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HomeMy WebLinkAboutTR-4144 GF �' 9 �� �__..� =�-�,�•�'��°,,, Fy"�,,a._ �!'�a!'�': ,r:�,;��rt?.'�"�„',t�°vs'��'•"_-��s�''��.�'s,^•'�_''Ip'"'��g? , y Board Of Southold Town TrusteesIN j SOUTHOLD, NEW YORK PERMIT NO. .....4144................ DATE: ...�k129193............ 5. ; •t..,�1 �� III. ISSUED TO .............JOSEPH...C.H. NUSHKA........................................................ c 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- Ib ti r titled REGULATING AND THE PLACING OF OBSTRUCTIONS 3 ! IN AND ON TOWN WATERS AND PUBLIC LANDS and the kti REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM jF ` LANDS UNDER TOWN WATERS;" and in accordance with the "31 .*. ' Resolution of The Board adopted at a meeting held on .....4U9............ JI I9....9.3..., and in consideration of the sum of $..... ............. .. paid by ................................ ....................................... .......................................................................... .. ........................ N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, \ E t of Southold Town Trustees authorizes and permits the following: k . Grandfather Permit to reconstruct bulkhead, deck & sunroof {rt{I all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- �:. '..;i;• by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of he said Board as of this date. F �f AllG .. ....� ................. ............ o ' J fir,,; � � • � ...... .. �Lti�• ih' - 1 y�0 .................................... 1 .1 Trustees 0 :f.a'uO�.eL�.�...Sar.�vt't' ,3.w�r..'� uLL�..'�.-wa.0 d rG r�,ai +W -J`'(t �.D' +t:I' �!�.P.�I A�'T'_rrs�u s.S? •wt o',y.P.fu.$a' II A T� WIT �•�^"Liy� .:,� -''� " .'\ �.. r�' r.`.'-'1a � 't"'�'.d � �r11.�Q1\\ � :rn..`,se''�� �� �;.'�'� TRUSTEES `, ' - , ,o SUPERVISOR per'' -� John M. Bredem SCOTT L.HARRIS eyer,-III, President , F ,a }ro Albert J:Krup,ski,Jr., Vice-President-.,. a , : - Henry P. Smith Town Hall�, .�; . John B.-Tuthill s,I`-; '; ' '3 53095 Main Road, William G. Albertson ''�n�v, y�;� P.O. Box 1179 So w York 71 ...Telephone (516).765-1892 _ old, New k 119 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30 year Maintenance Agreement Erosion Protection Structures Chapter 37 Southold Town Code / Southold Trustees as Administrator I (we) UOS e,�%I�`��u�r>r� Cieil rt type . or print name(s) the ow ers o record of property at: S��J /��� ��rr 1-1 DY( (type or prints reet address) SCTM 41000- oil to G/f:oo 0_2d.0 o in applying for a Coastal Erosion permit for .an Erosion Protection Structure do hereby agree to a 30 year maintenance program for -a structure commonly known as au/, /�c� gL of Z2 as shown on the attached feet of length licensed survey of the as-built'structure. It is my/our understanding that we are to maintain this structure with materials designed to endure 30 years_ and or., _ equivalent to -the original_.approved_.-struc:ture and =that 'for any` maintenance which involves more than 5% in length of, this -= structure we are to give prior written notice to the administrator, waiting for their approval in all but true emergency situation's which would seriously endanger life, property and important coastal natural resource features such as bluffs or wetlands. We further understand that failure to maintain the structure could result in a requirement to post a bond and or have the repairs ordered as a lien against the property upon a -finding by the Trustees that said lack of maintenance would risk life, property or important natural resources features including protected, rare or threatened animals and plants. 7S /!