HomeMy WebLinkAboutTR-5487
Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. . 5'117.
DATE: .I!.:.b~ 21, 2002
ISSUED TO ........
POSILLICO CONSTRUCTION CO., INC.
.....................-.-......
..m.···....... ........................................
Aut~nrilatinn
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 Y ork 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 W A TERS:~.'. and in accordance with the
Resolution of The Board adopted at a meeting held on ..f.!:,þ'.,...2.º...4.002·
.........., and in consideration of the sum of $..2~0.~.o..o..... paid by
Posillico Construction Co., Inc.
................--.................................
..........................
of ......w..~.s~~~:':T...... . .. ....... N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the foRowing:
Wetland Permit for the existing single-family dwelling under const
'and proposed 24'X28' detached two-car garage,with the condition
!·of a 50' non-disturbance buffer and a line of staked hay bales
'placed .down at the 50' buffer during construction.
aU in accordance with the detailed specifications as presented in
the oñginating apprlCation.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporate Seal to be affixed, and these presents to
be subscribed by II . majoñty of the said Board as of this date.
:;L~ tJ·
~k'eth Pol1woda (Absent)
Trusie..
TERMS and CONDITIONS
11>e Permittee Posillico Construction Co.. Inc
residiag at 31 Tennyson Ave., Westbury, NY 11590 N. Y., as
part of the cOllSideratioo for the sS,..nœ of die Permit does uødentand and prescribe to the fo1-
10wiøg :
1. Tbat the oaid Board cl T~ and the Town cl SoutboId are released from aøy and
all damages, Of: claims foe cIamages, of IIÚØ arlsiøg diteàI.y or JacIireody as . result cl my oper-
adoo perfoamed punuaat to tbis permit, and tho said p... "'eee wiI1, . his or her OWD areo"'.
defend my and all sUch suilS' ¡..;.I.fed by tbIrd patda, and the oaid J'1 1..- ....,.., fall JiIbI1/ty
with reSpect tbeteto. to the CO"'J"- --..a...Inn of the Board cl T~ cl the TOWD cl So..ð-Qld
2. That tbis PemIÎt Is wIid foe . pedod of 24...... -wbIcb Is ~Dllfu ed to be the
--to<! time· requited to C9"'p1~ the wade in'fOhecI, bat ihoaJd ~"""" warnøt, request
for 011 eDeDSioo may be made to the Board at . later date.
3. That tbis Peanit should be retained indef"UJite{y, or as loog as che oaid Permittee wishes
to m.I....;n the suuaure or project involved, to provide erideDœ to aøyooe coøœrned chat aad>-
.orizaâoo was originally obuiøecI.
4. That die work åm>lved will be subject to the ~ and appronl cl the Boud «
its agents, and non-œmpliaoce with. che ptovisioas cl the origI-,;"g appl;C'~ may be cause fOf:
reoocadoo of tbis Permit by RSQwtioo of the said Board.
5. That there will be no unreasoo....e intedereoce with ...-.igadoa as . result cl the wodc
baein auÜ1orized.
6. That there shall be 00 imerfereoce with tho right cl the pobIic to pass and repass a100g
the beach between high and low water marks. .
7. That if .fuaue openåoas cl cho Town of Soacho1d reqahe cho teII10ftl aad/Of: a1œradoas
in the location cl the wade berein ...tJ.-~ ¡~. or If, in the opInh-o of the Boud cl Trustees, the.
wodc sbaI1 cause unreaSOC'ob1e obstrucÞOD to free nav/g2doa. the oaid P "wl,,_ will be requI1ed.
upoo clue DOtice, to remove or alter tbis wad< at project baein stated widIoat ~''''''I to the Town
cl Soachold.
8. That the said Board will be notified by tbe ~rm;ø- ot the f' ",ok\il, n Of the wad< aad>-
orized.
9. That the permittee will obtain all other permits and o-en'" that may be requited sup-
p1emental to tbis permit which may be subject to revoke upoo failaro to obtain -.
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
February 21,2002
Mr. Anthony Posillico
Posillico Construction Co" Inc.
31 Tennyson Ave.
Westbury, NY 11590
RE: POSILLICO CONSTRUCTION CO., INC.
