HomeMy WebLinkAboutTR-5814
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Board Of Southold . Town Trustees
SOUTHOLD. NEW YORK
PERMIT NO. p S$.J ~ p.
DATE: 9~.t.().b<:rh.n,... 2003
U STEPHEN A. CUBELLS
ISS ED TO hhhhhh.h....P.hhh.hh.h...Ch.h.......hhhPh.h... .h. h.hh...h...hh......h.. h.hh....
Aulqoritatiou
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York. 1893; and Chapter 404 of the Laws of tha
. State of New Yon: 1952~ and the Southold ToWn Ordinance en-
titled -"REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBUC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;!:; and in accordance with the
Resolution of The Board adopted at a meeting held on ...Qf.j;.QQgr....22, .
2003........~.. and in consideration of the sum of $..~.~.~.:.~.~...... paid by
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of .........~~~.!~.!~.C;~......n........hh....h....... N. Y. and subject to the
Terms and Conditions Gsted on the reverse slde hereof.
of Southold Town Trustees authorizes and permits the folowing:
Wetland Permit to cut phragmites .to 12" and maintain phragmites
tOl~" height up to the landward' point of the dock, which shall
remal;n no less than 12".' and with the condition pictures are
siWm1ttrr upon completion of the project and every six montlis
earn :&:ordance with the detailed specifications as presented in
. the originating apprlCation. .
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corf>Ol'atc: S~al to be aff.ixed. and these p~esents to
be subscribed by a mlllority of the said Board as of thIS dat.e.
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TERMS and CONDmoNS
Tbe Permittee Stephen A. Cubells
residiag at 2475 Bay Ave., Mattituck N. Y., as
part. 01 1be coasideratioa for 1be isS>'.~ of &e Pamit does l>~nd attd ptaalbc to 1be fol.
lotriog:
1. That 1be said Board ol TtuSteeS attd &e Town ol Soutbold are R1caed from lAy attd
all damages, ClC claims for damages, 01 suks arlslag dltecd7 ClC 1acIl.tecd1 as a ~ 01 lAy opet-
adoa petfom>ed pmuaat to tbls petmit, attd che said p.. .1_ 1ri1I. at his ClC her own eq..,,~.
defend lAy aOd aU IliCh salts.,,,;.loted by tbi.t:d patties, attd 1be said p...... !f1.C .- fuI1 Uahil/tJ
wich reipect thereto. to 1be ~'exdusioo of 1be Board 01 'iiasttes vl1be To'RIi ol ~
2. That tblsPetmlt Js'TIlid fOe a period of 24 mol, wbich Js Cllarl-\.-ed to be the
...;_."" time. requirallo complete che wod< 14~ but 'iboaJd~ wamat, ~ .
for an -.ioa ma1 be made to che Board at a later dalIe. .
3. That tbls Permit should be rdaioed l4deflnitel" or' as loog as che said h...duee wlsbes
to . _......In the sttueturC or I project 14,.olvec!, to provide mdeace to aD)'OIIC cnncemed chat auch-
.oriZatioa was origlnall1 obtal4cd.
4. That &e wodc .hm>lTed will. be subject to1be ~ attd appron1 01 che Board or
its agents, attd ooa-cxxor'I."O'" with.1be ptoTisioas vi che orlg/...fl~ applkatloa,. mqbe cause for
rewcatioa of tbls l>emdt by ~utioa 01 the said Board.
s. That thete will. be no UIICCUOlIIhle 14terfereoce with ....~ .. . resok vi che wodo:
. betela aUtborited.. . . .
6. That thete sba11 be DO lmerfereoce with the right 01 1be publlc to pass attd npus aIoog
che beach between hl&h attd low water marla. .
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7. That if future operatioas ol che Town of South9ld reqaire tbe 1'CIDOft1 attd/ClC akeratioas .
ill che location 01 che wod< hetel4 ..~"'\ or if, 14 che oplnlnn vi the Board ol TIustees, the .
1lVtk shall cause uomIsoubIe obsttuctlOCl to. free uviguioll. che said PmDittce wl11 be recpdRcI,
upon clue IIOtia, to remove or. alter tbls wod< or project betela stated 'lrichout g.j..ellKI to che T_
. vi. Souehold. .
8. That che said Board will. be notified by the p.o.-I..... ot ihe cocapIedoIl. Of che work IUlh-
odzed.
9. That che Permittee will. obtain .U ocher pe<mits attd c:ot><eP~ chat mar be requiraI ~
pIemetUaI to chis permit wbich ma1 be subject to revoke upon flilute to obtain same.
