HomeMy WebLinkAboutTR-5443
Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. SLffl..3 .... ..
ROY WARD
ISSUED TO...H.............Hn.H....
DATE: ?:tob~r 26.
~-' J\ulquriZ!atiott
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter -404 of the Laws of the
State of New York 1952~ and the Southold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC lANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN. W A TERS;!~; and in accordance with the
Resolution of The BOard adopted at a meeting held on "HQ<?~.().1:>",I.:H.?4. .
. 20g.1..H' and in consideration of the sum of $H}'9.9..,.9.0H" paid by
'..~()YHH'ti',,!d.HHH....' . .....HHH . ...HHHH.......H...H.....H.H....HH
of HHH'HH...Q",!.c:l1,,,,.8t.t"'HH'HHH'H'H' N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
~f Southold. Town Trustees authorizes and permits the following: 1
Wetland Permlt to construct an addition to the existing flrst floor
1 approx. 72 sf.. an addition to the exist. deck, and to add a
second-story to the exist. one-story frame house, with the. cond.,
that the house and deck are no closer to the bulkhead than 36'.
a stakl'd row pf hav.ballis at tthedtop. of. the bulkhead duyinl! con
all .,n accoraance wlfl1 the de aJ\e specificatIons as presenlea In-'
the originating application. and that drywells and gutters are
installed to contain all roof run-off. .
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporat~ S~al to be a~xed, and these p~esents to
be subscribed by a malority of the saId Board as of thiS dat.e.
Trmie..
J
. .i..
TERMS and CONOmONS
The Permittee Roy Ward
residiag at 4075 Stillwater Ave.. Cutchogue N. Y.. as
part' of the eootideratioa for ~ isP'.~ of the Pd:mlt does "pA--nd aDd paescribe to the fol-
lowing:
1. Tbac the said Board of T_ aDd the TOWD of SoutboJd ate releued &om IA1 aDd
all damIges, or claims fOt cIamap, of suia adJiag cIhectIJ Ill' Jadltecdy .. a rauIt of IA1 ~.
adoa perfoaued I"i...."'nt to this peaalt, IUId the IIid P 1I""t wl1I, ac his Ill' her - ~'"
cIefead IA1 IUId a111UC'h PIS '1.d.I.-I by ddtd patda, aDd the said P 11[- - fuI1 JlahIity
wl1b reipect thereto, to the comp1ete 'adusioo of die Board of Taacta of die TO'RIl of ~
'. 24
2. Tbac this Permit is ....nd for . period of mos. 'Wbitb is ~ to be die
estimated time'requited to coG>p'<<e the wod< in~ bat'ihcaJd cit, "4 nres ---. nqu$
for an exlIl:aSioo may be made to die Board at a btec cIatz. '
3. Tbac this Permit sbouId be cetalDecI btdeflDicely, or as 10ag as the said ~ wlsba
to '_I_In the sttuCl\ICC or ptoject involved, to provide eftdea<:e to ao.yooe coocemed that anlh.
,odzatioa was originally obtained.
4. That the wodc ,lAVolved will be subject to die ~ aDd appcova1 of die Board Ill'
its agents, aDd aoa-GOCPPllaoce with ,the provisions of die nrI&I-t1.., 8{lpllcotlon. may be - fill'
cevocation of this Permit by taOlutioo of the said Board.
5. That tbece will be no _sorol-1e intedeceoce wl1b aavigadoo as a rauIt of the wod<
berein Ilitborized. . '
6. Tbac tbece sbaI1 be no intedecence wicb the dgbt of die p>bIlc to pass aDd lepUS I1Ga$
the beach between high and low _ marks.
7. Tbac if ,future opentions of the Town of Soud>!IId nqulce the ftlZIOftI and/or alleI:adoas
in the J.ocatioo of the wod< baein ...tJu-I-~ or if, in the opinIoo of the Board of T.-, die,
wodc sbaI1 cause UfIlelUOt"'h1e obs~ to feee aa~ the said p.-t- will be requInd,
upon due ootke. to remove Ot alter this wodc or project baein stated wicboat -~ to the T_
of Souehold.' '
8. That the said Board will be notified by the Permittee or die ~:Of cbe -" ...m-
orized.
