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Home My WebLink AboutTR-5513 Glenn Goldsmith,President �ZF SOUP Town Hall Annex A. Nicholas Krupski,Vice President Qy�lO 54375 Route 25 John M. Bredemeyer III Jx[ P.O. Box 1179 Southold,New York 11971 Michael J.Domino G Telephone(631) 765-1892 Greg Williams �O �� Fax(631) 765-6641 COUNT`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1808C , Date: April 14, 2021 THIS CERTIFIES that the as-built two story addition and renovation of facade to improve aonearance,with the condition drywells are installed to contain the roof run-off, At 3300 Peconic Bay Blvd.,Laurel Suffolk County Tax Map#1000-128-6-7 Conforms,to the application for a Trustees Permit heretofore filed in this office Dated February 25,2002 "pursuant to which Trustees Wetland Permit#5513 Dated March 20,2002,was issued and Amended on October 22,2003 and Amended again on April 14,202 land 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 as-built two story addition and renovation of facade to improve appearance,with the condition dnmells are installed to contain the roof run-off. The certificate is issued to Carll& Susan Austin owners of t10 aforesaid p operty. v Authorized Signature Glenn Goldsmith,President �QF sooty Town Hall Annex A.Nicholas Krupski,Vice President ,`O� Ol0 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III l lxi[ Southold,New York 11971 Michael J. Domino G Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 COUNVI BOARD OF TOWN TRUSTEES April 15, 2021 TOWN OF SOUTHOLD Carll Austin 3300 Peconic Bay Blvd. Laurel, NY 11948 RE: 3300 PECONIC BAY BLVD., LAUREL SCTM#: 1000-128-6-7 Dear Mr. Austin: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, April'14, 2021: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#5,513 for the as-built two-story addition; and as depicted on the, project plan prepared by Carll Austin,_r'eceived on March 29;2021 and stamped approved on April 14, 2021. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, A"Gle.A",- Glenn nn Goldsmith President, Board of Trustees GG/dd SURVEY OF PROPE5,7 r � SITUATE: LAUREL TOM 5OUTHOLD 5UFFOLK COUNTY, NY SURVEYED 06-12-01 SUFFOLK COUNTY TAX a j � a CERTIFIED TO CARLL AUSTIN - SUSAN AU5TtN Q h� APPROVED BY � BOARD OF 1 RUSTEES TOWN OF OF SOUTHOLD o fi E NAL 4,U?,l z ECS EVA MAR 2 9 2021 L ell Sout old Owrt Board of Trustees 4' Trust NOTES, I i >IIVPITIO'� 14 " , O e[Jifj� m MONUMENT FOUND oA'ae< "O's y yy�r AREA=38,544 5F OR O.bB ACRE5 GRAPHIC,5CALE lki 40` her BOK Foe-i 39j/ �✓2A4��9Wti+.vW'.w.e ..adY s. { ' JOHN C. EHLERS LAND SURVEYOR ; ��P\ 6 EAST MAIN STREET N Y.S.LIC.NO,50202 �^ RIVERHEAD,N.Y.11901 REFA\Hp sezveM\PROS101-197A pro f v 369-8288 Fax 369-8287 L, Michael J.Domino, President ��0� S�U 0 Town Hall Annex John M.Bredemeyer III,Vice-President �� lQ 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G � O Telephone (631) 765-1892 Greg WilliamsyOWTY, O Fax(631) 765-6641 � �� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 10161,1 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction 'h constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: SS13. S 6v-ze OAA,Vion iS scow y/5121 CERTIFICATE OF COMPLIANCE: Glenn Goldsm President O��S�FFQ(�-` Town Hall Annex A. Nicholas r\Zupski, Vice-President 54375 Route 25 John M. Bredemeyer, III N P.O. Box 1179 Michael J. Domino o Southold, NY 11971 Greg Williams y �� Telephone (631) 765-1892 Fax (631),765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 9117121 _S:go Completed infield by: C. Go ld,5mA CARLL AUSTIN requests an Administrative Amendment to Wetland Permit#5513 for the as-built two-story addition. Located: 3300 Peconic Bay Blvd., Laurel. SCTM#: 1000-128-6-7 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice/of Hearing Card Posted: Y / N Ch. 275 ✓ Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: .S�'cai a�.� �n�,✓G.ca I have read,& acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other J Carll L. Austin Susan E. Austin 3300 Peconic Bay Blvd. Laurel, NY 11948 March 29, 2021 Diane DiSalvo Southold Town Trustee This letter is a request to administratively amend Town Permit 5514 to show a two story as built addition. The area covers all the shaded areas on the survey. Sincerely, Carll L. Austin p EC EVVE BAR 2 9 2021 01 Southold Town Board of Trustees SURVEY OF PROPERTY - SITUATEa LAUREL TOM SOUTHOLD 5UFPOLi< coUNTY, NY 3I11 SURVEYED 06-12-01 1 SUFFOLK COUNTY TAX# i 1000-128-6-7 op I CERTIFIED TO, , CARLL AUSTIN SUSAN AUSTIN a P Z ECEQVE I . MAR 2 9 2021 ' Southold own Board of Trustees ao' ,ard Trust , w V Ilk, g> Q NOTES, t�>7PI�O� l� � p , ✓/.fiC Ei MONUMENT FOUND . � AREA =38,544 SF OR 0.88 ACRES ✓ �`� GRAPHIC SCALE, 1"=40" 3 AmlTlor( , "y 39` °; •� - � � bY+✓+,Mu+5Y 4. M3�a �,'� Ate•, JOIN C. EHLERS LAND SURVEYOR '6 EAST MAIN STREET N.Y.S.UC.NO,50202 RIVERHEAD,N.Y.11901 REF.\\Hp sezveA MROS\01-197A.pro 369-8288 Fax 369-8287 ;a- Michael J. Domino,President �*0� SO(/TyO Town Hall Annex John M.Bredemeyer III,Vice-President h0 l0 54375 Route 25 P.O.Box 11 Glenn Goldsmith l�[ Southold,New York 11971 ` A. Nicholas Krupski G Q � O Telephone(631) 765-1892 Greg WilliamsyCOUNTI, O Fax(631) 765-6641 � �� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: )016A9 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: G, God�sc•,; COMMENTS: CERTIFICATE OF COMPLIANCE: . . 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 October 22, 2003 Ms. Denise Heyse 206 Lincoln St. Riverhead, NY 11901 RE: CARL & SUSAN AUSTIN 3300 PECONlC BAY BLVD., LAUREL SCTM#128-6-7 Dear Ms. Heyse: The following action was taken by the Southo1d Town Board of Trustees at their Regular Meeting held on October 22,2003: RESOLVED, that the Southo1d Town Board of Trustees APPROVE the Amendment to Permit #5513 to construct a one-story addition and to renovate the fayade to improve appearance, with the condition drywells are installed to contain the roof run-off, and as depicted on the survey prepared by John C. Ehlers, dated June 12,2001. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, t1Ltt.~1- 'l ~. ~. Albert J. Krupski, Jr. President, Board of Trustees AJK:lms . . 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 Tuesday, October 14, 2003, the following recommendation was made: Moved by Don Wilder, seconded by Tom Schlichter, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Amendment application of CARL & SUSAN AUSTIN to Amend Permit #5513 to construct a one-story addition and to renovate the fac;:ade to improve appearance. Located: 3300 Peconic Bay Blvd., Laurel. SCTM#128-6-7 The CAC recommends Approval of the application with the Condition a 15' non-turf buffer is installed landward of the first bulkhead. Vote of Council: Ayes: All Motion Carried Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 55l~ DATE: M<l~ch2Q..2002 ISSUED TO. Ch,,~l:~A~LI\1.t'Str~tJ'1'S~~hf1'I:J~half .of ..... Aut~nrilatin" 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 en- titled "REGULATING 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 with the Resolution of The Board adopted at a meeting held on ..M.a....c:.h.Z.o. 2.0.0.2., and in consideration of the sum of $...200..{lO . paid by . ..Ch.arles...M......Thomas,.. Ar.chitect.... ....... ....................... Riverhead, of ......... ........ . .... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authori%es and permits the following: ~ Wetland Pennit to construct one story addition approximately 90 square feet interior renovation . _ renovation to facade to improve appearance.upon our environmental review there seems to be ~ no significant impact all in accordance with the detailed specifications as presented in . the originating application. . IN WITNESS WHEREOF, The said Board of Trustees here- by causes, its Corporat~ S~al to be a~ixed, and these p~esents to be subscribed by a malorlty of the said Board as of thiS date. a~~~ dUe /;7;i:.. )AA~~ Artie_ Fnstpr (Ah<:pnt) Trustees ... . . TERMS and CONOmONS The Permittee Carll & SUS;Jn Allc;:ti,., t<. ~..."....t. .... "'.... resicliag at 3300 Peconic Bay Blvd. Laurel, N. y~ u part of the coosideration for the lsSuaace of the Pennit docs lJ!ldentand and prescribe to the fol- lowing : 1. That the said Board of Trustees and the Town 01 Southold are released from IllY and aU damages, Of' cWms f<< damages, of suits arisiDg directly Ol' iadirecdy u a result of IllY oper- adoo performed pinuaDt to this permit, and the sdd p.. . ll'~ will, at his or bet own e..pease, defend IllY and aU sUch suits .loitlauod by third parties, and the said F.....lttee -- full JiabUiq wiIh reipect rhaeto, to the completeexdusioo of the Board of 'i'rusues of the Town of ~ 2. That this Permit is wild for . period of 24 mos. wblch h coasldeted to be the estimated time. required to complete the work invoheci, but ihoaId cirauilstanca waaaot, teque$t for an em:osioo may be made to the Board at a later date. 3. That thisPenn1t should be retaioed indefinitely, or u long as the said Permittee 'OrishCs to . maintain the sttuaure or project involved, to provide evidence to onyooe coocemed that auth- orization was originally obtained. 4. That the wotlt involved will be subject to the iospectioa and approval of the Board or Its agents, and non-axnpUance. with . the ptovisions of the originating application, may be cause for revocation of this Pennit by resolutioo of the said Board. 5. That there will be no unreasonable interference with navigation u a result of the work . bere1n authorized. 6. That there shall be no interference with the right of the public to pass and repass a100g the beach between high and low water marks. 7. That if .future operations of the Town of Southold require the removal and/or a1teradoos in the location of the "",tit berein anthorized, or if, in the opinion of the Board of TrusteeS, the. work ahaU cause unreasonable obsttucnon to free navigation, the said permittee will be required. upon due notice, to remove or alter this "",tit or project herein stated without ...j>eOSCS to the Town of Southold. . 8. That the said Board will be notified by the Pennircee ot 1he completion of the work anth- orized. 9. That the Permittee will obtain all other permits and consents that may be required sup- plemental to this permit which may be subject to revoke upon failure to obtain same. AlbertJ. 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 March 22, 2002 Charles M. Thomas,Architect 206 Lincoln Street Riverhead, NY RE: SCTM#128-6-7 CarIl & Susan Austin 3300 Peconic Bay Blvd. Laurel, NY Gentlemen: The foIlowing action as taken by the Board of Town Trustees during a Regular Meeting, held on March 20, 2002, regarding the above matter. WHEREAS, Charles M. Thomas, Architect on behalf of Carll & Susan Austin applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance ofthe Town of SouthoId, application dated February 25, 2002 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 March 20, 2002 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personaIly 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 standard set forth in Chapter 97-18 of the SouthoId Town Code. ~ . 2 . WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare ofthe people of the town, NOW THEREFORE BE IT. RESOLVED, that the Board of Trustees approved the application of Carll & Susan Austin for a Wetland Permit to construct one story addition approximately 90 square feet interior renovation _ renovation to facade to improve appearance. upon our environmental review there seems to be no significant impact. 