HomeMy WebLinkAboutTR-5380
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Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
July 26,2001
Mr. John L. Hurtado
10995 N. Bayview Road"
Southold, NY 11971
RE: Ma Tine Inc.
545 Albacore Drive, Southold, NY
SCTM#57-0l-l8&19
Dear Mr. Hurtado:
The following action was taken by the Board of Town Trustees during a Regular Meeting, held
on July 25,2001, regarding the above matter.
WHEREAS, JOHN HURTADO on behalf of MA TINE 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 June 18, 2001
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
July 25,2001 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,
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2
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NOW THEREFORE BE IT.
RESOLVED, that the Board of Trustee approved the application of MA TINE" INC. for a
Wetland Permit to construct a one family residence with attached gar.age with the stipulation that
there remain a 50' non-disturbance buffer and roof run-off be contained in drywell
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 of this notification.
Fees must be paid, if applicable, and permit issued within six months of the date ofthis
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,
tlLL.J ~ /~~4 9v
Albert J. Krupski, J r.
President, Board of Trustees
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cc: DEC
Building Department
Board Of Southold . Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO.
5?1tJ
DATE: ...July..25.,...2001
ISSUED TO .....~,^,..:J:~.~.E:, J!:'<::,...
......................... .n..··..····
1\utqnri;rutinn
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter -i04 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 Böard adopted at a meeting held on '!\Üy...?~,....~OOl·
........... and in consideration of the sum of $....200...00... ... paid by
.. J.Qhn .Jhu:.t.ado. .on...behalf...of Ma..Tine·,···lne·,..·······..·..······m,.....................
of .......$..Q.!,\.t..Þ..9.1d.,.......m...........m. N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits thè following:
Wetland Permit to construct a :one family residence with
attached garage with the stipulation that there remain
~ 50' non-disturbance buffer and roof runmoff be contained
In. drywells . . .
aU in accordance with the detailed specifications as presented in
the originating application. .
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes. its Corporat~ S~al to be a~xed, and these p~esents to
be subscribed by a ma orlty of the said Board as of thIS dat.e.
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TERMS and CONDmONS
The Penntl'tee M;:¡ T'inp T....,. ~ -e. '
. 545 Albacore Drive, S th ld tJr. --~
residiag at ou 0 -- N. Y.. lIS
pan' of the coosideration for the isSuaoœ of the PUmlt does ~.taød and prescribe to the fol-
lowing:
1. .That the said Board of T~ and the Town of Southold are released &om my aDd
all damages, or claims foe damages, of suits arisiøg cIhecdy oe IncIite<dy as a result of my opec-
atioa perfoomed poinuaat to this pemdt, aDd the said PI. II. ,.m, at his or her own at' ~.
clefen.t my aiad all such lUllS ·lnIH.....d by tbird patties, aDd the said P.....duee L- fo1111abU1t7
wiIh reSpect thereto, to the œmpl~exdus1oø. of the Baud of Trusrtes of the Town cl Southold
2. That this PetmIt Is·...nd for ...pèdod of 24 mas. wbIch Is CIODSli æd to be the
estimated time· required to coinp1ete the wodc 1n'VOhed, but ihoa1d citcaIiisWIca warraat, zeqaest
for an exœøsion may be made to the Board at a later daœ.
3. That chis Permit should be retained indefmite1y, or lIS loag lIS the said Pe=ittee wis&a
to maintain the strueture or project in'l'Olved, to provide evidenœ to anyoae coocerned that auth-
orization .... originally obtained.
4. That Ihe wode:hm>lved will be IUbject to the inspecdoa and approval cl the Baud oe
its agent;<. and non-compliance with. Ihe prcms;ODS of the orI&i_fl..g app1iatioa, may be canse for
revocaâon of chis Permit by resoluâon of the said Board.
S. That thete will be no unreasonable interfereace wiIh na-risaâoa as a result of the wod<
. baein aùthorlzed. . .
6. That thete man be no interference with the right of the public to pass aDd repass e10ag
the beach between high and low water marks. .
