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Home My WebLink AboutTR-5435 James F. King,President ��®F SOUf�� Town Hall Jill M. Doherty,Vice-President e`,® �® 53095 Route 25 P.O.Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen John Holzapfel � �® Telephone(631) 765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 17, 2006 Elizabeth Wolff 30 Platt Pl. Huntington, NY 11743 RE: 200 WEST LAKE DRIVE, SOUTHOLD SCTM# 90-1-20 Dear Ms. Wolff: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, May 17, 2006: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Permit#5435 from Joseph and Catherine Barbato to Elizabeth Wolff as issued on October 24, 2001 and amended on June 26, 2002, with the condition of the maintenance of the 20' non-turf buffer landward of the bulkhead. If you have any questions, please contact our office at (631) 765-1892. Sincerely, C James F. Wnpg Vice-President, Board of Trustees JFK: hkc i-. n;1 4 . %• ,��ti4y •p y ,! �' � 1, � � 0 oS a r_, t t r James F.King,President -``�OF SOUro Town�Wi Jill M.Doherty,Vice-President �O �l0 53095 Route 25 Peggy A.Dickerson P.O.Box 1179Southold,New York 11971-0959 Dave Bergen G Q John Holzapfel '�� Telephone(631)765-1892 `,QU '� Fax(.631)765-6641 (w � BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: Name of Applicant: Name of Agent: Property Location: SCTM#& Street W_eo L` Brief Description of proposed action: Type of area to be impacted: _Saltwater Wetland Freshwater Wetland _Sound Front ' Bay Front Distance of proposed work to edge of above: Part of Town Code proposed work falls under: Chapt.97 Chapt. 37_other Type of Application: '�Wetland Coastal Erosion Amendment Administrative _Emergency Info needed: Modifications: Conditions: Present Were: _J.King _J.Doherty_P.Dickerson. D. Bergen J.Holzapfel Other: Mailed/Faxed to: Date: 4 JAN 2 4 ,nr2 Z1 s m WEST LAKE ROAD o S 6725'20"E 100.00' U FD MON POMt dt rail a 84.38' °f (" z � Ih N lAFD v tn / N O s 4�- 77.4 35,1 DGAR e.a• 1 STORY FRAME o m O DWELLING i � m � cu 6) I x rrn PIe o A O \ 16 ° N N L C 7o m x � Om 00 b N FD MON ^? o v � N R c0 a Lq 8 � WOOD 9"-W-40 MOOD eulx HEM WOOD W"—HEM n n n n LAAlOw N 6736'14"W n n n n n n n ; n n n n n n n n HOG NECK BAY n n n nM OFFSETS(OR DWO NWO)!TOOT HEREON FROM TE STRUCnam 70 THE PROFEnn TRH ARE FOR A spa PUWW AM USE AND T UMO K ARE Nor JOB No. 01-604 FILE No. CEDAR BEACH PARK WDVTDED TO OUWE THE 8=nON OF FOCES,MEWING Wkl%POOLS,MTWTS, TiANmn AIMS.AWTION TO numm "w ANY ablER CONS UCTIOAL SURVEYED FOR JOSEPH BARBATO U)NrMOR a AUEW M OR AOWWN To TSII SUIF&V e A WTOTATM OF SMTaN 72W OF TTE MEW VOW STATE TDUTYTgM RAW. LOT NUMBER 123 OUANWTFSS SMSGTTED ROM*Wl AN ONLY TO TFE FF]1.90N FOR WHOM THE MAP OF CEDAR BEACH PARK SURVEY■PFIFAED.AND ON M AQ4A F TO THE TDTF CO~,DOWETW WOUAL SITUATED AT BAYVIEW mow Am Lmm vamunom LISTED HEREON,AM 10 THE AOI$IO K THE Rao"°RAnnunaN.aANWWDm ATE NOT TRWISPOWAnE TO ADOMMU.Permnas TOWN OF SOUTHOLD — SUFFOLK COUNTY N.Y. OR SUDDEquFur ONROM cav OF THS SURVEY rr ACT WANG YfE wo SURD RUM SE-AL OR SCALE 1" = 30' DATE 1-16-2DO2 EhOCO 1 SEW.SHATA.NOT K CONIMEAW TO IF A VALID TWUE COFf FILED MAP No. 90 DATE 12-20-1927 CERTIFIED ONLY TO: TAX MAP No.(REF ONLY)1000-90-1-20 DISK 500 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR r 1866 WADING RIVER-MANOR RD. WADING RIVER, Q� �T� n .t k.� NEW YORK, 1T792 �b LIC. No.048992 631--929-4695 HA LD F. TRANCHON JR. PENN. LIC. No. 2115-E Albert J.Krupski, Pres' Town Hall James King,Vice-PresiuCz«, �$UFF��-c 53095 Route 25 Artie Foster �O P.O.Box 1179 Ken Poliwoda Southold, New York 11971-0959 Peggy A. Dickerson Telephone(631)765-1892 Fax(631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 27, 2002 Mr. &Mrs. Joseph Barbato 200 West Lake Dr. Southold,NY 11971 RE: 200 West Lake Dr.,Southold SCTM#90-1-20 Dear Mr. &Mrs. Barbato: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday,June 26, 2002: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5435 for the existing 8'X 12' shed. This is not a determination from any other agency. If you have any questions, please call our office at(631) 765-1892. Sincerely, azzi.a n /&..'2.