HomeMy WebLinkAboutTR-5854
Board Of Southold . Town Trustees
SOUTHOLD, NEW YORK
PERMIT No.585"'i
MAGGIE-MEG REED &
ISSUED TO ...........-...........................,..........................
DATE: .J.'!:~llary..2.J,..2004
~Ic:;~(I:¡;;Lh.?c::;.Ei.TJ.13. :E..~I.
J\ut~nrilatinn
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New YoR, 1893: and eMpter 404 of the Laws of the
. State of New York 1952, and the SoutholdToWn Ordinance en-
titled ."REGULATlNG 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 acçordance with the
Resolution of The Böard adopted at a meeting held on .!.":Il.~....P!.....
. ~º.Q.~. and in consideration of the sum of $.....?O.~º.º.. ... paid by
F air.~".,,:~J;.".r~l3.. 'ê<:''N~. ..f.()r.. ~"e~ I. ~C!ll"þ".rt................._.._..····
of ........J.è."s.th.I>1.":r.~()Il.. .................n.. N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the folowing:
Wetland Permit to construct additions and renovations to the
1 exist~~g residence landward of th~ existing deck, with the
conditlOn gutters and drywells are installed to contain the roof
run-off and as depicted on the site plan prepared by .
aU in accordance with the detailed specifications as presented in
. the originating application. .
Robert 1. Brown dated December 12, 2003.
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 datø.
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TERMS and CONDI11ONS
11Je Pamiuee Maggie-Meg Reed .& Michael Schubert
rr"~¡"B It 815 Fire Rd. #3. East Marion N. Y.. as
put 01 die coasideratioa for !be _.oœ of dae PàmIt doa ....~_. 'I~"'¡ I0Il presafbe to die foI-
1owIøt:
1. That !be said Board 01 TrusIees IIDd the Towa 01 SouIboId lie released han Il1'f IIDd
all damages, or claims fot dama¡er, of suIø adsias dItecdJ « IDdIrecdy .. . ftIIIk oIll1'f ~.
adoa perfomaed ...........t to this pesmIt, I0Il dae.... ~ ,,01....... will. at his « bet owa a¡~ )".
delead uy Ud all sUch IIIhs ·Iftw..-l by dIIaI puda, IIDd die said P I"_,dj - fallliIIIIIkT
wid> nSpect thueto. to die ~.....I "'4 of die Baard 01 Truscees 01 the TowD 01 S ..I ~
2. That CbIs PemIIc is wUd IoC apedocl of 24 -. wbich is arar" I' to lie die
ectI-te<I tIme·requited ~ œcn~ die wotk Inwhed. bacÌlboald ch ... - --. nqaat
for an aœasIoo may be ØIIde to die Board at . btø daœ.
3. That this Permit sbould be ~ indefiaitely. or as 100g as the said Petmktee wishes
to ""'1....lft die stmcture or project Involved, to.pmvicle evidenœ to anyoae ~OOCI chat aøth-
oriHtlQn __ originally obcaJDcd..
4. That the worklavohed will be subject to die ~ IIDd appmn1 of die Baud «
iu agents. IIDd ......... -P'1e""" wid>. the pwYisloasof dleorl¡i""" applkaclo<1. -.y be cause 1«
tmK:&CÌ0II of this Permit by raoIudoa of die pld Boud.
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5. That cbere will be no _lOC"'hle Inted_ wid> aa\'igadoa .. . talk of die wotk
beteIa ~ized. .
6. That!bere sba1l be 110 Interf_ wid> the right of die pabHe to pus aøt .. .....
!be beam between bIgh IIDd low _ marks.
7. That if fuaue opendoas oldie Town of So-"'~,LI nqaJn the. -'- aød;« alea:adøas
in die Iocadoo of die wotk beteIa ","·"1 cf, or it. JDdIe opI'*- 01 the Board ol~-. the.
wadi: sbaI1 cause ~e absttucÞoa to free anipioa. die aid p..... 1..- will benqahed.
apoø .- aodœ, to reame or. alteI this wotk or project beteIa stated withoat e..l-a.... to die Towa
. 01 So..A .... .
ø. That the said Board will be aodfiecI by the ""n"lt~ ot die .. ..t.l. ....... CIf fIe wøtk auth-
orized.
9. That the Permiuee wi.Ù obcaIo aU ocher peamIIa IIDd -'~II~ dIat .., lID nc¡uIød sap;
p1emeotaI to this penult which -.y be subject to reYOke upon fúlaœ to obtaha -.
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Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
January 21, 2004
Ms. Amy Martin
Fairweather-Brown Design
205 Bay Avenue
GreenpOrl, NY 11944
RE: MAGGIE-MEG REED & MICHAEL SCHUBERT
815 FIRE RD. #3, EAST MARION
SCTM#21-1-1.3
Dear Ms. Martin:
The Board of Town Truslees took the following action during its regular meeling held on
Wednesday, January 21, 2004 regarding the above matter:
WHEREAS, Amy Martin of FaÎrweather-Brown Design on behalf of MAGGIE-MEG REED &
MICHAEL SCHUBERT applied to the Southold Town Trustees for a permit under the
provisions of Chapter 97 ofthe Southold Town Code, the Wetland Ordinance of the Town of
Southold, application dated December 15, 2003, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory Council
for their findings and recommendations, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on
January 21, 2004, at which time all interested persons were given an opportunity to be heard,
and,
WHEREAS, the Board members have personally viewed and are familiar wilh the premises in
question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
2
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WHEREAS, the structure complies with Ihe standards set forth in Chapter 97 ofthe Southold
Town Code,
WHEREAS, the Board has detennined that the project as proposed will not affect the heallh,
safety and general welfare ofthe people ofthe town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application ofMAGGIE-MEG REED &
MICHAEL SCHUBERT to construct additions and renovations to the existing residence
landward of the existing deck, with the condition gutters and drywells are installed to contain the
roof run-off, and as depicted on the site plan prepared by Robert 1. Brown dated December 12,
2003.
