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Home My WebLink AboutTR-1855 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 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 April 16, 2008 Mr. Richard Bren 430 West Creek Ave. Cutchogue, NY 11935 RE: 430 WEST CREEK AVE., CUTCHOGUE SCTM#103-13-3 Dear Mr. Bren: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., April 16, 2008: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #1855 to replace two galvanized metal pipes with two 6"X 16' wood pilings, to secure the floating dock. This is not a determination from any other agency. Sincerely, JaEng~ ~ President, Board of Trustees JFK:lms 04/11/2008 08:33 FAX 212~1372 KBS REALTV AOVISOR~ IaJ 002/002 April 11, 2008 Mr. James F. King - President Board of Town Trustees 53095 Route 25 Southold. New York 11971 " Dear Mr. King: RE: 430 West Creek Avenue. Culchogue SCTM# 103-13-3 I request an amendment be made to m . ling permit .# 1855 to replace two galvani"sd melal pipes (pilings) with tw 8", 6ft wood pilings identical in size and material to those pilings af my neighbo' cks. The reason for this request is beCOlJse the existing metal pilings are insufficient and break apart each winter. If possible, please put this amendmenf request on the agenda for next week as I have the dock work scheduled but do not wont to proceed without the proper amondment to the permit. Thank you in advance for your consideration. - - .-- -" LJO f. 1~-1-. St-, rVi ( (\ 4 j(JUd-1 apt. s-a J ichard Bren Owner, 430 West Creek Avenue . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 63096 Route 26 P.O. Box 1179 Southold, New York 11971-0969 Telephone (631) 766-1892 Fax (631) 766-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0116C Date June 9, 2006 THIS CERTIFIES that the catwalk, ramp, and float At 430 West Creek Ave., Cutchogue 103-13-3 Suffolk County Tax Map # Conforms to the application for a Trustees Permit heretofore filed in this office Dated 12/27/05 pursuantto which Trustees Permit # 1855 Dated August 31, 1984 Amended January 18, 2006 Was issued, aud conforms to all ofthe requirements and conditions of the applicable provisions of law. The project for which this certificate Is being Issued is for a catwalk. ramp, and float with the condition of a 25'non turf, nonfiisturbance buffer planted as per planting plan. The certificate Is Issued to FT~nk gr~vone owner of the aforesaid property. ~o<~ Authorized Signature . . 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 January 18, 2006 Mr. Frank Scavone 430 West Creek Ave. Cutchogue, NY 11935 RE: FRANK SCAVONE 430 WEST CREEK AVE., CUTCHOGUE SCTM# 103-13-03 Dear Mr. Scavone: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday January 18, 2006: RESOLVED, that the Southold Town Board ofTrustees APPROVE the Amendment to Permit #1855 to repair the existing catwalk from a 12" to 24" wide deck on existing piles, replace ramp, repair the existing 5' x 20' float, with no CCA treated lumber used in the construction of the catwalk and ramp, with the condition that a 25' non turf buffer be planted by May 15, 2006 landward of the tidal wetland line with no turf, fertilizers, or chemicals used in this buffer area, and all as depicted on the plan surveyed by Joseph Ingegno July 22, 2005 and revised Feb. 13, 2006 by Frank Scavone and as per the planting plan submitted by Frank Scavone Feb. 13,2006. This project will need a final inspection. Final inspection will occur on or shortly after the May 15 planting deadline. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, James F. King President. Board of Trustees . . James F. King, President Jill M. Doherty. Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 58095 Route 25 P.O. Box 1179 Southold. New York 1197].0959 Telephone (63]) 765-1892 Fax (63]1 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 18, 2006 Mr. Frank Scavone 430 West Creek Ave. Cutchogue, NY 11935 RE: FRANK SCAVONE 430 WEST CREEK AVE., CUTCHOGUE SCTM# 103.13~3 Dear Mr. Scavone: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, January 18, 2006: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Permit #1855 from Donald and Brigid Macleod to Frank Scavone for a walkway and float as issued on August 31, 1984, located 430 West Creek Ave., Cutchogue. If you have any questions, please contact our office at (631) 765-1892. ~i~c.e::IY~4 /~~~ F. King President, Board of T Nstees JFK: hkc KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND . MAlUNG ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE WCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 766-1938 Fax: 631 765-3136 . PLANNING BOARD MEMBERS JERlLYN B. WOODHOUSE Chair PLANNING BOARD OFFICE TOWN OF SOUTHOLD To: Town of South old Board of Trustees From: Mark Terry, Senior Environmental Planne~ LWRP Coordinator Date: January 17, 2006 Re: Request for Wetland Permit for Frank Scavone SCTM#1000-103-13-3 FRANK SCAVONE requests an Amendment to Permit #1855 to repair the existing catwalk from 12" to 24" wide deck on existing piles, replace ramp, and repair the existing 5'X 20' float, and to Transfer Permit #1855 from Donald & Brigid MacLeod to Frank Scavone. Located: 430 West Creek Ave., Cutchogue. SCTM#103-13-3 The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review ofthe Town of South old Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, the information stated by the applicant in a October 24, 2005 telephone conversation, as well as the records available to me, it is my recommendation that the proposed action is generally CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided that: 1. No CCA is used in the construction of the dock facility. 2. The catwalk is replaced in-place and in-kind. Pursuant to Chapter 95, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Please contact me at (631) 765-1938 if you have any questions regarding the above. , 2...'f-r ~:/\I ,..,~ & v.J ~ c- (E(' U.." 0 ~ i'2l r~ f\A,4-i)~~ ~tf I. /.,..}f0(-~ Wrll-1- {ld~ 015<-/( O{\.... i..'f..(~TI"""" R It' L')Il.-~ f'<n-f[: ~t''fl> lc>" '?t~~ ,'v" {., ;)'(/ a:f G..,J ~r- v-()ow<-"-"'7 . I -J ., ,~r 1\A"'....$I~L"''''f) H-~1G.-""1 C{-- \2t Df O-W ~ sc-,~ em ~ tis!!" C~/Sf/"') P....r It 7)7) (ffj 7'1 Y c:t 1)4rt fl, s 'i5 '10 sp~ It I d 3'tAJ1I}i- 'f. s- '0.-1. to",&,"",- +. ~ '''' 'Vd-"T/( r, r:'~ Li-" 2 ~ ~~','; ~~ " \';)~ I'" C1<l1"" L" ,( It fE .- NoT To S ~4ur- '\ , ,I Y 1\ ,.., 'lO O,\.\:. S "l; C\ 1" "- 12..",1 ,..J e , l' -./'" (") (.. .J(>. ov" \\9 .II~~ ..r. " ".;' Iti ~{"'I r fll"'- c.'" (,..'f) -;;If ~ f , \ 1tJ.l19 n3 t.! IO^"",{ ~L- ~ t-'" ~ "V cP<' "V-.#; \ ' ~ 0,(" <,.-I" ~V\) n (\''' 1) rJ..f.. ( \ X\~t,. ,.<11 ~-j:l S\ I' 'II, ';1 ~I" /" -1'\ (J.,j\\ (,,- "\-' 'i..--\'<; ~\O f"ll..w ~ 'TPfrl~ 1"2-" cV 70 It @? '0o(,I( (oJ >W4.......i1..'1 2:' h:~ ~ &''!.'T'I'''~ '-rIL~~ 'N\~s 0 ~ JUli'l,':;7- 0 P @ Lovv 'II fJtr Lv;!>,TtYl. --.-.--- .-.-' - ,- I I ",<:i '''"~''"O ~ ,('''V ....~ ,..;.." ~,.. 'i'" ' " ,,<:I o , 4',~#~~ .~'~ .,v)' r/ .J'(/ ~?1' . "I.......'~ .' 7:..\-f<r' u...... "'<"A.. ..I.... _\,,;~\ "...'..... ,,""'. ""~'", <'"-, 7>0.,- -..-.... ..\ ,,,,,,<1,'0- 4,"\~ ...-".,.... ':';...... i"'~' ............... ~ '\<~-Q^"- ~. '.'_ a~ u'.....,n... ~ 0~ -1-t- 0-? ~<0 '+ ,1M SIIHVEY OF PROPERTY SI1'UA THD AT CU'l'CHOGUF: TOWN OF SOUTHOLO SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-103-13-03 SCALE 1 "=30' FEBRUARY 7. 2005 JUlY 21. 200~ o.DDEO 10' C{]NTOUR LINE &< n.o~nNG OOC~ AREA = 32.228.J5sq. ft. (lOTlELI>lt)O.740a<:. CEEI1fl.&J2...T~ WASHI~G'O~ TITLE INSUllA~CE CO~PAN'l' PROFESSIONAL LAND SERVICES LlC TITLENo.P-5118-S WASHINGTON MUTUAL BANK riA FllANKSCAVQNE ~::z-~z,. 'fF.,jf,f,i.:;r.. ~.::s.; ~=""i~ ~":"'~~ _.----- ......- ,..........---.......--- _(111):/17-'" ,..(OJ1)m_ln' """",..,...... m__ _."''''''10111 ":'.;"'..~ -_...."""