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Home My WebLink AboutTR-5823Albert 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 CERTIFICATE OF COMPLIANCE # 0080C DatcNov. 7, 2005 is The certificate is issued to aforesaid property. two-story dwelling THIS CERTIFIES that the At 55 Bay Ave., Greenport Suffolk County Tax Map # 43-4-45 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 10/1/03 pursuant to which Trustees Permit # 5823 Dated 10/22/03 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 for a two-story dwelling PAUL JESELSOHN & FRANCIS DUBOIS owner of the Authorized Signature S A M U E L S & S T E E L M A N December 19, 2003 Southold Town Board of Trustees Town Hall Main Road Southold, NY 11971 RE: Paul Jeselsohn and Francis DuBois 41 Fifth Avenue Apartment 7C New York, NY 10003 DEC 2 2 2003 Dear Sir/Madam: Enclosed please find two revised SITE PLANS of the above project, showing drywells per the Trustees requirement. I believe this should complete the file, allowing you to send us the permit. Please call us with any questions or concerns. Sincerely, Thomas C. Samuels SAMUELS & STEELMAN ARCHITECTS eric. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEWYORK 11935 (631) 734-6405 FAX (631) 734 6407 Albert J. Krupski, 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 ¼ constructed ,-//'Project complete, compliance inspection. Board Of $outhold 'Town Trustees SOUTHOLD, NEW YO.RK ISSUED TO PAUL JESELSOHN & FRANCIS DUBOIS Anfl nri ulinn Pursuant to the provislo~s of Chapter 615 off he Laws of the Stale of New York, 1893~ end Chapter 404 of f~e ,L~. ws of ~ ' State of New York 19511 and fha S~fheld Town Ordinance e~- tiffed ."REGULATING AND THE PLAClN~ OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS end the REMOVAL OF SAND, GRAVELOR OTHER MATERIALS FROM LANDS UNDER TOWN'WATERS~ and in accordance with fha Resolution of The B6erd adopted at a meeting held on O..~.?.°..b.~...z..z., · 2.0.~.~.., and In consideration of fha sum of $...~..0..~..~.9. ........ paid by · Paul Jeselsohn & Francis Dubois .. of .......... ~.e.~...~[~ ............................. i ..................... N. Y. end subi~ to the Terms end Conditions Iided on the reverse side hereof, of Sculled Town' Trustees eufl~orizes end Parmlfs fha fofowlng: Wetland Permit to demolish an existing single-stor~ dwelling and construct new two-story dwelling (vithin exist, footprint, with condition drywe]Is are installed to contain the roof run-off, ~nd as dep.icted on the site plan prepared by Thomas C. Samuels,' Arch~[~ accordance with the deta~d specifications es peesenled in .fha orlg'ma~fing last revisea uecemb~r 1~, 2003. IN. WITNESS WHEREOF, The said Board of Trustees by causes ifs Corporate Seal to be ~,ed, end ~ese pres~h_ to b~ subscribed by ~'majodfy of fha sa~d Board es of this · Fpster Absent ~mslees 'iT'S and CONOmONS ~ ~ Paul Jeselsohn. & Francis Duboi$ ~k~ 41 Fifth Ave., New York l~ Y~ '~ 2. Th~d]bPmnkb'vdld~f,-~odo~.:, 24 tuos.~]khbcamid~edwbedJe upon dna no~ to remove et dtet d~ ~xk o~ pto~e~t het~n st~xl ~M~m~t etl~mes to the To~n · pieing,',! to this lXX-mk M]ld~ nay be subj,:ct to tev~e upon f-~,~_ to eba~ mae. · i 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) 765-1366 October 22, 2003 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Thomas C. Samuels Samuels & Steelman Architects 25235 Main Rd. Cutchogue, NY 11935 PAUL JESELSOHN & FRANCIS DUBOIS 55 BAY AVE., GREENPORT SCTMO43-4-45 Dear Mr. Samuels: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 22, 2003 regarding the above matter: WHEREAS, Samuels & Steelman Architects on behalf of PAUL JESELSOHN & FRANCIS DEBOIS 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 October 1, 2003, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Heating was held by the Town Trustees with respect to said application on October 22, 2003, at which time all interested persons were given an oppommity 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 PAUL JESELSOHN & FRANCIS DEBOIS to demolish an existing single-stoxy dwelling and construct a new two- story dwelling within the existing footprint, with the condition drywells are installed to contain the roofrtm-off, and as depicted on the site plan prepared by Thomas C. Samuels, Architect last revised December 19, 2003. 