The URL can be used to link to this page

Home My WebLink AboutTR-5826Albert 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 CERTIFICATE OF COMPLIANCE # 0086C At Date Dec.21~ 2005 THIS CERTIFIES thatthe removal of existing dwelling and construction of new dwelling, garage, and sep~s~-~m~ 730 West Shore Drive, Southold Suffolk County Tax Map # 80-1-48. ! Conforms to the application for a Trustees Permit heretofore filed in this office Dated 9/12/03 pursuant to which Trustees Permit # 5826 Dated Oct. 22, 2003 Was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is The removal of the existing dwelling, and construction of new dwelling, garage, and septic system. The certificate is issued to aforesaid property. Richard Heffernan owner of the Albert J. Krupski, President James King, Vice-President Artie Fester Ken Poliwoda Peggy A, Dickerson BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD To~vn Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 YOU ARE REQUIRED TO CONTACT THE 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 __ 1st day of construction constructed ~/Project complete, compliance inspection. SURVEY OF LOTS 4, 5 & BLOCK B MAP OF REYDON SHORES, FILE No. 631 FILED JULY 2, 1931 SITUA TED A T BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-80-01-48.1 SCALE 1"=50' FEBRUARY 27, 2002 M~Y 2, 2003 ADDED TO~O~HI~ S~R'~EY MAY lS. 2003 ,'~O PROPO~D ADD~ JULY 25, 2005 ADDED B.O.H. DATA AI~A = 12,351.13 sq. ff. ('m T~: UN[) 0.285 oc. ~Board 0! Trustees TEST HOLE DAT.4 ~JO BY JMM]~ML~_G~M~ ON ~NE ~. 2005) PROPOSED SEPTIC SYSTEM DETAIL I )I)-I Ft SURVEY' OF LOTS 4, 5 & P'/O ~ .~. MAP OF ~a] REYDON SHORES, ~4q...~ S.C. TAX No. 1000-80-01-48.1 SCALE 1"=30' ~v ~e, 2~3 ~[o P~ ~s ~-~- / /..~- ~ ~ x~.;~ ' ~ ~ ~) 0.28~ ao. PROPOSED SEPTIC SYSTEM DETAIL ~ ~-~ F~ (~I)~7-t727 SURVEY OF LOTS 4, 5 & P/O 3 BLOCK B MAP OF REYDON SHORES, INC. FILE No. 651 FILED JULY 2, 1951 SITUA TED A T BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YOEK S.C. TAX No. 1000-80-01-48.1 SCALE 1"=50' FEBRUARY 27, 2002 JULY 25, 2005 ADO~ B.O.H. DATa ~'.:.,.,.~,~(~,~ AREA = 12,$$1.15 sq. ft. ~o ~ ~) 0.283 ac. TEST HOLE DATA //~--FURtHEST LEACt'IM$ POOL Of A 5 POOL S'I~TEh4 2. J ~ TAMK GAI~5 ~OR 4 Jl~ HOUJ~ iS 1,0~0 GALLONS. ,]. J J ~IT. IiJ JroIJ I JJ~J~li)~ll JiOiJJ[ I~ i~J} Ill fl ~I~J~JAII JJlF-~. JOAoAJnS ~Jrl ouOoOUl '¥ closor g O/c~ ~ ~ '~ sa;oq ~0 k3ASnS Board Of $outhold Town Trustees SOUTHOLD, NEW YORK P~RMIT N 0.:,,,,~_~ ......... DATE: .O...cj.o..b~~- ....2..2..~... 2 0 0 3 ISSUED TO RICHARD HEFFERNAN Pursuant to the provisions of Chapter 615 of the Laws of the State of New Yod~, 1893; and C~apter 404 of the Laws of fha · State of New York 19521 and the Southold 'Town Ordlnar~e e~~ titled ."RE~UI~TINO AND THE PLAClNO OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS end the REIdOYAL OF SAND, ~RAVEL. OR OTHER IdATERIALS FROId LANDS UNDER TOWN'WATERS;..?. and in accordance with the Resolution of Ti~e B6erd adopted at a meeting held on ~..e..~.°..b..~T..~..Z. ' · ..~_0.9.~, and in consideration of the sum of $...~.~9..~...0.P ...... paid by Richard Heffernan of ........ P°.Y_~..°J~[ ......................................................... N. Y. and ~ubie~t to the Terms and ~onditions tided on the reverse side hereof, of Southold Town' Trustees authorizes and permits the following: Wetland Permat ~o remove the existing 30'X 30' ~w.o-stor~ frame dwelling ~d 15'X 30' deck. Construct a new 38'X 42' two-story frame dwelling and 3g'X 12' wood deck and 20'X 22' detached g~rage. Remove the existing septic s~tem and install a new septic s~stem approx. 