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Home My WebLink AboutTR-5307Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 $outhold, New York 11971-0959 Telephone (631) 765-1892 Fsx (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 25, 2002 Mr. Mark K. Schwartz, AIA PO Box 933 Cutchogue, NY 11935 RE: SCTM#113-6-4 Leonard & Joyce Beckenstein 830 Jackson's Landing, Mattituck, N Dear Mr. Schwartz: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, January 23, 2002. RESOLVED, that the Southold Town Board of Trustees grant an Amendment to Permit #5307 to extend deck to the north. If you have any questions, please call our office at 765-1892. Sincerely, Albert JbKrupski, Jr. President, Board of Trustees AIK:cjc Cc: Building Department Telephone (631) 765-1892 Town Ha~, ~0~5 Main Ro~d P.O. Box 1179 Southold. New York 1197[ SOUTHOLD TOWN CONSERVATION ADVISORY COUNCrL At the meeting of the Southold Town Conservation Advisory Council held Wednesday, January 16, 2002, the following recommendation was made: Moved by Melvyn Morris, seconded by Bob Ghosio, it was RESOLVED to recommend to the Southold Town Board of Trustees ,A~I~(~...L of the Amendment Request of to extend the approved de~qL~'T~o'~-he Located: 830 Jackson's Landing, Mattituck. 8CTM#113-6-4 Vote of Council: Ayes: All Motion Carried Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda October 25, 2001 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 Mr. Mark K. Schwartz, AIA P.O. Box 933 Cutchogue, NY 11935 Re: LEONARD & JOYCE BECKENSTEIN 830 Jackson's Landing, Mattituck SCTM#113-6-4 Dear Mr. Beckenstein: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 24, 2001: RESOLVED, that the Southold Town Board of Trustees Approve the request for an Amendment to Permit #5307 to construct an addition to the existing dwelling, 7'X 18'3". This is not a determination fi.om any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK:lms DEC Bldg. Dept. Telephone (631) 765-1892 Town FuOJ.. ~095 ~ Road P.O. Box 11'/9 8o~thold. N~w York SOUTHOLD TO~ItN CONSERVATION ADVISORY COUNC~7, At the meeting of the Southold Town Conse~ation Advisory Council held Monday, October 15, 2001, the following recommendation was made: Moved by Melvyn Morris, seconded by Bill'McDermott, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Amendment Request of LEONARD & JOYCE BECKENSTEIN to Amend Permi{ #5307 to construct an addition to the existing dwelling, 7'X 18'3". Located: 830 Jackson's Landing, Mattituck. SCTM#113-6-4 Vote of Council: Ayes: All Motion Carried Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO ~.~"7 .... DATE: ...A...P.?!!...~.:....~001 Authurizalimt · Pursuant to the provisions-of Chapter 615 of the Laws of the State of New York. 1893~ and Chapter 40~ of ~e I~ws' of the State of New Yore 19521 and the Southold Town C)rdinen~e 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;..'...': end in accordance with the Resolution of The Board adopted at a meeting held o~ A.~i..1....Z.5.., ..... g0.0.~..., and in comJderafion of the sum of $~.:..0..0. ........... p4id by Leonard & Joyce Beckenstein o( ...... M~.~"..tk. .................................... i ..................... N. ¥. ,nd~ ,,~t to the Terms and Condltlo~s fisted on the reverse ride hereof, of Southold Town' Trustees authorizes end permfls the folowlncj:. Wetland ?ermit £or ~ddit~on~ Lo t~e exi~tin~ $in~]e-£am~l¥ dwel~n~, ~ per ~urve¥ d~ted October g6, 2000 ~nd ]~$t ~mended ~ecember 6, 2000. al'in accordance with the deteiJed specif'mafions as presented in · the odglnating appl'matlon. IN WITNESS WHEREOF, The said Board of Trustees here- ib~Y causes ifs Corporate Seal to be aff'.