9. That the Pecmitree will obcain all other permits aDd ~IS that t:Da7 be requited sap-
p1emenb1 to this perlDit 'Wbitb _y be IUbjeer to revoke upoa fal1uce to obcala. --
~,.
"
.
.
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
October 26,2001
Mr. Charles Thomas
P.O. Box 877
Jamesport, NY 11947
,,-:
~
RE: ROY WARD
4075 Stillwater Ave., Cutchogue
SCTM#137-1-8.1
Dear Mr. Thomas:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, October 24,2001 regarding the above matter:
WHEREAS, Charles Thomas, Architect on behalf of ROY WARD applied to the Southold
Town Trustees for a permit under the provisions ofthe Wetland Ordinance of the Town of
Southold, application dated October 3,2001, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory Council
for their findings and recommendations, and;
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on
October 24,2001, at which time all interested persons were given an opportunity to be heard,
and,
WHEREAS, the Board members have personally viewed and are familiar with the premises in
question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 97 ofthe Southold
Town Code,
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,
2
"
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of ROY WARD to construct an
addition to the existing first floor, approx. 72 sf., an addition to the existing deck, and to add a
second-story to the existing one-story frame house, with the condition that the house and deck
are no c1oserto the bulkhead than 36', a staked row of hay bales at the top of the bulkhead
during construction, and that drywells and gutters are installed to contain all roof run-off.
BE IT FURTHER RESOLVED that this determination should not be considered a determination
made for any other Department or Agency, which may also have an application pending for the
same or similar project.
Permit to construct and cO!lIplete project will expire two years from the date it is signed. Fees ----
must be paid, if applicable, and permit issued within six months of the date of this notification.
Two inspections are required and the Trustees are to be notified upon completion of said project.
Fees: None
Very truly yours,
{lat.-I ~ /~-(>~~
Albert J. Krups{i, J r.
President, Board of Trustees
AJKJlms
DEe
Bldg. Dept.
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
.
.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
Coastal Erosion Permit Application
-LWetland Permit Application ........Major
_ W aiverl Amendment/Changes
L- Received Application:
,-Received Fee:$
~ompleted Application
_Incomplete
_ SEQRA Classification:
Type I_Type II_Unlisted_
Coordination:(date sent)
...-cAC Referral Sent: ',=
...-Date ofInspection:
_Receipt ofCAC Report:
_Lead Agency Determination:
Technical Review:
AUblic Hearing He~
Resolution:
Minor
IOW1 FT,
31.0' WD \"{\ ~ \).\'i:I\
YIouS<c rt\) \JUll'\.fu:t
~ CeS'S~D\ lO~
W Cl~Q,~
(' 'b-l~:;'\(\Oi'
"
,
'-'
Name of Applicant_~01 WAf:?
Address
Phone Number ( ) ?~ fl - ;t:f"1 z.
Suffolk County Tax Map Number: 1000 - I~' -, - ~ I
/
Property Location: ~()1J ~Iu' ~ ~vr;
156~. 4Q' '1"0 PE"GUA~ij Av~ C~ (LE1T~ NEc~ ROAD,
(provide LILCO Pole #, distance to cross streets, and location)
AGENT~~ ~A6, ~all~Gf
(If applicable)
c4
( 0'\
::J~ '\
Address:
Phone:
7%.1 - i'f~ ~
.
.
Board of Trustees Application
GENERAL DATA
Land Area (in square feet):jl, 3~'" ~Q. ff.
Area Zoning:~O
Previous use of property:
1(f~19~ "11AL.
1( E~ I P~~~A L..
Intended use of property:
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?
VNo_ Yes
If yes, provide explanation:
Project Description (use attachments if necessary):
A"p'1'"lo~ 1""0 6VI"J1"',~uf( App. ,2,. ~f.