Pennit to construct and complete project will expire two years ¡¡-om the date the pennil is signed.
Fees must be paid, if applicable, and pennit issued within six months of the date of this
notification.
Inspections are required at a fee of$5.00 per inspection. (See attached schedule.)
Fees: $5.00
Very truly yours,
~.19~'~·
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/lms
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
.
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Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
TO: mQ~~\,º-~\['Oe~ ~ePd <t Tn\·CI¡VlOl 'S('\lu.Ioor+-
Please be advised that your application, dated I
has ?~~~ reviewed by this Board, at the regular meeting of
I~D~ and the following action was taken:
( v') Application Approved (see below)
(____) Application Denied (see below)
(____) Application Tabled (see below)
If your application is approved as noted above, a permit fee is
now due. Make check or money order payable to the Southold Town
Trustees. The fee is computed below according to the schedule
of rates as set forth in the instruction sheet.
The following fee must be paid within 90 days or re-application
fees will be necessary.
COMPUTATION OF PERMIT FEES:
TOTAL FEES DUE: $ .fD CO - -\10ð..\. \()<¿,~eL*,~'Î
tlt.t.... -I '1 ~.. L?".I..· n I
SIGNED: Y" ~
PRESIDENT, BOARD OF TRUSTEES
BY:
~QJlll2fì _þMLOL
RK, BOARD OF TRUSTEES
4/98
January 19,2004 Field Inspe*l
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January 19,2004 Field Inspew
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Telephone
(631) 765-1892
Town Hall
53095 Route 25
P.O. Box 1179
Southold, NewYorlc 11971-0959
CONSERVATION ADVISORY COUNCIL
TOWN OF SOUTHOLD
At the meeting of the Southold Town Conservation Advisory Council held Tuesday,
January 13, 2004, the following recommendation was made:
MAGGIE-MEG REED & MICHAEL SCHUBERT to construct additions and renovations
to the existing residence landward of the existing deck.
Located: 815 Fire Rd., East Marion. SCTM#21-1-1.3
. The CAC did not make an inspection, however the CAC recommends no further
encroachment toward the Sound or Coastal Erosion Hazard line.
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FAIRWEATHER-BROWN
DESIGN ASSOClATES,INC.
205 Bay Avenue
Greenport, N.Y. 11944
477-9752 (fax) 477-0973
December II, 2003
Board of Town Trustees
Town of Southold
Town Hall Annex
P.O. Box 1179
Southold, New York 11971
Re: Maggi-Meg Reed
Michael Schubert
SCTM# 1000-21-1-1.3
Chairman Al Krupski and members of the Board of Trustees,
We would like to request a Coastal Erosion Permit for proposed work to be performed for
above named clients. The property is on L.r. Sound, the proposed addition starts
landward the existing deck and 35'+ landward of the Coastal Hazard line. According to
the survey (dated Augusl 2003) the top of the slope at this point is at an elevation 54' .
Enclosed please find:
la. Application for permit
lb. short environmental assessmenl form
2. 3 copies of the site plan
3. Color Photos taken showing the location of the existing home
4. I Stamped survey
5. Location Map
6. Letter of Authorization
Thank you for your time and consideration of our request. If you have any
questions, please do not hesitate to call me.
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Fairweather-Brown Design
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BASED ON SURVEY ,:JF
L'JT5 2, 3,44
SuBDI\lIS¡,JI\I MAP, LAND ,,)F
MARION G. R.ICHI\RDSO~
FILED DEC.31, 1927 M.A.P NO 8~·':;
SITuATE: EAST MARiON
TOWN OF SQUTHOLD
5UfF(:'I..K ,::'OUNTY, N.Y.
SuR.'JEYED œ¡ZblO3
SUffOlK ·::OuNTY TAJ/ NO.
1000-21-1-1.3
FOR:
MAGGI-MEG REED of
MICMAEL SCHuBER.T
"'REA ~ 45. I 7~ S.F.
OR. I ·J3 72 ACRES
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FAIRWEATHER-BROWN
DESIGN ASSOCIATES,INC.
205 BAY AVENUE
P.O.BOX 521
GRfENPORT, N.Y. I 1944
G31-477-9752 (Fax) G31-477-0973
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SUR\lE'(BY
JOM~ .:: EHLERS LAND SUR\ifYOR.