-- 2:1-2llllA 4~08 11:15 AM FROM: 6318788951 eMI TO: 765664~GE: 001 OF 001 CATHERINE MESIANO, INC. 12 MILL POND LANE EAST MORICHES, NY 11940 PHONE/FAX: 631-878-8951 e-mail: cmesiano@optonline.net TO: SOUTHOLD BOARD OF TOWN TRUSTEES FROM: Catherine Mesiano DATE: 1/9/2007 SUBJECT: RICHARO BREN REQUESTS AN AMENDMENT TO PERMIT #1855 TO REPLACE TWO GALVANIZED METAL PIPES WITH TWO 8"X 1B WOOD PILINGS, TO SECURE THE FLOATING DOCK. 430 WEST CREEK AVE., CUTCHOGUE. SCTM#103-13-3 I have been requested by a client who wishes to remain anonymous to bring to the attention of the Trustees that: 1. the floating dock referred to above is larger than the dock originally approved. 2. the dock rests on the bottom at low tide and 3. is located on the edge of the wetland. It is requested that the matter be further investigated before any determination is made with respect to this matter. Thank you for your consideration. Catherine Mesiano . . 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 # 0116C Date June 9, 2006 THIS CERTIFIES that the catwalk, ramp, and float At 430 West Creek Ave., Cutchogue 103-13-3 Suffolk County Tax Map # Conforms to the application for a Trustees Permit heretofore filed in this office Dated 12/27/05 pursuantto which Trustees Permit # 1855 Dated August 31, 1984 Amended January 18, 2006 Was issued, and conforms to all ofthe requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for a catwalk, ramp, and float with the condition of a 25'non turf, non ,disturbance buffer planted as per planting plan. The certificate is issued to Fr~nk Sc~vone owner of the aforesaid property. ro<~ Authorized Signature James F. King, President Jill M. Doherty, Vice-President Pegg~ 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 January 18, 2006 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Frank Scavone 430 West Creek Ave. Cutchogue, NY 11935 RE: FRANK SCAVONE 430 WEST CREEK AVE., CUTCHOGUE SCTM# 103-13-03 Dear Mr. Scavone: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday January 18, 2006: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #1855 to repair the existing catwalk from a 12" to 24" wide deck on existing piles, replace ramp, repair the existing 5' x 20' float, with no CCA treated lumber used in the construction of the catwalk and ramp, with the condition that a 25' non turf buffer be planted by May 15, 2006 landward of the tidal wetland line with no turf, fertilizers, or chemicals used in this buffer area, and all as depicted on the plan surveyed by Joseph Ingegno July 22, 2005 and revised Feb. 13, 2006 by Frank Scavone and as per the planting plan submitted by Frank Scavone Feb. 13, 2006. This project will need a final inspection. Final inspection will occur on or shortly after the May 15 planting deadline. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, James F. King President, Board of Trustees 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 Januaw 18,2006 Mr. Frank Scavone 430 West Creek Ave. Cutchogue, NY 11935 RE: FRANK SCAVONE 430 WEST CREEK AVE., CUTCHOGUE SCTM# 103-'13-03 Dear Mr. Scavone: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, January 18, 2006: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Permit #1855 from Donald and Brigid MacLeod to Frank Scavone for a walkway and float as issued on August 31, 1984, located 430 West Creek Ave., Cutchogue. If you have any questions, please contact our office at (631) 765-1892. Sincerely, F. King President, Board of Trustees JFK: hkc James F. King, President Jill M. Doherty, Vice-President Peg~'y 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 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. 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 Please be advised that your application dated reviewed by this Board at the regular meeting of following action was taken: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ~l/~, l Ob (L~) Application Approved (see below) (__.)Application Denied (see below) has been and the (__.)