HomeMy WebLinkAboutMcCabe, Benjamin F
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
November 27, 2001
Dear Mr. McCabe:
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Mr. Benjamin F. McCabe
PO Box 461
Southold, NY 11971
RE: SCTM#052-02-26
630 Ruch Lane
Southold, NY
The following action was taken by the ard of To n Trustee
on November 20,2001, regarding the above matter.
'ng a Regular Meeting, held
WHEREAS, BENJAMIN F. MC CABE applied to the Southold Town Trustees for a permit
under the provisions ofthe Wetland Ordinance ofthe Town of Southold, application dated
October 31, 2001
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 tl1e Town Trustees with respect to said application on
November 20,2001 at which time all interested persons were given an opportunity to be heard,
and,
WHEREAS, the Board members have personally viewed and are familiar witl1 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 tl1e standard set forth in Chapter 97-18 ofthe Southold
Town Code.
WHEREAS, the Board has determined that the project as proposed will not affect tl1e health,
Safety and general welfare of the people of the town,
2
NOW THEREFORE BE IT.
RESOLVED, that the Board of Trustees approved the application of Benjamin F. McCabe for a
Wetland Permit for replacing existing entrance porch inkindlin place - replace windows, roof,
cedar shakes, with the condition that the septic tank or cesspool located at the top of the bluff
be relocated to the street side ofthe house
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 project will expire two years from the date it is signed. Fees must be paid, if
applicable and permit issued within six months of the date of the notification.
Fee must be paid, if applicable and permit issued within six months of the date of this
notification.
Two inspections are required and the Trustees are to be notified when proj ect is started and on
completion of said project.
FEES: NONE
Very truly yours,
Albert J. Krupski, Jr.
President, Board of Trustees
AJKlcjc
cc: Building Department
DEe
Board Of Southold Town Trustees
PERMIT NO.
ISSUED TO .
SOUTH OLD, NEW YORK
5'11/1
DATE: .Nov,20.2{lOl
.B.ENJAMINF. .McClilBE
Autl1nrii!atinu
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 To r Ina en-
titled "REGULATING AND THE PLACIN OBSTRUCTI S
IN AND ON TOWN WATERS AND BlIC LANDS and f
REMOVAL OF SAND, GRAVEl 0 OTHER MATERIALS FRO
LANDS UNDER TOWN W A TE ;", and in accop:l~ith t e
Resolution of The Board adopt CI at a meetin~~n ~.~... ..uth,
. 2~:~j:':~ ~'::~::'Hof th'''1yf~ ... ... .. ,"' pd by
of,S(Hltl101ci'u ................ uu~. Y. and s lect to the
Terms and Conditio s list d e rever side hereof,
of Southold Town Trus ees au ixes and per . the following:
Wetland Permit for re lacing exis ing e rance porch in kind/in
place - replace windo s, roo, eda shakes, with the condi-
tion that the septic tan r cessp located at the top of the
bluff. be relocated to the str lde of the house. .
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 Corporate Seal to be affixed, and these presents to
be subscribed by a majority of the said Board as of this date.
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TERMS and CONOmONS
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1be Permittee
Beniamin F. Mr.~::Ihp
residing at t..'J.O Rl1....'h T ~......o > 5g~.tR8Id, N. Y., as
part of the coosideratioa far the isSuance of the Permit does understand and prescribe to the fol.
lowing:
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1. That the said Board of Trustees and the Town of Southold are released from I11Y and
all damages, or claims for damages, of suits arisiog direct1y or lndirecdy as a result of any oper-
ation performed pursuant to this permit, and the said p......._ will, at his or her own ~
defend I11Y I11d all such suits "initiated by third parties, and the said Fc..u.dtc.., assumes full 1iabl1ity
with respect thereto, to the complete exclusion of the Board of Trustees of the Town of SouthQId
2. That this Petmit is" wlid for .. period of 2 4 mos. wbkh is CX>QSidered to be the
estimated time" required to complete the work involved, but should citcumstances wartII1l, request
for 111 extenSioa may be made to the Board at a later date.
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3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes
to mainttin the structure or ptoject involved, to provide evideoce to l11yone coocerned that auth.
oriz.atioa was originally obt.aioed.