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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
October 22, 2003
Mr. Stephen A. Cubells
2475 Bay Ave.
Mattituck, NY 11952
RE: 2475 BAY AVE.,MATTITUCK
SCTM#114-4-5
Dear Mr. Cubells:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, October 22, 2003 regarding the above matter:
WHEREAS, STEPHEN A. CUBELLS applied to the Southold Town Trustees for a permit
under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the
Town of South old, application dated September 18, 2003, 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 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 standards set forth in Chapter 97 of the Southold
Town Code,
2
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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 approve the application of STEPHEN A. CUBELLS to
cut phragmites to 12" and maintain phragmites at 12" height up to the landward point of the
dock, which shall remain no less than 12", and with the condition pictures are submitted upon
completion ofthe project and every six months thereafter.
Permit to construct and complete project will expire two years from the date the permit is signed.
Fees must be paid, if applicable, and permit issued within six months ofthe date of this
notification.
Inspections are required at a fee of$5.00 per inspection. (See attached schedule.)
Fees: None
Very truly yours,
~9~.t}.
Albert J. Krupski, Jr.
President, Board of Trustees
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STEPHEN CUBELLS
KAREN CUBELLS
CHICAGO TITLE INS. Co.
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HSBC MORTGAGE CORP. (USA)
ROCHELLE PLACE
0.87 +/-
REV. 4/04/03 ADD BAN
SUFFOLK COUNTY TAX MAP
1000-144-04-05
DATUM -
JOB # 203107
E OF WETLANDS, RiGHTS-OF -WAY, AND/OR
ANY NOT SHOWN, ARE NOT GUARANTEED
37920 +/- S.F OR
ACRES
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GRAPHIC SCALE
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( IN FEET )
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DESCRIBED
PROPERTY
situate
of SOUTHOLD,
NEW YORK
SURVEYED MARCH 29, 2003 BY
TECHNICAD LAND SURVEYING, P.C.
PAUL W. WERLER, L.S NY5 LIC 049875
126 UNION AVENUE
CENTER MORICHES, NY 11934
(631) 878-2847
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Telephone
(631) 765-1892
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
CONSERVATION ADVISORY COUNCIL
TOWN OF SOUTHOLD
At the meeting of the South old Town Conservation Advisory Council held Tuesday,
October 14, 2003, the following recommendation was made:
Moved by Don Wilder, seconded by Tom Schlichter it was
RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of
the Wetland Permit application of STEPHEN A. CUBELLS to cut phragmites to 12" and
maintain phragmites at 12" height.
Located: 2475 Bay Ave., Mattituck. SCTM#144-4-5
The CAC recommends Disapproval of the application because cutting the phragmites
would be destroying the wetlands.
Vote of Council: Ayes: All
Motion Carried
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NOTICE
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Police Dept. - Bay Constable
lbwn of Southoldl ;.,
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Peconic, New York 11958
NOTICE" OF ~OLATION
Date:
7/Y~3
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57[I)c-~/U
(! JtleJJe;
(Owner or authorized agent of owner)
Address: :J
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(Address of owner or authorized agent ,9f'Owner)
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Please take notice ,there exists a Yiolationof the Code of the Town of Southold, Chapter 97
.
Article II, Section 97-20 a premises hereinafter described in that c.' Y4/t /N" -1/J S-
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ply with the following: 57';;>.I',I? / / f- eM' L .
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You are therefore directed and ordered to co
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on or before the <-/ 2. day of 'r7~J:, ,20 tJ 3 .
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Tb.e premises to which this N;otice of Violation refers are situated at:
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Town of Southold, Suffolk CountY, NY (Suffolk County Thx Map Designation: Dist. 1000
Section: >' Block: Lot: )
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Ftjure to Comply with the applicable provisions of the law may constitute an. offense pqnisQ. ....iab. ,.le. bY..' ~..~.' .'.
or Imprisomnent ol'both; NOTICE: You have the right to apply for a hearing befor.~~<<'~l'aQf 1tustee~
of the Town of Southold, provided that you file a written request with the Clerk cIlile 1h1stees within 10.
days after service of the Notice of Violatiol). Such request shall have annexed tl1ereto<ioopyoJ;the Notice
of Vjnl~n upon which a Hearing is requested and shall set forth the reasons why such' notice of viol~,.
tion sHOuld be modified or rescipded. ' ',.dy .
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To In of Southold
Suffolk County, NY
k 2080
- .. . TIle People DIllie Slate of New Yorho,
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AlbertJ. 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
May 30, 2003
Dwight Isacksen
551 Shore Drive
Oakdale. NY 11769
Re: Stephen Cubells
2475 Bav Avenue
Mattituck. NY
SCTM#144-04-05
Dear Mr. Isacksen:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held May 21,2003.
RESOLVED, that the Southold Town Board of Trustees Approve an Amendment to Permit
#4291 to extend a 12 foot ramp and attach up to a 6'x20' float, two six inch pilings to hold the
boat in place - as per plans submitted - May 29th, 2003 - transfer Permit 4291 from Joan
Halligan to Stephen Cubells
This is not a determination from any other agency.
