HomeMy WebLinkAboutTR-6746
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
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
CERTIFICATE OF COMPLIANCE
# 0311C
Date Mav 8. 2008
.
THIS CERTIFIES that the 4 'X 300' path leading to a 3 'X 40' open-grated elevated walk to a
4 'X 125' path to a 3 'X 53' open-grate dock with 4'X 8' steps to grade on the we side
At 105 Waterview Dr.. Southold
Suffolk County Tax Map #78-7-9
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated 9/12/07 pursuant to which Trustees Wetland Permit #6746Dated 10/17/07 was
issued, and conforms to all of the requirements and conditions of the applicable
provisions of law. The project for which this certificate is being issued
is for a 4'X 300' path leading to a 3'X 40' open-grated elevated walk to a 4'X 125' path to a
3'X 53' open-grate dock with 4'X 8' steps to grade on the we side.
The certificate is issued to DOMINIC NICOLAZZI owner ofthe
aforesaid property.
ro<~
Authorized Signature
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
.
Town Han
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
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
7-
INSPECTION S HEDULE
Pre-construction, hay bale line
1 st day of construction
% constructed
Project complete, compliance inspection.
.
.
TERMS AND CONDITIONS
The Permittee Dominic Nicolazzi. residing at 105 Waterview Drive. Southold. New York, as
part of the consideration for the issuance of the Permit does understand and prescribe to the
following:
I. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit, and the said Permittee will, at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto, to the complete exclusion of the Board of
Trustees of the Town of South old.
2. That this Permit is valid for a period of 24 months, which is considered to be the estimated
time required to complete the work involved, but should circumstances warrant, request for
an extension may be made to the Board at a later date.
3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to
maintain the structure or project involved. to provide evidence to anyone concerned that
authorization was originally obtained.
4. That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
for revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work
herein authorized.
6. That there shall be no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations in
the location of the work herein authorized, or if, in the opinion of the Board of Trustees,
the work shall cause urrreasonable obstruction to free navigation. the said Permittee will be
required, upon due notice, to remove or alter this work project herein stated without
expenses to the Town of Southold.
8. The Permittee is required to provide evidence that a copy of this Trustee permit has been
recorded with the Suffolk County Department of Real Properties Office as a notice
covenant and deed restriction to the deed of the subject parcel. Such evidence shall be
provided within ninety (90) calendar days of issuance of this permit.
9. That the said Board will be notified by the Permittee of the completion of the work
authorized.
10. That the Permittee will obtain all other permits and consents that may be required
supplemental to this permit, which may be subject to revoke upon failure to obtain same.
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
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
October 17, 2007
Mr. Dominic Nicolazzi
105 Waterview Drive
Southold, NY 11971
RE: 105 WATERVIEW DRIVE, SOUTHOLD
SCTM# 78-7-9
Dear Mr. Nicolazzi:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, October 17, 2007 regarding the above matter:
WHEREAS, DOMINIC NICOLAZZI applied to the Southold Town Trustees for a permit
under the provisions of Chapter 275 of the Southold Town Code, the Wetland
Ordinance of the Town of Southold, application dated September 12, 2007, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory
Council and to the Local Waterfront Revitalization Program Coordinator for their findings
and recommendations, and,
WHEREAS, the LWRP Coordinator recommended that the proposed application be
found Inconsistent with the LWRP, and,
WHEREAS, the Board of Trustees has furthered Policy 5, 6, 9 & 11 of the Local
Waterfront Revitalization Program to the greatest extent possible through the imposition
of the following Best Management Practice requirements: a shorter 3' x 40' open grate
material for walk starting and ending on grade and 2.5' above grade over ditch, an open
grate material is used for the dock, and
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on October 17, 2007, at which time all interested persons were given an
opportunity to be heard, and,
2
.
.
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 275 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,
NOW THEREFORE BE IT,
RESOLVED, that for the mitigating factors and based upon the Best Management
Practice requirement imposed above, the Board of Trustees deems the action to be
Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5
of the Southold Town Code, and,
RESOLVED, that the Board of Trustees approve the application of DOMINIC
NICOLAZZI to install a 4' x 300' path to a 3' x 40' open grated elevated walk starting
and ending on grade and 2.5' above grade over ditch to a 4' x 125' path on top of berm
to a 3' x 53' open grate dock with 4' x 8' steps to grade on the North East side, with the
condition that the walk and dock are constructed using an open grate material, and as
depicted on the survey prepared by Sea Level Mapping, last revised on October 25,
2007 by Dominic Nicolazzi, and received on November 13, 2007.
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 of the
date of this notification.
Inspections are required at a fee of $50.00 per inspection. (See attached schedule.)
Fees: $ 50.00
Very truly yours,
r-~~
James F. King
President, Board of Trustees
JFK/eac
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
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
DOiv\~ (\; (' ;(),'r olo..z..z.....i
TO:
Please be advised that your application dated SeD~ I ~ ,0J:::07 has
been reviewed by this Board at the regular meeting of c:t..ivber 1'7 OlOo?
and your Iication has been approved pending the completion otthe
follow' items checked off below.
Revised Plans for proposed project
Pre-Construction Hay Bale Line Inspection Fee ($50.00)
1st Day of Construction ($50.00)
_ ronstructed ($50.00)
~ Final Inspection Fee ($50.00)
Dock Fees ($3.00 per sq. ft.)
