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HomeMy WebLinkAboutTR-5746 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hail Annex 54375 Main Road 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 # 0496C Date: December 2 2009 THIS CERTIFIES that the construction of an enclosed porch~ new roof, and the installation of gutters to leaders to drywells At 1640 First Street, New Suffolk, New York Suffolk County Tax Map # 117-5-46.3 Conforms to the applications for a Trustees Permit heretofore filed in this office Dated 9/5/02 & 4/21/03 pursuant to which Trustees Wetland Permit # 5620 Dated 9/25/02 was issued and Trustees Wetland Permit # 5746 Dated .4/30/03 was issued and Amended on 9/17/08 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 for the construction of an enclosed porch, new roof~ and the installation of gutters to leaders to drywells The certificate is issued to GERARD H. SCHULTHEIS owner of the aforesaid property. Authorized Signature James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631 ) 765 -6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: ~ Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain l~t day of construction ½ constructed Prc.iect complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: ~) ~-~ June 6, 2006 Town of Southold Building Department Southold Town Hall PO Box 1179 Southold, NY 11971 A'I-rN: Building Inspecton Gerard H.: PO Box 2ffi New Suffolt, 631-73~72~ REFERENCE: Permit # 31218 Z I would like to take this opportunity to advise you of my change of plans regarding the subject Building Permit 31218 Z granted June 22, 2005. I have elected to downsize lhe project and the only work which will be under taken will be the addition of the enclosed porch on the north side of the house. I have completed the excavation for the piers and will be calling for a foundation3 inspection when the forms are in place. The mom will use new windows since the windows originally planned to be removed [~. the house and reinstalled on the porch will net be available. The door on the w~st will be eliminated. The layout of the beams and floor joists has been rotated to accommodate the locations of the bulkhead tie rods, anchor piles and lay piles. If you have any questions please do not heeltate to call. Thank you very much for your consideration. Gerard H. Schultheis June 6. 2006 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 September 17, 2008 Mr. Gerard Schultheis P.O. Box 299 New Suffolk, NY 11956 RE: 1640 FIRST ST., NEW SUFFOLK SCTM#117-5-46.3 Dear Mr. Schultheis: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., September 17, 2008: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5746 to allow for the existing enclosed porch, as depicted on the plan stamped approved on September 17, 2008. This is not a determination from any other agency. President, Board of Trustees JFK:lms b u rl,,I,x~ ~,.,,~do~,c- Fro ~'~ ~ Urv~/ 14,1 ' 14.1'-1&3'=/,8/ ! ! z! /Z, 7 = Jz'.. g4 = i'Z.7~ APPROVED BY BOARD OF TRUSTEES TOWN OF $OUTHOLD DATE ~-£,'~ /7 og SCHOOL, N 87' 37 50" HOUSE N 04' 45' 10' 34. 86 t~ z5' .~z' 20' w" 15.20' 1 STORY RESIDENCE N/F TUTHILL BLUESTONE DRIVEWAY 2 CAR AVG. EL =7.5 TM 1000-117-05-46.3 N SS' 49' lO" W VEL ED P OA D GUARANTEED TO GERARD H. SCHUL THEIS CAROL YN M, SCHUL THEIS N 8~' 49' 82.~7' ~ /V N/F SCHULTHEIS '~> 19 NOVOI ADD FIRA,I DATA 6) CREEK 191.19' .,~ 4 DE, NEW SUF/ SL SURVEYED I THIS PARCEL IS FOUND ENTIRELY IN FLOOD ZONE ,~£ -8 (EL. 8] SOURCE: FEA, fA MAP No. SEIE~$COSO/G ~$ PREPARED. ~ ~ H~ ~ ~ ~ OFFICE LOCATION: Town Hall Annex 54375 State Route 25 Main Rd. & Youngs Ave. Southold, NY 11971 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 To: Jim King, President Town of Southold Board of Trustees From: Scott Hilary and Mark Terry, LWRP Coordinators Date: September 13, 2008 Re: Chapter 268, WATERFRONT CONSISTENCY REVIEW Amendment to Wetland Permit for GERARD SCItULTHEIS SCTM# 117-5-46.3 GERARD SCHULTHEIS requests an Amendment to Permit #5746 to allow for the existing enclosed porch. Located: 1640 First St., New Suffolk. SCTM#117-5-46.3 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is our recommendation that the proposed action is an Amendment to Wetland Permit//5746 and has not been reviewed to Chapter 268. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfcl 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 APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT / PHONE PHONE ADDRESS PROPERTY LOCATION_/ g ~0 FI~ ..~. ~Jo,~, S~I~ TAXMAPNO. [-06G -- 0~--- tO00- ~,7 - os- 4;,3 Board of Trustees Application County of Suffolk State of New York 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. SWORN TO BEFORE ME THIS Ot}~ DAY OF ~z_p, ,20OF N6tary Public LAUREN M, ~ 01 ~mmi~ Expt~s Apdl ~;'~ ( [ Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion HazardArea. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listing both supporting and non- suooortin~ facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. SCTM# [000 PROJECT NAME A copy of the LWRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board of Trustee~'t,~ ~hmningDep_ag_ment, all DESCRIPTION OF SITE AND PROPOSED ACTION The Application has been submitted to (check appropriate response): TownBoard ~ Planning Board D Building Dept. [~ Board ofTrustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Location of action: Site acreage: 0,27~ Present land use: O. cce~ Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: ~e.o.~ ~, SC~x~/[ Jkke~ (b) Mailing address: ¢0 1~o tX ~C/t~ (c) Telephone number: Area Code ( ) 6.~]- 77,4- 7ggS - (d) Application number, if any: Pe.~-,..~ ~ S 74o/ Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] NoJ~ If yes, which state or federal agency?. C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. Yes ~ No [] Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria [-~ Yes [~ No l~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [-~ Yes ~ No [~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~ Yes ~ No~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria Yes No I Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No /~' Not ~licable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~ Yes ~] No[] Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~ Yes [] No ~7~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ~ Yes~ No ~' Not Applicable Attach additional sheets if necessary WORKING COAST POLICES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. Sec LWRP Section Ill- Policies; Pages 47 through 56 for evaluation criteria. Yes [-~ No ~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. Yes F~ No ~ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. VI Yes 7~ No ¢~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate usc and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. [] Yes ~ No/~ Not Applicable PREPARED BYG~ c~ ~ ~'C¢~,' I + [~ ~3 TITLE February 14, 2005 Gerard H & Carolyn M Schultheis PO Box 299, 1640 First Street New Suffolk, NY 11956 631-734-7265 Southold Town Board of Trustees Sou~oid Town Hall Main Road Southold, NY 11971 To Whom It May Con(em: ~ we wa'e finally granted Ihe vadan(e in October of 2004. We am currently finalizing the plans for At the Zoning Board Heanng a request was made by a neighbor that porous material be placed on the di~ ddveway leada~ to our house in ce~ler to minimize dust We wil~ accommodate ~e request and hereby request approval if such is required. Board of Trustees 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 TRUST~:ES TOWN OF SOUTHOLD April 25, 2007 Mr. Gerard Schultheis P.O. Box 299 New Suffolk, NY 11956-0299 Re: 1640 First St., New Suffolk SCTM#117-5-46.4 Dear Mr. Schultheis: In response to your letter dated April 24, 2007, the Board of Trustees reviewed your request and grants you permission to fill the washed out area south of the existing permitted bulkhead and west of the marine mattresses with sand, and to repair the east side of the access road by placing rocks, moved by the storm, in suitable mesh containment, and filling with soil and planting vegetation to stabilize the soil. This is not a determination from any other agency. Please contact our office if you have any questions. Very truly yours, F. King, President Board of Trustees JFK:lms ,,~ew York State Department of Environmental Conservation Division of Environmental Permits, Region One SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 444-0372 · FAX: (631) 444-0360 Website: www.dec.state.ny.us Alexander B. Grannis Commissioner February 11, 2008 Mr. Gerard Schultheis PO Box 299 New Suffolk, NY 11956-0299 Re: Permit #1-4738-00655/00004 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 carefully read all permit conditions and special permit conditions contained in the permit to insure compliance during the term of the permit. 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. Sincerely, Claire Wemer Environmental Analyst CKW/dj Enclosure 'N~.W YORK STATE DEPAK~ENT OF ENVIRONMENTAL CONSERV~ON ~acility DEC ID 1-4738-00655 PERMIT Under the Environmental Conservation Law (ECL) Permittee and Facility Information Permit Issued To: GERARD H SCHUTEIS BOX 299 NEW SUFFOLK, NY 11956-0299 Facility: SCHUTHEIS PROPERTY 1640 FIRST ST[SCTM# 1000-117-5-46.3 NEW SUFFOLK, NY 11956 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Facility Principal Reference Point: NYTM-E: 712.8 NYTM-N: 4540.9 Latitude: 40059'29.5'' Longitude: 72°28'12.5'' Project Location: WATERCOURSE: SCHOOLHOUSE CREEK/CUTCHOGUE HARBOR Authorized Activity: Repair storm damage by: placing 32 cubic yards of sand in a 25 ft. by 35 ft. area landward of bulkhead and marine mattresses and planting with beach grass, placing 37 cubic yards of sand in a 20 ft. x 75 ft. area, and relocating/enclosing 20 cubic yards of washed out rocks into a geogrid approximately 5 ft. x 100 ft. at the edge of the roadway, landward of existing