& rized Signature of owner of record. SWORN .TO BEFORE ME TH DAY OF a LINDA J.COOPER _ NARY CPU LI C Notary Pubiic,State of tVedy - - _------- - No:4822563 —, :-,..... „�...... ... . . : .:.... .: _.. :,.... . .; _..: � .Suffiolh County Term Expires December 31, iJ �. - _ . Please submit three copies of a licensed lan survey made within - one year of the original -construction. -This .maintenance agreement shall only be valid upon the final approval of the administrator. Subsequent owners may apply to the Southold Town Trustees to re-authorize this maintenance agreement. County of Suffolk ) State of New York ) . � f r Lei-.,51/� -� o caCA y-c C ee -1.us BEING DULY SWORN DEPOSES AND AFFIRMS 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 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 REPRESENTATIVE(s). , TO ENTER ONTO MY 'PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. 1-2 SIGNATURE SWORN TO BEFORE ME THIS / DAY OF �'ZGy ,19 t2 3 NOTARY� PUBLIC LINDA J.COOPER ,!otary Public,state of Newyork No.4822563,Suffolk Count�►�, Term Expires December 31.19 `7 Suggested space for location Map THIS IS NOT A PERMIT Page 3 Yds. to be excavated: N Yds. to be -filled- Manner in which material will be .removed or deposited: Width of canal, creek or bay fronting property: Depth at low tide: N Aver. rise in tide: w Distance to nearest channel.:. Distance project extends beyond similar projects in area: Area zoning: Land area in acr s: Is project for private or business use: a V0. Intended use .of. property: Describe known prior operations conducted on premises: 6 Has any prior license or permit .been issued to erect structures, " dredge, or deposit fill on said premises: N� Has any license or permit -ever been revoked or suspended by a Governmental Agency: N� Project Description The project description must also. include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures (i.e. , pipeline and septic system; make additional attachments if necessary) . Authorization (Where the applicant is not the owner) I residing at (Print-owner of subject property) (Mailing address-phone). do hereby- authorize to apply for Coastal Erosion permit(s) from the Southold Town Trustees Signature THIS .IS NOT A- PERMIT Page 2 TRUSTEES SUPERVISOR John M. Bredemeyer, III, President SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President HenryR Smith t `" Y _ Town Hall John B. Tuthill 4� ` 1'' L' �`' 53095 Main Road William G. Albertson � � � P.O. Box 1179 Telephone (516) 765-1892 Southold, New York 11971 Fax (516).765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD COASTAL EROSION MANAGEMENT. PERMIT APPLICATION TOWN- WETLANDS .PERMIT APPLICATION TRUSTEE LANDS PERMIT APPLICATION Office Use Only: 6160'astal Erosion Permit Application ✓Wetland Permit Applications' aiver f rom Chapter 97 �ffrustee Lands Permit Application. a DAGrandfather Completed Apps. Date: ' CAC comments-Date: Sent Rec. 919M Variance Required, Neighbors notified Date: SEQRA Type . — TOWN OF SOUTHOLD Coord. Review-opt. ,mand. Date Rec. by Office- Insp. comp./date: SEQRA Determin. /date: Public Hearing/date: Findings: Permit Vote: (YIN) : �Otnnn� Special Conditions: ( also see file) Application Fee: Application Number; SCTM #1000 °o 0( �'" 0�z©g 0�0 Project Name (If any) Date Prepared: Applicant: 'Pose LC�et-LA aL^� Tel �►vs�f�� . ddress: �O �� G � l�s� Maf,.t o � Phone ( 5/C.) � ) 47 7 8S `j UPS�.uPss s71•b-67c�.g(�o� Interest: (owner, consultant,lessee,.etc. ) © Lx- �"•e r Owner of Property: Address R 4vAe- 4z.-5-I llr/ - Phone ( ) 2gzl-3 z Subject Property Location: (Provide LILCO Pole #, Distance to cross Streets if not on location map) Page 1 mvT C. TO *rnrn T T"T")1%N r 1 Consultant C�,Project Name J C25'-eO A w Ja C ,� V,a. P d-yt v.s cl� SCTDI #1000- 63 D ate "��� The Southold '.Town Trustee office has determined that your application for a coastal erosi /wetlan permit is non-jurisdictional incomplete, please consider the following information in this regard for any required return submission: Trustee R present tive CC: Bari �ep-t-; eal Pia-rrrrrrtg Ba&rd— E-�r��ert,�+ ?QLr_Y_Cou�1. This notice makes no claim with respect to other jurisdictions within or outside the Town of Southold with respect to permits, permission required. 