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Home My WebLink AboutTR-6002 AlbertJ. Krupski, president. James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 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. J G'\ e ~ INSPECTION SCHEDULE Pre-construction, hay bale line 1 st day of construction Yz constructed ---..!L.... Project complete, compliance inspection. . Board Of· Southold . Town Trustees SOUTHOLD, NEW YORK PERMIT NO. bOO"L ISSUED TO .....ßIJA1ONES.......c....... DATE: .. Sept. 22, .................. ....................... "'ut~nrii!atinl1 Pursuant to the provisions of Chapter 615 of the laws of the State of New York, 1893¡ and Chapter 404 of the laws of the . State of New York 1952; and the Southold Town Ordinance en· titled "REGULATING AND .mE fLAClNGOF DBSTRUCI\OtiS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS-~M LANDS. UNDER TOWN· W A TERS:!~. and in accordance with· the Resolution of The Board adopted at a meeting held on ..s.~p.~...U....... 200.1........ and in consideration of the sum of $.~?O.,..Q.o... paid by R,i;t¡¡ J 0 nu> .....m....._........................... ......................-............ m.......····..·· ........................................................ of ..............~:'L":e.n.p.()I!!=.... ..... ... .. .. N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the foHowing: .¡ We;U¡;¡.Vld PeJunil to . C.OJ1..6ttr.u.c;t a .¡,'¿Vlg£'e -.6t~lty 10' )( 26' add.i.;t,lo f. 0' Ovl the. £.a.ndwM.d .6-<.de 06·-t~e ewuVlg hÓlU>e, wilh -the add.i.;t,lo '. Q dJr.y we.lli, aVld ill M dep-<.c;ted Ovl -the. p£.a.vl w/tveyed by Pec.- o'uc. SWLveyO!t.6 Sept 25 2002 aY).d ..the 4ile £.a.vl Ite a.Jt ,¡ .h.u . all in accordance ;..it\. the detai\ed speciticat¡gns af prij1sen~ö(nn .the originating appl'lCðtion. EVlvÀ.JLomnellt EMt .fM-t Itev-ù.ed Ju.ly 18, 2004. . IN WITNESS WHEREOf. The said Board of Trustaes here- by causes its Corporata Seal to be affixed, and these presents to be subscn"bed by . . majority of the said Board as of this dat.e. Pe.aQU Vil'bOhAnL1 {hn~1I6ª} - . Tnuitu l ~11 .. ", , .... . n:l>11<:' Þ~.J "J"')",nmn",<:. ne Permittee R,i;t¡¡ . ] 0 I!U> resldiag at GlteenpOJ1.t '. . N. Y ~ as pan oC the coosiðetatioo lor the ¡...,.~ of (he Petmit docs ~ and prcsai", to the fol- Iowiag: 1. That the Aid JIoard oi Trustees and the Town oi Southold are re1cued from any and aU damages, oe cWms foe d&QII¡CS, of salts IdÄøg ditecdr oe iodirecdr as a resuIt of lilT oper- -4d0a'f'CdormedI"'ØllaatctO.ihIs .¡>eøDIt,UIII.:iK..LI 11. J"-·!!fI!..lItl!hor~ OWII~. deleAd "T and aU JUCh IUIts-1n1t/.œc br dJhd .,atcief,and the said ~ __ fq111ab111tr with m~ thereto, to the ~~..{>1Þte esdusioo of the IIøud of TI1ISœa of the Town oi Soøtb.<M . 2. That this Peabk Is· wild for a pedod of 24 : IDOS. -whkh Is c:iOiøidcft>d to be the estimated time· requited comiaplete the 1iOtk hnol1ed, IJUt ·ihould ~ waamr, request lor III exœøs!Oß .maT be mode to the IIoud at a .. d4œ. . 3. That this Petmit should be œIained Indefiolcdr. or as loog as the said Pemùttee wishes to . m.