4. That the work involved wiI1 be subject to the inspection and approval of the Board or
its agents, I11d non-c:ompliauce with" the provlsiotlS of the otigioatiog application, may be cause for
revocation of this Permit by resolution of the said Board.
5. That there wiI1 be no unreasonable interference with navigation as a result of the work
herein authorized. "
6. That there shall be no intenereace with the tight of the public to pass and repass along
the beach between high and low water matks.
7. That if future operatiOtlS of the Town of Southold require the ftlDOVRI and/or alteratioas
in the location of the _rk herein authorized, 0 r if. in the opioioo of the Board of Tmstees, the"
work shaI1 cause unreasonable obstrucnon to free navigation, the said Permittee wiI1 be required,
upon due notice, to remove or alter this work or project herein stated without expenses to the Town
of Southold.
8. That the said Board will be notified by the Permittee ot the completion of the work auth.
orized.
9. That the Permittee will obtain all other permits and coosenu that may be required sup-
plemental to this permit which may be subject to revoke upon failwe to obtain same.
ffiARLES R. CUDDY
ATTORNEY AT LAW
445GRIFHNG AVENUE
RIVERHEAD,NEW YORK
"lailin~ Addres~;
P.O. Box 1547
Rive,head, NY 1190)
TEL (631) 369-82l.x)
FAX, (631) 369-9080
E-mail: crcuddy@earthlink.net
December 10, 2001
Board of Town Trustees
P.O. Box 1179
Southold, NY 11971
Attention: Charlotte Cunningham
,lr-r I. 2'
Re: Ben McCabe - Ruch Lane, South old
Dear Ms. Cunningham:
Ben McCabe has requested that I assist him in connection with his application for the premises at
630 Ruch Lane, Southold. He is proposing to complete repair work at his home, although he is
not extending it in any direction. Would you please send me a copy of the application pending
before you?
Very truly yours,
~epJ/
Charles R. CUdd;-----J
Enclosures
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Albert J. KnIpski, 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 Applicatiop""
t:- Wetland Permit Application ~ Major Minor
_Waiver/AmendmentL h nges
_Received Application: 0 (II ,/ !
Received Fee:$ . J Iqo
_Completed Applicatio
_Incomplete
SEQRA Classification:
Type I_Type II_Unlisted_
_ Coordination:( date sent) I~
CAC Referral Sent:JQ,L~ _0 /
Date ofInspection:_U(Ii.f{ I
_Receipt ofCAC Report:
_Lead Agency Determination:
Technical Review: ~
Public Hearing Held:~O I
Resolution:
Name of Applicant_1SeV\JAM ({\ P. t1CC~p-
Address h30 R.UG-~l?"
1C(
Suffolk CountyTax Map Number: 1000-
P. (), ho;r !/Jih
PhoneNumber~D2- 31.'3 '107 V
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Property Location:
Phone:
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(provide LlLCO Pole #, distance to cross streets, and location)
AGENT----H.\/~.e C p-
(If applicable) I
Address:
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Board of Trustees Application
GENERAL DATA
Land Area (in square feet): SO A" I W
Area Zoning: f( ~_<"ti() ~ vrtlL1l_
Previous use of property: R as, ~ f1 AL
Intended use of property: /Jc0/'JP/V1C (;:-
Prior permits/approvals for site improvements:
Agency
Date
-/fJ- No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
---,XL No _ Yes
If yes, provide explanation:
Project Description (use attachments if necessary):
~~ Pc Y7R?f ?HrrA1?(:e;;wrUr - -5A1?{Te.t'f4cY~/2:--e
~ LJtV1f)~/ /Ptf1~ / (lffiaA Ur;#:{;.S.
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Board of Trustees Application
WETLANDffRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: ~.LM..e t/11-sr;-q u tl-..$";12 Vc m re
Area of wetlands on lot:
square feet
Percent coverage of lot:
%
Closest distance between nearest existing structure and upland
edge of wetlands: 7--) feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 7 '-~ feet
Does the project involve excavation or filling?
