HomeMy WebLinkAboutTR-5793
Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. 5?93.. DATE:.A1,1gust2o..,2003
ISSUED TO......~~~~<:;~r-I!..·I3¡,:~C.J:Ic:;ONpOI.1~I'I~y~..w ..... .........
J\utqnrii!utintt
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 Ordinan<:e 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 accordan<:e with the
Resolution of The Böard adopted at a meeting held on ..~.":~.:... .?D..!..
20o.~.w..., and in consideration of the sum. of $...50.,..0..0........ paid by
Crescent Beach Condo!')inium .......w.w.........···..·w....w.........·...··
of ......w<:;~"".l:'p.()1."t.....w . N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town T rtntees authorizes and permits the following:
Wetland Permit to erect a 15'X 30'. pergola (sunscreen) on 30'
existing deck. which is approx. 99' long.
aU in accordance with the detailed specifications as presented in
the originating application.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporate Seal to be affixed, and these presents to
be subscribed by ð· majority of the said Board as of this date.
TERMS and CONDITIONS
1õe Permittee Crescent Beach Condominium
....:.1,__ 2500 Maple Lane. Greenport N Y
a---e,; at . Of as
part of the coosideraâoo for the is$o·.nce of die Permit does uøderstaDd and ptacribe to the fol·
lowiog:
1. That the said Board 01 Trustees and the T...... 01 Sooothold ale re1eued from tJ1Y and
all cIam.ges, ex: cWms for cIam.ges, of suiø adoiøc cIirecdr ex: ~ .. a ~ of tJ1Y opec·
adoo petfom>ed punuaat 10 chis petmIt, and the said J\. ...."" wiD, at his ex: her own ørc-.
delead uy and all oucb saill· nlti~ by chW putiel, and the said.... IU.... .__ fa1. JiIbIIIq
with reipect thereto, 10 the CO"IJ'Iete ~ of the Baud 01 1'.- 01 the Town 01 ~
2. That chis Peœdt is ..and foe . period of 24 mas. wbich is (XI -P<le1'Cd to be the
esâmated time· rec¡uJred ID CXICI>pIete the wodr ia~ but ihoaJd CÙCUIiIsUIIces warnar, request
for an exœasion may be made to the Board at a later cIaœ..
3. That this Permit should be retaiaecI iadef"wtely, or as loag as the said Petmittee wishes
to m.......n the struaurc or project iaToIved, to provide evideaœ to anyo"" c:oaœraed that oøch-
or/zatioo was origiaa11y obtaiaed.
of. That the wode iaToMd wi11 be subject to the ¡,.Ipectioo. and approval of the Baud Ot
Ja ageocs, and I1OI1-GOmf'Iiaoœ with. the prOYisioas 01 the ong¡_fl..g appliacioo, may be aase for
rewcaâon of this Permit by resoluâoo of the said Board.
S. That there wi11 be 110 ........sooable iaterfereoœ with ~ as a result of the wodc
beœia uichodzed. .
6. That there sba11 be DO iaterferenœ with the right 01 the public 10 pus and repus a1œg
the beach benveeo high and low ....ter maries.
7. That if future operatioos of the Town of Soutbold rec¡uite the ftIDOYÚ and,Iex: alcaadoos
In the Iocatioð 01 the ..ode beœia ...¡lvW.N\, or if, ia the opiaioo of the Board 01 Tmsœes, the
wodc shall cause lllmllsooahl. obstruclloo to free aaYipâoa, the said p.......m- wi11 be reqaIred,
upon due aotice, to remove or alter chis..ode oc project beœia stated ....w- e.I:f'" ""f to the Town
01 Soutbold.
8. That rhe said Board ..ill be noâfiecI by tbe Permittee ot the ¡ D'(oLotL - 01 the -" oøch·
odzed.
9. That the I'ermitœe wi11 obcaia all other permits and coaseaII &at may be required sup-
plemental to this permit wbich may be subject to moire upoo flilare to obcaia ..-.
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
.
. Town Hall
53095 Route 25
P.O. Box 1179
SouthoM, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTlON INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
C í~5.J ~k-J...
INSPECTION SCHEDULE
Pre-construction, hay bale line
1st day of construction
Yo constructed
~ Project complete, compliance inspection.
