HomeMy WebLinkAboutTR-5442
Board Of Southold Town Trustees
SOUTH OLD, NEW YORK
PERMIT NO.
GUIDO & MARGUERITE DOSSENA
ISSUED TO ....uuu.uuuu...uuuuuu ..... .... uuU'U
5C/9jJ
DATE: .()."tober
ro" Autl1nrilatinlt
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the Laws of the
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 W A TERS{', and in accordance with the
Resolution of The BOard adopted at a meeting held on ..<?.c.t..:...2~!....u
. 20?~.u, and in consideration of the sum of $u..?D..D..:.OO. paid by
.. ..C;tlido...&.u.l<la.rgu.",~~~",...])o:>s.s."n". ..........u..u.........u..u..u..............
of u.....uC;,,:':<l.,,:r':..<:::.~ty u.u. uU" ... N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town T rustees auth~iz!ls and permits tJ:Mi following:
WetlanaVermlt to remove the eXlstmg resldence In disrepair and
1 construct a new single-family residence in place. with the conditi
.. of a row of staked hay bales placed down at the 50' setback and :'
" the installtion of roof drains in order to contain the roof run-off.
all in accordance with the detailed specifications as presented in
the originating application. .
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes. its Corporat~ S~al to be a~xed, and these p~esents to
be subscribed by a ma(ority of the said Board as of thiS date.
Tr1Ulees
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TERMS and CONOmONS
The Pem>ittee
resldiag at 8180 Peconic Bay Blvd.. Laurel N. Y.. as
part. of the coasidetatioa for j;JI; lsSo..oce of die ~t does 1lOM- '(ond and ptueribe to the fol-
lowing:
Guido & Marguerite Dossena
~.
1. That the said Baud of T~ and the Town of SouchoId _ re1eued fzom u.y and
aU dam8ges, ot cWms .foe cIamages, of suIu adsi.ag dltecdy ot iadlreo;dy .. a result ofu.y ~-
adoa performed pinuaAt to chis pamlt, and the aid F J ...... wi1I, at his << _ OWD expel....
clefead any and aU such 1ala.!ah/f1e'! by tbltd parda, and the said p... II. e... ... full1llblllq
with mpect chereto. to the complete.e:rdusloD of the Baud of ~ of the Town of SoutJ'<lIA
2. That chis Permit is. ~ f<< apedocl of ~4 moo. 'Which is coasl:lom~ to be the
__..~ time. ftClulted to complete the worl< iIl'R)~ but. ibouId ~ -... Ieqa$
for an e:daISI.oa may be mule to the Baud ar a later dalIe.
3. That chis Permit sbould be retaioed iIldefU>ilely, or as loag as the said PemIhtee wlsbCs
to .....1....ln the struCQ1te or project iavolved, to provide C'Videaao to aayoae (Il)IICl!tIIed chat m&-
.orIzation was originally obtained.
4. Tbat cbe workiavolwcl will be subject to cbe I~ and appronl of the ]loud or
its agents, and IIOll-CllIIIpllance with . the ptovlsioDS of the ....w-,;.,g appllcadoa. -.y be couse fOf!
revocation of chis l'ermit by resolution of the said Boud.
5. That chete will be DO uareasooable iIlterfereace with amgatioo as a result of the wod< .
here10 aUtbo.dzed.
6. That chete sball be 110 iIltetfereace with the right of the puhUc to pus and RpUS a10ag
the beach betweeo high and low water marks. .
7. That if future opendoas of the TOWD of Southo1d nqalte cbe nmoval andIot allaadocu
iA the ioat/nn of the. wod< here10 an~--\ or if. ill the oplAiao of the Board of T-. cbe .
wodr: ahaU cause unreosooohle obsuucaoa to free aa\'lgadoo. the said p-I- will be required,
apoa due oodce, to remove or alter chis work or project here10 stated wicbout ~I to the Town
of~~ .
8. That the said Board will be ootlfled by the Permittee ot 1be COIJ'p...w.. Of !be wodt anth-
orbed.
