The URL can be used to link to this page

Home My WebLink AboutTR-5100 81/27/2004 10:55 6317440032 . MANZIHOMESINC . PÄGE 82 . MANZI HOMES, INC 6H-74+1DJ9 P.O. BOX 7D21fOCJ(Y POINT, NY 11778 FAX 6H-744·ØØJZ January 27, 2004 SOUTHOLD TOWN TRUSTEES RE: 10605 SOUND VIEW A VB PERMIT NUMBER #5100 As peT the permit fur 10605 SOlmdview Ave, it has stated that the above location requires gutters & drywells. The gutters for this residence are on the house but the drywells have yet to be installed due to the ground being ITozen. This letter is to assure you that once the ground has thawed enough for us to dig we will install the required drywells. It is our intentions that this property will still be inspected and that Manzi Homes will call in for the re-inspection of just the drywells come the spring. If you have any further question please call me @ 631-744-1039 Thank you 04 ~lECEIVE a .IAN 2 7 2004 .J Southold TowR Board of Trust..s Michelle Gcsseck Manzi Homes, Tnc 01/27/2004 10:55 6317440032 . MANZIHOMESINC . PAGE 01 MANZI HOMBS,INC E·MAIL. MANZIHOMESINC(éiJAOL.COM . ::s'~ 6JI-744-1/1J9 FACSIMILE TRANSMITTAL SHEET TO'l.ú.. v-.... ....-c.- :5~:'~\",ol c.! ~-k ~ \ FAXNUMDER: / 7 t~5 - 1361.::.0 5END~JtS FAX NUMBEJt: 631-744-0032 lIE. ,--. -.:) C) VV'\. d '0\ C<. ~ FROM: MICfffiT T 1': GESSECK DATE.: 1- dCl-O'-\ TOTAL NO. OF 'AGF.-S rNCLUDING COYER: ~ SBNDt.R'S R.F.F'E'R.ENCE (.\~ J CA. VVu.-. .3 -1 kl .) DU..c:...~. ) ~I-e ~ S'..e C' ú... \. \. ~" Î h G.. "" L..... ~C)'--'---- 0\"t C~~~ 01'23/2004 15:24 6317440032 . MANZIHOMESI~IC . PAGE m MANZI HOMES, INC 6H-744-1D19 1',0. BOX 7/12 aocJ(Y POINT, NY 11778 FAX 6H-74+/lDU January, 2401 2004 Southo ld Trustees Fax: 765-1366 Re: 10605 Soundview Ave, Southold ~~ J~N~: ~A~ ~ Regarding: Pennit # 5100 at 10605 Soundview Ave. This property is now ready fuT inspection. Sout.old Town Board of Trust..S Please call if you have any questions 631-744-1039 Thank you //J2 ;. / Michelle Gesseck ~ Manzi Homes, Inc jJv (/l1:) ~ (AU L.ú0 - ~urd W ð'U'J-0'W . . 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 SOUTH OLD October 29, 2003 Mr. William F. Smith 20 East 14th Street Huntington Station, NY 11746 RE: 10605 Soundview Ave" South old SCTM#54-5-37.3 Dear Mr. Smith: In regards to your letter dated September 30, 2003, you requested permission to trim trees on your property. The Board of Trustees made an inspection of your property and determined that no distuTbance should take place north ofthe hay bale line. However, any activity beyond 100' ITom the wetland line would be out of the Trustees jurisdiction. If you have any further questions, please do not hesitate to contact the office, Very truly yours, ~..t- ?- ~._~.~. Albert J. Krupski, Jr.~ Pr;s~t-'-" Board of Trustees AJK:lms 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 November 21,2002 Mr. & Mrs. William Smith 20 East 14th Street Huntington Station, NY 11746 ,I RE: SCTM#54-5-37.3 10605 Soundview A venue Southold, NY Dear Mr. & Mrs. Smith: The following action was taken at the Southold Town Board of Trustees Regular Meeting on . November 20, 2002 RESOL VBD that the Southold Town Board of Trustees grant a one year extension to Permit #5100 for a new footprint of the house, including a porch, deck and garage, and to bring in fill to regrade tront yard and structural fill for foundation, with the condition that hay bales are placed 20' trom the deck during construction and gutters and drywells are installed to contain all roof run off all in accordance with survey dated September I, 1999 and last revised August 17, 200 I This is the last one year extension that will be granted. However, this determination is not a determination from any other agency. If you have any questions please contact our office at 765-1892. Sincerely, ~ f). 1~_-;.,vL Albert J. Krupski, Jr. President, Board of Trustess .- (.'A,...-o-. AJK:cjc Cc: Building Department , . 1(1 ').002- .T~, ~JLc· ~~~ fl ~ j ~ #5/00. W~ Q/t( . OM-~IhL df~ .}~' D il:lo,O{})'-~ ~, O· I ~~ç~ . ~=~ _y, 'l.UfFOl.t ~'C~ .y ss.~ t'~ ' 1~ ~' § :2 <:> - on ~ ,~. ~ ~ !':.~ ~./ + ~~tt, -c,>--0':::'.:('z:¿.-:;.:-.I_1.- . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 South old, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 26, 2001 Mr. & Mrs. William Smith 20 East 14th Street Huntington Station, ~..ry 11746--- RE: SCTM# 1000-54-5-37.3 10605 Soundview Avenue, Southold, NY Dear Mr. & Mrs. Smith: The following action was taken at the Southold Town Board of Trustees Regular Meeting on November 20.2001 RESOLVED, that the Southold Town Board of Trustees grant a one year extension to Permit #5100. for a new footprint of the house, including a porch, deck and garage, and to bring in fill to regrade &ant yard and structural fill for foundation, with the condition that hay bales are placed 20' &om the deck during construction and gutters and drywells are installed to contain all roof run off all in accordance with survey dated September 1,1999 and last revised August 17,2001. However, this detennination is not a determination &am any other agency. If you have any questions, please contact our office at 765-1892. Sincerely, ~o/'/¿~~ Albert J. Krup~ Jr. President, Board of Trustees AJKlcjc Building Department .. "" \ (p\^\\ \ f. . 