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Home My WebLink AboutTR-5901 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 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 CERTIFICATE OF COMPLIANCE # 0280C Date December 5, 2007 THIS CERTIFIES that the two-story dwelling, sanitary system, pervious walkway and planted buffer seaward of the dwelling At 1755 Truman's Path, East Marion Suffolk County Tax Map # 31-13-4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 3/15/04 pursuant to which Trustees Wetland Permit #5901 Dated 4/21/04 and Amended on 12/21/05, and Coastal Erosion Permit 6263C Dated 12/21/05, Were issued, and conforms to all of the reqnirements and conditions of the applicable provisions of law, The project for which this certificate is being issued is for a two-storv dwelling, sanitary system, pervious walkway and planted buffer seaward of the dwelling. The certificate is issued to W. BRUCE BOLLMAN owner of the aforesaid property. rc;;:~ Authorized Signature Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . 6 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 YOU ARE REQUIRED TO CONTACT THE OFFICE 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 151 day of construction Yo constructed L Project complete, compliance inspection. I J.../ ~ld7 0~, ~ . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 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 SOUTH OLD > March 21, 2007 Ms. Linda D. Bertani John Bertani Builder, Inc. 1380 Oakwood Drive Southold, NY 11971 RE: W. BRUCE BOLLMAN 1755 TRUMAN'S PATH, EAST MARION SCTM# 31-13-4 Dear Ms. Bertani: The following action was taken by the South old Town Board of Trustees at their Regular Meeting held on Wednesday, March 21, 2007: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Permit #5901, as issued on April 21, 2004, and amended on December21, 2005 with the condition of the removal of the existing wooden walkway and replaced with a pervious walkway. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, J~in; ~ President, Board of Trustees JFK:eac L. U...;, > ,-- o IX ~ ~ <( ,~;; I " . I ,--,~ --" ( . I !; oYt .:B-'?/X-E BOLUJ1AN rRVMAALS 'pA-r'J./ EAS-r NUJ-'<J'DN, AI. Y; JAN - 5 2006 ?XOPOSEb , , pOUJ 0: , rf)'. I: t'l. ~. . \: ~\ ;'-\f\/6 L4r, ~ STiJ ,ye;- Sri) c( 131..1./;;; ST;OIVc II <:\../' ~ ~I I c,' fj''\V) , ../Y I , 'If l10v 161. :z,,,,'Pv' N G I -j , l'brur eo", f:=- E->("r'1')- :;J7)NJPt:: ,( :~< .- ~ ---- ----- ~ ~ ..---:;:.' I, , f I 841~~b / , '..----...... i . . ;i\'01~ ~'o too, ~ / ! I ,1 ; ..'-'---< /V/J"r'e: A-LL. N?EASUJU:lY!fNrs ~ME .4P,"-1fJX. AU, RlGB7'S RESERVED Plantlngs By The Sea, 1nc. FOR DESIGN COPY & USE ..sC./'rLE: '/B"~/" John Bertani Builder Inc. 1380 Oakwood Drive Southold, N.Y. 11971 (631) 765-1594 FAX (631) 765-3916 March 8, 2007 Bollman Permtt # 5901 SCTM#1000-31-13-04 Mr. James King, President Board of Town Trustees P.O. Box 1179 Soulhold, NY 11971 Dear Mr. King, I am respectfully requesting a one year extension to the above mentioned permit which expires on April 21,2006. Thank you. Sincerely, ct^-ci<- g . IJJ.J~ .----- Linda D. Bertani Vice President Ii A k __ C \Inl\ 13 ~9 ~ ~ M S; Address ~g,; ::U)"tUz OIL::;; - For "'0",:2 IL ",0 ozlOllji ;;:",0 Co '" !1f... o m AMI. PAID BALANCE DUE 044286 () Dollars $ . . John Bertani Builder Inc. 1380 Oakwood Drive Southold, N.Y. 11971 (631) 765-1594 FAX (631) 765-3916 March 7, 2006 Re: SCTM#31-13-4, 1755 Truman's Path, East Marion PERMIT NO. 5901 Mr. James F. King, President Southold Town Board of Trustees P.O. Box 1179 Southold, NY 11971 Dear Mr. King, We are requesting a one year permit extension for permit # 5901 for Mary Ann and Bruce Bollman, 1755 Truman's Path, East Marion, SCTM# 31-13-4 which expires on 4121/04. Endosed is our check for $1 0.00. ~ SO r Thank you. Sincerely, c;{:Hd<JJ f.S~V~M--- Linda D. Bertani Vice President MAR - 6 2006 . PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair . MAIliNG ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE WCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 WILLIAM J. CREMERS KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON PLANNING BOARD OFFICE TOWN OF SOUTHOLD To: Town of Southold Board of Trustees From: Mark Terry, Senior Environmental Planner - - / L WRP Coordinator ~ DEe 2 0 20G5 Date: December 20, 2005 Re: Amendment to Permit #5901 W. Bruce Bollman SCTM#1000-31-13-4 W. BRUCE BOLLMAN requests an Amendment to Permit #5901 to move the footprint of the dwelling 2.6' to the east, abandon the existing septic system and install a new septic system, and requests a Coastal Erosion Permit to allow for the construction activity in an approx. 108 sq.ft. section seaward of the CEHA. Located: 1755 Truman's Path, East Marion. SCTM#3l-13-4 The structure currently exists and is located in flood zone "X", an area outside ofthe 500 year flood zone. The Applicant proposes gutters and leaders into four subsurface drainage systems to control surface runoff generated by the structure. A pervious driveway is also proposed The land area seaward of the proposed structure consists of several existing erosion control structures which include: two wood retaining walls and a wood bulkhead. No other shoreline hardening structures are proposed The proposed structure will be served by public water. The applicant proposes to replace the existing septic system with a new septic system. The expansion pool within the existing septic system is located 74' from the top of bluff line demarked by the (6.3 wood wall). The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the Town of South old Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is generally CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided that the applicant demonstrates that the following policies are applied to the greatest extent possible prior to issuance of any permit. Policv Standard 4.1 Minimize losses of human life and structures from flooding and erosion hazards. . . The following management measures to minimize losses of human life and structures from flooding and erosion hazards are suggested: A. Minimize potential loss and damage by locating development and structures away from flooding and erosion hazards. 1. Avoid development other than water-dependent uses in coastal hazard areas. Locate new development which is not water-dependent as far away from coastal hazard areas as practical. a. No development is permitted in natural protective feature areas, except as specifically allowed under the relevant portions of 6 NYCRR 505.8. b. Avoid hazards bv sitinl!: structures to maximize the distance from Coastal Erosion Hazard Areas. Policv Standard 5.1 Prohibit direct or indirect discharges that would cause or contribute to contravention of water quality standards. B. Prevent point source discharges into Southold's coastal waters and manage or avoid land and water uses that would: 1. exceed applicable effluent limitations, or 2. cause or contribute to contravention of water quality classification and use standards, or 3. adversely affect receiving water quality, or 4. be contrary to Phase III of the Long Island Sound Study's Nitrogen Reduction Plan which calls for a 58.5% Sound-wide reduction in nitrogen levels. C. Ensure effective treatment of sanitary sewage and industrial discharges by: 8. providing and managing on-site disposal systems: a. use on-site disposal systems only when impractical to connect with public sewer systems, b. protect surface and groundwater against contamination from pathogens and excessive nutrient loading by keeping septic effluent separated from groundwater and by providing adequate treatment of septic effluent, c. encourage the evaluation and implementation of alternative or innovative on-site sanitary waste systems to remediate on-site systems that currently do not adequately treat or separate effluent, d. encourage the use of alternative or innovative on-site sanitary waste systems where development or redevelopment of grandfathered parcels would otherwise increase the level of negative impacts on ground or surface waters, including wetlands. To further the intent of Policy 5.1 and 6.3 A which states; . . . A. Comply with statutory and regulatory requirements of the Southa/d Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. It is recommended that the Trustees require that the septic system be relocated to achieve a 100 setback from the top of bluff line pursuant to Chapter ~ 97-12. Findings; purpose; jurisdiction; setbacks, unless the Trustees at their discretion deem it appropriate to grant a variance from this requirement, which is wholly within their jurisdiction. Pursuant to Chapter 95, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Please contact me at (631) 765-1938 if you have any questions regarding the above. .ani Builders 63.3916 p.l John Bertani Builder Inc. 1380 Oakwood Drive Southold, N,Y. 11971 (631) 765-1594 FAX (631) 765-3916 December 15, 2005 Bollman Residence -1755 Trumans Path, East Marion, NY 11939 DEe 1 5 2005 Albert J. Krupski, President Southoid Town Board of Trustees P.O. Box 1179 Soulhold, NY 11971 Dear Mr. Krupski: 6CTM" 'I0GG-34.U.o4 We are amending our letter of November 10, 2005 for an EMERGENCY coastal erosion permit for the ebOve as follows: The proposed new construction is land ward of the ooastai erosion zone, however, in the course of clearing for the purpose of iro.s1alling a new fllunde!icn alter the existing ene wa~ fllund structurally unsafe, the excavation over cut for the new foundation caused approximately 106 square feet of activity seaward of the zone line not the 32 square feet originally flQUred in our November 10, 2005 letter The material already removed was an existing lawn and when the foundation is completed, back filled and the home construction complete this area will become lawn again. The proper1ies to the east, west and Mr. Bollman's properties are being compromised by erosion due to the dura~on of the new perm~ application process to allow instailation of the new foundaoon. If there is any other information you need please do nol hesitate to call. Thank you. Sincerely, /f:) 7 .~ . n 1-:- ( . . u Ld,-- .,,,: '. /..;.1::./.../ (t:,,--- Linda D. Bertani Vice President . . HARVEY A. ARNOFF Attorney At Law 206 Roanoke Avenue, Riverhead, NY 11901-2794 (631) 727-3904 Harvey A. Arnoff Michael P. Sendlenski Para!e2al Colleen Grattan-Arnoff, R.N. November 21, 2005 Fax No.: (631) 727-3940" "Not for service oflega! papers Of Counsel George F. Biondo John A. MacLachlan Town of Southold, Board of Trustees c/o North Fork Bank Town Hall Annex Building P.O. Box 1179 Southold, New York 11971 Re: W. Bruce Bollman, Applicant LWRP Consistency Assessment Form SCrM #31-13-4 ___~..,~7""';;-C';-' r~~'i"':,...I; ""'.1 \\i'\,'!._:0~___,,:~~; .".~~_y >'.~.~~::_~---:~l'\\l J, III I- " .' " \ i,.: NOV 2 2 2005 I_oj \ L' L-. ;:.... .. c;.:;;--J I r:," :~~:':',~~~j ~ --~-'-- .~-_._---.-.- Gentlemen: Enclosed please find LWRP Consistency Assessment Form and rider attached thereto regarding the above-referenced matter. Would you kindly provide us with your evaluation of same. Should you require any further information or documentation, please do not hesitate to contact the undersigned. Very truly yours, MPS/db Enclosure cc: Mr. W. Bruce Bollman John Bertani Builder, Inc. 4(~~!:\ MICHAEL P. SENDLENSKI FROM : SOUTHDLD TOWN PLANNIN~ARD FAX NO. 631 765 3136 . Nov. 18 2005 11: 50AM Pi . . Town of Southold ~ \.WRP CONSISTENCY ASSESSMENT FORM A. INSTR\lC'TIONS J. All applicants for permits* including Town of Southold agencies, shall complete this CeAF for proposed actions that are subject to the Town of South old Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. * Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proDOsed action will be evaluated as to its si2Itificant beneficial and adverse effects UDon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the L WRP policy standards and conditions contained in the consistency review law. Thus. each answer must be eXDlained in detail. listinl! both SUDDortinl! and non- supportiOl! facts. If an action cannot be certified as consistent with the L WRP policy standards and conditions, it shall not be undertaken. A copy of the L WRP is available in the following places: online at the Town of Southold's website (southoldtOWll.northfork.net), the Board ofTmstees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 31 13 4 PROJECT NAME W. Bruce Bollman The Application has been submitted to (check appropriate response): Town Board G Planning Board G Building Dept G Board of Trustees ~ 1. Category of Town of South old agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) G G (b) Financial assistance (e,g. grant, loan, sllbsidy) (c) Permit, approval, license, certification: o Nature and extent of action: Application for a coastal erosion permit to allow for construction activity seaward of the coastal erosion zone for a one family dwelling to be constructed which will be landward of the coastal erosion zone. FROM : SOUTHOLD TOWN PLANNI~OARD FAX NO. 631 765 3136 ~ Nov. 18 2005 11:51AM P2 " ,. Location of action: 1755 Trumans P~th. Eas..:L M;;Jr; nn, Ne.w-YOH -"-- Site acreage: 9878.29 sq. ft. _.