HomeMy WebLinkAboutTR-1652 4
Michael J.Domino,President O��OF S0!/jTown Hall Annex
John M.Bredemeyer III,Vice-President ~ 54375 Route 25
P.O.Box 1179
Glenn Goldsmith CA Southold,New York 11971
A.Nicholas Krupski �p� Telephone(631) 765-1892
Greg Williams �y`,oU ,� Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
October 17, 2018
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 11716
RE: FOROSICH FAMILY IRREVOCABLE TRUST
1405 ANCHOR LANE, SOUTHOLD
SCTM# 1000-79-4-4.1
Dear Mr. Patanjo:
The following action was taken at the Southold Town Board of Trustees regular meeting
held on Wednesday, October 17, 2018:
RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a
Transfer of Wetland Permit#1652 from Anthony Forosich to Forosich Family
Irrevocable Trust, as issued on July 25, 1983.
Any other activity within 100' of the wetland boundary requires a permit from this office.
This is not a determination from any other agency.
If you have any questions, please contact our office at (631) 765-1892.
Sincerely,
J,ken
Michael J. Domino, President
Board of Trustees
MJD/dd
September 23, 2018
Town of Southold Trustees
Town Hall Annex Building
54375 Rte. 25 D (� VP.O. Box 1179
Southold, New York 11971 Li i,
SEP 2 7 2018
RE: 1405 ANCHOR LANE. -SOUTHOLD r
SCTM No. 1000-79-04-4.1 so-thold Town
PERMIT TRANSFER CHECK B a Tri
Dear Trustees:
Attached, please find check in the amount of$50 as requested for permit transfers.
If you should have any questions or require anything further, please do not hesitate to
call me at 631-484-9332.
Very truly yours,
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 11716
August 9, 2018
Town of Southold Trustees P
Town Hall Annex Building D
54375 Rte. 25
P.O. Box 1179
AUG 2 0 2018
Southold, New York 11971
RE: 1405 ANCHOR LANE. -SOUTHOLD Southold Town
SCTM No. 1000-79-04-4.1 Board of Trustees
PERMIT TRANSFER
Dear Trustees:
We hereby request all permits for the above referenced property be transferred into the
new owner's names as follows:
1. Forosich Family Irrevocable Trust
If you should have any questions or require anything further, please do not hesitate to
call me at 631-484-9332.
Very truly yours,
effrey Patanjo
P.O. Box 582
Bohemia, NY 11716
SU
Michael J. Domino, Pre it OHO FFD(4C'OG s, Town Hall Annex
John M.Bredemeyer III,Vice-rresident �� yam, 54375 Route 25
Glenn Goldsmithy z 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: (/ �' , LU/ Completed in field by:
21&,k-
Jeffrey Patanjo on behalf of FOROSICH FAMILY IRREVOCABLE TRUST requests a Transfer of
Wetland Permit#1652 from Anthony Forosich�to Forosich Family Irrevocable Trust, as issued on July
25, 1983. Located: 1405 Anchor Lane, Southold. SCTM# 1000-79-4-4.1
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 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:
ak
I have read & acknowledged the foregoing Trustees comments:
Agent/Owner:
Present were: J. Bredemeyer 0M. Domino G. Goldsmith N. Krupski
G. Williams Other
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PERMIT NO. .. ... DATE: .Jul 25, 1983 a'Ir-
1.652............
ISSUED T O ,...,.,..,Anthony Forosich
... ..............-....-..............................................................................
At' Pursuant to the rovi f Chapter 615
VMp lions o ffapt r of the Laws of
the State of New York, 1893; and Chapter 404 of the s of t'
to � r n Law file
State or New York 1952• and the S.,.,"-d Town Ordinance en- -'`''\
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS .
R REMOVAL
ON TOWN WATERS AND PUBLIC LANDS and
f the
AL OF SAND GRAVEL OR OTHER MATERIALS. FROM
LANDS UNDER TOWN WATERS;" and in accordance with the5 F"`
Resolution of The Board adopted at a meeting heft: on Jqjy 5
,, 19......8.3� and in consideration of the sum of $...10:5-.-00 .. paid by
') .........................................A _t.k14??.y.. Forosich ;_,�+ :may•. f1
....................................................._...........
of Southold Y. and f
\` ............................................... N. suti act to t e _ r
Terms and Conditions list �V n
listed on the reverse side hereof, ,i •,.,v ' j� ��
of Southold Town Trustees authorizes and permits the foilowin
Approved to construct a bulkhead consisting o' a 25
4.n,( section connected 5' landward of corner of existing
� bulkhead extending southward: 5' section
- �� =,• `C :,,:�: sec on in E—W
ect s will a.
