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Home My WebLink AboutTR-6174Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765~1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0152C-Amended Amended Date: December 14, 2010 THIS CERTIFIES that the construction of an 8' fixed open-grating walkway extension offof existing catwalk for a total length of 4'x68', with decking a minimum of 3.5' above vegetated grade; steps with a kayak slide on top of stairs on seaward end; and two 6' diameter piles at the most seaward end of fixed catwalk to accommodate extension At 850 Private Road #22~ Southold~ New York Suffolk County Tax Map # 76-1-15.6 Conforms to the applications for an Amendment to a Trustees Permit heretofore filed in this office Dated 9/24/2008 pursuant to which Trustees Wetland Permit #6174 Dated 7/20/2005 and Amended on 10/15/2008 was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of an 8' fixed open-grating walkway extension off of existing catwalk for a total length of 4'x68'~ with decking a minimum of 3.5' above vegetated grade; steps with a kayak slide on top of stairs on seaward end; and two 6' diameter piles at the most seaward end of fixed catwalk to accommodate extension The certificate is issued to VICTOR RERISI owner of the aforesaid property. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE INSPECTED BY: COMMENTS: __ Pre-construction, hay bale line/silt boom/silt curtain __ 1st day of construction ~ constructed Project complete, compliance inspection. CERTIFICATE OF COMPLIANCE: James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 CERTIFICATE OF COMPLIANCE # 0152C Date September 7, 2006 The certificate is issued to aforesaid property. THIS CERTIFIES that the fixed walkway with steps to grade At 850 Private Rd. #22, Southold Suffolk County Tax Map # 76-1-15.6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 31, 2005 pursuant to which Trustees Permit # 6174 Dated July 20, 2005 Was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for a fixed walkway with steps to grade VICTOR RERISI owner of the 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 SOTM~76-1-15 . 6 PERMIT NO (O.Iq~ ..... DATE: ..~):.~ ..~.g.~....~.g.95 ISSUED TO VICTOR RBR~Sl ntl ori tintt - Pursuant to the provisions o{ Chapter 615 o[ the Laws fha State of New YorJc, 1893; and Chapter 404 of {'he Laws of the State of New York 1952; and the Southold ToWn OrdinanCe titled ."REGULATING AND THE PLACING OF OBSTRUC]'IC)HS IN AND ON TOWN WATERS AND PUBLIC LANDS and.the REMOVAL OF SAND, GRAVEL-OR OTHER MATERIALSJ:~tLC)M I.ANDS UNDER TOWN WATERS;?~. and in accordance with 'the Resolution of The Board adopted at a meeting held o~ ..:~?.l.x.~.~g._,. ~0~ ...... and in consideration of the sum of $.....~..0.?~.... pald by Victor Rerisi o~ ............. ~.~ N.Y. ~.d. sallied ~o the Terms and Conditions listed on the reverse ~lde hereof, of Southold Town Trustees authorizes arid perm|ts the following: Wetland Permit to construct a 4'X60' fixed ~alkway with steps to grade, and as depicted on the ~lan prepared by Proper-T Permit Services dated May 2~7, 2005 and hydrographic survey prepared by Sea Level Mapping last revised August 5, 2005. all in accordance with the detailed spec~ications as presented in the orlglnatlncj application. IN WITNESS WHEREOF, The said Board 0f Trustees here- by causes ifs Corporate. Se. al to be afl?ed, and these [~.resents to be subsc.'bed by a'malority of the sa~d Board .as of this date. TERk, IS and CONOmONS '~ Pet~ Victor Rerisi ' 8. That the said Board will be notified by the l~mki~e ot ~he ~ioni~ the wod~ ~ ottzed. ' 9. 'that the 'p*,,-~,,~ will ~ all od.r p,~,-~,,. ~d. mn~,h ,that nu~/be requh~ sat~ tdeme~U m this ~ va,~ m*y'be subjec~ to tevote Ulm ~all~ to obtdn same. '* ~. 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: VICTOR RERISI 850 PRIVATE RD. #22, SOUTHOLD SCTM#76-1-15.6 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 VICTOR RERISI 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, 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 VICTOR RERISI to construct a 4'X 60' 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 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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: { ) I'(~¥ ~t~S ( Please be advised that your application dated 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 er re-application fees will be necessary. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: SIGNED: PRESIDENT, BOARD OF TRUSTEES July ~! 2~0o!] Boar] of )p~stes, 2oran 0~ So~,N~oid, Southold. N.¥. 