__--.--.- Pr~Mtl~d~e: one family dwelling (now demolished) and detached two car garage Present ~oning classification: Residential 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: Ca) Name of applicant: , W. Bruce Bollman (b) Mailing address: 208 Main street Greenport, New York 11944 Cc) Telephone number: Area Code C ) 631-477-0023 Cd) Application number, ifany: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes 0 No~ If yes, which state or feder'dl agency? C. Evaluate the project to the following policies by analyzing how the project will furthel' support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLlCY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient nse of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. []Yes 0 No 0 Not Applicable See Attached Schedule Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources ofthe Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria G Yes G No [i] Not Applicable SEE Attached Schedule FROM SOUTHOLD TOWN PLANNI~ARD FAX NO. 631 765 3136 . Nov, 18 2005 11:52AM Pi , Attach additional sheets ifncccssary Policy 3. Enhance visual quality and pl"otect scenic J'esources tbrougbout tbe Town of Southold. See LWRP Section lJI - Policies Pages 6 tbrougb 7 for evaluation criteria Cd Yes G No [!j NotApplicable See Attached Schedule Attach additional sheets if ncccssary NATURAL COAST POLICIES Policy 4. Minimize loss of life, stl"uctures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria G Yes G No [2B Not Applicable See Attached Schedule Attach additional sheets if necessary Policy S. Protect and improve water quality and supply in tbe TOwn of Soutbold. See L WRP Section m - Policies Pages 16 through 21 for evaluation criteria [!3 Yes G No GNotAPplicable See Attacned Schedule Attach additional sheels ifDeccssary Policy 6. Protect and restol"e the quality and function of the Town of Soutbold ecosystems including Significant Coastal Fisb and Wildlife Habitats and wetlands. See LWRP Section II1- Policies; Pages 22 through 32 for evaluation criteria. [!3 Yes G No G Not Applicable See Attached Schedule FROM : SOUTHOLD TOWN PLANNIN~ARD FAX NO. : 631 765 3136 . Nov. 18 2005 11: 53AM P2 , Attach additional sheels ifnecessary'---,. ....,." Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section m _ Policies Pages 32 thl'ough 34 for evaluation criteria. G Yes G No ~ Not Applicable See Attached Schedule Anach addition.1 sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hlU:al'dous substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria. G Yes 0 No Iia Not Applicable See Attached Schedule PUBLIC COAST POLICIES Policy 9. Provide for public access to, and l'eereational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for eValuatioD critel'ia. CO Yes 0 No ~ Not Applicable See Attached Schedule Attach additional sheels if necessary WORKING COAST POLICIES FROM : SOUTHOLD TOWN PLANNIN~ARD FAX NO. : 631 765 3136 . Nov. 18 2005 11:53AM P3 ~ Policv 10. Protect Southold's water-dependent nses and promote siting of new water-dependent uses in suitable locations. See LWRP Section 1I1- Policies; Pages 47 tbrough S6 for evaluation criteria. G Yes 0 No [il Not Applicable See ~~~a~h~d Schedul~ Attaeh additional sbeets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconk Estuary and TOWn waters. See L WRP Section 111- Policies; Pages 57 through 62 for evaluation criteria. [!3 Yes 0 No G Not Applicable See Attached Schedule Attach addition.l sheets if necessary Policy 12. Protect llgriculturallands ill the Town of Southold. See L WRP Section III - Policies; Pages 62 through 65 for evaluatioll criteria. [!J Yes 0 NoG Not Applicable See Attached Schedule Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 6S through 68 for evaluation criteria. ~ Yes 0 No ca Not Applicable See Attached Schedule A .-:. -::: -,..~ PREPARED By;'/I' ~I ~,JIf7I1(Av\ TITLE (.5Q UW 6((.(('5 of HfrRYEy 1fR-II1JFr Amended on 8/1/05 1t-t:;C:, ~oo--Nolt:.e Ave- R ~l!e0e...-J./ NY 11701 DATE~) . . RIDER TO PART C DEVELOPED COAST POLICY Policy 1. The submitted plan fosters a pattern of development that enhances community character, preserves open space, makes sufficient use of infrastructure, makes beneficial use of coastal location, and minimizes adverse affects of development in the following manner. The application seeks to rebuild an existing location upon the same dimensional footprint as the previously existing building on the location was constructed. This preserves the community character of the Town of South old and it preserves other open spaces while rehabilitating already developed areas. The instant application makes beneficial use of the coastal locations and minimizes adverse effects or development in that it is rehabilitating and reconstructing already existing development which currently has infrastructure in place. Policy 2. Policy is not applicable to present application as the present structure was not historical and there were no archeological resources involved in the property. Policy 3. The proposed application and building does not impact the visual quality and protects any resources throughout the Town of South old in that it redevelopment of an already existing business/home. While the applicant believes that it is a major esthetic improvement over the previously existing one family home, this is totally a subjective determination and there is neither a decrease or increase in the visual quality and protection of the scenic resources. NATURAL COAST POLICIES Policy 4. The instant application applicability to minimizing the loss of life structures and natural resources from flooding and erosion is not applicable to the instant application as the instant application simply seeks to reconstruct a one family dwelling on an already existing footprint. It marginally increases the minimization of lose of life, structures and natural resources from flooding and erosion through better design and the addition of runoff retention devices. . . Policy 5. The instant application protects and approves water quality and supply in the Town of Southold by the updating of the septic system and the enhancement of drywells on the property in order to control runoff into the natural resources. Policy 6. The instant application protects the quality and function of the Town of South old ecosystem in that it provides runoff retention measures which decrease point source pollution and allows natural habitats to better restore themselves without these intrusions. Policy 7. The instant application will not protect and improve air quality in the Town of South old nor will it decrease or impair the air quality in the Town of Southold. The reconstruction of a single family home will have no measurable impacts on air quality. Policy 8. The instant application will have no effect on the environmental degradation in the Town of Southold from solid waste and hazardous substances and wastes. The reconstruction of the home has negligible or no effect on solid waste in the Town of Southold and it is a redevelopment of a single one story home. PUBLIC COAST POLICIES Policy 9. The instant application does not provide for public access, to and recreational use of coastal waters, public lands, and public resources of the Town of South old as it is a redevelopment of a single family home. WORKING COAST POLICIES Policy 10. The instant application is not applicable to maintaining or protecting Southold's water dependent uses in promoting or citing of new water dependent uses in suitable locations in that the present location is zoned residential and the application seeks to rebuild a residential home on the location. Policy 11. The instant project promotes sustainable living marine resources in the Long Island . . . . Sound, the Peconic Estuary and town waters by providing for improved dry well capturing of gutter leaders, roof runoff which prevents possible point source pollution which could negatively affect ecosystems and habitats. The instant application exceeds the configuration of the previously existing house as it provides better protection for roof runoff recapture. Policy 12. The instant application protects agricultural lands in the Town of Southold by redeveloping already developed parcel instead of developing "virgin, natural, undeveloped or agricultural lands". Policy 13. The instant application promotes appropriate use and development of energy and mineral resources in that the new construction and redevelop many of this single family house uses significantly better energy efficient design and is compliant with the local building codes which have been strengthened in this regard over the codes in place at the time of the earlier construction. . . MAIliNG ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE WCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 WILLIAM J. CREMERS KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair PLANNING BOARD OFFICE TOWN OF SOUTHOLD To: Town of South old Board of Trustees From: Mark Terry, Senior Environmental Planner L WRP Coordinator. ,"-' ~,y-J) Date: November 15, 2005 Re: Request for Coastal Zone Permit for Bruce Bollman SCTM#1000-3l-l3-4 Bruce Bollman requests a Coastal Zone Permit to construct a single-family dwelling, driveway and new sanitary system. Located: Truman's Path, East Marion. The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the Town of South old Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. It is mv determination that the LWRP Consistencv Assessment Form submitted to vour department unsil!ned and undated. is incomplete (all policv standards are marked not applicable). A recommendation cannot be given to the Board at this time. Please have the applicant sign and date the form and assess if tbe proposed action will or will not support the LWRP policies and resubmit the form to your department. In addition, please have the applicant identify the top of bluff on tbe survey. The most applicable include but are not limited to the following: Policy Standard 4.1 Minimize losses of human life and structures from flooding and erosion hazards. The following management measures to minimize losses of human life and structures from flooding and erosion hazards are suggested: A. Minimize potential loss and damage by locating development and structures away from flooding and erosion hazards. 1. Avoid development other than water-dependent uses in coastal hazard areas. Locate new development which is not water-dependent as far away from coastal hazard areas as practical. a. No development is permitted in natural protective feature areas, except as specifically allowed under the relevant portions of 6 NYCRR 505.8. b. Avoid hazards bv sitinl! structures to maximize the distance from Coastal Erosion Hazard Areas. . . 