HomeMy WebLinkAboutTR-6008A
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
Permit No.: 6008A
Date of Receipt of Application: July 12, 2004
Applicant: William Fabb for Sean Peters
SCTM#: 144-3-40.4
Project Location: 1910 Bay Ave, Mattituck
Date of Resolutionllssuance: October 20, 2004
Date of Expiration: October 20,2006
Reviewed by: Board of Town Trustees
Project Description: Revegetate a cleared area within 100' of wetlands, plant
wetland species in the area shown on the plan, plant a 50' buffer area with large
conifers and keep as a non-turf area, install a bluestone drive way with
cobblestone edging to remain as a pervious drive, and all as depicted on the plan
approved the Trustees on October 20, 2004.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 97 of the Southold Town Code. The
issuance of the Administrative Permit allows for the operations as indicated on
the attached plan prepared by Twin Fork Landscape on October 20, 2004.
Special Conditions: None
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 97 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
Albert J. Krupski, Jr., President
Board of Trustees
Wet tolerant Shrubs and TreesIFreshwater wetlands and buffers
Red Maple (Acer rubrum)
Silver Maple (Acer saccharinum)
Black Gum
Willow (Salix spp.)
Black ash
Alder (Alnus serrulata)
Sweet pepperbush (Clethra alnifolia)
Highbush blueberry (Vaccinium corymbosum)
Sedges
Arrowhead (PeItandra virginica)
Pickerelweed (Pontederia cordata)
Bur-reed
Common Cattail (Typha latifolia) and Narrow leaved Cattail (Typha angustifolia)
Buttonbush
Spicebush
Groundsel Tree (Baccharis halmifolia)
Water Hemp (Acnida cannabina)
Jewelweed (Impatiens capesis)
Swamp Rose-mallow (hibiscus moschutos)
SIZES
Trees: 4' - 6'
Shrubs: 12'" - 18"
Density: Plant trees 10 - 12' apart
Plant shrubs 4' apart
Use grasses, rushes, and sedges in-between trees and shrubs
07/29/2004 11:16
6314440272
PAGE 01
Some Common Wetbmd Plants of Lolli Island
Common Name
Trees
Red maple
Silver maple
Shadbush
Gray birch
Atlantic white--cedar
SWeefguD1
Tupelo
pjll:hpine
Willows
Sbrubs
Red chokeberry
Bu\tOJlbush
Sweet pepperbush
Silky dogwood
Winklrberry
Spicebush
Swamp aza1ea
PusaywUlow
Higbbush blueberry
Arrowood
Herbaceous Plants
Joe-Pye Weed
BoDeaet
Soft rush
Cardinal flower
SeDaitive fern
CiDnamon fern
Royal fern
Chairmaket" s rush
Softstenuned bulrush
Wool grass
Meadow rue
Scientific Name
Actr TlIbrwn
Actr .raccluzrlmlm
Ame1Dnchitr spp.
BetvI4 popultfolia
~paris thyoitk,
liquidlJmbar nyrw:iftua
Nyua sylvalica
Pinus riguta
Salix spp.
ATOnia arlNtt.folia
Cep1lakulrlull occitkllttllU
C~rhra alnifolia
eomus amomum
lWt vertldllota
Lindera btnzoin
Rhododendton vi$cosum
Salix discolor
Vaccinium corymbotum
Vibumum recognilum
Eupatorium macukltum
Eupatorium perfoliatum
JU1/CU3 fIjfusus
Lobelia CQ1'Ilinali3
Onoc~a sensibllis
Osmunda cinntJmomers
Osmunda "ralis
Scirpus americanus
Scirpus valldus
Sdrpu.s~ptlrlnu.s
Tha/ictrum polyronum
Aquatic and Semi-aquatic Plants
Blue flag Iris versicolor
White water lily Nymp/ula odorata
Yellow waklr lily Nuphar /utrum
Pickerelweed Pom/!deria conklta
Arrowhead Saglttaria spp.
Narrow-leaved cattail Typha anrllStifolia
Wide-leaved cattail Typha llllifolia
Flower Color / Time
White
Showy white ball-like / August
Showy white fragrant / June
Whlkl umheIs
smaU white
SmaU yellow
Showy white fragnmt / JIIIIe-JuIy
SmaI1 arey ball-like / April
Small wbite / May
White umbels
Purple umbels
White umbels
Showy red /June - August
Showy purple / May - July
Showy white / June - August
Yellow / May to July
Showy purple /June . August
Showy white /June - August
Note: All plants listed above are avaUable COIIIIIICfCia1ly. This is only a paniallist of native wetland
plants.
. ,
07/29/2004 11:16
6314440272
Some CODIDlOD Wetland i' ',' .
Coromon N~
Trees
Reel DIlIP1e
Silver maple
SIIIdbl1sh
Gray birch
AdaDIIc white-cedar
SweelgUD1
Tupelo
PIlI:h pine
Wl110ws
Sbrub$
Reel cbokcberry
BuUolIbuah
Sweet pepperbush
Silky c:Iopood
Wlnlerbcrry
Spicebush
Sw.., azalea
Puaywillow
H1pbuah blueberry
Arrowood
H~ Plants
Joe-Pye Weed
Bolle8eI
Softruah
Cardinal flower
Seulitivefem
CiDDamon fern
Royal fern
ClWnnaker's rush
Sof'tstemmed bulrush
Wool grass
Meadow rue
Scientific Name
AceT'rubrum
Acer IaCc/uu'inum
Amelonchil!r spp.
BI!tJIJD poplllifolia
Chtunaecypori$ tllyows
Uquidombar atyT'Q{;jfIua
Nyssa sylvatica
Pinus rigida
Salix spp.