.
.
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
August 20, 2003
Mr. Emil Natale
P.O. Box 586
Greenport, NY 11944
RE: CRESCENT BEACH CONDOMINIUM
2500 MAPLE LANE, GREENPORT
SCTM#38-7-13
Dear Mr. Natale:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, August 20, 2003 regarding the above matter:
WHEREAS, Emil Natale on behalf of CRESCENT BEACH CONDOMINIUM applied to the
Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southo1d Town
Code, the Wetland Ordinance of the Town of South old, application dated June 3, 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
August 20, 2003, 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 standards set forth in Chapter 97 of the Southold
Town Code,
2
.
.
WHEREAS, the Board has determined that the project as proposed will not affect the health,
safety and general welfare of the people ofthe town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of CRESCENT BEACH
CONDOMINIUM to erect a IS'X 30' pergola (sunscreen) on 30' of existing deck, which is
approx. 99' long.
Permit to construct and complete project will expire two years ITom the date the permit is signed.
Fees must be paid, if applicable, and permit issued within six months of the date of this
notification.
Inspections are required at a fee of$S.OO per inspection. (See attached schedule.)
Fees: $5.00
Very truly yours,
bk·$9~·0·
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/lms
.
.
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOurHOLD
TO: ¿:- (n.J (] a.ta- k J 6. DJj ('1 f\* .£^¡tJ(WG Á..J ~Ð(yÚìnA 1111 U 'n'!
I
Please be advised that your application, dated~a3
has 9~~~\reviewed by this Board, at the regular meeting of
')\~O~ and the following action was taken:
( /) 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
fees will be necessary. D ¥G?d7
ij G c¡ /3/D3
re-application
COMPUTATION OF PERMIT FEES:
.s 5.00 (f\.l ~-c.QÉ)n t;--u-
TOTAL FEES DUE: $ 5" , 00
SIGNED:
tlL~·1 ~ ~ ìt-~' 9;
PRESIDENT, BOARD OF TRUSTEES
BY:
~{j~~
RK, BOARD OF TRUSTEES
4/98
,
.
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 Tuesday, July
15, 2003, the following recommendation was made:
Moved by Bob Ghosio, seconded by Nicholas Dickerson, it was
RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of
the Wetland Permit application of CRESCENT BEACH CONDOMINIUM to erect a
pergola (sunscreen) on 30' of existing deck, which is approx. 99' long.
Located: 2500 Maple Lane, Greenport. SCTM#38-7-13
The CAC recommends Disapproval of the application because of the lack of details.
The location and the actual design are also unknown.
Vote of Council: Ayes: All
Motion Carried
Albert J. Krupski, President
James King, Vice~Pre.!?ident
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
July 17, 2003
Dear Mr. Natale:
Please call the Trustee's Office upon receipt of this note.
The project needs a current survey and the dimensions of the plan for the pergola. This
must be submitted before the meeting July 23, 2001.
Thanks
q~~
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. .~ÁI!)ert J, Krupski, President
. James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
jþ
.. Town Han
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
1
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
_Coastal Erosion Permit Application
.......Wetland Permit Application _ Major
_ Waiver/Amendment/Changes
/'Received Application: ~/..3lo3
.........Received Fee:$ S'b -
_ .etfrñpleted Application ~ ¡.:y Q 2,
_Incomplete
SEQRA Classification:
Type I_Type II_Unlisted_
_Coordination:(date sent) f¡ ~ ~
CAC Referral Sent: 01 II
Date ofInspection: ,) / (p 1
_Receipt ofCAC Report:
_Lead Agency Determination:
Technical Review: ~
Public Hearing Held: í I ?lO!J
_Resolution: /
Name of Applicant &é XFlJ/
Address ..(sðo !f)wple... h1.ne. ,
,
GR..EFNf'Oe-r/ A/V. Phone Number:(
Suffolk County Tax ~p Number: 1000-
Property Location:
.
Office Use Only
v" Minor
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E Ol-cl-l- GAl .DIJ /11 / A//Ì.Á 111
I- D. £, X 8" / /
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(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
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Phone ~/6· 361 - d)$',š- ì
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Boar'of Trustees Application .