No
~
Yes
If yes, how much material will be excavated? <9, cubic yards
How much material will be filled?
c9-
cubic yards
Depth of which material will be removed or deposited: -3 feet
Proposed slope throughout the area of operations: tJ
Manner in which material will be removed or deposited: < <:f 11 ~
1h.e :;OUV/ n h n b-vt 4../111 Iv A/ ;dJtUf?d
1>>/"(0 3/ "'(l(lnerrr /4i,0i, J~ '/ IJ/lf.
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):
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Board of Trustees Application
COASTAL EROSION APPLICATION DATA
Purposes of proposed activitY:_~f j).IJ-11 frJf/fLI-- "
{/ YJ --.51lr./ rJ 0 fJ (JT't: It
Are wetlands present within 100 feet of the proposed activity?
No )( Yes
{
Does the project involve excavation or filling?
No 'A Yes
If Yes, how much material will be excavated?
1- (cubic yards)
How much material will be filled? 1- (cubic yards)
Manner in which material will be removed or deposited: d o-u-tf-
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
/YJ#7I€ ~ rte ~ (4") d(}r &-tLT/v..f~ .
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rH: 1ooffJfUA/lr c:f r1f ~, W--e
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NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applicant:
SCTM#1000-
YOU ARE HEREBY GIVEN NOTICE:
1. That it is the intention of the undersigned to request a
Permit from the Board of Trustees to: ~
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/Y1.lj(/$rr(/c~, Mhe- e(ti/fkrS1C-f. .911 tvncI
/lA/Vl t1 ?f1 }j 10Le -
2. lfhat'the prop~~whiCh is the subject of Environmental
Review-is located adjacent to your property and is described as
fOllOWS:.0f1~ rt1 &0/~{'f
3. That the project which is subject to Environmental Review
under Chapters 32, 37, or 97 of the Town Code is open to public
comment on: You may contact the Trustees Office at
765-1892 or in writing.
The above referenced proposal is under review of the Board of
Trustees of the Town of Southold and does not reference any
other agency that might have to review same proposal.
OWNERS NAME:jV~11/'vI ~ nC(ltf,e:-
MA~ING ADDRESS: ,. Ox: I fa
PHO~V~ J/~~3 11771;; ~ ..
Ene.: Copy of sketch or plan showing proposal for your
convenience.
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February 1995 '
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Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
r
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
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In the Matter of the Application
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--------------------------
OF SUFFOLK)
OF NEW YORK)
AFFIDAVIT OF POSTING
I, /s.,,,,J ~~ , residing at t... sO '€OC?t. L1-.
~~"':(1y;[{6 N~
being duly sworn, depose and say:
That on the 1/ day of I 3 , 200/, I personally posted the
property known as *' -::? 0 'R Ur: ?, ~-c>
by placing the Boar ~f 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 o~~he
public hearing. Date of hearing noted thereon to be held )!rl ~ W J
~N~1C~(f<Yh. I
Dated:
(~=-Jt~
Sworn to before me this
/3 day of tuK.J 200 I
'1\-,+<:.. ~ (J" "f" --
Notary pnblic
L1NDA.I. COOPER
Notary Public, State of N..w York
No,_ 4~225e~, slln'ol,k5:~unt'J -L-
Tu'l'.~ ~:j;)\"....s r:U:":'_'iYH.i'-"" .,)., ";ift:...a~f:XJ
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PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
Address:
STATE OF NEW YORK
COUNTY OF SUFFOLK
8~~ 11~ ,rMidinq "'
", f3>~<-Ihl
() , being duly sworn, deposes and says
that on the /(J day of ,~/ ,19J2/-, deponent
mailed a true copy of the Notfce 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; that said Notices were mailed at
the United States Post Office at , that
said Notices were mailed to each of said persons by (certified)
(registered) mail.
PO. ISO,A1 '-lb.!
Sworn to before me this
day of /0, ,~J ,19 Cl /
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Notary PUblic
ELIZABETH A STATHIS
NOTARY PUBLIC. State of New Yorlt
No. 01 ST6006173. Suffolk County
Tenn Expires June 6, 2O~~
. .
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Board of Trustees Application
County of Suffolk
State of New York
&w tJ1C(/t6~ 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 IllSIHER KNOWLEDGE AND BELIEF, AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN TIllS 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 REVIEW OF TIllS APPLICATION.