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 Chapter 97 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ BY: James F. King, President Board of Trustees FROM : C MESIANO INC FAX NO. : 631-878-8951 Jan, 1G 200~ 06:56PM P1 CATHERINE MESIANO, INC. 12 MILL POND LANE EAST MORICHES, NY 11940 PHONE/FAX: 63t-$78.8951 e.mail: cme$iano~optonllne,net Janua~ 16,2006 Board of Town Trustees Town of Southold 80x 1179 Southold, NY 11971 BY FAX: 631-765-664~I Application of Frank Scavone 430 West Creek Avenue, Cutchogue Sir/Madam: I am the agent for Nancy Bradley, an owner of the premises located at 550 West Creek Avenue, Cutchogue, which is adjacent to the property that is the subject of the above referenced application. We are in receipt of the Notice to Adjacent Property Owner and sketch of proposed activity. The sketch is deficient in that it lacks the requisite data upon which a sound decision can be rendered. The deficiencies include, but are not limited to: 1. Plot plan 2. Property lines 3, Wetland delineation 4. High Tide and ALW 5. Elevation contours 6. Soundings 7. Docks, floats, etc. of nearby and adjacent properties 6. Plan view and cross view of the existing and pmpesed improvements/activity, We respectfully request that the T~ustees defer making a decision on the referenced application until a complete plan is provided to assure a sound and equitable decision. Further, it is our understanding that it is the position of the applicant that all or part of the existing structures ara grandfathemd by virtue of a permit issued to a prior owner of the property. We do not believe that improvementS that may have been approved, but not constructed, can be considered to be grandfatherad. It should also be noted that the 5' x 20' float and 3" metal pipes, noted as "existing" on the sketch were not located at the subject site pdor to July 2005, We respectfully request your consideration of the aforementioned comments and concerns before a decision is rendered. Cc: N, Bradley.. FROM : C MESIANO INC FAX NO. : 631-878-8951 Jan. 16 2~6 06:56PM P2 O~i~/~G 16~1 ~~l-'/34~7'702 DEI~DRA~ DO~" ~SO ra~. ~ CONSENT I~: 550 W~s! Cr~k A~'~, NY l, NANCY BRADLEY, ~,siding al ~ Towne St. ree.~, Amit'yvill~, NY, ~ o~ of~e o~ ~, New York $~ Dc~: of ~viro~en~l ~a~n, ~e Town of ~, ~nd ~1 ~s ~ ~re~, Subscn'b~l and sworn ~o I~efore me PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND PLANNING BOARD OFFICE TOWN OF SOUTHOLD To: Town of Southold Board of Trustees From: Mark Terry, Senior Environmental Planne[~ f~ LWRP Coordinator MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 cot. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 Date: January 17, 2006 Re~ Request for Wetland Permit for Frank Scavone SCTM#1000-103-13-3 FRANK SCAVONE requests an Amendment to Permit #l 855 to repair the existing catwalk from 12" to 24" wide deck on existing piles, replace ramp, and repair the existing 5'X 20' float, and to Transfer Permit #1855 from Donald & Brigid MacLeod to Frank Scavone. Located: 430 West Creek Ave., Cutchogue. SCTM# 103-13-3 The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, the information stated by the applicant in a October 24, 2005 telephone conversation, as well as the records available to me, it is my recommendation that the proposed action is generally CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided that: 1. No CCA is used in the construction of the dock facility. 2. The catwalk is replaced in-place and in-kind. Pursuant to Chapter 95, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Please contact me at (631) 765-1938 if you have any questions regarding the above. Dec.14, 2005 Field Inspecti~ Dec. 14, 2005 Field Inspectit~ Dec~ 14, 2005 Field InspectioO 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 Wed., January 11, 2006, the following recommendation was made: Moved by Don Wilder, seconded by Jennifer Mannino, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the application of FRANK SCAVONE to Amend Permit #1855 to repair the existing catwalk from 12" to 24" wide deck on existing piles, replace ramp, and repair the existing 5'X 20' float. Located: 430 West Creek Ave., Cutchogue. SCTM#103-13-3 The CAC recommends Approval of the application with the Condition an engineer's report is submitted with regard to the safety of the structure. Vote of Council: Ayes: All Motion Carried ALL MOORINGS AND STAKES MUST DISPLAY VISIBLE MOORING NUMBERS 'ALL DOCKS AND BULKHEADS MUST DISPLAY VISIBLE p~RMIT NUMBERS Board Of Southold Town Trustees SOUTHOLD, NEW YORK Mooring # N/A PERMIT NO......],.8.;5_5 ............... DATE: .A~g~,.....