HomeMy WebLinkAboutTR-4992
Board Of Southold Town Trustees
SOUTH OLD, NEW YORK
PERMIT NO.
1..1 'I if ~
DATE: .M"y 26, 1999
ISSUED TO ....!9J:::1Ç· .I\E..RJ?!;>
Aut~ørilntin1t
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893: and Chapter 404 of the Laws of the
State of New York 1952: and the Southold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN W A TERSõ". and in accordance wIth the
Resolution of The Board adopted at a meeting held on ..M.ilY...2J>......J 999
19't9.., and in consideration of the sum of U5Q...0.0. . paid by
. JONÇ'](E:RB$ .....................................
of ........M.ª.t.tH.udL.. .. .... N. Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
Wetland Permit to remove an existing concrete patio (480s. f. )
~aise house on ecist. found. add 2nd story. lower concrete floor,
m basement, & erect a solid type fence on the west and east "id
~~ P~Pfne';s~d:a¡n¿g ~¡Nlle 3g~tgftenifec:~Jlti8Rf a1 pRlünfë ¡hence,
HWrJhe originating application. Replace eX1St. concrete patio with
porch and deck total 483 sq. ft. .
IN WITNESS WHEREOF, The said Board of Trustees Mre-
by causes Its Corporate Seal to be affixed, and these presents to
be subscribed by II majority of the said Board as of this date.
..;Z~?
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Albert J. Krupski, President
James King, Vice· President
Henry Smith
Artie Foster
Ken Poliwoda
.
.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
May 27, 1999
Mr. Jon C. Kerbs
430 Riley Ave.
P.O. Box 304
Mattituck, NY 11952
Re: 430 Riley Ave., Mattituck
SCTMU43-5-9
Dear Mr. Kerbs:
The following action was taken by the Board of Town Trustees
during its regular meeting held on May 26, 1999 regarding the
above matter:
WHEREAS, JON C. KERBS applied to the Southold Town Trustees for
a permit under the provisions of the Wetland Ordinance of the
Town of Southold, application dated April 29, 1999, and
WHEREAS, said application was referred to the Southold Town
Conservation Advisory Council for their findings and
recommendations, and,
WHEREAS, a Public Hearing was held by the Town Trustees with
respect to said application on May 26, 1999 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,
WHEREAS, the structure complies with the standard set forth in
Chapter 97 of the Southold Town Code,
.
.
WHEREAS, the Board has determined that
will not affect the health, safety and
people of the town,
the project as proposed
general welfare of the
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of
JON C. KERBS to remove existing concrete patio 480 sq. ft. and
replace with porch and decks total 483 sq. ft. Raise house on
existing foundation, add second-story, lower concrete floor in
basement, and erect a solid type fence on the west and east side
of property line to within 30' of HWM then add a split rail
fence to HWM.
BE IT FURTHER RESOLVED that this determination should not be
considered a determination made for any other Department or
Agency which may also have an application pending for the same
or similar project.
Permit to construct and complete project will expire two years
from the date it is signed. Fees must be paid, if applicable,
and permit issued within six months of the date of this
notification.
Two inspections are required and the Trustees are to be notified
upon completion of said project.
Fees: None
Very truly yours,
t2Ltf.~ I tJ. /~'!h.
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/djh
cc: DEC
Building Dept.
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
.
.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
January 25,2001
Mr. Jon Kerbs
440 Riley Ave.
Mattituck, NY 11952
Re: 430 Riley Ave., Mattituck
SCTM#143-5-9
Dear Mr. Kerbs:
The following action was taken at the Southold Town Board of Trustees meeting held on
Wednesday, January 24,2001:
RESOLVED, that the Southold Town Board of Trustees Approve the request for an Amendment
to Permit #4992 to remove lO'X 24' of asphalt drive and landscape, relocate 150' of the asphalt
drive, add II' of garage apron, add 3'X 3' section to porch, add TX 10' entrance steps, and
rebuild porch and steps on north side entrance.
This is not a determination from any other agency.
If you have any questions, please call our office at (631) 765-1892.
Sincerely,
t2tt~·1 tJ. /~~'~,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK:lms
DEC
.
.
