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HomeMy WebLinkAboutTR-5376 James F. King, President O~~~F S~UjjyO Town Hall Annex 54375 Main Road Bob Ghosio, Jr., Vice-President P.O. Box 1179 Dave Bergen * Southold, New York 11971-0959 John Bredemeyer - H Q y • ~O Telephone (631) 765-1892 Michael J. Domino Fax (631) 765-66441 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 13, 2013 Mr. Joseph Schafer 8 Eagle Lane Manorville, NY 11949 RE: 1030 WEST LAKE DRIVE, SOUTHOLD SCTM# 90-2-3 Dear Mr. Schafer: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, November 13, 2013: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit #5376 from Preston & Nancy Harrington, as issued on July 25, 2001. If you have any questions, please contact our office at (631) 765-1892. Sincerely, )X~" Cz James F. King President, Board of Trustees JFK:amn gUFFO(,~ James F. King, President CQG P.O. Box 1179 Bob Ghosio, Jr., Vice-President h d Southold, NY 11971 Dave Bergen Telephone (631765-1892 John Bredemeyer G Fax (631) 765-6641 Michael J. Domino Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: 714w, k to a - f JOSEPH SCHAFER requests a Transfer of Wetland Permit #5376 from Preston & Nancy Harrington to Joseph Schafer, as issued on July 25, 2001. Located: 1030 West Lake Drive, Southold. SCTM# 90-2-3 Type of area to be impacted: / -Saltwater Wetland -Freshwater Wetland -Sound V Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 _Chapt. 111 -other Type of Application: _ Wetland -Coastal Erosion -Amendment -Administrative-Emergency _Pre-Submission Violation Info needed: Modifications: Conditions: py`, Present Were: J. Ki _B. Ghosio D. Bergen, J. Bredemeyer Michael Domino D. Dzenkowski other Form filled out in he field by Mailed/Faxed to: Date: 0 0 Board Of Southold Town Trustees SOUTHOLD, NEW YORK July 25, 2001 PERMIT NO. `a 7.4 DATE:._.____ _ ISSUED TO ..PRESTO.N....a-..NANCY.... HARRINGTON Aut4arizatinn 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 Now York 1952; and the Southold Town Ordinance ee- 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 WATERS;". and in accordance with the Resolution of The Board adopted at a meeting hold on July 25, 2001. and in consideration of the sum of jpaid by ..Garret...Strang...on...6ehalt-of Preston a-..Neney-Herrington t ` d of .,Sauthald. N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the foAowing: Wetland Permit for minor altepations, addition to single family home including mud room entry and basement access. all in accordance with the detailed specifications as presented in .the originating approation. IN WITNESS WHEREOF, The said Board of Trustees 6m- by causes Its Corporate Seal to be affixed, and these present, to be subscribed by a majority of the said Board as of C. date. c~JFF t ~ ~ redsrs r - TERMS and CONDITIONS The Pecm4ta Preston R Nancy •Harrin 1030 West Lake Drive, Southold', l bt Y. .4w pain of the eomidersdoa for dw hvmom of the Permit done aadawmd foal paneer$u to the fol- lovrogt t. That &a rid Hoard of Truman; and the Town of Southold are released from a" and an der Npk at daima for damagia, of suits rising directs at indirectly r a remit of +wry opw- adoa pedmmed poremint to this prank seal dre aid Rrtoieefe will, at bis of her own mguhse, defend any and an an& adu'ldelemed by third pardn, and de add Rtmitoee taemm fall BdOW wbh rapes dhere% to doe aompleoe eadodoo of the Hood of Ttwsttef of the Town of SoodwN 2. That dds Remit fa'valid far s pried of . 