If you have any questions, please call our office at 765-1892.
Sinc.JJfe.e~l. (J.
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Albert J. Krupski, Jr.
President, Board of Trustees
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PO box 1179
Southold, NY 11971
May 18,2003
MAY 2 3 2llO3
Dear Town Board,
IGutIlold TOWI
loan! 01 Trustees
We recently received notice that our new neighbor, Stephen Cubells, is seeking
permission to build a very large dock, SCTM#l000 - 144-04-05. We object to the size of
this proposal; we feel that this project is too large for this area and that allowing a project
of this size binds the board to allowing us and anyone else on James Creek to build a
similar project.
Mr. Cubells has a shallow water dock. He is seeking to extend this dock out into
the dredged channel for a total of 123 feet (80 current feet, 30 feet extension and 13 feet
piles = 123 feet.) We believe this huge dock will make the area look like a marina.
There is already a marina diagonally across the creek. We do not need two.
Again, we object principally to the size of this proposed dock and hope that an
alternative plan can be accomplished.
Yours truly,
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Frederick M. tanley and
Dale A. Hanson Stanley
1001 Hancock Ave.
Franklin Square, NY 11010
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MAY-20-2003 rUE 04:25 PM rHI~D HOUSE
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FAX NO, 121229435
p, 02/02
I SALT LAKE LANE
ROCHELLE( PLACE(
MATTITUCK
N.Y. 11952
May 20 2003
Ref; STEPHEN CUBELLS
SCTM#1000-144-04-05
TO T.!:!!:..BO~~}> OF ~RU~TE~S, T()\1VN o!:. SqUTHOLI?..:
Our family has lived on Bay Avenue, Mattituck since 1990. Our property lies next door but
one [Q the applicant's, and we have a view over the Creek. We have read Mr. Cubell's Proposal to
extend his dock.
If Mr Cuben extends his dock as he has described, "extending it by 30', installing an 8'x 30'
float, and instal/i'lg 2 outboard piles 13' from the float"- will this give each homeowner
[hat borders the Creek, (on both sides) license to do likewise?
If this happened, the Creek would rapidly resemble a Marina, with the accompanying water
pollution and gas fumes,
The James Creek is not very wide. We feel that if the Board of Trustees allow the proposed
dock extension, the character of this working waterway will he irrevocably changed. For these
reasons wc oppose this extension,
sincerely
~~~/f/l~
Caroline Bowyer and Murray Greenfield
-
MAY-20-20Q3 TUE 04:24 PM THI~D HOUSE
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FAX NO, 12125229435
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1185 Avenue of the Americas 27th Floor New York, NY 10036
MAGAZINE
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Field Inspectio' 5/14/03
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Telephone
(631) 765-1892
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971
_ SOUTIIOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the South old Town Conservation Advisory Council held Tuesday, May
13,2003, the following recommendation was made:
Moved by Melvyn Morris, seconded by Bill Cook, it was
RESOLVED to recommend to the South old Town Board of Trustees DISAPPROVAL of
the Amendment Request of STEPHEN CUBELLS to Amend Permit #4291 to extend
the dock 30', install 3'X 15' ramp, an 8'X 30' float and two outboard pilings.
Located: 2475 Bay Ave., Mattituck. SCTM#144-4-5
The CAC recommends Disapproval because the extent of the proposed changes
requires a new permit.
Vote of Council: Ayes: All
Motion Carried
.
.
ISACKSEN DOCK BUILDING LTD.
Sp,a1glliln, In
Morin. Con.cru.llon and C...ral ConIMl.lln&
551 SHORE DRIVE. OAKOALE, NY 11769
Phon..: (631) 589-6201 - (631) 563.1164
FIX: (63\) 519-6201 .
Date: 1//' ')../ 0 ~
I, S-+~-p \k.t>J A-. C\.l.{>~A\~
(print name)
. ..uthonte
ISlIc::ksen Dock Buildinil to lIlCurt the ncc::cssvy permits for my proposed
waterfront construction
Site of proposed
cOnstruction:
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Home phone G" I - l{,3 - II '1 ~
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CERTIFIED TO:
STEPHEN CUBELLS
KAREN CUB ELLS
CHICAGO TITLE INS. Co.
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ROCHELLE PLACE
THE EXISTENCE OF WETLANDS, RIGHTS-OF -WAY, AND/OR
EASEMENTS, IF ANY NOT SHOWN, ARE NOT GUARANTEED.
ZONING -
LOT AREA -
37920 +/- S.F. OR
0.87 +/-
ACRES
25.1'
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STANLEY
GRAPHIC SCALE
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( IN FEET )
1 inch = 40 ft.
