The URL can be used to link to this page

Home My WebLink AboutTR-6387 Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall 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 # 0665C Date: July 7, 2011 THIS CERTIFIES that the demolition of existing and construction of new dwelling, deck, foundation, attached garage, sanitary system, shed, driveway, gutters to leaders to drywells, a 10' wide non-turf buffer to be maintained landward of the concrete wall At 1745 Bay Shore Road, Greenport, New York Suffolk County Tax Map # 53-4-7 Conforms to the applications for a Trustees Permit heretofore filed in this office Dated February 1, 2006 pursuant to which Trustees Wetland Permit #6387 Dated June 21, 2006 and Amended on May 16, 2007 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 the demolition of existing and construction of new dwelling, deck, foundation, attached garage, sanitary system, shed, driveway, gutters to leaders to do/wells, a 10' wide non-turfbuffcr to be maintained landward of the concrete wall The certificate is issued to BASILIO ESPOSITO owner of the aforesaid property. ~u~horized Sl~ a~u Jill M. Doherty, President Bob Ghosio, Jr., Vice-Pres/dent James F. King Dave Bergen John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 I) 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 1 st day of construction ~ constructed Project complete, compliance inspection. INSPECTED BY:-7'~' "--~ "-' ~5'f¢~/eY~t°7 ex` COMMENTS: CERTIFICATE OF COMPLIANC(~ New York State Depa ent of Environmental Conse ation Division of Environmental Permits, Region One Stony Brook University 50 Cimte Road, Stony Brook, New York 11790 - 3409 Phone: (631) 444-0365 · FAX: (631) 444-0360 Website: www. dec.state.ny,us Alexander B. Grannis Commissioner MODIFICATION OF PERMIT Basilio Esposito 1045 Budd's Pond Rd. Southold, N.Y. 11971 August 13, 2007 Re: Permit # 1-4738-03570 / 00001 Esposito Property SCTM # 1000-53-04-7 1745 Bay ShoreRoad Arshamomaque Town ofSouthold Dear Permittee: The Department of Environmental Conservation has completed its review of your recent request to modify the referenced Tidal Wetlands permit to authorize the installation of two drywells as part of the approved project to remove an existing house and construct a new single family dwelling with septic system and driveway. We have determined, pursuant to the Uniform Procedures Regulations and the Tidal Wetlands Land Use Regulations, that the permit may be modified. Accordingly, the permit is hereby modified to authorize the removal of an existing house, the construction of a new single family dwelling with decking, septic system, driveway and two drywells as shown on the attached survey by Robert H. Fox, L.S. dated January 12, 2006, last revised June 19, 2007 and stamped "NYSDEC Approved Modification 8/13/07". All terms and conditions remain as written in the original permit. This letter is a modification of the permit, and as such, must be available at the project site with the original permit and all approved plans whenever authorized activities are being undertaken. I can be reached at (631) 444-0371 if you have any questions or need to discuss this determination. Thank you for your attention in this matter. Enclosure cc: BMHP file Sincerely, George W. Hammarth Deputy Regional Permit Administrator DEC PERMIT NUMBER 1-4738-05570/00001 FACILITY/PROGRAM NUMBER(S) DEPARTMENT OF ENVIRONME~CONSERVATION PERMIT Under the Environmental Conservation Law EFFECTIVE DATE 23 October 2006 EXPIRATION DATE(S) 31 October 2011 TYPE OF PERMIT · New [] Renewal [] Modification [] Permit to Construct [] Permit to Operate [] Article 15, Title 5: Protection of Waters [] Article 15, Title 15: Water Supply [] Article 15, Title 15: Water Transport [] Article 15, Title 15: Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certifica- tion [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control '[3 Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYCRR 360: Solid Waste Management Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [3 Article 36: Floodplain Management [] Articles !, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Basilio Esposito 516-671-6514 ADDRESS OF PERMITTEE 1045 Budd's Pond Road, Southold NY 11971 CONTACT PERSON FOR PERMITFED WORK Andrew Nikolich, 850 Budd's Pond Road, Southold N 11971 TELEPHONE NUMBER 631-765-6015 NAME AND ADDRESS OF PROJECT/FACILITY Esposito Property, 1745 Bayshore Road, Greenpod LOCATION OF PROJECT/FACILITY SCTM: 1000-053~04-07 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Pipes Cove E: N: DESCRIPTION OF AUTHORIZED ACTIVITY Expand the existing single family dwelling. Install an new on-site wastewater treatment system. All work is to be done in accordance with the attached plans stamped NYSDEC approved. 