õ..../n the stt\actu.te or project Involved, to provide mdeoœ to anyone a>oœtn<od chat 1Utb- ø:/zatIon was ori¡:ioaUr obta/ðed. 4. That (he 1iOtk iaTOlftd will be IUbject to the ~ and apptoval of the Boud oe fa agents, and --0...'1'11....... with the prcnisioøs oi the ...;g¡Mdog appUcatioa, mar be cause foe m>ocation of this Peanlt br resolltdoa of the said Boad. s. That tbeœ will be no ....,..,SOtIlhle iaterf_ with aa1'igat/co. as a result oi the woes. baeIa 11ÌtI1oråed. . . . 6. That tbeœ Iba1l be GO '-f_ with the dtJIt oi .&e puIJUc to pass and .. aJœg the belch bet,,~ II/sb and ø water matb. . 7. That If future opendoas oi the Towø. of ~ nquIœ the œmovaJ. U1IJIoe II--t/onf Ia the Iorotl.>r oithe WOIk Lenia ...d I!d~ or If, ia cbe tIfIaIoa oidae JIoara oi n-, cbe . wock sbaU cause _......I,e obsttuason to free aa~ cbe said PermI- will be nc¡aIrecI. apoadue tIOdœ, to reøme or alter this wad< or project heœia IIáIed ,,1CL....t "I''''<et to cbe Towa . oi SouchoI.d. . . 8. That the aid Boud will be aodßed br the I'6n"- Oil cbe ~Of the wodt aach- orbed. 9. That the ............ will dJtåø. aU other pamks &ad _& 6at -r be nqaIred . pi_I to this permit ~ -r'be II1IIject to teWIfœ apoa fIJIaœ to oIItaIa ame. ., ~ ..~....__.oiiiio...._.~-~........'--.;......:..___"F_-,,_¡¡¡¡¡¡¡,Iiiiiiii.______~__..:__;,;.;,~-..;..i.,-,~-.. .--; . . . , . ,·.·..t . . . __ _n. . . & TJ:n1 1<: ,,~) ('11"'''''''1''\'''<: ne Pmnittee R,i;t¡¡ .J 0 VlU> resldmg at GfteeVlpoJÚ: ." . N. Y.. as ~ che coasiðetatiOQ loe !he ¡~,.~ of che Pemdt docs uødcøtaod And pæsaibe to che 101- 1. 'I11It che said Øoatd of Trustees and che Town of Souchold ate released .from lIlY and aU daoJa&es, oe claims foe daaJaaes, of so,úts adÄag. cIitcct11 oe tadincd1 as a ~ of lIlY oJU- -.-doG ¥doøued pmulatot&..èbIs 1""""t.1IId.:lbu,/d i>HmI~~.M.WJoc~ OWD~. defend "1 and aU IUCh IUIIS-I,,¡t/,œd by chhd .,udes,aad che said I'etmIttee __ {q,I1iabI1IIr 1riIh respect checeto, fO .~I"teexdusioo 01 chc &ud of TtaStteS of the Town of ~ 2. That cbis PatnIt Is ~ for a pedod 01 24 mos. -whkh is ~ to be chc estimated time· required to mInplete chc wotk Inwl¥Cd, bit ihoa1d CÚWIifsWIces 'II'UtIIIt, requat . for an exœosIoo ....1 be made to che Ðoad at a bIu ibIie. . 3. That this Petøùt should be zeUIned iadefiaice11. or as Ioog as the said Petllllttec -wúb.a to m.ln..ln cbe sttucture or project Involved, to provide evidenœ to anY01Ie 0><lCUIIeCI chat aad1- ~doo was or/¡:iaaUy obuIaed. 4. That che wotk ilm>lftd will be subject to chc /osþectioa and appronl of the Bod or fa agents, and 1IOC1-œmp1Janoe with !he prarisioas of cbe origIn'II"; app1icadoa, may be CIIISe foe mocalÍoo of cbis PetIIIIt by resolylÍoo of che said Board. S. That there wIU be no IItIRISOtIIble Interl_ with JIa'ri&adoo. as I ~ of cbe 1VOdc beœIø aùdioriœd. . . . . : 6. That there Ihd1 be 00 Interf_ with the r/gbt of the public to pus and repass 1Ioog' chc bead> bet1¥eca fIIsb and low water mad<s. . 7. That if fucure opendoas of !he Town of SonðW' ~ the. œman1 aad/oe a1C1M~ In chc IQrotlnn ofchc wodc beœIø ..d«Ved, or U, In chc opInIoa of4he Board of n-, die . ..