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DESCRIBED
PROPERTY
J
h
situate
~
,
HAMLET of MATTITUCK, TOWN of SOUTHOLD,
SUFFOLK COUNT~ NEW YORK
~
~
'"
~
SUFFOLK C UNTY TAX MAP
1000-144-04-05
DATUM
JOB # 203107
~
f~
SURVEYED MARCH 29, 2003 BY:
TECHNICAD LAND SURVEYING, P .C.
PAUL W. WERLER, L.S. NYS L1C 049875
126 UNION AVENUE
CENTER MORICHES, NY 11934
(631) 878-2847
FAX (631) 874-4164
:~
"
~
,.
'"
~
.
.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
Coastal Erosion Permit Application
/Wetland Permit Application _ Major ,- Minor
Waiver/Amendment/Changes
~ceived Applicati n' I,g/~
Aeceived Fee:$
-"Completed Application
_Incomplete
_ SEQRA Classification:
Type I_Type I1_Unlisted_
Coordination:(date sent)
....cAC Referral Sent:. tt//8/Q:l
Alate of Inspection: #'II IS 10.3
_Receipt ofCAC Report:
_Lead Agency Determination:
_ ~chnical Review:
_"f>ublic Hearing Held: IO/A.~03
.
Resolution:
SEP 1 8 2003
...
.. " TnI_
Name of Applicant S'-+t'p ll-l> ItJ A , C lL /':....( \ l ~
-
Address 6?J) :}4, S b A-~ Au-e. ~~-\--10 ~d(... N. 'i,
PhoneNumber:( )~-4,3-'IS('
Suffolk County Tax Map Number: 1000 - \ 44 - (') L{ - 0 .S-
IlSs-'#
Property Location:
:71t I :s-
e,p,.~
A-v-.L
.. ~\+""ck..
~
~~f)l~~
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone:
.
.
Board of Trustees Application
GENERAL DATA
Land Area (in square feet):
377d-O
Area Zoning:
~
f7.!.'>,('~,tvL
Previous use of property:
S Q h....L II- <;.
41.0 II\A.R
Intended use of property:
S"...k-c- AS
l<100~
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~
Project Description (use attachments ifnecessary):~ "". \.S. v_ -4
Cu..t- Plff~ (\A., k! +0 IJ II /.J...e'"5iJ4. oJ
-
fV\q w-+e. , "'-.
f 14-rCA. j""" -l-<.:.
44
),J-" tk'9-m
.
.
Board of Trustees Application
WETLANDffRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
~ ~~+-.J
+0
SIO
It 1l.JiI'~+-
~ -+(~
1-hJ\A1A.
-
u.-h.d.- {,f
"So
<
lac .IVk el'
If'^-
~\",,-<J d.,x.,\<...
Area of wetlands on lot:
3 ()'ZT1J
square feet
Percent coverage oflot:
J~
.
%
Closest distance between nearest existing structure and upland
edge of wetlands: / f4 0 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: feet
Does the project involve excavation or filling?
'f
No
Yes
If yes, how much material will be excavated?
cubic yards
How much material will be filled?
cubic yards
Depth of which material will be removed or deposited:
feet
Proposed slope throughout the area of operations:
-
Manner in which material will be removed or deposited:
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):
N1J
-&~-<~
b-.....
~ [)J-e...--\- lA-J~
.
.
Board of Trustees Application
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity: 1V
LIAr
P Hr-t..-j ~-ko
-=l-o
I'
I';}
u.e '7'/-H-
Are wetlands present within 100 feet of the proposed activity?
No 'fl Yes
Does the project involve excavation or filling?
'fJ No Yes
If Yes, how much material will be excavated?
(cubic yards)
How much material will be filled?
(cubic yards)
Manner in which material will be removed or deposited:
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
N1J)....e. -
-
.
.
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
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
---------------------------------------------------------------
In the Matter of the Application
of
----~t~D___~~_~lb---------------------
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
\5),!:C E I H ~
l\ru OCT 2 0 2003 IlW
AFFIDAVIT OF POSTING
I, 5.J.p1Pw Gtdle/ {S , residing at
-
VV14-44-. ,.j.,..u IL JJJ -'1.
being duly sworn, depose and say:
-/11;.
That on theJ3 day of tJ c f. , 200:3, I personally posted the proJlerty known as
'() 'I';: ~ Yl1c<.J4-,'+..-..-~fL , II
by placing the Board of Trustees 0 cial poster where it can easily be seen, and that I have
checked to be sure the poster has remained in place for eight dal~ prior to the date of the public
hearing. Date of hearing noted thereon to be held t 1 ,ca" ~...( ~ ~ ~ -
()C"\ or ~CUt I)' tI
lf7s
Southold low.