~~~~
~Signature
SWORN TO BEFORE ME TIllS / 0 DAY OF ..3 / ,20 01
~l}dIt~
tary Public
ELIZABETH A STATHIS
NOTARY PUBLIC. State of NewYorll
No. 01ST6008173. Suffolk County
T ann Expires June 8. 2Oa'2..-
tve 11 ~ (1 is
e- A$r ~ frN iN ~ ~ I ~ 7 t ~. 8'-S 7. 1 e;47
700 ((,IJ 0k LrA.-.
west; AJ!J1J.J 0{erg Vlts
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H.~6.4 (2187)- Text 12
I PRO,ECT 1.0. NUM8Eil
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617.21
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I-PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
SEa
,. APPUCANT,SPONSOR
3. CATION:
Municloality S County
4. PRECISE LOCATION (Street address and road intersections. prominent landmarks, elc., or proviae map)
b30 R,UGlA. L...~E
S:c;u ~ (J L..b W1
5. IS PROPOSED ACTION:
o New 0 Expansion
Modification/alteration
6. D~;l:;~ECW;I:;~~ ..$~/Vlll-e~) RL>of
K'e\1lA-6e 8,GtSr/hr; S/(;"e: /brc-I-, lJ(VJelJ. S/tV1e: E!)r;tf'"C..rJ)lf1e~-'d14r
e;>oL5.rt'iI)( 5'HGuc..fvre: is VI1S;9--Fcz'-1- f/11.:::pUI'JD_
7. AMOUNT OF LAND AFrECTED:
InitiaHy () acres Ultimatelv (J> acres
a. WILL r=AO?IJSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING '-AND USE RESTRrC710NS?
~Yes 0 No If No. describe briefly
9. VJHAT IS PRESENT LAt~O USE. IN VICINITY OF PROJECT?
mesldential [J.!ndustrial [J CQmmercial
~~~Ibe:
o Agriculture
: I ParK/ForesUOoen soace
LJ Other
10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL, AGENCY (FEDERAL,
STATE On LOCAL)?
DYes ftJ No If yes. fist agency(s) and permit/approvals
'r
11. DOES ANY ASPECT OF THE ACTIQr-l HAVE A CURRENTLY VAllO PERMIT OR APPROVAL?
o Yes ~ No !t Yl!s. list agency name and permit/approval
12. AS A RESULT OF PROPOSED ACTION WILL =;.<ISTING PEAMlTJAPPAOVAL REQUIRE .\.1QOIF1CATION?
o Yes No
I CERTIFY THAT THE INFORMATION PROVIDED AeOvE IS TRUE TO THE aEST OF MY KNOWLEDGE
Applicantlsponsor
name EeHlJ /1V7 I 0
F I-1CC~c
Dale:
1/IIl.OI
,
Slgnalure:
If the action is in the Constal Area. and "{au are a state agency, complete the
Coastal Assessment Form before proceeding with this a~gessment
OVER
PAM; II-o!-l'JIRONMEc<7A'.ScS.NT ,-;"0 be co,"ole!ea O'l.~;ec.c_
...... :JOES ;..c:-:c,'I :;:(C~=::: ':'NY 1.-'::' i 7i-i:::E3r.ClJ 'N 5 ,'eC;::,':;.;J';':;.T 5;/.' _. :t 'jes. .:ocrClnare :ne r~Vlt~W :roceS3 ana 'Jsa :r.e ,=:JL:... 2'Ar
. ;-,:'{~s ~o
3. 'NIL:... AC7tCN .~E':2::V= :8C2C!N;.,,~:J ;:!EVIEW....5 ?Q.C'Jl0E:J _'::'::M UNLS,'2:J ';C-:";CNS iN:5 :'\lYC:=.R. ;J!~;;L 5,;,57
:Tlay tle sucersedec :y :=.nC(iier :n....OlveO a<;ency.
- -
L y~s ~o
C. C::ULO .':"CTiCN ..ESUL7" ,N ).NY ....DVE?:S2: ~:=:=:,:75 ;"SSCC:..;,20 'NI7H --:-~= F'JU...CI,VI.'lG; :)..ns....,ers :T:;:;,y:e -,anCWrHten.