Permit fees are now due. Please make check or money order payable to Town
of Southold. The fee is computed below according to the schedule of rates as
set forth in Chapter 275 of the South old Town Code.
The following fee must be paid within 90 days or re-application fees will be
necessary. You will receive your permit upon completion of the above.
COMPUTATION'OF PERMIT FEES:
,_ 0<..)
TOTAL FEES DUE: $ :.J 0 ~
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('~ 1)')
1I1t>@
BY: James F. King, President
Board of Trustees
5Mf 10/47
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NEW V.STATE DEPARTMENT OF ENVIRONMENTAL ISERVATION
C PERMIT NUMBER
1-473e.o2838/00002
FACILITY/PROGRAM NUMBER(S)
o
EFFECTIVE CATE
Februarv 20 2004
EXPIRATION CATE(S)
February 20, 2009
:,1
Under the Environmental
Conservation Law
PERMIT
TYPE OF PERMIT. New 0 Rene"",1 0 Modification. Permit to Construct 0 Permit to Operate
o Article 15, Title 5; Protection of Waters
o Article 17, Tilles 7,8; SPDES
I
o Article 19; Air' Pollution Control
o Article 27, Tille 9; 6NVCRR 373;
Hazardous Waste Management
o Article 34; Coastal Erosion
Management
o Article 15, Title 15; Water Supply
o Article 15. Tille 15; Water Transport
o Article 15, Title 15; Long Island Wells
o Article 15, Tille 27; Wild, Scenic and
Recreational Rivers
o Article 23, Title 27; Mined Land
Reclamallon
o Article 24; Freshwater Wetlands
o Article 36; Floodplain Management
o Articles 1, 3, 17, 19, 27, 37; 6NVCRR
380; Radiation Control
. Article 25; Tidal Wellands
o 6NVCRR 608; Water Quality Certifica-
o Article 27, Tille 7; 6NVCRR 360;
tion Solid Waste Manaoement
PERMIT ISSUED TO TELEPHONE NUMBER
Dominic Nicolazzi (631) 698-5088
ADDRESS OF PERMITTEE
81 Pineaire Avenue Farminaville. NY 11738
CONTACT PERSON FOR PERMITTED WORK '. TELEPHONE NUMBER
Catherine Mesiano, 12 Mill Pond Lane, East Moriches, NY 11940-1222 (631) 878-8951
NAME AND ADDRESS OF PROJECTIFACILITY
Nicolazzi propertv, northwest comer of Waterview Drive and Main BaY\liew Drive SCTM #1000-78-7-9
COUNTY TOWN WATERCOURSE NYTM COORDINATES
Suffolk Southold Goose Creek
DESCRIPTION OF AUTHORIZED ACTIVITY:
Construct pool and deck at rear of existing single family dwelling, construct 3' x 100' elevated walk, 3' x 60'
elevated walk, 3' x 53' catwalk with 4' x 8' steps at seaward end and place wood chips on existing 3' x 200'
and 3' x 125' paths. All work must be done in accordance with the attached plans stamped NYSDEC
approved on 2/20/04,
~ ,I
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all
applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part
of this permit.
PE~MIT ADMINISTRATOR: ADDRESS :.'
Mark C. Carrara ICKWl Reaion 1 Headauarters Blda. #40 SUNY Stony Brook NY 11790-2356
AUTHORIZED SIGNATURE ~ k DATE
February 20, 2004 Page 1 of4
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SEA LEVEL
-MAPPING
b EAST MAIN STREET
RIVERHEAQ NY 11'101
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THI5 PLOT ~5 DEVELOPED
FROM 5URVEY5 OF 10-26-02
ROBERT H. FOX, NY5 Lie.- 5OIQ1
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.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
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 InspectionIWork session Report
Date/Time: \ D /10\ 01
DOMINIC NICOLAZZI requests a Wetland Permit to install a 4' X 100' on-
grade walk, 4'X 20" wood chip path, 3'X 60' elevated walk, min. 2.5' above
grade, 4'X 125' wood chip path, leading to a 3'X 53' timber dock with 4'X 8'
steps to grade. Located: 105 Waterview Dr., Southold. SCTM#78-7-9
~e of area to be impacted:
_Saltwater Wetland _Freshwater Wetland Sound _Bay
Distance of proposed work to edge of above:
Pyrt of Town Code proposed work falls under:
\L.Chapt.275 _Chapt. Ill_other
Type of Application: 4etland _Coastal Erosion Amendment _Administrative
_Emergency _Pre-Submission _Violation _Planning
ke. yk/GJ rM^ I\rlS iLeA- ~+ (OJ -hH
Info needed:
f'! ~ +0
Modifications:
Conditions:
./- tI ~/ / ./
Pr~t Were: _I.Ki)lg _I.Doherty _P.Dickerson _D. Bergen_ B. Ghosio, Ir
_H. Cusack _~. Dzenkowski _Mark Terry_other
Form filled out in the field by
MailedIFaxed to:
Date:
Enviromnental Technician
Review
.
.
Donald Wilder, Chairman
Lauren Standish, Secretary
Town Hall, 53095 Main Rd.
