HomeMy WebLinkAboutTR-5564
Board Of Southold . Town Trustees
SOUTH OLD, NEW YORK
PERMIT NO. ..~.s¡ r¡, DATE: ...M.iiy22,...2.Q.02
U ANTHONY lit LOUISE GAMBINO
ISS ED TO .......mumummu...U.C.u.....u..· .... ....m..··m. ....
Autl1nrii!uttnn
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York. 1893: and Chapter 404 of the LaW$ of the
State of New York 1952: and the Southold Town OrdinarK:e 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 W A TERS:!~; and in accordance with the
Resolution of The BOard adopted at a meeting held on u·May··ZZ·;u.,
. 2002., and in consideration of the sum of $...m..lI}O·;OO· paid by
.. ..Anth<>ny....&..Louíse...Ciamb'incf..... ...........u.umu...u.u...uu......u.um...u....
of um..E.ª:>.LMariorr. .... ... .... ... N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the fo80wing:
Wetland Per~it con~truct second story addition on house
(bedroom) --:rlth the stipulation that there be a staked row of
" haybales prIor to construction with the addition of gutters for
roof-~.ÙJl-off a" well as rJrvu.woll"\ed· ., d .
aR In accoraarK:e wlTn 'Tne 'C1lmI1 specifications as presente 1ft
the originating application. .
IN WITNESS WHEREOF, The said Boðrd of Trustees h.ere-
by CðUseS. its Corporat~ S~al to be a~xed, and these P!'esents to
be subscribed by a malorlty of the said Board as of this date.
Tnui...
TERMS and CONDmONS
The Pennittee
... "),. .. .c
~. ~: ~ .:./.~..
Anthnny Ri':T-Q'1Ï~9 GalTi13iR8
residiøg It 1705 Truman;'s Pªth.~ ¡<;.as~ .~arion N. Y., as
put of the coasideradoo for ahe m,........ of the Permit does uØ<'.... ......1 IIØd prescribe to the foI·
1owiø8 :
1. Th.r the said Boud of Trustees IIØd the Town of SoI>tIu>Id are released £tom Uf IIØd
all damages, oc claims foe damages, of AÚØ arlsiag dù:ecd.y oc iacIireo:dy .. · ~ of Uf o¡ø-
adoo pedomaecl p;nuaat to chis pcøaIt. IIØd the said 1'0-- "'4... will, It his or '- owu. ex¡..ø~.
defend Uf aDd all IIiCb 1Ui1l' ¡..ItI.-I b1 thUd puda, IIØd the said.....· I. (,.40 .......... fuI1 JiabIBt.T
with reSpect thereto, to the ~ .....a...w. of the e-d of TmsUet of the Towu. of s...c' !Id
2. That Ibis Pe1mit is· YaIid for . period of 24 mos. wbkh is ...cITtlI~~ to be the
ectI-'ed åme aequited 10 -Tete the wodc In"fOhed, butiboald ~"""" waaaar, request
for an exœasloo may be made to the Boud at . later due.
3. That this Permit sboold be retaIned indeCanitely, or .. loog .. the said Permiuee wishes
to m.i....;n the $UUCtUU or project Involved, to provide evidenœ to uyooe .....œroed chot auth-
orization was origiøally obtaIoed.
4. That the worlcimol.ed will be subject to the ~ IIØd appron1 of the Board or
iu apes, IIØd IlOI1-OIX"I'li.""" with. the ptovisioøs of the "';gi-,;"g applicadoa. may be cause for
revocadon of Ibis Permit by rosoIudoo of the said Board.
5. That !here will be no Ulltftsoþ.ble Interfereoœ with aa~ .. . ~ of the wod:
hetein auèhorized. .
6. That there shall be DO Interfereoœ with the right of the pab1Jc 10 pass IIØd repass aloøg
the beach between high and low water marks.
7. That if future operadoas of the Town of SouchoId rec¡aIre the ~ aødloc akendoøs
In the 1ocatioa of the wodc berda ..'" ..M~. or if, In the opiaIoo. of the Board of Tmscees, the.
wOIk shan cause unreasoa.ble obsttucUOG to free aavigadoo, the said p..-i- will be rec¡aIred.
apoa _ aoàœ, to remove or alter chis work or project bere1n staled wiIbouc -t.eI'I(' to the Towu.
of Souahold.
8. Tbar the said Board will be notified b1 the Permittee 01 the <00 'l"':don· of the work auth-
orized.
