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Home My WebLink AboutTR-5687 Albert J. Krupski, President . James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson ,) Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 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 """'--;re-construction, hay bale line sH /0' ole-. 2.,~ 1st day of construction Yz constructed ..L. Project complete, compliance inspection. . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwods Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD January 19, 2005 Mr. Alfred Magill 700 Glen Court Cutchogue, NY 11935 RE: 1145 FLEETWOOD RD., CUTCHOGUE SCTM#137 -4-26 Dear Mr. Magill: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., January 19, 2005: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Permit #5687, as issued on January 22,2003. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, dUe-I 9. ~.. (j,. Albert J. Krupski, Jr. President, Board of Trustees AJK:lms . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Building Dept. FROM: Board of Trustees RE: May 12, 2004 Alfred Magill 1145 Fleetwood Rd., Cutchogue SCTM#137-4-26 DATE: The Southold Town Board of Trustees reviewed the survey prepared by Stanley J. Isaksen, Jr. last dated February 27,2003 and determined the proposed new cesspool to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town Code. This is not a determination from any other agency. . . . .~. '.'.. ..' r. '. .. .. ..' '. .. .. .. .. " .. ......... .. I. .. .. ..' '. .. .. .' II .. .. .. .. .. II .. .. ..'.. .. .. .. .. .. .. . .. .. .. .. " TERMS and CONDITIONS r a JOe 1he Permittee Alfred A. Magill -:",__" 1145 Fleetwoon Ro,,j r"t(,~Qg'18 .. . N. Y u A.---e. . ' 1. -- ., put of the consideration for the /s9'f"<r of the Permit does UIKIentaod and prescribe to the fol. lowing , 1. That the said Board 01 Trustees and the Town 01 Soutbold ate releosed from any - all damages, or daims for damages, of suia arising dlrecdy or htcIirec:dy u a result of any opel- atioa performed pinuaDt to cbls permit, _ the said }\. .l,,~ will, It his or her own expeaK. defend any aod all such salts"lNtI-.f by third parcies, - the said ~...du~e - faUliablIity widt reSpect theleto, to the ~exdusioo of the Board of Trustees 01 the Town of Soud># 2. That cbls Petmlt is...ud for a period of 24 mos. wblch is CIllfJSi&led to be the estimated dmerequUed lo complete the wod< in~hed, but iboald cilcmiisIaDces WlIltIOC, request for an exceasioo may be made to the Board at a bw' date. 3. That cbls Permit should be retained indeflOicay, or u loog u the said Permittee wlsbCs to m.intoin the structUre or project involved, to provide ~ to anyone tlOOCttIIed that aoch- orizatioo was originally obtained. 4. That the work ~lved will be subject to the in~ and approval of the Board or its agents, and DOn-compJiance with the provisions of the origi....fl..g -t>pIicati..... may be cause for revocation of cbls Permit by IeSOlulioo of the said Board. 5. That thete will be no unreasonable interference with _vigotioo u . result of the wod< herein ...tborized. . 6. That there sbalI be DO interf~ with the right of the pWIic to pass - RpaSS eloog the beach between high and low water marks. . 7. That if future opendODS of the Town of Southold requite the ftIIlOV&l and/or altaatioas in the Iocatioa of the wod< herein aull>of'P..!. or if, in the opinioo of the Board of TrusteeS, the. work sball cause unreasonable obstrucbOC1 to free navigation. the said PemIlttee will be requited, upon due oock1e, to remove or alter cbls wod< or project herein stated without ~~ to the Town of Soulbold. 8. That the said Board will be oodfied by the Permittee 01 the completloo. of tbe wade aoch- orized. 9. That the Permittee will obtain all other permits and coasenlI dtIt mar be required sup; piemental to this permit wbkh may be subject to ~ke upon failute to obtain -- Albert J. Krupski, President James King, Vice-President Artie i;oster f Ken Poliwod.. Peggy A. Dickerson . . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 27,2003 Alfred A Magill 700 Glen Court Cutchogue, NY 11935 RE: SCTM#137-04-26 1145 Fleetwood Road Cutchogue, NY Dear Mr. Magill: The Board of Town Trustees took the following action during a Regular Meeting, held on January 22,2003 regarding the above matter. WHEREAS, Alfred A. Magill applied to the Southold Town Trustees for a permit under the provisions of the WetIand Ordinance ofthe Town of Southold, application dated December 31, 2002. 