HomeMy WebLinkAboutTR-868Jill M. Doherty, President
James F. King, Vice-President
Dave Bergen
Bob Ghosio, Jr.
John Bredemeyer
Town Hall Annex
54375 Main Road
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
# 0542C
Date: May 14, 2010
THIS CERTIFIES that the fixed 3'x54' catwalk with 3'x19' fixed "T" dock extension
and tie-off pile off of seaward end
At 1300 Strohson Road, Cutchogue, New York
Suffolk County Tax Map # 103-10-27
Conforms to the applications for a Trustees Permit heretofore f'fled in this office
Dated 5/4/00 pursuant to which Trustees Wetland Permit # 868
Dated 4/2/73 was issued and Amended on 6/22/01_, and Amended again on 2/25/04, and
Amended again on 7/22/09 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 the fixed 3'x54' catwalk with 3'x19' fixed "T~' dock extension and tie-off
pile off of seaward end.
The certificate is issued to JERRY & LINDA MATEJKA owner of the
aforesaid property.
Jill M. Doherty, President
James F. King, Vice-President
Dave Bergen
Bob Ghosio, Jr.
John Bredemeyer
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION:
J Ch. 275
Ch. 111
INSPECTION SCHEDULE
Pre-construction. hay bale line/silt boom/silt curtain
1st day of construction
% constructed
Project complete, compliance inspection.
INSPECTED BY: ~,
COMMENTS:
~',~a ~'r'?~'~ J ~,~' .~,~l,o ~.~ ~ ~
CERTIFICATE OF COMPLIANCE:
OFFICE LOCATION:
Town Hall Annex
54375 State Route 25
(cor. Main Rd. & Youngs Ave.)
Southold, NY 11971
MAILING ADDRESS:
P.O. Box 1179
Southold, NY 11971
Telephone: 631 765-1938
Fax: 631 765-3136
To:
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD _ .:
Jim King, President
Town of Southold Board of Trustees
From: Mark Terry, Principal Planner
LWRP Coordinator
Date: July 16, 2009
Re: Proposed Wetland Permit for JERRY & LINDA MATEJKA
SCTM#1000-103-10-27
JERRY & LINDA MATEJKA request an Amendment to Permit #868 to add a 3'X 19' fixed "T"
dock extension onto the seaward end of the existing dock. Located: 1300 Strohson Rd.,
Cutchogue. SCTM#103-10-27
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the
Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. Based upon the information provided on the LWRP Consistency Assessment
Form submitted to this department, as well as the records available to me, it is my
recommendation that the proposed action is CONSISTENT with the Policy Standards and
therefore is CONSISTENT with the LWRP provided that the following recommendations to
further the below listed policies are implemented.
Pursuant to Chapter 266, the Board of Trustees shall consider this recommendation in
preparing its written determination regarding the consistency of the proposed action.
Cc: Lori Hulse, Assistant Town Attorney
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapf¢l
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
APPLICATION FOR AN AMENDMENT TO A WETLAND PER_MIT'-'-~
ADDRESS
PROPERTY LOCATION
TAX MAP NO. //j' 6~ t) '
request an Amendment to Permit # ~'~, ,,~'
Si
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hall, 53095 Main Rd.
P.O. Box I 179
Southold, NY 11971
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application of
JERRY MATEJKA
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
I~"~¢,a.'/ Y'//~TL:O"~ , residing at 2dba
being duly sworn, depose and say:
Sworn to before me this
]$,44, dayof~00 c~
That on the/,0 day ot~x~_ , 200'~, I personally posted the property,known as
b/pCac~ng t~rus~t~s o~~wh~e ~t ~ e[tsi?yX'b; 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 Wed, July 22~ 2009 on or about 6:00 PM.
Dated: · )
Notary Public
CONNIE D. BUNCH
Notary Public, State of New York
No. 01BU6185050
Qua filed in Suffolk CountY
C~mmission Exoires ADd 14,
'~ PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Address:
Soothhold Town ,
Board of Trustees
· M~?4a.y /-qef~ , residing at _)~Y)~//~/.,. ..
/".3, Z,-~/...~q...e~e-~" , being duly sworn, ~eposes anc~ says mat on me
- ~-/.) day gt~ ~ ,200~, deponent mailed a true copy of the Notice
~et forth, inthe Boa{,d of Tqustees Application, directed to each of the above named
persons at the addresses set opposite there respective names; that the addresses set
oppo. site the names of said persons are the address of said persons as shown on the current
assessment roll of the Town of Southold; that said Notices were mailed at the United States Post
Office at ~./z-Tc:d-/O 6 1 ) ~ ,~otic~s were mailed to each of said persons by
(certified) (registered) mail. y // ~ ~
Sworn to before me this J '~ __
Day of 5~___, 20_D (~
Notary Public
Board of Trustees Application
County of Suffolk
State of New York
~"~ R ~ Y ft'//~7"~ ~ 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
^OREES TO.O~O ~HE TOW~ O~ SO~THO~O ~ THE ~OW~ T~STEES
.~SS ~ ~REE ~O~ ~ ~ AL~ D~^~S ~ ~,~S ,~SIN~
Sig'~re ~
SWORN TO BEFORE ME THIS c-~,q'4~ DAYOF ~c_L)~ ~
Notary Public
CONNIE D. BUN~
NO. 01BU§185050
(~ualifled in Suffolk County
Commission Fex~ir~ ~ 14,~0
Town of Southold
LWRP CONSISTENCW ~;SESSlVlENT FORM
A. INSTRUCTIONS
All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of Southold Water~ont 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.
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 Southold Town).
If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus~ each answer must be explained in detaii~ listing both supporting and non-
suooorting facts. If an action cannot be certified as consistent with the LWRP policy standards and
conditions, it shall not be undertaken.
A copy of the LWRP is available in the following places: online/-~
website (southoldtown.northfork.net), the Board of Trustees Off, lc
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION / ._..~
' ' ' L-.~oS~°rd of Trustees
The Appbeation has been submitted to (check appropriate response):
Category of Town of Southold agency action (check appropriate response):
(a) Action undertaken directly by Town agency (e.g. capital
construction, planning activity, agency regulation, land transaction)
(b) Financial assistance (e.g. grant, loan, subsidy)
(c) Permit, approval, license, certification:
Nature and extent of action:
Location of action: ~vBYJT_/
Site acreage: ~ ~
Present land use: ~9'~i~
Present zoning classification:
If an application for the proposed action has been filed with the Town of Southold agenc);, the following
information shall be provided:
(d) Application number, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes [] No [~ If yes, which state or federal agency?
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 LWRP Section III - Policies; Page 2 for evaluation
criteria.
~Yes ~ No [~/Not Applicable
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LWRP Section IlI- Policies Pages 3 through 6 for evaluation criteria
~ Yes ['~ No [-~N°tApplicable
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See
LWRP Section III - Polices Pages 6 through 7 for evaluation criteria
~ Yes ~ No~L~ Not Apphcable"
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP
Section III - Policies Pa~es 8 through 16 for evaluation criteria
[-'] Yes [] No[~-J/I ~r ~ Not Apphcable-
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section HI
- Policies Pages 16 through 21 for evaluation criteria
[-~ Yes ~ No[~l v INot Applicable
Attach additional sheets if necessary
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.
Yes No Not Ap~able
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 fo~/evaluation criteria.
[] Yes [] No IV[ Not Applicable
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
~ Yes [] No ~Not Applicable
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 IH - Policies; Pages 38 through 46 for evaluation
criteria.
~ Ye~-~ No ~/Not Applicable
Attach additional sheets if necessary
WORKING COAST POLICI~
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. S~e LWRP Section IH - Policies; Pages 47 through 56 for evaluation criteria.
[] Yes [--] No~ Not Applicable
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 LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria.
[] Yes ~-~ No ~/Not Applicable
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 ~ No[~t-~ Not Applicable
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.
TITLE.
DATE
1300 Strohson Road
Cutchogue NY 11935
Jerry W. Matejka
May 31, 2009
Board of Town Trustees
Town of Southold
Greetings,
I am writing this letter to request a pre-submission cenference at our property to
obtain input from the Trustees on our desire to add a "T' extension to the existing
fixed dock. The existing dock and tie-off pile was approved by the Trustees on
2/25/2004 and constructed.