2 2 200,7 By acceptance of this permit, the permittee agrees ti/at the permit is contingent upon strict compliance with the ECL, ali applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: (KSW) George W. Hammarth, Deputy Permit Adrninstrator ADDRESS Region 1 Headquarters Bldg. #40, SUNY, Stony Brook, NY 11790-2356 DATE /- . Page 1 of 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL ¢: NSERVATION Item A: Permittee Accepts Legal Responsibih~y and Agrees to InderrTnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal properly held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401 (3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621. The grounds for modification, suspension or revocation include; a) materially false or inaccurate statements in the permit application or supporting papers; b) failure by the permittee to comply with any terms or conditions of the permit; c) exceeding the scope of the project as described in the permit application; d) newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e) noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. DEC PERMIT NUMBER Basilio Esposito Page 3 of 4 1-4738-03570/00001 ~l~"~W YORK STATE DEPARTMENT OF ENVIRONMENT/'"'4B~"SERVATION ADDITIONAL GENERAL'~ONDITIONS FOR ARTICLES 15 (TITLE'S, 24, 25, 34 AND 6NYCRR PART 608 ( TIDAL WETLANDS) If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 2. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 5. There shall be no unreasonable interference with navigation by the work herein authorized. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environ mental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302,303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 9. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plans were prepared by Robert H. Fox, dated January 12 2006 and last revised April 26 2006. DEC PERMIT NUMBER Basilio Esposito Page 4 of 4 1-4738-03570/00001 7, 8. 9, 10. 11. 12. 13. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS ~ Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. All areas of soil disturbance resulting from the approved project shall be stabilized with appropriate vegetation (grasses, etc.) immediately following project completion or prior to permit expiration, whichever comes first. If the project site remains inactive for more than 48 hours or planting is impractical due to the season, then the area shall be stabilized with straw or hay mulch or jute matting until weather conditions favor germination. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 75 linear feet from the tidal wetland boundary. Ail disturbed areas where soil will be temporarily exposed or stockpiled for longer than one (1) week shall be contained by a continuous line of staked hay bales/silt curtain (or other NYSDEC approved method) placed on the seaward side between the fill and wetland or protected buffer area. Tarps are authorized to supplement these approved methods. All erosion control devices shall be maintained in good and functional condition until the project has been completed and the area has been stabilized. All fill shall consist of "clean" sand, gravel, or soil (not asphalt, flyash, broken concrete or demolition debris). Disturbance to the natural vegetation or topography greater than 25 feet seaward of the approved structure is prohibited. Necessary erosion control measures i.e., hay bales, silt fencing, etc. are to be placed on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and is to be maintained in good condition until thick vegetative cover is established. Roof runoff shall be directed to dry wells a minimum of 100 feet landward of the tidal wetland boundary for immediate on-site recharge. Driveways and parking areas shall be constructed of pervious material. Roads, driveways, and/or parking areas shall be graded to direct runoff away from tidal wetlands and protected buffer areas. Sanitary system (bottom of tank and leaching pools) shall be located a minimum of 2' above seasonal high groundwater. DEC PERMIT NUMBER Basilio Esposito Page 2 of 4 1-4738-03570/00001 New York State Deparl~ent of Environmental Const~ation Division of Environmental Permits, Region One SUNY at Stony Brook 50 Circle Road, Stony Brook New York 11790-2356 Phone: (631) 444-0365 · FAX: (631) 444-0360 Website: www.dec,state.ny.us Denise Sheehan Commissioner October 23 2006 MAR 2 2 200,' Basilio Esposito 1045 Budd's Pond Rd Southold NY 11971 Dear Permittee: Re: Esposito Property, 1745 Bayshore Road, Greenport DEC No. 1-4738-03570/00001 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 and approved plans. Please read all permit conditions carefully. 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, and the dual Notice of CommencementJCompletion of Construction. Please follow all instructions on the latter. Very truly yours, Karen S. Westerlind Environmental Analyst Enclosures: 4 cc: A. Nikolich James F. King, President Jill M. Doherty, Vice-President Pegg~ 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 May 16, 2007 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Basilio Esposito 1045 Budd's Pond Rd. Southold, NY 11971 RE: 1745 BAY SHORE RD., GREENPORT SCTM#53-4-7 Dear Mr. Esposito: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed, May 16, 2007: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #6387 to demolish the existing dwelling and the deck and to reconstruct a new dwelling with a new foundation 35' landward of the concrete seawall, and as depicted on the survey prepared by Robert H. Fox last dated June 19, 2007, and in accordance with the original terms and conditions set forth in Wetland Permit #6387. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, President, Board of Trustees JFK:lms Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Wed., April 11,2007, the following recommendation was made: BASILIO ESPOSITO to Amend Permit #6387 to demolish the existing dwelling and the deck and to reconstruct a new structure with a new foundation. Located: 1745 Bay Shore Rd., Greenport. SCTM#53-4-7 The application was inspected by Jack McGreevy and James Eckert and both members Support the application with the recommendation drywells and gutters are installed to contain the roof run-off and a line of staked hay bales is installed during construction. James F~ King, President Jill M. Doherty, Vice-President Pegg'd A. Dickerson Dave Bergen Bob Ghosio, Jr. ' Town Hall 53095 Route 25 P,O. Box 1179 Southoid, New York 11971-0959 Telephone-(631) 765-1892 Fax (631) 765-6641 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Southold Town Board of Trustees Field Inspection/Work session Report Date/Time: /- l--[ [- O~ BASILIO fiSPOSITO requests an Amendment to Permit #6387 to demolish the existing dwelling and the deck and to reconstruct a new structure with a new foundation. Located: 1745 Bay Shore Rd., Greenport. SCTM#53-4-7 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound U/Bay Distance of proposed work to edge of above: P~C of Town Code proposed work falls under: hapt.275 Chapt. 111 other Type of Application: Wetland __Coastal Erosion ~'~Amendment __Administrative __Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: __J.King __J.Doherty__P.Dtckerson D. Bergen__ B. Ghosio, Jr tM~L Cusack ~ D. Dzenkowski Mark Ten'y~other Mailed/Faxed to: Environmental Technician Review ~r~q ~,, ,-~, Date: Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 119714)959 Fax (631 ) 765-9502 Telephone (631 ) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTI-IOLD TO: Jim King, Chairman Town Trustees FROM: Pat Conklin ~b/ RE: Esposito property SCTM#43-4-7 DATE: April 20, 2007 With respect to the referenced property, the concrete wall which is specified on the survey is not a bulkhead and would not require zoning. ,APR 2 0 2007 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR TOWN OF SOUTHOLD MEMORANDUM APR 1 7 2001 ro~ James King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: April 17, 2007 Re; Request for Wetland Permit for BASILIO ESPOSITO SCTM# 53-4-7 BASILIO ESPOSITO requests an Amendment to Permit #6387 to demolish the existing dwelling and the deck and to reconstruct a new structure with a new foundation. Located: 1745 Bay Shore Rd., Greenport. SCTM#53-4-7 The proposed reconstruction of the dwelling is not in-place. 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 my recommendation that the proposed action is INCONSISTENT with the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP: 4.1 Minimize losses of human life and structures from flooding and erosion hazards. The following management measures to minimize losses of human life and structures from flooding and erosion hazards are suggested: Minimize potential loss and damage by locating development and structures aw'ay from flooding and erosion hazards. Move existing development and structures as far away from flooding and erosion hazards as practical. Maintaining existing development and structures in hazard areas may be warranted for: sites where relocation of an existing structure is not practical. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The proposed distance to the new residence from the concrete seawall/wetland boundary is 26 feetl the proposed distance to the deck from the seawall is 10 feetl a minimum setback distance of 100 feet is required pursuant to Chapter 275-3. Findines; ouroose; iurisdiction[ setbacks. The proposed residence is in an AE-8 flood zone~ a Special Flood Hazard Area. Please require that the applicant amend the application to meet the above policies to the greatest extent practical_ Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. March 21, 2007 Basilio Esposito 1045 Budd's Pond Road Southold, NY 11971 Board of Town Trustees Town of Southold RE: Permit No. 6387 I am requesting an amendment to the above referenced permit to demolish the existing dwelling and the deck and to reconstruct a new structure with a new foundation. The existing foundation cannot support the proposed addition. The footprint of the new proposed dwelling and the deck will not change from the one approved on the permit. Attached are copies of the drawings showing the new proposed foundation and the structure in elevation. Sincerely, Basilio F~srposito 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 DATE OWNER ADDRESS AGENT ADDRESS r7// PROPERTY LOCATION I/We /7~r~-2 !--z~ ~'~-/~ '~-- request an Amendment to Permit PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAil, RECEIPTS Address: esidingatl,~O:~,c~'~t.