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Home My WebLink AboutTR-6082Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliweda 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 $OUTHOLD February 16, 2005 Mr. James Fitzgerald Proper-T Permit Services P.O. Box 617 Cutchogue, NY 11935 RE: CHARLES WENDY, JR. 765 WILLOW POINT RD., SOUTHOLD SCTM# 56-5-28 Dear Mr. Fitzgerald: The Board of Town Trustees took the following action during its regular meeting held on Wednesday February 16, 2005 regarding the above matter: WHEREAS Proper-T Permit Services as agent for CHARLES WENDY, JR. applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated December 28, 2004, and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 16, 2005 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, 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, RESOLVED, that the Board of Trustees approve the application of CHARLES M. WENDY, JR. to construct a fixed platform 4'x 4', hinged ramp 3' x 12', and floating dock 6' x 18' with the condition that the dock does not exceed 26' seaward of the south shore, including the vessel and motor, and as depicted on the plan drawn by Proper-T Permit Services dated March 25, 2005. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) This is not a determination from any other agency. Fees: $50.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/hct Proper-T Permit Services P.O. Box 617, Cutchogue NY 11935 Phone: 631-734-5800 MEMORANDUM TO: FROM: SUBJECT: Lauren - Trustees Jim Fitzgerald Wendy; SCTM #10900-56-5-28X DATE: 12/7/05 Here's the original permit. Please issue the corrected version. Thanks. Fax: 631-734-7463 WILLOW POINT ASSOCIATION PO BOX 215, SOUTHOLD, NY 11971 November 30, 2005 Department of the army New York district, corps of engineers Jacob K Javits Federal Building New York, NY 10278-0090 Mr. Michael G. Vissichelli, RE: Application No. 2005-00529-L2 by Charles M. Wendy, Jr., Budds Pond,Southold NY., SCTM# 1000-56-5-28 Dear Mr. Vissichelli: As the owners of the property described in this application we oppose this construction. May it be noted that the measurements in the text of your letter conflict with those shown on the drawing. May it also be noted that we believe a maximum protrusion of 20 feet fi.om the edge of the natural shoreline, at this location on our property, is the most allowable to maintain a channel that can be safely navigated. We have expressed these concerns to the applicant and assumed they were being adhered to! Thank you for your consideration. Respectfully, Robert J Guarriello, Treasurer CC. Southold board of Trustees CC: New York State Dept. of Environmental Conservation New York State Department of Environmental Conservation Division of Environmental Permits Building 40 - SUNY, Stony Brook, NY 11790-2356 Telephone (631) 444-0372 Facsimile (631) 444-0360 Den]se M. Sheehan Acting Commissioner July 19, 2005 Willow Point Association Inc. 185 Willow Point Road Southold, NY 11971 RE: 1-4738-03327/00001 SEP 2 0 2005 I~.~ Southold Town Boarc~ of Trustees Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. CKW/ls Enclosure Sincerely, Claire K. Werner Environmental Analyst NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER 1-4738-03327/00001 FACILITY/PROGRAM NUMBER(S) PERMIT Under the Environmental Conservation Law EFFECTIVE DATE July 19~ 2005 EXPIRATION DATE(S) July 19, 2010 TYPE OF PERMIT · New [] Renewal [3 Modification · Permit to Construct [3 Permit to O_O_~rate · Article 15, Title 5: Protection of Waters [] Article 15, Title 15: Water Supply [3 Article 15, Titte 15: Water Transport [] Article 15, Title 15: Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers · 6NYCRR 608: Water Quality Certifica- tion PERMIT ISSUED TO Willow Point Association inc. [3 Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [3 Article 23, Title 27: Mined Land Reclamation [3 Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands ID Article 27, Title 7; 6NYCRR 360: Solid Waste Mana~lement [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control ITELEPHONE NUMBER (631) 765-6015 ADDRESS OF PERMi I ~ ct:: 185 Willow Point Road, Southold, NY 11971 CONTACT PERSON FOR PERMi¥ i t:u WORK Andrew Nicolich, 850 Budd's Pond Road~ Southold, NY NAME AND ADr~I.<~-.~S OF PROJECT/FACILITY 11971 ITELEPHONE NUMBER (631)765-6015 Willow Point Association Inc. property, Willow Point Road SCTM # 1000-56-5-28 COUNTY I TOWN I WATERCOURSE Suffolk Southold Budd's Pond DESCRIPTION OF AUTHORIZED ACTIVITY: NYTM COORDINATES Maintenance dredge 800' of canal and channel to Budd's Pond to a depth of -5' below mean Iow water, place a total of 900 cubic yards dredge material (in 100 cubic yard batches) in temporary transfer area on upland, for ultimate off-site disposal at an approved upland location. All work must be done in accordance with the attached plans stamped NYSDEC approved on 7/18/05. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: Mark Carrara (CKW) AUTHORIZED SIGNATURE IADDRESS Region 1 Headquarters, Bid9. #40, SUNY, Stony Brook, NY 11790-2356 July 18, 2005 Page 1 of 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. The proposed project is within 500 feet of a documented piping plover and least tern nesting area. For the duration of the permit, no work shall be conducted from April 1,t through August 31= of any year. 2. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. 3. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. 4. During the dredging operation, the permittee and his contractor shall prevent spillage of sediment during excavation and haulage. Dredging shall be accomplished with a clam shell or other closed "bucket" equipment. 5. No dredging shall occur within 10 linear feet of the seaward edge of the marsh. 6~ Dredging is prohibited from June 1 - September 30 of each year to protect spawning shellfish and/or spawning finfish. 7. All side slopes of the dredged channel shall have a maximum of 1:3 slope. 8. Material approved to remain on-site and/or within the Department's Tidal Wetland jurisdiction must be retained so as not to re-enter any water body, tidal wetlands or protected buffer area. Off-site, upland disposal of dredge material beyond the Department's Tidal Wetland jurisdiction requires the approval of the Division of Solid and Hazardous Materials (631) 444-0375 and is not covered by this permit. DEC PERMIT NUMBER 1-4738-03327/00001 PAGE 2 of 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES '15 (TITLE $), 24, 25, 34 AND 6NYCRR PART 608 ( TIDAL WETLANDS) If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 3. All necessary precautions shall be taken to preclude contamination of anywetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. There shall be no unreasonable interference with navigation by the work herein authorized. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 7. If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302,303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. 8. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 9. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plans were prepared by A. Nikolich stamped NYSDEC approved on 7/18/05. DEC PERMIT NUMBER 1-4738-03327/00001 PAGE 3 of 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION · ' ' NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permlttee Accepts Legal Responsibility and Agrees to Indemnification The permittee expressly agrees to indemnity and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractore to Comply with Pentflt The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition '1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Pemlit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this ~ermit~ Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg ~-40, Stony Brook NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621. The grounds for modification, suspension or revocation include: a) materially false or inaccurate statements in the permit application or supporting papers; b) failure by the permittee to comply with any terms or conditions of the permit; c) exceeding the scope of the project as described in the permit application; d) newly discovered material information or a material change in environmental conditions, relevant technology or applicable {aw or regulations since the issuance of the existing permit; e) noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. DEC PERM~TNUMBER I PAGE 4 OF 4 1-4738-03327/00001 Proper-T Permit Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 November 10, 2005 (631) 734-5800 Albert J. Krupski, Jr., President Board of Town Trustees Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re: Permit No. 6082; Charles M. Wend¥, Jr.: Corrected/Revisec~D~ocUr0ents Provided Dear Mr. Krupski: The dimensions provided in several of the documents submitted with our original application dated December 27, 2004, were inconsistent with the drawings included in the same application. In the "Project Description" in two of the application documents the dimensions were inadver- tently stated as those of an earlier version of the project, and not those which had already been approved by the Southold Town Trustees. Attached are revised versions of the two documents. Each document bears the notation "Revised Nov 10 2005" and provides in the "Project Description" the correct dimensions of the structure, which dimensions are the same as those shown in the "Project Plan - Detail" and in the "Section View" drawings. Please add this information to your file on this project and revise any published information con- mining the incorrect dimensions. I apologize for the inconvenience this oversight has caused. If there are any questions, or if additional information is needed, please call me. Enclosures: / Trustees' Application Form - General Dam Short Environmental Assessment Form, Revised 11/10/05 cc: Karen Westerlind, NYSDEC Russell Smith, CoE Jeff Zappieri, NYSDOS a subsidiary of THE PECONIC EASTERN CORPORATION 1446.4 {?./87)--Text 12 PROJECT I.D. NUMBER 617.21 Aplmndlx C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--I~ROJECl' INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR J 2. PROJECT NAME James E. Fitzgerald, Jr. I Wendy derek 3. PROJECT LOCATION: Municipality Southold , Cou.