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Home My WebLink AboutSWING, ROBERTSITE DATA' It 0 W N E R: ::~ Zo'n I.,ow-[)ensit¥ Remidont[,.-.71 (R---4. O) 1,2:[5 scI, f t. E x i s t i n g : [.., o t A 'r ,::; a 1.8,0S6 r:;q, Ft:, ~t Elev;.::tion.<; a~'e c,::>,f{:;cen<:;eci to N.G.V. f3atum t'v] ~:.9:kl, ,.'< )I>-I 0 : ,,::::,..::. / I/g,$ COV,E LOCA TION MAP SITE PLAN t ;:: ':2. <:':) *~ <:') 0 Z IJJ I > (i) o W W Z Project No' <:lc:) ~_:..::.:., ~'~%~p,~'~~,~j Drawn By' LJ ~"'1 Checked By [:)ate' :4 / ,.:::> / '::t t ,.)CdlO. A c,::3 Shoot Title: SITE PLAN DATA Sheot No: 1 lohn M. Btedcmeycr, IlL President Hem7 P. Smith, Vice President Albert J. Krupski, Jr. John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD scott L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK CO~, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOXIERNING THE 'COASTAL AND INTERIOR WETLkNDS, FLOOD PLAINS AND DRAINAGE AREAS 'OF SOUTHOLD TOW-N, AND 'i~HE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. APPLICANT'S NAME: MAILING ADDRESS: AGENT: DATE TEL NO. AGENT ADDRESS: PERMIT REQUESTED TO: LOCATION OF PROPERTY FOR REQUESTED PERMIT: SIZE '3F PROPOSED WORK: App, Page 2. YDS. TO BE EXCAVATED: YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: ~O~D DEPTH AT LOW TID~: ~, AVER. RISE IN TIDE: DISTANCE TO NEAREST CHANNEL: _~P(P --~d2~D ~T DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN-AREA: AREA ZONING: ~-4zo -is PRO~ECT' FOR PRIVATE OR BU~. USE: INTENDED USE OF PROPERTY:. ~F'C3~Z,~ '~,~/~/%~' DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: . HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: /t~ H~s ~ nICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY ~ GOVEm'~ENT~L AGENCY: DESCRIBE FULLY THE REHABILITATION OF PROPERTY: DESCRIBE PROPOSED CONDITION OF PROPER~ AFTER WO~ IS COMPLETED. INCLUDE ~ ADDITIONAL SURVEY OF PROPER~ SITE IF NECESS~Y: ~?~~ ~ ~E TnE~ ~ cOVEN--S O~ ZESTR~C~O~S ~N YOU~ ~EE~ W~C~ WOUND P~O~ WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: COUNTY OF SUFFOLK ) STATE OF NEW YORK ) BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE'APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARM. LESS AND FREE FROM'ANY AND ALL DAMAGES ANiD CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Applicant SWORN TO BEFORE ME THIS SU$.¥~ J. NAOY · Nobuy Pu~, S~e of New York · *No. 4896736 EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 IPROJECT I.o. NUMBER 617.21 Appendix C State Environmental Quali~y Review ,= SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR 2. PROJECT AME 3. PROJECT LOCATION: 4. PRECISE LOCATION (Street address and roa~ intersections, prominent landmarks, etc., or provIQe map) SEQR 5. IS PROPOSED ACTION: [] New [] Expansion 6. DESCRIBE PROJECT BRIEFLY: .~Modi ficatlonlalt er align 8. V/ILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? NO II NO. describe briefly 9. WHAT IS PRESENT LA~{D USE IN VICINITY OF PROJECT? j~ Residential [] !ndusfrlal [] Commercial [] Agriculture []ParklForesuOpen space O Other DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING,.NOW OR ULTIMATELY FROM ANy OTHER GOVE'RNMENTAL AGENCY (FEDERAL, STATE OR LOCAL}? [] NO If ye~, list agency(s) and permit/approvals ' 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes ,,~'NO Il yes, list agency ~ame and permit/approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE If the action is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 ART II--ENVIRONMENTAL ASSESSMENT (To be com~31eled by Agency) A. DOES ACTION EXCEED ANY TYPE [] Yes [] NO '' S, WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART ~it7.67 If NO, a negative Cle/~.latatlon may be superseded by anD[her Involved agency· [] Yes [] C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, it legible) Cl. Existing air quality, .surface or groundwater dualily or quantity, noise levels, existing traHl¢ palterns, solid waste production or 431sposal, potential for erosion, drainage or flooding problems? ExpJain briefly: ~ C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain brleflyt C,S. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered Specie~? Explain briefly: C4. A community's existing prans or goals as officially stippled, or a change in use or intensity of use of hind or other natural resources? Explain brletly C5. Growlh, subsequent development, or related aclivilies likely to be induced by the proposed action? EXplain htlehy. C7. OIher impacts (inclJJding changes in use of eilher quanlily or type of energyf? Explain briefly, D. IS THERE. OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] NO If Yes. explain briefly PART Ill--DETERMINATION OF SIGNIFICANC~. (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or othem/ise significant. Each effect should be assessed in connection with its (a) setting (I.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f} magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain Sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts whici'l MAY occur, Then proceed directly to the FULL FAF and/or prepare a positive declaration. · [] Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting Wis determination: ROBERT & CELIA SWING 24 MOORE'S HILL ROAD OYSTER BAY, NY 11771 March 5, 1991 We hereby authorize THOMAS C. SAMUELS of SAMUELS & STEELMAN ARCHITECTS to act as our agent in obtaining the required permits from the Town of Southold Trustees, Suffolk County Department of Health Services and New York State Department of Environmental Conservation, and Southold Town Building Department. TRUSTEES John M. Bredemeyer, III, Presidegt Henry P. Smith, Vice President Albert J. Krupski, .~ohn L. Bednoski, Ir. $ohn B. Tuthill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCO'FI' L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN (DF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE 'COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. APPLICANT'S NAME: MAILING ADDRESS: AGENT: AGENT ADDRESS: DATE TEL NO. PERMIT REQUESTED LOCATION OF PROPERTY FOR REQUESTED PERMIT: TOWN: J~/~--Z~ · No: 00o- -- - CREEK, BAY OR HARBOR FRONTING PROPERTY: SIZE '3F PROPOSED WORK: ' ' App,, Page 2. YDS. TO BE EXCAVATED: ~ YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: WIDTH OF CANAL, C~EK OR BAY PRONTING PROPERS: ~oo- 80o DISTANCE TO NEAREST CHANNEL: ._q'~D(9 -~ DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN. AREA: INTENnED USE OF PROPER~:. JT~;~Z,~ ~/X)' DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: _~/~.3~/~r HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: /%~ ' HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY A GOVERNMENTAL AGENCY; DESCRIBE FULLY ~HE REHABILITAT___ION OF PROPERTY: DESCRIBE PROPOSED CONDITION OF PROPER~ AFTER WO~ IS COMPLETED. INCLUDE ~ ~DITIONAL SURVEY OF PROPER~ SITE IF NECESS~Y: ~E THERE ~ COVerTS OR ~STRICTIONS IN YOUR DEED ~ICH WOULD PROHIBIT THIS PROJECT: ~I~ CONS~T OF O~ER IF NOT THE S~E AS APPLIC~T: COUN~ OF SUFFOLK ) STATE OF NEW YORK ) BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS K~OWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE'APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. 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, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER'ONTOMY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Applicant SWORN TO BEFORE ME THIS /3 DAY oF SUS,¥1 ~. NAOY Nobuy public, S~e of New York . No. 4~96735 EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 , ~ , ] PROJECT I.~. NUMaER 617.21 Appendix C State Environmental Quality Review .' SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 3, PROJECT LOCATION: 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc.. o~ provide map) IS PROPOSED ACTION: [] Hew [] Expansio. DESCRIBE PROJECT BRIEFLY: ,,~ AMOUNT OF LAN AFF CTEO: Iniflafly ~*' ~ acres Ultimately 4~- ~)/~'~ acres WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? DYes NO If NO. describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ~ Residential [] !n~/ustrlal [] Commercial Describe.' [] Agriculture [] ParYJForestlCpen space ~ Other . SEQR 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING.,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. STATE OR LOCAL)? [] No I! ye~, list agency(s) and permltlapprovals DOES ANy ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes ,,~o If yes, Iisi agency name and permit/approval 11. t2. AS A RESULT OF PROPOSED ACTION WILL'EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? I CERT[FY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE If the action is In the CoDstal Area, and you are a state agency, complete Coastal Assessment Form before proceeding with this assessment OVER ART II--ENVIRONMENTAL ASSESSMENT (To be compleled by Agency) : ~. DOES ACTION EXCEED ANY TYPE J THRESHOLD IN 6 NYCRR. PART 617.127 II yes, coordinate the rewew procesS'and use the EUI~"'~'~F~ ' [] Yes [] No '' S. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR U~'~LISTEO ACTIONS IN 6 NYCRR, PART 617.67 if NO. a negative may be superseded by another involved agency· C. COULD ACTION RESULT IN ANy ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may Pe hendwritlen, if legible) Cl. Existing air quality..surface or groundwater quality or quanlUy, no[se levelS, existing traffic patlerns, solid waste production Or disposal, potential for erosion, drainage Or flooding problems? Explain briefly: C2. Aesthetic. agricultural, archaeological, historic, or other natural or cultural resources: or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Expialn briefly: Growth. subsequent deVelopmen[, or related activi[ies likely to be induced by the proposed action? Explain br~elly. C6. Long term. short term. cumulative, or olher effects not identiUed in CI-C57 Explain briefly. 0. IS THERE. OR IS THERE LIKELY TO DE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMI~'NTAL It, tPACTS? PART Iii--DETERMINATION OF SIGNIFICANC~. (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it Is substantial, large, important or otherwise significant. Each etlect should be assessed in connection wilh ifs (a) setting (i.e. urban or rural); (b) probability el occurring; (c) duration; (d) trreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporUng materlalE. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts wi~ich MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. · E] Check this box if you have determined, based on the inform.~tion and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: ROBERT & CELIA SWING 24 MOORE'S HILL ROAD OYSTER BAY, NY 11771 March 5, 1991 We hereby authorize THOMAS C. SAMUELS of SAMUELS & STEELMAN ARCHITECTS to act as our agent in obtaining the required permits from the Town of Southold Trustees, Suffolk County Department of Health Services and New York State Department of Environmental Conservation, and Southold Town Building Department. Date: Date: TRUSTEES John M. Bredemeyer, III, President Henry P. Smith, Vice President Albert L Kmpski, Jr. .iohn L. Bednoski..Ir. .iohn B. Tuthill Telephone (.516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTT L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southo[d, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND .THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. APPLICANT ' S NAME: MAILING ADDRESS: AGENT: AGENT ADDRESS: DATE TEL NO. LOCATION OF PROPERTY FOR REQUESTED PERMIT: TOWN: J'OC/7/z --Z9 . NO: X000- CREEK, BAY OR HARBOR FRONTING PROPERTY: SIZE .3F PROPOSED WORK: App,. Page 2. YDS. TO BE EXCAVATED: YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: ~C'-)~> DEPTH AT LOW TID. E: ~. AVER. RISE IN TIDE: DISTANCE TO NEAREST CHANNEL: _~q'(D(9 --~dDCD ~-~ DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN. AREA: AREA ZONING: ~-~ "~S PROJECT FOR PRIVATE OR BUS. INTENDED USE OF PROPERTY:. j~/Z,2~L,~ /~W~;I~' DESCRIBE ~O~ PRIOR OPE~TIONS CONDUCTED ON PREMISES: ~?~m HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: H~S ~ LICENSE OR ~Em, IT EVER BE~ REVOKED OR SUSPENDED BY A aOVE~'~S~TAL ~ENcY: ,C30 DESCRIBE FULLY THE REHABILITATION OF PROPERTY: DESCRIBE PROPOSED CONDITION OF PROPER~ AFTER WO~ IS COMPLETED. INCLUDE ~E THE~ ~ COVerTS OR ~STRICTIONS IN YOUR DEED ~ICH ~OULD PROHIBIT THIS PROJECT: ~ WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: COUNTY OF SUFFOLK ) STATE OF NEW YORK ) BEING DULY SWORN DEPOSES AND SAYS THAT HE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AN.D CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER'ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Applicant SWORN TO BEFORE ME THIS SU$,¥~ J. NAOY · Nolary public, Sm'e of New York -No. 469575~ Gualfi~d In Suffolk ¢oun~ EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 · ' ' ' I PR~JECTI.