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. Fee 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 when project is started and on completion of said project. FEES: NONE Very truly yours, ~ 9. /4~~ 9t-. Albert J. Krupski, Jr. President, Board of Trustees AJKIcjc cc DEe Building Department ~ . . Telepbone (631) 765-1892 Town Hall. 53095 Main Road P.O. BOlt 1179 Southold. New- York 11971 . SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Monday, March 18,2002, the following recommendation was made: Moved by Bret Hedges, seconded by Drew Dillingham, it was RESOLVED to TABLE the Wetland Permit Application of CARLL & SUSAN AUSTIN for a one-story addition approx. 90 sq.ft. and renovation to fa~ade to improve appearance. Located: 3300 Peconic Bay Blvd., Laurel. SCTM#128-6-7 The CAC Tabled the application because the job description was unclear and the project was not staked. Vote of Council: Ayes: All Motion Carried .... . . URGENT CORRESPONDENCE Sent via U.S. Mail Overnight Express on March 18, 2002 DATE: March 17, 2002 TO: Board of Trustees, Town of Southold, NY FROM: Susan G. Souder & Others, Le. Barbara Zambelli and Unda Dunn * *Owners of adjacent property at 3270 Peconic Bay Boulevjilrd, Laurel, NY 11948 SUBJECT: Notice to Adjacent Property OWner(s) REFERENCE: a. Environmental Review SCTM# 128-6-7 (Enclosure 1) b. Envelope postmarked March 6, 2002 (Enclosure 2) On March 7, 2002 I received Reference 1 and 2 via U.S. Certified Mail from Mr. Charles Thomas, Architect, 206 Uncoln Street, Riverhead, NY 11901. The date of receipt was the same day (March 7, 2002) listed in Paragraph 3. This left the impression that publiC comment was only permitted on March 7, 2002 (the same date of receipt). The next day (March 8th) I called Town Hall and inquired why the notice was so short. Town Hall advised that the actual hearing regarding this matter was scheduled for March 20th and that the public comment period began on March 7th and would close on March 20th' Since the Survey of Property attached to Reference a. only shows the ground level "foot print" of the proposed addition to the adjacent property and not what the proposed addition would look like if built, Town Hall recommended that I request of the Architect that he provide me a drawing of what the proposed addition would look like so that any comment I and/or the other owners may wish to make would be based on that. I then immediately placed a telephone call to Mr. Thomas (631-727- 7993) and left a message on his answering machine requesting to be provided a drawing and provided my name, address, telephone number and FAX number. As of this date, March 17th, I have not received anything from Mr. Thomas. Additionally, on March 8th I notified the other two owners of our property, one of the other owners left on a business trip out of the country on March 16th and will not return until March 24th. 101- ~~ .q9~g1- ... . . March 17, 2002 Page 2 012 In consideration of the above, I hereby request that this matter not be dealt with on March 20th and that it be delayed for a period of at least one month so that we, the owners of the adjacent property, have adequate time to review the matter (assuming Mr. Thomas provides the requested drawing) and file comments with the Board of Trustees if deemed necessary. Please confirm to me, in writing, the new dates for public comment and the dates on which the Trustees will act upon this matter. Thank you for your understanding and assistance. Sincerely, ,~ Enclosures (2) .... . . +- + I ro . ~ I ~'1 I -<>-Z I ------ ~ ~ ~ . , ill ~--- +1 8~ ~~ ~.!;l: :;r ~"J! b- . ~~li ~l. 5"'< o -+- i ~-1~ 'i-' ; ~ .1 ,Im! .':lIj IWI !l ~ III ,hlnl I;jjjjl !.I,"l iiiii "i;1 i i I I ~ Ii Iii I'"'' I ! ! ~ 11 iiilii ; II.. I i111 1111 le!11 I Iii .. '1'" ,. I ~J ~41 ~ Pf-~~; p.': ....~ ~~ 14,(- r<,tJ ~'U y (p~0f'-(L,'./ /'/f..vN,j l-YI", 5 ... · (?\\.-\.- Y S/'h+d/t-y noA./;1Cllj 44y. ,v~,~ - /''''1'' "lc/'/I: b cw.. oYPt!' _./c../1 c.-h W!'-, ,(l.llK /).. ;91) ,t!C1',:."",, d , . _______________n_._________.n_ _ ______,.__________...~_____~_.___. SURVEY OF PROPERTY SITUATE: LAUREL TOJI'W: SOUTHOLD . SUFFOLK COUNTY, NY i I SURVEYED 0E?-12-01 SUFFOLK C.OUNTY TAX # 1000-128-E?-1 """ 4- * oS' ~ CERTIFIED TO, C.ARLL AUSTIN SUSAN AUSTIN APPROVED B" BOARD OF TRUSTEl TOWN OF SOtJTHOLD i~i,I'E 10/2..'/0':; .. ~ ~. ." / -J ;! IiJ Ii.. 0_' (j) -J s: >-0 J: f!ro 0 w< > <'I: <: f):1\j " J: " " Q( !r :c oriJ u ~Q( if oJ" >- <: -J Cl <:' n/ <:~ {lj 50 & iJ li..o f -J ---..-. u ,(J I~ >: > { ;xc . 'Ii. ~. '" ~ .~ .' ill 8 .. f .... tJ Ci? >--J -J{jj !D:{ <8 ffu Ii.. < 9:< o ~J 2[} 2}! " -J ffi d? ",. -J Ii..;! 01iJ >- ' ;;)$ ffiS) <\0 ff!!: LJ:.~ Q(rf o , ~$ 2S) \0 2& '(/-.. -JJ!! <: 'I: l f5)ICCIE~WlCrm lffi OCT - 2 2003 l.!dJ Soutl1olc1 Town Board of Trustees AWITloc,,( IN ~~.o.,17E'P ""eEl><. NOTES, . MONUMENT FOUND &XI?ltN1 ?ql.3kK AREA = 38,544 SF OR 0.88 ACRES 6RAPHIC SCALE ~ ~> !.,t). f.".. , . '. .,'. 1"=40' ........"...".rz.." "'''...-a'_ ar """"_'''''_~ "'''r>tMariog),'I<.........'',."......,...".....-..."" "Io'<>l_a<....<lIon,.201.......".......,.,2.oIlhoo ""'..y......_l<oE_ot_L...... .""'~<"l"'" f",,,, '"""'"'0/'<"'" w.......'"'J """""'Q....,,,.<>nor"JinQ'''''''''''''"'''~., .1""''f''ft'"M''''''''''' ,,,,,"""'.-.d I<> boo v<I,.......... ""P'n. .(_ct'FI<.Dl..... ""'I<.o~,,""'.."" ''9''''~ ""''''r. .....-v'"'J_f""'"f'C>""".."."",.""""...''''......K- ..,....c_""",,',,,.Q(.'I<.f"'"l.<h:l~'I""""'r>IQ.. "Jt.........~.,...st_A&_Ia\""'oI...."'...."""" 1.