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 January 22, 2003 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 standard set forth in Chapter 97-18 of the Southo1d Town Code. . 2 . , . , f WHEREAS, the Board has determined that the project as proposed will not affect the health, Safety and general welfare of the people of the town. NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approved the application of Alfred A.Magill For a Wetland Permit to remove "old" house/block foundation/replace with poured concrete foundation - new home on the same footprint with drywells, gutters and haybales. 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. Fee must be paid, if applicable and permit issued within six months of the date of this notification. Ifinspections are required, at a fee of$5.00 per inspection (See attached schedule). FEES: $10.00 Very truly yours, ~9- /~~J.L J Albert J. Krupski, Jr. President, Board of Trustees AJK/cjc cc Building Department Please be advised has been reviewed . Tqwn Hall 6309lj Main Road P.O,BoxP79 Sou~llOld; New York 11971 Albert J. Krupski, Presjdent James King, Vice-President Henry Smith Artie Foster Ken poliwoda 'elepbQIlP(5161766-l892 , fax IRI6) 765-1823 d BOARD OF TO TOWN OF' SO Jj ;l , , TO: A lfrpcj A 'A~gill_ .T;;:anll;;:al"~~ 7(Hl~ that your appli by this Bo~rd, ~ and the. follQ~ (~) Application Approved (~) Application Denied C__J Application Tabled -it .~. .permit fee is e Southold Town the schedule If your &pplication is approved as now due. Make check or money orde Trustees. 'l'he fee is computed bel of rates as set forth in the instr The following fee must be paid fees \'1ill be necessary. re-application COMPUTATION OF PERMIT FEES: Two Inspections.:,@$5. 00 each TOTAL FEES DUE: $__lQ..OO 1 ~296 - f;: ::v.~ m ~ ._' ',_ ,'W ,P: " ~;l 10;' Ul913~ :Jo""'S; I!=:I: Q)T'" !:iC:~ z ,g. 00.>- ;: '" z ~LL1il,; o~o IS ~i~ ~ of'! '" ~ II) ll' o ~ 0 V III ,.(l.MJ,PAlO - BAlANCE DUE "\:- -,..' A/OO , ')'! J, Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda , . Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: A If,..p,-l t:. Uilg;l1 Please be advised that your application, dated D"". 11 2002 has been reviewed by this Board, at the regular meeting of hn",,.y n, 700~ and the following action was taken: (~) Application Approved (see below) (____) Application Denied (____) Application Tabled (see below) (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 the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: Two Inspections @$5. 00 each TOTAL FEES DUE: $ 10.00 SIGNED: tltt....-I ~ ~,,/,..I.: 9; PRESIDENT, BOARD OF TRUSTEES BY, ~~;TR{l~ 4/98 Albert J. Krupski, President James King, Vice-President Artie Foster Ken poliwoda Peggy A. Dickerson . Town Hall . 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ALFRED A. MAGILL 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 -X- Pre-construction, hay bale line 1st day of construction Yo constructed -1L- Project complete, compliance inspection. 1/27/03 Albert J. Krupski, 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 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. vV\c.-~, \ I INSPECTION SCHEDULE V Pre-construction, hay bale line 1 sl day of construction y. constructed ~ Project complete, compliance inspection. . ~ 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 Wednesday, January 15, 2003, the following recommendation was made: A4FRED A. MAGILL to remove "old" house on a block foundation and replace with poured concrete foundation and new dwelling on basically the same footprint. Located: 1145 Fleetwood Rd., Cutchogue. SCTM#137-4-26 The CAC did not make an inspection, therefore no recommendation was made. . , New York State Department of Environmental Conservation Notice of Incomplete Application. TIns is NOT a Permit .. :~yl>}-_;1,.