24 mot whiff h eoacdend to be ate admred time' ngrmd to complete the weds Involved, bat .herd titatmmoca wrraat, •egaefe for an earemion mq be made to the Board at a later daft 3. Thu this Permit should be retched Indt$oitdy, or as long r the sold Pmdafe wiahne to maintain the structure or project involved, to pro" esidmae to anion concerned due an&- .orradon was originally obtdokd . . 4. That &a wodc.InvolvW will be voNectto the Inspection mad appeord of do Hoard ter its ageo% mod non-compliance wkh.der pmvicoos of do odgioadng applindon, may be cafe fa revocation of ebb Permit by resolution of the sold Boatel 5. That them will be no emaauoueNe Interference with navigation as a result of the weds herds aoithorhoL 6. Thu there shall be no interference with the right of the public to pane anti repass doog du bads between bigb and low wafer madcs. 7. Zhu if fugue operations of the Town of SoodwH require do removal wVor abneatimes In the location of die wodc hareta and oerd, or if, is die opinion of she Board of TYmfene, dw. work than came unreasonable obaaoonon to free aaAgerlon, the uhl Permitter will be segdto& open, due notice, to remove or alter this work or project herein stated wldmoe acpamn to tee T1owa no a Tbat the said Board will be notified b7 the Permitwo or dw aomphdon,of dee work sw& orh ed 9. That the Permitter will obtain an other pemdne and aemeon mat may be required mop= plemental to thine permit which may be adhject to re.w upon fail= on obnih amo. `YFS T N s '90 A ,AAV z s r 00. Cl~. / ' 19 Y. , GtA1'L2.ETT ,t~. STZAL..1~ ter O i e~ ary ~e~ f O y LOT 116 MW CM SAW AW No So AT BAYVEW TOWN OF SOUTHOLD r for SUFFOLK COUNTY, N. Y. 10p0~0-W-02-09 Scale: P(= 20( E ,y Sept. 5, 1998 ,y Bg Muy 2, 3KV /ere.a~ cERrstro TO, Agysi , : PRESTON AL MARRwcTom /If MANCY S. NARRFGTOM ARft' pF pewyD4 p0 1p r Y ~\y~ ELEVATIONS ARE REFERENCED TO MGV.D. N~c ~+~f hasa =aw( f°rn f/R.M 49 q 341o5ael6f e. MAY 4,/99D ' .°r .~,nunap oa AoLtrlw ro 7o slwvrr a A NnAnpv a• nar rm of nr yes Tax srA re eaxArNM ur ('Ot AYIOI reataen9lav L °u GEt1FlCASA]vs µi4 . 4968 veto fat ns YN+AN) ttv'rs llE11La~ wW r F ?M4ru1[~A17T~.ws~illld~it ~ ~w6 [r nE fiAlvkYCw ~PiCLYIC AREA = 10,921 sq.ft. ~r ro can QTR sAO rAM roog sr 0. ao 809 rs3 - lT9r to tie &W AIq amrr'c uDriL aw.s+sce"rer:lo 1230 TRAVELER srReEr TI~OiAIr-ro-M /F' MF WT N aW.aKE SRN n ,AM SOUT4OLD, ALY. 11971 96 - 216 Pi- N ~ s svnnn4 , u ? \ „a , IY, ,laeeb i - - ' s p 4. Pow ^a, any, J p ^ w ,a i xEra ~ m 1 n q~- m A ^ ; v ~R ° ~ aus , R 1 ~ I _ • n M d "an a 1 ?uW n ^ m m i m ^ KEOK BtY - - _ rm,c4 O OFWFFOM © > aecmxxo 90 • James F. King, President ~QF soTown Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road P.O. Box 1179 Dave Bergen ll * Southold, New York 11971-0959 John Bredemeyer Michael J. Domino Telephone (631) 765-1892 Fax (631) 765-6641 ~yCOUNt'1 D E C BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD OCT - 3 2013 ut iota zmvr. APPLICATION FOR A TRANSFER OF A WETLAND PE DATE OWNER PHONEe0I!'0"6862Z MAILING ADDRESS AGENT PHON ADDRESS PROPERTY LOCATION p2idE TAX MAP NO. / UWe request a Transfer of Permit # X376 from Signed By: c~~ a Board Of Southold Town Trustees , SOUTHOLD, NEW YORK b July 25, 2001 PERMIT NO.