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Home My WebLink AboutTR-6173 Glenn Goldsmith, President ��QF S®Ur�® Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President ® h ® P.O. Box 1179 Eric Sepenoski g [ Southold,New York 11971 Liz Gillooly cea Telephone(631) 765-1892 Elizabeth Peeples ® a� Fax(631) 765-6641 COUidT�,N BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 20, 2023 Andrew &Andrea Weisbach 497 Ripplewater Lane Southold, NY 11971 RE: 497 RIPPLEWATER LANE, SOUTHOLD SCTM#: 1000-76-1-15.3 Dear Mr. and Mrs. Weisbach: On April 10, 2023, a Field Inspection was performed and it was determined that the existing docking facility on the above-mentioned property does not match the dock permitted under Wetland Permit#6173. The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, April 19, 2023: RESOLVED, that the Southold Town Board of Trustees DENIES the request for a Transfer of Wetland Permit #6173 from Gail Rerisi to Andrew & Andrea Weisbach, as issued on July 20, 2005. If you have any questions, please contact our office at (631) 765-1892. Sincerely, _b* r 4" Glenn Goldsmith President, Board of Trustees GG/dd c � G'ienn Goldsmith,Presiaent �O��gVF COGy _. Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 0 Eric Sepenoski ,? P.O.Box 1179 Liz Gillooly �4 • o�� Southold,NY 11971 Elizabeth Peeples �Ol �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: 41 10 12'sCompleted infield by: El f+k PeepteS ANDREW & ANDREA WEISBACH request a Transfer of Wetland Permit#6173 from Gail Rerisi to Andrew & Andrea Weisbach, as issued on July 20, 2005. Located: 497 Ripplewater Lane, Southold. SCTM#: 1000-76-1-15.3 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: /Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment sAdministrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: pav nu� �4 Io113 c�.�cc "4'x b5' fisc�d uu a� uta 4'x bS' R x�� ai,mi is py�r Bank hu A 4(i-4�n�a 43;,x L21n�uu►T�a -'do 4,45 AoAr, *CAS eAirc. dark. a ploaaa lock Dew Present Were: G. Goldsmith N. Krupski E. Sepenoski L. Gillooly �E. Peeples ti AWL- February February 9, 2023 Town Of Southold: BAR 1 6 2023 Board of Trustees gouthold Town Transfer of Permits: Board of Trustees #8501—Pool/Deck #6173- Pier #5605- House We purchased our home at 497 Ripplewater Lane, Southold NY 11971- in March 2021.Just recently we realized that the permits are still under the original builder/owner of the property. The paperwork is still filed under Gail Rerisi 497 Private Road, #22, Southold SUM #76-1-15.3 We would like to transfer the name over to our name: Andrea and Andrew Weisbach 497 Ripplewater Lane, Southold. NY 1197 Enclosed is a check for$150 to transfer the permits to our name. Thank you. Best, Andrea and Andrew Weisbach John Holzapfel Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0151C Date September 7. 2006 THIS CERTIFIES that the fixed walkway with steps to grade At 497 Priyate Rd. #22. Southold Suffolk County Tax Map # 76-1-15.3 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 31. 2005 pursuant to which Trustees Permit # 6173 Dated July 20. 2005 'Vas issued, and conforms to all ofthe requirements and conditions ofthe applicable provisions of law. The project for which this certificate is being issued is for a fixed walkway with steps to grade The certificate is issued to GAIL RERISI owner ofthe aforesaid property. rG<~ Authorized Signature Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(631) 765-1366 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 1st day of construction ½ constructed Project complete, compliance inspection. Board Of $outhold Town Trustees SOUTHOLD, NEW YORK $CTM#76-1-15 . 3 PERMIT NO .... .... DATE: ..?..~.3:.~...~.~....~.(75 GAIL RERISI ISSUED TO ............................................ ~ ..................................................................................... Pursuant to the provisions of Chapter 615 of the I-~ws of the State of New Yor[, 1893; and Chapter ~ of the I.~ws of the ' State of New York 19S2; and the Southold ToWn Ordinance titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL. OR OTHER tdATERIALS~F~OM LANDS UNDER TOWN WATERSide, and in accordance with the Resolution of The Board adopted at a meeting held o~ ...:T.~..~..~..~ .... .207.~..., and in consideration of the sum of $..25P.~.