HomeMy WebLinkAboutTR-4796Albert J. Krupski, President
John Holzapfel, Vice President
Jim King
Martin H. Garrell
Peter Wenczel
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 1197t
Telephone (516) 765-1892.
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
Coastal Erosion Permit Applicati~
'Wetland Permit Application ii~'~~I~
~randfather Permit Application ii~i
Waiver/~en~ent/~n~es ~3k~.
~Rece~ved Application: ~/~/~ ~
Received Fee:$ '~ ~
~Completed Application ~/~/~; L ~LL~
Incomplete
SEQRA Classification:
Type I Type II Unlisted
Coordination:(date se~t).
'~AC Referral Sent:
~ate of Inspection:
Receipt of CAC Report:
Lead Agency Determination:
Technical Review:
~--~fublic Hearing Held:~
Resolution:
Name of Applicant
Address IWJ~,~
.~k ~?~ ~ Phone N~er. (~)
Suffolk Count~ T~x Map N~er: !000 -
Property Locauio~:
(provide LILCO Pole ~, distance to c~oss streets, and location)
AGENT:
(If applic~bie)
Address:
Phone:
0
0
r-
[ of Trustees Application
GENERAL DATA
Land Area (in square feet): , /?
Area Zoning: ~ ~
Previous use of property:
Intended use of property:
Prior permits/approvals for site improvements:
Agency Date
No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a
governmental agency? /No Yes
If yes, provide explanation:
Project Description (use attachments if necessary):
Board of Trustees Application
County of Suffolk
State of New York
SWORN TO BEFORE ME THIS
TRU~ TO ~ BE~T OF H~/~ ~O~~ B~, ~ ~T ~n
WO~ WILL BE ~ !N ~ ~ SET FORE IN ElS ~PLI~TION
~ AS ~Y BE ~PRO~ BY ~ SO~O~ ~ BO~ OF EUSE~.
~E APPLIC~ AGeS TO HO~ ~ TO~ OF SO~O~ ~ ~ TO~
TRUSTEES ~ESS ~ ~ ~OM ~ ~ ~L D~GES ~D C~
A~ISING ~ OR BY ~R~ OF SAID P~IT(S), iF ~T~. IN
CO~LETING ~IS .~PLICATION, I ~Y A~O~ZE ~ ~USTEES,
THEIR AG~(S) OR ~P~S~ATI~S(S), TO ~ O~ ~ PROPE~
TO INSPECT ~ P~ISES iN CON~CTION ~VI~ OF ~IS
~S~gEature~ ~
4TH DAY OF SEPTEMBER , !9 97
NAh~C'Y T, I:USCO
NOTARY PUBLJ~, ~ete c~ New York
Notary P~lic
APPLICANT
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of
interest on the part of town officers and...employees. The
purpose of this form is to provide information which can
alert the town of possible conflicts of interest and allow
it to take whatever action is necessary to avoid same.
(~st 'name, first naffe, 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's or company's name.)
NATURE OF APPLICATION: (Check all that apply.)
Tax grievance
Variance
Change of zone
A~p~oval of plat
Exemption from plat or official map
Other
(If "Other," name the activity.) ~/~-//~/S
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? '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 applicant)
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 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
noncorporate'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 d~ay o.J~ 199_
Signature ~J~//~
Board Of $outhold Town Trustees
SOUTHOLD, NEW YORK
ISSUED TO ....... p.AUL.
Aut'horizatimt
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 OrcJinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
Resolution of. The Board adopted at a meeting held on ...~/.~j.c~.?. ....
19...92.._, and in consideration of the sum of $..!O.0,..0.O ..... paid by
of ...... .~;~.~...~-~ ............................................... N. Y. and subiect '1'o the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
Grandfather Permit for an existing 81" timber bulkhead with
a 45' return and a 10' return.
all in accordance with the detailed specifications as presented in
the originating application.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporate Seal to be affixed, and these presents to
be subscribed by a majority of the said Board as of this daf, e,
...........
Telephone
(516) 765-1801
Tov~n Hall. 53095 M~in Road
P.O. Box 1
Southold. New York 11971
SOUTIKOLD TOWN
CONSERVATION ADVISORY COUNCIL
The following recommendation was adopted at the meeting of the Southold Town-
Conservation Advisory Council held Monday, September 22, 1997:
GF-49
Moved by Scott Hilary, seconded by Kenneth Meskill, it was
RESOLVED to recommend to the Southoid Town Board of Trustees APPROVAL
of the Grandfather Permit request of PAUL REILLY 37-5-13 for an existing
81' timber bulkhead.
300 Knoll Circle, East Marion
The CAC recommends approval because it appears the requirements for a
Grandfather Permit have been met.
Vote of Council: Ayes: All
Motion Carried