<ro"'~"""'Q""", <;o..,~....'w"''''..,.,._",.,,'''''~ ,~t""P"""""''''''''''''''I'''~r.~... "....,""~,.""""",,,v..,,"..'~go"'"""'""'n_ """9"''''.l'''"''' IQ"""'9...I'I"'''''' II...."......."".","", ,,,,,..,,.,;q-....,,,"""'ft"""'l...l'wl""'. c~~"',,_ 1'",",,,,",,""II~'Qr_ft'~O<XlI'''''''''''''~'''''''' JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIe. NO. 50202 RIVERHEAD, N.Y. 11901 REF.\\Hp server\d\PROS\01-197A.pro 369-8288 Fax 369-8287 1___ . . Albe~t 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 _Coastal Erosion Permit Application _'lYetland Permit . cation _ Major _ Minor ~aiv IAmendmen r)1ang~s -Received App Ica: i~/Q3 ~eceived Fee:$ 40"- -eompleted Application~ _Incomplete _ SEQRA Classification: Type I_Type I1_Unlisted_ Coordination:(date sent) ""<AC Referral Sent: 10/,) /O~ """'I:5ate of Inspection: ~/$~ _Receipt ofCAC Report: _Lead Agency Determination: Technical Review: A'Ublic Hearing Held: I()Jd.~ 10) Resolution: Name of Applicant c.0\.(' \ T S Vs,b..y) A,J.S ~ Address ~~oO VO=COVl:C ~ D\J~., I C1.J("L l-AlY t \ tfy ~ PhoneNumber:( ) t1<h . 5S~3 /'5 tl. 4 OO~ I Suffolk County Tax Map Number: 1000 - /1- ~ - 6 -1 ~ T~L Property Location:lJ..ltt 1-J t (nl(.1. ~ at '1.1Ld;- (;" t.\ Vi Lcw,: c.. B~y 5) 00 ~c.ol'r\c b~ 6IJ~. L; 1(0 (2.dL~72 I (provide LILCO Pole #, distance to ss streets, and location) -= cord AGENT: De..Yl; s<L Be. / s iJ r o. ~ \}~ :; (If applicable) y ~ 1 ; () C () in 5 t. L; V u-, h~(A ~ I Phone: '11-. {, 7 Q"3 Address: 1.06 I~ 0/ -~ y ~E :T~~ :Q,E ~ Southold Town Board of Trustees .Board of Trustees Applica&n GENERAL DATA Land Area (in square feet): 3fS. ~~4- Area Zoning: ~-~ Previous use ofproperty:~"1 "8'N'T I ~ Intendeduseofproperty:~~ I DE'NIIA. '-. Prior pennits/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? ---LNo Yes If yes, provide explanation: ~ Project Description (use attachments ifnecessary): l-S~l!:! M>V'L.lD~. ~~r2. 4lfo -s.c.. '"B": ---1tl'T'BT2..1 0 a. '" eN 0 \JA1~ ~O\I A'florJ Th..-~N:> t;'" 'To' ~(2.0\A; ~,..."'~. . . Board of Trustees Application WETLANDffRUSTEE LANDS APPLlCA nON DATA Purpose of the proposed op:rations: 1st 0 ("/ Ad.cL:J .... 01'\ +- 0 (!..X,'S tho ~ c u; . J e.'AU' . A pro)"" q () s 1-'-- t t TLt.-Y\,().J4r'O;' ttl f;.CtlrI -to (~fr-'vll Apr~<..c..- Area of wetlands on lot: o square feet Percent coverage of lot: o % Closest distance between nearest existing structure and upland edge ofwetlands:_ 65 Jeet Closest distance between nearest proposed structure and upland edge ofwetlands:_ _ ~feet Does the project involve e~vation or filling? No V'" Yes If yes, how much material will be excavated? 10 cubic yards How much material will be filled? I 0 cubic yards Depth of which material will br:~ordeposited: '3) 6 feettt~t\l...J I SP~Le..) Proposed slope throughout the area of operations: AJ /4 I I Manner in which material will be removed or deposited: 4 S V\a. t 1S Db (/b. 1- t;1; r L\1 OL Statement of the effect, ifany, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments ifappropriate): If 0 (\f _ . . Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: f- tLS. kt ,\ I:{ } V'o.f\ 0 \J a 1.- on ! (?,x Pti.., ),-tJ 1"\_ Are wetlands present within 100 feet of the proposed activity? ~o Yes h () IA1 (7" A P(',~ 90 Sl,n , I sto~-/ A ~~; +(.o~ Does the project involv excavatio or filling? No Yes If Yes, how much material will be excavated?~ ~(cubic yards) How much material will be filled? 10 (cubic yards) Manner in which materi.al will ~~r deposited:~ ~ I <; -I b Db Cti i \2a Co ~ h t> ~ I Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) \J ( tAl') f: L : ~tl 11 D (l,v.. Jv "V\ V'le'lTa ( IV") p/j ~t.<;.- Po ~St'Ablr .".lJfVJ[ Y'11"hOr Jq\,.)v'1 0J(l4-'S5 Mt'I1u:1.L dJL b L OVl S +r J (' --if- {7.-'\ .' H.t6-'" 121Sn- Text 12 1 PROJECT 1.0. NUMBER . . 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTtONS Oniy PART I-PROJECT INFORMATION (To be compieted by Applicant or Project sponsor) 1. APPLICANT ISPONSOjJ t.tli :) t.; 2. PROJECT NAMf\ vS 3. PROJECT LOCATION: "'"I'''' 17<<'1:.001'\\ c... . . 1,,\ c..\ ^' Municipality County 4. PAEC:SE lOCATION (Street ad ress and road intersections, prominent landmarks. etc., or proviCle map) SEQ 5. IS PROPOSED ACT~Ny o New IJ!'Expansion o Modification/alteration 6. DescRIBt ~ie~:=~FLY~d.o.:ti ell'\. 0. pO)</ q 0 S}. f-\-. 'fc(l-A. c:\. L 1"0 l.,p(iv'L. flPPt-M'v..,--L. t"(JI?+-p~;~-t i:> () " l..- . ell.. D 7. AMOUNT OF LAND AFPECTED: 90 54 . -t /t.L:t Initially acres l'Ultimatelv acres a. w~. -ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE REST'M.ICT10NS? ~ Yes 0 No If No. descnbe briefly /2. (l..r\OVC(. t 0"\ tq t-~?cc.II\Slt1"'- d 9. WHAT 15 PRESENT LAND lJSe:. IN VICINITY OF PROJECT? ~Resjci~tial D.!ndustrial [J Commercial Describe: o Agriculture LJ Park/Forest/Ooen space LJ Dlher 10. DOES ACTION INVOLVE A peRMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE On LOCAL)? ~Yes D No If yes. list agency(sl and permillapprovals + 5 OlJt~, Id Eo; l~~ (t.\r1; .~ 11. DOES ANY A~~T OF THE A~Tlor... HAVE A CURRENT. Y VAUO PERMIT OR APPROVAL? Dyes. (Y'"NO II yes, list agency name and permlUapproval , 12. AS A RESULT OF PROPOSED ACT! DYes D No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE aEST OF MY KNOWLEDGE ILL EXISTING PERMIT/APPROVAL REQUIRE MOQIFICATION? Applicant/sponsor 11 Ly Sll..- q/ :j ()! /) 3 Dale: SlgnalUre: If the action is in the Constal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this a~~essment OVER 1 I .l.. ::leES AC7;CN NTAeSESSMENT ,-:-0 :Je c:J~::::ietec JY -\genc. =.J ;"NY : I.'::=: i Ti-i2E.5i-iOLJ ~N:i ,'l"'C?R :'>,;':;T 3-7 -^... I ,es. ::ocrOlrlala -ne reVIew ::ocess ana 'Jsa ~r.e :=:JL:... ::")l..;:;. , i Y~s :. WILL AC7lCN ~E-:~: _:::CADINA,c;:J .