P.o. Box 1179
Southold, NY 11971
Telephone (631) 765-1892
Fax (631)765-6641
Conservation Advisory Council
Town of Southold
At the meeting of the South old Town Conservation Advisory Council held Wed., October
10, 2007, the following recommendation was made:
Moved by Jack McGreevy, seconded by Peter Young, it was
RESOLVED to SUPPORT the Wetland Permit application of DOMINIC NICOLAZZI to
install a 4' X 100' on-grade walk, 4'X 20" wood chip path, 3'X 60' elevated walk, min. 2.5'
above grade, 4'X 125' wood chip path, leading to a 3'X 53' timber dock with 4'X 8' steps to
grade.
Located: 105 Waterview Dr., Southold. SCTM#78-7-9
Inspected by: Jack McGreevy, Peter Young
The CAC notes that the project was not staked, however, Supports the application with
the Condition the walkway is constructed using "Flo-Thru" open grating.
Vote of Council: Ayes: All
Motion Carried
Board Of Southold Town Trustees
PERMIT NO. .
SOUTHOLD, NEW YORK
.~4'1t1'
DATE: ..Nov. .20thT. 2002
ISSUED TO .................J?QMJNICNICOLAZZI .... ..........
Aut4nrilutinu
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 WATERS;!.'; and in accordance with the
Resolution of The Board adopted at a meeting held on ..f'.l.()~.~. 2.G..!J:1
. 2~~.~..., and in consideration of the sum of $...200...00. ... paid by
.. Cather-il'le...Mesian""."n.behalf..nf..D~)"ihti'itc"'Ni"diT;fz.zi.....................
of.~.:.:Ea.G.t..Hodch.".s.,................... N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Ir\l.!tees authorizes af.l~--24!rmits the following:
Wetland Pennit to construct a SO'xl1S' irrcg. two story house and atlached garage - 4S'x79'
irreg. deck and inground pool, septic system, pervious driveway, site grading, two proposed
elevated walks. 3.5'x1OO' and 3.5'x6O' both minimum 2-1/2' above grade and 4'x6Y fixed
timber duck minimum 3.5' above grade with 4'x8' steps to grade - 3'x325' wood chip paths.
aU in accordance with the detailed specifications as presented in
the originating application.
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 maJority of the said Board as of thiS date.
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OFFICE WCATION:
Town Hall Annex
54375 State Route 25
(cor. Main Rd. & Youngs Ave.)
Southold, NY
MAIUNG ADDRESS:
P.O. Box 1179
Southold, NY 11971
Telephone: 631765-1938
Fax: 631 765-3136
LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR
TOWN OF SOUTH OLD
MEMORANDUM
To: James King, President
Town of South old Board of Trustees
./
From: Mark Terry, Principal Planner (f)
L WRP Coordinator
~ ~ ~. &::: n \') IF.: I.'~~.\
c; U G "" "I
1---.-----.' I'!
"I 0 CT 1 5 2007 . i
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Date: October 15, 2007
Re: Proposed Permit to Construct a Dock for DOMINIC NICOLAZZI
SCTM#78-7-9
DOMINIC NICOLAZZI requests a Wetland Permit to install a 4' X 100' on-grade walk, 4'X
20" wood chip path, 3'X 60' elevated walk, min. 2.5' above grade, 4'X 125' wood chip path,
leading to a 3'X 53' timber dock with 4'X 8' steps to grade. Located: 105 Waterview Dr.,
Southold. SCTM#78-7-9
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the
Town of South old Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. Based upon the information provided on the L WRP Consistency Assessment Form
submitted to this department, as well as the records available to me, it is my recommendation
that the proposed action is INCONSISTENT with the denoted following Policy Standards
and therefore is INCONSISTENT with the L WRP.
Policy 5. Protect and improve water quality and supply in the Town of Southold
The use and need for the dock is unsubstantiated. The proiect area demonstrates shallow
water depths in the vicinity of the dock structure area 1.8' and 0.8' AL W respectivelv.
The installation of the proposed structures mav promote power boat traffic and the
possible followinl! nel!ative impacts mav occur from vessel use:
1. Impacts to submerl!ed aquatic vel!etation,
2. Contamination from fuel discharl!es (if power vessels are proposed)
3. Erosion on shorelines, and
4. Re-suspension of bottom sediments and turbiditv
To further the above policv and to reduce turbiditv in the event that the proposed action is
approved, the followinl! Best Manal!ement Practice is recommended:
( )
.
The encirclement ofthe entire proiect area durin!! construction with a silt
boom or floatin!! turbidity screen to control the dispersal of suspended
solids in the water column.
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems
including Significant Coastal Fish and Wildlife Habitats and wetlands.
6.1 Protect and restore ecological quality throughout the Town of Southold.
6.2 Protect vulnerable fish, wildlife, and plant species, and rare ecological
communities.
The proposed action is located within a marine wetland. Activities durin!! dock
construction can destrov ve!!etation either above or below the tide line bv pullin!! them
from the substrate or destrovin!! their root svstem. The peat beds underlvine: salt marshes
can also be compacted throu!!h the improper use of heavv equipment.
The proposed construction practices ofthe dock have not been identified. It is
recommended that the applicant identifv the proposed construction practices.
6.3 Protect and restore tidal and freshwater wetlands.
A. Comply with statutory and regulatory requirements of the Southold Town Board of
Trustees laws and regulations for all Andros Patent and other lands under their
jurisdiction
1. Comply with Trustee regulations and recommendations as set forth in
Trustee permit conditions.
The applicant must demonstrate that the followin!! dock standards pursuant to &
275-11. Construction and operation standards have been met.