C1. ::;'(is,ing air ~ualit"(. .;urtac.e or '~rounawaler cuality .:)( :::t.:anclty. ,101se ;e'JeIS. ~x:s:lng :raitic :::atteffls. :;clic NaSle
;lotenual 'er ~rOSlon, :':ralnaga or :Iooc!inq orOOlems? -=..::.plam ::lneily:
u ,'~o. a neq3.cva :.:eC:2r::;
,/ :eGlblel
::l(Cc~c::=n Jr :lIs:;::
~
C2. Aesthetic, a<;ric:.;lluraJ, 3.rC:1aeological, ~IS,OrlC, Jr other ~at~ral or cUJ!ural ;esourc.es: or ;:ommunlty ~r i'1elqilocrnoca c::.arac:er? ~claln _'
~
......... '/e(fetatlon or :auna. 'Isn. 5r:ellfisn or 'Nlldlile soecies. slgmficanr :'laoilals, or :hre3te~ed or ~nC:an~ered 3cec:es? Sclam :lri"r!y:
~
C~. A community'S existing ;llans or ,~oals as aiflc:ally aaooted. or a cnange in usa or intensity at use of land or other natural resaures::!.? Explain :;r
~
CS. Growth. suoseauent ::e'lelooment. or retatea ac:iviiies likely to be induceo oy the :rcooseo ac:ion? SOla:n onefl.....
kW'
....,J. ~ong :erm. snor: :erm.:::.zmuiati'le, or -::ltner grtec:s not icentilied in C~-C5? =xolaln ::lrIerly.
.fd;1J
c: tr:er:moac:s
inc:;Jcing :::-:anqes in 'Jse at :l~ther ~l1antilY ~r :y~e or ~nergYJ? ::;t;:)laln :::r:eily.
~
_~es
:s 7riE?E '..:KE:..::' 70 3E. C8NTMGVE.='S'f :::l.E~ ,c:J 70 ?QTENT!AL "':'CVS::!SE ~:-lVIRONME.'~,;'L
'jlJ .'10 :1 '~es. ~xc!aln Clrieity
:.'.1P~C7S?
'J. ;5 ,HE:=iE.::)A
PART III-DETERMINATION OF SiGNIFICANCE (To 'Je comoleted by Agency)
[NSTRUCT10NS; For e3C:1 adverse effect identified atove. determine whether it is substantial, large. ;mcol1ant or QtherNise signific.
=a.c:l effect silouJd be assessed in connection with its (al setting (Le. urban or rural); (bl probability of oc::~q; (Cl duration'
irreversibility; (el geoqracnic 3coce: and (f) magnitude. It necessary, add attachments or reference supporting materials. S:lsure
~XClana{ions contain sufficient detail to snow that all relevant adverse impacts have bean identifiea and adequately acC::ressec.
, . C:'eck ~his box if tOU have identified one or ,110re ;:::otenriaJly lar<;e or signijicant 2c'/erse imaac:s whic:1 MA 'f
ac::ur. Then :Jroceea direc~ly 10 the ;=ULL =AF and/or preoare a positiVI? declararicn.
~ C:'ec:, this jox :f you have derermined, based on the information and analysis above and any sucoortin<;;
coc:Jrnen(ancr:. :t1ar ~he ;:)roooseo ac~icn l,VILL ~JOT result in..;).r.y significant adverse environmental imoac::
AND :!rCVlce en 3.t!aC:llTIents as necessary, che (e3S0nS supconing this determinarion:
'l""'o!' .,,, _<:..u ,.....~IlC'1
.-'''''1 J' ."t:e '>."n.. Jl -{c.,ocn~.OIO: '''':lllc~r .n ~<.'..o ".;<:n.::.,
: ,lIo: ';)1 ",-"oans,o,,=, 011lCl!!f
,,,;n.lIL:r~ " {C'~con\'OIl!' '::1:!CN ,n ~O:.JO .....;o:ncv
'i,\/;n..::'JI<:" .)1 ,-',....).I'<:"r ',11 ":":t!"o:nt :rQm ,o:~oon\lO'O: :JIT'C('r1
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2
.
