay Shore goad, c 6reenport,5CfM#1000-55-6-10 M 8 (9) Adjacent owners: I -Hayden c 2-Yantos 1) 10-foot non-turf buffer to be maintained 28.5' W landward of each bulkhead section(added 4-26-05) Z O v� x N U O�W' On W L.W - X \5; h N z SL V X z 3 — o \W � a 0 I- 9.7' 28.5' Q ~ f O t vPYY � O liW T3 I= 87�$ xQd d c� p`t Z \ 1 IK Z �.O I =N I / m O ri < 9 D o I WOOD TIES Ii O ' p• � Gar , GRAVEL DRNEWAY• ' y�D�� ' ` 150-00 P 47 ROPO%t9 f3Ui, M9 MMOVAI. ANn "� MAC�M�NT<IN-pI.AC�) �0� JO�I.I.�N CL •° D•. ANn WII.I.IAM AHMUTY ON PIM5 COVE, 0 BAY SHORE ROAD GMP P\f, 5UFFOLK COUNTY, NY 5H�tf I OF I 3/ 18/05, 26 05 SURVEY OF LOT 60 AMENDED MAP teA " PECONIC BAY ESTATES FILE No. 1 124 FILED MAY 19, 1933 Uri SITUATED AT 0� 59 No` :. =2 0 � cz ARSHAMOMAQUE . w L —�� ��� TOWN OF SOUTHOLD Z �c SUFFOLK COUNTY, NEW YORK \ ��o�o S.C. TAX No. 1 000-53-06- 1 0 a N\�►NEy Ga �� � SCALE 1 "=2 0' 60 JANUARY 26, 2005 e° { 4 ° 4A� sz AREA = 7,408.66 sq. ff. (TO TIE LINE) 0.1 70 OC. GO E�NGF- ° ���° >�°"�� GE� G� w°°D NOTES: e °. d � ENS 1 1 . THIS PROPERTY IS IN FLOOD ZONE AE (EL. 8) J °9 $�� k \ \ FLOOD INSURANCE RATE MAP No. 36103CO159 G °a °4. ,O ooEG`` sE ZONE AE: BASE FLOOD ELEVATIONS DETERMINED o- ° e j !L / rw c s O� O , v� e !� a q Q J �� V` PREPARED IN ACCORDANCE WITH THE MINIMUM O STANDARDS FOR TITLE SURVEYS AS ESTABLISHED ° r BY THE L.I.A.L.S AND APPROVED AND ADOPTED Q 6r°09 FOR SUCH US BY THE NEW YORK STATE LAND TITLE A OG� CD coo N.Y.S. Lic. No. 496 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 72 LA OF THE NEW YORK STATE Joseph A. 'n g e g n ' EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING �� Surveyor THE LAND SURVEYOR'S IN OR ® EMBOSSED SEAL SHALL NOTOT BE BE CONSIDERED TO BE A VALID TRUE COPY. e �{ V 4 ��N CERTIFICATIONS INDICATED HEREON SHALL RUN ISLAND VIEW 4/ �l 1 ONLY TO THE PERSON FOR WHOM THE SURVEY MAR 2 J �oo� y IS PREPARED, AND ON HIS BEHALF TO THE f 0 r 1 TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction layoa LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. Southold Town OFFICES LOCATED AT MAILING ADDRESS Board of Trustees THE EXISTENCE OF RIGHTS OF WAY 322 ROANOKE AVENUE P.O. Box 1931 AND/OR EASEMENTS OF RECORD, IF RIVERHEAD, New York 11901 Riverhead, New York 1 1901- ANY, NOT SHOWN ARE NOT GUARANTEED. 25- Q PI P'E S COVE 5 i%k County Hagstrom Map 28 Fc III _30001 BAX SO 3 ti0 - $ C ,� �7'HOLD ,�- BA ' ALW � S° Slt�(AGa55 VIA �'- `�" ' SL jt cf FpopEm) Mom ; C"j 1 PROPOSED +67' VINYL BULKHEAD , } 0= o TO BE CONSTRUCTED IN PLACE 4 ISLAND VIEW LA � `° OF EXISTING TIMBER BULKHEAD AHW Conicti,ng.P �. ADJ. D 3.5' x 5.5' STEPS --� +16 TO BE REMOVED & REPLACED EN-CONSMTANU iNC. +39' 1319 NORTH SEA AD. ADJ. BULKHEAD SOUTHAMPTOk NX 11908 w 631-283-6360 O _A--ox.-L'IN1 .'_OF_'_BA_C_K_FI_L Notes; p (71 8 1) purpose: Maintain exi5tinq erosion control 41% 3 structure 2) Patum;ALW 20' 30 New sheathnq to be vinyl 4) Approximately 25 cubic yards clean sand to be trucked in from an upland source for backfdl M5) property location:#405 l3ay Shore goad, c 6reenport, 5CTM 1000-53-6-10 6) Adjacent owners; I -Hayden 2-Yaitos 28.5' W W ... Z V, 2: N X— Z 1U _ w S W U (Nd �, k\ U W �n 3 mcs! 1�U g Si U x ro w W Z Vl o Q X �Ow O== W }W N$ �� ZO N c cn { x v v �v .i om N z� S �� 1 L id 7 9.7' 28.5' 3 U Z W I�w> 3 Ya IQ c� w z v Iz �$ 0o xN — v n DO I O co oil }' o_ z x 0 I WOOD TIES - 3 z ep GRAVEL DRNEWAY' o D Ulm U 50.00' UTILITY POLE #47 KOP05�P PUM V MMOV& ANP