~ Suffolk SEQR 4. PRECISE LOCATION (Street address and road Intsmentions, prominent landmarks, etc, or provide map) See attached map. 5. IS PROPOSED ACTION: ~[] New [] Expansion [] Modlflcationlaiteratlon 6. PROJECT DESCRIPTION: Construct fixed platform 4'x 4', hinged ramp 3'x 12', and floating dock 6'x 18'. 7. AMOUNT OF LAND AFFECTED: , N/A m~t~yless than 0.~acres Ultimately sores 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] NO If NO, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Inciustrlal [] Commercial [] Agriculture [] Park/Foree/JOpen space [] Other ~edium-size private residences. 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes [] NO If yea, list agency(s) and psrmlt/~ppro~als Required: NYSD~.O, }T~'SDOS, USACo~., Southold T~ustees 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [] NO If yes, list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACT[ON WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes [] Ne Signature: __ I ~ERTIFY THAT THE INFORMATION PROVIDED ABOVE/S TRUE TO THE BEST OF MY KNOWLEDGE James bzgerald, Jr. ' Dec 20, Date: Revised ~OV 10, action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment 2004 2OO5 OVER 1 Board of Trustees Appli~tion Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property:. GENERAL DATA 113,003 R-40 Association marina~ balance undeveloped Same, with one dock added Prior permits/approvals for site improvemems: Agency Date Trustees? Not known __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? XX No 'Yes If yes, provide explanation: PROJECT DESCRIPTION: Construct fixed platform 4'x 4', hinged ramp 3'x 12', and floating dock 6'x 18'. Revised Nov 10, 2005 Proper-T Permit Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 November 10, 2005 (631) 734-5800 Jeff Zappieri Supervisor of Consistency Review and Analysis Division of Coastal Resources New York State Department of State 41 State Street Albany, New York 12231 Re: F-2005-0483; Charles M. Wendy, Jr.: Corrected/Revised Documents Provided Dear Mr. Zappieri: The dimensions provided in several of the documents submitted with our original application, dated June 6, 2005, were inconsistent with the drawings included in the same application. In the "Project Description" in three of the application documents the dimensions were inadvertently stated as those of an earlier version of the project, and not those which had already been approved by the Southold Town Trustees. Attached are revised versions of the three documents. Each document bears the notation "Revised Nov 10, 2005" and provides in the "Project Description" the correct dimensions of the structure, which dimensions are the same as those shown in the "Project Plan - Detail" and in the "Section View" drawings. Please add this information to your file on this project and revise any published information con- taining the incorrect dimensions. I apologize for the inconvenience this oversight has cause$t. If there are any questions, or if additionfil information is needed, please call me. Y, Enclosures: Joint Application for Permit, Revised 11/10/05 Federal Consistency Assessment Form, Revised 11/10/05 Short Environmental Assessment Form, Revised 11/10/05 cc: Albert Kxupski, Southold Trustees Russell Smith, CoE Karen Westerlind, NYSDEC a subsidiary of THE PECONIC EASTERN CORPORATION Proper-T Permit Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 (631) 734-5800 November 10, 2005 Russell Smith Eastern Permits Section U.S. Army Engineer District 26 Federal Plaza New York, New York 10278-0090 Re: 2005-00529-L2; Charles M. Wend¥, Jr.: Corrected/Revised Documents Provided Dear Mr. Smith: As you know, the dimensions provided in several of the documents submitted with our origimal application, dated June 6, 2005, were inconsistent with the drawings included in the same applica- tion. In the "Project Description" in three of the application documents the dimensions were inad- vertently stated as those of an earlier version of the project, and not those which had already been approved by the Southold Town Trustees. Attached are revised versions of the three documents. Each document bears the notation "Revised Nov 10 2005" and provides in the "Project Description" the correct dimensions of the structure, which dimensions are the same as those shown in the "Project Plan - Detail" and in the "Section View" drawings. Please add this information to your