~,ed, and these presenh to subsoribed by amajorffy of the said Board as of fhls darn. H. enrv Smith ~ Ab~e~t -' 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 April 30, 2001 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Mark K. Schwartz, AIA 1755 Sigsbee Rd. Mattituck, NY 11952 LEONARD & JOYCE BECKENSTEIN 830 Jackson's Landing, Mattituck SCTM# 113-6-4 Dear Mr. Schwartz: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 25, 2001 regarding the above matter: WHEREAS, Mark K. Schwartz, AIA on behalf of LEONARD & JOYCE BECKENSTEIN applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated April 5, 2001 and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their fmdings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 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 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 LEONARD & JOYCE BECKENSTEIN for additions to the existing single-family dwelling, as per survey dated October 26, 2000 and last amended December 6, 2000. 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 pmject will expire two years from the date it is signed. Fees mu~t 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, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms cc: DEC Bldg. Dept. Tetepbone (631) 765-1892 Tm Hall ~,3095 Main 1~ P.O. Box 11'/9 Sm~hold. New Yet. k 11971 SOb"rHOLD TO~VN CONSEB.VATION ADVISORY At the meeting of the Southold Town Conse~ation Advisory Council held Monday, April 16, 2001, the following recommendation was made: LEONARD & JOyCE BECKENSTEIN 113-6-4 for additions to the existing single-fanCily dwelling. ' ' 830 Jackson's Landing, Mattituck The CAC did not make an inspection, therefore no recommendation was made. TER~S ~ad CONDITIONS The Pe~mim~ Leonard & Jcl/ce Beckenstein 830 Jackson's Landing, Mattituck, NY ' ,~m~ -, N.¥~u ~ ~t ~ ~b'~ ~ ~.~ of .,: , ~b~~ ,5:; OF: LOT 8 ~Nl~ LANI21N~ L C)_ NOTES, · MONUMENT FOUIND ELEV'S REFER. TO FiSL - NOVi~'2q AREA = ~1,184 SF OR 0,~2 AC. RES FLOOD ZONE LINE IS ANNOTATED FROM FEHA FLOOD NAP NUMIBER ~610~CO481 O S PAP~ ~ RECHARGE AREA ®RAPHIO SCALE AMENPED: 11¢2q-00, ' ~ 12-0~-00, 01-~0-01 I SUFFOL~ COUNT~ TAX ¢ C~TIFI~ TO: L~ONA~O B~O~ENSTEIN JO%0~ BEO~ENSTEIN TABLE OF AREA5 Total Lot Area = 31,184 sf ~tland Area = 8,424 s~' Acl]ocent Area : 22fi60 sF IMPERVIOUS COVERA®ES EXISTINO HOUSe : I~BI st: Ooroc3e : 542 sf Pool 425 sf Decks 4 ~lks : I~lO ~f Tof. ol = ~,q08 or I~.1~ P~OPOS~D House : 4.58 sf (of ~hich ~4q sf is existlncj deck) DecK T------------------~O0 sF = ~Oq sf or 2.6% TOTAL House : I,~Sq Ooroge = 542 Poo~ : 425 Decks ,~ k'k::llks = I,-I01 Total = JOHN C. EHLERS LAND SURVEYORi 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\XHp server~d~PROS~20-263E.pro New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2366 Phone: (631) ~.~?.~0365 FAX: (631) ~??.-0360 Website: www.dec.state.ny.us John P. Cahill Commissioner March 21, 2001 Leonard & Joyce Beckenstein P.O. Box 407 Mattituck, NY 11952 5 RE: 1-4738-02043/00003 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, 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 enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Marilyn E. Peterson ' Environmental Analyst MEP/Is Enclosure NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER 1-4738-0Z043/00003 FACILITY/PROGRAM NUMBER(S) TYPE OF PERMIT · New [] Renewal [] Article 15, Title 5: Protection of Waters [] Artic[e 15, Title 15: Water Supply O Article 15, Title 15: Water Transport [] Article 15, Title 15: Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers PERMIT Under the Environmental Conaervat L on Law [] Modification [] Permit to Construct [] 6NYCRR 608: Water GuaLity Certification [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater WetLands · Article 25: Tidal Wetlands EFFECTIVE DATE March 14, 2001 EXPIRATION DATE(S) March 31, 2004 [] Permit to Operate i [] ArticLe 27, Title 7; 6NYCRR :560: Solid Waste Management [] Article 27, Title 9; 6NYCRR 573: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: FLoodplain Management [] Articles 1, 3, 17, 19, 27, 57; 6NYCRR 580: Radiation Control PERMIT ISSUED TO Leonard & doyce Beckenstetn ADDRESS OF PERMITTEE TELEPHONE NUMBER (631) 298-9613 P.O. Box 407, Mattituck, NY 11952 CONTACT PERSON FOR PERMITTED ~ORK Mark Schwartz, Cronin & Condon Consulting Engra., 1755 Sigsbee Road, Mattituck, NY 11952 NAME AND ADDRESS OF PROJECT/FACILITY TELEPHONE NUMBER (651) 7'54-7250 Beckenstein property, 8~0 Jackson's Landing LOCATION OF PROJECT/FACILITY Mattituck COUNTY TOgN SuffoLk Southotd DESCRIPTION OF AUTHORIZEDACTIVITY: WATERCOURSE NYTM COORDINATES Construct additions and elevated deck and stairs to an existing single family dwelling. All work is to be done in accordance with the attached plans stamped NYSDEC approved. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict cml)Liance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as pert of this permit. PERMIT ADMINISTRATOR: Roger Evans (HEP) AUTHORIZED SIGNATURE ADDRESS BLdg. #40, SUNY, stony Brook, NY 11790-2356 .R_ DATE March 21, 2001 Page 1 of 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, agents, and assigns for all claims, suits, actions, damages, and costs of every name and description, arising out of or resulting from the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with the terms and conditions of the permit. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Perrnittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition '1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg M0, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a) the scope of the permitted activity is exceeded or a violation of any cor~"~..~f.~iae ' .............. of the ECL and .- .... pertinent regulations is found; b) the permit was obtained by misrepresentation or failure ~-,~ ---.-'~$1,;i"~'~ c) new material information is discovered; or ',~. ,,,~,,,.,, ..... d) environmental conditions, relevant technology, or applicable law Or regulatio~"~W '~haT~ ......................... " .......... changed since the permit was issued. I DECPERMITNUMBER I PAGE 2 OF 4 1-4738-02043/00003 I NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6NYCRR PART 608 ( TIDAL WETLANDS) If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the ~tate, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watemourse. No claim shall be made against the State of New York on account of any such removal or alteration. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from futura operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or dght to compensation shall accrue from any such damage. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. 4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 5. Any matedal dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. Thera shall be no unreasonable interference with navigation by the work herein authorized. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302, 303,306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. 9. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certitying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of preject, the bottom portion ofthe form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 10. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved survey was prepared by: John Ehlers dated 10/26/00 last revised 1/30/01. I I DEC PERMrFNUMBER ~ ~ PAGE 3 OF 4 1-4738-02043/00003 I I NEW YORK STATE DEPAm~IENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1, During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix trucks, mixers, or other devices enter tidal wetlands and or protected buffer areas. 2, Any debds or excess matedal from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. 3. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. 4, The storage of construction equipment and materials shall be confined to the driveway/parking area. 5. A row of staked hay bales or approvable erosion control devices shall be placed at the landward edge of the buffer area or as per NYSDEC approved plan. 6, Roof runoff shall be directed to drywells to the landward side of the single family dwelling. 7. There shall be no disturbance or modification to the existing vegetation between the house and the tidal wetland boundary. 