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Home My WebLink AboutTR-6232AJames F. King, President ~QF ~~Vry Town Hall Jill M. Doherty, Vice-President ~0~ ~~ 53095 Route 25 Peggy A. Dickerson P.O. Box 1179 Southold, New York 11971-0959 Dave Bergen en ~e O ~ T l h (631) 765 1892 Bob Ghosio, Jr. ~ ~ e one ep - ^a ~yCOU~'~~ Fax (631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0339C Date August 6, 2008 THIS CERTIFIES that the 7.5'X 22' addition on the north side of the existin¢ dwelling At 6242 Peconic Bay Blvd., Laurel Suffolk County Tax Map #128-2-4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 11/7/05 pursuant to which Trustees Wetland Permit #6232A Dated 11/16/05 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 for a 7.5'X 22' addition on the north side of the existing dwellin,. The certificate is issued to BENNET & BARBARA HESS owners of the aforesaid property. F~- ~~ Authorized Signature James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. ,~~OF SO!/ryo~yy ~~~ T • ~~,,0~ OI~CO~~,~.+4'' 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 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 APRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1 sl day of construction '/z constructed Project complete, compliance inspection. g~S ~~~ ~~~ ~) ~~ . . 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) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6232A Date of Receipt of Application: November 7,2005 Applicant: Bennet & Barbara Hess SCTM#: 128-2-4 Project Location: 6242 Peconic Bay Blvd., Laurel Date of Resolution/lssuance: November 16, 2005 Date of Expiration: November 16, 2007 Reviewed by: Board of Trustees Project Description: To construct a 7.5'X 22' addition on the north side of the existing dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. The issuance of the Administrative Permit allows for the operations as indicated on the survey prepared by John T. Metzger dated October 8, 1992. Special Conditions: None If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. b~.$?- ~.'f}. Albert J. Krupski, Jr., President Board of Trustees . . Albert J. Krupski, PresiQc"t 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) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: & fl Mot "f ())O/l (XlfWL f.L.uw Please be advised that your application dated If /1)/0 r reviewed by this Board at the regular meeting of 11/Ib!OS- following action was taken: has been and the L-~PPlication Approved (see below) L-) Application Denied (see below) L-) 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 PERMIT FEES: (1 \Q<' 1-[ nal UWfR C -um - ..f 50, () D "f' \\\~ TOTAL FEES DUE: $ 50,OD SIGNED: ~.j?- 47e~i'9n. PRESIDENT, BOARD OF TRUSTEES . ~ .f- J I " I ~>Z ---/ , ~ . III I! jl II + + . ~ ~ 00 i N ~ .-l Q "i! ~ g , . I I ~ .....,.. 2..<>- ej ~ ~ ~i' o _ ~.!!I! ::~Il ~"'j UJ! e "1'1 l' . w,lill ~ ~&~ = · "il' lI!i! !!~ IIJ Ill!!l! ~; jjljj l,I.!!1 i i ii i [nil I!!L nlll I"" , ,j!'!! I"., , I1II11 !I!!!! Ill! II I d ii 1 Ie!!! ..(1>-..;>0',9 I Iii ! - I!! .i i 11 ::. ~ ~ I ~ . I ~;! _ I -I 3 illld I' 'I i i ; ~ J , I + "'" + ~ , ! ~ i '," : !