(d) Review and approval of dock applications. Before issuing a permit for a dock
structure, the Trustees shall consider whether the dock will have any of the following
harmful effects:
[1] Whether the dock will impair navigation or be located in areas of high vessel
traffic or vessel congestion;
[2] Whether the dock will unduly interfere with the public use of waterways for
swimming, boating, fishing, shell fishing, waterskiing and other water-dependant
activities;
[3] Whether the dock will unduly interfere with transit by the public along the public
beaches or foreshore;
[4] Whether the dock will significantly impair the use or value of waterfront property
adjacent to or near the dock;
[5] Whether the dock will cause degradation of surface water quality and natural
resources;
The construction materials (type of timber) of the proposed dock and catwalks have
not been identified. In addition, plans indicate that water depth in the vicinity of the
dock structure is 1.8' and 0.8' at AL W respectivelv.
( )
.
[6] Whether the dock will cause habitat fragmentation and loss of significant coastal
fish and wildlife habitats;
The proposed dock and elevated catwalks will result in a net loss of a Critical
Environmental Area.
[7] Whether the dock will result in the destruction of or prevent the growth of
vegetated wetlands, sea grasses including eelgrass (Zostera marina) and widgeon grass
(Ruppia maritima) or shellfish;
The applicant does not propose l!rid deckinl! therefore the structure will result
impede the l!rowth of shellfish. Whether the dock would impede the l!rowth of sea-
l!rass is unknown the applicant has not submitted information on whether seas l!rass
is present or absent in the area.
[8] Whether the dock will unduly restrict tidal flow or water circulation;
[9] Whether the dock will be safe when constructed;
[10] Whether the dock will adversely affect views, viewsheds and vistas important to
the community;
[11] Whether the cumulative impacts of a residential and commercial dock will change
the waterway or the environment and whether alternate design, construction, and location
ofthe dock will minimize cumulative impacts; and
[12] Whether adequate facilities are available to boat owners and/or operators for
fueling, discharge of waste and rubbish, electrical service and water service.
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and
public resources of the Town of South old.
9.4 Assure public access to public trust lands and navigable waters.
E. Provide access to, and reasonable recreational use of, navigable waters and
public trust lands under water.
1. Provide for free and unobstructed public use of all navigable waters
below the line of mean high water for navigation, recreation, and other
public trust purposes, including the incidental rights of public anchoring.
Piers, docking facilities, and catwalks must not result in
an unnecessary interference with use of public trust lands.
Alternatives to long piers or docks include use of dinghies
to reach moored boats and mooring in nearby marinas.
Dredging solely to accommodate the draft of larger boats
is not a recommended alternative.
c. by extent and characteristics of the developable adjacent upland
area and its ability to support in-water development for the water-
dependent use.
f) .
c. by potential adverse effects on natural resources and their uses,
and
d. by potential adverse effects on public safety.
The applicant currently eniovs access to the water body. The proposed
leUlrth of the dock structure will impede navieation of Goose Creek. In
addition the dock structure would impede public access to navigable waters
below the line of mean hieh water.
Due to environmental constraints of this location (tidal wetlands. shallow
water depth of this area). the proposed action may not be suitable in the
proposed location. The applicant currently eniovs access to the water. A
moorine in areas of ereater water depth is a better alternative and would
further the above policies.
4. Structures extending beyond the milllIllum necessary for access to
navigable waters impair public trust interests and open space values
associated with the water's surface. Allow such structures only in the
following circumstances:
a. when necessary for practical and convenient operation of water-
dependent industry or commerce, and provided that obstruction
of commercial navigation does not result.
b. for commercial recreational boating facilities provided that:
(i) the loss of navigable waters and use of underwater lands is
offset by sufficient public benefit, and
(ii) obstruction of commercial navigation does not result.
c. when the principal purpose of the structure is necessary:
(i) to provide public access for recreational uses
(ii) for improvements for navigation
(iii) for protection from coastal hazards, or
(iv) for essential public transportation and transmission
facilities.
5. Ensure that navigable waters and marine navigation, whether on land or
sea, are not obscured or rendered ineffective through poorly placed or
directed lighting.
The proposed action is private. noncommercial and will not support a
pattern of development that enhances community character nor preserves
"public" access or public recreational activities.
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters.
C. Foster the occurrence and abundance of the Town's marine resources through:
1. protection of spawning grounds, habitats, and water quality,
It is recommended that the proposed action be amended to further the above listed policies
to the extent practical.
'1
f'
.
Figure 1. Nicolazzi parcel.
Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing
its written determination regarding the consistency of the proposed action.
,
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Town Han
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
~ Er: IU H Jffl
Sfp '2 2007 ~
------Coastal Erosion Permit Application
L Wetland Permit Application _ Administrative Permit
/ Amendment/Tra erIE tension
.o.eceived Application: .;2, 07
LReceivedFee:$ :r
~ompleted Application i:)
_Incomplete
_SEQRA Classification:
Type I_Type II_Unlisted_
_ Coordination:( date sent)
.....-r:wRP Consistency Assessment Form <:II \ 1.\\ CS)
..eAC Referral Sent:~
--"Pate ofInspection:~
_Receipt of CAC Report:
_Lead Agency Determination:_
Technical Review:
..-1'iiblic HearingHe~
Resolution:
SOUlhhold Tow.