140' landward of the AI-IW, all with the condition gu~ers and dtywells are installed to contain the roof run-off ~md a drainage plum is submitted to the . all in accordance with the daf al[nd spacif'mations as IX'esenfnd in · the odglnatlng apl~icafion. IN WITNESS WHEREOF, The said Board of Trustees here- by causes ifs Corporate Seal to be a~xed, and these presents to b~ subscnl~ed by ~ 'majorfly of the s~,d Boerd as of this darn, · '-- r~le~l~'st~r'- Absent The#eat TERMS ~ndC-C~ Richard Hef£err~an 730 West Shore Dr., Southold the comkk~i~ f~ the ~ of the P,'~ do~ ~l~s~l sad pmsaii~ to the roi- TI~t tlais t~t d~uld be ~ned imle~mitely, o~* u 1~ ~s dm s~id Pe~mlu~e ~ the stn~-uu~ or, project /n~ol~-~l, to l~ovi~ evidence to anyo~ ~ot~.~d d~ aud~ pleme~.l m this pemdt ~ nmy be sub,ct to mvo~e upon f.m,~ to ~ ~ Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 22, 2003 Ms. Catherine Mcsiano Catherine Mesiano, Inc. 12 Mill Pond Lane East Moriches, NY 11940-1222 RICHARD HEFFERNAN 730 WEST SHORE DR., SOUTHOLD SCTM#80-1-48.1 Dear Ms. Mesiano: The Board of Town Trustees took thc following action during its regular meeting held on Wednesday, October 22, 2003 regarding the above matter: WHEREAS, Catherine Mesiano on behalf of RICHARD HEFFERNAN applied to the Southold Town Tmstees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated September 12, 2003, 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 October 22, 2003, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and arc 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 standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of RICHARD HEFFERNAN to remove the existing 30'X 30' two-story frame dwelling and 15'X 30' deck. Construct a new 38'X 42' two-story frame dwelling and 38'X 12' wood deck and 20'X 22' detached garage. Remove the existing septic system and install a new septic system approx. 140' landward of the AHW, all with the condition gutters and drywells are installed to contain the roofrun-offand a drainage plan is submitted to the Building Dept., and as depicted on the survey prepared by Joseph A. Ingegno last revised September 17, 2003. 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 $5.00 per inspection. (See attached schedule.) Fees: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms OCT 2 0 20O3 .~ Seuthold Board of Trustees , Robert J. Kolye~ ~40 W. Shore Dr. P.O. Box 885 Southold, NY 11971 October 20, 2003 Board of Trustees Town of Southold Southold, NY 11971 Dear Sir: Re: New construction at 730 West Shore Drive, Southold Encl, Notice to adjecent property owner (at 640 West Shore Drive) I am owner of the residence at 640 W Shore D~ adjacent to the above referenced 730 W Shore Dr. As background history, 640 was purchased by my family when it was built in 1936. At that time .~_- the then empty adjacent plot was lower than 640 and there was no surface water problem at E40. Several years later, wheu a house was built at 730, that plot was filled in allowing substancial quantities of rain water and melted snow to flow onto 640, with as much as 16 inches of water flooding the cellar. I am describing this to explain my concern over new construction at 739 where additional fill may add to the oroblem. Also, water from existing front and rear gutters at ?30 now flows to my property. With a dwelling size increase from 900 to 1596 square feet, this may also increase the flooding problem. I see no other problem with this proposal, w~ich Certainly enhance Reydon Shores. Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box I 179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Tuesday, October 14, 2003, the following recommendation was made: Moved by Drew Dillingham, seconded by Tom Schlichter, it was RESOLVED to TABLE the Wetland Permit application of RICHARD HEFFERNAN to remove the existing 30'X 30' two-story frame dwelling and 15'X 30' deck. Construct a new 38'X 42' two-story frame dwelling and 33'X 31' wood deck and 20'X 22' detached garage. Remove the existing septic system and install a new septic system approx. 140' landward of the AHW. Located: 730 West Shore Dr., Southold. SCTM#80-1-48.1 The CAC Tabled the application because the project was not staked. Vote of Council: Ayes: All Motion Carried / / r· SURVEY OF LOTS4, 5 &P/O3 BLOCK B MAP OF REYDON SHORES, INC. FILE No. 651 FILED JULY 2, 1951 SITUA TED A T BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-80-01-48.1 SCALE 1"=50' FEBRUARY 27, 2002 MAY 2, ~ ,~ TOPOGRAPHICAL SURVEY ~ ,fo~-% MAY lg. 200~ ADDED PROPDSEB ADDmONS ~-~ 4~' AUGUST 5. 2005 ADDED EXiSTiNG WELL ACROSS STREET ~ ~,L~ ~P~.k~ER 2. 2003 ADDED NOTE No. 5. ~' ~0"' SEIalqEM~'R 17, 200.3 f~'~5[ PROPOSED DECK ~' AREA -- 12,551.15 sq. ft. fid ~ u.~) 0.283 ac. ~ PROPOSED SEPTIC SYSTEM DETAIL TEST HOLE DATA (T~'ST HOL~ DUG BY Jl~5?,~,.~ ON JUNE 26. 2003) LOT COVERACE DATA DESCRIPTION AREA LOT COV£RAO~ HOUSE 1526 ~q. ft. 12.5~J~ GARAGE 440 sq. ft. 3.57~ DECK SO0 ~cl. ft. 4.05~ TOTAL 2466 ~q. ft. 20.00~ .~.~FURTHIrsT LEACHING POOL OF A 5 POOL SYSTEM 1. ~ ~ ~ TO N.G.V,O. lg~ DATUM 1 T~; ~ ~. 4'-3" ~, a'-7" DE~ 3. M~ ~C~ ~M FO~ 4 BEDR~M MOUSE IS ~ mq fl SIDEWALL SMALL ~ ~ Cl.[AN ANO REMOVED. SURVEY OF i ~ LOTS 4, 5 & P/Gl!. BLOCK B MAP OF REYDON SHORES, Il FILE No, 651 FILED JULY 2, 1951 SITUA TED A T BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-80-01-48.1 SCALE 1"=50' FEBRUARY 27, 2002 MAY 2, 2005 AOOED TOPOGRAPHtCAL SURVEY MAY lg, 2005 AflD[O PROPOSED AOOITIONS JULY 95, 2003 ADD/D B.O.H. DATA ~.0'~, AaJSUST 5, 2003 ADOED EXISI1NG WELL ACROSS STREET i;~4~*-__K,~J ARIrA = 12,,]51.15 sq. ft. ¢o T~ UN[) 0.283 oc. Board of lrustee$ TEST HOLE DATA SOLE OUC. B~' ~ ON dUt~. 2~. ~OOJ) PROPOSED SEPTIC SYSTEM (Nm YO SC.A~ DETAIL ~--FURTHEST LEACH~G POOL OF A '5 POOL SYSTEM Land Surveyor PHON~ (~$)72q-2~ Fo~ (~1)727-~727 dlBI:R~AllONS ~D/OR OATA O~TAIN~) ~ OYHL'RS. TOWN 'I'IiUSTEE~S Office Use Onl,, "x h Tllt' ,'l Southold Tow Board of [rus~t o"r- H oc.~ Itl C105', Mit'el', ,llld It,udIlOlll \(,} %1 , I, .,i~i,n~.n-.I,.CATHERINE MESIANO, INC. 12 MILL POND LANE E. MORICHES, NY 11940-1222 Board of Trustees Applzcatlon Land Area (in square feet) Area Zonmg GENERAL DATA Prev,ous use Of property ,.,4 ~,~_./_.z~,~ Intended use of property Prior permits/approvals for site improvements Agency Date No prior permits/approvals for site ~mprovements Has any permwapproval ever been revoked or suspended b,, a governmental agency'~ ~, No Yes If yes, provide explanation Project Description (use attachments if necessary) __ 1. REMOVAL OF THE EXISTING (APPROX.) 30' X 30' 2-STORY FRAME DWELLING AND 15' X 30' DECK. EXISTING DWELLING LOCATED APPROXIMATELY 60' '~ LANDWARD OF AHW. EXI,,STING, DECK LOCATED 45' LANDWARD OF AHW. 2x,,~_O. NSTRUCTION OF A 38 X 42 2-STORY FRAME DWELLING, (APPROX) AND 3O~X $i' WOOD DECK AND 20' X 22' DETACHED GARAGE. PROI~OSED DWELLING WILL BE LOCATED 75' LANDWARD OF BULKHEAD AND APPROX. 80' LANDWARD OF AHW. PROPOSED DECK TO BE LOCATED 55' I.~NDWARD OF EIULKHEAD; 60' LANDWARD OF AHW 3. INSTALLATION OF NEW SEPTIC SYSTEM APPROX. 