9. That the pCnDittee will obtain aU other pCnDitI and coaseatl d1u -.y be tequired sup-
pIemeDtal to chis pCnDit 'Which _y be subject to re..olce upon failure to obtalo. -.
--'''~~,"","'
.
.
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
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
October 26, 2001
Mr. Charles Thomas
P.O. Box 877
J amesport, NY 11947
~-c~
~;
RE: GUIDO & MARGUERITE DOSSENA
8180 Peconic Bay Blvd., Laurel
SCTM#126-11-18
Dear Mr. Thomas:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, October 24,2001 regarding the above matter:
WHEREAS, Charles Thomas, Architect on behalf of GUIDO & MARGUERITE DOSSENA
applied to the Southold Town Trustees for a permit under the provisions of the Wetland
Ordinance of the Town of South old, application dated October 3, 2001, 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
October 24,2001, 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 ofthe people of the town,
2
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of GUIDO & MARGUERITE
DOSSENA to remove the existing residence in disrepair and construct a new single-family
residence in place, with the condition of a row of staked hay bales placed down at the 50'
setback and the installation of roof drains in order to contain the roof run-off.
BE IT FURTHER RESOLVED that this determination should not be considered a determination
made for any other Department or Agency, which may also have an application pending for the
same or similar project.
Permit to construct and complete project will expire two years from the date it is signed. Fees
must be paid, if applicabltr,and permit issued within six months of the date ofthis notification. --
Two inspections are required and the Trustees are to be notified upon completion of said project.
Fees: None
Very truly yours,
tkt.,.1 9. /~.~~ ~t
Albert J. Krupski, Jr.
President, Board of Trustees
AJKJlms
DEe
Bldg. Dept.
.
.
Telephone
(631) 765-1892
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town Conservation Advisory Council held Monday,
October 15, 2001, the following recommendation was made:
Moved by Bret Hedges, seconded by Melvyn Morris, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the
Wetland Permit Application of GUIDO & MARGUERITE DOSSENA to remove tlie
existing residence in disrepair and construct a new single-family residence in place.
Located: 8180 Peconic Bay Blvd., Laurel. SCTM#126-11-18
Vote of Council: Ayes: All
Motion Carried
.
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Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
.
.
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
Office Use Only
_Coastal Erosion Permit Application
/\Vetland Permit Application r- Major Minor
W aiver/ Amendment/Changes
-.L:Received Application: IO/'3/d
....-Recei ved Fee: $ 0100 ...
......-completed Application -1aaJDI
_Incomplete
_SEQRA Classification:
Type I_Type II_Unlisted_
Coordination:(date sent) OCT - 3
"--CAC Referral Sent /0/3/01
.Arate ofInspection: 10/11/01
Receipt ofCAC Report:
_Lead Agency Determination:
_JJ:chnical Review:
'Public Hearing Held IOlt!iJf/l.OL-
Resolution:
Name of Applicant~~. _o~r;~A (Q~-\-'f{\O-('Cl.M'(\,\Q
Address 1~ MA4 N_~J..IA' Iw~ &rM(~1Y
~y It '5'30 Phone Number ( ) e11- 0 ~ 1"2-
Suffolk County Tax J'i1.ap Number: 1000 - I 2.6 - I' - Ie
.. 't\"6J
Property LocationJIS'CO r-l~A-Y ~OlJl...eVA "Rl'
L. ~I oti A~ 0
(provide LILCO Pole #, distance to cross streets, and location
sl4\
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AGENT a~~ 11f!L"'1A&
(If applicable) .
.A1<c~
Address:
7
Phone:
7z.7 - 7 ~ '3
.
.
Board of Trustees Application
GENERAL DATA
Land Area (in square feet): '0, c> IS"'. '5 ~ ~ Q. f:f.
Area Zoning:_-:R - 40
Previous use of property:------t fS~I'PEN.r ,Al,..
Intended use ofproperty:-----=Ke~'l1ElIl1lkt..