11971 0 ~-' 3irs , I k .... h ,~0 -orotest bo_zs }rojecs as Lt will ',estroy the natural wet] '~nds which harcor,,'il,l fewl, a'qd {leer. )ue to 1;,ok of trsP_s}ortat'on a~zd i~npaip?d vision, I will mot '~e si]e to att~ 7d [Ne Fort~.coniRg meetinZ. Yes, I still us~ a ty)ewriter, ~s y>u <an n's h r uly, ? !3 534-S1 , ~rd of Telephone (631) 765-1892 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 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 RESOVLED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Wetland Permit application of VICTOR RERISI to construct a fixed open walkway dock 4'X 82'. Located: 850 Private Rd., #22, Southold. SCTM#76-1-15.6 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 SITE OF THE PROPOSED PROJECT IS SHADED LA. ./ CORPS OF ENGINEERS DATA PURPOSE: Construct fixed open walkway dock for private recreational purposes. IN: Goose Creek COUNTY: Suffolk DATUM: MLW AT: Southold STATE: New York TAX MAP Application regarding the property of Victor Rerisi, SCTM # 1000-76- ! - 15.6 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald, Jr. 631-734-5800 May 27, 2005 THE AREA OF THE PROPOSED .L PROJEC ' SC RCLED ~EDON Land£n~ $OUTHOLD B A Y~.,.~ LITTLE HOG NECK HOG NECK BAY Cedar Beach PoLn~ .j SHEI CORPS OF ENGINEERS DATA PURPOSE: Construct fixed open walkway dock for private recreational purposes. IN: Goose Creek COUNTY: Suffolk DATUM: IVlLW AT: Southold STATE: New York VICINITY MAP Application regarding the property of Victor Rerisi, SCTM # 1000-76-1 - 15.6 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald, .Ir. 631-734-5800 Ma,/27, 2005 Proper-T Permit Services P.O. Box 617, Cutchogue NY 11935 ,Phone: 631-734-5800 Fax: 631-734-7463 MEMORANDUM DATE: 9/26/05 TO: Lauren - Trustees FROM: Jim Fitzgerald SUBJECT: Victor Rerisi, SCTM #1000-76-1-15.6 As you requested, here is a hydrographic map showing the locat Hydrographic Survey Surveyed: 02-03-05 Amended: 05-28-05 07-11-05, 08-05-05 SCT~e 1000-764-15.3 & 1000-76-1-15.6 Situate: Goose Creek Town: Southold Suffolk County, NY Datum: M.L.W. Tide Range: 2.5' +/- . ................... 48 ..-"' , ~0.6 Pmpamd by: SEA LEVEL MAPPING P. O. Box 538 Rlverhead, NY 631-722.3390 SCALE 1"= 4O' I~BERT H. FO~ NYS PLS# 50197 Pro,per-T Permit Services P.O. Box 617, Cutchogue NY 11935 ,,Phone: 631-734-5800 Fax: 631-734-7463 MEMORANDUM DATE: September 12, 2005 TO: Lauren - Trustees' Office FROM: Jim Fitzgerald SUBJECT: Victor Rerisi, SCTM #1000-76-1-15.6 Here are three copies of the cross-section view that the Trustees requested. DECKING NOT LESS THAN 2.5' ABOVE GRADE SEAWARD OF THIS POINT. s. alt~emiflora MATERIALS TO BE USED ALL DIMENSIONAL LUMBER, TIMBER, AND PILES ARE CCA-TREATED. ALL HARDWARE IS GALVANIZED STEEL. PILES ARE 4 X 4 DIMENSIONAL LUMBER. SCALE: 1" = 10' CORPS OF ENGINEERS DATA PURPOSE: Construct fixed open walkway with steps to grade for private recreational purposes. IN: Goose Creek COUNTY: Suffolk DATUM: MLW AT: Southold STATE: New York SECTION VIEW Application regarding the property of Victor Rerisi, SCTM #1000-76-1-15.6 Represented by PROPER-T PERMIT SERVICES P.O. Box 617, Cutchogue, NY 11935 James E. Fitzgerald, Jr. 631-734-5800 May 27, 2005 Proper-T Permit Services P.O. Box 617, Cutchogue NY 11935 Phone: 631-734-5800 Fax: 631-734-7463 MEMORANDUM DATE: November 4, 2005 TO: Lauren - Trustees FROM: Jim Fitzgerald SUBJECT: Victor Rerisi, SCTM #1000-76-1-15.6 Here's his check for $50, the balance due on the permit to be issued. Albert'J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Ha~ 53095 Route25 P.O. Box 1179 South~d, NewYork 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~ c~- Coastal Erosion Pe~t A~cafion ~efl~d Pe~t A~Hca~on /~ajor __ ~or ~__Waiver/Amendmen~/Changes ceived Application: ~,~7 ~//O¥ ~--t~ceived Fee:$~,~O' Col~pleted Application Incomplete SEQRA Classification: Type I Type H Unlisted Coordinatien:(date sent) ~-~AC Referral Sent: ~7~- ~Date of Inspection: fs//~O Receipt of CAC Report: Lead Agency Determ{~tion:__ Technical Review: ~.$ubllc Hearing Held: $ Resolutiom Name of Applicant Victor Rerisi PO Box 112, Bayville, NY 11709 Address Phone Number:( ) 516-628-1150 Suffolk coUnty Tax Map Number: 1000 - 76-1-15, 6 Property Location: 850 Private Road #22, Southold (provide LILCO Pole #, d/stance to cross streets, and location) AGENT: James E. Fitzgerald, Jr. / Proper-T Permit Services PO Box 617 Cutchogue, NY 11935 631-734-5800 ~oard of Trustees Applicati Land Area (in square feet): Area Zoning: Previous use of property:. Intended use Of property:. GENERAL DATA 38,553 R-40 Und eve loped Private residence with dock Prior permits/approvals for site improvements: Agency Date Town T~ustees NYSDEC House - date unknown House - date unknown __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a govemmemal agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary):. Construct fixed open walkway dock 4' X 82' ~oard of Trustees Applicat: WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: Provide boat dockage and access to the water. Area of wetlands on lot: 6805 square feet Percent coverage of lot: 1 7.7 % Closest distance between nearest existing structure and upland edge of wetlands: 95 feet Closest distance between nearest proposed structure and upland edge of wetlands: - O~ feet Does the project involve excavation or filling? × 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 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. 