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 November 26, 200 I Mr. & Mrs. William Smith 20 East 14th Street Huntington Station, NY 11746 RE: SCTM# 1000-54-5-37.3 10605 Soundview Avenue, Southold, NY Dear Mr. & Mrs. Smith: The following action was taken at the Southold Town Board of Trustees Regular Meeting on November 20.2001 RESOLVED, that the Southold Town Board of Trustees grant a one year extension to Pennit #5100. for a new footprint of the house, including a porch, deck and garage, and to bring in fill to regrade front yard and structural fill for foundation, with the condition that hay bales are placed 20' rrom the deck during construction and gutters and drywells are installed to contain all roof run off all in accordance with survey dated September 1, 1999 and last revised August 17,2001. However, this detennination is not a detennination rrom any other agency. If you have any questions, please contact our office at 765-1892. Sincerely, ~o~/¿~~ Albert J. Krup~ Jr. President, Board of Trustees AJK/cjc Building Department t· 20 tat- l'flk Stwl.. ~ ~~,~~ /17% () ~T~ì~ p~ y ~ tL c¡,~ If/o.oo j¡, CWM.... k ~f Ir ðþ ~#5100 Y- É~ ! fIJ~ ~.tJ -thuv ~ ~ ~ daf¿ -161,26,2003. · :r- fi""T ]'- ð ~ ~ 1Aw~. ~ )t~~ p~ (63/) '{--2-3 --zIS0 ,! ! I I NOV - 2 2.001 ., ¡ \ , j . - ... l·-~· '~~, ~I f\ ;, ll.:-- .. p- ......-....-..-....-. __,"_ u .__._._..--___.. .. -- .... . -... .---..-.-- -..."-...- . . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Albert J. Krupski, President James King, Vice~Pre5ident Henry Smith Artie Foster Ken Poliwoda ~ 'ì>UfFOL.t t! ~ ~ f§ ~ :::. ,"", ~. ~^ ~QJ + ~~~ ~--(l-' Telephone (631) 765-1892 Fax (6311 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 30, 2001 !'vIr. & !vIrs. William Smith 20 East 14th Street Hlmtington Station, NY 11746 Re: 10605 Sound view Ave., Southold SCTM#54-5-37.3 Dear !VIr. & Mrs. Smith: The following action was taken by the Southold Town Board ofTrus:ees at their Regular Meeting held on Wednesday, August 30,2001: RESOL VED, that the Southolù Town Board of Trus:eèS Appro\'e the req·¡est for an Amendmem to Permit #5100 for a nèW footprint ofthe ¡¡(jUS;:;. inÒ:¿;!lg ~ porcíl. deck, and garage, anù to bring in fill to regrade tÌont yard and structural fill for fOl,nåarion, with the condition that hay hales arc: plaœd 20' from the de,;k during constmc1ion and illtters and ':ir:wells are installed to contain all roof run-off, all in a;;coTd:L'1ce with SI'TVe:; daled Septe!Ilber 1, 1999 and last revised August 17,2001. Transfer ofPem1Ít #51Jü fro:n Jo!m Fri¿~man to Willianl & Elizabeth Smith. This is ilot a determinatiü:l ITom any Jther ager:c:.·. If you have any questions, please call our office at (63l) 765-1892. Sincerely, th/."I ~ 1~~·(2,. ~ I ,. Albert J. Krupski, Jr. PTesident, Board of Trustees AJK: Ims Bldg. Dept. Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. $/00. DATE: }iln. 26, 2000 ISSUED TO. JO.I:I~ PlU:1:.E;MAN Î\utqnrilutintt 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 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 Board adopted at a meeting held on ..Jan.,.. 26...2000 t9::-2J)OP and in consideration of the sum of $ .150..00. paid by JOHNJ'lUZEMAN .. .......... .......... of w..50lJ.tlwld.. N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to construct a single family dwelling with attac deck, and to place haybales 20' from deck during construction. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees Mre- by causes its Corporate Seal to be affixed, and these presents to be subscribed by II majority of the said Board as of this date. bJ;£~ absent absent Henry Smith Arthur Foster Truslees . . ,I , August 14,2001 .-,..... 2 q To The Board of Trustees Town of South old .. I have come to this hearing to voice my concerns and my opinion on the changing of what I consider a very, very important and delicate issue. I received by registered mail, the proposed plans for a home to be built by William and Elizabeth Smith, on Soundview Avenue. It is my understanding that this past October, the board changed the minimum set-back for wetlands &om 75' to 100'. I am sure the board had a very important reason for this given the delicate balance between wetlands and building lots. My family and I bought our home in 1996. Since then we have enjoyed the natural surrounding area of wetlands and the abundance of wildlife that lives in the wetlands. We have deer that we see almost every night. We