file on this project and revise any published information con- talning the incorrect dimensions. I apologize for the inconvenience this 0yersight has caused. If there are any questions, or if additionkl information is needed, please call me. ~rely, ~ _ Enclosures: Joim Application for Permit, Revised 11/10/05 Federal Consistency Assessment Form, Revised 11/10/05 Short Environmental Assessment Form, Revised 11/10/05 cc: Albert Krupski, Southold Trustees Jeff Zappieri, NYSDOS Karen Westerlind, NYSDEC a subsidiary of THE PECONIC EASTERN CORPORATION Proper-T Permit Services POST OFF/CE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 November 10, 2005 (631) 734-5800 Karen S. Westerlind Environmental Analyst NYS Department of Environmental Conservation Division of Environmental Permits SUNY Campus, Building 40 Stony Brook, New York 11790-2356 Re: 1-4738-03327/00004; Charles M. Wendy, Jr.: Corrected/Revised Documents Provided Dear Ms. Westerlind: The dimensions provided in several of the documents submitted with our original application dated December 27, 2004, were inconsistent with the drawings included in the same application. In the "Project Description" in two of the application documents the dimensions were inadver- tently stated as those of an earlier version of the project, and not those which had already been approved by the Southold Town Trustees. Attached are revised versions of the two documents. Each document bears the notation "Revised Nov 10 2005" and provides in the "Project Description" the correct dimensions of the structure, which dimensions are the same as those shown in the "Project Plan - Detail" and in the "Section View" drawings. Please add this information to your file on this project and revise any published information con- raining the incorrect dimensions. I apologize for the inconvenience this oversight has caused. If there are any questions, or if additional information is needed, please call me. Enclosures: Joint Application for Permit, Revised 11/10/05 Short Environmental Assessment Form, Revised 11/10/05 cc: Albert Krupski, Southold Trustees Russell Smith, CoE Jeff Zappieri, NYSDOS a subsidiary of THE PECONIC EASTERN CORPORATION 2005 Field In~,,ction 2005 Field Inmection 2005 Field Inmection 2005 Field Ins 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) 765-1592 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1 ,t day of construction Ye constructed Project complete, compliance inspection. Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PEP, MIT NO .................... DATE: ... ISSUED TO c~A~n~s WENDY ................... Pursuant to the provisions of C:hepter 615 of the L~ws .of the State of New York, 1893: and C, hapter ~ of the L~ws of fha - State of New York 19!i21 and the Sou~hold ToWn Ordinance eh- fffled ."REGULATING AND THE PLAC:IN~= OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC: LANDS and the REMOVAL OF SAND, C=RAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;t~. and in accordance wlth the Resolution of The B6ard adopted at a meeting held on ...F...e..~.:.....~.~. ....... .2Q..0...5......., and In consideration of the sum of $....2...5..~.~...0..(~ ........ p~id by ..: ........... ~ ~!.!~ ...~-d.-~..; ............................................................................... : ........... :. ........ of Southol~ ........................... ; ......................... N. Y. and subjecl to the Ter~'"'"~'"'"~'gndifions hdnd on the reverse slde hereof, of Sou~hold Town Trustees authorizes and permlfs the following: W~tiand Permit to constmot a fixed platform 4' x 4', hinged ramp2,' x 12 snd flomting dock ~ t 8 ' with the condition thst the dock does not exceed 2~' sesward o~ the south shore, including the vessel and the motor, and ms depicted on the plan drawn by Proper-T Permit ServJc, e8 dated March 25, 200§. ell in accordance w;th the detailed Specifications as presented in .the or;ginatincj application. IN WITNESS WHEREOF, The seld Board of Trustees here- by causes its C:orporate. Se. el to be a~xed, and these I~.resents to be subscribed by ;s '.malority of the sa,d Board as of .tins daf=. TER~4S and CONDmONS Tbe~e~ . Charles Wendy ' ~ ~ Southold N.Y. ~ l~'t' of t~ cotatderafio, fo~ the is~,~e~_ of .he Petml~ do~ unit,rand t~! ptea~l~ to tl~ for- 1. That the saRI Board of Trustees and the T,w,, of S0ud~old axe t'eleased ft~m any and aa da. ag~ o~ ,~.~,,,. fo, d~,age% of ,u~ timing dlm~y ~t ~ -- · ~ of my Ol~- wida tz~pect ~heteto, to.~e caa~,lete ,,,~,4,~on of tl~ ~ of Tn~ee~ .f the Toga of ~ for an ~stoa may be made to the Bo~urd at a latex 5, That this Permit should be tetahxed indefinitely, or maintain ~ structure o~ project involved, to provide evidence to anyone ooncetned ottmlon was odgimlly 4. That the work involved will be subject to t~e inspectio~ and approval of ~e Bo~d its agen~ and n<~z-mn~::~,~e with the p~c,i~ions of t~e ori~,-~,~ appilcatlon, may be ~,,~ tevocatlon of this Pe~mlt by r~=,olu~.on of th~ ~td Boazd. 