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HomeMy WebLinkAboutTR-6010 Board Of Southold Town Trustees ... SOUTHOLD, NEW YORK �t ? O Qct....20.....2004 PERMIT NO. ... .................. ........ DATE. ' ISSUED_ TO PARKER AND BETSEY DICKERSON.......................................... .;r - .Qr 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 y State of New York 1952; and the Southold Town Ordinance en- #itled:"f E G ULATING--AND--THE P-LACING--OF:O-BSTRUC-TION5.. .-- ' IN AND ON TOWN WATERS AND PUBLIC LANDS and'-the REMOVAL OF SAND, GRAVEL-OR OTHER" MATERIALS-FROM ' LANDS UNDER TOWN*WATERS;'•.'• and in accordance with 'the :r Resolution of The Board adopted at a meeting held on 2.0 •�• � aid b � 2004 .............. and in consideration of the sum of $. 5.0.._0.0 P y PanFzen and.. Al2.r..c.(�e,�c�0A .5.e ey-. ................................................................:.......... � ........................... ' of .......S.a..wthutd.......................................................... N. Y. and. subject to. the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wettand Penh bon the existing. 6ixed dock, 2' x 28' and 14' i tampz, and 5' x 16' �Zoating dock , as pen the plan zutweyed F by Van Tuyt dated Jut y 9. 1986 and nevi s ed with the dock added on Sept. 30, 2004. y all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees 1wre- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board .as of this date. o A) e Fasten'( z ent ` ""�/•� , y1 � - Trusties Tl Peraiittee 9-7- PaAkeA and Betsey Dickeuon .residing at Southo.i?d ;.. N. Y., S.s.._ vart• of the consideration for the issuaaa of the Permit does uudastaad and psesrnlbe to the fol- lowing: i. That the Said Board of Trustees and the Town of Southold are releaed -from any sad all damages, or claims for damages, of suits arising ditecdy or iadirecdy as a result of any open- _ _ex or_her ow n defend.tiny and all such salts`initiated:by.d*d+atties,.and the said Vermhtee assmses.fqU liability with respect thereto, o the-vomplete'emdusion of'the-B,Qacd of Tcugees of the Town of Southold. _ 2. That this l is valid for a Qtriod of 24 = rocs. which is csek�sldeied to be the estimated time'required to complete the work involved, #ut'should Winces warrant, request for an omeasion may be made to the board at a later 6tr- - 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes ' to•maintain the structure or project involy/r.-' to provide evideme to anyone concerned that suth ociz.don was originally obtained. / 4. That the work involved will.be stibjea to the inspection and approval of the Board or Its agents, and non-oompiianoe with the provisions of the otigina ft application, may be cum 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 wodc hereto adthorized. G. That there shall be no interference with the right,of the public to pass and repass along the beach between nigh and low water marks. 7. That if future operations of the Town of Southold require dw removal and/or alterations In the bcation of the mode fieerein audiotized, or 14 in the opinion of.-the.Board of Tkuftes die. work.shall cause unreasonable obstruction to free navigation, the Bald Permidee will be rOquirods upon-due notice, to remove or alter thus work or project herein stated without fzpeases to the Town ` of Southold 8. That the said Board will be notified by the Permittee of the completion.of the wodc orized, 9. nat the 'Fermittee will obtain all other permits and consents that may be required s elemental to this permit which may be subject to revoke upon failrtre to obtain `ame. -' F0t� Albert J. Krupski,President ®®o� ��� Town Hall James King,Vice-President 53095 Route 25 Artie Foster P.O. Box 1179 Southold,New York 11971-0959 Ken Poliwoda Peggy A.Dickerson Telephone(631)765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 20, 2004 Parker and Betsy