=lE'IIEW':'S ?RC'JIDE:J .=.:" UNL;S,2:J ..;C7:CNS;N 3 .\lYC2A. :I.4..MI5,7.57 may be sucersede'" Y ~notr:er ,nvolvec1 a.gency. if .'~o_ i neqat!ve ~ec:.u<;. L..; Yes C_ C::ULO ACTjCN .:::l:ESUL7 ,N ~NY .:..QVERSE =.:=:=::CT5 ASSCC:':" 7ED ',vIT!--! :'":.-:=- ;:::.:JLL'':vVING; /),ns.....er$ :1"lay ::e .,andwruten. if ;eglcfel C1. ~'(isting air Quality, surface or' qrounowaler cuatify ~r .:lllantity, "oise ,e'/els. eXls.ing :raffic _::alOerns. sOlid -....as.e ;JrCCl:c:j:::n:;lr .115':;:: potennal lor erosion, ::r3Inage- or :loocing ;lroClems? ::.:'(olaln ~rieily: o eVe";;';' ;g~c~'~r ";~O'Og;~" "''51C;;' rt rhal;iu"ur3l/;urclj~ ;m;;~'~; 7t:;;;OOd r;;c:i ~'~' '!. ~~.~ or ,~~rs~;n."f~~7!;("e ,o~;:"~~~r~o;~,s, r~.~,~~ ~J .Xang~!',fe~d {i..~el~ vpev 17, o CJ, A c::mmunily'S existing ~lans or "~oals as otflc:ally adooted. or a cnange in use or intensity oi use ot land or atoer natural resources? 8plaln ::r o CS. Growth. subsecuem::evetooment or (elated ac.ivities likelY !O be inducea :JY !ne ::roooseo ac:ion? :.xolaln ufleflv. () ca. '-cng :erm, snort :erm. C:.Jmuia(ive. or other ~lfec:s not icentiliea tn C-:-C5? =.tOlaln ~rlerl'l. o .:7. emer imaac:s ;jnC:;Jclng :::.anqes In ~S2 of :l!lher quantity I)r :ype or energy)? Soialn :::rieily. b i ~ RE '_:K2:..'~ 70 Sf. GONT:::lOVE?SY =lELATE0 TO ?QT2NT!.AL ACV:.~Sc =NV1RONMENT;'L :MP~C7S? :f ':'es, ~xclain orieity 'j. ;5 ,HE:=iE, -~R ; :-: Yes PARi 1II-0EiERMINAiICN CF_5iGNIF1CANC~ (To ~e comoleted by Agency) INSTRUCTIONS; For e3C:"I adverse effect identified acove. determine whether it is substantial, large, fmcortant or otherwise signific. :ach eifeco;: si'lould be assessed in connection with its (a) setting (i.e. urban or rural); (b) ;)robability of oc:::~g; (el duration: irreversIbility: (el geogracnic 3coce; and (t) magnituc:e. It necessary, aCId attachments or reference supponing materials. ;nsure exclanaticns contain sufficient detail to snow thar aU relevant adverse impacts have been identified and adequately aCdressec. C~eck this box if 'IOU have identified one or more potentially large or significant aaversa imDac~s whiciI MA':' Qc:::.!r. Then ;)rocaed dirac:ly to the ,=ULL E.AF and/or prepare a positive- aeclaraticn. , C~ecx thiS ::ox it you have derermined, tlased on the information and analysis above and any suooortinr; doc:Jmenratlcn, :hat ~l1e arooosea action WILL ~~OT result in~ny significant adverse environmental imcac:.: AN 0 .:Jrovice on attac:1ments as necessary. the reasons supcorting this determination: '\l..",~ ill ~C,j,j .-'\..~nC"1 :'fln{ '.)1 : v(.:t: '\:..lfH~ :JI o(.',oon~IOl~ Glllc'!r ,n ;.~..o ......;l:nc.1 :,u~ 01 ...:....~oonS10h! UI{lc~r :i,,~n,J{Ufe -)I ':o!'~con\IOle ''::I:,c.;>r ,n ~C'.1Q ....\;.mcv )...:nd~ure .)1 r'~~~.Her \lr';lI:e!~r'l1 :rom n:,~oon~IO'o! :.H!'CUI J..ltC ~ .:. ~ . . 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of _____fur__\.~__~~\i._~___________ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDA VlT OF POSTING i,l/ltV1;<,j? t1tj5( 1\ ql.{ 1; being duly sworn, depose and say: {r\ That on the \<;' day of Ot.~ fvU , 20o'~, I personally posted the property known as . residing at Q'!;6 Albo Dr. / Jt1,}ve.( )./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 nor to the date of the public hearing. Date of hearing noted thereon to be held .D - :t 1" Dllted: 10-10-03 S~rn to before me this 10 Qlay of(hf-2003 N~P~ ... : CAROLYN C. 1i0~;i\iIJ . , Notary Public, StOle 01 New Yc"< ~ rJo. 4962570 .~ ' Quaiilied in Suffolk County /lif) ~ __,_Co,m~IS310~ Expiren FCbru"ry 20, , V- --,-- eard of Trustees APPlicat. .'. AUTHORIZATION (where the applicant is not the owner) I, '50SttYJ AJSTIa (print owner of property) residing at )300 0ctw).-c (mailing address) tJ4y Vtr1 ;5(1_ P\J~, / H"t5t~ t 4v/t LdO hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. _~I'~ ~1k (owner's signature) 8 . . Al'I'LtCANT . TRANSACTIONAL DISCLOSURE FORM The To~n of S~u~hold'S Code of Ethics iohibits contlicts at nterest on the part of town off cers and employses. The purpose of this form is to provide information whIch can alert the town of possible conflicts of interest and allow il:. \;0 take whatever action is necessary to avoid same. '.'.-,. ". ..: :,"':'.4t.hr" ! ~~,,~~~~-:,,'!m..~~(. tOUR NAHRt Last name, first name. m ddle you are applying In the name of someone else or Qth~r entity, such ~8 a company. If so, indicate the other person's or companyls name.) NATURE 0' AI'I'LICATION. (Check all that applY.) ;'::'~;~~i,::-;;;.,'i.':.~I-;'!..~: Tax grlSVands Varlands changs of Eons Ap'p~~al of plat ~ Exe.ption from plat or officIal map other (If .othsr,. nams ths adtivlty.) i~ "'e' Do you person.liT (or t.hrough ruui:' co..patt,., "PUUd4!, ttlbltno, parent. or child) haye a relationahip with any officer or employee of ~he Town of Southold7 -Relatlonghlp. includes by blood, .arrlage, or business intereB~. .uunlnesB interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or emrlOY nt by) a corporation in which the tovn officer or eM oyee owns .ore than 5% of ~he sliares. . . YRS_ NO_ '::.i!'ih If fOU answered "tRS,". coaplete the balance of ~hle lora and date and sign where indicated. Name of person employed by the To~n of Southold Title or position of th~t person Describe the rel~tionship between yourself (the applicant) and the town officer sr employee. ti~her check ~hG appropriate line ~) through D) and/or describe in the space provided. The town off ieer or employee or his or her epouse,' slbllng. parent, or child is (check all that apply). _A) ths owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant' is a corporation), _9) the legal or beneficial owner Of any interest in a noncorporate'entlty (when the applicant is not a corpora Hon) I _c) an officer, director, part~er, or employee.ot ths applicant, or ~D) the ~ctual applicant. .,,' . :;~:i..." ''':'',. "'" DESCRIPTION OF IlELATIDNSIIIP . '.." ". ..", .."