140' LANDWARD OF AHW AND REMOVAL OF EXISTING SEPTIC SYSTEM. ~ard of Trustees Applicati~ Purpose of the proposed operations: Area of wetlands on lot: - ~ ~ square feet Percent coverage of lot: ~ % Closest dista~lce between nearest existing structure and upland edge of wetlands:___~ feet Closest distance between nearest proposed structure and upland edge of wetlands: ~' feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? ~ cubic yards How much material will be filled? ! I~ cubic yards Depth of which material will be removed or deposited: - ~ feet. ~4~-~,~ . Propose~ slope throughout tne are~ of operations.~~__ Manner in which material will be removed or deposited: 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): 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 $OUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING ,residingat 12 ff],ll I~o~ being duly swom, depose and say: That on the l4 dayof Oct- ,2002, I personally posted the property known as 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 [13~.. ~..~C o~I~. ~ ,. Dated: Swom to before me this ay of Notary Public DE. BOR~ A. NICOLA Robert Kolyer P.O. Box 885 Southold, NY 11971 moo-8o4-47a Linda Ann Wenk & Susan Capozzoli 321 W 24th St, #17H New York, NY 10011 [000-g0-1-44 Peter M. & Linda Wenczel West Shore Dr. Reydon Shores Southold, NY 11971 1000-80-[-45 Douglas & Benita Pearsall 1725 Oak Dr Southold, NY 11971 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: RICHARD HEFFERNAN SCTM # 1000-80-1-48.1 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees for: A. REMOVAL OF THE EXISTING (APPROX.) 30' X 30' 2-STORY FRAME DWELLING AND 15' X 30' DECK. EXISTING DWELLING LOCATED APPROXIMATELY 60' LANDWARD OF AHW, EXISTING DECK LOCATED 45' LANDWARD OF AHW. B. CONSTRUCTION OF A 38' X 42' 2-STORY FRAME DWELLING, (APPROX.) AND 33' X 31' WOOD DECK AND 20' X 22' DETACHED GARAGE. PROPOSED DWELLING WILL BE LOCATED 75' LANDWARD OF BULKHEAD AND APPROX. 80' LANDWARD OF AHW. PROPOSED DECK TO BE LOCATED 55' LANDWARD OF BULKHEAD; 60' LANDWARD OF AHW C. INSTALLATION OF NEW SEPTIC SYSTEM APPROX. 140' LANDWARD OF AHW AND REMOVAL OF EXISTING SEPTIC SYSTEM. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 730 WEST SHORE ROAD, SOUTHOLD 3. That the project which is subject to Environmental Review under Chapters 32, 37,or 97 of the Town Code is open to public comment on October 22, 2003. You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNER'S NAME: MAILING ADDRESS: OWNER'S AGENT: Richard Heffernan 730 West Shore Road Southold, NY 11971 Catherine Mesiano, Inc. 12 Mill Pond Lane East Moriches, NY 11940 631-878-8951 Enc.: Copy of sketch or plan showing proposal for your convenience. May Name Proof of Mailing of Notice Attach Certified Mail Receipts Adddress State of New York County of Suffolk Anne W. Hill, residing at P.O. Box 1245, Center Moriches, NY being duly sworn, deposes and says that on the 8th day of, Oct. 2003, 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 their respective names; that the addresses set opposite the names of said persons are the addressed of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at East Moriches, NY, that said Notices were mailed to each of said persons by certified mail. Anne W. Hill Swo~n to before me this ~ day of (~:::::~c7~ ~ A. NI .Cq~.k ~, UINI~UO ~M Wk ~n~ ~ ~~m ~mh 16, 20 ~, ,2003 Albert J. Krupski, Presiden~ 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) 765-1882 Fax (516) 765-1823 BOARD OF TOWN T~tUSTEES TOWN OF SOUTHOLD April 23, 1998 Richard and ~ebarar Heffernan 50 Raydon Drive N. Merrick, NY 11566 RE: Richard and