7. That if ·future operations of the Town of Southo1d teqaire the. remon1 and/oe alterations
In the location of the ..ode: herein mlbo«:1l(1l, or If. In the opinion of the Baud cl T~ the .
work man cause unreasonable abstraCtIon to free naYigadon, cbe said Peøn!ttee will be required,
upon clue notice, to remove or. e1ter this ..ode: or project herein stated without ....~ to the Town
of Southolcl. .
8. That the said Board will be noâfied by the Permittee ot the comp1edon: Of cbe wotk auth-
orbed.
.
9. That the Permittee will obcain all other petmits and coaseaÞ chat may be required IU¡>;
plemental to lhis permit which may be subject to revolœ upon failure to obtain same.
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Telephone
(631) 765---1892
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town ConserVation Advisory Council held Tuesday, July
17, 2001, the following recommendation was made:
Move(j by Bill McDermott, secol)ded by Bret Hedges to
TABLE the Wetland Permit Application of MATINE, INC. 57-1-18&19 to construct a
single-family dwelling and garage.
545 Albacore Dr., Southold
The CAC Tabled the application until a more detailed wetland delineation is received, in
order to establish an accurate buffer area.
Vote of Council: Ayes: All
Motion Carried
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CATHERINE MESIANO, INC.
12 MILL POND LANE
EAST MORICHES, NY 11940
631-878-8951
.
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March 2, 2000
o~
----
Town of Southold
Board of Trustees
Box 1179
Southold, NY 11971
Re: Albacore Drive, Southold
SCTM # 1000-57-1-18 & 19
Gentlemen:
Enclosed please find a copy of a survey of the above referenced property with
the proposed location of a single family dwelling indicated. Kindly provide me
with a letter of jurisdictional determination.
Thank you for your attention to this matter.
Very truly yours,
~-))~
Catherine A. Mesiano
Enclosure
.
.
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) 765-1~2
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
March 7, 2000
Mrs. Catherine Mesiano
Catherine Mesiano, Inc.
12 Mill Pond Lane
East Moriches, NY 11940
RE: Albacore Dr., Southold
SCTM#57-1-18 & 19
Dear Mrs. Mesiano:
The Southold Town Board of Trustees reviewed the survey dated
October 6, 1999 and received in our office on March 6, 2000, and
determined that the construction of a single family dwelling to
be out of the Wetland jurisdiction, under Chapter 97 of the Town
Wetland Code.
However, any activity within 75' of the Wetland line would
require permits from this office.
This determination is not a determination from any other agency.
If you have any further questions, please do not hesitate to
call.
Sincerely,
~9· /~y~'ç.
Albert J. Krupski, Jr.
President, Board of Trustees
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I am familiar wl/h Ihe STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SINGLE FAMIL Y RESIDENCES
and will abide by Ihe eondillons sel forlh Iherein and on Ihe
permil 10 eonslruel.
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SCDHS. Ref.# R/o-99-0223
ANY AL TERA TION OR ADDITION TO SI.flVEY IS A VIOLA TION
OF SECTION 7209 OF TIE NEff YQIiIf STA TE EOUCA TION LAW.
EXCEPT AS PER SECTION 720fJ - SI.JBDIVJSION 2. ALL CERTIFICA TIONS
H£REON AIt£ VAU) FOIf THIS /llAP AND COI'/ES TH£REOF OM. Y IF
SAD IIAP OR COPIES IJENf THe WRCSSUJ SEAL OF THE SUffVEYOR
II'HOÆ SItINA TutrC A~ H£REON.
ADDITK;INIoLL Y TO CON'l Y WITH SAID LAir THe TERM '''L TERUJ BY'
/llCJST Ø£ VS£D BY ANY AND ALL SUffVEYORS UTILIZMi " CopY
OF NIOTHC/f SLttVEYQIrS IIAP. TE:/fMS SUCH "S ~CT£IY AND
'WfOU5HT - TO - DA TE' AIt£ /lOT /Ii COIiPL/AIiCE WITH THe L"Ir.
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TOTAL AREA = 2~ ooo.q. ft.
or 0,482 acres
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SURVEY OF
LOT 29 & DRAIN
"MAP OF SOUTHOLO. ..a_S....
