HomeMy WebLinkAboutTR-5825James F. K~ng, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631i 765-1892
Fax 1631 ~ 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
At
0096C
THIS CERTIFIES that the additions and drywells
Date January 31, 2006
3534 Peconic Bay Boulevard, Laurel
Suffolk County Tax Map # 128-6-5
Conforms to the application for a Trustees Permit heretofore filed in this office
Datedg/25/03 pursuant to which Trustees Permit # 5825 Dated Oct. 22, 2003
Was issued, and conforms to all of the requirements and conditions of the applicable
provisions of law. The project for which this certificate is being issued
is additions to single family dwelling with drywells to contain runoff.
The certificate is issued to
aforesaid property.
Henry Von Elm
owner of the
/ Authorized Sig~ure
Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
ISSUED TO HENRY VON ELM
Pursuant to the provisions of Chapter 615 of the Laws of.
the State of New YorE, 1893: and Chapter 404 of the laws of the
State of New Yore 19!~21 and the Southold Town Ordinance
titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REtdOVAL OF SAND, GRAVEl OR OTHER IdATERIALS FROM
LANDS UNDER TOWN WATERSide. and in accordance with the
Resolution of The B~ard adopted at a meeting held on .~..c.~.9..b..~....~.2,
..3.0.g~and In consideration of the sum of $.....~.9.~.'..?.~ ...... paid by
Henry Von Elm
of .................. ~.a.)~! ..................................................... N. Y. and ,ubiect to the
Terms and Conditions lis~ed on the reverse side hereof,
W ..of ~SckuthoJd Town' Trustees authorizes end parm~ the [ol~wlng:
screen po~¢~, and £oye~ 1~o tJ~e e~$t~g ~g]e-£~mil¥ dwe]]i~E,
~o9£ ~un-o££, a~d ~$ depicted o~ t~e su~,e¥ p~epa~ed by'
all in accordance with the dete~d Specifications as pre~ented in
· the oriqin~tinq &pplicatlon.
.Tohn C. EhTe~s c[~t~c~ 3~1y 30, 2002
IN WITNESS WHEREOF, The *aid Bonrd of Trustees kere-
by c~use$ its Corporate Seal ~o be affixed, and these pre~enis to
be subscr,'bed .by ~imajorlty of the ~ald Iloa~ as of this dat~.
TEP~S end CONDITIONS
Henry Von Elm
re~l~;~g ~ 3534 Peconic Bay Blvd., Laurel
1o,~..
for sa ~o~ m~7 be m~de to d~e Board ~ a ~ a._~__
~,. Thst ~ Peaalt ~vld be ~ iade~mitely, o~'as 1oag as the said P,.~,~,'~e withes
to ,--i~-.~,. d~ m-ucu~ O~,lx~oject lavolved, to p.o,4de evidence to ~one moce~md that sud~
~ due no,ce, to remove o£ alter dfis wodt or project het~n sttted wida~t ~ to d~ Town
. o~ Sombold.
8, Thac the sam Bo~d will be no~ ~ the Pennittee ot ~he . ..
That the Petmktee will o~n all o~er perm's and c°memts d~at m~y be te~lz~zlrap'
this [~nn[t '~ may be subject to 1~ u~ootl f~lh,~ tO ~ ~
Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, NewYork 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OFTOWNTRUSTEES
TOWN OFSOUTHOLD
October 22, 2003
Ms. Denise Heyse
206 Lincoln St.
Rivcrhead, NY 11901
HENRY VON ELM
3534 PECONIC BAY BLVD., LAUREL
SCTM#128-6-5
Dear Ms. Heyse:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, October 22, 2003 regarding the above matter:
WHEREAS, Denise Heyse on behalf of HENRY VON ELM 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 September 25, 2003, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory Council
for their findings and recommendations, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on
October 22, 2003, at which time all interested persons were given an opportunity to be heard,
and,
WHEREAS, the Board members have personally viewed and 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 ItENRY VON ELM to
construct a second-story addition, enclosed screen pomh, and foyer to the existing single-family
dwelling, with the condition drywells and gutters are installed to contain the roof run-off, and as
depicted on the survey prepared by John C. Ehlers dated July 30, 2002.
Permit to construct and complete project xvill 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 $5.00 per inspection. (See attached schedule.)
Fees: None
Very truly yours,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/Ims
"FF_. BY
,. .~F TRUSTEES
TOWN OF SOUTHOLD
6 EAST MAIN STREET N.Y.S. LIC. NO. 50202
RIVERIdEAD, N.Y. 11901
369-8288 Fax 369-8287
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~"~: .................... JOHN C. EHLERS LAND SURVEYOR
' ' ...... .......... ~ ........ RIVERHEAD, N.Y. 11901
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Telephone
(631) 765-1892
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 119714)959
CONSERVATION ADVISORY COUNCIL
TOWN OF SOUTHOLD
At the meeting of the Southold Town Conservation Advisory Council held Tuesday,
October 14, 2003, the following recommendation was made:
Moved by Don Wilder, seconded by Drew Dillingham, it was
RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH
A CONDITION of the Wetland Permit application of HENRY VON ELM to construct a
second-story addition, enclosed screen porch, and foyer to the existing single-family
dwelling.