Boanl of Trustees
Dated:
~~
( signature)
Sworn to before me this
1'-/ dayof~~
LORI A. HAYOE
No. 01 HA6061205
Notary Public. State of New Yort<
Qualified in Suffolk County
My CommlsaJon Expires 07/1612001
.
.
NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applicant: 5'+ep ll<-v- Cu-e.A 111
~~..,~
€>~ ~ /'^c#-h-d'- SCTMUOOO- Of..( -D's-
YOU ARE HEREBY GIVEN NOTICE:
.
1. That it is the intention of the undersigned to request a
Permit from the Board of Trustees to:
Cu+ plt"--<"jr""k~ to Id'"
(Y\c.~~ /'J" /.k';iltt--
,
....
I-H-\ ;, }/4- Ci.,....,t
2. That
Review.-is
follows:
the property which is the subject of Environmental
located .adjacent to your property .and is described as
';}l.(1 S-
'if '30 s:
~~
~~ .-J
AV-L
It~
fVI.~+t..~I'- N. 'i
Me..-\+. t... d-- N. ~ ( .
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: ~)Je.l.V Gl.t.ae\U.
MAILING ADDRESS: ~nS ~~ A~
~~(IL N."" - It ~:;l.
PHONE #: 1t>31-Y")'3-JI<'1D
Ene.: Copy of sketch or plan showing proposal for your
convenience.
.s
.
.
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name: (l'I(l. <<. ""\C.o;.. ~t;I'U' I/"
~4.,> _ e.~ ~v<-
Il<>c..++, n.,<.... (V.-(. It 'I S .7
Address:
d'lr:) l'>Aj Av<.
/1Ac-.v.n +.. cI~ N. '(. It C, s- ~
N\\'l 'f J'hVl-S. r'I^"r4<r1~
~,0';- B~ I'r~
v\'\.~h..dL N.'-<, I \ ~~;).
}"30'S'
e.1t~ '+'-<'
M...++.+n..(L N.,!.
, ,.. S",;;l-
STATE OF NEW YORK
COUNTY OF SUFFOLK
5+c,Ju- C...4-<('\ ,residing at ,+\() {' P..AJ /h.........
I'hc.:.h.i... ,k /V'Y. ('S ,~ ,being duly sworn, deposes and says that on the
IF _ dayof ~b-o.-- ,20~deponentmailedatruecopyoftheNotice
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 ClfSouthold; that said Notices were mailed at the United States Post
Office at /J1e, .fhA,Ic. IV- y. , that said Notices were mailed to each of said persons by
(certified) (registered) maiL
~b_
Sworn to before me this ,~
Day of ~~< , 20fZ;L
~(~~A.j*
Notary Pub 'c
LORI A. HAVDE
ND.01 HA6061205
NoIaryP.bIIc. Sta18 of New_
Q.Olmed In Su'olk ~-.
My Cammilllon Expirea 07/1 _ I
.
.
.<
1-4-16.4 12/8n- Text '2
I PROJECT I.D. NUMBE'1
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)
SEO
,. APPLICANT !SPONSOR
I 2. PAOJEC7 NAME
J. PROJECT LOCATION:
Municipality County
4. PAEC:SE LOCATION {Street address and road intersections, prominent landmarks, ele., or prQviae map,
5. IS PROPOSED ACTION:
o New 0 Expansion
6. DESCRIBE PROJECT BRIEFLY:
o Modification/alteration
7. AMOUNT OF LAND AFr=ECTED:
Initially acres Ultimately acres
a. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
[J Yes 0 No If No. ~escribe briefly
9. V-lHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
[J Residential O.!ndusUial 0 Commercial
Describe:
o Agriculture
U Park/Forest/Ooen space
LJ Other
10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,
STATE On LOCAL)?
DYes 0 No If yes, list agency(s) and permiUapprovals
-
..~
11. DOES ANY ASPECT OF THE ACTIOf-l HAVE A CURRENTLY VAllO PERMIT OR APPROVAL?
DYes. 0 No If yes, list agency name and permiUapproval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE .'v10DIFICATICN?
DYes DNa
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE aEST OF MY KNOWLEDGE
Applicant/sponsor name:
Date:
Signature:
If the action is in the Coos tal Area, and 'Iou are a state agency, complete the
Coastal Assessment Form beiore proceeding with this a~~essment
OVER
PAMT 11_=NVIRO~~MENTA' .S3MENT iio Oe c:Jr;-;:le!eC ~'I Age:!c' .
"". ::leES AC7;CN ::::":C;:;:.=.::: ';"NY ,,'::S, 7i-1;::.E.5i-iOL:) ~N -5 .'f'~C2? .::l;r=.T '5:7.':-: ;1 yes. :OCfOlnalS :ne re'tIl~'N :roces:J ana 'Jsa :r.e ~:JL:.- :::'Hr.