3040 Kerwin Blvd., Greenport
SCTM#53-4-44.35
Dear Mr. Posillico:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, February 20,2002 regarding the above matter:
WHEREAS, POSILLICO CONSTRUCTION CO., INC. applied to the Southold Town
Trustees for a permit under the provisions of the Wetland Ordinance of the Town of South old,
application dated January 31, 2002, 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
February 20, 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 standards set forth in Chapter 97 of the Southold
Town Code,
2
WHEREAS, the Board has detennined that the project as proposed will not affect the health,
safety and general welfare of the people of the town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of POSILLICO
CONSTRUCTION CO., INC. for the existing single-family dwelling under construction and
proposed 24'X 28' detached two-car garage, with the condition ofa 50' non-disturbance buffer
and a line of staked hay bales placed down at the 50' buffer during construction.
BE IT FURTHER RESOLVED that this determination should not be considered a determination
made for any other Department or Agency, which may also have an application pending for the
same or similar project.
Permit to construct and complete project will expire two years from the date it is signed, Fees
must be paid, if applicable, and permit issued within six months of the date of this notification.
Two inspections are required and the Trustees are to be notified upon completion of said project.
Fees: None
Very truly yours,
t2!.i.,- ¡ (1, /¿._~~, C.
;' I ".
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/lms
cc: DEC
Bldg. Dept.
Health Dept.
.
.
~------~-------~-~-------~------
JOB No AUG-33
REV 02104102
WETlANDS
TAXLD. No. 1000-53-04-44.35
APPROVED BY
BOARD OF TRUSTEES
TOWN OF SOUTHOlD
DATE 2 /2--.0 /02.
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FIRM ~ANEL No 36;o3C0159 G
WETLAND BOUNDARY FLAGGED
BY DESTlN GRAF ON 02101102
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FILE MAP No. 9107 6/3/91
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Un3utnotizecl alteration or addition to tn!!; document Is a .111)1.31'011 0í Section 7209
of the New YOll< State Education Law
Certrflcatlons indicated hereon sMail run only' 10 the person for w~"11l11 .;; prf'~'\f1red
;]nd or. h'~ behalf to the Title r.ompanr. Governmental Agency ann LMrtmg
tnst.Mion listed hert'M)n, and t:J the assl<;¡nees of the lending ¡nsu!tltlon... or
subsequent owners
Cop,e~ of thIS document nol bearing the professlonars Ink:9( seal or embo~sod
seal shall not be considered a 'valid true copy
The offsets I or dimensJons I shown hereon from structures 10 tf'Ie ¡:;roperty lin~ Bre
ror a specific purpose and use and therefore are nOI intended to gUlete !he erection of
fences, retaining walls, poolS, planting areas, addition 10 bU!ldlngs or any olher
conSlructlQn
Tl1e eXistence of right otways andlQf easements of record, "any, nOI shown are
notguaranleed
--.-----. -------------.--
SURVEY OF LOT 33
M/O AUGUS~ ACRES SECTION 1
ARSHAMOMAQUE, TOWN OF SOUTHOLD
SUFFOU< COUNTY, NEW YORK
SURVEY DATE: 01/14/02 SCALE: 1"=50'
------~-
DESTIN G,GRAF
LAND SURVEYOR
CERTIFIED ONLY TO:
POSOLLlCO CONSTRUCTION
By DESTIN G. GRAF N.Y.S. LIe No. 50067
-
.
.
------
JOB No AUG-33
REV 02/04/02
WETLANDS
TAX ID. No 1000-53-04-44 35
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nauthOrlZed alteration or aadrtJOIl 10 [hIS document IS a .10latlOn of Section 7209
of tne New YOrl< Stale EducatJon La~
':ertrficatJons Indicated hereon shall r..n ani) to tile persen for Mom It IS prepared
ana on his Deha!f to the Title wmpan¡r Governmental Agency and lending
InstitutiOn I.Sted hereon and to the assl\õlnees of tile leno'ng <nstltut'ons or
Subsequent ownen¡
::Oplt'S of thiS docclment not Dearing tile prof&.¡s,onal's InKe(l seal or embossed
seal shall not oe conSidered a val,O true COpy
Tr.e offsets [or dimensions) shown hereon from structLJres to the property lines are
fOf a specific purpose and use and tnerefore are not ,ntendea to gUide the erection of
tences retaln,ng walls POOlS p¡antln¡;¡ areas addition to bLJlldlngs or any other
:onsU"uctlon
Tne 91CJstence of ngnt of ,^,ays ana/or easements of record If any, not shQWl'1 are
n0tgLJaranteed
VACANT
FILE MAP No. 9107 6/3/91
SURVEY OF: LOT 33
MIO AUGUST ACRES SECTION 1
ARSHAMOMAQUE, TOWN OF SOUTH OLD
SUFFOLK COUNTY, NEW YORK
SURVEY DATE: 01/14/02
SCALE: 1"=50'
CERTIFIED ONLY TO
POSOLLlCO CONSTRUCTION
By DESTIN G. GRAF N.Y.S. LlC No. 50067
DESTIN G.GRAF
LAND SURVEYOR
1-31-2002 3:31At.1
F"Œ1.ILLICO
Ir".IC 516 333 6903
.