-ZZ' C�` , Albert J. Krups�i, Jr. President,Board of Trustees AJK:Ims �• r •� h�t�'�i � t 3.. Board Of Southold Town Trustees SOUTHOLD, NEW YORK .r PERMIT NO. . ...y��, DATE:Octobe ...._.. ...r .....26�.. ....2001 .�" ;•. } ISSUED TO .............JOSEPH...&...CATHERI .4..BARBAT.Q_ ....... Pursuant to the provisions of Chapter 615 of the Laws of ` the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance on- titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS y 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 October .. ' Resolution of The Board adopted at a meeting held on ..................,........ 2001and in consideration of the sum of Z00.00 paid by + Joseph & Catherine Barbato -` .... ......... . ....... .............. ......................................................... ..................................... ...... ....... '•` '� of ............Southold........................................................................... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, 1� of Southold Town Trustees authorizes and permits the following: Yz Wetland permit for the existing bulkhead as depicted on survey ` ' dated January 16, 2002. all in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees hare- by causes fts Corporate Seal to be affixed, and these presents to be subscribed bye majority of the said Board as of this date. ,r � Albert J.Krupski,President SV�E�(�, Town Hall James King,Vice-President ��,� C'Q 53095 Route 25 Henry Smith ��' Gy P.O.Box 1179 Artie Foster y Southold,New York 11971-0959 Ken Poliwoda Dy • �g Telephone(631)765-1892 Fax(631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 26, 2001 Mr. &Mrs. Joseph Barbato 200 West Lake Dr. Southold,NY 11971 RE: 200 West Lake Dr.,Southold SCTM#90-1-20 Dear Mr. &Mrs. Barbato: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 24, 2001 regarding the above matter: WHEREAS,JOSEPH & CATHERINE BARBATO applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated October 3,2001, 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 24,2001, 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, NOW THEREFORE BE IT, l RESOLVED, that the Board of Trustees approve the application of JOSEPH & CATHERINE BARBATO for the existing bulkhead as depicted on survey dated January 16, 2002. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency,which may also have an application pending for the same or similar project. Permit to construct and complete project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Fees: None Very truly yours, Albert J. Krupski,Jr. President,Board of Trustees AJK/lms DEC ACE Dept. of State �DU-/4old , ill re ties 4-t rm c f n o S VeA 0 J,0 6Wb&,�v no 0eT- oa(,-�,/ )-oo/ bt tr"-9(-�r ,�-X 7"-0 n4ly n '�D MA-k-.P- 41-8 n 6e-,"st43 r6f 4,tl� 7� 4-(Le- v(514?'T5 /:?W(c&-4- MAY - 2 2006 Board Of $outhold 'Town Trustees SOUTHOLD, NEW YORK DATE: (~.~ob~r .,~.~.t..., 2 0 01 ISSUED TO .............. ],.QS.E;F.~....~...GA.T[~.R!N.E.. B.ARB~TO ....................... Pursuant fo the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the L~ws of the State of New York 19521 and the Southold Town Ordinance en- titled ."REOULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN'WATERS;.'/. and in accordance wlfh the Resolution of The Board adopted et e meetlng held on ...Q~p~r...~4, · ZOO1 nd ...................... ............. a in consideration of the sum of $200.00 .. paid by Joseph & Catherine Barbato o{ ............ ~.~.