.
. . Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO
N.Y.S. Dept. of Environmental Conservation (DEC)
SUNY, Bldg. 40
STONY Brook, NY 11790-2356
444-0295
Suffolk County Dept. of Health Services
County Center
Riverhead, NY 11901
852-2100
U.S. Army Corp. of Engineers
New York District
26 Federal Plaza
New York, NY 10278
212-264-3912
N.Y.S. Dept. of State
Coastal Management
162 Washington Ave.
Albany, NY 12231
518-474-6000
. .
. .
Print or Type: ACCESS CONSENT FORM Office use Only
FOR ACCESS Fi 1 e #:
THROUGH PRIVATE PROPERTY Permit #:
1) _bVl 1:Av'1 t' V\ Vi C [,ft-:{?,e b3 D R. 17G \/\: L 4..., -Sou"YlAClW:)
(Name 6fI App 1 i cant) (Add ress )
2) ~~~~L~~~ ofOc~~~f~~~t:d)vJt
3) bsv R.(JG~ L~ Sevnu-tc{ , : 1000-as-0l--002 - O(b
(Project Location) (S.C.T.M. #)
4)
5)
6)
7 )
8)
9)
(Name of Road or Private Property Involved)
t11cS\) if HtrI-\ (/Vl,' iJl[, Co /0 n,.
(Name & Address of Homeowners Association / Property Owner)
~II,^~ ILrj' LJlV/bOW5 .s~n1i t~, ~tJ4:-'
~~b DescriPtion)) . I
Ra~ ( S I Q.p S VI. Iv-- y fb ~ .s If1rl e e>o;tC- , Of n e'if-5trYJ
~ - (.
?0Jl,S 11 V\ 1 S true fv (' f' J.S IJ /1.S () V 11 () r-- (//1 ..sAP e:
Starting Date: ~:4:P Completion Date: W
OIrJ, '{}t}tJ -OU
(Hamlet)
Estimated Cost of Proposed Work:
Insurance Coverage:
A. The coverage required to be extended to the Property Owner:
Bodily injury & Property Damage;
$300,000/$500,000 Bodily Injury & $50,000 Property Damage.
~I~o(, .rVV;(/-r~e-:
.
B. Insurance Company:
C. Insurance Agent
Name & Telephone #
D. Policy # :
E. State whether policy or certification
is on file with the Trustees Office:
(If "0, Pcovid. · ooPY 'E~u-t.1 (,,:/"/tll!-CJ/
(Si ature of Applican'N-/ (Date)
------------------------------------------------------------------
To be completed by the Property Owner:
I/We the undersigned, fully understand the nature of the Proposed
Work referenced above and have no objection to allowing the
Applicant to cross My/Our Property t 0 the or
(Si nature of e Pro rty Owner
or dul y aut hori zed represent at i ve)
. .
. .
TOWN OF SOUTHOLD
HIGHWAY DEPARTMENT
PECONIC LANE
PECONIC, NEW YORK 11958
Print or Type:
Office use only
Fi 1 e #:
Permit #:
1)
2)
3)
4)
5)
6)
7)
8)
PERMIT & BOND APPLICATION
FOR ACCESS THROUGH TOWN OWNED PROPERTY
~lV rtCC J~~e
(Name of Applicant) (Address)
----f.J.eV\VV~ "CJV\~ tJtJeVv rPtJ IV) V-- ,
(Name & Address 0 Contractor Involved) ,
h31) ~(J(/~ L~
(Project Location)
s;,oul""holv(
bJ(J ~ 17 cL.. Lc,...---
NY
v
1000- a5"""al. - Gd.-- ,;(,h
(S.C.T.M. #)
~AvvZ
(Name of Road or Town Property Involved) (Hamlet)
'R.tr!M PI [J/IJ Ol/"WS 1Q,(Jf1 F, ~t,till1 f~ S
(Brief Job Description)' ,
~(Jf~/ ~t!::,t!V1) s'1C!l p~ VIweJ, e;o/tGr (;)/trt'I4Jt7':::f
C;:JJSnh)' /b('(/~ 15 SYf{(J(fvrtt't {/t1.J~E .