Aronia arbulifolla
Cephala1lthus occwnttllis
Cklhra alnitolia
Comus anromum
l/e!c vl!rtidllota
UnMra benzoin
Rhododendron vUcosum
Salix discolor
Vaccinium corymbosum
Vibll1'1Wl1l1"l!Cognitwn
Eupatorium maculotum
Eupatorium perfo/iQtum
JIl1/CIU ejfums
Lobelia aJI'Ilinal~
Onoc1ea sensibilia
OstllWl(/Q ci1l1lQll'/O/MQ
OstllWl(/Q regaUs
Scirpus _riC(J1lU.<
ScirpWi vaI/dus
Sclrpus cypl!rinus
77ra/ictrum polygonum
Aquatic and Semi-aquatic Plants
Blue flag Iris ve1"$icolor
WhIte water lily Nymphea odo,,,,'"
YeUow water lily Nuphar luteum
Pickerelweed POlllelkria con'" '
Arrowhead Saglttaria spp.
Narrow-leaved cattail Typha angliS/ifiJ,
Wide-leaved cattail Typha latifolia
Note: AU plants listed above are availabll: c.olI~~m
plants.
PAG!" a:
. ~ IsllIDd
"1<."."r Color f Time
Whit:
Showy whire t.2'",ll~.., i
Showy whilef1igran' " '"lie
White umbel.
Small white
Small yellow
StY.'\1t".J ~I'~_~;;;" ',r' ~'"d:t:.."':..,,,
.i'~i.'J g/:'f:Y t",,;Hii;:,. '
S:mal~ whitr :' M~i'~'
,~.rh:be lJmbeh:
\~!;HJ'l;:~i'
'Wj,' U!' u(rh!";'"
stl~"l'WY r~_"J~ " ;.,'.. -1;:..lijnSt
," i'm-pk ! May 'hlly
., y wMte ! JUlIC . Au1M'
"Jlh;w f May to July
')"\ ~.", purple / l~Jne August
,"'ry "..hit" i Jun,,- .A,ogtl'\:!
~n "",j"i'!; t:'t\.rti~l Hst OrtlBi '\'~-"(;:>i'
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
July 29, 2004
William J. Fabb
Twin Fork Landscape
5005 Depot Lane
Cutchogue, NY 11935
Re: MitigationIPlanting Plan
Violation A 2941, June 17,2004
Sean Peters, Tax Map # 144-3-40.4
1910 Bay Avenue
Mattituck, NY 11952
Dear Mr. Fabb:
As per the Board of Town Trustees meeting of July 21, 2004 enclosed is a survey of the
above referenced property showing the area to be replanted and the buffer area from the
wetland to be a no turf/no fertilizer buffer zone.
The wetland area in the comer of the property near the culverts/drain pipes is to planted
with any of the wetland plant species on the attached list at intervals suggested by the
grower. In addition I have listed other acceptable wetland habitat plant species.
In addition, there is to be a 50' buffer from the edge ofthe wetland line, as depicted on
the survey, of native vegetation.
As per Chapter 97 of the Code of South old Town, WETLANDS AND SHORELINE,
there is no activity allowed within 100' ofa wetland area without a permit from the
Board of Town Trustees.
The planting must be complete within sixty days of receipt of this letter and at that time
there will be an inspection with a $50 fee.
After the violation has been mitigated the Board of Town Trustees will resubmit your
application for clearing within 100' of a wetland
Please contact our office with any questions.
}\
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SURVEY OF PROPERTY
SITUATE: MATTI TUCK
TO~N OF SOUTHOLD
SUFFOLK COUNTY, NY
~ 01/09/"'15
A~ 01/20/"'15
09 lib / ~o
SlA"FOLK c.out<lTY TAX MAP
1000 1-44 ;! 40-4
CERTIl"'"leD TO,
JOHN ""J:<I""'N
NOTeS,
. MOM.M:NT POUND
- ~ l"'eNCe
-i'iII'i!EP"eNC.e
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ELeVATIONS SHOJo"IN HEReON ~
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6E.lSTI4A.INSfllEn
Rt~.N_YtlllOt
3IS9-828llFu3GQ-82B7
'I.Y!! LIC.NO.50202
REFERENCE' 97-0109
Wet tolerant Shrubs and TreesIFreshwater wetlands and buffers
Red Maple (Acer rubrum)
Silver Maple (Acer saccharinum)
Black Gum
Willow (Salix spp.)
Black ash
Alder (Alnus serrulata)
Sweet pepperbush (Clethra alnifolia)
Highbush blueberry (Vaccinium corymbosum)
Sedges
Arrowhead (Peltandra virginica)
Pickerelweed (pontederia cordata)
Bur-reed
Common Cattail (Typha latifolia) and Narrow leaved Cattail (Typha angustifolia)
Buttonbush
Spicebush
Groundsel Tree (Baccharis halmifolia)
Water Hemp (Acnida cannabina)
Jewelweed (Impatiens capesis)
Swamp Rose-mallow (hibiscus moschutos)
SIZES
Trees: 4' - 6'
Shrubs: 12'" -18"
Density: Plant trees 10 - 12' apart
Plant shrubs 4' apart
Use grasses, rushes, and sedges in-between trees and shrubs
07/29/2004 11:16
6314440272
PAGE 01
~ 11. ..'r#~.~
0f:~ f?IIJfl..Oh'Z. 5()l.ITJjJLk!L'I7l-I.i.}.__~,A1-
;n,-~ ~~ /l /\. ___
Some Common Wetlaod PIaots of Long IsIaod ~ <./
Common NlUDe
Trees
Red lDllPle
Silver maple
Shadbush
Gray birch
Atlantic whillH:edar
SWeetgum
Tupelo
Pill:bpine
Willows
Shrubs
Red chokeberry
Buttonbush
Sweet pepperbush
Silky dogwood
Winlerberry
Spicebush
Swamp ua1ea
PuasywUlow
Higbbush blueberry
Arrowood
Herbaceoua PIams
Joe-Pye Weed
BoDeset
Soft rush
Cardinal flower
SeIlsitive fern
Cinnamon fern
Royal fem
Chainnaker's ru8h
Sof\stemmed bulrush
Wool gnsa
Meadow rue
Scientific Name
ACU rubrum
Acer IQCcharlnum
AmeJanchier spp.