Prior permits/approvals for site improvements: ~
Agency Date
~ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
~No_ Yes
If yes, provide explanation:----H~
Project Description (use attachments if necessary):
Cb~f(U",~ ~,,..jCfLE - fAt-11LY ~1f~1~a::
I JJ----=gl Ad:
. .
Board of Trustees Application
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity:
Nl-e-
12e-~ ]7~c€
Co
Are wetlands present within 100 feet of the proposed activity?
"
No Yes
Does the project involve excavation or filling?
No V' Yes
If Yes, how much material will be excavated? i'Q (cubic yards)
How much material will be filled?
~Q
(cubic yards)
Manner in which material will be removed or deposited:----.HUVY
t;;&.\J'r l'1e~r
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
W~1f
.
Board of Trustees
.
Application
WETLANDrrRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
e
Je-sIV~~~E'
ILl'tAc-e
Area of wetlands on lot:
o square feet
Percent coverage of lot:
c:J %
Closest distance between nearest existing structure and upland
edge of wetlands: 1 ~ I feet
Closest distance between nearest proposed structure and upland
edge of wetlands: eo' feet
Does the project involve excavation or filling?
No
~
Yes
If yes, how much material will be excavated? ~O cubic yards
How much material will be filled?
~
cubic yards
Depth of which material will be removed or deposited:
b
feet
Proposed slope throughout the area of operations: ~ ""f~ 5 jt
Manner in which material will be removed or deposited:
dE'AVY 6"G.lJl~
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 Project sponsor)
I '-. ~'::L1.r~~:::ON;~A I 2. PAOJECT NAME
~:
1.'.~6.4 12/8n- ,p.xl 12
I PAOJECT 1.0. NUM8E.e
.
.
SEO
Municfpallty County
4. PREC:SE LOCATION (Street address and road inlersections. prominent landmarks. etc., or proviae map)
1c; GO,,", I c..
l4~A~6~f
8/>.y
C#..O~
~Oul.ev~~p
~OAV, 8~A,/ A"~,
5. IS PROPOSED ACTION:
flr'New 0 Expansion
6. DESCRIBE PROJECT BRIEFLY:
Rt!,...WV! g)CI~1",t-t'1 HQU?E. IN
CONofftLlG-f NI!'''' ~'N11.~-f"HIL..Y
IN c.-S"
~OdificatjOnialteration
-P'?~pA'e.
12~IP~ce
7. AMOUNT OF LAND AF;=ECTE
Initially 0 acres Ultimately 0 acres
3. VlILL ?RO?OSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTrlIC7iONS?
~es 0 No If No. describe briefly
9. VJt-<!j,IS PRE3ENT LANG !JSE iN VICiNI1l' OF PAOJECT?
~;:;eslden1jal 1I,!ndus:nal C Cummercial
Describe:
U Agricuiture
: I Park/ForestJOoen space
UOther
iO. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (F::DERAL,
STATE OM LOCAL)?
~es 0 No
If yes, list agency(s) and oermit/aoprovals
~o~o....?
~UI~D;,.Jtr Wp....rz:rMl:Nf
-:r,-
11. _D~S ANY ASPECT OF THE ACTIOf-l HAVE A CURRENTLY VAUO PERMIT OR AP. PROVAL?
~es 0 No If y~s, list agency name and permIt/approval "'XI~1i'N'i fZ.er~'P6'1J.GE
12. A~~ESULT OF PROPOSED ACTION WILL =XISTING PERMIT/APPROVAL FlEQUIRE .\o10DIFICATICN?
~es oNO__.
