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Home My WebLink AboutTR-5264Proper- T Permit Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 (631) 734-5800 October 3, 2~ _ 3 Presidem Board of Town Trustees Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re: Application of Christopher Showalter, SCTM #1000-90-4-15 Dear Sir: Enclosed is Mr. Showalter's check in the amount of $652 in paymem of the permit fee for the project which was approved by the Trustees at the November 2, 2000 meeting. a subsidiary of THE PECONIC EASTERN CORPORATION Albert J. Krupsld, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application, dated has been reviewed by this Board, at the regular meeting of O~C_Q~D~(~ and the following action was taken: (~/) Application Approved (__) Application Denied ( ) Application Tabled (see below) (see below) (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 PE~41T FEES: o20' SIGNED: PRESIDENT, BOARD OF TRUSTEES BY: OF TRUSTEES 4/98 Board Of $outhold Town Trustees SOU..THOLD, NEW YORK DATE: ...g..~(~er~...~?, :~( ISSUED TO .CH.RI_STOPHER SHqWALTER ........... Pursuant · the State of New YorE, 1893; and Chapter 404 o} the ,L~. ws .oF the · 'State of New York 1952~ and Se Southeld To~n..Ordmanca eh- rifled-"REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, ~,RAVEL' OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;.-';: and in accordance with the Resolution of The Board adopted efa meeting held on .....D~.c-.:....~.°...~... 2000 ............. aha in consideration of the sum of $..~:.~.~'~Z..'...0. 9..... paid by. Christopher Showalter of ......... ~.~.~..b:.~..g.~:~. .............................................. N. Y. and subject fo fhe Terms and Conditions lided on the reverse side hereof, 'of Southold Town' Trustees authorizes and permits the following: Wetland Permit to construct a fixeki open walkway 4'X 53', hinged ramp 4'X 16', and floating dock 6'X 20'; install two piles to secure floating dock. all in accordance with the detailed specifications as presented in the originating appficafion. IN WITNESS WHEREOF. The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these p/esenf~ to be sul~scdbed by 'a'majorlfy of the said Board as of th',s darn. - ' '~rmtces TERMS and C.~NDmONS The Perm~ee Christopher Showalter reskllng at 445 Pequash Ave., Cutchogue N. ¥. ss parc of the coasklerafion for lhe ismaa~ o[ ~e ~t d~ ~dm~ ~ p~ m ~e [ol- 1~: .~. That ~ Permit should be zetained inde~u~tely, or ss long as the said p, emlr~ee wishes to m.!~caln ~he scmcm~ or project involved, to provide evidence co snyo~e concerned ~bat stuth- orlz~tioo was orlg~-~,y 4. That dze work involved will be mbjec~ to the iaspect~on smd approval of d~e Boa-M o~ its s~ents, and ~ou-o,mplhnce with the p~vislom of the m'iS~gng spplicatlon, may be _-~,,,e fo~ t'evocation o[ ~ p,rmlt by fesolutlon of the sam Board. 5. That there will be no unreasonable interference with ntvigatlon as · remit of the wo~ herein authorized. 6. That there ~ be tm iate~fereace with the tight of the public to pass tad tepus alazg the beac~ betweea high and low wat~r mazks. 7. That if futu~o opc~ioos of the Town of Sore. hold x'equh'e the ~ sad/or slcel'sgcas In the location of the worlr herein sug~tzed, or if, in the opiat_,~ of the Bo~'d o[ Tr,~te~ Ihe. work shall cause ~le obst:mctxon to f~e navigation, the said Pemgttee will be ~ upon due aoclce, to remove or alter thls wodt or project het~.in stated without expenses to the Town of 5outhold. 8. That the said B°afd will be notified by the Permktee ot ~he completion 0f the work auth. or, ed. That the Permictee will obtain all other pexmlts and ~onsents dutt may be vecluh'ed sup. plemental co chis permit which may be subject to revoke upon f~twe ~o obisin s~me. Albert J. Krupski, President James King, Vice-Presiden~ 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 December 27, 2000 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD James E. Fitzgerald, Jr. Proper-T Permit Services P.O. Box 617 Cutchogue, NY 11935 Re: CHRISTOPHER SHOWALTER 1015 Orchard Lane, Southold SCTM#90-4-15 Dear Mr. Fitzgerald: The following action was taken by the Board of Town Trustees during its regular meeting held on Wednesday, December 20, 2000 regarding the above matter: WHEREAS, Proper-T Permit Services on behalf of CHRISTOPHER SHOWALTER applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated November 2, 