FLED AUG. 29. 79tJS FLE NO. -.s
AT ARSHAMOMAQUE
TOWN OF SOUTHOLD
SUFFOLK CÒUNTY, N. Y.
1000-67-07-.".
SCALE: 1" z MY
AiM r 2UØør
TIte IKfIHons of "./fs and cesspools
lIhown "'1'_ tin from l/eJd obstJr~allons
and or ".." tIlIIo obta/neá (rom olhtJrs.
, .
CERTFED TO'
A(A TINE INC.
CI'ICAGO TITLE INSURANCE COMPANY
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APPROVE' (
BO'-'" .ITE"-
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5OUTHOI..D,
.5. LIC. NO. '49618
,P.C.
" «ßIJ 76.5 - f797
5 T1ff:£ T
1/97/
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Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
!(,n Poliwoda
~~ <ilUfFDL,r t'~
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Telephone ,631) 765-189~
Fax ,.631i 765-1666
~c_~') OF TOWN TRUSTEES
TOWN OF SO~ -:::-J:OCJ
Feoruary ~3, 2001
. ,
Mrs. ': crh.::rine '."siaT'.o Tnc.
~:: }fill Pond Lane
East '"loriehe" Y: 1194ù
( ~'''J Albacore Dr.. 'Southold
SC-:-:.:< ~-l-18&19
Dear '-"lrs. Mesiano:
The Southold L ·.nl Board of Trustees reviewe" :he survey da: ::l October 6, 1999 and last
revisea January 8. 2001, and determined the construction ofa single-farrllly dwellins ,0 be )ut of
~l,e 'V~tlandjurisdiction under Chapter 97 of the Town Wetland Code.
However. any act:,ny within 100' of the Wetland line would require ,;emurs E"u' ,;11> 01lice.
T:1is determination is nor a determination ITOë.\ any otller agency.
If you \lave any further questions. please do not hesitate to call.
Sincereiy,
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.·I.!bert J. Krupski, Jr.
D'ò.iluem, 30ard of Trustees
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CATHERINE MESIANO, INC.
12 MILL POND LANE
EAST MORICHES, NEW YORK 11940
631-878-8951
.
February 25, 2001
FEB2r
Town of Southold
Board of Trustees
Box 1179
Southold, NY 11971
.-
Re: 1fÀlbacore Drive, Southold
SCTM # 1000-57-1-18 & 19
;BY FAX:
l
765-1366
Gentlemen:
Enclosed please find a copy of a survey of the above referenced property with a
proposed single-family dwelling indicated. Kindly provide me with a letter of
jurisdictional determination.
Thank you for your attention to this matter.
Very truly yours,
/,
fØ;:~ <~~
Catherine A. Mesiano
Enclosure
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ANY AL 7'£)þ TION OR ADDITION TO suor\IE'Y IS A \IJOLA TION
QF SECTKIN 7ZOII OF THE NEJlI"'CMII' STATE EDUCATION LA..
DtCEPT AS f'Ðf SECTION no. - ~ I. ALL C£lfTFICA TIØNS
HDlEON AM VAUI FOIf THIS IIA1' AIiD COI'fES T/'fEIf€OF OM. Y F
SAÐ IIA1' 0It COI"I£S IJ£Mf TIfE WlfESSED SEAL OF TIfE SLffVf:YOR
WfIOS£ SItlNA TIJRE Al¥E.fJfS HDlEON.
ADOITIONALL Y TO CQWL Y IIITH SAÐ ~W TIfE T£RM 'AL TEM/) øY"
WST Ø£ USED 6Y IWY AIiÞ ALL SLffVf:YOItS UTI.IZM6 A COI'Y
OF ANO THEIf SLffVf:YQt'S MAl'. TE/fMS SUCH AS "PISf'f:C TED" AIiD
"ØROU6HT - TO - DATE" AM NOT '" COWLIANC£ WITH THE LAW.