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 $5.00 per inspection. (See attached schedule.) Fees: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tuesday, October 14, 2003, the following recommendation was made: PAUL JESELSOHN & FRANCIS DEBOIS to demolish an existing single-story dwelling and construct a new two-story dwelling within the existing footprint. Located: 55 Bay Ave., Greenport. SCTMffA3-4-45 The CAC did not make an inspection, therefore no recommendation was made. 4/1~: Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town HaU 53095 Route 25 P.O. Box 1179 Southo]d, NewYork 11971-0959 Telephone(631) 765-1892 Fax(63D765-1366 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Office Use Only Coastal Erosion Permit Application -~'~retland Permit Application ~ Major Waiver/Amendment/Chan~es .,~'~ecei~'ed Application: /0]//~J'~ _.t~eceived Fee:$ o~ ~' ,,,Completed Application Incomplete SEQRA Classification: Type I .Type II Unlisted Coordination:(date sent) ,,,,,C~C Referral Sent:' lO · ,"Date of Inspection: Receipt of CAC Report: Lead Agency Determination:__ Technical Review: --,~l~blic Hearing Held: ! Resolution: Minor OCT -I ~,:cd Southold Town Board of Trustees Suffolk County Tax Map Number: Property Location: NameofApplicant ~'P~O.-L W~E-CSr~I4~ ~ 6'~:/~4C15 0tX t~caS Address ~/ ~/K~ AV~t ~PA~~ , M~ Yang. M~. Phone Number:( ) 1000- ~3- o~-~ (provide LILCO Pole #, distance to cross streets, and location) AGENT: .-7~ff-t> ~40tsl (If applicable) Address: Phone: f-/,3/-/- 6 Board of Trustees Application Land Area (in square feet): Area Zoning: r-~ _ 6/0 Previous use of property: Intended use of property: GENERAL DATA Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspend/ed by a governmental agency? /'No Yes If yes, provide explanation: Project Description (use attachments if necessary): '7-E> ¢2)~ t~Or_ tS [4 Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~7~o Area of wetlands on lot: square feet Percent coverage of lot: ~ Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No / Yes If yes, how much material will be excavated? g//~ cubic yards How much material will be filled? cubic yards 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: ~} 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): 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART i--PROJECT INFORMATION (To be completed by Applicant or Prelect sponsor) 1. APPLICANT/SPONSOR I 2. PROJECT NAME 3. PROJECT LOCATION: PRQ SED ACTION: 5. IS ~NeSw [] Expansion [] MoOiflcaflonlaJteretlort --$. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF ~ND AFFECTED: Initially ~~ acres Ultimately · ~ acres WIL~'IL~FROPOSED ACTION COMPLY WITH ~ISTING ~ONiNG OR OTHER ~ISTING ~ND US~ ~ESTR~CTIONS? ~ NO If No, ~escnbe briefly SEC p. WH IS PRESENT LAND US;: IN VICINITY OF PROJECT? Describe; [] Agriculture 10. DOES A~TION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. STATE iR LOCAL)? ~es [] NO If yes, Fist agency(s! and~permltlal3Drovals - ANY ASP T OF THE ACTION HAVE A CURRENTLY VAL)D PERMIT OR APPROVAL? [f the action is in 'the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this a.?_.~essment OVER PART II--ENVIRONMENTA' ESS,~,IENT ;CO be com21e!ed 2y Agenc . 006S .ACT;CN ~]<C~D A¢4Y ,,9~L THRESHOLD ~N 5 ~IYCR~, ~A~T ~7.127 If yeS, :~ara,na:e :~e r~v~ew :roces~ ~n~ ,J~a :ne FUL~ ~F PART III--0ETERMINATICN OF $1GNIFICANCE (To be completed by Agency) INSTFtUCTIONS.' For each sdverse effect identified score, determine wnelher it is sUbstsntial, large, im¢or~n! or otherwise signi E~C.~ ei~ec: ShOUld be assessed in connection wi~n its (a) setting (i.e. urban or rural); (b).DrobaDilit¥ of occ~,'~Lng; (c) duration irrevers~bility; (el geocJrssnic scope; end (f'/ magnitude, if necessary., add s[tschments or reference supoordng malerlals. ,~nsure explanations contain sufficient detail ~o snow ii, et ail re!event adverse impacts hsve been JdentHieo she adedus[ely acdresseo. Check this box if you have identified one or more ootendaliy large or significant adverse imoacts which occur. Then ~aroceed direc:ly {o ,~he FULL ~AF and~or prepare a positive-declaration. Check ~his box if you ,lave ale',ermined, based on the in¢ormadon and analysis above and any suooortin( documentation. :~a[ ;l~e ~ronoseO ac:ion WfLL NOT result in -_,1..ny significant adverse environmental AND 3rovice on a[t&cnments as necessary,. (he reasons suppo(dng ti~is determination: Board of Trustees Application County of Suffolk State of New York "/'~/JO ~ ~..