HomeMy WebLinkAboutWexler, Donna
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llbert 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) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
_Coastal Erosion Permit Application'
_Wetland Permit Application /Administrative Permit
AmendmentITransferlExtension
~eceived Application: 'III')
....LReceived Fee:$
/Completed Application
_Incomplete
_SEQRA Classification:
Type I_Type II_UnIisted_
_ Coordination:( date sent)
_LWRP Consistency Assessment Form
CAC Referral Sent:
~ate ofInspection: <('llbrm;-
_Receipt of CAC Report:
_Lead Agency Determination:_
_Technical Review:
--.d'Ublic Hearing Held: 'j'1ri..\1K
_Resolution:
JUL 1 7 2006
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Phone Number:( ) (,-,,(_ n'5:- 13<10
~ - b31-lr3l?"- 1"'0 c)
Suffolk County Tax Map Number: 1000 - ~ - If - .;l?>
Name of Applicant \:',~"""^,,,
AddressJ\~ ~ ,~ "Q.-S).
Property Location:
11<< W\<...k ~ M,
d ""'~ c;Q \..JgQ~
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~~- '^-'
- _.(provide LJLCOPole #, distance to cross streets, and locat on)
AGENT:
(If applicable)
Address:
Phone:
4Ifoard of Trustees APPlic~n
,
GENERAL DATA
Land Area (in square feet): ~l....no ~. ~;
Area Zoning:
Previous use of property:
~,,,(}..~
~~~
Intended use of property:
Prior permits/approvals for site improvements:
Agency
\:', <; ('
\J)..,,~
_~-QA ~
Date
_ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
----k"No_ Yes
If yes, provide explanation:
Project Description (use attachments ifnecessary):
'--VZ'i:'.t P~cQ ~ ~f"-'''O cr.J)o_^-
tlfoard of Trustees APPlic~n
,
WETLANDrrRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: ~k-C<-'" ~~"tS:'
Area of wetlands on lot: ~
squarefeet-~~ -~(/~
Percent coverage oflot:
%
Closest distance between nearest existing structure and upland
edge of wetlands: feet
Closest distance betwee!) ne~est proposed structure and upland
edge of wetlands: '35-1 Q feet
Does the project involve excavation or filling?
No / Yes ._~~.
If yes, how much material will be excavated? ,.2;.
cubic yards
How much material will be filled? . ~ > cubic yards
1';>1 II "_
Depth of which material will be removed or deposited:~
Proposed slope throughout the area of operations: \ J.. 0<-<> ,
Manner in which material will be removed or deposited:
~ . -f t;r-- ~
\ '
Statement of the effect, if any, on the wetlands and tidal waters ofthe town that Ill!!}' resllltllY
reason of such proposed operations (use attachments if appropriate):
,
617.20 .
PRO.JECT ID NUMBER APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
PART 1. PROJECT INFORMATION (To be completed by Applicant or Project Sponsor)
SEQR
1. APPLICANT I SPONSOR
~
2. PROJECT NAME
~' ~
3.PROJECT LOCATION:
Municipality
County
provide map
4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent
It ":t<' l.U0r ~ "WJ.
5. IS PROPOSED ACTION: D New
6. DESCRIBE PROJECT BRIEFLY:
~~~,~~
7. AMOUNT OF LAND AFFECTED: [<3 'i2<>
Initially acres Ultimately acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
~es D No If no, describe briefly:
9. WHAT IS PRESENT LAND USE IN VICINITY
D Residential D Industrial Dcommercial
OF PROJECT? (Choose as many as apply.)
DAgriculture 0 Park I Forest I Open space~ (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (F~~ State or Local)
DYes ~o If yes, list agency name and permit I approval:
11~
~es
ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APP.ROVAL?
D No 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
Applicant I Sponsor Name ~ ~
MY KNOWLEDGE
Date ':tJ jn! ~ (;,
Signature
If the action Is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment
.
.
