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HomeMy WebLinkAboutTR-7250 0 ( 5° _e4CAEEr r `} Michael J. Domino, President ��OF S0(/rTown Hall Annex John M. Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O. Box 11 Glenn Goldsmith 1�[ Southold, New York 11971 A. Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams O Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ",!�F� Z APPLICATION FOR A TRANSFER OF A WETLAND PERMIT W►'G,dra"-) n y//ol ev/8" DATE q OWNER_S k DhGi h 1 C. Lau 0 U 01 I L PHONE MAILING ADDRESS i I1'L to I I I 'Yl Iyaj twI 11S '(o AGENT <,-k Ve, L040U O IS PHONE q I1 8 '12-3 ADDRESS I I 7LL i L2 at Lu Xq I ( yq (.o PROPERTY LOCATION S�u r l d Vl-f W "I l r l OUtj W l6 I TAX MAP NO. I, L� — 1 —.2'�•co I/We S-0hGn t Ltl1'Jud b request a Transfer of Permit# 111'W40m. 00 Y10 812 /i l-C, 4 AD 'f)h1 r1,d �OldovdrL ) UL-PhOn t I 44Dun( i �r art V� Atg cdau-' FY- /00 c tUg_ ftU41 kjt�_ Signed y. vu �aJ Board Of Southold Town Trustees q, " SOUTHOLD, NEW YORK b DATE: .Januaxy 31 9.997 r PERMIT NO. 4696. ISSUED TO ... Angelo,Padoven„ , �. Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en ' titled "REGULATING AND THE PLACING OF OBSTRUCTIONS ., IN AND ON TOWN WATERS AND PUBLIC LANDS and the 'r REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the GF' Resolution of The Board adopted at a meeting held on 0� b 150.00• aid b r 19 9.7...., and in consideration of the sum of $... P y T, o Mr.•,P.adovan.,,. -T Permit rSexviaes on , y bel�al� of :..... -. and u ' c o t N. Y. s bje t f the ! Terms and Conditions listed on the reverse side hereof, to of Southold Town Trustees authorizes and permits folloanwdg. construct a concrete retaining wall totalling seaward side of retaining Wall construct a rock revetment on sl y v� all in accordance with the detailed specifications as presented in z the originating application. , IN WITNESS WHEREOF, The said Board of Trustees Mere i l:, I x 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. ',1,,; / t 5 v`�[ ��Q�• ® Trustees... ............ ;'lir; �} �.-- = mss^- �•%"�'" " �WA 10 6 tl C5'i P,Qo��s AW 6WIA PFJ W p QTR � P"P- 4 C wp #66 *oard of Trustees Applica n AFFIDAVIT � BEING DULY SWORN DEP6S1kS AND AFFI S THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION,' , INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature o o y Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF r-Yhfi a 20j—L— Notary ublic ALEX THOMAIDIS Notary Public, Srato of New York No. 02TH6140840 Qsu�lified in Queens Comet J� Commission ExPires February 13�20..._� f FILE NOTES DATE & INITIALS: "�d' ' emyw chtL F-go* 6fix'` y®1� LUVPEKJA►r�- IF rfc5 iP.�N� c, W,4:S ON '91)4 Y•ll"l8- A6j�-A/D/q-. 7�0 /+rrR yr-s/ OJT-IH*r J- MV AEQC-57W A r- Hid 0/2- 0) dwA �a qp& oup, Mow. -I-' 7xo thim Hs- couto � e, UP Tiu. r14#p-4L&�- of /#5fono ' 7� �km,fk ag- N�' �r�s7l4e�0 S IT 14—pAt i I2 5-0G cars fP-. �(,p EF��t z SuPPu�p that_ wwr- A- eoly 4-0 ffclm ftftcr tlt- PR460 ffC-- AhO C"W G/A#-W -P TX1W � icT BUJ thM 79 PFA5e E 41A-tL- Ale -iW,+T �- A(60 TO -FR& MF WV* ` 7V Pa w c t k5 Chi-, fit- P" 7&,v- Ay U-NAtt— APP4535. DIP NO-1 Jill M.Doherty,President �QF S0!/ry Town Hall Annex James F.King,Vice-President h0 Ol0 54375 Main Road P.O.Box 1179 Dave Bergen Southold,New York 11971-0959 Bob Ghosio,Jr. G Q John Bredemeyer �Q Telephone(631) 765-1892 Fax(631) 765-6641 COU ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE r #0608C Date: November 12, 2010 THIS CERTIFIES that the connection of gutters to leaders to drxwells on the seaward side deck roof and house roof, removal'of debris and stored wood on bank; removal of the sand that was Waced along the north side of Lot 24.1 and re-deposited on the bank to re-fill the excavated area on the bank; restore the area with native sea grasses; existing stairs to beach and wood retaining Lwall. . At 22615 Soundview Avenue, Southold,New York Suffolk County Tax Map# 135-1-23 24.1 &25.1 Conforms to the applications for a Trustees Permit heretofore filed in this office Dated 1/28/10 pursuant to which Trustees Wetland Permit#7250 Dated 2/24/10 and Coastal Erosion Permit#7250C Dated 2/24/10 and conforms to all of the requirements and conditions of the applicable provisions of law.The project for which this certificate is being issued is for the connection of gutters to leaders to d!Myells on the seaward side deck roof and house roof,removal of debris and stored wood on bank; removal of the sand that was placed along the north side of Lot 24.1 and re-deposited on the bank to re-fill the excavated area on the bank;restore the area with native sea grasses,• existing stairs to beach and wood retaining wall The certificate is issued to MARIO ABATE &JOSEPHINE PADOVAN owner of the aforesaid property. &44 )Vitborized Signatur l 4 Jill M.Doherty,President QF SO(/�yO Town Hall Annex V' James F.King,Vice-President ,`O lQ 54375 Main Roadp.0.Box 1179 Dave Bergen J�t Southold,New York 11971.0959 Bob Ghosio,Jr. N John Bredemeyer �l� �� Telephone(631)765-1892 Fax(631) 765-6641 C�Ul�l,e`� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 1/ Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain . 1st day of construction iY2 constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: J� f sS 4 )"gLc d!J J -6 _-T UlN CERTIFICATE OF COMPLIANCE: Jill M.Doherty,President � Town Hall,53095 Main Rd. James F.King,Vice-President n - P.O.Box 1179 Dave Bergen � Southold,NY 11971 . Bob Ghosio,Jr. � Telephone(631)765-1892 John Bredemeyer # `�' Fax(63 l)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. . ✓ Pre-construction, bay bale �c.er q-�Ic� Cti�'1ec'�a� V) . 1 st day of construction % constructed Project complete, compliance inspection. ,,i•1 /j r ...i ll��r. - -.,i iil /7. ,,,`y i 1//�i ',Q`•ill ••li•11 'ra ai•� }/%�rr -. } BOARD"OF SOUTHOLD TOW. N TRUSTEES •\ill/�' ,` _ -/•/'1s SOUTHOLD,NEW YORK I PERMIT NO. 7250&7250C' DATE: FEBRUARY 24.201,0 f 1•cl I ISSUED TO: MARIO ABBATE&JOSEPHINE PADOVAN { PROPERTY ADDRESS: 22615 SOUNDVIEW AVE.. SO.UTHOtiD SCTM#135=I JA3 24.18i251 AUTHO),RIZATIQN %sr 4 1� Pursuant to the provisions of Chapter 275 and/or Chapter l 1 I of the Town Code of the Town of ` c.. Southold and in accordance with the Resolution of the Board of Trustees adopted at theymeeting field on .t < , l ,t♦� �% February 24 201.0 inconsideration of application fee in the sum of$1,000 00. aid b Mario Abbate.&Jose hin N �K Padovan and subject to the Terms and Conditions as stated'iri the Resolurion'the Southold Town'Board of ` •.. ", Tiusfees authorizes and permits the followu►g' ; �,♦1�� HII A Wetland Permit&Coastal Erosion Permit to connect'the roof gutters and leaders from = ` the seaward side deck roof and the house roof tots'dr w,eh; remove the debris and wood"stored 4 the bank,in the area excavated; remove the sand placed along the north side dTbt 24:1 by han and redeposit on the bank to re-fill the excavated area on the bank; restore,the.area with native sea grasses planted within six(6)months'from fhe date of this permit and i low for the as-built stairs to the beach and existing wood retaining wall;and as depicted':on`the revised'plans receiv on January 28,2010 and stamped approved on.February 24,2010.g. ?!. _ •:,1,� <.j ' IN WITNESS'WHEREOF,.the said`Board of Trustees hereby?causes its Corporate Seal to be affixed, and these presorts to be subscribed by a;ri ajority of the.s aid Board-as of this�date,. £' '� '•ell ��� G�� Ill, `. ti P , ..III♦,♦`E : 1`i�••r... F' �v •S "Y 'q `o t ail 11 1•�!.• l.� 11 eer ..r li• �I i., ar/ 1l .� ll. t..:.4••- pr y:«•- °•-'..♦I� .,.i ♦lI ♦1�IV an ,.♦♦,{ :1,«!^ / 1,e, ,•!�� ( L« "'. TERMS AND CONDITIONS The Permittee,Marion Abbate&Josephine Padovan residing at 22615 Soundview Ave., Southold,NY,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 six(6)months,which is considered to be the estimated time required to complete the work involved. 3. That this Permit should be.retained indefitlitely,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 maybe cause for revocation of this Permit by resolution of the said Board. 5. That there will be+no unreasonable interference with navigation 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 perrnit,`which may be subject to revoke upon.failure to obtain same. Jill M.Doherty,President �QF S0(/ly Town Hall Annex James F.King,Vice-President ,`O� Ile�1 54375 Main Road P.O.Box 1119 Dave Bergen Southold,New York 11971-0959 Bob Ghosio,Jr. John Bredemeyer �� Telephone(631) 765-1892 Fax(631) 765-6641 CUT'1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT PERMIT Permit#7250C Date: February 24, 2010 SCTM#135-1-23,24.1&25.1 Name of Applicant/Agent: Patricia C. Moore, Esq. Name of Permittee: Mario.Abbate & Josephine Padovan Address of Permittee: 22.615 Soundview Ave., Southold Property Located: 22615 Soundview Ave., Southold DESCRIPTION OF ACTIVITY: To connect the roof gutters and leaders from the seaward side deck roof and the house roof to a drywell; remove the debris and wood_stored on the bank, in the area excavated; remove the sand placed along the north side of Lot 24.1, by.hand and redeposit on the bank to re-fill the excavated area on the bank; restore the area with native sea grasses planted within six(6) months from the date of this permit; and allow for the as-built stairs to the beach and existing wood retaining wall.. CONDITIONS: Permit to complete the project will expire six(6) months from the date of the permit. INSPECTIONS: Pre-construction inspection and final inspection. The Coastal Erosion Management Permit allows for the activities as indicated on the revised pla s_receive n n 28, 2010 and stamped approved on February 24, 2010. Jil . Doherty, Preside t Board of Trustees JMD:lms Jill M.Doherty,President �QF SO(/ry Town Hall Annex James F.King,Vice-President ,`�� Ol0 54375 Main Road P.O.Box 1179 Dave Bergen J Southold,New York 11971-0959 Bob Ghosio,Jr. G Q • O Telephone(631) 765-1892 John Bredemeyer Fax(631) 765-6641 