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SITE PLAN
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SCALE. 1'=52
I SURVEY OF PART OF LOTS 2, 3 ~ 4
SUBDIVISION MAP, LAND OF
MARION G" RICHARDSON
SlìUA TE: EAST MARION
TO¥'tN: SOUTHOLD
SUFFOLK COUNTY, NY
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FILED DECEMBER 31, 1'121 MAP No. B5'1
SURVEYED OB-2b-03
SuFFOLK COUNTY TAX #
I 1000-21-1-1.3
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CBlRTIPIBD TO:
MaggI-Mcg Reed
Michael Schubert
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ELEVATIONS REFERENCE N6VD'2'1
COASTAL EROSION HAZARD LINE AS ANNOTATED FROM
COASTAL EROSION HAZARD AREA MAP PHOTO No. 51-bO'l-B3
SHEET 15 OF 4<1 DTD B/2'1/BB
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JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S. LIe. NO. 50202
RlVERHEAD. N.Y. 11901
369 8288 Fax 369 8287 REF.I\Hp serverldIPROSI03 24l.pro
AREA ~ 45.11'1 S.F. OR 1.0312 ACRES
. .
.
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Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Route 25
p,O.Box1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
, Office Use Only ~~ CEIU~
dJ Coastal Erosion Permit Application /.~ EC 1 5 2003
_Wetland Permit Application _ Major _ inor
_ Waiver/ Amendment/.Changes
_Received Application: '1' ¡. f 0 ?J Southold Town
_Received Fee:$ ..57. ~ , . Board of Trustees
_Completed Application } v¡ J .... /0 !;
_Incomplete
_SEQRA Classification:
Type I_Type II_Unlisted_
_Coordination:(date sent) ,
_CAC Referral Sent:J 'vl~G:Df!;
_Date ofInspection: } 1 11' I 0
_Receipt of CAC Report:
_Lead Agency Determination:
_Technical Review: I j:l¡J 0 tf
_Public Hearing Held:
_Resolution: .
NameofApplicantJ~(.,/~-MGb P~F.'" .J... MlchuJ 5fki:Jert
Address 43 S,f)IJ~Ia..c.<e....- , tJr-ookLr /'(, IId-Of-4-?,;;!.'
PhoneNumber:() cJld - ~3 - ~'I-~O ;1
Suffolk County Tax Map Number: 1000 - ð I - I - '.:'3 --{l!' \\;) '?
Property Location: FL ~t Ro cO. *" 0 '\
j¿A"::>T MIon N' \);:
(provide LILCO Pole #, distance to cross streets, an
AGENT: Hm\J. (Y)Mtý) Fø..-IIQ,WPAg·-n,ffJt- ~ðWn I::~:2·<q0
(If applicable) I -J
Address:
á05 'BÞr'-
GVR,p.¥\~
Ä:Ile...fîÙ-L.
Phone: ~í7 - Cn&¿..
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Board of Trustees Application
GENERAL DATA
Land Area (in square feet):
Area Zoning: R -
45) 17C¡
Previous use of property:
e::>ld..erJ,·
u~: :OJ~ ~
Intended use of property:
00 old Town
Board of Trustees
Prior permits/approvals for site improvements:
Agency
Date
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£1S" ?
No prior permits/approvals for sile improvemenls.
Has any permit/approval ever been revoked or suspended by a governmenlal agency? J<'n bw IfJ¿, '---
~No_ Yes hoT t)¡ ~......v
If yes, provide explanation:-
Project Description (use attachments if necessary):
ÅDJ),.ílDkJ f- k'p.-n-ovðfIÐI'1. <:. to e..¡Jd;;~
_r-e.?íthw?.J> . br. J LI)o..¥&' () -fl e-1¡ 5:t.4 d eck~
-,f ~5~ Ia.ntiuJMrl of Ú>a.:d-tJ J,Ú-2tLVJ. I~( ,
~ Df t~ \'"5 lor€-' I or buLk 1'5 oJ- Q.¥\ J.eJJ~ d' 'sJf-
.
Board of Trustees
.
Application
WETLANDrrRUSTEE LANDS APPLICATION DATA
MMr'1, feAt (t,¡dt~IC~ tVtlJ..
Svrr)/f' -f2m~ ¡re-~JeAt~
Purpose of the proposed operations:
.....a.J J. Iii ú't1 ~ to .vý,..1 4~
Area of wetlands on lot:
square feet
fõ)[E ~ [E ~ WI [E rñì
lJll DEC 1 5 2003 gI
Percent coverage oflot:
%
Closest distance between nearest existing structure and upland
edge of wetlands: feet
Closest distance between nearest proposed slructure and upland
edge of wetlands: 10D:!: feet
Does the project involve excavation or filling?
/ No
Yes
If yes, how much material will be excavaled?
cubic yards
How much material will be filled?
cubic yards
Depth of which material will be removed or deposiled:
feet
Proposed slope throughout the area of operations:
1"/,2-"
.
Manner in which material will be removed or deposited:
Southold Town
Board of Trustees
Statement of the effect, ifany, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use altachments if appropriate):
V" r'lot e,cpecf dM..'1
tl.¥\J px:.é -t'.- d l 'f)-ý\ O-t
l f\(\ pl.em-t>n t-e...L
~pa.d- - C-ut'.-tLLI
$,T-e.. w'¡ll h·L
u.:,-e...-
4IÞBoard of Trustees APPlica~on
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity: mob reKJDv dl~fi .J tvYld. aJJdï~.s
--to 0f- ~
~'11e... .-f I1AY1 J"1 r Ii "?Júl iUI ÚJ -
Are wetlands present within 100 feet of the proposed activity?
No / Yes
\Õ),H ~ ! ~ ~ ~
\\ru GEC \ ~ 2003 ~
Does the project involve excavation or filling?
/ No Yes
If Yes, how much material will be excavated?
