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HomeMy WebLinkAboutTR-985 Michael J.Domino,President 0f S0Ujy0 Town Hall Annex John M.Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 CA A.Nicholas Krupski • Telephone(631) 765-1892 Greg WilliamsO Fax(631) 765-6641 o enu N,�1c� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 13, 2017 Joseph Frohnhoefer 235 Azalea Road Mattituck, NY 11952 RE: MAMIE CHIANG & GORDON LAU 1450 JOCKEY CREEK DRIVE, SOUTHOLD SCTM# 1000-70-5-17 Dear Mr. Frohnhoefer: On November 8, 2017 and on December 5, 2017, Field Inspections were performed and it was determined that the existing docking facility on the above mentioned property is non-functional and does not match any of the dimensions of the dock permitted under Wetland Permit#985. The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, December 13, 2017: RESOLVED, that the Southold Town Board of Trustees DENIES WITHOUT PREJUDICE the request for a Transfer of Wetland Permit#985 from Agnes Pagnozzi to Mamie Chiang & Gordon Lau, as issued on August 6, 1973; with the condition that an application for a Wetland Permit be submitted for the existing docking facility. If you have any questions, please contact our office at (631) 765-1892. Sincerely, W&Xt'd/ 4-rt ► Michael J. Domino President, Board of Trustees MJD/dd Michael J. Domino,Preside �Og11FF0(,�Co �y Town Hall Annex John M. Bredemeyer III,Vice-Presfoent ��� Gym, 54375 Route 25 Charles J. Sandersy P.O.Box 1179 Za Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski Telephone(631)765-1892 HCl �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �5 Completed in field by: c> Joseph Frohnhoefer on behalf of MAMIE CHIANG & GORDON LAU requests a Transfer of Wetland Permit#985 from Cheryl Pagnozzi to Mamie Ciang & Gordon Lau, as issued on August 6, 1973. Located: 1450 Jockey Creek Drive, Southold. SCTM# 1000-70-5-17 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: C c�, 'A6 Present were: J BredemeyerM. Domino . Goldsmith Krupski C. Sanders Other Page 1 of 2 Michael J. Domino, Preside O�Q$UfFO(�COG Town Hall Annex John M.Bredemeyer III,Vice-President �� y� 54375 Route 25 Charles J. Sanders ti z P.O.Box 1179 Glenn Goldsmith 0 Southold,NY 11971 A.Nicholas Krupski A � p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Joseph Frohnhoefer on behalf of MAMIE CHIANG & GORDON LAU requests a Transfer of Wetland Permit#985 from Cheryl Pagnozzi to Mamie Ciang & Gordon Lau, as issued on August 6, 1973. Located: 1450 Jockey Creek Drive, Southold. SCTM# 1000-70-5-17 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 .�� +; r►j ,., "k r. 1 i'y\ y. t:y tri l� Marnic Chiang&Gordon Lau t i _p Jockey Crock Drive,Southold A, 4 1000-70-5-17 rl'2/5/17 two, r - _ �l`-=- � •k.'�'i� �� �' �. ♦-. 1� '• �, >.3. _ IL i' 000 WWI- os r i l JIt -�� IL mix`�� i 1?i - .; - '" ;r� ' '��, �re i�' � /,.ql :� 1;t^�• _ir � kr, ��� 1 1 1 1 AtV - ' '7,l.,;`- oil � oil �i - ` Michael J. Domino, Presi g�FFO(,�O�Q CCG Town Hall Annex John M. Bredemeyer 111,Vice-President W_ 54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith ® Southold,NY 11971 A.Nicholas Krupski y p! Telephone(631)765-1892 �Ol �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: � / �`7 Completed infield,by: 4 Joseph Frohnhoefer on behalf of MAMIE CHIANG & GORDON LAU request a Transfer of Wetland Permit #985 from Cheryl Pagnozzi to Mamie Ciang & Gordon Lau, as issued on August 6, 1973. Located: 1450 Jockey Creek Drive, Southold. SCTM# 1000-70-5-17 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: Alld ��J&44_110, Present were: J..--Bredemeyer _ M. Domino ^�G. Goldsmith N. Krupski r C. Sanders Other Page 1 of 2 Michael J. Domino,Presi(I SUFFO(� � �0 C� Town Hall Annex John M. Bredemeyer III,Vice-President �y� Gym 54375 Route 25 Charles J. Sanders y P.O.Box 1179 Ze Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski ypl� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Joseph Frohnhoefer on behalf of MAMIE CHIANG & GORDON LAU request a Transfer of Wetland Permit#985 from Cheryl Pagnozzi to Mamie Ciang & Gordon Lau, as issued on August 6, 1973. Located: 1450 Jockey Creek Drive, Southold. SCTM# 1000-70-5-17 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: , Completed By: M Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski I C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 Mamie Chiang&Gordon Lau 1450 Jockey Creek Drive,Southold SCTM#: 1000-70-5-17 I1-8-17 4 / � •tel A ' 'M 1 Jockey Creek Drive,Southold .