'Y-!s 1-,\40
:. 'NIU... ..:..C71CN ~E':;:;::V= ':;::CHOINA 7";::J ;:l:E'/IC'N AS ?RC'JIDE0 ....':n UNL;ST2,:J ,.;C71CNS iN 5 .'l"fC2R. .~.~;:;:, .;: i.57
may tie suoersecec -::;y :!.nOlr:er ;nvClVea a<;ency.
L..! Yes L.; No
C. C':ULD ACTiON .?ESUL7 ::-1 ~NY ADVeRSE ~;=::~G'iS ,.\$5CC:;.. 7:::D '.VI7H -:-:-:E .=.JLLCWI;-.lG: (Answers :nay ::e .,anawrntefl. ;/ :eqJclel
C1. E;cisting 3.ir quality. 'iurtaca ,jr grounawa[e~ ::ualily or .::uanllty, .,oise ie'/els. ~xls:ing :.affic :::anerns. sclid....aste jfOct.:c:::::njr J!s~::
pOlenllal lor ~rosien. ;:ralnaqe or :loadinq "recterns? S'totaln :Jrietly:
il ,'~o. 3. .,et;.3.t:...e -:ec:ar::
C2.. Aesthetic. agricultural. :Hc:laeoJogiC.:l.I. ;'istorlc. jr other ;'latural :)r cuitural ;esources: or c::lrnmunJty or ;'leignccrnooa c~arac:er1 :::.xolaln ~.
C:::. Ifet;elatlon or :auna. :Isn. Sl'!eJlfisn or wIldlife Suedes. slgOlficant ~aoitats. or ~hre3lene<:l or ~ncanc;ereo soec:es? Stetaln :lrlarly:
C..1. A c::mmunHy's existing ;:IlanS or 'Joals as o1flc:aily adooted. or a anange in use or intensity oj use of tand or other natural resourc8s? Explain :::r
CS. Growlh. subsecuent"Jevelooment. or related ac:i'tilies likelY to oe inducea by tne orocoseo ac:ion? :xolaJn oneily.
.-.#~. I..ong :erm, snort :erm. ..:umuialive. or alner ~ifec,s not icentifiea In C~.C5? :XOI3.n oneil',.
...... Ctr:!!!~ :rnoac:s ;jnc:~cinc; c:-:anges In 'Jse 01 :!lIther qcantily .')r :ype at =nergYI? S::lialn :::rietly.
il
.J. ;5 THERE. SA is 7HERE. '_:KcL':' 70 3E. CONTMOVE?SY ~E~IED 7"0 ?QTEN7IAL ;.QV5.RSe :NVIRONMENT;'L ;.'.1P~C7S?
:--' Yes
;_No
:t ':"'es. ~xcl3in :Jrieily
PARi III-DEiERMINATION Ol;..SiGNIFICANCE (To oe comoleted by Agency)
INSTRUCTIONS; For e3c:l adverse effect identified above. determine whether it is substantial, large. :mcortant or otherwise signific.
:ac;, eifec: snouJd oe assessed in connection witn its (a) setting (La. urban or rural); (b). probability ot occ~g; (al duration'
irreversibility; (e, geogracnic .3coce: and (f) magOltuce. If necessary, add attachments or reference supporting materials. ::1sure
exolanations ccntain sufficient de!ail to snow that all rele'lant adverse impacts have been identified and adequately accressec.
-'
C:'eCK this box if 'fOU have identified one or "'ore ;.:::otenrially large or significant aC'Ierse imoac:s whicn MA'f
oc::ur. Then :Jrcceea direc:Jy to :he FULL =AF :ind/or prepare a positive- declaration.
C~ec:< this !:lox if you have derermined, based on the information and analysis above and any sucDortinc;
doc:Jrnentatlcn. :hai :he prooased ac:ion WILL :~OT result in~i1Y significant adverse environmental imcac:::
AND Ofovlce an attacnments as necessary, (he reasons supcorting this determination:
.~..,,'~ ~l ~c...u .....;I:'n("
:"mt 01 . VCl:' .....lnP. .)1 ";~'~ocn\IOll:' '....:ll'c~r .n :......0 .">;I:nc'/
,,110:: 01 ,(~')oon\,olo!' VIl,cer
;,,,,nJ.llHC')/ -("~con\lOIl!' ''':r:'c~r ,/1 ,,~..1(1 "'>;o!'ncy
;.'(n..:ure .)1 r'~,,"'..l.1r~r \lr .":'I:"~ent :rnm rt:\Oon\IDI~ "r'''ifl
JJ.1C
"
~
.......
.
.