--'---------
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TAX '.D No. 1000-53-04-44.35
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SURVEY OF
LOT 33
MIO AUGUST ACRES SECTION 1
ARSHAMOMAQUE. TOWN OF SOUTHOLD
SUFFOLK COUNTY. NEW YORK
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I=~~';;~~ED ONLY TO
I POSOLLlCa CONSTRUCTION
SURVEY DATE' 01114/02
SCALE
8y DE:::.TIN G GRAF N'r 5 LlC No 50067
-----
DESTIN G.GRAF
LAND SURVEYOR
1177/3
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TAX I.D. No. 1000-53-04-44.35
JAN j 1-'"
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FLOOD ZONE X
FIRM PANEL No. 36103C0159 G
N 43°09'40"W 160,00'
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VACANT
---....
FILE MAP No. 9107 6/3/91
LJnautt10nzed alteration or addition to tn,s document IS a ,",olation of Section 7209
of the New York Stale EOi,lcabon Law
Cert,fications Indicated hereon shall run only to the person for whom It IS prepared
iH1d on hiS behalf to tna Title Campan)'. Governmental Agency and LendIng
Institution I,sted hereon and to the assignees of the lending mstltutions or
suDSeQuent owners
COpies of thiS document not bearing the professional's Inked seal or embossed
seal shall not be consloered a valid true copy
Tria offsets [or dimenSions] shown hereon from structlJres to the property lines are
for a specific purpose ana use and tnerefore are not Inlendeo to guide the erection of
fences. retamlng walls, pools plantmg areas, addition to bUildings or any otner
con'!;!ruC'tlon
Tne eXIstence of nç ht of ways and/or easements of recora, If an~, not shown are
notgloaranteed
SURVEY OF: LOT 33
MIO AUGUST ACRES SECTION 1
ARSHAMOMAQUE, TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
SURVEY DATE: 01/14/02
SCALE: 1 "=50'
By DESTIN G. GRAF N.Y.S. LlC No. 50067
DESTIN G.GRAF
LAND SURVEYOR
CERTIFIED ONLY TO:
POSOLLlCO CONSTRUCTION
.
.
Fred K. and Dorothea T. Salzberg
2890 Kerwin Blvd
Greenport, NY 11944-2745
(631) 477-9733
February 22, 2002
Mr, Gerard P. Goehringer, Chairman
Southold Town Board of Appeals
Town Hall
53095 Main Road
Southold, NY 119711-0959
FEb 2 ~ .
Re: Appeal no. 5066 and Environmental Review
3040 Kerwin Blvd, Greenport, NY, 11944
Dear Mr, Goehringer:
We, the undersigned Fred K. Salzberg and Dorothea T. Salzberg, residing at 2890 Kerwin Blvd,
Greenport, NY 11944-2745 ( also known as lot 9 on MlO August Acres, Section I,
Arshamomaque, Town of Southold, NY ) and located immediately adjacent to the subject
property, make the following statement:
We believe that the house and proposed detached garage will be an attractive addition
to the neighborhood, and urge that the variance requested by Posillico Construction be
approved.
$~Y~
cc
Board of Trustees, Town of Southold /
Posillico Construction
.
.
Telephone
(631) 765-1892
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town Conservation Advisory Council held Tuesday,
February 12, 2002, the following recommendation was made:
Moved by Bob Ghosio, seconded by Jason Petrucci, it was
RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of
the Wetland Permit Application of POSILLlCO CONSTRUCTION CO., INC, for the
existing single-family dwelling under construction and proposed 24'X 28' detached two-
car garage,
Located: 3040 Kerwin Blvd., Greenport. SCTM#53-4-44,35
The CAC recommends Disapproval of the application and recommends that the
applicant re-establish 100' of native vegetation, non-turf/non-fertilization buffer.