+ c' 1000-70-5-17 11-8-17 411 it ,�-,,'• .. .R� ,�fy �.: ! ` ` hy .f �.'�a',r i� � . 711. ot 410� M 1 � - f v , MIN, Marnic Chiang&Gordon Lau —04 1450 Jockey Creek Drive,Southold i�CTM#: 1000-70-5-17 , ' to R r 09 w 44 vp OL Nt Ip k. as lig 44 r _ T . �? ., ?•`• Y•••.\`.� � W, .', - -..:fes _ `-_ yr-'• ♦mr pi so Michael J.Domino,President V,�'' yOIO Town Hall Annex John M.Bredemeyer III,Vice,President r 54375 Route 25 Charles J.Sanders P.O.Box 1179 en `., CSouthold,New York 11971 Glenn Goldsmith G�, � �` � Telephone(631)765-1892 A.Nicholas Krupski �CO' e�:` Fax(631)765-6641 t BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD APPLICATION FOR A TRANSFER OF A WETLAND PERMIT ,a DATE----.Z> OWNER cr� _4-N&i,t Lc;A.I i PHONE b Lb .4: MAILING ADDRESS P�i� 4a� "l ►�� �c ,,,�•[A AGENTA1C, PHONE 63i ADDRESS c1t- PROPERTY LOCATION 'r 'vlcac:(e-m C r e-ex iD:i e 5 c'0t1A&'11)/1; ( L`CA-7 k TAX MAP NO. la,-5 — �1 1 I(We. ���A. ono•� �. a iA Lu, request a Transfer of Permit# from 4 �� Signed y. OCT 1 3 2017 Southold Town ar Tito Board of Trustees Application AFFIDAVIT v avvit'A,Cl%vkA• ay.l6ctrdoN LaU BEING DULY SWORN DEPOSES AND AFFIRMS HAT 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 I NOWLEDGE 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 BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRAN'T'ED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF PERMIT. *ct e S' r Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF 20 l Notary Public Alyce May Len Lau Notary Public,State of New York No.01LA6066304 Qualified in New York County Commission Expires Nover?bw 13,2Qjlq Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I1We, U"4mmie- A, 6_1VCV A �,au owners of the property identified as SCTM#1000- 0. -S�J �� in the town of New York,hereby authorizes +� L to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town - Board of Trustees for this property, f exrv- . .a aL4prt Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS `C DAY OF 1 .01 otary Public Alyce May Len Lau Notary Public,State of Now York No.09LA6066304 Qualified in New York County Commission ExPirQ5 November 13,2Qa APPLICANVAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts ofinterest on the part oftown officers and employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same r YOUR NAMAA E: U"1VAL'&' A. (:A&k At n t:VCih d (Last name,first name,ipiddle initial ess you are applying in the name of someone else or 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 Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibl'mg,parent,or child)have a relationship with any officer or employee " ofthe Town of Southold?"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%ofthe shares. YES NO r` ` Ifydu answered"YES",complete the balance of this form and!late 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 appiicant/agcnt/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,or child Is(check all that apply): A)the owner of greater than 5%ofthe shares ofthe corporate stock ofthe applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(whey the applicant is not a corporation); ' C)an officer,director,partner,or employee ofthe app Gcanh or p)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of QW 7i0 i Signature Print N e / ` ' Form T5 1 r.r Gln�.kt� APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of ILossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,first name,.rpiddle initial,unless you are applying in the name of someone else or 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 Building variance Trustee Change of Zone Coastal.Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,name the activity.) 