~'DDt_q ,~o~0 R~_~D ',0P }7, dePonent mailed a true copy of the Notice ,lication, 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 _Ca ~..7"/9'oZ-,~ _, that said Notices were mailed to tach of said persons by (certified) (registered) mail. Sworn t~ before mo this Day o f~t.4~- Notary Public 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ..... ........................ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn, depose and say: 7e That on the 26' day of ,/'/~1~,, 200 'l I personally posted the property known as · ,,. ' 1'7/-/.~- ~o.y' ,~'~>,-e ,~__>~ot/ ,-~fee,-~/-o~ 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 O,J~l:~5 ,0.~'./ I~: 81~'D ~ On oa odou-t fa;,.~ ?~, Dated: (signature) ~S~/xo.m to before me this J3 day o f~--¢ 200 ~L BARBARA ANN RUDDER Noteq Public, State o~ New York No. 4855805 Qua ilie(J in Sutlolk CountV- Commlaaion Exp rea April 14~~/.--~ Survey of Lot 27 & 28 Amended Map 'A' of 'Peconic Bay Estates' Filed May 19, 1933 as Map # 1124 SCT# 1000-53-4-7 Surveyed: JanuaQ/12, 2006 Amended: April 26, 2006 June 19, 2006, Feb. 22, 2007 Mamh 20, 2007, June 5, 2007 June 12, 2007, June 19, 2007 Situate: Arshamomaque Town: Southold Suffolk County, NY Area = 0.56 Acres to HW I I 1" = 40' N APPROV BY BOARD OF TR[ISTEE5 TOWN OF SOUTHOLD DATE ~,~ JUN 2 0 20O7 Southotd Town Board of Trustee~ ROBERT H. FOX NYS PLS# 50197 POBOX#538 RIVERHEAD, NY 631-722-33g0 Survey of Lot 27 & 28 Amended Map 'A' of 'Peconic Bay Estates' Filed May 19, 1933 as Map # 1124 SCT# 1000-5,3-4-7 Surveyed: January 12, 2006 Amended: April 26, 2006 June 19, 2006, Feb. 22, 2007 March 20, 2007, June 5, 2007 June 12, 2007, June 19, 2007 Situate: Amhamomaque Town: Southold Suffolk County, NY Ama = 0.56 Acres to HW i I 1' -- 40' N ~.J~,OBERT H. FOX NYS ~ 50197 P OBOX#538 RIVERHEAD, NY 631-722-,.'.'.'.'.'.'.'.'.~ James F. King, 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 (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 A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SH/~LL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PER, MIT. INSPECTION SCHEDULE V/Pre-construction, hay bale line 1 st day of construction ½ constructed / Project complete, compliance inspection. Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO....(D..~ ........ DATE: gu.~e ~.~ BAS~%0 BS~OS]TO ISSUED TO .......................................... ~ ......................................................................................... ut' ariz tiau P'urs~ant to iM provisions of Chapter 615 of ~e ~w$ 9f the Sta~ of Hew Yor~ 1893; and ~apfer ~ of ~e State of New Yo& 19521 and the Southold ToOn Ordinance en- tBled '."RE~U~TIN$ AND ~E P~ClNG OF: OBSTRUC[~SS IN AND ON TOWN WATERS AND PUBLIC ~DS and'*t~ ~EMOVAL OF SAND, ~VEL-OR OTHER MAT~IAL~M ~NDS UNDER TOWN 'WA~RS:t~. and in a~ance ~fh 'the Resol~ion of ~e Board adopted afa meeting hem on ......J~.~.~.~- .2Q~...., and in conslderatJon of the sum of ~....~.?..:.~ ....... paid by ......... Greenpo=t ' ' N. Y- end Sublect ~ferms and ~nditions ll,tea on the reve.e d~e hereof, of Soufhold Town' Tmsbes authorizes and permlh the follo~n~: Wetland Pe~Jt to extend the existing dwelling by ~nstructJng 700 sq.fl, of a~ditional living space on the ground fl~r. ~nstruct a new one-~r attached garage and ~nstru~ a se~nd-sto~ stm~ure over the ground floor level. Construct a 10'X ~' ac~sso~ building (shed); install a new sanita~ system and install a new pe~ious driveway, with the condition d ~ells and guRe~ and Installed to ~n~in the root ~n~ff, a line of stak~ hay bales is ins~fled prior to any activity, a 10' non-turf buffer is installed landwaM of the ooncrete wall, and all as depicted on the su~ey prepared by Robe~ H. Fox last dated Apdl 26, 2006, · · a~ in accordance with the detei~d spoliations as pre. hied .~e odglnatlng IN WITN~S WHERe, %e sdd Board 0f Traders ~re- by ~u~; ih ~r~rat~ S~al 1o be a~xed, an~ ~ese presen~ be su~%ed by ~'.~l~ of sa~d ~ .as of Jh~ date. TER~S and C. ONDmONS Basilio Esposi~o 1745 Bay Shore Rd., Greenpor~ ..~.. N.Y~'~ James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 June 21,2006 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Andr~e,_w Nikolich 850 Bpdd s Pond Rd. Southpld, NY 11971 RE: i BASILIO ESPOSITO i1745 BAY SHORE RD., GREENPORT i SCTM#53-4-7 Dear Mr. Nikolich: The Board of Town Trustees took the following action during its regular meeting held on Wed. June 21,2006 regarding the above matter: WHE~ Town Code 2006 lEAS, Andrew Nikolich on behalf of BASILIO ESPOSlTO applied to the Southold Trustees for a permit under the provisions of Chapter 97 of the Southold Town the Wetland Ordinance of the Town of Southold, application dated February 1, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory CounCil and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEI~EAS, a Public Hearing was held by the Town Trustees with respect to said appliqation on June 21,2006, at which time all interested persons were given an opportunity to be heard, and, WHEI~EAS, the Board members have personally viewed and are familiar with the premi~ses in question and the surrounding area, and, WHEI~EAS, 