I am familiar wIth fhe STANDARDS FOR APPROVAL
AND CONS TRUCTfON OF SUBSURFACE SEWAGE
DISPOSAL SYSTEMS FOR SfNGLE FAMfL Y RESIDENCES
and wI/I abfde by Ihe condlllons sel forlh Iherein and on Ihe
perm" 10 consfrucl.
SCDHS. Ref.# R/O-99-0223
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TOTAL AREA = 2t ooosq. ft.
or 0,482 M::rtlS
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SURVEY OF
LOT 29 & DRAIN
"MAP OF SOUTHOLD SHORES"
F'-ED AUG. 29, 19B3 FI.E NO. 3853
AT ARSHAMOMAQUE
TOWN OF SOUTHOLD
SUFFOLK CÒUNTY, NY
1000 - 57 - 01 - 18 & 79
SCALE: r' = SO'
AM Y 21. 2007
.Jv'l~ ~. 'ZOOI(~t".)
(O~
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AI(s. /
r~Co~
.....,~-9 ~
4 ; s-" Db
~~l' .I 'T'/V~
1""h6 loC( lfons of welts and cesspools
shown _eon are from fiflld observalions
and or from d#Ifa obfoltuuf Ú'Øm olhers.
CERTfFl£D TO'
!rIA TINE INC.
CHCAGO TITLE INSURANCE COMPANY
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STR££T
N. y, "971
01- 178
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 ApplicatiQII
_Wetland Permit Application ~ Major
~ Waiver! Amendment/Changes
_Received Application: j,
_Received Fee:$ ~,
_Completed Application
_Incomplete
SEQRA Classification:
Type I_Type II_Unlisted_
_Coordination:(date sent)
CAC Referral Sent:
_Date of Inspection:
_Receipt ofCAC Report:
_Lead Agency Determination:
Technical Review:
_Public Hearing Held:
_Resolution:
Minor
Á\ ¡~ '-_____
~ lip I (; [' !.', :-.
~ "1._. .",' c..
r...- -.......
, . ..' ~
J 82001
,
Name of APplicantJ AÍI Vé.) I fJ C I
Address P.D, 80'1- /9.15 SOU1/IDLj),JJrY 1/97/
!JJ /
~ Phone Number:( ) b 3 / 65 - &;JeJ- 0
I
Suffo k County Tax Map Number: 1000 - .,7 - 0 I - I ¥'c:4- / c¡
Property Location: S'f:J jlL¡)A COf/..f! DllltJf SCJcJl/-lD<.Ð ¡,J.y. //97/
I ( ;'/ ;' q \ .Jf.
lfg/,n éAJ¡1 of S¡(.2..S SovíflOL/) S/lOAf5..Jtoí';;27
(provide LILCO Pole #, distance to cross streets, and location)
AGENT: JOHJ L. /-IulLTADo
(If applicable)
Address: 10995 ;J. ßAYV lev.! r<.D,
_ Ç'A IY/. (! .A-S A f¡n v (! Phone:
Sou7f¡()~, ~/971
~~
· .
Board of Trustees Application
GENERAL DATA
Land Area (in square feet): j /. Duù 5, F, 57 - 0 I - [8'--1- L ~
I
Area Zoning: J-o ) O()¡) 5, f,
Previous use of property: VA-cA A/ T
Intended use of property: J.lEv ((WS1Iluc7f()V'cC>1l Dµcl FAIU./LY
Á~S/l) ¡zv7/ÆL HOU5ef WITH At (ACI/(fO GÆÆ,;ÁG-õ'
Prior permits/approvals for site improvements: R f API L.1 ío C (, µ s T flu c 1
Agency DaPeIFFŒJl...t¡./1 HðU5(f' -r ('OVf:fK&O
SW(;;:;(s-'v&O /)/öDÐ Dtcf,(
DC1C- 4/17/01 IH¿AIfL/ffO rot/.. ¡vé'-.I f/ov'){¿ (n'le
ìfluSí~ßS J/nþJ ¡Joµ TU/t.ISDICTto¡./ Lf:síT(;{1l.. W(qL)ßI~
(f>/FFe./l~v'1 !-10USé) R/fAf!L'ý
_ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or SUSP1ed by a governmental agency?