also have red fox living here. We have seen them several times throughout this summer. Another animal, and what I consider rare, is the black squirrel. In the 41 years I have lived in Suffiok County, I have never seen black squirrel until we bought our home in Southold. My understanding is that they are rare. When you see deeT, fox, black squirrel and any of the other wildlife living in their habitat, you have to think how special this is. You have to think of development versus wildlife; and we do think of them, and the surrounding natural environment they live in! That's one reason we have a Board of Trustees, to help set up our guidelines. That is why I believe the setbacks have been changed from 75' to 100': to allow the wildlife to have their space, to let them live where they feel content and safe; not to drive them away. This is why an environmental change is not acceptable or warranted here. A change would upset the balance between nature and development for future generations forever. Once this is changed you can neveT reverse it; it is too late. In addition to not changing the 100' setback, I think it is equally important to leave a 50' buffer area of trees to help stop or at least slow the runoff into the wetlands caused by the clearing of land for house, driveway and lawn. . . , Hickory Road is just east of the Smiths' property. This road runs into Soundview Ave, and the runoff spills onto the vacant lot to the east of the Smiths. You can see what road runoff has done to that piece. There is erosion, pollution, etc. [feel additional runoff from lawn pesticides, fertizilers, weed controL and grub control etc.; driveway runoff and their pollutants such as oil, gas, and grease etc.; not to mention large amounts of rain water from the gutters and the Soundview A venue runoff, will cause irreversible damage. [ trust the board will take all of these issues into consideration and the full impact that this proposed project will have on our wetlands. My family and [ want the Board of Trustees to uphold the 100' code you have preciously mandated. We also feel that the 50' tree buffer in &ont of the wetlands is an absolute necessity. [ thank you for your time. Ø~)~ . . August 22, 2001 Vincent A. Fischetti, Ph.D. 448 Joan Court West Hempstead, NY 11552 :. ~¡ ,. ( ì Board of Trustees Town of South old Main Road Southold, NY 11971 -.. Aœ 2 A 2001 Re: Applicant, William and Elizabeth Smith SCTM #1000-54-5-37-3 10605 Soundview Avenue Southold, NY 11971 To Whom It May Concern: We, as adjacent property owners at 830 North Sea Drive, strongly request that the board reject the application of the above to grant a variance for a proposed structure. The applicants are requesting that the regulations set by the town to preserve our valuable wetlands be broken to satisfY their building plans. These rules were wisely and specifically designed to enable our fragile wildlife to remain with minimal disturbance. If this application is granted, it not only "breaks the rules" but sets a precedent for other applicants to do the same. We have a large number of indigenous wildlife that depend on the shelter and food that the wetlands offer. Deer, red fox, rabbits, swans, ospreys, mockingbirds, red winged blackbirds, as well as a number of finches and other species of birds have all been seen and enjoyed by those of us who live along these wetlands. The number offeet that the applicants are requesting to encroach on the wetlands may not seem to be a lot to the applicants, but to the wildlife it is equivalent to someone moving into your home, and the result will be that they will need to find a new home. We ask that the Trustees carefully consider this request in light of the impact it will have on the local environment and not "bend" the rules. The Board has always done a fine job in protecting the natural environment as well as curbing extraordinary development, making it a pleasure to live in the Town of Southold. Please maintain your standards without faltering. L?/ ~~"7-7-' Barbara A Fischetti - ~ Certified Mail No. 7001036000031177 9548 . . The Board of Trustees P. O. Box 1179 Southold, NY 11971 Steve Tenedios 690 North Sea Drive Southold, NY 11971 (20 1 )~6~-~38'! .. !;"" !' _ 1 I I. I ,.. ... , AUG ¿ U :'::1 To the Board of Trustees ¡ C'·:" . My name is Steve Tenedios, together with my wife Olga we own a home at 690 North Sea Drive. We have lived here in the Town ofSouthold since December of 1994. The cause for our concern and reason for this letter is the notice that we received for a new home that is to be constructed for a William and Elizabeth Smith on Sound View Ave, directly behind our property. Although we respect our new neighbors wishes and their proposed improvements, we are gravely concerned that if they are given the variance they seek to expand the set-back &om the wetlands