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Home My WebLink AboutTR-5908 - TERMS and CONDITIONS 'I1e Permittee Marc Rubenstein -''''h_ Madeline Ave., Fishers Island N v ..~at . I.., as pan oC the coosidentioo lor Ibe ¡....."'"r of Ibe Permit does IIØdeataod and p<=ribe to the £01. lowing. 1. That the said .JJoud of Thutees aad Ibe Town of Southold ate rdcued from any aad aU damages. « cWms fOl: damages. oC IUIts &åsiag cIiftcd, « todirecd, .. a result oC any opet"- adoa pedoøaed pusuaot to Ihb ~ aad Ibe IIid p...,..¡<ue will, lit Ids « her own npease. defend «111 aad aU JUCh lilies '¡nltI,ted by 1bI.td.,atda, ucI the said p.. ....IIIe(' .-v~ luI.1li1b1Uty wiIh reSpect ~ ~ the ~·.c'-.wœ of the IIøud of T_ of the Town of I:nnthoJd . . 24 2. That Ihb Pe1IbIt Is ftJld for apetiod oE . mos. wIW:h Is ~~ to be the e.uimated time required Co '"""IpIete !be work 1n'fOl~ but IhoaId ~ WUtIDt, request lor III exœasionma, be made to cbe Ðoad at a bier d-. 3. That this PetIDit IhouId be retaJøcd indeCinilel,. or .. loog .. the said Petmitœe wishes to ",.in..'" the sttucaue or projea involved, to provide evidenœ to 1ll)'OlW> ronœmed chat IDth- .odzadon was od&inaU, obtained. 4. That Ibe work Involved will be subject to the Inspection aad approvd of the Boud « ia agents, ucI 11Oð""OPJf'1/....... wilb the provisions of the origIn.dog app1icadoa, ma, be awe f« ftVOCalÍon oE this Permit by IaOlI1rioo of the said Boud. 5. That there will be no ~e interCeœnœ wiIh anigatioa as a result of the work bereIa aùchorized. . 6. That there dWJ. be no lnterCeteOCe wiIh the right of die public Co pass aad repas doag the bead1 benv_ túgb aad low water awb. . 7. That If future opendons of the Town oE S<M'chøId nc¡aIte tbe. aemon1 -VOl: dœndoas in the Io--'¡"'¡ oflhe work bereIa ..ot1"J I>e'f, or If, In the opIn/oa of die JJoud of TIascees, die . wadi; shall cause _......hl. obstrucnoo to Eree 1UI\'I¡:adoo, the IIid p." .Iuec will be nc¡a/tecI, apoa due notice, to remove or ~ Ihb work or projea herein stated wkboat (''I [aJa to the Town . of Soucbolcl. . . 8. That the aid Board will be notified by tbe PHn,1ttee ot Ihe ~.oC the wodc IDth- orizcd. 9. That the 'p;.~ will dJtain aU other peaaia and œn'eltU,doIt ..., be nc¡uIred ....... pi............, to this permit wIùd1 ma,be ....jea to revoIce upœEdJaœ to dJtain -. '- . . 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 (63lì 765-1892 Fax \631, 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 21 , 2004 Mr. Glenn E. Just J. M.O, Environmental Consulting Services P.O. Box 447 Quogue, NY 11959-0447 RE: MARC RUBENSTEIN MADELINE AVE., FISHERS ISLAND SCTM#6-7-7 Dear Mr. Just: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 21, 2004 regarding the above matter: WHEREAS, Glenn E. Just on behalf of MARC RUBENSTEIN applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated February 13, 2003, and, WHEREAS, said application was referred to the South old 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 April 21, 2004, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 . . 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 MARC RUBENSTEIN to construct an addition and terrace between the existing dwelling and guest cottage; construct an addition and porch between second existing guest cottage and studio; relocate existing septic tank; abandon and fill existing leaching pool, and install a new leaching pool, and all as depicted on the plan prepared by Richard H. Strouse last revised June 1, 2004. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection, (See attached schedule.) Fees: None Very truly yours, I.lt«-.f- 1/ ~. ff . Albert J, Krupski, Jr. President, Board of Trustees AJK/lms . - . v -=1122/03 Eo~~ çJ.lèL.:)~ -r ~~ \~ ~ :S~IJ ~~~ \\:fC( ~(J. IN'-~ \\ '1.if(, 1I-;:¡9' (jà '. ~~ ('C~~'" cf0 ffiQ\rc.. 1?\J..~'^~t ~ -f¡,-')~':::. ::r..slo",-~ lQ w~ tà w...~ uV\..~ \ , ~\ V\ ~ \'-\ 1>0~~O{\-€.. ~ r fe~ I'\\' rV\4 \.'::> ~l~e- ~-t.tAð c('.. ~> a..