__ ~ Applic",;oll J/J: 1-4738-01073/00001 Facility: MAGlLL PROPERTY 1145 FLEETWOOD RD SCTM#looo-137-4-26 CUTCHOGUE. NY 11935 Barch Number: 911619 Applicnlll: ALFRED ANDREW MAGllL 700 GLEN CT CUTCaOGlJF, N,' 11935 OWller W: 1490007 Permil{.')Appliedfor: 1- Anicle 25 Tidal Wetlands Project lom/io": ill SOl/TH(.LD in SUFFOLK C'OUNTY . Your llllpllcation for I'ermit is Incomplete. The following items are required: The j!llisd;~liol1ul cut-off OlllJlis property is the top of bank/concrete wall at approximately elevahn 24 or the submitted survey (not the 10 foot elevation contour as stated in your letter). Acco! .lI1gi y, it appears from the rendered photograph which you submitted that part of your prop" " : ". ~'Ides squurill,: ',ff the existing deck seaward ofthis line. The 7/29/02 legend on the survey ide~,f: :ies additiol1s '1';lh a particular cross-hatching pattern but does not label theRe additions a; p.-op',,;e,i (\;,,; CloeS not cross-hatch the deck extension/addition in the same manner. Pleas'.' ""h'P;1 1I detailed !"'''.i('ct deRcription itemizing dimensions of all proposed additions and deck ( . .~ll' i,'IIS and highli..ilt same on four copies of the survey. In additiol. please suhmit 111'0 copies of the Chuck Thomas architect plans referenced 011 the subrn' ',"; ,':IL'lc.;graph. Upon ,-.e:: t of all of the "')(lve information, processing will resume. "r'. {'f,., '1'1' submif requested information by Nil jilri'er (i ';'/1/ can be taken until all of these materials are received. Contal "(."",'-1.'. ,~nUJ"....L\.: ~C(jVAZ~~O SigfUl/Ure: ,\ .~;)LC ., ':y (iil STONY ":OOKBUll..DING40 iY [moeJ.:.: . [1790 . -Ii,.' /;/l/lIb",: '.:) 444-0365 Date: Augusl27, 2002 o , '" 0"';':':'." " ~'__~::..L~_ . . December 18, 2002 Alfred A. Magill 700 Glen Court Cutchogue NY 11935 (631) 734-6140 N. Y.S. Department ofEnviromnental Conservation Stony Brook @Stony Brook University Bldg 40 Stony Brook, N.Y. 11790 Subject: Letter ofnon-jurstication Application ID: 1-4738-03073/00001 Owner ID: 1490007 Date Received: August 15,2002 Applicant: Alfred Andrew Magill Facility: Magill Property-I 145 Fleetwood Road, Cutchogue NY 11935 DEC Contact: Laura J. Scovazzo I would like to apply for a letter of non-jurstication after consulting with Glen Just. The construction will be landward ofthe top of the bank! concrete wall at approximate 24' elevation as required in your letter dated August 27, 2002. Enclosed you will find two copies of surveys indicating the elevation and contour lines. Thank you for your time and patience regarding this matter. Sincerely, Alfred A. Magill 'J 7 h-(' L , ~rn.tl'r-<1 d.il.uC\ \wiSe.-- fa-(Dul teL. . . April 3, 2002 N.Y.S. Department of D. E. C. SUNY Bldg. 40 Stony Brook, New York 11790-2356 RE: Letter of Non-Jurisdiction from D.E.C. I plan to do an addition/alteration to my property located at 1145 Fleetwood Road, Cutchogue, New York. The construction will take place landward of the l~oot line as per ~he enclosed survey. Thank you for your kind cooperation in the above matter. Sincerely, Alfred A. Magill 700 Glen Court Cutchogue, New York 11935 631-734-6140 L DEe 2 7 c L~ . . (fold #2) ... NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ., DIVISION OF ENVIRONMENTAL PERMITS NYSDEC REGION I HEADQUARTERS SUNY @ STONY BROOK BUILDING 40 STONY BROOK NY 11790 ALFRED ANDREW MAGILL 700 GLEN cr CUTCHOGUE, NY 11935 (fold'!) -" staple her~ NOTICE OF RECEIPf OF APPLICATION The Division of Environmental Permits has received the application referenced below. The material submitted is being reviewed by staff, and you will be advised in writing regarding the department's findings. In all future communications, please refer to the Application ill number. Application ID: 1-4738-03073/??oo1 Date Received: August 15, 2002 Applicant: ALFRED ANDREW MAGILL Facility: MAGILL PROPERTY Description: ji-const addns to existing sfd landward crest bluff> JO'el DEC Contact: LAURA J SCOV AZZO --JOINT APPLf6~ ~1~2 FOR PERMIT . BANNER BUSINESS FOO~~ (SIA) :182-8321 -0- . *~ 95-19-) ~fMj()1 ,-.(p New York tilale United Slates Army Corps of Engineers I. Chock ponnlta IppIIod for: IV" AppliCabr. 10 ~... ~ permll c.8I~ie. ~sted ., Rem 1 PIuH (.~ allnatrudiona on b8dl Attach additlOO8l nformehon .. rlNded PM.,. print legibly 01/ type NYS Dept. of Environmental Cons.rvadon o Stream Dialurbllnce (Bed and Banks) o N<lvigath! Waters (Excavation and F~I) o Docks, Moorings or Platforms lCl.,"slrud or Place) o Dams and Impoundment Structures (Construct. Reconstruc\.or Repair) [l Fresh....ater WeUands :ldal Wellqfl(JS b Coastal ErosIOn Control o Wid. ~"ic iInC(I-Reeteational Rivers "~-3f- ar.rhPf:, _d. ._ ) '~~y'~:~~0;:~i:' " . CUTCHOGUE' :" , r:-.;,..i,~.'" .;. '.." : ~.jt.,t..