~P paid by Gail Rer:Lsi of ............... P.~;~Y.~ N.Y. and subject to the Terms end Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to construct a 4'X 65' fixed'walkway with steps to grade, and as depicted on the plan prepared by P~oper-T Permit Services dated May 2~, 2005 and hydrographic survey prepared by Sea Level Mapping last revised August 5, 2005. all in accordance with the detailed specifications as presented in · the odgin~flng appl{catlom IN WITNESS WHEREOF, The ~a|d Board Of Trustees here- by ~uses itl Corporate Seal to be affixed, end these presents to be ,ubsc~'bed by ~'majorlty of the said Board as of this date. i TERIvIS and CONDITIONS ~Perml~ee Gail Rerisi tl~dl~gat 497 Private Rd., #22, Southold .... ~t'ofthe co~ideca~o~otthei~,~'eof~he~doesunder~dtndptescr~tothefol- 1. That the said .~Boa~d of Ttm~ee~ t~ the Towa of ~mthokl a~e t~lea~cl ~vom any and all da~ge~ o~ ~-~ for ~ge~ of ~ aR~l~, dh~dy o~ t~dim~ a~ a t~dt of say ope~- wlth ~e~p~ thereto, ,o-~-~omp~ ,~,-~s~o~ of the Bom'd of T __twe~___ of the Town of ,So,~hold Z That thisl~ls'~valld~ofapetiodof ~24 7. mos.~vl~-h.~ftuldefedtobe~he es~mated t~me't~luired to complete the wodt tnvot~ ~ut'should ~it'oumtatges wan~nt, x-ecluest lor tn e~4on .may be mtde to d~e Bo~xd at a I,~ 5. T~at thi~ Permit ~hould be retained inde~m~ely, or as long ~ the said p,,~ml~e ~ tO' maincaln tlxe ~mctu~e or p~oject involved, to provide evidence to anyone concerned chat 4. Tl~t d~e wod~ iavolved wilt be mbjea to the ~ ~d ~,~owl o~ d~e ~ t~ocafioa of th~ P~ I~ ~olu~io~ of the s~icl ~ 5. T]~c (he~c wilt Ix~ no unn~sooable iaterfe~c~ce with mvi~/~ is s remit of the wo~ het~n ~Chot'i~. ' upon d~e notice, to remove o~ alt~ this wod~ or p~oject herda stated ~o~ ezt~m~ to the Town~ 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) 765-6641 July 20, 2005 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. James E. Fitzgerald, Jr. Proper-T Permit Services P.O. Box 617 Cutchogue, NY 11935 RE: GAlL RERISI 497 PRIVATE RD. #22, SOUTHOLD SCTM#76-1-15.3 Dear Mr. Fitzgerald: The Board of Town Trustees took the following action during its regular meeting held on Wed., July 20, 2005 regarding the above matter: WHEREAS, Proper-T Permit Services on behalf of GAlL RERISl 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 May 31, 2005 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 July 20, 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, 2 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 GAlL RERISl to construct a 4'X 65' fixed walkway with steps to grade, and as depicted on the plan prepared by Proper-T Permit Services dated May 27, 2005 and hydrographic survey prepared by Sea Level Mapping last revised August 5, 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.) Fees: $50.00 Very truly yours, Albert J. Krupski, Jr., President Board of Trustees AJK/Ims Albert J. Krupski, President James King, Vice-President Artie Foster I~en Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765~1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated .~7~ reviewed by this Board at the regular meeting of following action was taken: has been and the (~') 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 nec~sary. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: SIGNED: PRESIDENT, BOARD OF TRUSTEES June 15, 2005 Field Inspectio~ June 15, 2005 Field Inspectio~ Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tues., June 14, 2005, the following recommendation was made: Moved by Don Wilder, seconded by Tom Schlichter, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Wetland Permit application of GAlL RERISl to construct a fixed open walkway 4'X 110', hinged ramp 4'X 12', and floating dock 6'X 20', and install two spiles to secure floating dock. Located: 497 Private Rd. #22, Southold. SCTM#76-1-15.3 The CAC recommends Disapproval of the application because the project was not staked. The CAC further recommends an onshore/offshore stake because of the Iow water depths in that area. Vote of Council: Ayes: All Motion Carried THE AREA OF THE PROPOSED PROJECT IS CIRCLED HOG NECK BAY LITTLE HOG , NECK CORPS OF ENGINEERS DATA PURPOSE: Construct fixed open walkway, hinged ramp, and floating dock for private recreational purposes. DATUM: MLW IN: Goose Creek AT: Southold COUNTY: Suffolk STATE: New York