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 BASILIO ESPOSITO to extend the existing dwelling by constructing 706 sq.ft, of additional living space on the ground floor, construct a new one-car attached garage and construct a secor d-story structure over the ground floor level. Construct a 10'X 8' accessory buildil ~g (shed); install a new sanitary system and install a new pervious driveway, with the cc ,ndition drywells and gutters and installed to contain the roof run-off, a line of stake J hay bales is installed prior to any activity, a 10' non-turf buffer is installed land~ ard of the concrete wall, and all as depicted on the survey prepared by Robert H. Fox st dated April 26, 2006. Permlt to construct and complete project will expire two years from the date the permit is sig~ed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspe~ctions are required at a fee of $50.00 per inspection. (See attached schedule.) Fees:i $100.00 Very !ruly yours, Ja~F. K~ng PresiClent, Board of Trustees JFK/Ims James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John HolzapfeJ. 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: i af- i PleaSe be advised that your applJcat on dated ~LI I IQ/,, review, ed by this Board at the regular meeting'of follov~ing action was taken: - · ' (. v~) Application Approved (see below) (. j) Application Denied (see below) (__) Application Tabled (see below) has been and the If yom application is approved as noted above, a permit fee is now due. Make check or mone], order payable to the Southold Town Trustees. The fee is computed below accorc lng to the schedule of rates as set forth in Chapter 97 of the Southold Town Code. The fo lowing fee must be paid within 90 days or re-application fees will be necessary. COMF~UTATION OF PERMIT FEES: TOTALL FEES DUE: $ IL~O, BY: lames F. King, President ~oard of Trustees James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095Route 25 P.O. Box 1179 Southold, NewYork 11971-0959 Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ~ / S' Blame of Applicant: Name of Agent: l~roperty Location: SCTM# & Street 13fief Description of proposed action: ~ype of area to be impacted: ,/ ~Saltwater Wetland Freshwater Wetland Sound Front~"Bay Front Distance of proposed work to edge of above: ~¢~t/of Town Code proposed work falls under: ~___Chapt.97 Chapt. 37 other ~ype of Application: Wetland __Coastal Erosion __Amendment __Administrative __Emergency Info needed: ~]flocO ~l,~w - ~ bo,(( C-,~be Tk2 [o~0~ ~r~ ~4~.~.~ Modifications: Piesent Were: ~x~.King __J.Dohert3~P.Dickerson /D. Bergen'/'J.Holzapfel ~Other: Mailed/Faxed to: Date: Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At th~ meeting of the Southold Town Conservation Advisory Council held Wed., June 14, 2006, the following recommendation was made: Mow,d by Jack McGreevy, seconded by James Eckert, it was RES ~)LVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A C( ~DITION of the Wetland ,Permit application of BASlLIO ESPOSITO to extend the exist, g dwelling by constructing 706 sq.ft, of additional living space on the ground floor, cons :ruct a new one-car attached garage and construct a second-story structure over the c~ round floor level. Construct a 10'X 8' accessory building (shed); install a new sani! ary system and install a new pervious driveway. Loca ted: 1745 Bay Shore Rd., Greenport. SCTM#53-4-7 The .~AC recommends Approval of the application with the Condition a drywell is insta lied to contain the roof run-off from the existing dwelling as well as the additions, and 10'non-turf buffer is installed landward of the concrete wall. Vote~ of Council: Ayes: All MotiOn Carried PLANNING BOARD MEMBERS JER~LYN B. WOODHOUSE Chair KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND PLANNING BOARD OFFICE TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 To: Frond: James King, President Members of the Board of Trustees Mark Terry, Senior Environmental Planner ~'~ LWRP Coordinator Datei June 15, 2006 Re: Proposed Wetland Permit for BASILIO ESPOSITO SCTM#1000-53-4-7 BAS~LIO ESPOSITO requests a Wetland Permit to extend the existing dwelling by cons,t[ucting 706 sq.fl, of additional living space on the ground floor, construct a new one-car attacl~ed garage and construct a second-story structure over the ground floor level. Construct a 10'XIS' accessory building (shed); install a new sanitary system and install a new pervious driveway. Located: 1745 Bay Shore Rd., Greenport. SCTM#53-4-7 The p Town Stand subm the p~ COb Pursu its wr roposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy ~rds. Based upon the information provided on the LWRP Consistency Assessment Form tted to this department as well as the records available to me, it is my recommendation that 'oposed action is generally CONSISTENT with the Policy Standards and therefore is ~ISTENT with the LWRP. mt to Chapter 95, the Board of Trustees shall consider this recommendation in preparing tten determination regarding the consistency of the proposed action. Pleas~ contact me at (631) 765 - 1938 if you have any questions regarding the above. Albert J. Krupski, President James King, Vice-President At'tie 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 __St Type __C¢ Re Lc Te Re Sanle AddreSs Office Use Only Coastal Erosion Permit Application --,~cfland Permit Application __ Administrative Permit Amendmcnt/Trans fcr/Extension ~ivcd Application: o~l~ l~to ceived ree:$ t~-h,~~ mpleted Application ~11106 :omplete QRA Classification: [ Type II Unlisted ordination:(date sent) ~RP ConsistencyAssessmentForm ol.] l ]O~, ~ ~--[1~]0~ .C Referral Sent: o~1 ! ! 