do °. L: Ft ACL WNT C IWPLAC�) FOB JO-I.I % ANn WILL,IAM MMUTY ON PIM5 COVL , BAY SHORE ROAD CAM Np0� 5UFFOLK 18/COUNTY, NY Albert J. Krupski,President Town Hall James King,Vice-President ��� CMG 53095 Route 25 = y� P.O. Box 1179 Henry Smith' Southold,New York 11971-0959 Artie Foster CD W Z Ken Poliwoda �� • Telephone(631)765-1892 Fex(631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application Major Minor Waiver/Amendment/Changes ✓Received Applica ' . .3a310 w-Received Fee:$ g 0`14 Completed Application 0 Incomplete E C E U E SEQ RA Classification: Type I Type H Unlisted Coordinat.on:(date sent) MAR 2 3 2005 ,/CAC Referral Sent: ,Date of Inspection: t of CAC Report: Sou-bold Town Receipt p Board of Trustees Lead Agency Determination: Technical Review: 4rublic Hearing Held: Resolution: Name of ApplicantJO ELLEN&WILLIAM AHMUTY Address 24 DANTON LANE,LATTINGTOWN,NY 11560 Phone Number: 516-671-7271 Suffolk County Tax Map Number: 1000 - 53-6-10 Property Location:3405 BAY SHORE ROAD,GREENPORT (provide LILCO Pole#, distance to cross streets, and location) AGENT:EN-CONSULTANTS,INC. (If applicable) Address: 1319 NORTH SEA ROAD,SOUTHAMPTON,NY 11968 Phone: 631-283-6360 Board of Trustees App11c on. GENERAL DATA Land Area(in square feet):7,408.E Area Zoning: R40 Previous use of property:RESIDENTIAL. Intended use of property:NO CHANGE. Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permittapproval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description(use attachments if necessary): REMOVE AND REPLACE(IN-PLACE)APPROXIMATELY 67 LINEAR FEET OF EXISTING MMER BULKHEAD WITH VINYL BULKHEAD AND BACKFI<LL WITH APPROXIMATELY 25 CUBIC YARDS CLEAN SAND TO BE TRUCKED IN FROM AN UPLAND SOURCE. REMOVE AND REPLACE EXISTING 3.5'X 5.5'TIMBER STEPS TO BEACH,ALL AS DEPICTED ON THE PROJECT PLAN PREPARED BY EN-CONSULTANTS,INC.,DATED MARCH I$,2005. _toard of Trustees Applica n WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: MAINTAIN EXISTING EROSION CONTROL STRUCTURE. Area of wetlands on lot: U square feet Percent coverage of lot: o ENO Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated?N/A cubic yards How much material will be filled? +/-25 cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: NIA Manner in which material will be removed or deposited: APPROXIMATELY 25 CUBIC YARDS CLEAN SAND WILL BE TRUCKED IN FROM AN UPLAND SOURCE AND USED AS BACKFILL LANDWARD OF BULKHEAD. 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): THE PROJECT ENTAILS THE ORDINARY AND ROUTINE MAINTENANCE OF AN EXISTING TIMBER BULKHEAD,WHICH WILL HAVE NO SIGNIFICANT ADVERSE M'ACTS ON THE ADJACENT TIDAL WATERS OF THE TOWN. THE REPLACEMENT OF THE CCA-TREATED TIMBER SHEATHING WITH VINYL WILL ACT AS AN M'ROVEMENT TO THE ON-SITE ENVIRONMENTAL CONDITIONS. 14-16-4(21B7)-Text t2 PROJECT I.D. NUMBER 617.21, S E Q R Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART[—PROJECT INFORMATION(To be completed by Applicant or Project sponsor) 1 APPLICANT/SPONSOR:JO ELLEN&WILLIAMAHMUTY BY 2.PROJECT NAME EN-C-ONSULTANTS,INC. 3 PROJECT LOCATION: Municipality GREENPORT County SUFFOLK 4 PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc,or provide map) 3405 BAY SHORE ROAD,GREENPORT,TOWN OF SOUTHOLD,SCTM#1000-53-6-10;MAP PROVIDED 5.IS PROPOSED ACTIO ® New Expansion Modlfication/alteration 6 DESCRIBE PROJECT BRIEFLY: MOVE AND REPLACE(IN PLACE)APPROXIMATELY 67 LINEAR FEET OF EXISTING TIMBER BULKHEAD WITH VINYL BULKHEAD AND BACKFILL WITH APPROXIMATELY 25 CUBIC YARDS CLEAN SAND TO BE TRUCKED IN FROM AN UPLAND SOURCE. REMOVE AND REPLACE EXISTING 3.5'X 5.5'THVIBER STEPS TO BEACH,ALL AS EPICTED ON THE PROJECT PLAN PREPARED BY EN-CONSULTANTS,INC.,DATED MARCH 18,2005. 