marine mattresses and planting with rosa mgosa. All work must be done in accordance with the attached plans stamped NYSDEC approved on 2/I 1/08. Permit Authorizations Tidal Wetlands - Under Article 25 Permit ID 1-4738-00655/00004 New Permit Effective Date: 2/11/2008 Expiration Date: 2/11/2013 Water Quality Certification - Under Section 401 - Clean Water Act Permit ID 1-4738-00655/00005 New Permit Effective Date: 2/11/2008 Expiration Date: 2/11/2013 Excavation & Fill in Navigable Waters - Under Article 15, Title 5 Permit ID 1-4738-00655/00006 New Permit Effective Date: 2/11/2008 Expiration Date: 2/11/2013 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: MARK CARRARA, Deputy Regional Permit Administrator Address: NYSDEC REGION 1 HEADQUARTERS SUNY ~ STONY BROOKI50 CIRCLE RD STONY BROOK, NY 11790 -3409 Authorized Signature: ~ Date / / Page 1 of 6 C UT~ H Loy 44 APPROVED BY BOARD OF TRUSTEES ;,+ TOWN OF SOUTHOLD S'T R C-- ~.T iooo- HI- 7- z~/ S ro~ -D~ R~ RAI.R. Row O~.eo.E.O To: New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40- SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0365 · FAX: (631) 444-0360 Wabslta: www.dec.state.ny.us PERMIT MODIFICATIQN Denise M. I AcUng Co~ Mr. Gerard Schultheis PO Box 299 New Suffolk, NY 11956 March 22,2005 Re: 1640 First Street, New Suffolk, NY DEC# 1-4738-00655/00003 Dear Mr. Schultheis; Your request to modify the above permit has been reviewed pursuant to 6NYCRR Part (Uniform Procedures Regulations). It has been determined that the proposed modificat not substantially change the scope of the permitted actions or the existing permit conditi~ Therefore, the permit is modified to authorize: Place bluestone on driveway in area marked "bluestone driveway" aa shown on pi Gerald Schultheis, NYSDEC stamped approved on 12/19/02, Special Condition # 7 la modified to read: No grade changes, filling or clearing la authorized by this permit with the ~ of placing bluestone in the area of the driveway. Additional Special Conditions to the permit are as follows: Be 9. 10. All driveway material shall consist of "clean" sand, gravel, or bluestone asphalt, slag, flyash, broken concrete or demolition debris). Driveways and parking areas shall be conatructed of pervious material. Driveways and/or parking areas shall be graded to diract runoff away frol wetlands and protected buffer areas. This letter is a modification to the original permit, and as such, shall be available at the whenever authorized work is in progress. All other terms and conditions remain as written In )ns will ~ns by caption )t :idal ,b site istrator cc: file Febn.~-y 14, 2005 Gerard H & Carolyn M Schultheis PO Box 299, 1640 First S~'eet New Suffolk, NY 11956 631-734-7265 Southold Town Board of Trustees Southold Town Hall Main Road Sou~old, NY 11971 To Whom It May Concern: Gerard H & Carolyn M Schul~heis 2/14/~5 Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route25 P.O. Box 1179 Southold, NewYork11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 March 23, 2005 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. & Mrs. Gerard Schultheis P.O. Box 299 New Suffolk, NY 11956 RE: '1640 FIRST ST,, NEW SUFFOLK SCTM#1 '17-5-46.3 Dear Mr. & Mrs. Schultheis: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., Mamh 23, 2005: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Permit #5746, as issued on April 30, 2003. This is not an approval 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:lms February 14, 2005 Gerard H & Carolyn M Schultheis PO Box 299, 1640 First Street New Suffolk, NY 11956 631-734-7265 Southold Town Board of Trustees Southold Town Hall Main Road Soulhold, NY 11971 To Whom It May Concem: We would like to take this opportunity to request an exten..<.<.<.<.<.<.<.<~n to our Permit # 5746 granted on April 30, 2003. conslruction we were finally granted ~he variance in October of 2004. We are oJrmnity finalizing the plans for At the Zoning Boacd Heanng a request was made by a neighbor that porous mate'iai be placed on ~e dirt driveway leacting to our houee in o~'~* to minimize dust VVe will accommodate lhe rec~Jest at'x1 hereby request approval if such is required. If you need any additior~ inf(xmafion please don't hesitate to contact us. Thank you very much for your consideration. Sincerely, Gerard H & Carolyn M Schultheis 2/14/05 New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0365 · FAX: (631) 444-0360 Webslte: www.dec.state.ny.us PERMIT MODIFICATION Den[se M. Actin Mr. Gerard Schultheis PO Box 299 New Suffolk, NY 11956 March 22 Re: 1640 First Street, New Suffolk, NY DEC# 1-4738-00655/00003 Dear Mr. Schultheis; Your request to modify the above permit has been reviewed pursuant to 6NYCRR Part (Uniform Procedures Regulations). it has been determined that the proposed not substantially change the scope of the permitted actions or the existing Therefore, the permit is modified to authorize: rls. Place bluestone on driveway In area marked "bluestone driveway" as shown on ins by Gerald Schultheis, NYSDEC stamped approved on 12/19102. Special Condition # 7 Is modified to read: No grade changes, filling or clearing Is authorized by this permit with the e of placing bluestone irt the area of the driveway. Additional Special Conditions to the permit are as follows: 9. All driveway material shall consist of "clean" sand, gravel, or bluestone asphalt, slag, flyash, broken concrete or demolition debris). Driveways and parking areas shall be constructed of pervious material. Driveways and/or parking areas shall be graded to direct ru wetlands and protected buffer areas. :ldal This letter is a modification to the original permit, and as such, shall be available at the ~b site whenever authorized work is in progress. All other terms and conditions remain as written_~ln t~,/orlg~ cc: file 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, NewYork 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 March 23, 2005 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. & Mrs. Gerard Schultheis P.O. Box 299 New Suffolk, NY 11956 RE: 1640 FIRST ST., NEW SUFFOLK SCTM#117-5-46.3 Dear Mr. & Mrs. Schultheis: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., March 23, 2005: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extensior to Permit #5746, as issued on April 30, 2003. This is not an approval 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:lms Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson 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 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~ONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. GERALD H. SCHULTHEIS INSPECTION SCHEDULE X 1st day of construction ½ constructed x Project complete, compliance inspection. Material fence prior to and during Construction Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. "~"~)/'/~ DATE: Ap-ct! 30, 2003 ISSUED TO ..... ?E.R'~t~g .H' .SCHULTHEIS ut'l ri ati u Pursuant to the provisions of Chapter 615 of the Laws of the State of New YorE, 1893: and Chapter 40~ of the ,1~. ws of the State of New Yore 1952; and the SouthoJd ToWn Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;?; end in accordance with the Resolution of The B6ard adopted at a meeting held on ~.P~...~.~ ..... · ~0.~3.., and .in consideration of the sum of $...~g~.~..~.0 ..... paid by Gerard H. Schultheis of ........ N93~....~4.ffg!~ .............. N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of S'~'dd_ T,~,,. T,~.~ authorizes arid pgrmlts the fplJowlnq: wing ex/sts and add a second-story to northwest section of house. Replace roof over porch on north side wStll new roof. All building to be performed within existing building Permit #5620, in terms of fencing prior to and during constTuction, and the installation of · drywells and gutters for roof run-off control. aJJ in accordance with the aetmmd specifications as presented in ' the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seas to be a~ixed, and these present~ to be subscribed by ~ majority of the said Board as of this date. TERJdS and CONDITIONS Gerard H. Schuttheis 1640 First St., New Suffolk put' of the considexation for the issuance of the P~'~i~ does undetstaud and ptescrl~ to the foL lowing: 1. That the said Board of Tm~_-e*_ and the To~n o~ ,~hold ~e ~ f~ ~ ~ 24 2. ~t ~~~of ~ ~~~ for ~on ~y ~ to ~ ~ as a ~ ~_ ~. That this Petmlt should be i-e~!m,d indeirmltdy, or as long as the said F~ittee ~ to maintain the s~uctu~e o~ project involved, to provide evidence to anyone cotscemod d~at suth- odzatlon was o~iginally obtained. 4. That ~e wodc involved will be subject to the inspectio~ and approval of the Board ~ Its agents, and non-~p~i~ ~ the p~ovislons of the odginatiag application, may be _~,,_~ fo~ t~-~cation of chis P~mlt by t~olution of the said Bowel That the~e will be no un~easonable interference with navigation as · result of the wc~ notice, to t~nove o~ slte~ this wodc o~ project hex-da sts~ed without ~ to the Town 8. ~ the said Board wUl be notified by the Petmittee ot the o~eti0o O~ the ~ auile orized, 9. That the Permittee will cilia all other permits sad comeaU that may be ~ ~ plememal m Otis permit whic~ may ~ subject to tevol~ upon fslh,~ tO dltata ~ ~tbert J.' Krupski, President James King, Vice-President Artie Foster Ken Peliwoda 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 April 19, 2004 Mr. Gerard H. Schultheis P.O. Box 299 New Suffolk, NY 11956 Re; 1640 First Street, New Suffolk SCTM#117-5-46.3 Dear Mr. Schultheis: In response to your letter dated April 6, 2004, and in accordance with the new Chapter 97-13 of the Southold Town Code, a new permit is not required to repair your permitted bulkhead with Tongue and Groove Plastic Sheathing. If you have any further questions, please don't hesitate to contact the office. Very truly yours, Albert J. Krupski, Jr., President Board of Trustees AJK:lms Gerard H. Schultheis PO Box 299, 