Betula populifoUa
0ItImtu1cypari$ tll'Joides
Liquidambar styrw:if1u4
NyUD sy/vcuica
Pinus riglda
StW spp.
Aronia arbutifoUa
Cepha/ollthus occidenta/b
Clerhra alnifolia
Comus amomum
I1a vertidUota
Ulukm benz.oin
RlIodotkndron vi8CO$U1/l
StW discolor
Vaccinium corymbotllm
VWII17IUnI rt!Cognitum
Eupatorium maculDtum
Eupmorium perfolilJtum
JUIII:US ejfusus
Lobdia cardinali3
Onoclea sl!1ISibllis
OsltlUlldD cinMmomea
Osmunda T'lIgali8
Sdrpus ameri=
Scirpus validus
Scirpus cyperinus
Thalictrum polygonum
Aquatic and Semi-aquatic Plants
Blue flag Iris versicolor
White water lily NympMa odorata
Yellow waler lily Nuphar /uteum
Pickerelweed POlllederia cordata
Arrowhead Saghtaria spp.
Narrow-leaved cattail Typha angustifrJlia
Wide-leaved cattail Typha Iad/olia
Flower Color f Time
White
Showy white ball-like f August
Showy white fragrant f June
White umbels
Small white
Sma1l yellow
Showy white ft&il8lll f JUlIe-July
Sma1l &feY baII.like f April
Small white f May
White umbels
Purple umbels
White umbels
Showy red f June . August
Showy purple I May - July
Showy white f June - August
Yellow I May to July
Showy purple f June. August
Showy white f June - August
Note: All plants lilted above are available COIlIIIICI'CiaJly. This is only a partiaJ list of native wetland
plants.
.h1--,,'1 c..e :
f),vu .
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Han
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
"
Telephone (631) 765-1892
Fax (631) 765-'tJ5ISelf'f /
BOARD OF TOWN TRUSTEES
TOWN OF SOUTH OLD
r -:;-
1/" ,ji'G'-
y/v
;v
July 29, 2004 ,
O/l>t 1...vvr HA/J .
wTII1am . l'abb -
Twin Fork Landscape
5005 Depot Lane
Cutchogue, NY 11935
~~-
/4
.", 1." /
y' M/rvl/;v~
Re: Mitigation/Planting Plan
Violation A 2941, June 17,2004
Sean Peters, Tax Map # 144-3-40.4
1910 Bay Avenue
Mattituck, NY 11952
~r-. ~~
Dear Mr. Fabb:
As per the Board of Town Trustees meeting of July 21, 2004 enclosed is a survey of the
above referenced property showing the area to be replanted and the buffer area from the
wetland to be a no turf/no fertilizer buffer zone.
The wetland area in the comer of the property near the culverts/drain pipes is to planted
with any of the wetland plant species on the attached list at intervals suggested by the
grower. In addition I have listed other acceptable wetland habitat plant species.
In addition, there is to be a 50' buffer from the edge of the wetland line, as depicted on
the survey, of native vegetation.
As per Chapter 97 of the Code of South old Town, WETLANDS AND SHORELINE,
there is no activity allowed within 100' ofa wetland area without a permit from the
Board of Town Trustees.
The planting must be complete within sixty days of receipt of this letter and at that time
there will be an inspection with a $50 fee.
After the violation has been mitigated the Board of Town Trustees will resubmit your
application for clearing within 100' ofa wetland
Please contact our office with any questions.
~
Sincerely,
~~
Heather Tetrault '
~ ~1/_~yv_~1~/tL/'~ ~
.
Cc: Sean Peters, Owner
E.Brownell Johnston, Assistant Town Attorney
Justice William Price
Lori Hulse - Montefusco, Assistant Town Attorney
Donald Dzenkowski, Bay Constable
1Y1~/?vv~vI:Jf$ )
5EPTlc. DETAIL
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5URVEY OF PROPERTY
5ITUATE: MATTI TUCK
TOi"4N OF SOUTHOLD
SUFFOLK C.OUNTY, NY
SURve'r"eD 01 I 09 I &foe.
AMeNDeD 01 I 20 I "te.
relit> I "It.>
SLFFOL.K COUNTY' TAX MAP
1000 144 9 40.4
CBUIf"1eD TO,
.JOHN ""'Z&IAN
N01lOS.
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- I'IOODON I"l!NGe
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6 EAST MoI.IIl STIEF!
RI\I6lHEAD.N.Y JllKlt
3&9-e<!8lIFa" 369-62S7
".Y $ LtC. 1f(I. 5020~
REfERENCE. 97-0109
tv..~- ft/Jv.-.. _ ~v<,,-<A--
Red Maple (Acer rubrum) _ ~ .~
Silver Maple (Acer saccharinum)
Black Gum
Willow (Salix spp.)
Black ash
Alder (Alnus serrulata)
Sweet pepperbush (Clethra alnifoli
Highbush blueberry (Vaccinium co bosum)
Sedges
Arrowhead (peltandra virginica)
Pickerelweed (pontederia cordata)
Bur-reed
Common Cattail (Typha latifolia)
Buttonbush
Spicebush
Groundsel Tree (Baccharis halmifol a)
Water Hemp (Acnida cannabina)
Jewelweed (Impatiens capesis) I
Swamp Rose-mallow (hibiscus mos~hutos)
,
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Wet tolerant Shrubs and Trees/Freshwater,l)Vetlands and buffers
11.<-. .
d Narrow leaved Cattail (Typh angustifolia)
SIZES
--, Trees: 4' - 6' n
~>ShrubS: 12'" -18"
--T Density: lant trees 10 - 12' apart /
(tyf'J ~. - Plant shrubs 4' apart i. ..