No Yes
If yes, provide explanation:
Project Description (use attachments if necessary): .SEe¿ .A-T'T4-C ¡..I{..;!)
r5U/lt./6'Y ðr pr¿Col/lC- SuÆ//GYO'l.S DATeÙ 0~ I
FO'l. oil/if FA,"f'-" II..r;S(f)~1V1(AC
UeJ V (t"}"-I Sf' IltJc.:"(_~ L' I~r(t' .. rV:-- ~- JJ. '¥J GÄ.A.A,~.. .1' HQ/scr
IV Iff-( A77'l>rctl-(-TJ GUÞ.c.,..¡/
1I!ard of Trustees ApPlicati~
WETLANDfrRUSTEE LANDS APPLICATION DATA 57- 01- /84-/<1
Purpose of the proposed operations: }/(:),,} /-h)u S~ Cou Sí lI.u C.1fòV
W(flJ Ii F1 ì< 15' FT. CovelUZD !l(AIt scfS.JièlJgj) WoòD
J~Cf( (p()(L(¡.j) ....... JJ() fcJù¡J{)A1¡ov ()/lLy Fou T¡A/G---S
MOIH¡J/4L.-
Area of wetlands on lot: JOD j: square feet p, IE I (OYU/6Il /) Y CAA/A L
,
Percent coverage oflot: 1/0111 I iliA I...- %
Closest distance between n~rest existing structure and upland
edge of wetlands: f,/ A feet
Closest distance between nerest proposed structure and upland
edge of wetlands: 9' feet
Does the project involve excavation or filling?
No ¡ Yes
If yes, how much material will be excavated?
cubic yards 38"X" FDU )Ml/o"/
How much material will be filled?
()
cubic yards
Depth of which material will be removed or deposited:
o
feet
Proposed slope throughout the area of operations: ¡: L.k -r J..... () í
.
Manner in which material will be removed or deposited: ~ ~
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):
J/!ft
· .
Board of Trustees Application
County of Suffolk
State of New York
JòHAI f,...., He/ILl A Dc) 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 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.
~,'1s~<ZÂ
SWORN TO BEFORE ME THIS
/c-l-h DAYOF T<lµ(§
.20~
~~~.C{ S~f{lfJ1/~J'
Notary P he
ì t ~ \ ,:
"
JON I 8 :~OIJl
BARS"'!" STfPliOWSIiI
NoUJlY Public, StIIB of New 'lark
r!u. O!ST~752
Q!IIIi:iOO in Suffolk ~"7""V
~&pIrøsSept.3O,~,
~ of Trustees APplication.
AUTHORIZATION
(where the applicant is not the owner)
(Cflfi./S7ivcr C. HuA. TAM)
)1A1íJ/é IV r. residing at /0, /3ox 19;;'S
(print o~er of property) (mailing address)
0"
I,
SO(JríkJt...{), tJ. X" /(1'7/ do hereby authorize Jt}f{U L r
I
IIU!l1A~O
(Agent)
to apply for permit(s) from the
southold Board of Town Trustees on my behalf.
(Ij/~Á.iJt1¡c / (! !úuá~ fflÔ \
OWner's signature)
8
1.4-16-4 (2187)- ¡exl 12
·1 PROJiCT 1.0. NUMBEi1
.
.
617.21
Appendix C
State Environmental Quality Review
SHORTEN~RONMENTALASSESSMENTFORM
For UNLISTED ACTIONS Only
PART I-PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
1. APPLlCA';,T ISPO:IS~ "r 2. PROJECT NAME
,... N€ IV\. 1(J0t.) ··57- 0' !'if+/~
3. PROJECTLOCATION: $"JfS ALßA CC,Ilf? SOU TIIOl..D ,'7', 1197/
Municipality U L- County Su
4. PREC:SE LOCATION (Street address ana road intersections. prominent landmarkS. elc_. or provlae map
S~~ .Á1-bACDJ/.é þllIV(Ç Sdu7IfOW/ ¡./,¡', //97/
'f8l,t'(' ~Asr Or S,f(¿;2Ç
"Sou 0 LD S Ho nt'S 11 J () T ::Þ- ;;) '7
SEO
5. IS PAP/OSED ACTION:
ΠNew 0 Expansion
6. DESCAIBE PROJECT BRIEFLY:
)feW f{CJJ5<[ coµçrn.iJCliov' kilTµ-
SctltBy¡,;-P "'OO/) D eC K (10,( c..H) .
o MOdification/alteration
/1 Ff. X (5 ¡=r: (0 úM&f) Æ((A.;t.