GENERAL DATA
Land Area (in square feet): 7, ! ...4c:!RE5
Area Zoning: Lt!f)(,/ do hf /II/Ie.¡ mS'
Previous use of property: SJf?fJ<!?,
Intended use of property: $Ã?J(P
Prior permits/approvals for site improvements:
Agency
Date
¡(jpr:
~ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspe'd by a governmental agency?
No Yes
If yes, provide explanation:
--- -/J
Project Description (use attachments if necessary): /0 ERec I /?
fJ¿~Gð/t:¡ (SaN SCI?<=~N) i!JN ;J¡;/ ¿if" RX/Sl-/N&
cÙck. I túj,IC~ 15 IìffIUX/ 19i LA./c;. (.f~c Il/f/lc/I e-J)
dAIHV,¡JC" 7i~ /?",I(&¿jÙ /5 J~/Nc.- ¿;,t(~c"Kc/ /z. ~dl/kk
$ÁJ}j(' fJ,fðM J/,é' S.,/\/ /h.IoI Æ~VcAJ¡ 5i;·/N¿-,~~ø:<.
4' IUÁ¡,C!-/ ¡(EG/4~N& fJMe.
BoarJltf Trustees Application ...
WETLANDITRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: ¿;; h"'/ j) f1~~tkµ I S~N6q~AI
,4vq' SkIN CAN'C~ ~ AJE5ìde.N .f.s-
Area of wetlands on lot:
square feet
Percent coverage oflot:
%
Closest distance between nearest existing structure and upland
edge of wetlands: feet
Closest distance between nearest proposed structure and upland
edge of wetlands: feet
Does the project involve excavation or filling?
/ No
Yes
If yes, how much material will be excavated?
cubic yards
How much material will be filled?
cubic yards
Depth of which material will be removed or deposited:
feet
Proposed slope throughout the area of operations:
Manner in which material will be removed or deposited:
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):
v
Boar.Of Trustees Application .
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity:
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?
(cubic yards)
How much material will be filled?
(cubic yards)
Manner in which material will be removed or deposited:
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
ITom implementation of the project as proposed. (Use attachments if necessary)
.
.
t{
NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applir~"~
CREsce-lI/i l3e.4:::'H
CDN'doft//N /U/Y} SCTMUOOO- ó'f! -7- /3
YOU ARE HEREBY GIVEN NOTICE:
1. That it is the intention of the undersigned to request a
Permit from the Board of Trustees to:
E£ECI /l jJa<:rðL,~ (SUN S'<'A'e~N )
2. That the property which is the subject of Environmental
Review·...is located adjacent to your property and is described as
follows:
C~~SCðJ7 Be4¿;¡..j . ¿?r~eP /J?~/~ L~i!::--
G¡:¿~<::'N )?¿>,.Q T
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: 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.
c;,,µ ~ /J'1 / /J I ¿¡/f19
Ene.: Copy of sketch or plan showing proposal for your
convenience.
if
s
.
.
NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of appli~~"~
CI?E~'~Nr øeAc.'/-I .
CC/l/'dDÆ/AI/Un') SCTM;100·0- ð~ -7~/3
YOU ARE HEREBY GIVEN NOTICE:
1. That it is the intention of the undersigned to request a
Permit from the Board of TrustEles to:
E¡(¿cr /I fJør<jôb; (SUN$<"~e"~N)
2. That the property which is the subject of Environmental
Review.~s located adjacent to your property and is described as
follows:
CI{~SCðJ7 B~4c:¡/ ·.;/trlÞ¿> /11A?/~ L~~-
G,Q~<!"N )?¿>,.Q r
3. That the project which is subject to Environmental Review
under Chapters~. 17, or 97 of the Town Code is open to public
comment on: 7 t3 O~, 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 ~hat might have to review same proposal.
CÞ/-./ ¿ /1'1/ ,N NI/1'7!7
PHONE It:
Ene.: Copy of sketch or plan showing proposal for your
convenience.
BtlÞrd of Trustees ApPlicatioAIÞ
County of Suffolk
State of New York
~ /Îì f I fJ A + A- (ê 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 mSIHER 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 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
REPRESENT ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
~7fd7.f~.