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 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 ifyou answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold (-L L G 0 e 1�S�rrJ4 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,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner 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 RELATIONS141P _ r-1 rc o X46,0 3 r &-L/ C0-- L,-,0n/21frz r s Cif Submitted this ay o ® 201V 17 Signature ---� Print Name ": 1 E ifA - �- Form TS I PEP ab. .. :!'�'"�t � ':Yc";: d N �`:g :, `.c,�'.,H \;,•\. N.j -.. ,, ./irk,y �� / ., S: r'A{ ,rS �_,.� ;`✓;: l��s "\"- .:;�_`_ bi�; \�4?�xr :r x`14 ,, •'C�. � iY¢,� vr� <, / / I ` .�' / __-- —_ _ __ ,` ` _'— ` __ " ___ _ _ _ __'_ •' _ ,v /� =�s �"sT�/s-."��'�i��e�",;,sa✓,s°��,��'�"�'sj"�'�e'r ,:;'��..,P�ar�-� z•'=� E'_''�.`?;.��•�,�v�r„w,T':;E'�'"r„ � ''A�3— :Y ®ard ®f Southd d Town Tru sues ff SOUTHOLD, NEW YORK 985 August 6, DATE: g 197 j ? °: n1• PERMIT,NO. Cheryl Pagnozzi mea ISSUED TO . .. !� ` a `�. .� 'SII ,- ` � ,� ' � ` • Pursuant to the provisions of Chapter 615 of the Laws of . A a� 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 \ . 1 " ed REGULATING, AND 'THE PLACING OF OBSTRUCTIONS i'. IN AND ON TOWN WATERS AND PUBLIC LANDS and the { REMOVAL, OF SAND, GRAVEL OR OTHER MATERIALS FROM �d LANDS ,UNDER' TOWW WATERS;" and in accordance with the' Resolution of The Board adopted at a meeting held on August 6 AI 19•'73 , and in consideration of the sum of 18.40 paid by �o Cheryl Pa,gnozzi oJocke Creek Dr Southold' f ..-Y , �N. Y. and subject to the A \ f' Terms and Conditions listed on the reverse side hereof, �'• , ' , r ' s -• ii ' '.of Southold Town Trustees authorizes and permits the following: r litr« ; Construct a ramp 1- ft.- by 12 ft. , float 6 ft. by ;,j :'� 18 t. , with 4 pilings in front of her property at ' q�• 'Jockey' Creek, off Jockey Creek Drive, Southold, New York. =1 ` all in 'accordance with the detailed specifications as presented in lt; the originating application. rye '" 'IN ,WITNESS WHEREOF, The said Board of Trustees here- by,causes its Corporate ,Seal to be affixed, and these presents to Via' be subscribed by`a majority of, the said Board as of this date. �- ' ! '' ,I Trustees !., _f -a' �- �f.d_-cT-•---. ',P r�t d'.F'',Y'� =x., S J 1C VF �_,S r..`�Y .�- _ `:Y: , • \ �5 "r-o-t`a _ ,d -a'^ a*`d�..'T ._ —rir_-`-f.-• _.r• �,.tL:..s:�•.�+^� t �. ''eC, iX4 �i.�.-\4��y .J`r1{•:\-_�.� 'l/l1'1� i ,,.f rzh� 'Rem , :.�,sem,, - .. , f�`; `�. • „'�`, ._=1.'' -, ,r'% - - 'r,; n: i`.- - ,J;•', '• „ 'Qu:Ss;r4 t)..`.'�'.tro. . _ �Y u r 1`�1 ' - , .... . ,T1•..,"'R'' 1.,tea J ` i1• 5'i r {i , i • TERMS and.CONDITIONS The Permittee __ Cheryl Pagnozzi 43-44 161 ' Street, Flushing, New York 11358 residing at,Jockey Creek Drive, Southold N. Y, as pan of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: 1. 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 oper- ation 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 Southold 2: That this Permit is valid for a period of 12 " mos. which is oDnsidered 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 .I to maintain the structure or project involved, io provide evidence to anyone concerned that auth- orization was ,originally obtained. 4. That the work involved will be subject to the inspection and approval of the bard or its agents, and non-compliance with the provisions of the originating application;may because 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. „ G. That there shall be noninterference 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,off 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 unreasonable obstruction to-free'navigation,'the said Permittee will be required, upon due'notice, to removeor alter this work or.project herein stated without expenses to the Town `off Southold. That the said Board will be notified by'the,Permittee of the c6mpleta6n of the work auth- orized. 9. That the Permittee will-obtain all other permits and,consents that may'be required sup- jilemental to,this permit which may be subject to revoke upon failure,to obtain same. ....Lb•,`., °;nn,e „nT•ir.x:'r,T.l`t'4>t+•7T`+.:...i ?r,... , ,.