Debarah Heffernan SCTM #80-1-48 Dear Mr. & Mrs. Heffernan, The following action was taken by the Southold Town Trustees on Wednesday, April 22, 1998, at their Regular Meeting: RESOLVED, that the Southold Town Board of Trustees grant a Waiver to construct a 15' X 33' deck onto existing dwelling. Located 730 West Shore Drive, $outhold. However, this approval does not constitute approvals from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/jmd cc. Bldg. Dept. New York State Department of Environmental Conservation Buildlng 40 -BUNY, Stony Brook, New York 11790-2356 Telephone (516) ~J365 Facsimile (516) 444-0360 LETTER OF NON JURISDICTION-TIDAL WETLANDS John P. CabflJ Commissioner February 23, 1999 Richard Heffeman 50 Roydon Drive East Merrick, NY 11566 Re: 1-4738-02181/00001 Heffernan Property 730 West Shore Dr., Southold SCTM# 1000-80-1-48 Dear M=r. Heffeman; Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: The portion of the property landward of the existing bulkhead constructed prior to 8/20/77 as shown on NYSDEC Tidal Wetland Map//718-546 and the survey prepared by Roderick VanTuyl dated 11/8/76 is beyond the ,article 25 Tidal Wetlands jurisdiction. Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that ail necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. cc:KFJfile Very truly yours, Re: Richard Heffeman 730 West Shore Road, Southold SCTM # 1000-80-1-48.1 STATE OF NEW YORK) COUNTY OF SUFFOLK) SS: Richard Heffeman being duly sworn, deposes and says: I reside at 50 Roydon Drive East, Merrick, NY In the County of Nassau and the State of New York , And I am the (owner in fee) (officer of the Corporation which is the owner in fee) of the premises described in the foregoing application and that I have authorized ,~. HERINE MESiANO, linC. to make the foregoing application as described herein. Sworn before me this /~/day of~ ,20~L~. Notary Public VIRGINIA D. TUNISON Notan/Public, State of New Yo~k No. 01TU4963358 Qualified in Nassau County Commission Expirss March 12. 3~t~ PROJECT ID NUMBER I 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by .a )licant or Project Sponsor) 1. APPLICANT / SPONSOR 2. PROJECT NAME RICHARD HEFFERNAN 730 WEST SHORE DRIVE 3.PROJECT LOCATION: SOUTHOLD SUFFOLK Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prcmlnent ~andmarks e~c -or prowde map N/SIDE WEST SHORE DRIVE, 65' W/OAK DRIVE REYDON SHORES SOUTHOLD 5. IS PROPOSED ACTION: [] New [] Expansion [] Modification / alteration i. DESCRIBE PROJECT BRIEFLY: SEQR , REMOVAL OF THE EXISTING (APPROX.) 30' X 30' 2-STORY FRAME DWELLING AND 15' X 30' DECK. EXISTING DWELLING LOCATED APPROXIMATELY 60' LANDWARD OF AHW, EXISTING DECK LOCATED 45' LANDWARD OF AHW. · CONSTRUCTION OF A 38' X 42' 2-STORY FRAME DWELLING, (APPROX.) AND 33' X 31' WOOD DECK AND 20' X 22' DETACHED GARAGE. PROPOSED DWELLING WILL BE LOCATED 75' LANDWARD OF BULKHEAD AND APPROX. 80' LANDWARD OF AHW. PROPOSED DECK TO BE LOCATED 55' LANDWARD OF BULKHEAD; 60' LANDWARD OF AHW · INSTALLATION OF NEW SEPTIC SYSTEM APPROX. 140' LANDWARD OF AHW AND REMOVAL OF EXISTING SEPTIC SYSTEM. 7. AMOUNT OF LAND AFFECTED: Initially .28 acres Ultimately .78 acres 8 WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [] Yes [] No If no, describe briefly: CONSTRUCTION OF PROPOSED HOUSE COMPLIES. PROPOSED DECK WILL REQUIRE RELIEF FROM ZBA 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Fedmal, State or Local) ]Yes [] No If yes, list agency name and permit / approval: SCHD (pending) NYSDEC SOUTHOLD ZBA & BUILDING DEPT 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL'~ ~-"'~Yes []No If yes, list agerlcy flame and permit / approval: NYSEDC - NJ 1,~ASAR ~ SULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION'~ No ~ CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sl~ Na~e CATHIE MESIANO,,tI~. o~te: September 11,200~. Signature __ _ If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment F-Er4L-iJ l ~l :2t£S6,626.