1640 First Street New Suffolk, NY 11956-0299 631-734-7265 Board of Town Trustees Town of Southold Town Hall Southold, NY 11971 Attn: Lauren Standish G~tifl~d ~il R~m I~c~ipt I~qu~ff~l ApB - 8 2004 Board of Trustees Dear Tn~staes: I would like to ~ ~is opportunity to advise you ~at I am repairing worm damage to my bulkhead. The bulld3ead was ~ tz~der VVei~nds Perrnit No. 439 issued on November 25, 1967. It is my understanding that under ,Nticle 97-13, Exceptions, Paragraph A, Item 5 of the new Chapter 97 Wetlands and Shoreline' of the Code of the Tow~ of SoulY~ld that the chapter shall no~ affect or prohibit nor require a permit for the repair. The repair will be accomplished ~, adding a layer of Z' x 10" Tongue and Groove Plastic Sheathing to the existing bulkhead where the damage has occun'ed. On April 6, 2004 I stopped in the Trustees Office and spoke to ~ Standish and she agceed a permit was not required. Sincecely, Gerard H. Schultheis Apdl 6, 2004 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 April 30, 2003 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Gerard H. Schultheis 1640 First Street P.O. Box 299 New Suffolk, NY 11956 1640 FIRST ST., NEW SUFFOLK SCTM#11%5-46.3 Dear Mr. Schultheis: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 30, 2003 regarding the above matter: WHEREAS, GERARD H. SCHULTHEIS 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 March 28, 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 April 30, 2003, at which time all interested persons were given an oppommity 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, WHERIEAS, 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, 2 NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of GERARD H. SCHULTHEIS to demolish the unstable east wing and build a new addition where east wing exists and add a second-story to northwest section of house. Replace roof over porch on north side with new roof. All building to be performed within existing building envelope, using existing foundation, and subject to the same conditions as the prior Permit #5620, in terms of fencing prior to and during construction, and the installation of drywells and gutters for roof run- off control. 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 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 April 18, 2003 Mr. Gerard H. Schultheis P.O. Box 299 New Suffolk, NY 11956 RE: 1640 First Street, New Suffolk SCTM#117-5-46.3 Dear Mr. Schultheis: The Board of Trustees made an inspection of your property on Thursday, April 17, 2003. It was determined that the proposed project is a substantial increase in house size and would therefore require a full Wetlands Permit application. Enclosed is an applicatien for your convenience. Please complete the first three pages of the application and return to our office, along with a check in the amount of $160.00, which is the balance of the application fees due. If you have any questions, please don't hesitate to contact the office. Very truly yours, Albert J. Krupski, Jr., President Board of Trustees AJK:lms Enc. April 12, 2003 UBALDO & PAT GONZALEZ 885 ORCHARD STREET PO Box 248 NEW SUFFOLK, NY 11956 Town Trustees Town of Southold Town Hall 53095 Route 25 Southold, NY 11971 To Whom It May Concern: We would like to express our support for the addition and alteration project you are reviewing for Mr. & Mrs. Schultheis on First Street in New Suffolk 'We are concerned about the amours[ of dust that will be raised due to the extra construction ba~c and ask reduoe the dust Thank you for your consideration, Sincerely, Telephone (631) 765-1892 Town H'a.R. 5309.5 Main Road P.O. Box 1179 Southold. New. Y~k I1971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Wednesday, April 16, 2003, the following recommendation was made: GERARD H. SCHULTHEIS to Amend Permit #5620 to construct additions to the existing dwelling, all within the existing building envelope. Located: 1640 First St., New ouffolk. SCTM#117-5-46.3 The CAC did not make an inspection, therefore no recommendation was made. Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. ~ el~0 DATE: ...~pt.. ISSUED TO .......... C~?'i~:LD.. ~.:...~.~.LLL.THI3][~ .................. . utl nri atinn Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893: and Chapter 404 of fha ,L~. ws of the State of New York 1952; and the Southold ToWn Ordinance en- titled ."RE-~ULATING AND ~E P~OlNG OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC ~DS RE~OVAL OF SAND, ~RAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WA~RS:~: and in accordance with the Resolution of The ~ard adopted at a meeting held on ..~P.[... . g?g.~.., and in consideration of the sum of $...g~.~.g.0 paid by ~r~l~.. ~ ~... ~ ~.h~l ~h.~is. ............... of ........ ~.~ .~ffq!~, N.Y. and subject to the Terms ~nd Conditions listed on the reve~ side ~f, of Southold Town T~ustees ~uthorizes end permi~ the foflowing: Wetl~d Pe~it to repair roof by reframing and reshingle tem,~ve existing roof and replace with new flaming- d~ells and gutters for roof mn off.