~.~........,l. 9~4 ISSUED TO _ Donal. d J,.. ,~ B_ri,~,id...~a.,c,.L.?...o..d. ...................... Aat r, rt atitm Pursuant to the provisions o{ Chapter 615 of the Laws o{ +he State of New Yorl~, 1893; and C~apter 404 of the L.aws of the State' of New YorJc 1952l and the Soufhold 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 ac,cordance'wlfh the Resoluflon of The B0ar~ adopted at a meeting held on ,~.,~L%~-.._,3.0, 19~.....4__.Z, and in ¢onslderaHon of the sum of $_._5..:..O.~_.'..._..pald .by Donald J. a Brigid MacLeod of .......... q,u..t...q,h...o. 9',,u.~ .............................................. N. Y. and subiecf to the Terms and Conditions l;~ted on the revers~ side hereof, , of Southold Town Trustees authorizes and permits the following: Application approved under the Grandfather Clause to secure a pezTRit for a walkway and float in Wi¢~ham Creek as per application submitted. ail in. accordance 'with the detailed specifications as presented in · fha originating app cation. IN WITNESS WHEREOF, The said Board of Trustees here- by causes, its Corporate. Seal fo be affixed, and these presents fo ','. be su~,s¢,,be~ by a ,.o~ority of ~ha sai~Bo~a ,, of t~ .~r~. '. BOARD OF TOWN TRUSTEES TOV/N OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold,.,New York 11971 GRANDFATHER APPLICATION TELE?HOiql~ 5. Sketch of ~he work including sizes: . /~ ~..,..., $, Ma~g oSf on ~he map fee, for ~his application. Albert J. Kxupski, 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 ~EC 2 7 20(}5 APPLICATION FOR AN AMENDMENT TO ~ PERMIT PHONE ADDRESS t_~9~ ~.~4.F~ C.klb~k.t_ ADDRESSAGENT ~ PHONE PROPERTY LOCATION TAX MAP NO. / DO~) '--" ~ Q~q~-'~ FWe Signed By: request an Amendment to Permit # PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAII, RECEIPTS SalTle: U.S. Postal Service CERTIFIED MAIL,~ RECEIPT Clerk: RTB2<O rn 4,42 01/04/06 Address: ~ .............. dingat qt%~ t~,~r ce~.t~ ~ ................ ,gdu,yswo d ose. d.a . ,o. the ,~~>.-w._?_._:..: ........... i .......... ' ...................................... '-~-'" -. · ice opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town cfi Southold; that said Notices w~re mail~ at the United States Post Office at ~,rc ~r~'l~c' , that said Notice* w~re mailed to each of said persons by (certified) (registeredl mail. Sworn to before me this ,&5-'~ Dayof ~O~)HOtc/, 20 V ~ / 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-t,,~ ~ 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 duly swom, depose and say:' That on the 3, day of OQ~o ,200t~, I personally posted the property known as by placing the Board of Trustees official poster where it can easilybe seen, and that I have checked to be sure the poster has remained in plac~ for, eight days prior to the date of the public hearing. Date of hearing noted thereon to be held (.RJ(~; '~/'0 t3 d a°~ 0100/e, . 0~ ~://obet~,f "): Od/om. Dated: Sworn to before me this ~'44'1 day o£~J~o 200 Notary Public of Trustees Applicatio~ County of Suffolk State of New York 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 HARM. LESS 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. SWORN TO BEFORE ME THIS ~-- DAY OF /~-~c /'~. (~otary Public NANCY T. FUSCO Public.State of New ~ I~ 01.FU4882475 7 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the nm of town officers and emolovees. The ouroose 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. ;.~--~, ,~ \ ~, YOUR NAME: /~'h ~.~ ~ C~w)Ob)"~ (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 pcr~oa'$ or company's nanle.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Other", name the activity.) 