HomeMy WebLinkAboutTR-5742
Board Of Southold Town Trustees
SOUTH OLD, NEW YORK
~?c¡~
PERMIT NO. . ..... .
DATE: ...~pril 30,. 2003
JAMES & MARGARET FLANAGAN
ISSUED TO .m" ......".. ... . ...
Aut4nrilutintt
Pursuant to the provisions of Chaptef" Ó 15 of the Laws of
the State of New York, 1893: and Chapter 404 of the Laws of the
State of New Yon: 1952; and the Southold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;". and in accordance with the
Resolution of The Böard adopted at a meeting held on ..Apr.il.. }º.L
20.g.3., and 'in consideration of the sum of $.2.0.0..,.0.0... ... paid by
.. J ":IIl"s& ¡, argaretF:lanag"," .......m...···· ....
of .. S.~tl~I1?ld N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the foUowing:
Wetland Permit to construct a second-story on the existing
dwelling and to expand the house by constructing a garage
toward the road with the condition that drywells and gutters
ara,I'Rstall"cio on thl:hhQUSå & .11:a,rage .iUld.as. depicted tor¡ .the
an I ðcClß'tlanCe wit tne etall&d specltlcatlOns as presen eo In
the oñginating tPPlication. site plan prepared by Donald Feiler,
Architect last dated June 26, 2003.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes. its Cor )Orat~ S~al to be a~ixed, and these P!esents to
be subscnbed by a malority of the said Board as of thiS dat.e.
TERMS and CONDIl1ONS
'l1>e I'ennittec James & Margaret Flanagan
......,ftft 695 Bayview Ave.. Southold
.__" ~~u
put of the coasideratioo fo< the isSo..oœ of the Permit does uødcnw>d and prescribe to the foI·
lowing:
1. That the Slid Boord of Trusues and the Town 01 SouthoId a.œ reIeued ftom 1111 and
aU damages, or claims fDt damages, of suIa adsùIg dinàiy or iadhecdy as . rauk of 1111 opet·
aûoo pedom>ed pursuant to this pemØt. and the oaid 1'»-. '4...., will, at his or her own e.J' ( 000:.
defend 1111 aDd aU such saits·Jaitiaœd br dIitd pudeo, and the said 1'»-. I..·e a_ fa11 JJabIIky
wùh reipect thaeto, to the CIOr'I"- .-I..,InQ of the Board 01 T~ 01 the Town 01 SoacMId
2. That this PemIÌt is wBcI foe . period of 24 mas. wbich is 0011.11' ed to be the
esåmated time requited to compkœ the wad< iavohed, butihoald circaIi>stmccs ~ request
for on exœasion may be mode. to the Boord at a Iuer cIaœ.
3. That this Petmit should be retoinecI indefUlÍtely, 0< as loag u the said huuåtee wishes
to maJntIin the sttuCtU<e 0< project involved, to provide cvidcDcc to anyone a><>«mcd thu auth-
orization was originally obuiocd.
4. That the work involved will be subject to the ¡,.~ and approval of the Boord or
ia agents, and DOQ-GI1\1Opll....... wùh. the ptovisioDS ol the or;g¡....,;" t appliatioa. may be cause for
revocation of this Permit by resolution of the said Boord.
s. That chcrc will be 00 WlfeaSONh1e iaterfereaœ wùh navigation u a rauk of the work
bc<dn auihorized.
6, That there shall be 00 iaterfcreøcc with the right of the public to pus and repass a100g
the beach between high and low water marks.
7. That If future opcntioos of the Town of Souchold require the .-.I and/or aIœradoas
ia the Iocatioa of the wad< bc<dn ..."",..vtd. or if, ia the opIaIon of the Boord of Tøœes, the
wodI: shall cause unrcosonoble obsttucUOO to free navigatioo. the said p..-/H_ will be required,
upon due øodœ, to remove or dter this work 0< project bc<dn stated wi~ ~... to the Town
01 Souchold.
8. That the Slid Board will be notified by the Permittee ot the (O/'r IIOf' of the work auth-
orized.