,
PART II - IMPACT ASSESSMENT To be com leted b Lead A enc
A. DOES ACTIO CEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.41 If yes, coordinate the review process and usa the FULL EAF.
o Yes No
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative
declaration ma be uperseded by another involved agency.
c=J Yes No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, ~Iegible)
C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal,
r::r erosion, drainage or flooding problems? Expiain briefly: J
C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly:
I~ I
C3. Vegetation or fauna, fish. shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
~ :1
C4. A~'S existing plans or goals as officially adopted, or a change in us. oc intensity of use of land oc othec natural r.soucces? Explain bdefly il
C5. ro~uent development, or related aclivities likely to be induced by the proposed action? Explain briefly: I
C6. Long term, short term, cumulative, or other effects not identified in C1-C5? Explain briefly:
I~ I
C7. Other im acts including chan es in use of either uanti or t e of ener ? Explain brief! :
~
D. WiLL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONME~REA (CEA)? (If yes, explain briefly:
c=J Yes ~o I
E. IS THERE, O~THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain:
c=J Yes ~NO I
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 otherwise 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 of the 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 youh~ive-aetermmecr.baseaonthe information and analysis above and any supporting- documentation,thatthe proposed 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
-=t-/,<:{ IOh
} Date
Signature of Responsible Officer in Lead Agency
om responsib e 0 cer)
Pnnt or rype Name of Responsible Officer 10 Lead Agency
.
~ Board of Trustees APPli!!!ion
County of Suffolk
State of New York
~"\.."" ~ 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
REPRESENT ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
~~-~~;/
Signature
SWORN TO BEFORE ME THIS_( 7+b
DAYOF \ TuJu
-v f
,20~
MElANIE OOROSKI
IIOTARY PUBLIC, Slate 01 New lIlIk
No. 01004634870
Co Q~alilied in Suffolk CounlY "' /-vY_
IIIIIlIssioo expires Septembar30.~
.
.
APPLICANT/AGENTnREPRESENTATlVE
TRANSACTIONAL DISCLOSURE. FORM
The Town ofSouthold's Code of Ethics orohibits conflicts ofinterest on the Dart of town officers and emolovees. The Durnase of
this Conn is to nrovide information which can alert the town of oossibJe conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME:
(Last name, first name, .qtiddle initial, unless you are applying in the name of
someone else Of other entity, such as a company. If so, indicate the other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance
Variance
Change of Zone
Approval of plat
Exemption from plat or official map
Other
(If "Other", name the activity.)
Building
Trustee
Coastal Erosion
Mooring
Planning
Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee
of the Town of Southold? "Relationship" includes by blood, marriage, or buslness interest "Business interest~ means a business,
including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation
in which the town officer or employee owns more than 5% of the shares.
YES
NO
lfyou answered "YES", complete the balance of this 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/agent/representative) and the town officer or employee. Either check
the appropriate line A) through D) and/or describe in the space provided.
The town officer or employee or his or her spouse, sibling, parent, of child is (check all that apply):
_A) the owner of greater than 5% of the shares of the corporate stock of the applic~t
(when the applicant is a corporation);
_B) the legal or beneficial own~ of any interest in a non-corporate entity (when the
applicant is not a corporation);
_C) an officer, director, partner, or employee of the applicant; or
_D) the actual applicant
DESCRIPTION OF RELATIONSHIP
Submitted this _day of
Signature
Print Name
200
Form TS I
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Ms. Donna Wexler
1175 West Hill Rd.
Southold, NY 11971
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
August 23, 2006
RE: 1175 West Hill Rd., South old
SCTM#70-4-23
Dear Ms. Wexler:
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
As per your request, your application for an Administrative Permit to install a fish
pond and Japanese Garden has been withdrawn. Enclosed is your refund check in the
amount $50.00
AJK:lms
Sincerely,
Jam~g,~6
Board of Trustees
.
.
James F. King, President
Jill M. Doherty, Vice-President
P~~.Dickerson
Dave Bergen/
. ~. ~ Holz~fel
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Southold Town Board of Trustees
Field InspectionIWorksession Report
,
Date/Time: <:tj
-
Name of Applicant:
POf'I1IA uJeJ... Ie....
