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HomeMy WebLinkAboutTR-5207 12/02/2004 15:17 631-218-1156 S.C.W.A. FINANLL rAut Ill/ni 12/02/2014 15:06 G317296639 GREGOR:WEL PAGE 01 9 28�4 2_'°13 637Y21e-1156 S.C.W,A. FINANCE PAGE el/Illu i..2 . rp nicvid Dlaalmsalc $21-294-10111:17 p. 1 ,o w�I TNts�F 'tQ: COMPIUANM 4 Oft PAX TO:63144 -0291 \� 40-SUNY . '�7 lR�ny. NY 117�0,2H P Mrr NUMBER: t88t1E1.11'O; � CONTRAMR HARM. add -11g, TEE WHONE: der 8k: P1lrata�l'd io DArten�►Cpq+drllp���of thQ reierQt�d p0111111,you a�kl9lnlby►1eYlMd Ut�y dw aufho,�d e[AI�'1ly'af�1 oor4rnanoe on ��b tit we haua na0 the rellbt+e+ncad pOtMl'tYd approwad Dlgnt auMd urider�gli Mnd IRr,au�ho�tare �m Annef 11Y1�his Ru�haQ>tra p�®tta mNMO��eeMn�ie�ire���a d�lhe su� P�f NOW.vgd plena. Va m do win dill eff %ft Oil plan no("No OWN MOWon L-ft F ��d ae depl�led dit fhs �Mt! i e<3iort ir1 ale0otslrnoe Wig IP rad dhlml Na 1- �► �Ip�til pU1riM�ehd��tpy4�pbha�yil P9RMMM 0,w.,-, a 4,f/ DATE _ Y�I w .+ COIYTRACTUfi OATl_ Two NOTiL`,EIKUsrBN AT 4ASr 7Wp vats M'10,R TO COVAjtRaw;I?pol;�yr of 7fiEAggJ��TANO�oiR VYl4S817AJ�47 AI��I�Ata� onvrr��, ►w 7iy l v rFas nlbT q Pear �lpl 01-S ORPO +,�TM 'AN,DIIOi IMA6AVa+ABWAT'7MERMWEMRTHEbLeAT10lMofViEPR0AIRC7-M4Y , THE MOWW R COMM40TIM 7fl� SUR MNOMW Anrp oc sae nro�+r coMpr.l��u� rt �r MTVW'171tQ 1"OIBO TO: CbIJP1J4NCE Of!FAX TO:631-444OZ1e1' Mb1�nA l pltll�IkM1 N1rADL0 W 40-SUW Oro*NY 117MUM 8—ADDy?a/6vp� t�r, �t MWED' � /l�B � d LOGATIOwADDR6Sgi ONlTRACTOR NAME: u�l> s; ris A;, l swl _gg, ,psuent�Benaral o�i7,R M 9 at t>14 anal par�t�lt,you eie heretyr notHkd�mt aho�u�ho�iad��I y aoi�ao�pteled an Yale hove tiny oDrnpw W16 to tm end at"010 a of MS pates{*nd apptor k pbam®,.Malt a1Q11stWlsa ngtdr PERa EE QATe I 0*4rR/ICrOR • .._• AATU �•r•w..�,.�..� M8 Noi7o%M"NpHo BURVBY,MCI p 7�0�RdA1F4 bRJ$p s wrro 7� WABOWAAd Wl s WW 30D,AM W 11E RTmV or 7 �RClAE1CT. .,. cam►-�.�.,� ,� �- ���, , � ccc ) DEC VE MAY 16 2003 Southold Town Board of Trustees -�z� . r �l - - I R:0.•N'+M,T^,.!y;A'i�iii�t9�°� �:. :r�•.,� .,. , ,,....._ .. o........spt.�..,ma��n�ty .e ?'.`.^C�.r.,�'n BOARD OF HEALTH . �i... .. .. . . . . . , FORM N0. V 3 SETS OF PLANS . . . . . .. . . . . . . . . TOWN OF 'SOUTHOLD SURVEY . . . . . BUILDING DEPARPI..rNT CMCR . . . . . . .i. . . . . . . :.. .. TOWN HALL S;r}?Tk FORM . . . . . . . . . . . . . .:. . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL: . . . . . . . . . . . . . . . . . . Faamined.................. 20.... MAIL TO: . . . . . . . . . . . . . . .. . . . . Approved.................., Permit No. ................................... Disapproveda/c .................................... ................................... ........................., ................... ..... ..... (Building Inspector) APPLICATION, FOR BUILDING PEPMIT Date. . �(/VF ZB 20.Q� INSTRUCTIONS a. This ication must bee-ecmpletely filled in by typewriter or in'ink and submitted to the Building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving_a,detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work cowered by this.application may not be cormlenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such . ,permit shall be kept on the-premises available for inspection throughout the work. e. No building-shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. r APPLICATION IS HM1Y MALE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of,the"Tmm of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or'demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections.?. °. `' 1 ................