allowed by the zoning laws of the Town of South old, irreperable damage will be done to the wildlife and the natural eco-system that exists there. My wife and 1, as well as our two children and many ftiends and relatives cherish greatly the fact that we live where we do and are witness to the pristine natural beauty that exists in these wetlands. It is the reason we moved here. It is to date undisturbed by man or machine and it is worth fighting for. It would be a great shame to disrupt what mother nature has painstakingly created. After seven years we still get excited at the sight of the foxes, deer, rabbits, quail, pheasants, turtles, snakes and multitude of birds that call the marsh behind our property home _ It is further our understanding that the Board of Trustees only last October wisely increased the setback ftom 75 feet to 100 feet. All we are asking, which will also benefit our new neighhors once they get settled in, is that the Board of Trustees uphold the current zoning laws. . . AuguJt 27, 2001 Board of Trustees Town of S outhold P.O.Box 1179 S outhold, NY 11971 !r " ' , , . ~ .. , AUG 2 9 2001 , I lL :'.. . (, '"I' or" Dear BOald of Trustees: &garding the proposed det.~lopment plans jòr the home of lf7jlliam ,,-'" Elizaheth Smith on S ound/iew At~nue, plea,-e confider our objection to t11IY change in the iPTling 1m than 100'. The 100' zoning is iT/ plaæ to prote,1 the Intland and lJiU asJist in preseniTlg the free line on the bluff aboœ Ollr home. Within this iPning it is important to retain a 50' tree buffir as part of this project. I trust that you wiU uphold the 1 ()()' setback code and require a 50' free buffir in addition. Thankyoll. 1-01lf'S Jincerely, V4'(tiJJ~ Vem ¿~ Mo Ahmadzadeh 925 North Sea D,it~ S outhold !>,¡'Y 11971 . . Telephone (631) 765-1892 Town Hall. 53095 Maio Road P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the South old Town Conservation Advisory Council held Monday, August 20, 2001, the following recommendation was made: WILLIAM & ELIZABETH SMITH.to Amend Permit #5100 fQr a new footprint of the house, including a porch, deck, and garage. To bring in fill to regrade front yard and structural fill for foundation. Transfer Permit #5100 from John Prizeman to William & Elizabeth Smith. 10605 Soundview Ave., Southold. SCTM#54-5-37 The CAC did not make an inspection, therefore no recommendation was made. -+ Albert J. Krupski, President James King, Vice~President Henry Smith Artie Foster Ken Poliwoda . . Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 27, 2000 John Prizeman 131 Hicks street Brooklyn NY 11201 Re: SCTM #54-5-37.3 Dear Mr. Prizeman, The following action was taken by the Board of Town Trustees during a Regular Meeting, held on January 26, 2000, regarding the above matter: WHEREAS, JOHN PRIZEMAN, applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated December 10, ,1999 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 January 26, 2000, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, . . RESOLVED, that the Board of Trustees approves the application of JOHN PRIZEMAN to construct a single family dwelling with attached deck, and to place haybales 20' from deck during construction. Located: 10605 Soundview Ave., Southo1d. 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 pro;ect 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, ~L./~ /~.~, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc . DEC Dept. of State Bldg. Dept. . . Telephone (516) 765-1SC12. Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVTSORY COUNCTL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, January 18, 2000, the following recommendation was made: Moved by Richard Smith, seconded by Scott Hilary, it was RESOL VED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Wetland Permit Application of JOHN PRlZEMAN 54-5-37.3 to construct a single family home with an attached deck. Soundview Ave.. Southold The CAC recommends Disapproval because of the negative impact it would have on the adjacent wetlands, as well as creating additional fragmentation to a unique ecological area. This wetland is only one parcel in a freshwater system, which is important both as a corridor and habitat for many native wildlife species. The DEC has given the responsibility to the Trustees to manage this unregulated wetland system. Vote of Council: Ayes: All Motion Carried New York State Departl. "of Environmental conservatk. Building 40 - SUNY, Stony Broót!'New York 11790-2356 Telephone (516) 444-0365 Facsimile (516) 444-0373 ~ ~. ~ FRESHWATER WETLANDS - NON JURISDICTION September 14, 1999 Mr. John Prizeman JP Modular Homes Inc. 131 Hicks street Brooklyn, NY 11201 Re: Application #1-4738-02421/00001 Prizeman Property 10605 Soundview Avenue, SCTM 1000-54-5-37.3 ¡Jf :~0WN Of ~~. Southold, NY 11971 -- . Dear Mr. Prizeman: In response to