~ Iii I,. ,', + !) II ,I Ii .J <>8 ....4to..;>.... I! , ' II ,I II 3, :3 . :l f !i!i~ ,. I ~~~ '+~:- ~ "Y ..L "YL ~ <o~..J.. ~0 00 <(~ ~- \ N ~ SURVEY FOR BENNET j HESS & BARBARA S. HESS o~ \ ATLAUREL TOWN OF SOUTHOLD \ >lip.55 ,,', \ SUFFOLK COUNTy' N. Y. ... \48.4 -n 1000 - 128 - 02 - 04 , 1Q Scale: 1" = 40' 54.89 ",^ '!' U\ Oct. 8,1992 O ~\' N ~~. (,'~_1 o. "C. \ dQ~\\. ~ ~ 4:. fJP~ ~ C. :/\ ~ \ f,lOo \ ~ " ~'f \ ES1 P. ~ of 1/1' " o' e:. \ 9'33'3 I'l. 6 , I I ,~ "\ / t ----- J11Y " I e _________ C"{l-('~ ., .-- J )to"~ ~JFi~'.. / J 1l ~ " -<. 'Z. - o - -n 9 ~ ~ r ~ CERTIFIED TO' BENNET J. HESS BARBARA S. HESS 0 ~ -4 of )> rn ~ i ,~ "- z \,!!. 0 g '-" -n Il, 'Q. U' '\ g .-~ -4 ~ :x: 0 rn -< .- (Jl 0 i I ( v " v/ .<'>~"",'''\ /~,] '/~' , e. l . "'-. \ \'\;0 .~o. '~"', .":JO~":J " ~, ~ ":JO) ~~ I")-;'~ r,. ) \ (; w,,-- ~ o~/// ~i<) ~00\~ \'V 1<)0\ <( 'rei IO- u; <o~..J.. I---~~ \ r \ \ :z: co <: , to tie lines . t /, // /1,>,. "'j / / ~ 0<(..~~ I ! \ i <" c c '-" '\ :L. "_ l_-- _. .1 cO ( P. . MAIN SOUTHOLD, N.Y. 11971 Y.S. Lie. NO. 49618 Prepared In accordance wilh Ihe minimum standards for tille surveys as established by the L.I.A.L.S. and approved and adopted for such use by The New York Sfafe Land Tille Association. / 92-277 .' ~'l \ ~1"1f. of .". " o' f:. \ 9'33'3 N. 6 , I I "? ~ '17,L. '17L. ~ !1c.u,\, S+o.V\!lL( .;2q ~ - 4 ~ Lf ( <c~-.{ ~(; (;0 <(~ 'f> N o . N Cl'l ~ 0.. '. l!' N I\O~ -4. ~ W"5~1 \ \48. ~" 1.1 'Z. - o - ~ Q tn ~ \ ~ 9:0 o ~ SURVEY FOR BENNET j HESS &-liJARBARA S. HESS ATLAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, N. y. 1000 - 128 - 02 - 04 Scale: 1" = 40' Oct. 8,1992 , >i 0(\ Q~~ 'Z. - o - -n ,'> '\ ~ " -<. 9 ~ ~ \ CERTIFIED TO' BENNET J. HESS BARBARA S. HESS ~ l>l '9. i / ( ~ " ~/ .....- "- '//.~~\ / / t l ;... '-. ,\'\;^ ,nO, . ~" 9"J~~"J 0~",,, "if) , ..~~~ \ f:>' (; ;/JI.U'---:- ~ ~ / b 0'-" ,,,-0'> ~~ <(~G .0 lO- ti) <c ~-.{ AREA = 41,899 sq.ft to tie lines #'// / /. ( . . / ~ 0<(..~~ ( )'. P. . MAIN SOUTHOLD, N. Y. 11971 Y.S. LlC. NO. 49618 Prepared in accordance wilh Ihe minimum slandards for IIlIe surveys as eslablished by Ihe L.I.A.L.S. and approved and ado pled for such use by The New York Slale Land Tille Assoclalion. / 92-277 Co oN J- &.-v. o.J;- ~ (JC 0 I\i l ~ l B( cd , ~ -ttJ( \'v (' \t lY\00-U~ ~ eoq ~hi ~ ~, ~~:xJ:- U l \lQ U C\ l;uL I C\t.j \ I S'\ 0 T . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 _Coastal Erosion Permit Applicatioll _Wetland Permit Application ~ Administrative Permit Amendment/Transfer/Ex!!;J1sion ~eceived Application: i ( r r; 10 "\ _ -..Keceived Fee:$ ,;rsn / _ -€l5mpleted Application f ( r ( )fO ~ _Incomplete _SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:( date sent) _ L WRP Consistency Assessment Form _ CAC Referral Sent: _Date ofInspection: _Receipt ofCAC Report: _Lead Agency Determination:_ Technical Review: A'Ublic Hearing Held: III/ ~ fO -S- . _Resolution: Office Use Only --~--"- ,-~,-,-"'- .-.-'- ----', ...-,' \ :','~\'\ .,_~l . l'.- r--- '""....'\i II UI NOV - 7 20u:J , L____. -i'~~~~ \\~S~ Address c., 'd-lt'"d.. ~C'C)N\c' ~'7 'OL\\D L~)QJ,L ~" \\~4-~ PhoneNumber:g d,.C)<<...lt<6\::)b Suffolk County Tax Map Number: 1000 - \. d.~ '- <:::r~ 'CJ ~ Property Location: ~ ~4 '::L ~~N \G \6t\'1 \.6L.\J b I ~"1~l; L \'D \-\.O\JS'E$. 'N sty ~ W~'1 ~\J~ (provide LILCO Pole #, distance to cross streets, and location) AGENT:_(4~ ~)\}-l ~ (If applicable) Name of Applicant~~ ~ ~ ~1 SY~'W1.