Board of Trustees Application
County of Suffolk
State of New York
s-~ ~ IT- ('..A. ~((..1 BEING DULY SWORN
DEPOS S AND AFFIRMS THAT HElSHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR
REPRESENTATlVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
-
Signature
SWORN TO BEFORE ME THIS I 'r
DAY OF ~ y"'(")})Q (' ,20il3.
1Y1.> ~
Notary Public -
LORI A. MAYDE
No.01HAIlO61205
NOIIIY ~Ubllc, s.... of NOWVoll<
Mv~~=~~1
^
.
Al'l'tt~ANT
TRANSACTIONAL DISCLOSURE FORN
.
The Town of S~uthold's Code of Ethics. rohibits conflicts at
nterest on the part of town off cers and employees. The
purpose of this form is to provide information which can
alert the town of possible conflicts of interest and allow
it to take whatever action is necessary bo avoid same.
YOUR NAHE.
". ..: """:;'Ii'.Jt~'\
':' ! ~~f-~~~:it..:':,t{{t."f'::.!o(':
(Last name, firot namo, middle initiai;~nless
you are applying in the name of someone else or
other entity, ouch ~o a company. If so, indicate
the other persohls ot compBny.g name.)
....
<:,~~-<A:.;.:;:::.(.'t:~-:'~'lf}.;"~~'
NATURE ot AI'I'LI~ATION. (check all that apply.)
Tax grievance
Variance
Change of Eone
Ap'p~pNal of plat ~
Exe.ption from plat or official map
ot.her
(If .other,. name the activity.)
Do you persona11r (or through your ~bMp."r, ~pbd8e, blblthU.
parent. or child) haYe a relaUonship with eny officer or
employee of the Town of Southold? ~Relatlonshlp~ includes
by blood, .arriage, or business IntereB~. -Business
interest" means a business. in"luding a partnership, in
vhi"h the tovn officer or employee has eyen a partial
ovnership of (or employment by) a corp.oraUon in vhich
the town officer or eMployee ovns .ore ~han 5% of ~he
stlares ..
,10
YBS
NO
';:.,lr"
If you ansvered "YBS,". "o.pl~t~ the ba1anc~ ~f ~hl. tor. and
date and sign where indicated.
Name of psrson employed by the Town of Southold
Title or poaition of that person
Deacribe ths relationship betveen YOUrself (th. applicant)
and the town officer 0r employee. Either che"k the
appropriate line ~) through DJ and/or deocribe in the space
prov~ed .
The town offi"er Or employee or lIh Or her SpOUse, elbllng,
_Il)
or child is ("heCk all that apply).
the ownsr of greater than 5% of the shares of the
corporate stock of the appli"ant (vhen the appli"ant.
is a corporation),
the legal or benefi"ial ownsr of any interest in a
noncorporate 'enHty (when the applicant is not a
corporat.ion) ,
an offi"er, director, Part~nrl or nmployne. of thn
applicant I or
the actual applicant.
parent.,
-~)
_C)
_D)
..,'
DESCRIPTION OF REL~TIONSlllP
, :~\~;',~ .
....'...'.e.'
"'" ',," ~. . . .~ .: _ ,...~, ....~.-. A........:M...,;.,. .
J-.I.
. :'; t!~,~,
,'" ...., ~~ ...
sublftl tted
'. ", ....: . . ".\~,';'Yl;" "'l'.'k-'-:~{.~
" '''''.:' ,.?,r ,l':;:l'!t~t(:.;. i-\l~ \...$:71:'-'. . :.~J .f.'.~~fr
~.. ,d' : 'r"', ,,~, .. ,~,_~,":.' . '.1P'~''li'l'V
thln.'~clay nt;~ig9_ .
sigllOtUrs. .
':: ".' ;.': ii-.: ~ ;'~(;~'
"i.,-..;.'r'l::
...'"-,......
-.
"'-.
,,"
.print
hams.:,':. :..:.' '. ; :'!:.;;:~~_'l:~!;i~.~,,~,:':~~i~,t~:;:.'
,.::<,'l'~;l;{:~ii~~~~~~j;;.~Jri~j\,,;, .,
;;. .:...;-" -"',' ,,~I:1.I1IiI;~WP~.~..:r~"l"~ .'
I~Y~f'
:.'......,
~---
- ,-
.
.