4/92 ,r 1-1-46-4(2187)—Text 12 PROJECT I.D.NUMBER _ 61r.�� SEQF Appendix C State Environmental Quality Review - - SHORT ENVIRONMENTAL. ASSESSMENT FORM For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1 PLIC NT, ON SOR �i 2. PROJECT NAME d.s'Q 'ZJ def-hsZ- ' E G� �n S. PROJECT LOCATION: Municipality G f ��lZh County s� 4. PRECISE(LLOOCATIO�((S'treet/address and road intersections,prominent landmarks,etc.,or provide map) Sd n S. IS PROPOSED ACTION: ,.,/ • ❑New ❑Expansion L�Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAN AFFECTED: Initially /t acres Ultimately acres 8. WILLL OPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? L_I Yes ❑No If No;describe briefly 9. WHAT S PRESENT LAND USE IN VICINITY OF PROJECT? L—J Residential ❑!ndustrial ❑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 Lf No If yes, list agency(s)and permit/approvals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes tJ No If yes, list agency name and permit/approval •12. AS A RESULT�O-F PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? El Yes U No CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TnUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name Date: ��I-L3 \ Signature: f If the action is in the Coastal Area, and you are a State agency, complete the Coastal Assessment Form before proceeding with this assessment OVER ". - 1w1- .tt=ly t. l I U UL COmpluled by !1(iency) A. DO[S ACTION EXCEED ANY TYPE 1-THRESHOLD IN 6 NYCAR, PART 617.12? • If.yes,c< �nalo the review process and use trra FULL ❑Yes ❑No f3. WILL ACTION RECEIVE AN REVIEW AS PROVIDED FOR�UNLISTED'ACTIONS IN 6 NYCAR,PART 617.61 , may be superseded by another involved agency. If No,a negative declaration ❑Yes ❑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 patterns, solid waste potential for erosion,drainage or flooding problems? Explain briefly: production or disposal,. _ C2. Aesthetic;agricultural,archaeological,historic,or other natural'or cultural resources;or community or•neighbonccod character? Explain briefly: C3. Vegetation or fauna, fish,shellfish or wildlife species,significant habitats,or threatened or endangered species? Explain.brlefly: . 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?Explairi briefly. C5. Growth, subsequent development,or related activities likely to be induced by the proposed action? Explain briefly. C6. Long term,short term,cumulative,or other effects not identified in C1•C5? Explain briefly. C7. Other impacts(including changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE.OR IS THERE LIKELY TO-OE,CONTROVERSY RELATED`TO POTENTIAL ADVERSE ENVIRONh1ENTAL I1IPACTS? ❑Yes ❑No If Yes,explain briefly ,.. 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. ' ❑ Check this box if you have identified one or more ally large occur. Then proceed directly to the FULL EAF and/or pr pare a p siittivelgnificant decla ation.verse impacts which MAY ❑ Check this box if you have determined, based on the information 'and analysis above and an •su documentation, that the proposed action AVILL NOT result in any significant adverse environmental pPOrting AND provide on attachments as necessary, the reasons supporting this determination: Pacts Pfamc of Lead �geney Print ur lype N.trnr of Keipunstolr Ulltcef in Lrad Agency ' • fthe of Krsponftblr Ufhcrr JIgndture ut Krsponsible Uthcer to Leed Agency . _=4 StKOJ1Url•Uf Preparer(If different from retpunftble 0"'Cer I Date 2