Board of Tl1Isleet
Name of Applicant })6VYl1NIL NICOL/12-z-/
Address (0 S- \/Uv"/-Tt.Jt 0[Ev..I
PtZ.IV'f_
:> DJTHvUJ kY
Phone Number:(n.) b 67 -70C 7
Suffolk County Tax Map Number: 1000 - 7 IS - 7 - <J
Property Location: COiILNt:-..A. Or M,tJ-f'V Ilift/J/G'-J ~o""r()
A--r4 0 ,-,nITtf.LVt~ '-V -t?.ttvt _ LrLco fote #'S $ 7 - s: t
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
N/"
,
fHPlIU'l~
v
C~ 0"
~ \'}O\
<:.}I\
Address:
Phone:
,
/
~rd of Trustees APPlicati~
GENERAL DATA
Land Area (in square feet):
2:15)0/'-1
Area Zoning:
f(-'-fo
Previous use of property:
Vt101"" L~O
Intended use of property:
(l~ -:. I ~f..,-7I-o l-
Covenants and Restrictions:_ Yes
If "Yes", please provide copy.
X No
Prior permits/approvals for site improvements:
Agency
S"'o.s<I/-<>'-!l ~.J
I'd,"). 06-C
~ate
II 2"'/" z..
I l-
i sl ~L
_ 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:
;4A>
I'L. tz.-" T i/-n L-v""'-. '5 ""~
/It:-t/o~ "'... "5"~f~","o""O.
Project Description (use attachments ifnecessary):
.
3/l(~~
'])oc k:.. ~
(
""
wlTtof
CA-T'-^'III-t..-k (6L~V"'-IItf) W4LkS)
"'--, , I I
:? x. ~o I 3 X 100
'-t' I\..g' 5fffy" ro Gtl.,.OF
'-f I ^ '() 2 5'" I .....,OGO r I/. I P I.,.nf"
c<.>........~TL'7 /'7€(M""C-Q €. ~'
"'rd of Trustees APPlicati~
,.
WETLANDffRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: l)<:>C-L.- ,;. c "'FT'--J of<. 4. ,-..0
11 <CCf> s S
C-c:, cst: C ~ IE /r
Area of wetlands on lot: 107, 00 () square feet
Percent coverage oflot: (0'. -:;-8 %
Closest distance between nearest existing structure and upland
edge of wetlands: 75 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: <0 ' feet - ~ 7' ui7'c..~
Does the project involve excavation or filling?
x
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:
/VC> f/YIli7l:.vl9' l.- ..-v"L- ;f; !'
(L./- #*"'\6U"'-A 'biL 1)~.....S,t ~
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):
-FlI~ L-vILL (I,~ ~ e.,cFI€c r 0"-' ~
v" trt.-,q-,...",) i T rOo/t..- "'-'ffT'Ul-5 of 7fff' 7O.....Ai.
f
",rd of Trustees APPlicati~
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity:
Co 11/ -'V 4 C{:bf 1 ~
k"OU c~.L:
~ 't ""197' of
C -'1-(<-v,f~4. ~ 00cA..
L
Are wetlands present within 100 feet ofthe proposed activity?
No X Yes
Does the project involve excavation or filling?
k. No Yes
If Yes, how much material will be excavated? =------- (cubic yards)
(cubic yards)
How much material will be filled?
Manner in which material will be removed or deposited:
>-10
>10 -t-74u HZ
....'u ,z"i
A'&~ oA--
OVc><"V'Ln
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
from implementation ofthe project as proposed. (Use attachments if necessary)
{I/l-~ Sl/of../LO JgL-. AfO 6.NV'''-L>N~ ' -..I''''c-r-}
,IJ.'j ~ tU<fjvt4 0':: T/k; flZ-tJeJur.
PROJECT ID NUMBER
I-
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
I
PART 1 - PROJECT INFORMATION
1. APPLICANT I SPONSOR 2. PROJECT NAME
DO"'-"\INIC jI)(CoLt1-Z-Z- ( pVICoCP'f"Z-"Z- f
3.PROJECT LOCATION:
Municipality :Souif/Ol-Q County Svq::.Fo,-~
4. PRECISE LOCA TtON: Street Addess and Road Intersections. Prominent landmarks ete - or provide map I
/O~ Gv""/~(..(')l'~ DilNL C o-<AI f..<t. of M~ I1/rtVIC-/ tLP to.
- . I
~b.,),llfo~ N." .........~r<.tt-UJ 4A.....J o,,-<vr. .
5. IS PROPOSED ACTION: ~ New D Expansion D Modification I alteration
6. DESCRIBE PROJECT BRIEFLY:
I' .", ~ 4..<- Ooc:..-4-
c4To.-v"1 L4 .' loC '0 ,
f/rvQ
7. AMOUNT OF LAND AFFECTED:
Initially ~ acres <0 Ultimately a acres 0
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
~s D No If no, describe briefly:
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.)
eM.. Residential D Industrial DcommerCia' DAgriculture D Park I Forest I Open Space D Other (describe)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
~Yes ONO If yes, list agency name and permit I approval: O€.c..
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
~Yes ONO If yes, list agency name and permit I approval:
N.'I.S. O~
1Q; A ~~T OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION?
es 0
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant I Sponsor Name ), 1J Q..-v-.' "" L IV I {JJV'9 "'L f Date: Y/l <>!o 7
Signature y- ~ ~'-v1
~
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 ITa be comDleted by Lead Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF.