~ Dn!..
Name of Agent:
Property Location: SCTM# & Street \\ 1 S weH fu \ \ r../ ./ S ov'lb..<>lj
Brief Description of proposed action:-vs h ro" ~ ".J.. 30\rZ.ecJ
~ of area to be impacted:
_Saltwater W etland _Freshwater Wetland _Sound Front _Bay Front
Distance of proposed work to edge of above:
Part of Town Code proposed work falls under:
_Chap!.97 _Chap!. 37 _other
Type of Application: ~ W etland _Coastal Erosion _Amendment _Administrative
_Emergency
Info need9d: ('t. r ( . r
n.~~!.. f>c, b..... -s.f.". /t.Ld . ~-'" tc.,,-cl 0- I'
Modifications:
Conditions: ~-('(:...... ,......C~ ;'r~'
--Present Were: _J.King _:.I. Doherty _P .Dickerson ~ Bergen _J .Holzapfel
Other: .
..
Mailed/Faxed to:
Date:
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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) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
November 16, 2005
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Donna Iglesias-Wexler
200 Castle Hill Rd.
Cutchogue, NY 11935
RE: 1175 WEST HILL STREET, SOUTHOLD
SCTM# 70-4.23
Dear Ms. Wexler:
The following action was taken at the Southold Towrl Board of Trustees regular meeting
held on Wednesday, November 16,2005:
RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a
Transfer of Permit #2048 from Agnor and Elaine Benson to Donna Wexler, for a
bulkhead and dock, as issued on August 28,1985, located 1175 West Hill Rd.,
Southold.
If you have any questions, please contact our office at (631) 765-1892.
Sincerely,
d.u~. -t tJ. ~.' (j, .
Albert J. Krupski, Jr.
President, Board of Trustees
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New York State Departmetof Environmental conservaln
Division of Environmental Permits, Region One
Blilding 40 - SUNY, Stony Brook, New York 11790-2356
Phone: (631) 444-0365 . FAX: (631) 444-0360
Website: www.dec.state.ny.us
Ai
....
~
Denise M. Sheehan
Acting Commissioner
LETTER OF NON JURISDICTION - ARTICLE 25
December 5, 2005
Ms. Donna 1. Wexler
200 Castle Hill Road
Cutchogue, NY 11935
Re: Application #1-4738-03511/00001
1175 West Hill Road, SCTM# 1000-70-4-23
Dear Ms. Wexler:
Based on the information you have submitted and a review by our technical staff, the
Department of Environmental Conservation has determined that:
The property landward of the bulkhead greater than 100 feet in length and constructed prior to
8/20/77 as shown on the survey prepared by John C. Ehlers'last revised 08/03/05 is beyond
Article 25 (Tidal Wetlands Act) jurisdiction. Therefore, in accordance with the current Tidal
Wetlands Land Use Regulations (6NYCRR Part 661)no permit is required.
Be advised, no constrnction, sedimentation, or disturbance of any kind may take place
seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit.
It is your responsibility to ensure that all precautions are taken to prevent any sedimentation or
other alteration or disturbance to the ground surface or vegetation within Article 25 jurisdiction
which may result from your project. Such precautions may include maintaining adequate work
area between the tidal wetland jurisdictional boundary and your project (i.e. a IS' to 2Q' wide
construction area) or erecting a temporary fence, barrier, or hale bay berm. -...
.
John Wieland
Permit Administrator
Please note that this letter does not relieve you of the responsibility
permits Or approvals from other agencies or local mnnic' alities.
cc; BMHP
file
Albert J. Krupski, President
Jame8 King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A, Dickerson
.