I CERTIFY THAT THE INFORMATION PROVIDED A80VE IS TAUE 70 THE 3EST OF MY KNOWLEDGE
Applicant/sponsor
name:
~Ael.B'~OMA6
. ."./~ :, -' ... -__n..:..._..._
A eclJ de- cf
Date:
/0- / - 0/
Signature:
._-~
If the action is in the COilstal Area, and ,au are a state agency, complete the
Coastal Assessment Form beiore proceeding with this a:?~essment
OVER
..:... :JCES AC7;C,~ ;:;<C2~J ':'.'iy
'~'\'lENT
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,:) ':Je c::)~::letec ,:;y ,~g:e:'lC
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PART Il-=:NVIFiO:-JMENi,j,'
;N -3 ,\lye;::;::., ,:1.:.'::,,5,7, 'Z"
:t '{as, :ocrQlCla!E1 :ne ;e'll~"'" :roces::! ana 'Jsa :r.e :=:Jl:.... ::-AF
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1-,'10
3. 'NIL:... ":'.C7:CN ::1E':2.iVS::::CP,OINA7'2:J=!E'/IEW...:.S ,::IRe'JlOE:) =,::; UNL57~:J ...:..C7;01'15 iN:5 -'HC2R, ,:1"':;'7 .,,;",:=7
."ay be suoerseC:ec :;y ~nct:ier ;n'lolveo a~ency.
:/ ,'~o. 3. "eq3.t:'tEl ::ec:ar:c.
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C. C::;ULO .';C7iCN .~ESUL7:N ...:.NY ..I.DVE?S2 ~'=~SC75 ASSCC:..;72] .v17~ -:...,=. .=DL!..C\"IING: :Answers :1'1ay ::elanCWrlnen.;/ :eglblel
C1. ~~istlng air quality. :;urtaca or ]rounawater ;::uality .:)r :uantlty. ,10lse ;e'fels. ~X!S;:lng :~adic ::allems. 3clid .vas;e :lrCCL:c::::n :)rJls;;::::
;:lOtentlal !er ~rosjon. :::ralnage or :loaC:inq oroQlems? '~to!aln :lrieily:
C2. AeSlhetlc. a.:;ric:.;lIural. :uc::aeologIC3!. ;'is,OflC, :)f otner lat:.Jral :If CUllural ,esources; or ::ommunlty or ,1ell;:iCCrncoa c:.arac:ar" ~~Cllaln _'
C:. '1e<;etat!on or :auna. :Isn. sl":ellflsn or wildlife soeCles. slgmficant ,'1acilals. or :nrearened or '!ncanC;erea .!cec:es? SClam ~rjally~
c~. A c:::mmunity's exis.:ng ,J!ans or :~oals as otflc:aUy adoQted. or a cnange in use or intensity ot use of :and or other natural resources? 2;'(ptain ;;
C.5. Growln. suoseouent ::evetooment. or related ac::vilies likely to oe ,nducea jy tne ::rooos20 ac.ion? ~'(olam :meily.
'-...:l. '-ang :erm. snort ~ef:7l.'::.Jmuiatjve, or C1iner '!dec:s not icentilieo ;n C~.-c.5? ~,~Olaln ':metl'l.
Ctr:e! :moac:s dnc:;jCin~ ..::-:anges In 'Jsa of '!!lner quamity .':Ir :'l~e OT '!nergYJ? S:!!';'ln :;riei!y.
'J. S ,~E::;,E.:)R:S 7nE?:E '...;~E:..":' ,0 5E.:::NTrtOVE?S'f ~ELAT20 70 ?OTENTIAL ,.;Dv=.~S2 ~NVIRONMEN7;'L :MP~C7S?
'_':'e5
'- No
'f ';'es. :xclain :lriefly
?ART III-DETERMINATION OF SiGNIFiCANCE ITo 'Je comoleted 'Jy Agency)
INSTRUCTIONS; For e3C:'l adverse effect identified aceve, determine whether it is substantial, large, imcorrant or otherNise signHic.
=ach ~ifec': snouJd be assessed in connecrion 'Nith its (a) setting (Le. urban or rural); (b) ;lrabability of occa.::;wg; (el duration'
irre'/erslblJity; (et geogracnic .icoce; anCl (t) magnltuce. It necessary, add aUachments or reference supporting materials. ::1sure
~xClanaticns contain sufficient delail to snow ihat all relevant adverse impacts have been identified and adequately accressec:.