� on. This � connect to Koch s.. ,lulkhead.
all in accordance i "7 anc with f;1e detailed speci:fcations as presented in i", l�
the or iginating application. % c
backfill 25 `with cu. yds. sand trucked in from
,��;�. ,`s,, =3• . upland c
I `t`, .'�•' -'`` st� causes IN WITNESS WHEREOF, The said Board of Trustees here- `
y �
uses its Corporate Seal to be affixed, and these presents to
Ar L�'.':± l`�`�•: be subscribed by a majorft r e said B y or the Board as of this date,
/p��,�.'• _ . l (`�1 I L ........�..........................
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—
Boar�.jOf Soutf,oI' d TownI rusrees
lei SOUTHOLD, NEW YORK
9���.� I jG NO. N/A-
` PERMIT NO, 1652 Jul 25 1983
���f� � .
DATE: .....:. Y. ......
w� ISSUED TO ........ Anthony ......
Ir certify that the work as authori--ed
in this permit has been ccmpleted and is now ready for your insoec—
tion. also, the nu^�tier required on this pro-ect is clearly visible.
I further understand this permit is not valid until this tear sheet —
is returned to the Trustees.
I�I
�l
t�
I TERMS and CONDITIONS
�I
I
The Permittee Anthony Forosieh
residing at Anchor Lane, 'Southold N Y•'
as
Part of the consideration for the issuance of the Permit does understand and prrscribe to the fol-
lowing: 1. That the Southold Trustees Permit must be prominently
YPI displayed on the premises effected thereav during the period of
2. That the said Board of Trustees and the Town of Southofd" are released from any and
all damages, or claims for damages, of suits arising directly or indirectly as a result of any open- work.
ation performed pursuant to this permit, and the said Permittee will, at his or her own erpease, under
defend any and all such suits initiated by third parties, and the said Pennirtee assumes full liability the
Y,."y with respect thereto, to the complete =clusion of the Board of Trustees of the Town of Southold'permit.
3. That this Permir is valid for a period of 9`'E `T^A w is considered to be
i sufficient time required to complete the work involved, but should circumstances warrant; .equ--t
f= for. an extension may be made to the Board at a later date.
4. Tliat this Permit should be retained indefinitely, or as long as the said.Permicree wishes
t=� to maintain the structure or project involved, to provide evidence to anyone concerned Char auth-
orization was originally obtained.
5. 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
K5I revocation of this Permit by resolution of the said Board.
6. That there will be no unreasonable interference with navigation as a result of the.work- i
herein authorized.
a�
S~I 7. That there shall be no interference with the right of the public to pass and repass along ;t
the beach between high and low water marks.
�, 8.• That if future operations of the Town of Southold require the'removal and/or alterations
in the location of the work herein authorized,
p E
$�I ed, 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., K
K � upon•due notice, to remove or alter this work or project herein stated without esperises to the Town k
9 pf Southold.
9. That the sal r d Board will be•notified by the Permittee or the completion of the work auth- 4
orized. (See tear off sheet. )
l 10. That the Permirtee will obtain all other permits and consents that may be required sup.
+ i plemental to this per-nit which may be subject to revoke upon failure-to obtain same.
k; - .
Y!t Aevrij=,ig,
<_ Bi):1li,p Or TOW 7RUSTEES
1 Town of So,:::.:.z1rl
Main Road _
Southold, New York 11971
NOTICE OF ACTION - NOT A PERMIT
Anthon Forosich Anchor Lane Southold New York 11971
To: ....................Y.......................�............
6 15/83 I 1. Ycur application, dated .........f ..........
has c=en reviewed by this
_13 Board, of a meeting of the Trustees held, orl ....................Jujy., 5,,,,,1983
........................
and resulting in the acrion, as indicated below:
....XXX) Application approved.
�.......... .) APPHcotion denied.
"< (............) Application tabled. ,
2. Comments and remarks:
.1�y
I i
Your application was approved at the July 5, 1983 Meeting.
3.