BAY~. SHE~ sO~ ~v VICINITY MAP Application regarding the property of Gall Rerisi, SCTM #1000-76-1-t5.3 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald, Jr. 631-734-5800 May 27, 2005 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: Goose Creek AT: Southold COUNTY: Suffolk STATE: New York TAX MAP Application regarding the property of Gall Rerisi, SCTM # 1000-76-1 - 15~3 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald, Jr. 631-734-5800 May 27, 2005 Surveyed: 02-03-05 Amended: 05-28-05 07-11-05, 08-05-05 SCT#'s 1000-76-1-15.3 & 1000-76-1-15.6 Situate: Goose Creek Town: Southold Suffolk County, NY Datum: IVLL.W, Hydrographic Survey APPROVF, :; BOARD OF ' ..... TOWN OF **'m ':':i'''t r~ [L\TE / ~/,.._~/~5.Z ....... -0.4 Prepared by: SEA LEVEL MAPPING P. O. Box 538 Rlverhead, NY 631-722-3390 SCALE 1"= 40' ROBERT H. FOX NYE PL$# 50197 Proper-T Permit Se?ices Phone: 631-734-5800 P.O. Box 617, Cutchogue NY 11935 Fax: 631-734-7463 MEMORANDUM TO: Lauren - Trustees FROM: Jim Fitzgerald SUBJECT: Gail Rerisi, SCTM #1000-76-1-15.3 DATE: November 4, 2005 Here's her check for $50, the balance due on the permit to be issued. Albert J. Krupski, President James I~,g, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53096 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES · TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application ~thnd Permit Application f Major Waive~/Amendment/Cb,~ges ."~eceived AppHca_tion: ~ ~ ~ ~ ~-'Keceived Fee:$ ~..~'¥" ' ,,-- Completed Application (~ ~ t ( (~ Incomplete __SEQRA Classification: Type I Type II Unlisted Coora~-~tion:(datc sent) ~...¢AC Pcfcn~al Sent: (O ~ ,.eatc ot peotien: (O I P~eceipt of CAC P cport: Lead Agency Determination: Technical Kevicw: Kesolution: Minor Name of Applicant Address Gail Rerisi PO Box 112, Bayville, NY 11709 PhoneNumber:( ) 631-628-1150 SuffoLk County Tax Map Numbcr: 1000- 76-1-15.3 Property Location: 497 Private Road #22, Southold (provide LILCO Pole #, distance to cross streets, and location) AGENT: James E. Fitzgerald, Jr. / Proper-T Permit Services PO Box 617 Cutchogue, NY 11935 631-734-5800 eoard of Trustees Applicat Land Area (in square feet): Area Zoning: Previous use of property: Intended use 0fproperty: GENERAL DATA 33,537 R-40 Private residence Private residence with dock Prior permits/approvals for site improvements: Agency Town Trustees NYSDEC Dme House - date House - date unknown unknown __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency.9 X No Yes If yes, provide explanation: PROJECT DESCRIPTION: Construct fixed open walkway 4' x 110', hinged ramp 4' x 12', and floating dock 6' x 20'; install two spiles to secure floating dock. ~oard of Trustees Applicat~n WETLAND/TRUSTEE LANDS APPLICATION DATA Purposeofthepmposedoperations: BoaSt dockage and access to water. Area of wetlands on lot: l 5,744 square feet Percent coverage of lot: 4 6.9 % Closest distance between nearest existing structure and upland edge of wetlands: 05 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 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): It is expected that the project will have no significant effect on the wetlands and tidal waters of the Town. 617~Z0 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be completed by A~plicant or Project Sponsor) 1. APPLICANT/SPONSOR /2. PROJECT NAME James E. Fitzgerald, Jr. / Proper-T Permit Services [ Gall Rerisi dock 3. PROJECT LOCATION: Municipality Southotd County Suffolk 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 497 Private Road #22 Southold, NY 11971 (See attached maps) 5. PROPOSED ACTION IS: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: Construct fixed open wa~way 4' x 110', hinged romp 4' x ]2', ~md floating dock 6' x 20'; install two spiles to secure floating dock. 7. AMOUNT OF LAND AFFECTED: Initially N/A acres Ultimately acres 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 [] Lndustrial [] Commercial Describe: Medium- to large-size private waterfront residences. [~Agriculture [] ParK/Forest/Open Space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? L~ Yes L~ No If Yes, list agency(s) name and permit/approvals: NYSDEC, NYSDOS, USACoE, Southold Trustees 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? L-~ Yes [] No If Yes, list agency(s) name and permit/approvals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? []Yes []No I CE~-~( THAT T~NFO~ATION PROVIDED A~OVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applica,t/sponsor na~.