Vote of Council: Ayes: All
Motion Carried
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1-31-20('2 3.30MI FPŒ~ POSILLlCO WC 516 33:' 6983
Ul,'Jl/U..! IHL IJ:JU ....~.\. :)!~ ltì~.b ~OUtnoHl 10\\'11 .'t'C'öUnT:ln~.
Albert J, !úup.ki, ¡>r.,sident
J&ID~, VjcE:..Pre,ident
Henry S,Aith
Artie f'oBter
Ken Poij'oode
T.lephg". (631) 765-1892
Fa>: (631) 765·1366
To-n Hall
53095 a.",. 25
P.O, Box 1179
S""U,old, Newy""k 11971·0959
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Offiç~ Use Only
_Coastal Erosion Permit Applíc;atio~
~etland Pennit Appliçation /Major
-Waiverl Am~ndmentlChangcs -
_Rcc~ived Application:
_Received Fee:$
_Completed Application
_Ineompleti!
SEQR-\ Classification:
Typi! I_Type ß_Unlistcd_
_Coordinalion:(date sent)
_ CAC Refem.l Sent:
_Date of Inspection:
_Receipt ofCAC Report:
_Li!ad Agency Determination:
_Teclm.ical Review'
_Public Hearing Held:
_-.-Resolution:
Minor
JAN,J I
,
L
Name of Applicant "fbs; ¡//Cð C-.-..:s/-y.",c./-"vv., G..Znc
,
Address 31 Te"'''75h-- Av~ w-estb.o.vy/ ÆY //5"<Jò
Phone Number:~J b) 3"3'3 - 06(, (,
Suffolk County Tax Map Nwnber: lOCO - 5' 3 - £f - 4' t( 3 ">
propc:rtybcation: 3o¥o ke~wíh a/v), ¡Çyf'f'.n porf
- v
IYHIi wesf ;,..,'¡'e'rs.ecf¡~ of Kevwi,... Blvd ~ PJ,ep,s",...f PI..(e
(provide L1LCO Pole 11-. distance to cross streets, and location)
AGENT,
(If applicable)
Address'
Phollc:__.
P -
.¿
~\JU.l
~~
~S)y
1-31-2082 .3, 30At.1 FPOfl POSILLICO INC 516 333 6903
Ul:Jl1U;! lKl IJ:Jl l-A....\ ~11) I~~.I) ~(JUt.nUlU tuwn Al'l'UUlJ.llU.
~
P. 3
IiL.1 UU!
Board of Trustees Application
'--~
GENERAL DATA
Land Area (in square feet):
~tJ77Þfz
Area Zoning'
R- 80
Previous use of property:
Vaca""f ¿aV?d
Intendeduseofpropmy' 5;"1-,,, ~......,(ý ~{,,5;je.-.(.., """,;AK
Jek.J...€.J 2- cC;¡,.- jq,r"'je
Prior permits/approvals fur site improvements:
Agez
5,A;(;,1J<. ~¡ý /.kQ.i fÞ¡f
~I
.5 /J !3vi/.L"5 D",!f
Date
?,/(./oo
f '
/2 /7/0 I
I ,
__ No prior permits/approvals for site improvements.
Has any pmnit/approvlI1,~vu been revoked or suspended by II govemmental agency?
~No_Yt's
If yes, provide explanation'
Project Desaiption (use !Lttachments i[necessary): E..:; s /; ") Si "jle
kM'/ý 1Ju.-,..e: uhd~.,.. c-..S¡""fA.Ch·~ (ff?¡........¡1- #
z 7 {51 Z) -.J ,I'r'JP0se j 2'-f' ~ 28 ' de f-o..cJ..-eJ
2- c<-;v j< ....~je (4'vvð¡;L'j ZBA h-f''''''¡''') r"", 3/14/{>2.
ZBA F./e # SDb'=- -f""", ,...,/'!(e"",J ;~ +rø-n.+ vc;rJ.\
r ~~
· .
Board of Trustees Application
WETLANDITRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: 2- S·h,,-v· 5', ~) (-e h,.""'1 ~
{
R i?5, d"" (e with 1NV'''f " 'rVlA " J po v-ct-... ~.l 2",-0
5 I-vv t ßð,lcc"y c",) 'ì)p-f-.:cf-"J '2...- (.¡ v (,...¿; Ir<j e
,
Area of wetlands on lot:
6, 3 b 5 square feet
15'. <1 %
Percent coverage of lot:
Closest distance between nearest existing structure and upland
edge of wetlands: 71, 5" feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 7'1- feet
Does the project involve excavation or filling?