7. AMOUNT OF LAND AFFECTED Initially 0.11 acres Ultimately 0.17 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes 1:1No If No,describe briefly 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ®Residential Industrial ❑Commercial ❑Agriculture ❑Park Forest/Open space ❑Other Describe: io. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)? Oyes No If yes,list agency(s)and permit/approvals DEC,COE 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes ®No If yes, list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ❑Yes ®No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicantfsponsor name ROBERT E. ,COASTAL MANAGEMENT SPECIALIST DATE MARCH 21,2005 Signature: If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER Boaru of Trustees App Lica -ion AUTHORIZATION (where the applicant is not the owner) residing .at D� �!d��t �41 (print owner of property) (mailing address) o3 'G /ywu,/V /� � do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner' s signature) 8 Board of Trustees Appli ion County ofSuffolk—V&2-f-4-V State of New York 04 ,1]� BEING DULY SWORN DEPOSES AND AFFIRMS THIkT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLDANO THE TOWN 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(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS DAY OF 20_8y Notary Pu is p LLEc SHUTKINt) Ncffary State of New Qualified�n 4863555 York Commission Nassau County Expires June 23,29 04/20/2005 15:44 FAX 63128361,'- EN-CONSULTANTS,INC. 1@ 002 S (.wq k guFFQ(� Albert J.Krupski,President O�Q cdG Towns Hall James King,Vice-president �.�'` 'l� 68095 Route 25 Artie Foster C2 - P.Q.Box 1179 Ken Poliwoda Southold,New York 11971-0959 Peggy A.Dickerson w ©�ijJ4 aQt' Telephone(631)765-1892 1 '�► Pax(631)765.6M"Y f BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application ofAFIA /I' wdml CUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly swom, depose and say: That on the jPday of "( , 200 51 personally posted the property known as 3go5 l' rrir �h4ar� Q�I �ut.�i►+r�of�' 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 �.Pd,. a e�bi00 on o4► 000 Asovin Dated: (signature) Sworn to b .ogre a-m this C day of t1(20Q5- N_ y Public 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 3-6136 EN-CONSULTANTS, INC www.enconsultants.com ENVIRONMENTAL CONSULTANTS March 24, 2005 Town of Southold Board of Trustees f I; L Post Office Box 1179 Southold,New York 11971 Attn.: Lauren Standish j MAR 2 3 2005 Re: Jo Ellen&William Ahmuty f 3405 Bay Shore Road,Greenport 5uut;oid ic�;n SCTM#1000-53-6-10 Board of Trustees Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 1. Three(3)Wetland Permit Applications, (including Notice and Proof of Mailing to adjacent owners). 2. Three(3) Short Environmental Assessment Forms. 3. Three(3)copies of authorization&disclosure forms. 4. Three(3)work plans. 5. Three(3)copies of survey. 6. One(1)set of site photographs. 7. Application fee of$250.00. I trust this information shall allow you to process our permit request. Should any additional information be required,please do not hesitate to contact our office. Sinc rely, Robert .Herrmann Coastal Management Specialist /khs Enc.