Subsequently, we had hoped to add a ramp to the existing fixed dock and add a
floating dock, but were denied in April 2006 by DEC. We then appealed for a
formal hearing scheduled in August. We have been working with DEC on a
compromise and they have recently recommended the fixed "T" as a solution they
would accept obviating the need for a hearing
Enclosed is our check for $50., and a site plan and cross section of the proposed
work.
We grant permission to the Trustees to visit the property and we will plan on being
there on 6/10/2009 to answer any questions. Should the plans change, please call me
at 631-838-2900 to inform us of the date of the visit.
We look forward to your thoughts about out plans
Sincerely,
CC: DEC- Ms Dawn McReynolds
O
:~.
'LACE
S 82'26'50,,
N 84'54'20" W
NOUs£
F/o/x
162.45"
138.94'
SUFFOLK
S.C. TAX
V'V
S;TUA TE
NEAR PECONIC
TOWN OF $OUTHOL.D
COUNTY, NEW
No. 1000-103- 1~
~[~-C'ALE ~ "--'~0W
JANUARY 5, 2000
AREA = 15.587.2~ sq. ft.
BOARD, USTEES
'L OF
TOWN OF SOUTHOLD
NYSDEC
APPROVED AS PER TERMS
AND CONDITIONS OF
PERMIT NO
DAT~ ~'/,,s"/~, /~'/( '
Pa~7~ On/7-o
Southhold Towe
rd of Trusteee
6Y l S T/ I,O (,
c os5
F~9~ /._9
/!T" O/V-TO
NYSDEC
APPROVED AS PER TERMS
AND CONDITIONS OF
PERMIT NO, [' '/7 3 J~ - ,'~'~o//00~
DATE ~/,,s"]o9 k"62~'
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghos±o, 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
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~ONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
Pre-construction, hay bale line
1st day of construction
¼ constructed
Project complete, compliance inspection.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
July 22, 2009
Mr. & Mrs. Jerry Matejka
1300 Strohson Rd.
Cutchogue, NY 11935
RE: 1300 STROHSON RD., CUTCHOGUE
SCTM#103-10-27
Dear Mr. & Mrs. Matejka:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wed., July 22, 2009:
WHEREAS, JERRY & LINDA MATEJKA applied to the Southold Town Trustees for an
Amendment to Wetland Permit #868 under the provisions of Chapter 275 of the
Southold Town Code, the Wetland Ordinance of the Town of Southold, application
dated June 29, 2009, 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 issued a recommendation that the application be
found Consistent with the Local Waterfront Revitalization Program policy standards,
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 the Board of Trustees have found the application to be Consistent
with the Local Waterfront Revitalization Program, and,
BE IT FURTHER
RESOLVED, that the Southold Town Board of Trustees APPROVES the Amendment to
Wetland Permit #868 to add a 3'X 19' fixed "T" dock extension onto the seaward end of
the existing dock, and as depicted on the plan prepared by Jerry Matejka last dated
June 1, 2009 and stamped approved on July 29, 2009.
This is not a determination from any other agency.
Sincerely,
Jam F.~nK'ng, Presid~
Board of Trustees
JFK:lms
James F. King, President
Jill M. Doher~y, 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
Please be advised that your application dated ~ f~5']~ has
been reviewed by this Board at the regular meeting of ~) ~-~0 ~
and your application has been approved pending the completion of the
following items checked off below.
__ Revised Plans for proposed project
__ Pre-Construction Hay Bale Line Inspection Fee ($50.00)
__ 1st Day of Construction ($50.00)
__ ¼ Constructed ($50.00)
,,/' Final InsPection Fee ($50.00)
v"' 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 Southold 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:
TOTAL FEES DUE:
BY: James F. King, President
Board of TrUstees
James F. King, President
Jill M. Doherty, Vice-President
Pegg~ A. Dick~rson
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
Please be advised that your application dated ~ [o~q
been reviewed by this Board at the regular meeting of
and your application has been approved pending the completion of the
following items checked off below,
has
__ Revised Plans for proposed project
__ Pre-Construction Hay Bale Line Inspection Fee ($50.00)
__ 1st Day of Construction ($50.00)
__ ¼ Constructed ($50.00)
V"/Final InsPection Fee ($50.00)
__ Dock Fees ($3.00 per sq. ft.)
Permit fees are now due. Please make check or money order payable to Town
of Southold. The fee is computed below according to the schedule of rates as
set forth in Chapter 275 of the Southold Town Code.
The following fee must be paid within 90 days or re-application fees will be
necessary. You will receive your permit upon completion of the above.
COMPUTATION OF .PERMIT FEES:
TOTAL FEES DUE:$
BY: James F. King, President
Board of Trustees
Donald Wilder, Chairman
Lauren Standish, Secretary
Town Hall, 53095 Main Rd.
P.O. Box I 179
Southoid, NY 11971
Telephone (63 I) 765-1892
Fax (631) 765-6641
Conservation Advisory Council
Town of Southoid
At the meeting of the Southold Town Conservation Advisory Council held Wed., July 15,
2009, the following recommendation was made:
Moved by James Eckert, seconded by Peter Young, it was
RESOLVED to SUPPORT the Wetland Permit application of JERRY & LINDA MATEJKA
to Amend Permit #868 to add a 3'X 19' fixed "T" dock extension onto the seaward end of
the existing dock.
Located: 1300 Strohson Rd., Cutchogue. SCTM#103-10-27
Inspected by: Peter Young, James Eckert
The CAC Supports the application with the Condition of a 10' non-turf buffer and the dock
is constructed using appropriate materials such as Thru-Flow Interlocking Panels.
Vote of Council: Ayes: All
Motion Carried
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
P,O. Box 1179
Southold, NY 11971
Telephone(631) 765-1892
Fax (631)765-6641
Southold Town Board of Trustees
Field Inspection/VVorksession Report
Date/Time:
JERRY & LINDA MATEJKA request an Amendment to Permit #868 to add a
3'X 19' fixed "T" dock extension onto the seaward end of the existing dock.
Located: 1300 Strohson Rd., Cutchogue. SCTM#103-10-27
Type of area to be impacted:
__Saltwater Wetland Freshwater Wetland
Sound Bay
Distance of proposed work to edge of wetland
Part of Town Code proposed work falls under:
__Chapt.275 Chapt. 111 other
Type of Application: Wetland __Coastal Erosion ._Amendment
._Administrative__Emergency __Pre-Submission Violation
Info needed:
Modifications:
Conditions:
Present Were: __J.King __J.Doherty __P.Dickerson __
D. Dzenkowski other
Form filled out in the field by
D. Bergen__ B.Ghosio,
Mailed/Faxed to:
Date:
New York State Department of Environmental Conservation
Division of Environmental Permits, Region One
50 Circle Road- SUNY, Stony Brook, New York 11790-3409
Phone: (631) 444-0365 · FAX: (631) 444-0360
Website: www,dec.state.ny, us
PERMIT MODIFICATION
Mr. Jerry Matejka
1300 Strohson Road
Cutchogue, NY 11935
Re: Matejka property
1300 Strohson Rd., Cutchogue
DEC# 1-4738-02701/00005
Dear Permittee;
June 15, 2009
$outhhold 10wn
Board of Trustees
Your request to modify the above permit has been reviewed pursuant to 6NYCRR Part 621
(Uniform Procedures Regulations). It has been determined that the proposed modifications will
not substantially change the scope of the permitted actions or the existing permit conditions.
Therefore, the permit is modified to authorize:
Construction of a 3' x 19' fixed "T" onto seaward end of existing dock, as shown on plans by
Jerry Matejka, last revised 6/1/09, NYSDEC stamped approved on 6/15/09.
This letter is a modification to the original permit, and as such, shall be available at the job site
whenever authorized work is in progress.
All terms and conditions remain as written in the original permit.
rieland
Deputy Permit Administrator
cc: KPK
MHP
file
James F King~ President
Jill M. Dohel~ty. Vice-President
Peggy A. Dickel~on
Dave Beqgen
Bob Ghosio, Jr.