5. Manage development in floodplains outside of coastal hazard areas so as to reduce adverse environmental effects, minimize the need for future structural flood protection measures, or expansion of existing protection measures and to meet federal flood insurance program standards. Policv Standard 5.1 Prohibit direct or indirect discharges that would cause or contribute to contravention of water quality standards. B. Prevent point source discharges into Southold's coastal waters and manage or avoid land and water uses that would: 1. exceed applicable effluent limitations, or 2. cause or contribute to contravention of water quality classification and use standards, or 3. adversely affect receiving water quality, or 4. be contrary to Phase III of the Long Island Sound Study's Nitrogen Reduction Plan which calls for a 58.5% Sound-wide reduction in nitrogen levels.' C. Ensure effective treatment of sanitary sewage and industrial discharges by: 8. providing and managing on-site disposal systems: a. use on-site disposal systems only when impractical to connect with public sewer systems, b. protect surface and groundwater against contamination from pathogens and excessive nutrient loading by keeping septic effluent separated from groundwater and by providing adequate treatment of septic effluent, c. encourage the evaluation and implementation of alternative or innovative on-site sanitary waste systems to remediate on-site systems that currently do not adequately treat or separate effluent, d. encourage the use of alternative or innovative on-site sanitary waste systems where development or redevelopment of grandfathered parcels would otherwise increase the level of negative impacts on ground or surface waters, including wetlands. 5.2 Minimize non-point pollution of coastal waters and manage activities causing non- point pollution. A. Minimize non-point pollution of coastal waters using the following approaches, which are presented in order of priority. 1. Avoid non-point pollution by limiting non-point sources. a. Reduce or eliminate introduction of materials which may contribute to non-point pollution. b. Avoid activities which would increase off-site stormwater runoff and transport of pollutants. c. Control and manage stormwater runoff to: . minimize transport of pollutants . restore sites to emulate natural stormwater runoff conditions where degraded stormwater runoff conditions exist . . . achieve no net increase of runoff where unimpaired stormwater runoff conditions exist 2. Reduce pollutant loads to coastal waters by managing unavoidable non-point sources and by using appropriate best management practices as determined by site characteristics, design standards, operational conditions, and maintenance programs. Policy Standard 5.4 Limit the potential for adverse impacts of watershed development on water qnality and quantity. A. Protect water quality by ensuring that proposed expansion or intensification of existing watershed development results in: I. protection of areas that provide important water quality benefits 2. maintenance of natural characteristics of drainage systems, and 3. protection of areas that are particularly susceptible to erosion and sediment loss B. Limit the individual impacts associated with development to prevent cumulative water quality impacts which would lead to a failure to meet water quality standards. Policy Standard 5.5 Protect and conserve the quality and quantity of potable water. A. Prevent contamination of potable waters by limiting discharges of pollutants to maintain water quality according to water quality classification, and limiting, discouraging or prohibiting land use practices that are likely to contribute to contravention of surface and groundwater quality classifications for potable water supplies. B. Prevent depletion of existing potable water supplies by limiting saltwater intrusion in aquifers and estuaries, through conservation methods or restrictions on water supply use and withdrawals, and by allowing for recharge of potable aquifers. C. Limit cumulative impact of development on groundwater recharge areas to ensure replenishment of potable groundwater supplies. Policy Standard 6.1 Protect and restore ecological quality throughout the Town of South old. Policy Standard 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction . . 1. Complv with Trustee rel!ulations and recommendations as set forth in Trustee permit conditions. B. Comply with statutory and regulatory requirements of the State's wetland laws. 3. Comply with the regulatory requirements of the Tidal Wetlands Act for the protection of mapped tidal wetlands including coastal fresh marsh; intertidal marsh; coastal shoals, bars and flats; high marsh or salt meadow; littoral zones; and formerly connected tidal wetlands. D. Provide adequate buffers between wetlands and adjacent or nearby uses and activities in order to ensure protection of the wetland's character, quality, values, and functions. The adequacy ofthe buffer depends on the following factors: 1. Potential for adverse effects associated with the use. Uses such as those involving hazardous materials, on-site sewage disposal, or mineral extraction have high potential for adverse effects and may require substantial buffer. 2. The nature and importance of the wetland and its benefits. Substantial buffers may be necessary to avoid adverse effects from adjacent or nearby uses based on the nature of the land use and the characteristics of the affected wetland. 3. Direction and flow of surface water between a use and adjacent or nearby wetland. Buffer widths may be reduced in areas where drainage patterns normally do not lead directly to the wetland and where adverse affects on the wetland, other than those due to runoff, are not likely. 4. Buffer width necessary to achieve a high particulate filtration efficiency of surface runoff as determined by vegetative cover type, soil characteristics, and slope of land. 5. Other management measures or design alternatives to protect wetlands from adverse effects where site constraints do not allow sufficient buffer width. E. Maintain buffers to ensure that adverse effects of adjacent or nearby development are avoided: I. Maintain buffers to achieve a high filtration efficiency of surface runoff. 2. Avoid permanent or unnecessary disturbance within buffer areas. 3. Maintain existing indigenous vegetation within buffer areas. Policy Standard 9.2. Protect and provide public visual access to coastal lands and waters from public sites and transportation routes where physically practical. A. Avoid loss of existing visual access. I. Limit physical blockage of existing visual access by development or activities due to the scale, design, location, or type structures. 2. Protect view corridors provided by streets and other public areas leading to the coast. 3. Protect visual access to open space areas associated with natural resources. . . B. Minimize adverse impact on visual access. 1. Provide for view corridors to the coast in those locations where new structures would block views of the coast from inland public vantage points. 2. Use structural design and building siting techniques to preserve or retain visual access and minimize obstruction of views. 3. Visual access requirements may be reduced where site conditions, including vegetative cover or natural protective features, block potential views. 4. Vegetative or structural screening of an industrial or commercial waterfront site is allowed if the resulting overall visual quality outweighs the loss of visual access. E. Protect visual access to the natural shoreline from the water. 1. Prevent loss of natural vegetation due to excessive land clearing and inappropriate non-native landscaping. Please contact me at (631) 765-1938 if you have any questions regarding the above. . . 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 APPLICATION FOR AN AMENDMENT TO A PERMIT 1- DATE J\.lu~tN-iotr [0 I .~O( , ' I NOV 1 0 LDCS i , {,,'?Jl J!(O:::OiOsr~ OWNER W. i?J1'~L~ r?Jo\.\ vY\Ur-J PHONE ~ ~ \ ~.~ ADDRESS aut mo..,,,- h~ J Gf'C.-eApor ~ : MY 1/9ltY AGENT LI(\dc....-13U'-+u.n;, liP PHONE (,,?>t 7~'-'('q'f rJ-on" (?U,tv.I1; (~Ic-r::!..N- ADDRESS I?,fV OO-t..u)oo~ rJrllrc..... SJu.'ffiolL I My' /lqll PROPERTY LOCATION /1(\" 1(Ll.rYUuw Pv.--'f--I--. I &.rl- y'Y1CV!/M 11'1;'1 TAX MAP NO. /000 -SI-I3-DLf VWe j,U. r3ru..u. 13ot/mCL-..... request an Amendment to Permit # ~qO( b'c...e l~t-\--c,- $;","By' 4 (,lP~ ~. \:)OCIL f.: 9. (\k (O>~O ~ 1/0( ~I~ ,if 1 . . John Bertani Builder Inc. 1380 Oakwood Drive Southold, N.Y. 11971 (631) 765-1594 FAX (631) 765-3916 November 10,2005 Bollman Residence -1755 Trumans Path, East Marion, NY 11939 :- ,\ Nbert J. Krupski, President Soulhold Town Board of Trustees P.O. Box 1179 Southold, NY 11971 NOV , 2CGS Dear Mr. Krupski: i I L.__..__'-. SCTM # 1000.31-13-04 We are applying for an EMERGENCY coastal erosion permit for the above as follows: The proposed new construction is land ward of the coastal erosion zone, however, in the course of clearing for the purpose of installing a new foundation after the existing one was found structurally unsafe, the excavation over cut for the new foundation caused approximately 32 square feet of activity seaward of the zone line. The material already removed was an existing lawn and when the foundation is completed, back filled and the home construction complete this area will become lawn again. The properties to the east, west and Mr. Bollman's properties are being compromised by erosion due to the duration of the new permit application process to allow installation of the new foundation. If there is any other information you need please do not hesitate to call. Thank you. Sincerely, ~d,- ~. r3.iX~ . Linda D. Bertani Vice President r -d srse:ssl.re:s s~apIJnH ~u~~~aH dl.e::e:O so or ^O~ Nov 10 05 03:45p Bertani Builders . 6317653916 . p.2 John Bertani Builder Inc. 1380 Oakwood Drive Southold, N.Y. 11971 (631) 765-1594 FAX (631) 765-3916 November 10, 2005 Bollman Residence -1755 Trumans Path, East Marion, NY 11939 Albert J. Krupski, President Southold Town Board of Trustees P.O. Box 1179 SOulhold, NY 11971 Dear Mr. Krupski: SCTM # 1000-31-13-04 We would like to amend the permit application for the above as follows: As per the ZBA decision of October 27, 2005, it has been determined that the location of a new dwelling and small addition which was to be buill on the original footprint of the former home on this property be moved 2.6 to the east to make the side yard on that side a minimum of 10 feet and as per the Suffolk County Department of Health Services abandon the existing septic system and install a new septic system in the area shown on the attached survey which will be less than 100 feet from the existing bulkhead. If there is any other information you need please do not hesitate to call. Thank you. Sincerely, ~ \"'1.2 . i'-"Juul()... ~ .IO.f2~"--' Linda D. Bertani Vice President Nav 10 05 03:45p Bertani Builders . .6317653916 p.1 John Bertani Builder Inc. 1380 Oakwood Drive Southold. NY. 11971 (631) 765-1594 FAX (631) 765-3916 I /) l )" C1O--wlLJ---J YJ /\f{u.~ ~ "e,2 /,--'( 02. to At-V- f ~cL.L I~~ ~h(/u...{ rL- ~ /t/-uu... Gd ~ ~~~ ~?-- h o...e-.lc-> \\ c:-~tL~ r B~d of Trustees APPlicatio~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: C(S'/\..I-\.cu.c..-t- u-. \'\[" W 01'L. -fr....m It rTW~ J tu~ . dwe...\\'''1 two re.e.,1- to.-ur 0+ '+/-..u {,wl-jlrd\+-o~ ().../ D(\Ee- J"\-o(YdvLi\\n8' '" Iv..t'-<\vo-ro....o^' Q.O()-4""'V-\ (~IOJ\""<'- -wru.... bu.--T wO'-L\<L "'\)D\\,~ ~~,,,,.L:h0-.- ci..J:,,-hu,t-~ Are wetlands present within 100 feet of the proposed activity? \ ^ 0. f)' "-f enJ'!' ()I."'- i-<... <31.. ~ / ~ c.c.+- v\... ~ '-'-.".)~ D<r u, ",it...- \ No 'res e.ru~ \tJY'., I,...... Does the project involve excavation or filling? No / 'res If 'res, how much material will be excavated? 1.11(\ (cubic yards) o..I~ ~U4a...1<-JJ How much material will be filled? I.t k-( (cubic yards) - Manner in which material will be removed or deposited: ma...~e.r,,,,- \ , ()...\R~ rc..m~'{,,& - \,.\\\\ lo~ N'f\tH'c1~ ,.JI'-U-.Stl~_ ',:lo-d..er Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) Q...rc:.a. O--\~ f'-'f~(J-.1JCL.t" <i..- ,,)"-<:) \u...w>" (U'-J- \..uk" h\w I w\\\ fu(\()t'N...- \l'i.MJ1\ CL6iU.:"'- Boar~f ~Tustees APplication ~ .. County of Suffolk State of New York W. (!JrtLt r. l11)lImc...,-, BEING ,DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. BEFORE ME THIS ~ / D DAY OFI)~ ,flt-YJO';- .. Notary Public Veronica F. Cidone Notary Public. State of New York No: 52-4661406 Q~al.ifjed in Suffolk Coun~ ,.,.- Commission Expires Dec.31 #)'D,:;) 7 . PROOF OF MAILING OF NOTICE ATTACH .cERTWlliD MAiL RECEIPTS Name: (i\!. Je.nI\\L Go....l~ J' Ofe... re.rd-2- Address: p. 0.. P.,1If '32- I Eo...r -to m 0.<-. ~ A.J L{ II'dCj 6ru... ((otl.e..