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Home My WebLink AboutTR-6050 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 # 0179C Date January 5. 2007 THIS CERTIFIES that the second-floor addition to dwelling, open porch, & shed At 440 Sunset Way. Southold , Suffolk County Tax Map # 91-1-8 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 11/4/04 pursuant to which Trustees Permit # 6050 Dated 12/20/04 Was issued, and conforms to all of the requirements and conditions of the applicable provisions oflaw. The project for which this certificate is being issued is for a second-floor addition to dwelling, open porch & shed. The certificate is issued to EDWARD JENSEN owner of the aforesaid property. f-o?~ Authorized Signature Albert ,J. ILru James King, \rice PreAdent Artie Foster Ken Poliwoda Peg~/A. Dickerson ~fuwn Hail 53095 Route 25 P.O. Box 1179 Southold. New York 1197[-095 Telephone (031) 765-1892 Fax (631).768:1366 BOARD OF TO'~"N 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 __ 1~t day of construction ~ constructed Project complete, compliance inspection. Board Of $outhold "Town Trustees SOUTHOLD, NEW YORK Pursuant Jo t~ provislon~ of Chapter 615 of the hws of the Sta~ of New Yor~ 1893; and ~pfer ~ of the ~ of the · State of New Yore 1952= and the Southold To~n Ordinan~ IN AND ON TOWN WATERS AND PUBLIC ~DS and REMOVAL OF SAND, GRAVEL. O~ O~R MATERIA~.~M ~NDS .UNDER TOWN 'WA~RS;~., and m acc~a~ w~h Resol~ion of ~e Board adopted at a meeting held on ...~.:~..,~fi ..... . E~d Je~en of Southold To~n Tr~ee~ ~uthorlzes ~nd petmi~ th~ follo~ng:. W~and P~ to co~ a 'second-floor ad. on ov~ e~n~ ~ng, co~ an open porch~, and a n~ p~ched over ~he ~ng s~e~ w~h ~ co~on t~ g~ and · ~ ~gl~fieg a~fi~.and ~ ~ depi~ed on the p~an IN W~S WHERe, ~e saia~a~ ot ~ees by ~uses tis ~ate ~al ~o be a~xed, an~ ~se~ fo ~ subsc~ed by i'~i~ of f~ sa~d ~ .as of ~ daf~. Edward Je~en ~o-d~e?..~te '~,~to~ ot d~ ~ d Tms~es o~ d~ Iowa the ~ at a ~,~', a~', · ~x:ado~ of dd~ Pff'm~t ~ molufloz o~ d~ s~M BoLd. ldeme~l m d~ l~mlt ~4ac~ m~'l~ magect to tffo~ Nm ~iam w d~la ~m~. 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 December 20, 2004 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Edward Jensen 110 Shore Rd. Mt. Sinai, NY 11766 RE: 440 SUNSET WAY, SOUTHOLD SCTM# 91 ~1-8 Dear Mr. Jensen: The Board of Town q'rustees took the following action during its regular meeting held on Monday December 20, 2004, regarding the above matter: WHEREAS, EDWARD JENSEN 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 November 4, 2004, 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 December 20, 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, 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 application of EDWARD JENSEN to construct a second-floor addition over the existing dwelling, construct an open porch, and a new pitched roof over the existing shed with the condition that gutters and drywells be used to contain all roof runoff and all as depicted on the plan prepared by Edward Jensen dated October 19, 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, Albert J. Krupski, Jr. President, Board of Trustees AJK/hct Albert J. Kmpski, President James King, Vic~.-President Artie Foster Ken Poliwoda Pr-ggy A Dickera,m Tm~m Hall 53095 Route 25 P.O. Box 1179 South~Ad, New York 11971-(195 'lelepbone (631,765-1892 Fax (63D 765-1366 TO: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated i / I ~-I / o q has been reviewed by this Board at the regular meeting of__ I ~- I z o I o ~ and the following action was taken: ( W~)Application Approved (see below) ( ) Application Denied (see below) ( ) 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: TOTAL FEES DUE: SIGNED: PRESIDENT, BOARD OF TRUSTEES RESOLUTION RESOLVED that the Board of Trustees of the Town of Southold hereby finds that the application of EDWARD JENSEN more fully described in the public hearing item #3 of the Trustee agenda dated Mon. December 20, 2004, is classified as a Type II Action pursuant to SEQRA Rules and Regulations, and is not subject to review under SEQRA. Telephone (631)765-1892 To~m Hall 53095 Rou~ 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 Tues., December 7, 2004, the following recommendation was made: Moved by Jack McGreevy, seconded by William Cook, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of EDWARD JENSEN to construct a second-floor addition over the existing dwelling, construct an open porch, and a new pitched roof over existing shed. Located: 440 Sunset Way, Southold. SCTM#91-1-8 The CAC recommends Approval of the application with the condition gutters and drywells are installed to contain the roof run-off. Vote of Council: Ayes: All Motion Carried New York State Department of Environmental Conservation Division of Environmental Permits Rm 121, Building 40-SUNY Stony Brook, New York 11790-2356 Telephone (631) 444-0365 Facsimile (631) 444-0360 Erin M. Crotty Commissioner October 22, 2004 Mr. Edward F. Jensen 110 Shore Road Mount Sinai NY 11766 RE: Permit# 1-4738-01673/00005 Dear Permittee: In conformance with the requirements of the State Unifom~ Procedures Act (Article 70, ECL) and its implementing regulations (6 NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also euclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yoursk~ Matthew R. Penski ECPA MRP Enclosure