~ll'-C.~\~. . J~V\ Jut 2 2 ~v,J . SoII\IIaId To..n loon! øI Trustees - , Telephone (631) 765-1892 Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town ConserVation Advisory Council held Wednesday, March 12, 2003, the following recommendation was made: MARC RUBENSTEIN to construct an addifion, deck, and terrace onto an existing single-family dwelling and to construct an addition porch onto an existing cottage. Located: Madeline Ave" Fishers Island. SCTM#6-7-7 The CAC did not make an inspection, therefore no recommendation was made. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER 1'4738-03171/00001 FACILITY/PROGRAM NUMBER(S) o PERMIT EFFECTIVE DATE September 29, 2004 EXPIRATION DA TE(S) Under the Environmental Conservation Law September 29, 2009 TYPE OF PERMIT . New 0 Renewal 0 Modification 0 Permit to Construct 0 Permit to Operate o Article 15, Title 5: Protection of Waters o Article 17, Titles 7, 8: SPDES o Article 27, Title 9: 6NYCRR 373: Hazardous Waste Management o Article 15, Title 15: Water Supply o Article 19: Air Pollution Control o Article 15. Title 15: Water Transport o Article 23, Title 27: Mined Land Reclamation o Article 34: Coastal Erosion Management o Article 15, Title 15: Long Island WeUs o Article 15, Title 27: Wild, Scenic and Recreational Rivers . Article 24: Freshwater Wetlands o Article 36; Floodplain Management o Article 25: Tidal Wetlands o Articles 1, 3, 17, 19,27,37: 6NYCRR 380: Radiation Control o 6NYCRR 608: Water Quality Certification o Article 27, Title 7: 6NYCRR 360: Solid Waste Management PERMIT ISSUED TO TELEPHONE NUMBER Marc Rubenstein (203) 432-6012 ADDRESS OF PERMITTEE 594 Prospect Street, Apt. B1, New Haven, CT 06511 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER JMO Consultinq, P,O, Box 447, Quoque, NY 11959-0447 (631) 653-0607 NAME AND ADDRESS OF PROJECT/FACILITY Rebenstein Property, NIW c/o Madeline Rd,& Central Ave" Fisher's Island, NY 06390 SCTM# 1000-06-07-07 COUNTY TOWN WETLAND # NYTM COORDINATES Suffolk Southold NL-5 DESCRIPTION OF AUTHORIZED ACTIVITY: Construct addition and terrace between existing dwelling and guest cottage, Construct addition and porch between second existing guest cottage and studio. Relocate existing septic tank, Abandon and fill existing leaching pool. Install new leaching pool. All work must be done in accordance with the attached plan prepared by Richard H, Strouse last revised June 1, 2004 and stamped approved by NYSDEC on S~ember 29, 2004. By acceptance of this perm,t, the permittee agrees that the permit IS contingent upon strict compliance with the ECl, all applicable regulations, the General Conditions specified (see page 3 & 4) and any Special Conditions (see page 2) included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS Region 1 Headquarters George W. Hammarth Bldq, #40, SUNY, Stony Brook, NY 11790-2356 AUTHORIZED S~ DATE ___1>"'# 7'-'~ September 29, 2004 Page 1 of 5 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1, The existing cottages and studio will remain unheated and not be improved from their current condition except for the cottage attached to the existing house, 2. Any work, disturbance, and storage of construction materials shall be confined to within the "Limit of Ciearing and Ground Disturbance" as shown on the approved plan, 3, Heavy equipment, inciuding bulldozers, backhoes, payloaders, etc., shall not be operated in the wetland, 4, A snow fence or other temporary project-iimiting fence shall be erected prior to the commencement of any permitted activities along the upland edge of the designated buffer area in order to prevent the inadvertent intrusion of equipment into the protected area, The fence shall be maintained until project compietion, 5, Prior to commencement of any construction activities, a continuous row of straw bales shall be staked end to end along the eastern edge of the "limit of grading, clearing, and ground