9. That ahe Permittee will obtain all ocher peanits IIØd c:oa.<eøto dJat may be required lOp-
p1emental to Ibis permit which may be subject to reooIœ upon failure to obaIn ame.
:.
FROM : JENNIFER B GOULD
~ FAX NO. :631-477-2601
~
JENNIFER B. GOULD
Attom,y at Law
., 13 2002 10:S9AM Pi
210 Mi\in 5trc~t . P.O. Box I?? . Crr!enport', New York: 11944
T~lcphQnc 631·477·8607 . Fas (,;¡ 1-477.',fi01
February 13, 20{)2
Soulhold Town TrusteeS
PO Box 1179
Soulhold, NY 11971
RE: Anthony Gambino
Premises: 1705 Truman's Path, East Marion, NY
SCTM # 1000-31-13-5
Dear Town Trustees:
Please be udvised that J represent Anthony and Louise Gambino, Evidently, they have
misplaced or never received copies of the Trustee permit and resolution that were issued
in Muy 2002 authorizing ¡¡n addition to their single family dwelling at thc ubove
prcmises. Kindly send me copies of the Trustee permit and resolution,
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
".
May 30, 2002
Crowley Marine Construction
c/o Susan E. Long Permits
PO Box 46
East Marion, NY 11934-0046
RE: SCTM#31-13-5
Anthony & Louise Gambino
1705 Truman's Path, East Marion, NY
Dear Ms, Long:
The following action as taken by the Board of Town Trustees during a Regular Meeting, held on
May 22, 2002, regarding the above matter.
WHEREAS, Susan E. Long Permits on behalf of Anthony & Louise Gambino applied to
the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the
Town of South old, application dated April 29, 2002
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
May 22, 2002 at which time all interested persons were given an opportunity to be heard, and,
WHEREAS, the Board members have personally viewed and are familiar with the premises in
question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold
Town Code.
WHEREAS, the Board has determined that the project as proposed will not affect the health,
..
2
..
safety and general welfare ofthe people of the town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approved the application of Anthony & Louise
Gambino for a Wetland Permit to construct second story addition on house (bedroom)
With the stipulation that there be a staked row of haybales prior to construction with the addition
of gutters for roof - run off - as well as drywells,
-.
BE IT FURTHER RESOLVED that this detennination should not be considered a detennination
made for any other Department or Agency, which may also have an application pending for the
same or similar project.
Fee must be paid, if applicable and pennit issued within six months of the date of this
notification.
If inspections are required, at a fee of$5,OO per inspection (See attached schedule),
FEES: None
Very truly yours,
a!/. t.-I (J /..1 ¡) C.
/, /Q...ï~·-vÞ~ P
Albert J, Krupski, Jr.
President, Board of Trustees
AJK/cjc
cc DEC
Building Department
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
- ,
COASTAL EROSION MANAGEMENT PERMIT
Permit Number: 5564
Date: May 29, 2002
Name of Applicant! Agent: Crowley Construction - Susan E, Long Permits
Name of Permittee: Anthony & Louise Gambino
Address of Permittee: 1705 Truman's Path
East Marion, NY
Description of Activity: Construct second story addition on house (bedroom) with the stipulation
that there be a staked row ofhaybales prior to construction with the addiion of gutters for roof-
run off as well as drywells,
Date of Permit Issuance: May 22,2002
This permit is valid for a period of two years ITom the dates of issuance,
SPECIAL CONDITIONS:
------Bluffrestoration through a re-vegetation agreement is a necessary special condition of this
permit.
_A relocation agreement is attached hereto and is a necessary special condition to this permit.
_A maintenance agreement as attached with application and is a necessary special condition
ofthis permit.
~ ç /4.-(~~ 9,
Albert J, Krupski, Ir.
President, Board of Trustees
AJK:cjc
.
.
Telephone
(631) 765-1892
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971
. SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town ConserVation Advisory Council held Monday, May
20, 2002, the following recommendation was made:
Moved by Drew Dillingham, seconded by Jason Petrucci, it was
RESOLVED t~ reco~m~nd to the Southold Town Board ofTrustees ~~~:AL of the
Wetland Permit Application of ANTHONY L. & LOUISE GAMBINO fM tt iii
second-story addition onto the ctI_ ,"~",.... . '.:'''' "':":"i'~ ;' .'.