Use grasses, rushes, anVdgeS in-between trees and shrubs
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SURVEY
SITtJA TE. O~APROPERTY
TO\lllN O' TTITtJCK
SUFFOL~ ~OUTHOLD
~ Ol/O.,.~UNTY, NY
FO\koIO'. Loc...OII ;201..e.
AMCNDED 04j4.; 22 / "ftJ
c. ....ec I "Ie.
_VFFOLK c.
1000 144 OUNTY TAX MA
S 40,.4. P
c.e!RTll'"ll!t:> TO,
.JOHN PRIZeMAN
NOTES"
MON.JMENl" FOUNP
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TOY'lN OF SOUTHOLD
SUFFOLK COUNTY, NY
5Ul'tY'f:YB;) 01 / 09 / "Ie>
AMeNDED 01 / 20 / "Ie>
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6 EAST MAIH snEET
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SUFFOLK COUNTY TAX MAP
1000 144 3 40A
CERTIFIED TO,
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PHILLIP R, MARRINER
STEY'lART TITLE INSURANCE CO.
#"I"I0336S
NOTES,
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N Y S LIC NO 50202
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET
RIVERHEAD, N Y _ 11901
369-8288 Fax 369-8287
REFERENCE # 97 0109
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Address:PO Box 460
Culchogue, NY 11935
Phooe:734-6643
Fax:
Project Designer:
J.Fabb
Scale:
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Project., wo#
1
Date: Rev. Date:
8/10/04 8/16/04
02 Viburnum Opulu$ (European Cranbeny)
03 Pinus Strobus (White Pine)
04 Pice. Pugens (Colorado Blue Spruce)
07 Ables (Norway Spruce)
06 Flexlis Vanderwolf (limber Pine)
010 Existing Evergreens
011 Acer Rubrum (Swamp Maple)
87 Baech_rla Bush (Groundsel Tree)
Twin Fork landscape
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D3 Pinus Strobus (White Pine) J.Fabb
D4 Picea Pugens (Colorado Blue Spruce) Contracting Scale:
D7 Ables (Norway Spruce) 1" = 50'
D8 Flexlis Venderwolf (Limber Pine) Project' woo
Address:PO Box 460
010 Existing Evergreens Cutchogue. NY 11935 1
011 Acer Rubrum (Swamp Maple) Phone:734-6643 Date: Rev. Date:
Fax: 8/10/04 8/16/04
87 Beecharia Bush (Groundsel Tree)
TWIN FORK
LANDSCAPE CONTRACTING
1'0 B,,'. 460
Cutchogue. NY II!)})
8119/2004
To: Southold Town Board Of Trustees
Enclosed is a proposed planting plan for the property located 1910 Bay Ave, Mattituck,
tax map #144-3-40.4 . When reviewing if you have any questions or suggestion, please
contact me.
Sincerely,
W. J. Fabb
Twin Fork Landscape Contracting
Phone: 734-6643
rB)!~
If\l AUG 19 3104
I W [E
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IntlIIM Town
Board of TMtees
144.-3-40.4
1910 BAY AVE
= OWNER & MAILING INFO
MARRINER PHILIP R &
JEANNE P
PO BOX 915
NORTH CHATAM NY
12132-0915
DATE 06/15/2004
ROLL SEC TAXABLE
TOTAL RES SITE
TOTAL COM SITE
ACCT NO 14
1======== ====== ASSESSMENT DATA ===========
I **CURRENT** RES PERCENT
I LAND 1,800 **TAXABLE**
I TOTAL 6,200 COUNTY
**PRIOR** TOWN
I LAND 1,800 SCHOOL
I TOTAL 6,200
==DIMENSIONS ===1======= SALES INFORMATION ==================================
ACRES 1.35 IBOOK 11974 SALE DATE 06/23/99 SALE PRICE 225,000
IPAGE 538 PR OWNER PRIZEMAN JOHN
=======TOTAL EXEMPTIONS 0 =============1== TOTAL SPECIAL DISTRICTS 4 =====
CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE
IFD030
I PK071
IWW020
I SWOll
F3=NEXT EXEMPT/SPEC
F6=GO TO INVENTORY F9=GO TO XREF
'. .
NYSRPS ASSESSMENT INQUIRY
SCHOOL MATTITUCK SCHOOL
PRCLS 210 1 FAMILY RES
47~889. SOUTHOLD
===I=MISC
IRS-SS
I 1
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6,200
6,200
6,200
F1=NEXT PARCEL
75.10- 03-050
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F10=GO TO MENU
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Town of Southold
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The People of UIe Slate of New Yorl< vs.
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I'VoTE TYPE
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0 "",LlAC
0 PCYM
0
0 .us 0 MCY
0 VAN 0
o s.w.
VEHICLE MAKE
0 BUICK 0 CHEY
0 FOAO 0 0lDS
0 TOYOTA 0 VOU<s
'OOy 0 'OIl 0 .""
TYPE 0 TRue, 0 ""'LEI<
V1N NUMBeR
o 0ll0GE
o PON11AC
THE PERSON DE8CIllBa) ABOVE IS CHARGED AS FOLLows
_JPOT
lET SlEFOLKCOUNTYNY
FACTUAL PART (NOT FOR TVB)
THE ABO'IE IW.lEO DEfENDANTDlD ON THE STATED DATE, llMEANOPlACE ~
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PAAKlNG SCHEDULED FINE'
CONTACT COURT 0
THE PERSON DESCRIBED ABOVE IS SUMMONeD TO APPEAR AT
SOU'ntOL.oTClWN JU8l1CE COURT, 830M ROUTED, 8OUTHOt.o, NY 1"71
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FAI1lESTATEMENTs I'EREINAAEPlNSHA8LEASACLAS8A~~T08ECT1ON210.46C6THEP.LN.Y.8.