disturbance" line as shown on the approved plans. The bales shall be maintained, repaired and replaced as often as necessary to ensure proper function, until all disturbed areas are permanentiy vegetated, The average useful life of a bale is approximately 3-4 months, Sediments trapped by the baies shall be removed to an approved upland location before the bales themselves are removed, 6, Prior to commencement of any construction activities, a continuous row of straw bales shall be staked end to end along the base of the snow fence (or other temporary, project limiting fence) on the upslope or project side of the fence, The bales shall be maintained, repaired and replaced as often as necessary to ensure proper function, until all disturbed areas are permanently vegetated, The average useful life of a bale is approximately 3-4 months, Sediments trapped by the bales shall be removed to an approved upland location before the bales themselves are removed, 7, Straw bales shall be recessed two to four inches into the ground, 8, All disturbed areas where soil is temporarily exposed or stockpiled for longer than one (1) day shall be covered with a tarp or contained by a continuous line of staked straw bales placed on the downslope or wetland side, 9, Any demolition debris, excess construction materials, and/or excess excavated materials shall be immediately and completely disposed of on an approved upland site more than 100 feet from any regulated freshwater wetland, These materials shall be suitably stabilized so as not to re-enter any water body, wetland, or wetland adjacent area, 10, Excavated sediments shall be placed directly into the disposal site or conveyance vehicle, No side-casting or temporary storage of excavated sediments is authorized, 11. All fill shall consist of clean soil, sand and/or gravel that is free of the following substances: asphalt, slag, flyash, broken concrete, demolition debris, garbage, household refuse, tires, woody materials including tree or landscape debris, and metal objects, The introduction of materials toxic to aquatic life is expressly prohibited, 12, The permittee shall incorporate the following language as a notice covenant to the deed: "Regulated freshwater wetlands associated with Nl-5 are located on/near the properties of Marc Rubenstein and her heirs, assigns or successors, This property is subject to the provisions of Environmental Conservation law (ECl) Article 24, and the conduct of regulated activities may occur only pursuant to ECl Article 24 if prior approval is given by the New York State Department of Environmental Conservation (NYSDEC) or its successor(s), Regulated activities include, but are not limited to clearing of vegetation; application of chemicals; excavation; grading and filling; and erection of any structure(s):' This deed covenant shall be recorded with the Clerk of Suffolk County within 90 days of the issuance of this permit. A copy of the covenanted deed or other acceptable proof of record, along with the number assigned to this permit, shall be sent within one calendar year of the issuance of this permit to: NYSDEC, Regional Manager Bureau of Habitat, SUNY Building 40, Stony Brook, New York 11790-2356, DEC PERMIT NUMBER 1-4738-03171/00001 PAGE 2 OF 5 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 13, A Permit Compliance Site Monitor (hereafter, "Site Monitor") shall be hired by the permittee to oversee and inspect the work that is the subject of this permit. (A) Qualifications The primary Site Monitor shall have at least two (2) years experience or formal training in each of the following areas: environmental sciences, construction practices, protective measures and mitigation techniques. In case of emergency, a back-up Monitor shall be made available and must have a minimum of one (1) year experience or training in the aforementioned areas, The quaiifications and contact information of the selected