1 --4738-02043/00003 Albert J. Krupsld, 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) 765-18q2 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD LETTER OF REQUEST FOR AN AMENDMENT ' 0TM ~. ~,~ S~.,... PHONE AGENT /~,~L J~,~/~ ~ PHONE PROPERTY LOCATION S,~0 J~ff~z/' ~,e'~ TAX MAP NO. /~P~ '//3 --~ - ~ ~ Signed By: Albert J. Krupski, President James King, Vice-President Henry Smith At'tie ~'oster · 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application AFFIDAVIT OF POSTING I, ~/~ t~4~7 ~ residing at e~ng ~u~y sworn, ~e~ose a~d say: That on the /~ Of~, 200~ I ~rso~[l~ Dy placing ~ne soarc of Trustees ozIlcial poster wnere i~ 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 ~publtc hearing. Date of hearing noted thereon to be hel~~~ ~~ Dated: Swor..n; to before me this ~.-~--day of~~ 200.~.- Notary Public HELENE D. HORNE Not~/Public, State of New Yo~k No. 4951364 Qualified in Suffolk CouniX ~,0,~, HO~ PHON~ NU. : F~,x: (~31) 734- 41g$ ~AX TEAJ~81~lri rAL To: Pages: October 3, 2007. ~uthold To~a Hall Board 0~ Town Trust. s P.O, Box 1179 5outhold, NewYork 11971 83o Imd~ou's Landing Mattituck, New York M~rk K. Schwartz, AIA - A.-r. hitec~ 6 (includi~ this O[:T - Comments: Please review the lollowing amended survey. The Owners had requested a change to 't. he w~st side acklilion to be 7'-0~ x 18'-3# in lieu of the 10'-6# x 9'4Y' addition as approved. The approved addition was 94~5 SCluaze feet, ~ modili~ addition is 128.8 s~lare feet. The additional area o~ 34~ square f~ brin~ the overall coverage to 44643 squa~ feet Please revimw the kdlowir~ information and r~il ~th 'q't,~'tio~ you may have. TI~ ~0t~. 10/05/01 WED 11:42 FAX $18 78~ I$S6 $outhold Town acco~utlng re~e~ve ~mes~ ~at Were ma~l~ to e~ch of aaid Persons N~W Public, State of N~ ~ No, 4951364 ~ qualifi~ in Suffolk Cou~w_ mm~on ~~ ~ ~ FAA 919 ?$~ 185~ $outhold To~m Accounting County of Suffolk State. of New York BEING ,DULY S~I~N DEPOSES AND AFFII~ ~AT ~/$~ IS ~'~ ~PLI~ F~ '~ ~ ~ WILL BE ~ IN ~ ~ S~ F~ IN ~IS' ~P~I~ON ~ ~P~ ~ ~ISES IN ~N~C~ON ~ ~I~ OF ~IS HELENE D. HORNE NOmrf Publio, State of New Yo~k No. 4961364 ' . Qualified In Suffe~k County..< ~004 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, /~/~ ~~ , residing at ~/~ ~S/~F~/~/J being duly sworn, depose and say. ~e~yt~o~n~as a~°~ ~6~0~I ~/AJ ~pers°nally posted the 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 ~he . public hgaring. Dat~ of hearing noted thereon to be held ~_~~O~ Dated: Swor~to bef~e me. this YZ day of Notary Public HELENE D. HORNE Notaw Public, State of New No. 4851364 Qualified in Suffolk County OC! ~,2PO~ 2.,~ FRO~ ~ AUT~O~I ZA~XO~ (wh~re the applicant is not the o~ner) southold Bomx~ of Town Trustee~ on m~ behalf. (~s~ signa=ure } 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 Office Use Only Coastal Erosion Permit Application -,,"'W~and Permit Application ~'~Major Waiver/AanendmenffChanges ~,~Received Application: tJ ¢,Received Fee:$ ~'~ompleted Application ~ Incomplete SEQRA Classification: Type I Type II Unlisted .Coordination:(date sent) _~-4~AC Referral Sent: ~ate of Inspection: ~[[~ Receipt of CAC Report: Lead Agency Determination:__ Technical Review: · '~tCublic Hearing Held: qt:nl Resolution: A,}R 5 Minor Name of Applicant Address Phone Number:( Suffolk County Tax Map Number: 1000- //fl Propero/Location: t~.~I .~¢~oZ-fit/t (pro~id~ g~CO Pol~ ¢, dis~¢~ to cross strc~s, ~dd~.: 17~ ~/~ ~ Phone: 774- 7? sto Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: Board of Trustees Application GENERAL DATA Prior permits/approvals for site improvements: Agency · __ 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): Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~tff6(~'- ~,~ t¢¥ ,rgb' $1r~"'/,~. Area ofwetlands on lot: ~! 4 ~_.,/~- square feet Percent coverage oflot: ~'~. 4~ % Closest distance between nearest existing structure and upland edge of wetlands: ~ C> feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ t~ feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: ,~ ~ 0 ~t Proposed slope throughout the area of operations: t v~ 3o feet 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): ~d of Trustees Applicatio~ AUTHOP. I ZA~IO~ (where the applicant is not the owner) (print owner of property) (ma~llng address) ~/~/-~ do hereby authorize o apply for permit(s) from the Southold Board of Town Trustees on my behalf. 