< ..................,................... (Sigaatu a of aWlicant, or name, if a corporation) (Mailing address of applicant) . State whether applicant is owner, lessee, agent, architect, engineer,'general contractor, electrician, plumber or builder .... �. .. .............._ .. .... .........................,.............................................. Name of owner of premises i/ l G D.L0...:t... ......................... (as on the tax roll or latest deed) . If applicant 'is.,_a corporation, signature of duly authorized officer. ... .......:. ............................................ (Name and titles,of corporate officer) Builders License No. Plumbers License No. ...!...................... Electricians License No. .:`.7:.�.e.....— G. Other Trade's License No., .....:.:............ 1.. Location of land on which proposed work will be dam.............................................................. .... �r............... t.4..C. . .......................11Z. ..,................ ..... House Number Street Hamlet County,Tax Map No. 1000 . Section ......41. .. Block .: ..,.. ,...:.. Lot .............. Subdivision cr..'k.J 4.9 Z.E ! ,. ,yd .�`T/ 5.... Map NO. Lot R-.! �'i Filed 2. State existing use and occupancy of premises and intended ime and occupancy of proposed construction: a. Existing use and occupancy .G.'.��... :!�4'J4. Z. � ,Pxy'.,....f!.... .....,..,........ ......... b. Intended use and becuPenCy V..�.. � .r':::.�.. {,;`� ���='`},y,�J`L�''�°�r �/Yf!f•�'..... � �f . �!';a:1er'i'• •�67'•i,: i�..�f�'.�f l•1r71ATCV1 1. Nature of work (deck wliictf appli able): New Building Addition tic: Alteration liepai r ............ Remwryvai .............. IIEs�r l i t ion ............ Other Work ...... ............................ r; ��.. (iiescription) Estimated Cost :!�' (.. ........ fee ......................... .................. �- (to be paid :gin filing; this application) If dwelling, nunlaer of dr<ielting units ............ Number of dwelling ut-dts on each floor ..............:: Ifgarage, minber of cars ....w. ............................... If business, commercial or mixed occupancy, specify nature and"extent of each !_rpe of use.........::....... :... Dimensions of existing structures, if any: A-ot :7ll mar •- .�... Depth Height �.I..`:�........... Number of Stories Dimensions of same structure with alter lions or additions: 'Front .�.�?..� . Rear 3 Z Depth ..� �.-V:........ height _ c..9a�� ....... Number of Stories ..d , .........1. -- ........ Dimensions of entire new construction: font ................ Rear ............... Depth .............. height............................. Number of Stories ..................... Size of lot: Front .................... Rear .................... Depth 0. Date of Purchase Name of Former Owner .................... Zone or use district in which premises are situated .............{ 37�!�'.!e.�!�.'.� 1�lfi'............... ............ Tl ND .,)c 2. Does proposed construction violate any zoning law, ordinance or regulation: -/................... A J n- /w /T 3. Will lot'be'regraded ... .......rr.��.. Will excess fill be removed from pres,.ises: YES • NO 6. Names .of Owner of premises �U �'�:.J?.16 �2?z) Address C-t-'7. p .C r... Phone No. , Ad )�' 7ress Name of Asdileer � y No�,NO.�Qn:�G�-1�7�0�.Na a of.Contractors0 � �.L .... Address G.. Sff%1 5. Is this property within 300 feet of a tidal wetland? * YGS ........ NO .......... *1F_WS,'SMM MM 1R[JSIFES PERMIT MAY BE MQJIRM. .,}.ri5.t'• � , ;. , t / DOV ,� i, .. '��Yt�,i.�'�1,' ''1f''ll �YY�U(�a:"i PLOT(DIAGRAM w, �t. a'>-;•,: Iocate ctearly'and distinctly all buildings, whe isting or proposed, and indicate all set-b6ck'dimoensions ran property :lines: Give strrnet and block nu be o ption co ing t clod,.' and show street names and i icate Iwetl�er interior or corner lot.jc4Lr, ` 1 [ IL— —� �'4 tbr rNm or: N;.w Y(w, 3 - Z )UNIT OF .................`..... � t ................ ............... ...................__.....being duly sworn, deposes'acxi says that he i.s the applicant Mane of individual signing contract) )ove named, isthe !![,!,/V!�1�..................................................................... .. (Contractor, agent, corporate officer., etc.) I: said owner or owners, and is duly authorized to perform or have performed the said work and to make and Zile this ppl.ica'tion; that all statements contained in this application are true to''the best of his knowledge and.belief.,,and 'uat the work will be performed in the mamier set forth in the application filed therewith. Porn to before me this .... .....d of ° ( �, .20e Notary Pub1i t ....,..... .... Ui r }*' IZABE W A SMATHIS -.......4 ........•... NOTARY PUBLIC,Statee:f Now YbA (Signature of Applicant) No.d1ST60081'73,Suffolk County Test Expires Juno 6;70.E Albert J.Krupski,President Town Hall James King,Vice-President Q$uFfO�/�'C 53095 Route 25 Artie Foster ���' D�j P.O.Box 1179 Ken Poliwoda o y Southold,New York 11971-0959 Peggy A. Dickerson cc = Telephone(631) 765-1892 Fax(631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 27,2002 Mr.Nicolo DiBartolo 475 Condor Court Laurel,NY 11948 RE: 475 Condor Court, Laurel SCTM#127-3-6.2 Dear Mr. DiBartolo: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, June 26, 2002: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Wetland Permit#5207 to construct a second-floor-addition on the same footprint, add an attached garage, and add an open porch and second-story deck. 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 Pon ,f Board Of Southold . Town Trustees ' h� SOUTHOLD, NEW YORK , �O 7....: DATE ARK- : . .29 PERMIT NO. ... 5.........- i 1 NICOLO DiBARTOLO a. ISSUED TO .......................................................... ti a ` Pursuant to the provisions of Chapter 615 of the Laws of. the State of New.York, 1893; and Chapter 404 of the Laws of the ' State of New York 1952, and the 'Southold Town"Ordinance °en- ' 41 titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL-OR OTHER MATERIALS FROM LANDS ,UNDER TOWN-WATERS;'.': and in accordance with the Au 23 RR , Resolution of The Board adopted at a meeting held on ............�........... 00. 150 00 aid b ` ' 14 '.., and m consideration of'the sum of $............................ p y � •E Nicolo DeBartolo ....... ..... ............................................................................ .... _ ......................Laurel �� ��. rof .............................................•--.......................................... N. Y. and, subject to the ` Terms and Conditions listed on the reverse .side. .hereof, of Southold Town Trustees authorizes and permits 'the following: Wetland Permit to construct a second-floor addition on the same :..footprint, add an attached garage, and add an open porch and ` second-story deck. �•• all in accordance with,.the detailed specifications as presented in he originating aPPlicaion. «` The said Board of Trustees hare IN WITNESS WHEREOF, " by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as ofJRL this date. - ' O1 y►`b�� - rrinrees « ♦ -T �,a y� �—ter .