Dickerson 1485 Mill Creek Dr. Southold, NY 11971 RE: 1485 MILL CREEK DRIVE, SOUTHOLD SCTM# 51-6-29 Dear Mr. And Mrs. Dickerson: The Board of Town Trustees took the following action during its regular meeting held on Wednesday October 20, 2004, regarding the above matter: WHEREAS, Parker and Betsey Dickerson applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated September 30, 2004, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 20, 2004, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, 2 RESOLVED, that the Board of Trustees approve the application of PARKER AND BETSEY DICKERSON for the existing fixed dock, 2' x 28' and 14' ramp, and 5' x 16' floating dock as per the plan surveyed by Roderick Van Tuyl dated July 9, 1986 and revised with the dock added and received in the Trustee office September 30, 2004. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. '(See attached schedule.) This is not a determination from any other agency. Fees: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/hct I r Telephone C Town Hall (631)765-1892 G 53095 Route 25 P.O.Box 1179 y 0� Southold,New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Monday, October 18, 2004, the following recommendation was made: Moved by Don Wilder, seconded by Doris McGreevy, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of PARKER & BETSY DICKERSON for the existing fixed dock, ramp, and floating dock. Located: 1485 Mill Creek Dr., Southold. SCTM#51-6-29 The CAC recommends Approval of the application with the Condition the existing dock and walkway is included on a survey by a licensed surveyor. Vote of Council: Ayes: All Motion Carried SOUND IM ISLAND LONG 43 P D TOO A lu m P .100 VA tzts —m-m N. E NOTICE COUNTY OF SUFFOLK Q X, SOUTHOLD SECTION NO Red Property Tax Service Agency y C—ty Cw IU=*ANY WDI Pmrea A 051 I 1 S11fF01,� Albert J. Krupski,President ��� C� Town Hall James King,Vice-President 53095 Route 25 Artie Foster p P.O.Box 1179 Ken Poliwoda W Southold,New York 11971-0959 Peggy A. Dickerson Gy • ��� Telephone (631) 765-1892 ��,� �a Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application 'Major Minor _Waiver/Amendment/Changes /ReceivedApplication: -)Uvq Received Fee:$! 50 C{LLP-- G (Ally ,completed Application 9IJ91N n„ _Incomplete R U _SEQRA Classification: Type I Type II Unlisted Coordu;ztion:(date sent SEP 3 Q "LUU4 SAC R ferral Sent: q . --5ate f f Inspection: JOIL5 _Rezzipt of CAC Report: Southold Town _Lead Agency Determination: U Board of Trustees Technical Review: ,/Prublic Hearing Held: j Resolution: Name of Address 1 4 g'S K i I Cf LW_ Phone Number:( Suffolk County Tax Map Number: 1000- ©`j - (p — cZ C ,S-F- o Property Location: t!h p � , X �— 4 (provide LILCO Pole#, distance to cross streets, and location) �y AGENT: C (If applicable) �C)I l Address: Phone: Board of Trustees Application GENERAL DATA Land Area(in square feet): Area Zoning: Previous use of property:, Q, Intended use of property: Prior permits/approvals for site improvements: ncy �(gei�.e Lek D�Date -t— No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description(use attachments if necessary): Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: &IOT,V 0- Area of wetlands on lot: �- o �® square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: (5 feet Closest distance between nearest proposed structure and upland edge of wetlands: (9 feet 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 Depth of which material will be removed or deposited: � 0� feet Proposed slope throughout the area of operations: f\ Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): PROJECT ID NUMBER 617.20 SEAR APPENDDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJECT NAME 3.PROJECT LOCATION: Municipality St�GI. County 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map n l 4 S (''1 l Cv -ee,(`—D J- v­e n 4-ee se�}-r o k m fro