Located: 3534 Peconic Bay Blvd., Laurel. SCTM#128-6-5
The CAC recommends Approval of the application with the condition that a 20' non-turf
buffer and swale is installed in order to prevent run-off from lawn chemicals.
Vote of Council: Ayes: All
Motion Carried
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Axtie Foster
Ken Poliwoda
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
Coastal Erosion Permit Application
."~qetland Permit Application ~'Major
Waiver/Amendment/Changes
___~ceived Applicat~
~'ffeceived Fee:$~
..gompleted Applica ~ ~/~//~3
Incomplete
SEQRA Classification:
Type I Type II Unlisted
Coordination:(date sent
Sente~
,,..CAC Referral
-,'Date of Inspection:
Receipt ofCAC R .
Lead Agency Determination:__
Technical Review: ' ·
· ,'"Public Hearing Held:
Resolution:
Name of Applicant
Address
Minor
8EP 2 5 L,~J
Southold Town
Board of Trustees
Phone Number:( ) 5/~
Suffolk County Tax Map Number: 1000- J ~' '~ ' 6 '
(provide LILCO Pole ¢, dist~cdt¢cross streets, ~d location)
AGEm: ~4;5 L ~ 6-q ~L
(If applicable)
Address: ¢ 0 0 L~ COI~
Phone: ~f~/ · ?zg-'Tqq3
Board of Trustees Ap~>lica ~on
Land Area (in square feet):
Area Zoning: ~ ~ ~
Previous use of property:
Intended use of property:
GENERAL DATA
Prior permits/approvals for site improvements:
Agency Date
N//WNo prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspen$1~d by a governmental agency?
No Yes
If yes, provide explanation:-
~oard of Trustees Applicat~n
WETLAND/TRUSTEE LANDS APPLICATION DATA
Area of wetlands on lot: 0
.square feet
Percent coverage of lot:
Closest distance between nearest existing structure and upland
edge of wetlands: C) feet
Closest distance between nearest proposed structure and upland
edge of wetlands: O feet
Does the project involve excavation or filling?
No ~' Yes
If yes, how much material will be excavated? ~ ~' 5 cubic yards
How much material will be filled? cubic yards /
Depth of which material will bef~emoveC/or deposited: lb, ~' 0 feet
Pro~d slope t~oughout the area of operations: 0~: ~ ~0
Mann~ in which material ~ill be removed or de.sited: ~* ~ ~ a
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):
Aorta. Th,-3 ¢co?e t7
Board of Trustees Applica :1on
COASTAL EROSION APPLICATION DATA
Purposeso£proposed activity: 31~ ~_ ~ 0r1
Are ~Tnds present within 100 feet &the proposed activity?
v No Yes
Does the project involve excavation or filling?
No ~'/ Yes
If Yes, how much material will be excavated? (q' q (cubic yards)
How much material will be filled? 0 .(cubic yards)
Manner in which material will be removed or deposited: [,~ i t ~
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
fi.om implementation oft? project as proposed. (Use attachments if necessary)
i5 a~..~,-;/I~~ -
¢!.~., +,~ !._ h0~; _&Ye_
PROJECT i.e. NUMBER
617.21
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I--PROJECT INFORMATION (To be com01e[ed by Aoplicant or Project sponsorl
5. IS PROPOSED ACTION:
[] New [] Expansion~rMooificalionlalleralion
6. OESCRIBE PRO BCT SRIEFLY:
I0. DOES ACTION INVOLVE A PERMIT ApI=ROVAL. OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FE ERAL.
11. DOES ANY ASPECT OP THE ACTION HAVE A CURRENTLY VADO PERMIT OR APPROVAL?'
[] Yes' ~'NO If yes. lis! agency name and I:)ermitla~0roval
12. AS A RESULT OF PROPOSED ACTION WILL ~_XISTING PERMIT/APPROVAL REQUIRE MOOIFICATION?
[] Yes [] NO
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE EEST OF MY KNOWLeDGe
SEQ
If the action is in the CoGstal Area. and you are a state agency, complete the
Coastal Assessment Form before proceeding with this as._,s, essmen~
OVER
1
PART IIIiOETERMINATICN OF. SiGNiFiCANCE (To be comf31eted by Agency)
INSTRUCTIONS: For each adverse e;fec: identified above, determine wnetl~er it is substantial, large, irncor~sn[ or odle~-wise signi ftc.