~). NUMBER I 617.21 Appendix C State Environmental Quality Review ." SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 3. PROJECT LOCATION: 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) SEQR S. IS PROPOSED ACTION: [] New [] Expansion 6. DESCRISE PROJECT BRIEFLY: .[~Modlflcat ionlalt eratton 7. AMOUNT OF LA<~ AFFECTED; ,n,tt..y · .crc. Ultlm.tety 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? DYes [] NO II No, describe briefly 9. WHAT IS PRESENT LAi'~D USE IN VICINITY OF PROJECT? ~ Residential [] !ndustrlal [] Commercial [] Agriculture [] ParklForest/Open space [] tO. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING,.NOW OR ULTIMATELY FROM ANy OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] NO It ye~, list agency(s) and permit/approvals ~ - ..~_/ . ' ~_ ~. ,~ ..~.~_ 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes .]~o If yes. list agency name and permit/approval I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE If the action is In the Coostal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER A,,~ If--ENVIRONMENTAL ASSESSMENT (To be completed by Agency) : , A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.127 If yes. cooreinele the revmw pro(~es~ Ina use the EUL"~'~AF: E] Yes [] No ', B. WrLL ACTION RECEIVE COORDINATED REVIEW AS PROVrDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617.67 If NO, a negaUve de~.taration may be superseeed by another involved agency· C. COULD ACTION RESULT JN ANY ADVERSE EFFECTS ASSOCIATEC WITH THE FOLLOWING: (Answers may be handwritten, it I~gibJe} C1. Exrsflng air quality, .surface or groundwater quality or quantity, noise ~eveis, existing traffic palterns, solid waste prOducUon Or disposal, potential for erosion, drainage or flooding problems? Explain brtelry: C2. Aesthellc, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly:. C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted· or a change In use or Intensity of use of land or other natural resources? Explain briefly C5. Growth. subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. O. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED 'rD POTENTIAL AGVERSE ENVIRONMENTAL ]t, tPACTS? [] Yes [] NO If Yes, explain briefly PART Ill--DETERMINATION OF SlGNIFICANC~ (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supportJng materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts wl~ich MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. · E~] Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: ROBERT & CELIA SWING 24 MOORE'S HILL ROAD OYSTER BAY, NY 11771 March 5, 1991 We hereby authorize THOMAS C. SAMUELS of SAMUELS & STEELMAN ARCHITECTS to act as our agent in obtaining the required permits from the Town of Southold Trustees, Suffolk County Department of Health Services and New York State Department of Environmental Conservation, and Southold Town Building Department. - Celia Sw'fng ~ TRUSTEES John M. Bredemeyer. I11. President Henry P. Smith. Vice President Albert J. Krupski. Jr. John L. Bednoski. Jr. John B. Tuthill Telephone {5161 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ScoTr L. HARRIS Supervisor Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fax (516) 765-1823 Telephone (516l 765-1800 April 5, 1991 Samuels & Steelman 25235 Main Road Cutchogue, New York 11935 RE: Waiver Request for Robert Swing Dear Mr. Samuels: The following action was taken by the Board of Town Trustees during its regular meeting held on April 4, 1991: RESOLVED that the Town Trustees APPROVE the waiver request to construct addition to existing house plus 3 decks as noted on revised survey dated April 1, 1991 SUBJECT to no activity landward of the existing deck on the south side of the house. Please return to the Building Department for a determination on the need for any other permits which may be required for this project, as this approval is only from the Board of Trustees. Very truly yours, John M. Bredemeyer, III President, Board of Town Trustees JMB:jt cc: Bldg. Dept. CAC File S A M U E L S & S T E E I_ M A N March 21, 1991 Board of Town Trustees Town of Southold Southold, New York Re: Swing Residence Island View Lane