Telephone
(631) 765-1892
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New. York 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town Conservati9n Advisory Council held Thursday, January
18,2001, the following recommendation was made:
JON KERBS 143-5-9 to Amend Pennit #4992 to remove IO'X 24' of asphalt drive and
landscape, relocate 150' of the asphalt drive, add 11' of garage apron, add 3'X 3' section to
porch, add 7'X 10' entrance steps, and rebuild porch and steps on north side entrance.
430 Riley Ave., Mattituck
The CAC did not make an inspection, therefore no recommendation was made.
.
Albert J. Krupski, President
.lame!'! King, Vice-President
Henry' Smith
Artie Foster
Krm Poli\'I.'oda
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Town Hall
53095 Main Road
P.O. Hox 1179
Southold, New York 11971
Telephone (516) 765-l8q2
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
. TOWN OF SOUTHOLD
LETTER OF REQUEST FOR AN AMENDMENT
DATE 5?117
OWNER I: i/J \A... K.e,v-l. ') PHONE d ~ f - s- S:s S-
ADDRESS 'i if) HI Þ~/!1v~ ¡1f~ ¡¡/vet ,Vr¡ 1195'--
AGENT
PHONE
ADDRESS
PROPERTY LOCATION ~ ?>o ~ I k, k Me¡ trlcJc. ,
TAX MAP NO. \ ~ 3 - 5' - C\.
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Telephone
(516) 765-1892
Town Hall. 53095 Main Road
P.O. Box 1179
SouthOld. New York 11971
SOUTHOLD TOWN
CONSERV ATION ADVISORY COUNCIL
A1 the meeting of the Southold Town Conservation Advisory Council held Monday, May 24,
1999 the following recommendation was made:
-.If I. Illtf ?'t'emove existing concrete patio 480 s.f. and replace with porch and
deck totaling 483 s.f. Raise house on existing foundation, add second story, lower concrete floor
in basement.
430 Riley Ave" Mattituck
The CAC did not make inspection, therefore, it has no recommendation.
.
.
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765-18't2
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
. TOWN OF SOUTHOLD
DEC22
LETTER OF REQUEST FOR AN AMENDMENT
DATE /J.hf /00
, ,
OWNER JUIA,- ~JoS
"ADDRESS, .!.fýo R(l]
AGENT
PHONE )q P ~)S5 S-
A- (' ;it. -Ii it' f-. /1/1
PHONE
ADDRESS
PROPERTY LOCATION L( 3 ó f(, £:, Jf¡/~
TAX MAP NO. I O¡){) -IY: S - .5 -<]
~ I/We ~U"'-- !4Jð S
IJ\ 5er- Q ~r L....o
[\ ~
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request an Amendment to Permit # '(rrz
'_By ~r~. Å
t..¡d
J......n
.
.
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Maln Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765·18,'/2
Fax (516) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Onl œ_œ & Œ U W 2 ~.,
_Coastal Erosion Permit Applicatio I ----- [I.-,(µì,/
-X-Wetland Permit Application :!/
_Grandfather Permit Application UL APR 291999 ".'"
Waiver/Amendment/Changes _ ¡ ,
Received APplication:~ TO'f¡'r;-hT (--,;' :;7:! _
..... ~~~~i~~~/~~~~i¡~i~ C¡¡:/~':M ~~~~'L' I ",
Incomplete
SEQRA Classificati~
Type I Type II~Unlisted
Coordination: (date sent) ----
CAC Referral Sent:
~ate of Inspection: !illqlo~
Receipt of CAC Report:
Lead Agency Determination:
Technical Review:
Public Hearing He~
Resolution:
~o
"
Name of Applicant --' ð'^-
Address l{ ~O R LlR ,ß '30 ~ (V~ JJJJ{-
_Wi') L Phone Number: ( Sib) -709 - ,J.& ) ~
Suffolk County Tax Map Number: 1000 - / c¡ 3 - ðS -~ '1
ProI¡>erty Location:3 ~ 0 \<\ L", ~ i\t~\. ~'c£:.:
i~L",)~ ~~ <'ß~ ()¡v<- ' c""-- s/s f(,'I¿7 ?)v~
(provide LILCO Pole #, distance to cross streets, and location)
APR 2 9 mg
.