A-VPI1'jC:lJ_-r~ t;\( I.t,~#
AtJr; .z~D 4(0~1 1""0 1i)('.(,";N~ I ~'f"0t..1 f~ot)~~
. .
Board of Trustees Application
WETLANDffRUSTEE LANDS APPLICA nON DATA
Purpose of the proposed operations: A-17DJ'f'cJ 1"'0 ~J~'fltl~ ~IZ.. ,biff. 7'l.. $G...P'r
~"p'fIOJ "1'"0 f:f)(I~~ AU. 7Z ~Gl.ff
J.'9f) 2,.,J1) -trlJey 1"0 E)(J~l'IJ~ ~'ro~Y ~()U~6'
Area of wetlands on lot:
o
square feet
Percent coverage of lot:
o
%
Closest distance between nearest existing structure and upland
edge of wetlands: 55' feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 5"5' feet
Does the project involve excavation or filling?
II
No
Yes
If yes, how much material will be excavated? 0
cubic yards
How much material will be filled? 0 cubic yards
Depth of which material will be removed or deposited:_NA feet
Proposed slope throughout the area of operations: ~ A
Manner in which material will be removed or deposited: N A
Statement of the effect, ifany, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
~E
.
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Board of Trustees Application
COASTAL EROSION APPLICA nON DATA
Purposes of proposed activity: AVJ1I1"O~ "f"o E:ltl~~W(}1Z . ~~ 1Z- Sf.
mI11Dtl:mjSltl~1IJo.1t1 f)~~ .A~ Avo z."'D 'If'o'''Y 1'0 e'tl"'fl~~ I ~o,.y
:f'-A+1 ~ Ho u46
lUe wetlands present within 100 feet of the proposed activity?
No
II
Yes
Does the project involve excavation or filling?
-I No
.
Yes
If Yes, how much material will be excavated? ~A
N~
(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)
~cr:
.
.
1.4-16.4 12JSn- Text 12
I PROJECT 1.0. ,"UMBEM
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)
SEQ
1.
I 2. PROJEC7 NAME
J. PROJECT LOCATION:
Municipality
County
~L1
4. PRECISE LOCATION (Street address and road intersections. prominent landmarks. etc., or prQvlae map)
~1L.1. WAf"~
1~,~.4'" 1'0
A,,~. .1
ft(QAlM~ A"~ O~ fl.E"if~ I'(EtK ~t>.
5. IS PROPOSED ACTION:
o New ~xpanSion 0 Modification/alteration
6. DESCRI8E ;JJE~;;';;L,Y~~ 1"0 f"~"'" F~ 1 z. ~. pro A-pp.
~~ "'OP''''''O~ fD fltl~'N'1 ~..eK '1z.. ~f1'. ~fP.
/..VP ~~'P flPO~ 10 g)('~II"'~ , -S'rf.;f'l fJ(J.+11:f 4ov,g-
7. AMOUNT OF UNO AFrECTEO:
Initially tJ acres Ultimately 0 acres
a. WILL FRO?QSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTnICTIQNS?
~s 0 No If No. describe brietty
9. IfJHAT is PRESENT LAND USE. IN VICiNITY OF PROJECT?
~sldentjal n,!naustriat [J Commercial
Describe:
U Agriculture
; I Park/Forest/Ooen soace
i..J Other
.
10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (F::DEAAL.
STATE On LOCAL)?
~es 0 No If yes, list agency(s) and permit/approvalS
-r
11. DOES ANY ASPECT OF THE ACTIO'" HAVE A CURRENTLY VAllO PERMIT OR APPROVAL?
DYes 0 No If y~s. list agency name and permillapproval
12. AS A RESULT OF PROPOSED ACTION WlLL EXISTING PERMIT/APPROVAL REQUIRE .\.10QIFICATION?
DYes DNa
I CERTIPf THAT THE rNFORMATION PROVIDED ABOVE IS TRUE 70 THE BEST OF MY KNOWLEDGE
""<O"<""n~~~
SIgnature: -... ../ "~c '
DJ.te:~
If the action is in the Co~stal Area, and "IOU are a state agency, complete the
Coastal Assessment Form beiore proceeding with thiS a~~essment
OVER
PAMT 1'_=:NV1RO:--JME~rIA'
'SSeMENT
'-;-0 Of'::: cor.;:;iet80JY .~genC"
.