A PERMIT FEE
If ��cur r.�-nlirn�,n•� icr,n_nr^vecl rl _ir,. ��., d�;� and shoulc be mode 7�
_-=.� p. gable
to the order of the Eoord of Southold 'down 1'ru:rees. This fcr•� is comruted be!ew according to
;he,5crequl pf R t^s s set forrh in the Instructicirl ghee �Ferm I/11. Z,'hic £l� mus: be
paid witefitn 90 days or re—applying Arid .3cc;ic:ienal fee �,{;_If the Permit Fee IS co!C1 in person to ihv :ecrerary of the 8ccrd, i ha Permir will be obit nn jec tea,:
of the some tir.,e. If the fee is poid by mail, the permit will be rnoiied in reply.
Ccrnputation of Permit Fee:
25 feet of Bulkhead at $3.00 a lin. . ft . _ $75. 00
Total amount due for this application.
i-
Total Fee for thi �p�litcti ...........................on $ 75 00
.. Q ..............................
gried
E;uarcl of Soutil
c1dr Town Trustees.
Ear
f tY by I ... 0 .. ...,..
FOLI
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ZIP
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TELEPHONE
(516) 765-1892
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
August 26, 1983
Mr. Anthony Forosich
190 14 47 Ave.
Flushing, New York 11358
Re: Bulkhead Fees
Dear Mr. Forosich:
Transmitted herewith is your receipt for the additional
bulkhead fees. ° I have enclosed another permit with the
proper amount of fees paid entered.
Again, my thanks to you, for your co-operation.
Enjoy your structure, and please be sure to post your
permit number on the work, after the work is done.
Very truly yours,
Board of Town Trustees
4_Z�7Ilene Pfifferling
Clerk
Attachments ;
Lima -
EO OOII" 4 + TELEPHONE ��
(516)765-1801 1
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
July 25, 1983
Mr. Anthony Forosich
P. 0. Box 299
Anchor Lane
Southold, New York 11971
RE: Bulkhead
Dear Mr. Forosich:
Thank you for your prompt payment for your bulkhead.
I am sorry, but I neglected to include in that fee, two
5' sections of bulkheading. The additional fee for this
will be (10 lin. ft. @ $3. 00 per lin. ft . ) $30. 00_ additional.
Again my apology.
Very truly yours,
Bogard of Town Trustees
Ilene Pfifferling
Clerk
-Attachments
J
i
fi
TELEPHONE
(516)765-1801
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
July 6, 1983
Mrs. Judith T. Terry
Southold Town Clerk
Southold Town Hall
Main Road
Southold, New York 11971
Dear Judy:
Transmitted herewith is the action taken by the Board
of Southold Town Trustees at a regular meeting held. on
July 5, 1983:
RESOLVED to recommend to the Southold Town Board approval
of the Wetland Application #147 submitted by En-Consultants,
Inc. on behalf of Anthony Forosich to construct a bulkhead
off a dug canal at Harbor Lights, Southold.
Very Truly yours,
Board of Town Trustees
Paul Stoutenburgh
President
PS/ip
•. o �
cps Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (S16)76S-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
June 9, 1983 ! �.__... ......
Mr . Paul Stoutenburgh, President
Board of Southold Town Trustees
Southold Town Hall
Southold, New- York 11971
Dear Mr. Stoutenburgh:
Transmitted herewith is application no. 147for a
wetland permit submitted by Enconsultants, Inc. , on behalf
of Anthony Forosich.
Please prepare a written report of findings and
recommendations with respect to this application.
Very truly yours,
Judith T. Terry
Southold Town Clerk
Attachment
APPENDIX B NAME OF.PROJECT
SHORT ENVIRONMENTAL ASSESSMENT FORM
INSTRUCTIONS:
(a) In order to answer the questions in this short EAF is is assumed that tho
preparer will use currently available information concerning the project. and the
likely impacts of the actions . It is not expected that additional studitep research
or other investigations will be undertaken.
(b) If any question has been answered Yes the project may be significant and a
completed,Environmental Assessment Form is necessary.
(c) If all questions have been answered No it- is likely that this project is
&ot significant.
