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Home My WebLink AboutTR-5267 -. Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 5'~'1 DATE:~~rlUary 24, ISSUED TO .. BUDD"S PONDMAJUNA Autlforh;ation . Pursuant to the provisions of Chapter b 15 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 JaIl",aryJ4. 200L., and in consideration of the sum of $ 150..00.. . paid by .B UDD'SPONDMARINA of .Sou.thold, 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 tie into existing bulkhead next to travel- lift slip. An ~rea 5 'x8' will be added to make a launching area for fork 11ft. The launch area will be 11 feet wide. Material will be treated lumber and 4 treated piles. No all in accordance with the detailed specifications as presented in the originating application. Dredging. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this det.e. .- 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 January 29,2001 Albertson Marine PO Box 937 Southold, NY 11971 Re: Budd's Pond Marine 61500 Main Road Southold, NY SCTM#56-6-2.2, 3.2&3,3 Gentlemen: The following action was taken by the Board of Town Trustees during a Regular Meeting, held on January 24,2001, regarding the above matter. WHEREAS, ALBERTSON MARINE on behalf of BUDD'S POND MARINE applied to the Southold Town Trustees for a permit under the provisions ofthe Wetland Ordinance of the Town of South old, application dated December 20, 2000 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 24. 2001 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 approved the application of BUDD'S POND MARINE for a Wetland Permit to tie into existing bulkhead next to travel-lift slip. An area 5'x8' will be added to make a launching area for the fork lift. The launch area will be 11 feet wide Material will be treated lumber and 4 treated piles. No dredging. 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 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 ofthis notification. Fees must be paid, if applicable, and permit issued within six months ofthe date of this notification. Two inspections are required and the Trustees are to be notified when project is started and on completion of said project. FEES: NONE Very truly yours, aLLJ l' /~. ~. Albert J. Krupski, Jr. President, Board of Trustees AJKIcjc cc: DEC Army Corp. of Engineer's t II"""¥",,, ~ ....."'"1'" -------- / .~ ~r ~" , -----.--. -.. ~- ~, ......"....'._"."."",. .._~~.,-- . . 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 ConservatiQn Advisory Council held Thursday, January 18,2001, the following recommendation was made: Moved by Bill McDermott, seconded by Bret Hedges, it was RESOLVED to recommend to the Southold Town Board of Trustees Al'PROV AL of the Wetland Permit Application of BUDD'S POND MARINE (ALBERTSON MARINE) 56-6- 2.2,3.2&3.3 to tie into existing bulkhead next to travel-lift slip an area 5'X 8' to make a launching area for the fork-lift. The launch area will be II' wide. Material will be treated lumber and four treated piles. No dredging will occur. 