(cubic yards)
Southold 10wn
Board of 1ruSte8S
How much material will be filled?
(cubic yards)
Manner in which material will be removed or deposited:
Describe the nature and extent ofthe environmental impacls reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
-e-n\Jllè~Cl~
c.ø-sttJ
~_fXopd k of h~ hJps ~ th'
%.tJ\ hR f[/1l'pA WUJ6J./J
h~á IkL ~FJW1
~vis of éo",<;truc..hfYYL,
ð...ec1c:.. Cl& J ~ t-~ 0 V\ '" o..Jf.¿ o-t- rY1. l () l m J IM1 ~
OM.&.. 1tW.dt.uoJJ 01 ~lS~, struch...N~
!k'..t)\')d) ..:,t;.,...v-u Md.~L~, ",he-u.lð b,µJ-£....,
I
,,",,0 ~íP/1.ð
-Äc:Cf''S ç I S --Pv- D yY""\
of
W VVLct - born..//..-
I ÚAI- L Q.A/ c1
b[LJ~
\
617.20
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
.
.
PART 1_ PROJECT INFORMATION (To be comDleted bv A IDlicant or Proiect SDonsorl
1. APPLICANT/SPONSOR 2. PROJECT NAME
Am'1 1Y\M.(lV/¡:¡} ·'·r...... j..-<b ..~lJWn lY.71GJ R£fD i ~í'Jb rt C~tI,,~d
3. PROJECT LOCATION: . 0 IE (G IE ~ WJ IE n
Municipality E'A-5í "^'~L> OtJ County 5<JFfol.,/Z.
4. PRECISE LOCATION (Street address and road intersections. prominent landmarks. etc.. or provide m i DEC 1 h r-,,', '~ï ~
gl:r ~;J\_',j
fiRe fèvÞr t:> "*3
Southold Town
5. PROPOSED ACTION I~
o New Expansion o Modificationlatteration
6. DESCRIBE PROJECT'BRIEFL Y: (R\RT;'" ~ Re'SiD£N(¿"
J;Æe..I<.. A/J I> 5ecoIJ C> S TO~'1 AÞD,íloloÒ ~ 10 AfJ Ë.'¡'-' s r ,06-
L.At->Þ(.t)AÆt> OF E'4G 5.T ,µ 6 ST/ê-" cT UfU:; ~1oJ'" 3s'''' la.n&<-v<vJl of (OQ..-:;.i-.J
¡J./'IUrfU:) L¡~. fÀ:t ""'- e..(.eùc..t wA 0+ 5'+' AbU'/,,- sT..... ¡ !?v:'A
7. AMOUNT OF LAND AFFECTED:
In~ially .0' acres Uttimately .0\ acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
3Yes o No If No. describe briefly
g. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
g Residential o Industrial o Commercial D Agriculture o ParklForesUOpen Space o Other
Describe:
Re:slDe"mAI..- þe:\>E L-tff lYle/Jí oF" SlffioL-ArL fi!Of()eS 0':- ..5 m. LA.R.- w""E~F~DIJT
t'ro~tl-t.5 . s"nm<K + "feu- \- Ou.' J 'íe~1 c\.e nC f' ~
10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR UL TIMATEL Y FROM ANY OTHER GOVERNMENTAL AGENCY
(FEDERAL. STATE OR LOCAL)?
¡g Yes 0 No If Yes. list agency(s) name and pennitlapprovals:
5o"n.\oLto> 10v:. ,.... ·'R.oSíe·E- S , \iJ\1 S . DE e....-
SoOTH-o,-b 10..':"" CÙlLD,t,J" "þ¿ P'T.
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
DYes øNO If Yes, list agency(s) name and permit/approvals:
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
DYes rn No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLE~
Applicant/sponsor nr "- ~ 1<'. YY\ A R r J N Date: 11.- IU U 3-
Signature: , ,r " It'. ,'] Jî A.AJ::;. 1
If the action'-i's in the Coastal Area, and you are a state aøency, complete the
Coastal Assessment Form before proceeding with IS assessment
OVER
1
.
.
Albert J. Krupski. President
James King, Viœ~President
Artie Foster
Ken poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
---------------------------------------------------------------
In the Matter of the Application
?!!iöF~¥ifLl~~~1J,~r-
STATE OF NEW YORK)
-) ì
I, ~,)7á-~
AFFIDAVIT OF POSTING
,-5 ~_yJr~
. residing at "i/ f/
~
.
~
<
being duly sworn, depose and say:
¡J
That on the /J""cÍay of ~! ' 200 , IpersonaUyposted the property known as
":J .'7 .' '->j. ;lei.;#" 1 /(),r)C! -./ /-/..3
by placing the Board ofT .' tees offiCial poster where it can easily be seen, and that I have
checked to be sure the poster has remained in pia for eight days prior to the date of the p blic
hearing. Date of hearing noted thereon to be held I ).fhj 4 tv ~ 0 1cêvt:.J...rf' M
Dated:
-'~
\ . 1
V}¡:(A' ,~
l..{SIgna
J
Sworn to before me this
o? IS" day ofr' 2004
pa~~
N~ lic
JOYCE A. STEVENS
NOTARY PUBLIC. STATE OF NEW YORl(
NO. 4875122
QUAlIFIEO IN SUFFOLK COUN1Y
COMMISSION EXPIRES NOVEMBER 3. 2~
.,.