(d) Environmental Assessment
le Will project result in a, large physical change.
to the project site or physically alter more
than 10 acres of land? . . . . . • . • . Yes No
2e Will there be a major change to any unique or
unusual land form found on the site? You No
3e Will project alter or have a large effect on
an existing body of water? . •. . . . • . Yea T No
-4o Will project have a potentially large impact on
groundwater quality? . • . . . . . . . . Yea No
5. Will project significantly effect drainage flow
on adjacent sites? . . . . . . Yea No
60* Will project affect any threatened or endangered .
'Plant'-or, animAl 'species 7 Ywa No
7e Will project result in a major adverse effect on
air quality? . . • Yes No
$e Will project have a major effect on visual char-
acter of the community or scenic views or vistas
known to be important to the community? . . Yea I No
9e Will project adversely impact any site or struct-
ure of historic, pre-historic, or paleontological "
importance or "any site designated as a critical
environmental area by a local agency? . ® . Yes ... No
10e Will project have a major effect on existing or
future recreational opportunities? • • _,_ Yee No
lie Will project result in major traffic problems or
cause a major effect to existing transportation
systems? . . . . . . Yes No
12e Will project regularly cause objectionable odors,
noise, glare, vibration, or electrical disturb-
ance as a result of the projects, operation? a Yes No
139 Will project have any impact on public health or
safety? : . e . e e e . Yes No
14. Will project affect the existing community by
directly causing a growth in permanent popula-
tion of more than 5 percent over a one-year
period or have a major negative effect on the
character of the cc unity or neighborhood? , Yes No
15. Is there public oversy concerning the project Yes No
PREPARERIS SIGNATURE: TITLES
REPRESENTING: DATE:
9/1/78
14
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
JUDITH T.TERRY ;.:. TELEPHONE
TowN CLERK (516)765-1801
REGISTRAR OP VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
NEGATIVE DECLARATION
NOTICE OF NO` SIGNIFICANT EFFECT ON THE ENVIRONMENT
Dated: July 20, 1983
Pursuant to Article 8 of the Environmental Conservation Law
State Environmental Quality Review and 6NYCRR Part 617, Section - —_
617. 10 and Chapter 44 of the Code of the Town of Southold, notice
is hereby given that the Southold Town Board, as lead agency for
the action described below, has determined that the project , which
is unlisted will not have a significant effect on the environment .
DESCRIPTION OF ACTION
Application of Enconsultants, Inc. , on .behalf of Anthony Forosich,
for a Wetland Permit to construct a bulkhead and fill behind the
bulkhead at Anchor Lane, on dug canal off Peconic Bay, Southold,
New York.
The project has been determined not to have a significant effect
on the environment for the following reasons:
An environmental assessment has been submitted which indicated
that no significant adverse effect to the environment are likely to
occur should the project be implemented as planned.
Because there has been a response. from the Board' of Southold
Town Trustees and Southold Town Conservation Advisory Council indicating
that this project would not have a significant effect to the environment .
Because there has been no response in the allotted time from the
New York State Department of Environmental Conservation and the Southold
Town Building Department , it is assumed that there are no objections nor
comments from those agencies.
Further information can be obtained by contacting Mrs. Judith T.
Terry, Southold Town Clerk, Southold Town Hall , Main Road, Southold,
New York 11971.
Copies to: David DeRidder, DEC, Stony Brook
Commissioner Williams, DEC, Albany
Southold Town Building Department
Southold Town Trustees L.-'
Southold Town Conservation Advisory Council
Town Clerk' s Bulletin Board
Enconsultants, Inc. , on behalf of Anthony Forosich
I HEREBY AUTHORIZE EWCONSUL,'1'AITS , INU . TO IPF-r.,': : . -
PERMITS ON MY BEHALF.
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SOUTHOLU TRUSTEES
NO.
Issued To 4olhon i4 rnens, Date ,iu /03 .
Address 0xickop- Lane . Sauj&td- r1J• V.
THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE, TOWN OF SOUTHOLD
SOUTHOLD. N. Y. 11971
TEL: 765-1801
�.1
" A/8 - Rev. 6/72
BOARD OF TOWN TRUSTEES
Town Of Southold
Southold, New York 11971 I i
Main Road
APPLICATION FOR A BULKHEAD, DIKE, OR JETTY
1. Does this project involve the use of WETLANDS as defined in the Southold Town Wetlands
Ordinance? YES GF-00. If it does, you must file through the Town Clerk's Office.