Signature
SWORN TO BEFORE ME THIS
3RD
DAY OF ~ un e.
,2003
~~~. (~/
I Notary Public
1Mr8iM
...,~~" M
- --...1It Q
OoII.,llIlan '£:1... _
./
Boa. of Trustees Application .
.0.
AUTHORIZATION
(where the applicant is not the owner)
I,
(print owner of property)
residing at
(mailing address)
do hereby authorize
(Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
(owner's signature)
8
. . .
1.4:16-4 (2/871 íl!xt 12
.. I . I 617.21
PROJECT I.D. NUM8E?; SEQ
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I-PROJECT INFORMATION (To be completed by Aoplicant or Project sponsor)
I 1- APPLICANT ¡SPONSOR I 2. ?AOJEC7 NAME
3. PROJECT LOCATION:
Municipality CoJunry
,. PAEC:SE LOC). TION (Street address and road in!ersecllons. prominent lancmarks. etc., or ,(ovloe mao)
-
-
5. IS PROPOSED ACTION:
.. DNew o Expansion o Modification/alteration
5. DESCRIBE PROJEC"i BRIEFLY:
,. AMOUNT OF LAND AFFECTED:
Inl(lally a.cres UltimatelY acres
I 3. 'IJIL!... ,=AQ?OSEiJ ~CT!ON C8MPL':' WITH Ex¡s¡rNG ZONING OR OTHER EXISTING '...,..I.ND USE .':¡E.Sï~[C710NS?
eVes UNO If ~o. desc:LOe briefly
I
! o. '..."HAT is ?RE.3ENT LAI":ù 1J::t; IN 'JlC:NITY 'JF ,JqOJECT'?
~"ndus~nat C C.:.mmercl31 CJ .~gncUI!ure .~ P3n</ForesIlOoen 'Soaçe -
'--..: ~esldenua '~Otner
I !Jesc~IDe:
'D. DOES À.CTION INVOLVE A P=RMIT ....PPROVAL. OR FUNDING. ,\lOW OR ULTIMATELY ~ROr.1 ANY OTHER GOVEMNME!'-ITAL AGENCY iF'EDERAL.
STATE crt lOCAL)?
DYes DNo If yes. fist agency(s) anCl permit/approvals
.--
11. DOES ANY ASPECT OF THE ACTlOI~ HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
DYes ONO If yes, list açency name anCl permIt/approval
12. AS A RESUL; OF PROPOSED ACTION WILL ~:(IST¡NG PERMIT/APPROVAL i1.EOUIAE Y10QIFICA710N?
DYes DNa .h
I CEi1.TIFY THAT ¡HE INFORMATION PROVIDED ABOVE IS TRUE -:-0 THE 3ESï OF MY KNCWLËDGE
).,pplicantlspon$or ,1ame: D.ue:
SlqnalUre:
I If the action is in the Co"stal Area, and you are a state agency, complete the
I Coastal Assessment Form beiore proceeding with this a~~essment
OVSR .
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V
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:rr)C~S" ane 'Jsa :r.e .='JL:... ~:A,..
.:.. JoCE3 .),(:7;":~ =.\C.::~:: :.;.¡y ".:r;"
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3. 'NIL:'" ,~C7:CN .qE,:~:'i= :::;CFlCIN;.,7êJ :1:eVIE'N.:.S ~:::::C'¡IGEJ =,:ñ U~ L.S7~:J ..:.C7:C;,, S.N j ,\, '(~:=:R. :Jo\,:;ï ::;;7.37
:TIay ce sucersece'.: =v :!.nctr:er nvalvee açency.
:1 .'~a. :i ..,e'G~t:'e :::~c;.!r::.