No
-/
Yes
If yes, how much material will be excavated? 3¿1î) cubic yards
How much material will be filled? tilffYO)/ ISO cubic yards
Depth of which material will be removed or deposited: Lf X
o.S-Ivi.o
Proposed slope throughout the area of operations: 2 -f., :, %
Manner in which material will be removed or deposited: EX(qvtl ~'¡J-v-., S' £ B<:chfi II
will h... ¿..... WI ¡.,~ ßcAfUczl'ý' /ÞIU-. +v-<.1 laClJ",.
feet t'l,C6.V<i I; '-'Y\
f~t r::--,II
Þ.dat-. A,,! -r,/I ni'fJ"J 4/'11 h€ bnrnjA+,V\ 6(
J"'''''D ,fv-vck c..J 'f~.('CjJ WI~ <,-laO"'" /'VIe", ¡¡Impel e<;<·;,pno PVlf.
, I v
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):
,None
J
-10
1/"" be>!-- <.f
M"¡
f
k"'ék-Vledje
· .
Board of Trustees Application
County of Suffolk
State of New York
r ßs; /I iGc C;"" s fv",cI-¡ ,- Co. / J;,c.
IIn+I"-fJl- Pos;//¡co -J... -fa« BEING DULY SWORN
DEPOSES 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 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 TIllS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR
REPRESENT ATlVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
'l~.£?_ /ð~
l-~jj¿ þí~ / .
i ature
SWORN TO BEFORE ME TIllS /8~ DAY OF !;Lhll//"'íl ,20ð?-_
/}~LO ~
Notary Public
HELENE D. HORNE
Notary Public. State of New York
No,4951364
Oualified in Suffolk Coun~
roo ........-. .-:--:-'."",~ f-'~rÙ"'!::: May 22, 6t.003
~tt) 3 ,\.
J0Ø~U~ß0 Œ0(ï)ØÛ;1!1ßÛ~0(ï)
31 tennyson aye . westbury· ny 11590
. 516-333-0666 . fax 516-333-6903
Dlte 3/1/ oz..
, ,
TRANSMITTAL
To 5~,-<>/j B<'><"ty--J of ?;-tA.,j-e-es
Address 'R O. 130 )( / /7 "l s.~ #0/ cf ,
,
Attention: L <'t.« ¡r f"v¡
AI Y //97/- ð'l5'1
We Ire sending herewith
o CONTRACT
As follows:
C~ ¡r /-"'¡:;Yi
o PRINTS
o
Me-¡ i! IJ~
T^ì~ 5/........./'" 6e M IaJ-I--
rejC!Y' ,"']
ÁjVJ+ k""J V-H- !>J
Ov-R .
Received
Your. truly,
POS/LLICO CONSTRUCTION CO.. INC.
By
By ~? Æ~
.
.
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
Address: 3ot¡-o k-eYIÑ/I" Blvd
G~e~'YftT~ /II f /I? 't'-/
STATE OF NEW YORK
COUNTY OF SUFFOLK
/lr,414"'''¡ ~s;/lu> S'r ,residing at :2Q(.e C"""J Ave. /3.;/d<.ulr-
Iv Ý I / I s: I D , being duly sworn, deposes and says that on the
h H--- day of ¡::éby«" vý ,200 '-, deponent mailed a true copy of the Notice
set forth in the Board ofTru$tees 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 South old; that said Notices were mailed at the United States Post
Office at /I1J">~LiVy' NÝ , that said Notices were mailed to each of said persons by
(certified) (registered' mail.
~¡?~~/.
Sworn to before me this i d. 'Ik
DayO~~ j¡...'I..v...'O ' 200 ~
'?\CJì -'2 (hßL
Notary Public
LYNDA M. BOHN
NOTARY PUBLIC. Slale 01 New York
No. 01 B06020932
Qualified in Suffolk Counw -?
Term Expires March 8, 20 ~
617.21
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I-PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
,. APPLICANT IS,P9NSOR ", I 2. ?AOJEC7 .\lAME
po>i /1 í Co {",,> ,cJYIA C f-;.... c,. (
3. PROJECT LOCATION:
Munlelpa,;,y 5'0 <-1f/..o Ii í ðTAn'\ 5 /,;
H.~q.412187)-ïext 12
PROJECT '-D. NUMBEi<
.
