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Home My WebLink AboutTR-5504 Board Of Southold Town Trustees SOUTH OLD, NEW YORK PERMIT NO. . S-~()4 DATE: ...March 20·, ISSUED TO .. ...BUDD'SPOND··MARINE· J\ut4ørizatiou 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 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 TOWNWATERS;~.'; and in accordance with the Resolution of The BOard adopted at a meeting held on ····MarC"h····Z6 . 2.9.92.., and in consideration of the sum of $.200..00. ... paid by ....Budd'B.··Pond· Marine .................................... of ..§g".t.hqld,....... . .... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the folowing: . étland Permitdor . Maintenance 0 Dredging two areas of marina . adding 4 slips to marina. 40 cubic yards to be dredged and " unloaded upland. aU in accordance with the detailed specifications as presented in the oñginating application. IN WITNESS WHEREOF, The said Board of Trustees h,ere- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a· majority of the said Board as of this dat.e. Artie .Foster (Absent) Trws"" ~ ,'. . . . . . .. . . . '~'~!..-~-'-'-' '--'-'--' -'-~ _.___~-_.__.- '-~ ~-'"-.-!- .-~,,o'-' . ~.. ~ t" TERMS and CONDITIONS . ' .. '.. '.,., ," ~., Òc ~ .... .. --. The Permittee B l:idd 1.;;0 r .....uJ Ma~ ~uc residiagat hl¡;On Rnn+ø ??, 5QutR.alà. N. Y., as part of the coosideratioo for the is$o',nœ of die Permit does uødenuod and prescribe to the fol- lowing: 1. That the said Board of T.- and the Towa of SouthoId ale released &om oø.y and all damages, or cWms fIX damages, of suJø arisiøg dIrecdy ot' indirecdy .. . n:suh of oø.y oper· adoo pedOODed pursuaDt to this petmIt. and the said ~ IN... will, at his ot' her own a¡.eaK. defend oø.y Ud all such IUIIS·I..;.;.-, by ddtd panies, .... the said ~ 'W' ,- fall JIabIIiq with reiped thereto, to the CllllllplHe esdusioo of the Baud of Tmstta 01 die Town 01 51 _.<1 old 2. That this Petmic is 'ftIid fOr . period of 7 ð. ..-. which is (JODI'" "Ød to be die ecn.....(.,I time· required 10 ~ the ~ ¡"vohed, butihoald ~"""" warnot, request for an e<œasÍoo may be made to die Board at . /aœr date. 3. That this Permit should be retaioed indefillicdy, or as loag as the said Pt.A.Ittu wúbcs 10 .....inn;n the sttuCtUU or project involved, to provide nidenœ to oø.yooe (OQCIeftle(/ that auth- orizatioo was originally obtaioed. 4. That the wod< imobed will be oubject to die ¡,.~ and approval of die Baud (It lIS agents, and ooo-compliaoce with. the provisioas 01 die 0"Ï8ì"'';.., appIicadoa. may be ause fot' revocation of this Permit by resolutioo of the said Board. 5. That there will be no WtteIsoo.b1e ¡"terfereoœ with aavigadoo .. . n:suh of die wad< betein auèhorized. 6. That there shall be DO iøterfereoœ with the right of die pabIIc to pus and repass aIœg the bea<h between high and low water marks. 7. That if future operatioos of the Town of Soo>~ reqaite die remooaI and/at alceradœs ¡" the Jocatioo of die _de bere1n ..."'-. "' or /l, ¡" die opIøIoo 01 die Board of Truscees, die. work shall cause unceasooable obsttuaJoo to ftee aaYigatloa, the said PeudIuet will be reqa/1ed. upon due aoåœ, to remove or alter-this _d< or project betein stated witbouc ~. to die Town of Soulbolc/. 8. That the said Board will be -U¡ed by the Permittee ot the ( 14-1 L of die wad< auth- orized. 9. That the Petmitœe will obcaIn aU other pamits and coaseois dJat may be required lOp- plemental to this permit wbIch may be oubject to revoke upoo failure to obcaIn same. . . ,. ,. ,. ,. ,. ,. ,. ,. . . -.'