PO. Box 1179
Southold, NY 11971
Telephone (63 [ ) 765-1892
Fax (631 ) 765-6641
Southold Town Board of Trustees
Field InspectionNVorksession Report
Date/Time:
JERRY MATEJKA requests a pre-submission inspection to discuss the
possibility of adding a "T" extension to the existing fixed dock. Located:
1300 Strohson Rd., Cutchogue. SCTM#103-10-27
Typ&~alt~,f area to be
impacted:
ater Wetland Freshwater Wetland
Sound Bay
Distance of proposed work to edge of wetland
_~haf Town Code proposed work falls under:
pt.275 Cha, p~¥ other
Type of Application: v Wetland __Coastal Erosion __Amendment
~Ad ministrative__Emergency __Pre-Submission Violation
Info needed:
Modifications:
Conditions:
Present Were: ~J.K~g jL~oDo herty P Dickerson ~D. Bergen B~.Ghosio,
__ D. Dzenkowski Scott Hilary__other
Form filled out in the field by
Mailed/Faxed to:
Date:
uthold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO.
ISSUED TO .............. Lg.;.is.. Po!esn~ ........
868 .... DATE:~p~il ~.L...~973
Pursuant 'to the provisions of Chapter 615 o{ the Laws of
the State of New Yorl(, 1893; and Chapter 404 of the Laws of {'he
State of New York 1952; and the Southold Town Ordinance en-
titled "RESULATIN$ AND THE PLACIN$ OF OBSTRUCTIONS
IN AND ON TOWN WATER5 AND PUBLIC LANDS and the
REMOVAL OF 5AND, C=RAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
Resolution of The Board adopted at a meeting held on ~pr±l 2
~97~... , and in consideration of the sum of $ 5.00 paid by
Louis Polesny
-Stronson Rd. Cutchogue,
ot ....................... ' .... N. Y; and subiect to the
Terms and Conditions I~sfed on the reverse side hereof,
of Soufhold Town Trustees authorizes and permits the following:
Place a fixed dock-catwalk 3 ft. by 24 ft. (10 ft.
below high water mark) in front of his property at
Mud Creek, off Stronson Road, Cutchogue, New York.
all in accordance with the detailed specifications as presented rn
the originaHng applcaflon.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes ifs Corporate Seal to be affixed, and these presents fo
be subscribed by a majority of the said Board as of fh~s d~fe.
TERMS end CONDITIONS
The Permktee
Louis Polesny
residing at Stronson Road, Cutchoque N.Y., as
parr of the consideration for the issuance of Ifie Permit does understand and prescn~ to the fol-
lowhag:
1. That the-said Board of Trustees and the Town of Southold are released from any and
all damages, or rialtos for dainages, of suks arising directly or indirectly as a result of any oper-
at/on performed pursuant to this permit, and the said Permittae will, at his or her own expense,
defend any and all such suits initiated by third pardes, and the said Permittee assumes full ~ity
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 perio4 of 12 mos. which is considered to be the
estimated time required ro complete the work involved, but should circumstances warrant, request
for an extension may be made to the Board at a later date.
5. That this Permit should be reeaned indefinitely~ or as long as the said Pei'mittee wishes
to maintain the structure or project involved, to provide evidence to anyone concerned that auth-
orization was originall7 obtained.
4. _That the work involved will be subject to -the inspection and approval of the Board or
its agents, and non-com~:liance With the provisions of the originating applimfion, may be cause for
revocation of this Permit by resolution of the said Board.
5. That there win he no unreasonable interference with navigation as a result of the work
herein authorized.
6. That there shall be no interference with the tight of the public to pass and repass along
the beach between high and low water marks.
7. That if furore 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 unreasonable obstruction to fi'ee navigation, the said Permittee will be required,
upon due notice, to rexnove or alter this work or project herein stated without expenses to the Town
of Southold.
8. That the said Board will be notified by the Permittee of the completion of the work anth-
orized.
9. That the Permittee will obtain all other perm/rs and consents that may bc required sup-
plemental m ~is permit which may be subject to revoke upon failure to olXaln same.
BOARD OF TOWN TRUSTEES
Town of Southold
Main Road
Southold, New York 11971
James ti. Rambo, Inc., T. E. Samuels, Pres., Wunneweta Rd. , Cutchogue,NY
To: .... t~E '.;" ' "L'6ii'f ~' "p~5'~ ~'~'fi~' ~' ' "S ~'f6 h'~ ~5'ff ' ' K6 ~'c~ ;' '"C U'~ h'~ ~'t~ ~';" ' I¢ 7 ~: ...........................
I Your application, doted ..... ~.a..r...q.~....3..0.,.....1.~.7.~. ................................. has been reviewed by this
Board, at a meeting of the Trustees held on ...... ..A.p..z:.i..:~ .2..,.....]:.?..7..3. ................................................
and resulting in the action, as indicated below
(.~,~ ...... ) Application approved.
) Application denied.
) Application tabled.
2 Comments ane remarks:
3. [f your application is approvea above, A Permit Fee ~s now due, and should De made payable
to the order of the Board of Southold Town Trustees. This fee is computed below according to
,the Schedule of Rates as set forth in the Instruction Sheet (Form I/i).
it the Permit Fee ~s ~aid in person to the Secretary of the Board, The Permit will be obtainable
at the same time. ~f }he fee is paid by mail, the permit will be mailed in reply.
Computation of Permit Fee:
fixed dock-catwalk 3 ft. by 10 ft. ~ 10¢ sq. ft. = $3.00
Minimum fe9 $5.00
Total Fee for this application ........................................................... $ .5...aD ..............................
Signed ......... . .A..~...V...~..,., .B,, :... ,G.o..~...c1.. ~, .m. ~ ?...h. ...............
Chrr Board of Southold Town Trustee.~
~// Secretary,
BOARD OF TOWN TRUSTEES
Town Of Southold
Main l~oad
Southold, New York 11971
APPLICATION FOR FIXED and/or FLOATING DOCKS
2. Contractor's name and address:
3. Briefly explain the purpose of this application:
4. After issuance of a Permit, I expect to: (mark by an//X)
(a) Commence work -- AT ONCE ......... .,.; ASAP ..~ ......... ; UNKNOWN .............
(b) Complete work in- 1 DAY ............ ; 1 MO ............. ; 1 YR ............. ; FUTURE .............
Secure the correct Area Map from the Secretary of this Board, gnd 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 floati.ng dock
or tie-up a boat. Give oll 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 i.nto Town Waters beyond aFr-i~aginary
line or boundary formed by other similar structures a ong the area's shoreline? ~E~or NO
..... ~,T~ / i '
If it does extend beyond th~s so-called dock line ~nd,cate by how far, approx~mately,....'..C?...ft.
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 Ordinopf--kJi_gh Water
Mark or the Dredging of any material from Town La,nds under water? YES o~NO.~f it does,
Form A/4 (Application for Dredging/Filling) must be completed and attached a-'~l~rt of this
application.
In requesting approval of this application, I submit that: the information presented herein
is true and correct to the best of my kno~vledge 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.
Accepted by: fz
Dated:
;oye
~ef
Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. 86 8
DATE:A~ril 2, 1973
ISSUED TO .. LQu.is.....~Qles.ny..
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 t952; and the Southold Town Ordinance en-
rifled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and fha
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 ~pril .2
1973., end in consideration of the sum of $. 5.00 paid by
.Louis Po. lesny
ofS~.~°~.s~n...R~.~..,., cu.tch°que' . N. Y. and subject fo the
Terms and Conditions listed on the reverse side hereof,
of Soufhold Town Trustees authorizes and permits the following:
Place a fixed dock-catwalk 3 ft. by 24 ft. (10 ft.
below high water mark) in front of his property at
Mud Creek, off Stronson Road, Cutchogue, New York.
all in accordance with the detailed specifications as presented in
the originating applcafion.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes ifs Corporate Seal to be affixed, and these presents to
be subscribed by a majority of the said Board as of this date.
'- . ' '.
Trustees
BOARD OF TOWN TRUSTEES
Town of Sonthold
Main Road
Southold, New York 11971
James H. Rambo, Inc. , T. E. Samuels, Pres. , k;ur~n(-=weta Rd. , Cutchogue,N
To:
1. Your application, doted ..... ~.Qb...~.Q,....~.7.~ ................................. has been reviewed by this
8oord, at ~ meeting of the Trustees held on ....... ~P.~.~..~.,....~.~.~ ......................................................
and resulting in the action, os indicated bela.v:
( ............
( ............
Application approved
Application denied.