C:leck ~his box :r you have identified one or ,110re .:Jotemiallylarc;e or significant aG'Iersa imoac~s whic:1 MA':,
OC:::.Jf. Then :Jrcceec airec:ly to :he FULL ::AF andJor preQare a positive'declaraticn.
---' C~ec~< this ::ox f you have determined, ~ased on the information and analysis above and any suooonjn~
doc:Jmentarlcn. :har :he Jraoosea ac:icn \.'VllL ~~OT result in...i;f1Y significant aCverse envircnmental imcac~.:
AND .Jrovlce an anaC:1ments 3S necessary, the ieasons supconing this determination:
"..",~ 'l' _.:.HJ __~,cnc',
-'''nl~' '....(:" ",..n~ ':>1 -(,.,iJon,.o,,, ''''':l11C:'f n ;......e "'"cn('1
: ,Ue 01 <,,':oon\'Ole ,jlf<cef
;,..n.J1UIC' ')1 ~..~con\,o,,:, '':;I:J(c' ,0 ~t:.lQ .....;..ncv
;,>:n,,:\.I'" ,)I :-'~"'Jol'~r ~Ir ...;,::e-.,."t :r<)m r~~oon\'o'~ "If,c,>r,
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. .
Board of Trustees Application
County of Suffolk
State of New York
~~ ~o fVlA~ BEING DULY SWORN
DEPOSES 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 illS/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 TillS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR
REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REYfr OF Till APPLICATION.
I .
SWORN TO BEFORE ME TillS
~.,.d
-1rVL
'- J
DAYOF Och4d(2/j/,20k
e
e
.
'--' 1"'-".',...,..... ".....
,.................. """"~""
.d of Trustees Applicatio4
Atl'I'HoRJ:ZATrON
I where the applicant is not the owner)
.'.
I, Gu,Jo f MdKvve",te l)055e"r~sidinq .at 7Q Mo~.JoLIA IwE~
(print owner Q)f property) (mai.lln~essJ
do hereby authorize~~5 "'.
(Agent)
to apply for pe~t(sJ from the
~"'5 , ~1J!C--\-.
Southold Board of Town Trustees on my behalf.
~ ~ Q~l-d-
_ (Owner's ~i~
8
.
.
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
Address:
t;,"1"6
~o1(AK
1b070 f~c:.o4lc. P>>'( 50,", ~
6>o'll 814
MIr11I IV cK. tJV /I q"S' z..
f!Jz8o fe-c.oJ,c.. &1>.1 8~v!7
L.A~~eL. I NY /l'l4-t>
f, 0 , r;o)( 12-1?4-'
~Afil1'tHK NY II ~p; "
I
W It..~u~ 'f O~L~ 1IL
l;~ l../l. ijA~1 -(. KA~ ~
f I t.l.A-1
STATE OF NEW YORK
COUNTY OF SUFFOLK l. D\
....~ "'.~ 4' ... P..J. =. ~ e,....
~ ~IDO ~i~~~f~~ S-::siding at 18 ~o U~ ~~. tJY 1I1"\"L
, being duly sworn, deposes and says
that on the IS' day of o.c.(U 1\Et- ,~A-, 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 the names of said persons are
the address of said persons as shown on the current assessment
roll of the Town of Southold; tha~otices wer~ mailed at
the United States Post Office at ~J;. J. 1OII.t1""1 ",vlJIC'that
said Notices were mailed to each of said persons by (certified)
(registered) mail.
.
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Sworn to)J~~ore me this ~
day of VWk2.Pv ,-l-9 c.oo I
H~t~y~
A?~~ ~(l3.
OlTtfL/tf7b373
~~ 5/;ZC./03
.
.