.' .. ,. . ,. ,. ,. Albert J. Krupski, preSiden. James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . Town Hall 53095 Route 25 P,Q.Box1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765·1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD March 22, 2002 Mr. William Witzke c/o Budd's Pond Marine 61500 Route 25 Southold, NY 11971 RE: SCTM#56-06-2.2,3.2,3.3 Dear Mr. Witzke: The following action as taken by the Board of Town Trustees during a Regular Meeting, held on March 20, 2002, regarding the above matter. WHEREAS, BUDD'S POND MARINE applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of South old, application dated February II, 2002 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 March 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 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, ~ . 2 . NOW THEREFORE BE IT. RESOLVED, that the Board of Trustees approved the application of Budd's Pond Marine for a Wetland Pennit for maintenance dredging two areas of marina adding 4 slips to marina, 40 cubic yards to be dredged and unloaded upland, BE IT FURTHER RESOLVED that this detennination should not be considered a detennination made for any other Department or Agency, which may also have an application pending for the same or similar project. Fee must be paid, if applicable and pennit issued within six months of the 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, tWL-1 ~ /4~ß- Albert J. Krupski, Jr. President, Board of Trustees AJK!cjc Cc DEC Army Corp. Department of State ~ , . . 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 Monday, March 18, 2002, the following recommendation was made: Moved by Drew Dillingham, seconded by Scott Hilary, it was RESOLVED to recommend to the South old Town Board ofTrustees APPROVAL of the Wetland Permit Application of BUDDS POND MARINE to maintenance dredge two areas of marina adding 4 slips to marina. 40 cy. to be dredged and unloaded upland. Located: 61500 Route 25, Southold. SCTM#56-6-2.2,3.2&3.3 Vote of Council: Ayes: All Motion Carried , .... TEL 631-765-3232 FAX 631-765-5126 Þ EVEIf rTH'N~ FO'!... 80~TI"o- f"'" -=:; ALBERTSON 1.1arine ,inc. E-mail: am61500@aol.com www.albertsonmarine.com MAIN ROAD SOUTHOLD. N,Y, 11971 February 6, 2002 Board of Town Trustees Town of Southold Town Hall 53095 Route 25, P.O, Box 1179 Southold, New York 11971-0959 Dear Members of the Board, Reference: Proposal to perform maintenance dredging on private bottom Proposal to perform maintenance dredging as follows: 1) 10 cubic yds of private bottom in the travel-lift slip. 2) 30 cubic yds. in area of boat basin by southeast comer of marina, by breakwater, 15 ft, x 20 ft" to a depth of 4 ft, ML W, allowing the addition of four docking slips to this same area of the marina, over private bottom, with five 10" piles to hold these docks in place, The dimensions of the floating docks would be 6 ft, x 44 ft. for the main float and three finger floats measuring 3 ft, by 26 ft, N,8. Dredging materials to be deposited off-site, This area has been dredged before, during construction in the mid-80s. Thank you for your consideration of this proposal. Should you require any additional information I can be reached at the address, telephone and fax nwnbers above, f;":$ Bill Witzke, President Ene Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda ~ .., Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit ApplicatigJ1 _Wetland Permit Application L Major _ Waiver/ Arriend~Cr;;ges _Received Application: ( "\.,/ _Received Fee:$ .9-tnJ ~ ~ ' _Completed Application '1' / () g- _Incomplete I _ SEQRA Classification: Type I_Type II_Unlisted_ _Coordination:(date sent), ~ - CAC Referral ~ent: 1f/¡ ~I . :2- _Date ofInspectlon: D '):/'" ~Receipt ofCAC Report: - Lead Agency Detennination: _Technical Review: I , ./ _Public Hearing Held11 (H) I D -ý Resolution: I Minor ~b:J - ~ . Name of APPlicant~ v ",j J ;'s- r: /,Ç"OO f ()AJr~ ì17 Û ~í Ne ~..) Souf1olJ Phone Number:() G 3/ - 70.