..'~- , . ~- ~.. . ~, . :'.:'" ~'~,'..~:~' .~...,..:__..,~:~.t~;.. sub..i He ;i:\:,::'::'\':;':~'~?!f;.i~~\\: ~~"i~~~ i his'.-.........;.dlly ot"."' sig"" bure. 'Prlnt :q.~:~'. Albert J. Krupski, President Jam!!s 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 r BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicati6n _Wetland Permit Application L Major Minor _ Waiver/ AmendOWl1l191an.ys _Received Application:""';U fO _Received Fee:$ :J..t.r./ l . . _Completed Application T y(J () y' _Incomplete ' _ SEQRA Classification: Type I_Type I1_Unlisted_ _ Coordination:( date sen _ CAC Referral Sent: _Date ofInspection: _Receipt ofCAC Repo : _Lead Agency Determination: _Technical Review:..:;j I / _Public Hearing Held:=t ~ /6 y _Resolution: Name of Applicant ~L..L. .. ~u~M.J AV-sfIN Address ~~"4l' PEG-ONIc:. ~~CiV~ ' LJ..1Jfl;;L... to\. '( II 'i 4- ~ Phone Number:{i)b oS 4~ -4-oc::>fl (tJJ). oz...ey fl - ?"S"'f ~ c.H) Suffolk County Tax Map Number: 1000 - 12-~ - /.... - ; Property Location:-PI!!&oN I c. ~jflo\ ~Olll I:IivAW LH.. c-o po t..llf ~ 7 z. . (provide LILCO Pole #, distance to cross streets, and location) AGENT: ~~ 11h>",,~. (If applicable) Address: -z,o" U ~ e-o ("N ~r . k~"'ec:r e.1 \ll?Tl. ~ ~-II 0/4 Pho~e;~ ~I -/~3 . . Board of Trustees Application GENERAL DATA Land Area (in square feet): 38, /;4fo4- Area Zoning: f.-~ Previous use ofproperty:_f!f.t" 't)ErN""[ I ~ Intended use ofproperty:~1&<? I D eo IoJ Ie ~ L.. 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 If yes, provide explanation: ~ Project Description (use attachments if necessary): '-Sfl>~ M>V\1JO~ ~~r2. ~O ~Q. ~ '~""B12..IOa. R.ewo"AT.,J ~O"A'nO~ ~Ai>t;S To H"-PI2o\1; ~.~c.-r;-. eB d f l' t. oar 0 Trustees App 1ca 10n WETLANDITRUSTEE LANDS APPLICA nON DATA Purpose of the proposed operations: \ i'f1)~ M>OlnOtJ To ~O SQ.l:J, 1"l> 1M ,\,/Z.l),/lir ~1F-A-f2,,-.tolc.tf" ~I~""''J ~~ID~C.l!. ~i)"A-noJ 1'll '";=-~~ Area of wetlands on lot: (:) square feet Percent coverage of lot: o % Closest distance between nearest existing structure and upland edge of wetlands: "505 ' feet Closest distance between nearest proposed structure and upland edge of wetlands: "'1' feet Does the project involve excavation or filling? No v Yes If yes, how much material will be excavated? ~cubic yards How much material will be filled? 10 cubic yards Depth of which material will be removed or deposited: ~ feet Proposed slope throughout the area of operations: NA. Manner in which material will be removed or deposited:_~ r C;;;Q,lJI p"" ~ r: 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): Not-1~ lard of Trustees ApPlicatit COASTAL EROSION APPLICATION DATA Purposes of proposed activity:-I ~(Z.'( M)1)rrl 0...\ "TD l&Yliorl",\ ~W~o"A11O..\ 11 t=-IloCA-O W" it> ll-'Iprtol/Iif ~~~a.........c4 AfP~' ~I P...~(.fj '10~" o Are wetlands present within 1 00 feet of the proposed activity? No ~ Yes Does the project involve excavation or filling? No ....--. Yes If Yes, how much material win be excavated?~(cubic yards) How much material win be fined? t 0 (cubic yards) Manner in which material win be removed or deposited:~s..rr- Describe the nature and extent ofthe environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) No~e. ~oard of Trustees ApPlicat~ County of Suffolk State of New York -?,' ~ lA. LilA.. I """"ff2.o '"" TKl:; offlCt:; 0 p- CAl.....,ftt--. 1tlor--t.A6. ~~ BEINGDULYSWORN DEPOSES AND AFFIRMS THAT HFJSHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF illS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TillS 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 TillS 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 TillS APPLICATION. , ~+::::: Signature SWORN TO BEFORE ME TillS 0< do 11 d/ DAY OF ;:;.. hruu rU ,20 i!.d,. f e><kz~ ~~ j- ./ Notary Public DEBRA FREDERICK Notary Public, State of New - SuffoI~ CouI1ly" No. 01FR6047399" " COmmlssio'l Exjllres August 28, 20 ~ em of Trustees Applicatioe . .~ AUTHORIZATION" (where the applicant is not the owner) I, (,JIlt. u, ~ ~t.J ~ArtJ ~~l1rJ residing at ~~c:> 1'ez:o...llc.. (print owner of property) (mailing address) ~&O\) ua Vt.(l..f;) " u..&l/2.e;l.,. do hereby authorize ~ur$ (Agent) 'fYo 1-1~. ~"'BV"I. to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ~~.;~ Ch-LL ~ < (Owner's signature) I 8 . . URGENT CORRESPONDENCE Le~Ifp~~l~.' , '----t." . j:i '1~.1 ." ~AY~~~,~ 'l'~ .. ,{JYVtL,; _.L:.tJJU~ . ,I ~"'t .,.,.- .._....._.." ' ,/ 1 -, i Sent via U.S. Mail Overnight Express on March 18, 200 I. ;~:; ;....J 1.;-- DATE: March 17, 2002 TO: Board of Trustees, Town of Southold, NY FROM: Susan G. Souder & Others, Le. Barbara Zambelli and Linda Dunn * *Owners of adjacent property at 3270 Peconic Bay Boulevard, Laurel, NY 11948 SUBJECT: Notice to Adjacent Property Owner(s) REFERENCE: a. Environmental Review SCTM# 128-6-7 (Enclosure 1) b. Envelope postmarked March 6, 2002 (Enclosure 2) On March 7, 20021 received Reference 1 and 2 via U.S. Certified Mail from Mr. Charles Thomas, Architect, 206 Lincoln Street, Riverhead, NY 11901. The date of receipt was the same day (March 7, 2002) listed in Paragraph 3. This left the impression that public comment was only permitted on March 7, 2002 (the same date of receipt). The next day (March 8th) I called Town Hall and inquired why the notice was so short. Town Hall advised that the actual hearing regarding this matter was scheduled for March 20th and that the public comment period began on March 7th and would close on March 20th' Since the Survey of Property