-ark. aha11 cause anmSOlllb1e obsttuctsoo to feee aa~ chc IIId P-mI- wU1 be ~ apoadue ooda, to RQIO\'e oe alter cbis wade or project beteIn IùIed without ~.ft~, to chc Towa . of Soucho1c1. . . . 8. That the aid Board wIU be notIfIecI by the ~ ot die CIOØIp'et/<>ot Of cbe wodc aad1- ocbed. 9. That cbe 'p..nd_ wU1 dJtaIn aU ocher petmIa and _Ii 6at may be reqaItecI .p; fIea-..1 to this permit ~ may'be ....feet to moire apoa faIIaœ to obta1o__ - - ., - ...,¿. itL....,..... ~ PERMIT NO. bOO"L .~ .. Board Of Southold Town Trustees SOUTHOLD, NEW YORK DATE:~('pt~ 22, ISSUED TO .....ßJTA.JONES ..............-. . ...-......--.....-....... "'ut~nrii!atint1 Pursuant to the provisions of Chapter 615 of the laws of the State of New York, 1893¡ and Chapter 404 of the laws of the . State of New York 1952; and the Southold Town Ordinance en- tìtlðd .''REGULATING AND .mE fLAClNG-OF DBSTJWCIIOtiS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS.f.iOM LANDS UNDER TOWN WATERS;!'. and in accordance with the . t ,7o~:j£~:::;: =:=::~;nS'P~':b; ~, T~r~~~~~Jt":·¿::£:¡~~s listed~~t~' ~v::e su;1:ct ~r:;f. ti:r of Southold Town Trustees authorizes and permits the foUowing: r ., ""III We;U¡;¡.Vld peJun,(;t to .C.OJ1..6ttr.u.c;t a .6Ù¡gte-,~tOf¡Y 10' x 26' addil¿o~ .. . Ovl the ta.Vldwa.Jr.d Hde oo·the e>Ù6t.i.Vlg hOu..6e, w,(;th ;the a.dcLi..ti.0t· .-- '. 0ó MY we1i4, a.¡d ail. M dep,¿c;ted Ovl the pta.vl .6uJLveyed by Pec- . oruC. SuJLVeyoM Sept 25 2002 al'!.d ..the 4,ile .pta.n Jte ,{.b . .. aU in accordance with the detai\ed spacifleatrons a¡~£V¡¡iikl IÍ1 . the originating application. EVlvVtoYtl1lent EiL~t la..6;t Jtev.ued'" Ju.X.y 18, 2004. ·f .. IN WITNESS WHEREOF, The said Board of Trustees kere· t Ì!- . by causes its ~at~ ~al to be a~lXed, and these p!"sents to 1:.. . -ill ", be subscribed by a malority of the said Board as of this dat.e. r . ~ ':f ~.1' L~ .. t~¡ 1'. PeGal! Vif1ho!rArH,1 {hQ<'''1ª) Tnuteu . .. . . 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 TeJephone (6311 765-1892 Fax(631i 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 22, 2004 Peter Stoutenburgh Environment East. Inc. P.O. Box 197 Peconic, NY 11958 RE: RITA JONES 1335 ISLAND VIEW LANE, GREENPORT SCTM# 57-02-15 Dear Mr. Stoutenburgh: The Board of Town Trustees took the following action during its regular meeting held on Wednesday September 22, 2004, regarding the above matter: WHEREAS, Peter Stoutenburgh as agent for RITA JONES 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 August 25, 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 September 22, 2004, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area. and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 . . WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, RESOLVED, that the Board of Trustees approve the applicatio~ of Peter Stoutenburgh as agent for RITA JONES to construct a single-story 10' x 26' addition on the landward side of the existing house, with the addition of dry wells, and all as depicted on the plan Surveyed by Peconic Surveyors Sept. 25, 2002, and