0~, te of Inspection: ~_~/t~{O~, :eipt of CAC Report: id Agency Determination: :hnical Review: )lic Hearing Held: 3.I ~'-I 0h~ :olufion: )fApplicant ~/~,511--10 ~.$ izO..q i 'T-(D /qz.7' //'~ 7/ PhoneNumber:(.q/~'. ~7/.-~S"/q Suffolk County Tax Map Number: 1000- ...~-3 - O/¥- 7 Prope~yLocation: /7/-/.-5.- ~-~ .f/-/O/~:~ /~t:~,4~ (provid AGEN' (If appl Addres e LILCO Pole #, distance to cross streets, and location) icable) ~t>Jc-~l/ l~{-~f' Ii ~' 7/' Phone: Board of Trustees AppliCon GENERAL DATA Land Area (in square feet): 2 Area Zoning: Previous use of property: /2,~or~.oe--,,/rt,at..- Intended use of property:. ,~e~.r~,o e-t~,r/,,~ c Prior ~ermits/approvals for site improvements: Agency Date i No prior permits/approvals for site improvements. Has arly permit/approval ever been revoked or suspended by a governmental agency? t~ No Yes If yes,iprovide explanation: Project Description (use attachments if necessary): / Board of Trustees Appli¢ ton WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: ~o o o square feet Percent coverage of lot: ~,~ % CloseSt distance between nearest existing structure and upland edge ~f wetlands: / o feet CloseSt distance between nearest proposed structure and upland edge ~f wetlands: 2,.5' feet Does lhe project involve excavation or filling? No v/' Yes If yes,[ how much material will be excavated? ! $'0 cubic yards How ~auch material will be filled? ~.5"' cubic yards Depth[of which material will be removed or deposited: ~ feet PropoSed slope throughout the area of operations: ~/~ ~/ Manm~r in which material will be removed or deposited: Stater~ent of the effect, if any, on the wetlands and tidal waters of the town that may result by reasonlof such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION I APPLICANT / SPONSOR 3PROJECT LOCATION: / 7/-.~,~' ~y~'~c_~,~-- /d~o~O Municipality; ~"~-,&-A/~*O ~g:~ ~-t ~//%/ 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME JCounty 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide map 5' IS PROPOSED ACTION: g~ New ~:] Expansion E~] Modification / alteration SEQR 7 AMOUNT ~F LAND AFFECTED: Initially/i acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~Yes [] No If no, descdbe briefly: 9. WHAT IS ~RESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) {~Residentlal ~--~lndustrial j'~Commercial j~Agriculture [-~ Park / Forest / Open Space r--tother (describe) , 10. DOES A TION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (F~ral, State or Local) [~Yes ~ No If yes, list agency name and permit / approval: r--']Yes ~-X]No if yes, list agency name and permit / approval: Applicant / ~ponsor Name /~/Vb~ ~$~-~/-t~'~ Date: Signature i~t~ / ,-~--~o ~ ~/~' r If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment )ard of Trustees Apg GENERAL DATA Land Area (in square feet): Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Agency Date -' ~No prior permits/approvals for: Has ar~y permit/approval ever been revoked, If yes, provide explanation: y a governmental agency? ~-/ No Yes Proj ec~ Description (use if necessary):. ~ard of Trustees Applica~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: ~:~ Ooc~ square feet Percent coverage of lot: ._~.~ % CloseSt distance betwee.n nearest existing structure and upland edge Of wetlands: ,/'~ feet CloseSt distance between nearest proposed structure and upland edge df wetlands: 2. 5 feet Does the project involve excavation or filling? ~ No ~ Yes If yes, ihow much material will be excavated? How n~uch material will be filled? Depth Of which material will be cubic yards cubic yards deposited: 3. ~-- of operations: /- ~v-~ / ar deposited: feet Statem~? 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): PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS NaiTle: TOtal Address: g duly swom, deposes and says that on the ~, deponent mailed a true copy of the Notice set forth in the Board ¢ 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 p~sons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~q~u4/'t~lto/, I~."/' , that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to he,fore me this ~-.