2000, and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 20, 2000 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the 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, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of CHRISTOPHER SHOWALTER to construct a fixed open walkway 4'X 53', hinged ramp 4'X 16', and floating dock 6'X 20'; install two piles to secure floating dock. BE IT FURTHER RESOLVED that this determination should not be considered a det~iifination made for any other Department or Agency which may also have an application pending for the same or similar project. Permit to construct and complete project will expire two years fi.om the date it i~ signed. Fees must be paid, if applicable, and permit issued within six months of the date-of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Fees: $802.00. Very truly yours, Albert $. Krupski, Jr. President, Board of Trustees AIK/lms cc: DEC ACE Dept. of State APPROVED BY BOARD OF TRI ~'~ Proper- T Permit Phone: 63%734-5800 Services P.O. Box 617, Cutchogue NY 11935 Fax: 631-734-7463 MEMORANDUM TO: FROM: SUBJECT: DATE: December 20, 2000 Southold Trustees Jim Fitzgerald Showalter; SCTM #1000-90-4-15 Here are 3 copies of a revised project plan. The overall length of the structure has been short- ened to 65' per my meeting at the site with Ken Poliwoda. ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE O}'FICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) '/65-1800 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD AI~PLICATION FOR PUBLIC ACCESS TO RECORDS INSTRUCTIONS: Please complete Section I of this form and give to Town Clerk's Office (agency Freedom of ~lnformation Officer). One copy will be returned to you in response to your request, or as an interim response. SECTION I. TO: (Department or Officer, if known, that has the information you are requesting.) RECORD YOU WISH TO INSPECT: (Describe the record sought. If possible, date, file title, tax map number, and any other pertinent information.) supply Signature of Applicant: Printed Name: Mailing Address (if different from above): Teleohone Number: 7[~-- [~ 7/ Date: [ ] APPROVED [ ] APPROVED WITH DELAY* [ ] Freedom of Information Officer DENIED* eECI~IVED NOV 2 1 ..... 'D'-at~ .......... * If delayed or denied see reverse side for explanation. Telephone (631) 765-1892 Town Hall. 5~9.5 Main 9.oad P.O. Box 1179 Southold, New York ~197t $OUT]tOLD TO~VN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Adviso .fy Council held Wednesday, November 15, 2000, the following recommendation was made: CHRISTOPHER SHOWALTER 90-4-15 ilo construct a fixed open walkway 4'X 66', Mn.ged t~fii~"4"X'~i':~"iff6~l~ 64)( 20'; install two piles to secure floating d~ck 1015 Orchard Lane, Southold The CAC did not make an inspection but have a concern THE'SITE OF THE PROPOSED PROJECT IS SHADED CORPS OF ENGINEERS DATA PURPOSE: Construct fixed open walkway, hinged ramp, and floating dock for private recreational purposes. DATUM: MLW IN: Cedar Beach Harbor AT: Southold COUNTY: Suffolk STATE: New York TAX MAP Application regarding the property of Cbristopher Showalter, SCTM # 1000-90-4-15 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald. Jr. 516-734-5800 November 1, 2000 SOUTHOLD BA Y~ HOG NECK BAY THE AREA'OF THE PROPOSED PROJECT IS CIRCLED ./ ./ NI~CK N CORPS OF ENGINEERS DATA PURPOSE: Construct fixed open walkway, hinged ramp, and floating dock for private recreational purposes. DATUM: MLW IN: Cedar Beach Harbor AT: Southold COUNTY: Suffolk STATE: New York VICINITY MAP Application regarding the property of Christopher Showalter, SCTM #1000-904-15 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald, Jr. 516-734-5800 November I, 2000 Proper:T Permit Services POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 734-5800 November 1, 2000 President Board of Town Trustees Town of Southold Town HaH, 53095 Main Road Southold, New York 11971 Re: Application for Permit on Behalf of Christopher Showalter; SCTM #1000-90-4-15 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 Christopher Showalter in the Town of Southold. Proper-T Permit Services represents Mr. Showalter 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 ($150) Letter of Authorization Notarized Statement of Applicant Survey of Property Application Form (3 copies) Short EAF (3 copies) Vicinity Map (3 copies) Tax Map (3 copies) Project Plan (3 copies) Section View (3 