\ci \e.r PI,,2<\.., ~ .l\-~ll)or N e...>a~ I ~ ~ \ 00'2..0 (fo\,\>", 'T. 6o<}f'- [r J..rr.l'r<. Yo Son" :r~O(f-1' r' 310 \...Uoo<L-IG<./'..c!,; Avu m/J.^o",~IW\ M. ~ ileN., ..D Cl <r LO ~ ,fw>>1 ;g Po,t.., $ O.:n ::siding at \?>~ O~ooc... Orl'J-<_ ru e,rtifiadF" 2.30 po"mart< eingd!llYJ>w()m,_g~o~~_ands.ll~that on the g R.tum R,,~ptF" 1.1'5 H." 0 01, deponent mailed a true copy of the-Notice Cl (End""m,n' Raq,,,ad) Clerk: KKQlIlO lication, directed to each of the above named o Restricted Delivery,Fee l.. ti' th th address ..D (End""m.n' Raq",ad) "ere respec ve names; at e es set ~ Tota' Postag" Fe" $ 4.112 11128/05 ,the address of said persons as shown on the current LO ld; that said Notices were mailed at the United States Post g s,ntTO r\\C:;;r~r~______~1.?-p_--.__nnnn_----J*-f( that said Notices were mailed to each of said persons by r'- Sf,~~:t:~:.; DN- (?oc..U.,fd.\if_.....J~?A..~l--..--J ~j&:.Si.i.;Zi"'4tJW..- IOOL C:)f!.Jk ::::J. 13.ui~ Sworn to before me this ;)<(11-( Day of_'1-.1 ou ,20 DS- ~~':;:.;J ~ Q) r 'CJ' l.-~ Y\'\ \ J- <!.- . Notary Public LYNDA M BOHN NOTARY PUBLIC, State of NewYorf< NO. 01 B06020932, Suffolk County - Term Expires March 8, 2O..a..l .ard 6~ ~tees APPlicatie AUTHORIZATION (where the applicant is not the owner) ..- I, Lu. 61'ut.-e. l1011 mc...__ (print owner of property) residing at ..2& r1Icur- S J-r"e...f' (mailing address) G~ot+, NY i1qcf'f do hereby authorize /....111,4,_ f'1iffwl/, if (Agent) :khY1 r6u1Mi r31Ll1~tr:I:AC/ to apply for permit(s) from the Southold Board of ~own Trustees on my behalf. (Owner's signature) 8 '\ , . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Han 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-Wl@<f!fJfolIl BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ---1u~-6U-t..D...._ID..DLL1::Oa..q.___________________ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, L I (\~ v.. ,3u+CU'I; , residing at I?' f1) OcJ::.o.>>OOd.-- On ~ I J'Ovl'I-ALllv being duly sworn, depose and say: ~ Yl /' That on the 2.l day of '10 , 200~, I personally posted the property known as ~sr l.u..rNu\..O Po.-Th. Sc.xm<tt. \OOO-~\- \1>-~ by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held U./~. /) ~(', 02' I d 00 r o 1{ fYI a6lYJr I);Q) pm. N~ /I q '71 Dated: ~1Ui"- i:::J ' 13.uli:A-.., (si ature) Sworn to before me this J. ~ day of N"l 200 f> ~ 'rY\b.-O, otary ubhc L YNOA M BOHN NOTARY PUBLIC, Slate 01 New York NOT' 01 B06020932, Suffolk County erm Expires March 8, 20d1 . . . APPLlCANT/AGENTIREPRESENtATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the Dart arroW" officers and emnlovees. The DUrnaSe of this (onn is to nrovide information which can alert the town of DOssihle confliw of interest 8Ild allow it 10 take whatever action is necessarv to avoid same. . YOUR NAME: W. BI'/,l.u..- f?>oll/Ylt4--- (Last name, fIrst name, l/liddle initial, unless you are applying in the name of someone else or other entity, such as a company. If SOt indicate the other person's or company's name.) -, NAME OF APPLICA TJON: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning (~mffid.O"\(J\t- t-o e><?\~ tf, Is fum It Do you personally (or through your company, spouse, sibling, paren~ or child) have a relationship with any officer or employee of the Town of Southatd? "'Relationship" includes by blood, marriage, or business interest "Business interest'~ means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO"/ If you answered "YES", complete the balance of this fonn and date and sign where indicated. Name of person employed by the Town of South old Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, paren~ or child is (check all that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the applic\lllt (when the applicant is a corporation); . _B) the legal or.beneficial owner of any interest in a non-<:orporate entity (when the applicant is not a corporation); _ C) an officer, director, parmer, or employee of the applican~ or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP / 200~ Submitted this 10 'IL day of NUre.n..h,"'" Signature Print Name 10. f3"W'.i' /'30 lime..- Form TS I - - -- -- ----- Town of Southold LWRP CONSISTENCY ASSESSMENT FORM NOV l"i 2:;.J5 , A. INSTRUCTIONS ~__ _ __- j . \ 1. All applicants for permits* including Town of Southold agen~s, shalL-60mplElte'this ~CA!J for proposed actions that are subject to the Town of Southold Watemont LonslstencY-Iieview Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. * Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the L WRP policy standards and conditions contained in the consistency review law. Thus. each answer must be explained in detail. Iistinl! both supportinl! and noo- suPportiDl! facts. If an action cannot be celtified as consistent with the L WRP policy standards and conditions, it shall not be undertaken. A copy of the L WRP is available in the following places: online at the Town of Southold 's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 3 \ \~ Lf l...U, B (' u.LL. (oj 0 \ \ \'Y1 0. ^ I< €..-J' \ ~ e 1\ u.-J PROJECT NAME The Application has been submitted to (check appropriate response): Town Board 0 Planning Board 0 Building Dept. 0 Board of Trustees IRl I. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) o o (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: [Xl Nature and extent of action: ~?\\e.Lu-\'II~ t-or 7XY\et'l.e.l\.0--1 rl\r'-"'l\-r. I e rO"'I~ (.)(f'fl\',+- I I I .\-or 1>1.. Sc"u.u...re.... f-e...tT (a-rprvy:) Ot- o...c.....i-.:\.,'"', IIV St'fU.JCu--~ ~ --fur CAfe.(L.)(.l-4-I~ o,,-e..!L.u-.+ -fnr INt-(,...Ua.*,,~ O~ Y\ew --k>,,-^ck,..~~ G"d St6ESSl.tES s~apl~nH ~ue~~a8 dl.E:EO so Ot ^O~ . . Location of action: \ "I ss-T(u...~~n...\.. Po..:tL Site acreage: Ci, 'X" let .1'1 cl\'+ \- Present land use: Dne.. .t-r.l..(T'''\j c\UJ-(...i\\~8c.l"\')t.,U Present zoning classification: ru \l'l..f'\~ c- \ CCL-.rt- (Y\ U/'\ CI"'- J d.e.moh"~ ,r\ ") 6-."c- (/,(,.:lu..ukd.- .J.. C t..< () W'CJ.-!J' 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: L0. ~rWJ-. &0 \ \0'0.. "-' (b) Mailing address: J20k m 0-\" ~ -\-n:.e. +- (9't.e..\'\..ror~. j\J~ \\q'-'i'1 (c) Telephone number: Area Code ~9-TI.'l - Oo;;l b (d) Application number, ifany: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes D NoL81 If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. ljYes D No ~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria D Yes D No I8J Not Applicable E'c1 916ES91.1E9 s~apI~n8 ~ue~~a8 c1l.E:EO so 01 ^O~ . . Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See L WRP Section III - Policies Pages 6 through 7 for evaluation criteria DYes 0 No ~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria DYes 0 No ~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of South old. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria DYes 0 No ~NotApplicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria, o o ~ j,'d S16E5S1.1ES s~apl~nB ~ue~~aH dl.E:EO 50 01 ^ON . . Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. DYes 0 No IZI Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria. DYes 0 No ~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. DYeD No IZI Not Applicable Attach additional sheets if necessary S.d S16ESS1.1ES s~apl~n8 ~ue~~a8 dBE:EO SO 01 ^D~ . . WORKING COAST POLICIES Polley 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See L WRP Section I1I- Policies; Pages 47 through S6 for evaluation criteria. DYes 0 No ~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria. DYes 0 No 1ZI Not Applicable Attach additional sheets ifnecessary Policy 12. Protect agricuIturallands in the Town of Southold. See L WRP Section III - Policies; Pages 62 through 65 for evaluation criteria. DYes 0 No ~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See L \VRP Section III - Policies; Pages 65 through 68 for evaluation criteria. DYes 0 No ~ Not Applicable PREPARED BY TITLE DATE S'd SlSE5S1.1ES s~apl~na ~ue~~aH dSE:EO 50 01 ^O~ . . John Bertani Builder Inc. 1380 Oakwood Drive Southold, N.Y. 11971 (631) 765-1594 FAX (631) 765-3916 November 10, 2005 Bollman Residence - 1755 Trumans Path, East Marion, NY 11939 Albert J. Krupski, President Southold Town Board of Trustees P.O. Box 1179 Southold, NY 11971 Dear Mr. Krupski: SCTM # 100G-31-13-04 We would like to amend the permit application for the above as follows: As per the ZBA decision of October 27, 2005, it has been determined that the location of a new dwelling and small addition which was to be built on the original footprint of the former home on this property be moved two feet to the east to make the side yard on that side a minimum of ten feet and as per the Suffolk County Department of Health Services abandon the existing septic system and install a new septic system in the area shown on the attached survey which will be less than 100 feet from the existing bulkhead. If there is any other information you need please do not hesitate to call. Thank you. Sincerely, \ (jj~"-d,-~' /~ Linda D. Bertani Vice President -----. r (,'f\'.! n 2'2:G5 i',U\, , t PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: m.s. .Jen nl e... 60 LLI cL- Po. 00{. 3.::u, Eu.-j't- f1lc"nuf\. /liLf !19:Yj Juse- Pe...I'e--r"l-- l)6"3> C(J..r,,:~_( St.J'yJt-. ~ jJl(./VY!IJ7TO...i ~u\'\{)T b~'i1c,-~r Trr\ri 61b-S-O~(\ JYe..VLr'\ ba,,- STATE OF NEW YORK COUNTY OF SUFFOLK J...,nc.<---16er+o.n: ,residing at IMv Otl...t.-w(}0~ (){,:u ~OLLrf,O 1cL- JJ'j II qll , being duly sworn, deposes and says that on the J'-rL. day of 0f.r,'\ . 20~ 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 ron of the Town of Southold; that said Notices were mailed at the United States Post Office at (lOll 't-f, 0 \<L- , that said Notices were mailed to each of said persons by (certified) (reglsterea) lftftil. '310 WOoQ.JW\d....- ~ I (Y'0.I\O(v, \le- MY l\q~4 ctLA~ ~> Sworn to before me this f?'l-i& Day of O~ ,20~ ~~t (J mhf'f/ Notary ublic LINDA J, ((}Jr:-;.::R Notary Public, Slate of N.w York f,,:,,' "~~,:,,,:.~:::.,,:! C,,!' 'l. C . .. .." '. 1""'-' .t,. ,'I},/<., ,,("-'.tnty . ,. ''', <ei:ioO,b . .. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 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 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: 3 ~ \ '1 - 0 -, Name of Applicant: Go\\ rf\vtJ Name of Agent: k~,,; Property Location: SCTM# & Street Brief Description of proposed action: S)(,~J fL""".\- Type of area to be impacted: Saltwater Wetland Freshwater Wetland _Sound Front _Bay Front Distance of proposed work to edge of above: Pay( of Town Cqde proposed work falls under: ~Chapt.97 ....{Chapt. 37 _other Type of Application: J Wetland J Coastal Erosion _Amendment _Administrative _Emergency Info needed: C~Ll- -f-r ~\l~') ~I~ Ch ~v-I~kc..J..d--A""L Modifications: 'E\u...e. {~ Or W\>u).. r""n- -fUr ~ ~ lc.-t,,.,,, W1<11.. ""'j ~... en."",,- f"'~ Conditions: J 1/ J j Present Were: _J.King _J.Doherty _P.Dickerson _D. Bergen Other: J Bob Ghosio, Jr. MailedIFaxed to: Date: Comments of Environmental Technician: Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . 6 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 YOU ARE REQUIRED TO CONTACT THE OFFICE 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 151 day of construction Yo constructed L Project complete, compliance inspection. . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 March 22, 2006 Mrs. Linda Bertaini John Bertani Builder Inc. 1380 Oakwood Dr. Southold, NY 11971 RE: W. BRUCE BOLLMAN 1755 TRUMAN'S PATH, EAST MARION SCTM#31-13-4 Dear Mrs. Bertani: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 22, 2006: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Permit #5901, as issued on April 21,2004 and amended on December 21,2005. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, rd<~ James F. King President, Board of Trustees JFK:lms . . 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 COASTAL EROSION MANAGEMENT PERMIT Permit #6263C Date: December 21, 2005 SCTM#31-13-4 Name of ApplicanUAgent: John Bertaini Builder, Inc. Name of Permittee: W. Bruce Bollman Address of Permittee: 1755 Truman's Path, East Marion Property Located: 1755 Truman's Path, East Marion DESCRIPTION OF ACTIVITY: Coastal Erosion Permit to allow for the construction activity in an approx. 