·..,!!S
"0
c. c.::ULO ~G",;":CN :J.!:.SUL';"·N ).NY ),D\¡E;:::Së ~:=-=:::':73 AS3Cc;;:.,::J ',Vlï!-! "-Ë .=·JL:....:I,'JI.\lG. .~ns.....ers "7:ay ':9 ¡ancwn¡:en, f :e:;¡~le
.:,. ::.tISung :ilr '::uaILt"f. :ounaca .Jr 'Jral.:na'Nale~ :uali!y .Jr -::IJantlty. ,10lse ,e'/f!IS. ~X.!S~lnç '~a;fic :al~er!'":s. ~cLid. ,vas~e .JrCC1..:c::cn J( Jls,;::
;¡O!erHlal ~c: ~ros¡on. ::talnaça or :Ioocmq ~roclems·? =-,:claLn ~r1elly:
c:;:. AesthetiC. :it;O(lc:,¡ltural. 3,(C:JaeologIC3.I, :'Is.onc. ~r :m'ler ,'2[!.Jral :Jr c:,:ltUt31 ;esourcas: :Jf :::Jmmunlly ':Jr ,¡e,ç:-:ccrnooo .:::-:arac:er? ~c¡aLn -.
........ '/eç!!tð[ On Of 'auna. :Isn. 5r:ellfisn ,Jr -Nlicllfe ~DecLes. ~uJnliiC3nt :l3Cltats. :Jr :hre:,Henea Of '!ncan~erea :;;:ec;es? Scclam JrLðlly:
c~, A c.::mmunH'('S ¿xis~Jng ;¡Ians or 10al5 as otflc:õl ~ ::J.coctec. :Jf a cnange In use or intensLly aT use of land or :)ther natural resources? Explazn :::
C5. Growm. sucseauent -:eyeloorr.enl. :)r relatea aC::Vlues likelY to ::Je ,nducea "Jy ~ne :rccosec aC:lon? S::Olam Jner v.
.':3. '_cng ~erm. :¡nor~ :¿r."7l. ::,¡muja[;'/e. :lr ·J[ner '!Ifec~s no! Icentified ,n c~·":.5? :::t:llaLn ::)(Ierly.
::t:-:!!~ :moac:~ .mc:..JG:nç ::;~anç2S ,n 'Jse ar ~!thef aIJanmy ""r ~yçe '.;H ~ne~g'lJ' ~:JI';'Ln ,:rrerl'l.
S :''--iE:::.E. .JM:S -¡",:::<.E .....-: 'J C 3E, :,::,' T::10VE,-S'( ~Ë!....A-;-~J ,0 ?QT:;~ITI;":"" ':";:;I/=-.4.5ë :':- 'J!RCNM~.· 7";'L .!.:P~C,:S?
_·;'es
_,'10
r ·J~s. ~)(C!aln Jne!lv
?ARi 1J1_0ETE~MINA¡ICN OF SiGNI¡::¡CANC::: l~O :Je cariloletad jy ~genCï)
INS7RUCi10NS; Far ~3C:1 aaverse e~fec: identlfie(] accve. determine wnetner it is sucstantiai. targe. ;mcartanI or otherwise siçnific
:ac:1 ~ifec: silould ~e :assessed in connection 'Nun Its (a) 3etting (i.~. urea" or ~ural); (bl ~robaci!ity of oc~~g; (el duration
irre'/erslbllity: ie! .;eogr:acmc 3C~ce: :ana (f) magnltuae. If necessary, aad aItac!1ments or reference supporting marerials. =:1surt::
-=xclanaticns comaln suttic:ent ;JeI31i to snow thar 3.11 ~e!e"ant aaverse impactS have been iCentitied a.nd adec:uatelv aCCressec.
'::-JeCK ;his ::Jox if ',IOU ,1ave identifiea :Jne 'Jr more ;Jotenrially !arçe or significant =.c·¡erse imD2c:s 'Nnic:1 ,'.1;"'7
OC::.Jr. :hen ::Jrcc.eea airec:ly to :ne ,=üL!.. ~AF 3.naJor .:reoare a positive" ceclara!icn.
_ C:'ecK ~nis ::;ox :f '{au ;"lave ,je!ermlned, basea '::m ¡he intcrmation and analysis above and any si..looor~i:-;c
doc'Jmenraocn. :na.! :r.e ;Jrocosed a.c~icn WILL ,'~OT result inJ{lY significant adverse envlrcnrr.enr21 imcac::
AND .:Jrovlca çn :3.'\:aC:1mentS :3.5 necessary. the teasons supcorring thiS determInation:
"",,,~ 11 _'-'~u ....;O:I1c·,
J"nz JI . _Ct: "'.:..rnf" )1 ":~'~wcn\,O't: ...11,c-::r n _,-",,::J -.';0;1"("1
:,tlc ·::JI -{,-,>¡; on~'Olc '.)II'C0=1
""nJI\,;11!' '1 {~~ccn~IOLI!' ';¡:'c~r n .C'J-O ~~cncy
~,>:n';':UI~ H c'·..·J.H~r :lr ~'::""~nl :r;)m :t!',conllO...!' JII,c<!'r'
.)...¡('
.,
.