Site Monitor and the designated emergency back-up Monitor shall be submitted In writing to: NYSOEC, Bureau of Environmental Protection (BEP), Regional Manager, SUNY Building 40, Stony Brook, New York 11790-2356, at least one (1) month prior to commencement of the project, for staff review and approval. (B) Site Responsibi/itie As a minimum, the Site Monitor must be present at the project site to oversee any environmentally sensitive work including, but not limited to, installation of protective measures, use of equipment near buffer areas, planting of disturbed areas, creation of wetlands, etc, The Site Monitor shall also oversee the ongoing inspection and maintenance of required protective devices, equipment, etc. In the event that the Site Monitor is unable to be at the project site during environmentally sensitive work, the emergency back-up Monitor shall be utilized by the permittee, The back-up Monitor will have the same responsibilities as the primary Site Monitor. Use of the back-up Monitor shall be reported to the BOH Regional Manager within twenty-four (24) hours via telephone (516) 444-0275 or facsimile machine (516) 444-0373, (C) Schedules and Reportina The Site Monitor shall submit a detailed construction schedule prior to work commencement. After work has begun, the Site Monitor shall submit bi-weekly written reports which must include items such as changes in the construction schedule, work accomplished over that period, problems encountered, etc, These reports must either be hand delivered or sent via facsimile machine to the BOH Regional Manager. Extraordinary events such as accidents, vandalism, failures, and natural disasters affecting the project, and any counteractive measures taken by the permittee, shall be reported to BOH Regional Manager within twenty-four (24) hours via telephone or facsimile machine. Additionally, the Site Monitor must supply a contact telephone number; response by the Site Monitor to a call from BOH staff must occur within 24 hours, (D) Authoritv The Site Monitor shall be empowered with the authority to suspend project work, within the NYSOEC jurisdic- tional 'area, at any time she/he feels that permit compliance is in jeopardy or that other site violations have occurred, The Site Monitor shall contact the BOH Regional Manager within 24 hours of the occurrence, via telephone or facsimile machine, for instructions on how to proceed, (B)DEC PERMIT NUMBER 1-4738-03171/01 PAGE 3 OF 5 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts legal Responsibility and Agrees to Indemnification The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all ciaims, suits, actions, and damages, to the extent attributable to the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent acts, Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmentai Conservation law as those prescribed for the permittee, Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, iands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL Such representative may order the work suspended pursuant to ECl 71-0301 and SAPA 401 (3), The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including ail referenced maps, drawings and special conditions, must be avaiiabie for inspection by the Department at all times at the project site or facility, Failure to produce a copy of the permit upon request by a Depart- ment representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewai, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires, Any renewal, modification or transfer granted by the Department must be in writing, The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621, The grounds for modification, suspension or revocation include: a) materially false or inaccurate statements in the permit application or supporting papers; b) failure by the permittee to comply with any terms or conditions of the permit; c) exceeding the scope of the project as described in the permit application; d) newly discovered material information or a material change in environmental conditions, relevant technoiogy or applicable law or regulations since the issuance of the existing permit; e) noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activit) DEC PERMIT NUMBER 1-4738-03171/00001 J PAGE 4 OF 5 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION .ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6NYCRR PART 608 . (FRESHWATER WETLANDS) 1, If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration, 2. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage, 3, Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S. Army Corps of Engineers, U,S, Coast Guard, New York State Office of General Services or local government which may be required, 4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 5, Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6, There shall be no unreasonable interference with navigation by the work herein authorized. 7, If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition, No claim shall be made against the State of New York on account of any such removal or alteration, 8, If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. 9, At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and retum the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, aiong with photographs of the completed work and, if required, a survey, 10, All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application, Such approved plans were prepared by Richard H, Strouse last revised JlI{Ie 1, 2004, DEC PERMIT NUMBER 1-4738-03171/00001 PAGE 5 OF 5 1,) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED HEREON, ANY EXTENSiON OF THE USE BEYOND THE PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE ENGAGEMENT, 2,) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY, 3,) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF THE LAND SURVEYOR, 4,) COORDINATE DISTANCES ARE MEASURED FROM U,S, COAST AND GEODETIC SURVEY TRIANGULATION STATION "PROS", 5,) SITE is LOCATED IN R-80 ZONE, 6,) SITE IS SERVICED BY MUNICIPAL WATER AND ON SITE SEWAGE DISPOSAL SYSTEM, 7,) BASE FOR LEVELS: NGVD 1929, NYSDEC APPROVED AS PER TERMS AND CONDITIONS OF f'ER~þIT !\JÙJ,-;:lf:¡,03171Ioocol DATI:: ,,<<::'0 I dOOl¡- I .sLIt SITE PLAN PREPARED FOR PATRICIA D. PIERCE & MARC A. RUBENSTEIN OR FORMERLY (ANT 'ATION . . . ...... r-. ,..,..... ~\ I~ r<ïfl.lTnAI A\/L 0.. UIII\II\I^TA\MW:"T fj,\/~ r Albert J, Krupski, preAid!' James King, Vice-President Hcnry Smit.h Artre Fo~ter Ken Poliwoda . Town H.II 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 ~oastal Erosion Permit Application ..L- Wetland Permit Application _ Major Waiver/Amendm ha es _Received Applicati -y' _Received Fee:$ _ / _Completed Applicat on V _Incomplete _SEQRA Classification: Type I_Type II_Unlisted_ Coordination:(date sent _CAC Referral Sent:,;J.. I _Date of Inspection: _Receipt ofCAC Report: _Lead Agency Determinatio _Technical Review: ...;¡, I I / _Public Hearing Held: ~ / I rJ /0 y _Resolution: Minor Name of Applicant Marc Rubenstein Suffolk County Tax Map Number: 1000 - 006-7-7 £ y~~~ Address 426 Prospect Street /14, New Haven, CT 06511 Phone Number:( ) 701-41? -nn 17 Property Location: Madeline Avenue, no /I, Fishers Island (provide LlLCO Pole n, distance to cross streets, and location) ~\'U~ ~ AGENT: Glenn E. Justl JMO Consulting (If applicable) 1 3 2003 Address: P.O, Box 447, nuogue NY 11959 0447 IdTown Board of Trustees Phone: 653 -060 7 · . Board of Trustees Application GENERAL DATA Land Area (in square feet): 60,112.8 R-RO Area Zoning: Previous use of property: Existing single family dwelling Intended use of property: same Prior permits/approvals for site improvements: Agency Date _ No prior penn its/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): ;:: It !: lEU ~ IE ~ l~ FEB 1 3 2003 1l1lJ Applicant proposes to construct an addition, deck a terrace onto an existing single family dwelling and to construct an addition and orch on to an existin Soulhold Town cot t a e. Board nf Truslees ,- . ., . Board of Trustees J\pplication . WETLANDrrRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Existing single familv . dwelling + Area of wetlands on lot: -22,000 square feet Percent coverage of lot: n/a % Closest distance between nearest existing structure and upland edge of wetlands: 36 feet Closest distance between nearest proposed structure and upland edge of wetlands: 30 feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated?:!: . 