your request for a freshwater wetland determination for the property identified above, the New York State Department of Environmental Conservation has determined that: The parcel is more than 100 feet from regulated freshwater wetlands. Therefore, no permit is required under the Freshwater Wetlands Act (Article 24 of the Environmental Conservation Law). . This determination may be subject to modifications due to change in environmental conditions, a revision in the law or new information etc. We suggest that you retain this document along with other documents related to this property. Please note that any this Department. contemplated. additional work may require authorization by Please contact this office if such are Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. sincerely, Ø"/¿ Mark C. Carrara Permit Administrator cc: J. Teatom Bureau of Habitat . . ELIZABETH A. NEVILLE TOWN CLERK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR PUBLIC ACCESS TO RECORDS INSTRUCTIONS: Please complete Section I of this form and give to Town Clerk's Office (agency Freedom of Information Officer). One copy will be returned to you in response to your request, or as an interim response. ------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------- SECTION I. /'"\ TO: Ç> J) ,J' IZ..A (Department or Offcer, if known, that has the information you are requesting.) RECORD YOU WISH TO INSPECT: (Describe the record sought. If possible, supply date, file title, tax map number, and any other pertinent information.) , -... '5"<-{-- -.,:- - '3:¡" . 1--- ~'t - .;- - ? f . -:z, Ct....V"\..-- .9 ;:-\-D \..;",~ . ~~tø~ lrv- .- Signature of APPlicant:~tI'AA~ 1111"IVl""¡ I L. Printed Name:---.r:lav'îq'A ,.." _ ,vj()vt;.,~_ "1 k_ . '" () /' <: -L I ,r¡ Address: I G Y- II C) . )nu,'^ ~ i/ 1-e_·J i-I v ~ ,)(Ij.--,-I hn/ r' / Mailing Address (if different from above): !\/ "/. ,.~::.I- I Telephone Number: h,J·-~ 7.</0 -I Date: / I . :¡'.'" ~ 1 J^,/ ======================--=======================================--===================== [ ] APPROVED [ ] APPROVED WITH DELAY* ~M,if1.ï:/wil¿ Elizabeth A. Neville Freedom of Information Officer [ ] DENIED* >fIH"EIVED JUL 1 6 2000 .....'hOld lolAMWerk * If delayed or denied see reverse side for explanation. .-.-.....,.--.....---.-....--. - . . - - . - .. . . . ....: ...'... .-. - --.:--.:.-..~.....-.-.-.-.. -..'...-. - - ... - -. .·~-_~'o _ .,. o. - -"-.--... / . . ELIZABETH A. NEVILLE TOWN CLERK ~--~ A(i~ ~y~ ~~ Q .. ,. en :!: .& , ...., '"?/! ~~~ ~; ~Q./ + i-'ð<:::':~' ~? Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765·1800 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR PUBLIC ACCESS TO RECORDS INSTRUCTIONS: Please complete Section I of this form and give to Town Clerk's Office (agency Freedom of Information Officer). One copy will be returned to you in response to your request, or as an interim response. ------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------- SECTION I_ r--- TO: ,1J ~ I w_,{ ~ (Department r Officer, if known, that has the information you are requesting.) RECORD YOU WISH TO INSPECT: (Describe the record sought. If possible, date, file title, tax map number, and any other pertinent information.) . ^ r rJ1 \, (\;;:,10s:? !) I /2 . ~ (, i1((J~ ·1/'- '-- supply j) [r-_ r-/ 1--", ~ I'/...[Pr.....,---{L, /IU (( /l ~ r- 0 . f,n ¿t7(¡/J/J<;'1 i/ / -';:¡" -. I 3---';> ~ I. V I -I , " ! Signature of Applicant: / / I C Printed Name: ~ Address: I Telephone Number: 6 3/-~b('- 2./0 '-/ It ¿1 / Mailing Address (if different from above): Date: tlll'- /¡J , ===========================--======================================================== [ ] APPROVED [ ] APPROVED WITH DELAY* ~flJdla Zle~~/' EI abeth A. Nev i lie Freedom of Information Officer QECEIVED [ ] DENIED* NOV f 5 2000 - ::ao,nhnJ6i T 9'ßR <:'.FI( ate If delayed or denied see reverse side for explanation. . . Trustee Inspection File Report Name 5 \'\A. \ --\A." w \ ~ \ \ ti... "\.""' , Address II) &, 0;- SL: ___..-.. & v ~'--.,)- S '. . . .f-tLi' I ,.0, SCTM# 1 st Insp Finallnsp cu..e ~/1& P'-4!i -j-Q 4 L'-~ _ sfJ.'f/ð..J ../~ ~ ~_~v~ ~ ./ Notes ,'~ ....··'.'...L --. , - 5LJRVËY OF PROPERTY SIlVA TEl 5OlJTHOLD TO¥f\l1 5OlJTHOLD· SUFFOLK GOUNTY, NY SEPTIC DETAIL no~to sçale PFtOPOSED DIiIELL I NG SURVEYED OC-Ol-CC AMENDED 11-21-CC, 06-05-00. Ob-14-00, Ob-20-01, 01-05-01, 01-13-01 Oð-13-0I,oð-11-01 SUFFOLK C.OUNTY TAX II 1000 - 54 - 5 - 31.3 w*~ 8 f:¡.~ 17.:--. _---;¡;--¡--IkRTY1II1 grldl lun: l' 1nv.- Cov.,. ]nv,- U.3 u~._"--= - IItn, Olten 1/.' OIl" tt pra130.ld QI"IOI' IIln. ]. ..ølrlt1on ---~---._--"-------~- grounø IIlt,r EL. - 2+/. C.ERTIFIED TO, VIIILLIAM F. SMITH ELIZABETH R. SMITH ~ .\ """~o"",o" 0' ,0~~1~"" "-p~""g\o? 'v~ 0'·· ,'''> <Ø'. if '~o~ _ò ..-p"" ~(.l> "\ fÒ 'vcr ~&,\< \.~\.. ,,~ ,"J¡~ o':J'"S ~,,"; .. ~ ~o .rd'. -d 0__ ~ . .,.,""'...