Located: 1705 Truman's Path, East Marion, SCTM#31-13~5
Vote of Council: Ayes: All
Motion Carried
APPL.ICANT:
ANTttON~ L.. GAMl,INÖ
1705 T~iJMIH'¡S ?ATH
I"ASí HARloN I N'ý 11'13'1
LAN!>
seTH;; IOOO..!J/-/3..- t
.
.
-
(
25 RlbHT
,
TRV MftN 5
o P vJl\~
'PAT H
~R.£rA!l..E..D BY:
SUSAN. E.. LDN~
Po.ßox "It-,
E.AsT MAl<lc.N . NY ¡ q3q
G.31 477-3'/55
~
s
5 ()O ,.
-
-.:.
Z>:J..
;¡!,
<.~
....,
-..1_
""rr¡
I'<J,
"- Q
Q <J
:::
Q'f:/¡
¿<:
...JI-
·u
Vi
()
~
«5 It¡
~'
~
<tJ
-
1/-1\')
0'
/Q§
ét/1
/
I
,
/ ~<:
')'~
...
<;;¡'
/f~.>
, lJ..'" ~
o~
q,~,g:-
tf
~fU1'6.s~l:I :
CðN5TRII<:T .:I.Nb
srbp.,/ f\t>D 1T'lbN o~
"OUSE..
[jj
N
$r~ps......-fj
.... SEi ~JLS 3/2"5/&6.
.---
---
--- --.
Tie
w/'o1 E. i-<..
L../NC
MAR.""
ORD't-{Aq.ty
H'~¡.¡
,
/
I{ {
SCI·d..i:..~ l -= 3D
Gp...Q.DINERS
BAY
SHEfr [ of I
APPLj CANT',
ANittoN'j L. GAMl>INO
1705 T!,<úMJ\NS ?ATH
IOAST HARloN I N'{ 11'16'1
~ANb
-
I
25 Rlt;I-IT
.
TRV MftN:5
PR.EPAR.ED BY'
, .
-SUS AN. E.. LONG.
Po,BoX "its.
E.Así MAI1.I~N . NY JiBq
cA3l 477-J'I55
<'>J..
ir/¡
-.l ì
-...J,
"''''1
"<i,
t<. <)
Q~
....
<:1'f/;
.f~
.,J ¡..
·u
v¡
PRb1'65ED:
CóNSTRIIC.T .:lND
Sí6p..\I ADD IrlbN ON
HouSE..
7Jj
seT/I{ # 1000.,3/-/3..-/
-
-
o P WI\'l
PATH
!'YO,
.-..
--
()
~
Q31¡J
~IV)
~7
-
[c.1\'
.Q /
c.z8
~o
. 5i
I .;r
. /
/
~';
v....
..... ....
~,
u-
"1
~l
()
Q'
>'11:
-.i'~
-.II-
ò{
~?:
~<?
...
<;)'0,
fI1~.> ~ II(
fJ..'tJ'II;'
0':>'"
. .f-'.g:
tf
$n~ps......-L1
, SET """LoS '3i2'5/tJó.
.---
---
--- ---.
ORD' "'Aciv "'C;;H
~Tle
wI' ~ . K.
I...INt.~
/
/
G¡....QDINER.S
BAY
/ý
MAR.\<.
If I
SCf\ \...i:..~ I -= 30
SHEt:r l 01" I
.. ~>.~"~>
~;;;,-_.._..~~'-~-
,;,"'~~\\FFOL.t -~
:/S:;.C'(2."'-;..
.r~ ~_'"
.-'''''-: .~';:'J,
~' ::) -...c:. ~,
..0 . '"
Ä '" :e I)'
~ 'õ .z: ii
, . ",.'
" -" '- ,.
~.~ ~,<",
~,,:Z°.{ +~~v,;y
~-~.,.,>L
f·~. '_.fj.:okI P:',:_~,~J'-'nt
. '. - L_.-.~ \ 1-:,:·Pre:'l,jt'r¡l
¡.' . ~T, ~L
.. ., <:" F~, ~ I.,J
I':. . P_I... _,'::.!
.
.