•r,7" For a P3..-i•',\=i ' i ''��,',f' :i,.i;., , , va.,,r„ i '') , , ,l ,a 1 `v....r..�,4�,';j,y •a nil�t is�. Mei '1'%' 'f P/1 Rev/6/72 ,''' '' • ' - , ' ,' BOARD OF TOWN TRUSTEES Town 'of Southold Main Road ' ` Southold, New York 11971 =Miss Cheryl Pagnozzi; 43-44 161 Street, Flushing, New York 11358 ` To: ............ . ........ .I........ ........................ l: Your application, dated ...,,August 6 , .1973 .... has been reviewed by this August 6, 1973 Board, at a meeting of the Trustees held on .......... .................. ........... ............... ................. .. ... and resulting in the action, as indicated below- , ,F' • , (:..X ....) Application approved ` {..........:.)' ',Application denied., (............ Application tabled. 2.' 'Comments and remarks: 3. lfyour•application is approved above, A Permit Fee is now due, and should be made payable 'to the-order of the Board of Southold Town ,Trustees.; This fee is computed belovi according to the,Schedule of Rates as set forth in the Instruction Sheet (Form 1/1). 'If the Permit,Fee is paid in person to the.Secretary of the Board, The Permit will be obtainable ' 'at-the 'same time. If the fee is paid by mail, the permit will be mailed in reply. Computation of Permit Fee: ; Ramp—.,3 ft. , by 12 ,ft.= 36- sq. ft: ^C� 104, -------------- 3 . 60 Float= 6 ft. by 18 ft., = 108 sq'. ft. @10�------ -----$10. 80 : 4' .Pilings @ $1® 00 each----------------------------------$ 4. 00 $18'.40 TOTAL ;. Less filing fee —5.00 $13.40 DUE Total ,Fee' for this application .$.18.40... L....., $ 13..41 .. ..DUE.............. ALVAH B. GOLDSMITH ; Signed .............................................................. Chm. Board of Southold Towri Trustees " } , by .......... ....... ../.. Secretary. A. ,.,..^;f,''_ „,"Y'.; ,. .i:'s'�i. J'.i i.'7..,,.'a.. ,.,,.,r,'r•,. n„-.}`- ....._. .1;..__i...,..-.._ .,}(��,I4ru dtU\a e'`w''e,...;`.�`i,�:'�'x�int:rzi0.,'�s..,i=�Y ,Yb fid,,..aa: u r.,.,x..•�'.-,.,;F,v ri«� .. . nl v n , '' ;1} ,'i. A/2 - Rev. 6/-72 BOARD OF TOWN TRUSTEES Town Of Southold Main Road Southold, New York 11971 APPLICATION FOR FIXED and/or FLOATING DOCKS 1. Applicant's name and address: .. .C. r L. Z.V L 11 C, �N0 L......... ............................................................................... 2. Contractor's name and address: ..................................................................................................... ..................................................................................................... ............................................................... 3. Briefly explain th purpose of this application: ...../..4..�. ..... .© .1'`..... ...... r �........... ................................................................................................................................................................. .................................................................................................................................................................. 4. After issuance of a Permit, I expect to: (mark by an )0 (a) Commence work — AT ONCE .....,K.; ASAP ............: UNKNOWN ............. (b) Complete work in — 1 DAY /.,,?�­; 1 MO. ............: 1 YR. ............; FUTURE ............. 5. Secure the correct Area Map fromthe Secretary of this Board, and by using an X WITHIN A CIRCLE indicate as closely as possible the location of this dock. On the reverse side of this map, provide a SCALE DRAWING which will show Ordinary High Water Mark, the shape and size of the dock and any supplemental pilings which are needed to hold a floating dock or tie-up a boat. Give all dimensions necessary to determine the area of the dock surface which extends offshore from the O. H.. W. M. 6. Will any portion of this construction extend offshore into Town Waters beyond an imaginary line or boundary formed by other similar structures along the area's shoreline? YES or NO. If it does extend beyond this so-called dock line indicate by how far, approximately...........ft. /Q-0 7. Provide the following documents: (a) A Licensed Engineer's Survey of the property involved. (b) A copy of the Contractor's Plans and Specifications. 