108 sq.ft. section seaward of the CEHA. The Coastal Erosion Management Permit allows for the operations as indicated on the planting plan received on January 5, 2006 and the survey prepared by Joseph A. Ingegno last dated December 22, 2005. Permit to construct and complete project will expire two years from the date the permit is signed. SPECIAL CONDITIONS: (apply If marked) ---X Bluff restoration through a re-vegetation plan is a necessary special condition of this permit. _ A relocation agreement is attached hereto and is a necessary special condition of this permit. _ A maintenance agreement is attached with application and is a necessary special condition of this permit. l'~.f 9. ~.. ~ Albert J. Krupski, Jr. . President, Board of Trustees . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Towo 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 December 21, 2005 Mrs. Linda Bertani John Bertani Builder, Inc. 1380 Oakwood Dr. Southold, NY 11971 RE: W. BRUCE BOLLMAN 1755 TRUMAN'S PATH, EAST MARION SCTM#31.13-4 Dear Mrs. Bertani: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, December 21,2005: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5901 to move the footprint of the dwelling 2.6' to the east, abandon the existing sanitary system and install a new sanitary system, with the condition the disturbed areas seaward of the dwelling are replanted in accordance with the planting plan received on January 5, 2006, and all as depicted on the survey prepared by Joseph A. Ingegno last dated December 22, 2005. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, ~.$9. ~..t}. Albert J. Krupski, Jr. President, Board of Trustees AJK:lms ~ I 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 Wed., December 14, 2005, the following recommendation was made: Moved by Jack McGreevy, seconded by Don Wilder, it was RESOLVED to recommend to the Southold Town Board ofTrustees APPROVAL WITH A CONDITION of the application of W. BRUCE BOLLMAN to Amend Permit #5901 to move the footprint of the dwelling 2.6' to the east, abandon the existing septic system and install a new septic system, and a Coastal Erosion Permit to allow for the construction activity in an approx. 32 sq.ft. section seaward of the CEHA. Located: 1755 Truman's Path, East Marion. SCTM#31-13-4 The CAC recommends Approval of the application with the Condition the seaward side of the house is planted with native species after construction and a retaining wall is installed on the southwest corner of the property. Vote of Council: Ayes: All Motion Carried . . JENNIFER B. GOULD Attorney at Law 210 Main Street. P.O. Box 177 . Greenport, New York 11944 Telephone631-477-8607. Fax 631-477-260t November 3, 2005 Albert J. Krupski President, Board of Trustees 53095 Main Road, P.O. Box 1179 Southold, NY 11971 RE: W. Bruce Bollman 1755 Truman's Path, East Marion, NY (SCTM # 1000-31-13-4) Trustee Permit No. 5901 (dated 4-21-2004) Dear Mr. Krupski: I am the owner of 1820 Truman's Path, East Marion, NY (SCTM # 1000-31-13-3), my property borders Mr. Bollman's property on the west. ~ In your letter dated October 19,2005, to the Board of Appeals, you stated that the new foundation at the Bollman premises is landward of the Coastal Erosion Hazard line, according to the survey revised on August 29,2005 by Joseph Ingegno Land Surveyor. However, the excavation at the Bollman premises presently extends at least 5 feet seaward of the Coastal Erosion Hazard line and is more than 10 feet deep. Any excavation in this area is defined by the Southold Town Code as a regulated activity and requires a permit issued by the Board of Trustees as the Administrator. See Sections 37- 6; 37-11; 37-12; & 37-13 under Southold Town Code, Chapter 37, Coastal Erosion Hazard Areas. Enclosed please find 3 photos taken in September 2005 of the Bollman excavation. Mr. Bollman needs a Coastal Erosion Permit; before a building permit may be issued pursuant to the Board of Appeals decision rendered October 27, 2005. A copy of the ZBA decision is attached. , In addition, Mr. Bollman needs Trustee approval for construction of a new septic system that is proposed in an area of his property that is within 100 feet ofthe Bluffline, in contravention of the setbacks mandated by Southold Town Code Section 97-12 D. (I )(b )[2]. Trustee Permit No. 5901 was issued based on a survey dated May 6, 2004 by Joseph A. Ingegno Land Surveyor that did not include any plap {0!31!le.'Y2(:ptic;_~ystem. NOV - 3 20GJ I , . . On December 28,2004, the Ingegno survey of the Bollman premises was updated to show the addition of the proposed septic system; it appears on all subsequent surveys of the Bollman premises. In conclusion, if Mr. Bollman intends to proceed with his project as proposed and approved by the ZBA, he must apply for a Coastal Erosion Permit and a Trustee's Permit, both subject to notice and public hearing, before any building permit may be issued. If you have any questions regarding this matter, please contact me. Very truly yours, ifer B. Gould Enclosure cc: Michael lVerity, Chief Building Inspector Board of Appeals 2 . .J . APPEALS BOARD MEMBER Ruth D. Oliva, Chairwoman Gerard P. Goehringer Vincent Orlando James Dinizio, Jr. Michael A. Simon ei Southold Town Hall 53095 Main Road. P.O. Box 1179 Southold, NY 11971-0959 Office Location: Town Annex /First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809. Fax (631) 765-9064 , ,- L RECEIVED J.- Fe.. tJ:,3 d ~ . OCT 3 1 2005 ~;ttdla n~u'/l~ So 13D:U16old Tow~(7e';k~ FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF OCTOBER 27, 2005 ZBA Rehearing File Ref. 5680 - W. BRUCE and MARY ANN BOLLMAN Property Location: 1755 Trumans Path, East Marion CTM 31-13-4 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicants' 9,878.29 sq. ft. parcel has 50 feet along Truman's Path and 206.07 feet along the south/westerly side property line. The one-story, single-family dwelling was recently removed, and the accessory garage building remains as shown on the April 3, 2002 survey, last amended March 7, 2005 by Joseph A. Ingegno, L.S. BASIS OF APPLICATION: Building Department's Notices of Disapproval, issued February 3, 2005 and amended March 31,2005, citing Sections 100-239.4B and 100-244 in its denial of an application for a building permit to substantially remove (or demolish), and construct a new single-family dwelling. The reasons stated in the Notices of Disapproval are that the new construction: (1) will be less than 10 feet on a single side, (2) will be less than 25 feet combined side yards, (3) will be less than 75 feet from the bulkhead, and (4) will have lot coverage exceeding the code limitation of 20 percent. FINDINGS OF FACT The Zoning Board of Appeals ('ZBA') held a public hearing on the rehearing of this application on October 20, 2005, at which time written and oral evidence were presented. The entire file and transcripts of the previous hearings regarding the original application under Appeal No. 5680 held on March 31, 2005 and May 4, 2005 were also entered into this rehearing record. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: ZBA DETERMINATION RENDERED MAY 12, 2005 for AREA VARIANCE RELIEF: In a decision rendered May 12, 2005, the ZBA granted applicant's request to retain the existing nonconforming location of the foundation, with reconstruction of the dwelling on the first and second floor and enlargement with small addition, as shown on the March 7, 2005 amended survey prepared by Joseph A. Ingegno, L.S. The relief granted was related to the location of the new construction areas, as follows: (a) minimum setback at 10 feet for the second-story from the westerly side property line and minimum 5.9 feet from the existing foundation measurement to the westerly side property line, (b) minimum setback at 12.6 feet from the easterly side property line at its closest point, (c) lot coverage at 21 % (exclusive of waterfront dock, walks, apron, and minor step areas), and (d) setback at 35.2 feet from the bulkhead, at its closest point. , Page 2 - October 27, 2005 . ZB Ref. 5680 - W. Bruce and M. BOlo,,, elM 10: 31-13-4 . During the first Appeal under File No. 5680, hearings were held on March 31, 2005 and May 4, 2005 and testimony indicating that the existing block foundation would not be removed or demolished because it would be too expensive, and that the foundation was stated to be structurally sound and intact, with very little work done to it and only to have the basement there for the heating system on the north side. RESOLUTION SCHEDULING DATE FOR REHEARING: At its September 1,2005 meeting, a Resolution was adopted by unanimous vote of all the members, to reopen Application No. 5680, with a rehearing date scheduled for September 29, 2005 and October 20, 2005 before the ZBA. MODIFIED REQUESTS: During the October 20, 2005 hearing, discussions were held regarding circumstances that resulted after issuance of the May 12, 2005 ZBA Grant of Alternative Relief relative to the applicant's request for variances, and the Building Department's grant of a building permit on June 28, 2005 (No. 31232-Z) concerning demolition and reconstruction of a new single-family dwelling per ZBA Decision No. 5680 and Trustees Permit: 1. Testimony was received by the applicant, the applicant's builder, and the town building inspector, indicating that a new foundation plan (ref. Page 4 of 10 prepared by Penny Lumber, date stamped August 9, 2005) was approved by the Building Department as an amendment to Building Permit No. 312320-z for new construction of the existing foundation in the same place. The Building Inspector's amendment was issued after reliance on the information furnished by the builder to the Building Department in August 2005, and the August 9, 2005 letter from the applicant's engineer as to why the foundation was unsafe to build upon. The Building Inspector also confirmed that the Building Department contacted representatives of the Trustees and ZBA Departments regarding the proposed in-place reconstruction of the unsafe section of the existing foundation that was crumbling. 2. Simultaneously with this Appeal hearing (on October 20, 2005), the ZBA received testimony under the Appeal of Jennifer Gould (ZBA No. 5681), the adjacent landowner west and closest to the new construction activities. Testimony was received concerning personal observations, activities related to the boundaries and adjacent land areas between the Gould and Bollman properties, the removal of the foundation that existed, the hole recently excavated for the entire new foundation, use of the existing accessory building over the years, building permits and amendments, as well as other extensive information. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Grant of alternative relief will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The ZBA relied upon information offered during the first Appeal in the Spring 2005 indicating that the applicant's foundation would not be removed. Since that variance determination, circumstances changed substantially. The foundation is no longer existing, and the area has been cleared and excavated, planning for construction of an entirely new foundation. Based on these circumstances, the applicant is able to relocate the dwelling to increase the setback on the westerly side yard, and to bring the yards into more conformity with the code requirement. Several other houses in the neighborhood that have similar side lines and yards related to the applicant's long and narrow lot. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The lot is only 50 feet wide. The total remaining yard area for both sides, if the dwelling were at a maximum of 29.5 feet in width, would only be 20.5+- feet, instead of the code-required 25 feet. 3. The variances granted herein is substantial. The foundation has been removed, and a more conforming side yard setback can be obtained by moving the proposed dwelling location. , Page 2 - October 27, 2005 ZB Ref. 5680 - W. Bruce and M. BOI,,,,o.. CTM ID: 31-13-4 . During the first Appeal under File No. 5680, hearings were held on March 31, 2005 and May 4, 2005 and testimony Indicating that the existing block foundation would not be removed or demolished because it would be too expensive, and that the foundation was stated to be structurally sound and Intact, with very little work done to It and only to have the basement there for the heating system on the north side. RESOLUTION SCHEDULING DATE FOR REHEARING: At Its September 1,2005 meeting, a Resolution was a~opted by unanimous vote of all the members, to reopen Application No. 5680, with a rehearing date scheduled for September 29, 2005 and October 20, 2005 before the ZBA. MODIFIED REQUESTS: During the October 20, 2005 hearing, discussions were held regarding circumstances that resulted after Issuance of the May 12, 2005 ZBA Grant of Alternative Relief relative to the applicant's request for variances, and the Building Department's grant of a building permit on June 28, 2005 (No. 31232-Z) concerning demolition and reconstruction of a new single-family dwelling per ZBA Decision No. 5680 and Trustees Permit: 1. Testimony was received by the applicant, the applicant's builder, and the town building inspector, Indicating that a new foundation plan (ref. Page 4 of 10 prepared by Penny Lumber, date stamped August 9, 2005) was approved by the Building Department as an amendment to Building Permit No. 312320-z for new construction of the existing foundation in the same place. The Building Inspector's amendment was Issued after reliance on the information furnished by the builder to the Building Department in August 2005, and the August 9, 2005 letter from the applicant's engineer as to why the foundation was unsafe to build upon. The Building Inspector also confirmed that the Building Department contacted representatives of the Trustees and ZBA Departments regarding the proposed In-place reconstruction of the unsafe section of the existing foundation that was crumbling. 2. Simultaneously with this Appeal hearing (on October 20, 2005), the ZBA received testimony under the Appeal of Jennifer Gould (ZBA No. 5681), the adjacent landowner west and closest to the new construction activities. Testimony was received concerning personal observations, activities related to the boundaries and adjacent land areas between the Gould and Bollman properties, the removal of the foundation that existed, the hole recently excavated for the entire new foundation, use of the existing accessory building over the years, building permits and amendments, as well as other extensive Information. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal Inspections, the Board makes the following findings: 1. Grant of alternative relief will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The ZBA relied upon information offered during the first Appeal in the Spring 2005 indicating that the applicant's foundation would not be removed. Since that variance determination, circumstances changed substantially. The foundation is no longer existing, and the area has been cleared and excavated, planning for construction of an entirely new foundation. Based on these circumstances, the applicant is able to relocate the dwelling to increase the setback on the westerly side yard, and to bring the yards into more conformity with the code requirement. Several other houses in the neighborhood that have similar side lines and yards related to the applicant's long and narrow lot. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The lot is only 50 feet wide. The total remaining yard area for both sides, if the dwelling were at a maximum of 29.5 feet in width, would only be 20.5+- feet, instead of the code-required 25 feet. 3. The variances granted herein is substantial. The foundation has been removed, and a more conforming side yard setback can be obtained by moving the proposed dwelling location. " P~ge 3 - October 27, 2005 . ' ZB l<ef. 5680 - W. Bruce and M. an . CTM 10: 31-13-4 . 4. The difficulty has been self-created. The area that contained the foundation has since been excavated and cleared for an entirely new dwelling. 5. No evidence has been submitted to suggest the relief granted will have an adverse impact on the physical or environmental conditions in this residential neighborhood. 6. Grant of alternative relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of his property and at the same time, preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town law 267-B, motion was offered by Member Dinizio, seconded by Chairwoman Oliva, and duly carried, TO VOID and TERMINATE the May 12, 2005 Decision under ZBA Appeal No. 5680, and TO GRANT variances, setting back the new second floor wall by three feet (for more side yard conformity), as shown on the hand-drawn elevation diagrams with ZBA date stamped April 11, 2005, SUBJECT TO THE FOllOWING CONDITIONS: 1. a) The 29.5 ft. wide dwelling shall be a minimum of 8.6 feet at its closest point to the westerlv propertv line. resulting in a 2.7 ft. further setback to the east (instead of the prior ZBA requirement for a 5.9 ft. minimum setback.) b) In addition, the 29.5 ft. wide dwelling shall be a minimum of 10 feet from the easterlv side vard line, resulting in a 2.6 feet reduction in the setback, instead of the requested 12.6 ft. setback approved by the Board in the May 12, 2005 decision. 2. Both side vards shall remain open and unobstructed for access of emerClencv and maintenance vehicles. 3. The basement entrv and wooden steps that are presentlv located on the easterlv side vard must be moved to another location so that thev do not interfere with or encroach into the setbacks approved by this board. 4. The height shall remain limited to a maximum of 27 feet to the highest peak (as proposed and approved in the May 12, 2005 variance determination). 5. The new second floor wall on the west side shall be a minimum of 11.6 feet from the westerly propertv line, resulting in a further setback of 3 feet from the 8.6 ft. side yard setback noted in Condition 1-a, above. 6. That the area covered with canvas in the front yard (street side) of the house be entirely removed. 7. That the driveway shall consist of pervious or gravel materials for proper drainage. 8. No buildinCl permit shall be issued until a new application for a buildinCl permit is submitted that meets all of the conditions set forth in this decision and is reviewed Ifor compliance with the ZBA conditions) by the ZBA Chairperson or other representative in the Department of the Board of Appeals. 9. That the kitchen area and cookinCl facilities shall be removed from the accessorv buildinCl prior to issuance of a certificate of occupancy for the new dwellinCl. Page 4 - October 27, 2005 . ZB Ref. 5680 - W. Bruce and M. Bo,,,,, CTM ID: 31-13-4 . . 10 The setback to the bulkhead shall be a minimum of 35.2 feet and the lot coverage shall not exceed 21 % (exclusive of waterfront dock, walks apron, and minor step areas), as applied for. 11. The owner or his/her authorized aQent shall notify the Zoninll Board of Appeals in writinQ in the event of any proposed chanlle in circumstances. or new developments. after issuance of this variance. The ZoninQ Board of Appeals reserves the rillht to require a new application with respect to any chanQe in nonconformitv that is restricted bv this variance determination and the provisions of the zoninll code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in' this action. (Absent Page 4 - October 27, 2005 ZB Ref. 5680 - W. Bruce and M. Bo." 'u" ClM 10: 31-13-4 10 The setback to the bulkhead shall be a minimum of 35.2 feet and the lot coverage shall not exceed 21 % (exclusive of waterfront dock, walks apron, and minor step areas), as applied for. 11. The owner or his/her authorized aClent shall notify the ZoninCl Board of ADDeals in writinCl in the event of any DroDosed chanCle in circumstances. or new develoDments. after issuance of this variance. The ZoninCl Board of ADDeals reserves the riClht to reCluire a new aDDlication with resDect to any chanCle in nonconformity that is restricted bv this variance determination and the Drovisions of the zoninCl code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in' this action. Vote of the Board: Ayes: Members Iiva (Chairwoman), Goehringer, Dinizio, and Simon. (Absent was: Member Orlando.) This Resol ion as unani ously C)' Ruth D. 0 IV a, Chairwoman 10/28/05 Approved for Filing . . 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 October 19, 2005 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD MEMO To: Southold Zoning Board of Appeals From: Board of Trustees Re: W. Bruce Bollman 1165 Trumans Path, East Marion SCTM# 31-13-04 The Board of Trustees has received a new survey for the above referenced property that shows the Coastal Erosion Hazard line and the location of the new foundation landward of this line. The new survey is revised August 29, 2005 and locates the foundation nails landward ofthe Coastal Erosion Hazard line. Please contact our office with any questions. Very Truly Yours, ~o.i/. .l.t;.. Albert J. Krups16' '~ President, Board of Trustees Cc: Mike Verity, Building Department Linda Bertani Tel: (631) 727-2090 Fax: (631) 727-1727 . . Joseph A. Ingegno Land Surveyor P.O. Box 1931 Riverhead, N.Y. 1190 1-0965 OFFICES LOCATED AT 322 Roanoke Avenue Riverhead, N.Y. 11901 Email: jaisurveyors@aol.com October 19, 2005 Town of South old Board of Trustees P.O. Box 1179 Southold, New York 11971 15) ~ !: ~ U':J [ !~ lrul OCT 2 0 iM IS Sonil;;.<d 10':Jn Bf::':;) (tf Tru~~_ees Att: Heather Re: W. Bruce Bollman 1165 Trumans Path East Marion S.C. tax no. 1000-31-13-04 Dear Heather: The survey map in your possession dated August 29, 2005 is the latest survey of the above mentioned property. On October 7, 2005 we superimposed the footing location survey onto the survey that showed the previous existing house. Due to the fact that we did not make any changes to the map, the date does not change. If 1 can be of any other assistance in this matter, please do not hesitate to contact me at anytime a the above number. A. Ingegno, P.L.S. djc 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 October 3, 2005 Mr. W. Bruce Bollman 208 Main Street Greenport, NY 11944 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Re: W. Bruce Bollman 1165 Trumans Path, East Marion SCTM# 31-13-04 Dear Mr. Bollman, The Board inspected the above referenced property as per request of the ZBA for compliance with the Trustee permit issued April 21, 2004. The Board found on site that the new foundation is 22 feet from the existing bulkhead, with the hole for the foundation at 19 feet from the bulkhead. The plans that were approved by the Trustees as per Permit # 590 I, as depicted on the survey prepared by Joseph A. Ingegno last dated May 6, 2004, approve construction of a new two-story dwelling on the same footprint as the house that has been removed. In the field the Board found the construction to be seaward of the Coastal Erosion Hazard Line, and seaward of the demolished house's footprint, according to the survey. The applicant may be required to apply for a Coastal Erosion Permit and may be required to move the new construction landward by several feet. Please provide this office with a survey that shows the Coastal Erosion line and the location of the new foundation. Please contact our office with any questions. Very Truly Yours, ~ 1/ 9. ):~.. po" Albert J. Krupski President, Board of Trustees Cc: Mike Verity, Building Department Ruth D. Oliva, Chairwoman, Zoning Board of Appeals September 9, 20 . . APPEALS BOARD MEMBERS Rutb D. Oliva, Chairwoman Gerard P. Goehringer Vincent Orlando James Dinizio, Jr. Michael A. Simon http://soutboldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809. Fax (631) 765-9064 Mr. and Mrs. W. Bruce Bollman 240 Grange Road Southold, NY 11971 . Soutbold Town Hall 53095 Main Road. P.O. Box 1179 Soutbold, NY 11971-0959 Office Location: Town Annex IFirst Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Soutbold, NY 11971 o \~ r , \ L_- l L~J5 -..I -I I;" _.