~ 7.4 DATE: ISSUED TO ..PRESTON ....&..-NANCY ....HARRINGTON ¢ M d ~ ,~u#I~nri~tt#inn 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 on- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS M IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;". and in accordance with the July 25, Resolution of The Board adopted at a meeting held on 2001. 200.00 . and in consideration of the sum of $ paid by s A e Garret... Strang. ..an...behalf of -Preston &...Naney...Harrington ' of ..Southold, N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: g' +j Wetland Permit for minor alterations, addition to single family home including mud room entry and basement access. r all in accordance with the detailed specifications as presented in .the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. ~ 5~FF0L,~-`~ z . Nale" j *l/1 ~ Trrultes \ - .i"-- S ,ter s' k i TERMS and CONDITIONS The Permittee Preston & Nancy Harrin ton 1030 West Lake Drive, Southol~ 4z; C N Y, as residing at parr of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: 1: That the said Board of Trustees and the Town of Southold are released from nay sad all damages, or claims for damages, of suits arising directly or indirectly as a result of any opet- stion performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits'inidsted by third parties, and the said Permlttte assumes full liability with respect thereto, to the complete exclusion of the Board of Tru>ttes of the Town of Somhold 2. That this permit is valid for a period of . 24 mos which is considered to be the estimated time required to complete the wodc involved, but should dram stances warrant, request for an extension may be made to the Board at a later date. . 3. That this Permit should be retained indefinitely, or as long as the raid Permittee wishes to maintain the strucahre or project involved, to provide evidence to anyone concerned that auth- orization was originally obtained 4. That the work involved will be subject to the inspection and approval of the Board at its agents, and noa-aomplianoe with. the provisions of the originating application, may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable Interference with navigation as a result of the wodc herein aathothed. 6. That there shall be no interference with the right of the public to pass sod tepass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the wodc herein authorized, or if, is the opinion of the Bard of Trustees, the. work shall cause unreasonable obstramon to free navigation, the aid Petmittee will be requited, upon due notice, to remove or alter this work or project herein stated withwt expenses to the Town of Southold a. That the said Bard will be notified by the Permittee of the completion of the work nth- orized. 9. That the Permittee will obtain all other permits and con drat may be required sup- plemental to this permit which may be subject to revoke upon failure to obtain same. I • • Albert J. Krupski, President ~gpFFO(,~c Town Hall James King, Vice-President 53095 Route 25 Henry Smith = Gy~ P.O. Box 1179 Artie Foster C4 Southold, New York 11971-0959 Ken Poliwoda 0 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 26, 2001 Garrett A. Strang Architect PO Box 412 Southold, NY 11971 Re: PRESTON & NANCY HARRINGTON 1030 West Lake Drive Southold,NY SCTM990-02-03 Dear Mr. Strang: The following