2. Is the proposed work entirely within the boundaries of your own property as substantiated
by your Deed or Survey? YES ep=W. If it is, a Permit is NOT required from this Board,
but the Town Building Inspector should be contacted for full details.
3. Applicant's name and address: Anthony, Foro ch,,,.Anchor Lane... Southold....................
NY 11971
.................................................................................................................................................................
4. Contractor's name and address: EN-CONSULTANTS, INC. 64 North Main Street
.............. ..................................................
...............................................................................................................
5. Explain briefly the purpose of this application: .�.R�iS.lrru�l...a bu�lchead„consisting„of
25•'„section connected 5; landward of corner of existing, bulkhead extending ...
southward; and„a.5' in E•-W direction;,,..This will be connected to RroPosed bulk.;
.... .... ...................................................
head of Koch: Bacicfill• with— —
andward of MHW.
6. After issuance of Permit, I expect to: (mark with an X)
(a) Commence work — AT ONCE............: ASAP ...A......; UNKNOWN TIME .............
(b) Complete work in. — 1 DAY ............: 1 MO. ............; 1 YR. ............; FUTURE ...3„Veeks.
7. Secure the correct Area Map from the Secretary of this Board, and by using an X WITHIN
A CIRCLE as a mark, indicate as closely as possible the location of this project. On the
reverse side, provide a SCALE DRAWING which will show Ordinary High Water .Mark as well
as the size and shape of the structure or work to be done. Also include all dimensions for
portions which extend offshore from the O. H. W. M.
8. Provide the following documents:
(a) A Licensed Engineer's Survey of the property involved.
(b) A copy of the Contractor's Plan. and Specifications.
9. Does this project extend into Town Waters beyond on imaginary line or boundary formed
by existing works of a similar nature along this area's shoreline? NO. If it does, state
the approximate distance beyond. ............ ft.
10. Will this construction require the Filling of any land offshore of the Ordinary High Water
Mork or the Dredging of any material from Town Lands under water? lT-Mzz NO. If it does,
Form A/4 (Application for Dredging/Filling) must be completed and attached as part of this
application.
1 I. In requesting approval of this application, I submit that: the information presented herein
is true and correct to the best of my knowledge and belief; I am the person accountable for
the performance of the work in accordance with the plans and specifications attached; I have
read or am familiar with the provisions of any Southold Town Ordinance pertinent to the work
involved; and further, I intend to adhere to and abide by the Terms and Conditions of the
Permit, whe.ra _and if issued to me,
-L, S, ..... . ............ ........................................
.Accepted by: Dated. June 13, 1983
Town Of Southold k
Town Clerk's Office t
Southold, N. Y. �....W_,.�.. �_ ,W•.,.�.
APPLIC_1TION FOR WETLANDS PERMIT
Application No. .........
�/' . ............ Date of Application .....J:me.l.:...19. .....................
tAtWJV=x4111.'fs Mr.
Identity of Applicant .....Hilt 1rc?i�Y...E.vrosiclr..................... 64 N.QR
?`'�7�"AMPT04 NEW YOP,K 11. 68 .
Address of Applicant ......�'.f�.... .4�.,;,,1405 Anchor..La; , Southold NY 11971
.. ...................................................
INSTRUCTIONS FOR PERMIT
i
A. This application is to be completely filled in by typewriter or ink and submitted to the Town
Clerk in quadruplicate, accompanied b writter q P p y permission from the owner of the property if not i
the some as the applicant.
i
B. Pilot Plan must be drawn to scale on the reverse side of this application showing the location j
of property, the names and locations of owners of adjoining properties, and a detailed description
of ,proposed project. (Note: Copies of the Pilot Plan may be made by a copy machine and attached
10 the Permit Application.) i
C. No operation shall be initiated by the applicant until all permits that are required are issued. '
I
D. A detai!e::l statement of the rehabilitation and proposed condition of the premises after the
work is compietcd must be given, including a survey if required.
, I
E. If permit is being sought for a more sizeable excavation than the construction of a private
single dock or jetty, then this application must be accompanied by a survey and topographical map
certified by a registered land survey or Professional Engineer. The horizontal control of survey
shall be based upon an approval local coordinate system. The vertical control for elevation and sound-
ings shall be based upon United States Coast and Geodetic Survey and/or United States Geological
Survey datum.