.
APPLtCANT ...
TRANSACTIONAL DISCLOS~FORH
The Town o~ S~ulhold'e Code of Ebhics rohibibs conflicbs of
nbsrssb on ths part of town off cers and smployees. The
purpose of this form is bo proYide information which can
alert the town of possibls conflicts of interest and allow
it to take whatever action Is 11ecessar bo avoid same.
TOUR NAHB.
na~e first name, m dd~e
you are applying in the name of someone else or
other entity, suell ~B a company. If 80, indicate
the other person's or company's name.)
r" . .
NATORB 01' APPLICATION. (chsck ali that apply.)
;. :...~'W.'.;,/' ~~:~,..:.~'.
Tax grisvancB
VarIance
Change of Eone
Ap'p~pN.l of plat _____
Exemption from Riat or Of~Clal map
otner .-r~ ~
(If ·other,· name the act vitYI)
Do you per8ona1.1r (or ~hrough your C!o..p.ny, spouse, Þlbl1ng,
parent:, or chl1d) hDye B re1atlonshlp vith Bny officer or
emp.1oyee or the "I.'ovn of Southold1 -Relationship" includes
by b1ood, Marriage, or business interest. "Duølness
interest" means a buaineus, including a partneruhip, in
which the town officer or employee has eYen a partial
ownership of (or employment by) a corp.oration in which
the town of [leer or e~ployee ovn9 ~ore than 5% of the
shares. ~
TBS NO V
..
".~. ..
If you anevered ·YBS,~. co.pluta the balance of this for. and
date aod sign vhere indicated.
Name of person employsd by bhe Town of Soubhold
Title or position DC that person
osscribe the ralatlonship between yourself (bhe applicant)
and the town officer ør employee. Either check the
appropriate lIne ~) through D) and/or describe in the space
prov~ed.
The town offlcsr or smployee or hia or her spouss, sibling.
_B)
or chlld is (check all bhat apply).
the ovne~ of greater than 5% of the shared of the
corporate stock of the applicant (when the applicant·
18 a corporation), '
the lagal or benaficial owner of any inberest in a
noncorporate'entity (when the applicant is not a .
corporation),
an officer, dttector, p~rtner, or employee of the
applicant, or
the ~µtual applicant.
parent,
_A)
_C)
_pI
....
'.~~:' ~ .
. ..
""('
~ . .
..,...'.
¡."
.' ~:.!~:'
, ..... ~. ..
DESCRIPTION OF nELATIONSIIIP
. ~
;:;.....,.. .,,"" .,'~!..
~·,,~!·:.:..~rJ..,;.
sublnit.ted
.' '" .: ,:' .-:;.' ,--:.', ····.:;\{~:t:
'Print: hahle :' ,...' . ,. .. ,~'tj"·
. "'.'. ,'. .'~~~"'~'~'f""·,"..'·'~:·'·.:\: I.
. '.' Ll\:~~';~I·t,;: .!If"..;!. ·l!;.Í!~ ~,'.~~~ý,);:i.. ",' ':~ :.-'.
.... ,,0 ~" ·.v. ,., ·01", '" -,\0.:.' ~
(;\
!~1!~/~~~3 1~:2G
E31~77eS73
FAIRWEATHER 3RQWN
.
PAGE ~2
.
IIP."I!!A""
"UIISAI:'rIONAL 018_U.. rOlUl
.
..
aD _ I. d
·Sc~w.\u..-¡+ ~.,~,,~I?~~'.. ~lvd15~:{~~
(La.' n.... rlr.~ "...1 .ldd~. lnl·~~¡;·UnlJ.. . ~
you .r. arP1Yinv In ~h. .... Dr ...eone el.. D~
q'~.~ en' ky. .~çh ,. . CQMP.øy. If eo. Indle.~.
~h. ob~.r ..raGÞ·. or co.pan,'. ft....J
"ATUII8 O' A'~~I~"IDlh (Cheek all tho t .ppl;~»·· ,,;;~!;:,,~...¡.¡,;.:.....
TUUR "IUUII
,... ,d,..."Q.
Y.ri..c.
Ch.n.. 01 .If'"
A~P~....1 01 .1.. _ .
....pt.... rroe pitt or vIr .lale! .up
n~:Ot"or,' ft... th ."thhy, (nk1ílL.FJ'IS,ð¡) Ar'I"Y,;t
..
.. I'D" ...._..11,. (.E" .....a.gllt ,.... ......"r.' .....-,. .1...U....
"cell'. Or' ahl.1d, h..... . .relatio""llp .1t.. .... ore-Ia.,. 4,'t1t'
..p.lO'_ OIl ..... 'I'cnf_ .. .0.'....1d., -"e1at1.",'I1.- 1.011&4..
br Itla04, _rei.... OlE' bU.ln... 1.'.C'..'. ·....t....
Ift~r..'- ..-ft. . be.I..... inal..1., _ ..~t..~hip, 1_
.hick ,~. to.. otCieer or ..,lOr" h.. ey.. . partial
.lIfter.hip of CalE" _.J.G,._at. It,) a cot'pCIraãloa ia wklct1
'h~ to.. orrlear uc ..~l07.. Dwn. ..t. ~~.. ~. ø~ t~
...."'.. ..
TO
.~
~
. "L{'_
JI 70U en...,." ·.13,·. co.pl.t. khe ,.1..0.'., '~i. lar. .a.