Application tabled
Comments and remarks:
3. If your application is approved above, A Permit Fee is now due, and should be mode payable
to the order of the Board of Southold Town Trustees. This fee is computed below according
the Schedule of Rates as set forth in the Instruction Sheet (Form
If the Permit Fee is paid in person to the Secretary of the Board, The Permit ,viii be obloir, cbic
at the same time. If the fee is paid by mail, the permit will be mailed in reply.
Computation of Permit Fee:
fixed dock-catwalk - 3 ft. biz 10 ft. ~ 10¢ sq. ft. = $3.00
Minimum fee $5.00
Total Fee for this application ............................................................ $ 5, 1~)...l(.,sr/..'....i ............
James H. Rambo, Inc. , T. E. Samuels, Pres., Wunneweta Rd., Cutchogue,5
To: .... R']~ '~ '-" · L'~ ~'i'§ ' · 'p~']~ ~'~'i~? ~' ' "S t~'i"~6 ~'~ ~'~ ' ' R~ ~i h~ ',' ' ' 'C b.'~Z ~ b'~ ~ ~'~' ' ' ~ Y T ~' ..........................
1. Your application, dated ..... ~;C..c.b...3.O.,.....1.~..7.~ ................................. has been reviewed by this
Bo~rd, at a meeting of the Trustees held on ....... ..A.R'~.i.~...~.,....~.?.~ .....................................................
and resulting in the action, as indicated below:
(.F-J{ ...... )
( ............
)
Application approved.
Application denJed.
Application tabled.
2. Comments and remarks:
3. If your application is approved above, A Permit Fee is now due, and shculd be made payable
to the order of the Board of Southold Town Trustees. This fee is computed below according to
the Schedule of Rates os set forth in the Instruction Sheet (Form I/1).
If the Permit Fee is paid in person to the Secretary of the Board, The Permit will be ob?ainoblz
at the same time. ff the fee is paid by mail, the permit will be mailed in reply.
Computation of Permit Fee:
fixed dock-catwalk - 3 ft. by 10 ft. ~ 10¢ sq. ~t.. = $3.00
Minimum fee $5.00
Total Fee for this application ............................................................ $ .~.,.C~)...,;...; ....... : .............
Chm. Board of Southold Town Trustees.
Secretary.
TERMS and CONDITIONS
Louis Polesny
residing at Stronson Road, Cutchoque N.Y., as
part of the consideration for the issuance of ~Iae Permit does understand and prescribe to the fol-
lowing:
1. That the said Board of Trustees and the Town of Southold are rehrased from any and
all damages, or claims for damages, of suits arising directly o£ indirectly as a result of any oper-
ation performed pursuant to this permit, and the said Permirtee will, at his or her own expense,
defend any and all such suits initiated by third parties, and the said Permittee ;rssumes 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 coasidet~ to be the
estimated time required to complete the work involved, but should drcumstances 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 auth-
orization was originally obtained.
4. T&at the work involved wi/l be subject to the inspection and approval of the Board or
its agents, and non-com?liance with the provisions of the originating application, may be cause for
revocation of this Pernfit by resolution of the said Board.
5. That there wiU 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 removai and. or alterations
in the location of the work herein authorized, or if, in the opinion of the Bo~trd of Trustees, the
work shall cause unreasonable obstruction to free navigation, the said Pernfittee will be required,
upon due notice, to remove or alter this work or project herein stated without expenses t,~ the Town
of Southold.
8. That the said Board will be notified by the Permittee of the completion of the work auth-
orized.
9. That the Permktee will obtain all other permits and consent~ that amy be required sup-
plemearal ro this permit which may be subject to revoke uF, on failure to obtain same.
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 (6311 765-1366
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.
INSPECTION SCHEDULE
Pre-construction, hay bale line
1st day of construction
constructed
Project complete, compliance inspection.
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
February 25, 2004
Mr. Jerry Matejka
1300 Strohson Rd.
Cutchogue, NY 11935
RE: 1300 STROHSON RD., CUTCHOGUE
SCTM#103-10-27
Dear Mr. Matejka:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wednesday, February 25, 2004:
RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to
Permit #868 to construct a 3'X 10' extension to the existing dock and install a tie-off pile
20' past the end of the dock, and as depicted on the plan prepared by Jerry Matejka last
dated June 15, 2003.
This is not a determination from any other agency.
If you have any questions, please call our office at (631) 765-1892.
Sincerely,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK:lms
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Please be advised that your application, dated//~7/O~
has been reviewed by this Board, at the regular--meeting of
~/~./OV and the following action was taken:
( ~'/) Application Approved (see below)
__) Application Denied (see below)
(__) Application Tabled (see below)
If your application is approved as noted above, a permit fee is
now due. Make check or money order payable to the Southold Town
Trustees. The fee is computed below according to the schedule
of rates as set forth in the instruction sheet.
The following fee must be paid within 90 days or re-application
fees will be necessary.
COMPUTATION OF PERMIT FEES:
TOT EES DUE: $ 93,00
SIGNED:
PRESIDENT, BOARD OF TRUSTEES
BY:
CL~RK, BOARD OF TRUSTEES
4~98
Telephone
(631) 765-1892
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
CONSERVATION ADVISORY COUNCIL
TOWN OF SOUTHOLD
At the meeting of the Southold Town Conservation Advisory Council held Monday,
February 23, 2004, the following recommendation was made:
Moved by William Cook, seconded by Don Wilder, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH
CONDITIONS of the Amendment application of JERRY MATEJKA to Amend Permit
#868 to construct a 3'X 10' extension to the existing dock and install a tie-off pile 20'
past the end of the dock.
Located: 1300 Strohson Rd., Cutchogue. SCTM#103-10-27
The CAC recommends Approval of the application with the Condition of a 10' non-turf
buffer and ne treated lumber is used.
Vote of Council: Ayes: All
Motion Carried
1300 Strohson Road
Cutchogue N3t 11935
Jerry W. Matejka
Board of Town trustees
Town of South'old
Mr Krupski,
I am in receipt of )'our letter dated June 18,2003relative to the disapproval of my
request to add 15 feet to my existing dock. I did not want to get into a debate on
the night of the hearing, but I was totally shocked at the arbitrary and capricious
nature of the denial. The reasons cited are:
1- The shallow water depth in the creek. This is ludicrous. There are 25-30 foot
boats in the creek and I have a 19' fishing boat. While the creek is shallow, my
sounding data as performed by En Consultants was that adding 15 feet onto
the existing dock will put my boat into about I0" of deeper water
2- ]'he physical intrusion into the creek. This is equally baffling and one of the
Trustees indicated in the hearing that I would protrude beyond my neighbor if
the)' approved the 15 feet. I beg to disagree by this is not true. My neighbor on
the left has the same shoreline as our property and their fixed dock at present
already is 15 pas1 my existing dock. Add their yearround floating dock and
they are out anotherlS-20 feet.
The unnecessao' damage 1o underwater lands. How is this possible if the boat
would be moored 15 feet beyond where it presently is as shown in the
consultants report that I paid $500 to obtain ?
The location in the creek would be inappropriate. 'fh~s reason makes no sense
whatsoever. Inappropriate to what.? A neighbor on the other side of the creek,
a neighbor.etc ? There is well over 400 feet to the opposite shoreline
The whole nature of this hearing was unfair and as a taxpayer in the Town, I want
to pursue this case. I am willing to meet the Trustees at my house or meet at
Town Hall at your convenience. I can be reached at work at 631-563-6800 x398
~.--~g~ncerely,
.Mbe~t J. Krupski, President
James King, Vice-President
Artie ~oster
Ken Poliwoda
Peggsz A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone ,1631) 765-1892
Fax (1631) 765-1366
June 18,2003
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Mr. JerW Matejka
1300 Strohson Rd.
Cutchogue, NY 1!935
RE: 1300 STROHSON RD. CUTCHOGUE
SCTM#103-10~27
Dear Mr. MatQka:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wednesday. Jtme ~8, 2003:
RESOLVED. :hat thc Southold Town Board cf Trustees DISAPPROVE the Amendment to
Pem~it :t868 ro const~.ct a 3'X ;5' ..:xrenslon to the existing dock '~nd instal! ,:ne pile for a piling
pulley system because .,f the ~bi!owmg reasons: ,) the shalio,v ,'.'2ter ~lepth in the creek. 2) t~e
physical intms:on into tl:e cree~, 3) the urmecessary damage to the underwater lands, and z) the
location in the creek ~* onid be inappropriate.