:t les. :::Jcrcmats :ns re'lIl~W :roces:3 ana 'Jsa ',l"ie ,=:Jl:... :::~.=-
........:JOES "':"C;';C.'l ;::.;C::~:; ;....u', ".:::;:, 7i-1;::.ESHOLJ 'N '3 .\l~C;::;:::, .:l:..F.7 5,7.';:"
'~YdS C.'to
3. 'N1U... ,.:..C7:CN ,~E':::';V,=:::CP,OINA 7~:J .~E\fIEW ...:.S ?RC'J!OE::J ,:-,:;::: UI'lLS7ED ,.:..C7;CNS iN :5 .\j'(C2A,~!~;:'7 '5; ;'.37
may:,e sucersedec ~y :=.nOlr:er :n'lol'leo aGency.
,f .'~o, 3. :jeg;;.t:,,!} :::::!c:ar:::;
L.; Yes
~,~O
c. C:::ULO AC7iCN ~.ESUl:- ,1'4 "':"NY AOVE?SE ::.~~::.,:75 ASSCC:..=. 7'Ei] .v17H -:~= .':-'JLLC~'1ING: :Answers :nay :e1ancwrmen. ,/ :eglblel
C1. :;;l;lsling ~ir quality, ;,urfac2 Jr 'Jrounawaler ;:ualily or ::::t.:anllty. ,101se :e'/eIS, ~xls,lng ::adic :atterns. $clid ....as:e Jrcc:t.:c::::n ;}r :lIs;;:.:
?OtenUal Icr ~raslon, :.::ralnage or :loocinq JroOJems?=-tolam Jrieily:
C2. AesltletJc, agricullural. :Hci"laeological. ;'is,OflC, Jr other :1at:.Hal Jr cultural :eSQurc2S:Jr.:ommunlly or ,1elgn/::crnood c~arac:er? :..;t;DlaJC1 ~.
C3. Vegetation or :auna. :Isn. si1ellfisn or 'HllolHe soec:es, $lgmiicant ~acilals. 'Jr :r'lre3tened or ~nc:ano;;erea scec:es? Sclam ::lrjarly~
C~, A c::mmunity's existing ;Jlans or 'Joals as otflc:aUy adooted. or a. cnange in use or intensity at use of !and or other natural resourcss? E:cplam :;:::
CS. Growth, suoseouent 1evelooment. or related ac:ivities likelY !O ":le induceO ':Jy !tle :::rooosea ac:ion7 "S-r;otam :meily.
GS.
I_cng :erm, 500n :erj,'\.;:;muiative, or other '!tfec:s not icentitied in C~ .C57 =:COlam :lfleily.
SIner :moac:s .inc:'-lcing :::-:anges In 'Jse of ~!ther quantity ~r :ype or ~nergYJ? ~:Jiam :;rietly.
oJ. 5 ;i-!E~E. ':;A :S 7HE?;E. ,-:KE:...::' ;-0 SE. C8NT:=!OVE?S'( ~E~IE:J 70 ?OTENT!Ai.. ";CV=~Sc =NVIRONME,'H Ai.. :MP~C7S?
'-- Yes
:_'\/0
:f ':'es, ~xc!ainJrietly
'ART III-DETERMINATION OF SiGNIFICANCE: ITo oe comoleted oy Agency)
lNS7"UCTJONS~ For e3c:'l adverse effect identified atove. determine whether it is substantial, large, imcOl1am or otherNise signific
:3.C~ :!ifec~ silouJd be assessed in connection with its (a) setting (Le. urban or rural); (bl ,:)robaoility of occ~g; (C) duration
irre'/erslbility; (el geogracnic scoce; ana (f) magOltude. If necessary, add attachments or reference supporting materials. E:1sure
~xCJanations ccntain sufficient deIail !o snow that aU relevant adverse impacts have been identified and adequateiy aCdressec.