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Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
December 21, 2005
BOARD OI'l'OWN TRUSTEES
TOWN OF SOUTHOLD
Ms, Donna Wexler
1115 IN. Hill Road
SQl.1thold, NY 1 ~971
,
;,.---
Re: 1175 W, HILL ROAD, SOUTHOLD
SCTM# 70-4.23
J U L 1 7 2006
Dear Ms. Wexler:
The coard of Towll Trusttltll3 took the following action during its regular meeting held on
Wednesday, December 21, 2005 regarding the above matter:
L.H_
WHEREAS, DONNA WEXLER applied to the Southord Town Trustees for a permit
under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance
of the Town of Southold, application dated October 21,2005, 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 December 21, 2005 at which time all interested persons were given an
opportunity to be heard, and,
WHEREAS, the Board members have personaliy 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 proposal complies with the standards set forth in Chapter 97 of the
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,
Board Of Southold 'Town Trustees
SOUTHOLO, NEW YORK
PERMIT NO. . ("2~9... DATE: ..!l.~c;..2l..,.2.005
. . DONNA WEXLER
ISSU ED TO .........................................~.................................. ..... .......................... .... ...........
i\utqnri!tttiutl
fUrzUll!1T to Hie provl$!ons of Chapter 615 of tho Law~ of
the State of New Yor~ 1893; and Chapter 404 of tho laW$ ofthe
. State of New Yor~ 1952; and the Southold To-.4-n Ordinance en-
taloa ~(<REGUl:ATlNGAND .THE.PLACING OFOnS.T.R.UCllO/::lS
IN AND ON TOWN WATERS AN!) PUOLlC LANDS and.the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS.f-iOM
LANDS UNDER TOWNWATERS;\!. and in Accordance with .tho
Rosoliltion of The Board adopted at a moetlnq held on ..!1.!l.!;..,."ll;..
. ~.QQ.?~.. and in consideration of the lum of $?,?Q....Q.Q..... p41d by
.. .....__......~'?f.lf.I!3....~~ ~~-,!.:r...................... .... .......... ................... ..........................;...................
of . ........5.9.':'.t)1.Cl.1.9..........................:............... N. Y. and $ublect to the
Terms and Col1difjQns Ii$ted .on tho reverse side horllof.
of Southold Town Trusteel. authoriles al1d permlh the followln9:
Wetland Permit to conslruct an addition to the existing dwelling, repair the existing deck and construct a
new dock, relocate the sanitary system. maintain the existing driveway. and construct stone walls at the
north entry, with the condition of containing ail runoff In drywells. and the placement of haybales during
constr~ction. and ali as depleted In the plans drawn by Ira Haspel Architect last dated 10-18-05.
all in accordance with the detailed ~pe<ljficatlons as presented In
.the onglnatl119 appneatiOl1.
IN WITNESS WHEREOF. The $ald Soard of Tnl$toos here-
by cau"", Us ClriWrato'l Sea! to be affl~ed. ~i1il f/:,ml pre$enk to
be subsetlbed by 04 m&j,,'ffy of t~{. $1I1c: Boflt'! U Qf this dllb,.
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TERMS and CONOmQNS
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~.. of doe eootlderatloa lOt the ISsuaaL'e of che Pctmltdoes \IOdeltta.lId and l'~ lo ili~ M. .
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t. Thatfhe md,~ ~l 'rrW-Wtf ~d tb~ Tmm of Sootlm!d .ue t-e1~1ed -&om t.D.)' a4d
. ~ . .~n;'-'6("" ~ r.IAi!l:lil tIM: 'd~ 0' ~ "..~.u.Nf31"~ hc!lr.t<t!r (I' .l't$U~t of ~ o~.
~.p1o~"-'ll:d .f.liN~tllt:'!(t'!t.1\'~I.,..~'fi1't,. W."'~ ~ l~:~"~~r'.,j:'!i..l!f..H.~!~ ~r"~~ ~ (~. .
cieleoci.aA1 &Ad .u tud1 tul((I..,tl'~br tbltd.,utie$, and wuaid~ .""I"~~ ,,'!1llab1rA!i
~+, .1tt.i~. th~, 1,q.~~p1etC~uslOll of fhellQud of ~. of ~ ToWn of ~.