-.: I. --," UARBOR .'~,""r.-~,-'-' ~', ~ ,",.._;.'0>"",-, ~ . ~;';"'.- v,~,,,..//ry MAP . kl/6~T,f'p.., /If,<ft' Si.Y",~ Zj .:sC"'IIr r =3000' L",r ~/' 00" AS" ':',,""6 7Z' l1' f-Q" 2. Name of Applicant (Use fun name) A~r.('CJ) -'9M.D/U;;V m1961LL Mailing Add..... 700 ~L~ u,c.JR..r TIIoplIono Nllmbet' (dayti""'l 6,J/. 7~y- ~/f'O 3. Taxpayer 10 (If applicant is not an individual) ZIp ~ 1/9oS$' Post Office C(Jrc:.II-O ~<JC 4. Applicant illlan: (check as many as apply) av,,,.r D 0""0'''' D l..... D .....idpatity I Governmenlal Agency 5. ti applicant is not the owner. identify owner here. otherwise. you may providl! AgenI/ConIact Person information Owner or Agent/Contact p....,. 0 Owner D Agent IContId Person I Tllophone Number (doyti""'l ailing Address Stale ZIp Code .....~roJ'9ctJF.clltty Locetton (mafk Jocationonrnap, see instruction1..) ~..r ~~O~ . County: TownICityMRage: Ta'( Map SectionI Block Jt.~'i~~-: A..ut,. ,<J,""r-'O...I< t:'..,n/hJ,..N: "'~rn<cr 'OeoU "r1'.OIlIl ..: ocatlon (inci.J~II'9Stfeetor.Road) e~_Nutnbe' (r1aytimp,' /) ""t" I"_NC 11~5 r-"Lt::.7:. rWOO.J) ","0/1-.:1) I.:JI-71't-""E-J SlaW ZIp Code 7. Name of Str~:1m or Wiilterbod., (on or Ilea; tlroJ'i',~! .l.i1ell AI'f IdS;, E(/(:.,-~~-i: C~~-4~...-all' Nome ~f USGS Quad MIIp: LocatJon Coo~ln.tes: C NYTM-E NY..:"_ .~ 4 --.J ~ -" -.-..., - Je-:t Oescrlpth."rl and Purpose: (Category of Activity e.g. new C()(''1lfu.~I'<::n/inst..lla:jcl\. l'1'a,;':~;nal":e 01 i 'ptal;elT'lE'nt; Type of StnJclUle or Acti\.;ty e.g bulkhead, dredging, fiiling. ciat;;, dQck, lai'Jr.g of W:1tt'_I; "l'~ of M~.te'i".1is 'I .in !)u3nlitill~; Stru::lt!'c ~nd Work ..\rea DimenslOm.. NeeO or PWPCH 5et"c.-d) I I ,Z ,,",0,11--4 ,,-, 'c.,C TO ~'pi:-7 PO-'l... -"1 -<'(,~7L.. "';-- AI ~..J .::r".n..., s ,I> , ("'"17 ::I ^' I A-z... L. nl'~ Co.,./ .s:-;rn'''C:::T";E>..,j -V,,,--L-.4~ Ln^-"-<3 "J~ o r 77 rc '7'1>"'" trJ F 77-I'-C 4,.,.-..I,.c:.. / t' 0;0./ t::.R f::7-r IJ/JLt... /1-r ?/"~-/1-r.''''''OKIr7'''7F 2,<;' c-i-I::V~r-"",,..) /IS ""-?4--,pvut.(;'"V,..-../ YC1vl"L,. ~ ~ T7l:; -n.... ...L) ~--r=-n /)-y/ r; OJ r r "7 .. ~ ,~'"" ~ '-, ~oz.. I' ' 111 !! C~~j ~!':-;t'.~n H' :P"";lil; ;l"d 1i;.':J;~r:: ,'.ct: i!. ::,: ;'.:i~~~~;'~:"~ 1~~~~~~~; \~) ! ~ .. _ '._ _=::...-=:-1 II rO:II\:;" .cyUSfI O~;)' II (IE': APPUCATt~Jt.I NUMeE'\ I t ~JS"'A;n~\:-coR;':;Cl:EI~Z';'EF:l:(S- . Fi:.mc""€it~T a;;ii: ----TTI:wnCPrcjett' &cuiii i'ip'iU;'o'"i;d SUlI! -.f1.Eii'imaiidC"O';'-nrl.-;ill,)~ .-. i_.___.__.._.... _.__.JC~~r~_12.::~.:.:J Slale l.rKl?g ~ oate,r If) '! __JD':d~::!:_ . __: I ...--.----------- , -::1-'- --- -- -----, , 14. fl.,. .Work Begun Ofl Prclecl7 {It jes, iltta.;h_ 0 IiJ 115. Ust Vre1flout Perm~ I Appll':.!II~QO NumbP.,. ~nd 'lath: (If P.r.:!l ~ ~A~lil:'la:!""; 1)1 ,,'lilY ""..,:k 'Nas 5t",-:ed 'NIUIQ~t permIt' ;e, N.l -----.----.-.- -- .----------.----------------- 16_ Will th!s Project ROQulri) ,-l.drJiUona! 0 ~ :1 "'I~S. . Fcderar..Sta\.G,Qr lor.,Jlf)erm:t!? 'f~.. ~ ~'Ij>...:;eLisl.. , ~-~".~; "ppllcant Is not the _c,wner, both n1U'~-s;gn tho ;'PPIi:::l- ..--------~.._-----. -------~- II I h:m'~by atfi.lT. that Rllcrmatior. pro..idcti on thIS form an1aH 3rtachnllmts submitted herewflh IS llOf! to ihe t>e1t at my 1m..."'...~oI!Ogr a~ belief Fal~/?' Sl:;.lemt'l~b 1lI3de "terein iJ."(! ~'\lmshabl! &S . CI3t.S A misd~me(ll~-or purwanllo Saction 210 4'i llf the P~nallaw. Fl.:lther, tne ilPP':.r;.-'.,,: 'li:cepm ft:ll reSJ.'l.lflsitili!\l fc! an ;Jl:I1T-.agt!, din'lcl :Jf llldirtd. I r)t~nalever ,nature, and t)' ~ver suffered, arising o'Jt 0' the ~w)jl.!(t desai:,ed he.ein iind <l.1J~C~.i):O i!\dl!r:ilrify CllW 50\'(> t,allnl~, thr. Sl.ite fr:>m ~uils. ac;ti0ll$. camages and CO!ts of iNery name and descript;on resuttir.g from said~, In addilion, F~ra: Law, 18 U Sc . Set:oon lOC1 r:'f1'Wides!Of' a f..,.. of not more than $10.000 or i~sonmenl for not nlOIe than 5 yea.s. or both where an apot.cant knowingly and wiH;ngi'l td:31f1es. cox.elds. Of ....overs ;JP a material fact or knowingly mattes 01 uses a false. lk:ticious Of frauduJenl statemant Q. '" \ ~_.~~~~ ~, -~\ . ..'~;7 I (; / ~ I I 'I / / ..,/ ' "'vi I "~ '" " Q. ~ ~CJ 1~f1''SIOIJfl'LD t 1 m , -- -- -'" ..-'" + - ....... - .. ~..... ~~;~ -~- ----;y.;''''-'''T-- . . f . , . 