T,.!\'.n ILII
5309:5 RUlll¿. -.::'
PO 8ùx 117.¿¡
Southuld. t\'.::.o,,\ Ì'Jf. 110-:-1·'~1:<'
TL' ephJrh- It.3·~ll -', ~.~~.I_
Fd.'>: l~j311 -:r)~, l1ul
BOARD OF TOWN TRUSTEES
j ,y,I'N OF SlJL'THOlD
ORIGINAL
-- --------~-------
Office Use Only
/
tI C'J,131 Erù51()n Pel mil "-pplicaliyn
~ Ilòll:illJ Permll "-!,pllCdll,'" L_ ~1aJùr
_ II .il'o er .-\mendme!1} han~es /
Recel '. eJ ."-pplicauon If ~ 0 "V'
~~Recel't'd Fee $ ,251r-: _
. _ C.'~lr:e[cd .-\ppllcatlùn..t.J:-/~, /0 ~
I n'~'L":ììp l('ft' .____.______ __ _ ~__ !____ __
. '[(,IR-\ Clà551lic,1Ilùn
[,~è 1.__ T\pe 11._L'nli'led.._~
-- ___l·~.!O_"r.J.llldrI0n (datt senlt~-} . .
i.' ·\l- RC:èrr,ll SCnI '1 ~1¡;V
~~ U.~!ç: ~,! [n:-~"è'-.!lLìn ~~--- irLêi~~_
_. P.e':CIf"¡ :,I'C\C Repl'l1 __,..____,_
Le},j -\'....:(n...:\ Dêtèrmlna.¡l\.ìfl
--
1 " ,III I: I I Re, I e\\ ;;:¡;::;t:--/
- :~~~'I~I\Cr~r,n~ Held.~i-.~
--~-~--'--'--
______u __ _, ___
\.1 r~', ~'. '-~,:.
·\:'I'II(,1nl A"'\~. L. 'f-
1~_:'OlJí H V I ~ eMIT J
~ ' ,
n__ _ __________
F'hùnè :\;umber I
--~-----
f..lInor
r; -
'I " : --;=)
:, ,., r~ :1
¡,._:-..__!__,L,
¡ ¡
tI I'J .2 U'.WWI'J
",,1/ v LUI.I(.
.....:"'\\-:;~ ""':" - ~
It} " J O!: ""'!'" C·" '.
~":d i '-~-_~6._ ~ ,~, 'J '
---=----.....:::. ~
,-
I..O\)I~E: (;At-\..Blt-JÖ
C.ARL.e.. f'l-Å~š--'}\¡-i-_JIS!t
I _.5) ~ 3.3.~ ... u.-º1';;¡"s:.
., " I, '.1.:','.. 1.[\ ,\1,,", \;ulnl'-cl IUI,)') - ..3L-:...13:-_£ .._
I
[- : "I', I ,:,11 ,·:n _.L2Þ5"__-r.~U MJI¡ tiS-. PA-í tI
--- -._-- - --.
-- --------_.---
. _u _ß..ft51 'vI A:.1'S.Hì-H~+- I-! ~ (1 .3 '7
C':. ,~c I.Il.CO Pole ". dislance 10 cross Slfee s, and location)
::ìl\ '. -lu~.s::..RDl-OL-E..-J_...c..oM' :SUSMJ e... L~ßIèHi'
:·'I",It,1 't>,O. 130~ If-fp J
¡ \Q
c.":: ':,' .t:PrS1:_.HARlDl-L.. t---H}--J.l3 3_'L...._C2. 0_ t.JCe.__ ,_ __ _ " . ~ j\ \\
. . - _'u.. Pltonl (ç3L-:- 477 - 34 S-$"::it V'¿ \'
I~
:I)
·.
Board of
..
Trustees Application
WETLANDrrRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
5F='(,()~ h
5 'HJ K' \( l'i\Ë...1'\ £0 D H
1
Area of wetlands on lot:
¡i.¡fA
I
AI{A-
I
sq uare feet
Percent coverage of lot:
%
Closest distance between nearest existing structure and upland
edge of wetlands: /<J r.4 feet· r=.. "f.Isn N (; 50 L-l<. \-t ~AÞ
Closest distance between nearest proposed structure and upland
edge of wetlands: N(t't feet
Does th~ject involve excavation or filling?
/ No Yes
[fyes, how much material will be excavated?~cubic yards
How much material will be filled?
N(A
cubic yards
Depth of which material will be removed or depo~ited: N(A
Proposed slope throughout the area of operations: - 0 _
feet
------r--
\ ¡' r;-'
" ¡:~ ) ,
1;· --__.
Manner in which material will be removed or deposited:
'.¡ AIV>.
. c -!c. IIr'T{ L
;
r,
"r..