DEC PERMIT NUMBER 1-4738-01673/00005 FACILITY/PROGRAM NUMBER(S) PERMIT Under the Environmental' Conservation Law EFFECTIVE DATE October 22, 2004 EXPIRATION DATE(S) October 21,2009 TYPE OF PERMIT · New [] Renewal [] Modification [] Permit to Construct [] Permit to Operate [] Article 15, .Title 6: Protection of Waters [] Article 15, Title 15: Water Supply [] Article 15, Title 15: Water Transport [] Article 15, Title 15: Long Island Wells LJ Article 15, Title 27: Wild, Scenic and Recreational Rivers LJ 6NYCRR 608: Water Quality Certification [] Article 17, Titles 7, 6: SPDES [] Article 19:Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article24: FreshwaterWetlands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYCRR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Edward F, Jensen (631) 331-9606 ADDRESS OF PERMITTEE 110 Shore Road, Mount Sinai NY 11766 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER NAME AND ADDRESS OF PROJECT/FACILITY Jensen Property, 440 Sunset Wa),, Southold NY LOCATION OF PROJECT/FACILITY SCTM # 1000-91-1-8 COUNTY TOWN WATERCOURSE Suffolk Southold Cedar Beach Description of Authorized Activity Construct a second story above the existing footprint of the dwelling and garage, a new porch, and a new roof on the shed. All work shall be performed in accordance with the plans prepared by Edward Jensen on 10/19/04, and stamped NYSDEC approved on 10/22/04. NYTM COORDINATES E:719.2 N:4546.0 By acceptance of this permit, the regulations, the General Conditions s PERMIT pon strict compliance with the ECL, all applicable ,s 2 - 4) and any Special Conditions included as part of this permit. ~t40, SUNY, Stony Brook, NY 11790-2356 DATE October 22, 2004 Page 1 of 4 Albert J. Krupski, President James King, Vice-President Axtie Fester Ken Poli~voda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD ,CwOaStal Erosion Permit Application etland Permit Application AmendmentrDans fer/Extension ~'Receiv~d Application: t t l q ! ~,Received Fee:$ ~22~ ~' ' . . ' .~'Completed Application I II qlO¥ __Incomplete __SEQRA Classification: Type I Type II U~flisted __Coordination:(date sent) ...~'AC Referral Sent: ~Date of Inspection: __Receipt of CAC Report: Lead Agency Determination: Technical Review: ~t.,~Public Hearing Held: /o9-1/,~']0/ Resolution: Office Use Only Adminisu;ative Permit Southold Town Board of Trustees Name of Applicant Address Phone Suffolk County Tax Map Nulnber: 1000 Property Location: ~e9 ~5'e~/q~x'~- (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: Board of Trustees Application GENERAL DATA Land Area (in square feet): ]~J/~ -5~ / Area Zoning: ~ oe'O Previous use of property: Intended use of property:. 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? Y No Yes If yes, provide explanation: Project Description (use attachments if necessary): Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 0~ La/t~ F} DDt 7/o A//9~- Area of wetlands on lot: /~/0 A/~_~ square feet Percent coverage of lot: % Closest distance 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 Yes If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: cubic yards cubic yards feet 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): Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: ~e wetlands present ~thin 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 from implementation of the project as proposed. (Use attachments if necessary) IPROdECT iD NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME coun 5'Z.Y SEQR 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: [] New ~-xpansion []Mcdification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially ~) acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER RESTRICTIONS? E~Yos [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~Residential E~]lndustrial E~]Commercial E~Agriculture [~ParklForestlOpenSpace []Other (descdbe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) 'l~]Yes ~]No If yes, list agency name and permit I approval: tl DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Yes E~]No fl yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ ,APPROVAL P~EQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant ! Spon~ ~ Date: Signature L/ ~" ~ ///~ --0 / If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohiblts conflicts of interest on the oart of town officers and emnlovees. The ouranse of this form is to omvide information which can alert the town of oossible conflicts of interest and allow it to ~ake whatever action is necessary to avoid same. (Last name, fLrSt name, ~aiddle 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 APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Emsion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Other", name the activity.) Do you personally (or through your company, spouse, sibling, patent, 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 NO ~- If you answered "YES", complete the balance &this form 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/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 apply): ___A) the owner of greater than 5% of the shares of the corporate stock of the applic0nt (when the applicant is a corporation); __.B) the legal or beneficial owns' 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 Form TS I Submitted this~day of ~ O~ - 200 ~ Signature ,,~"f~¢~"~ ~ Print Name ~'-~ c.~/9-~ ~ ~ ~ ~