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A 2940
Town of Southold
Suffolk County, NY
The People 01 the Slate 01 New York vs.
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STREET AOOftESS IJ.eA ' v A/.I NO
S60.r &+ t"'-. . .
CJTV~ ~ STATE~,
I ; ~ f ~ UCENseOR REGlSTRATlON NUMBER
PlATE NO.
STATE I'VoTETYPE
o N.Y. o N.J. o N.Y. o N.J. 0 0,,,,,, o COMM 0
VEHIClE MAKE 0 0ll0GE
0 BUICK 0 CHEY 0 CAl>UAC 0 PON11AC
0 FOfIO 0 0lDS 0 Pl.YM
0 TOYoTA 0 VOU<s 0
BOOy 0 'OIl 0 ."" 0 BUS 0 Mev 0 S.W.
TYPE 0 TRue, 0 TlWLEIl 0 VAN 0
V1N NUMBER
POT
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PARKJNQ SCHEDULED FINE $
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CONTACT COURT 0
ONI
THE PERsoN DeSCRIBED ABOVE IS SUMMONED TO APPEAR AT
SOOTHOt.D TOWN JUSllCE COURT, UOII ROUTE 21, 8OU'1'HoL.D. NY 11871
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FALSEsrATEMeHrs HERelNAAE Pl.JNSI.WLeAS AQAS8 A~ F'l..RSlJANTTOSECl1ON21l1A6OFTHEP.LN.Y.S.
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NOTICE
...
Police Dept. - Bay Constable
Town of Southold
Peconic, New York 11958
NOTICE OF VIOLATION
Date:
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To:
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(Owner or authorized agent of owner)
Address:
F)/) <-.::>; / /)(/(- /'/?4///7Z,-c,l'
/' (Address of owner or authorized agent of owner)
Please take notice there exists a violation of the Code of the Town of Southold, Chapter 97
Article II, Section 97-20 a premises hereinafter described in that
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You are therefore directed and ordered to comply with the following:
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on or before the
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The premises to which this Notice of Violation refers are situated at:
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Town of Southold, Suffolk County, NY (Suffolk County Tax Map Designation: Dist. 1000
./
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Section:
/ '-/ './ Block:
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Lot: "-/(J ~. )
Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine
or imprisonment or both. NOTICE: You have the right to apply for a hearing before the Board of Trustees
of the Town of Southold, provided that you file a written request with the Clerk of the Trustees within 10
days after service of the Notice of Violation. Such request shall have annexed thereto a copy of the Notice
of Violation upon which a Hearing is requested and shall set forth the reasons why such notice of viola-
tion should be modified or rescinded.
/
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Bay Constablti own of Southold, NY
.
.
Twin Fork Landscape Contracting
10120/04
Soutbbold Town Trustee's
To wbom it may concern.
As contractor/agent for Mr. Sean H. Peter's, I have constructed this overview for
the property residing 1910 Bay Ave Mattituck.
Intended Proiect Goals:
Renovate wetland areas to become viable natural habitats by installing large wetland
species.
Provide a natural buffer of 50' between turf areas and wet land area . Entire buffer to
have large conifers installed within.
Install a 3/8 bluestone drive with cobblestone edging. Driveway not to encroach within
65' of wetlands.
If any further questions need clarification please don't hesitate to call.
Sincerely
William J. Fabb
0 refL:IEIWIe ....
a
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OCT 2. 0 2004
Soulhold Tow.
Board 01 Trustees
.
.
Twin Fork Landscape Contracting
10120/04
Southhold Town Trustee's
To whom it may concern.
As contractor/agent for Mr. Sean H. Peter's, I have constructed this overview for
the property residing 1910 Bay Ave Mattituck.
Intended Proiect Goals:
Renovate wetland areas to become viable natural habitats by installing large wetland
species.
Provide a natural buffer of 50' between turf areas and wet land area . Entire buffer to
have large conifers installed within.
Install a 3/8 bluestone drive with cobblestone edging. Driveway not to encroach within
65' of wetlands.
If any further questions need clarification please don't hesitate to call.
Sincerely
William J. Fabb
.
.
APPROVFE' P' "
BOARD 0\: .II,U:.H......~
TOWN OF SOUTHOLD
DATE / () /.2.0 /0 y
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10/13/04 Field Inspection
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10/13/04 Field Inspection
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10/13/04 Field Inspection
.
.
10/13/04 Field Inspection
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10/13/04 Field Inspection
.
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August 20, 2004
William J. Fabb
Twin Fork Landscape
P.O. Box 460
Cutchogue, NY 11935
Re: SEAN PETERS
1910 BAY AVENUE
MATTlTUCK, NY
SCTM # 144-3-40.4
Dear Mr. Fabb:
The Board of Town Trustees has received and approved your planting plan for the
above referenced violation, submitted to this office August 19, 2004.
You may proceed with the planting in the wetland area. There will be an inspection with
a $50 fee at the completion ofthe work. Please contact our office when the planting is
complete.
Your application for landscaping within 100' of the wetland will be on the agenda of the
September 22,2004 meeting of the Board of Town Trustees.
Return Receipt Fee
~ (Endorsement Required)
CJ Restricted Delivery Fee
o (Endorsement Required)
g Total Postage & Fees $
~ Name (Please 3'n:i~Y!. (to ~ 2~ by ____u-_~u_________n__".n_________.__
gSi;eei:APiN;:-O~O~O~N;---_~-~!~-_u?_I~~_I&-..__~_it._._._._.__
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ant Town Attorney
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postage $
Certil\edFee
.
.