C;'ecl< ~hjs box if 'IOU have identifiea ene or more Garemiallv lart;8 or significant aC'Jersa imoac~s whici1 MA ';
ac:::.Jr. Then :)roc~ed airec:ly to :t1e f=ULL :::AF 3.naior preaare a positive- declaration,
C:"'iec~< this 80X if '{au have de!ermined, based on the information and analysis above and any suooerti:i{
COC',lmentatlcn, :ha! :he ;Jrocosea aerien 1.vllL ~~OT result in~{1Y significant adverse environmental imcac::
AND ,:Jrcvlce cn 3.!tac:1ments 3S necessary, the reasons supconing tt1is determination:
....,..,,'-. ClI '_<:..u ,""->:t'nC'r
"'''nl 'Jr Vl,;t:" "..,n.. .)1 "'~'",cn\'Olt:" ,....:rlll~~r ,n ;,."..0 "'';l:n':'1
: <ll.,. 01 ,(....'oons.OI.,. '.JIIl':!?f
~1>.;n.llU't! ')1 ~t:"~con"Cle' '':;I:'Ci!f ,n _~J.a '''.;~ncv
;,,<n..:Ufe n r"~~.,Ife'r ~II ',;,"e-",nl :rDm rr::100n~,ol~ JIIIC~n
..J..lC
2
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PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
JO'fc.e ~ ~~A-ft.L.
Address:
\..O~~I~E ~~OWf1
z.,. ~lJ~C;c.A ~.
~14I\1WIr~ , NY 117/ f)
4115 ~I~~ AvE
c..LJrC-~otjl.l~ , NY " '1~S
'4- .A."'y Iw~
W~'(&ve.11 NY /I5"tto
:J ~r~ ~ wF ~A"~Ar()vr
.~ e t. AJrol~~1TE VI':~E"O
3870 ~rli-/.-WA"feR... ~E
CII(C.~O~l,)E, ~1 Ilet'>5'"
STATE OF NEW YORK
COUNTY OF SUFFOLK
!/!.tfl W/.~ "i~
Li"" 40
, residing at
l,o~ ~ot4 eJ .
~
, being duly sworn, deposes and says
that on the ,~ day of n~"fo~~ ,~~, deponent
mailed a true copy of the~rth in the Board of
Trustees Application, directed to each of the above named
persons at the addresses set opposite there respective nameSi
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 southoldi that said otiCJ: ~~ie mailed at
the United States Post Office at ,~ IV~hat
said Notices were mailed to each of said persons by (certified)
(registered) mail.
$;1~'-
L....:-
Sworn to before me this /7 m
day of tJ(;/-nbeV ,oM' :2061
Mt.~~~/ A.
,i?~ (/0 - _1I() - . - U!/
d?. nl L(rf 7C 373
~ N/- <;/2"/{!/
.
.
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
__1)o~-~ii---------------------
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
.os I 'a'" L-i '"
I .-;7 -" \'I.~-
I~r~
l)J~.!I~ ~N~
being duly~worn, depose and say:
That on the r~ day of Q'10~ 2001, I personally posted the
property known as 'H"ILiMlwr~.
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 of the
public h~aring. Dat~~f hearing noted thereon to be held ~B~t~1
en or a.vw.'\ '1 ~OO "'''1 .
AFFIDAVIT OF POSTINGL nil..). r2.cl
40 OIVj ~
, residing at
Dated:
~Signatu~
~
Sworn to before me this 1~17?
day of C2::lOt:"!:n./200 (
.dl&htl ~
1'i'otary Public .k"L.f.1fp//
olI~!k ~VV - v/c- a
() 'Z/7-f4t!7/:> 375
. 'A~ S/;?-;/ OJ
. .