cae cQ - 5. IS PROPOSED ACTION: ❑ New ❑Expansion ❑Modification/alteration l 6.DESCRIBE PROJECT BRIEFLY: F 7.AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Lz�jYes ❑ No If no,describe briefly: 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential ❑Industrial ❑Commercial ❑Agriculture ❑Park/Forest/Open Space ❑Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ❑Yes 69 No If yes, list agency name and permit / approval: 11.DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ElYes El No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? Oyes ❑No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE t Applicant / Sponsor Name Date: Signature If the action is a Costal Area,and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: M&Aj Po Qox 30 -7, sow 303 Re roz r St-, toy w i000 3 Ml(ti�rS . SQrl�2'$ W[(IS� �� 309 1. eykd, 1.&vi,,, N-d • 0 MllIU1 ro c1Jv nt�h�cjC �are��0. l Z75�- M i 11 Ce'�--I<`Nu,e , !V I.A P't;t �r�e d��a uQ aQ V STATE OF NEW YORK COUNTY OF SUFFOLK residing at I �-f $ N( r ( C yC-� ✓i�U-� o ,being duly sworn, deposes and says that on the day of /1 r�& e,,,—,2004 deponent mailed a true copy of the Notice set forth.in the Board of Trustees Applic tion, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold;that said Notices were mailed at.the United States Post Office at that said Notices were mailed to each of said persons by (certified) (registered)mail. 4Lal Sworn to before me this Day of 20_4_ Notary P blic 0101 Yak �WW 1 2W Board of Trustees Application County of Suffolk b State of New York a �e--6 BEING DULY SWORN DEPOSES A AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. �. igna ure SWORN TO BEFORE ME THIS D DAY OF ,20© �' L Notary ublic PAYRICIA CORWIN Public,State of NOW York No.mC05017852 Ci3lified in Suffolk County f crnmusinn Expires Sept 13, Q/ 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 possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,firs name, fiddle 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 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 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 RELATIONSHIP Submitted this aC� day of 200 Signature Print Name .o . Form TS 1 SU FFOL.K CO. H444#.APT AP 6Ti/AL r; ='.Vf�,' p `Q `f STATEMENT OF INTENT -,- vU ~� `< ! 6.4- ;• ,_ ' � � t � ,, THE WATER SUPPLY AND SEWAGE DISPOSAL #a e SYSTEMS FOR THIS RESIDENCE WILL 6 _` CONFORM TO THE STANDARDS OF THE G� 3�S .' '---- _`fii'` '`�- — vV y C AL_E-- 4-D i SUFFOLK CO. DEPT. OF HEALTH SERVICES. t IEr1l?C`rr t \ Q'! NPIPEAPPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES FOR APPROVAL OF \\\ CONSTRUCTION ONLY DATE: �(o H. S. REF. NO. K)-50--41 APPROVED: H. S ° : ` SUFFOLK CO- TAX MAP DESIGNATION: 7. L_:.� D1ST. SECT_ BLOCK PCL. 29 ADu 47 _�:DRESS: Acr .• �+ SEP a Southol Tow DEED: L. 50 36 P. $ b \ Board of r - Y �- � � •�•�s"s �• � OLE STAMP - ? a Q 4lnauthorirsd alteration or addiCurt `0 ��,. -- ? to thij survey is a violation of i Section 720 of the New,Ycrk o _I W bfbJ7tttJ� � Education Law. Copies of this sure map net b9ar£n �r C�:131sr�3Y CLAY tfie Sand surveyor's Inked sen!or. f'•:_r 1. l� •s:k.. i ,� '�4 ernbossi?d seal mall not be conside> 1 , to be a valid true copy. ►!{2 ` \ '�� t Guarantees indicated harcen eholl rG only to the person for whom the Sur ! is prepared,and an his behalf,to the 1� { t !t1!�1 A s��f +3 1 S t� , r CLAYIE-Y ,t.,,,, title company,governmental agency and �V! 1 t #„ y / } Y ti �;! .:1'tAP J'�s."!.EN C).EG' ��t.�f �1���a� `� lending institution listed hereon and r t? _ Y to the assignees of the landing insti- .. ...... ---- — —....- ._ . --.. --- - .... . .. _.._ ... - to ion. Guarantees are not transferab o a institutions or subseque t C t relic uiti n I �. ; i �� �,..:,` f•.•-•, �L . 1, , I ; y ! r•� 7, -}�^- tag� -a8^-- /-�-�p+*�{ � ..�. 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