9. That the Permittee will obtain aU other pcmúts and coo<e"lJr thu may be ¡equircd sup-
plemental to this pcmút which may be subject to rcvoIœ upon failute to obtain --
_____~_--..-~-....~~~-~~...,. ~_~. It It It . . '" . , IO.It ..' . .. . " It . . . . . It,
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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
CERTIFICATE OF COMPLIANCE
# 0005C
Date 8/23/04
THIS CERTIFIES that the
second-story addition to dwelling and new garage
At 695 Bayview Ave., Southold
Suffolk County Tax Map #
52-5-20
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated 3/31/03pursuantto which Trustees Permit # 5742
Dated 4/30/03
Was issued, and conforms to all of the requirements and conditions of the applicable
provisious of law. The project for which this certificate is being issued
is a second-story addition to dwelling and new garage
The certificate is issued to
James & Margaret Flanagan
owner of the
aforesaid property.
~ ? ~.t}.
Authorized Signature
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
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-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
r /c.."1 <\j C~......
INSPECTION SCHEDULE
Pre-construction, hay bale line
151 day of construction
Y:. constructed
V Project complete, compliance inspection. '6'1?-~\b4 ~.V- ~~
e~L 1\.Q..'ò~
.
.
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
April 30, 2003
Mr. & Mrs. James Flanagan
7 Young Street
Cortlandt Manor, NY 10567
RE: 695 BA YVIEW AVE., SOUTHOLD
SCTM#52-5-20
Dear Mr. & Mrs. Flanagan:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, April 30, 2003 regarding the above matter:
WHEREAS, JAMES & MARGARET FLANAGAN applied to the Southold Town Trustees
for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland
Ordinance of the Town of South old, application dated March 31, 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
April 30, 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,
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,
2
.
.
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of JAMES & MARGARET
FLANAGAN to construct a second-story on the existing dwelling and to expand the house by
constructing a garage toward the road, with the condition that drywells and gutters are installed
on the house and garage, and as depicted on the plot plan prepared by Donald G. Feiler,
Architect last dated June 26, 2003.
Pennit to construct and complete project wil\ expire two years from the date the pennit 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,
b~.19~:t}.
Albert J. Krupski, Jr.
President, Board of Trusteès
AJKIlms
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AlbertJ. Krupski, President.
James King, Vice·President
Henry Smith
Artie Foster
Ken Poliwoda
.
Town Hall
53095 Main Road
P,Q. Box 1179
Southold, New York 11971
Telephone (516) 765·1892
Fax (516) 765·1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
TO: y () m In c¡- 7r)/lí)1I'M.. I f- -:f{ ¡') no q fl ()
Please be advised that your application, dated ~/31/~
has be~_5eviewed by this Board, at the regular méeting of
~D-3 and the following action was taken:
( ~APPlication Approved (see below)
(____) Application Der¡ied
(____) Application Tabled
(see below)
(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 ir¡ the instruction sheet.
The following fee must be paid within 90 days or re-application
fees will be necessary.
COMPUTATION OF PERMIT FEES:
G -is,Cb·-t Y\.D~aDJ(\ µ.z
® rt.uv p lo.n JJ hOLVln'fj dA.L/ UJULD 1- q-u-ttvUJ Or¡ h r:.ìù.~ "4- O¡Q.//ß·11!...·
TOTAL FEES DUE: $ 5.. fYJ
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Dollars $ .J
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HOW PAID
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A.MT OF
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AMT. PAID
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BAlANCE
DUE
CHECK
MONn ORDER
CREDtTGARD
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4/98
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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 Wednesday,
April 16, 2003, the following recommendation was made:
Moved by Bob Ghosio, seconded by Don Wilder, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH
CONDITIONS of the Wetland Permit application of JAMES & MARGARET
FLANAGAN to construct a second-story on the existing house and to expand the house
by constructing a garage toward the road.
Located: 695 Bayview Ave., Southold. SCTM#52-5-20
The CAC recommends Approval of the application with the condition that hay bales are
placed down and a 10' non-turf buffer is installed.
Vote of Council: Ayes: All
Motion Carried
.