~ my of ~ l'~ot~'y ~ublic SUSAN K TOOKER NOTARY PUBLIC, State of New York No 01T05078120 Qualified in Suffolk County Commission Expires May lq, o 7 UA'( 2 5 2006 James F. King, 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 (631) 765-1892 Fax (631) 765-6641 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In theIMatter of the Application of COUNTY OF SUFFOLK) STA~E OF NEW YORK) AFFIDAVIT OF POSTiNG being Culy sworn, depose ~d say: That oh the day of ,200 , I personally posted the prope~y ~own as by pla~ing the Bo~d of Trustees official poster where it c~ easily be seen, ~d that I have checked to be sure the poster h~ remained in place for eight days prior to the date of the public heafin~. Date ofhe~ng noted ~ereon to be held ~. ~ ~n t. ~ ~, ~n ~ . Dated:[ ora 06o Swomito before me this 52~ da~of~/a~ 200(~ Nof~ar~ 15~blic N~_j SUSAN K TOOKER ~I~'RY,,PUBLIC, Sta~ of New L ~o. 0~T05078~20 (Pualified in Su~fo k Coun Com~nission Expires May (signature) L IPROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only SEQR PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1. APPLICANT / SPONSOR / 3.PROJECT LOCATION: /7~ Municipality ~ ~ ~ [ /~ County 4. PRECISE :LOCATION: Street Addess and Road Intemecfions. Prominent landmarks etc - or ~rovide map 5.1S PROPOSED ACTION: ~ New ~pansion ~M~ification/alteration 6. DESCRIBI PROJECT BRIEFLY: -- / ' ~Z / / / / 7 7. AMOUNT ~F ~ND AFFECTED: Initially O~ ~ acres Ultimately S. ~LL PROI 'OSED ACTION COMPLY ~TH EXISTING ING OR OTHER RESTRICTIONS? ~ves ~ ~o ~r no. ~escr~e ~e~ 9. WHAT IS RESENT ~ND USE IN VI~I~ OF PROJECT? (Ch~seasmanyasapply.) 10. DOES AC FION INVOLVE PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Fed ~rai, State or I~ ~v~s ~ No ~ ~es, ~s~ agenc~ name an~ nemt ~ a..rova~: ~~ ~ ~~_~ 11. DOES Ally ASR CT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Yes ~ If yes, ~ist agency name and permit I approval: 12. AS A ~ ;ULT OF PROPOSED ACTION WiLL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? ~es No I DERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / S~onsor Name ~~ Signature ~ /~~ Date: , 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 (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD N 6 NYCRR PART 617 4'~ If yes, coordinate the review process and use the FULL EAF. B. WiLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 if No, a negative declaration may be superseded by another involved agency, [] es; [] No COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwdtten, if legible) C1. ExiSting air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, , drainage or flcoding problems? Explain briefly: C2, C3. C4., historic, or other natural or cultural resoumes; or community or neighborhood character? Explain bdefly: a, fish, shellfish or wildlife s pecies? Explain briefly: g plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: subsequent development, or related activities likely to be induced by the proposed action? Explain bdefly: C6. terrn, short term, cumulative, or other effects not identified in C1.C57 Explain bdefly: C7. ]Yes [] No -2 AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF ! E. IS THERE, ~R IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL MPA 3 ' · Yes ! No ~ .... CTS, If}/esex~la!n' .^--.T.t-.E-----; :"M'N^T,ON P y gency) INSTRUC'I IONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect shou geographic sufficient d~ yes, the der Checl EAF Chec WILL deterr d be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain tail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked ~rmination of significanca must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed direcfiy to the FUL nd/or prepare a positive declaration. this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actio~ NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi dnatJon. Name of Lead Agency Print or !ype Name of Responsible Officer in Lead Agency signature of Responsible Officer in Lead Agency Date Title of Responsible Officer Signature of Preparer (If different from responsible officer) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS SaiTle: Address: 21 ,L/u/vr ~ Ce~fled Fee C3 (~'~;sement Office at ,~ (certified) (registered) mail. Sworn to before me this Dayof ~tbx n ~ ,200~o lqota~blic BONNIE I. DOR0Slq Notary Publi~, State Of New Yod~ No. 01D05095328, Suffolk County Term Expires July 7. 20 ~ ~:"or~ /tmuder'do/e ½-Z. 33324, I-) o .52 / at IO4'.5' Buoo'6 Po,~D ,~o,~o dy sworn, deposes and says that on the 'eponent mailed a tree copy of the Notice ~, directed to each of the above named pective names; that the addresses set address of said persons as shown on the current hat said Notices were mailed at the United States Post , that said Notices were mailed to each of said persons by James F. King, 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 (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD In the ~VIatter of thc Application of .... /5 ...................... COU~ [TY OF SUFFOLK) STAT E OF NEW YORK) AFFIDAVIT OF POSTING ,residingat /0/-[~- d~t~dcl~s being That c by pla check{ hearin tuly sworn, depose and say: a the ~ day of ~ ,200 ~'I personally posted the property known as ting the Board of Trustees official poster where it can easily be seen, and that I have =d to be sure the poster has remained in place for eight days pr/or to the date of the public ;. Date of hearing noted thereon to be held ~1.1~: ~ h o~.1, e~0~ ° Datedi Swor~ to b.~fore me this daf oftf~. 