.
SEG
-'-5 M-# 33
5uf 0 k
County
4. PAEC:SE LOCATION {Street a( Clress and road Intersections. p mmenl1anamarKs. etc.. oJr ,::Irov,ae mac!
3ot.¡o kf'vwi^ /11'-1'(
",f kf''rwiY\
(fA" rno5>f
c) asHe
Blvd I C-VOVlr['0tt J NY
S&u. -ftf'.+ I ð-f-- "'" ¡ r:e We 51 > / cI ~
P/'eæsc¡YI + Plc,ce)
13/v'cI
5. IS PROPOSED ACTION:
~ew 0 Expansion
5. DESCRIBE PROJECT BRIEFLY:
2- :':,h,Yj 5iYl51<? F;¡h1;1y jJes/Je-.-,(€
(rc,..-c.,)", L'1^- I 40-'" 4/f 111
o MOdification/alteration
Wlft.... De!-r..(kf'j
!lz,¡j f/sr Ac~ 5 5C<bcl/YlS;,....
Z-CC;V
'. AMOUNT OF ~ND AF¡::¡:CTED:
y~ IVL
Initially acres Ultimately _ acres
3_ WIU.. :=RO?IJSêù ACTION CCMPL':' WITH Ð:ISilNG ZONING OR OTHEr¡ E.XISTrNG LANO USE .:¡;eS7RIC7'tQNS?
~es 0 No If ~Jo. describe briefly
9. V¡HAT IS ?RESENT LAtW U8E IN '/ICINIP- OF ?ROJECT?
i~'::¡es denllal [j,lnaus:na C C.)mmerciaJ U Agriculture
Desc:lbe:
/111 5<-1.,...""""J'''5 Ic-l5 i", /I.1J,-'!,f )10-<'5
ð'>"- / <Joe lei)
10. aOES ACTION INVOLVE A PERJIIIT APPROVAL. OR r-UNO!NG. .\J.OW OR UlTIMATELf ,i:"RQM ANY OTHER GOVERNMENTAL AGENCY (F::ùERAL.
ST A T~g.¡¡ lOCAL)?
~ Yes 0 No If yes. lisl agencYIs) and oermitlapprovals /J I- / /-. I L ~ -4' 5" ~
5.'.Af£/h. ~~I¡- Dí1f ·ðf /-k.:-.LúC 5e....v;<e5 - ,?o'''''¡ h.> '-"'1~TYhr 'f' <_ )-'J
5c--G<-It..,IJ I~ ßu; 11,-,... /)2 i - 8",¡1c!1 R-o',,",,¡ f ~/,j T.-"'slee:.-; t1le-{-¿~J I?r..,f
:-.J Pan<;/ForestIOoen space
L Other
<1... -;';"'5' ~ £""..,.,; Iy I-. UVrl' s
11. --.99ES ANY ASP:CT OF THE ACTlor~ HAVE A CUR ENTLY VALID PERMI OR APPROVAL?
(!f Yes' 0 No U Yf!s. list agency name and permIt/approval
5Ú(.(,¡h &unt-¡ 1*$ 171- <'vi" 5..-d4<.1cf ----r.:.......... B.Ú/¿;''j .Ph"" 1 r
12. AS A. RESULT OF PROPOSED ACTION Wll!.... EXISTING PERMIT/APPROVAL ME·:)UIAE '....'OOJFIC)., ¡ION?
0_ ~o ...
I CERTIFY THAT THE INFORMATION PROVIDED ~eOVE IS TRUE:-O TH: 3EST OF MY KNQWL':;íJGE
~pplicanllsponsor name:
?o5,j/¡-~o
c;. 5 Iv-... (/-,"'" 0. , J;, c.
,
D.tle:
Z/¡z/o 2
, ,
Signature:
If the action is in the Co"stal Area, and ,au are a state asency, complete the
Coastal Assessment Form before proceeding with this a:j..~essment
OVER
:..:.y
. ~~Jï . oJ je '-::::H:":::;¡e-~e,= ~y
,-': . 7¡..,::;E3i-:CLJ 'N 5 .'.':'::=;¡::. ::0 :..F¡ 5= 7.':'"
---
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jf :¡~S. :::cro,nate ::"Ie re....'p.w
:::cceS3 ana 'J$i:t :!".9 ='JL_ ::~,=-
P..\ñ¡ l1-~:\NI¡;C:"IM=;'~ï"\'
I "
=- ',vIL~ .:"C'';":CN ·=tE·::::;'·¡=: ::;CPOIN':','2J :::¡E~/IE'N ....$ ?RC'/ICEJ =.:;:; 'J~ L.S7=:J .:.C7:C;"IS :N :5 .~'('::~R. :J~;;ï 5' ;-.37
Tlay ':Je suoerseCec ::Jy :!once:":er ,n....ol....ea açency.