..'e ... .1.. _bece ift.Lo~t.ø.
"a.. af par.on .~pl01.ð b, ~h. Town or Southolð
~itl. or pOllt!Dn or .h.b pl~.on
b..crlb. the reLatlDnah1þ b.tw... taur..lt (the appllca.'.
and 'h. ~Q.. o'rLc.~ .r ..pIOr... litheIE' ch.ck th.
approprt.t. l1n. kJ throuOh p) .n'/or d..orL~. In bhe .p.a.
provided. .
- ' . '..
The ~own oft Ieee or ..pl0Y.. a~ bl. or har .pau.., .1~11~.,
parent. or child 1. lCheek a11 that .pplr)¡
A) ,.. o...~ 01 ør..~.r t~.n 5_ of th. .h.~.. Dr the
----- eorpora~. .'Q~k ar the .ppl1c.n~ (whe. tha .pþll~ant
I_ I Qorpor.'LanJ, .
______a) th. 1...1 ar ~_n.tlclaL owner of .h, inter..t in I
nonce~.are..·."~I~, (v~.n kh. a,,11c_nt I_ no~ a
co,......U,on), "
_____C) ,ft orrlc.r. dl~.ckoE, ..r'~.r, or ..plot.. of 'h_
.ppLle."b. or
______V, ,~ ~~'..1 .ppllcan..
,..
"
'.'cl<.<
Þløel¡rtJOH O. .CLA"I'lotII..I1P
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,.
..
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81/12/2004 18:03
5314770973
.
FAIRWEATHER BROWN
.
FAIRWEATHlR-BROWN
DESIGN ASSOCIATES.INC.
P.O. DO:l 521
413 MaiD Streel
GroeDporl, N.Y. 11944
631.477.9751 (fax) 631-477-0973
Dale:January U, 2004
AdjoiDÎDg lots 10: 1000-11-1-1.3
Name: ReedJSebubert
Addre..: 815 RoteDburg Rd (Fire Rd 113) Ea.1 M.rioD
SCTM: 11-1-13.2
Henry Viscardi Jr.
305 Steamboat Road
Kings Point, NY 11024
SCTM: 21-1-2
Michael Schubert
Not mailed - same owner
SCTM:: 21-1-3
Raymond Grace
5795 Rocky Point Rd
East Marion, NY 11939
(645 Rosenburg Rd)
(935 Roseuburg Rd)
(280 Rosenburg Rd)
PAGE 01
~1/12!2004 18:03
5314770973
.
FAIRWEATHER BROWN
.
PAGE 02
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
Address:
STATE OF NEW YORK
COUNTY OF SUFFOLK
/)_..~~I residing at 311 J ~ ~.
-!'"ë~ : bein';!ulY swom, deposes and says that on the
/ j, >L- day of ~!:Y:1 ' 200 deponent mailed a true copy of the Notice
set forth in the Board of Trusties Application, directed to each of the above named
persons at the addresses set opposite there respective names; that Ihe addresses set
opposite the names of said persons are the address of said persons as shown on the current
assessment r of the Town lIj Southold; that said Notices were mailed at the United States Posl
Offi t . tJ-Y r fl ,that said Notices were mailed to each of said persons by
certified 'ste mail'~ l~
i....../
~
before me this I j, .¡z,
20~
JOVCE A. STEVENS
NOTARY PUBLIC. STATE OF NEW YORK
NO. 4875122
QUALIFIED I'" SUFfOLK COUNTY
COMMISSION EXPIRES NOVEMBER a. 2Dob
,
81/12/2004 18:03 5314770~73
.......,.....l::"il Service
CERTIFIED MAIL RECEIPT
iDoo" I.!::.r/f..- ~',j" Only; No In$llranc_c Cov'-'ray..: PIOl"d~d)
~ L r~AT 1It~~. N~ 110'4
U1
U1
-"
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,.,.,
c::!
c::!
CJ
C
....,
U1
ru
POlSlage . 0.37 UNIT IP: 09/ 4
CtII"Ilfletl FÍ'II 2.30
PO,5IFT'ÃI'II
Return R~l,tIt Fee 1.75 "...
ndOl'sen-n' A"':¡ulf6d)
RII$lnCh!ICI DellvcwyFea Clerk: KTY4C4
noorsS1I9f,1 R.qulRld¡
Tot.., PO.lag. &. F... $ 4.42 01112/04
..
,E
S.~'TDU~~
... .. ..........u.........u.. ..........u...........;i!i:.u h.........u.
Sl"Wr,A.pt,Nø; 3 .- , . ~
"'PC Br;;"No ()~ ...,~
... un_' -. n_. U'.. nn. __ n. u.. n. __.. un _'.. un 'n. un... n_..._ _. __n.... .........__
C'!.y. SUJI.. ZIP..." '/ p,;: ~
....,
r::;¡
<=>
.....
FA I R'¡' EA THER BROWN
-.
PAGE 03
.---
U S Postal Service
c'EFmFIED MAIL RECEIPT
¡DO/flt:SfIC M.'IlI Ooly: Nu /I·.lJr.~f1r::t: COV(.fJ!J1:: pr.)Ylded)
=r
fTl
.,...
.,...