�++.�...�.�� v..••��. '�,�"• a �µ •`YaF,. .j•t'r�N, �.• __ r 1' G�! _ ,��!��^": .r���we�� i- .�►'• � `�='Kk-_�s• `�•, sctk. �_A , - �� TERMS and GONDMONS Nicolo DiBartolo The Permittee residing at 475 Condor Court, Laurel . N. Y., as part• of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowrpg: 1. That the said Board of Trustees and the Town of Southold are released from any and allf:damages, or claims for damages, of suits arising directly or indirectly as a result of any oiler- ation.performed pursuant to this permit, and the said Petmittee will, at his or her own-expense, defend any and all such suitsInitiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete"exclusion .of the Board of Trustees of the Town of Southold 2. That this'Permit is valid fora period of 24 mos. which is considered to be the estimated time•required to complete the work involved, but*should cirauhstances warrant, request- .. for an extension may be made to the Board at a later date. I That this Permit should be retained indefinitely, or as long as the said Permittee wishes to'maintain the structure or project involved, 'to provide evidence to anyone concerned that auth orization was originally obtained. -� 4. That the work-involved will be subject to the inspection and approval of the Board .or its agents, and non-compliance*with the provisions of the originating application,.may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. G. That there shall be no interference with the right of the :public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or aItemdons . in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the. work shall cause unreasonable obstruction to free navigation, the said Perm cc will be required, upon due notice, to remove or alter this work or project herein stated without expenses to the Town` . of Southold 8. That the said Board will be notified by the Permittee of the completion.of the work auth- orhed. 9.. That the Permittee will obtain all other permits and consents that may be required sup: plemental to this permit which may be subject to revoke upon failure to obtain same. Albert J.Krupski,President �"�g%af 014-co Town Hall James King,Vice-President �.�� G� 53095 Route 25 Henry Smith o= P.O.Box 1179 Artie Foster COD = Southold,New York 11971-0959 Ken Poliwoda Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 29, 2000 Mr. Nicolo DiBartolo 475 Condor Court Laurel, NY 11948 Re: 475 Condor Court, Laurel SCTM#127-3-6 .2 Dear Mr. DiBartolo: The following action was taken by the Board of Town Trustees during its regular meeting held on August 23, 2000 regarding the above matter: WHEREAS, NICOLO DiBARTOLO applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated August 1, 2000, 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 August 23, 2000 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 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 NICOLO DiBARTOLO to construct a second-floor addition on the same footprint, add an attached garage, and add an open porch and second-story deck. 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 project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. 