:1 ..~O. ~ îeç.3.(:·¡e ::~c:ar::
1-..: y~s
!_."IO
c. C::ULO ,~C7;CN .=!ESt.:L7:N ,.!,.NY .:.[jVE::;S¡: :::.==:;:·:;73 AS3CC:..;7"2J ·,vl':.! -:....,S .=·JL:.....:'NI~G. :An.s.....ers .-:-;ö.v::e ianCwr¡[:en../ ..~-; clel
(;1. ~,(lsllng .ilr ~uallt·l. sut:'ac~ Jr ,¡rot.:nawace~ ;:ualify Jr '::t.: an II !y, ,101se .e....els. ~X~S¡lng :~â;:ic ::al:erns, 30lic .....as:e :)root.:C:;=., :Jr JIs.:;::
;JOtenllal fer ~ros¡on. ::ralnaçe or :toocmq Jrac!ems? ::"-:o!am ::merly:
C2. AestneUc, a~rlc:.II!Ural. HC:1aeoloqlc.al. :'¡s;onc, :Jr :Jcner 'at~ral :Jr C:.Jllur31 ,-¡¡sources: :Jr :::;mmun,ly :lr ,'el~t1ccrnooo .:~;¡rac:er'" =-'(Olaln ~
.J..... '!eçelatlon .)r :auna. ~ sn. sr:ellfisn or 'lfllclHe s¡Jec:es. .3lqmiicanr .iacltals. :lr :nre3teneo :Jr ~n":a.nc:;ereo .:;cec:es? :'H:tam :¡rially~
C..:.. A c~mmuml'f'S exist:ng ;)!ans or ~oatS as olflc:aJly aaootea. ':Jr a cnange In use or intensllY or use at rand or :Jtner natural resources? S;¡:plaln :~
c.::. GrowIM. suoseauenc :evelooment. :>r relalea ac:~""lt[es likelY (0 :>e ,nduceo :;y !ne ::rcooseo ac:icn? S;Jlaln Jf1eilv.
C3. ~cng :erm. snort :~r;";l. .::;mutò.live, .)( 'Jcner '3lfec:s no( IcenlltieCl In C;-ÇS? =.1:l!aln ::Inet]',_
::!r:~! moac:s ¡nc:.Jc:n~ :::~an<;es ,n 'Jse .:It ~~tner q1,)antlly .': r ~y~e or ~nerçÏJ? =-t:)Iò.JO :::r:etly.
j. S ':"HE:=.E. JA :S -;-.=::!c; :":!{2!..·:' :-C 5e. ::0Nï:=iQVE?S'f :J¡:!....r<.7"=:J '7"0 ?QT::~ril";L ":'~'Ë.=!Sc; ::::'WIRCNMPIT":'L ....:P.1.C-:-3?
'_':'es
__ .' O
:f ·:'es. ~XClaln :meffy
.'AR7 III-DETë::!MINAïICN OF SiGNI¡:iCANC" ¡To ~e comoleted "y .~gencï)
!NS7i1UCi¡ONS; ¡:or :!3C:1 a.dverse ~!fec~ identified accve. determine woerner it is substantial, large. :mcorcant or otherwise signific.
::.3.ctl :!jfec~ siloula ~e 3.ssessed in c:Jnnection wltn Its (a) setting (Le. urean or rural); (b) ¡:)robacility ot oc:::~g; (c duration'
jrre'¡erslo¡JHy: ;el geQqracnic ¿¡c:Jce: ana (f) magmtuce. If necessary, add aUachments or reference supporting marerials. :nsurF.!
o:xolanations c~nta," suttic:ent aetali !o snow that all ~e!e'lanr adverse impacts nave been identified and adec:uatelY aCCresseG.
C;'ec:x: ;his box :f 'fOU "ave idemifiea one or .-nore .:JotenciaHv Jarçe .Jr significam 2.C'Ierse imoac:s 'NnlC:1 ~.1';"·:'
oc:;:.Jr. Then ~rcceec airec:I'I ~o :he FULL ::'AF ana/or preaare a positive' declaration.