the site plan prepared by Environment East last revised July 18, 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.) This is not a determination from any other agency. Fees: $50.00 Very truly yours, b(,,·~ IJ. ~. r;.. Albert J. Krupski, Jr. President, Board of Trustees AJK!hct . . . , . Telephone (631)765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tuesday, September 14, 2004, the following recommendation was made: Moved by William Cook, seconded by Don Wilder, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of RITA M. JONES to construct a single-story 10'X 26' addition on the landward side of the existing house. Located: 1335 Island View Lane, Greenport. SCTM#57-2-15 The CAC recommends Approval of the application with the Condition roof drains to drywells are installed and directed away from the wetlands. Vote of Council: Ayes: All Motion Carried .\'~~(.:-; ,- 'T- _/r'- ~ ;.¡[)' .::~: "h"·F' ~._~'-~' ;},,:! '''V~~ý( . ,. ~ i ;;; :¡ ~ ,.:-1 c '" "T;'" , -t·.:'"....\' " i I ~ !L ""~CT .'- o '" ..:J1 " I' " . -/.' \ ! .---:,\ ·0 - ~_I()· 7 '4 C::, 'PD-i- 01 HA .,. '-~-~ ~~':"?""") - í'-" ..' "t) yOt.WGS P . " , , ". - .,:~-.. /" .- "-, ( " '. , , THOLD ,AY ( , " <,' ./ -------- . ./ ,....... /- , -- / I . . I ls, ~; A 2 C 3' C 41 C ~~ ~ 7 C ~; ~ @C A E E F , //.f \ ~ " .. \.~ ,¿ 0/ J '. \ PARADISE "'i,:;O~ -,~ . . Sf-! l.Tf~ :5LflNt) J v'~ / '- ') I 'ji' ~, \ A.CH P1 (. I _~ ),0 ~::> r ,I,' 'I \~ " C'V ~ ¡.,\ .J1 ,-'" ", \" , ) J. ,__ t , (,/,:\'. ...., \,,--., '\ \ ---~' '. reD leI ^,,",n C::()II,,"/n I / ir~d.. _~Ci ., " 1 + , <::0- Z ____ , " ",'I, I',' I'l' II ~~,I, :' ¡'I"" ,III,' , ·Ii 1',1' f I II ". Ii I", . +~ o ~ o ~ 'l! ~ w '::> w ~ ~ + --' ·",;. -t- - o "":<\ ð ,..~ ð .£. ~ ~, . ~ -a.q. <;¿, " .,. .. SURVEY OF PROPERTY AT ARSHAMOMOQUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NY 1000-57-02-15 SCALE: 1-=30' SEPT. 25. 2002 m 2~ -. ~ ~~ ~: ~~ ," - 1 - ~ ffi :t> , ~ '.,) r__' ffi 'n = ~ ~.. ~<vc, ~ ~\of / -t- o -;(\ ~ ~.L ~ "'tt- ~ û' <t: ~ "Y~ <;> ~ ~ fR. HS£· ~. ~. .. ~ '-?i . .~ ......- '?" ~ 9:, ~ ..... ........ ð.> ·1t"ð- J/>L iJ'.... ~ ð:' ~ " . . .... , IYO ... ð....~ r~ "., .. ........ I <::> ~ ~ '''' OJ ~ ~ Is <::>. ~ ~ I~ "- ~ ~ I ~ ~ W<:Tl..ANDS ~ t, ,~ ~ ::: Vi , ~~~ /.... !3 fS ~ ~ :;;:¡ ~ f§J ?5 Š ~ .~ $ ~ ~ R.coD 7.:0"1" A! ,.-' ~ \ c::.~ ". . '.. ( C( '-' . rlRM ~',-.(,è::- ,: -:........':> .' ,-" s/tJ,I 'It, AREA = 14, 140 S.F. TO 77£ L/Nç e=PIPE .. ANY N.. rERA ITCN t;f/ ~TICN TQ THIS $tRV£Y IS A. VIQ.A TICN Cf" S£CTICl-I 7æ9 ÇF' 1}£ tE:V Y1:)¡K STAT£ £w:ATICN·LAV. £XŒPT AS ÆR S£CITCl-I 7æ9-S1JBDlVISICN Z. ALL ŒRTIFICATICNS f£fIf;CN. ~ VALiD FeR THIS ¡.w> ;WI] CCPI£S Tf£R£Cf" en. Y IF , SAID. /Jot>e'qI CCP~:.æ:AF/ TI£ 1WRf:SSE:D S£N.. Cf" TI-£ S/..RVf:YeR , . ~ $IG-vtTl.Æ APÆ:ARS I£R£CN . ··r .' .... 02-28 '~. . '. .. . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application ~etland Permit Application _ Major 'W ai verI Amendrne C ges ....