~ 'y -::LS\ ~\)c&_/l- )j Y \\Cj~ Phone: f~. q~ -4> ~ 1t C; Address'\J t:) \~'-jl 4Ilard of Trustees APPlicat~ GENERAL DATA Land Area (in square feet): 1+\ q~~ ~ n- j , ~~S I \)~~\ I /7..L R~<:'I ~ \-Jt\~L R t..:S \ \:)~ \J T,\ 0..1 Area Zoning: Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Agency '" ~o/t ~ ~~ j ~~-C },..),z)'V k)~V Date \ ~ " \~ ,<} cr- <n ~9~ _ No prior permits/approvals for site improvements. Has any permiUapproval ever been revoked or suspended by a governmental agency? ~No_ Yes If yes, provide explanation: Project Description (use attachments ifnecessary):-A\J I ud-d.. ~\,,\t'>>J ~. ~'i:)Q.\\) ~'t)\)<;~ K~, " f.e II '>4 ~, t5k.. CJ~ . 4Itard of Trustees APPlicati~ WETLANDITRUSTEE LANDS APPLICATION DATA purposeOftheproposedoperations:~ \ \J ~-xr-~ . ~\<..~~ \J"~ 'C)~ 1~(Of ' Area of wetlands on lot: C) square feet \) % Percent coverage oflot: Closest distance between nearest existing structure and u~and edgeofwetlands:~'i fk<:i)~v ~~~X q:o} Closest distance between nearest proposed structure and upland / edge ofwetlands:_t)~ "!~~~ \' ~ ~-X ~ C) Does the project involve excavation or filling? No )(1 Yes Jfyes, how much material will be excavated? b\) cubic yards How much material will be filled? cubic yards 1., II Depth of which material will be removed or deposited: ~ feet Proposed slope throughout the area of operations: S+\~ ( ~ tX! 1$1\ ~ Manner in which material will be removed or deposited:~ j~~L Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of suchproposed operations (use- atiacIllTIents if appropriate): - . . Hu__m_ - -_.~ I PROJECT ID NUMBER . I . PART 1. PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only (To be completed by Applicant or Project Sponsor) SEQR 2. PROJECT NAME 1"\ R. ,,\\\ R 5 \1(, County S\)~~uL~ 4. P~~tf:r~~~dica~~nte~t\)\)mi~\~~OY\\ ~~ 5. IS PROPOSED ACTION: D New Expansion D Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: C\\J ~\>~ ~~,,\~ --'\\:) 0\J<K\\-\ <Ul~ 'O~ \\\J\)S~ -, ) G II 'lG d- ~ 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8:.':':!L PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~Yes D No If no, describe briefly: ~6t:J ~ 9. WHAT IS PRESENT LAND USE IN VICINITY 94'ReSidential D Industrial 0 Commercial OF PROJECT? (Choose as many as apply.) DAgriCUItUre D Park I Forest I Open Space OOther (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~ Yes 0 No If yes, list agency name and permit I approval: C 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? DYes ~o If yes, list agency name and permit I approval: ~.- -. .-- - _..-. - PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDE~OVE IS TRUE TO THE BEST OF Applicant I Sponsor Name '\il<t)J \J ~"?> \f;.C-j Signature MY KNOWLEDGl Date l\)~ r-s If the action Is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment . . PART II - IMPACT ASSESSMENT ITo be comDleted by Lead A!lencyl A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.4? If yes, coordinate the review process and use the FULL EAF. DYes DNa B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617.6? If No, a negative declaration may be superseded by another involved agency. o Yes DNa c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten. if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal. potential for erosion, drainage or flooding problems? Explain