---.. '¡.', <~ .., c/'-",?"'J... I..;;..~q.,q., J.P?. Q",t -y,?1;> ~o~ C""1 s.",,,'\., 1-;-">");1/,,"$ ~3- 0... '. , TEST HOLE MGDonald ""'. ....~ ..... c_ O\. 1 o· ""-' ........ .... OM 3.0 ...- 5Ill!t ..... .... 13. O· POI. "'_0 .-. to Goa"o. ..... .... ...""'" 15.1 ....r P.", ...- .,,'" ,. Go..... ..... .... 22· ~ c::ïo '{... . ( ~. / ""l--'· ,/("d \ -{',." ,-(~r[ I \ ~ . \ ~ , .-~. .,1(; \ .....Z \ .... (j'~ . , - ........ ""\$-........ . --rì-, '~...-, /1/ ò 0'" of'"O\ ,^Oç O~ .ç.,^Þ'- \..\(\Ð 15' f- \,0 /" ,,~ 1..0 \" \OoÒ.ç.\..---\ . . ~'Þ'-.ç. . ~O"· OÒ .. ~\O "'i-- "' ~'\ "':;.\ L" 9- "1C' 'é SUFFOLK COUNTY DEPA.RTIIINT OF ~~ H SERVICES PERMIT 1"0" A,..".""A.L 01' CONSTRuðt~N Folt A. SINGL"'- F,' 'LV':· ~'\;t:NCC ONLY DA.TEJ,"~ ~ REF!1.)._ ~~ -();)).'L APPIIOVED ( 7'l~ ._ FOR MAXIMUM OF c..¡ dEDROOM50 UPIRES THREE YEARS FROM DATE OF APDP . o'IJ r¡,"" / r , .0"1-·· c!f!;¡;,ò'. - ~lß NOTES, . MONUMENT· o PIPE AREA = 3C,CCC S.F. OR 0.C2 AC.RES ELEVATIONS REFER TO MSL N6VD'2C ~~L~ ~'~ 40' -.J! di~' t. '" ".,~~,~.-""., .Ir..·.., ,"" '" ,","'" ."n r" , ,.,'"'' .,~ ,,, or ",,) 0 . """"',, I""" ,,,.n,...,," ., ,on, "., .,."""",."".",,,,1209 ..."."""",,¡ ,,,,,.. ~,_ ,"r, ;,"" '.,.,.-,' ,,", ,.. ''''''''''''0'''''-'''''''''·,9,,,,1 "'n",,u·'" ~""'"'' _,." nn ",,,,,".1 n' .,__ ",.." ,..'.,,--,.., . _, ".',,',1 ,,'., ,,,". L to" . "n" ,""r." ,,, .,.. ." L ;:~.,; :.: ."··..·,,..,,,··.'''.1,ro''..,..P.·.,,''.,'..,......,,.·,, ,,'....,., .... "....".1~",' ." "'.0,'''''00'. .' ". ;".. " .., ."" ..-"". ~.·.r' ,r. 'O' _M.' ¡"".,,, ."0,""' "1 ",. ~r. ;",., ~.",.. .. n." ,.' ,no '" '" 0' '.' ",.,." ,~,.~ ~"'."'." ~"'" r,·,· .' ,r..", ''"' ",." " ew' ....L' ,",,,.,,.,,.,,,,..r""'.""."'u'···"".'"OOrp,, ",,,, "n "'" ,."." '.' 'n,· ," I" '-".0.'''' ~n,or".,· 'n, n~"n" .1M :.,,,,,\nQ ,r_'.....'.!". J,.".., """,..," .r." ,no "'" ,.,..,.... n. ...~ I.·'","~ ,.,", .1'.' ,n' Ln""'-. "on" ~,._ '.r,' "'"'' '~'":." '0 .'M,' .,,".,, ,h,. n..' ,'.r, JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 N.Y.S. LIC. NO. 50202 REF.I\HP SERVER\DIPROSI99-229H.pro ~ ,-.:'''''' ,.."~ \ ..". ,....rp,n,""n<"'\_"',,, ,.r., - I SURVEY OF PROPERTY I 51TVA TE: SOUTHOLD I TOWN: SOUTHOLD SUFFOLK COUNTY, NY SEPTIC C:ETAIL not to scole tv w*~ s pr"ooased gr-edes ,I " SURVEYED 0'1-01-'1'1 AMENDED 11-21-'1'1, 06-05-00,06-14-00. 06-20-01, 01-05-01, 01-13-01 08-13-01,08-11-01 SUFFOLK COUNTY TAX # 1000 - 54 - 5 - 31.3 max-. 2' min. 1· cover' II!'Xisn''-lfgrSCle lIIax. 2· ¡nv.. min. t· II 31 cover \"t·t- '. . Ileacn!n; I ',un.- PllCrt l pools - 1/4" per 6· deep I B au. , 1nV.", 12.0 11.!J IIIUI. pltCh 1/.01" per ft IIIln 3· SI!H¡r"atl0n CERTIFIED TO, ~ILLlAM F. SMITH ELIZABETH R SMITH - gr-oun( water- EL . 2+/- ,. o \, / '" / \/ / / AUG 2 0 "I .,'j ,...,~,0' ;; ',::/ ~.';'<'-- <-- ::/ «::-j{¿;~t'~ .. ,_,¡- ",0 '\ ,~ "V ({''"'. ." f\ \J ,.0' ,,(,,:,0 ....~ ("v ,,\.. vÛ ',<?".. \..'-1 o· to r,-(,~~:;P:\"f; _ ~u... 2,..-;Z,'....8 -.' , r.r-"-.J0".-/) ,,('u 0"\,.0 O'~/ ",c/''- ,'~ ,');~ 0"" ~",'f, APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTH OLD -DATE.? /21/0 f / // / // ./ // <& :90 /,p, ...3 0__ ~ TEST H,:]LE fvlc. Don 0 Ic:l 11 00 ú' ?, ~ 0" ~ (ç ê" c,,"/2) '/,;..-"v L;;:,.:-<'o G,-. ~."'ç.- /;., ...-f'?'. v'--'.... ~-,Q ........., ." '-- '" -::<-:'"'<"' -"?A'""'Q, ? -::-. ·V;-. -/«-5 <? t-_ "c C78o:S"":_ien(~e Con::. B~"",,, So,·,,-, Loom OL- o 0 D<':-,,,r, 11. L-oom'j '1.:,c-6 ~,O.J ~ -:;". o¡:::.',,-, ý'.... ..... . p..'(. '..... ..... G '1 Of. f·".OO~·; S(,mo SM ~ 0 >-eÓ ,(".::;;\O,:'",ç.' "II·' ~.U' J.0.~\,!,.p.. ;'.~',~ D~' Ý B~o",n S"'J Sana '::oM 13 0 Po'e 5~o~.... F,ne W Coa~~e Sana s" 6~c,'na is I f'lo!e~ P,,'ç: 6r"....... F,~e W C."o~~e Sa"d ~ ¿¿ -:.., " C"6- ,~ ~ '\-S '" ' L~,'~. -S~ ç; ::.~;. ~,~.\ ç .:: ~.y~ -,:;~ f.'t " q "" o '." , / ß . ., Ae; . .."",- ^-V' / .. 4e;Vø ~/ / ,'\.~ .. e;~ .~ ~, ..' 4~.. .,,::" ...:;. ";/. ~,," .. ~ .,~... :::>. <:¿p /~. ,- / . ."."- h' /' , , / _c'. , ~OTES, ~ 6 EAST MAIN STREET RIVERHEAD, NY 11901 369 8288 Fax 369 8287 . MONUMENT PIPE o c,,-,., " " n,ce,",,-"._ "",., 'REA = 3'1,'1'1'1 SF OR 0.'12 ACRES LEVATIONS REFER TO MSL N6VD'2'1 ""J- - "'I' JOHN C. EHLERS LAND SURVEYOR N.¥.S. LIC NO. 50202 REF.\IHP SERVER\DIPROS\99-229H.pro I =<.APHIC SCALE --- I _... [":= 40' '-'I'C__, PROPOSEO OI'IELLING - t . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-18'12 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES . TOWN OF SOUTHOLD LETTER OF REQUEST FOR AN AMEND~N',[-~-;-:-, - ,'-~ . .:' .:;,_1., -,:_ JIll I 6 2001 DATE 1~ (f/2/:() I : . .- t)(.. t:l ' l OWNFJ<<<JI~ ~ PHo4~~~ -?-:,- ADDRF.SS 7LJ ~ Pf1i-~ t-JU" AI f;,;"o"ß-y ffT'f-þ AGENT PHONE It J ~~~~t ~ ~ \\ <:t Signed By: I t. ·l ¿~ /7 Vt'L..tW. .. ,~ /'-:; ADDRESS PROPERTYLOCATION.Æ!(t>_'5 ~A~E. ~ TAX MAP NO. '-fÎ3~J .)ter,OO ðE>4 &0<' ()oS ý/-rI31,003 ~ I rÒ- C~ \' Z ~"?\ s!