7. AMOUNT OF LAND AFr=ë:CTED;
Initially acres Ultimately
3. VIlLI .-ROPQSED ACTION COMPL':' WITH EXISTING ZONING OR OTHER E.':(ISTlNG
Yes 0 No If No. desctLbe tHlefly
it I To F~eSHIJ/AT&l k/C:-TLAIt/{J5
ND UjE FlEJiTRIC710NS?
/'INU 100 I 7ã
CA.....A-c:..
-3. 'IJH¥ IS PRESENT LAND tJSê: IN VICINITY OF ?AOJECT?
~ Residential [j.!nauslnat 0 CommerCIal
aesc~lbe:
o Agflcuiture
CJ Park/Forest/ODen space
LJ Otner
10_ DOES ACTION INV0rJ,V A PERMIT APPROVAL OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNME~TAL AGENCY (F::DERAL.
5T ATE OM LOCAL)?
o Yes No If yes. list agency(s) and permlt/aoprovals .
'r
". DOES ANY ASPECT OF THE ACTlQr.¡ HAVe A CURRENTLY VALID PERMIT OR APPROVAL?
DYes 0 No If yes, list agency name and perrmt/approval
12. AS RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL ;:!EQUIRE .\10QIFICAilON?
Yes 0 No
I CERTIFY THAT THE INFORMATION PROVIDED AeovE IS TRUE TO THE 3eST OF MY KNOWLEDGE
Applicant/sponsor
D.:lle:
t(; 1-/0 /
Signature:
If the action is in the Cons tal Area, and ,ou are a state agency, complete the
Coastal Assessment Form before proceeding with this a'j.~essment
OV!::R
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
'06D- 5"7-0(- (NIt(
-----------------------------------
In the Matter of the Application
. of D. .
~¿[~-~---~---------
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
I, JDJ.{J.I L. !jUR.TAflQ, residing at 1C>,995 ¡(JDIt?,/! 154,7'l//at</
f?c) A f) .!Òc.l m() LO . j../, y / / 97/
being duly sworn, depose ánd say: '
That on the ,..f{ day of ;fUCI, 200), I personally posted the
property known as 5'15 Ai-I3/1colfr- j)~/(/c::: J()U /"hOLJ) A/.y'
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 eight days prior to the date 0hhe
public hearing. Date of hearing noted thereon to be held. '><rí¡ }tp I
flY,. It ~ Î() ~.~ . .
If ;locJ/
I
Dated:
::JllLý
~~
Sworn to before me this
/11 day of JUL;/ 2001
~.A./O I;; .Ú<?~
¡Ñ"otary publi;Y ---
BARBARA STEPNOWSKl
NotIIy Public, Stale of Now 'forti
No.OlST4844752
Qualified in Suffolk Counly
Cornmiuion Expires Sept 30~ I
'JOH,¡./
L . #U¡¿TÆ-1'Jò
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
Address:
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I. H A fI.. 0 { D <>- CA'( In.: E. S E
il7 tA<;;-{,.r= C/-I AScI WOO DB if R. Y/ iJ' y. !/7{f7 ) YI/50
C\'_f'lUl-t-\R.DLb f2EEs E. ){.5-SSU.tJf\ISfJ-fWYjLI/vBROOK)). 3
j-JAVYlES <l- /Y1AF<.ihtV MAINO fR ~-5ALBACOR..EDQ}5(}tlTIIOL~JVY/Jq7
t..j _ MR g..EO R. &E I<AN LA C- k S 7 SO /AT/jl3/t r A- VEj MJ, S':>A PE 4LA./t N 'f
I , 7 !J-JY
b-GCI<A-/....D i-..:jUlDIT/-ISfltJIJOiJ lLj.qtVJ[)NIR.~srDR"j PTSEFF-
r:RSON 5Th'l NY, II 776
Postage $
2.10
Certified Fee
c.'