.
Office use Only
File #:
Permit #:
Print or Type:
ACCESS CONSENT FORM
FOR ACCESS
THROUGH PRIVATE PROPERTY
1)
(Name of Applicant)
(Address)
2)
(Name & Address of Contractor Involved)
(Project Location)
1000-
(S.C. LM. #)
3)
4)
(Name of Road or Private Property Involved)
(Hamlet)
5)
(Name & Address of Homeowners Association / Property Owner)
6)
(Brief Job Description)
7 )
Starting Date:
Completion Date:
8) Estimated Cost of Proposed Work:
9) Insurance Coverage:
A. The coverage required to be extended to the Property Owner:
Bodily injury & Property Damage;
$300,000/$500,000 Bod i 1 y Inj ury & $50,000 Property Damage.
B. Insurance Company:
C. Insurance Agent
Name & Telephone #
D. Policy # :
E. State whether policy or certification
is on file with the Trustees Office:
(If no, Provide a copy with Application)
(yes/no)
(Signature of Applicant)
(Dat e )
------------------------------------------------------------------
To be completed by the Property Owner:
I/We the undersigned, fully understand the nature of the Proposed
Work referenced above and have no objection to allowing the
Applicant to cross My/Our Property to do the work.
(Signature of the Property Owner
or dul y authori zed represent at ive)
.
.
Print or Type:
TOWN OF SOUTHOLD
HIGHWAY DEPARTMENT
PECONIC LANE
PECONIC, NEW YORK 11958
Office use only
File #:
Permit #:
PERMIT & BOND APPLICATION
FOR ACCESS THROUGH TOWN OWNED PROPERTY
1)
(Name of Applicant)
(Address)
2)
3)
(Name & Address of Contractor Involved)
1000-
(Project Locat ion) (S.C.T.M. #)
(Name of Road or Town Property Involved) (Hamlet)
4)
5)
(Brief Job Description)
6)
Starting Date:
Completion Date:
7) Estimated Cost of Proposed Work:
8) Insurance Coverage:
A. The coverage required to be extended to the Town:
Bodily injury & Property Damage;
$300,000/$500,000 Bodily Injury & $50,000 Property Damage
B. Insurance Company:
C. Insurance Agent
Name & Telephone #
D.
E.
Po 1 icy # :
State whether policy or certification
is on file with the Highway Department:
(If no, Provide a copy with Application)
(yes/no)
(Signature of Applicant)
(Dat e)
------------------------------------------------------------------
To be completed by the Superintendent of Highways:
Bond Amount
Required:
(Signaturè)
. .
.
. Town Hall
53095 Main Road
P.O. Box 1179
SouthoId, New York 11971
Albert J. Krupski, President
., James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Telephone (516) 765-1892
Fax (516) 765·1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO
N.Y.S. Dept. of Environmental conservation (DEC)
SUNY, Bldg. 40
STONY Brook, NY 11790-2356
444-0295
Suffolk county Dept. of Health Services
county Center
Riverhead, NY 11901
852-2100
U.S. Army Corp. of Engineers
New York District
26 Federal Plaza
New York, NY 10278
212-264-3912
N.Y.S. Dept. of State
coastal Management
162 Washington Ave.
Albany, NY 12231
518-474-6000
.
AP~Lt~ANT .
TRANSACTIONAL DISCLOSURE FORK
The Town ot ~ ~hold'a ode of E~hica tohlbi~a contlic~s of
nterest on t e part of town off cers and emplOYSe8. The
purpoee of thie form~o provide informatlon whIch can
alert the town of posaible conflic s of interest and allow
it to take whatevor Bct on 8 necessary to avo d lame.