Starting Date: ~# Com letion Date: 1W~~ ~
Estimated Cost of Proposed Work: ;Jd ()OrJ . 00
)
Insurance Coverage:
A. The coverage required to be extended to the Town:
Bodily injury & Property Damage;
$300,000/$500,000 Bodi ly Injury & $50,000 Property Damage
~c1'J7! JCh.svy~'
B.
C.
Insurance Company:
Insurance Agent
Name & Telephone #
D. Policy # :
E. State whether policy or certification
is on file with the Hi9hway Department:
(If no, Provide a copy with Application) (yes/no)
(er!:ft::e(~M-- (Date)
To be completed by the Superintendent of Highways:
------------------------------------------------------------------
Bond Amount
Required:
(Signature)
.! .
I APPLtCANT
TRANSACTIONAL DISCLOSURE FORM
The Town of S~U~hold's Code of gbhics prohibibs conflicbs of
interest on the part of town officers and employees. The
ur ose of this form is to rovide information which can
alert the town of pass ble confl cts of nterest and allow
it to take whatever action is necessary to avoid same.
tOUR NAHBI
I A If .&0 -... ,,,:,,,,I;t,",\
/" \ '-t....-T\.De &~ . '~"~--fln . p:,,;.,y.,.,t:rh-ft1'.
J J - .' .. ,(;.,_ ,
(Last name, first name, middle initial, unless
you are applying in the name of someone else or
other entity, such ,S a company. If so, indicate
the other person's or company's name.)
NATURB ot APPLICATIONt (CheCk all thab applY.)
'<'!.,'!k,t)'ir ,::':;;':':l~:, :-~Jilt, .:",!.:~~.
Tax grievance
Variance
Change of zone
Ap'p~~al of plat .
Exe~ption from plat or official map
other . 1/
(If "other," name the activity.) ~
,~
.~/'~.
Do you personally (or through your cO.pany, spouse, sibling,
parent, or child) have a relationship vith any officer or
employee of the Tovn of Southold1 "Relationship" includes
by blood, marriage, or business interest. "Ousiness
interest" means 8 business, including a partnership, in
vhich ~he tovn officer or employee has even a partial
ovnership of (or employment by) a corp.oraUon in vhich
the tovn officer or employee ovns more than 5% of the
shares.
YBS
NO
x
'::'lV"
If you ansvered AYBS,". complete the balance Of ~bi~ form and
date and sign where indicated.
Name of person employed by bhe Town of Soubhold
Title or position of that person
Describe bhe relationShip bebween yourself (bhe applicanb)
and the town officer er employee. gibher check bhe
appropriate line hI through DI and/or. describe in the space
provided.
The town officer or employee or his or her spouse, sibling,
parent, or child is (check all bhab apply).
h) bhe owner of greaber than 5% of bhe shares of the
corporate stock of the applicant (when bhe applicant
is a corporation),
B) the legal or b~neficial owner of any inberesb in a
noncorporate'entity (when bhe applicanb is not a
corporation) ,
C) an officer, dlrecbor, parbNer, or employee at bhe
applicanb, or
DI the actual applicant.
. ~.'
DESCRIPTION 01;' ngLATIONSIIIP
..
. '" ..',-,
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subldbted
,.,', ''I ;, . ,"W.i;;'f'" ,r .," ._;j".,;~~~,..!
....1, -:,.~'f,' '~1'"'' \'" .t!:v"'_;;"I';"'"
.. ':. . 1" ',", ,.':-,'i.," . :',;':~I'q!.,~.
thh ............:day at,;,"
"\.'1'"'' ""1':'"
. -"'j:' ,II:,.,. ';,'y.'ll~1"".
",'" '''ltltJ~);:rF:
l!l9_" .,
. ": ,.;~ ." ,'j. .
Signabure ........,. . ......
. P r I h b n a me,:. '. :,'::" ':, .~... ,,}~:,::.::~-,:~;"~(ti~;:::'::'~<~i~J:~i'
"....i'\.:~';;~,t'"'(%1~~ttWi_~i',..~'?1. . \:"..,
'.}' :....~.,J. '.~'~ '..,'.;,.l~~/' J';b.}7t~t~:.::1.~.r.',/4~~; ~1\~.:','
~ APPLICANT
TRANSACTIONAL DISCLOSURE
.
