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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 $5.00 per inspection. (See attached schedule.) Fees: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/Ims "FF_. BY ,. .~F TRUSTEES TOWN OF SOUTHOLD 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERIdEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\'d-Ip server~dkPROS\02-232.pro 0/4,00~>~ ZOZOg 'ON 'DFI 'S'X'N ~IOX~IA~tfI$ ONV~ SkI~YIH~t 'D NHO£ ,OG :,,I ~]qV'~ 'DIHdV~C~ ~:qH'DV ~'~'0 HO ~ ~L"9~ : V:~'~V ~LldO ~Lbll'q ~'~N~4~ CI~CI 61NflO:3 /N31NflNOI,,I · :cS~.tON o~nOH N ~ I~OA A~INHH EO-O~-LO AN 'A.LNflO0 ~-10 ', Cl-IOH. LflO~ 'NMOJ. A_t~:-3dO~ct -40 51TUA'T"E-" LAUI~EL TOP, N: E~)U'rHo~ 5UI-I-OLK~ C, OUNT¥, NY ,.~,U~VEYE~ [~ 0~-~0-02 c:~CT~ 1000-128-~,-~ HI~RY VON ~ GAIL VON ~ SEP 2 5 2003 l~Ir~ ~ Tn~S ,, N pRoPO~E~ ENCLOS~O/ ~lNO0~ PORCH NOTE~: · ~ONU~ENT FOUND OF:ED ~E!FERENCE L.IlCl-/2 ¢p1'75 AREA = ~,~2~ 5F OR 0.5'4 ACRES ®t:~.APHIC SCALE I"= ~0' ~"~: .................... JOHN C. EHLERS LAND SURVEYOR ' ' ...... .......... ~ ........ RIVERHEAD, N.Y. 11901 ..... ' ........... ' ......,~5A ' 369-8288 Fax 369-8287 REF.\~vlp server\d~PROS\02-232.pro ,.SUI V ' SITUATE, I_AUP~L TOIdN, 5OUTHOi D ~U~OLK COUNTY, N'r' SUFRVI~'r'EP 0'~-~0-02 SGT# IOOO-128-~-5 {~Z~'I'I~I~ I~: SEP 2 ~ 2OO ',% I Stor~ AoDITION NOTE.~: ENCLOSED./ ~E~N pO~CH · HONU~dENT FOUND ~ - i ~ ' ', :;~:=='-":":" ':"='"~:" JOHN C. EHLERS LAND SURVEYOR .:':: ,/. '.,-'. ';. ~ :' '.:' 5:" .".'' 6 EAST MAIN ST~ET N.Y.S. LIC. NO. 50202 , .................. ..~,.,..,..~,0.',.,. ,....,.. 369-8288 Fax 369-8287 ~F.X~p se~er[d~ROSk02-232,pro 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.