TOUR NMlI. CfE6'è/ "'t''?:' 'i:--¡¡c/lO~/I'J.~~
m 1e n t 01, Un eBB I illY/5'
you are applying In ~he name or Bomeone else or
Qther ent:l.by, Buch fi8 a company. If 80, Indica~e
the at-he." peraoh' fJ or company's naI'lG.)
p.
:.-:~.. :·t...:~~<1i.'·:·.':'~'
NATURI ot A"Lt~ATtON. (Check all that apply.)
TIX grisvance
Varilncs
Changa of Eone
App~~al of plat ~
Bxs.ption from plat or offloial map
oth.t'
(If "other," nams t~e activity,)
Do rOd p.t.on.~lf (or through tOUr cOMþany, epou.., ølbling,
parent, or child) haye a relatlonehlp with anJ oUicer or
employee of the Town of Southold1 "Relationship" includen
by blood, .arriage, or buaineen interent. "Dusinesa
interest· _ans I business, including a partnership, In
which the town officer or employee han even a partial
ownership of (or employment by) a corp.orsUon in vhich
the town officer or eMployee ownø .ore than 5. of the
share..
,~
TIS
NO
L
If you anavered ·YB9,·. complete the baiance of ihia form and
date aDd aign where indicated.
Nome of person employod by tho Town or Southold
TI~lo or position or that person
Daocribe the reletionehlp between youraslf (~h. eppllcant)
end the ~own officer or employee. Ei~her check the
øppropcLate l1ne ~) through D) and/or describe in the space
provided.
The town officer or employee or hls or her epou.., sibling,
peren~, or child io (check all that apply).
^) ~h. owner of gr.a~ør ~han 5% ot the ahar.. of ~h8
----- corporate s~ock of ~he applicånt (when the epplicah~
is a corporation),
_____B) the 18gal or bèneflcial owner of any interea~ in a
noncorporate ·ehtlty (when ~he applicant h no~ a
corporation II
_____C) an offioer, dIrector, Par~"nr, or s.plbY.. of thn
appllcent, or
_____0) the ~~bU.1 appl1can~.
.,.
DI!SCRIPTION OP nEL^TIONSIIIP
.,
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'..'-'"
,I'
. ;..~.
,""Oft'
subud.t.ted
v
Slgnatur.
·Prlnt name . '."'. .. .... ..:~_. j\.
.:<{\:f·),~i~~.r.~~~· ~~":ð·. . ." .
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,
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.
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§ 58·1
NOTICE OF PUBLIC HEARING
§ 58·1
Chapter 58
NOTICE OF PUBI"IC HEARJNG
§ 58-1. ProvidIng notice ot µuhUc hearings.
¡WSTORY, Adopted by the Town Boerd or tho Town or
Southold 12·27·1995 as L.L. No. 25·1995. Amend=nenta
noted where applicable.)
§ 118· I. Providing notice or public hearings.
Whenever the Code caBs for a public hearing, this section
shall apply. Upon determining thol an application Is complete,
the board or commission reviewing the same shall fix a time
and place for a public hearing thereon. The hoard or commission
reviewing an application shall provide for the giving of notice:
A. By causing 8 notice giving the time, date, pLace and
nature of the hearing to be pubU:¡lhed in the official
newspaper within the period prescribed by law. .
B. By requiring the applicant to erect the 8igo provided by
the town, which shall be prominently displayed on the
premises Facing each public or private street which the
property involved in the application abuts, giving notice
of the application, the nature of the approval 90ught
thereby and the time and place of the public hearing
thereon. The sign shall be set back not more. than ten
(10) feet from the property line. The sign shall be
displayed for a period of not less than seven (7) days
immediately pf'eceding the date of the public hearing.
The applicant or hlather agent shall file an affidavit that
s/he has complied with this provision.
C. By requiring the applicant lo send notice to the owners
of record of every property wnich aLuts and every
property which is across from !lny public or private street
,~
§ 58·[
SOUTHOLl) CODE,
§ 58·1
from the property included in the application, SU,ch
notice shall be made oy certified mail, return receipt
requested, posted at least seven (1) dtlys prior to th~ date
of the initial public hearing un the &'.ppUcation and
addressed to the owners at. the addre'\lscs listed for them
on the local assessment roU. The applicant. or agent shall
file an affidavit that s/he has complied with this
provision.