617.20 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 Proiect Sponsor) 1. APPLICANT/SPONSOR m2,PROJECT NAME James E. Fitzgerald, Jr. / Proper-T Permit Services m Victor Rerisi dock 3. PROJECT LOCATION: Municipality Southold County SuffoLk 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 850 Private Road #22 Southold, Ny 11971 (See attached maps) 5. PROPOSED ACTION IS: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: Construct f'med open walkway dock 4' x 82'. 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 [] Industrial [] Commercial [] Agriculture [] PaddForest/Open Space [] Other Describe: Medium- to large-size private waterfront residences. I 0. 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(s) name and permit/approvals: NYSDEC, NYSDOS, USACoE, Southold Trustees 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? N Yes r'~ No If Yes, list agency(s) name and permit/approvals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? r~Yes []No I~/~FY THAT TH~q?/~I~._~PROVIDE~VE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/spons~name: ~r~a~nes E. ]~gei'al~irJ$. /~ /] Date: May 27, 2005. -/ /1-- /, I If the/~/tion is in the C~'~stal Area, and you are a state agency, complete the I I Coastal Assessment Form before proceeding with this assessment ~ OVER 1 PART II - IMPACT ASSESSMENT (lu oe 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. [~Yes ~Z~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 production or disposal, potential for erosion, drainage or flooding problems? Explain bdefly: ~ f C2. Aesthetic, agricultural, amhaeological, historic, or other natural or cultural resoumes; or community or neighborhood character? Explain briefly: 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 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 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: I E IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explatit 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) probabil~/of occurring; (c) duration; (d) irreversibility; (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. 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. ] ~heckthisb~xify~uhaveidenti~ed~ne~rm~rep~tentia~~y~arge~rsigni~cantadverseimpactswhichMAY~ccur~ ThenproceeddirectlytotheFULL EAF and/or prepare a positive declaration. [] Check this box if you have dotermined, based on the information and analysis above and any supporting documentation, that the pmpceed action WILL NOT result in any significant adverse environmental impact~ AND provide, on attachments as necessary, the reasons supporting this determination. May 27, 2005 Name of Lead Agency Date Pdnt 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) 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 of a dock on my property located at 850 Private Road #22 and designated by Suffolk County Tax Map No. 1000-76-1-15.6, 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, Victor Rerisi, being duly sworn, depose and affirm that I am the owner of the property located at 850 Private Road #22, Southold, New York 11971, and identified by Suffolk County Tax Map No. 1000-76-1-15.6, and that all work will be done in the manner set forth in the presem application and as may be approved by the Southold Board of Town Trustees. 1 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. Sworn to before me this ...~..7...?... day of .......... ..~..~.~. ................ ,200...~.... APPLICANT · TRANSACTIONAL DISCLOSURE FO'RTvl The Town of Southold's Code of Ethics prohibits conflicts of interest on the pan of Town officers and enmlovees. The numose of this form is to nrovide information, which can alert the Town of possible conflicts of interest and allow it to take whatever action is necessan' to avoid same. YOUR NAME: Victor 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.