DYes ~o
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No. a negative
declaration may be superseded by another involved agency.
Dves ~
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, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
I jJO I
C2. Aesthetic, agricultural. archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly:
I ,uo I
C3. Vegetation or fauna. fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
I ND
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:
I AjU I
C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:
I NO I
C6. Long term, short term, cumulative, or other effects not identified in C1~C5? Explain briefly:
I tVU I
C7. Other im acts (includino chanoes in use of either Quantity or type of enerqy? Explain brieflv:
I JvOA..i't- I
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA (CEA)? (If yes, explain briefly: I
Dves ~o I AJCyV L
E. IS THERE, OR IS THERE L1KELV TO BE, CONTROVERSV RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ves explain:
Dves ~NO I fvOA./L-.
I
PART III . 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) selling (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (el
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, the determination 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 direcUy 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 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
Date
Print or Type Name of ResponSible Officer In Lead Agency
Title of Responsible Officer
Signature of Responsible Officer in Lead Agency
Signature of Preparer (If different from responsible officer)
.
.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, If.
Town Han
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
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
---------------------------------------------------------------
In the Matter ofthe Application
of
- ,
____~!)J)Ctl_{lLj:~__~(_~Qt~~~____________________
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
I, jjo <M<N' c..N1 (.L 1-L?./ , residing at Ii:>)" Vv~7>f:.R..U( ~ O-z.
,So-..l7ff-el-O
being duly sworn, depose and say:
That on the fltf day of 0 cr , 2007; I personally posted the property known as
lor '-V?-It.L-.t~....., ()L. ~ow-.-tf,Jv..o
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
hearing. Date of hearing noted thereon to be held U 1Ot1. ("'J6f. lI.dO:),) - "
In 0'1. (Jt{)u+ (p;OO 11 .
Dated:
~~~( r./
(SI e) '"
Sworn to before me this
, aday ofOd. 200 T--
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No Public
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PS Fonn 3811. February 2004
7007 1490 0004 0640 5421
DomestIc Return RoceIpl
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CERTIFIED MAIL RECEIPT
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341081929
1189290477 -0095
(239)513-9161 03:41:32 PM
Sale. Receipt
Sale Unit
Oty Pri ce
Product
De.cription
Final
Price
SOUTHOLD NY 11971
Zone-6 Fir.t-Cla.s
Letter
0.30 oz.
Return Rcpt (Green Card)
Certified
label #:
$0.41
$2.15
$2.65
70071490000406405469
.."'.....~
Issue PVI:
$5.21
$0.41
SOUTHOLD NY 11971
Zone-6 Fir.t-Cla..
Letter
0.30 oz.
Return Rcpt (Green Card)
Certified
Label #:
$2.15
$2.65
70071490000406405452
.............
I..ue PVI:
$5.21
$0.41
SOUTHOLO NY 11971
Zone-6 Fir.t-Cla..
Let te r
0.30 oz.
Return Rcpt (Green Card)
Certifi ed
Label #:
$2.15
$2.65
70071490000406405438
.........
I..ue PVI:
$5.21
$0.41
SOUTHOLD NY 11971
20ne-6 Fir.t-Cla..
Letter
0~.30 oz.
Return Rcpt (Green Card)
Certified
Label #:
$2.15
$2.65
70071490000406405445
.....=......
I..ue PVI:
$5.21
$0.41
SOUTHOLD NY 11971
Zone-6 Fir.t-Cla..
LetUr
0.30 oz.
Return Rcpt (Green Card)
Certified
Label #:
$2.15
$2.65
70071490000406405391
........
Issue PVI:
$5.21
$0.41
FLUSHING NY 11358
Zone-6 Fir.t-Cla..
Letter
0.30 oz.
Return Rcpt (Green Card)
Certified
Label #:
$2.15
$2.65
70071490000406405407
I..ue PVI:
$5.21
$0.41
SOUTHOLD NY 11971
Zone-6 Fir.t-Cla..
Letter
0.40 oz.
Return Rcpt (Green Card)
Cert i fi ed
Label #:
$2.15
$2.65
70071490000406405384
Is.ue PVI:
$5.21
$0.41
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NEW YORK NY 10013
Zone-6 Fir.t-Cla..
Letter
0.30 oz.
Return Rcpt (Green Card)
Certified
Labe 1 #:
$2.15
$2.65
70071490000406405421
........
.
~
Issue PVI:
$5.21
$0.41
SAG HARBOR NY 11963
Zone-6 Fir.t-Cla..
Letter
0.30 oz.
Return Rcpt (Green Card)
rert ifi ed
. 'Label #:
$2.15
$2.65
70071490000406405414
........
I..ue PVI:
$5.21
Total:
$46.89
Paid by:
Di.cover $46.89
Account #: XXXXXXXXXXXX2413
Approval #: 003040
Tran.action #: 591
23 903572139 1602870816
... IMPORTANT: For Return Receipt
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enter label number(.); select 'Reque.t
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PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
,.f/kM,ur ~{\jtc'flll tJt<>oA/
. vILT3/L 0 LI 0<'-'
Address:
qs- eU-e-ulTrl <--trJt, So--TIIo<-<? '^'-~. 11"(71
(, sZo ",,,,"'~""vo"''-<J "-0.) Sou 7tf< <..o,;.-':f, "~"'f
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STATE OF NEW YORK
COUNTY OF SUFFOLK
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I Do"",,,,,/( N,cot...ltZ-cl,residingat IO~ (....HtTtiut'f..o-i r.OlZ.