27' 4011 E NOTE: [Lrv. LOt'ER WOOD DECK ~NC AREA =- '7.90 W/ RAIL ) . " FRAME 20 \ OOl..S EXIST. GARAGE T1USER MELL 1 STORY . FLOOD FRAME STEP \. ZONE X HOUSE 1 14 F. F. EL. =25.86 24. r lMNeY 4 · 04 I 00" W () 22 . N/F RYBECKY DESCR/BED PROPER TY SlTUA TE CUTCHOGUE, TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. SURVEYED FOR MAGILL RESIDENCE ~ 22 eM \ 264.05' ~G C~~I\I~S , FLOOD CR~~A- , , ZONE AE-8 \ EXIST. 110OO " , , v 320.36' cP.. t"\ 4.0' ;" ~ FRAME GARAGE " r fT\ fT\ --\ ~ o o CJ ::G () J> CJ N 9' 27' 40" E (0)137' ..." wpfJI ro eM .... c::i ~ o. . wru.(APPROX) N/F CAMPBELL ---z- P/PC .- ELEVATIONS IN 1929 NGVO SURVEYED OJ APRIL. 2001 SCALE 1"=JO' U\ o ~o "~ :lI 1')~'" rCJ-. ~. F\~ t:". )li r/" AREA= IS.08UJ65SF OR O. J46 ACRES GUARANTEED TO GUARANTEES INDICA TED HERE ON SHALL RUN ONL Y TO THE PERSON FOR 'MfOM THE SURVEY IS PREPARED. AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY, LENDING INSTITUTION, IF LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEOUENT OWNERS. FLOOD MAP DA TA FROM FIRM MAP J610JC0164G EFFECTIVE DA TE 4 MA Y, 1998 ~' ~. ! f SURVEYED BY Ir" 2 7 ' UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A \oIOLA TlON OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. ~ 10oo-IJ7-04-26 COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPy. MAGILL NOTE: /. 29 JUL Y. 2002 SHOW ADDITIONS THUS: E22 O/C99? < )> () )> z --1 / \ '0 -\ 'to" ~ \ 1'\ 1'\ ---\ ~ o o D TM 7000-137-04-26 MA GILL GUARANTEED TO f COTE. EXISTING HOU9 ON SITE. , ' ',tary s"stem . ~ eltlSt\ng san " ment by ,:!ealth ~~rt ' EXISTING CESSPOOL TO EMP11ED, REMOVED, AND BACKFILLED. N/F RYBECKY RESIDENCE WITH PUBLIC WA TER PROPOSED SEPTlC TANK '\ 264.05' N '390 27' 40" E lti2' 18 'i" . FRAME ~ ~~ GARAGE ~~ ~ -<.o~ -l>' lA.. 280' BLUESTONE 67.1~N -:;e DRIVEWAY / /~ LP --tC1-' \ TEST WATE:Ry _.. ~ HOL sup/Oh ""'---- FD' eM FD eM -l>'Z 'Pen --......l-<:J..\ N 0 '- 10' FLOOD ZONE AE-8 '\ '- '- '- '\ " TIMBER S 400 04' 00" W 22 ;OJ, CM "o's~/- -----:RQo~.S)"9Tb..y ----::'eo I\Ic~.-l7Sl1NG' · ceSs; ~L WELL(APPROX.) "'Do, N/F CAMPBELL (SEASONAL USE) /~ \ ':::D o '}> D. o " o. NOTE: NEW SCWA WA TER SERVICE TO BE SLEEVED AS REQUIRED DUE TO PROXIMITY OF NEW CESSPOOL NEW WA TERLlNE SERII/CE TO RUN JUST NORTH OF SOUTH PROP. LINE. PIPE FD '" " FD CIJ TEST HOLE DA TA PERFORMED BY McDONALD GEOSCIENCE 24 FtBRUARY 2003 ,- txlSTING GR/iDE BROWN SIL TY SAND SM 2' GUARANTEES INDICA TED HERE ON SHALL RUN ONL Y TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY, LENDING INSTITUTION, IF LISTED HEREON, AND TO THE ASSIGNEES or THE LENDING INSTITUTION. GUARANTEES ARE NO' TRANSFERABLE TO ADDITIONAL INSTITUTlCWS OR SUBSEQUENT OWNERS. PALE BROWN FINE TO MEDIUM SAND SP UNAUTHORIZED AI' TERA TlON OR ADDITION TO THIS SURVEY IS A VIOLA TlON OF SECTION 720.9 OF TNE NEW YORK STA Tr EDIICA TION LA W II' CUr'/L" UI IHI:'; :';Vllvi Y MAr' NOI IJt.AHING 1111, I/iND SIIRVEWR,; EMBOSSED SEAL SNAIL NUT Nt CONe,mUltI) 10 8i. A VALID TROl' (~()P'( 2. 27 FEBRUARY 2003 SHOW PROP. DWELLING NOTE: I. 29 JUL Y, 2002 SHOW ADDITIONS .IJ/ S9 6'6'0 "" 'Sa' 77' vC/y If<, </9" '1 ~R ,f' I I , FOR S.C.D.H.S. USE ONL Y ,..------- ! 1 PJ i ('-I ! I;~ , ..~~ !~ 1....( I"'" , ,/..1 <: tl~ P f!;-I 320,36 ' ''-.-:r:.> 1"-, ,rt.. '~."I ;.....1 f. I' " > " t "'" '" ,> .;3' ~-l ~,. ':5 '.) ;;.) i.~,":i ~~ t:: , j.~r, I ~:) Vj :~F_' ',,~ ~i1 '0'1 ;:.~ "" '-'-- o..l ~ o g: I>., ..; lx. o ;Il f-' ~ ~ o K..: rv' ".j D:: ~-~) (:<; '....: p;J ~ ~,~ ,f;! ""p ..,...., {:) ~ ~ (J'J & e SURVEY OF DESCR/BED PROPER TY SITUA TE CUTCHOGUE, TOWN OF SOUTHOLD SUFFOLK COUN TY, N. Y. SURVEYED FOR MAGILL RESIDENCE eUe; ['elves CReeli \j) ~~.....l VI. <.0 .....l 0 ~ ~~ ..A <'" EXIST WOOD RAM \Yo cp.. '" ~~ 1::5 ~ '-i~ .e Y" "- 1- ')l... --1FLOOD MAP D.A TA FRC!J!L:fIR"tf!IIAPrfl6103C0164G ""'t:' '4:FFECTlVE DA TE 4 MA ~'4.998B c..." d. -.-\ ...., :t " ~o ~ ...,,-;0 -n ~, om 1.1' ::lE::x; :::0 r-n < T p~ , ~m 6' j i1 ~p ,r:- "'- 'J, d 3 ",c::. n"::' ::lE:x: ~ om p __ co SURVEYED ~ .0 ~ ~ J ;XJ - o. f'" z::' .- -< STANLr!J.riY. ISl4KSEN, JR. P. 0. B6ifI'294 NEW SUFFOLK, NY 11956 516 734-5835 ELEVATIONS IN 1929 NGVD SURVEY.ED 0.3 APRIL, 20Dl SCALE 1"=.30' AREA= 15,081.065SF OR 0..346 ACRES ~ o .