$"' - ~;).3;ì ~<5"'(;-00- ~J J.~';J.3 foµJ cd Address R-I Suffolk County Tax Map Number: 1000- !it,.!l <; Property Location: 0 µ -1llf\eqL + ~IJ Îí\ û-~I¡Je (provide LILCO Pole #, distance to cross streets, and location) , AGENT: (If applicable) Phone: . \P If ,0 ;' /\g' f\'} ? 0;) (Ì' '»' t Address: ·. Board of Trustees . Application WETLANDITRUSTEE LANDS APPLICA nON DATA Purpose of the proposed operations: ß ClFff1 (;~Jv cfo -fY\ c. (IV -+ t' ¡.) C. ¡J:.. e . Qc- -I-r ¡j e. t f~// / !h c. fl{ JJc. / Gv'J / Olv Area of wetlands on lot: square feet Per~nt coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: 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? i 0 cubic yards How much material will be filled? -µ Ii cubic yards Depth of which material will be removed or deposited: Lf feet Proposed slope throughout the area of operations: ßi &/I[ II(.J Manner in which material will be removed or deposited: 0 iR e ~ eLfl Jxi ~(ÃIù£. ~(cSEJ.. CRQ,Je/ iOYjjJ OIJ~Ò +ð OJtnfJ tR.r.nJ( r;) USt'J.. tv;' , 511- L Oi'J /Y\ V< (l( 10::'" (flu fI-c h Ij , . FE!:) - 6 Statement of the effect, ifany, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): 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 11971-095~ . Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------- MAR - 5 ?np? In~he Matter of the A~plication -~-~~~-~-------- COUNTY OF FFOLK) STATE OF N W YORK) AFFIDAVIT OF POSTING . I, Win, G.IY\ w,'-Id(c , residing at SOU-+t(J being duly sworn, depose and say: That on the.:s:- day of posted the property known as by placing the Board 0 Trustees official poster where 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~~e public hearinß' ~ate of hearing noted thereon to be held ~~aZo p.~,1J.. H- ^ ~ I'J ð ~0 ,IV} . I 'S:- .1 ~ !.-.c.ufl-eL l1utL: Dated: U (signature) !>.tW Sworn to before me this ." ..-<..-v.... day of -'?1J~200 2.-. /)~d~e Notary Public HELENE D, HORNE Notary Public, State of New York No. 4951364 QUd!ified ir. $1I;k!k County......s 5 . -.. 0(00..J .. -.,- NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: H1;(ñl~ Pnnn mrlrin~ SCTM#lOOO ~h Qh ? ? 3 2 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: Dredge 40 cubic yards from the marina and to add 4 new slips and 5 piles to hold same docks. ~ 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: Albertson Marine 61500 Main Rd Southold 631-765-3232 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 on: J11t¡/!( CJ.O You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: William Witzke MAILING ADDRESS: P.G.Box 937 Southold NY 11971 PHONE #: O.,jl Ib~ jL3;¿ Ene.: Copy of sketch or plan showing proposal for your convenience. .s .. . l Board of Trustees Application GENERAL DATA Land Area (in square feet): 7() I S- C; Ò Area Zoning: h1:JJ: 1'"",", _ of ~Y' rn r,Rl 11" I f\ o/J-t -¡. pJ Intended use of property: ,g ~ }7) ~ Prior permits/approvals for site improvements: Agency r[O () ,51' ee5 p~ c.. r / Date . ¿- '71- /~ 71'- 0°/, r'- 9.3 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? _2{....No_ Yes If yes, provide explanation: Project Description (use attachinents ifnecessary):-11J Q {/..,{íe,.J a..)Jc.!2.. s 10 -to 5 Jfì C.RI~~ ;J ~ e¡ cl ð."11 Q J r:-J ~u u )J J...