AGENT:
(If applicable)
Address:
Phone:
FAX#:
1
BOa of Trustees APPlication.
GENERAL DATA
Land Area (in square feet):
It ò' Z¿
Area Zoning:
property :_K e S
property:~ S
Previous use of
Intended use of
Prior permits/approvals for site improvements:
Agency
Date
No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a
governmental agency?
;<
No
Yes
If yes, provide explanation:
Project Description (use attachments if necessary):
~e.-W\.òU_ € ,><-,',J-,,,-,, 01A-';-V",,+; '-' ¿¡f()ß £:<I..Q
~~:<' ~'J~" Y.<~ ~ts M~~ ~t3¢
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2
BoJla of Trustees Application 4IÞ
WETLAND/TRUSTEE LANDS APPLICATION
Purpose of the proposed operations:
\ "'" y.u 11,'_
DATA
\ IIJ~ L( L'~
Area of wetlands on lot:
¿Ç1)
i' %
square feet
Percent coverage of lot:
Closest distance between near~t existing structure and upland
edge of wetlands: S-S feet
Closest distance between nearest proposed structure and upland
edge of wetlands: ç L. feet
Does the project involve excavation or filling?
No X Yes
If yes, how much material will be excavated?
S Ò cubic yards
How much material will be filled?
o
cubic yards
Depth of which material will be removed or deposited:
feet
Proposed slope throughout the area of operations: ~Wt~
Manner in which material will be removed or deposited: \oL.-. lOv~
\
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):
~'l6 IILL
3
Boa. of Trustees Application .
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity:
Are wetlands present within 75 feet of the proposed activity?
No
x
Yes
Does the project involve excavation or filling?
If Yes, how much material will be excavated? ) ù
No
x:
Yes
(cubic yards)
How much material will be filled?
o
(cubic yards)
deposited:_bIA ~C(..~.o
~
Manner in which material will be removed or
Describe the nature and extent of the environmental impacts
reasonably anticipated resulting from implementation of the
project as proposed. (Use attachments if necessary)
II\. b ~e....
4
---
617.21
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I_PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
.
\
.
1.4-16.4 (2187)- Text 12
.. . \ PROJECT I.P. NUMBER
SEG
1. APPLlCA~~ ISPONSORC
Ù'^-
3. PROJECT LOCATION: . I I
MUnicipality (~
4. PREC:SE~~~ON (S~:Í:;~ ana ~etlons. '{t~t\n:t"~(~. or ''0"0. ma'¡
s,
I 2.
?AOJEÇ7 NAME
CountY S U (h'~ K
5. 15 PROPOSED ACTION:
o New 0 Expansion
'i2r MOdification/alteration
6. D~CRIBE PRO,JECT BRIEFLY;. r\ ---;) \., u. "...,....,(, Q.......J;} ....." I <.oW'
t<Q.V'l.",o!. <-f,~.h"'>... l.......~<- Io(G.-'I\O US<.!p ~lQ.cL
fUoa\..-S . ~ ~c..l:...s ..Jç...~~\.. \f~~~ )Ro.,.;( (",~...",<:...
. Õ~'- t',...ò\.-.~ ~.....£Jo...~Ù~ Lo""-,,ý C-<>_......k, ~''''~l2..- i.......
10 ¿~>.(1I'rl" ----{--
7. AMOUNT OF LAND AFFECTED: V\.~
!nitially acres Ultimately acres
3. WILL. PAO?0SED ACTION COMPLY WITH EXIStING ZONING OR OTHER E,':(!STING '-AND USE :=IES7RIC710NS?
.£ Yes 0 No If ~o. aescnbe briefly ,
9. VJI-1AT;5 PRESENT LANiJ tJSë.IN VICINITY OF ?ROJECT?
,g}Resldentlal O.!ncustri81 [J C,;¡mmerClat
Desc~!be:
o Agriculture
~ Park/ForestlOoen scace
L Other
10. DOES ~CTI0N !NVOLVe A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMAíEL:' FROM ANY OTHER GOVERNME~íAL AGENCY \F~iJERAL,
STATE QR LOCAL)?
ø Yes 0 No If yes. list agency(s) and oermitfacprcvals
't"EC- .