action was taken by the Board of Town Trustees during a Regular Meeting, held on July 25, 2001, regarding the above matter. WHEREAS, Garret A. Strang Architect on behalf of PRESTON & NANCY HARRINGTON applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 29, 2001 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 July 25, 2001 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 97-18 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, • 2 • NOW THEREFORE BE IT. RESOLVED, that the Board of Trustee approved the application of PRESTON & NANCY HARRINGTON for a Wetland Permit for minor alterations, addition to single family home including mud room entry and basement access. 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 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. 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 when project is started and on completion of said project. FEES: NONE Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/cjc cc: DEC Building Department .2 Town Hall. 53095 !lain Road U-1 T P.O. Box 1179 Telephone O O~ Southold. New. Yak 11971 (631) 765-189201 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, July 17, 2001, the following recommendation was made: PRESTON & NANCY HARRINGTON 90-2-3 for a minor alteration & addition to single- family home including mudroom entry and basement access. 1030 West Lake Dr., Southold The CAC did not make an inspection, therefore no recommendation was made. I Albert J. Krupski, President ~O$VFFD(AC 6 Town Hall James King, Vice-President hr0 ~(/y 53095 Route 25 Henry Smith P.O. Box 1179 Artie Foster H x Southold, New York 11971-0959 Ken Poliwoda Oy Telephone (631) 765-1892 Fax(631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only oastal Erosion Permit Applicatioty Wetland Permit Application _ Major _ Minor Waiver/Amendment/C anP -Received Application: (v 01 `1 0-t -Received Fee:$ -Completed Application -Incomplete _SEQRA Classification: !u+ Type I_Type II Unlisted -Coordination: (date se t) -CAC Referral Sent -Date of Inspection: -Receipt of CAC Report. -Lead Agency Determination: Technical Review: -Public Hearing Held: y Resolution: S Name of Applicant _<Sioj 11Atp1,jCT0tj IIA,:C/AtvTox) ` v Address h l~9LL~y A~bAO /Lictircui~ n :T D%L~~f2 Phone Number:( ) Suffolk County Tax Map Number: 1000- Y0-02 -63 Property Location: h/E_ST ZAk6 . dE ti'z /'/S- OF 1jjb(~IAV P0 A0 (provide LILCO Pole distance to cross streets, and location) AGENT: A JiQA&1 /12ct- lizci ltc-&Ajy (If applicable) Address: t O fo / `f D J; Ha _ o N, Phone: 7(s5-6 5~5 S 0 y • • Board of Trustees Application GENERAL DATA Land Area (in square feet): /O/ 121 Area Zoning: Previous use of property: N -E H , _ y FSi~~ tic t Intended use of property: J i n e =y - x. cc Prior permits/approvals for site improvements: Agency Date UTA No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? „ C No Yes If yes, provide explanation: Project Description (use attachments if necessary): A-11, c.C /Ic iC4i c... &DL) IT Ia.J 11 1i,N 6^LE l-An/may ryO ryE. ~NC L~JJ/w/G F'I UJ nOOh C.-'i 2 y -'~ASEhE.~I~ "CC-E 5 Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: l~ Ji Nc3 ~L-' L-n .