61500 Main Rd., Southold Vote of Council: Ayes: All Motion Carried TRUSTEES John M. Bredemeyer, Ill, President Henry P. Smith, Vice President Alben J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 ~ , Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 . SCOTT L. HARRIS Supervisor BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 14, 1990 peconic Associates, Inc. P.O. Box 672 Greenport, NY 11944 RE: Budds Pond Marine (Albertson Marine) Dear Mr. Wiggin: Please be advised that after an on-site inspection of the above-referenced project on March 13, the Board of Trustees determined that a full application was not needed, since this will be an ordinary repair. Therefore, we are refunding $115.00, constitutes the difference between a inspection fee. (check enclosed) which full application fee and an (jc;relY, ~~ ¡~~ John M. Bredemeyer, III President, Board of Trustees JMB : j b cc: CAC File I Y Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 . ff.~'FÓL~ i/~.~\ l~. ¡þ ~~O ~~ j.{1 '¢-~"1..¡j-V . Telephone (516) 765-18.'12 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ¡'coastal Erosion Permit Application ~Wetland Permit Application . ___Grandfather Permit Application Waiver/Amendment/Cha es Received Application: / Received Fee:$ completed Application Incomplete SEQRA Classification: Type I Type II Unlisted coordination: (date ~1t) I ~ CAC Referral Sent:) 'vD ~ Date of Inspection: /ì Receipt of CAC Report. ' Lead Agency Determination: Technical Review: ~ . I Public Hearing Held: "')tJ /6/ Resolution: I ŒC20~ I L Address 00 Suffolk County Tax Map Number: Property Location: R + '¡) s oe+ C) FE· LILCO Pole *, dis a R.i iJe. cl So ) 7(;,:;- 3~3~ 1000 - 5t'c-t.. 00b ß d ·oob BefweeN ßCt-¡ Nome Rei , mCl RIve cross streets, and location) Name of Phone Number: ( GENT:~I~ \ hI-I r.,., (If applicable) kJlfz.. He Address: A I{Je íl.. T 2:>0 /.) rn CA R ((V e p. Ü' o,o'J.. Cf37 Soù+L(~ 'vi Phone: 7GS-I~JJ FAX* :7G\ ,,\,,": c... 1 ~rd of Trustees APPlicatio4IÞ GENERAL DATA Land Area (in square feet): 80, 0 DOS. r. Area Zoning: trJ ïr.r Previous use of property: maR ¡ ANI / !Jolt! i û.. RJ. Intended use of property: ~tl~ Prior permits/approvals for site improvements: ~encYr -=röWIV rl H\J5ICes Do E. C. q Date - 86- y~ 3'0 J - 1 D -- II- 17 J- ?o·- II-Ý7 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): ~'~/::: .~ e iNfo eY.i5h';1 ~/!;.f _ /Ue .f¡ 1-Qc,u Lief , L'p 1 G-h.J DJ(f"G.- ' /5/ win QC'kJeJ.. If) lr1G.-ke Q A. c..(}A)/'IIJ' t7 fl.R(':"{).. FOR- ou-þ r:: 0(2 k Á Iff" /)" e tc;uwc..)., a R.eo.. U¡J..L be // tFeef Lul/t=> mC,,+eRIGJ ull-./... he .fR.ec...f,.,ß- /"'uJntell. -PJAJJ ý. 