copies) Project Site Photos yes E. Fitzgerab~ a substdiary of THE PECONIC EASTERN CORPORATION LOT 59 20" E 21~99' ~000 FRAME R£$. "~'~ ~,,AflTH oRIVEYl,4 Y k 165.60' 62' 07' 20" W 2#6' p~Sl~: ConstruCt fi~cd op~ walk'way, hinged · dock for private recreational purposes. DATLI~: l~uW cedm' Bach Harbor AT: $outholCl l~I: ~ ,.:_.. SI'ATE: New York ------- ~COUbYYY'- :~uuo~ · / REPLY TO AVTE NT~ON OF Eastern Permits Section DEPARTMENT OF THE ARMY NE~/YORK DISTRICT, CORPS OF ENGINEERS JACOB K. JAVITS FEDERAL BUILDING NEON YORK, N.Y. 10278-0090 April 10, 2001 SUBJECT: Application Number 2001-00439-L2 by Christopher Showalter To Whom It May Concern: The New York District, U.S. Army Corps of Engineers, has received a request for Department of the Army authorization for the following activity: APPLICANT Christopher Showalter 445 Pequash Avenue Cutchogue, NY 11935 ACTIVITY: Construct a 4 foot by 53 foot fixed timber pier, elevated a minimum of four feet above the grade of the intertidal wetland, a 4 foot by 16 hinged ramp, a 6 foot by 20 foot float secured to four piles with fixed stops to support float at 2.5 feet off the bottom. The purpose of this project is to provide an adequate mooring facility. WATERWAY: Cedar Beach Harbor, Shelter Island Sound LOCATION: Cutchogue, Town of Southold, Suffolk County, NY As this is minor in nature, authorization may be by Letter of Permission. This is in accordance with current Federal Regulations governing work in navigable waters of the United States. To accomplish the coordination required, prior to the issuance of a Letter of Permission, your review of the enclosed drawings is requested. Pursuant to Section 307 (c) of the Coastal Zone Management Act of 1972 as amended (16 U.S.C. 1465 (c) (3) (A)), the applicant has certified that the activity complies with and will be conducted in a manner that is consistent with the approved state coastal zone management program. To allow for the timely processing of the subject application, your comments are requested within 15 days of the date of this letter. Enclosures Sincerely, . .. Ja~es W. Haggerty b d ~Chi~f, Eastern Permits Section SOUTHOLD HOG NECK B .4 Y THE AREA'OF THE PROPOSED PROJECT I$ CIRCLED / / / ./ N CORPS OF ENGINEERS DATA PURPOSE: Construct fixed open walkway, hinged ramp, and floating dock for private recreational purposes. DATUM: MLW I~l: Cedar Beach Harbor AT: Southold COUNTY: Suffolk STATE: New York VICINITY MAP Application regarding the property of Christopher Showalter. SCTM # 1000-90-4-15 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 Jmes E. Fitzgerald, Jr. 516-734-5800 November I. 2000 wwZ Og/~GO N/Od ~V0-~9 ~ o/ ~ 0 / / / / / Albert J. Krupski. President John Ho!.zapfel. Vice President 3is King Martin lq. Gan'ell Peter Wenczel Town Iqall 53095 Main Road P.O. Box 1179 Southold~ New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD office Use Only ~oastal Erosion Permit Application etland Permit Application Grandfather Permit Application Waiver/Amendment/Chan~es Received Applica~n: Received Fee:$ /Db - ' ' Completed Applidation Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date~ CAC Referral Sent: Date of Inspection: Receipt of CAC Repor Lead Agency Determination: Technical Review: Public Hearing Held:~ Resolution: Name of Applicant Address Suffolk County Tax Map Number: 1000 Property Location: 1015 O~h~d Lamer Christooher Showalter 445 Pe~uash Avenue, Cutchogue NY Phone Number:(631} 9o-4-15 Southold 11935 (provide LILCO Pole ~, distance to cross streets, and location) AGENT: James E. Fitz~erald~ Jr. / Proper-T Permit Services (If applicable) Address: Post Office Box 617, Cutchogue, NY 11935 Phone: FAX#: 734_ 8ooNOV - 220 ~oard of Trustees Applica~ GENERAL DATA Land Area (in square feet): 19,029 Area Zoning: R-40 Previous use of property: Intended use of property: Residential Residential Prior permits/approvals for site improvements: Agency Date Not known No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No__Yes If yes, provide explanation: PROJECT DEScRIptION:' Construct fixed open walkway 4' x 66', hinged ramp 4' x 16', and floating dock 6' x 20'; install two piles to secure floating dock. ~oard of Trustees Applica~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: W~te~ ane~s~ for recreational purposes. Area of wetlands on lot: aoorox 2~00 square feet Percent coverage of lot: approx 1~ % Closest distance between nearest existing