EAST IiARIOH, NY 1 ~
U1
U1
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N
P<>~lage
0.37
UNIT IU; 0'144
Cerhll~d Fo:oe
2.JO
1.75
f'oSlrr,,yK
"'Æ
Rl!lb.lrn ReG Jjpl FM
IEndor=mllnl ReQulredl
Fla¡;.\nctad Del'Y8ry Fe6
¡EndOfselT"olfOt Requored}
,.,.,
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Clerk: KTT4C4
01/12104
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....,
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Tlltgl ÞQ_r..g.ao &. F..II $
4.42
....,
o
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81U)!2Q~4 ..18:_03_ ___5314770973
1'/l'/'~B3 18:26 6ji~7~
FA I R'NEA THER BROWN
. '.:..::a---
FArRloEA TI£R ""--w'
~AG¡: 0~
PAGE 82
IIP,"U!"'"
'D...."nz_~ Dr_a. raatI
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ø.... 01 .....
ADPt,.,¡ .t .L.. _____
.....,u... r.... ,LIt: ar ..rril;'~.1 ..,
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1...f.... ...ft. . ......... 1..1..... . ..~t,,"-I.. t.
..18_ ,~. &0.. .tILa.. ~ ...&.,.. ~.. .... · ..~'&.I
......r.hlp or 1.1f _,1.,_.. .,J . _..,rlltJ_ t. ."Iah
"be .... en:1.. Oil' ...lD,... ...". _... kb_ !II ", ...
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D..crl_. &h. ,eL.'i.n.~l' ..,.... t.u~.ear r'ft- a.ptle..tÞ
... ,.. te.. .IfLd.r .r "p10'..' .~th.E v~Dk ~..
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11'...,1... .
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Tne &own .frl~~ or ..,loto. .r _I. .r har ....... .1~11R"
,.,IRa. .~ eh11t 1. (e_.c_ .1L '~k ..~lr)'
a. ... 0.... .f .r..ker ,_.R 5. .r ,~ .h.,., .r t~.
----- c.r,.r.~. ...ø_ er c.. a,piJa.ft' (w~.. ,~ eþþl1ø..L
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_____a) l~ 1...1 .r '.nerlvlal ..Re~ 01 .., j~~.r..~ In a
,,",aoE.-r.'. ......" (..."..,. ..... ...Ltcr..... 1_ ..e' - .
co.........S.."I, .-
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01/12/2004 18:03
5314770973
.
FAIRWEATHER BROWN
ArPLt~ANT 4IÞ
T~ANSACTIONAL PISCLOSURI FonM
PAGE 04
¡'. Tow ot 0 old'. Cod of Ibhice con lic~s
nt.c..~ on ~he Dart of town Off cars and emD oyee.. TIe
ur ose of s forM is to ro.lde for abion which can
ale t khe town 0 OIG Þle II C 8 of nt.~.øt and 8110w
i~ to ~ak8 v at.vur act Q 11.causar ~o aYO d øaMe.
I ¡....ø,. ;" "¡''''~iì'õ.. \
. r..~~~ ~J..'\i'~-"'-"·
l
TOUR NIIKI.
'.'
n... r ret na.., m !ø
you are .pp1r1ng in ~h8 ".~. of .0..on8 .1.. or
Qt.her .ntit.y. Bueh ".. I cOlllpany. If '0, 1"die.te
the oth.~ per.on·. O~ company'. n....)
." 1.1:.'
KATORI O. APPLIeATION. lCheck all ~hat .pplY,)
... ·x.... .. . ,.<" ...~.
. "';'~"'~.'::"'\"''!''"ft'I'''''.
;.
Tax orl.vano.
vadanc.
chan9. of sone
^p'p~~al of plab _____
Sx..p~ion froa ~lst or of~ola1 map
othn ~Ê~.&'" ~
(It .oth.r,· na.. . act vi~Y.)
Dø :FOUl p.l[".ona11.r (or k.hE'OUlgh J'our Cb.p."'" .po...., Bibl!",_
p.r.nt., ot ehl1d1) )I_VB . ~e1a.~ionllhl.p ,,1~" anr afrla_r' or;'
e..ploye. Df t.lts Town ot Soul:ho.ld7 -t:telatlon8h1p'" 1nc.1udes
by blOod. ..rr1.g.. or buølneø. latere.~. -Du.ln...
lnt.r..t" ..ane . b....ln.... including a part.nership. In
.hlch ~h. ~ovn officer or ..plol.. has .~.n a pBrt181
owne~.hlp of (or emplor_.ent by) . cOII'"P.oratløn in whlc:h
the town of[lce~ O~ .~plol.. ovnD more ~haft 5$ øf the
.har... /
TIS NO
..~
".-A'"
It YOg .n...~.d .~.9.~. øo.pløte ~h. batance øf ~hl. !o~. and
date .~d .1gn .here lndla.ted.
...... "t p.uon elftploy.d by ~he T"Wn of Sou~h"ld
Ti~le or po.i~ion "t that person
D..crl". tn. relatl"nsnip betv..n your.e1f (th. app1ic.nt)
anð the town o(~lc.r ~r employee. El~h.r check the
appropriate l1ne A) ~hrouOh þ) and/or d..erlbe 1n ~hA .pace
pr-ov:Lded.