\J"L,6,~ I)
CntJ,-ST~UCTiOJl/ - ï'1M..ßFR ¥'I\-1'~:tfÁI.5
Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
}..,)D' ËFFEc..í Ot{ ¡:::N\JIROI\\J.II.t=:."-!"\
"
·.
Board of
..
Trustees Application
GENERAL DATA
Land Area (in square feet): Ib¡ DOO 1-
Area Zoning: ~EÇ !D~I-J TI Þrk uJf.-Ttst2.. FJ2.( to\ S( J6~ç F4MH-j
Previous use of property:
l?ES' þë: NC.E
µo CIf ANtG £.
Intended use of property:
Prior pennitslapprovals for site improvements:
Agency
d No KN.m'ù "-I
Date
_ No prior pennitslapprovals for site improvements.
Has any permit/approval ever been revoked or suspende;J. by a governmental agency?
~No_Yes
If yes, provide explanation:
1{A
Project Description (use attachments ifneCeSSary)::m-;-;:-:-r-;'
I"ì ~ I' !L' '.
C.olot.sT~U('T S~C.6N..D 5T'ÒR' :I.,,"'ADDIT ION
. ~--- úu; MlifTg-1ûOL'
TGlfl Q;- Si)J} ;..:: ¡ l
I
·.
..
Board of Trustees Application
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity: .s S-CO ~ 1) S\Õ R'f "'1)1) (T Jf) tf
e 'BE.1YRDötv\)
Are wetlands present within 100 feet of the proposed activity?
No /Yes""
Does the project involve excavation or filling?
/NO
Yes
If Yes, how much material will be excavated? -0- (cubic yards)
How much material will be filled?
-0 -
(cubic yards)
Manner in which material will be removed or deposited:
Nf,A
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
trom implementation of the project as proposed. (Use attachments if necessary)
ND
--c ~ PAC' I
IÜ
E. jJ lit RD IJ Me:. NT '
D'f'l.ANb
c..DN 5TRÙ rTI () N .
I' 1 ,.
i I
Ii, ~ Z ~ 2002
f'··- ,
,
. ....,,':., .~ Oi ~(~.-~!- . ~
.IL,~,J ;...,:-, :-'~.;~
c~ .
PROOF OF MAIL' i OF NOTICE
ATTACH CERTU H..-, MAIL RE EIPTS
Name:
U,S. Post..1 S"'VICP
CERTIFIED MAIL RECEIPT
(DomestIc Mdll O:¡/}. Nt, IfI~{/r mi"f' C.)~'.'r 'ge Provided)
rn
ru
.-'I
..,
o,~
2,10
litH ID: 0'139
.-'I
U.S, Postal SP'VIC" ~
CERTIFIED MAIL :1::(1t~ r-
(Domestic Mall Of1J~. ,1''''fI,.'.rfilll''~er.J M
ru
I:J
I:J
1:1::(tf:::U~
Po~tm"rk
Here
~···'''''-'.I -¡.·~;"II:j~)
CIeri<: KzatIO
I:J
III:J
....II
I:J
"-
Total P'qsY¡
Name (Please rrnf Clearl}1 (to De complefed D~ mal/a~1
_ m:BR\)('E.m.R.C!.LL.MANmmnm....n.........
....... street'Rt. No.. or PO .~)( No.
g m~m.A.I:\G.£.:m.KÖ.êJLmmmnmnm.....