- materi:~! ~nce prior to and during construction all in accordance with the detei~d s~ificetions es pre.hied in the originating application. IN WITNESS WHEREOF, The said ~ard of T~stees ~re- by causes its Cor~rate Seal to be affixed, and the~ presenh to be subscribed by ~ majorJ~ of f~ said ~ard as of this date. .. . T'ER~$ end C. ONDmONS Th~ P~nkt~ . Ge~:ld $chu!t,h~!~ ~ at 1640 First Street, New Suffolk N. ¥~ as ~ of ~he comlderadoa for zbe ~ of ~e Pem~i~ does unc~s~m~ ~d paddle m ~he roi- 1. That the raid Board o~ Tn~tee~ ami the Town o/ So. hold a~e released *'or aa ~on m~y ~ ~ to d~ ~ ~t · h.~. d~. 3. That this Permit ~mld be t~ained indd'mitely, or as 1o~ ~ the s~d F~ ~ to maio~jn the ~tructure or project involved, to provide evidence to anyone cor, c~c~d ~hat ~ orizatio~ w~ originally obtained. 4. That ~he work involved wtll be subject to the i~pection and approval of the Board its ageau, and noa-eompn-,,ce with the provision~ of the originating appti_xatlon, may be cause revocation of this Permit by resolu~io~ of the said Board. 5. That there will be no unreasonable interference with m~,allon as · result of the ~tJc herein s~'thodzed. 6. That there shall be no interference wid~ the tight of the ptd:fic to pa~ and repass along d~e beach between high and low w~tet masks. 7, That if future opet~tlons of ~he Town of So~tbold In the locntion of the work berda nad~4~ or i/~ in th~ oplmkm o~ ~he Bo~d o~ Tmstee~ dae 'WOI~ ~h. II cause tmtensoa~ble obsm~:non to free n~vi~atloa, the sald Petmlttee ~ clue notic~ tO remove Or =lter mi; work or project herein stated without ezpens~ to the a. That the said Board will be t~:if'ied b~ the Permittee ot orlzed. 9. That the permittee will obtain all other petmlt~ and co~__~e~_es that may be teclulted plemental to this permit which may be mbject to revo~ upon f.~h,~e to olxaln same. Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson 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 September 30, 2002 Mr. Gerald Schultheis PO Box 299 New Suffolk, NY 11956 RE: SCTM#117-05-.46.3 1640 First Street New Suffolk, NY Dear Mr. Schultheis: The following action was taken by lhe Board of Town Trustees during a Regular Meeting, held on September 25, 2002, regarding the above matter. WHEREAS, Gerald H. Schultheis applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated September 5, 2002. WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a Public Heating was iheld by the Town Trustees with respect to said application on September 25, 2002 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. 2 WHEREAS, the Board has determinted 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 approved the application of Gerald H. Sehultheis for a Wetland Permit to repair roof by refraining and reshingle - remove existing roof and replace with new framing- drywells and gutters for roof run off.- material fence prior to and during construction 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. Fee must be paid, if applicable and permit issued within six months of the date of this notification. If inspections are required, at a fee of $5.00 per inspection (See attached schedule). FEES: $10.00 Very truly yours, President, Board of Trustees AJK/cjc cc DEC Building Department Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TItUSTEES TOWN OF SOUTHOLD TO: Gerald Schultheis Please be advised that your application, dated sepfember 5, 2002 has been reviewed by this Board, at the regular meeting of ~Septemkcr 25,~0n~,. and the following action was taken: ( X) 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 PERM/~I~~ Two Inspecti~s @$5,00 each ~, 10.00/ TOTAL FEES DUE:$~ SIGNED: BY: PRESIDENT, BOARD OF TRUSTEES CLERK, BOARD OF TRUST~ES 4/98 - (631) 765-1892 TowrtH'a. ll.. 53095 Main Road P.O. Box 1179 Southold. Ne~ York 11971 SOUTHOLD TOWN CONSERV~.TION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Monday, September 23, 2002, the following recommendation was made: Moved by Melvyn Morris, seconded by Drew Dillingham, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit Application of GERARD H. $CHULTFIEI$ to repair the roof by refraining and re-shingling. Remove existing deteriorating roof and replace with new framing. Eliminate roof resting on roof. Located: 1640 First St., New Suffolk. SCTM#117-5-46.3 The CAC recommends that measures be taken to prevent the shingles from going into the water during construction. Vote of Council: Ayes: All Motion Carried ,~Z'lOl Z4 ,,0l ,~'g .90 S ~ ~ ,0_¢ ,0l .90 /V ~ -Y .,Og ,Ol .90 N O6' lO' 5O" ~ ~.~. 