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
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 SOUTH OLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application
of
_~o_~_tYn.rnua.o!l2.~n'L
COUNTY OF SUFFOL~)
STATE OF NEW YORK)
'"'7('O~ (,..;0\. AFFIDAVIT OF POSTING
(Jldl~ I t4'"~..J.Ilct€
I, ~- Jflt~ ' residing at 40
fliUt\16 &/11'( ~BW I "W1.ltP
being duly sworn, depose and say:
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That on the I~ day ofoe1~ 2001, I personally posted the
property known as ~~V
by placing the Board of Tru tees offici 1 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
p"ublic lle~!J1g. D~r.. of hearing noted thereon to be held fr3ntx2r ~4,~1
V f\ C:("()l)LU;t l i aD 't'VY)
Dated:
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(signature) ~
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Sworn to before me this
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Al1l1LtCANT
TRANSACTIONAL DISCLOSURE FORH
The Town of S~U~hOldls Code of ~bhic$ prohibits confllcbs of
inberest on the parb of town officers and employees. The
purpose of bhis form is bo provide informabion which can
alert the town of ossible conflicts of interest and allow
it to take whatever action is necessary to avo d same.
YOUR NAMB t "'''' \'e~ o""A~ .
Last name, f rst name,
you are applying in the
other entity, such
the other person's
NATURB or APPLI~^TIONI (Check all that applY.)
;.' ~:' '~::'~.*Ik ,: :.:/:. :i~'~ :'~'j'~j/" .:."t,'lli~
Tax grievance
Variance
Change of zone
hp.pJ;'p.Yal of plat .
Exe~ption from plat or official map
other
(If "Other," name the acbivity.) ~~IDtr~
,'.'
'ff!i<.M If'
Do you personally (or through your oo~pany, spouse, sibling,
parent, or ohild) have a relationship with any offioer or
employee of the Town of Southold1 -Relationship- includes
by blood, marriage, or business interest. -Dusiness
interest- means a business, including a partnership, in
vhich ~he tovn Officer or employee has even II partial
ovnership of (or employment by) a corporation in vhich
the town of ricer or employee owns more than 5% of the
shares.
YES
NO
.;
-,"1< '
If you answered aYEs,M complete the balance ~f ~htu torm and
date and sign where indicated.
Name of person employed by the Town Of Soubhold
Title or position of that person
Describe the relationship bebween yourself (the applicant)
and the town officer Gr employee. Eibher check bhe
appropriate line ~) through D) and/or describe in bhe space
provided.
The town officer or employee or his or her spouse, sibling,
parent, or child is (check all bhabapplY)1
h) bhe owner ofgreaber than 5% of bhe shares of the
corpora be stock of bhe applicanb (when the applicant
is a corporation),
B) bhe legal or b~n~{icial owner of eMy Interest in a
noncorporate'entity (when the applicant is nob a
corporation),
c) an Officer, direcbor, .parbMer, or empluyee ot bhe
applicant, or
D) the ~~tual applicant.
. ,.'
DESCRIPTION OF RELhTIONSlllP
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Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
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
April 26, 2001
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Joan C. Hatfield-Matthews
Attorney at Law
Twomey, Latham, Shea & Kelley, LLP
33 West Second Street
P.O. Box 398
Riverhead, NY 11901
RE: Stewart to Dossina
8160 Peconic Bay Blvd. Laurel, NY
SCTM#1000-126-11-18
Dear Ms. Hatfield:
As per your request, the Trustees made an inspection of the above-captioned
property regarding the reconstruction of the existing residence.
The Trustees have determined that an application for this project would be
considered.
Any activity within 100' of the wetland boundary requires a permit from this office.
Very truly yours,
Ck/. L .1 9. /~.~.
Albert J. Krupski, Jr., President
Board of Trustees
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TwOMEY, LATHAM, SHEA & KELLEY, LLP
ATTORNEYS AT LAW
THOMAS A. TWOMEY, JR.