-
11. DOES ANY ASPECT OF THE ACTI0r~ HAVe A CURRENTLY VALJD PERMIT OR APPROVAL?
Dyes· <Ç1' No If yI!S. list agency name and permit/approval
12. AS ~ RESULT OF PROPOSED ACTION WILL '::XISTING PEAMITIAPPQOVAL "-EQUIRE .YlOQIFICAiI0N?
0_ ~....
I CERT~~:F~T~::C':;VE IS TRUE -0 THE 3EST OF MY KNOWL:DGE ~ 7
"pHe,ntl.,onsor ¿am.. ,.........leY-'- ~ A D." - ~--
Signature: -
'-----I
If the action is in the COGS tat Area. and you are a state agency, complete the
Coastal Assessment Form before proceeding with this a:¡.~essment
OVER
1
---
PART II_:NVIRONMENTAL ASSE
ENT (To be completed by Agency)
.
A. DOES ACTION E' GEED ANY TYPE I THR SHOLD IN 6 NVCAA. P.A.RT ô17.12'? If yes. coorOlnate tM review crocess aM use [he FULL E'A'=.
o Yes No
a. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIOED FOR UNLISTED ACTIONS IN ò NvCRA, PART S1ì.5? if No. a negative dec:aratlc
may De superse Q by another ¡nvolved agency.
o Yes No
C. COULD ACTION ESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING; (Answers may oe nanQwrltten. If Teglble)
C1. EXistIng air quality, surface or groundwaler Quality or Quantity, nOise levels. eXisting :raffic patterns, sOlla Naste proauc:lon or d!scosa
potential lor erosion, drainage or flooding proctems? Exølain brieily:
NO
C2. Aesthetic, agricultural, archaeological, histonc. or other natural or cultural resources; or community or nelgnbornooCl character? =.:cotaLn Oriel
rJ 0
CJ_ Veqelatlon or fauna. IIsn. sMelltlsM or wllClllfe species. slgmficant hablla!s. or threatened or enaangereCl specIes? ExPlam Melly:
NO
CJ.. A communIty's existing plans or goals as officially adooteCl. or a change in use or Intensity of use of lanCl or other natural resources? Explain oner
fJO
CS. Growth. suOseQuent Clevelopment. or relateCl activities likelY to oe mduceCl by !he proposea action? Explain orlefly.
No
C6. Long term. snort term. cumulative. or other eHeets not iClentifled in Cl·CS? :xPlain orlefly.
~ü
,:7. Other impacts (inClueing changes In use of eIther quantIty or type of energy)? Explain brietly.
yJO
"
:MPAC7S?
Q. IS ,HERE. ·JR I;..¿HEAE LIKELY TO BE. CONTROVERSY RELATE:! TO POTENTIAL ADVERSE =~VIAONMENT;'L
n Yes ~ No If Yes. explain briefly
PART III_DETERMINATION OF SIGNIFICANCE (To be comoleted by Agency)
INSTRUCTIONS: For each adverse effect identified above. determine whether it Is substantial, large. important or otherwise sigmficar
Eacn effect should be assessed in connection with its (a) setting (I.e. urban or rural); (b) probacllity of occ¡µ¡j,rlg; tCI duration; I
irreversibility: {el geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure tho
explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressea.
o Check this bOX if you have identified one or more potentially large or significant adverse impacts which MAY
occur. Then proceed directly to the FULL EAF and/or prepare a positive'declaration. '
~ Check thiS box if you have determined, based on the information and analysis above and any supporting
documentatIon, that the proposed. action WILL NOT result in...:ß...ny significant adverse environmental impacts
a¿¡;;:;n ~Ch:rts as neces ~y'fj.,.reasons supporting this determination:
At..¡1,ç-¡}7 :\. f(,2.fA./J,J¡((
~rol1( Of I v!)e .....rne 01 '¡c,pon\,o!e UUlcer .n Lt:dO Agencv
-.T¡/
....,'lI1e 01 lC.ld A¡;enCy
;'Jo:n.1(ure or 1(t<\pOn1,Ole ùrI,ccr ,0 LeðO ^~oÒ'ncv
';".:,n.uure 01 ¡'>reoD.1rer tit o,tler~"t rram reSoan\la ~ ·Jrf'cerl
~-( r- p,
0.1(('
2
-
.