~' ~s ~~_ ~/~ Date: ~,y ~7. ~f the a~on is in ~tal Area, and you are a state agency, complete the C~stal Assessment Form before proceeding with this assessment OVER · Reset PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. r~Yes E]No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. [-'"]Yes [~No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste p~gduction or disposal, potential for erosion, drainage or flooding problems? Explain bdefly: C2, Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain bdefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered 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 bdefly: 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 Cl-C57 Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? [] Yes~-~'~ No If Yes, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain briefly: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. [f 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. If question D of Part II was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ] Check this box if have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL you 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 resufi in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination May 27, 2005 Name of Lesd Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) Reset STATEMENT TO THE SOUTHOLD BOARD OF TOWN TRUSTEES County of Suffolk ) State of New York ) I, Gail Rerisi, being duly sworn, depose and affirm that I am the owner of the property located at 497 Private Road #22, Southold, New York 11971, and identified by Suffolk County Tax Map No. 1000-76-1-15.3, 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 pemfit(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. Sworn to before me this .....2..."]...'~... day of ....... ...~..1~.~. .................. 200.~.. Notary Public EUZABETH,~ RERI~ Post Office Box 112 Bayville, New York 11709 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 ora dock on my property located at 497 Private Road #22 and designated by Suffolk County Tax Map No. 1000-76-1-15.3, and to furnish, upon request, supplemental information in support of the application. Sincerely, APPLICANT TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts o£ interest on the part of Town officers and employees. 'rhe purpose of this form is to provide information, which can alert the Town of yes sible conflicts of interest and allow it to take whatever action is ne :essarv to avoid same. YOUR NAME: G~il Rerisi (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person or company name.) NAT~ OF APPLICATION: (Check all that apply.) Tax Grievance Variance Change of Zone Approval of Plat Exemption from Plat or Official Map Other X If "Ottter", namethe activity: Wetlands l--ermit Do you personally, (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, mamage, or business interest. "Business interest" means a business, including a partnership, 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 shares. NO X If you answered "YES", complete the balance of this form and date and sign where indicated. 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 cheek 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 stock 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) an officer, director, partner, or employee of theapplicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this Signature: Print Name: Proper- T Permit Serwces POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 (631) 734-5800 May 27, 2005 President Board of Town Trustees Town of Southold Town Hall, 53095 Main Road Southold, New York 11971 Re: Avvlication for Permit on Behalf of Gail Rerisi; SCTM # 1000-76-1 - 15.3 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 Gail Rerisi in the Town of Southold. Proper-T Permit Services represents Mrs. Rerisi 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 Notarized Statement of Applicant (to follow) Transactional Disclosure Form Survey of Property Application Form (3 copies) Short EAF (3 copies) Vicinity Map (3 copies) Tax Map (3 copies) Hydrographic Survey/Project Plan (3 copies) MAY ,: 2005 Southold Town Board of Trustees a subsidiary of THE PECONIC EASTERN CORPORATION AFFIDAVIT OF POSTING TO THE SOUTHOLD BOARD OF TOWN TRUSTEES IN THE MATTER OF THE APPLICATION OF: Gail Rerisi 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 14th day of June, 2005, I personally posted the property known as 497 Private Road #22, 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 heating, which date is note~d ~e~on to be~eAln.