5. That there wi[[ be no untea~le inte~fefet~ce with na. vlgatloG as · result of t~e ~ hete/n au'd~odzed. 6. That there shall be no imerfereace with the tight of the public to pass the beach between hi.th tad low water -~rk~. 7. Tlat if fuu,~e opet~iom of t~ Town of So,ti,old ~ the removal ,x,d/m iath~ location of the ~vofi: he~e~n aut~ot~ or if~ ia th~ opink~ of ~e B~rd of Tm~ze% th~ wot~ .A.II cause um~L~zble o~stngucm to free navigation, tt~ ~ald Pe~mitt~e ~ b~ ~ d~ ~otlc~ to t~nove or alte~ ~ work o~ p~ojec~ here~ ~tated ~4thout txl, eme~ to the 8. That the said Boazd will be notified by the Petmittee ot the c0m~le~lon, of the wot~ auth- oriel 9. That the Petmittee will obtain aLI other permits and consents d~tt mty be required sup- plen~ntal m this permit which may be subject to revoke upon ftatu~ to ~ ~ Albert J. Krupski, President James King, Vice-President Attic Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 16, 2005 Mr. James Fitzgerald Proper-T Permit Services P.O. Box 617 Cutchogue, NY 11935 RE: CHARLES WENDY, JR. 765 WILLOW POINT RD., SOUTHOLD SCTM# 56-5-28 Dear Mr. Fitzgerald: The Board of Town Trustees took the following action during its regular meeting held on Wednesday February 16, 2005 regarding the above matter: WHEREAS Proper-T Permit Services as agent for CHARLES WENDY, JR. applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated December 28, 2004, and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 16, 2005 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, 2 RESOLVED, that the Board of Trustees approve the application of CHARLES M. WENDY to construct a fixed platform 4' x 4', hinged ramp 4' x 6', and floating dock 5' x 20' with the condition that the dock does not exceed 26' seaward of the south shore, including the vessel and the motor, and as depicted on the plan drawn by Proper-T Permit Services dated March 25, 2005. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) This is not a determination from any other agency. Fees: $50.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/hct 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-t55~ (~o~l TO: Please be advised that your application dated reviewed by this Board at the regular meeting of following action was taken: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ~)~6, ,~ ~ ~-c~OV has been ~..L. /Al ~o%c andthe ( v )Application Approved (see below) (__.) Application Denied (see below) ( ) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: SIGNED: PRESIDENT, BOARD OF TRUSTEES FEB -4 2005 ,.~,~' $oetllOl~ Tawfl Board of Trustees 'f r Telephone ~63[) 765-l$92 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-fl959 TO: Southold Town Board of Trustees FROM: Southold Town Conservation Advisory Council DATE: January 11,2005 RE: Recommendations A meeting of the Southold Town Conservation Advisory Council was held Tues., January 11,2005. The following recommendations were made: DISCUSSION AND RECOMMENDATION OF, WETLAND PERMIT & COASTAL EROSION PERMIT APPLICATIONS CHARLES M. WENDY, JR. to construct a fixed platform 4'× 4', hinged ramp 4'X 16', and floating dock 5'X 20'. Located: 765 Willow Point Rd., Southold. SCTM#56-5-28 The CAC did not make an inspection because the gate was locked, therefore no recommendation was made. PHOTO A: Looking S from adjoining floating dock. Pink-flagged stake (circled) marks extended eastern edge of proposed float. (11/9/04 at 1430 hrs PROJECT SITE PHOTO Application of Charles Wendy Willow Point Association. SC]`M #1000-56-5-28 Represented by PROPER-]' PERMIT SERVICES P.O. Box 617, Cutchoguc, NY 11935 James E. Fitzgerald~ Jr. 631-73J~-5800 November 9. 2004. Cc ~UTHO .J THE AREA OF THE PROPOSED PROJECT IS CIRCLED SOUTHOLD BA Y'~ PIPES COVE .~,~ . ~ f / CORPS OF ENGINEERS DATA PURPOSE: Construct fixed platform, hinged ramp, and floating dock for private recreational purposes. IN: Budd's Pond COUNTY: Suffolk DATUM: MLW AT: Southold STATE: New York VICINITY MAP Application of Charles Wendy: propert3' of Willow Point Association, SCTM #1000-:56-$-28 Represented by PROPER-T PERMIT SERVICES P.O. Box 617. Cutchogue, NY ~ 1935 James E. Fitzgerald. Jr. 631-734-$800 November 29, 2004 THE SITE OF THE PROPOSED PROJECT IS SHADED CORPS OF ENGINEERS DATA PURPOSE: Construct fixed platform, hinged ramp, and floating dock for private recreational purposes. IN: Budd's Pond COUNTY: Suffolk DATUM: MLW AT: Southold STATE: New York TAX MAP Application of Charles Wendy; property of Willow Point Association, SCTM #1000-56-5-28 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue. NY 11935 James E. Fitzgerald, Jr. 631-734-5800 November 29. 2004 ,c,~ IRVEY :~' · -...-. ,..,F PRQPE?T'r' Hillo~ Point 5~T~ 5ou~hold Hem Tork T[d~ Ro~q~: 2,~'+/- Ootum: ~L-N~VO'2q ~Floo[. Docks, SEA LEVEL MAPPING P. O. BOX # 558, pFI ( Tie Line.