-„may %LC-;;~E nIC~ Area of wetlands on lot:_ do square feet Percent coverage of lot: 7. Closest distance between nearest existing structure and upland edge of wetlands: 4S- feet Closest distance between nearest proposed structure and upland edge of wetlands: S£' feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? S cubic yards How much material will be filled? o cubic yards Depth of which material will be removed or deposited: 3- S feet Proposed slope throughout the area of operations: AI IAI /,AL 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): /V /JE Board of Trustees Application. County of Suffolk State of New York T 's 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. Signature n SWORN TO BEFORE ME THIS U7 DAY OF J 20 / Notary Public darbor* A, Strang NOTARY PUBLIC, New York No. 4730095 Qualified - Suffolk County :n(nm. Expires ,July 31. 2on2 Albert J. Krupski, President • ~O$UFFO~~C • Town Hall James King, Vice-President ~.r~ GGy .53095 Route 25 Henry Smith P.O. Box 1179 Artie Foster y Z Southold, New York 11971-0959 Ken Poliwoda WOy ~.1C Telephone (631) 765-1892 ~01 r ~.DD Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I,L .-A E7r-1 ,~ir-n.-/c= residing at ~2-11"- LeAz J:2ef7- '~~7 yp LQ ~i.c-/ being duly sworn, depose and say: That on the day of , 200!, I personally posted the property known as i?o ~~c.-Lti~ri 176, }='~ncLO 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 o he public hearing. Date of hearing noted thereon to be held~ / ~N rte. tr A-n-,,[.~e t O-c-QOta~. ~p yy,) Dated: L-P. c, rV (signature) Sworn to before me this day of Yz-~ 200/ Notary Public Barbara A. Strang NOTARY PUBLIC, New York No. 4730095 Qualified - Suffolk County Comm. Exoires July 31. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: sCTM #1000-90-2-2 DAI, W. MOY 88 MULBERRY STREET NEW YORK, NY 10013 SCTM #1000-90-2-4 MCDONAI,D, CATHERINE AS TRUSTEE 100 HILTON AVENUE . GARDEN CITY, NY 11530 STATE OF NEW YORK COUNTY OF SUFFOLK [ A-eWc„A residing at x %toc-c.ti s~, being duly sworn, deposes and says that on the O,H day of Td ,113uw!, 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 roll of the Town of Southold; that said Notices were mailed at the United States Post Office at °007-eoL L~, &A-/ , that said Notices were mailed to each of said perso~is by (certified) mail. Sworn to before me this iU7-H day of TV , 2GO/ NOTARY'Wig 91A W TO-rk No. 4730095 Qualified - Suffolk County Comm. Expires July 31, 2olj 14-!6.4 (2187)-Te%t 12 • • PROJEDT I.D. NUMBER 617.21 SEQ 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) PROJECT RNAME 1. APPLICANT,IISPONSOR 2. AccN17E1&e.,7- 71A1- 3. PROJECT LOCATION: Municipality''/`/ County "1v`FG -K_ 4. PRECISE LOCATION (Street address and road intersections, prominent landmaras, etc.. or provide Mao) _4 e~. bl r?L ~nT FT /i la ( le /.-Ate 5. IS PROPOSED ACTION: ? New ? Expansion yy Mo(Jification/alteration 6. DESCRIBE PROJECT BRIEFLY: Nl //UC ,t- 4 LT-6 -Z A 7- P) fo v, ti'G(1-r-AnI y KLS /r~C ..J CF 7. AMOUNT OF LAND AFFECTED: Initially - 2 ~ acres Ultimately S acres d. VVILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ZYes No If No. describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Z Resrdenual ?dnaustnal ? Commercial ? Agriculture ParklFOresdOoen space L-- Other 77 Describe: , yoC~ b KF~ /DarNT /A L io. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ® Yes ? No If yes. list agency(s) and permitfapprovals - 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR .APPROVAL? ? Yes ENO if yes, list agency name and permiUapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? ?Yes ?NO IJA I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE -0 THE BEST OF MY KNOWLEDGE (~A/L k'c SA'JTP_Aal;~ /QPc .V VK_ AppliCad VSponadr name: T Dale: 6z ''/O, 1 Signature: If the action is in the Coastal Area, and you are a state acency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART 11-d_VVIRC` ,%IE?1TA 'SS`A E:`1T ,..J 50 _-rmc,_teO Cy ~ge..c' - A. -GcS AC :C.V E y csrCU yes. Zoom a :ne :_vre,v :rocess and ,se :ne =UL_ _,A~ fey _ NO E. VILL :CT;CN .RECENE ZCCPCINATED REVIEW AS PRCVICED =-A UML.ST=D ACT:CNS N S N'rC=R, -ART 9: 57 f `+o. a negarve cedar= .may he sucersece^_ :y '_netner nvoivea agency. Yes _ NO i C. CCULD AC`TCN RESUL- N ANY AOVERSE EF=ECCS ASSGCIATED 'NITN -:-E =OLLCWING. Ansners may _e nancwnIan. f agiciel :1. =15(ing air quality. surace or grounowaler cualily or ouanuty, nurse revels. rising :.anic :aCains. solia .vas:e orccuc::cn if clsc= potential !or erosion, crainage or'Iooding oroolems?'=:olam onefly: CZ Aesthetic. agricultural. afchaeologiow. hrsronc. or other .natural of cultural -esources: or Community or ]eigncCmOdd c-araCer? Exoldin C3. Vegetation or :auna.:Isn. arellflsn or 'edallie species, significant naoilats. it :hreatenea or endangered acec:es? Ez Clain manly: C=. A community's existing plans or goals as offlc:atly aaooted. ar a change in use or intensity or use of land or other natural resources? Ezplam :r C_. Growls. suoseduent :evewpment. or related ac:mtles likely !o as induced oy me orccosea ac:ion? Explain oneily. CS. '_ong ;arm, snort :erm.:amulative. or other erfec:s not identnea in C:J5? E.olam orletly. I .'.ICer :moac:s Id Cdcing• C'anges in use at either quantity of :Vpe or energy)? =xotain ]deny. I S -MERE. CF; S 7h ERE JKE_'.f 7C BE. CONTROVEPSY RE'aTED 'O POTEN-IAL AOVERSE '_.`IvirONME47:1_ mPGCTs? . Yes - NO 'f '!es, exclam onelly I~ I VAR- III-DETERMINATICN OF SIGNIFICANCE (To be completed by agency) INSTRUC'IONS: For each adverse effect identified above, determine •.vnetner it is substantial, large.:moortant or otflervise sight fic Eacn effect should be assessed in connection win its (a) setting ti.a. urban or rural); (b) probaollity of occazing: (cl duration irreversibility: ;et geograomc scope: and (f) magnitude. It necessary, add attachments or reference supporting materials. ensure exolanations contain surficient detail !o snow (flat all relevant adverse impacts have been identified and adeCuately acdressec. ' heck this box 'f 'you nave identified One or more CO(en(Ially large or significant adverse Imoacis 'shim MAY occur. Then orocesa directly to the FULL EAF and/or prepare a positive- declaration. Checx ;his cox f you have determinea, based On the information and analysis above and any support; r.c docpmentancn. :hat the O(OCOSea action WILL NOT result in~my significant adverse environmental imcac:7 AND orovlce cn attacnments as necessary, the reasons supcorting this determination: .ml ar +uv ..m.