This is not a ~letermination from any other agency.
If you have any questions, please call our office at (631 ) 765-I 892.
Sincerely,
Albert J. Krupski, Jr.
President. Board of Trustees
AJK:lms
Telephone
(631) 765-1892
Town H',fll. 53095 Ma~n[oad
P.O. Box 1179
Southold, New York 11971
$OUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town Conservation Advisory Council held Monday,
June'16, 2003, the following recommendation was made:
Moved by Bill McDermott, seconded by Meivyn Morris, it was
RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of
the Amendment application of JI::RRY MATEJKA to Amend Permit #868 to construct a
3'X 15' extension to the existing dock and install one pile for a piling pulley system.
Located: 1300 Shrohson Rd., Cutchogue. SCTM#103-10-27
The CAC recommends Disapproval of the application because there was no need
shown for the extension. There would still be inadequate water depths with an additional
extension.
~/ote of Council: Ayes: All
Motion Carried
A~bert J. Krupsld, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765-1892
Fax (516) 765-1823
~OARD OF TOWN Ti%USTEE,~
TOWN OF SoTYrHOLD
Please be advised that your application, dated
has been reviewed by this Board, at the regular .T, ee~xnq cf
~/~//C/ and the following act. io~. %-.'as taken;
Application Approved {see below)
) Application Denied ~s=~ below)
Application Tabled (see below)
If your application is apprcve~ as noted above, a permit fee is
now due. Make check or money order payable to the Southold Town
Trustees. The fee is computed below %c~crding to the schedule
of rat~s as set forth in ~he instruct~cn sheet.
The fo].lowinq fee must be pa&d wzLhi:; 90 ,iays or re-applicAtion
tees will be necessazTf..
COMPUTATION OF PE~IT FEES:
TOT FE S DUE:
SIGNED:
PRESIDENT, BOARD OF TRUSTEES
BY:
CL~RK, BOARD OF TRUSTEES
Telephone
(631) 765-1892
Tov~ -l-,hdl. 5.'1095 ~,.in Road
P.O. Box 11"/9
Soc, thold. New Yo~k 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town Conservation Advisory Council held Tuesday,
Jun_e 12, 2001, the following recommendation was made:
JERRY MATEJKA & MILDRED POLESNY 103-10-27 to Amend Permit #868 to
construct a 3'X 15' extension to the existing dock and install one pile for piling pulley
system.
1300 Strohson Rd., Cutchogue
The CAC did not make an inspection, therefore no recommendation was made.
115, 30,01 0§:00 F.~X 631 $63 6882 LOCICON LC[$ ~062
PERMIT
r~
P£RNI[ ISSUED TO
~_~jldred ~otesny
Jerry Natejka, 9~ Futten Bt~d., ¢_oea~c~r N?
DESCRIP~ON OF AUTHOrIZeD
1172~
65,30'~1 0~:00 FAX 631 563 6882 LOGICON LCIS ~001
LOGICON
A Noc~rop Grumman Company
FACSZMZLE TRANSMITTAL LEAD SHEET
TO:
COMPANY:
TELEPHONE:
FAX #;
FROM:
TELEPHONE #:
Number of pages + Lead
DATE:
Eastern
Permits Section
DEPARTMENT OF THE ARMY
NEW YORK DISTRICT, CORPS OF ENGINEERS
J,~COB K, JAVITS FEDERAL BUILDING
NEW YORK, N.Y. 10278-0090
August 31, 2000
SUBJECT: Application Number 2000-00914-L2 by Mildred Polesny
To Whom It May Concern:
The New York District, U.S. Army Corps of Engineers, has
received a request for Department of the Army authorization for
the following activity:
APPLICANT:
Mildred Polesny
1300 Strohson Road
Cutchogue, NY 11935
ACTIVITY:
Add to an existing pier, a 4-foot by 12-foot ramp
leading to a 6-foot by 20-foot float secured to
two-pile dolphins. The purpose of this project is
to provide a mooring facility for a vessel.
WATERWAY:
Mud Creek, Little Peconic Bay
LOCATION:
Cutchogue, Town of Southold, Suffolk County, NY
As this is minor in nature, authorization may be by Letter
of Permission. This is in accordance with current Federal
Regulations governing work in navigable waters of the United
States. To accomplish the coordination required, prior to the
issuance of a Letter of Permission, your review of the enclosed
drawings is requested.
Pursuant to Section 307 (c) of the Coastal Zone Management
Act of 1972 as amended (16 U.S.C. 1465 (c) (3) (A)), the applicant
has certified that the activity complies with and will be
conducted in a manner that is consistent with the approved state
coastal zone management program.
To allow for the timely processing of the subject
application, your comments are requested within 15 days of the
date of this letter.
Enclosures
Sincerely,
Eastern Permits Section
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1300 ~ROHSON RD, CUTCHOGUE, NY, 11935-2162, US
Save this Address
ADDENDUM TQ.~PPLICATION #1-4738-02701/0001
I) Requested depths in mooring areas at 10 foot intervals
2) Depths,or soundings referenced to Iow water at the same spots as above
3)_AHW and ALW lines are shown ou the diagram and taken on August 20, 2000 at 10:15 AM for
Iow tid~ readings a~nd at 4:IOPM on the same for the high water readings.
We hereby subm/t specifications and estimates for:
Floating Dock, Ramp, Mooring Piles
6' x 20' Floating dock
4' x 12' Ramp with hand rails on both sides.
(R) T~o pile dolphins 30' in length.
We believe that after this winter's l~e damage in the local
that double bolted mooring piles ar~ ~e~essary.
All lumb~r and piling $outhez-~ yellow pine CCA pressure
treated to 1.5 lbs/cu, ft. maxlJ~u~ :~'~t~tion.
June 25, 2000
To:Board of Trustees, Town of Southold
From: Jerry Matejka & Mildred Polesny
Subject: Application for a permit amendment to allow a floating dock added to a
fixed dock catwalk (permit #868 )
At the meeting on June 21, my application was tabled pending the DEC approval.
Since this process has just started, it will take several months. At the meeting, Mr
Ke.~ P~l_~ved_a ~'~commended a pile or stake. He said that the bo:~t could be pullied
into the dock
At the meeting, I was so preoccupied with trying to get the Board to go ahead with
my application that I was not thinking about what I would do tiffs summer with my
recently purchased 19' boat. I would like to go ahead with Ken's recommendation
and have something temporary for this summer which will at least allow me to me
to tie up my own small boat on our property. It doesn't even need tr, be a permanent
piling.
A stake or ball mooring will be ok.
In the meantime. I am moving fo~'ward with the DEC.
Thanl~ou for all your wisdont
June 12, 2000
To: Board of trustees, Town of Southold
From: M Polesny and J Matejka
Subject: Application for a permit amendment to allow a floating dock- Sounding
data requested
Our application was reviewed and tabled at the last meeting on May 24, 2000
because of inadequate sounding data. These had been gathered based on neighbors
estimates.
We have now done a thorough reading at several locations
Date of readings
June 9, 2000
· Low tide readings at 12:45PM
· High tide readings at 7:15PM
The table below shows precise measurements taken at the same spots and at various
locations from the end of the existing fixed catwalk. Since the floating dock will start
12 feet from the end of the existing dock, it will always be floating in water and will
not need to be pulled out.
Feet from catwalk end
TIDE 3 feet 12 feet 25 feet 30 feet
Low 0" 10" 19" 24"
High 33" 40" 55" 59.2"
We thank you in advance for your consideration at the next Board meeting.