~. ........................................... N. Y. end subieO to the Terms end Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit for the existing b~lkhead as depicted on survey dated January 16, 2002. all in accordance with the detailed specifications as presented in .the origin~fing appl;cut;on. IN WITNESS WHEREOF, The sa;d Board of Trustees I~ere- ~ causes fix Corporate Seal to be affixed, and the~e presents to subscribed by ~ majority of the said Board as of this daf~, Trmtee$ TER~S end C. ONDmONS Joseph & Catherine Barbato ~dd~ga~ 200 West Lake Drive, Southold N. puc. of fl~e comtdersdoa for the LsS,,-,,,'? of ehe P,..,.~¢ do~ nmi,~i~,ml sad proscribe ~o 2. Th~dgsP-e,~k:_ls'~lldfozs. _p~odof : N/A r~s. whkh b amskl~d to be d~ for sa orlzado~ was odglnall7 ~dned. 4. That fine wofl~ .involved will be mbja:t to the imlxealoa sad spproval o~ the Boe*l z~ lu agents, and non-zomt~tiofl,:e with the pram. dom of the od~*~,,~ Spl~!...~toz, may be ,'*~-,' fm revoctdoa oE figs p,..,.~i~ bI. t~ohtion of the sam Bo~u'd. 6. That d~,~ d~ll be no int~ference with the tight of the pulgic to ~ -_,~ n~ass along the I~fi betwema htgh and low water mazi~ 7. ~ i~ future operations of the Town of So~thold sequire d~ mnovd sad/re' sh~lem the _le~_ don of the work herein amhoclzot, or if, In the op~s~m o~ dm Boent o~ Tn~cee~ the. ~ shtll came ~le obstzucuon to free nav/g~d% cbc said P~ will be ~ utxm ~ notice, to remove or aher ~ wodc o~ project he~n s~tecl ~ expenses to the Town S. That the said Board will be nmtfled by the Permittee ot d~ con~i0~ t~e wodc mth- orlzed. 9. That the Penniu~e ~ obtsln all ocher p,'~,,~'- ~d comems d~t stay be m~lzed rap. plemem~ to this permit which may be mbjecc to revoke upon ~.n.,-e to obtain sam~ ! 1 ! ! ! Joseph & Catherine Barbato PO 90 - 200 West Lake Drive Southold. NY 11971 July 2, 2002 Albert J. Krupski, President Board of Trustees, Town of Southold 53095 Route 25 PO Box 1179 Southold, NY 11971-0959 Re: Approval of the Amendment to Permit ~5435 for the existing 8' X 12' shed. Dear Mr. Krupski: Our sincere thanks to You and all the Members of the Board of Trustees for RESOLVING to APPROVE the above Amendment. We gratefully appreciate it. 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 June 27, 2002 BOARD OF TOWN TI~USTEES TOWN OF SOUTHOLD Mr. & Mrs. Joseph Barbato 200 West Lake Dr. Southold, NY 11971 RE: 200 West Lake Dr., Southold SCTM#90-1-20 Dear Mr. & Mrs. Barbato: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, June 26, 2002: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5435 for the existing 8'X 12' shed. This is not a determination fi.om any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krups~i, Jr. President, Board of Trustees WEST LAKE ROAD $ 6725'20"E /% ,/x, N 67'56'14"W /'% ,-'X 1 STORY F'P, AME DW£L/JNG HOG NECK BAY /% /% /% CERTIFIED ONLY TO: TRANCHON JR. ~. LIC. No. 048992 PENN. LIC. No. 2115-E JOB No. 01-604 FILE No. CEDAR BEAC SURVEYED FOR JOSEPH BARBATO LOT NUMBER 123 MAP OF CEDAR BEACH PARK SITUATED AT BAYV1EW TOWN OF SOUTHOLD - SUFFOLK COUN]~t' N.Y. SCALE 1" = 30' DATE 1-16-2002 FILED MAP No. 90 DATE 12-20-192 TAX MAP NO,(REF ONLY)1000--90--1--20 DI,' HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR 1866 WADING RIVER-MANOR RD. WADING F NEW YORK, 11792 6.31-929 -4695 84.38' .~A~JAN2 ~ WEST LAKE ROAD S 67'25'213"£ 8.8' OAR. 1 STORY FRAME DWELLING platform 16 100.00' .o.t ~ ~ 23.0 cD JAN 2 /%' ~ ./k, HOG NECK BAY ~ ~ ~ CERTIFIED ONLY TO: HAi~r~LD F~. ~'I1"~~' ..~ TRANCHON JR. I~. LIC. No. 048992 PENN. LIC. No. 2115-E JOB No. 01-604- FILE No. CEDAR BEACH PARK SURVEYED FOR JOSEPH EIARBATO LOT NUMBER 125 MAP OF CEDAR BEACH PARK SITUATED AT ~AYVIE~N TOWN OF SOUTHOLD - SUFFOLK COUN~¢ N.Y. SCALE 1" = 30' DATE 1-16-2002 FILED MAP No. 90 DATE 12-20-1927 TAX MAP NO.(REF ONLY)1000-90--1--20 DISK 500 HAROLD F. TRANCHON JR. P.C. LAN[} SURVEYOR 1866 WADING RIVER-MANOR RD. WADING RIVER, NEW YORK, 11792 651-929-4695 Telephone (631) 765-1892 Town H'~. 