< J OlC997 ~ Albert J. Krupski, President tit 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 Applicati9" _Wetland Permit Application ~ Major _ Waiver/ AmendmentlChange~ _Received Applic 'on:~ _Received Fee:$ -./ _Completed Application ( 1 _Incomplete _ SEQRA Classification: Type I_Type II_Unlisted_ coordination:(date~ent) - CAC Referral Sent: I _Date ofInspection: _Receipt of CAC Report: _Lead Agency Determination: Technical Review:~ Public Hearing Held:~ Resolution: Minor !JEC 3 I IH' " Name of Applicant /lLP~I::.2) 4. frl;9-(:/LL Address 70 0 6"L c.7J ("0 </ /Z- r CV77:.#' 0 Cue A./. '7'. /19JS Phone Number:( ) ~ 31- 73'/- C:- / <10 Suffolk County Tax Map Number: 1000- /37- O<{-2-fa Property Location: 1/ L/ r r L c.'=. r &./ 0 o.L) )20 4-LJ fJOL..t!::: #-/0 /..Fo/ /3€rrs ~ FLtE'E7r.JOO~ k'd. (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: - ~ Board of Trustees ApPlic~on GENERAL DATA Land Area (in square feet): /S. 0#/. t!)6S .sF Area Zoning: Previous use of property: RES /~ c7\JT/~L..- Intended use of property: RE3 /J) ~-.v r,. -9 L- 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: nre 3 , 1, " ,. Project Description (use attachments if necessary): RE; -.... 0 v ~ t!:)L.JJ /hvse- ,/ 4~oc../c:. rQv../...L)-;t-7/0-J / ///c!::v ~ 4::.-p Jt..". C C 4/ " 777 P (;) (/ /Z e-zJ C' "" ..v c.. /2 c.~"7F" FOt/,J.L)4-T7 o;J' '" ""4 /l/ C ~ /.4,....,r 0 ,.,/ ......a.n-S /C""-; L-L '" /7/-f S n,..-z ~ FoP/ p/Z" -v/ " , ~ Board of Trustees Applic~on WETLANDITRUSTEE LANDS APPLICA nON DATA Purpose of the proposed operations: ..2>e,.., D L '''''0'''/ DF OL-J> /.k>v.$c "7 -.--0 Co,..{ .s77Z.JJ c.-,- ~ ,.,; t::V /,<0,.., ~ D,./ 77/ E ..s~~ -&~/r Foa-r-P/l"""'/ SD.,O Area of wetlands on lot: ~.... square feet Percent coverage of lot: .3 3 % Closest distance between nearest existing structure and upland edge of wetlands: .....:;0 't: feet -'1 'Ide-Co Icy ~ CuT ou-'- .dc~ .r~/p /~6' 'TO E/J(;~:S C/26.C-/c /.,'1:.# t:../47li7L L../-.lt; Closest distance between nearest proposed structure and upland edge of wetlands: a 0 '!: feet I 'I r., 'FT. 's""'" E /1-S "kto.J C Does the project involve excavation or filling? No x Yes If yes, how much material will be excavated? ~t;; cubic yards How much material will be filled? No cubic yards , ' Depth of which material will be reIllilved or deposited:S - ? ifill:. feet Proposed slope throughout the area of operations: 7'E"S Manner in which material will be removed or deposited: RE~A/-.I"-'C ..sO/L I./n.L.. dE ,i2~-......o t./C:-=r:J /.S '? 77Zc.I~<- , , I L. "-"--.-- Statement of the effect, if any, on the wetlands and tidal waters of the to;n that may result by reason of such proposed operations (use attachments if appropriate): NOH€"- ...Lrur /M'f /;$i?-C.t:""3 4/ N~ L- ..ere ~.s ~'"7) -ro , ,.o/Zf.:Vc..-..J/ ~ j>" ,o"a.o a L6~ s /J-Ls 0 L).R.)' 4/6-z.L5 7l> co ,v7'Y-J,. ,,/ ,n -" '7 ;€os><>r- R",,J eJFr . . PROOF OF MAILING OF NOTICE ATTACH CERTll'lliD MAIL RECEIPTS Name: Address: 'pi/ILL If' (2:>E/1/Z.A R'It!cz..K'I ~7 V/,S,/I 41.qy "tORr iJ/1.sIl/;,,/C'7~,.J "Al If /loSO STATE OF NEW YORK COTJNTY OF SUFFOLK ALI::"~~) A P1/1-CILL ' residing at 700 ~L.~-..J tOcHz.:r C CJTC./f"oC vcr: .. A/ Y 1197$; being duly sworn, deposes and says that on the t1 day of ,q", oJ , 20!}1, deponent mailed a true copy of the Nonce 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 South old; that said Notices were mailed at the United States Post Office at 1t"J"rlt.;HC (/ E .. that said Notices were mailed to each of said persons by (certified) (re~ed) mail. ny ~~ \.-~_ Sworn to before me this '? ;-A-- Day Of~....,....u. r' 20.2.3- ~~~ 9:- ~ 'fcJ Notary Public ~ ':.~".;- QllIII(ed" SlMCiItI1f .g.. (>0.3 ~L", IlJlQle;QIMII:lIIO,_ . . PROOF OF MAILING OF NOTICE ATfACH CERTIFIED MAIL RECEIPTS Name: Address: ANNe 77C C4- F'LJCZ-L /.5'3 [//tN..cr 4VE ;C .</UZAL PA/z./<,. N.y' //00/ STATE OF NEW YORK COUNTY OF SUFFOLK /.JLP~L~'> A M/1-t:.":L , residing at 700 CL(:..J 4~/Z:/" C<.rre/l-ofvr N Y '(~}l, being duly sworn, deposes and says that on the e day of q-~.J. , 20DJ , 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 South old; that said Notices were mailed at the United States Post Office at ~-rr/141 tf'~C , that said Notices were mailed to each of said persons by (certified) (registered) maiL C:ty-_e ~ - q-. 'fL Sworn to before me this Day of 6~~' 200) ~pm,~" Y"l'i~1 !;,r..... '-"#0"" " '.JU6\..,AWM' ~ ...., Nlk. SldI ClIN1WYtIIt ~. No. 484lIOO8 Qded ~ SUllok ColrIIy ,) 00-" Da..IMb'a ExpIres March 20,_ .J , . . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: E I. /I / N E" /h1-rJ..s-EAf .s I( 1~8 FLcz:rNotU) -f'o4:Z) C:vT~//o6JC 1/7305- . ...vI:"'" yo/L/c. STATE OF NEW YORK COUNTY OF SUFFOLK -"LI:::/z'c:i) A. /7'1~"u , residing at 700 6L~--../ Co<.ucr C(Jrr~/-06'cJC ,AJ't /(9:1;-, being duly sworn, deposes and says that on the 8 day of ::T,IJ.AJ. ,2063, 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 r~ll of the Town of South old; that said Notices were mailed at the United States Post Office at ~<rrz/h CJ E , that said Notices were mailed to each of said persons by (certified) (regi6tered) mail. Oo~ . .L-~2_ y0- Sworn to before me this ~ DaYOf~,20~ ~r2, ~. Y~t wJ Notary Public "..,~;-. LlleAI. TA4lWIf ... Nlla.lI1BIt a1N11rYllt No. 4848S08 ,} ecm:~~"O) 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------- In the Matter of the Application of ~~~~~;~~----- STATE OF NEW YORK) AFFIDAVIT OF POSTING I,ALr:'IZ.CD'<}. M/Jelil-, residing at 700 6L.~~ ~/Z.-r C U7Z/,H:7 Cu tr , "T , N ~1-./ Vo.tt.L'L 1'19:1 r being duly sworn; depose and say: That on the /0 day of ..:rAw , 200..1, I personally posted the property known as /I~S" ,rL/;;.1::'rwo').Jj ;at. c'..n-r~~. CvF /~7- o~~ Z~ by placing the Board of 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~ ,A. Rublic hearing. Date of hearing noted thereon to be held TV) ~ (rv t1 ffv.-r "/ 0 ~ f>1 . Dated: 1110/03 Sworn to before me this II;:) day of JonvCtc'1 2003 air f. J~ Not Y Public ltv? , OO-f-...-.fL ~ (signature) Notary JUNE E. SAYR"- ~ State 0/ ~I.w Ydr Q.."n-d: 4948505 ~""" IIlSull t'<:;lmJ."" r:,,", v!h ~ ~'",I=It~t""/~3/~ .- ;1 JAN I :3 l;rn-!> ie,"; L..-.~.- , . ~ Board of Trustees Applic4llon County of Suffolk State of New York /h-Ffi-fc--:D /9. /1? /JC / L c.... BEING DULY SWORN DEPOSES AND AFFIRMS TIIAT HElSHE IS TIIE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND TIIAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO TIIE BEST OF mSIHER KNOWLEDGE AND BELIEF, AND TIIAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TillS APPLICATION AND AS MAY BE APPROVED BY TIIE SOUTHOm TOWN BOARD OF TRUSTEES. TIIE APPLICANT AGREES TO HOLD TIIE TOWN OF SOUTHOLD AND TIIE 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 TIIE TRUSTEES, TIIEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT TIIE PREMISES IN CONJUNCTION WITH REVIEW OF TillS APPLICATION. o n.t7 ---e q~ T Signature SWORN TO BEFORE ME TillS '3 / DAY OF "';:>~---z. ,20~ z- JUNE E. SA YRf: NlllaIY PubIlc. StaI8 01 New V4'1l1 No. 494850; QlalIlIed In Su\IOIk County r.ommlsslaR EJiIllra 3/Ut'il3 ~~ary~d~ PROJECT 1.0. NUMBer; .7.21 SEa H-~6.4 (21871- Text 12 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I-PROJECT INFORMATION (To be completed by Aoplicant or Project sponsor) 1. APPUCANT 'SPONSOR 4~ P/?O /I. /?1/1-(; IL'- I 2. PROJEC7 NAME .J>/9 -./..1) .4 3. PROJECT LOCATION: "'un'elp.lIIy C.rrt../~ C"c.I C County ...s., I'="I="D"-I<- 4. PREC:SE lOCATION (Street address and road intersections, prominent landmarks. etc., or proviae map) /1.yS'"~Uc-rt,/oO.J:> KcAd:J, ~CJ7Zlt4JC.J,", ,.J.y. 5. IS PROPOSED ACTION: [2 New 0 Expansion o Modifieationialteration 6. DESCRIBE PROJECT BRIEFLY: h --~...,..." &JL,r/O,.J DF 77/c D&-..j') ./~"'.,$~ A-a 'CC-J77't.vc..r ~ Nt"-?.I /k~C ''''''; 77/E .s'?~tC ..,r"T-r c..Q.. ,;CcO'~/t'.....Jr 7. AMOUNT OF LAND AFi=ECTED: Initially acres Ultimatelv acres A,) tl} . 3. WILL ~RO?OSEO ~CTION COMPLY WITH 2XIST1NG ZONING OR OTHER 8<ISTING LAND USE ::1ESTr:tIC7iONS? ~ Yes U No If No. describe briefly 9. WHAT IS PRESENT LANQ 1;$: iN VICiNITY OF ?c::OJECT? ~ :=!esldenlial L..!.!ncus:nar r--: Cummerc:al Describe: ~ Aqncw:ure I ?:3rKIForestlCoen scace _ether 10. DOES ..:..CTION INVOLVe A ?r:RMIT ~PPRQVAL OR FUNDING. ;~OW OR ULTIMATELY .<::"RQM ANY OTHER GCVERNMe~TAL. AGENCY (FEDERAL 57 A TE OM LOc..:.U? 00' Yes U No If yes. list agency(sl and oermiUaoprovals ~ E"IL..IJ""" 0 I Tn. -.J~ T1:-C; .1' ho""'11.""'" r F/I.e-r fOrJT1/-oL.l:) /"'Dv"; - '..J>~ "".-/ ..:J'c.J.ft.,S"C"l,.,OA../ ''''-~''''A..-t..t:} Or ,y' ,,=--z.~-V~r,oN 7'P;'-1 t:I,&:" 4n~~.c I~DAtlC"-t;-rc k/,.",- 11. DOES ANY ASPECT OF 7HE ACTIQH HAVe A CURRENTLY VAUD PERMIT OF! APPROVAL? o Yes ~ No If yes. list ageflcy name and permiUaoprovat ;2. AS A RESULT OF PROPOSED ACTION WILL S<1$TtNG PERMIT/AP?ROVAL MEOUIRE .'ADDIF!C;. TION? DYes ~NO I CERTIFY THAT THE INFORMATION PROVIDE!) AeOVE IS THUE 7"0 THE 3EST OF MY KNCWL'::DGE Applic3nusponsor name: A~FH.c") /I. Ma-{;,ILL. D.,., .f)f,c. ~!:l , 2..004.