C: r- CISS"" ZIP.4 II q 7
2,1¡4
05115/02
J4
10
OOT ID: 09J9
2.10
PostmarK
Here
Total Postage & Fees $
2.44
Clerk: KzatIO
05115/02
I:J
I:J
....II
o Name (Please Pnnt Clearly) Ito De completed by mailerl
I:J ·~~1!I~ono;~g~oc;..Amm mnn .m ·:¡jò,in
~ ~~i¥P~~:i:;ì.tifm]>·()~~1;¡.~Lm nn
··.___n___·__n
_PAuL::. BAK.Ë . residing at
~ÞPOR\)
1\11=11) I.LJ?~ i::... , being duly sworn, deposes and says
that on !the ¡çof1\. day of MA~ ,U~, deponent
mailed a true copy of the Noticà set forth in the Board of
Trustees Application, directed to each of the above named
persons at the addresses set opposite there respective names¡
that the addresses set opposite the names of said persons are
the address of said persons as shown on the current assessment
roll of the Town of Southold¡ that said Notices were mailed at
the United States Post Office at , that
said Notices were mailed to each of said persons by (certified)
(registered) mail. Q~ g~
Sworn to before me this /<t\
day of i'AA.4 ,3.~ðL
\ -f _ ./
_~Å1~'rY ~Ubl~
SUSAN E, LONG
Notary Public, Stale of New York
No. 01 L04956343
Qualified in Suffolk County
Commission Expires November 6,;JI.QS
·
NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applicant:
1'I1-I'n'hNi l, CAMPlI N'D
SCTM#lOOO- 3(- I~ - S
YOU ARE HEREBY GIVEN NOTICE:
1, That it is the intention of the undersigned to request a
Permit from the Board of Trustees to:
C.ON5.íR.UC-T SE-C.D¡'¡b STO~'f !H:JI>IT/ðJlj
2, That the property which is the subject of Environmental
Review·~s located adjacent to your property and is described as
follows:
17D) T~ÚMAN\S 'PITTI-\
3, That the project which is subject to Environmental Review
under Chapters 32, 37, or 97 of the Town Code is open to pUblic
comment on:~ ~al~D~YOu may contact the Trustees Office at
765-1892 or in writing.
The above referenced proposal is under review of the Board of
Trustees of the Town of Southold and does not reference any
other agency that might have to review same proposal.
OWNERS NAME: A-NT¡.}ON'/. l. (.',A loA J! 'NO
MAILING ADDRESS: c.! () S\)~~"I I" 'ÿ"'/.Jr:. 'PE. <}ot rrs
PoRo,!, '-If., EA-ST' NA~( N m3'f-oO'/k
PHONE #: lOól- ~77-""'l./rç-
Enc,: Copy of sketch or plan Showing proposal for your
convenience.
I
s
APPLICANT:
ANTftON'I L. GAMbiNO
1705 TR\/ MIHIS ?ATH
!:ASí HARloN, N'{ 11'13'1
LAN!>
.
-
seTH #0 lDCð-,3/-/3..-/
.
I
2.5 RlC;/-\í
.
TRVMftN :5
o F- vJf\~
'PATH
PR,£I'AltE.D BY:
SUSAN LLDNG.
Po.Box "It..
EAST' MARIi:>N ,NY JiBq
1.3\ 477-J'/55
~
:¿-,¡..
¡,:,
,
-.I,
-.I,
;;ø~
~1
,
q'f/;
¿~ '
4 ~ rSt.D
Q
~
ti3''¡>
:r:/Y
~7
-
[¡,/Y
0'
Q8
<:',
5'ur
~
<.J
VI
?Rt>1'ð.5ED:
tONST R\JeT .:lND
$TOR\! ADD IrlbÑ ON
HoUSE..
,to'!'
[jJ
~<::
"r~
I-..
<;¡'
/!{~~
n'" ~
. Ó'.:>...
,,,<1;'<1:-
:..,.~
?
~
-II:"
s;r&pls......-!j
, SET NA.JI-S '3I2"5/tJó.
~
MARio<.
ORDII'/AQ.Y
wI' "{ E. ¡:<.,
1.../1'1 ~O
-
H ç.~
.---
---
--- -_.~
TIe.
f I
SC./\ \...E..~ l -= 30
t'
Gf-..QDINEQ5
BAY
S¡¡EET [ of I
.
-...
--
/ý
4IJar~f Trustees APPlicati4IÞ 4IÞ
County of Suffolk
State of New York
.5VSA ~ E.. l-D N C; 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 TOWN
TRUSTEES HARMLESS AND FREE FROM ~ 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. ~
~.MAM1/'£- __.
Signature
SWORN TO BEFORE ME THIS c:2-dl'l d DAY OF !1t<. ref¿ ~ dJ-ù?J?)
~~~~GJ
CLAIRE L GLEW
Notary Public, $t818 of New York
No. 01 GL4879505
Quolifled in Suffolk Co~ ')
Commission Expires Dec. 8.
7
..
..
"
AUTHORIZATION FORM
Date:
I /2'1 ID~
( r
!, AI-J'T\-!{)~Y L. ~RiNÒ owner of 170s ( e¡'¡/vIAAJ.S FJTH
(name). (street address)
located at EAST HltØoÞ:J , N. Y do hereby give :z:;;;jN CRCW~
(town & state) , (contractor)
and Susan E. Long the authority to act as agent on my behalf in applying for aU necessary
permits for work to be done on my propeny described above.
Signature
APR L ~ 2G~v