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
July 29, 2004
William J. Fabb
Twin Fork Landscape
5005 Depot Lane
Cutchogue, NY 11935
Re: Mitigation/Planting Plan
Violation A 2941, June 17,2004
Sean Peters, Tax Map # 144-3-40.4
1910 Bay Avenue
Mattituck, NY 11952
Dear Mr. Fabb:
As per the Board of Town Trustees meeting ofJuly 21, 2004 enclosed is a survey of the
above referenced property showing the area to be replanted and the buffer area from the
wetland to be a no turf7no fertilizer buffer zone.
The wetland area in the corner of the property near the culverts/drain pipes is to planted
with any of the wetland plant species on the attached list at intervals suggested by the
grower. In addition I have listed other acceptable wetland habitat plant species.
In addition, there is to be a 50' buffer from the edge of the wetland line, as depicted on
the survey, of native vegetation.
As per Chapter 97 ofthe Code of South old Town, WETLANDS AND SHORELINE,
there is no activity allowed within 100' of a wetland area without a permit from the
Board of Town Trustees.
The planting must be complete within sixty days of receipt of this letter and at that time
there will be an inspection with a $50 fee.
After the violation has been mitigated the Board of Town Trustees will resubmit your
application for clearing within 100' of a wetland
Please contact our office with any questions.
.,".
Sincerely,
~~
Heather Tetrault
t:nv,r",,,,e,,,~l ,€d.....'-,'"
Cc: Sean Peters, Owner
E.Brownell Johnston, Assistant Town Attorney
Justice William Price
Lori Hulse - Montefusco, Assistant Town Attorney
Donald Dzenkowski, Bay Constable
5EPTJG DETAIL
not to $(;.ale
T5T Hr::l\.e DETAlI..
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SURVEY OF PROPERTY
SITUA-n::: MATTITUc.K
TOI^IN OF 5OIJTHOLD
SUFFOLK c.OUNTY, NY
SUR~ OI/06/~e
A~ OI/:2OI"e
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SLf9"'OL.K COUNTY TAX MAP
1000 144 S 40.4
CERnf"1eD TO,
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NOTeS.
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PI.YS LIe. NO. 502C2
REFERENCE., 97-0109
.
Wet tolerant Shrubs and Trees/Freshwater wetlands and buffers
Red Maple (Acer rubrum)
Silver Maple (Acer saccharinum)
Black Gum
Willow (Salix spp.)
Black ash
Alder (Alnus serrulata)
Sweet pepperbush (Clethra alnifolia)
Highbush blueberry (Vaccinium corymbosum)
Sedges
Arrowhead (peltandra virginica)
Pickerelweed (pontederia cordata)
Bur-reed
Common Cattail (Typha latifolia) and Narrow leaved Cattail (Typha angustifolia)
Buttonbush
Spicebush
Groundsel Tree (Baccharis hahnifolia)
Water Hemp (Acnida cannabina)
Jewelweed (Impatiens capesis)
Swamp Rose-mallow (hibiscus moschutos)
SIZES
Trees: 4' - 6'
Shrubs: 12'" -18"
Density: Plant trees 10 - 12' apart
Plant shrubs 4' apart
Use grasses, rushes, and sedges in-between trees and shrubs
07/29/2004 11:16
63144402.
.
PAGE 01
Some Common Wetland Plants of Loug IslIUId
Common Name
Trc:ea
Red maple
Silver maple
Sbadbush
Gray birch
Atlantic white-cedar
SWeetgmn
Tupelo
Pltchpine
Willows
Sbrubs
Red chokeberry
Buaonbush
Sweet pepperbush
Silky dogwood
Winterberry
Spicebush
Swamp azalea
PusaywUlow
Highbush bluc:berry
Arrowood
Herbaceous Plants
Joe-Pye Weed
Bonesel
Soft rush
Cardinal flower
Sensitive fem
Cinnamon fern
Royal fern
Chairmater's rush
Softstemmed bulrush
Wool grass
Meadow rue
Scienliflc Name
.deft" J1Ibrum
Acer IQCcluuinum
.dmekulchier spp.
BfiII/Q JK1PUlifolia
OIamtl<<ypam thyoldes
Liqu/dDmbar atymciflua
Nyua sylvadca
PInus rigida
Sa/b; spp.
Aroni4 arbulifolia
CephDlantlua occidtr1lltllU
Clethra alnifolia
C'omllStlItIOmIU/I
1la vertJc/1/ota
Undem beM.oin
Rhododerrdrt>>I vi8cosum
Sa/b; discolor
Vaceinium eorymbo$lllll
Vibrunum 1Y!Cognilwn
Ellpatorlum rnaculotum
Ellpatorlum pflrfbliatum
JIUlCU8 ejJIuus
Lobelia cardbtalb
Onoclea smsibllis
OsllllUldo cin1uJmoIMa
Omumda regali8
ScirplU ameri=
Scirpus valldus
SclrpIUCYperlmu
77la1ictrum polygO/lU1ll
Aquatic and Semi-aquatic Plants
Blue flag Iris vfl1'$icolor
While water lUy NympMa odorata
Yellow water lily Nup/rQr luteum
Pickerelweed POTllederla cordata
Arrowhead Sagittarla spp.
Narrow-leaved canail Typ/rQ angustifolia
Wide-leaved cattail Typ/rQ ladfolla
Flower Color' Time
White
Showy white ball-like , August
Showy white fragrant' June
While umbels
Small white
Small yellow
Showy white frapant I June-July
Small grey ball.like I April
Small white' May
While umbels
Purple umbels
White umbels
Showy red 'June. Auaust
Showy purple I May - JulY
Showy while I June - August
Yellow I May to July
Showy purple' JUDe - August
Showy white I June - August
Note: All plants listed above are avallable commercially. This is only a parda1list of native wetIand
plants.
,
7/15/04 Field Inspection.
.
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7/15/04 Field Inspectione
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06/21/2004 20:11
"7
6312873.
.