50 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: :!:4 feet Proposed slope throughout the area of operations: 1 : I Manner in which material will be removed or deposited: Pavloader 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): As proposed project should not have negative imDactq ¡¡; ç II:! In ~ on existing wetlands. 0 U fEB 1 3 1003 ~ - , Southold Town I Board of Trustees I . . Board of Trustees Application COASTAL EROSION APPLlCA nON DATA Purposes of proposed activity: Existinp, sinp,le family dwelling Are wetlands present within 100 feet of the proposed activity? No X Yes Does the project involve excavation or filling? No X Yes + If Yes, how much material will be excavated? - 50 (cubic yards) How much material will be filled? o (cubic yards) Manner in which material will be removed or deposited: P a v loa d e r Oescribe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed, (Use attachments if necessary) There are no negative environmental impacts anticipated. . . 817.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART ,- PROJECT INFORMATION ITo be comoleted bv ADollcBnt or Project Soonsorl I, APPLICANT/SPONSOR 2, PROJECT NAME Rubenstein Proposerl adrli lions to dwelling Marc 3, PROJECT LOCATION: Suffolk Fishers Isl'and MunlcJpalily Counly 4. PRECISE lOCATION (Street address and road Intersedlons, prominent '8OOmaft., etc., or provide map) Madeline Avenue, no 1/ Location map enclosed 5, PRO¡SED ACTlDN IS: New 0 expansion o Modllicatlonla~eratlon 6, DESCRIBE PROJECT BRIEFLY: A r> p 1 i can t proposes to construct an addition deck and onto an existing single family dwellinp, and terrace to construct an addition and porch onto an existinp, cottage. 7. AMOUNT.g' ~ND AFFECTED: Ultimately .~ 0 ,a::L- InRially . n ì Icres leres 8, WlLiOPOSED ACTION COMP.L Y WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes 0 No If No, describe brieny g, WHAJi!PRESENT lAND ~SE IN VICINITY OF PROJECT? o Agriculture o Plrt<lForestlOpen SPIce o other Resldenlill 0 Industrial 0 Commerclll Des : Single family dwelling 10. ~CTION INVfi!F:IT APPROVAL, OR FUNDING, NOW OR UL TIMATEL Y FROM ANY OTHER GOVERNMENTAL AGENCY FE ERAL, STATE 0 LO ? Yes If Yes, IIsllgeney(s) nlme Ind permltllpprovals: Southold Town Trustees .... fE ~ fE ~ WfE -- 11. DOES ANY ASPE~ THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? .... o Yes No If Yes, fisl Igeney(s) nlme Ind permitlapprovIIs: FEB 1 3 2003 L-. 12, AS A RESUU OF ~~SED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODI Board of Trustee. D~s ~ No ' I CERTIFj' ct f'E INFCR! ~ N PROIfDED ABOVE IS TRUE TO THE BEST OF MY KNOWLE~ Applicant/sponsor name: !n E. t ' as agent Date:.:l- Ù Signature: . / /}Jv\;. \ . , . ~. , If the action Is In the Coastal Area, and you are a state aøency. complete the Coastal Assessment Form before proceeding with IS assessment OVER 1 rd out 01 To"" Acc~tlng of Trustees APplication~ ~OOl ,"- AUTHORIZATION (where the applicant is not the owner) I. f¥\Q.V"'C (print 'R u.1D-€ V\ "5t ~ l' \r\ .,wner of property) residing at oIf..:2lD ?n,,~.,)-e..cJ--~t,#:-SC (mailing ad~ss) tJ Ø..1 t+aÙ<c..v1 CT 0 CD 6"U do hereby authorize . ~'~ (Agent! T.tl1.o, Z-(IIlJI'(OV"Mº-Vl.t-.J t~apPlY for permit(s) from the southold Board of Town Trustees on my behalf. \N~ ~'----. \. (owner' ,9 signature) .. , B 12 2J:02 MaN 12:0~ FAX 516 765 lJ66 50utho1d To"n Acc.tlng ~rd of Trustees Application County of suffolk state of New York l(Ý\o./C_3dJ..