'Íd2Cctfrcß- f¡/e.s - - tV 0 OReJ~ 'd 2 ~d of Trustees APPlicatio~ 1-1 lA<.JL 0/. "lAuNcÀ , <; fÀ Fe-II. WETLAND/TRUSTEE LANDS APPLICATION .be -I- J..e DATA ßoflfs ío t.J HI-. a.b!e 10 Fo(lK /..Iff Purpose of the proposed operations: Area of wetlands on lot: o square feet Percent coverage of lot:~OOI % Closest distance between n7arest existing structure and upland edge of wetlands: ~ I~ t) feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No V Yes If yes, how much material will be excavated? How much material will be filled? d f cubic yards cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: fAù/k lIet;) . Manner in which material will be removed or deposited: C¡('ON rleÞ()sdrJ fF,}...1-- , (;" ----8 Qerl w -.. OP be. fOUR-J J../J,J,J AJ (' L,.) C.DI\J c(2.efe ßu/klkr./f'J c)¡J 70p , 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): --- lìJ t) r\J e .... 3 617.21 Appendix C State Environmental QuaJity Review SHORT ENVIRONMENTAL ASSESSMENT FORM Far UNLISTED ACTIONS Only PART I-PROJECT INFORMATION (To be completed by .~Dplicant or Proiect sDonsOr) 14-~5·4 ,2l87)-7"i!)(! 12 I P>10JECC 1.0. .,uMaE" . . SEC e 12 J. PROJECT LOCATION: C Munlcloaritv V C,:¡unty ,S '¿7";- ~C;ION ~e.~a;:ss ana R;J·e,"eŠ'(;'~'fl~ïJ"s, .'Jû' T'ae~aOI lJe+wee¡J- ßc.: Ii Oh\e cReek 5. is PROPOSED ACTION: o New [j Expansion ~ MOdi fica rion/alteration ô. DESCRIBE ?AOJEC7 9RIEFLY: uSe Foa. ex 1:5+( d (J 01++5 US I úJu/k I/ec..jl fo I}1c)re "'Jc.. FuR-if AI'F + l1 Á.c..u/oJd 7. AMOUNT OF LAND AFFECTED: Initially lilt 001 acres Ultimately acres 3. 'lIl~ '=!=IO?t'JSEiJ AC-;-10N CCMPL':' 'NITH 2XI$7ING ZONING OR OTHEM EXISTING ~ND USE .~Ë5TRrC";"¡ONS? ~es 0 No If ~o. Jesc:¡be brle/ly 9. 'NHAi 1$ ?RESENT LAt,ù !J~ë IN 'IICINIT':' OF .=I110JECT? L ;::¡eslden[¡a rr,rnOlIs:naJ (5(C.:JmmerC!ãl Oesc:lbe: L1 Agnculture --! ParKIForesuOoen soace ~Olher 10. OOES ACTION !NVOLVE A P':RMIT APPROVAL. OR FUND!NG. ,\lOW OR ULTlMAiELY ,i:ROM ANY OTHER GOVERNMENïAL AGENCY \F2iJERAL, STATE OR lOCAL!? ítJ Yes 0 No If yes. list agency(sJ aM oermit/approvals OUIJ Rù)%>e.5 us D- c. .-- 11. DOES ANY ASPECT OF THE ACTIO'" HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? DYes ß.No It yes. list agef'lcy name and permIt/approval 12. AS A RESULT OF PROPQSED ACTION WILL '::XISTlNG PERMITfAPPCOVAL rlE':)UIAE VlOOIF!CAïJON? DYes &0 I CEi1TIFY THAT THE INFORMATION PROVIDE!) ABOVE IS T'=¡UE 70 THE 3EST OF MY KNCWl'::OGE Q..¡le: ;..) -Ire, . 00 Slgnalure: If the action is in the Co,,"tal Area. and you are a state agency, complete the Coastal Assessmen! Form before proceeding with this a~essment OVER 1 P...;.,ñ-:- :1--=-.'~'JI.~C~JI\~=:J7:'" ':~E::; ..:.,.::-...::.'~~:=.=:: :",'¡'! """!S ~~~O ·.3:'1~'JT .- -~ ~ ~ -~. .-;::.;r-......L_ .:¡ :~ ::~:,~~ec: :', ..:. ";'2r-.C ;~:'] :,'1-=- ·~v,~'N :;r:c~s~ anc JS~ :r:~ ='':L_ 0- r4 '3 'j":;::::=. :J.:.,:: -:- j'~.': ~ r , ~'ò.. _. ·,vIL... ..:.C7':':,," :H::::=:'¡: :'::::PCI~J,:.7=J :;¡E'/lE'N":'::; ,:=aC',ICE:J "':'1av ':)e 5U:::erSec~~ ::;y .3.nC{',er nvO¡Vea açenC"I - 'J~IL.S7:::! ':';:-:-:'::,'15,.'1 .'I"':,'==R, ::JJ..