:),~ JTIHl <-9 ' being duly sworn, deposes and says that on the
day of (~C T. ,2007, deponent mailed a true copy of the Notice
set forth in the Board of Trustees Application, directed to each of the above named
persons at the addresses set opposite there respective names; that the addresses set
opposite the names of said persons are the address of said persons as shown on the current
assessment roB of the Town of South old; that said Notices were mailed at the United States Post
Office at PL;:: ~ that said Notices were mailed to each of said persons by
certified (registered) mail.
~u- tl.c. u.4.
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Sworn to before me this ~;l
Day of 0&0<< , 20...at.
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Town of Southold
.
.
L WRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
I. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
making a determination of consistency. * Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area (which includes all of South old Town).
3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the L WRP policy standards and conditions contained in the consistency
review law. Thus. each answer must be explained in detail. lisoo!!: both supportin!!: and non-
supportin!!: facts. If an action cannot be certified as consistent with the L WRP policy standards and
conditions, it shall not be undertaken.
A copy of the L WRP is available in the following places: online at the Town of Southold 's
website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# /0 0 0 - 7 B
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PROJECT NAME
The Application has been submitted to (check appropriate response):
Town Board 0 Planning Board 0 Building Dept. 0 Board of Trustees a
1. Category of Town of South old agency action (check appropriate response):
(a)
Action undertaken directly by Town agency (e.g. capital
construction, planning activity, agency regulation, land transaction)
o
o
(b) Financial assistance (e.g. grant, loan, subsidy)
(c)
Permit, approval, license, certification:
~
Nature and extent of action:
TfLv~ l't "8 !f:.rL....-" / TO cO"'VSJi!.-u:.-r
rH7Lv-'1Lk
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, ~
.
.
Location of action: !DY ...,>4T<t.LVI",,-/ rN.../IIL. ;jOi.JrW-v<-a.
-
Site acreage:
5: Y;
Present land use:
f2 ~ "'> I O-<;'~1141 _
Present zoning classification:
~ - 'ti)
2. If an application for the proposed action has been filed with the Town of Southold agency, the following
information shall be provided:
(a) Name of applicant: ~O,"",,^",,<-j\JI6:l0<."Z t'
(b) Mailing address: /0"- <-./.>9--nt:J2-I/l t:-v
01'/.,
, Sov/If<J"1J
,
(c) Telephone number: Area Code (96) & D 7 - 700 7
(d) Application number, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes 0 No IEl If yes, which state or federal agency?
A.)M.;"L
C. Evaluate the project to the following policies by analyzing how the project will further support or
not support the policies. Provide all proposed Best Management Practices that will further each policy.
Incomplete answers will require that the form be returned for completion.
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and
minimizes adverse effects of development. See L WRP Section III - Policies; Page 2 for evaluation
criteria.
[EtYes 0 No 0 Not Applicable
'If'. (}cx-4 /J--;c-(.. ..."IV,_1n-
fJ9 1\1 0, II"'U lion- 11 jC L-"..-r I
,^,1/lV'H- ~
L ~ ,vt-TJ.f
~
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
L WRP Section III - Policies Pages 3 through 6 for evaluation criteria
~ Yes 0 No 0 Not Applicable
.
.
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/"'0
I~ ^'O ~'" CrtJ\)~
FII-u^V- t:7"L tL6- ""-<lv""'--
/l.~ ~\JI~ V)
t>~ "n~_
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See
L WRP Section III - Policies Pages 6 through 7 for evaluation criteria
o Yes 0 No 0 Not Applicable
IAiI't-1'I
.floc,,^- ~ &<Q~ "- rlftRlI-
""'"h~ l-&/V/"IPTJ ;#M~ ~
Lo4,J f'1!k!'O~ L~
-v 1f1~
,I:ft..-
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See L WRP
Section III - Policies Pages 8 through 16 for evaluation criteria
QJ Yes 0 No 0 Not Applicable
\~ 0ou.. IS
<:.11 /Q-llY _ I /\J 0 \1(" iI- rro
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"'l,JA/l.-Vl""'J.-~
~"""
,/\" 'iJ 'HI- ~
L-' tr~ ftNO trJ't---
I'H3 dVC-
rv
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III
- Policies Pages 16 through 21 for evaluation criteria
~ Yes 0 No DNotAPPlicable
D,)~ /l--tlr 6-4-;-./ -0'- ~/ ~1"'f___ lA ~
10 ~ ~ J.u I!Il4')
Attach additional sheets ifnecessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22
through 32 for evaluation criteria.
~
o
o
W~RKING COAST POLICIE.
.
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See L WRP Section ID- Policies; Pages 47 through 56 for evaluation criteria.
gYes D No D Not Applicable
-r FI-<c iP<-4
4ulf-\<' 70
<
~ (].o<1.:j',./VIJ-( '- <V I{ (
C:<X>-;;L " 11''' ~h..
F/k.Ir'~
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters. See L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria.
G2l Yes D No D Not Applicable
,tI-r
T-fhI.
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PLO~C-("-v
c 4--r-IA/~ ~ C """" I S v--....---
.:) I'" .-1-7 J?-'U/I./-z '--t-9 ~ v , , " R
cv('rfi
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages
62 through 65 for evaluation criteria.
