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Home My WebLink AboutTR-4350Board Of $outhold Town Trustees' SOUTHOLD, NEW YORK PERMIT NO ..... 4~.5.0 ...... DATE.: ....A~¥ .1_~_,...!.994 ISSUED TO Charles & Penny Burnham Pursuant to the provisions of Chapter 615 of the Laws, of the State of New York, 1893; and Chapter 404 of the Laws of fha State of New York 1952; and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS:" and in accordance with the Resolution o{ The Board adopted at a meeting held on ...~. 3(~ ..... 19 .9.4, and in consideration o{ the sum of $..]:Sg..~.g0 . paid by ........ .C. ~arle~. ~...P~A~Y. Burthen! ........................................ o~ ........................................................................... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permlfs the following: to renovate existing residi~de on same foot print except Eor the southerly end which will be extended 30~ as per survey dated April ga, 1993. all in accordance with the detailed specificaflons as presented in the originating application. IN WITNESS WHEREOF, The said-Board of Trustees here- by causes its Corporate Seal fo be affixed, and these presents fo be subscribed by a majority of the said Board as of this date. ~T~ustee$ 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 $outhold, New York 11971-0959 Telephone 1631,765-1892 Fax ~631 ~ 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0099C Date Feb.13, 2006 At THIS CERTIFIES that the addition and drywells 3155 Pine Neck Road, Southold Suffolk Count>' Tax Map # 70-6-19 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 12/8/04 pursuant to which Trustees Permit#4350 Dated 7/ll/94 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 addition to existing dwelling, with drvwells to contain runoff Charles Burnham owner of the Tile certificate is issued to aforesaid property. A&d Sign~at 'r~e~ Albert J. Krupski. President James King, Vice-President Artie Foster Ken P.liwoda Peg~.. ' A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone ~631) 765-1892 F~ ~631) 765-1366 Januaw 19,2005 BOARD OF TOWN TRUSTEES TOX, VN OF SOUTHOLD Mr. Charles Burnham 3155 Pine Neck Rd. Southold, NY 11971 RE: 3155 PINE NECK ROAD, $OUTHOLD SCTM# 70-6-19 Dear Mr. Baumann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday January 19, 2005: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit # 4350 for the one room addition to the existing house with the condition of drywells on the addition and the existing house and the placement of a hay bale line between the bluff and the new addition and all as depicted on the plan received Dec. 8, 20O4. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK:hct K. L. Dickerson Inc. 2120 SKUNK I_ANE ° CUTCHOGUE, NY 11935 Albert J. Krupski, President James K/ng. Vice-President .-M't ie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 1197t-0959 Te ephone (631,, 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEE~ TO~3,rN OF $OUTHOLD APPLICATION FOR AN AMENDMENT TC DATE 12- AGENT PHONE ADDRESS PROPERTY LOCATION TAX MAP NO. 1(50~2 I/We ~t~e5 ~.Oa,tOt'l,Ot~ request an Amendment to Pemfit # Albert J. bh'upski, President James King, Vice-President .-M't ie Foster Ken Poliwoda Pegg3' A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone ~ 631) 765-1892 Fax ~63].1 765-1366 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 being dui.,,' sworn, depose and say: That on the~'t-~ da3' o f, Jp,~tvate,(, 200 personally posted the property kmown as by placing the Board of Trustees official poster where it can easily be seen, and that [ have checked to be sure the poster has remained in place for eight days prior to the date oft~e public hearing. Date ofhearing noted thereon to be held t/.Jt'~/~. ~t~.t3,P~,~ _ . c3r o0ait'-9;o0 tom, Dated: (si~ature) S,,vom to before me this /{?t~ day/o%f/~ ~ ~t2004~' Notat3, Public / PROOF OF MAILING OF NOTICE AI'I~ACII CERTIFIED MAIL RECEIPT,q VIRGINIA BARD GP~CE & Y~RGARET BOHN CHRISTOPHER DIGREGORIO JAN & CHARLOTTE JUNGBLUT Address: APT 12A 200EAST 16th. STREET NYC,NY lOOO3 45 PARKWAY SOUTHOLD, NY 11971 100 PARKWAY SOUTHOLD, NY 11971 PO BOX 489 SOUTHOLD, NY 11971 ,~TATE C,F NEW YORK (7(3~ ]]~' O1: SUFFOLK Charles_ Burnham , residing at 3155 Pine Neck _R_d__. S__ooCtho%d, NY 11971 , being duly sworn, deposes tu~d says that on the ~.]