59. ~ S 06' 52' lO" W 101.74' February 14~ 2005 Gerard H & Carolyn M Schultheis PO Box 299, 1640 First Street New Suffolk, NY 11956 631-734-7265 Southold Town Board of Trustees Sou~otd Town Hall Main Road Southotd, NY 11971 To VVhom It May Concern: We would like to take this opportuni~f to request an extension to our Permit # 5746 granted on April 30, 2003. construction we were finally granted the vanance in October of 2004. We am currently finalizing the plans for At the Zoning Board He&ting a requ~-t was made by a neighbor that porous matedal be placed on the dirt request approval if such is required. Sincerely, FEB Board of Trustees 0426~9 Dollers Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1t79 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 · ~: Wetland Permit Application f Major Waiver/Amendment/Changes ~'Received Application: ,~Received Fee:$ 01013 ' ~Completed Application Incomplete SEQRA Classification: Type I_.. Type II Unlisted Coordination:(date sent)_ CAC Referral Sent: ,4)ate of Inspection: Receipt of CAC Report: ~Lead Agency Determination: Technical Review: i~Public Hearing Held: Resolution: Minor SuffolkCountyTaxMapNumber: 1000- II7 - 05'- 46'. Property Location: /{ z/O IC,),~. ~t _ ZOO H r~or-~{~ O~ '~¢5~ (p~ovide LILC0 Pole ~, dist~ce ~ ~oss stre~d locat'ion) i ' AGENT: (If applicable) Address: Phone: Board of Trustees Application Land Area (in square feet): Area Zoning:. //~ '_-~. _ Previous use of property: Intended use of property: GENERAL DATA Prior permits/approvals for site improvements: A ency 9 Da e l -~ _ ~ u~ ,~ , rl~3' .71~,1~ / oe~- P~ i- 47J~-eo~sr/~ ' ~ No pdor pemits/approvals for site improvements. Has any permit/approval ever been revoked or susp, ended by aeovernmental 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: ~0 ['-re ~4~ Area of wetlands on lot: (..) .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? 0 cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: B O Manner in which material will be removed or deposited: 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): 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 -~¢~1{~_, residing at [~O~h~ APR 28 being duly sworn, depose and say: 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 h~aring. Da~e of hearing noted thereon to be held~J~. ~L~0~0~ Dated: Sworn to before me this ~ day of ~ ~ 200~ Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-18q2 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD LETrER O]F REQUEST FOR AN AMENDMENT AGENT '~- PHONE ADDRESS PROPERTY LOCATION I ~ 4 0 TAX MAPNO. lAVe ~7 ~ M. S ~ ~ ~ r~uest ~ ~endment to Pe~it ~ ~ ZO Signed By: ~/fi~ x~_ ~./~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Narne: Lo s 4 .4 4-7 Address: STATE OF NEW YORK COUNTY OF SUFFOLK Cx-~ 56~4~'-~ , residing at MS('llqJ-6 , -' being duly sw°m' dep°ses and sJays that °n the ~ day of~p~ff_~_,-, 200~, deponent mailed a tme copy of the Notice set forth in the Board o[' 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 persorts 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 Officeat ~Ja'q 5 ,,~[L> ,NL") ,thatsmdNot~cesweremmledtoeachofsmdpersonsby (certified) (re~t~d) mail.' ~~ Swom to b~ore me this Day of f~,x-~ ,20 Not~ Public No. 01C050178 Z Qullified In ~uffo~ ~ ~mmission ~ S~Pt, 13, ~J March 27, 2003 Gerard H & Carolyn M Schultheis PO Box 299, 1640 First Street New Suffolk, NY 11956 631-734-7265 Southold Town Board of Trustees Southotd Town Hall Main Road Southoid, NY 11971 To Whom It May Concern: Attached please find an updated drawing for our proposed alterations. Due to the requirerrents of the new building code ard ~be unstabte nature of our living room on Ihe East side of the house we have eteclecl to rebuild the first floor of the living room as well as turn ~e additJooal second floor area created by the new roof 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 OFTOWNTRUSTEES TOWN OFSOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application ~ Major Waiver/Amendment/Changes Received Applicafio.~lO Received Fee:$ z)/j J - Completed Application Incomplete SEQRA Classification: Type I _Type II Unlisted__ Coordination:(date CAC Referral Sent~q/~.'-~D-~ Date of Inspection: Receipt of CAC Report': Lead Agency Determination: Technical Review:~~ Public Hearing Resolution: Minor Name of Applicant ~:¢cot~ ~ '~"c. ko I~-kt h Il ~ Phone Number:( ) ~1-- 73Z~-- '7Z~_~- Suffolk County Tax Map Number: 1000- t 17 - O ~"- '~g, AGENT:(pr°v~de LILCO Pole ~, dtstance to cross streets,__~d location) (If applicable) Address: Phone: Board of T~ustees Application Land Area (in square feet):__ AreaZoning: GENERAL DATA Previous use of property:_ ~ntended use of property~ Prior permits/approvals for site improvements: __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspe, nded by a governmental agency? _X 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: Area of wetlands on lot: Percent coverage of lot: .square feet 4 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 propSsed operations (use attachments if appropriate): PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: STATE OF NEW YORK COUNTY OF SUFFOLK N~S~IL ~-Y Il ~ , being duly sworn, deposes ~d says ~at on the ~k ~f~- ~, 20o~ deponent