attached to Reference a. only shows the ground level "foot print" of the proposed addition to the adjacent property and. not what the proposed addition would look like if built, Town Hall recommended that I request of the Architect that he provide me a drawing of what the proposed addition would look like so that any comment I and/or the other owners may wish to make would be based on that. I then immediately placed a telephone call to Mr. Thomas (631-727- 7993) and left a message on his answering machine requesting to be provided a drawing and provided my name, address, telephone number and FAX number. As ofthis date, March 17th, I have not received anything from Mr. Thomas. Additionally, on March 8th I notified the other two owners of our property, one of the other owners left on a business trip out of the country on March 16th and will not return until March 24th. . . .a, March 17, 2002 Page 2 of 2 hl-\K 2 2 :' , In consideration of the above, I hereby request that this matter not be dealt with on March 20th and that it be delayed for a period of at least one month so that we, the owners of the adjacent property, have adequate time to review the matter (assuming Mr. Thomas provides the requested drawing) and file comments with the Board of Trustees if deemed necessary. Please confirm to me, in writing, the new dates for public comment and the dates on which the Trustees will act upon this matter. Thank you for your understanding and assistance. ,~ Enclosures (2) .t, .". UJ i",,\ ~?<N ~;"f ~ . CI 0 (I) c- ~ I OO<%O'Z til , a.._LiJCJ)(O;:) a::::z:-O~ CO vi"-~-lE "g => - E a: ' , I , I I ~ N i I. i I~~ ~H ~. .s l" ,f ... ~~ ~-J /171 <S"" 00 ~ Ll1 .-'I '" ::r ~ >- ~ 00 '0 ~ q ..D C 1t- Ll1 C 1 c 4- c -.r ~ c .,. ? ~ ~ c '" ..D '::> m c ~ ~ ~ .-'I ! c t(\ c j(\ -::l:"' r- ~ .~ ~ ~ - \S l- I"'- lif - Q f l:l"' J , ( ~ j ~ ~ r- -l ~ . I r ~l '1 It ..J 1 " ~ ~~ ~ . "r,~ ,~ '. .:.) ,~ ..:.. ',.. 1:.....:.1 , .. .........'- ",.1 ...__A . ~ - - - (I.J I.(J .;) I/) + I.,) III III o N .= ..--~-----~-- ....- . . 1&5 -'- - 7. ,AU'S+loJS PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: rz.8-, - 8. sOcJDIr~ ~us...~ t Ofs Address: I .. I ~'!:l lat-4AiJ c; AIT*al.S ~_ ~ ""r I-lP 'Z.Ot!ll",\ Z.a-I. - 1..7 ~ 10lA plllLrp t W'F- 12.9-'- 2.' HEck. WILLIAM 11: oes 2.8- ~ - z.4 MC.Doweu.. M Vie ~I2IA l&- 3.- . MArOl/e/k g~ P.u.^ .. VEl? STATEOFNEWYORK ~...,..". ONIC. COUNTy OF SUFFOLK ~~ ,residingat-1lAdA"'5A ~ , being duly sworn, deposes and says that on the V~ day of : 2Og,__....._oflhoN_ 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 oftpe Town of South old; that said Notices were mailed at the United States Post Officeat..(ll~~ . that said Notic eremai to h of said persons by (certified) (registered) mail. ""50 P~O''',,, 'At' &c..'II>' lAOf2.~ NY II C! 4b . ~s.,o pe-c, "....[ Bc.llp p, O. 6dX ~.&.'. lAoelit... ~.r'{II~'$ 'i;:-f-. ts~ be, Ro<<r f>c>(/llr Ny 1'778 NY ""f 4-&. Sworn to efore me this 7 ~ Day of 20~ /a~e DAWN C. THOAl'AS Notary Public, Stale of !,..w York No.02Tri49763 ~~ ~ QualifIed in Sllffofk ~ ~ L/" Commission Expires May 26, . . 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 ~ I ~f /:J ~ __~~3t_~_~______ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, C ~ 71fo1ltf4.J , residing at r11~7SA- ~ bein~~~y~~, d~se and say: & That on the 0 day I personally posted the property known as by placing the Board of Trus ees 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\,~~e_J 11.141 Rublic hearing. Date of hearing noted thereon to be held~~ :.J{)(J A trlt.di/ ~ '7 (J ~(j> IYl . Dated: ,--,S~ to ~:fJf~,. ~e this 004.day ~L/lUWCYi 20~ ~ - DAWN C. THOr-flAS Notary Public. Stale of I\dW York No. 02T ..l49763' 3 Qualified In SI.Holk -':o~ Commission Expires May 26. 617.21 Appendix C Slate environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I-PROJECT INFORMATION (To be completed by Applicant or Project sponsor) ,. APPU ANT ISPONSOR ~"0" 0 lea 2. PROJECT NAME ~ /IN I 19li1 3. PROJECTLOCATION: ~..oo p&"~"'Ic.- 5oUI....VPr12-O. L,to.\J~ Municipality O. i ~. County Ll 0 l.1c::.. ~. PAEC:SE LOCATION (Street address and road intersections. prominent landmarks. ere.. or proviae map. ~\ BovUiiV"'~P. 1\C\4e. 1+-1S.4.12f8n- Text 12 I PROJECT 1.0. NUMBER . . .' SEa 421 ~'()C> fEfeDNI(" l-~uaeL.., 'I-lT 1..1l..CC>. ,... 7 2. . 5. IS PROPOSED ACTION: o New ~pan'lon 6. DESCRIBE PROJECT BRIEFLY: ~ MOdlffcatlonialteratlon ,~(Z..\ Aot)\1iON. . APPI2.. rz,.l'hv ~II:>,.J 1ll f"~ GA." Cli" et,o . $6\.. F'\. "tl' ,''"' "rz.ol/" A('P~M"Cii" 7. AMOUNT OF LAND AFFECTED: . 4\0 ~Q r-r. Initially acres UUimately "eres a. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ev;;~ 0 No If No. describe briefly l 9. WHAT IS PRESENT LAND USe: IN VICINITY OF PROJECT? ~slC:ientJal O.!ndustrial 0 C..,mmercial Oescribe: o Agriculture U ParklForesUOOln space o Other 10. DOES ACTION INVOLVE A PERMIT APPROVAl- OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAl- STATE On LOCAU? eves 0 No If yes. list agency(s) and permlUapprovalS ~O LI'l1IoLO IW ll." "i '7!f"rl-!.f rr. ..". 11. DOES ANY ASPECT OF THE AcrlO,., HAVe A CURRENTLY VAUO PERMIT OR APPROVAL? DYes. JM..No If Y"5. Jlst aQency name and permlUapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL "SQUIRE MODIFICATION? DYe. DNa l<1A I CE;;~mAT TIjE INFORMATI~l~OVIOED ABOXl' IS TRUE TO THE aEST OF MY KNOWLEDGE ,7 W Lh\.. -Ik.. O\l (,~ of .. name:~< ~~, kclh~ . 0.,,,, -z.-/v:?/O'L Apptlcantlsponsor SlonalUre: ~ II the action. is in the Constal Area, and 'Iou are a state agency. complete the Coastal Assessmen! Form before proceeding with this a.~essment OVER 1 .:.. aOES AC7;C~ =:\c:::~ ':'NY I'?_; llyo!s r NO 3. WILL AC71CN FlE-:::'iVE .:::CRCINA, cO .