~_._---"'- Re: Re-Hearing of Variances Granted May 12, 2005 under Appeal No. 5680 (CTM 31-13-4) Dear Mr. and Mrs. Bollman: Please be advised tbat the Zoning Board of Appeals adopted a Resolution on September I, 2005, reopening the hearing under Appeal No. 5680, based on the development of new circumstances. Enclosed are copies of the Notice of the Hearing scheduled for I :50 p.m. on Thursday, September 29,2005 at the Southold Town Hall, 53095 Main Road, Southold, New York. In the event you have an attorney that represents you, we request a Notice of Appearance from their office for future communications and procedural steps. Our Department has been in contact with John Bertani Builder, Inc. as continued agent in your behalf, and a copy of the Notice of the Hearing with letter explaining the requirements for posting of the town's sign, and requesting that certified mail notices be sent to neighbors as required under Chapter 58. Please do not hesitate to call our office if you have any questions regarding the hearing procedures. Thank you. Very truly yours, Encls. -------Coplesto:------- .,.Mr. Albert 1. Krupski, President Y'.' Board of Town Trustees .-.RuthP,91iyL Chairwoman . . LEGAL NOTICE SOUTH OLD TOWN BOARD OF APPEALS THURSDAY, SEPTEMBER 29,2005 PUBLIC HEARING NOTICE IS HEREBY GIVEN, pursuant to Section 267 of the Town Law and Chapter 100 (Zoning), Code of the Town of Southold, the following public hearing will be held by the SOUTHOLD TOWN BOARD OF APPEALS at the Town Hall, 53095 Main Road, P.O. Box 1179, Southold, New York 11971-0959, on Thursday, September 29,2005, at the time noted below (or as soon thereafter as possible): 1:50 p.m. RE-HEARING (to reconsider ZBA decision rendered May 12, 2005), in the Matter of the Application of W. BRUCE and MARY ANN BOLLMAN #5680, requesting Variances under Section 100-244, and the Building Department's February 3, 2005 Notice of Disapproval, concerning an application for a building permit to substantially remove (demolish) and construct a new single-family dwelling: (1) at less than 10 feet on a single side yard, (2) at less than 25 feet combined side yards, (3) with lot coverage exceeding the code limitation of 20 percent. Location of Property: 1755 Trumans Path, East Marion; CTM 31-13-4. The Board of Appeals will hear all persons, or their representatives, desiring to be heard or desiring to submit written statements, before the conclusion of each hearing. Each hearing will not start earlier than designated above. Files are available for review at 54375 Main Road (at Youngs Avenue), Southold before the date of the hearing. If you have questions, please do not hesitate to call (631) 765-1809. Dated: September 6,2005. BY ORDER OF THE ZONING BOARD OF APPEALS TOWN OF SOUTH OLD RUTH D. OLIVA. CHAIRWOMAN .'\. /' "- "" Board Of Southold Town Trustees SOUTHOLD. NEW YORK PERMIT NO. ... 510 L. w. BRUCE BOLLMAN ISSUED TO ......u.u....U.UUh....UU..uuu.....u.......u...................... .... ............. DATE: U. ~pril 2~L?004 ........m............·..··.. 1\ut~nrii!atinu Pursuant to the pc-ovisions 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 ."REGULATlNG AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBUC LANDS and the REMOVAL OF SAND. GRAVEL OR OTHER MATERIALS FROM LANDS. UNDER TOWN· W A TERS;!.~. and in accordance with the Resolution of The Board adopted at a meeting held on u:Þ.'?:r:~lu.~.~· . 20~.~.. and in consideration of the sum of $u~5~.:~~. ... paid by W. Bruce Bollman ... ........... ........ ".-. ............................................-..... ..-...........-~.....-........... .....--.....-...... of .....!'~".~...!v\."',i().I.l....... ... ... . ... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof. of Southold Town Trustees authorÍ%es and permits the folowing: Wetland Permit to demolish the existing dwelling and construct a new two-story dwelling on the same footprint. and construct a first floor and second-story addition to the new dwelling. with the condition drywells and gutters are installed to contain the roof rulHJff, and all as depicted on the survey prepared by Joseph A. Ingegno last dated May 6. 2:¡¡, accordance with the detaaed specifications as pc-esented in . the originating application. IN WITNESS WHEREOF. The said Board òf Trustees here- by causes its Cor¡x>rat~ ~al to be aff'.u'ed. and these ~sents to be subscn"bed by a malority of the said Board as of thÎ$ dat.e. . ¿1f~b1ð~ .~ ~::r :~-~~-'-'-' '-~-'~'~'~-'-~~-'-'-~--'--~--~~-"-'-' . '-"-- _.~ . '-' .'.' ... TERMS and CONDITIONS W. Bruce Bollman 11Ie p....nI~ ~;"f: at 1755 Truman's Path, East Marion '. N. Y.. as pen vi cbe œasideraâoo lor the sa..~ vi the PUmlt docs .....se..1aOd and pœsaibe to the 101- 1owÎÐ: 1. TIw the aidPoud vi Trustees and the Towa. vi SouthoIcI ate rcbed ftGm Il11 aDd aU cIaJu&cs, oe cWms fIX cIaJu&cs, vi suits ~. dúecd1 oe tødirecd1 as a result of Il11 oper- ation petfOOlleCl panamt to this peauIt, and the aid p....n:~ .w, at Ids oe bet own ~. delead aD.1 and aU tad> IlÚts' ..&I·teA lIT 1IIiøI.,atda, and cbe aid 1\. .III_~ faI1làb11iq with reSpect thaáo, eo the Ø)'1)f"'w .~ of the IIøud oJ. Tnscees oJ. the Town vi ~ . . 24 2. That cbIs PcaDk Is \'aDd foe . pedod of -. ..tdd. Is (O' I'~~ to be the e<fI....teA time· required to coft1pI~ the woå: Iowlwd, IJUtsboald ~....... warnat, request for an cxœøsIooma1 be mode to cbe Boatd at a bier ~ 3. That this I'wDit should be maú>cd iodcfioidy. or as loog as the said ~ wishes CD m.I....;n the sttuaurC or project Involved, to provide cridcooe to anyoae c:ooc:aøcd that oath- odzatioa was ori&ùWIY obWoed. 4. That the woå: únolYCd will be lUbject to the ~ and epprovaI of cbe Baud oe Its 8pU, and ~...,.,. with the ...,OYisioas vi the NigI...II"f: -rrIlcodoa, may be CIUSe foe reovcatiOQ of this PamIt lIT resol\ltioo vi the said Board. S. That th= ..w be no uømlSOI',hle interfereaœ with D&'riptioo as a raak vi the woå: bcteIo aùthodzed, 6. That th= sbaU be 00 imedcrmœ with the rip vi cbe pdJUc CD pass md .. IIœg the bcatñ bct,,1CCd hIP and low water mark$. . 7. That II future opcndoas vi the Town of ~ nqa!rc the. -.I aød¡oe alcendoas 10 cbe focotln.. of·the woå: beteIo ...,¡- -I r \ or 1f, 10 the opJ..w. oJ. che BoeØI of TmÞef, cbe. wade sbaII ause IIœlo_aI.IC obstracIIoo CD free ~ the aid 1\. !I'te will be au¡aked. apoa due nodœ, CD _ oc alter this woå: oe project bcteIo IIWed ~ ~ ..., CD the Town . of SoIUboId. . . . 8. That the aid Board will be DOCified by tbe tw·..II"'f' lit the [)"""(~-'..Of the woå: IIIJIh. odzed. 9. That the .p.,.~..~ will abtúø. aU other pemIÌtS and _Ii -that may be requited sa¡>; pJ.emrn"" to this peøDIt ~ maybe I1i>ect to reY01ce apoa füJaœ CD obaIo -. 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 YOU ARE REQUIRED TO CONTACT THE OFFICE 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. W,ßrutt. ~oHMO/I INSPECTION SCHEDULE Pre-construction. hay bale line 1 st day of construction Yz constructed ../' Project complete, compliance inspection. . . 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 Yor.k 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 21, 2004 Mr. John Bertani John Bertani Builder, Inc. 1380 Oakwood Dr. Southold, NY 11971 RE: W. BRUCE BOLLMAN 1755 TRUMAN'S PATH, EAST MARION SCTM#31-13-4 Dear Mr. Bertani: The Board of Town Trustees took the following action during its regular meeting held on Wednesday. April 21, 2004 regarding the above matter: WHEREAS, John Bertani Builder, Inc. on behalf of W. BRUCE BOLLMAN 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 March 15, 2004, 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 ofthe people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of W. BRUCE BOLLMAN to demolish the existing dwelling and construct a new two-story dwelling on the same footprint, and construct a first floor and second-story addition to the new dwelling, with the condition drywells and gutters are installed to contain the roof run-off, and all as depicted on the survey prepared by Joseph A. Ingegno last dated May 6, 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: $50.00 Very truly yours, J'~~$ 9- ~.~, Albert J. Krupski, Jr. President, Board of Trustees AJKllms . . 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 SOUTH OLD TO: (j 1, t>t Ll( (L ß~ u 1Y1('l('\ Please be advised that your application dated ~ reviewed by this Board at the regular meeting of ~Ú\( following action was taken: has been and the ( ~) Application Approved (see below) L-) Application Denied (see below) L-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: ~&y-..,. _.....,.. _ ~..J' , _ 14294 01/03/2004 " m ~ ~gt~t: a:oQ)O> I-~§;: Z :> J: . ,.,00.>- >(/ . o 'Cz For f-~:g:Q ... a:o o ~.£~ CO~o a:l-lC}cn ëš g m 10 AMf PAID BALANC E DuE DoII.rs $ ~- m " ü B Bollman permIt -' . . iCerJ Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southo1d. New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tuesday, April 13, 2004, the following recommendation was made: W. BRUCE BOLLMAN to construct a first floor and second-story addition to the existing one-family dwelling. Located: 1755 Truman's Path, East Marion. SCTM#31-13-04 The CAC did not make an inspection, therefore no recommendation was made. i!ii o z ~ ~ w w ~ :; ~ " z Z õ a < ~ o ~ - ... r - IW ,I ''-Y i1" , :j;-,- .. ~r. " ;¡.. . . ,;¡I , " .... " ) ~r.:, "'""' .- ,".". -.; ~ , ; , ,. -'. ;¡, ~;ur'; >'~':. ., i i~ ,: -~. .---.,- # -r ! ;: ,-.-, T;'¡'¡¡ l . ~ § .-I " "'"' i + ~ 0 c I g § I § - . . . ¡ill ~ . . I .....~ "'''''co. ejø ~l c . ~El! c ~~f¡ ~! [3"'1 I Uj! 0 I ;:J:r ~fm! · "ill filiI !!~III.I Ii I!dlli f~ 'I I;jjjjl ". !.I,!!I ¡i¡ii ..¡cr iili: , Ii ill , I ., I ' " " .!!!!! I"", IIIIII ~ I' II I 11111 hili ie!!! I Iii I. ¡I; , , , II I G.. ~ I ./ ¡ ¡llId Ilil rf.¡:'J Iii II. ., Jj illìi ......<,)...zc "'.':;f'!:..,7'~~"~:<:"_. 1'J.... ..... " - +- <>Z ___ ~ + ..... . .:~ Ii , , J'o-';>+ú '~.... ~~ " ~ \\~ - .' , l- i ! ! ¡. I ;, ~ . i I i t ~ ?:" -'\- "i0~ ·Á -.:.':1:. .ú' '> -'\ ;OZO ,:.. ..., '..,?:' "'- ",0,> ..... '> -<. ü \ \ .- ~d_~' \ MdJ\ ~ 5' <"I o ) ,1 / ~ ~$ f,~ _e ..,- 'õ"Ø ~;! ~1 //.. ,-,' .. '", ' ,r- ~. ,~ <:)Q = ..~ ~ ~ :::;¡¡ SURVEY OF PROPERTY SITL'ATED AT EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-31-13-04 SCALE 1 "=20' APRIL 3, 2002 DECEMBER 5. 2003 ADDEO TOPOGRAPHICAL SuRVEY JANU~RY 28. 2004 ADDEO WATER LINE, CESSPOOLS & PROP. ADD. '1~PCH 23. 20G4 '-oom CO",STAL EPOSION >'AlARD AREA LINE MAY 6. 2004 A.oDED PROPOSED DRYWELLS AREA = 9,878.29 sq. ft. . TO 1,[ LINE) 0.228 ac. NOTES. 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATU.. EXISTING ELEVATIONS ARE SHOWN THUS, ó.,; EXISTING CONTOUR LINES ARE SHOWN THUS, -- - 5- ¡:- F~ rIR$T r:LOOR G FL - GARAGE ¡:-L00'"' T B - TOP OF BUll<:HEAD B.B - BOTTOM OF BULKHE,AO r 0\- TOP r:;,r NAL~ (' 2. FLOOD ZONE INFOR..ATlON TAKEN FRO": FLOOD INSURANCE RATE "AP No. 361D3C0064 G Z0NE.AE BASE FLOOD tLE\',ðTIONS DETERMINED ZONE.E COASTA<- ~-L0GD WITH /ELGCITY HAZ6.RD ::WA'/E ~CTlGN'I, BASE r:LOúD ::LE\VIOt6 DETERMINED ZQNr)( ':'PElI..S D[TERMINED TÜ BE C'UTSIDE 50,)- (U.P FLOODPL).IN ,.1JJ.l .1JJ.l "'-.. ~ '" 'fJ ~ <" - '5: o ::.~ <" " ',,- ',,- o .,~~_. <Iei'" ~~;t.. "1 i4~1) ..." \ _~ <<ð' _ ~ . / .~ , ~ ,~. I \ \ r ~ \ 'J < ~ ,/ --\ I \./....~" --~' ø'\~~S~.J ;w1, -:e , '"<', '7'{¡?,,- / ~').... .s-..w¡ \ ~1::- I /, \ J.~.J ~ ~..y- \ T, / ~ O/'l~o,~\O"JLÍ) ~ '';/' ,~<%\ / ~ J>~ / \~\ ,1 \ii/.,\" \ \ 1\ J.l.Q ~" , ., ''ai'' )~ i I -Z'r¡ '\" "''''''' <}\ "- ~, ..¡,.. ö ~, -:s:. ~ ~ ~ ..¡,.. "",,;;- 'Ó~ ..¡,..~ C¿ ~ '?('> ,,;; o ~ .', '1',-<:",) ,...,,"\~ -<'IJ" ~tr,(J· ti~rf <J'~ :rft- ~~ -:z. ('> CERTIFIED TO.' W. BRUCE BOLLMAN PREPARED IN ACCOADNiCE WITH THE MINIMUI.4 STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE LI A.L.S AND APPROvED A.ND ADOPTEe rOR SUCH USE BY THE NEW YORK STATE LAND TITLE ASSOCIAnON. ~ ð' '0 ~, N,Y.S. Lie No. 49668 ,/ C:¡ Josep A. Ingegno Land Surveyor UNALfTHORIZED ALTERATION OR ADDiTlO'" TO THIS SuRVEY IS A. vtOLÞTtON OF SECTION nag or THE NEW YORK STAT[ EDUCATION L..'w COPIES OF THIS SUPro/E'T' MAP NOT BEARING THE LAND SURVEYOR'S INt<EC. SEAL OR ["BOSSED SEAL SHALL NOT BE CONSIDERED TO BE A '¡"LID TRuE COPy CERTIFICATIONS It-IDI{;ATED tiEREON SHALL Ru~. ~,v TI"I "rUe nt'""'..",.. ...".... .." .~.. ~"_ _. ._. ~ Title Surveys - SuOdivisions - Site Plans - Construction Layout HONE (631 )727-2090 '0' (631 )727-172" ~ .- - '0"'" c.-:s:. _ .-0 ~ ~Jì ~--- ~,,,,.t...O 0(;)~' ~~ ~~ .- .- "Z- "Z- OO I, Q /" 1.-5'. 31 V 010H1nOS ~O NM01 S3~lSm11 ~O mrv08 A~ 03AO'dddV '----1 ; I ! ·'ð , Jß.J /,,/ \01 0\01 E ~5 5>101'1 7.~RD ~\\oI ER05\O\ol >I~ 7.8 Of 49 CO~51~~ \ 83 S>lEE1 48-640- P>l010 \010. ,///',/,/ / /,// /// , / , / / / ~ <Q /;/ ~ / / ~ // ~.