, Postmark: r'1 r'\, \
Clerk: K\A:l~]:. '\ ,:c'
.
,,'-\.
0'{/03/01..," .
residing at
IDe; Y 5 1/0;<..171 i3AYII/(:,w- /(6Af)
Return Receipt Fee
rn (Endorsement Required)
o
C Restricted Delivery Fee
Cl (Endorsement Required)
Cl Total postage & Fees $
IT1 .
~ enlTo MuR_____~E_t2l?JiEj{A.!fl{jC.i:{u--
Streei,-ApTNo.;-or PO Box No. A
~ uS..z...s.l2./d-77I-~AX-m- j)E._____u______________m____
I:] cly,Sate,ZIP+4 /- [
l'- S ' .
:11 . ...
being duly sworn, deposes and says
n y ,aJRoo I , deponent
_ )tice set forth in the Board of
;ed to each of the above named
opposite there respective names;
resses set opposite the names of said persons are
the address of said persons as shown on the current assessment
roll of the Town of Southold; that said Notices were mailed at
the United States Post Office at J'()U//!OL-() , that
said Notices were mailed to each of said persons by (certified)
(r~~i8~~~~d' mail.
/If)
Sworn to before me this 3
day of :rUL.Y ~()() I
~ il1JO ~h
Notary B blic
8ARBARA STEPNOWSKJ
NoIaIyNo.PubOIic, Stale of New YoI1l
IST4844752
Qualified in Suffolk Count):
Commi'~!nn <!!pires Sept 30~O I
t
Attttttt!AN'l'
TRANSACTIONAL DISctOSURK FORM
.
.
~he Town of åouhholdts Code of ~bhicäþtohibibs
inl;eresl; on
alerl;
il; 1;0 I;ake
YOUR NAMI.
...: '-"""¡'~¡;¡'\
AA1iI/&/ I I/l,".. I;.¡,¡~:;,.""i'~~:'f:.^'
(LUb ttllmeí firsb nams, IIIldd-le lmrài",'""ùnhu
you 8ré apþlying in bhe name at someoné eise or
obh~r enbib" such as a comþdny. it so, indicabe
bhe öbher þersoH's or company's name.)
'1'U udevBnce
\1ar1ahcø
Chönglt at zone
^þ.Þt~al at þlab
E~é~pbion frOM þlab or official map
obhet"
Cíf ·obhet",· nallle bhe aCbiviby.)
-
v
.. I.', ..",". "... _~" , . f .'
·r. ~.:r<~: t:".'-":."o'-~~ ,~.; ,,;,~,~,
't"\,; . c ,. .
'5::fr V'Ì! ~ /,f,f/1
. .~
"
JJN I 8 2001
I,' _.
NAtuäl 0; AttÞLtt!ATtONt (Check all bhab IIpþly.)
I.
. .
.......
Do you personally (or bhrough your ~b~pany, sþbüde, Sibling,
paren!:, or child) hllvö a rölnl:ionbhip wHh ant öEUt:!er or
employee of bhe Town of Soubhold? -Rèlll!:ionShip" ih~lUded
by blood, marriage, or business inberesb. "Dusin@ss
inberesb" Means a businens, includin~ a parbnershipl in
which bhe bown officer or employee has even a patblal
ovnernhip of (or emplOfme~b by) a t:!orþ.oraUon In which
bhe bown officer or employee ownb morè bhan 5% of bhe
shares.
YES
NO -L.