~7;· .. f '~a, a 1e-.:;::;,t:·/13 :=C.;;'"- "'':!S .'0 ~'::L.:LO ':"C7:CrJ ::J.E3;";L:" N ,J...,'Y ....CVE:=S¿ ::'-.=;;:':75 .\,S.sCc:;.. -;"'=:J ."'7;-< -'.=' .=::.L:.....:',·JI.·~G. .':"ns·ners ~.:;,v ::e ~ancwrl{:='1. I e-:;,:::121 :1. ::.(IS{lnq a,t :ual,t,. 3urrac~ Jt JtOl..:na'Na!e~ :uallly Jt ::1..: an lIty, lQISe e'/I'!IS, ~):.:s::nç ,.. ;ic :a!:2!~s. :CI,C ,vas:e :;JtCCL;C:.':.'1 :r :Is:~ Jo!en!!a! 'er ~ros;cn, :::r:3.¡na<;e ùt 'Ioocing :roClems ~ =..:~O!aln Jrlef!Y: 'Iv 0 C=:. J"~S!ne!lc. açr:c:..l!tur3.I, ltC:1aeologlc.3.l. ,1IS;CtlC, Jr :nner lat:HJI Jr r::.JI!L;f:l1 '~sourC2S; Jt :::Jmrnun,!y :Jt -:e1(':--:~crncca .::--:arac:=r" ~:Ialr. /Vo leç~!allon Jf :auna. ·:sn. ~1"'.eIUisn ,Jt ",Iarile ;;iJec:es. ~I<;n!fican! 'aOHa!.~. :)( :nre3!eflea :Jr ~ncançerea ~;:ec;es? S::CI':;'n ::;rldrl'f: ruù 'J.... A c.::mmunl!·('S eXls::ng .Jlans or ;0315 as oll!c:ally :!.cootea. Jr 3. cnanqe m use or rntenSI!Y'" use ar :anC.:Jr :lIMer natural resolJrcas? =.~Dlaln NO '-~. ·,3row!M. Juoseauent :::eve!oomenl. ;:,r relalea ac::v,tles likelY ~O ::e ,nducea 'JY 'ne :::rOCOSèa aC:lon? ='-':::u3,n .:¡nerlv. /Vo ':3. '_.::ng :etm. snort :er~. ::.Jrr.ula!lve. ,Jr :Jtner ':!Ifec:s olot ,cen!!riea ,n C~·..:.s? :=.t:J¡a¡n Jrlerly. /\)0 :tt':o.=! moac:s .lnc::...CIMÇ :::-.ançes Ln 'JS2 ..:¡i ~!tner ,'Juantuy ')r :'¡:e ..:¡r õ'nerçy!" =-~:Jlãln ~tle!!'(, (V0 :J. S -;-I!:;:ÕE. :::R _'-!es :5 -¡....,E~E £:'.-'0 ·_:K';::"·-! 7'0 5E, ::::rr¡.::¡cvE.::<5Y ~E~.E:J 7'0 ;:QT:=:'Jî¡;.i.... ':'CIJ::=!SE :::"IVIRCNME~II;'L ,·.~P4.C7'37 f ·"es. õ'xclaln ':)fle!lv ?ART III-DEïE"MINATICN OF SiGNIFICANCE ¡To :¡e comoleted :Jy Agency) INSïRUC;ONS~ ¡:::or 'i!3C:'1 adverse erfec: identified :aCcve, determine wnetner it is suCstantial. large. ;mcortant or ottlerNlse signlfi. ::ac:'l ~rtec: silould :Je assessed in connec:ion 'Nitti ,ts (a) :setting (i.=:!. urean or rural); (t) ;Jrooaoliity of occ:1;-o-Wg; (c duratlQr irre'lerslbllity: :e geoqracnlc 3coce: ana (f) magOltuae. It necessary, add attacnments or reference sUDDoning: materials. ~:1sure ~xolanauons contain suttic:en[ oelall 10 snow tnat all re!evant aaverse impacts nave been ;dentifieo ana adec:uatelV at::t::ressec C:-Jecx: ;his box ;f IOU ,1ave identifiea one 'Jr more :Jotemially larçe \)r siçnificant ¿c',erse imoac:s whlC:1 .'.'';'' oc"':.Jr. :)1en :)rcceea airec:!y to :he ,=UL!.. =...l,F" 3.na/or preQare a positive" declararicn. ~ec';{ ~t'lis ~ox :f you 'ave ,Je!ermmed, :,asea an the information and analysis above and any suooort,i. coc:;mentancn. :i12r :t':e Jrooosaa 3.c:ion \.\IIL!.. ."JOT result ¡nJoy significant adverse anv!rcnment2.! imcac: AND JrO'Jlce ::;n 3..i.aC:1r.1ents 3.S nec2ssarv, the reasons 3u¡::;coning rnJS der8!'mIn2tion: fJu clef -.5 fÒ/JrJ CJ (t¿,xr=- )1 (~·,.:;on\,o,,, '- I(-:r n_.~.,:,:::,o .....;:<.:[\(, m ú. ßci III E- ........,,'" lr .",..<.1 ....,<.:net l' f.Ef>IJp",f :'110:: .)/ -(~·,oon\.o,o:: Vlr,(~· W¡J...k.lMn "',nl.H "c" .....In~ C-V ;"n.Jlure- H .