E3c.~ =.ifect Should be assessed in connection w~tl~ ,fa (a) setting (i.e. urban or rural); (b) ~robaoiiity of occo..~g; f~:l duradon-
irrevers¢3diW; ~el geogr3[3nic ~coce: and (0 magmtuCe, if necessa~/, ado attachments or re~erence sul3eorffng materials. E.~sure
~×a~ana[icns ccnta;n sui'ficJent 0eza~i !o snow ~ha[ <iii relevant adverse impacts nave been identified and adecu~[ely acrressec.
ChecX :his box if you have identified One or more sotendalJy large or significant acverse imoc. c:s which
occur. ,,-hen proceed oirec:ly ~o :he FULL £AF anolor predate a positive' deClar~dcn.
ChecX this box if you have de:ermined, based on the information and analysis above and any sucDor:ir':c
documentation. :ha~ :he 2roooseo ac:ion WILL ,',~OT result in.~?ny significant adverse environmental imcac:~.
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
BOA--~D 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
)~ ~ of'~(~., residing at qSj~ A/b~)
being duly sworn, depose and say:
That on the 1¢ day of 0 &~ b~,, 200 ~, I personally posted the property known as
by placing the Board of Trustees official poster where it can easily be seen, and that I have
checked to be sure the poster has remained in place for eight days prior to the date of the public
hearing. Date of hearing noted thereon to be held
Dated:
- Sworn to before me this
/O~"~ay of Oa~ 200 3
NotaryPublic~] "'I .-(~i ' .__.,
CAROLYN C. F/OG.t~r
Notaw Public, State cf New Yo~
r..o. 496257.,
Q~a;;fied in Suffolk CounW
Commla.:i.~,~ Eypire~ F~b;uary 20,
~rd of Trustees Applicati~
AUT~ORI ZATION
(where the applicant is not the owner)
(print ~wner of property)
Southold Board of Town Trustees
residing at ~0 ~0/
(mailing address
do hereby authorize
(Agent)
to apply for permit(s) from the
on my behalf.
Print or Type:
1)
2)
3)
4)
5)
6)
7)
8)
9)
ACCESS CONSENT FORM J Office use Only
FOR ACCESS ~Fi]e #: _._
(Name oEAppl~cant) (Address)
(Name ~ Addres~ of Oontractor Involved)
(Project Location) ~
: 1000-/2~- ~'- ~
(S.C.T.M. #)
=
(Name of Road or Private Prop'erty Involved) (Hamlet)
(Name & ~dres~ Of Homeowners Association//~oper~y Ow~
,,~
Starting Date: ~L~;~ Oompletion Date:
Estimated Cost of Proposed Work:~ %O,O~P '
Insurance Coverage:
A. The coverage required to be extended to the Property Owner:
Bodily injury & Property Damage;
$300,000/$500,000 Bodily Injury & $50,000 Property Damage.
B. Insurance Company:
C. Insurance Agent
Name & TeleBhone #
D. Policy # :
E. State whether policy or certif~c t~
is on file with the Trustees Office: ~
(If no, Provide a ~o~y_with Apl~i~.~t~"~ (yes/no)
gna' Applicant) (Date)
To be completed by the Property Owner:
I/We the undersigned, fully understand the nature of the Proposed
Work referenced above and have no objection to allowing the
Applicant to cross My/Our Property to do t/i~work.
($~gnature of the Property d/wner
ordu]yauthorized representative)
The Torn o~ ~u~hold's Code of E~hica p~oh~b~e
interest on bile part dE ~ewn officers and employees. The
purpose of this form is to .provide lsformatioe which can
alert the town of poes~-~ conflicts of ~-t~et and allOW
it to take whatever action is necessary to avoid same.
other entity, such gsa company. If so, indicate
·· ..
NATURE OF APPbICATION~ (check all th
Tax grieva~ea
Change of sase
A~pNp~al of
Exe;pElon from plat dC' official map
~mploy~ Of ~h~ Town o~ Sou~hold? "R~ia~lon~hlp'
~hiuh ~h~ tu{n o~lc~r or ~mploy~ ha. ~v~n a
ownership of (or employmen~ by) a corpora%ion In which
th~ bown oE[luer ur ~mpioyee owns mo~e than 5~ oE the
data and sign where indicated.
Name o~ par{on employed by ~h~ Town of
TI~XO or posl~on of ~hab per.on
Describe ~ho rela~ionmhip between yourself (~h~ nppiiuan~)
and ~he %own offiu.r or employee. ;i~h.r cheuk ~ho
appropr[a~e li.o A) ~hrough D) and/ur demerits in
providmd.
The town oiliest or employee o~ hl~ or her ~pou8~
parent, or uhild i; (check ail ~ha~ apply)~
~.A) Eho owner of ~roaEer ~han 5% of %he shares or 5he
corporate s~ouk of tho appiic~n~ (when
l; a corporm~iun)l
nonuorpora~e'en:i~y (~hen ~be appiluan~ is nu~ a
uorpora~ion)~
C) an otfiuer~ direubor, pa~t~er, or empleyoe, o~ bhe
D) the actual applicant.