---9 P .q4 ,EM TRANSACTIONAL DISCLOSURE FORM The Town Of ,~ouU~olcl's Code of.Eti3i.c~ orohi~,it$ OOnfl~e~e of i~ere~ on t~e oatt: o! to_wa officers aaa em,'*ovees_ The ouroo, se,_of ~ie form Is Io provlc~e iMorma~n w~.Rg..can atari the oossible_c0r~fllcts ~' iNerest and allow Jl to take whelever action la ne~,'~,~arv to avnld...S3.ma YOUR NAME RICHARD HEF.?_ERNAN NATURE OF APPLICATION: (Check al that aPI~Y.) Tax grieve nc~. _. Variance Change 0-f tone Ap~0val of plat__ Exem;~on from plat or official map Other (11 'Other,° name the aCtivRy) TRU.$~EE$ PERMtT Do you personally (or thrOugh your company. -'Douse. Sibling. Detent. or child) have a relations~qlp with any officer or en~oyee of the Town of Southo~? "RelatiOnShip' ;n~l~,des by I~oo,~, me,age, } or buSiness interest. 'E~u~rtess ;ntereat" means a bus, ness. including a ¢sftnem~ip. ~ whic.~ the~ town officer or ernpa~yee ~a5 even a papal ownership of (or eml~eymen~ by) a corporation in, which the town o/~r Or emptoyee owns more than 5% of the steams. YES NO_ ~.. __ If yOU anew~ ~YESi# completa the ~)~3nC~l of this form one date and s~gn whom indicated. Name of pa__t~o~ employee by t~e Town of $o~thold r,Ue or Dosition of lhat per,on ~_ Descdl~e [he relationship I)etween yourself (the applicant) and the tow~ 0~cer o~ employee E,ther check t~a appropriate line A) through 0) arlcl,~r de$cdbe ir~ the s0ace provided The 10wa off'ruer or err~p~oyae or his or t~er spouse, si~ling, p~rent or ohi~i Is (~K ~l t~al apply): . A) t~e ~ner ~ gfealer than 5% of ~e shar~ ~ ~e ~te ~o~ of Ihe B) the I~al or ~neflgal own~ of ary tntere~ ;n a non~mte entity (~en tae C~ an off~r, dim~or. ~nner. or ~o~e of :~e ap~i~t: or . D) the a~uel opulent. DE~CIRIPTION OF RELATIONSHI~ CATHERINE MESIANO, INC. 12 MILL POND LANE EAST MORICHES, NEW YORK 11940 516-878-8951 September 10, 2003 Town of Southold Board of Trustees Box 1179 Southoid, NY 11971 Re~ Richard Heffeman 730 West Shore Road, Southold SCTM # 1000-80-1-48.1 Southold T(]wn Board of Trustees Gentlemen: I am the agent for the above referenced applicant who is seeking a Wetlands Permit for removal of the existing (approx.) 30' x 30' 2 story frame dwelling and 15' x 30' deck and construction of a 38' x 42' 2-story frame dwelling, 30.3' x 31' wood deck, 20' x 22' detached garage, installation of new septic system and removal of existing septic system. Enclosed please find original and two copies of the following: 1. Application for Permit. 2. EAF Short Form - Part 1. 3. Survey last dated August 5, 2003 4. Owner's authorization. 5. Owner's release. 6. Notice to adjacent property owner 7. Application fee in the amount of $200.00 Kindly direct any requests for additional information to my attention. Thank you for your consideration. Very truly yours, Catherine A. Mesiano, President Enclosures SURYE¥ OF LOTS4, 5 &P ~0o~ 6- 1~0 BLOCK B ~IAP OF REYDON SHORES,; I: FILE No. 63! FILED JUlY 2, 1931 SITUA TED A T BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C, TAX No. 1000-80-01-48.1 SCALE 1"=~0' FEBRUARY 27, 2002 PROPOSED SEPTIC SYSTEM DETAIL '"' I--.' I SEPTIC TANK (I) '% TEST HOLE DAT~A LOT COFt?.&4CE D,47'A O[$DRIPTION HODS[ CARAG[ DECK TOTAL FURTHEST L£~CHI"G POOL