~1\ 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------- In the Matter of. the Application . of u.m$Q.~~_~~~_~ro.~n__ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING , residing at "'J.n ~ 1Lfn+ Si-øxt- OtJ N elJJ ~ (>(ZJ<- /17 being duly sworn, depose a d say: That on the ~day ot-k9M9S'[ 2001, I, persona lIy property known as 0 '5 V', W N by placing the Board of Trustees official poster whe e it can " easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of,.~î ^'~ p}1-':>ll-~ M~Fing. Date of hearing noted thereon to be held ~ ,dq élOOl ~.{l:CP~· Dated: ~. /B,:WO/ 1~~~ (signature) Sworn to b~7r~~m:~this . /g'!' day Of~ 200( ~~4~ Notary Public NoTARyBtu'ð~'\MUlLER QIJB~9. 0IMû46"1~i¡¡7NewYorlc Comrniss;o~ In ~uffok Counrv XPlres April 3D, ~o9i.. . . e ß: '; ') 7 "I'U· t h.-,-, L L·J ~ 73,7fX)j ~I ~ X/ùk r..(j j-.fc~ (JML j~, -¥'? A1tf ct7J~ ;i£ ~(J d£il . . Çz, Jt''t -- ~ ~ ,-#_/0 ~~ · ¡5iJJ1 . t~ ):',.-rt . . p=C=. l'~'ìI$fFOL.t;;-~ ,,' ~~JI~ f~ ~ \~. i~ N,~~ ~i N,; '0./ . i-~ .,;}" -G--..-..... '1."1.- ~....~.::-.::;....-:(¡},- . Albert J. Krupski, President James King, Vice· President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-18'12 Fax (516) 765·1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application -;7Wetland Permit Application ---Grandfather Permit Application ---waiver/Amendment/Changes ...-Received Application: ,,-/lO(q, ecei ved Fee: $ ¡ S1) - ompleted Application 1:J../lO,qt¡ Incomplete --SEQRA Classification: Type I Type II Unlisted coordination: (date sent) ---- CAC Referral Sent: 'd-1¡6TZJq ..rDate of Inspection: IJ/~t1.()/)() Receipt of CAC Repor~: Lead Agency Determination: Technical Review: ~ublic Hearing Held: JJb~OOD Resolution: . ~Gl 0 ~~; t . ~'\1..::. I. ..·.c \. Name of Applicant J 0 HN PJ.< I 2.l:::/v Ar\.J Address 1'31 HrCI\'5 ßR{)OL-r¡u JJ"/ 112.-0 I FAy. 7/'6-6"?4-NC4-19 Phone Number: (719') 62--+ o3"l{; Suffolk County Tax Map Number: 1000 - i' 1-- ~::; - 3 7 ' :3 Property Location: '5{)UfJO \)/EU/ A VE/\Jut=:-. 56úTf/OC--() , . '7.. 7 O. b b I ID DOC; wOOD ¿..A/VE (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: FAX#: ~rd of Trustees APPlicati9IÞ GENERAL DATA Land Area (in square feet): "3 OJ , C, crcr 5. F. -- - ~ - Area zoning: _1<.l:2.5/ D £. f../T / AI--. Previous use of property: VA CAlVi ~AfJ P Intended use of property: DIVE r;4MIL-'7 HoME Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been governmental agency? revJked V No or suspended by a Yes If yes, provide explanation: Project Description (use attachments if necessary): ~ÚfL-~ '~Z FAMI'-'1· {¡ 1~ J HO/lí E z ~rd of Trustees APPlicatio", WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:_BUI¿..D ONE FA-f1fL'I_Housi:· Area of wetlands on lot· IftCJ¡Cf ") () % ~square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: / feet Closest distance between~~rest 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? z... 'I cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet 3/ proposed slope throughout the area of operations: - Manner in which material will be removed or deposited: í3 /)L D OZ¡:;¡:<., 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): /JOIJE 3 ., .~ . lZ'Zl'99 MO~ lO:O~ FAX ~lG IG~ lJGG Soutnola Town Accounting @OOl 1.d-!6-4 ¡2iS7)- íp.:c! 12 PROJ E::.r I.Q. NUMSE::1 .'-~ 517.2: Append ix C State Environmental Oual,ty Review SHORT ENVIRONMENTAL ASSESSMENT FORM F<>r UNLl5ïED AC¡'O~'S Only SEC PART I-PROJI:CT INFORMAT :IN (To oe c~mple!ed by App:icant' or Proiect ~MnsJr: 2. ¡.)RO":EÇ7 NA/\1= o¡vE ¡--74/l-IIL -., H Ou 5/== CO""t"/ S HFFð/:-k I" A?~N~'ÑNSþRP-IL-~HA¡V f, ~. coO.ECT lC';~TICN. .< /7, lI'-1 H (') / T, Municfa.;-!!ly rJ U c-- V 1"-:';': ~îç~'ÊÂ~';:'~Fl)~'çï;;~ ;,"õ'¿:;,¡t::Ë" '07:; ~ØUN D I fAY- ff /et1o-5"£j--37,3 1- V/~lV Ávi= :5 .~~SE.~: ....Ç':'~N: L.... ~H"" : :t.ë:a:-;:;:ç-' ~ ~.1;;::::fil;;,rlon,a.terã(·-:'" oS. ::ESC....Ie.E ~t;G..2.·::' =r-.,~::~..'~: OIJG, FA/'1/ L- 'I HO U 5~ ---- . _Ol'~T .~ - , .. ....:J F--=·~-=-.· .... ....r .........,~ ... rq....~.J. :n, ~¡ó:;f (). '2- () , '2¡--¿. .3.C~~~ ¡¡,~r~~ lJ!tim.D.!e~v .. ~. '/!:I.'~?~?0S~9-;\C"';'\r)~~ ::;~M;:; ., ·.VIT¡.. ê;<i5':'"IN<3. :.o""::-"G ~!:I ")7,..E:,R ::X:STING :....A;-..i:I ,;3::= .=~S··~:C"';'iC.·:'::~ ¡sf Yas L..J \:0 '1 ~o, ':i.::tlce :¡T'~ilv r , . -- "IHI/I"S -...." ...·'T . ...- , .... ., I·'-··I~ -F -'0 .---';) . :fr f::: '-""'-.::'1:.:-. ~"I,"". :-.:. .,. '.." ,. "'. .~~ ....c..... . _ .,~sder.~I¡I ,_,;nt:uß:" ~.! C ·....:¡¡T.m-efcl¿1 Cc~¢~':¡e: !.-: ;.q~lc!...,:.;.:re ~ ?.=.~;o;.!Fore~:¡:ç~e:1. ::;cæ:ca :......... t}tr.cr m. :::>ce$ AC71CN 'NVO!a·,'E.4. F1s.?r rï ,.¡.PPRQVAI... OM FU"'O:DI~~G. NOW :R 'JLI i~1A-;-ë:~Y ,..~.(.'''' .:.NY :'T;-.!E~ Q.")VE.;-:NM:'NïA:" AGENC':' \F;::.:Jt.:-IA:". ST~TE GþtOC;"U~ ~e~. L..: No :f ':s, Ii.:;: .1gency{s) and (;~!mt¡ac¡:rC:V;¡i5 11. 0 ANY ASP:!;C-: OF THE _ GTlOfol HAvE A ÇURPa:'!'-ITLY VALID PERMIT OR ,;p!