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HomeMy WebLinkAboutColletti, Scott �. ufFQc
Michael J. Domino, dent O�QS COG Town Hall Annex
John M. Bredemeyer III,V1CePresident �� ��,, `:-54375 Route 25
Glenn Goldsmith y 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: ���/t9 2 ` 361 Completed in field by:
Timothy Hough of Shore Marine Construction on behalf of SCOTT COLLETTI requests a Pre-
Submission Inspection for the proposal to replace the existing timber retaining wall and possible
options for said wall. Located: 2140 Deep Hole Drive, Mattituck. SCTM# 1000-123-4-4.1
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:
}conk o Lu I he_aj ngAS �0 �4-1 re—" ria 424
` "'Al car, Le- yeSpf`aCej wilt Jkar o off"i o n
-in k, nd ('e-Placemen} rnoy 1-- coos;jer&_� a new bulkhead,
I have read & acj- ledged the foregoing Trustees comments:
Agent/Owner:
Present were: ✓ J. Bredemeyer ✓ M. Domino ✓ G. Goldsmith ✓ N. Krupski
'�G. Williams. Other
INO
cott Colletti
?} 140 Deep Hole Drive,Mattituck
CTM#: 1000-123-4-4.1
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Michael J.Domino, President �*zf SO(/TjyO Town Hall Annex
John M.Bredemeyer III,Vice-President �� l0 54375 Route 25
P.O. Box 1179
Glenn Goldsmith Southold, New York 11971
A. Nicholas Krupski • Telephone (631) 765-1892
Greg WilliamsO a Fax(631) 765-6641
�y00UNT`I,��
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: I Is/JCi
Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1St day of construction
'/2 constructed
Project complete, compliance inspection.
_JL- P4-"00MI SS OAt
INSPECTED BY: G 6Jd5��,� �
CO'M'MENTS: `
Ln cA �O mePT \n ��[���� Ia IsGUSs
CERTIFICATE OF COMPLIANCE:
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SHORE MARINE COh1S4RUC80OV�
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275 Alois Lane
Mattituck, NY 11952 I ` ` DEC 12 2018
Ph. (631)617-2800 � I
December 11,2018 s —n '
shoremarine@yahoo.com Boar(!_c+
www.shoremarineconstructioncorp.com
Dear Southold Town Trustees
I would like to request a pre submission site meeting at 2140 Deep Hole Drive in Mattituck the
residence of Scott Colleti. The owner is going to apply for a wetland permit to replace his
existing timber retaining wall, and would like to know his options.
Thank you
Timoth ough
PleG�Se ra eU2 l/m 4o stl
rnu.t 10
(Df -7-zWOO
1
APPLICANT/A.GENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Sduthotd's Code of Ethicsinhibits conflicts of interest on the art of town officers and em to ees.7'he n"----of
this form is to rovicle information which can alert,the town of ossible cdnfIjqja2fj0=st and allow it to take whatever action is
necessary to avoid same.
YOURNAME:
(Last n - ,first name,q ddie initial,unless you 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'I'own 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 Southold
Title or position of that person -
Describe the relationship between yourself(the applicantlagent/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 5016 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
Submitted this 17- day of >;LLtgk 20
Signature`� -
Print Name �.
Form TS 1
Board of Trustees App;' ration
AUTHORIZATION
(Where the applicant is not the owner)
I/We, 5 c�
owners of the property identified as SCTM# 1000- 17- 3 —® _ y ' in the town of
a .New York, hereby authorizes ���' �
OF J��®�� /��lRfnr�, �^'S��w�-�:�''" to act as my agent and handle all
necessary work involved with the application process for permit(s) from the Southold Town
Board of Trustees for this property.
s
roperty Owner's Signature Property Owner's Signature
SWORN TO BEFORE ME THIS DAY OF 20 Lb
LISA OSHESKE
Notary Public,State of NewYork
Notary Public No.OlOS6262746
Qualified In Suffolk County
My Commission Expires MAY 29,20]d)
Board of Trustees App: ration
AFFIDAVIT
!st,i+ 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
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 of Property Owner Signature of Property Owner
SWORN TO BEFORE ME THIS DAY OF 20
LISA OSHESKE
Notary Public,State of Newyork
Notary Public No.OlOS6262746
Qualified In Suffolk County
My Commission Expires MAY 29,20