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)765-18~2
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
. TOWN OF SOUTHOLD
LETIER OF REQUEST FOR AN AMENDMENT
DATE 41'J.~J()~
, ,
OWNER ~+-c.tL... Cv-L II S PHONE (~3 04 7 ~ - 71'7 (,
, "',' ~:' ".- "
. ADDRESS I OJ::""", 'Q./ Dr. ,'11...... P fA t-~ IV Y
AGENT DAn', ~{- ,sp..clc:J.t.... PHONE ~51) S'~ -b7--~-r
ADDRESS 6'<') S~...... 'Dr (J ~ I~ ~ C. N If /17 v 7
:I J
PROPERTYLOCATION;Z'-l7~- 13~lA\I<.) ,u..++:-LAc..k/IJY (1'1~~
TAX MAP NO. /000 - ,...,..., - ()4- - 0';- ,,,.X 'f?J
lIWe "'-+....L.- c.L 11 , _ on Am"'-" p""," # ". " -Fiji ~
f7<.4-~_J do(..k 3c> '; t'h ,,+"'11 a '7\/s"' rD..... I' 0..",,;" ~"'-
e-'('30'r-I"~+j"\So 4--WG o.....-\-~Otl\.....~ p,.ll~n-s.r
~.Lt. _ +0 J- s.f-..fo,.'lL s..(C<A....... joc....k...p (L,...- Q... 30' ~+.
j/"il'w>R'-r penn,"';f-:#= l.{tJ.if1 ~ SOhW. ('tCt"I'j"'N +0 5ffpf.#"-'" cu~~
SignedBY:.,~ .
IE~WlE
APR 2 8 2IXI
Southold Town
Boord of Trustees
.
Albert J. Krupski, President ..
James King, Vice-President T
Henry Smith
Artie Foster
Ken Poliwoda
.
Town Hall
o 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
c~~nmm
STATE OF NEW YORK)
MAY '0 2003
$aIIlIIoIlITIn
10111I tl TmlIII
0'
AFFIDAVIT OF POSTING
J~7 S-
6S~'j A-lK..
I, Sh-~be..--... CulYtl) , residing at
f1'\c,,+-tJ~ /)J'-y-
being duly sworn, depose and say:
That on the q-toJr- day of IlMlj , 20Q:3, I personally posted the
property known as 91{?, 0A-~ 4,~
by placing the Board of Trustee official poster where it can
easily be seen, and that I have checked to be sure the poster
has remained in place for eight days prior to the date of~e
p~~ic hearing. Date of hearing noted thereon to be held 011
~3 ~th ~ 7(J~~,m.
Dated: o/q/o3
SWArn to before me
I day of MA'j
~~
ignature)
this
2003
'-
Notary Public
R.E!N F.1WlVEY -...".. ·
NoIIIIy NIllc. 8IIIit 11__
QuaIIfledlnSuffolk~ . W --
~~ElcpQa l"Ji b
~
.
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
J<c~"'" rt,,"-v....-
Address:
I '"' If 1(J""; '"'I ~."- f3 Iv t
Ro-,...."'o....k.~},vY 11711
100, 1-4.....c.. J. A-................
':;;:"'......LI...... r).....MJ IJ r t/lJl U
,. ,~() l3,,-y A"'j..,.lA-t
M...++-.'+",:1J;() r lIt:; ('3
1- '3 cr. 0 (3"'1,4 .....~........
1Vt..++..'-kJ, IJY lie; ~ 3
Name:
IN.'I!.ll.....\e L:~ t'1...n"'~,\"
0...1-'. s+-....LI
[A~..t.lo Oe..\rl'-ft'l y....S
~I.""O..... ArvA._ " t...k,.!;
STATE OF NEW YORK
COUNTY OF SUFFOLK
D~+ r ~J$-<<._ , residing at 5'~ I sit,.......... Dr" 01-<... ,
~ L A J'r" "'7<''' . being duly sworn, depoSes and says that on the
1S"1:1- ' day of ~, 20~ deponent mailed a true copy of the Notice
set forth in the BoardOfTnlstees 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,ofthF Town of South old; that said Notices were mailed at the United States Post
Office at <9.. \<~a.I"",-- . that said Notices were mailed to each of said persons by
(","fi"')(re~'''''') ,",,1. / ~ 4 .
Sworn to before me this r -t h
Day of .-m 7~ ,20.Q.3.,.
v1!/jAUUk.e. ;$~
Notary Public
.
..
.
.. ., .
,.
~;~:':
BO~ of 'frustees APplication.
County of Suffolk
State of New York
S+.e J.)efJ If
DEPOSES AN AFFIENS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT/S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF. HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL
WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION
AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES.
THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD MtU THE TOWN
TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS
ARISING UNDER- OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN
COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,
THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY
TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS
APPLICATION.
ClA(J,-e
s
BEING ,DULY SWORN
~~#~v
Signature
SWORN TO BEFORE "ME THIS ) {9
DAY OF ~v'll
~
61t/ A~
Notary P lic
LORI A. HAVDE
No. 01 HA6061205
No..ry Public, s.... of__
QuaUfl9dlnSuf(olk~_~-:J....
MrC<lmmilllon EJqlInlB07I1~
7