~ ~R = 367.59 Willow' p t Road .. L= 114.18'.. ...... oin SCALE I": 40' i~l x Mel~s & Bounds shown on x x ~Filed Map of 'Willow Point" 1966 N APR - 4 2005 S01Jlh01d 1own Board of Truslees C~ORPS OF ENGINEERS DAT. L PURPOSE: Construct fixed platform, hinged ramp, and floating dock for private recreational purposes. DATUM: MLW IN: Budd's Pond AT: Southold COUNTY: Suffolk STATE: New York N · . % ~olk~ ",,,,,~- ~ ~ _ .,. . ~.,?,,, ~ -,, ~,~ ,... ~ ~ ,~ , ,,,,?.. -,,, '.,,. .. .,,~:. _~ .,,,,'% --,,..,.,, ~,;~o,,.::.::.~ ~ -,. .,.,~ ........ · ,, .,,.. o ,~,~,,~,'_-'~-~.~. .... ~ ,~,% I.. "". · ' ' ~o,.-~.'.'.'.'.'.'.'.'.'~e;,_ '.. -.. . . , '; SEE PROJECT PLAN-DETAIL" "v '... ... ....... ~ cT4_.~....,. .~ '~''i "..... "...;. ' '... c~ "-.;;~.. ' , '..... '..,. ~'"'\ . ~ · , ,~.. ; -~ ,, PROJECT PLAN Application of Charles Wendy; property of Willow Point Association, SCTM #1000-56-5-28 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald, Jr. 631-734-5800 March 25, 2005 I Proper-TPermit Services Bo×6 7. Cutchog,,eN¥ 11935 Rhone: 631-734-5800 Fax: 631-734-7463 MEMORANDUM TO: FROM: SUBJECT: Lauren - Truste~.L Jim Fitzgeral~ Wendy, SCT~0-56-5-28 DATE: April 19, 2005 I saw Trustee Krupski last Wednesday, after the Trustees had inspected Wendy's project. He said that the overall length of the structure could be 26' from the stake. The drawing we have most recently submitted, dated 3/25/05, shows the overall length to be 24', which is two feet less than the figure Al gave me. We would like to have the Trustees approve the project as it is shown in the 3/25/05 drawing, and presumably that can be done by having Al look at the drawing again and his saying it's okay. A copy of the drawing is attached. z PROPOSED DOCK 4X4 PLATFORM · 3X12 RAMP · 6X18FLOAT SCALE: 1" = 20' P.ROJECT PLAN - DETAIL Applicalion of'Charles Wendy; property of Willow Point Association, SCTM #1000-56-5-28 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald, St. 631-734-5800 March 25, 2005 James YAng, Vice-Preside~l~ Henry Smith Artie Foster · · I~n Poliwoda · Town Hall 53095 l~ute 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 ~Wetiastal Erosion Permit Application and Permit Application ~ Major Minor Waiver/Amendment/Changes --l~ved Application: ~Reeeived Fee:$ ...,C~ompJeted Application / Incomplete SEQRA Classification: Type I Type II ~Unlisted~ __~.~rdination:(date sent)__ c Refe Se=: . ~Date of Inspeetion: Receip~ of CAC Report: Lead A~ency Del~ugnation:__ Teclm/cal Rev/ew: H insHeld: Resolution: NameofApplicant Charles M. Wendy, Jr. Address 3t~5 Budd's Fond Road,. Soulhold Phone Number:( ). 765-9607 Suffolk County Tax Map Number: 1000 - 56- 5- 28 PropertyLocafion: 765 Wi.~low }oint Road (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: James E. Fitzgerald, Jr. / Prooer-T Permit Services PO Box 617, Cutchogue NY 11935 Phone: 73~-sann Land Area (in square feet): Area Zoning:. Previous use of property: Intended use of property: GENERAL DATA 113,003 R-40 Association marina; balance undeveloped Same, with one dock added Prior permits/approvals for site improvements: Agency Date Trustees? Not known No prior permits/approvals tot site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? XX No 'Yes If'yes, provide explanation: PROJECT DESCRIPTION: Construct fixed platform 4'x 4', hinged ramp 4'x 16', and floating dock 5'x 20'. of Trustees WEIlJd~D/TRUSTEE LANDS APPLICATION' DATA · Pfirposeofthepwposedoperations: Add one dock to Association marina for private recreational use. Area ofwetlands on lot: 35,000 es t .square feet Percent coverage of lot: 31 es t % Closest distance between nearest existing structure and upland edge of wetlands: - O- feet Closest distance between nearest proposed structure and upland edge of wetlands: - 0- feet Does the project involve 'excavation or filling? X × No Yes If'yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: cubic yards cubic yards feet Statement oftha 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): It is expected tha~ the project will have no significant effect on the wetlands and tidal waters of the Town. Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PAF:T I--I~ROJECT INFORMATION (To be complstecl by Applicant or Project Eponsor) '-~APPUGANT/SPONSOR ~ 2. PROJEC'FNAME James E. Fitzgerald? Jr. I ~endy dock 3. ~PROJECT LOCATION: Mu,ic~;.,~ $outhold , Cou.~ Suffolk 4. PRECISE LOCATION (Street address and roa~ Intereections, prominent landmame, etc., or provide maDI SEQR See attached map. 5. iS PROPOSED ACTION: [] New [] Expansion [] Modification/alteration PROJECT DESCRIPTION: Construct fixed platform 4'x 4', hinged ramp 4'x 16', and floating dock 5*x 20'. ?. AMOUNT OF LAND AFFECTED: , ~/A inltlallyleS~ than 0,1acree Ultimately e~ 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR O~ER ~IS~NG ~ND USE R~TRI~IONS? ~ Yes ~ NO If NO, ~eecrl~ ~flefly g. WHAT I$ PRE~I~NT LAND USE IN VICINITY OF PROJEGT? [] Reeldentla~ [] Inauatrlal [] Commerctal ~ Agriculture Deecr,~e: ~edium-size private residences. 