~t;As\-e.-ìý\ BEING.DULY SWORN DEPOSES MID AFFIRMS THAT HE/SHE IS THE APPLICI\N'r FOR THE ABOVE DESCRIBED PEHMITIS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE ~ BELIEF. AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION l\ND AS MAY BII': APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICMfr AGREES TO HOLD THE TOWN OF SOUTHOLD ~ THE TOWN TRUSTEES HARI'fioESS AND FREE FROM ANY MID ALL DAMAGES AND CLAIMS MUSING UNDE:R OR BY VIRTUE OF SAID PERMIT IS), IF GRJ\NTED. IN CO!1PLETING THIS APPI,ICATION, I HEREBY AUTHORIZE THE TRUSTEES. THEIR AGEN'l'IS) OR REPRESENTATIVES IS), TO ENTER ONTO MY PROPERTY TO INSPECT TflE PREl'IISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. tÁ l~c>- ~\.,~ \Signature SWORN TO_~EFORE ME THIS 't'\.<..ì,...cJ OF :t4~\.o\.~'~~3. DAY D~ C~;~ ~ ql3úJb(, 7 li!Io02 :: . ..' .. -- ......... UC:;'..1p jMo con5ultinr; . p. I S31 S53 3348 . Albert J. I<mpski, President Jamc8 King, Vicc>-PrE'sident Henry Smith Arti~ Foswr Ken Poliwoda Telephone (631) 765·1892 Fax (631) 765-1366 Town Han 53095 Route 25 P.O, Box 1179 Southold, New York 11971-0959 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------- In the Matter of the Application of 7Jf.tU~__l&~~________ COUNTY OF SUFFOLK) STATE OF NEW YORK) I, (' /¡,,~ E,lw ç), AFFIDAVIT OF POSTING , residing at ,h)J.Pfj J~lfI'"d being duly sworn, depose and say' That on the C¡'Á day of fh.,e L, 200 S. I personall)( posted the property known as rho, c: í?u /'PhJ/,<1'L- fhA //,I\J- fill e. 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 _it p,ublic hearing. Date of hearing noted thereon to be held nl1ld tfr:::: ,!In!J /Ì,L 0-... ltltvt-l- 7¿J ~ç.-/-r:t--(f Ih . Dated: '1lß/CÁ./^f, dOO'1 S~oÆn to be~~[~ me this !^fJ!!'day of f!v.uCJL 200..3 -... ----- . . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name I SENDER CO^IP~ E TE THI':- ~.F' '1..'. · Complete items 1. 2. and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: A~ Gt..eb.e.. ~.O.~ S-=l-fo 'Ç'~~~<::' :I:S\o.~ ¡lV.....I, O(o3>Qo-o ~b ........----. " -" f. '-,"..;'. 'f,; If-, A. Jõlec~Vedt by (PI~ Print Clearly) I B. Date?f Delivery , 1z::.., ( ð V-- IC)3-p -C3 C. Signature X &.~ .J ,Tk· vì ~gent o Addressee DYes o No D. Is delivery address different from item 1? If YES, enter delivery address below: 3. Service Type ljC.Certlfled Mail o Registered o Insured Mail o Express Mall o Return Receipt for Merchandise o C.o.o. 4. Restricted Delivery? (Extra Fee) 0 Yes -1õ'C~~be' ~2lõ'3em~o \ \ A.() ot qM PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1789 STATE OF NEW YORK COUNTY OF SUFFOLK ~..N'\ "E.:s.V~ , residing at t~~§m~r~~i:~(_~Y s~~3~P~:~~n:~~ sa~'s 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 saið'persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at rJ\ ~Il ð -I IV-- '-I. . that said Notices were mailed to each ~ša d perllons by (certified) (registered) mail. Sworn to before me this day of ,19 Notary Public . . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: SENDER. ;I\lPU.~f ~HI-.c·t 'T!'.A · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: ~ ""1'c-o ~.soV'" ':f\O~i S.3 \0 'Ç~u.u. ~\ 0.."6.. ¡rV...'-l t OlD3QO- 05'3.10 ,', "f -0' " A. Received by (Pf~s~t Clearly) B. r2......\t.?S .p, L~G.....·::;>;ë C. SIgn tu o Agent cg. Addressee . Is delivery address dIfferent from item'? 0 Yes If YES, enter delivery adaress below' D No 3. Service Type tLcertified Mail o Registered o Insured Mall o Express Mail o Return Receipt for Mercnandise D C.O.D. 4. Restricted Delivery? (Extra Fee) DYes 2. Article Number (Copy from service label) _:tact'\. 3~OO OOd~ llPx')q~ PS Form 3811, July 1999 Domestic Return Receipt STATE OF NEW YORK COUNTY OF SUFFOLK 102595-99-M-1189 Ge~E- ~_l~~~ Lr ~-----1=:= ' being duly sworn, deposes and sa'fS that on the I~J.oII\.. day of Ma.rèJ.