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HomeMy WebLinkAboutMutsakis, Michael & Capassakis, Evelyn Michael J.Domino,President q SOUlyO Town Hall Annex John M.Bredemeyer III,Vice-President h0 l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • Q Telephone (631) 765-1892 Greg WilliamsO Fax(631) 765-6641 �y00UNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: h4!2�� rg ' -ze 2e 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: ?'t. 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I]w K _ $, b ao R 41 By11a> 413 Bb I� 2s w �ryp1y,axe^j1 G \�' ' 6 �3F'•� 'ES ,k- '� a - B FORPCLNO < H SEE SEC NO 16A(l) y5 w 1 411 m> \ T _ SEE BEG NO VA " b OSSOltb0.1 ® v'r J( \"4i..a.15AIc) 20A 5 9 s J m 27 O e R : k E d,�m,,,a� —�— ou>. ti (21) ua o..e°.. -- -- mew --a-- a NOTICE O¢W., COUNTY OF SUFFOLK © E ,30 a SOUTHOLD SECTION NO G mew a. O2 .-- Real Property Tax Service Agency v E --- --- _ ___ -- _ __ C.—yCwrowR—d.NY„44, 050 of 051 Uw.ra a -i2°, ��� wf ® A No 1000 P — kPROPE—F1' IAP —— mvs+9o+o.1E...q,4 nfe ».-sc::w...•___,..... _ ...............—.e.;�.-__...;^c--.xr,:*....,.....�.......w..�d..=_.. :"«�.a.+cr -' _ __ _ —�=`'-=Y...,.` _ _ _ __ _ •�"�v.a*'�ia�,w.:�_'�''.,:i. _�.�3'd."iniw�?�_`r�'.T.n3'.:.'.im:`.�s-xa�m�;LL`+'� Z�.S^�...�a--"'1w_� ..c a mow - COSTELLO MARINE CONTRACTING CORPORATION DOCK BUILDING - JETTIES - BULKHEADING • STEEL& WOOD PILING - FLOATS 423 FIFTH STREET - P.O. BOX 2124 • GREENPORT, NEW YORK 11944 • (631)477-1199/477-1393/477-0682 • FAX(631)477-0005 July 6, 2018 Southold Town Trustees D E EIV E PO Box 1179 Southold,NY 11971 JUL - 6 x}18 RE: Mutsakis Property 20985 Soundview Avenue,Southold southald Totivn SCTM#1000-51-4-16.1 Dear Trustees: I am requesting a pre-submission on-site meeting at the above-referenced property. This property has endured storm damage this past winter. Jack Costello would like to meet at your earliest convenience to discuss possible solutions. Jack can be reached on his cell at(631) 902- 1811. I have enclosed the three required authorization forms from both of the property owners and a check in the amount of$50.00. A property survey is also included. Please do not hesitate to contact me if you have any concerns. Sincerely, 4 Jane P. Costello Permit Manager enclosures MBoard of Trustees Xpp3sation AFFIDAVIT EVELYN CAPASSAKIS BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF 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,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 THE PERMIT. (ZM64 Signature&ropertOwner Signature of Property Owner SWORN TO BEFORE ME THIS 10 DAY OF J L) -, 20 /9- Notary 20 /9-Notary Public LYNN E STEVENS Notary Public-State of New York NO.OIST6269424 Qualified in Suffolk County Commission Expires Q rgy,)Oc?U APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of lithics prohibits conflicts of interest on the part of town officers and employees."I'he.nurpose_of this form is to provide information which can alert the to of possible conflicts of interest and allow it to take whatever action is necessary to Avoid same. YOUR NAME: CAPASSAKIS EVELYN (Last name,fiist name,tltiddle initial,unless you are applyingin the name of someone else or other entity,such as a company.If so,indicate,thb other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievanceBuilding Variance Trustee X 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 rclationship,witti any officer or,cmployee of the Town of Southold? "Relationship"includes by blood,-ularringe,or business interest"Business interest"mcans 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 X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A),the-owner of greater than 5%of die shares of the corporate stock of the applicpnt , (when the applicant is a corporation); B)the Icgal'orbeneficial 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 RELATIONSHIP 1 Submitted this CO qday of J^vim 2009 Signature _ Print Na aEVELYN c SAKIS y Form TS 1 i Board, of Trustees App 0ation AUTHORIZATION (Where the applicant is not the owner) I/We, EVELYN CAPASSAKIS owners of the property identified as SCTM# 1000-51-4-16.1 in the town of SOUTHOLD New York,hereby authorizes COSTELLO MARINE CONTRACTING CORP. 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. operty Ow 's Sign ture Property Owner's Signature SWORN TO BEFORE ME THIS DAY OF JTiJ120/k J7(Ll Notary Public LYNN E STEVENS Notary Public-State of New York NO.OIST6269424 Qualified in Suffolk County Commission Expires g a y-act Board of Trustees Application AFFIDAVIT MICHAEL MUTSAKIS BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF 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,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 THE PERMIT. Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS 3r �✓ DAY OF , 20 '� otary Public EVELYN M.CAPASSAKIS !i Notary Public, State of New York ii a No.02CA4865487 1 (; Qualified in Kings County Commission Expires June 23, 2022 1 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, MICHAEL MUTSAKIS owners of the property identified as SCTM# 1000-51-4-16.1 in the town of SOUTHOLD New York,hereby authorizes COSTELLO MARINE CONTRACTING CORP. 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. Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS 3rd DAY OF 20 OF (Notary Public EVELYN M.CAPASSAKIS Notary Public, State of New York i No.02CA4865487 Qualified in Kings County q Commission Expires June 23,20?Z APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on llte,)art of town officers and emnloyecs.The numose of this form is to provide infonnation which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary.to avoid same. YOUR NAME: MUTSAKIS,MICHAEL (Last name,first name,i,iddle 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 X 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 will,any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interesL"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 X If•you answered"YES",complete the balance of this form and bate and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/ag(;nt/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 applicont (when the applicant is a corporation); B)the legal orbeneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); G)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this Jrg day ff 20Q& Signature _ Print Name MICHAEL MUTSAKIS Form TS I