PAGE 03
/
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J. Krupeki, President
ftB King, ViCEl-Pre5l.idant
Artio FQster
KeD. Poliwoda
Peggy A. Dickereon
Town Hill
53096 Route 25
P.O. Bm< 1179
6outhold, N"", York 11971-0959
Telephone (631) 765-1892
F"" (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
_ CgaBIal Bro.i"" P.rmit Applica~
;ill'""'etlBDd Pcnnil Application ./" Major
-=.. Waivp,IAmondmeotlChaDges-
...."'Rec.ived Application: IJ-
,...-Received Fee:$ 0-
......-c-ompl.W Application
_Incomple..
_SEQRA Classification:
Typ. I_Type II_Unlistcd_
_ Coordination:( date sent)
~AC R.fe:ttal sent:~
~.le of Inspection; Dr-
_Rec.ipt of CAe Report:
-Lead Agency Determination:
Technical Revi.w: -----:-
A'Ublic Hearing Held: ? / :J II Qf
_Resolution: ' I
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IJlJ JUL 1 2 ?004
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Sou/hold Town
Board of Trustees
Name of Applicant Sc4..J 1-1 ~
/'1/0 Bill' lillt/lue , 1fc<lllu,f; /lit //7S2-
63/ 7<-,(;1 /J /
Phone Number:() ,. 'I" - / 36
Address
.
Suffolk County Tax Map Number: 1000-
Property Location: ~ Pr;J.J r:::-_
j{fC/-3-t;o,y
fYJA1 J ..1.-1 Zc.I("""
(provide Lll-CO Pole #, distance to cross streets, and location)
AGENT: t..h:L1;r~ ~ -r:-..n::,...J ~ ~A{Jr_
(If applicable) f () /)t>i- ,,\,,"0
Address: SOoS ~, ~IC:.
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5\<.."
'I ~J'S ')<:
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Cv~jJY IIO,3S-
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Phone: h3J 73</ -664 "3
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Received Jun-22-2004 08:17am
From-6312873833
To-crT/GROUP
Paie 003
.
.
Board of Trustees Application
GENERAL DATA
Land Area (in square feet): idOl (}1JO ~~
Area Zoning: ~?~~
Previous use of property: SArJ€..-
Intended use of property: Skr) rG.
Prior permits/approvals for site improvements:
Agency
NeN1Z-
Date
~ prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
X No_ Yes
If yes, provide explanation:
Project Description (use attachments ifnecessary):_~~ ~~b
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Board of Trustees Application
WETLANDITRUSTEE LANDS APPLlCA nON DATA
Purpose of the proposed operations: ~..,JoUJ>n--y-_ ~':::;"7'"WVb
J1S7f/\
Area of wetlands on lot: /0/ (J1YO square feet
f
Percent coverage oflot: /0 %
Closest distance between nearest existing structure and upland
edge of wetlands: feet
Closest distance between nearest proposed structure and upland
edge of wetlands: feet
Zj:: involve exc:::on or filling?
If yes, how much material will be excavated?
o
cubic yards
How much material will be filled?
o
cubic yards
Depth of which material will be removed or deposited:
o
o
fJ/.,A
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):
JJIA
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I PROJECT 10 NUMBER
PART 1 - PROJECT INFORMATION
617.20
APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
( To be completed by Applicant or Project Sponsor)
SEQR
1. APPLICANT I SPONSOR
f,c....J f-l ~~
3.PROJECT LOCATION: 19/0 ~ AJ€-
Municipality MA-'l,;l.A.... County
4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent
2 pr;;;~
5v~Uc.
landmarks ete . or provide map
/9/0 ~ 4,ul!:- (4~ ~ 84tL ~)
5. IS PROPOSED ACTION: 0 New D Expansion odification I alteration
6. DESCRIBE PROJECT BRIEFLY:
c~
p{k,Pt:ZA"Y 0 p
~-s.
7. AMOUNT OF LAND AFFECTED: _
Initially acres _ ~ Ultimately acres ...,2S
8. WlL ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
o No If no, describe briefly:
IS PRESENT LAND USE IN VICINITY
o Industrial D Commercial
OF PROJECT? (Choose as many as apply.)
DAgricu,ture D Park I Forest I Open Space
OOther (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
DYes 0 No If yes, list agency name and permit I approval:
11. DOES
DYes
A~T OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
~o If yes, list agency name and permit I approval:
PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION?
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant
Oat. tjoy
Signature
If the action Is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment.
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x
PART II. IMPACT ASSESSMENT To be eom leted b Lead A ene
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.41 If yes, coordinate the review process and use the FULL EAF.
DYes 0 No
B. WILL ACTION RE IVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative
declaration may superseded by another involved agency.
c=J Yes No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible)
C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, soUd waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
I AJD I
C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly:
INO I
C3. Vegetation or fauna. fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
I~o I
C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly:
IA/o I
C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:
IliD I
C6. LOIig term, short term, cumulattve, or other effects not identified In C1-GS? Explain briefly:
I~o I
C7. Other im acts includin chan es in use of either uantl or e of ener ? Ex lain briefl :
NO
VE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
EA CEA? If as, ex lain brietl :
D.
E. [:r~:'E, OR IS No rE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
If yes explain:
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PART 11I- DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or othelWise significant. Each
effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e)
geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain
sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked
yes, thedetermination of significance must evaluate the potential impact oltha proposed action on the environmental characteristics of the CEA.
Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL
EAF and/or prepare a positive declaration.
Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the propo~ed actio
WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi
determination.
Name of Lead Agency
Date
Pnnt or Type Name of ResponsIble OnlC8r In Lead Agency
Title of Responsible Officer
Signature of Responsible Officer in Lead Agency
Signature of Preparer (If different from responsible officer)
05/21/2004 20:11
5312873__
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PAGE 04
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NOTICE TO ADJACENT PROPERTY oWNER
t
BOARD OF TRUSTEES, TOWN OF SOUTHOI,D
In the matter of applicant:
SCTM#
....::
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YOU AM HEMBY GIVEN NOTICE:
I. That it is the intention of the undersigned to request a Permit from the Board, of Trustees
" ..'
to: .- '.