Respectfully,
~ Noreast Salt~vater [Tide Chart~
Page I of I
Tide Charts
Tide location New Suffolk
Starting date June 9, 2000
Ending date June 23, 2000
Caution: Although every effor~ has been made to ensure the accuracy of the
tide predictions below, Noreast Saltwater assumes no liability due to the use of
this information in any way. Weather and other conditions may affect the
actual tide levels.
i:I9AM Low 0.4 2:20AM Low 0.4 3:17AM Low 0.3
7:36 AM High 2.7 8:40 AM High 2.5 9:37AM High 2.5
1:39 PM Low 0.3 2:32 PM Low 0.3 3:21 PrVl Low 0.4
8:14 PM High 3 9:09 PM High 3.1 9:57 PM High 3.1
4:08AM Low 0.2 4:54 AM Low 0.2 5:37 AM Low 0.2
10:26 AM High 2.4 11:09 AM High 2.4 11:49 AM High 2.4
4:08 PM Low 0.4 4:51 PM Low 0.4 5:34 PM Low 0,5
10:40 PM High 3.2 11:19 PM High 3.2 11:56 PM High 3.2
6:lgAM Low 0.2 12:33AM High 3.2 1:lOAM High 3.2
12:27 PM High 2.4 7:00 AM Low 0.2 7:42 AM Low 0.2
6:16 PM Low 0.5 i:OSPM High 2.4 1:45 PM High 2.4
6:58 PM Low 0.5 7:41 PM Low 0.6
1:47 AM High 3.I 2:26 AH High 3 3:07 AM High 2.9
8:24AM Low 0.2 9:08AH Low 0.3 9:53AM Low 0.4
2:26 PM High 2.4 3:09 PM High 2.4 3:55 PM High 2.5
8:27 PM Low 0.7 9:15 PM Low 0.8 10:05 PM Low 0.8
3:51AM High 2.8 4:39AM High 2.7 12:14AM Low 0.4
10:40 AM Low 0.4 1I:27 AM Low 0.5 6:28 AH High 2.8
4:42 PM High 2.5 5:32 PM High 2.5 12:43 PM Low 0.2
10:58 PM Low 0.9 11:53PH Low 0.8 7:14 PM High 2.9 //
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Telephone
(516) 765-t~Z
Town Hall, 53095 Main Road
P.O. Box 1179
Southold. New York t1971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town Conservation Advisory Council held Monday, May 22,
2000, the following recommendation was made:
Moved by Melvyn Morris, seconded by Richard Smith, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the
Amendment Request of MILDRED POLESNY & JERRY MATEJKA 103-10-27 to Amend
Permit//868 to add a 4'X 12' ramp and a 6'X 20' floating dock to an existing fixed dock.
1300 Strohson Rd., Cutchogue
Vote of Council: Ayes: All
Motion Carried
May 18, 2000
To:Sothhold Town Board of Trustees
Subject: Soundings
In response to your request for additional information following your ste visit on
Wednesday May 17, I am providing the following information. At Iow tide, the area
of the proposed floating dock will be at 3-3.5 feet of water. At normal high tide, the
water the dock ~vill be in 5.5-6.5 feet of water.
As you are aware, we are requesting a modification to the existing fixed dock-
catwalk permit from the town in order to add a floating dock. This dock will be
similar in design to what the neighbors currently have.
Thank you kindly for your consideration
M Polesny & J Matejka ~ ' '~ '~l][}
~e be=eby eubmit spe=i~io&tions an~ esti~tes ~or:
~ioating Doc~, Ramp, ~ooring ~iies
6' x 20' Floating dock
4' x 12' Ra~p with hand rails on both sides.
(2) Two pile dolphins 30' in length.
We believe that after this winter's ice damage in the local
that double bolted mooring piles are necessary.
All lumber and piling Southern yellow pine CCA pressure
treated to 1.5 lbs/cu.ft, max£m~m retention.
Permits are not included. Please call Eh-COnsultants, Inc.
for an estimate of costs at 283-6360 or others.
All hardware hot dipped galvanized.
Or.FO
.5: c.y/o rv
01/21:04 ~%~D 0g:l? FAX 6317651366 Southold Town Accounrlns .-- ~001
Albert J. I<rupski, President
James King, Vice-President
Arkie FosS;er
Ken Po~woda
Peggy A, Dickerson
Town Hall
63095 P~ute 2§
P.O. Box 1179
Southo]d, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWi~ OF SOUTHOLD
APPLICATION FOR AN AIVIEND1VHgNT TO A PER1VIIT
AGENT PHONE
ADDKBSS
PROPERTY LOCATION
T~X ~ NO. /f 3 -/~ - 3 T
01121/2004 WED 09:16 [TX/'RX NO 58211 ~001
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OFTOWNTRUSTEES
TOWN OFSOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application
of
COUNTY OF SUFFOLK)
STATE 0]7 NEW YORK)
AFFIDAVIT OF POSTING
//7
being duly sworr~epose and say:
That on the/~ day of~" ,200~, I personally posted the property knosvn as
_
by placing the Bo~d of Trustees official poster where it c~ e~ily be seen, ~d that I have
checked to be s~e the poster has remained in place for ei~t da~ prior to the date of the public
hemng. Dale ofhemng noted thereon to be held ~.. ~h. ~, ~- ·
Dated:
Sworn to before me this
day of Iz---g 200'(
Notary lSublic
V~RGINIA G. GREEN
No~Y Public. Stste a( New York
No. 01GR~O66656
Quslified in Suffolk Coun~lf
Commission Ex,aires Sept. 30, ~
01./2.1/04 WED 09:17 FAX 6317651366 Southold Town Accounting ~003
PROOF OF 1VLA ri JN'G OF NOTICE
Al'TACH CERT[VllC_,D MAIL RECEIPTS
STATE OF NEW YORK
COUNTY OF SL1YFOLK
(~9~.~.7r~~ , being duly sworn, deposes and says that on thc
-- ~ d;afo f -7~v,.r--~ ,20~_~.,~ deponent mailed a tree copy of the Notice -
~eet forth, in'the Board ofTrust6es Appliealdon, directed to each of the abo~e 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
assessmentjoll o, ftho Town of Southold; that said Nolices wore mailed at the United States Post
Offive at ~~ ~ ~. _, that said Notices were mailed to each of said persons by
(certified) (registered) mail. x-T
Sworn to before me tlaig I 7
Dayof ~el0~.~ , 20_o~-i
t
'~Notaty PulJlic
VIRGINIA G. GREEN
Notary Public, Stere of New York
No. 01GR50~6656
_(~ualifled in Suffolk County
Commismon Expires Sept. 30,, ~b[~
01/21/2004 WED 09:16 [TX/~I NO 5821] ~003
0i/21,'04 ~ED 09:17 F.4~ 63176.~&66 Southold ;own Accou~[~ng
Boar~ of Trustees Application
County of Suffolk
State of New York
DEPOSES AND AFFIRMs T~tAT ~E/F~F, IS THE A~PLICAN~ FOR 1-~. ABOVE
DES~B~ P~IT{S) ~ ~T ~5 STAT~S ~AIND ~EIN ~
TR~ TO ~hm BEST OF HIS/~ ~GE.~D B~IEF, ~ ~AT ~L
WO~ WILL BE ~ IN ~E ~ER S~ FOR~ IN ~S ~PSICATION
~D AS ~Y BE ~PRO~ BY ~E ~O~OLD ~ BO~ OF ~US~ES.
~ ApPLIC~T A~ES ~ HO~ ~ ~ OF $ODTHOLD ~ '~ ~
~US~S ~.ESM ~ F~E ~OM ~ ~ ~L D~GES ~D C~IMS
~SIN~ ~ OR BY ~R~ OF S~ID P~T(S}f, IF ~'fEO. IN
CO~LETING ~I-S ~PLICATION, I ~BY A~O~ZE ~ ~RUS~ES,
TO INSPE~ T~ P~SES IN CON~ION WI~ ~I~ OF'
APPLICATION.
Notary Public .
VIRGINIA G. GREEN
Notary Public, State of New York
No. OIGR5066656
Qualified in Suffolk County
Commission Expires Sept. 30, ~
7
01/21/2004 WED 09:16 [TX/~K NO 5821! ~004
0i/21/04 ~,~D 09:17 F.'L~ 6317651
Southold Town Accounting
OO5
APPLI CANT/AGE NTflLE PRE S ENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold'~ Code of Ethics l:~oin'bit~ conflicts of interest on the part ofWWn officerg and emvloyees. The vuroosc of
this forrp is to !~rovidc ilfforrnation which ainu alva the town of possible. ~:gnfliciz of inter~: ~al~ow !t ro take whatever action
necesaapt' to avoid samc.
(Last uarnc, fir'st name, mlddlc initial, unless you are applying in the namc of
someone ¢].~a or other cutity, such a~ a company. If so, indicate thc other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Variance
Change of Zone
Approval ofpha
E~i~mption from pl~t or oflqcial nmp.