` v 4.POm.ore n,rr n _.m :,tie m tc:oonvore cirrmer :,n.mrc v tr•commrs .:Tarr n ua +¢cncy r i,cnamrc n /~arer •u _ r•-ter :.nth :eroon.m.c vr.c... J~IC APPLICANT • TRANSACTIONAL DISCLOSURE PORH The Town of Southold's Code of Ethics rohibits conflicts of interest on the part- of town off crs and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAHE! /1_1ts7 JHd2L',n,6i-cL~ Last name, first name, middle 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.) NATURE UP APPLICATION: (Check all that apply.) Tax grievance variance Change of zone Apprq,val of plat Exemption from plat or official map other _ (If ,other," name the activity,) _/2J~1ee5~M~% 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 NO _Z If you answered "ICES,".complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold O lc Title or position of that person Describe the relationship between yourself (the applicant) i ~ LETTER OF AUTHORIZATION RE: Premises, Cedar Point Drive West, Southold, NY I (WE), PRESTON and/or NANCY HARRINGTON, Hereby authorize GARRETT A. STRANG, ARCHITECT to act on my (our) Behalf(s) when making application(s) to New York State, Southold Town and any other governmental agency in connection with the above referenced premises. Date: 2000 PRESTON HARRINGT N NANCY HARRINGTON Sworn to before a this Day of 9~2000. Notary Public State of OVALE NOTARY PUBLIC OF NEW JERSEY EY My Commission Exp 2002 IFS T N s ~ so-~ q C O { 1 1,00, 00, r q. JUN 2 9 2001 Zop r' SURVEY OF S `ra Ohs LOT 116 • ? K" ~,6 Ire CEDAR. BE4CH PARK .0O 3/G. 3 .o. u. FEED DEC 29x'17 RE Na Q 80 AT BA YVIEW TOWN OF SOUTHOLD a, io , ~ ~g 3 4(or SUFFOLK COUNTY, N. Y. ® Z op, woo - 90 - 02 - 09 \ zotiE ti. Scale: 1" = 20 qE Sept. 51 1996 n; Sg• May 2, 2cXN (eievnfio~3 ) ao~4 ~ ?3q0 ~ wo°a 8~ 4 3. a e T c~` •~d CERTIFIED TO# c'Qy~i h PRESTON M. HARRINGTON III NANCY S. HARRMTON Ps ~ ~ ~ 9g9s 4 , C ON/ ELEVA TIONS ARE REFERENCED TO N.G. V.D. SPA OF Nr* w f4o00 2oNE F4. m P/AGM S ~aa~b 4,/998 NN T.,4 -3G09coIGj4 MAY -10 1%3w FQ AN Y AL MU TIM sa a:. A SECTION aR W TO THIS IS T wou rpnr `a'p OF F 7PM 09 QOF* THE T/E NEW YQRK STA TE TE ED EDUCATiION uw ~ Exctrr AS PER SECT)ON 7209-PAa A N r. ALL cgwrWVASoa Y.. L . NO. 49618 llllEOw ARE VALD FOR rm mAP Aw Comes flE7 ar oc y jr ~ SAO AUF OR COPES GEAR TFE a/°RESSm SEAL OF THE "VEYOR MI+nbE dNinATUIE AREAR3 FE7iFprL Pc C S (6311 ~i 1J AREA 10, 921 SQ.ft 7 765 -17970.13wt0 t/@ /l7@ rro ,M ~ w TIMMS SUCH E WJW ~ AND TRA SOUTHOLD, N.Y. 1197 ET 96 - 216 IFS T N s ~ 43SO• q F , v_ ~p JLN,~° N v~ / q OQ 00, , L Nr° 9w ,l l f'a / P h P ate: LOT 116 z k ga:o~ '+roo lNe 'CEDAR BEACHPARK y• • 3i --3 FLED DEC. 20, M27 ALE 90 a° 6lT~ AT BA YVIEW •a~'' TOWN OF SOUTHOLD 40" P X83\ s~ SUFFOLK COUNTY, N. Y. \ <~-oa.n Zop 1000 - 90 - 02 - 08 zoti ti pis Scale: 1" = 20' -4 E ` Sept. 5, 1996 May 2, 2~, ~e/e va E.o/Ja-. o° * Eg 23/O °°a ( EJ t Gam/ •~l CERTIFIED TO, Aqy o/ h ti PRESTON M. HARRINGTON, 111 - NANCY S. HARRINGTON ~F 6w+a d - _ pF NEW YO C Q w ELEVA DONS ARE REFERENCED TO N.G. V.D. ~,~Poa? t. ME*1Q~ 9,~ ,11C \ yam( F~°aa ZovE F2on PI/LM I -~AP d?e'`~ 3le/o3eol4f G MAY 4,/99b 4& ANY ALTERATION OR ADDITION TO TW SURVEY IS A VIOLATION S ~~'`H JM4 ~ q O /7.~/~ EXCEPT AS PER SECTION 7209-SLODMSION Z. ALL F SECTION 7209 OF TIE NEW YORK STATE EDUCATION LAW /EREON ARE VALID FOR THIS MAP A COPES THEREOF ONL ~S N.49 O. 99618 SAD MAP OR COPES BEAR 7IE M°RESSED SEAL OF TIE SURVEYOR / NWSE Sl" TUBE APPEARS rEWOM4 P,CONIC NQl . (631 / 765 - 50 1 765 -1797 AREA = 10 921 s ft. AWITOVALLY To cppLY NYTH SAD LAw rhE TERM ALTERED BY- 9 MUST Be USED BY ANY ANO ALL SURVEYORS UTA/ZWG A COPY F. O. BOX 9O9 R`S TEIMS t0 t/@ //1@ *ROUGHT--rTo ATr A°RE Nor w cowumcE SUCH wrH THE LA S, 11971 96-216