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 Building Dept. Town Hall, 53095 Main Road T P.O. Box. ii?9 Telephone � 0 � � (516) 765 Southold. New York 11971 SOUTHOLD TOWN. CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Tuesday, August 15, 2000, the following recommendation was made: Moved by Bret Hedges, seconded by Bob Ghosio, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit Application of NICOLO DiBARTOLO 127-3-6.2 to add a second-floor addition on the same footprint, add an attached garage, and add an attached open porch and second-story deck. 475 Condor Court, Laurel Vote of Council: Ayes: All Motion Carried \ ' a���os����� �lLMA 0 L 4 l O�OSVFFo(�C� Town Hall Albert J.Krupski,President ht. l/y 53095 Main Road James King,Vice-President c t P.O.Box 1179 Henry Smith y Z Southold,New York 11971 Artie Foster p Ken Poliwoda A Telephone(516) 765-18,92 Fax(516) 765-1823 BOARD OF TOWN TRUSTEES a TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application Grandfather Permit Application Waiver/Amendment/Chan es ; 1005'eceived Application: 1 �h, �- 11 rr — F ./lfeceived Fee:$ .completed ApplicationT I 1PPI 11� Incomplete A - 12000LW ; I SEQRA Classification: n �� Type I Type II Unlisted ,. Coordination: (date sent @; ; �' SAC Referral Sent: T ,"�k Ue �'��� [ L, _.)`- ate of Inspection: Receipt of CAC Report: Lead Agency Determination: Technical Review: - ✓lTublic Hearing Held: 4ia.3 6 Resolution: Name of Applicant / G v Ld g`r0 O Address * 75 C691V,004 G 7` Phone Number: (6-N ) Z q g — s ' --Z 3 Suffolk County Tax Map Num er: 1000 - 2 7- ` 6> d Z Property Location: �y1 0 jp9407- ��LC PIZ C40ss) ,�©0 ' ✓Z// 7&IE 4.23/1 (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: FAX*: 1 F. -d of Trustees Applicatio. GENERAL DATA Land Area (in square feet) : pj Q©a Area Zoning: Previous use of property:— �/�f/�� /6-/O/VFn Intended use of property: Prior permits/approvals for site improvements: Agency N 0�� Date 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) : Vd (21, /Or/44 0 It LM OP I)C C- ,r r //7- 6 773�P 5 TV It 0A) ,:! h-m o 7-P1 t,,v T _ 61n AMI-ok.8-i) P �4a' )2MC� r2 N o f7-044 PAC C 'e5��—Z Z-7TACGS.,41��TS 2 Bc- 'A of Trustees Application " WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ��1/C��Q9��? Gil����/✓ �`' Area of wetlands on lot: ° square feet Percent coverage of lot: o Closest distance between nearest existing structure and upland edge of wetlands: + — :2 O feet Closest distance between nearest proposed structure and upland edge of wetlands:-; r feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations:&4-S X1,5✓-3— /0 f Manner in which material will be removed or deposited: M tV VIL Po m 7-I V G- 6)(64 61q T/o 91 Q-W 46 E An/p 201C,4 r-O,,:77-1A 5 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) : y�DN� 3 1.4-16•d(2/87)—Text 12 J PROJECT I.D.NUMBER 617.21 SEC Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME �co!0 rvt!o 3. PROJECT LOCATION: Municipality u��L County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc.,or provide map) 1�5 10�> .- 5. IS PROPOSED ACTION: ❑New SExpansion PFModification/alteration 6. DESCRIBE PROJECT BRIEFLY: /11 b 4`G y 70 71*r 0 7. AMOUNT OF LAND AFFECTED: C; Initially A 47 acres Ultimately ®° / acres 3. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes ❑No If No,describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? I�QQ; Residential ❑,!ndustrial p Commercial !C7 Agriculture L l Park/Forest/Ooen space U Other Describe: �u6a7— /"i ieiT-e- SO On/ 3-s 110�3 klfi5 F'4A rGAw,# 0wti611 ray A Q/J(iGGfY/✓rT-r gBCctid6-,O �bY /i/4125Gte1' F15I ,06-' 11Z7-19 6- /,-146Al9­J H12,01G 6-070 r ItIff5r of- 5Ire—r , 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING, Now OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)? V�Yes No If yes, list agency(s) and permit/approvals IPEA/4 r r 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes O�No if yes, list agency name and permit/approval , 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ❑Yes b I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE To THE BEST OF MY KNOWLEDGE Applicant/sponsor name: ` G© � r o Date: A ac�v Signature: 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 _:SJMEN I i�o Ite COrncietec by •Agenc, �r A. DOES ACT:CN EXCEED :.NY I irn :HRESHOLJ :N 5 NYCR.R, PLF.T 517.,.Z? it yes. me review process and use :ne FUL_ _-AF. 'yes r No 3, 'NILL ACTICN RECEIVE C OADIN ATE D.1EVIE'N AS PRCV10ED =CR UNLISTED ACT1CNS iN d NYC-R, PA AT 517.S, if No, a negative dec:ar. may be sucersedec by anctner:nvotvea agency. LE Yes 'I_-'No 1 C. CCULD .ACTION RESULT"IN ANY ADVERSE EF=cCT3 ASSCC:ATED'LAITY. -HE FOLLJ'NING:fAnswers may ce nancwrltten, it :eglblel C1. Existing air quality, surrac3 or'grounawater cuatity or auanuty, noise revels, existing : -ific -attafns. solid waste Prccuc::cn or JIsc potential for erosion, drainage or iloecing problems? =;plain briefly: CZ Aesthetic, agricultural, arcnaeological,historic, or other natural or cultural resources: or community or n eignbernood character? =plain = C3. Vegetation or fauna. 1sn, sneilfisn or midlife species, significant habitats,or threatened or endangered Scec:es? Exclam ❑rlerly: C-1. A community's existing plans or goals as offlcmily adooted,or a cnange in use or intensity of use of land or other natural resources?Explain C5. Growth, subsequent:evelooment,or related ac:fvities likely to be induced by the orobosea action? Exalain briefly. iCS. Lang term, snort term,cumulative,or other effects not identified in Cl.-CS? Exotaln 7rlefly. I ' Other imoac:s iinc:ucing changes in use of -either quantity or :ype of anergyl? `xotaln 5riefly. I --D. ;S 7HERE,08 is Ti-iERC !KcLY TO 3E,CONTROVERSY RELATED TO POTE;1TIAL.ADVERSE =:JVIROWAENTAL:f.:P.ACTS? ias f Ito If.Yes, explain oriefly PART III—DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important or otherwise signi' Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b),probability of occa=ing; (c) duratit irreversibility;(e) geogracnic sccee: and (f) magnitude_ If necessary, add attachments or reference supporting materials. Ensur exotanations contain sufficient detail to snow that all relevant adverse impacts have been identified and adequately addresse I Check this box if you have identified one or more potentially large or significant aaverse impacts which ilil. - occur. Then 6roceed directly to the FULL EAF and/or prepare a positive-declaration. i C;epic this box if you have determined, based on the information and analysis above and any supoorti documentation, :hat the proposed action -WILL NOT result in_3-ny significant adverse environmental imcac AND provide on attachments as necessary, the reasons supporting this determination: I .v.wle of Lvid Agency I . I I r1rint:1r ;Vt:C `•lln f! JI jCsGOnstO1C l:ttlC:f.n.CJO.14enC'r rItIC OI :t Ci00nsI01C 0111CCf t ingnatum 9t .(escomicle'_Incaf-n ;eAU AgenCY i-gndtwe Or Ire-jarer tit dllrefent :ronl resconswie off,cef) i i Jalc • 2 . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS ]Name: J Pt' Address : l!o A.cl /1/u f2s�/�y � Gr W D � AUG — ��� 3 20M eve=_r. STATE OF NEW YORK COUNTY OF SUFFOLK /Go�0 D 16,4tZ roto , residing at 7 5 C oiv,001E G r' oG1e !✓c-- 1V; / , being duly sworn, deposes and says that on the day of +9 ✓V, deponent mailed. a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post office at ,c/�tt��� T , _ hat said Notices were mailed to each of said persons by certified) (.r�egrsr�d) mail . Sworn to efore me this da of Notary Public LYNDA M.BOHN NOTARY PUBLIC, ate of New York Qualified in Suffolk Counter - Term Expires March 8,2 Albert J.Krupski,President �QSVFF���'�o Town Hall James King,Vice-President h�0 �y 53095 Route 25 Henry Smith o P.O.Box 1179 Artie Foster r� Southold,New York 11971-0959 Ken Poliwoda 4 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 _MA ---- ------ COUNTY OF SUFFOLK) STATE OF NEW YORK) j� AFFIDAVIT OF POSTING T '---- AR( 0(0 , residing at LT 66e 16-C R71 • /�SG� !,lCl.` _ lx'—g duly swore, depose and say: // //JJ That on the�1-3- 7 day of 200o, I personally posted the property known as 11-15 C7. by placing the Board-of Trustees official poster where it can easily be seer_, and that I have checked to be sure the poster has remained in place for seven days prior to the date of the ubiic hearing. Date of hearing noted thereon to be held ,�3�oZD� Dated: (signature) Sworn to bef re me this �j? .aW day of Hvc4.v; 200 0 c ota FLgkE rH A STATHIS OTARY PUBLIC,State of New York No.01 ST6008173,Suffolk County Term Expires June 8,209-R. B,J "--d of Trustees Application County of Suffolk State of New York /V(L(gt-o BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S) , IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S) , ,.TO ENTER ONTO MY PROPERTY CK TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. r Signature SWORN TO BEFORE ME THIS Z, t ec DAY OF `��c�sT ,-1-9 Oil. Notary Public LYNDA M.BOHN NOTARY PUBLIC,State of New York No.01 B06020932 Qualified in Suffolk Counsy. Term Expires March 8,20 i - 3 2OW OF SOUTH OLDi APPLICANT TRANSACTIONAL DISCLOSURE PORH The Town of Southold ' s Code of lthica okohibibs conflicts at interest on the part of town officers and employees . The purpose of this form is to provide information which can alert the town of poss ble conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR HAMS t co Last name , initial , unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person ' s or company ' s name, ) NATURE OFF APPLICATION: (Check all that apply. ). Tax grievance Variance Change of zone Appig-val of plat Exemption from plate or official map Other (If "Other, " name the activity. ) Do you personally (or through your company, speune, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO `If you answered "YES, ". complete the balance of thin form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided '. The town officer or employee 'or his or her npouse ,- sibling, ' parent, or child ,•is (check all that apply) s A) the owner of greater than 596 of the shares of the corporate stock of the applicant (when the applicant' 4 is a corporation) ; B) the legal or beneficial owner of any interest in a noncorporate 'entity (when the applicant is not a corporation) ; c) an officer, director, partner, or' employee, of the applicant; or D) the actual ' applicant . DESCRIPTION OF RELATIONS111P 1 j.. `T submitted thls'' /daY ,dig ; o signature.. 