.
Office use only
File #:
Permit #:
TOWN OF SOUTHOLD
HIGHWAY DEPARTMENT
PECONIC LANE
PECONIC, NEW YORK 11958
Print or Type:
PERMIT & BOND APPLICATION
FOR ACCESS THROUGH TOWN OWNED PROPERTY
1 )
(Name of Applicant)
(Address)
2)
(Name & Address of Contractor Involved)
3)
(Project Location)
1000-
(s.C.T.M. #)
4)
(Name of Road or Town Property Involved)
(Hamlet)
5)
(Brief Job Description)
6)
Starting Date:
Completion Date:
7) Estimated Cost of Proposed Work:
8) Insurance Coverage:
A. The coverage required to be extended to the Town:
Bodily injury & Property Damage;
$300,000/$500,000 Bodily Injury & $50,000 Property Damage
B. Insurance Company:
C. Insurance Agent
Name & Telephone #
D.
E.
Policy # :
State whether policy or certification
is on file with the Highway Department:
(If no, Provide a copy with Application)
(yes/no)
(Signature of APplicant)
(Date )
------------------------------------------------------------------
To be completed by the superintendent of Highways:
Bond Amount
Required:
(Si gnaturè)
-
.
.
Office use Only
File #:
Permit #:
Print or Type:
ACCESS CONSENT FORM
FOR ACCESS
THROUGH PRIVATE PROPERTY
1)
(Name of Applicant)
(Address)
2)
(Name & Address of Contractor Involved)
3)
(Project Location)
1000-
(S.C. T .M. #)
4)
(Name of Road or Private Property Involved)
(Hamlet)
5)
(Name & Address of Homeowners Association / Property Owner)
6)
(Brief Job Description)
7)
Starting Date:
Completion Date:
8) Estimated Cost of Proposed Work:
9) Insurance Coverage:
A. The coverage required to be extended to the Property Owner:
Bodily injury & Property Damage;
$300,000/$500,000 Bodily Injury & $50,000 Property Damage.
B. Insurance Company:
C. Insurance Agent
Name & Telephone #
D. Policy # :
E. State whether policy or certification
is on file with the Trustees Office:
(If no, Provide a copy with Application)
(yes/no)
(Signature of Applicant)
(Oat e )
------------------------------------------------------------------
To be completed by the property Owner:
I/We the undersigned, fully understand the nature of the Proposed
Work referenced above and have no objection to allowing the
Applicant to cross My/Our Property to do the work.
(Signature of the Property Owner
or dul y authori zed representat i ve)
.
.
.'
APPLtt!AN't
TRANSACTIONAL DISCLOSURE FORM
.
The Town of Southold's Code of Ethics Þtohibits conflicts ot
interest on the art of town officers and em 10 ees. The
ur ose of this form is to rovide information wh ch can
alert the town of oss ble conflicts of nterest and allow
it to take whatever action is nece sa to avo d same.
~ C'
tOUR NAMR.
ev
Last name, first name, m ddle
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.)
NATURE ot APPLICATION I (Check all that apply.)
..'
. ;'::C~",~~·:·::~~;~~··;~i1f¡·)j~·
Tax grievance
Variance
Change of zone
^p'p~~al of plat
Exe~ption from plat or official map' l
n~e~other," name the activity.) t..ua+kvJ) c::;;.~~ \d-\.J~
Do you personally (or through your company, eþoues. eibling,
parent, or child) have II relationship with IIny officer or
employee of the Town of Southold1 ·Relationship· includes
by blood, marriage, or business interest. .Business
interest· means a busineRs, including a partnership. in
which the tovn officer or employee has even a partial
ownership of (or employment by) a corporation in vhich
the town officer or employee owns more than 5% of the
shares.
YES
NO
>C
.:..;;:¡,.
If you anevered ·tES,·, complete the ba1ance öt ~ht. lorm and
date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself (the applicant)
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 spousei 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 app1icånt (when the applicant'
is a corporation),
B) the legal or bèneficia1 owner of any interest in a
noncorporate'entity (when the applicant is not a
corporation) ,
C) an officer, director, partner, or employee ot the
applicant, or
D) the actual applicant.
.,
.
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