- C;'ecx: :his :;ox :( 'Iou ;'ave de !ermined, JaSed on the informarion and analysis above and any SiJDDort:r:c
doc:Jfì1enrar!cn. :hat ;/":e :JrODosea ac:ion ¡:¡JILL ~JOT result inJny significant .3.CYerSe -::nvlrcnmental imcac::
AND Jrovlce .:n 3.t:aC:1r.1ents 35 necessary, ¡he ~eason5 sucr:oning this dete:"mlnarion:
......,"... H _c..<.J "',t."OC·¡
"",OI.JI 'C~ '..rnfO' .)¡ <~·,wOO\.O'C "';llIc-:r 0 _"..0 ...~"nc·¡
:,u~ )1 ..(c'OOO\'O'~ Vlr,c~r
;.,n.JIl.:,C' )1 <~·con'.o f' ":1:,.:C'r ,0 ~C:.1Q ~.;",ncy
)',<:",,:U'l" )f ....·..".),Jf"'( 'Ir ":":er",nl 'f::lm 'e'ooo"o'~ 'Jl"C",,,
~
J~[C
o
1-31-20223,30AM
FRO~_LLICO INC 516 333 6903 _
[;JUJ0~UU~L5œ (B(]üJøß(fI!1í5ß~øüJ
P. I
31 tennyson aye . westbury' ny 11590
TRANSMITTAL
To .5&<-0.. -H... /J.
Addr... ~ ^ #-
{3.,., ~ CJ f
(n:.. s k€' 5
. 516-333-0666 . fax 516-333-6903
Dlt. I I;, / lo-¿
. ,
6; / - 7{, '5 - 13' b
('Zo~ ( f?'J""!> = 'f)
Attention; Lt:f c...c yeV\
W. Ir. ..nding h.r....ith
o CONTRACT
A. /0110....,
o PRINTS
GY 4;,,$/1'< <={-;,;»-.
V
;304..J "f 7;-"" k'-$ Af7?l/¡c:... -/-,.~
R..c.iv"'¡
Yours truly,
POSfLLICO CONSTRUCTION CO., INC
By
By /ð
¡ú'~
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TRANSACTIONAL DISCLOSURE FORM
The Town of Sou~hold's Code of ~thics rohibits contlichs of
nberesb on bhe part of bown off cers and employees. The
purpose of bhis form is to provide informabion which can
alert the town of possible conflicts of inberest and allow
ib bo bake whabever acbion is necessary to avoid same,
YOUR NMfR.
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(Last name, first name. mida~e initial, unless
you are applying in the name of someone else or
other enbiby, such as a company. It so, indicate
bhe other person's or company's name.)
NATURB 0' ArPLI~^TtONI (Check all bhat epply·)
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TeX grievance
Variance
Change of zone
Ap'p~~al of plat .
Exe~ption from pla~ or official map
Other V I j /)
(If "other." name the act! vity.) 1Y- t/:rl-'U> W -et ¿>y¡ , rev""" f
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Do you perøona11y (or through your cömpany, øpöune. nibling,
parent, or child) have a relationship with any officer or
employee of the 'l'ovn of Southold1 ·Relationship· includes
by blood, marriage, or business interest. "Dusiness
interest" Means a business, including a partnership. in
vhich ~he tovn officer or employee has even a partial
ovnership of (or employment by) a corporation in vhich
the town of ricer or employee owns more than 5% of the
shares.
YBS
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If you answered ÞYBS," complete the bàlance Of ~bis form and
date and sign where indicated.
Name ot person employed by the Town of Souhhold
Title or position of that person
Describe the relationship between yourself (the applicant)
and the town officer ør employee. Either check hhe
appropriate line ~) through D) and/or. describe in hhe space
provided.
The town officer or employee or his or her spouse, sibling,
parenb, or child is (check all hhah applY)1
~) hhe owner of greater than 5% of the shares of the
corporate stock of bhe applicånt (when the applicanh
is a corporation)/
B) the legal or beneficial owner of any interesh in a
noncorporate'entity (when the applicant is noh a
corporation)/
c) an officer, direchor, parhner, or emplöyee of the
applicanh/ or
D) the ~ctual applicant.
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DESCRI PTION O¡;' RELATIONSI!! P
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