'Print name . i:'•i•M•j�;i•�ir''��''.'ln•r't1 '.:•::•.. ... .r. lH4i:r ..:1"�,FR: :'. / LL t t r , s _ e , .} ti y� 1 j F i �fA Cy IAn r, t a'. 1 � .. P� .,{ ''' s ."art" r 9 0 * J `�') `t4 K x w • ,, , s , ^CjFir.z. , tt f%!„*Stt1 17 t t i , f jC t T { , !' . yy cop , r , s° i g r t r r x VE 11 : f , ft - -2, i " 8 r i ' h 4 P,a AUG 1 <`Y; k - BSnauthori3ed alteration or addition C i the i CI SOUTH to this survey Is a violation of i tr" Section 7208 of the New York State { Education Law. " NE°r/j% copies of this survey map not bearing f y(V d y1; the land sunreyor's inked seal or � �Q t`e`�J ��T t j, embossed seal shalt not be considered t es, 0 Q G to be a valid true COPY. r' _.. . a ed hereon shall run f f�- cuerenteesfhdkat only to the person for whom the survey r� r o is prepared.and on his behalf to the ro rnmental agency title compan. C�c�jt,S�0.C 2�� �� lending institution listed hereon and and ✓ 'r j LAND to the assignees of the lending insti- E 3 tution.Guarantees are not transferable n additional institutions or subsequent a t -aers, P A-7 ff Cr'ncral Not.(,, �r o fo 0 oa/4Z1 �Idd N N ,-- _Oi26, 2 0 4 2 0 4 22 O , 0 : . , , r , o y 41OH1nos 40 N,'A01 ddV i it-Olt O O o a • i i I --K4 EX. HOUSE TRAP EX, WELL TO REMAIN WATER TANK ' N TO REMAIN j N REMOVE EXISTING �` 0 o it j 4 f- WINDOW & BLOCK 11N.EXCAVATEI � Ni UP OPENING N `� CV W EX. HWH U z • i J O NEW CONCRETE r — U - 3 STAIR SEE DETAILS DOUBLE UP RUNNERS z v AND STRINGERS FOR (� N w N A_8 SHEET A-9 OPENING FOR NEW x 01 2 I �i STAIR. (2) 2X6'S x I ! 'ib EACH WAY. EXISTING W `� EXIST. E=LEC, A-8 BOILER PANEL TO BE JI�JEXC RELOCATED — --- --� ; I t(P 5 R {�I, J _ I 1 r it UP 111 R I TO GARAG - ` t� I O A-7 A-7 8 1'-7' 5'-6" ; EXISTING STAIR TO BE REMOVED PATCH, CLOSE UP OPENING WITH NEW '.AAll 14 O fl 0 i 6�1 I ii II L { 1 - j �! ' -J O i ► ,/ � � U , 2'-O" 4'-1011 f ` , i I I N I ! i I O 7F 1 I 24'-1" 1 r � 24'-O" i r O EXISTING r EXISTING NEW - }+� p(ga - 1 --- 1 r _ O _, •• , CV . n• N . °,� • — i i jp 10'-11111 �_ n i_ a 11'-34" '_'\ 2'-Oii• 10'-114" 2i_On . 4 r2 O r 4 r2 O r c ------ y '� /� FOUNDATION PLAN A-7 "1O �{ ( F Firm fir•ne cn(I F.c,dv- 1/41, = 1'-On 1 �- ,- r��. of ��J. 1� \', a�! •1,,' d,^!,, � 3 7-03 =1 A. TI :U r ^ 70111.`n, N"I'. 111 C. �.� TF L. (718) 72! -1700 FP.}'. (718) 7,:' _-17F'� 4P, `°T:'r171 V"T01,P, *1.' Y. li I T%L (71C) 777-70`3� 1 AX (71 ,} 77 r -iO3 , 1` jp�bs,o rr•t - I, EXIST. ADJACENT FOUND. ° ° ° WHERE BEARING SHELVES e EXIST. ADJACENT FOUND. VARIES e DO NOT MAINTAIN THEIR � ! NEW FOUNDATION NEW FOUNDATION SHAPE REINFORCE INFO C@ FOOTING it _ + ` ;, f I� C , 7TT EACH WAY. li R0 - ��'_" ED 2TN 1) 1 L. NEW FOUNDATION TO ° NEW EXCAVATION I ' GARAGE AGE ADDITION I OR r:`I . rRI s. nlr,1rTaI_a GO TO LEVEL OF EXIST. NOT TO DISTURB ADJACENT FOUNDATION. IFF ANGLE OF REPOSE ° L ? �1 Ji I ° OF SOIL UNDER ' ° 475 CONDOI'. CT., I.1�.11I'Ffz, NY 1191C NEW FOUNDATION IS SHALLOWER T... ° c� i i; EXISTING FOUNDATION STEP FOOTINGS WHEF'E 1 THAN THE EXISTING ADJACENT REQUIRED @ MAX. 30 i I THEN STEPPED FOOTING c AS SHOWN. DEGREES TO HORIZONTAL / a I b ,� ° !'•� 7 _ I rl I•' I . .lc° ntrr,e: 'ref: IS TO BE CONSTRUCTED. SEE UNDISTURBED STEPPED FOOTING DETAIL THIS O ° -�GJ SOIL ''� BIl?AI2TOIaa^.D":C= 1.D7 ij 1 ' SHEET. N - - 30 DEGREES MAX, MBA M T Peference no. }1Aeti '1 ' FOUNDATION CONDITION '2 ' STEPPED SOOTING DETAIL EXCAVATION DETAILS FOUNDATION CONDITION —_ I . 4 r�rr��a11 ' ! f: r ,