8. Will this construction require the Filling of any land offshore of the Ordinary High Water Mark or the Dredging of any material from Town Lands under water? YES or NO. If it does, Form A/4 (Application for Dredging/Filling) must be completed and attached as part of this application. N 0 9. In requesting approval of this application, I submit that: the information presented herein is true and correct to the best of my knowledge and belief; I am the person accountable for the performance of the work in accordance with the plans and specifications attached; I have read or am familiar with the provisions of any Southold Town Ordinance pertinent to the work involved; and further, I intend to adhere to and abide by the Terms and Conditions of the Permit, when and if issued to me. L. S. ......... ................. .Accepted by: Date .� . v" o .. A/1 - Rev. 6/7 BOARD OF TOWN TRUSTEES Town of Southold Main Road Southold, New York 11971 "APPLICA ION FOR A MOORING IN TOWN CONTROLLED WA RS: 1. Applicant's name nd address: ...11.f�.4. .. .•. ....,1„ ;; :� j.... ................................ ......................................... ................::5.oCJ_e.4..... . ................................ 2. Contractor's name an address: ........................................................... ......................................... ............................................... .................................................................. ............................................. � 3. What is being moored? .. _21a 7nn�..j......................................... .................................................. 4. If a boat is being moored, tate: Name of manufacturer .h}:c s � .................. .............. Reg. No. Nameof boat ...........N . .................................. .............. Color .Q b. dc................. Length .........I.q. .:zcr. ... Powered by W.t.b.ownd....kyu(f.Ir. -............... 5. What is your method of mooring? (mark by X in the proper space) ( 9 OFFSHORE MOORING (ty e & weig t) ...................................................................... ( ) OFFSHORE STAKE ( ) OFFSHORE STAKE with pulle ine to ONSHORE S/T/AKE (X) TIE-UP BETWEEN PILINGS ( umber of piles ....7:...P.. . '�� � � F/o)+fi/v� hoc_ ( ) SOME OTHER METHOD (des ibe) ...................................t................................ ................................................................. ..................... .......................................................................... ............................................................ ............................ ....................................................................... 6. After issuance of a Permit, I expect to: (mark y an X) (a) Commence work AT ONCE .. ....... .; SAP .............. .: UNKNOWN ................. (b) Complete work ' —1 DAY ....X.; 1 MO. .. .........: 1 YR. ............; FUTURE............ 7. Secure the correct Ar Map from the Secretary of thi Board, and by means of an X WITHIN A CIRCLE indicate a closely as possible the location o this mooring. On the reverse side of this map, provide a CALE DRAWING which shows Ordi ary High Water Mark, stakes, pilings or other anchoring evices to be used, and all distances in, feet 'between stakes and stakes. 8. Is access to the roposed mooring from PUBLIC or PRIVA shoreline property? (state which) ...�.�..1.V.IA. ...... If from private property not belongi to the applicant, provide a letter of con ent from the property owner. 9. At the mo ring's location: Wh is the approximate distance to the channel? ................ .............. ft. IN mber of other boats moored within 100 ft. ........ ................. .. 10. In aking this application, I declare that the placement of this moo 'ng will not be an im- pe ment to the normal boating needs of others. L. S. ?. ........ .................... Accepted by: Dat 3/-7 ' Doc.K a . so )N� CJ 1 20 �Qo�c�p p Po5 j v - I