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TR-7686E
Jill M.Doherty,President O��QF SO!/T Town Hall Annex Bob Ghosio,Jr.,Vice-President O 54375 Main Road P.O.Box 1179 James F.King Southold,New York 11971-0959 Dave Bergen G Q John Bredemeyer Telephone(631) 765-1892 �yCoU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD EMERGENCY WETLANDS PERMIT Permit No.: 7686E Date of Receipt of Application: November 21, 2011 Applicant: Beixedon Estates Association, Inc. SCTM#: 66-2-47 Project Location: Right of Way at End of Arshamomaque Lane, Southold Date of Issuance: November 22, 2011 Date of Expiration: N/A Reviewed by: Board of Trustees Project Description: Temporarily place approximately 100 sandbags (filled from an upland source) along the western half of the bulkhead to prevent any further erosion. Findings: The project meets the requirements for issuance of an Emergency Wetlands Permit as determined by the Board of Trustees. The issuance of an Emergency Wetlands Permit allows for the operations as indicated in the application received on November 21, 2011. Special Conditions: A full Wetland Permit must be obtained in order to conduct any further activity. This is not a determination from any other agency. II M. Doherty, Pre ident Board of Trustees PLAN FOR. PLACEMENT OF 1/2 to 1 TON STONE RIP RAP E z. END OF ARSHAMOMAQUE LANE MAP OF o�g'O -- BEIXEDON ESTATES 1P� F BLOCK 7 SITUATE S Q o SOUTHOLD. TOWN OF. SOUTHOLD SUFFOLK COUNTY, NEW YORK .Ssil S.C. TAX No. 1000-66-02-66 SCALE 1"=40' MAY 14, 2010 AREA = 19,282 sq. ft. s (To BULKHEAD) 0.443.cc. 111 So 93 4 • oT� s'��o• ����, •sp• �_I �„; Nav a21,02011 �Q,�., L °o�•' NOTES: �` .q� Sa;�tflcld Te,an Board of?CL'S`e° 1. ELEVATIONS: ARE REFERENCED. T0. HIGH. WATER BEING ELEVATION 0.0' 89 s EXISTING ELEVATIONS ARE SHOWN THUS: '5.0.0 '�3• TO Tim WED ALTERATioN«�AD F ro THLS SURVEY 15.A vmFw YO of 7 SECUON r OF rHE NETv YDRx STATE . TB: = TOP.OF BULKHEAD EDucAnar+LAW. BOTTOM OF BULKHEAD �� ' �°F rtxs MAP NOT MANG 70P OF JE711' •� rEA SSE suRVEYOR's u NOT SEAL OR . 0 S10, TOB E A .SEAL SHE C Nor BE CONSfoEREO �r0 BE A ViWD TRUE.COPY. SHALL-F a lO.n1DNEE PEI FDR THE SURVEY . IS PREPARED:km ON.Nis BEHALF To THE' TN1E COMPANY,GOVERNMENTAL AGENCY.AND LENDWG a+srrt6RwN UWZ 11EREOK AND .. •� - O `!�P TO THE ASsiGNFFS.OF 7HE LENDING OlSn— .. � 0.1 � TUnON.CERT*rATpNS ARE NOT 1RANSEERABLF_ THE EXISTENCE OF RIGHT OF WAYS AND/OR EJSELENTS OF RECORD. IF . ANT, NOT SHOWN ARE NOT GUARANTEED- SECTION OF �_ _ - oy�°° PROPOSED ..CROSS pOJ�� S ��• F mm o, "DE °. + FOR _ STATE LAND . RIP RAP PLACEMENT ry , V. SCALE 1 " = 10' y � -(AFTCC� ���� PROPOSED RIP RAP �� (112 TO I TON ROCK) HIGH Y4ATER s. uG Na_ 50467 LOW INI�TER - Nathan, orwin III I EXISTING BULKHEAD �' Land Surveyor Title Sarveys—Sabdrvisions — Se Plans — ConstrrxGon loyout - PHONE (631)727-2090 Fax (631)727-1727 OFF/CES LOCATED AT AmumG ADDRESS 1586 Win Rood P.O. Box 16 Jamesport, New York 11.947 Jamesport. New York 11947 Issued To' Be�xed�nSX6.ksmll 't��. Date44a-aL ���-�t.�]wr a E.�d o� Arshow� Qo��Ln: �,�,1!„Id Add.r es�'R � THIS: NOTICE MUST BE DISPLAYED DURING CONSTRUCTION SOUTHOLD TRUSTEES TOWN,TRUSTEE,S QFFICE,TOWN OF: SOUTHpLD SOUTHOLD. N.Y. 11971 , TESL.: 765.1'892 Beixedon Estates Association Inc. Bulkhead Damages from Hurricane Irene ti t .' .'.�� Ya'i'.'.tl• +>,!, flit , j �^11, + f K 04 ��, ,�• k P. �.., "�. 