~day,June 22, Jag49ts E. F gerald, J Sworn to before me this ~- day of x,~c~L. ,2005. 1(o. 01D06095328, Suffolk Ceurd~ Term F.~ims July 7, 20 .._..... Hydrographic Su~ Suweyad: 02-03-05 Amended: 05-2~05 Situate: Goose Creek . Suffolk County, NY Tide Range: 2.5' +/- pre.red by:. SEA LEVEL MAPPING June 10, 2005 GAIL RERISI: ADJACENT PROPERTY OWNERS NOTICE NOT SENT (PROPERTY OWNER) 1000-76-1-15.3 Vincent Matassa and Gail Rerisi 5 Bethpage Road Hicksville, New York 11801 NOTICE SENT 1000-76-1-15.1 Vincent Matassa and others 5 Bethpage Road Hicksville, New York 11801 1000-76-1-15.5 Victor Rerisi and Deborah Matassa 5 Bethpage Road Hicksville, New York 11801 1000-76-1-14 Arthur and Mary Jane Gross Post Office Box 812 Southold, New York 11971 1000-76-1-12 Ruth Stapleton 53 Link Avenue Hicksville, New York 11801 TO: Date: June 13, 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: Gall Rerisi; SCTM #1000-76-1-15.3 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 110', hinged ramp 4' x 12', and floating dock 6' x 20'; install two spiles to secure floating dock. The project described above is proposed on property adjacem to yours. The street ad- dress of that property is as follows: 497 Private Road #22, Southold, NY 11971 I The project, which is subject to Environmental Review under Chapters 32, 37, 95 or 97 of the Town Code, is open to public comment. A public heating will be held at Town Hall, 53095 Main Road, Southold, New York 11971 at or about 7:00 PM on Wednesday, June 22, 2005. You may contact the Trustees Office at 631-765-1892 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 govemments. PROPERTY OWNER'S NAME: MAILING ADDRESS: PHONENO.: Gall Rerisi 5 Bethpage Road Hicksville, New York 11801 516-939-0669 A copy of a sketch or plan showing the proposed project is enclosed for your convenience. Proper-T Permit Services Phone: 631-734-5800 P.O. Box 617, Cutchogue NY 11935 Fax: 63%734~7463 MEMORANDUM TO: FROM: SUBJECT: DATE: June 14, 2005 Town Trustees Jim Fitzgerald LWRP Consistency Assessment Fores: James Eckert Harold Baer Susan Souder Gaff Rerisi Victor Rerisi They are attached. Town of Soutlt01d - A. - INSTRUCTIONS LWRP CONSISTENCY ASSESSMENT FORM Al1 applicants for perm/ts* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town 6f Southold Waterfront Consistency Review Law. Th/s assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, Yhe piep~hr°er of this form should review the exempt minor action list, policies and explanations of each polic, y contained in the Town of Southold Local · : ',[~ : ~. .~ ~_, . , , Waterfront Rewtalization Progi'~. A propose~ actmn vail be evaluated as to ~ts mgmficant beneficial and adverse effects upon the coastal area (wi'rich includes all of Southeld Town). If any question in Section C on this fgr[a is~.answered "yes", then the proposed action may affect the achievement of the LWRP policy Staffcrards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the max'unum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and cendifions~ it shall not be undertaken. A copy of the L~7'ILP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Depa~hnent, ail local libraries and the Town Clerk's office. B. DESCRIPTION oF SITE AND PROPOSED ACTION SCTM# 76 _ i 15.3 The Application has been submitted to (check appropriate response): TownBoara [~ Plann~gDep~ ~ Bu,~n~Dep~ E .