OOUMY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 24, 2010 Patricia C. Moore, Esq. 51020 Main Rd. Southold, NY 11971 RE: MARIO ABBATE & JOSEPHINE PADOVAN 22615 SOUNDVIEW AVE., SOUTHOLD SCTM#135-1-23,24.1&25.1 Dear Ms. Moore: The Board of Town Trustees took the following action during.its regular meeting held on Wed., February 24, 2010 regarding the above matter: WHEREAS, Patricia C. Moore, Esq. on behalf of MARIO ABBATE & JOSEPHINE PADOVAN applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland.Ordinance, and Chapter 111 Coastal Erosion Management, applications dated September 30, 2009 and revised on January 28, 2010, and, WHEREAS, said applications were 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 issued a recommendation that the applications.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 February 24, 2010, 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 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 and Chapter 111 of the Southold Town Code, and, 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, and, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees has found the applications to be Consistent with the Local Waterfront Revitalization Program, and, BE IT FUTHER RESOLVED, that the Board of Trustees APPROVES the applications of MARIO ABBATE & JOSEPHINE PADOVAN to connect the roof gutters and leaders from the seaward side deck roof and the house roof to a drywell; remove the debris and wood stored on the bank, in the area excavated; remove the sand placed along the north side of Lot 24.1 by hand and redeposit on the bank to re-fill the excavated area on the bank; restore the area with native sea grasses planted within six (6) months from the date of this permit; and allow for the as-built stairs to the beach and existing wood retaining wall, and as depicted on the revised plans received on January 28, 2010 and stamped approved on February 24, 2010. Permit to complete the project will expire six (6) months from the date of the permit. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $100.00 Very truly yours, Jill . Doherty, Presid nt Board of Trustees JMD/Ims 11a �J� fJ � � � ,•� I PAN trhold Tow ` `, _ �oG of TrusEees L e : Av 74,276 w ,07 PPR BOAR® OF TRUSTEES .�� � -. 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Revised Plans for proposed project Pre-Construction 1 lay Bale hi Inspection Fee($50.00) 1 st Day of Construction ($50.00) %Constructed($50.00) _ Final Inspection Fee ($50.00) Dock Fees ($3.00.per sq. ft.) 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: $ /('�`�, CD BY: Jill M. Doherty, President Board of Trustees 11 ' 12/02/2009 10 : 12 f I_ .r Mob- CLj` �0�� RM G - r � _ - _ ;. � �. A:,� F ` -^1�2�/02/2009 10 � 12 11 ,.k' i ti. r yy� � - ;�, „! � t ,�r ` _ ;" �, .�. i,p 1 - , � - � � .. � . y ��-.' i - ...4" - •1 r y,. � '�% Y A� i � ` � y• /^ r ;•. ;... .: � k ;�... ,.i. -`,ti:- 12/02 2009 10 : 1 ��r- - �. -: . .. r - ' 1 12/02/2009,;10 :(13 ,: • �����t- i � Ill►`( �' Xj 00, ' = 12/02/2009 10 : 13 I ' 'i4 Ar M 1 ,77 • r ,. - 4 4. � i lk P aY.. x' K r ,Y s Vol 0 t 12l02/2009 10 . 1NO t ' 12/0`2/2009 10 . 1 TIr 1 _d _ r w , r _ ,e ` 4 '?'-cam .r.Y,� �`�"`�`rf• ��1. � � .1�!"r. -.f'-. !�'Zip - l � I iL L 1 1 11 . 1 : Q��gpFFO�►,�CO James Eckert,Chainnan cei C Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O. Box 1179 ttl • Southold,NY 11971 yTJ Telephone(631)765-1892 Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., October 14, 2009, the following recommendation was made: Moved by Peter Young, seconded by James Eckert, it was RESOLVED to NOT SUPPORT the Wetland Permit and Coastal Erosion Permit applications of MARIO ABBATE &JOSEPHINE PADOVAN to restore the sand excavated from the bluff and to restore the bank along the edge to the original configuration/breadth. Located: 22615 SoundviewAve., Southold. SCTM#1 35-1-23,24.1&25.1 Inspected by: Peter Young, James Eckert The CAC does Not Support the applications because of insufficient information and detailed restoration plans should be submitted. Vote of Council: Ayes: All Motion Carried James F.King,President Cp P.O.Box 1179 Jill M.Doherty,Vice-President Gy Southold,NY 11971 Peggy A.Dickerson ti Telephone(631)765-1892 Dave Bergen ,y Fax(631)765-6641 Bob Ghosio,Jr. Southold Town Board of Trustees Field Inspection[Worksession Report Date/Time: 19 D MARIO ABBATE & JOSEPHINE PADOVAN request a Wetland Permit & Coastal Erosion Permit to restore the sand excavated from the bluff and to restore the bank along the edge to the original configuration/breadth. Located: 22615 Soundview Ave., Southold. SCTM#135-1-23,24.1&25.1 Typ of area to be impacted: _ altwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt�111 other Type of Application: L` Wetland _Coastal Erosion _Amendment Administrative_Emergency Pre-Submission Violation Info needed: AM, `nU6V-S'e-, P� Modifications: Conditions: Present Were: King 'UJ.Doherty t�.Dickerson /D. Bergen_ B.Ghosio, D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: M f j \ -,Jr Or 17, o ti..a .I t' OO���O�OOg Oga�� s- f O'� /12/2009 09 : 17 08/ 12/2009` 09 : 17- • �� �4 t, I � f t 09 , 18 _1 di d �p 0� 12/20�09 09 : 19 r i t �, `� r��} �. I� �'a� ii��� •ran. 1��� +4' Y� 4 1 �a A Y" t 00 a.. '.x� "( sb f r/F t I aL •� t .,� t i James F.King,President P.O.Box 1179 Jill M.Doherty,Vice-President Gyp Southold,NY 11971 Peggy A.Dickerson Telephone(631)765-1892 Dave Bergen ,y tw Fax(631)765-6641 Bob Ghosio,Jr. Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: f d Inspect the property of JOSEPHINE PADAVAN (MARIO ABBATE) to discuss a re-vegetation/remediation plan as a result of the Summons dated 7/23/09 issued to Mario Abbate. Located: 22615 Soundview Ave., Southold. SCTM#92-1-2.1 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland �und Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt. 111 other Type of Application: Wetland _Coastal Erosion AmpKdment —Ad ministrative_E merge ncy Pre-Submission V Violation Info needed: Modifications: Conditions: G' Present Were: Viking `�Doherty Ll::�-Dickerson Bergen_ B.Ghosio, D. Dzenkowski other Form filled.out in the field by Mailed/Faxed to: Date: Town of Southold A ' 4164 1. The PeopleSuffolk County,NY of the State of New York us. LAST NAME(DEF AND,, FIRST NAME M tE INITIAL STR�q A,�nfRSI��ES�S�,J(�(J( C/IAAPPT.NO. /STATE ZIP LICENSE OR REGISTRATION NUMBER STATE TYPE OF LICENSE DATE EXPIRES SEX DATE OF BIRTH OPERATOR My OWNS VEHICLE [J V�G DYES ❑NO THE OPERATOR OR REGISTERED OWNER OF VEHICLE DESCRIBED BELOW PLATE NO. ' DATE EXPIRES STATE PLATE TYPE - ❑N.Y. ❑N.J. ❑N.Y. ❑N.J. ❑ ❑PASS ❑COMM ❑ VEHICLE MAKE ❑ DODGE ❑ BUICK ❑ CHEV ❑ CADILLAC ❑ PONTIAC D FORD ❑ pef ❑ PLYM ❑ TOYOTA - VOLKS - ❑ BODY 2 DR ❑ 4 DR ❑ BUS ❑ MCY ❑ S.W. TYPE ❑ TRUCK ❑ TRAILER ❑ VAN ❑ . VIN NUMBER THE PERSON DESCRIBED ABOVE IS CHARGED AS FOLLOWS _PL&CE6OCCURRENCE PCT DA OF OFS�NSE AM. TIME PM / CITY,TO VILLAGE.OR HAM SUFFOLK COUNTY NY ";r.z ❑)z ®' N VIOLATION OF SECTION SUED. OF THE❑VEHICLE AND TRAFFlC LAW OF THE STATE OF NEW YORK �r ❑OTHER(SPECIFY) - ❑O.S. ❑COM ❑BUS ❑HAZ C / DEF VEH MAT N r ❑ SPEEDING OTHER FEN R MPH IN A MPH ZONE "s N co FACTUAL PART(NOT FOR TVB) z THE ABOVE NAMED DEFENDANT DID ON THE STA D DATE TIME AND PLACE 7f Al4 ;0i;' � � Tfre Foregoi s based on reonel knowledge)and/or lief),the source being the attecftad wom depos'sion(s)of dated PARKING SCHEDULED FI E$ CONTACT COURT❑ THE PERSON DESCRIBED ABOVE IS SUMMONED TO APPEAR AT SOUTHOLD TOWN JUSTICE COURT,53095 ROUTE 25,SOUTHOLD,NY 11971 ' DATE OF APPGRAyNOE�jINOT FOR TV9) ON /a AT d FALSE STATEMENTS HEREIN ARE PUNISHABLE AS A CLASS A MISDEMEANOR PURSUANT TO SECTION 210.45 OF THE P.LN.Y.S. COMPLAINANT DATE z.71 BADGE •vr.rr s■ V� VyY�11V IY ' A- 41 6 3 Suffolk-County, NY The People of the State of New York vs. LAST NA (D FIRST NAME - MIDDL NITIAL SW ADDRESS APT.NO. Pv' C ZIP .LICENSE OR REGISTRATION NUMBER .- . STATE TYPE OF LICENSE DATE EXPIRES SEX_ DATE OF BIRTH I IT PERATOR ,m9r" ply OWNS VEHIC_ `SO OYES ❑NO THE OPERATOR.-OR REGISTERED OWNER OF VEHICLE DESCRIBED BELOW PLATE NO. - DATE EXPIRES STATE PLATE TYPE ❑N.Y. ❑N.J. ❑N.Y. ❑N.J. ❑ ❑PASS ❑COMM ❑ - VEHICLE MAKE /"`✓ ❑ DODGE ❑ BUICK - ❑ CHEV CADILLAC ❑ PONTIAC (. ❑ FORD - ❑ OLDS ❑ PLYM ❑ TOYOTA ❑ LKS ❑ BODY DR ❑ 4DR ❑ BUS ❑ MCY ❑ S.W. TYPE ❑ TRUCK ❑ TRAILER ❑ VAN ❑ VIN NUMBER THE PERSON DESCRIBED ABOVE IS CHARGED.AS FOLLOWS PLACE OF OCCURRED-E / T >",;�90 DA OF OFFENSE -AM TIME PM CITY,TOWN,VILLAGE,0 HAM �SUFFOU<COUNTY NY 2a a °i Z o p .moo IN VIOLATION,OF SECTION SUED. OF THE❑VE LE AND TRAFFIC LAW OF THE STATE OF NEW YORK ❑OTH�Eq�yECIFY) ❑O.S. ❑'COM -❑BUS ❑HAZ J �C P 7�— DEF VEH MAT ❑ SPEEDING OTHERF,E{�SEr»" MPH IN DIA MPH ZONE :W MISDEMEANOR❑ FACTUAL PART(NOT FOR NB) • TH OVE NAMED DEFEN DID ON THE STAIED DATE,TIME AND PLACE The Fore Ing Cased on(p oral knawl�end/or(w erto�=n S belief),the source heirg the ettacned swo deposalon(s)of 1 dated 2- PARKING SCHEDULED FINE$ CONTACT COURT❑ THE PERSON DESCRIBED ABOVE IS SUMMONED TO APPEAR AT SOUTHOLD TOWN JUSTICE COURT,53095 ROUTE 25,SOUTHOLD,NY 11971 PE4RANCE(NOT FORTVB) ON aryA IO/ AT 40d A PM . FALSESTATEMENTS HEREIN ARE PUNISHABLE AS A CUSS A MISDEMEANOR PURSUANT TO SECTION 210.45 OF THE.P.LN.Y.S. COMPLAINANT BADGE f/ G COURT COPY SOUND LAND is LONG as ' S raArco"r`muwuMuwr r r Y' � � ran a wrga ¢' fi ' 9 LpNp ISURD 'OjWs a K b b 61� '\ n IL • e� ]Sl .a' a DR. 'P a t U IG it Mph i.o I L NOME COUNTY OF SUFFOLK Q x SOUTHOLD f21 eal PTy x ery c Agency rpper Ta �m.R�revmr S_�.,... 1+3 Asa YYw.s•IF__JY fex�ea rd�.laai D� .i.� PROPERTY NM 1 '4EM0 LE PATRICIA C. MOORE, ___TORNEY AT LAW 51020 Main Road Southold,NY 11971 (631)765-4330 email:pcmoorel @optonline.net DATE To SUBJE I euv)�Q� I r 1 ' c-„±hold To in Coard of Trustees o L T- CA-L_C_ - sIGNED Please reply No reply necessary PATRICIA C. MOORE Attorney at Law 51020 Main Road Southold,New York 11971 Tel: (631) 765-4330 Fax: (631) 765-4643 January 27, 2010 <<' - JA N 2 8 2010 Southold Town Trustees Southold Town Hall Main Road P.O.Box 1179 Southold, NY 11971 (By Hand) Re: Josephine Padovan and Mario Abbate 1000-135-1-23 , 24 . 