'C�. aye. Y.. .brt,ro _ lad ! _ 1 _ �. - 4 t r 1 Air /i / / �' • /i / / • Beixedon Estates Association Inc. Bulkhead Damages from Hurricane Irene 44 ✓ i r k A a I A 8/28/2011 8/29/2011 Jill M.Doherty,President Town Hall,53095 Main Rd. James FDave Bergen Vice-President P.O.Box 1 179 g ' Southold,NY 11971 Bob Ghosio,Jr. Telephone Telephone(631)765-1892 John Bredemeyer Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Acs3 ,p Office Use Only Coastal Erosion Permit Application _Wetland Permit Application Administrative Permit NOV 2 1 2011 Amendment/Trans er xtension �C Received Application: Received Fee:$5 f) _Completed pp hG, ; ,sar t A lication - - _�.��-,�.. rLr 'ae.s _ —..J.. _Incomplete _SEQRA Classification: Type-I Type II Unlisted —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: 'Name of Applicant DC I'/I ' pn —Tr) G M W 0-V I a.n Address"Po _ 8 4 )43) 5oc.t-k-)o � d oy IJ�y1 _ Phone Number:( ) �� �� Z S Z -- '/3 9'6 Suffolk County Tax Map Number: 1000- 7 Property Location: Pj'q !?� D �Ct y GL� �y�(� 0 A-� �g�,y�0 446 t[ (provide LILC II ,Pole#, distance to cross streets, and location) AGENT: Ivy ( ch apd e t xelY) (If applicable) Address: `i�� ��� 132— 56L-tl l a 1 CI l Phone:_ i i ! H d of Trustees Applicatio,_ GENERAL DATA Land Area(in square feet): o76—a e Ire— Area Zoning: e �16 Previous use of property: den-iaw�- Intended use of property: U\ 1'Cf�►]� p IN 6l�Z CGSS Covenants and Restrictions: Yes ✓ No If"Yes",please provide copy. Does this project require a variance from the Zoning Board of Appeals Yes ✓ No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes No Prior Prior permits/approvals for site improvements: Agency Date 74— wo7► ees 117 -FO ✓rw %yr sh S Cans-huc� bu l k hew d 41 NYOE /J�f�38 -t�39�1/oa�a -TI v1 !i ee-hahill-I Ae races sated replehisd��e 8/%8 e4)17Sfiuc� bgIJ<bead N f�tr C No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? J/ No Yes If yes,provide explanation: Project Description (use attachments if necessary): i5�IVi�g �r��'✓I e���gey�C y Dev✓v�i7�' � whore �p 6� hr'� c� Ae gre4 -Aa�- u-gs W a hec✓o u �Mrn Ilu y-o'can e, our- 0 40'ce n-�- IC b,omeoyiner awns � Ahe- 6P-b&- rDdd arl- ri' h�-d-f auQl. I,U l S� 7v 1Gle� G r�x `D(� 1 hC�x95 �j 1�2 - -Dmp/ar�e�Source, W2 S fa�Ce 6 rn 4h2 W�ferr� hr (13a l I ic�e� o -l-l�� bu lkh�ac� • This c�i i S I to-�+ - rom -{-fie e�l e+i ng ea5 ern rd of Trustees Applicatic WETLANDfIRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: -A9&Xeaop? �sfa s�SSoC/��br�,�hc- -6-d n e-m erd e racy Den" ►i4-+ S ko re �� b-p-h►�d �-(n� �m m�►�► ! bulkAeQd an area 4k&+ was wds_hed ,o y 16vrice�h,e Tr=ene` - help' ' � byliz -} 't�:v�t��h Qu �Rel-iir "H'%e jb+Llkhe�c�o Area of wetlands on lot: square feetu �Ju o� bu/k17e 4� Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet a e#a, Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No 1z Yes If yes,how much material will be excavated? y cubic yards i I in I00 Sarvdkv 40M an plated Source How much material will be filled? cubic yards ` Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: ,5ct n¢ ba q,S Will h� 1�a v�c� -�r ���c� -�vv� a� u D la�d Aso u v-c� ®--� �anc� • 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): Nora PROJECT ID NUMBER 61720 SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW' SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1-PROJECT INFORMATION (To be completed by A plicant or Project Sponsor) 1.APPLICANT/SPONSOR 2 PROJECT NAMEeewd/1. �kf�• / rrk4w dC{/ry)Q • hal k) 0 3.PROJECT LOCATION:.� Municipally 5.a4�} l County 4.PRECISE LOCATION. Sire Addess and Rod intersecligns. pro ,Went landmarks etc-or provide map tt�aX ar. ild 6 r5 ha M a:7rape >t/�e- . S.IS PROPOSED ACTION: ❑ New ❑Expansion Modification/alteration L�vn,evgev�cy' �2trrnl 6.DESCRIBE PROJECT BRIEFLY: GtPP1y)'►7,5 4r aY7 awr eor-r pee-n4Il- 4o 5 hnI-e" �,,p be,hi v)d +h2 CeIrnrruvl d y bulkhe417 An tit re-6- `I-h&4 "4 5 W4shecl o u+ /b' 11}�i,�y((e�j�e+ot vI Ana° I re Lt-i 5 k -{0 1)la C� u��,�/,-, /G b Sa v� �q�� f,p -ri'8 d1't �t'1 �p +41�t 0 5O Ll req, 6 n �-hJ i.CJ'e,5Te rr) bu !1<Jgead, TY,;s d isTT�I )ee 43 k-k7 -the ex1 64-►',3 , ea s+, rn 4-h e bu l k A ecl_d , 7.