=tEVIEW .:.$ ?RC'JIOE:J .=.:R UNWSiEO ..:.C7ICNS iN d NYC?R. ?AM' ii..37 it ,'~o. I ne-;:auve :!C:~(a may be sucersec!ec ~Y U1ot~er ;nvclvea a~ene"l. U Vas L.;-:-.Io C. COULD ..:.C7.iON .~ESUL7 iN ANY ADVERSe =::~E"",S ASSCC:;,,::,O wITh ~-;E ?,.'jU..CWING; (Answers :nay =e :,.nQWncten. if :eqlclel C1. Existing air ~ualir/, surtace or. grounawaler cualily <:Ir ~uanuty. Itaise ;.".15. -!xls:ing :raf1lc ;:)anems. SOlid 'Naste ,rcal.:c:::n 'Jr ::lIs;::: potenllal ror erosion. ::ralnaqe or :loaC1inq .,reDlems? E.-tolaln ::meily: cSSMENT r:-o ~e c::m~oleteo ~y Agenc- . 7h?ESHGL:J IN 1 ~~C;:::R. ?:.;:;T 517. ;,1 II yes. _ .alOat!! :ne feYl"W :raceS3 ana 'Jse !ne ~IJL:" ::"''=. PART II_~NVIRONMENTA' C2. Aesthetic. ac;rlc:Jllurat. Jrcnaeoloqic:al. l'1istonc. Jr otner :tauual or cultural :esoutces: or .:::Immunity or neu;nccrnOOd cnarac:er? ExOlalM ::r .-,.,,; c:3. Vegetation or ~auna. ~Isn. sr.alltlsn ot 'lfddllle sDeeie$. slgniiicanc haoilats. at :nreatened or !OCan~ered !cec:es? :;r:claln ~r1.(Iy; .~ ~ - ~'i. c.t A ccmmunilY's existing ;Jlans or goalS as afflc~IIY adooted. or a cnange in use <<Intensity at use 01 land or other natural resoutC8s1 Explain :: ~. GtOWln. $UDseouent ~eveloomenc. or I'8latltG ac:iviUes likelY to be inducea Oy, tne oroOOl8O action? :.xClaln on,tly. .~ ~- ; CS. ~cn9 :arm. snort :erm. -::JmuJacive. or atner ttfec:s not icen~itled in C:~1 :XOI.." :JneflY. '< ';:. Clner :moac:s ilnc::'cinc; :::':ant;es In ~s. of !ftner quantity or :yoga or !nergyJ? :s:ualn :netty. " 'J. :S THE::!.E. ~R is 7HE~E ~Ka!..,:" 70 SE. CONT~OVe.=rS" =l:EUTED 70 ~TENnAL. ACV!.=lSC: :."IVIRONMENT,1L. ;IAP.4.c;rS? .- ~ ':"es L No :f '1'15. '!xclain ~ri.t1y ?ART III-DETERMINATION OF SIGNIFICANCE (To ~e completed by Agenc'!l _ INSTRUCTIONS: For e3C:1 adverse etfect identified atcve. determine whetner it Is substantfal. large. important or otherwise signW, Each effect snould !]e assessed in connection 'Nilh its (a~ senJng (I.e. urban Of' rural); Cb),j:)robabillly of oec~g; (C) duratlor irreverSIbility; (el geoQracnic scoce: and (t) maQnttuae. If necessary, add aUachmentS Of' reference suppontno materials. E."1sure eXDlanations centain suttle:ent delail 10 snow that aU relevant adverse impacts have been identUied and adequately ac:cressec C~eck this box if you have identified one or more potenlially large or slgnitrcant aaversa imoac:s whicn MA occur. Then proceed direc:ly to the PuLL :..l.F ana/or prepare a positive- declaration. . '-' C~eck this box if you have determined. ~ased on the information and analysis above and any suooortir. coc:Jmentallcn. :nat :he proDosaa ac:ion WILL NOT result inAJ1Y significant adverse environmentaJ imcac: AND ;Jrcvice on attacnments as necessary, the reasons supporting tnis determination: ....wlllo:! ru :'0:."" "~1:"CV :lr,nl 'oJ, ,vue 'l..n,.!' )1 <..',oon\IDle "':lIlc~r .n 'o.VolO ...."I:t'lc.J i'lht 01 )(.:,gon"olc ullOccr in:n.UUI~." <o:!\con\IOIW .':;n'cer.n :'0:.10 ...."fltc., ,ncn,I(UI"'" r'r~.al..r lit ;JU:If!'..nt :ram 1I1'tOO"\IOI" 1JIlIClrl ,... ,JolU: 2 .- . · .l\.l'lILt~l\N't . TRANSACTIONAL DISCLOSURE FORH . ,. , The Town a! S~U~hOld's Code of Kbhic8 bfohibibs conflicbs ot inberesb on bhe part of town officers and employees. 'l'he purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to bake whatever action is "ecessar to avoid same. -S 'I'" U~ -RD- '""'-t 0 ,c.e 0 . ..:, . YOUR HAHRt M.~ ~~ t.~C': . . . ,'.,' ~;if~'~\ .' , Last name, f rst name, m d~e n tal, un ess you are applying in the name of someone else or other entity, such ~s a company. If so, indicate the other pereonls or company's name.) ". ',~ ; .." '.!.-= ." '.. '~" .....^.;.<~"l...j '. ....;~.'...,,~ ;,.:,~..c:...'N'i.~.f:~~" .. t. ...." ,. H.I\.TORE 0' .l\.PPLl~T10Ht (Check all bhab apply.) Tax grievance Variance Change of zone ^P.PliCWal of pht . ,to Ex.~ption from plat or Official map other . _ _ _, J . (If "other," name the acthlby.) :2!.'ln:t oU) -r1L"\1liel$..UIlf~O f'1i\'L~1'l. Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship vith any officer or employee of the 'l'ovn of Southold1 "Relationship" includes by blood, marriage, or business interest. "Ouslness interest" lIIeanR a business, including a parbnership, in vhich ~he tovn Officer or employee has even a parbia1 ovnership of (or emp1oym4!nt by) a corp.oraHon in which the tovn of ricer or employee owns more than 5% of the shares. us N~ ,/ '. ';:"I:.t.. If you answered .YBS,N. complete hhe balance~f hhl.'form and date and sign vhere indlcated. Name of person employed by bhe To"n of SoUbhold tJ /Or Tibie or position of that pereon ),,1 A Describe the relationShip between yourself (bhe applicant) and the town officer Qr employee. tibher check bhe appropriate line ~) through D) and/or. describe in the space provided. The town officer or em~loyee or his or her spousei sibling, parent, or ~hild is (check all thab a~plY)1 ~) bhe owner of greaber bhan 5% of the shares of bhe corporate stock of the applicant (when bhe a~plicanb' is a corporation), . a) the legal or beneficial owner Of any inberesb in a noncorporate'entlty (when the applicanb is nob a corporal:1on), C) an Officer, director, p~rb~er, or employee of bhe applicanb t or D) the ~~tual appllcant. . ~.' DESCRIPTION Ol!' ItBMTIONSIIIP 'J>l~",,",',," "'~';~~~~"" . ." .~ ',. .. . . . . .1.,'.' .... . .....;~.. ~. ..... .:..:. ,... :~...;.~ ~::L...;~...,... , ..,,, .;:.~. t1+'.' . ~\YIA UK I . . .. ~.~ighabUre. ... ~'- ~ (~'. 'prittb nallle .'. '" '. .'. m:rcr. : \:>~'l(\.I.!~A~~~\~;~,~_. " "B', ~~:~t'. I .!~~..:i.~ . \: .~:,'~~. . ._.::l"';;"'-'I".,:~. ft." f":O' J.';/.~.ldt~\';. ".r. : '.~ . .,.....(..'....... :". .' .. '.' .-' 'r/> ......" . ..:\.~....~..:....".""'tJ): . '.\.... . '"