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New York State Department of Environmental Conservation
Division of Environmental Permits, Region One
Building 40 - SUNY, Stony Brook, New York 11790-2356
Phone: (631) 444-0365 . FAX: (631) 444-0360
Website: www.dec.state.ny.us
~
~
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Erin M. Crotty
Commissioner
Letter of Non-Jurisdiction - Tidal Wetlands Act
James and Margaret Flanagan
7 Young Street
Cortlandt Manor, NY 10567
February 28,2003
Re: Flanagan Property, Bayview Avenue, Southold
SCTM# 1000-052-5-20
Application # 1-4738-03136/00001
Dear Mr. and Mrs. Flanagan:
Based on the information you have submitted, the New York State Department of Environrnental
Conservation has determined that:
The property that is landward of the pre-existing (prior to 8/20/77) bulkhead which is more than
100 feet in length, as seen on in-house inITared aerial photograph # 684 is beyond the jurisdiction
of Article 25 (Tidal Wetlands).
Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part
661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no
construction, sedimentation, or disturbance of any kind may take place seaward of the tidal
wetlands jurisdictional boundary, as indicated above, without a pennit. It is your responsibility
to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration
or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may
result ITom your project. Such precautions may include maintaining adequate work area between
the tidal wetland jurisdictional boundary and your project (i.c. a 15' to 20' wide construction area)
or erecting a temporary fence, barrier, or hay bale berm.
Please be further advised that this letter does not relieve you of the responsibility of obtaining
any necessary permits or approvals from other agencies.
cc: MHP
File
Sincerely,
ø·
Mark C. Carrara
Permit Administrator
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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. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
_Coastal Erosion Permit Application
vWetland Permit Application -- Major
_Waiver/Amendment/Changes ..-
_~eceived Application: 3/31ID:l.
__ Received Fee:$ .JoO.m..
..Æompleted Application 3.. 31 J03
Incomplete
SEQRA Classification'
Type I_Type II_Unlisted_
.....cOordination:(date sent) --
.......-cAC Referral Sent 3/lJJrB
vÐate of Inspection: "#117 J~
_Receipt ofCAC Report:
_Lead Agency Determination:
Technical Review:
/1'>ublic Hearing Held 'f/ ?Jot 03
Resolution:
Minor
- -
-
Name of Applicant JA~6:5 J,,4~(òt:¡Riir ft.ANAG>A.¡J
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Address l'1tJ.i'-lt»lP: 7 YÐ0l.JG> Sr. Ce-e,£.4,.ibr!llAAX>P N Yo /o.Jb 7
,..-' 1/91/ "!AI"","", ((1'(- ó~g~Fð6h
(,/IJ ð/J tlJiÓuJ ,Q <.>.5 s,~ Phone Number:( ) 4;.c.... '- Ié .~ 1- 7b::F- ,')<f>9h
Suffolk County Tax Map Number: 1000 - 0 S :'} - j - ~O
Property Location: foff dllYvtÈw JIvE ~V77-kJt..ò N· y, 1/f7¡
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone:
.
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Board of Trustees Application
GENERAL DATA
,
Land Area (in square feet): ß. Pf¡¿o'/I ¡J111 rl5Ll/
I
Area Zoning: R 6"5 ;1)#", r;¡:¡ V
Previous use of property: R E7I{~E^, :r;.Av
Intended use of property: Rd:=5;Òb,v..,.;/Iv
/qvoo 7Q FI:
Prior permits/approvals for site improvements:
Agency
Date
~5 ~I?C.
Ç¡:;,ð d~ gJ=~
,
i6.,..,.ðf' tJF /VON- JV.("I<7ÒrC-TIOP
_ TrÒ4/... IÞlErlA/Vò'5 Ilc.-,
_ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
V No Yes
--
If yes, provide explanation:
Project Description (use attachments if necessary):
C)N'5"r1<VC.;- ?\ S£c",¡v'tl c;ñ'Æy ON f7..f.-£ £){/;.,.;/V(o
!-fo,,?¡;; liNt:, /ò £x~4¡vb /JfE. /'/"V"1G ,By C(;W?ì;('i.'C;-IIo.>6"
A Ge>.e!X".,¡;;. TDw/>.!2'¡", -rH-i5 I2oA't::...
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Board of Trustees Application
WETLANDffRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
COM ,r;t!i/c;.;- //
5sCa./~
ÌP ÞY#4:J
.4 (}4~p Ì?JiAMÆj j---#S..~J
'7 11P4..1.( () AJ 'J1/£ E ýI t9l-tÑ b j--/¡p c>/jG d ,vrJ
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77/E. !-6v¿;G ",r¡ tøAJ1¡£"CT/Þ?