Oth~
(If'OUher" namethc ~:tivity_)
Do you l~SOnally (or through your company, slx, usc, s~lin$, pareat, or child) have a rclafio~hip with any ofilcc~ or employee
of thc To'~ of Sou~old7 "Rala~innship" include~ by blood, marriage, or busin~ int~cst. "Business interest" mca~ ~ bu.~ness,
including a par~ership, in which the town officer or employee has twcn a partial ownership of(or croploymem by) a
in which the town officer or employee owns more th~n 5% of the shares.
YBS NO
If you answered "Y'~S", complete the balance of this form and date aud sign where indicate, d,
Name of person .mlpl oyed by thc Town of Southold
Title or position of that person
Describe the rc.lalionship be~-een your~If 0hr applicant/agent/rcpre~mtive) and thc town o~]cer or employea Either check
thc appropriate line A) through D) a~d/or describc in thc space provldcd.
Thc town officer or enkoloyc= or hi: or her spousc, s~ol/ng, parent, or child is (check all that apply);
__A) the ¢,wn~' of gtealm- ~n 5% of the ~haxes of thc corporate stock of~c ~li~t
(whc~ ~ ~pli~t ~ a c~on);
B) ~c l~g~ or ~c~ o~ of~y int~ ~ a aoa~o~e enfi~ (wh~ ~e
applier is not ~ ~r~on);
_ ~ ~ m~c~, ~r, pa~er, or ~plo~ of ~e applic~g or
~) ~e ~ appli~at
D~SCPdPTION OF F~LA~ONSHIP
01/21/2004 WED 09:16 [TX/RX NO 5821] ~005
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggs' A. Dickerson
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
APPLICATION FOR AN AMENDI~
AGENT
ADDRESS
PHON]
PROPERTY LOCATION
Town Hall
53095 Route 25
P.O. Box 1179
Southold, NewYork 11971-0959
'T'~lephOne (631) 765-1892
Fax t631) 765-1366
~J MAY 2 8 Z(~03
Beard ef Tmstee~
TAX MAP NO.
UVCe
request an Amendment to Permit
~.O,v.sw&tc, c_.r- ~ ~/y/,5-'/ cex'/--~--wS/zp,v, ~ 7-trw
May 28, 2003
To: Southhold Town Trustees
From: Jer~' Matejka
Subject: Amendment
I am requesting the Trustees to kindly consider my request to add a 3x15
foot dock extension to the existing structure and to add a piling mooring
post. The original permit #868 is dated 4/2/1973, and was last modified
in June 2001 when the trustees allowed a previous extension of 15 feet.
This request is being made since it will result in less turbidity, as my
boat ~4ll be in deeper water. Please schedule me for the next meeting.
Respectfully,
Cutchogue NY 11935
Tel 631-838-2900 (cell)
Work 631-563-6800 x398
I A'f 29 2O03
Southotd Town
Board of Trustees
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggs' A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1!.79
Southold, New York 11971_-0959
Telephone 1631i 765-1_892
Fax 11631-) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application of
............................
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFDAVIT OF POSTING
residing at /..~o~2 .~7'-~O/'F5~>
~. ' ~ Y~tTO~o~ *~W //03 )~-
being duly sworn, depose and say:
That on the (':' day ofU~ o,~r ,200 3, I personally posted the property knox~vn as
13oo s,wuoOso,~ Ao,,~, oa)z47o6vC- wy//~
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 (.0 !} g }0~ ~r'~ Of' aB(XI-~' "/',IX} Om..
Dated: ~/c~/0 '~
....
J /(jff'gnature)-~---'"'"'~
Sworn to before me this
day o¢~ 200~
JUN 1 2 3X~
PROOF OF MAILING OF NOTICE
ATTACIt CERTIFIED 5IAIL RECEIPTS
Name:
Address:
STATE OF NEW YORK
COUNTY OF SUFFOLK
,J'~=r~___,/ h., ,'-/a-~'-~J'/~.~ , residing at/2~ _~-~ /rz~
O,..c~C~o~ ~ ¥ r/q.*~"' , being duly sworn, deposes and says that on the
~' day of Cru,o~ ,20 0), deponent mailed a true copy of the Notice
set tbrth 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 sa/d persons are the address ofsa/d persons as shown on the current
assessment roll of the Town of Southold; that said Notices were ma/led at the United States Post
Office at al.O-/" C./.-~O~U~- , that said Notices were mailed to each of said persons by
(certified) (registered) mail.
Sworn to before me this
Day of ~== ,20--0.5
,,.S. Postal Service ....
~ CERTIFIED MAIL~,., RECEIPT
nj (Domestic Mail Only; No Insurance Coverage Provided)
rtl
(~omemem Requ~d)
m
U.S. Postal Service
CERTIFIED MAIL:,,, RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
.~!~a~.t (~ A L USE
'$ 0.3/
Postage
~: ~o
~- ....... ..._...;[,,. -- ~=,;~ ............ ~,~,~.
U.S. Postal Service,.,
CERTIFIED MAIL,,, RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
$ 0.37
2.~0
$ 4.42
UNIT I[m: 09~
Postmark
'e~97/03
May25,2001
To: Southold Trustees
From: Jerry Matejka & Mildred Polesny
Suhject: Amendments/waivers/changes
On 6/27/00, we presented our request for a floating dock to the Town Trustees.
Subsequently, the DEC did not want to permit me for this project as proposed.
Instead, they have approved a fixed dock extension.
1 am enclosing a set of the approved plans which are dated 5/5/01. Mr Chris Arfsten
of DEC called me on May 23rd to vverbally inform me of the approval of the plans
and that Ms Farkas will be sending the letter shortly.
We are therefore changing the original proposal to indicate that we;
Request an Amendment to permit #868 dated April 2, 1973 in order to
add a 3' X 15' extension to the existing dock and one (1) mooring post.
Located at 1300 Strohson Road, Cutchogue. SCTM #103-10-27.
As soon as I hear from your office when we can schedule for a meeting, I will again
notify the neighbors by registered letter, i can be reached during the day at work at
631-563-6800 ext 398
Thank you for your kind patience and understanding
Jerry Matejka
June 8. 2001
To: Southold Trustees
From: Jerry Matejka & Mildred Polesny
Subject: Amendments/~vaivers/changes
Enclosed please find the following in support for our application to
modify Southold trustees permit #868 dated April 2, 1973. The hearing
is scheduled fi~r June 21, 2001
!. DEC permit #1-4738-02701/001 dated May 23, 21}01
2. NYDEC stamp approved Cross Section Plan and Site Plan
3. Notarized proof of mailing to neighbors
4. Notarized affidavit of posting
5. A cop)' of the original Trustee permit
The scope of new work encompasses adding YxlS' to lhe existing fixed
dock and adding 1 mooring post.
I hope that this covers all the materials requested. If there are any
questions, please call me at work (631-563-6800 x398)
~l~ank you
Jerry Matejka ~
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York [1971-0959
Telephone(631) 765-1892
Fax(631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OFSOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In the Matter of the Application
of
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
I~J--~z~ /~k~ , residing at
being duly 'swor~, depose and say:
That on the ~ day of~-uf;~ , 2001, I personally posted the
property known as
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 ~earing. Date of hearing noted thereon to be held'~~-~
Dated: ~/~/~l
Sworn to before me this
9 day of-~¢'¥~ 200/
PROOF OF MKILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name: Address:
STATE OF NEW YORK
CO[5~TY OF SUFFOLK
~3-~¥ _~JT-~ , residing at ~ ~71~ ~u',b
___ , being duly sworn, deposes and say~-
that cn the ~ d~y.?f ~ ,~, deponen% maJ!ed
a tt-u.e copy r ,_ne Not~ce~et forth ~n the Board of Trustees
Application, directed to each of the ~ove named persians at the
5ddresses set opposite there respective n~es: that the
ad~3res~es s~c opposite the n~es of said persons are the address
of said persons as shown on the current assessment roll of the
Town of Southold; that ~~re mailed at tb~ United
States Post Office at that said Notices
were mailed to '
mail. each of ~aid per__certified) (registered)
6
U.S. Postal Service
CERTIFIED MAIL il=l.~ LMJ
(Domestic Mail Only: No tiT.~Wlfl
U.S. Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
~ ~ HICKSVILLE, NY 11801
U.S. Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Mail Only: No I~$ur,3r~co Coverage Provided)
Postage 16
Albert J. Kruv :ki, !'('esi.~e~,t
,[ames King, \'ice P;esident
Henr3 Smith
Artie
Ken Foliwoda
Town Hall
53095 Mein Road
P.O. Box 1179
Sou thold, New York 11971
Teiephone (516) 765-18.T2
Fax (516) 765-1823
BOARD I)F TOWN 'rRus'rEES
TOWN OF SOUTHOLD
Office Use Only
Coastal Erosion Permit Application
WeUland Pgrmit Application
Grandfatb~r Permit Application
· ~./~Wa ive r / Ame ndme n t / C h~3).~
Rece.---~ved Application:
Received Fee:$ ~0~ '
Comp keted Application ~7~/
Incomplete
__SEQ~A Classification:
Type £ ........ Type Ir Unlisted
coor'din;~tion: {date sent)
~CAC 9efez.,.r,! Sent:_ ~
_~_~Date of Im;pection:_ ~/[]~_
i~ev J.ew:
___Technic3 1 ~_/
_~---~Public [:lc.a [ J. nq Held:
Rose] ~lt J.o~:
Name of ApFllcant
Addres:~_ 3_7_ t--t,
Fhon~ N,~ber:
Suffolk .~ouJ,t5 Tax Map Number: 10tH)
-~-~ovi~L~L~;~ Bole' ~ ~s~'e ~ cross streW'ts.