\... ..)4)...Q3, 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; tha~aid Notices were mailed at the United States Post Office at QlhJ..f!. N...'-f , that said Notices were mailed to each 0 sai,d peisons DY (certified) (registered) mail. , residing at I:;}( ;j~IoIf>Aveil\t.C..~ Sworn to before me this day of ,19 Notary Public ------- ----------- J / ----- ----- ----- ----- ----- ,,- ~~ N/F SUSANNA S, DOYLE QUALITY CONTROL CERTIFICATION :;ROUP R I WED DATE ='ROJECT MANAGER "_ . ~ :;URVEY 1l,¿/-' . t· , ~NVIRONMENTAL ::;IVIL 'v ~ ' :;TRUCTURAL ~RCHITECTURAL .----'- ~~-_. " -~~--------'---- -- --'---- -_.._~~-'-~._-----~---'- -.-- _.~------- ----,-------- - \ I I \ \ \ \ APPROXIMATE LOCATION FLOOD ZONE AE PER FIRM. SUFFOLK COUNTY PANEL 19 OF 1 D26 M',P NO, 361D3CDD19G MUNNATAWKET AVENUE EDGE OF PAIlEMENT N 4517,78 W 135,71 S 44"19'4:5"" E 310.08 ;" '" I I I I I I I \ \ , \ \ \ , SECOND ACT AREA=4100±" S,F. SCTM DIST. tOOO S~006 BLOCK 4 LOT 8 %. ',¡< ¡" ~ PROPOSED SILT FENCE BACKED BY HAYBALE BARRIER \ \ \ \ \ \ /\~~ \~~'i rJ \ ",%f;.?- \ 't, «\ \ ~~~ \'" "'~ \ '~'" ·O~~ \ ' ~ \ <Òí::'~ \ ~<,,~ \ í?....\ ~ \ ~"Y.~ LIMITS OF GRADING. \ ",", of> LEARING AND GROUNO\ ~ ~ t DISTURBANCE \ ~ ~ <" \ o'~~ ,~.~\'\ " -- - - -:1""- - - - J ~ --- ~ '/};-;>, ~f~ f~ '/};-6: ~ FIRST TRACT AREA=1.38::f:: ACRES CTN DIST, fOOO SEC. 006 BWCK 7 LOT 7 EXISTING STUDIO (UNHEATED ~& - - - - - --- --- HYD, I":: --- --- EXISTING CONC, BLOCK- LEACHING POOL TO BE ABANDONED '" FILLED . FLOOR (/ -.... ".. ELEV,=14.0 \ '. \ / PROPOSED SILT FENCE BACKED BY HAYBALE BARRIER 55' LEAN-OUT EXISTING PRECAST CON lEACHING POOL PROVIDE NEW 8' DIA. PRECAST CONC. lEACHING POOL ~<J~ ~~ ~ ~~ ~V +~ RElOCATE EXISTING 1 DOO GAL SEPTIC TAN '" EFFLUENT LINE EXISTING HOUSE 1ST FLOOR ELEV,=17,Q6 BSMT, FLOOR ELEV,=8.66 AVG, ELEV, OUTSIOE= 14,0 FILTER FABRIC POST (2)-2"x2"X3' STAKES FILTER EACH BALE~ FABRIC') " C~">[HIH1 REVISIONS 20 , 10 o ....~~ .. ,. EO"<",, y.þJ\DH.Sl' \ ,Co -90 .<ë ,_, , ~"l~-(I> ,f'";¡ ';1,:,- ~ I I I), I' -" 'I i~¡ I I:/-' ,,":1 ! ~ r,d",' {' ,t, 0;:. 'ó If",' -, ~~ <:- .. <~ GRAPHIC SCALE IN FEET COMPACTED BACKFILL ANGLE 10' UP SLOPE FOR STABILITY AND SELF CLEANING ~ ~ ~\ ~ '%, '??~ .'&\~t>% ,,~ ¡o ~ ~ ~ \ \ "~ \ "'~\ '- ~ N ';361.38 W 165,98 20 , LEGEND N/F NOW OR FORMERLY HYD HYDRANT ELEV ELEVATION MON MONUMENT JOB PROJECT 2001215 BOOK NO. DESIGNED R.H.S. DRAWN J.J.M. CHECKED FILE 2001215 PIERCE.DWG OAT A NO, DATE 01 09/14/01 02 09/27/01 03 04/29/02 04 06/05/02 05 09/11/03 06 01/03/04 07 01/19/04 08 06/01/04 DESCRIPTION ADDITIONS & REVIISIONS REVISIONS ADDITIONS &; REVIISIONS ADDITIONS &; REVIISIONS ADDED BUILDING SETBACKS REVISED BUILDINGS ADDITIONS &; REVIISIONS ADDITIONS &; REV~SIONS SILT FE~CE BACKED BY HAYBALE BABRIEB NOT TO SCALE / DATE: JUNE 15, 2001 SCALE: 1" - 20' SHEET 1 OF 1 ..,-- ,p 0" " ,p <o.:t :?-<v<-'o {;ò ~c,'\c~ ~9c'" .j<' LOCATION MAP SCALE 1 "=400' NOTES 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED HEREON, ANY EXTENSION OF THE USE BEYOND THE PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE ENGAGEMENT, 2,) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LANO SURVEYOR, TO ALTER AN ITEM IN ANY WAY, 3,) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF THE LAND SURVEYOR, 4,) COORDINATE DISTANCES ARE MEASURED FROM U,S, CDAST AND GEOOETIC SURVEY TRIANGULATION STATION "PROS", 5.) SITE IS LOCATED IN R-BO ZONE, 6,) SITE IS SERVICED BY MUNICIPAL WATER AND ON SITE SEWAGE DISPOSAL SYSTEM. 7.) BASE FOR LEVELS: NGVD 1929, f5) lE ~ lE ~ \W lE fR1 Ifù OCT 2 5 1004 lW SITE PLAN PREPARED FOR PATRICIA MARC A. D. PIERCE & RUBENSTEIN MADELINE AVE" CENTRAL AVE, & MUNNATAWKET AVE, FISHERS ISLAND, NEW YORK - -- ~-...~ - - -ii- ....-. ..... - CMB/CPK Design Group 110 Broadway, Norwich, CT 06360 860-889-3397 Fax 860-886-7801 www.cmeengineermg.com CHANDLER, PALMER & KING ADlv,s,cn of CME Mlociales, Ino. Offices Qlso In Woodstock, CT and SDu\hbrld~". iotA Architecture, Engineering, Environmental Science & Surveying