. :;¡<"
It you ans1tered "rES,". t:!omplöbe hhe bdancö·of ~hh·forlll IInd
dabe and ign where indicabed.
h emþloyed by I:he Tolin 01' soUbhold
on 01' bhab person
~anté of þer
Tible or pos
Describe bhe
and bhe !:own otfic
Bpproprlabe line
provIded.
ionøhip bebween YOUrself (bhø aþÞlicanb)
ør employee. kibher check bhe
.hrough D) and/or describe in bhe äpace
The I:olln ofticer or e 6r hib ör het SpoUser Þiblirt~,
parenl:, or child is (check 1 bhab àþþly),
A) I:he owner of ~teal:er~h 5% 01' bite èltared bt bhe
corpotal:e sbock of bhe licånb (when ~h. ftþþlicanb·
ib a corporablon)/
B) bhe legal or benefit:!ial öWne of any iH~'flll: ih a
noncorporal:e'enl:iby (when bhe licãhb i~ nob a
corporãHon) /
C) an ötticetl dIrecl:or, at bhe
lIþpllcahb/ or
D) bhe acbual apþlicanb.
. '0.
'" ,'...
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~I
'.
DESCIHPTION OF ItELATíONSllíÞ
."
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¡
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Att&tLWAN'l'
TRANSACTIONAL DISCtOSURK rORM
.
'rhe Tolin of
cantHcI;s 01'
.
toUR HAMil.
#I. A7í//(¿
LAMb hAmø, f rsb name,
you Nf@ Ar'Þ1YiH~ in bhs
obh@t @hb by, sUbh as ~ campany. it 80, iHdi~abs
bh@ öbh@c þer~olt 8 or company's nam..)
pc,
'."
I :":"1f.:;·~.;·!;J;}~:~:¡~';;::,.
" 'f~~' ~ :-'~!{;:'4:~."r..'
.... . ':'::;',:~):L.::::.·. t~.:~il.f,'.; !.""i'
NA'i'blUt bit A&t~Li~Â'rtONt (che~k a11 bhab apþly.) SC¡:'O/~ ¡HIe¡
ra~ ~rldvAhce ,
\tar h 1t!:!1t .....
Cl1l1ltgll at !tol1l!
^Þ.Þt~Ai of þlab .
EXë~pbion from þiab or official map
Ol:her
(ít "obher." name I:he aCbiviby.)
Pi-:;")'-" j>0......;-~·_¡_·~
I· r' J I .
:",. ",: c
JUN 1 8 2001
........
Do you perøortallr (or hhrough tour COMparty, SPÖUdê, sibl1hØ.
p~renh. or child) hnvs a rslahionshlþ wibh nn, o~tlt:!et or
employee of bhe Town of soubhold? ·Rslablonshlþ~ ih~lUdes
by blood. marriage, or business inhsrêsb. .Dusihêøs
lrtbatl!sb" iteaM a busihMS, Iht!luditt~ a parbhe,tbltlp, itt
which bhe bown ofticet or I!~plo,ae has evan a þatblal
ollnership of (or elnplö'lIIè~b by) a t!otll.ouUIUt lit which
bhe bown orricør or employee ollne mote bhan 5% of bhe
shares.
YKS
NO
,/
. :~! "
If you answer ·rKS.... complsbe bhe balancaör ~his lot. ähd
dal:e and Bign v re indicated.
red by bhs Towlt öf Soubhoid
bhab pB.I:'SOI1
Name of þe.l:'Boh emp
Til:lë or þoeibion 0
DesQ.I:'ibe bhe .l:'elabioneh
and bhe town officer ør e
appröprlate line A) bhroug
provided. .
The bd~h offl~er or emþ10yse ot 8 ör het 8þOU~8( älblihg,
patenb, 0.1:' chiid Ie (aheck a11 bha èPþ1Y)1
^) bhe ovl1et of gteaber bhèh 5 l' bhe share8 òt bho
cotporabe sbock of bhe apþii~a (liheN bho 8pþlicahb'
is a cO.l:'potabian)/ .
a) bhe le~äl or beheriai8i owlter öt Ihb8fAäb lh a
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cotporabion)/ .
C) al1 ottlaet¡ diteabor¡ þArbl1sr, or elnþlo
appH~al1b / or
b) bhe ~cbuai àþplicanl:.
bebveen yourse1t (bhe aÞÞiiaanh)
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