F. A statement must accompany the application describing any known prior operations conducted
on the premises in cluestion and whether any prior licenses or permits have been issued to erect
structures or to dredge or deposit fill on said premises and whether any such permits or licenses
were ever revoked or suspended by a governmental agency.
G. A filing fee of $25.00 shall accompany the application. This filing fee includes one inspection,
there is a S5.00 fee for each additional inspection.
H. The Town Board upon request9Wfapplicant for a permit, moy waive in whole or in part,the provisions of Article II, Sectionsubdivisions (b) and ('where it finds that nature of the
proposed operations are such that the requirements of such provisions are not necessary for a
proper consideration of a permit application.
I. Upon approval of this application the Town Clerk will issue a permit to the applicant. Such
permit shall be available for inspection at any time, upon request.
Y �
1
Examined ....... 3�.................. 19.. �3
Approved ........9��...
�f ..............
Disapproved ...........................................................
Conditions, if any .................................................................................................................................
..........................................................................................................................
.............................................................................. ..................................................................................
ExaminingBody ... ... ... ................... .................................
Signatureof Chairman ........................................................................................................................
i
APPLICATION IS HEREBY MADE to the Town Board of the Town of Southold, Suffolk County,
New York, for the issuance of a permit pursuant to the Laws, Ordinances and Regulations govern-
ing the Coastal and Interior Wetlands, Flood Plains and Drainage Areas of the Town of Southold:
Permit requested to . construct a bulkhead„cpn.S. .$.�. 4g..4. ..a.. �� ...$.�G.>r.;.P. ..c4.ACl€G. .c ... ....
to 5' landward of corner of existing bulkhead extending southward, and a 5'.
section in E-W direction. This will be connect7d to proposed bulkhead of Koch.
B'�fUkfi'11" itH"25"cy"oP"clean"sand"to"b'e"truckecT"iri from' commerciaY upTarici"sou'rce.
Bulkhead will be landward of MHW.
Location of property for which permit wanted..................ARch4z..Laj ,,,souttzola„.... 11y71......
.................................................................................................................................................................
Home address of permit applicant if different from aforesaid location ...P:O...Box 1!+05
Anchor..La:.z..S ou tho l d..NY....11971..............................................................................................
- i
Creek, Bay or Harbor fronting property AP9..caizal.............econic B;iy
..................................................................................................................................................................
Size of proposed work:
Length .....5Q.4..a.>f': .Gl1.�d.......................................................................................................................
n/a
Width .....................................................................................................................................................
HeightAbove High Water .....................4.:.............................................................................................
DepthBelow Low Water ............T Z.!.......................................................................................................
none
Yardsto be Excavated ...........................................................................................................................
Yardsto be Filled ..........................25.................... ...............................................................................
Widthof canal, creek or bay fronting property................ ...........................................................
Depthat Low Tide ................ ................................................................................................................
2'6"
AverageRise in Tide .............................................................................................................................
}1
Private .•................•....................
is this for private or business use ,;,
Area Zoning ....l��.S.I.Sf. .Ll�. ,1L.................................. ...............................................................................
Manner in which material will be removed or deposited ....... . ;;I
I.
..................................................................................................................
No ahall``'c �....�...... .. `` `-
intended use of property ...•.••••••••
........................................,.................................................................................... (j
�% r;tien consent of owner of property,
if not the some as the applicant ..... .: ...... ' ..... li
............... ....................... . ......................................................
!!i
..........................................................•....................................................,................................................ 1
COUNTY OF SUFFOLK ) !
ST;',TE OF NEW YORK ) SS.
L?4Y...L:..HJ ..................•.....•....... being duly sworn deposes
..................................................... I{!
orid says that he is the applicant for the above described permit, and that all statements contained
herein are true to the best of his knowledge and belief; that the work will be done in the manner set
< application and as may be approved by the To Board of the Town of Southold.
orth in this app
The applicant agrees to hold the Town of Southold and the own Baar/c�' harmless and free from
�1
any and all damages and claims arising under or by virtue �� said de m!t if granted. =�i''
Y- Ap` plicant
... .. 1...........•............... ......Signature �I�
Sworn to before me this ................................
of ......•.... �."L-q.—:................. 19..';!....-�
day ll f
Notary 01C
SMLI A.�•���:t " �`I
"I""pUd1IC,Stele 01 Nor Y06 4
Ne.010tN7f52TT,S006 Coin
Tim ExNres Merck 30,0 I
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