='~OV;'.L1 f~$' D NO If y~s. 1St agency name ana per:-nJt.la.D~rova.1 ~z. ;.S J.. r:ES:.,,_T ~~JRJPGS!:;) ;. :TI::;1\I WIL:" =';-::Si"ING p=r.Mli,A~?;OVAL. "=:;:::I..'I;::E. '¡''::.'C != c~ I ¡,;;..:';) LY~S ~o --. , I I Aø:JiC.:I.fH/;:o--:~..~ I $IÇ'UUUII~; I...- : CER.TIF"' 'r -~.:.ï T!-IE :NFQ~MAPCN r:oAOVIOEc. .;SOVE IS 7~UË 70 -:-~.:: aE.::::" ,:F '/1."( .".:-':CWI.=:~~E '7- f5: Iv1 LI ;J. .._.:..1..~~_______ ].:1:". L5"IJ-?,AJ'LOaD ¡; !t~ i f the actio I is in the Constat Area, and you are a state ec;ency, complete Caas: 11 .Assessrnen~ Form ~e1al'e ~(oceedir'? "iith this a~es:;merH L_ ov,,¡:¡ . 7ì · / )" M 7_00 CJ P ß/Ar L, (UU'V,,- ,pv(~fJ~ J)(ÁF 5-tflvNJ tÆd C;rØ}'- µyJ(, . - '; / Ýw4 Pi tl ~ Æ E1f~ 1M t?r; ?"7J e<A 7~ðÓ ~. ~ i- h. I1IJ f1J1r~ (¡{1v9{ tJ- ï u"fy ~iM-J~¡µT I . . . I I' ~Ur-<'- J- ÎÍ- \ /UJ 1 tr /9 r:A,-Y- ()...A _2 ø .ø 0 II It/, . d..d tk ¡t;-slff cuuJ >; i\ (L/LifÜ) 1 . I Y Oil/H SUV~ '}-t, ar7'"~\ p~ #7/1; GJ.4-- 038" Þ FAt 7/75 62--4- G4-1 9 . . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 D ss.~':>\lfFOl.t t'~ . §ýK ~~ ~~ f"t,i c::>~. ~I ~QJ +~~~ Telephone (516) 765-18f2 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------- In the Matter of the Application of __~~tlr)_~r!~~_______________ COUNTY OF SUPPeLK)¡¿t..t(,l STATE OF NEW YORK) AFFIDAVIT OF ~OSTING I,T0\1N Vf2-/Z¡::'NA-\!, residing at /0/ H¡C--Ií5 :; T I;~E E / :Jkc·/,d¡L· A.''f being duly sworn, depose and say: That on the ?-- Î day qf ÐU 199Q, I perso,nallx-posted the _ . property known as =tf/tJ(}()-'Jtf?;;7.--Š' L 7()rbt FAS, orfJoçWO~ LltfVt: )O()fV~~lþ.; by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for seven days prior to the date of the public hebring. (date of hearing noted thereon to be held ~on.,.q, c1000 o 1'\ or a O(kt- '1: IX) Pm. Dated:~7-(,t-.DEc 19C¡¡ . J f) - ,:Yi¡ (Æ/! PC, )l/fl-ÿ\ (signáturè) / Sworn to before me .,2'1 day of'y f c.:.. ~y~ this 199 <>¡ .. C' VITZCHOK RING NOT_PlJØUC._ar_yook No.OIRIIDI.' ..- In.... CaunOy CcJrnMUCWt ExpIr_ July '8. aoot ~rd of Trustees APPlicatiJIÞ County of SuFÉ-Olk ¡¿,"''-.! State of New York J() f-\ru PfZ-.I2-E/'--//V\--} BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM 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 THIS APPLICATION. . .{) "--~i( aJ~y{'((þ' S~gnature ,. i/ I SWORN TO BEFORE ¡'¡E 'IHIS )'"'1 DAY OF 1>r<::. ,19~ ~~. ~ Nota-yc YI1zc¡Ø(~_.,.. NOTARY pUI!lIC._su:., No. 01 CøuIIIJ ~~~>III'"'''' . . . . APr1.ICANT TRANSACTIONAL DISCLOSURE FORM The Town of Sou~holdts Code of E~hics prohibi~s conrlic~s of interest on the part of town officers and employees. The ur ose of this form is to rovide information which can alert the town of poss ble conflicts of n~erest and allow it to ~ake whatever action is necessary to avoid same. YOUR NlI.HB. ..~'::':~":\ ' '7 /' 1'-'1 '-- L-C-, { ( Last name, first name, you are applying in the other entity, such as a company. If so, the other person's or company's name.) unless else or indicate NATURE OF APPLICATION, (Check all tha~ apply.) ;'''~ ' .,. Tax grievance Variance Change of zone ^p'p~~al of plat Exemption from plat or official map other (If "other," name ~he activity.) Do you personally (or through your company, spouse, sibltng, parent, or child) have a relationship with any offtcer or employee of the Tovn of Southold1 "Relationship" includes by blood, marriage, or business interest. "nusiness interest" means a business, including a par~nership, in vhich ~he tovn officer or employee has even a par~ial ovnership of (or employment by) a corporation in vhich the tovn officer or employee ovns more than 5% of the shares. ' YES \ ' ý NO If you answered ·YES,· comple~e ~he balance of ~hiB form and date and sign vhere indicated. Name oC psrson employed by ~he Town of Sou~hold Title~r position of that person l' Describe the relationship between yourself (~he applican~) and the town officer ør employee. Ei~her check the appropr~ate line ^) through D) and/or describe in ~he epace provided. The ~own officer or employee or his or her spouse, sibling, or child is (check all ~hat apply), the owner of grea~er than 5% of the shares of the corpora~e s~ock of the applicant (when ~he applicant is a corporation), 8) the legal or beneficial owner of any in~ereBt in a noncorporate'entity (when the applicant is not a corporation) , c) an officer, director, partner, or applicant, or D) the actual applicant. parent, ^) emp~.ee of the 'O~~'~ II ' n I! [lEe I 0 '99~ DESCRIPTION OF REL^TIONSIIIP ,. , .. . ~ '';.'.u ~ , '.., . .. . .. tX':·'·'~~¡,~,:'~;'(TJt!~)i.~·:· ..;/ f"(4r" ;/,:' submitted thi,. (~dáY i(t: C> 1!J9_1 \ I . .. I Signa ture -";' ~,~:'~ ¡I.I ~tf·l~,~.(·t~Vj,<'::ì." Print name , 'JÓD/Y, f::ß, ~~1'::'~~, . -..'.,. .,;?:.~. r....,~i<~:'·~(·.v, ~,,;!it:";o~....., .' . o,,~, ~ ¡. ;;(";' '.~~.. ¡:'~''''':·¥.~l~~~' .f.; .--~ t.. '.. .2~"~~,~:".,\,~~~~.~~,.~ :~'~ ~~~~~~,;<