Southold, N.Y. Dear Trustees, We are submitting an application, site plan and a check for $35.00 for a proposed addition to an existing residence located on Island View Lane in Southold. We are requesting a waiver from the Trustees for the construction of the addition. If we can answer any questions, please do not hesitate to call. Yours Truly, SAMUELS AND STEELMAN ARCHITECTS Tom Samuels Principal ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEW YORK 119~,5 ~ 516) 734-6405 TRUSTEES John M. Bredemeyer, III. Presidefit Henry P. Smith, Vice President Albert J. Kn~pski, Jr. John L. Bexinoski, Jr. John B. Tu~hill Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SCOTt L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK, FORT HE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE'COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. APPLICATION NO. APPLICANT'S NAME: MAILING ADDRESS: AGENT: AGENT ADDRESS: DATE TEL NO. LOCATION OF PROPERTY FOR REQUESTED PERMIT: TOWN: JoC~/zf~ D · T~X ~ so: iooo- ~7- ~ - CREEK, BAY OR HARBOR FRONTING PROPERTY: SIZE OF PROPOSED WORK: Page 2, YDS. TO BE EXCAVATED: ~ YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: WIDTH OF CANAL, CREEK OR BAY FRONTING PROPERTY: ~O-- ~C-D ~- DISTANCE TO NEAREST CHANNEL: _~'~)(O- ~d)C) DISTANCE PROJECT EXTENDS BEYOND SIMILAR PROJECTS IN. AREA: AREA ZONING: £-~ -IS PROJECT FOR PRIVATE OR BUS. USE: INTENDED USE OF PROPERTY:.~'C3~M,3~ ,~,g'/~/%~ DESCRIBE KNOWN PRIOR OPERATIONS CONDUCTED ON PREMISES: ~k~C-~/~Zc. .... HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: /t~ ' HAS ~ LICENSE OR PEP~IT EVER BEE REVOKED OR SUSPENDED BY A GOVEm'~ENTAL AGENCY: DESCRIBE FULLY THE REHABILITATION OF PROPERTY: DESCRIBE PROPOSED CONDITION OF PROPER~ AFTER WO~ IS COMPLETED. INCLUDE ~ ~DITIONAL SURVEY OF PROPER~ SITE IF NECESS~Y: ~E THeE ~ COVerTS OR ~STRICTIONS IN YO~ DEED WHICH WOULD PROHIBIT ~IS PROJECT: WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: COUNTY OF SUFFOLK ) STATE OF NEW YORK ) BEING DULY SWORN DEPOSES AND SAYS THAT HE tS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS, AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE'APPROVED BY THE TOWN BOARD OF THE TOWN OF SOUTHOLD. 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, IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT OR REPRESENTATIVE, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Applicant SWORN TO BEFORE ME THIS SUSAN J. NAGY Ho~y Pubic, St-'e o! New York . No. 4896735 EXAMINED BY APPROVED DISAPPROVED CONDITIONS (If any) SIGNATURE OF CHAIRMAN COMPUTATION OF FEES Approved 2/27/85 617.21 Appendix C State Environmental Quality Review ." SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPMCA~/SPONSOR 2. PROJECT AME 3, pROJEGT LOCATION: S. IS PRQPOSED ACTION: [] New [] Expansion 6. DESCRIBE PROJECT BRIEFLY: SEQR AMOUNT OF L~. APP CTED: 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? DYes NO NO. describe briefly 9. W.AT ~s PRESE.T L~;D UEE ~. wc~..~ o~ STATE OR LOCAL)? ~ No II ye~, list agency(s) and permlUapprovals DOES ANY ASPECT OF THE ACTIOtl HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes ~o n y~s. list agency name and permltlap~rOVal Dyes ~..o I CERTIFY THAT THE INFORMATION PROVIDED ABOVE I$ TRUE TO THE BEST OF MY KNOWLEDGE If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER A T II--ENVIRONMENTAL ASSESSMENT (To be completed by Agency) DOES ACTION EXCEED [] Yes [] No ' B. WILl. ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 It NO, a negative may be superseded by another involved agency· C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, it legible) Ct. Existing aii' quality, ·surface or groundwater quality or quanli/y, noise levels, existing tralnc patterns, solid waste produc, tlon Or disposal, potential for erosion, drainage or tloodlng problems? Exelaln br[elty: C2. Aesthenc, agricultural, archaeological, historic, or other nalural or cullural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, signiEcant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change In use or intensity of use of land or other natural resources? Explain briefly CE. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain brielly. C6. Long term, short lerm, cumulative, or other effects not identified in Ct-C5? Explain briefly. C7. Other impacls (incl[Jding changes in use of either quanlily or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL JMPACTS? [] Yes [] NO If Yes, explain briefly PART Ig--DETERMINATION OF SIGNIFICANC~. (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otheP, vise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (C) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessa~', add attachments or reference supporting materials. ERsure that explanalions contain sufficient detail to show that all relevant adverse impacts have heen identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. · [] Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any signii'icant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: ROBERT & CELIA SWING 24 MOORE'S HILL ROAD OYSTER BAY, NY 11771 March 5, 1991 We hereby authorize THOMAS C. SAMUELS of SAMUELS & STEELMAN ARCHITECTS to act as our agent in obtaining the required permits from the Town of Southold Trustees, Suffolk County Department of Health Services and New York State Department of Environmental Conservation, and Southold Town Building Department. Date SAMUELS & STEELMAN ARC*I~I'ECTS 25235 Main Road CUTCHOGUE, NEW YORK 11935 (516) 734-6405 TO WE ARE SENDING YOU ,~Attached [] Under separate cover via . f× i ~/'~'~---~ the following items: [] Shop drawings [] Prints [] Plans [] Samples [] Copy of letter [] Change order [] Specifications COPIES DATE NO. DESCRIPTION ~ ,~, z/. ~-/ ,~p~~o~.~ / ~ ./~ q/ //~/~ ~ ~ ~ THESE ARE TRANSMITTED as checked below: ,~For approval LJ For your use C.J As requested [~ For review and comment [] FOR BIDS DUE [] Approved as submitted [] Approved as noted [] Returned for corrections [] 19__ [] Resubmit [] Submit__ [] Return __copies for approval .copies for distribution __,corrected prints [] PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO 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) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6150A Date of Receipt of Application: July 18, 2005 Applicant: Robert & Celia Swing SCTM#: 57-2-27 Project Location: 445 Island View Lane, Greenport Date of Resolution/Issuance: July 20, 2005 Date of Expiration: July 20, 2007 Reviewed by: Board of Trustees Project Description: To construct a roof and screen walls on the existing deck. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. The issuance of the Administrative Permit allows for the renovation to the existing deck as indicated on the survey prepared by John Metzger last dated November 13, 2001. Special Conditions: Compliance inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Board of Trustees Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerso~ BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 YOU ARE REQUIRED TO CONTACT THE OFPICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1 st day of construction ½ constructed -~'"Project complete, compliance inspection. James }rang, Vice-President .ax-tie Foster Ken Poliwoda Peggy A. Dickerson To~m Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone1631)765-1892 Fax(631,765-6641 BOARD OF TOWN TRUSTEES TO~VN OF SOUTHOLD Office Use Only Coastal Erosion Perrrdt Applicatton/ __Wetland Permit Application./-,X&Administrative Permit AmeadmenffTrans fer/Extension ~'~Rece~ved .Application: -""Received Fee:$~:~ ~ Completed Application Incomplete SEQP, A Classificatton: Type I Type Il Unlisted Coordination:(date sent)_ LWRP Conststency Assessment Form (_'AC Refenal Sentr.~"'"'- __Date of Iaspcction: Recetpt of CAC Report: __Lead Agency Determtnation:___ Tcctuucal Re', --,~bhc ltea, n,g Iteld: Resolunon: ' JbL 1- Y)5 l 1- Name of Applicant Address I..~/~ ~' 'Z.¢ o.~d U i-e_,..; C_~¼ ca v- r~ -e..~_5 I Phone: ~O3 1,-/o3---/&8 / ~vcenpor&I W,Y. Phone Number:( ) {g3 1 ' Suffolk County Tax Map Number: 1000 - Prope~y Locat,on: ~ ~ ~ ~ (provide LILCO Pole ~, distance to cross streets, and location) ISLAND VIEW LANE KLOOD ZONE FRO,4 FIRId (]lOHlnO$ ~0 N,%01 g~lsn~l ~0 a~vo8 kq fi~lAO~lddV SURVEY OF PROPER_TY A T ARSHAMOMOOUE TOWN OF $OU~:htOLD SUFFOLK COUNTF, N Y ~oo0 - 57- ~_ ~7 ' SCAL~. I" -- ~Y OCE 2o, I~0 99-306 nOS dO NA40i 'NOIAIVHS~V I V ?(~d dO A..~A,dDS ¢oard of Trustees