~Yes D NoD Not Applicable
Oo~
AcT (Pl.' 4Jl.. ~
"v I TI/-
Itt:..ttl C~L M.A.-4L /~ ~
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III - Policies; Pages 65 through 68 for evaluation criteria.
~ Yes D No D Not Applicable
fie < 4J /hV n c. 197<-o/4C4
1O.Rc.-S p.e r L4"~U"'t 7 ~ ~SOU~
PREPARED BY Dr) \,N\ I/VI c.- Nt Cd [1'f2? 4TITLE
D <.N1'lf ~
-
DATE~
Yes
No
Not Ap.able
.
-r -If-.c< f1.rC- I <,.
<,~ %!4J
NO
A-'r
F l.-o t9-"1 T H---Pr
DOvJ 7/LJ(..
v><,t:-#-f
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Attach additional sheets if necessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies
Pages 32 through 34 for evaluation criteria.
~ Yes D No D Not Applicable
o~s
/lA) '1
G~/'J~~
~ PULL- r:,~
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
[!j Yes D No D Not Applicable
{)pt.~ I\-()v c-+.-.I\JEI--~I'€:.- "",vH'n- ,,/=- ~ 0,'-'4
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public
resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation
criteria.
[f] YeD NoD Not Applicable
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(1"'/'bfLH-I..... vv 11/1
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fv V!. /....IC
1"',<.-,:),<c~
'" Cc..bS ~
Attach additional sheets if necessary
4Ilard of Trustees ApPlicat~
County of Suffolk
State of New York
I Ow"v..-I '- ~~ ~. BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HEI HE 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.
&- L"l~J-
Signature
SWORN TO BEFORE ME THIS
"
DAY OF St:...f/
2007
'-
ft5:'^~~7Z~
Notary Public
NoIarJ ~~..;,...
No.UI 0....
Quotlllldflt...~
Commlaalon EIjlIIn...... If, ~ '8
.
.
APPLICANT/AGENTnREPRESENTATfVE
TRANSACTIONAL DISCLOSURE FORM
The Town of South old's Code of Ethics orohibitc; conflicts of interest on the Dart of town officers and emnlovees. The nuroose of
this Conn is to nrovide information which can alert the town of DOssible conflicts of interest and allow it to take whatever action is
necessarY to avoid same. '
YOUR NAME:
AJICO{t<f-2-'Z.{- O~''IA'-,T
(Last name, first name, J1liddle initial, unlesJ ynu are applying in the name of
someone else or other entity, such as a company. If so, indicate !heather
person's or company's name.) .
NAME OF APPLICA nON: (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
ofthe Town of South old? "Relationship" includes by blood, marriage, or business 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
k--
If you answered "YES", complete the balance of this fonn and date and sign where indicated.
Name of person employed by the Town of Southold .Pvo>V2-
Title or position of that person p./N'"z.-
Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check
the appropriate line A) through D) andlor describe in the space provided.
The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply):
_A) the owner of greater than 5% of the shares of the corporate stock of the appiicant
(when the applicant is a corporation);
_B) the legal or beneficial own~r of any interest in a non-corporate entity (when the
applicant is not a corporation);
_C) an officer, director, partner, orernployee of the applicant; or
_D) the actual applicant.
DESCRIPTION OF RELATIONSHIP
pI/l'NL--
Submitted this _day of 200
Signature ~ ~ .
Print Name ..::.. ;:: t h"vul
Form TS I
Plan View
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SGALE 1"= 100' ....
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Propooed Timber
DoGk - 3' x 53'
(min. 2.5' oIcN. 'iTJ
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Applicant. Dominic. Nlcolazzl
~ Proposed. Dock 4 Ii'lalks
~, Purpose. Private Moarlnq
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on top or bet""m
pla"e VIIood c.hlps
3' x 125' -t/-
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Proposed
D~elllng
See plans
by other.
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Cro~,~ S,ections BClYview R;;'''''''''''' 0" ~""I/S"Je.
Scale. I - 20 d Pi'.v &:-c2-r'\--fu ct
Proposed ~?.....-<L)
Dock - 3' x 53' ~
10.:"'. - - -.." - _ed~~,9'-.., (mJrL 2-5'_.abo"'LgcadeJ,..,.. -.
( ...... ond. ...Ith 4' x e' steps
4" x 4"
po.t.
12' o,c.,
of e oJ G'1/-,}'f'E
'0" ..~~~"~~,.. Proposed"1:levated "alk (typlGO! of 2) edqe of
;" I I 3' x 1J0' (min. 25' above grade) ......flond.
:-, 14'X 4" 1- '''! l"X\;;'~' \' ',Ion' I "I""
p05t5
100,c..
:l
5 --_._"-
: utilize
, 8xleting
o~path-on-.----
: top of
berm
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AL~
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If Do-''''<''
NICo,"'/l~ I
PREPAR
SEA LE'
, ,--MAPPI
exIst. bttm.
utHize
exi!iotlng
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berm
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AM
11-18-02. 06-13-03. 01-
THiS PLOT I"lAS DEVE
FROM SURVC:YS OF 10-
ROBERT H. FOX, NYS Lic.'
e,33,Ob~ \\Hp "1""",,e..\(:I""I,"\(1;,.
Sheet I Of I
LOr"l.dViard m05t HalkVia~ l"Iill 013
l^loodc..hlp Path Or"l grade - iF permitted
1120/2004
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