(~1conhO"!' :,(, .':.JC ......;~n(v IJ , l'>:n.,¡,:....r~ H r'·..·.JJ.r~. 'If ~.I:~."n( :rom rl:"~Ocn1Io,~ Jr"c~r, 1(- úG J..le- o ( \ . I I . "Þcl ~ a ò \ ~t'f"'''~y I:) ~ I l:1,j't) _ .11- l!J 'f<1'5{J ~., ....!~ I ~ - ~ ) ~ oj.. . K 7,;)tJO I J' ~ DOCK .irl FLOATING I LJ L r c I l- . / . ; , . EX/STNG '. ! V-- ~ BOA T LAI.ß.JCH RUNWA YS AIÐ AREA = 1 764 ACRES :t \ } WORK DOCK "- ""---- "'- WORK AReA .. .. . I .... , .:;: ...I DOCK \.¡J FLOATING 'Z . 'Z ..... - ~~ L . ~~ ". ~ . . ,,' ~ .. ~t " ~ 0/,' .. . ~ I:)~ I:) :Ie p t/ , r1 " _ EDGE OF' ~T SPRINØ HIGH WA rnr, ~ 0\ . LIE AIÐ IIEAN LO -0 '"' - WA TER LIE ~ <: DOt!K \ , FLOATING . øu.JOVD_ 7 . .. -= ,. " - . . $. 6'.9'~ . - - ... . ;'-0- ~ R K I N G CQ>C ~7] . \~ -~ P A QI . R I ,. R A ,. '. ~ . Albert J. Krupski, President James King, Vice· President Henry Smith Artie Foster Ken Poliwoda ~ 'ilUfFOL.t ¿J ~~ ~ .§ ~ Q - en . ~ ~ rt . .,. -. - . Town Hall . 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone ,63!) 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 ~'¿--~--~--- .MN , 8 2001 COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, WI1JiC{YI!' Gvtf'dæ, residing at J::JJ Ác...vlleL it 112:" ES 0 u i-), 0 k.f being duly sworn, depose and say: That on the I g' day of It:, '" , 200 I, I personally posted the property known as !1lbt'¡7Tsc.- !V1Cf///V-e by placing the Board of Trustees official poster where it can easiiy be seen, and that I have checked to be sure the poster has nO!r.ained in place .E.;);:, eight days prior to the date ofAh_/ '. J ublic hear·ng. Date of hearjùg noted thereon to be hel~~".~1 "!I,('pm. " Dated: LV ßl~ (signature) ~- Ab[/, Sworn to before me this I,'" day of 9~ 2001 ~~ (7 J~J--<- Notary P lic LINDA J. COOPER Notary Public, State of New York __~0,,~E'225~3, Suffolk.Cp'JOty..900 L- T'AI.. -":"> , __5.)eCG.n!...;~ ,,:,~___ BO" of Trustees APPlication. County of Suffolk State of New York G..J 111-- ( c..", 1v- Lv I Ie. k~ 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. SWORN TO BEFORE ME THIS é). O~ ¥ ~~. .. ~tarY Public BEING DULY SWORN &JdLk~ Signature DAY O~ LYNDA M. BOHN NOTARY PUBLIC. State of New York No. 01 B06020932 Qualified In Suffolk County Term Expires March 8, 20.DJ 7 ,:i:9-~ . . ~':' NO'l'ICE TO 1>J)JACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SoUTHOLD In the matter of applicant: BUDDS POND ll1fS¡~R~Sb<?t~IA~\~tN\N£:~A sCTMHOOO- SECT. .056 BL. .006 LOT 2.2.8.3.2 8.3.3 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Replacement of Existing dock. and to dredge to 4' .at mean low water. 2. That Review is follows: the property which is the subject of Environmental located adjacent to your property and is described as 2.5 acres bordered by c&L Realty, Port of Egypt to the East and Philip O"Hara to the West. 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of. the Town Code is open to public comment. 