HomeMy WebLinkAboutTR-6010
Board Of Southold Town Trustees
SOUTH OLD, NEW YORK
PERMIT NO. roo I 0 DATEq~t.~ 20, 2004
ISSUED TO m...~~.~~.E~. ~"!f:I..BET~~V ~lC/(ER$9N ... m .m. .......
Autl1nrilattnn
Pursuant to the provisions of Chapter 615 of the UlWS of
the State of New York, 1893: and Chapter 404 of the UlWS of the
State of New York 1952: and the Southold Town Ordinance en-
titled "P.EGULATING AND THE PLACING OF OBSTRUCllOt:>IS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL· OR OTHER MATERIALSFQ..OM
LANDS UNDER TOWN WATERS;". and in accordance with the
Resolution of The Board adopted at a meeting held on .Qc.tPÞe,~..zO
2004 d· 'd t· f th f $250 00 'd b
...... m' an In consl era Ion 0 e sum 0............... ... pal Y
..m fo/lk~.'l,...í1Hd ..B.e.1/~.eY..D.i..cJ<.e,JW,on.m ... ......m............m...........
of ...Sriil1w.id.... . .... N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
f Weila.¡¡d Pe~.U: 6o,~ the ex.{.-6tJ.¡¡g. 6Üed dock, 2' x 28' and 14'
,t,1mp~, ,uld, 5 x 16 6,[oat-lng deck , ,"t,~ pr~t tile ptwl~u,tw.¡(e.d
blf V,m TUIf£. dated Jutlf 9. 1986 iwd "-(>.v.L~e.d w.U:h tit" dl1c" ~"d.'i
011 Sept. 30, '2004. ~ ",," u
aU in accordance with the detai\ed specifications as presented in
. the originating application. .
IN WITNESS WHEREOf, The said Board of Trustees here·
by causes its Cor )Ol'at~ ~al to be a~xed, and tI1ese pyesents to
be lubscn"hed by a ITIð(Oflty of the said Board as of thiS dat.e,
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'Ir"t"_'" A<' "..J t"'n o.lnm!'t.'<:
ne Permittee
PMk.e.~ cwd Be.t~e.y V.i.C.k.C.!U>é'll
te$iding at SolLthotd .- , N. Y.. as
pan of the coosidCraûon for Ihe i....·n(JO of che Petmit does undentand and prescribe to the fol·
lowing:
1. That the said I!oard of Trustees and the Town of Soulhold _ releucd from any and
aU damages, or claims for damases, of suits adsiog diœctly or todircd1y as a result of any oper·
.«tIoa peáoaøedpuauanctlLèbis -J>eØDIt, and ..Ibud4_I'-nIH#orlI!. M flhor ÞÇr own ~.
defend ...y and aU aKh sults-Jnltl·ted by Ibhd.,atties, and the said I'etmIttee ISSUIII<I fq .lJabIlIty
with mpect thereto, to ·~e exdusioo of the Baud of TtUStteS of che Town of ~
2. That this Pe11\IIt is· Wid for a pedod of 24· øos. -which is ~ to be the
estimated time· required to complete the wodo: in,.olved, tJutihoold årc:utiIstmccs wam.nt, request
for an exœosion may be made to the Ðoard at a later eWe.
3, That this Peanit should be retained indefioitely. or as loog as the laid PC!tDiuee wishès .
to ma;n~'¡n the structure Ot project Involv,,-':' to provide evidenœ to anyone coocemed chat auch-
oriq,tion was originally obtained.
4. That (be wad< inwlved will be sUbject to the InspectIoø and approval of che Board or
its ~ts. and DOO~1iaaœ wilh the ptoWioos of the otiginaliog application, may be cause fIX
œvocation of this Petmit by resol\ldoo of the said Board.
S. That tbere will be no unm.sooable Interfereoœ with aavigatiœ. IS a result of the work
beteIn aUd1orized. . .
. 6. That tbere sbaU be no interf= with tbe right of the public 10 pass and œpass aloøg
che beach between fUgh and low walei' marks. .
7. That if future operatioos of the Town of South9Id RqaIre che œmon1 and/or .......tWK
In the Iocadoo of the work bereIA ...,!L«V'iI, or tf, ¡., che opiadoa of6e Board 01 TIIIIIeer, che.
wodc shall cause lII1re85OIII'bIe obstrucbOtl 10 free aaYigadoa, the said Permittee will be re.prcod,
apon clue ðOtIct, 10 remove or alter this wad< or project hetein stated wlcbout ~~ to the To.m.
. of Soutbold. . .
8. That the said Board will be notified by the I'etmIuee at the ~...w.. Of the work auch-
orbed.