~ C.- ,, ,~ A ~-n t~6-C$ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), Ile GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO ,20 Notary Public PATRICIA R/CHARDS Notary Public, State of New York No. 01RI6042467 Qualified in SUffolk County Commission Expires May 30, Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliweda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I,~PJ~'~,.~~ , residing at 70~ being duly swo~m, depose and~say~t~ ~at on ~ day of ~ ~ ,20~ I pe~on~lypostcd ~e pr~c~ ~o~ ~ by placing ~e Bo~d of Trustees official poster where it c~ e~ily be sero, ~d ~at I have checked to be s~e the poster h~ remmed in place for ei~t days prior to ~e date of~e public h ng. Vat ofhe g"oted to he'd 0 - Dated: Sworn to before me this ~..day of0(2~~ 200(l'~ Notary Public PATRICIA RICHARDS Notary Public, State of New York No. 01RI6042467 Qualified in Suffolk County Commission Expires May 30, 20~L~ Paul Jeselsohn and Francis G. Dubois Apt. 7C 41 Fifth Avenue New York, New York 10003 (212) 477-2400 FAX: 477-2014 pjeseisohn~surfree.com September 5, 2003 LETTER OF AUTHORIZATION Owners: Address: Paul Jeselsohn and Francis G. Dubois 55 Bay Road, Greenport, NY 11944 Town of Southold County of Suffolk State of New York Telephone contact: 212 477-2400 We hereby authorize act as our agent in SUFFOLK COUNTY and NEW YORK STATE residence at 55 Bay Road, Greenport, Tom Samuels of SAMUELS & STEELMAN ARCHITECTS to obtaining all permits required by SOUTHOLD TOWN, of our Date for the construction New York. Date ~PP~iU~NT TRANSACTIONAI~ D]SCLO~URR FOI~H The Town o~ S~ukhoid'e Code of Ethics Pfohibibs inberesb on bhe par~ o£ town officers and employne~. Tho p~rpoae el this form ia bo orovide information which can alert the town of poeoible conflicts o£ interest and allow it to take whatever action is necessary to avoid same. u2her en~i~y, aueh ~s a company. I~ es, indicate th~ o~her pe~o~s et company's name.) ~ax rtl.vance Variance A~p[~al o~ piab ,, gx{tptio, from pla~ or ogfiulal mmp o~h~r (Ir "o~her," hams ~he au~ivl~y.) ..... vhich ~he teen u~icer or employee has even a partial uvnership o[ (or enploymen~ by) a corporation in vhich l~ you anuvere~ '~BS,".~omplebe ~he baianoe oE ~h{~ form and da~e and sign vhece indica~ed. Name u~ person nmployed by ~h~ Town o~ SoO~hold Dss~ribs ~hs relationship bs~s~ yourself (~bs applicant) and the town officer or employee. Either cheo~ appropttabe line A) bhrough D) and/or de;otibe in bhe spar= provided, The bown oEtluet ot employee O~ hi; oc her spouse, sibling, pacenb, o~ ohild is (oheck ail bha~ apply)~ A) ~he owner dE grea~er ~Han 5% og the shares o~ ~he corporate e~ock o~ ~he appltc~n~ (~hen . is a oorpota~lon); B) the legal or bkne~l~lal ovnec o~ any in,crash in a nonuo~pora~e'en~i~y (vhen ~he appltuan~ Is no~ a corporation)~ c) an o~ioer, direc~or~ pa~tp~t~ or ~mploy~e.o~ applica.~l or ~D) ~he ~;bual appli~an~. .... ~.~. ~ ~~ ..v. S A M U E L S & S T E E / M A N October 1, 2003 Southold Town Board of Trustees Town Hall Main Road Southold, NY 11971 RE: Paul Jeselsohn and Francis DuBois 41 Fifth Avenue Apartment 7C New York, NY 10003 Dear Sir/Madam: We are requesting a Permit for the above reference project. For your review we are submitting the following documents: 1. Application 2. Short Environmental Assessment Form 3. Application Affidavit 4. Three Site Plans prepared by Samuels & Steelman Architects 5. Current Survey 6. Letter of authorization from Owner7. Check for $200. Please call us with any questions or concerns. Sincerely, lhomas C. Samuels SAMUELS & STEELMAN ARCHITECTS $outhold Town Board of Trustees enc. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEWYORK H935 (631) 734-6405 FAX (631) 734-6407 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS CERTIFIED MAIL RECEIPT Address: ~ F~54.gl( , being duly sworn, deposes and says that on the ~ day of ~F ,200~, deponent mailed a true copy of the Notice - set fo/th in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on th.e e. urrent assessment roll oSthe Town of Southold; that said Notices were mailed at the United States Post Office at (~A3~ ~{,. , that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this Dayof OcEo{~e.r ,20 Notary Public LISA K. GLUCK NOTARY PUBLIC - STATE OF NEW YORK NO. 01-GL8052340 QUALIFIED IN SUFFOLK COUNTY MY COMMISSION EXPIRES 12-11-200 ~5