- SIgnature: If the action is in the Coos tal Area, and you are a state agency. complete the Coastal Assessment Form beiore proceeding with this a.~essment OVER " . llrrttcllN'l' TRANSACTIONAL DISCi4ItnB FORH The Tovn of Southold's Code of Ethics rohibits conflicts of nterest on the part of town off cers and employees. The purpose of this form is to provide information vhich can alert the town of possible conflicts of interest and allow it to take whatever action Is necessary ho avoid S8Me. TOUR MAHRI M/J.6/LL AL,c,e ,,"':/1; Last name, first name, m dd~e you are applying in the name of someone else or ether enHty, such ~s a company. xr so, indicate the other persoh's or company's name.) NATURI 0; APPLICATION. (Check all that applY.) . ;,:;~~~!.::-~~'.i..:'~}.:'~; Tax grhvance Varhncs Change of ",ene Ap.P~I"'a1 of pbt ~ . .1- Bxe~ption from plat or official map ~ other ~ (If "other," name the activity.) .4",...,O,"'CPC-'7VcIT' foJ"""'-v(JJ t?C~."I Do you peruorta11r (or'through your COMpany, .~u.e, aibl1ng. parent, or child) ha"e a relationship vith any officer or eMployee of the Town of Sou~hold1 -Relationship. includes by blood, .arriage, or business IDtereB~. -Dusiness interest" means a buainess, including a parbnership, in vhich ~he tovn officer or employee has even a parbial ovnership of (or employment by) a corporation in vhich the tovn officer or e.ploTee ovns more than 5% of the shares. YBS NO -25- If you ansvered "fBS," co.plete ~he balance Uf ~hid form and date and sign where indicated. Nams of person empluyed by the Tovn of Southold Title or position of that person Describe the relationship betveen yourself (bhe applicant) and the tovn officer or employee. Either check the appropriate line ~) through D) and/or describe in the epace provided. The tovn officer or employee or hid or her dPOUSS, sibling, parent, or child is (check all that apply). ~) the owner of greater than 5% of the sharea of the ----- corporate stock of the applicant (vhen ths applicant is a corporation), _____B) the legal or beneficial owner of any interest in a noncorpora~e'entlty (when the applicane 18 not a corporation) I _____C) an Officer, director, partner, or a.ployse.of the appUcant, or _____0) the actual applicant. :.... . ::~~:'...' '-n .... DESCRIPTION OF ItELATIONSIIIP . ',.,. '. ,-.. .'--~ ~. - ~ '.. ... . .......,.:~'-1-:. ~ . J.'" I . "::h'~:~'-~~:: sub,.i Hed .' ,." "';';;"'''1'':';'''' "',,,;''''';'. :"~1>i~-"Jii;c . '.~::-;.:"';' 'r!t:.~J::!t"'l'::.l ~;:'l -:;<l(.', If'f: thia,,'3:'!~a( '~?-.19~ '"Z.....- sigllBture '.' . -. - - " "A~;c, : ";""J;ii~~,,~.:.,..".:,;~. 'Prinb ham". . '.. .~~.~.::~_..__. .' ~ ,:;<,~...;:~_...-.,;~:. :~f;.~'~"." .' : :~t,if.~.l:":l~';1,tt~ 9i;;lt' ,.&. .t~'.:...'- ..~,,',..~'." ..... ,.\' ;~'. _ oi .;.~., T', U':. '.~ :' . ..';,('., .....1fJ.... I ..~". .' . i 68.1 NOTICE OF PUBt HEARING i 58.1 Cbapter 58 NOTICEOFPUBWCHEMUNG '58-1. ProvidIng notice of public bearJnp. [BISrORY, Adopted by tbe Town Boud of tho Town of SouthoJd 12.%7.1995 as I.I. No. 25.1995. Amend:oenlo noted where applleable.) f 58- J. ProvidIng notice of public hearlngll. Whenever the Code calle ror a public hearing, this section shall apply. Upon determining th.1 an appUcation is complete, . the board or commission reviewing the same shall fix a time and place for a public hearing thereon. The hoard or commlssi.on 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 publiehed In the official neW!paper within the period prescnbed by law. . B. By requiring' the applicant to erect the sign provided by the town, which shall be prominentJy 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 ,hall be di8pla~d for a period of not less than seven (7) days immediately pteceding the date of the public hearing. The applicant or his/her agent shall file an affidavit that slbe 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 i 58.l SOUTHOLD CODl'; 168.1 from the property included in the ~ppUcation. S~ch notice shall be made by certified mall, return receipt requested, posted at least Beven (7) dtlys prior to th~ date of the initial public hearing on the application and addressed to the owners at the addrnae5 listed for them on the local assessment roll. Tbe applicau;\t or agent ,hall file an affidavit that s/he has complied with this provision. ,~