5309.5 Main Road P.O. 8ox 1179 Southold, New Y~t'k 11971 $OUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Monday, June 24, 2002, the following recommendation was made: Moved by Drew Dillingham, seconded by BOb Ghosio, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Amendment Request of JOSEPH & CATHERINE BARBATO to Amend Permit #5435 for the existing 8'X 12' shed. Located: 200 West Lake Dr., Southold. SCTM#90-1-20 Vote of Council: Ayes: All Motion Carried 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 11971-0959 Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 26, 200l Mr. & Mrs. Joseph Barbato 200 West Lake Dr. Southold, NY 11971 RE: 200 West Lake Dr., Southold SCTM#90-1-20 Dear Mr. & Mrs. Barbato: The Board o f Town Trustees took the following action during its regular meeting held on Wednesday, October 24, 2001 regarding the above matter: WHEREAS, JOSEPH & CATHERINE BARBATO applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Toam of Southold, application dated October 3, 2001, 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 24, 2001, 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, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of JOSEPH & CATHERINE BARBATO for the existing bulkhead as depicted on survey dated January 16, 2002. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency, which may also have an application pending for the same or similar project. Permit to construct and complete project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Fees: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms DEC ACE Dept. of State Telephone (631) 765-1892 Tov~ Ha. ll. 5309.~ ~ Road P.O. Box 11'79 flout, hold. New Yo~k 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conse~ation Advisory Council held Monday, October 15, 2001, the following recommendation was made: Moved by Scott Hilary, seconded by Bret Hedges, it was RESOLVED to recommend to the Southold Town Board of Trustees DISAPPROVAL of the Wetland Permit Application of JOSEPH & CATHERINE BARBATO for the ekisting bulkhead. Located: 200 West Lake Dr. Southeld. SCTM#90-1-20 The GAG recommends Disapproval of the application because there was no survey submitted, making the request unclear. The CAC recommends a survey be submitted showing the existing bulkhead, for the record. Vote of Council: Ayes: All Motion Carried ,_~ ~. . ....,~ .: . ~ / .. / .,.~ ~ ~ ..... ~1~ ~-.- V ~ ' --'4 ~ ~' . . /z/ .,. ' I ~ ~ , · '. x :- / ~ :. I II I , ~ ~..~..' ' ~ : . - .~ I II ~ ~. :~:;,$' '-7~ / ' / '~T~ ..~ , .-.-Y:: .~ .~1-/. ... i; .'l . ' f ',' , '" ~'/, '/ ~.~, ~ ~1 ....- - -. 't' - ~, ~ ~ ~'~ Albert J. Krupski, President James King, Vice-President Henry Smith Artie Fester Ken Poliwoda BOARD OF TOWN TI~UST~ES TOWN OF SOUTHOLD Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 LETr ~;R OF REQUEST FOR AN AMENDMENT / ADDRESS PROPERTY LOCATION TAX MAP NO. ~. ~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: "7"'"~ ,z.z -E STATE OF NEW YORK COUNTY OF SUFFOLK ~_J"~'oa~,~be~o, "~/~fob~.7~residingat ~,Zoo ~Z ~V~ ~., , being duly sworn, deposes ~d says that on the & ~ day of ~o ~ ~ ,20 0 ~ deponent mailed a ~e copy of the Notice set fo~h in ~e Board of Trustees Application, dffected to each of the above named pe~ons at the addresses set opposite there respective nines; that the ad.asses set opposite the nines of said persons ~e the ad&ess of said persons as sho~ on the c~ent ~sessment roll of the To~ of Sou~old; that said Notices were mailed at the U~ted States Post O~ce at ~o ~ T~ ~ / ~ , that said Notices were mailed to each of said persons by Sworn to ~ore me this Day of "~.~. ~ ,20 Notary Public 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 11971-0959 Telephone (631) 765-1892 Fax (631) 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) .