structure and upland edge of wetlands: -0- 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: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited:. cubic yards cubic yards Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason os such proposed operations (use attachments if appropriate): It is expected that the project will have no significant effect on the wetlands and tidal waters of the Tnwn. PROJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To he completed by Applicant or Project sponeor) 1. APPUCANT/SPONSOR 2. PROJECT NAME James E. Fitzgerald? Jr. Showalter dock 3. PROJECT LOCATION: Municipality Southold ,, county Suffolk SEQR 4. PRECISE LOCATION (Sires! addrese and road Intersections. ptommmlt lancimlrkl, etc., or provide mil)) 1015 Orchard Lane, Southold, NY 11971 See attached maps. 5. IS PROPOSED ACTION: ~ New [] Ex;sharon [] Modification/alteration s. PROJECT DESCRIPTION: Construct fixed open walkway 4' x 66', hinged ramp 4' x 16', and floating dock 6' x 20'; install two piles to secure floating dock. 7. AMOUNT OF LAND AFFECTED: Inilially ~/~ aems Ultimately acme 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No if No, describe briefly g. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] !n~ustrlal [] commamtal [] Agriculture [] Park/Forest/Ogen alsace [] Other Medium-s~Lze pr±¥ate waterfront 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 yes. list agency(e) ancl DermlUlgprovals Required: NYSDEC, NYSDOS, USACoE, Southold Trustees 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? [] Yes [] No If yea, list agency name and permit/approval 12. AB A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes [] NO , CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE James E.~i~gerald, Jr. ~.~roper-~ ~e~it Services Appl,cant/sdonsor n~e:. ~' ~ " DAte: 11 /1 /00 If t tlon Is In t he Coastal Ama, and you are a state agency, complete the Coasts AsBessment Form before proceeding with this assessment OVER 1 PART ii--ENVIRONMENTAL ASSI~IENT ('Fo be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.127 ~f yes, coordinate the review process and use the FULL EAF. [] Ye~ [] .o B. WILL ACTION RECEIVE COORDINATED REVlBN AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quahty, surface or groundwater duality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cult.ural resources; or community or neighborl~ood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or enciangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly· C6. Long term, short term, cumulative, or other effects not identified in C1-C57 ~xplaln briefly. C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. O. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain briefly PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) · INSTRUCTIONS: F~reachadverseeffectident~fiedab~ve~determ~newhetherit~ssubstantia~arge~imp~rtant~r~the~visesignificant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibllity; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. [] Check this box if you have determined, 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 of Lead ^gencv Date 2 Alber~ J. Krupski, President James I~ing, Vice-President Henw Smith .~rtie Foster Ken Poliwoda Town Hall .53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In %he Matter of the Application ..... STATE OF NEW YORK) AFFIDAVIT OF POSTING I James E. Fitzgerald, J~.residing at 385 Haywaters Drive Cutchogue NY 11935 being duly sworn, depose and say: That on the13th day of Nov , 200 , I personally posted the property known as 1015 Orchard Lane. Sm]tbo]d +~ 11971 by placing the Board of Trustees of{icial 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. Date of hearing noted thereon to be held 11/21/00 Dated: //~/~O Sworn to before me this '~-I ~ day of ary Public JANE R. MINERVA NOTARY PUBLIC, State of New York No. 4853t08, Suffolk Comlty Commlssloe E~plres February 18,/J~l~,,O~) 0 ature) TO: Date: November 13, 2000 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: Christopher Showalter, SCTM #1000-90-4-15 YOU ARE HEREBY GIVEN NOTICE THAT: 1. An application is being submitted to the Board of Trustees for a permit to: Construct fixed open walkway 4' x 66', hinged ramp 4' x 16', and floating dock 6' x 20'; install two piles to secure floating dock. The project described above is proposed on property adjacent to yours. The street ad- dress of that property is as follows: 1015 Orchard New York 11971 ] Lane, Southold, I The project, which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code, is open to public commem. A public hearing will be held at Town Hall, 53095 Main Road, Southold, New York 11971 at or about 7:00 PM on Tuesday, November 21, 2000. You may contact the Trustees Office at 765-1892 or in writing if you wish to comment. 