9. That the ·p,orm1ttee will .obtain all otbet peøaIts and _li·ChIt may be tequhecI .
~ to chls permit ~ rœybe sab ect to revoIre apoo ûIIure 10 obtalo __
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Albert J. Krupski, President
James King, VlCE'- President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
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To\,,-n Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone '.631' 765-1892
Fax ,.63lì 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTH OLD
October 20, 2004
Parker and Betsy Dickerson
1485 Mill Creek Dr.
Southold, NY 11971
RE: 1485 MILL CREEK DRIVE, SOUTHOLD
SCTM# 51-6-29
Dear Mr. And Mrs. Dickerson:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday October 20, 2004, regarding the above matter:
WHEREAS, Parker and Betsey Dickerson applied to the South old Town Trustees for a
permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland
Ordinance of the Town of Southold, application dated September 30, 2004, 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 October 20, 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 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,
WHEREAS, the Board has determined that the project as proposed will not affect the
health, safety and general welfare of the people of the town,
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RESOLVED, that the Board of Trustees approve the application of PARKER AND
BETSEY DICKERSON for the existing fixed dock, 2' x 28' and 14' ramp, and 5' x 16'
floating dock as per the plan surveyed by Roderick Van Tuyl dated July 9, 1986 and
revised with the dock added and received in the Trustee office September 30, 2004.
Permit to construct and complete project will expire two years from 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 $50.00 per inspection. (See attached schedule.)
This is not a determination from any other agency.
Fees: None
Very truly yours,
~ ? ~··7·tA-J..· r;. ~
Albert J. Krupski, Jr.
President, Board of Trustees
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Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone
(631) 765-1891
CONSERV AnON ADvrsORY COUNCIL
TOWN OF SOUTHOLD
At the meeting of the Southold Town Conservation Advisory Council held Monday,
October 18, 2004, the following recommendation was made:
Moved by Don Wilder, seconded by Doris McGreevy, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH
A CONDITION of the Wetland Permit application of PARKER & BETSY DICKERSON
for the existing fixed dock, ramp, and floating dock.
Located: 1485 Mill Creek Dr.. Southold. SCTM#51-6-29
The CAC recommends Approval of the application with the Condition the existing dock
and walkway ;s included on a survey by a licensed surveyor.
Vote of Council: Ayes: All
Motion Carried
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Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (6311 765-1892
Fax ,6311 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
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Soulhold Town
Board of Trustees
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Coastal Erosion Permit Application
_.7\Vetland Permit Application ------=--~[aj
\~r ai \'eriA.mendmenUChanges
/ Recei,;;:d APplication:-4bh~ ~vu'f
/Recei\'edFee:$J,5ü ;;¡~.lD ctlL
_--eompleled Applicatio~~qlº--
__[ncompIete
__SEQR'\ ClasSification:
Type I_Type II_Unlisted__.
__Coordn.ltion:(date senÆ
~C R .:ferral Sent: q ~ _
- -Date..f Inspection: _J L 0___
__Rr."lpt ofCAC Report:_____
__Lead Agency Determination:.___
Technical Review:
:ðublic Hearing HeW 10 b1.,==,-=.
_Resolution:_________
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a 0 þ~ 1) 'c-kçu-s O.li1.___
C'(u.-k-lk;~ S'OLL~~ 1ð2-
Phone Number:( ) k õ (~ 7 G s-- L ~.-2~__
Suffolk County Tax Map Number: 1000 - é) 0' (- !Ó - oZ î
Property Location: En,,} 0 s;: C~r>-€- QJ2¡ IU> ~~+--h <> ~)
Name of Applicant_ !(~~
.N i
Itf1~ /t\; tt
¡¡C?11
Address
\Vt. ~ l a-N.o_
(provide ULCO Pole #, distance to cross streets. and location)
AGENT:
(If applicable)
rorØ.
9.~ ,Oil
Address:
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Phone:
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Board of Trustees Application
GENERAL DATA
Land Area (in square feet):___l~j_~ .1J ____
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Area Zoning:
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Previous use of property:
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Intended use ofproperty__~_ ~
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Prior permits/approvals for site improvements:
Ag~ I" Date f
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___ 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):
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PROJECT 10 tJUI\ŒER
SEQR
617.20
APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
PART 1 - PROJECT INFORMATION (To be completed by Applicant or ProJect Sponsor I
APPLICANT i SPONSOR 2 PROJECT N.I\ME
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MuniCIpality County
4 P~~IS~ ;A~; ~t¿~e=;dl;:i):r~::s ~ro::t- I;n~\':;~:;~ ~v:~e" m: -Ç' (;0 UIL R d
LOCATION
5ðwt-Ltð [1
cL..ç..ç ¡ I~
5. IS PROPOSED ACTION' 0 New
o Expansion 0 Modification l alteration
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6. DESCRIBE PROJECT BRIEFLY·
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7. AMOUNT OF LAND AFFECTED·
Initially acres Ultimately acres
8. WilL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER RESTRICTIONS?
oo.Ves 0 No If no, describe briefly.