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance Change of Zone Approval o£ Plat Exemption ~om Plat or Official Map Other X If "Other", name the activity: We tlands Permit Do ygu 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, marriage, 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. YES NO X If you answered "YES", ~mplete 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 thc 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 (cheek all that apply): A) the owner of grea~er than 5% of the shares of the'corporate stock of the applicant (when the applicant is .a. enrpomtion);, 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 the. applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP · . Submitted this. ~r7 .day_0.j[~ay, 2005 Signature: Prim Name: "v~c~or/Herisi AFFIDAVIT OF MAILING TO THE SOUTHOLD BOARD OF TOWN TRUSTEES IN THE MATTER OF THE APPLICATION OF: Victor Rerisi 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 14th day of June, 2005, deponent mailed a tree 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 mil 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. Sworn to before me this ~-~ ~. day of ~ ,200 ~ . Notary Public ~x,~- BON#I£ I. llelaq Public, Stste Of Iio. 01D06095328, Suffolk Term Expires July L 20 J,~ I AFFIDAVIT OF POSTING TO THE SOUTHOLD BOARD OF TOWN TRUSTEES IN THE MATTER OF THE APPLICATION OF: Victor 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 Jtme, 2005, I personally posted the property known as 850 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 hearing, which date is n,p~thereon t.~o~ }y.~;~lnesday, Jtme 22, 2005, at or about 7:00 PM. Y/~nes E. Fitzgerald,~3r/ Sworn toxbefore me this ~.~ day of ~.16/X~ ,2005. Notary Public [,~ -- $0NNI£ I. DOfl0$~I l~,tari Public, State Of New York Wo. 0]D~6095328, Suffolk Cgpnq "rem Expi~ July 7, 20 ~ TO: Adjacem Property Owners (Names and addresses are listed on the attached sheet.) une 13, 2005 BOARD OF TRUSTEES, TOWN OF SOUTHOLD NOTICE TO ADJACENT PROPERTY OWNER In the matter off Victor Rerisi; SCTM #1000-76-1-15.6 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 dock 4' x 82'. The project described above is proposed on property adjacem to yours. The street ad- dress of that property is as follows: 850 Private Road #22, Southold, NY 11971 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 hearing 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 governments. PROPERTY OWNER'S NAME: MAILING ADDRESS: PHONE NO.: Victor 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. June 10, 2005 VICTOR RERISI: ADJACENT PROPERTY OWNERS NOTICE NOT SENT (PROPERTY OWNER) 1000-76-1-15.6 Victor Rerisi and Vincent Matassa 5 Bethpage Road Hicksville, New York 11801 NOTICE SENT 1000-76-1-15.3 Vincent Matassa and Gail Rerisi 5 Bethpage Road Hicksville, New York 11801 1000-76-1 - 19 William Leeds and Diana Loomis 16 Park Avenue, Apt 15A New York, New York 10016 1000-76-1-15.1 Vincent Matassa and others 5 Bethpage Road Hicksville, New York 11801 1000-76-I-20 Frank and Linda Sills 655 Smith Drive Southold, New York 11971 1000-76-1-15.5 Victor Rerisi and Deborah Matassa 5 Bethpage Road Hicksville, New York 11801 1000-76-1-16 Margaret Busching 155 West Creek Road Southold, New York 11971 1000-76-1-21 Julianne Shiels Att: Kevin Rambold, Esq. 228 Deer Meadow Road Manchester Center, Vermont 05255 1000-76-1 - 17 William Leeds and Diana Loomis 16 Park Avenue, Apt 15A New York, New York 10016 1000-76-1-18 William Leeds and Diana Loomis 16 Park Avenue, Apt 15A New York, New York 10016 Hydrographic S Surveyed: 02-03-05 Amended: 05-26-D5 SCT~I'S 1000-76.1-15.3 Situate: Goose Creek Town: Southold Suffolk County, NY Datum: M,LW, Tide Range: 2.5' +/- _~ -,~ /-,~ / SEA LEVEL MAPPING Proper-T Permit Services' 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: Application for Permit on Behalf of Victor Rerisi; SCTM # 1000-76-1 - 15.6 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 Victor Rerisi in the Town of Southold. Proper-T Permit Services represents Mr. 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. Sincerely, 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) S0]]th0ld Town Board of Trustees a subsidiary of THE PECONIC EASTERN CORPORATION ~r. oper-T Permit Services 'Phone: 631-734-5800 P.O. Box 617, Cutchogue NY 11935 Fax: 631-734-7463 MEMORANDUM DATE: June 14, 2005 TO: Town Trustees FROM: Jim Fitzgerald SUBJECT: LWRP Consistency Assessment Forms: James Eckert Harold Baer Susan Souder Gall Rerisi Victor Rerisi They are attached. Town of South01d A. ' INSTRUCTIONS LWRP CONSISTENCY ASSESSMENT FORM All apphcants 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. Th/s assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consisteiicy. *Except minor exempt actions including Building Permitr and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C,' th~ preparel~ Of this form should review the exempt minor action list, pol/cies and exp!~a~figns of egq¢~oli~y contained in the Town of Southold Local Waterfront Revitali~atic~n Program.