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Area of wetlands on 10t:;3' i/"-Kl-fð:?$,\ square feet
Percent coverage oflot:
%
Closest distance between nearest existing structure and upland
edge of wetlands: 7' CJ feet
Closest distance between nearest proposed structure and upland
edge of wetlands: i.[¿J feet
Does the project involve excavation or filling?
No
/ Yes
If yes, how much material will be excavated?
cubic yards
¿t tV r1-I-E /2oÂI\".·<=) 1M
Ii^-, £¡r.,-,5.t>.>'5/L:.,J (9/= 3.? r/-
[ ¿"f ..<j,¡,1:, C,,~Æ'//(:;'&] U-JIJ...(
feet I?tfl'i$= c)ø,«,f: b/ú,"",tS
WGeE t"J NIJ C. J.h(PCÆ-
,
f µ 71H= G RJI 61=.
How much material will be filled?
cubic yards
Depth of which material will be removed or deposited:
Proposed slope throughout the area of operations:
Manner in which material will be removed or deposited:
Statement of the effect, ifany, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
~E 7 ~ lIv,~ Bs
/tltJ ¡;.,cFEcr tY,tV ¡HE
Wk.T"'''''''''>.Ä 'S /"'<-<= ~¿ WI/..¿, 1]£ NO W~rÆVC-¡-,-:,,--
c ~o 'J 8è 'ìO '11-/-l':. Lv.4"ï1.7'e .
.
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New York State Department of Environmental Conservation
Division of Environmental Permits, Region One
Building 40 - SUNY, Stony Brook, New York 11790-2356
Phone: (631) 444-0365 . FAX: (631) 444-0360
Website: www.dec.state.ny.us
~
.....
~
Erin M. Crotty
Commissioner
Letter of Non-Jurisdiction - Tidal Wetlands Act
James and Margaret Flanagan
7 Young Street
Cortlandt Manor, NY 10567
February 28,2003
Re: Flanagan Property, Bayview Avenue, Southold
SCTM# 1000-052-5-20
Application # 1-4 738-03 I 36/0000 1
Dear Mr. and Mrs. Flanagan:
Based on the infonnation you have submitted, the New York State Department of Environmental
Conservation has detennined that:
The property that is landward of the pre-existing (prior to 8/20/77) bulkhead which is more than
100 feet in length, as seen on in-house infrared aerial photograph # 684 is beyond the jurisdiction
of Article 25 (Tidal Wetlands).
Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part
661) no pennit is required under the Tidal Wetlands Act. Please be advised, however, that no
construction, sedimentation, or disturbance of any kind may take place seaward of the tidal
wetlands jurisdictional boundary, as indicated above, without a pennit. It is your responsibility
to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration
or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may
result from your project. Such precautions may include maintaining adequate work area between
the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area)
or erecting a temporary fence, barrier, or hay bale benn.
Please be further advised that this letter does not relieve you of the responsibility of obtaining
any necessary pennits or approvals from other agencies.
Sincerely,
úØ/
Mark C. Carrara
Pennit Administrator
cc: MHP
File
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NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applicant:
JA .\e:5h'r1'~~A~ET FI.A>JPG.PuJ SCTMUOOO- 05"~-S-:tO
I
YOU ARE HEREBY GIVEN NOTICE:
1. That it is the intention of the undersigned to request a
Permit from the Board of Trustees to:
ßv;t..i:::> A SÆCo,.,~ 57el1y ÐÑ T7-Jé. J:.x/".,r~~ "",...:;ë
/l,,'l!¡ Tö ~PA/'IÒ ~ ¡'¡'¡J~ ß'f c<!),v'}rll UG.,.../Þ(, f.I G A~I! (; E 7""'.4-"1)'
77f6 RÐA;:;'.
2. That the property which is the subject of Environmental
Review.-Ís located adjacent to your property and is described as
follows: C. 1,)" ð,-qf//,ðu.J ,;:(Vé,
Sc9uTHOI-ì;:) ¡Ù. y. 11((1/
3. That the project which is subject to Environmental Review
under Chagters 32, 37, or 97 of the Town Code is open to public
comment on: Lf-30-0_~ 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: J. (."q /1, Ft..AIIJAfDA,.)