STEPHEN B. LATHAM
JOHN F. SHEA, Itl
CHRISTOPHER D. KELLEY
MAUREEN T. L1CCIONE
DAVID M. DUBINO
P. EDWARD REALE
PETER M. MOTT
SUZANNE V. SHANE
JAY P. QUARTARARO
JANICE L. SNEAD
MARTHA L. LUFT
33 WEST SECOND STREET
P. O. BOX 398
RIVERHEAD, NEW YORK 11901
www.suffolklaw.com
EAST HAMPTON OFFICE
20 MAIN STREET
EAST HAMPTON. N.Y. 11937
(631) 324-1200
SOUTHAMPTON OFFICE
51 HILL STREET
SOUTHAMPTON, N.Y. 11968
(631) 287-0090
TELEPHONE: (631) 727-2180
FACSIMILE: (631) 727-1767
JANE M. BARTON
DWAYNE S. WAGNER
ANNE MARIE GOODALE"
PHILIP O. NYKAMP
DENISE R. NEUHAUS
LAURA I. SGUAZZINt
JOAN c. HATFIELDt
OF COUNS"L
EMail Address:)Hatfield@suffolklaw.com
PORT JEFFEASON OFFICE
105 MAIN STREET
PORT JEFFERSON STA., N.Y 11776
(631) 928-4400
APR
6
April 5, 2001
BAY SHORE OFFICE
ONE EAST MAIN STREET, SUITE 1
BAY SHORE, N.Y. 11706
(631) 665-8300
HAUPPAUGE OFFICE
400 TOWNlINE ROAD
HAUPPAUGE, N.Y. 11788
(631) 265-1414
o NY & LA BARS
tNY&CTBARS
. NY" NJ BARS
HAND DELIVERY
Town of Southold Town Hall
P . O. Box 11 7 9
Southold, NY 11971
Attn: Building Inspector
fe' 'oJ1~ ~r\tend Ity\{)lo.~
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Re: Stewart to Dossina
8180 Peconic Bay Boulevard, Laruel, NY
SCTM# 1000-126.00-011.00-018.000
Dear Sir/Madam:
I represent the contract vendees, Guido and Marguerite
Dossena, in the above mentioned matter. In anticipation of
closing on the above premises shortly and making an application
for construction, we would respectfully request that you perform a
Pre-Application Inspection. I understand that this inspection can
be conducted on April 18, 2001 if you receive this request by
April 6, 2001.
Enclosed please find my firm's check in the amount of $40.00
made payable to the Town of Southold, which I understand to be the
fee for this inspection. If you have any questions or require any
additional information, please do not hesitate contact me or my
secretary, Doreen Weiss.
Thank you for your kind attention to this matter.
J
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Sincerely, .
~fi4C Cfh-~t&~dt/~
(/&oan C. Hatfield-Matthews
JCH/dw
Enclosures
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TwOMEY, LATHAM, SHEA & KELLEY, LLP
ATTORNEYS AT LAW
THOMAS A. TWOMEY, JR.
STEPHEN B. LATHAM
JOHN F. SHEA. III
CHRISTOPHER D. KELLEY
MAUREEN T. LlCCIONE
DAVID M. OUBINO
P. EDWARD REALE
PETER M. MOTT
SUZANNE V. SHANE
JAY P. QUARTARARO
JANICE L. SNEAD
MARTHA L. LUFT
33 WEST SECOND STREET
P. O. BOX 398
RIVERHEAD, NEW YORK 11901
www.suffolklaw.com
EAST HAMPTON OFFICE
20 MAIN STREET
EAST HAMPTON, N.Y. 11937
(631) 324-1200
SOUTHAMPTON OFFICE
51 HILL STREET
SOUTHAMPTON. N.Y. 11968
(631) 287-0090
TELEPHONE: (631) 727.2180
FACSIMILE: (631) 727-1767
JANE M. BARTON
DWAYNE S. WAGNER
ANNE MARIE GOODALE"
PHILIP D. NYKAMP
DENISE R. NEUHAUS
LAURA I. SGUAZZINt
JOAN C. HATFIELOt
OF COUNSEL
EMaiI Address:jHatfield@suffolklaw.com
POAT JEFFERSON OFFICE
105 MAIN STAEET
PORT JEFFERSON STA., N,Y. 11776
(631) 928-4400
BAY SHORE OFFICE
ONE EAST MAIN STREET, SUITE 1
BAY SHORE, N.Y. 11706
(631) 665-8300
o NY & lA BARS
t NY & CT BARS
. NY & NJ BARS
April 10, 2001
HAUPPAUGE OFFICE
400 TOWN LINE ROAD
HAUPPAUGE, N.Y. 11788
(631) 265~1414
Town of Southo1d
P . O. Box 11 7 9
Southo1d, NY 11971
Attn: Melissa, Board of Trustees Dept.