~oaraom,stees [] Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning ~tivity, agency regulation, land transaction) Co) Financial assistance (e.g. grant', loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: PROJECT DESCRIPTION: Construct fixed open walkway 4' x 110', hinged ramp 4' x 12', and floating dock 6' x 20'; install two spiles to secure floating dock. Locationofa~tion:~ ~w? Private Road #22 Site acreage: 0.770 Present land use: S ingle family dwelling Present zoning classification: R- ~4 0 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofappllcant: Gail Rerisi (b) Mail~ngaddress: PO Box 112, Bayville, NY 11709 (c) Telephone number: Area Code ( 628-1150 (d) Application nUmber, if any: Will the action be directly undertaken, require funding, or.approval by a state or federal agency? . Yes ~ No[-~ Ifyes, which state or federal agency? NYSDEC, NYSDOS,. USACoE DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes'beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [~Yes ~ No ~ Not Applicable Attach additional sheets if necessary policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LW'RP Section II1 - Poticies Pages 3 through 6 for evaluation criteria [] Yes ~r'No ['~ Not Applicable Attach additional sheetS if necessar~ Policy 3. LWRP S~ction IH - Policies Pages 6 through 7 for evaluation criteria Enhance visual quality and protect scenic resources throughout the Town of Southold. See Yes ~ No [] Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~ Yes ~ No ~-~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section m -Policies Pages 16 through 21 for evaluation criteria Yes No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section IH - Policies; Pages 22 through 32 for evaluation criteria. Yes ~] No ~ Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Sect~oq ~II Policies Pages 32 through 34 for evaluation criteria. , , Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~-~ Yes ~'~ No ~d~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, pnblic lands, and public resources of the Town of Sootbold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ' Yes ~ No [-~ Not Applicable Attach additional sheets ff necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-d~p~ndent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation eriteria~ ~ Yes ~ No ~ Not Applicable Attach ~ddit~nal sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peeonie Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. [] Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. Yes ~-~ NoN Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ~ Yes ~ No [] Not Applicable Created on 5/25/05 11:20 AM Town Of Southold LWRP CONSISTENCY ASSESSMENT FORM INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the prepar~er of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Rewtalization Progiam. A proposed-action var be evaluated as to its sigmficant beneficial and adverse effecm upon the coastal area (which includes all of Southold Town). If any question in Section C on this f~r~n is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maxLmum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions~ it shall not be undertaken. A copy of thC LWRP is available in the following places: online at the Town ofSouthold's website (southoldtown.norttffork.net), the Board of Trustees Office, the Planning Depamnent, all local libraries and the Town Clerk's office. ~~ SCTM# 76 _ 1 ~ ~/ ~': ::'i~> ~ The Annlication has been subvmrted to (check aovrooriate resoonse]' I ~-:~ ,w~:~, ~--~ TownBoard ~] PlannmgDept. [] Building Dept. I I Board of Trnstees-~ '. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken'directly by Town agency (e.g. capital construction, planning agtivity, agency regulation, land transaction) Co) Financial assistance (e.g. grant~ loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: PROJECT DESCRIPTION: Construct fixed open walkway 4' x 110', hinged ramp 4' x 12', and floating dock 6' x 20'; install two spiles to secure floating dock. Location of action: "q-97 Private Road #22 Site acreage: 0. 770 Present landuse: Single family dwelling Present zonlng classification: R - 40 If'an application for the proposed action has been filed with the Town of Southotd agency, the following information shall be provided: (a) Name of applicant: Gall lerisi (b) Mailing address: PO Box 112, Bayville, NY 11709 (c) Telephone number: Area Code ( 628-1150 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~-~ NoN Ifyes, which state or federal agency? NYSDEC, NYSDOS, USACoE DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes be~eficml use of a coastal location, and minimizes adverse effects of development. See LWRP Section III- Policies; Page 2 for evaluation criteria. ~-~ Yes [] No [--] Not Applicable Attach additional sheetS if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~ Yes ~5~No [~ NotApplieable APPLICANT: GAlL RERISI SCTM #: 1000-76-1-15.3 LWRP CONSISTENCY ASSESSMENT FORM Policy 1 YES Foster a pattern of development in the Town of Southold that enhances com- munity character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. [] NO [] NOT APPLICABLE The construction of a small private-use dock is consistent with the character of the waterfront community, and because of the relatively small area of the proposed dock it is felt that there is no adverse impact on the desired preservation of open space. Infrastructure use is not a factor since the project is accessory to and ac- cessed from private property. The project is certainly a beneficial use of the coastal location, and the incremental increase in development in the area is insignificant. Policy 2 Preserve historic resources of the Town of Southold. [] NO [] NOT APPLICABLE There is no evidence to indicate that the immediate area of the project includes his- toric features, and it is to be expected that the mainly intertidal nature of the project area is unlikely to have been to site of activities of past civilizations. Policy 3 ~.YES Enhance visual quality and protect scenic resources throughout the Town of Southold. [] NO [] NOT APPLICABLE The structure proposed is low profile and will be inconspicuous in the proposed location. It is compatible with other existing shoreline structures in the area, and will not adversely affect the dynamic landscape elements (tidal fluctuations, sea- sonal vegetation changes) which might contribute to ephemeral visual qualities. · Policy 4 [] YES Minimize loss of life, structures, and natural resources from flooding and ero- sion. [] NO [] NOT APPLICABLE It is intuitively obvious that the likelihood of the structure proposed contributing to increased hazards which could result in the losses listed is minimal. Natural protec- tive features will not be adversely affected Policy 5 [] YES Protect and improve water quality and supply in the Town of Southold. [] NO [] NOT APPLICABLE The proposed project will not include a pump-out station nor will liquid or solid wastes be discharged into the water or wetlands. Disturbance of the creek bed dur- ing construction and thereafter during active use of the structure will be minimal. Policy 6 ~ YES Protect and restore the quality and function of the Town of Southold's ecosys- tem. [] NO [] NOT APPLICABLE Although the shading resulting from the project structure may adversely affect the wetland vegetation immediately under it, efforts will be made in the construction to space the deck planking to permit some sunlight through. During construction, the indigenous plants will be protected insofar as possible. The project is not lo- cated in a Significant Coastal Fish and Wildlife Habitat. All statutory and regula- tory requirements, at all levels of government, will be strictly complied with. No dredging, excavating, or filling is proposed. Policy 7 ~ YES Protect and improve air quality in the Town of Southold. [] NO [] NOT APrLICABLE The construction or use of the project as proposed will not result in significant mounts of new air pollution. The siting of the dock is such as to limit the usable size of the boat, and thus its engine. Policy 8 ~,YES Minimize environmental degradation in the Town oif Southold from solid waste and hazardous substances and wastes. [] NO [] NOT APPLICABLE The project as proposed will not result in the generation of any additional solid waste. The handling and storage of petroleum products will be accomplished through the use of approved containers and facilities, and approved methods of handling and storage will be followed. Policy 9 [] YES Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. [] NO [] NOT APPLICABLE This policy is not applicable to the proposed project. Policy 10 []YES Protect Southold's water-dependent uses and promote siting of new water- dependent uses in suitable locations. [] NO ~ NOT APPLICABLE This policy is not applicable to the proposed project. Policy 11 [] YES Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. [] NO [] NOT APPLICABLE This policy is not applicable to the proposed project. Policy 12 [] YEs Protect agricultural lands in the Town of Southold. [] NO ~ NOT APPLICABLE This policy is not applicable to the proposed project.