MAILING ADDRESS: 7 YIItJ#J{O:> 5"
CoRr'-"Wli T !'1AtJi9Æ N, "t ~() of" 7
PHONE it: q ''-1 - 5"" ~~ - ;1../,
Ene.: Copy of sketch or plan showing proposal for your
convenience.
s
U·~6·4 12lan-Tex! 12
I PROJECT I.D. NUMBER
.
.
617.21
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I-PROJECT INFORMATION (To be completed by AooHcant or Project sponsor)
SEQ
1.
Æ",
FMN,(c..f"J
I 2. PAOJEC7 NAME
J. PROJECT LOCATIO : , 4
Municipality V ì7--kP (... ~ C;)unty .J U ¡::::'Po ¿
4. PREC:SE LOCATION (Street address and road Intersecllons. prominent lanamarks. etc.. ojr ;:¡rOvtoe :nap)
h?tJ ð,Ayu/£1D fivE. i'i /'1/1-6
"'7,-, "TIfo,-,~ f\J Y 11f7!
{3L9 '
5. IS PROPOSED ACTION:
o New 0 expansion
6. DESCRIBE PROJEC¡ BRIEFLY:
~caUOniaJteratlon
¡f{ruò /0
/TJ tÅ.>A-Qì::I
ß U/~Ó
E ;(1;),4"'6 77+E
elJlfb
A
SéC",-",ð
/-Ie v';>6
'5 17)-<2 Y () AJ TN£.
"sy CON1f<f"v<'r/P0
£XI5T1NG;;, h{,'-'''5E
A c.,A.t'ACò&
~
." AMOUNT OF LJ..NO AFï=¡:CTEiJ: r _
Intttally 300~, F, _ Ultimately =?bO ?t.2.Fï; ~ LC.Ø.A.eA~b ìVr..t.u4,Q.~
" IfJIL!... .-~O?0SEiJ ~CT¡ON CC'MPL';" 'NITH E.XISTING ZONING OR OTHER EXISTING ~,"JO USE .::J.EST~IC7' ONS"
~S 0 NO If No. deSCribe brt~ily
R",,,,,;;)
'3. '.'JbAT IS ?RE3ENT LA¡';C fJ::ë. IN 'IIC:NIT':' GF ::JROJECT?
'~de-nlJat G.!ncus:r:at C C.JmmerC¡ðt
lJesc:lOð:
~ .:..gncul:ure
~ c~rKIFor3S!100en ~cace
'_Otner
TO. DOES ~C710N INVOLVE ~ :::H~RMIT ~PPROVAL. OR FUNDING. ,'{OW OR ULTIMATEL':' C"ROM ~NY OTHER GOVE¡:¡NMENïAL AGENCY \F:::iJERAL,
ST A T~ GR LOCAL¡~ /
U Yes l1d"flo If yes. ~ist agencytS ana permi!/aoorovals
.--
11. DOES ANY ASPECT OF THE AcnOl-l HAVE A CURRENTLY VALJD PERMIT OR .-'lPPROVAL?
o Yes ~ /I y~s. list agency name ana permlt/aoproval
'12. AS A RESuLT OF PAOPOSEiJ ";CTION WIL!.. S<ISTlNG PEiiMrTlAPPROVAl MEQUIRE ,\r100lFICATlCN?
o y., G21<Ío .
I CEñTIFY THAT THE INFORMATION PAOVIOED AeOVE IS T¡:¡UE :-0 THE 3ESï OF MY KNCWL=¡)GE
t/4AJ4bt/\.J
O,ue:
3Þ/ ¡{, 3
If the action is in the Co"stal Area, and ,au are a state agency, complete the
Coastal Assessment Form before proceeding with this a~~essment
OV!õR
· .
Board of Trustees Application
County of Suffolk
State of New York
" ) A IY/E 5 f11. F¿'~/1¡4{P4~ 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 IllS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN TIllS 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
REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF TIllS APPLICATION.