-AM6UNT OF LAND AFFECTED: lhitialy, Q Z acres Ultimately acres 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes ❑ No If no,describe briefly: S.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential ❑Industrial ❑Commercial ❑Agriculture ❑Park/Forest/Open Space ❑Other (describe} k9t h a-F Wmy — Jccc/7 a r-ces t 10_"DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ❑Yes rM No If yes, list agency name and permit /.approval: 11.Do ACI UN HAVE A CURRENALlD Ml OR APPR VAL? ❑Yes Nor if yes; list agency name and permit / approval: 12.-AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT APPROVAL REQUIRE MODIFICATION? Dyes 0 No. 1 CERTIFY E INFORM ON PROVIDED ABOVE IS TRUE TO THE $EST OF MY KNOWLEDGE Applicant 1 Sponsor me ate: _ Signature 1/j1 2If If the action is a Costal Area,and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment APPLICAN L/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emniovees The puroos6 of this to is to omvfde information which can alert the town of possible conflicts of interest and allow it to take whatever action • necessary to avoid s�apme./' J�/� + �• YOUR NAME (Last name,first name,griddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate thb.oiher 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 Of"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 ofSouthold? "Relationship"includes by bloom marriage,or business interest"Business interest"means a business, including a partnership,i n which the town officer or employee h ven a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5% f a shares. YES NO If you answered'YES",complete the balance ofthis.form and date and sign where indicated. Naine 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 descr(be 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 fhe applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(wheat the applicant is not a corporation);. C)an officer,director,parhre%or employee of the applicant;or D}the actual.applicant. DESCRIPTION OF RELATIONSHIP Submitted this 4 f.() 201 1 Signature. Print Name Form TS I Board of Trustees Application County of Suffolk State of New York JA1(.fhk0- VV Mtjp j .'BEING DULY SWORN DEPOSES AND AFFIRMS THAT HI;/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAngED BEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILT,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 THIr PREMISES IN CONJUNCTION WITH RE ?F7. P L I C AT 1160 N. Signature SWORN TO BEFORE ME THIS , l DAY OF 0 1L 20�- J BE rH CONNOR < NOTARY PUBLIC,Stat of New York Notary Public 7.3 Qualified in New York County Commission Expires Rnard of Trustees Appl-icatii AUTHORIZATION Jt (where the applicant is not the owner) I, -hoV a-5 4arbara- & (1 residing .at 7U BOX (print owner of property) (mailing address) so u4 dU , do hereby authorize Be;xefdlon I� Cho e-( CX (Agent) E-'61ak5As:SO6 � , uVQY-IQ t o ae / f V) rrl Yor permit(s) from the Southold Board of Town Trustees on my behalf. (owner' s ignature) 8 T. BE—Z-No.osa „ — ---- ! sm.NO. BEE BEC.NO. ' S F 6584SW1] rIs l 40fyc) �,� . .,•5 ' .0 ygµcl O s Tea ' e .v,��c^0 • �'(/ N 4 @ a of An. F ..o d P p�,`;`O s �� -per.•b ' J 4 41 r ' SEOTION NO COUNTY OF SUFFOLK © x 'w"10° souniew NOTICE E P, -- �. a �'^ "-- ,.•x,w•u.w„Aw�:a.•�a Real Property TaxServiceAgency r L n....wu ,•� q ��•• ,,,,,,., --.-- �'• -- cwa,r amn�,tvaJ,NY11.01 m E,,._o,�o� —�.— R1I �. OO o...u. --.-- �.-- -- M m ,aa xo G.r+u,.. 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