~ - AFFIDAVIT OF POSTING r,C~rh~;o~ '~V~o residing at ~Zvm ~J~ ~/~ '~,. being duly sworn, depose and say: That on the ~[~day of ~0~ , 200~, I personally posted the property known as ~ ~,.3~s~ ~ ~. J~ ~/~ 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. DDte of hearing noted thereon to be held~~ (signature) Sworn to bef~re me this day of 200 ~oearg~ ~ub~c ~ ~ ~ ~ in S~olt Coun~/ ~ ~ Sept ~3, ~ ![. 101//;10F-SI IFTHOLD 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 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~laal Erosion Permit Applicatio~gn nd Permit Application ,"Major ~R~[vWaiver/Amendment/Changes ed Application:. ,fReceived Fee:$ ~ -' ~Completed Application Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ~CAC Referral Sent: /~tt,..~/O ~ of Inspection: 10.]/7,/01 Reeeipt of CAC Report: Lead Agency Determination:__ ~bhnical Review: lic Hearing Held: Resolution: Minor Name of Applicant Address '"-~ ~ Phone Number:( Suffolk County T~ Map Number: 1~0 - (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: Board of Trustees Application Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: GENERAL DATA Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes · ?yes, provide explanation: Project Description (use attachments if necessary): · PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: CERTIFIED MAIL REC:::Ir,'r 4~ (Oomestic I[I~il Only: No Insurance Coverage Provided) Address: U.S. Postal Service CERTIFIED MAIL RECEIPT (Domestic Mail Only: No Insurance Coverage Provided) SOLtTHOLB- NY 11971 UNIT ID: 097! ru 2.10 t-"l Ce~ifled Fee Rerun1 Reccg!~tt Fee Here ~ (E~dor~m~ gler~::: KW2JC4 STATE OF NEW YORK COUNTY OF SUFFOLK ~p~ , C~,,~ ~6~ , residing at ~th~l~, ~. //~/ , being duly sworn, deposes and says that on the'~- day of ~0~-~ ~, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that~aid Notices were ~iled at the United States Post Office at ~ ~~, , that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this ,. ~ day of t~--~ ,~,J," ,~:t~ ~.~ ,J Nmry Public, State d New yod~ No. 01ST4844752 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 11971-0959 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) AFF DAV OF POSTING I, Jo~fk~da~,t,2~ ~ah~residing at ~ , being duly sworn,/depose and say: That on the J day of ~g~.~_200/, I personally posted the property known as ~ao ~/~E L~e ~. ~al~, ~ I;~7/ by placing the Board of Trustees official ~oster 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 ~g~ Date of hearing noted thereon to be held ~aql~[ Dated: Sworn to before me this ~ day of~ 200' ( signature ) Boar~ Trustees Application County of Suffolk State of New York ~E~O~S ~D AFFI~S ~T .E/S.E IS ~S ~LIC~T FOR ~E ~o~ DESCRIBED PERMIT(S) ~ ~T ~L STNA'~S CO~AIN~ H~IN ~ TRUE ~ ~E BEST OF HIS/H~ ~O~E ~ BELIEF, ~ ~T ~L WO~ WILL BE ~NE IN ~E ~ SET FOR~ IN ~IS ~PLICATION ~D AS ~Y BE ~PROV~ BY ~E SO--OLD ~ BO~ OF ~USTEES. ~E ~PLIC~ AG~ES ~ HO~ ~E ~ OF SO--OLD ~D ~E ~ ~USTE$S ~ESS ~ ~E ~ ~ ~ ALL D~GES ~ C~IMS ~ISING ~ OR BY VIR~E' OF SAID P~IT(S),'IF G~. IN CO~LETING ~IS ~PLICATION, I H~EBY A~ORIZE ~E ~USTEES, ~EIR AG~(S) OR ~P~S~ATIVES(S), ~ ~ O~ ~ PROP~ Signature Q~t:~ in S~olk C~ , te ',VRAN.qA~'.TIONr, L UI~C~.O.qU~ ~ Tho Totm o~ ~eu~held*s Code o£ B~hJ.c= .~oh~b[~:~ =ott~Xicts og n~'~' on the .~,a=t og to~n oggicers..~an~_~mpXoy*=~=, The Uu_~pose.of.t~,'.{~.§.._~orm is to provide ln~o~'~.~'-~lofl ~hich can alert the tm;n o~ possible conflicts o~ )nteres~. and allo~ it to take vhatevor action i~ necessu~:[ to avo~ same. NATURE OF APPI,I~R~IONt (check a1.1 titan. Apply.') Vsrinn.e 'f Nume or per~t~ ~,'d)loyed by ~he ToWn of So,JL,hold ....... . 3'ttle or p~w.t~,Vo,; of ~hat per. non .. and the Lown oCfl~cer or employee. ~i~het cheek the appropr~:m~ lirle h) ~hrouuh D) and/or dp~erlhe !:i ~he epace provided,