briefly: I I C2. Aesthetic, agricultural. archaeological, historic. or other natural or cultural resources; or community or neighborhood character? Explain briefly: I I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: I J C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I.... .. I C6. Long term, short term, cumulative, or other effects not identified in C1-C5? Explain briefly: [ I C7. Other imnacts (including chanaes in use of either nuantitv or ty e of enerqy? Explain briefly: I D. WlLL THE PROJECT HAVE AN iMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? {If yes, explain brieflY: I o Ves 0 Na I E. IS THERE. OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ves exnlain: o Yes DNa PART 111- DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreverSibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, thedetermination of significance must evaluate the potential impact of the proposed action on the environmental characteristics oftheCEA. Check this box if you have Identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed direcUy to the FUL EAF and/or prepare a. posltive-dectaration. CheckTt;-isboxlfici'lJEave-determTned~'baS:ed'o'n -ftielnformation and analysis above and any suppo-rting documentation,- thafu,e"propos-ed a'-Ctlo- WJLL.HOI.rasuJUD_aD}L.SignificantadY~rse j3!1)y.irQr'lm~IJ~!__irnp~cts AND provide, orlatta_c_~~e.!1ts ?_~Ilecessary, the reasons supportingthi determination. - -- Name of Lead Agency Date Pnnt or Type Name of ResponsIble Officer In Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) . . Board of Trustees Application County of Suffolk State of New York ~'\J)~ .D ~~€I 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 TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~~~ Signature -- J I f--h SWORN TO BEFORE ME THIS 'I DAY OF nlf'lttnbeJ ,20~ {~Aw- Notary Public ' - -.~~: . . ~. '. October 15, 2005 I hereby give, Kevin Stakey, pennission to apply for pennits for the construction to take place at: 6242Peconic Bay Boulevard Laurel, New York 11948 "'''''''J 1;D ~ V~~ Barbara S. Hess ~~ 4ilA.t.J/ . . APPLlCANT/AGENTIREPRESENtATIVE TRANSACTIONAL DISCLOSURE FORM The T ofS u 01' d 0 Ethics r h'bits conflicts of interest n the of to n Ice an e t is nn' vi e i formatio which can alert e town f ss'ble cantlie 0 re t d w't necessary to avoid same, YOUR NAME: B~\J ~ ~ \;\~ <is (Last name, first name, J)liddle initiol, 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.) e u wa ae f NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning y ">d - Do you personally (or through your company. spouse, sibling, parent:. or child) have a relationship with any officer or employee of the Town of Southotd? "'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 \4 lfyou answered "YES", complete the balance ofthis fonn and date and sign where indicated. Name of person employed by the Town of Soulhold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or desc~be in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check 011 that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); _B) the legal or "beneficial own~r of any interest in a non-corporate 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 RELATIONSHIP S~bmitt.ed.~~.. "'~::, SIgnature . L:1. Print Name. c:S1 {;){;( FOnTI TS 1