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.: Christopher Showalter 445 Pequash Avenue Cutchogue, New York 11935 631-734-5254 A copy of a sketch or plan showing the proposed project is enclosed for your convenience. CHRISTOPHER SHOWALTER: ADJACENT PROPERTY OWNERS 1000-90-4-16 Anne Marie Welker 37 Birch Tree Drive Westwood, MA 02099 1000-90-4-20.2 Charles Jr. and Shelby Bleifield St. Johns Med Office Bldg 48 Rte 25A - Suite 106 Smithtown, NY 11787 1000-90-4-12 Erika C. Swimmer Stettinstr 22 22880 Wedel, Germany 1000-90-4-14 Joseph Melynis and Maureen AHen PO Box 714 Southold, NY 11971 445 Pequash Avenue Cutchogue, New York 11935 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 of a permit application for the construction of a dock on my property located at 1015 Orchard Lane, Southold, and designated by Suffolk County Tax Map No. 1000~90-4-15, and to furnish, upon request, supplemental information in support of the application. Sincerely, STATEMENT TO THE SOUTHOLD BOARD OF TOWN TRUSTEES County of Suffolk ) State of New York ) I, Christopher Showalter, being duly sworn, depose and arleen that I am the owner of the property located at 1015 Orchard Lane, Southold, New York 11971, and identified by Suffolk County Tax Map No. 1000-90-4-15, 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 agem(s) or representative(s) to enter upon my property to inspect the premises in conjunction with the review of the present application. Sworn to before me this ...,~...~..... day of....~ ........... Notary Public " ' ~ '~ NOV- 2 Christopher Showalter 1000-90-4-15 PROOF OF MAILING OF NOTICE ..D '" IT" ..D U1 I"- '" m u.s. Postal Service CERTIFIED MAIL RECEIPT (Domestic Mall Only, No Insurance Coverage Provided) 1'187 Postage $ Certified Fee CJ Return Receipt Fee C (Endorsement Required) C C Postmark Here lerk: K\IllJYO Restricted Delivery Fee (Endorsement Required) 1/13/00 c C :I m Name (Please Print Clearly) (to be completed by mailer) IT" J1h~~_1~!L;r_;r;'_.___~___Sh~_1l:>Y__Jll~_:!.JJ_~lg__ IT" ~,.Apt.r?:iHfflfo'Jlred Office Bldg. o::J I"- .l4aiiltcnu;e-m2-5Am.---SUi-t"e---1-06m----------- own 11 8 Total Postage & Fees $ :I ru IT" ..D U1 I"- '" m Postage $ Certified Fee 1.1tO C Return Receipt Fee C (Endorsement Required) C C Postmark Here lerk: K\IllJYO Restricted Delivery Fee (Endorsement Required) 1/13/00 c C :I m !VIme (PleasehPrlnt.qeadf) (to bf3,comp/Wed ~mailer) All Josep Me~yn~s ~ Maureen en g::-sri86t;Aj:;t:"NO.;-or-ro-ao;-f.Jo.----------------nm-uuu-m--------.--.--------------- c PO Box 714 r-"ctiY:siiiie,.z/P+4-------------...-----------n----nnn--H_h.___n____________________.. Southold. NY 11971 Total Postage & Fees $ m r'l C I"- u.S. Postal ServIce CERTIFIED MAIL RECEIPT (Domestic Mall Only; No Insurance Coverage ProvIded) U1 f"'- Postage $ '" lT1 Certified Fee C Return Receipt Fee C (Endorsement Required) C C Postmark H'rn lerk: KIIGJYO Restricted Deli....ery Fee (Endorsement Required) 1/13/00 h tiS 8! .o. ..~ 0" .. c C :I lT1 Name (Please Print Clearly) (to be completed by mailer) __A 1'lne__l\II"....iemW_elker_______mmmm srreer.APt. ND:;7ir1f6Sox No. ..3.1...:s.j,.~_Qhm~;r;'~_~_mPJ:j,y~mm ummm__mmmm_ "'W~trr.t\H)Od, MA 92099 &JMO-;p/o3 Total Postage & Fees $ Reg~ ~ I"- Cha e Postage $ Received by ~ . ! E ~ ! .~ . 0 u-o. ~'~3 l~.= IJ~ ~!!:.! u '" .; : ~ ~ w .. ::;; o a: u. ~ PS Form 3806, February 1995 Additional mailing receipts on reverse side 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 1 "5th day of November. 200...Q..., deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respec- tive names; that the addresses set opposite the names of said persons are the addresses of said s as shown in the current assessment roll of the Town ofSouthold; that said Notices were mailed at Post Office at Cutchogue, NY 11935, that said Notices were mailed to each of said . s by Sworn to before me this 21,} f- day of )Jo i/ EVn 1"?67e. . 200 L. G-- f? ~ ftary Public JANE R. MINERVA NOTARY peBUC, State of New York No. 4853108, Suffolk County Commission Expires February 18,~