-R:eceived Applic ti : 0 ~ceived Fee:$ ~mpleted Application _Incomplete _ SEQRA Classification: Tjpe I_Type ll_Unlisted_ _COOrdination:(dateJRent ...L:-AC Referral Sent: ~te oflnspection: _Receipt of CAC Report: _Lead Agency Determination:_ _Technical Review: ~lic Hearing Held: '/U}f:Iý Resolution: Minor IT5)~!C~~WJ~ lIìl AUG 2 5 2004 Soutl1old Towa Board of Trustees Name of Applicant_/'Ý\R5. R l"1ï4 rY\. JONES Address ì33'S 18LAND \[18vJ LANG G R..EEN fORT Phone Number: ( ) 0.3(- 4î1- OB88 Suffolk County Tax Map Number: \000 - 57 - 0 '1.. - 5 PropertyLocation:_1"335 I$LAND \fIP,1I\J <...AN'ë? - CótJ"-UN ?T. ~. Of" CD/'J~~ RD. (provide LILCO Pole #, distance to cross streets, and location) ~~~ AGENT: E~'hKDNr(\'C.NT fAsT INc. (If applicable) Address: PD· BD >< [Ctl recD".JI<; IJ '-(~I H SE>. Phone: 03 \ -134- 7414-_ . . Board of Trustees Application GENERAL DATA Land Area (in square feet): /4 J 140 ~ Area Zoning: Rss\(> EÑ \1 ÆL Previous use of property: 'S(f,\G\..£ FÅiY\ \ L-i bWELLl.N (;.. Intended use of property -Sj ~L-e:; rAMtL'i t:>WEU...ltJ<;. \.U/ ADOIT10rJ . Prior permits/approvals for site improvements: Agency Date jylA.R.<!.H ID /'2-003. Z.Dr,h~& ~"R.D A~PRe:.\lAG _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~No_ Yes If yes, provide explanation: Project Description (use attachments if necessary): A S "6" ..-:- c-r... Y I· ., 2 I "A ...... DD A 1"'....--= ~\uR. .- 10-0 /< . <0-0 f"'o1..~DI\lOI\.ì. ()r:j ll-\-E LA~w^R.D ~\~E {)F""T'H.B Ek\ST(I\j6- t-\ú VSE . . . Board of Trustees Application WETLANDffRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ;Nc..R~ Sl21:: 'Dr J)\Á) Eu....JÑ G ß '1 t\DD{I~ G- t¿ 1~ -rD eXls1l NG !kúùS 6 Area of wetlands on lot: 2460 tþ--,-square feet Percent coverage oflol: $,1 % Closest distance between nearest existing structure and upland edge of wetlands: '2.5'-0" feet Closest distance between nearest proposed structure and upland ",""",( ,. edge of wetlands: -"oJ -0 feet Does the project involve excavation or filling? No ,/ Yes If yes, how much material will be excavated? 50 cubic yards A-T CfZAvJL-S'f'ACE FOurvcATl ON' How much material will be filled? 50 cubic yards BÆcK.FlU- @ FDU~Tt ON I "+ Depth of which material will be removed or deposited: 5 -0 - feet CRA:\AJ~·PI\e'e.· Proposed slope throughout the area of operations: No CH1\;/'JGE" pROM EX(STt"'<:; I 'I Manner in which material will be removed or deposited: DI Go Cf'~wWPAc:e:. -5-0 DeeP , i\ <::. t1'"... \ "PoP.... ID-fo A.DDITl ()'J. 0TDfZË GRADE U'J ~"l"""\E" ut--r,( L- FÒUI\}OÆ:TlDr0 I-S If\..) ?LJ\c6 t_J~CK-Flu.... uP W NSvJ lJ}A.LLS - ~ESTVR.6 exl&\ fr0& LA.-NDSrl\-fl=: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): .:n-tE; A:DDli1(ltJ IS Of\..) ~ LANDL0A(-1.¡Ç) SIDe; DF :J1-tE B<I.SI/ÑG- -:S\R.0CTlJR..e"- We- EXPECT"""TW\\ (Hl.-S Ä.t>D \ T\ t)/\j WI GL- ~e ~ EFFP-CT Dr,}·11-+ ¡¿- lAJ C\LA.~ -- ANa It DA~ \AJ A: TEt<'.S . . Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity:~8o !l-D A '2.13 tit A.D.Dl::I1 oN 12tJ...-=rt\'E LNJOIiVAR.D .s (D E.. Of' AÑ Ex!S\{ NG- SiN (; LE FAm. (L,..'i Re.-s ¡ .D ENCE.· Are wetlands present within 100 feet of the proposed activity? No V Yes Does the project involve excavation or filling? No V Yes If Yes, how much material will be excavated? 