()rtel~J 6§~ (/)- cncn -(1) 18e 1! 0:::: ;, ilj gl! I ~ ~i 'Irr '" :q I u ~. ~ ,¡. e ~N ¿ 1~ Ii a ..:or -!':' ~ :: :I 0 i! " '¡; ";&t, E ~ ~.L1iH.,'I 0 o:Šu Iñ Iñ ~ .;¡ r:x &ú :; ¡; '0 .. '0 ...c v ìõõfo - :: 2 Õ ~ i! " ~ t 1 ~ ~Cíð;!.. ~J.: '-' ~ ~ jIt I ~ )( co I l ~~ i ~~ t.. .. ~~ ~.. ~ .. ~ ~~ ~ I , ...... .:1: Jõ'o 1: 1 . "I 'Z I ø~ Ed..... ~ - ~:!J::::EJci1..q0l ! t z '0 CJ) f/) ~ .. is g ~ "w -03 !i! l<i I~~ r~ "'I" ~: IU ~ c"! ... ." =l < o ,.;2?i-:::::-....- í,! . ....., . -.... ..~::.:~.:..: '.......... \. ~~.-...c. '.,...... .... ; ~l'" .. ~;>iJJf n; "" ....., '-<; ....., .... . . 0·.. 1- ~J . uitii.. ~ "¡!I~ i ~~ ,0 ~ tI~O ~u! " ....-. ~:h=.. '-:2~~::_- :.-:.:.._ ~~~.~'!. ~':~. ..~ 3 Jr <6 /,~.- '. . 3)( 28 ,/I2"),f······..···· ~. it ~... I . . -" .-...~~" ...... I I" j -" ,;'9-;.~ 0"£'· .. ... '\.,:."_. I . ! -'. '. - -.... .....:.::- ~~.. ~ - '. ...... ,1? .~' ..... -. """. 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"'.. ;i!: .1 .J;-ij' \ - N3IfJN'IWØ :10 10 lL6\\ 1\JO~ tA~ 'P\O\\\ßOS IJ) ~ -0 ¡o: tS . pen. ~Vy¡ CII ; 0 ~1Þ . ;II! .~M' '3t\œ~Vi 1&OSUBlltJ r , '-i , ~ . ~ . , I \n ";.'. " ~; ., . r ,: - )/'00 9'" J..",.0'1:J ~. ~ , , '" i r- I"3lW JiIIo.. . -¡ i . .~V H¿1 = v3lN aNl"1Dff. Yo »10.1 I \ --J ICWIn= . ÐllJ.SfX3 ~.. ~ j~ 'QI"3IOITIfI 9/'US1X3 "II"'. t» 'Xo&IJ'/ , ~ fft~r.~1fI~~ \ ~ 3Ø 0.1 'f3NV . \ I ~ i ~ ¡:) o O· . )/:100 ~'Ð",,-¡"01¡/ . ~ I . '401~ (2/87')- Text 12 I PROJECT I.D. NUMBEñ 611.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACÍ10NS Only PART I_PROJECT INFORMATION (To be completed by Applicant or Project sponsor) ,. APPUCANT /SPONSOR 2. PROJECT NAME Budd's Maintenance dred in -Docks 3. PROJECT LOCATION: Municipality Southold eounIV .. PRECISE LOCA nON (Slreet address and road Intersecllons. prominent landmarkS. Ite.. or proviae map) . I ,. SEQ .' 6150.0. Rt. 25 Southold at Albert 0 LI' . usn ,·arlne lnc. '- ------- -~ 5. IS PROPOSED. ACTION: o ~'"".' X panslon 0 ModlllcatlOnlaltaratlon 5. DesCRIS.!; PROJECT BRIEF\. Y: ~~~~~~~î~rE gíI~q~R8 ~b Ya~áša¥r8£ÈRõ ~8oiH~êa~~ ~¥g~co¥a€R~£á~~n~~e Second area i~ by the ~ève wall. Also to ftdd 4 new slips and 5 tl:;eated piles 'to the docks . 7. AMOUNT OF u.ND "'FFE~ Inlll&lIy acres Ultimately ,"cr.. B. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LANO USE RESTRICTIONS? G::~~ 0 No It No. dese"ba briefly -. -. -. 9. WHAT IS PRESENT LAND USë IN VICINITY OF PROJECT? o R.sid~ttal O.!ndustrlal 0 Commercial Describe: Active boatyard and marina o Agriculture o ParklFor.SUODln space XÜOt.e, '0. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. ST'" TE OR L.OCAU? X}Q¥o. 0 No . If yes. list aoency(s) and permit/approvals Southold Town Trustee's N Y Department of Environmental Conservation n. DOes ANY ASPECT OF THE ACTIOl< HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? o Yes' X~ If yes, list ager'lçy name and permltlagproval FEß - '2. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APpRovAL REOUIRE MODIFICATION? O~ O~ - . '-. . .' I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLECGE Signature: DIu.: ?R_n? Appllcant/spanser If the action' is in the CO:lstal Area, and 'IOU are a state agency, complete the Coastal Assessmen! Form before proceeding with this a.