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 proposa¡. OWNERS NAME: William witzke, Albertson Marine MAILING 1>J)DRESS: PO Box 937 southold, NY 11971 PHONE *: 516-765-3232 ~~~~¿nI~Ze~f;J?~;fri Pëo~t::- Y ¡lMJ ~ - I . . . List of names of owners-of-record oflands adjacent to the tidal wetlands Name Philip O'Hara Address 140 Remsen Street, Brooklyn, NY 11201 Ned Harroun, Island Tree Co. Main Road, SOUthold, NY 11971 "\ William Leiblein, Port ofEgypt Main Road, SOUthold, NY 11971 Emmanuel & Geo Thomas 65-22 Perry Avenue, Maspeth, NY 11378 Fred and Ann Bennett 594 Alwick Avenue, West Islip, NY 11795 .. AP-fA 1 0 \~ f ü-~ '-.-' t~ 0' 56 (.Í nEC 2 (1 ".'-' E'j.1 $1í~ tRQ.()eL,FT SL.r"f . o - o ! ~ VI r ( /I" ')---- E'f. 'I~ ~ l3iJlt-R~IJ. 10 be I' ~ (N -fo EXI:7i"/) Bulk ¡¡eel·... F,¡r 4Jlf~ ; .s ¡:;.",J.. .,; C Ouf^ t.J If¿ 0ùloJ CP tie - t.J oJ l( /,J f/ 1 t: 'k.,dí, G Rn ueL FO-\t!(llVd / ßOf-ll £1oR'ðe Ii Rr-c.. E 'X . .s1í~ C û rDc Rete A t"R D}J ND I 10 SCa / e tv RI d~ ---- , .- . FORM -1 . A....Ll(!ANT TRANSACTIONAL DISCLOSURE The Town of Sou~hold's Code of E~hics prohibi~s conflic~s of in~eres~ on the part of ~own officers and employees. The purpose of this form is to provide informa~ion which can alert the town of possible conflic~s of interest and allow it to ~ake whatever action is necessary ~o avoid same. YOUR NAMB I -:z. . Las~ name, first name. m ddle n tal, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate ~he other person's or company's name.) .:?!~::" "',,; NATURE oP AP"LI~^TIONI (Check all ~ha~ apply.) Tax grievance variance Change of zone Ap.P~~81 of plat Exemp~ion from pl~or official map other ~ r-r- ~ (If "o~her," name ~he activity.) I f:¿l)Sle~ ¡Of ¡¿/Y¡ / + . Do you personally (or through your company. dPouse, sibling, parent, or child) have a relationship wi~h any officer or employee of the Town of Southold1 ·Relationship· includes by blood, marriage, or businesd interest. -nusiness interest- meanR a busineos. including a par~nership. in which ~he town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YEsL NO If you answered -YES,-. complete ~he balance of this form and date and sign where indicated. eIV J Po 1/ w,)C~A Name of person employed by ~he Town Title or position of ~hat person Describe the relationship be~ween yourself (the applicant) and the town officer ør employee. Either check ~he appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all ~hat applY)1 A) the owner of greater ~han 5% of the shares of ~he corpora~e s~ock of ~he applican~ (when ~he applican~ is a corporation), B) ~he legal or beneficial owner of any in~eres~ in a noncorpora~e'entity (when the applican~ is no~ a corporation)1 C) an officer, direc~or, par~ner, or employee of ~he applicant I or D) the actual applicant. DESCRIPTION OF RELATIONSIUP KeN IS IV.ep) ~Ç¡¡....... .. . 1Ÿ")f- ç ,- .f.....) I -e..r. .,. .. .. . ~;, '.. ':';~li~'~;1·. ',~.... ?;: ~·}c. 'i".'" .: a J;" :::::::::.B~:[l,~: ',<:,;;,,~ ::'c~.,M.tJi~~~~;', . ::" '\ ~", . .:. , :,~'; 'I".~~:~·,