1 & 25 . 1 Dear President Dougherty and Board: In accordance with your request at the meeting the following notations were added to the plans prepared by Angel Chorno, Architect and the application is amended to include the following: 1 . The roof gutters and leaders from the seaward side deck roof and the house roof will be connected to a drywell located as shown, by hand, on the 7-26-07 lans and revised January 27, 2010, prepared by Angel Chorno, of Chorno Associates, Architects . 2 . The debris and wood st o:?-ed on the bank, in the area excavated, will be removed from the bank. 3 . The sand placed along the north side of Lot 24 . 1 will be removed by hand and redeposited on the bank to re-fill the excavated area on the bank. The owner/applicant will advise the trustees prior to commencement of the work, and will advise the Trustees when the work will be performed. I have advised my client that the Trustees have offered to make a "progress" inspection during the corse of the work to confirm that J the restoration is being performed as expected. (The client believes the work may take a few hours to remove the sand) . 4 . After the sand is removed, the area will be restored with native sea grasses (either seed or plants) . Grasses will be planted within 6 months of issuance of the permit . 5 . The as built stairs to the beach and existing wood retaining wall are included in this permit . Thank you for your courtesies . Very truly yours, Patricia C . Moore r Office Use Only _Coastal Erosion Permit Application fj �1�~��; (� '•;`/7 �, " _Wetland Permit Application Administrative Permit _Amendment/Trans fer/Extension _Received Application: _Received Fee:$ L_ JAN 2 8 2010 ,f j —Completed Application �' 1 _Incomplete <.... .. _SEQRA Classification: s. Type I Type II Unlisted -�--•---�-.-...,.w_�,=� —Coordination:(date sent) _LWRP Consistency Assessment Form _CAC Referral Sent: _Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: _Public Hearing Held: Resolution: /�/l� r, ,�/� r ��c! ✓o�� ,zP a d yarL Name of Applicant Address /a/- Z c) �/ Ve , Oy"nS /V Y• // ���' Phone Number:( ) _24 r e'7 Suffolk County Tax Map Number: 1000 - / 3S - / - C;2 Property Location: S cryUr7�::-lV (provide LILCO Polled#, distance to cross /streets, and location) AGENT: (If applicable) Address: M 7/ Phone: 2 — V J 3 d Board of Trustees Application GENERAL DATA Land Area(in square feet): o y3 4—e Area Zoning: YO Previous use of property: 1 Intended use of property: j�fit'cL Gclz Covenants and Restrictions: Yes V' No If"Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? _J%C No Yes If yes, provide explanation: Project Description (use attachments if necessary): Za M e A aV,ae a-PL,,DDo era`' Description of Project : 1 . The roof gutters and leaders from the seaward side deck roof and the house roof will be connected to a drywell located as shown, by hand, on the 7-26-07 plans and revised January 27, 2010 , prepared by Angel Chorno, of Chorno Associates, Architects . 2 . The debris and wood stored on the bank, in the area excavated, will be removed from the bank. 3 . The sand placed along the north side of Lot 24 . 1 will be removed by hand and redeposited on the bank to re-fill the excavated area on the bank. The owner/applicant will advise the trustees prior to commencement of the work, apd will advise the Trustees when the work will be performed. 4 . After the sand is removed, the area will be restored with native sea grasses (either seed or plants) . Grasses will be planted within 6 months of issuance of the permit . S . The as built stairs to the beach and existing wood retaining wall are included in this permit . =rd of Trustees Applicati - F.. WETLAND/TRUSTEE LANDS APPLICATION DATA. Purpose of the proposed operations:_.g g r � / - GIY4-rtW aci2v 1-,6)At�-frg-7 Area of wetlands on lot: S(Q Ft /!� uare feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: ""--M feet Closest distance between nearest proposed structure and upland edge of wetlands: A111/4- feet C �° aas2� spa Does the project involve excavationor filling? No "' Yes If yes,how much material will be excavated?