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING. NOW (~R ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY 51'ATE OR LO~AL)? [] Yea [] No If yea, list agency(s) end permit/approvals Required: NYSDEC, NYSDOS, USACoE, Southold Trustees 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? [] Yes [] NO If yes, list agency name and perm~t/apDrovai 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes [] NO , CERTIFY THAT THE INFORMATION PROVIDED ABOVE I$ TRUE TO THE BEST OF MY KNOWLEDOE James E. FLtzgerald, Jr. Dec 20, Al~!O~icant~sponsor n~m~- --D~O pe Se] Date: 2004 If'the action Is in the Coastal Area, and you are a state agency, ;omplete the Coastal Assessment Form before proceeding with this assessment OVER 1 STATEMENT TO THE SOUTHOLD BOARD OF TOWN TRUSTEES County of Suffolk ) State of New York ) I, Charles Wendy, being duly sworn, depose and affirm that I have obtained written permission from the Willow Point Association to construct a dock on Association property located at 765 Willow Point Road, Southold, New York 11971, and identified by Suffolk County Tax Map No. 1000-56-5-28, and that all work will be done in the manner set forth in the present application and as may be approved by the Southold Board of Town Trustees. I agree 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. I hereby authorize the Town Trustees or their agent(s) or representative(s) to enter upon my property to inspect the premises in conjunction with the review of the present application. Charles Wendy Sworn to before me this ................ d,~j ....................................... auv._,.. To whom it ma)' concem: Oct. 25.2004 As Presidem of the Willow Point Association, I give official authorization to Charles M. Wend), Jr., of 345 Budd's Pond Road, a resident and member in good standing of the Association to exercise his deeded right to construct a dock on the Association's property pending the proper approval of all required permits and compliance with the Association's roles and regulations. Dr. Richard Kubiak President Willow Point Association 185 Willow Point Road Southold, NY 11971 AFFIDAVIT OF POSTING TO THE SOUTHOLD BOARD OF TOWN TRUSTEES IN THE MATTER OF THE APPLICATION OF: Charles M. Wendy, Jr.; SCTM #1000-56-5-28 STATE OF NEW YORK COUNTY OF SUFFOLK I, James E. Fitzgerald, Jr., residing at 385 Haywaters Drive, Cutchogue, NY 11935, being duly sworn, depose and say that on the l0th day of January, 2005, I personally posted the property known as 765 Willow Point Road, Southold, 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 of the public hearing, which date is note.&tber, m to be Wednesday, January 19, 2005 at or about 7:00 PM. ~~..~ ~/~~ Sworn to I~fore me this { ~ day of,,h \)cG..,~ ,2005. No/tat:y l~blic LYNDA M BOHN NOTARY PUBLIC, State of New York NO. 01 BO6020932, Suffolk Term Expires March 8, 20~ AFFIDAVIT OF MAILING TO THE SOUTHOLD BOARD OF TOWN TRUSTEES IN THE MATTER OF THE APPLICATION OF: Charles M. Wendy, Jr.; SCTM #1000-56-5-28 STATE OF NEW YORK COUNTY OF SUFFOLK James E. Fitzgerald, Jr., residing at 385 Haywaters Drive, Cutchogue, NY 11935, being duly sworn, deposes and says that on the 11t~ day of January, 2005, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the addresses of said persons as shown in the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at Cutchogue, NY 11935, that said Notices were mailed to each of said persons by Certified Mail/Return Receipt Re- quested. , J~mes E. Fitzgerald7 7 Sworn tc~efore me this day of~ ~...~.__ ,200 ~.. Notary ~ublic LYNDA M BOHN NOTARY PUBUO, State of New York NO. 01B0002~2, Suffolk County T, rm F_xplr~ M~,h 8, . TO: D9 January 7, 2005 Adjacent Property Owners (Names and addresses are listed on the attached sheet.) BOARD OF TRUSTEES, TOWN OF SOUTHOLD NOTICE TO ADJACENT PROPERTY OWNER In the matter of: Charles M. Wendy, Jr.; at SCTM #1000-56-5-28 YOU ARE HEREBY GIVEN NOTICE THAT: 1. An application is being submitted to the Board of Trustees for a permit to: Construct fixed platform 4'x 4', hinged ramp 4'x 16', and floating dock 5'x 20'. The project described above is proposed on property adjacent to yours. The street ad- dress of that property is as follows: 765 Willow Point Road. Southold, NY 11971 The project, which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code, is open to public comment. A public hearing will be held at Town Hall, 53095 Main Road, Southold, New York 11971 at or about 7:00 PM on Wednesday, January 19, 2005. If you wish to comment you may call the office (631-765-1892), or applications may be reviewed and comments may be submitted in writing up to 24 hours prior to the hearing. The project described above will be reviewed by the Board of Trustees of the Town of Southold. The project may require independent