~essment OVER 1 ., . A. DOES ACTION EXCeED ANY TYPE I THRESHOLD IN 6 NYCRR PART 617.41 D v.. a No If vel. coordinate the review Droce.. and UN the FULl EAF. B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNUSTED ACTIONS IN 6 NYCRR PART 617.61 a Yea 0 No If no. a neaativ, declaration may be luøe,..ded by another involved aaency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THe FOLLOWING: (An.w.... may be handwritten, If legible) C1. ExisUng air quality. surlace or groundwater quality or quantity, noin levell. IxI.ting traffic panama. lolid waite production or diapoaaJ; potential lor aralia", drainage or floodi!'); problema? Explain briefly: C2. Aesthetic, agricultural. arChaeological. historic, or other natural or cultural ,.saute..; or community or neighborhood character? explain bne"v: C3. Vegetation or fauna. fish. shellfish or wildlife species, significant h~bj(ats. or threatened or endangered specie.? Explain briefly: . CC. A community's existing plans or goals as otfiCtally adopted. or a Change in use or intensity of use or land or oth.r natural resources? Explain brieny: CS. Growth, aubHquenl developmenl, cr relaled activities likely 10 be induced by the proposed action? ~laIn briefly: C6. Long tenn, ahort term, cumulative, or other elf.eII not Idenllfied In C1-CS? ExptaJn briefly: CT. Other ImPKII (Including chang.s in use 01 elth.r quantity or type of energy)? Explain Þneny: O. Will THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABUSHMENT OF A CEA? o Ves D No E. IS THERE. OR IS THERE UKELV TO BE, CONTROVERSY RElATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? DYes D No It ye., .xplain briefly PART II-ENVIRONMENTAL ASSESSMENT (To be complBted by Agency) PART II-DETERMINATION OF SIGNIFICANCE (To be completed by AgBncy) INSTRUCTIONS: For .ach 1Ov..... effect td.nUfied above, determine whether n I. subltantial. large, Important or ott'Ierwise significant. Each .If.ct .hould be ass....d In conneCtion wtlh Its (a) letting (I.e.. urban or rural): (b) probability at occurring; (C) duration; (d) Irreversibility: (e) geographic scope; and (I) magnitude, It nece..ary. add attachm.nts or rel.rence supporting mal.rials, Ensure that explanation. contain .utllcienl detail to .how Ihal all relevanl adverse Impacts hive been identified and adequately addre"ed. It queslion D of Pari II was ch.cked yes, lhe determination and sig- nilicance must evaluate the po.ential impact at the proposed action on the environmental charactertalica 01 the CEA, o Check this box if you have IdBntilied one or more potentially large and significant adverse Impacts which may occur. Then proceed direclly to the FULL EAF and/or prepare a positive declaration. o Check this box if you have detBrmined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result In any significant adverse environmental Impacts AND provide on attachments as necessary, the reasons supporting this determination: Name 01 Lead Agency Prinl or Type Name 01 R.sponsible Officer in Lead Agency TiU. of Aesponsible Officer Signature 01 Responsible Otticer In Lead Agency Signature 01 Pr.parer (It ditt.r.nl'rom r.sponaltMe olllcer) Dale · _. NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: 1~nr-nl~ pnnñ m;::¡rinp SCTMilOOO-~h nh ? 7 , 2 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: Dredge 40 cubic yards from the marina and to add 4 new slips Bnd 5 piles to hold same docks. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: Albertson Marine 6150Q Main Rd Southold 631-765-3232 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 on :ff1.ú(lc. ^ ~ 0 You may contact the Trustees Office at 765~1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: william witzke MAILING ADDRESS: p.D.Box 937 Southold NY 11971 PHONE i: O,j 1 II):::> jLjL Ene.: Copy of sketch or plan showing proposal for your convenience. s I I \ . ò ~1 0 \ c:5 I .~ ~ AI/EIt TO 1£ FLL ( WEl~Wr~~:ir¡ASJ!f. « t . 