2. 1':~t'lhlJ~.11b: ~,; ~f.lM. let ,. ~.Md of ..;,k4~cnos. wbkh. b ~. to be ~
~tcd tilac' R<{ulted to .(:t;mplete doe _de fnyol\'Cd, but 'sboo1d Qr_~ .....uW<, :~d~t..
for t.D. exteaSIon ftlA)' be made to the lloUd f.( .. .btcI: -el(.'", . .
..' 5. That chis l'eQnit should be retained lndeflolte1y, or as loog as doe ,a1~ i'c,url"~". <'rhl;", .
(Q '",.lnt.I'1 the stt\lCtUCc ot J><C!Je<:t 1n'l'Olvcd, to J>rovlde evldtflQl to ....yOM (ol1cerocd !hat autb.
~tion was orflllnallJ obt;'!~-
4, '[bat the wo/k Inyolvcd wiUbe IIIhlea to the ~on and awrcna1 i)f ~ iD<oct.] ""-'
!r< ..,,~n(l<, on" QQn-wi1.i!'~ .",lib. ;,h.: pt,.,iI1:I<l1 (,( lb., cd,~c:'*,.!: 'r1>llQltioa, maybe calISe for
mOcatiOQ of chis Puml.t by ~1"tlUi.i III ~ ;.::.W iJ.:~ld. .
. S. That ~ will be no unreasooalile intedetel1(e wi<h oa~ as .. rcoWt of the wock
h<~tfi a~thmv.eod. . ,.
'6, That chctc sbaU' be QO intetfetU1ClC with the right of .che JiUl>l.k w ~ ~d ~"i'H' 'h~'
.b~ "'''.clJ l~'-Cl! ~'!f1and low 11"* marks.
7. That if futulC operadoos of 6.~ T.M(('- ,,( tloutb?ld ~ die. ~ aad/ot a1tel'&lloc!s
In. the loottJM oiw. ~ ~--cl.. ;:.:!!:.._l~i .,r U, 10 the O!'fnIoaof.>>oara oi n.-e.i, cbo,
work. shall cause u~lc ob.~tNmOC1 to free M..-ls2doo, the sat>!! Pritlll:l!!~" 'r.'i.ij ~ ~<:4
lIpon'due nolke, to ...,.,,,,, 0. .It;: 01.1. 'l'P'!:'rl< or !,"')ea~' ~ '1iWl.:.t :tl:;:"~1['l "ol~"'~ T;r:yr.'
. of $o!ltholcl.
. 8. That the said Boatd wiU be ,,,,t:I::.111y t~~ ~':1tIluee 0\ ihe ~ec1oIl:Of the wo/k.tlJlh.
otbcd.
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9. 'Ibatche :pCJ:mltUe wl.:I;J,t-ln ,tl ~. ~ and CIOCIIeilei -dJat -1 be requhed sap;
(llemeotal cocblc {*lIilt wbld1 ma1'be .Jea torevo~ Ilj>OO (aIJQn to ...-
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Albert J. Krupski, PreSident.
.James King, Vice~President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
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rrown Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765.1366
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SH/\.U. BE CONSICl::RED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
j Pre-construction, hay bale line
1st day of construction
7
Y:i constructed
Project complete, compliance inspection.
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F (',;: :"":,', 'c::', i'-,::,L the Board ofTrustees approve the application of DONNA WEXLER to
construct an addition to the existing dwelling, repair the existing deck and construct a
flew deck, relocate the sanitary system, maintain the existing driveway, and construct
stone walls at the north entry, with the condition of containing all runoff in drywells, and
the placement of haybaies during construction, and a!! as depicted in the plans drawn
by Ira Haspel Architect la:3t dated 10..18-05,
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 0"1 the
date of this notification.
Inspections are required at a fee of $50.00 per inspection. (See attached schedule.)
Thi8 is not a determination from any other agency.
Fees: $100.00
Very Truiy Yours,
tll~ 9. 4~'r},
Albsli J. Krupski, Jr.
President, Board of Trustees
AJK/l1kc
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