....---.;/
(;) r~ ß~l'â~-- j
i/ S¡gñåture
SWORN TO BEFORE ME TIllS 3{
DAY OF ~ ,20 üg'
~~-~~'
JOVCE M. WILKINS
Notary Public. State of New Vork
No. 4952246. Suffolk County
Term Expires June 12, ;l.o c> ~
'.
APPLtCANT .
TRANSACTIONAL DISCLOSURR FORK
The Town of Sou~holdos Code of ~bhicB ·tohibibs contlicbs or
nbenst on the part of town off cers and employees. 1'he
purpose of this form is to provide information which can
alert the town of possible conflicts of interest and allow
it:. 1::.0 lake whatever act-ion is necessary 1;0 avoid same.
TOUR NAHR.
Ft.-A
Last. name, firs
you are applying in t:.he
other entit.y, Buell
t:.he other persohlg
..
;';""~~"'::'":'Ì;.·":ïMf'·:'·~"';'·
NATURR OP APPLICATION. (Check all that applY·)
Tax grievance
Variance
Change of zone
App~~.l of plat ~
Exe.ption from plat or official map
other I/r_
(If .other,· name the acHvHy,) W¡;¿¡-t-.I{lf/¡J rr.=><:::-'/ij--
,~
Do you persorta11r (or th~ough tOUr ~ö.pa"y, øpöude, blbl1ng,
parent, 0[' child) hove a relationship vith Bny ofrit!er or
employee of the Tovn of Southold? -Relationship· includes
by blood, .arriaga, or business interest~ -Uusiness
interest" ..eanB a buslness, including a par\;nerBhip, in
vhich ~he tovn officer or employee has even a partial
ovnerBhip of (or employ..ent by) a corp"ration in vhich
t~e town of ricer or e~ploree Qvno more than 5% of the
shares.
YRS
NO
~
If you anevered "YRS,". co.plete \;he balance of ~hi. ror. and
dale aDd s1gn where indicated.
Name of person employed by ~he Town of Sou~hold
Tl~le or peøillon of ~hat person
Deecrlbe the relationehip be~ween yourself (the applicant)
and the town officer ør employee. Ei~her check thø
appropria~e line h) ~hrough D) and/or. deecribe In the space
provided.
The tovn officer or employee or hi. or her BPOUSe, sibling,
paren~, or child ie (check all that appiy),
_____h) the owner of grea~er ~h.n 5% of the share. of the
corporate .tock of ~he applicant (when ~h. .ppllcant
is a corporation),
_____B) the leg.i or beneficial owner of any Interest in a
noncorporabe'entlty (when the applicant is not B
corporation)
_____c) an officer, director, partner, or employee. or bhe
applicanb, or
_____D) the actu.l applicant.
.,.
.~;. ~ .
-....
DESCRIPTION OF ItELhTIONSIIIP
I'.'
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sublal. tt.ed
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.: ".',. ~. '. :;~ ';. "._.f"," ;"..<:'} .~~~.
,.J
signatur
'Prln~ ne
,I!~~~!'
.
.
March 16,2003
To: The Southold Board of Trustees,
We, James and Margaret Flanagan, own a house at 695 Bayview Ave. in Southold N. Y.l1971
(Suffolk Co. Tax Map#lOoo-052-5-20 lots 23 and 24). We are planning to renovate our house by adding
a second story to the structure and by extending the structure towards the road (away from the water).
Since this is bulk headed waternont property at Arshamomque Pond, we were advised to contact you
concerning a letter of non-jurisdiction. We are enclosing a plot plan drawn by Donald Feiler, architect,
outlining our project. We also enclosing a copy of the Letter of Non-Jurisdiction from the New York
Department of Environmental Conservation that we obtained concerning this proposed project.
We hope that this information is sufficient to grant us a letter of non-jurisdiction for our renovation. Our
present home address is: Flanagan, 7 Young St. Cortlandt Manor N.Y. 10567 (914) 528-5266
[5),1E Ii: IE n 11 ~, ~
\fìJ UAR 1 6 1003 i~
Thank You.
...., -//
c/., .vr".Ji¡;1/¿l, \~~;l/~--<--
v ·ft~ ~rI'~
Southold Town
Board of TrLI~\"¡;S
James and Margaret Flanagan
.
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