9 WHAT IS PRESENT LAND USE IN VICINITY
Il} ResIdential 0 Industrial 0 Commercial
OF PROJECT? (Choose as many as apply.)
DAgriculture D Park I Forest! Open Space
o Other (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or local)
DYes gj No If yes, Jist agency name and permit I approval:
".DOES
DYes
ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR
D No If yes, list agency name and permit I approval.
APPROVAL?
Applicant
Date
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION?
No
Signature
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF
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MY KNOWLEDGE
If the action is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment
,
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I'ROOF OF MAILING OF NOTICE
ATTACH CERTlFŒD MAIL RECEIPTS
IT' U.S. Postal Service . - .
m CERTfF(ËD MAlt R
~ . (Domest'cMai'On'~'NoJ. ".. ECEIPT
~ . .. ,. ".' nsur".nce.Coverage Provided)
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Posliige $ 0 37
b . UNIT 1[1: ()<}71
D Certlf,ed Fee
L.:J Fter;,¡rn lìec,"epfFee
(Endorsement Ru':¡ujred
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,....:; (:eSITIC19óDelivIJrYFI>e
rl noorsemf:nt Required)
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Total Postage & Fef!s r:---$ _4 4'
rr¡ L!L..._ . - 10/12104
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'feet. Apt. ^'o~; - - unu_._.___h l
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Clerk: KK1XIRO
Address:
{!;O}( 307, SðlA-rL.." {ó-......IJV ({CZrr (
~ j\{e.rCt¿r 5t"', ~61+' A ~ò~. IVY,JJY rðOð ~
/Xx 30!?". {\{e.,.d..~M, (\I.J. 01 q '-I S
T ~ 1'1 ; ¡ I Vb..- /< 'þ;¡<>4 , $o.....-t-kut&, 1J.'f . ( \ 11{
"1-0 "\,ll Cr--4-e.~~":~, ':Ç'C>~~Ñ~ 11'1'11
" residing at J Lf 8"L1:!J .. I ( e" -eJ L<;)_ 0",' ~
.' being duly sworn, deposes and says that on the
"" '" . ___ _, 206 V, deponent mailed a true copy of the Notice
set forth in the Board of Trustees Appliclrt"ion, 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 ;)'... ~-t-k" (&. , that said Notices were mailed to each of said persons by
(certified) (registered) mail.
Sworn to before me this 14M
Day of ~¿frJ 11M / , 20 Æf:-
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Notary P~blic
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Board of Trustees Application
County of Suffolk
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State of New York
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(De,-\-'~ ß ,Thc:..KQ C2.d~ BEING DULY SWORN
DEPOSES A 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 MAANlõR SET FORTH IN THIS APPLICATION AJ'.<l) AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD HIE TO\\!N OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR BY VIRTUE OF SAID PERWT(S), IF GRANTED. IN COI\1PLETING 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.
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7 ¡¡[v~ rl /;{ <' ~ ?:, 4-C~ ~/
Igna1ure
SWORN TO BEFORE ME THIS
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5 0 DAY OF
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Notary P'ublic
C'.T':.]~ CO,''''N
: -... StMofNewYorh.
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-",d In Suffolk Cou,ty -yr r )
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APPLICANT/AGENTIREPRESENT A TIVE
TRANSACTIONAL DISCLOSURE FORM
The TO\\11 of South oJ d's Code of Ethics Drohibits conflicts of interest on the Dart o[tO\\'O officers and emDlovees. The Durnose of
this Conn is to DTovide information which can alert the town of DOssíble conflicts of interest and allow it to take whatever action is
necessarv to avoid same.
YOUR NAME: /~ ¡;r;," Æ'i ,~ .-i!:. ¡l,"-AU,""",-
(!Last name, firsJn~dle 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.)
NAME OF APPLICATION: (Check all that apply.)
Building
Trustee
Coastal Erosion
Mooring
Planning
-~-
Ta.x grievance
Variance
Change of Zone
Approval of plat
Exemption from plat (1f official map
Other
(1[··Other". name the activity.)__
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Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee
of the Town of South old? "'Relationship" includes by blood, marriage, or business interest "Business interest" means a business,
including a partnership. in \'vhich the town officer or employee has even a partial ownership of (or employment by) a corporation
in which the lown of1ìcer or employee owns more than 5% afthe shares.
YES
NO
A
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If you ans\\ered ··YES··, complete the balance of this fonn and date and sign where indicated.
Name of person employed by the Town of South old
Title or position of that person
Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check
the appropria[c line .1\) through Ð} 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% ofthe shares of the corporate stock of the appliqmt
(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 :3(;;> day of
Signature
Print Name
200f
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Form TS I
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