= `5 Ecubic yards How much material will be filled? Se S cubic yards Depth of which material will be removed or deposited:. "' 02 feet Proposed slope throughout the area of operations: j Manner in which material will be removed or deposited: %I��6111L-Ne?y < 1000 N "x / ) '*VV �R7 �S io�v `gig `, r x '7) _ X �c �' Statement of the effect,if any, on the wetlands and tidal waters of the town.that may result by ; A 3 0 CA/ reason of such proposed operations (use attachments if appropriate): Y 4., - ZIlit77A'� 4 I t rd of Trustees App7icati� COASTAL EROSION APPLICATION DATA Purposes of proposed activity: _ 1��V Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated? S-, ,(cubicyards) How much material will be filled? —� � (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated.resulting fror#implementation of the project as proposed. (Use attachments if necessary) Board of Trustees Application County of Suffolk State of New York EING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE PLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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 C� ;J Notary lic BETSY A PEt3KiNS NaWy Public.State of Now YO& No.01 PE 613W36 Clualified in Suffolk County Commission Expires July t J 01/13/2010 10:25 FAX 631 765 4643 MOORE LAW OFFICES Trustees IM 002 FROM NCMA PHONE No. : 954733= ` JAN. 12 2919 o5:34PM P1 ya�uur. U1ia2;2010 17:85 FAX 631 76- jS43. lilOORF, L OFFi�69 W Josephine Padovan 101.20 67 Drive Forest Hills NY 11375 J Board of Trus Southold Town t Jp +f Town Malt 1 3 2010 53005.Main Road L NY 11971 -Lu?zrc; o 7r`rl4i'R R5. SCTM: 1000-125.1 23, 24.1 25.1 Dear Sit or Madam: pl ease be advised that my attorney, Patricia C, Moore is authorized to appear on our behalf and to execute any and 8ll documents relatirtig there o. i • Thank you. Very truly yours, fill lE pADOVAN I I I i i James F.King,President �OF SO!/jy Town Hall Jill M. Doherty,Vice-President �O� Ol0 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen G Q Bob Ghosio,Jr. �� Telephone(631)765-1892 I�COU '� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only V"Coastal Erosion Permit Application L.AVetland Permit Application Administrative Permit _Amendment/Transfer/Extension Received Application: '3(310 ✓rZeceived Fee:$ (��(}) _,,,2ompleted Application _Incomplete • SEQRA Classification: Type I Type H Unlisted E Coordination:(date sent) �/LWRP Consistency Assessment Form I y; /CAC Referral Sent: w-NA SEP 30 2009 ,,,Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: Southo'a of Wn _Technical Review: Board of Trustees D691c Hearing Held: I 44-( Resolution: Name of Applicant V Address �f� Awe myF Phone Number:( On S-4 Suffolk County Tax Map Number: 1000 - Property Location: / c�DUti�Ul�?i(J � (provi e LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) Address: 113 ZF Phone:_ ���Vk "-)ard of Trustees Applicat' - GENERAL DATA Land Area(in square feet): !�3 6t t l� Area Zoning: Previous use of property: �0 S 6W1 1 7-&A—Z Intended use of property: 1&10 SZdWl' CI-L'rSe Covenants and Restrictions: Yes No If"Yes",please provide copy. Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has'any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes;provide explanation: ,1 1100 TZ) Al/G 7 Project Description(use attachments if necessary): "bard of Trustees Applicat;;. '- WETLAND/TRUSTEE LANDS APPLICATION DATA. Purpose of the proposed operations: 'k C6��Ioc:- -.ecev VoN S' r 0ov�a �,O,di-y-/117 wact- Area of wetlands on lot: trtwt �' /SAC&ware feet Percent coverage of lot < " Closest distance between nearest existing structure and upland edge of wetlands:_ " �p feet Closest distance between nearest proposed structure and upland edge of wetlands: feet 644 Does the project involve excavationor filling? No Yes If yes,how much material will be excavated? "' `S cubic yards How much material will be filled?-'-- ` cubic yards Depth of which material will be removed or deposited: "' 02 feet Proposed slope throughout the area of operations: " Manner in which material will be removed or deposited: W^46'4'L_2G_0A-,T � -L��k 6/0-0 IOx , �) �-0 &X 7ZWS/®.y °i,9 `, r x rI� _ ��� ems, j fit, a. Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by ; 3 0 reason of such proposed operations (use attachments if appropriate): /�/%V 197S c,v y4r "-)ard of Trustees Applicat;" COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? No Yes If Yes,how much material will be excavated? 14Zcubic yards) How much material will be filled? �-�~` 5� (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated.resulting from implementation of the project as proposed. (Use attachments if necessary) Lodw f $� D � PROJECT ID NUMBER 617.20 SEAR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJECT NAME 7IA44 z1103 ,q 416 3.PROJECT LOCATIOT—L //�� -11,6 3 AZ'Z L l (o Municipality County 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map � yz-4/✓ Sly VdVId VI&W Sd 4,0,WV-//TV/ 5.IS PROPOSED ACTION: ❑ New ❑Expansion E360dification/alteration 6.DESCRIBE PROJECT BRIEFLY: 7.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8.WILL ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes ❑ No If no,describe briefly: 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) YResidential ❑Industrial ❑Commercial ❑Agriculture ❑Park/Forest/Open Space ❑Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ❑,Yes ❑No If yes, list agency name and permit / approval: 11.DOfiS ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes 1:110 If yes, list agency name and permit / approval: 12. A.8 A RESULT OF PROPOSED ACTION WILL EXISTING PER-MIT/ APPROVAL REQUIRE MODIFICATION? es ❑No (�/7D�v d•� �i2cv I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Ap onsor ame Date: Sign2Rtre O If the action is a Costal Area,and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II- IMPACT ASSESSMENT(To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.4? If yes,coordinate the review process and use the FULL EAF. Yes ❑✓ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.67 If No,a negative declaration may be superseded by another involved agency. El Yes 0✓ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,if legible) C1. Existing air quality,surface or groundwater quality or quantity,noise levels,existing traffic pattern,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: No C2. Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: [No C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitats,or threatened or endangered species?Explain briefly: No C4. A community's existing plans or goals as officially adopted,or a change in use or intensity of use of land or other natural resources?Explain briefly: No C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: LN 0 C6. Longterm,short tern,cumulative,or other effects not identified in CI-05? Explain briefly: No C7. Other impacts(including changes in use of either quantity or type of energy? Explain briefly: No D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA? If es,ex lain briefly: ❑ Yes 0✓ No E. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex lain: Yes No PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important.or otherwise significant. Each effect should be assessed in connection with its(a)setting(i.e.urban or rural);(b)probability of occurring;(c)duration;(d)irreversibility;(e) geographic scope;and(f)magnitude. If necessary,add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes,the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur.Then proceed directly to the FULL EAF and/or prepare a positive_declaration. Check this box if you have determined,based on the information and analysis above and any supporting documentation,that the proposed actin WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Board of Trustees ��7, Cme of Lead Age Date Jill M. Doherty President Print or Type N 7 of Responsible Officer in Le Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(If different from responsible officer) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: i�i�2�vs Ago s A /P/Ua27�i�o,/ZG��3�3G1i�/7/l�J/�2 ��.��S c?©v,�v�y .Q� • 'e �S o 07�.�,�%, / 11971 STATE OF NEW YORK COUNTY OF SbWFMK JQS:6P41/j(�- P,q0-0U;q-7U ,residing at 6e, l I3 7F being duly sworn, deposes and says that on th _ -day of 20q�, deponent mailed a true copy of the Notice set forthm 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 assessment3pll of the Town of Southold; that said Notices were mailed at.the United States Post Office at /4t of ,that said Notices were mailed to each of said persons by (certified) (registered)mail. Sworn to be r�e} e this Day of (.E , 20_?5 _ Notary Public MOHAMED S. RAHMAN Notary Nob101' State of A New York 6041406 Qualified in Queens county Commission Expires May 8,0@2 �`� James F.King,President Town Hall,53095 Main Rd. Jill M. Doherty,Vice-President M. P.O.Box 1179 Peggy A. Dickerson �`g Southold,NY 11971 Dave Bergen '�'�� ��� Telephone(631)765-1892 Bob Ghosio,Jr. Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of MARIO ABBATE/JOSEPHINE PADOVAN COUNTY OF SK) STATE OF NEW YORK) tt AFFIDAVIT OF POSTING I, doSe //�J R6d^ ,residing at/dba O —c710 &? -7 - J�� being duly sworn, depose and say: That on the I day of OCR , 2067, I personally posted the property known as -'S�9 UA/�J U18Z-rJ SO Vl7'ff�L4> /�/�y. //5 7/ 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 Wed., October 21,2009 on or about 6:00 PM. Dated: i o- � - o l fiAgnore) Sworn to b fore me this 9� day of � 2001 MOHAMED S. RAHMAN State of Nptary Nob101 RA6041406W York J County in Queens Notary A MIA44 Commission Expires May ew YorkF,fU41 1 oinCusens county 2r�to Expires May 8, 2002 Board of Trustees Applica—in County of S� State of New York BEING DULY SWORN .DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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- , TH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS DAY OF 200 Cam" ' Notary Public MOHAMED S. RAHMAN Notary Nob01°RA6041406 State of W York Qualified in Queens county Commission Expiresy APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSUn FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide inforination which can alert the town of possible conflicts gf interest and allow it to take whatever action is necessary to avoid same. " YOUR NAME: , ��"7 C �d (Last name,first fiame,ipnadle initial,untessty d are applying in the name of someone else or other entity,such as a company.If so,indicate,the.other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance' Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship.with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Sout old Ate/ 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 