2. That the propeny which is the subject of Environmental Review is located adjacent to
your property and is described as follows:
3. TIlal the project which is subject to Environmental Review under Chapters 32, 37, and/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: 5t!CA..,'J 1/ A-ir3
MAILlNGADDRESS: 350 Msl f;/St ~-I. Iyd-'I/J
/lite N{; /00/'7
PHONE #: 1/7 7-'1 -05'1. .
Ene: Copy of sketch or plan showing proposal for your convenience.
Received Jun-22-2004 08:17am
From-631Zmm
7o-CITIGROUP
Pail 004
05/21/2004 20:11
'7
5312873.
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PAGE 05
Board of Trustees Application
County of Suffolk
/ State of New York
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~ H ~~S BEING DULY SWORN
DEPOSES 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 TIfAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN TIllS APPLIC^iI'ION AND AS MAY
BE APPROVED BY THE SOUTHOll TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOm 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 COMPUi..TING 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 TIDS U/t DAY OF J:i1 e .20-if
~~)~
Notary Public
z(
CA1WL'r;:mVING
NotM'J Public, State of New YOI'k
No. 4857573
Qualified in Suffolk Co.un~O V
Oommi98ion Exptrea Apr. 2&QZ-
(
Received Jun-22-2004 08:17am
F rDm-631287l833
TD-CITIGROUP
Pa,e 006
_06!21!~90~_~0:11
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6312873.
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PAGE 06
Board of Trustees APPlication
0"-
,I\UTHORIZATION
(where the applicant is net the owner)
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atJ5V U77 ~I ~4H-
(~~~nq address)
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YANt/ ~~
(print owner of property)
< residing
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N 't. /1/1, Jt}O/~
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(~~~o
do hereby authori.ze t..klLJA..tvJ.
(Agent)
apply ror permi~) from the
<..o:.,~
Southold Beard of Town Trustees on my behalf.
Lr$
/' (owner' s signature)
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."';Ill
:
8
Received Jun-ZZ-Z004 08:17am
Frcm-88IZ8738BB
T c-C I TI GROUP
Pa.e 006
05!21!~~04__20:11
5312873.
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PAGE
APPLlCANT/AGENTIREPRESENTATIVE
TRANSACfiONAL DISCLOSURE FORM
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:: ~::"un~~';:;;~=":-:~fcbno;:~ '::="~;==I:"~;:': ~=..:.'::~= :;';:"" ...::.::::::r.
pe---"" to avoid ~ame. ~ /I' /J ' .
YOUR NAME: ...J EiI /,J . r t;-r€ 15' .
(Lasloamo, first _ 'l\iddle initial, unl... you "'" """lying In lba .-,. of
someone else or od1crCDlity, such OS acom.....y- If$O, i,.dioo....tbt o1hcr
person'sorcornp8DY~sname.) '~'-
,~
NA-ME OF APPLICA nON; (Cbc<*. all - apply.)
,I
,.
!:i
Tax grievance
VariBnce
Change or:ZOne;
AlJPlll"ol of plot
E~emptlon from pial or officio! map
Olher
(If "Other", namcthe acti.ity.)
00 you JICT'Onally (Ofthrough your company. spouse. aibling, paren~ or child) ha.e a rellBionsllip .willl any ofli= or "",ploycc .
of the Town of South?ld? "1l.I,wonsbip" includes by blood, marriage, or buiincsa ~ .Ji........., inteR:Sl" mealls a buslllcas,
ll'\cludip,t; Q, partnersh;p., in which the town oftic::er or emp~~.x a pAtia1 ownership of (or employment by) a corporation
in which the town officer or employee owns morc tb'll1 '\/' G.
YES NO' . ..,
Building
Truslce
Coastal erosion
Mooring
Plnn.ing
:.'~].,:,
If you answerea "YES", comple~ the bahUlce armis form and date and sign where indi~.
1'1""", ofpe""", omployed by lb. Town ofSoutbold
Title or po,ition of rhal penon
Oe5C1'ibc !be relationship be<wccn yoursclf(lIlc epplioontl_otlrep_tatiYC) ""d the town officer or employee. Either c~k
the appropriare Ii.. A-) Ibrougl1 D) andfo< d....;be i. tho """'" provided. .
The \OWn officer o~ employee or his or her spollSC, sibling, pan:n~ Dr child is (check alltl* apply):
_A) the owner of .......r than 5% of !be shares of the corporate stock onlle appliconl
(when the appllC\ll\I isa corporallon); . , .
_B) !be 1~ga1 or 'beneficial ow~ of !mY inlercst In a JlDI~......,@ entity (when the
appllcantls nota COrporatiOD); . .".
_ C) an officer, diredor. penner. or employee oflhc applicant; or
_D) tI1e aetual appl;cant.
OESCIllPTION OF R.ELA T10NSHll'
Form TS I
Sublllittcdthis ~.
Signature~ _ " /
Print NadIe tJ. .. . A-ro f <
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Reoaivad Jun-ZZ-Z004 08:17am
Frcm-6BIZmm
To-CITIGROUP
Pall 007
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Twin Fork Landscape Contracting
Post office Box 460
Cutchogue, NY 11935
(631) 734-6643
Board of Trustees
Town of Southold
To Whom it May Concern:
I have respectfully constructed this letter to request an administrative permit regarding the
property, 1910 Bay Avenue, Mattituck. As the Contractor/Agent for Mr. Sean H. Peters, I will
be able to answer any questions regarding this matter. Please contact me for any reason
necessary at the number above.
Sincerely,
William 1. Fabb
lBJ~ (G fE n Wi fE,[m
IJl) JUt 11 "'" ~
SoUlhold Town
Boa'" of Trustee.
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