~ A propbgCd~ action will be evaluated as to its significant' beneficial and adverse effects upon the coastal area (wh/ch includes all of Southold Town). If any question in Section ~C pn ,t,his. form is answered "yes", then the proposed action may affect the achievement of the LWRP~I~ol~cy stanc~ards 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 maximum 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 cozy of the L~q'RP i~ available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION oF SITE AND PROPOSED ACTION SCTM# 7 6 i 1 5.6 The Application has been submitted to (check appropriate response): TOwnBoard ~-] Planning Dept. ~ Building Dept. [~ Board ofTrustees [] Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, plann/ng agtivity, agency regulation, land transaction) (b) Financial assistance (e.g. grantl loan, subsidy) (c) Penn/t, approval, license, certification: Nature and extent of action: PROJECT DESCRIPTION: Construct fixed open walkway dock 4' x 82'. I,ocationofaction:'- 850 Private Road #22, Southold Site acreage: 0.885 Present land us¢: Single family dwelling Present zoning classification: R- 4 0 If an application for the proposed action has been filed with thc Town of Southold agency, the follow/ng information shall be provided: (a) Namcofapplicant: Victor Rerisi (b) MaiHngaddress: PO Box 1~2, Bayville, NY 11709 (c) Telephone number: Area Code ( 51 6- 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 ~-] If yes, which state or fed~al agency? NYSDEC, NYSDOS, USAC oE 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 us~e 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 ~ No ~'] Not Applicable Attach additional sheets if necessary~ Policy 3., Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP SeCtion III - Policies Pages 6 through 7 for evaluation criteria [~ 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 IIl -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 III - 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 Sectioq III Policies Pages 32 through 34 for evaluation criteria. [] Yes ~ No ~ Not Applicable 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 II1 - Policies; Pages 34 through 38 for evaluation criteria. [-~ Yes ~-] No [] Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Yes ~ No V-] Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dePendent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. W] Yes mo [] mot Applicable Attaqh ad. di~{}nal sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic 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. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - l~olicies; Pages 65 through 68 for evaluation criteria. [] Yes [~ No _~ Not Applicable Created on 5/25/05 11.'20 AM ? Town ~f Southold LWRP CONSISTENCY ASSESSMENT FORM A. - INSTRUCTIONS All applicants for pennits* /ncluding 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 preparel' of tkis form should review the exempt m/nor action list policies and explanations of egc,~ ¢olicy contained in the Town of Southold Local · ] 2 . r ' , 7'[',ff' .! Waterfront Rewtahzat~on Program. A propo~e2t action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southeld Town). II'any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP-pohcy stanc~ards and conditions contained m the consxstency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a defermination that it is consistent to the maximum 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 co~y of the Lx~P i~ available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 76 1 15.6 The Application has been submitted to (check appropriate response): Town Board [--] Planning Dept. ~-~ Building Dept. ~ Board of Trustees ~'~ 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken'ctirecfly by construction, planning activity, Co) Financial assistance (e.g. grant} loan, (c) Permit, approval, license, Nature and extent of action: PROJECT DESCRIPTION: Construct fixed open walkway dock 4' x 82'. Locafionofaction:' 85~ p~.ivate Road #22, Southold Site acreage: 0.885 Present land use: Single family dwelling Present zoning classification: R - 4 0 If an application for the proposed action has been filed with thc Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: Victor Rerisi (b) Mai~ngaddress: PO Box i~2, Bay~.~ille, NY 11709 (c) Telephone number: Area Code (). 51 6- 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 Southoid that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial u~e 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 IH - Policies Pages 3 through 6 for evaluation criteria [~ Yes [~ No [~ Not Applicable APPLICANT: VICTOR RERISI SCTM #: 1000-76-1-15.6 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 [ ws 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 bc discharged into thc water or wetlands. Disturbance of the creek bed dur- ing construction mad thereafter during active usc of thc structure will bc 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 advemely 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 APPLICABLE The construction or use of the project as proposed will not result in significant amounts 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.