u day of E -66, 00 Signature Print Name Form TS 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. .Thus, each answer must be explained in detail, listing both supportinL and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: 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 f3 � SCTM#_�V—- _- o , PROJECT NAME The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Buildiing Dept. ❑ Board of Trustees L!I- 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 actin : Location of action: 6 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: U.czS, (c) Telephone number: Area Code( )��l� 63�� (d) Application number,if any: Will the action be directly undertaken,require funding; or approval by a state or federal agency? Yes ❑ No ET 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 !91 6w `eZy - ?.mac 3 .s ''� v� !2G � � � ����L�- 6�IG/ ►2 r1Z 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 i ElYes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 3: Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria U Yes ❑ No ❑ Not Applicable '!•�'/1/�'/yd2��CY3,f��S G j�✓7� �1 FCC tis�E s v.v 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 MotApplicable 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 A cable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No 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 allot 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. ❑ Ye�] No[Not Applicable Attach additional sheets if necessary WORKING COAST POLIC 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 YNot 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 0 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 IYNot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No E?Not Applicable PREPARED BY_ TITLE p � fi DATE 3°f 1 toard of Trustees. AppLicai= �i AUTHORIZATION (where the applicant is not the owner) I, residing at (print owner of property) (mailing address) do hereby authorize /�/ �D (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. c ( er' signature) 8 Young & Young 400 Ostrander Avenue, Riverhead, New York 11901 631-727-2303 Howard W. Young, Land Surveyor Thomas C. Wolpert, Professional Engineer Robert C. Tast, Architect Ronald E. Pfuhl, Landscape Architect Douglas E. Adams, Professional Engineer N *00 '• �� .,y„'y,`���.. ��'--4 Tom`.O°� 0" S 0AV N \ _ 5 AAA IP \\' IPINGPL�R�T1N6 ° F of _ -- ------ --'''+S.9e { �a•\\r ties, SL.,\�,\• $ 6.44L " +9.19 _�_'''''/' ��' '5" ,1� //// 6.26 ,•„{„/■,1r"{ // /��_ D6 FOUND 1 Q Q 5 I ? .see {,\ro{,\{\' /' zGv00 ' I _,,__—_' ---- AOJV 4 , Q . pD 1 ,b9 N - ''' _� \I•\\{11•\\•I`{\\r ;, s69, REPAIR EXISTING 6b, I Q _ _____________ .eoa 1 \{,\r"{"�, STRUCTURES IN PLACE ; •a,+a \\�" " pO.O ' 3 CjJ _ N�5 {\• AND IN KIND / V3N 1 fl �II.II■�I ,1 Glugue C,r E■ OF 8E • ra• OLELN1f !4 1 I_ � m ;■_.I.° v---- \0g65OsR 8 �p\(0p-.4 ---- ee. II■ P` � >o ee4 _ L \ 1 11■I{ i_�-.._ice --_-. BOTTOM OF SLOPE Toe ,�'�a lal■ua �la!_'_I,■yam= 10 I 11s �1,, I■I�lit.�lJ■11i�J 1■luu■.0■/la,u u■ua.usi.:■is�,1■ui'.1 _F_LOO_D ZONE A_E Q Q 't \O/� — €al _---- — los4 loss 1+ \ F.OAD «w< _— —te a_-+�*� �«� �P1.ODD�9NE�UN73�RY------- `OVER \TIE \9a. �0 Q Q 11 1 90� %� -�-_—_----------------_ r+115 �.� �.lo�."��, aj _ N u oll` fool y� A 'S \ lol NOTES ��T'z ' '�__ --�------- _ _�—_—_—_—_--_____ ...... ,�oflwAL,< c � —� 1 AREA = 188�14 5G2. FT. i'_ _ __ -_---- - _�-_ -� ZBNE' \ I� -II.ID 099 \ 9b �'' Y Q I OD .iOse \— ---- 9V \ • VERTICAL DATUM = ) G � 33, N.G.V. DATUM M.S.L. Icf2cf b4 x' • ZONING USE DISTRICT = z \ Zoso ---- -- —`9.4, �S -- 4.0' 14.0' _ -- s R-40 � SLOPE • 50ME INFORMATION PROVIDED BY OTHERS ��W 1 2136 `sue/\ \ Cl 1�� _/ 1 \ \\ O \•\ 2 \\'''' ij� --_ __— \ \ � ry ♦2050 22.49_ / It1 �\ 20.20 ----- / / 21e9 /ii �`\ \\\ \�\` \\\ \\\ ~\\ 19.49 -1 \\\ \�_- 0<o� o z''' RFOO J►r� � '-• / "'L /// 7Oj a19.42 - -- \`\ \ \ 1,\� \\\ 14.10 n 21.,9 it , , , _ urn_�NEs \���19A1 SUR1/EYOR'S CERTIFICATION a = 8 =100 N \ ♦ �, ice' P/ `\ O«� a 1 S�V w.4a �' ' •._ / F \ sb9 sse u N Jam, \\ / ♦ �, .__ /// � \\ N7�° 19b1 alp \ �azu 70A6 \ S/6Hy� leo4 ( \\ /%u (\f rSa laze ,_ ♦I,el 16.24 \ \\ AATER .,,.„'..w✓.....,,'.,,ems 16414 METER Z 192PS 1 \ OP PA i COASTAL ER05ION HAZARD LINE-THE LANDWARD LIMIT OF 1 \ \ ft'ft' \ �� NATURAL PROTECTIVE FEATURE AREA SHOWN HEREON BY 1 \ nso �' "� \♦ aa, \ �% r> "' fi W'` g o SCALINS FROM THE COASTAL EROSION HAZARD AREA MAP PREPARED$Y THE NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DATED AUSUST 29,1988 1� HOWARD W. YOUNG, N.Y.S. L.S. NO. 45eci3 IT" \ 1\ SURREY FOR Wino W� s 1625 Expo AN&r-Lo PADO\/AN O W At Southold, Town of Southold �� Suffolk County, New York <Wd c O�Lm�?a O � o 1000 155 OI 25 County Tax MOP District 1000 Section 135 Block 01 Lot 24.1 a; a SXISTIN& CONDITIONS MAP �oas< OF Z ; s� DEC. 15, 2006 m DEC. 15, 2006 MAP PREPARED APR. -7, 2006 0 E' SCALE: I"=201G JOB NO. 2006-0440 E = MONUMENT SET ®= MOINUMENT FOUND Q= STAKE SET ®= STAKE FOUND DWG. 2005-0145-exist-r-ond