5[) (cubic yards) How much material will be filled? 50 (cubic yards) Manner in which material will be removed or deposited: t).G- CMwwS PA<:E 6"-0" .Deer' Fbf'. (O'-b' ÂJ).(X' ( ON. STDRé: GM De: o,() S't-ns- UI\J\'I.l.. FÛLJ/~OAT'f ðfJ I, $; Fe l'.hS\ \tV l{ ß I.....CK-f'YL.L. UP \t) Ñ 8VJ \l...JAl.-l..S'. Describe the nature and extent of the environmental impacts reasonably anticipated resulting rrom implementation of the project as proposed. (Use attachments if necessary) ...It-tE <s m A I..-L- AD D \l.'ö tV I S Df\.) \l:-{ E l.-^ND~A-~ SlOE OF -n-tE E><l<S\ìN6- ð[RùCTORE ,., 1 l( Æ:N D~R£ (s .t- I -0 OF FXl.sT 1f\J~ ~ùctùR.E BEI('ùFF.t\"\ --rHE. 'PRDf'OS'ED AODf\"lON M\J D ï1-tE WETL.ANDS'. WE AÑ'TIOfA-Tc ~\ ::::I1tER.F:.. WI L-L 'BE ÑD ~'JI~EtJ\7\L /lV\f'AC.TS. '"THE. A«..EA W~E ì1-\t ADD I \1 DN ~fLAN^-.I€D IS ENCd)~F.í) OI'J \1Iùõ -S'IDðS 'E'( E>Cl<ST1N6- R..ÐSl De-Y'£ Mo ïttE kl<.EA IS L.-At-....(0SCÁ:f>eÞ. . . 617.20 PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) SEQR 1. APPLICANT I SPONSOR 2. PROJECT NAME E,N'J lRONl'(\eNT EAST I rJQ. ::rDf.Jes ÆDÞi.\lON 3.PROJECT LOCATION: ~_ I ~'35 ISLAND \I \ e.vJ c:. :SC\FF~· Municipality ";'~ ~ ---.. f'~:r County 4. PRECISE LOCATION: Sr.-eet Addess and Road Intersections. Prominent landmarks ate - or provide maD '·~35 ISLAND \JiE.\,O L..NJe. - SOúlli Ot=' Cb/'-.:)~uÑ ¡:<CAe ~\ CCtJ I.~ L.(~ POll\Ì\' 5. IS PROPOSED ACTION: D New ~)(panSiOn D Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: oµ It-\"E. LANDIU^R.D IO'--{/'y: '2.b'-O" Or-JE.- STO~'( AD.DlTtON SIDE Vr ~ ex \ST1 ~ G ..sf r-J<:::~ Le. {"'A.,Y\lL...'( ~e.s (PENCE . '-n\€: ,":æ.10 A:t:>P\\löN I ~ E.i'JC\_Ds:eO ÖÑ TWO .$' ( De::.S 6Y -nt€ E:Xl.sT,NG S TR.ù c...""nJ R.E:" A-tJ P ~~ (S Q... ì '-0" 0 f' ~)( 1,s\1 1\.16- <S\RÙC\ù t.E BeTWEÐJ -n-te ~~ Po-~ED AcPmû/l AND It-{€ WE:\L!\NPS. 7. AMOUNT OF LAND AFFECTED: '2 J.i3?eIY '* ADPiTlO\j - 4Wcp OF 'f A,fl-..P Initially acres acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? DYes ~NO If no, describe briefly: we; I-\AIjE AL-«EAD'( RÐ=BIVE:.D Af>f'R.cVAL F'R.OrY\ \HE" z.otJlr-.J6 ßDA~ Or ^P~ 'W Al..L.ö v.J A 1.4' ~e:-t"ßAQ::. F~m ~lt>E PRDP8R,\Y UNE (I\J l..ei ù OF R6Q. , ~I lO.o SSÎ~ 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~eSjdential D Industrial D Commercial DAgriCUlture D Park I Forest I Open Space DOther (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~ "\D1,I)r-.) UN,I\.IG 6(\ARD - HAve ~Yes DNO If yes, list agency name and permit I approvai: SOU\l:tOL.. \Ov.-Ñ "Bù ¡LO,NG "DeP"t: p,e·c- 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~es DNO If yes, list agency name and permit I approval; we; I-\A.\JE AÑ ~f~ölJ^L- FP-DM .sOI.1n-\O...D 2òÑtt,J(,. ~ DA: Tt'P MARCH 10 t¿CD 3 12. AS A ~~LT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? []ves No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant '7Þ'e ~ïE-R. ~ 8TOù\t:N "òúR.GA+ FDR.. Date: B. Q..3Q04- ~, Ã)\.'