~ 112illll
Re: Stewart to Dossina
8180 peconic Bay Boulevard, Laurel, NY
SCTM# 1000-126.00-011.00-018.000
Dear Melissa:
On Friday, April 6, 2001, my assistant delivered a pre-
inspection application to you for the above referenced property. I
enclose today, a letter signed by the owners of the property,
authorizing the inspection.
If you have any questions or require any additional
information, please do not hesitate to contact me. Thank you for
your help and prompt attention to this request.
Sincerely,
-~~
JCHW'c1wJ
Encl~e
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AUTHORIZATION
April 9, 2001
Board of Trustees
Town of South old
53095 Main Road
Southold, New York 11972
Re: Evelyn A. Stewart to
Guido Dossena and Marguerite Dossena
Premises: 8180 Peconic Bay Blvd., Laurel, N.Y.
SCTM#1000-126.00-011.00-019.000
Dear Board Members:
I hereby authorize the Board of Trustees, or their representative, to conduct a pre-
application inspection of my above-referenced premises. ~ ~
~~~T d(i)f-
TWOMEY, LATHAM, SHEA & KELLEY, LLP
ATTORNEYS AT LAW
THOMAS A. TWOMEY, JR.
STEPHEN S. LATHAM
JOHN F. SHEA, III
CHRISTOPHER D. KELLEY
MAUREEN T. LlCCIDNE
DAVID M. DUBINO
P. EDWARD REALE
PETER M. MQTT
SUZANNE V. SHANE
JAY P. QUARTARARO
JANICE L SNEAD
MARTHA L LUFT
33 WEST SECOND STREET
P. O. BOX 398
RIVER HEAD, NEW YORK 11901
EAST HAMPTON OFFICE
20 MAIN STREET
EAST HAMPTON, N.Y. 11937
(631) 324-1200
TELEPHONE: (631) 727-2180
FACSIMILE: (631) 727-1767
www.suffolklaw.com
SOUTHAMPTON OFFICE
51 HILL STREET
SOUTHAMPTON, N.V. 11968
(631) 287-0090
JANE M. BARTON
DWAYNE S. WAGNER
ANNE MARIE GOODALE'
PHILIP D. NYKAMP
DENISE R. NEUHAUS
LAURA I. SGUAZZINt
EMail Address:jHatfield@suffolklaw.com
PORT JEFFERSON OFFICE
105 MAIN STREET
PORT JEFFERSON STA., N,Y. 11776
(631) 928-4400
BAY SHORE OFFICE
ONE EAST MAIN STREET, SUITE 1
BAY SHORE. N.Y. 11706
(631) 665-8300
.JOAN C. HATFIELDt
OF COUNSEL
o NY & LA BARS
t NY&CTBARS
- NY& NJBARS
April 13, 2001
HAUPPAUGE OFFICE
400 TOWNLlNE ROAD
HAUPPAUGE, N.Y. 11788
(631) 265-1414
Town of Southold
P . O. Box 11 7 9
Southold, NY 11971
Attn: Melissa, Board of Trustees Dept.
Re:
Stewart to Dossina
8180 peconic Bay Boulevard, Laurel, NY
SCTM# 1000-126.00-011.00-018.000
Dear Melissa:
Enclosed please find a print of a current survey for the
above mentioned premises. I hope this will be helpful to you in
the upcoming inspection scheduled for April 18, 2001.
If you have any questions, please do not hesitate to contact
me.
Sincerely,
J~iMJf;~tJ1:;!ll-IYI act1k i1h
JCHM/
Enclosure
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