FORK
'J!-\/Y\ I--'U:
.-----
The Town of Southold's Code of Ethics prohibits conflicts of
interest on the part of town officers and em 10 ees. The
ur ose of this form is to rovide information wh ch can
alert the town of possible conflicts of nterest and allow
it to take whatever action is necessary to avoid same.
YOUR N^KE.
1)u\/,- r- CLW1l.--
(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's or company's name.)
NATURE OF API?LICATIOIh (Checlc all tha t apply.)
Tax grievance
Variance v/
Change of zone
Approval of plat
Exemption from plat or official map
Other
(If "Other," name the activity.)
.~
Do you personally (or through your company, spouse, sibling,
parent, or child) haire a relationship with any officer 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 the town officer or employee has even a partial
ownership of (or employment by) a corporation in vhich
thetovn officer or employee owns more than 5" of the
shares. .
YES V
NO
If you ansvered "YES," complete the balance of this form and
date and sign vhere indicated.
Name of person employed by the Town of
Title or position of that person
Describe the relationship between yourself (the applicant)
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 app1ic~nE (when the applicant
is a corporation):
B) the legal or beneficial owner of any interest in a
noncorporate 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
-~~~~t'NfL "f.mJJm~ q; o1oJt(~) 1\ r>> Ie UhUnehh l(),(a:tacL
print'name
this /day of ~
'D.0:~f- .o.Wn..
''Dle\< FAWN
1991
SUbmitted
Signature
"'"
.
.
,
~ 58-1
NOTICE OF PUBLIC HEARING
~ 58-1
Chapter 58
NOTICE OF PUBLIC HEARING
~ 58.1. Providing notice of public hearings.
[HISTORY, Adopted by the Town Board of fun T,)WD of
SouthoJd 12-27-1995 as 1..1.. No. 25.1995. Amend.."11ents
noted where applicable.]
~ 58.1. Providing notice of public hearings.
Whenever the Code calls for a public hearing, t.his section
shall apply. Upon determining t.hat an application is complete,
the board or commission reviewing the same shall fix a time
and place for a public hearing thereon. The hoard or commission
reviewing an application shall provide for the giving of notice:
A. By causing a notice giving the time, dat.e, place and
nature of the hearing to be published in the official
newspaper within the period prescribed by law. '
B. By requirin!,\, the applicant to erect the sign provided by
the town, which shall be prominently displayed on the
premises facing each public or private street which the
property involved in the application abuts, giving notice
of the application, the nature of the approval sought
thereby and the time and place of the public hearing
thereon. The sign shall be set back not more, than ten
(10) feet from the property line. The sign shall be
displayed for a period of not less than seven (7) days
immecliately pteceding the date of the public hearing.
The applicant or hiather agent shall file an affidavit that
sthe has complied with this provision.
C. By requiring the applicant to send notice to the owners
of record of every property which abuts and every
property which is across from any public or private street
,'.'
~ 58-1
SOUTHOLD CODB
~ 58-1
from the property included in the application. Such
notice shall be made by certified mall, return receipt
requested, posted at least seven (7) days prior to the date
of the initial public hearing on the 8.pplicatlon and
addressed to the owners at the addre~ses hsted for them
on the local assessment roll. The applicant or agent shall
file an affidavit that sthe has complied with this
provision.
----~------
.
.
Telephone
(631) 765-1892
Town Hall. 53095 Main Road
P.O. Bolt 1179
Soutllold. New. YorIc 11971
..
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
.a.t the meeting of the Southold Town ConserVation Advisory Council held Tuesday,
November 13, 2001, the following recommendation was made:
Moved by Drew Dillingham. seconded by Bill McDermott, it was
RESOL \fED to recommend to the Southold Town Board of Trustees ....:tl.~oftl1e
Wetland Permit Application of B~.AUIIIP.MCe.E to replace the existing entrance
porch, inplace, replace windows, roof and cedar shakes.
630 Ruch Lane, Southold. SCTM#52-2-26
Vote of Council: Ayes: .4.11
Motion Carried
.'
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