mailed a tree copy of the Notice set forth, in the Bo~d of Tmst- ~ 'ecs Application, directed to each of the above nmed persons at the addresses set opposite there respective n~es; that ~e ad~esses set opposite the nines of said persons ~e ~e ad.ess of said persons as sho~ on ~e c~ent ~sessment roll of the Tom of Southold; that said Notices were mailed at the United States Post Office at ~ ~ ~ ~k __, that s~d Notices were mailed to each of s~d persons by (ce~ified) (~st~,~d) mail. ~ Sworn to be~e me this Day of~ ,20 Notary Public 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 Permit from the Board of Trustees to: request a 2. That the property which is the subject of Environmental Review~s located adjacent to your property and is described as follows: ooo - tV- 46.3 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.~Z~0~- _ You may contact the Trustees Office at 765-1892 or zn 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. Enc.: Copy of sketch or plan showing proposal for your convenience. Board of Trustees Application County of Suffolk State of New York ~ c~144. ~ 5-~ I ~4,,:, BErG Dray SWO~ DEPOSES AND AFFIRMS THAT HE/SHE IS T~ ~PLIC~T FOR T~ ~O~ DESCmED PE~T(S) ~ THAT ~L STATEmNTS CONT~D ~ ~ TR~ TO T~ BEST OF ~S/~R ~O~EDGE ~ BEL~F, ~ T~T ~L WO~ Wlr~ ~ ~o~ m tm ~ s~r Fo~r. m ~s ~mc.~o~ ~ .s ~.~ BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSTEES. T~ ~PLIC~T AG~ES TO HOLD T~ TO~ OF SOUTHOLD ~ T~ TO~ TRUSTEES H~E$S ~ F~E FROM ~ ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~T~ OF S~ PE~T(S), ~ G~TED. ~ CO~LET~G T~S ~PLICATION, I ~BY AUTHO~E T~ ~US~ES, T~ AGENT(S) OR ~P~SENTATI~S(S), TO EN~R ONTO MY PROPERTY TO ~SPECT T~ P~SES ~ CON~CTION ~TH ~W OF ~IS ~PLICATION. ~ ~ ' ~Si~naiure SWORN TO BEFORE ME THIS DAY OF~ ,20_ O ~ Notary Public ELAINE M. DOMALESYd N~aq Public, S~ate of New Yo~k ; 0 '6~, ~ ,.,0~' ,0l .90 N 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,he Matter of the Application ....... COU OF SUFFOLK ) STATE OF NEW YORK) AFFIDAVIT OF POSTING I,C-r~.~ ~.~C~u;~,: residing at I~0 ~~ being duly sworn, depose and say: by placing the Board of Trust~es official poster where it can easily be seen, and that I have checked to be sure the postz~r has remained in place for eight days prior to the date of~e / public hearing. Date of hearing noted thereon to be he~~ Dated: ~ s~gna'tur'e,f Sworn to before me tlhis / ~ ~day o f ~_/~ 200~-- Notary Public $17.21 AppendJ× C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTtONS Only PART I--PROJECT INFORMATION (To be completed by ADDlicent or Proiect sDonsor) SEQ 5. IS PROPOSED ACTZON: [] New [] Expansion XModificationlalteration 5, DESCRIBE PROJECT BRIE~LY: 7. AMOUNT OF LAND AFFECTED: '~fYes No if No, describe ~rieily ~ Agricuiture ;0. ODES ACTION iNVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY PROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE C,R LOCAL)? BYes [] No..If ~es, Jj~t age~;~y(s) an~ permltla~provAls 11, DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes ~.¢NO If yes, Iisi a_denc¥ name and permitlapproval If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this as~s, essment OVER I PART [II--OETE.=,MINAT]CN OF SiGN[F]CANCE ~To be comole~ed by Agency) INSTRUCTIONS; For ea¢~ adverse e!fect iden[ified z=ove, determine whether it is substantial, large, imoo~n[ or odter',vise $ignifi¢ -:zc2 eifec*, s,~ould be ~ssessed in coanection witi~ its {~) setting (i.e. urlaan or rural); (b) proDaDility of occs.~qg; (cl duration: APPLICAN? TRANSACTIONAL DISCLOSORR FoRM The Town o~ Soukhold's Code of Ethics prohibits interest on the part of town officers and ample, sZ~_e~.. The purpose of this form is to provide information., which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. Tax grievance Variance change of zone ARp~i~'ai of plat , E~S~ption from plat or official map ' other ~ ~'~~.-, ~' (~f ,,other," .ams the ~mployoo of the Town o~ Southold7 by blood, marriage, or business inter.st" m~an, a bovine,s, inuludin~ a partn~rship~ in which ~he town officer or employee has even a partial ownership o~ (or employment by) a corporation in ~hich the town officer or employee ovn~ more than 5~ o~ the share~. YES .~ NO the balance or ~h{$ ~orm and If you answered o~ES,~ complete date and sign where indicated. . am, of p,rso, emplo,ed b, tbs own of o thold. ( Title or position of that parson ~e~ ~9~ ~$¢~$~ ~¢~ Describe the relationship between yourself (the applicant) and the town o~ficer or employee. Either check the appropriate line A) through D) and/ur describe in the space provided. The parent, ~) town officer or employee or his or her Spouss~ sibling, or child is (check all that apply)~ the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant' is a corporation)~ the legal or b~neflcial owner of a~y interest in a noncorporate'entity (when the applicant is not a corporation); applicant! or the actual applicant. ~) c) MAR 2 8 2003 Snuthold Town Poa~d ~f TpJstees