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, nlarringe, 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 ~ 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 applicantiagenffreprescotative) 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 greator 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 Form TS 1 Submitted this Signature Print Name 200_0 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including To~vn of Southold agencies, shall complete tlfis CCAF for proposed acti6ns that are subject to the'Town bfSouthold Waterfront Consistency Review Law. Ttfis assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *K~'cept minor e.,cempt actions including Building Permits and other ministerial Fermits not located within the Coastal £rosion Hazard Area. Before answering the questions in Section C, the preparer of this for~n should review the exempt minor action list, policies and explanations of each policy contained iT1 the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all ofSouthold To~q0. If any question iii Section C on this form,is ~mswered "yes", then the proposed action may affect the aclfievement 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 thc maximnm extent practicable with the LWRP policy standards and conditions. If m~ action cannot be certified as consisten! with the LWRP policy standards and conditions, it shall riot be undertaken. SCTNI#~_poO (o_'5 - I~ -- ~3'~ A copy of the LWRP is available in the tBllowing places: online at thc Town of Southold's website /southoldtown.northfork.net), the Board of Trustees Office, thc Plmming Department. all local libraries and the Town Clerk's office. , ....... I)ESCRIPTION OF SITE AND PROPOSED ACTION The Application has been submitted to (check appropriate response): To, n oara 5] P,ami ,e t. 71 Dep,. [] o, Trustees CategoW of Town of Southold agency action (check appropriate response): la) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) lb) Financial assistance (e.g. grantl loan, subsidy) lc) Permit, approval, license, certification: Nature and extent o f action: Location of action: Site acreage: Present land use: Present zoning classification: ~.~ i 9~,~' ,-~_ If an application for the proposed action has been filed with the Town of Southold agency, the fblloxving information shall be provided: (a) Name of applicant: (b) Mailing address:_ (c) Telephone number: Area Code ( )__ (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [~ No/~l If yes, which state or federal agency'? _ 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. RYes ~ No/~/Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southoid. See LWRP Section II1 - Policies Pages 3 through 6 for evaluation criteria ~Yes [] No [-~ Not Applicable · Attach'additional sheets if necessaryO Policy 3. E~ahance 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 Secti~ III - Policies Pages 8 through 16 for evaluation criteria ~W~ Yes [-] No ~ Not Applicable Attach additional sheets i f necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III -Policies Pages 16 through 21 for evaluation criteria [~ Yes ~ No ~/Not Applical~le 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. Pages 32 through 34 for evaluation criteria. ~ Yes [~ No~//Not Applicable Protect and improve air quality in the Town of Southoid. See LWRP Section II1 - Policies 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 CNot 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 L~TRP Section III - Policies; Pages 38 througb 46 for evaluation criteria. [~ Yes [~] No CNot 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 ~WRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ~-~ Yes [~ Nor~-l/L_~ot Applicable , . Attach additional 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 [--] NoT'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 [-~ No7Not Applicable A[ Attach additional sheets il' necessary Policy 13. Promote appropriate use and developmeut of energy and mineral resources. See LWRP Section III - Polic~ages 65 through 68 for evaluation criteria. [-7] Yes ~-~ No~[/X{ Not Applicable Created on 5/25,/05 ! 1.'20 AM