review and approval by other agencies of the Town, State, or Federal governments. PROPERTY OWNER'S NAME: MAILING ADDRESS: PHONE NO.: Charles M. Wendy, Jr. 345 Budd's Pond Road Southol& NY 11971 631-765-9607 A copy ora plan showing the proposed project is enclosed for your convenience. January 5, 2005 WENDY: ADJACENT PROPERTY OWNERS NOTICE NOT SENT (PROPERTY OWNER) 1000-56-5-28 Willow Point Association, Inc. c/o Joe Magagnin 535 Bay Home Road Southold, NY 11971 NOTICE NOT SENT (PERMITTEE) 1000-56-5-28 Charles M. Wendy, Jr. 345 Budd's Pond Road Southold, NY 11971 NOTICE SENT 1000-56-5-40 Carol Cassel, a Revoc Liv Trust PO Box 190 Patchogue, NY 11772 1000-56-5-29 Nevio Blaskovic & ano 580 Willow Point Road PO Box 1431 Southold, NY 11971 1000-56-5-27 Robert Boger 455 Willow Point Road Southold, NY 11971 345 Budd's Pond Road Southold, New York 11971 President Board of Town Trustees Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Dear Sir: Please be advised that I hereby designate and authorize James E. Fitzgerald, Jr. of Proper-T Permit Services to act in my behalf as my agent in the submission and processing ora permit application for the construction of a dock on Willow Point Association property located at 765 Willow Point Road and designated by Suffolk County Tax Map No. 1000-56-5-28, and to furnish, upon request, supplemental information in support of the application. Sincerely, Charles Wendy APPLICANT ~ TRANSACTIONAL DISCLOSURE'FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of Town officers and employees. The purpose of this form is tQ provide information, ~vhich can alert the Town of possib]e conflicts of interest and allow it to take whatever action is necessary to avoid same. ~rOURNAML: Charles '~endy 3','~ (Last name, first name, middle initial, unless yon are applying in the name of someone else or other entity, such as a compaay. If so, indicate the other person or compaay name.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance Change of Zone Approval of Plat Exemption from Plat or Official Map Other XX If "Other", name the a~tivity: Trustees ' wetlands permit Do yl~u p~rsonally, (or through your company, spouse, sibling, parent, or child) have a relationship with any 'officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a parmership, in which the 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 YES NO XX ' If you answered "YES", complete the balance of this form and da~ and sign where indiea~. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D (below) and/or describe the relationship in the space provided. The Town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shares of the corporate sto~k of the applicant (when the applicant is .a. corporation);, B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C) aa officer, director, partner, or employee of the. applieant; or D) thc a~ual applicant. DESCRIPTION OF RELATIONSHIP Prop '- T Permit Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 (631) 734-5800 December 27, 2004 President Board of Town Trustees Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re: Application for Permit on Behalf of Charles Wendy Property of Willow Point Association, with permission; SCTM #1000-56-5-28 Dear Sir: Attached are documents which have been prepared in support of the application for a permit to construct a dock on the property of the Willow Point Association in the Town of Southold. Proper-T Permit Services represents Mr. Wendy in this matter, and a letter of authorization is part of this submission. If there are any questions, or if additional information is needed, please call me. Enclosures: Application Fee ($250) Letter of Authorization Letter of Permission · erely ~- Notarized Statement of Applicant Transactional Disclosure Form Application Form (3 copies) Short EAF (3 copies) Vicinity Map (3 copies) Tax Map (3 copies) Survey of property; Sea Level Mapping 5/10/04 (3 copies) Project Plan (3 copies) Project Site Photo (3 copies) 1, Jr. a subsidiary of THE PECONIC EASTERN CORPORATION SC, ALE I"= N · (6) ~:lo~r~. CORPS OF ENGINEERS DATA PURPOSE: Construct fixed platform, hinged ramp, and floating dock for private recreational purposes. DATUM: MLW AT: Southold STATE: New York IN: Budd's Pond COUNTY: Suffolk ,,.C~":,' ',,,,,. '"'\ ~,~,, ~. * "7 "~ .... ,... '....... PROPOSED NEW DOCK: 4' X 4' PLATFORM }% "'-,, °~et°t,~ ", ~ ' ~ -~ 'i AT LANDWARD END 4'X 16' HINGED RAMP ] '"',, "",, ' · LEADING TO A 5' X 20' FLOAT ] ",., '% '"'. --o~ '~-.. ~'. '.; ,e .;~%~ % "'"',,,,~ '" "" ~ "-' ,,"' .=:, / " ........... Wi:Il ................................. '" '~" ..... w ?oi ........ '"" ':"' / R ......................... x.. ~' ,; ,.: / o nt oad , PROJECT PLAN Application &Charles Wendy; property of Willow Point Association, SCTM #1000-56-5-28 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 ,lames E. Fitzgerald, Jr. 631-734-5800 November 29, 2004