and location)
AGENt.:
( If applic,M)ie)
Address:
Phone:
FAX9:
Board~
Trustees A]~plication
GF~ERAL DATA
Land Area (in square feet):
Area Zoning:
Previous use of property:
Intended use of property:
Prior permits/approvals for site improvements:
Agency Date
No prior
Has any permit/approval ever been revoked or
gover~nental agency?
No
If yes, provide explanation:
permits/approvals for site improvements.
suspended by a
Yes
P~oject Oescrip~ion (use attachments if necessary):
Board~ Trustees Applicati~3)n
WETT~%ND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
Area of wetlands on lot: .square feet
Percent coverage of lot: %
Closest distance between nearest existing structure
edge of wetlands: feet
Closest distance between nearest proposed structure
edge of wetlands: feet
Does the project involve excavation or filling?
No Yes
If yes, how much material will be excavated?
How much material will be filled?
Depth of wh].ch material will be removed or deposited:
feet
Proposed s]o~ th.~oughout the area of operations:
~4anner in which material will be removed or deposited:
and upland
and upland
cubic yards
cubic yards
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 ].f approf~riat.e}:
Albert J. Kmpski, Pce~idc,,t
James King, Vice-Pre'.:id',nt
Henry Smith.
Artie F.-,stvr
Ken
Town Hall
53095 Main Road
F'.O. Box 1179
'3c, uthold. New York 11971
'felephone 1516) 765-18~/2
Fax (51.6} 765-1823
BO~P,D OF TOIVN 'I]{US'rEE$
TOW OF SOUTHOLD
BOARD OF TRUSTEES: TO~ OF SOUTHOLD
fn the Mattec of the Application
COUNTY OP SUFFOLK) ~
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
I, ,f , residing at
being duly ~;,,~orn~ depose, and say:
That o,~ t:h~" day o~ ' ' 197 , /. p.e,_,~ol]ally po~ted the
p?yoC, ertj' kno~;i] as ,-
by placing the Board of.' Trustees oificJal poster where it can
easily be seer,, dDd 'that I have checked to be sure the poster
has remained in F.[ace for seven days prior to thr3 date of Lhe
p~l,bl~lg. (date of hearing noted thereon to be held~~
(sSgnature)
Sworn to before? me this
/? day oF /~gy 1~9~..
AUTHORIZATION
twhere t.h~.: applicant i'~
res i.d }.,~g .'~ t
(print owner . ~ _
o~. property} (m~:iiidg address)
do hereby authorize
(Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
( Owner ' '~' sJ gnature )
BoaOof Tr~;st:ees App;icatio'n
County of Suffolk
State of New Ycrk
BEING DULY SWORN
DEPOSES AND AFFI~4S 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 AGR!~ES TO HOLD THE TOWN OF SOUTHOL9 AND THE TOWN
TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAmaGES AND CLAIMS
ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN
COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,
THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY
TO INSPECT THE PR~%~ISES IN CONJUNCTION WITH REVIEW OF THIS
APPLICATION.
Signature
~ TC, BEf'C. RE ME THIS
NOTARY
4963140,
Ex~lrea June ~4
Notary Public
,19
OF NOTICE
\t L PF, CE]
STATE OF NEW YORK
COUNTY OF SUFFOLK
'~"~-~. ;: ........ , residing at
~b~,,?..~_~ - _ , being duly sworn, deposes and says
thlat on the day of . _,19__~, deponent mailed
a true copy o~ the tq~tice s~t 'fort~' in th~ Board of Trustees
Application, dir~-~ct~.d to each of the above n~med persons at the
addresses set opposite there respective names; that the
addresses set o~:,?osJ_te the names of said persons are the address
of said persons ~,.s shown on the current assessment roll of the
Town of Sout.~.o):~: t~nt sai~ Mc.t'~.ces were ~aiied at the ~nited
States Post O£ffice ?t , that said Notices
were mailed to r"a.?h of said persons by (certified) (registered)
mail.
6
May 1, 2000
Town of Southhold
Main Road
Southold NY 11971
Dear Board of Town Trustees:
We are submitting this application for a permit to add a 'floating dock' onto the existing fixed
dock-catwalk. As per the attached specification, a ramp and 2 piles would be added to
accommodate the floating dock. Neighbors throughout the area including next door have
recent floating docks.
The following is being submitted for your consideration
1. A propen~y survey completed within the last 6 months
2. The original permit/authorization from the Town to construct the fixed portion
3. A sketch of the proposed work
4. A copy of my Power of Attomey for presenting this request on behalf of my aunt.
5. A picture of the existing dock.
If possible, I would like to request a modification to the existing permit.
Thank you for your kind consideration
Sincerely,
M Polesny
1300 Strohson Road
Cutchogue NY 11935
Please respond to:
Jerry Metejka
94 Fulton Blvd Commack NY 11725
Board
Trustees Application
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity:
Are wetlands present within 75 feet of the proposed activity?
No Yes
Does the project involve excavation or filling?
No Yes
If Yes, how much material will be excavated? (cubic yards)
How much material will be filled? (cubic yards)
Manner in which material will be removed or deposited:
Describe the nature and extent of the enviror~ental impacts
reasonablv anticipated resulting from implementation of the
project as proposed. (Use attachments if necessary)
APPLICANT
The Town of Southold's Code o£ Ethics prohtbite c0n~llcts or
interest on the part of town officers .~ em~!~_~y0es. The
purpose of this form is to provide information which can
alert the town of ~o~s~i~- conflicts of [~-~-rest and allow
it to take whatever action is necessar~ to avold same.
YOUR
you ar~ applying Jn the name of someone else or
other entity, gucb ns a company. I2 ~o, indicate
the other person'~ or company's name.)
NATURB OF APPLICATION{ (check
ali that apply.)
Tax grievance
Variance
Change of zone
App~tal of plat
Exemption from pl~t or official map
other
(If "Other," name the activity.) .
parent, or ~hild) have a relat[onehip with any oEfi.~er or
empl. oyee or the To=n of 5outhold7 'Relationehip* lncludee
hf blood, marriag~, or buninene interent.
interest" mean~ a bueinen., ineluding a partnernhip~ in
which the town officer or employe~ ha. ~ven a
ownerehip of (~r employment by) a corporation in Mhich
HO .......
Name of person employed by the ToW~ of Southold
~[.t3g or po~i~ion of that person
~egcrib~ th~ relati, o~lahtp between yourmel/~ (th~ applicant)
and the town offic!er ~r employee. Either check the
~pproprLato line h) through D) and/et describe t.n the space
The
parent,
town officer or employee or his or her spouse, ~{bling,
or child ia {check all that apply}t
the owner of greater than 5% of the share~ of the
corpoLats stock of the appl[c~nt (when tho applicant
ia a eorporatlon)~
B) the legal or b~neficiaL owner o~ a~y ~t~re~t ~n a
noncorporate~entity (when the appl~ant ia not a
C) an ofricer~ ~irsctor, partner, or ~mpioy~s of the
applt{:ant! or
__D) the ~ctual applicant.
DP,:3CRIPTION "'