-,L --., ~\llf'..OOIY\9\)\ Ð\SÎ Signature '---' CK. If the action Is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment . . Albert J. Krupski, Presiden.t James King, Vice-M'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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of --~\~-~--------------------------------------- COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, f'E:t"E'fI., 'S'tDlr~ßùRQ;fresiding at LP/òS INO(¡\N IJ~CiL l.ArJE, PE.CðI\J(C , being duly sworn, depose and say: That on the day of , 200 , I personally posted the property known as 133'5 \8L1\NS) \llE:;W L.A1'Jt( GREENf'O(Z\ 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 /J..¡,t$. ~Qt ,~ I ~ ' Qr¡ ôfo.~b.I..~ ~, Dated: cr It /0,/ (jl:,~vø s ature) Sworn to b9for~_ me this / dayof~OOlf ~. JOYCE M. WILKINS Nomy Public, St8te of N_York No. 4952248, Suffolk County Term ExpIres June 12, ;)-007 . . Board of Trustees Application County of Suffolk State of New York f'l:::lt;(Z 8~Bù~K 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 IllS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TIllS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING TIllS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF TIllS APPLICATION. (JJ£fJŒ.~. . Signature SWORN TO BEFORE ME THIS ;)... !-/ DAY OF ~, ,2od JOYCE M. WlLKotlNNS York Not8ry Public, St8te fIW ~.r:==2.~r)7 · H&1e!ltMtg Ite 7-1' J£e 6ita6!1fVhg fÍp F@2e ~--'.. {11_»-oi' !}:!=-~ ~ ~-4#- ð= .~ .' .~~~ ~- ../ ....:.::~_-::- Environment East, Inc. R. R. NO.3 - 3075 Indian Neck Lane Pe..:oni..:. New York 11958 516-734·7474 To Whom It May C~ncern: I, _R\TA (Y\ - qð~ authorize E~1Vironment East, Inc. to act as my agent in appling for ?ermits to construct an an my property at t'3 3'5 Si;,:ned: ~L /","", \:\~ Owner éJ Met t-t-\ ölì . I s I and.. Ij (-.e w !..-An -e . Includinr;: ,'<is Dept. of r.rlViron. Conserv. US Army Cor?s :>1' h nl';i œe rs 1'::JIlr1 of S n LTT\:toLD ;: ,~ . . APPLICANT/AGENTIREPRESENT ATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics Drohibits conflicts of interest on the Dart of town officers and ernolovees The Dumose of this form is to orovide information which can alert the town of DOssible conflicts of interest and allow it to take whatever action is necessarv to avoid same. . YOUR NAME: _"fetER. 8to0i:Et0Sû~H- 1'RES· 6f,:¡'¡\RöN~"t EAST INC. (Last name. first name. 41iddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLlCA nON: (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 ,............ Do you personally (or through your company. spouse, sibling, parent:, or child) have a relationship with any officer or employee of the Town of Southold? "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 v 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 -:PEG<;.~ 'Dl (!1'-i::'~crJ Title or position of that person ¡OllJN \R~\Srê.E 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, parent, or child is (check all that app1y): _A) the owner of greater than 5% of the shares of the corporate stock of the applic~t (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 S \STER... Fonn TS I SUbmitte~.~.t Signature¡ \.) Print Name ÞE\E~ 200 ~ é Q I ST00TE:Ñ 'aU R.<3t+