HomeMy WebLinkAboutCapozzi, James & Kathie Glenn Goldsmith, Presid,� Town Hall Annex
A.Nicholas Krupski,Vice President yJ, 54375 Route 25
John-M. Bredemeyer III ca P.O. Box 1179
20
Michael J. Domino Southold,NY 11971
Greg Williams Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD 'l
Date/Time:3/� �� � � �� Completed in field by:
Patricia Moore, Esq. on behalf of JAMES & KATHIE CAPOZZI requesting a Pre-Submission
Inspection to discuss a proposed pool and trees that will remain and trees to be removed. ,Located:
1525 Gull Pond Lane, Greenport. SCTM# 1000-35-4-12
CH. 275-3 - SETBACKS
WETLAND BOUNDARY: Actual Footage or OK=4 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:
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I have read & acknow edged the oregoing Trustees comments:
Agent/Owner:
Present were: :,' J. Bredemeyer / M. Domino ( G. Goldsmith N. Krupski
_�G. Williams Other
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SO�JTHOLD NY 11971 D � CEO
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FEBMEMO, RAND UNI ® 4 2021
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-COMMENT.
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APPLICANT
'TRANSACTIONAL DISCLOSURE FORM
(FOR SUBMISSION BY OWNER�add-QWNER= AGENT)
The Town of Southold=s Code of Ethics prohibits conflicts of interest on'the parf of Town officers and employees
The purpose of this form is to provide information which cab alert tt►e Toinfn of possible conflicts of interest and
allow it to take whatever action is necessary to avoid same ;;
YOUR NAME: CAPOZZI, JAMES & KATHIE AND,MOORE, PATRICIA C: '
(Last name, first name, middle initial, unless you are applying in the name 'of someone else or other entity, such
as a company. If so, indicate the other person or company name.)
NATURE OF APPLICATION: (Check all that apply.)
Tax Grievance
Variance
Special Exception
If AOther@,
name the activity:
Change of Zone
Approval of Plat
Exemption from Plat
or Official Map
Other Trustees X
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? ARelationship@ includes by blood, marriage, or business interest.
ABusiness 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_X
Complete the balance of this form and date and sign below where indicated.
Name of person employed by the Town of Southold:
Title or position of that person: '
Describe that relationship between yourself(the applicant) and the Town officer or employee. Either check the
appropriate line A through D (below) and/or describe the relationship 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 ``
Submitted this y of!'�� zo
Signature: — ----_
James Capoz/zii�
at ' C ozzi
Patricia C. Moore
Board of Trustees Application
County of Suffolk
State of New York
JAMES CAPOZZI AND KATHIB CAPOZZI 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
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 FREETROM 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.
�7
James Capozzi
V -
K hie Capozzi
Sworn to before me this
day of March, 2020
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Notary Public
Christine L.Lesueur
Notary Public,state of New York
No.01LE6260681
Qualified in Nassau County
Commission Expires April 30,2020
Board of Trustees Application
AUTHORIZATION
(where the applicant is not the owner)
JAMES CAPOZZI and KATHIE CAPOZZI, as owner of premises 1525 GULL
POND LANE, GREENPORT NY (sctm: 1000-35-4-12) residing at 14 Meadow
Lane, East Williston NY 11596 do hereby authorize our attorney,Patricia C.
Moore,to apply for permit(s)and appear before the Southold Board of Town
Trustees on my behalf.
✓" (owner's signature)
JAMES CAPOZZI
4
(owner's signature)
KATHIE CAPOZZI
SWORN TO BEFORE ME THIS
DAY OF MARCH,2020
Notary Public
Christine L LeSueur
Notary Public,State of New York
No.01 LE6260681
Qualified In Nassau County
Commission Expires April 30,2020