8 Board of Trustees ApplicatiOn County of Suffolk State of New York DEPOSES AND AFFIRMS TI-IAT 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 THI~ APPLICATION. Signature SWORN TO BEFORE ME THIS ~ DAYOF dJ~'~./(-- ,200 Notary Public HELENE O. HORNE Notary Public, State of New Yod[ No. 4951364 Oualified in Suffolk Coullty Commission Expires M~y 22, ~. ~' / PROJECT LD. NUMBER Appendix C State Environmenta! Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by A~plicant or Project s0onsor) SEQ IS PROPOSED ACTIO~I: E] New ~ Expansion [] Moaificatlon/alteration DESCRIBE PROJECT SRiEFLY: 7. AMOUNT OF LAND AFFECTED: ~. WILL 7ROPOSED ACTION COMPLY W~TH ~ISTING ZONING OR OTH6R ~iSTING ~ND US~ ~ESTRiCTIONS? ~ NO I~ No, describe briefly WHAT IS PRESENT LAI~D L/E;: IN VICINITY OF PROJECT? [] Agriculture 10, DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, OF THE ACTIOI4 HAVE A CURRENTLY VA[JO PERMIT OR APPROVAL? I! yes, list agency r~ame and permit/approval AS A RESULT OF PROPOSED ACTION WILL E~ISTING PERMITIAPPROVAL REOUIRE ~.4OOIFICATION? 12. [] Yes ~No ..:. I CE,~TIFY THAT T~E INFO~MAT~ON PROV~OE~ AeOVE ~S TRUE TO TNE ~EST OF M~ ~NOW~OE If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART 11--SNVIRONMENTA' :cSMENT ,'7o ~e comc~e.'eo b.y.-~u~. · ~'~-,c' PART III--OETERMINATION OF SiGNIFiCANCE (To be comfoleted by Agency) INSTRUCTIONS; For each adverse effect identified adore, determine whether it is substantial, targa, [m~onan~ or sidewise signific, Esc~ ~ifec: ShOUld ~e asses5~ in conn~tion with its (a) setting (i.e. urDan or ~ral); (b).proOaDH[ty of occ~g; ~c) duration: ~rreverstbili[y; (e) geographic 5cooe; an~ (~ magmtu~e. If necessa~, a~ attac,hments or reference suo~o~ing materials. Ensure exotanadons contain sufficJen~ de~aii ~o snow ~ha( all remvant adverse impacts have been identif~e~ an~ adequately addressed. Chec.~ this box ~t you have identified one or more sotendaJly large or significant adverse imeac:s which occur. Then 2rcceed direcdy :o :~e driLL ~AF And/or prepare a positiv~ declaration. ChecX :his box ~f you have determined, based on the information and analysis above and any suooortin¢ documen[a[tcn. :~a~ :he ~rooosed ac:ion WILL ~4OT result in.ny significant adverse environmental AND prowce on ~Ac2ments as necessa~, (he reasons supcordng ~is determination: NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: CO~J~.C~-~ A~),~,~J~ 2. That the property which is the subject of Environmental Reviews-is located adjacent to your property and is described as follows. 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:' _~/~/ 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. OWNERS NAME: MAILING ADDRESS PHONE #: Enc.: Copy of sketch or plan showing proposal for your convenience. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK that on the ~ day of , residing at JY]' r//~ ~~ · being duly sworn· deposes and says ~/~&~ ~ ,~0[ , 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 ~id Notices were mailed at the United States Post Office at ~d~777~ , that said Notices were mailed to each of said persons by (certified) (re~istered) mailW'~ // Sworn to before me t~is ~-~ day of ~{C ,~{ ' tary Public HELENE O. HORNE Notary Public, State of New York No. 4951364 Qualified in Suffolk County Commisaion Expires May 22. ~ Cronin and Condon Consulting Engineem, LLP 1755 S~bee Road Matlltuc~, New Yod( 11952 LICENSED PROFESSIONAL ENGINEERS NEW YORK NEVV JERSEY Pho~m: 631-7~4-7250 Fax :631-734-7014 T~ITFA~. Date: To: Apdl 4, 2001 8outhold Town Trusteea Southold Tow~ Hall Annex Southold, New York APR 5 Project: Frofn: Beckea~tein Property 830 Jackson's Landing Matfituck, New York $CTM~ 1000-113-064)4 8outhold ZBA Approval #4893 (rear yard setback) NYSDEC Permit # 1-4738-02043/00003 Mark K. Schwartz, AIA- Architect We transmit the following by hand delive~: · 1 Copy of NYSDEC Permit · Completed Trustee Forms · Application fee check Remarks: Please review and call with any questions. My direct line is 631-749-3289. Thank you. BeckensteinS.doc