-
Th. t"wn oftioer or employ.e ~r hi. Dr her .pou..i albling.
parent, or child i. lch.ck all ~hat applY)'
_____A) the owner ot gr.8~Ðr than 5~ of the ehare. of the
co~pora~e 8to~k or the .ppllc~nt (whRn ~h. .ppli~.ht·
1. . corpo~.tion), '
_____8) the 1.ga1 or beneficial owner ot any in~er..t in ·
noncorpor.~з.ntlty (vh8n ~h. .ppLLc.n~ 1. not a
øorpor.tion),
_____C) an orfic.r. director. plr~~.r, "r ~~þlÞY.. ot ~h.
.pplicantl Dr
~þ) kh. ~øtu.l .þpl1cBnb.
:"'
.. )':~;'..'
. ..
;.\
DßBCRIPTIOH or RBI.IITIDNSJlIP
I·'·
;,c~.t~:·
".
,'.
-
. ,.
:;;:;,.,~..··iI,.
. ".Jf.~ r\·
~ ~"".':~_.' ..
..
:G:~V
sublni'::ted
.' ,','
·prln~ nlm.
....,.... .,..' .~.. ····'~.L·.'
t.:,·l':!~·;~'1t-.~. . ·_.w· 9lI" ·:':.f,,' _
...'.... ,....... ..r..:
Dec 12 03 07:508 MIchael
12/11/2aa3 14:32 G4IIÞ70973
\718889898
FAIRWEATHER ~
,..1
PAGE 02
AtJTHORlZATION
(where appliclDt is nOIIh" o....er)
~~ :c~\ ~ ~.Oë~ ~
1,
if-AJ d~
4>
Sc-b~ ~ íAA"jS'-
6veJrfld.-<-øJo , ¢J I ( 2.0 J
residiD¡ at
S"~(""~I
(mailing .)
do hereby authorize Amv K Marlin, or other of
F.n_tiler-Brow. DeaI&a Auoda_, IlIe.
to act as my ageal to apply for aU permits necessuy for the proposed work to b.
perfonned 81 ~I';- ñ'v-e G>o...{ -:ff:- "3 , W ~¿,.,. JJ..f
I
I [ '1 3 "!
~ ~~~~
~~ D~C ~ :W"[ ~
Dpc 15 03 IO:35a
',il,/2ijÐ3 18:26
Southold Town
Board of Trustees
MIChai!!'l
.46.4770973
1718889898
F.IRWEATHER~
111""11:&117
naHSAc:'I'lOHAL DI8CLOSual roM
F. I
FAGE: 02
The a
.
.
f
t
YOUR RIIIIII.
~I_"'" ;~~;~,.::"'t""\õ.·.1ff/"~'IÍ;
(Ch.e. .Il th.b opplW.)
or... O'ti...hO'.
Yari..c.
ch..... 01 .on.
ARP~"'U .r pl.' _ .
..,iHiIpUo. rr.. p1.t: or øtUcia.1 ..p IJ
n~~Clt:hor,' ft... ~h. oeU.ltw, C ,ild1!-L. £R0'5;ril """.,¡..
.to
Do 1"0" ..~..I.IJ' COe' .hraa.1t ,.... ........1' ........, .1..11....
..~,. Dt" aIlU..) h.". . .relatla...laip _11th .... ..tlo.,.. vol"
..p~D'" ~ 'he TDwD oW .d.t~1.' -..a.'lan.hlt- 1.o104e. .
br blood. ..r~l..., O~ bu.1n... 1...~e... .... ....
later..'- ..-ft. . be.I...., tna1..1.. _ v-~t..~ip, 1_
.hlrh '~e ~GWft ot~i~r 0« ..,10'" ... .v.. _ ,.rtlal
."ner.b.p of (Dr _p.1ar__t. It, J . I!OI'pGC'atdOll i. _hleh
tho ta.. o~rl~c O~ e.~lor.. own. ..~. t~.. s. a~ .~.
.h·.r.. ..
....-
~
.~
. .~..', h
If :rOIl .n......... ara,-. ~..L.I:. kh. b~1....·.t 'hi. fam ...
..k. .Dd .1.. wh.ce iftdløaLed.
"... Gf p.r.on eMplot_ð bt ~h. Town of Sautholf
~ttle or .~.I~ID" of 'h.~ par.on
b..crib. ~be relation.hip b.tw... Tour..lt r~ft. appliea...
and 'h. to.. uffLcer ar ..Plor... Ilth.~ ch.ck ~b.
aDproprtata 11n. ~J throuvh DI aad/or d..or'~. jft the apac.
prov~a..
The town offlee~ or ..plOy.. ør bl. or har epo...' .1~L'~"
parent, or child 1. (cneek alL that .pplr),
A) the OWft.~ 01 gr..tar tban S. ar the .har.. or the
- corpol'at.. .toak of th. app1!c.nb ("h.. ..... apþl1.,ant·
Ie a oorpor.'1on). .
______I) th. 1,,'1 or ~_n.ri~1.1 owner ot aft' inter..t in .
ftonc.r.gr.'.'."~I~, (w~.n the a,.11aen' 1. no~ a
eor~rationl, '
______C) .n orrlc.r, dlt~'o~, ..ct~.r, dr ..pIOt.. of the
appUcant, Dr
_____ÐI tbe ~c'..l .pp~ican'.
...
:'~'. ~~.
OlscaJrrlOH Of' RCL~"IDH.II'
,.J.....
,.; -:;.~:
,. .~_. ...
" ..
.. _.~
'.. -.
'Prln.~ hit..
.:;~.~~ .
"'~'.N:.)''fì. _. ." .
~,-clk.J- .