-' ~ if ~<V ~,,~ , / ./ / ,/ //'/ /. .' ~~/ Rpr 06 04 11:10a Bertani Builders . John Bertani Builder Inc. 1380 Oakwood Drive Southold, N.Y. 11971 6317653916 . p.1 (631) 765-1594 FAX (631) 765-3916 April 6, 2004 Bollman Residence - 1165 Trumans Path, East Marion, NY 11939 Albert J. Krupski, President Southold Town Board of Trustees P.O. Box 1179 Southold. NY 11971 Dear Mr. Krupski: SCTM # 1000-31-13-04 We would like to amend the permit application for the above as follows: Existing one family residence will be demolished and a two story one family residence will be erected on the same footprint with a 7'6" x 12'6" x 1 '3" to first floor as requested in our original permit application. If there is any other information you need please do not hesitate to call. Thank you. Sincerely, ^ )- d ''"', ,,7). - - ____./LI\... .. .::...... ,"../ . I "- ~.tili(./!-L- Linda D. Ber1ani Vice President r~, ~ lG lE ~ W lE ¡~ lfìl APR - - ~- ~ l1lJ Southold Town Board of Trustees . . 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 f\OQS't::1.\ e m~[ on "'? Office Use Only _Coastal Erosion Permit Application ~etland Permit Application ~ajor _Waiver/Arnendmen Changes ~eceived Application: oKeceived Fee:$ ~mpleted Application _Incomplete _SEQRA Classification: Type I_Type ll_Unlisted_ Coordination:( date sent) ,,£AC Referral sent~fj.~'I ~ate oflnspecnon: V _Receipt ofCAC Repo : _Lead Agency Determination:_ Technical Review: "public Hearing Held: 1/f;J J 1::Ii... Resolution: Minor íõ)1~ (C l\ru MAR Sou old TOWA Boar of TlUst..S Name of Applicant \ .1. ). \ ~ (" lA.C' ,e.. \ ~C \ \ I'Y\~~ Address 20 ç¿ ~ \\C,\..\ ~ j t- \ tJ ru,,'i) ,J r' t- \ \CH...'-{ PhoneNumber:(~)~n-OO'J.6 ~b l-t..kO- Ú(¡,)'( c..0L( J c<J~ Suffolk County Tax Map Number: 1000 - '3 \ - \ ð -- 0'1 J;j ~\*~ Property Location: \1';Ç TnA.M<J\'~ ¡')~i-h ç:-tL-å V)ìG<.r\ùí\ \ \'¡?.C¡ ? 1.-\ PA pole... '* I "?>. .I e.e.. IoQ.(L i\ù~ in" J CL --H-~ed...-- (provide LILCO Pole #, distance to cross streets, and location) AGENT: k,^tl¿-J I¿el~(\\ Vr -:r;)",f'\ '~i'\-z:(IÎ' \j\'-\\cler~t.-- (If applicable) ) Address: \?,W OcLlvJOù~ {)(\\f'€....> . JJ\-L-te.DlcL \\C(l\ Phone: (0 ~\ -110 <. - I ( 'it ( . . Board of Trustees Application Land Area (in square feet): GENERAL DATA '1 I ~ Î.!. ;;) Cl f \.<.w\t\.ef\ ~'",- \ ~ ,niJ\ e... _1;-,>.\,.", \ \9 c.L..uë. II \ () ð Ijgj-o-I!.-Iv. d <1 ll¡-C\.c1 €...I s\ (\~L -\-'\ (\~df ""-1A!R II, o~ I ~e..:k.oM¿'1 o..¡-tA.6 Area Zoning: Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Age~ S'''''thv Ie.. 1o",,,," Ü I ~6" <Í<fH . Date 'll~q1 _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspenged by a governmental agency? ;< No Yes -- If yes, provide explanation: AiJPr , Project Description (use attachments if necessary): (id. cl \ hù ~ t-ü ~<! -I.,"ð' ON< +r,uY\\\'t hQ~ Î I b o..."L >uc'ý\.¿' S I-vrer c.u!-¿'-\-'o,-.) "x 1:2 ',," Y 1'3" f:'H+-i-1ù"t" . . Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity:_Çic\.-J.l,ùi.... I-c &¡1!~;"[/Oo..L fc...md';J (L.-c:.ll,,,¿ " ", "".. I . J \ II r f-- ". l . .1 . {'" I' 12 ~ I' I:?' ".! 1- ("or G-"~ ). - ( 'D r], o..¿U \ "-'''''-' Are wetlands present within 100 feet of the proposed activity? No /' Yes Does the project involve excavation or filling? /' No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting ITom implementation of the project as proposed. (Use attachments if necessary) 001\U 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISiED ACilONS Only PARi I-PROJECi INFORMATION (io be completed by Applicant or Project sponsor) 1.1.16.4 (2187)- Text 12 I PROJECT I.P. NUMBER . . SEa ,. APPLJCA~_~:SPONSOA ·-k'h'1 .3 ·1 clrl. 2. PROJEC7 NAME > ¡¿ . (,,,,1. I, ,-t, ", ¡) 1. I {·''¡',,·,i I~....¡<! -1..",-. Jjol/lY1C<,,-, eJidÆf\<..-J 3. PROJECT LOCATION: t )î Cúl" ..:... J'.....-I¡ +vi Ie.. Municipality ['"CUi- County 4. PREC:SE LOCATION (Street address and road intersections, prominent lanamarks. etc., -'r ,:)(oYloe map) }7íí Tn.LfY\<Vl· ~ I] Co- 'i-':"" I EcJ.H- I '}1<A'f C!,--.J ¡ICf 3q /...1PA 'J 01 t: 'If ;3 J e.L. o~.:..._.-fw.~ "l,._ù.....,l r/v W l d.L eL.- I - - 5. 15 PROPOSED ACTION: ~ClitiCatiOnlaleration o New o Expansion 6. DESCRIBE PROJECT 8RIEFL Y: ftctcl.'h~~ t-v éA{IJh;"t ð~~·J~"""·'rJL''f.-.I''''r ) '", I' J( /¿ '(, I X I'!' If f,r;¡r+ C--^.L ;2 - JTt.í;r ct..d-d. I+'ù~ . 7. AMOUNT OF ~N.D AFF~CTEC q¡ 7P 2'i 4 'o.o;allv "J r1t. :Xj .......- Ultimatelv ",,"s 3. W~O?OSEÙ ACTION COMPL'f WITH 8<¡STING ZONING OR OTHER E..'<J$TING LAND USE .~ESìRIC710NS? es 0 No If ~o. deSCribe brrefly 9. WHAT S PRESENT LAND I;:::ë IN '/lCINlrf OF ?AOJECT? - - w ~S'denua Desc:"IDe: [J.!naustrra¡ C C.JmmerClal . o Agflculture <--.! ParK/Forest/Ooen soace ~Other . 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (F:ùERAL. STAr~_Cß LOCAL)? [g'Ves 0 No If yes. list agency(s) and permit/approvals L..bv..'"f1) 0 \L -rz1(J/ì'\... ìru.....,tfe...(J" .:;- ". DOES ANY ASP~ OF THE ACT'or~ HAVE A CURAENTLY VAUD PERMIT OR APPROVAL? DYes CY'NO If yes, list agency name and permIt/approval 12. AS A RESULT O~ ~OSED ACTION WILL EXISTING PERMIT/APPROVAL FlEQUIAE .'v1QQIFICAdON? DYes ~o ... I CEi1T1FY THAT THE INFORMATION PROVIDED ABOVE IS TRUE :-0 THE 3EST OF MY KNCWLËDGE ,,!.,ppHcant/sponsor ) .---- name: LI(\~<J f.Jtrhrl' - Joh" (Y lA-d.<~ ¡3.¿-:c:tz~ dv -Itlr1, j&, Ie! U::r;."-Qò,. .3JIO/DY I . Slgnalure: If the action is in the Cons/al Area, and 'fou are a state agenc'f, complete the Coastal Assessment Form before proceeding with this a.:¡,,~essment OV"R 1 ?ART 11_=NV!RO~JME:'Jï:'" .ë.s:SMENT ,"70 'Je C:X~:::ie~a'J ~y Açe!'1C" . :., JCE.5 .;C7:C,"" =;\r..t~:: ":':-'¡Y "..:r:., 7¡..,;:;E~i-:GLJ:N i ,'~':'C;::.M. :I:.,,;ï oj,;..;:? :1 :!~s. .:ocrOlnat9 :ne r~VII~W :rocess ana 'JSð :n9 .=:":L:.. ::-,)..= ·~':"~S 1-::.'lO ::. 'NIL!... AC71CN ~E·::::;V= :::CP..OINA,c0 .=l.EV!EW.:..S ~P.C'JICE:J =.:¡::¡ UI'IL.S7"2.:J .:.C7;CNS ,N 5 .\JY'::?R. .:I"'';ï -)~i" 57 :1 ·~o. 3. ,¡eçat:ve ::~c:ar~ :'nay 'Je sucerset:ec .=y a.nct~er ¡nvOlvee! açenc'{, GV!S f...:~o c. C::ULD ';C7.1CN .::I,ESUL7:N ,"NV ..\.DVE:;SE ::':=:=~,:75 ..\.S5CC:":'7"=::J '.v17~ -""E ,=·JL!..'::WI:-IG. :).nswers :nay:.e ¡¡¡ncwmten. ,f :eçlcleJ C1. :Xlstlng ,lIr Quality. :>urtac~ or qro~nawa!er ::uatily :.r -:::~an!lly. ,¡Olse ;e·/eI5. ~x:S'JnQ ::-aific :::at'erns. sOlia ,vas:e :Jroc~c::::n Jr JIs;:.:: ;Jolenual for :!rOSJon. ::ralnaçe .Jr .'100cing :¡roclems? :""I:o!am :Jnerly: cz. Ao!stnelh:. a.çnc:.sUurat. :Uc:JaeologIC.J.1. :·us;onc. Jr :;Hr'ler .¡a[:.sral .Jr cOHoral ;esourc~s: or ·:.;Jmmunlty ::Ir ,'eu:;i10crnOOQ c::arac:er? ~claln ~. ~. 'eçetatlon or :auna. ·Isn. sneJlfisn or 'Nllalife 1oecjes. slgmficant ~ac[tals. ~( :nreatenea or ~nc:an-;;erea .:¡;::ec:es? E.xclaln Jrlarly: c~. A c::mmunlty's eXls,ing ;Jlans or -'¡oaIS as offlc:;¡lly aaootee!. or a cnange in use or intensity or use of !ana or olher natural resource:s? :,Xplaln :::~ C::. Growln. suoseouent ::evetooment..Jr relatea aC:lvltre:s likely !o ::Je Inducea .Jy !he :rCQosea ac:ion? .:::<.:lIaln :merlv. ':3. !-cng :erm. .;inort :erm. .::,¡muiauve. .::Ir ·Jlner ~ffec:s not Icentified In C:·":.5? ~;(o!aln :mer!'. ':(r:~~ ·moac:s inc;;,¡clnç :::-:ançes ,n 'Jse iJi !!Inl!r ouanWy ~r :y~e or ~nergYJ? =-'(;:)I.iln :;nel1y, .J. ,S :"i-IE?E. JA:S :-ME~ë _:!'<2!.::':-0 3E. ::.:r"';::¡GvE?S'( =!E~7E:J:-0 ':!OTç:'¡ï!Ai... "'8V=::!Sé =:'IVIfì.CNME~H":'L .,'.:P~C73? __ 'fes _No :t ':'es. ~xclam :=Jnerty ?ART III-OETERMINA TlCN OF SiGNIFICANCE ¡To Je comoleted JY AgenCï) INSTRUCTIONS: Far ~3C:1 ao'(erse ~rfect identified atove. determine wnetner it is substantial. large. imc::ortam or otnerNise sic;nific. :3C:1 ~ifec: si10uld ~e assessed in c::Innection 'Hlltl Its (a) setting {i.~. urban or rural); (b) ;JrobaCility of oc:::J¿il1g; (C) duration· irreversibility; íe -,1eogracnic 3C::Ice; ana (f magnltuce. If necessary, add aUac:lments or reference supporting materials. ::1sure ~xctana[icns c::ntam sufficient deI311 to snow ¡hat ail ~e!e'(ant adverse impacts have been identitiea ana adequatelY ac:cressec. C:'eCK ~his ~ox if 'fOU ilave identifiea ene or ,11ore ~oten[ia(ly larçe iJr significant 2C'Ierse imoac:s 'Nl1iC:1 M.A':' oC::::.Jr. Then .:)rcceea Clirec:ly :0 :ne FULL ::'AF :ma/or preoare a positive- Cleclararicn. , C:'ed< ~his ~ox :r you :lave de!ermined, basea on the ¡ntarmarion and analysis above and any suooar~i.-:c COC:Jr7:enca[lcn. :har :r.e ::)(000580 ac=ion I:.JILL ~~OT result in~(1Y significant adverse anVlrcnmenral ~mcac;.: ~N 0 ::HOV!Ce an ;;',taC:1ments 3.5 necessary, ¡he ~e3S0ns sUDconing this derermlnarion: .....",... '1 ~.....u ......:n<"1 "'''"1 JI _(:1;: ....unp. .)1 <~·,¡;on\.aL~ "';II'c~r n ~.....a "..\:nCl ,,(I': Of ":o:)con~IOI'" 0'I,c~r ~'l:n.lIUle' ) <e~con\LOII!' ..::I:,.;~t ,n ~.:"..Ia ,~\;...ncV ),~n,¡:ure )r ""·,:,,::).II'=" 'If ~":~~",,,t :rom r",socn"a'~ :,)rr,c.?r' ~ J..tc o ~ . . Board of Trustees Application County of Suffolk State of New York '"13 (C{ ( f Ö 0 II YI1 tJ J1 BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF IllSIHER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUfHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUfHOLD 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 AUfHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~~ . i Signature SWORN TO BEFORE ME THIS ,2001 Veronica F. Cldone Notary Public. State of New York No: 52-4661406 Qualified in Suffolk County. _ _ ____ Commission Expires Dec.31, c7-W~ . . 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 \Õ),I: «: ~ ~ ~,I: ~ ,¡ru APR " ~ Southold Town Board of Trustees --------------------------------------------------------------- In the Matter of the Application of _1JL)..~r-~~~~~l~!'-1------------------------- COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, W' r3rl.\.U _ t~o II m{).^- , residing at AiL-[ /I Ý Yl being duly sworn, depose d say: .,?ok' OQ,",--.J+rc.e. f- . , G rt €J\fJ"r, That on the day of ,200 , I personally posted the property known as I?';( Trl1 (Ý\{IIIJ ,oŒ-'U- by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held I ~I . on (Y t" Dated: -I-/? /of I (Si~?? Sworn to before me this 1 day Of4¡JeIL 2007 T.!'IJ!1CO .. NIle, e:a!I of Now Yoof< No.01F\14882475 DuaI.1ed ìt S<ti ~f IJ CQG_' '111 ExlIne Jin. 20, 2\).Q./ . . January 14, 2004 Bollman Residence -1165 Trumans Path, East Marion, NY 11939 To II\Ihom It May Concern: SCTM # 101JO..31-1~ I, W. Bruce Bollman, residing at 208 Main Street, Greenport, New York 11944. do hereby authorize Linda D. Bertani, V.P. of John Bertani Builder Inc., 1380 Oakwood Drive, Southold, NY 11971 to apply for permits on my behalf regarding the construction of an addition to my existing home at '\I1S;S Truman's Path, East Marion. This includes but is not limited to the NYSDEC (Regulatory Affairs), the Southold Town Trustees, the Suffolk County Department of Health Services (Waste Water Management) and the Southold Town Building Department Sincerely, õd W. Bruce Bollman Owner . . APPLICANT/ AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold 's Code of Ethics Drohibits conflicts of interest on the Dart of town officers and emolovees. The Duroose of this Conn is to orovide information which can alert the town of DOS sible conflicts of interest and aJlow it to take whatever action is necessary to avoid same. YOUR NAME: -----1A) . t.3rlÁ.C.-e... /6ollrY\(.c,.../ (Last name, first name, middle initial. unless you are applying in the name of someone else or other entity, such as a company. Ifso, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from pLat or officia( map Other ___ --- ' (If "Other". name the activity.) ,\\\I.l't-hð\~ low" 1¡\.AJ1-tu ¡)u'IYlIt- Do you personally (or through your company. spouse, sibling, parent, or chird) have a relationship with any officer or employee of the Town of South old? "Relationship" includes by blood, marriage. or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of~shares. YES NO ~ !fyou answered "YES", complete the balance of this fonn and date and sign where indicated. Name of person employed by the Town of South old Tide or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) andlor describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); _B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); _C) an officer, director, partner, or employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP ~~:=:ed this?~ of ~ (KGL- 200 i Print Name ,r3r ""-- i'¿of/rnà~