_~]~' day of~aa~{rx, q_ .... 20v~, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite lhe names of said persons are the address of said persons as shown on the current assessment roll of the Town o~ Southold; that said Notices were mailed at the United States Post Office at ,5 ~ ~x-kh c icl ~'? _, that said Notices were mailed to each of said persons by (certified) (rcgistered) mail. ~; of Trustees Applicatio0 County of suffolk state of New York 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), IF 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. Signature SWORN TO BEFORE ME THIS Notary Public APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of tov. m officers and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a compan_~. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Variance Change of Zone Approval of plat Exemption from plat or official map Other (If"Other". name the activity ) 1~'4/'4~--J.~0 ~'~ Ol~.,OIl~' ~ff~t't[r ~ 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, marriage, or business interest. "Business interest" means a business, including a partnership, in which the tox~m officer or employee has even a partial ownership of(or emplosmnent by) a corporation in which the town officer or employee o,,~ms more than 5% of the shares. YES NO ~ 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 the relationship between yourself(the applicanl, agent/representat~x e) and the town officer or employee. Either check the appropriate line A) through D) and/or describe 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 the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submi~ed ~day o f .~ ~/~( 200~_ Signature ( ~.~,~,.~ ~ · ~ P~t Name ~ ~~ [o,,~ n Itall CONSERVATION ADVISORY COUNCIL TO'WN OF SOUTHOLD TO: Southold Town Board of Trustees FROM: Southold Town Conservation Advisory Council DATE: January 11,2005 RE: Recommendations A meeting of the Southold Town Conservation Advisory Council was held Tues., January 11. 2005. The following recommendations were made: Moved by Don Wilder, seconded by Doris McGreevy, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the application of CHARLES BURNHAM to Amend Permit #4350 to construct an addition to the existing dwelling. Located: 3155 Pine Neck Rd., Southold. SCTM#70-6-19 The CAC recommends Approval of the application with the Condition drywells are installed on the addition and on the existing dwelling. Vote of Council: Ayes: All Motion Carried January 31,2005 Board of Trustees Town Of Southold Southold, NY 11971 To Whom it may concern. Requesting an amendment to my original building permit # 4350 to my home at 3155 Pine Neck Road, Southold, NY. I agree to install dry wells for roof run off & to install hay bail buffers on the Jockey Creek side of the constructioin site during construction. Charles Burnham 3155 Pine Neck Rd. PO Box 65 Southold, NY 11971 Se) n~tottr Bard 'E 16thSt. ^p~ 19A v York, NY 10003 Jill JAN 1 9 2005 Southold Town Board of Trustees /, ru UNIT ID: 0971 Clerk: 2.67 01/07/'05 / V:rg:n:a Bard [~tY---[~ .................................................... %~fio,~pt :9A ~.~OE. i6th. otree2 0.37 I1~: 0971 Cled::: KKf~R0 2.30 UNIT ID: 0971 Clerk: kKQORO 01/07/05 Lee & ~a.r ret Bohen · ~o ~5 Parkway s~ ~ffi~ ~': ......................................................... :'-" ~outhold, NY 11971 m {Endorsement Required) rtJ 0.37 UNI! ID: 0971 2,30 Cler;:: K ~',RORO ~ '7 01/07/05 & Charlotte Jun~blut o~O~,~o, ru Box ~89 oouthold~ NY 11971