40 .'1011. sU/(H£AD. ~ ~ . FLOAT..I/IIG.· DOCK .,' . EXlSTM . f' ~u.1.WCH ~l&tcAJl) AREA = 1 764 ACRESj \ ~W(Ø( . -- . IoREA '. -I t \AI ' o· Z Z FL.O·;.r /116 DOCK ·i ' ~ - '. , .. .~~ ¡ ~ , . . 001( ... ·t ~l![R1S01 t4~R\.i. 'Nt. ..... J 3t .t lam load . . ~ 0 o~ P :If Sou\bo\d.ltw ~ork 11911 ~ \ IQ - =,OF ÐI8NI/O£N r 1~S·3iZ2 0\ - . LME H/IfH irA J.EA. T ~ irA rAfJLMEItII£AH 0 FLOAT/N' DOcK .i ~ .s: 6'9- ".,... vO' a OXtt..s '10 \ Ir. &- IJI PARKING . aJIC I RIp R A ,. b. . ·. . Board of Trustees Application County of Suffolk State of New York (~ ll..J.lû. M 1\ Lv I Mop BEING DULY SWORN DEPOSES AND AFFIRMS THAT HElSHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HISIHER 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 SOUfHOLD 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 REPRESENTATlVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. I,j) Jij", {::, tv/- Signature (;, DAY OF Fe b SWORN TO BEFORE ME THIS ,20 --.t2l IJLL~¿ø III ~ Notary Public "'--- HELENE D. HORNE Notary Public, State of New York No. 4:;151364 Oualified in Suffolk County ~,,""~"."on Expires May 22. ~ 00..5 ~ ArPLt~AN'1' TRANS~TIONI\.L DISCLOSUR~ FORM The Town of S~u~hold's Code of tbhics rohibibs contlicbs or nberesb on bhe parb of bown off cers and employees. The ' purpose of this form Is to provide Information which can alert the town of possible conflicbs of Interest and allow Ib to take whatever action is necessary bo avoid same, . " YOUR N/\HB. ,. I ",) .. ."".,..,,,¡'::.t,i({ç.¡~~~'.':\ vJ,jý\ . -: ''''·r~,I¡,.~:)I Lasb n tal, un ess you are applying in the name of someone else or othêr entity, such ~s a company, If so, indicate the other person's or company's name,) . .. '. ~ :: - NATURB ov I\.PPLI~A'1'IONI (Check all bhab apply,) .. '¡'. "':: -. ~.' .'~"¡¡' ·..1 ,r '., . .,~');.'I!.,~ . ....' '- "'"".. "t:!:. ';·'>r.:fr..'·'",,· 'p": .;,.,". . Tax grievance Var lance Change of zone ^p'p~~al of plat , Exe~phion from plat or official map other r n ,,-(' (/J "1' (If "other," name the aoHvlty.) ~I .ep)· 1..E.'.~thlf ,." Do you persona11y (or through your cb~pany, spbuse. öibllng, parent, or chi1d) have a relal:ionsllip vil:li any officer or employee of I:he Tovn of Soul:hold1 wRelal:ionship" includes by blood, marriage, or business inl:eresl:. "nuøiness inl:erest" lIIeanB a business, including a partnership, in vhich ~he tovn officer or employée hns even a partial ovnership of (or employment by) a corp.oraHon in vhich I:he I:oyn of ricer or employee ovno more I:han 5% of I:he shares. TEsL NO "::'''!'' If you ansvered ·YES,". complel:e the balance of ~his form and dal:e and sign where indical:ed. Name of person employed by the TQwn Title or position of that pereon et-i PoL,~¡J . e Describe the relationship between yourself (the applicant) and the town officer ør employee, Either check the appropriate line A) through D) and/or. describe in the space provided, The town officer or employee 6t hie or h~r epousei ~ibling, parent, or child is (check all that apply)! ~) the owner of greater than 5% of the shares of the corporate stock of the applicånt (when the applicant is a corporation)/ In the legal or beneficial owner of any interest i" a noncorporate'enHty (when the applicant is not ar\;.b- corporation), c) an officer, director, parb~er, or employee at the applicant/ or D) the ~ptual applicant, ., , " . .~~~~:\"" . . . 0" . . . . ".:-" DESCRIPTION OF nEL^TIONSIltP K of. ~ . , Î' S. ..', . JD.i . . 0' . W· """~~.j"!';' ._ ,{ .. f'u,¡ .,. ,,:~,. . 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