Board of Trustees Application
"
-
County of Suffolk
State of New York
c~ ~S BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF 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
REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIE"~F THIS ~PLICATION
. "
01
Wf'-"f<---
Signature
SWORN TO BEFORE ME THIS ~ '( c{ DAY OF oct6'\aev- ,20 l2J-
W"~~-- --
l\.l'l'Ltl:!l\.N'l'
TRANSACTIONAL DISCLOSURE FORM
.
.
The Town of Sou~holdts Code of ~thics prohibits contlicts at
interest on the parb of town officers and employees. The
purpose of this form is to provide information which can
alert the bown of possible conflicts of i~terest and allow
it to take whatever action is necessary to avoid same.
YOUR Nl\.HB.
Las name, rirst name. ddle
you are applying in the name of someone else or
other entity, such ,S a company. If so, indicate
the other person's or company's name.)
NATURB ot Al'PLIl:!ATIONI (Check all that apply.)
.;';':' !':~~):t.: ::>,:':~;'; :-i~;l!,I,,;,:!~:
Tax grievance
Variance
Change of zone
^p'p~~al of plat .
Exe~ption from plat or Official map
other
(If "other," name the activity.)
,..
s
l'
Do you personally (or through your cb~pany, spouse, sibling,
parent, or child) hove a relationship with any officer or
employee of the 'l'own of Southold1 "Relationship" includes
by blood, marriage, or business interest. "Ousiness
interest" Means a business, including a partnership, in
which ~he town officer or employee has even a partial
ownership of (or employment by) a corporation in which
the town of ricer or employee owns more than 5% of the
shares.
YBS
NO "".
';.'.~,' ,.
If you answered aYBs,M complete the baiance of ~his form and
date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself (the applicant)
and the town officer Qr employee. Either check the
appropriate line h) through D) and/or. describe in the space
provided.
The town officer or employee or his or her spouse, sibling,
parent, or child is (check all that apply).
h) the owner of greater than 5% of the shares of the
corporate stock of the applic~nb (when the applicant
is a corporation),
B) the legal or beneficial owner of any intareet in a
noncorporabe'enbiby (when bhe applicant is nob a
corporation) ,
c) an Officer, director, partner, ~r empl~yee ot the
applicant, or
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Telephone
(631) 765-1892
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971
. SOUTHOID TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town ConserVation Advisory Council held Monday,
October 15, 2001, the following recommendation was made:
Moved by Melvyn Morris, seconded by Bret Hedges, it was
RESOLVED to recommend to the South old Town Board of Trustees APPROVAL of the
Wetland Permit Application of ROY WARD for an addition to the existing first floor,
approx. 72 sf., an addition to the existing deck, and to add a second-story to the existing
one-story frame house.
Located: 4075 Stillwater Ave., Cutchogue. SCTM#137-1-8.1
Vote of Council: Ayes: All
Motion Carried
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iSURVEY OF LOTS 12 i 13
'MAP OF PROPERTY OF M.S. HAND
FILED SEPT. 16, 1c{30 FILE No. 130
51WA lEI aJTa-t06IJE
TO~I 5OlJTHOLD
SUFFOLK GOUNTY, NY
SURVEYED 04-01-01
SUFFOLK COUNTY TAX .
1000-131-1-1'>.1
I CERTIFIED TO.
ROY R VllARD, II
CITIBANK, NA IT'S SUCCESSORS AND
,OR ASSI6NS, FOR THIS TRANSACTION ONL Y.
II FIRST AMERICAN TITLE INSURANCE
,COMPANY OF NEW YORK
NOTES.
. MONUMENT FOUND
AREA = 31.334 SF OR 0.12 ACRES
GRAPHIC SCALE
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JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET
RIVERHEAD, N.Y. 11901
369-8288 Fax 369-8287
N.Y.S. Lie. NO. 50202
REF.-\\Hp server\d\PROS\OI-I40.pro
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