200 ~o~'ar~ ' Publi0 ' :OfJNI£J. Notaq ~ublic, S~ ~ N~ No. 01[ )6095328, Term , pires July 7, 20~ Board of Trustees Application County of Suffolk State of New York ~r~ t,d Ordt~. ~N/t ~Vi id. 0/- I F.3 bl BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DE! TRI WII BE. AG] I-IAI UN] APl RE[ PRE SW~ CRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE [E TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK L BE DONE 1N THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY kPPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT tEES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES ',MLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING )ER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS LICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR RESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE MISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. )RN TO BEFORE ME THIS ,5;~''T'/c~ DAY OF~.~L~.~I~,20 O ~ ~oard of Trustees Applica~n AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at lO'l~-:~ BclDD~'S' pO/J~ (mailing address) hereby a~thorize ~ A/~/F~%4/ Sou ( Agent ) ~//~/~'~ to apply for permit(s) from the ~hold Board of Town Trustees on my behalf. ( Owner ' s s~nature ) 8 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The T~wn of Southold's Code of Ethics nrohibits conflicts of interest on the oart of town officers and emolovees. The nuroose of this form is to nrovide information which can alert the town of ~ossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR~NAME:-- /t~o~e (5 ~ /&~/ll (Last name, first name, s, niddle initial, unluss you are applying in the name of [ someone else or other entity, such as a company. If so, indicate thc other i person's or company's name.) NAME Tax gri Varlan~ Chang~ Appro~ Exert Othel (If"Otl OF APPLICATION: (Check all that apply.) vance TrnsteeBuilding fZone Coastal Erosion of plat Mooring ion from plat or official map Planning er", name the activity.) Do yoqpersonally (or through your company, spouse, sibling, parent, or child) have a relationship with any o~eer or employee of the Town of South01d? "Relationship" includes by blood, marriage, or bufiness interest. "Business interest ? means a business includiOg a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in whi4h the town officer or employee owns more than 5% of the shams, / YES i NO ~ lfyou Name Title m Deseril the app The tm nswered "YES", complete the balance of this form and date and sign where indicated. f person employed by the Town of Southold )osition of that person e the relationship between yourself (the applicanffagent/representative) and the town officer or employee. Either check x)priate line A) through D) and/or describe in the space provided. ,n officer or employee or his or her spouse sibling parent, or child is (check all that apply): IA) the owner of greater than 5°,0 of the shams of the corporate stock oftbe applic0nt (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-coq:orate entity (when the / applicant is not a corporat ~n); ~C) an officer, director, partner, or employee of the applicant; or __ID) the actual applicant. DEscRIPTION OF RELATIONSHIP Form' 'S 1 Submitted this __..~a~, of Signature Print Name ,,,/3/0~ t.-v'x/ 200~ 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 Hazard Area. B. DES' scm# / PROJECT 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 sj~,~nificant 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 detafl~ listing both supporting and non- suooortim, facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. 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 Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. 2RIPTION OF SITE AND PROPOSED ACTION 9oo - O/-t - 7 The Applied lion has been submitted to (check appropriate response): Town .oarO' ~ Planning ~oara [] ~ni,ding Dept. 73 ~oard of Trustees Category of Town of Southold agency action (check appropriate response): 1. (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 e> tent of action: Location of action: Site acreage:. Present land use: /~ e-SI Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following infommtion shall be provided: (a) (b) (c) (d) Will Yes lame of applicant: dailing address: 'elephone number: Area Code ( )_ application number, if any:. the action be directly undertaken, require funding, or approval by a state or federal agency? IN No[] If yes, which state or federal agency?. C. Evalua! e the project to the following policies by analyzing how the project will further support or not suppo< the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOP Policy 1. F, preserves o minimizes criteria. Yes ~- gD COAST POLICY ~ster a pattern of development in the Town of Southold that enhances community character, Den space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and dverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation · No [] Not Applicable Attach additional sheets if necessary Policy 2. ~rotect and preserve historic and archaeological resources of the Town of Southold. See LWRP Sec~ II1 - Policies Pag~ 3 through 6 for evaluation criteria [] Apphca le 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 additio!al sheets if necessary NATURAI~ COAST POLICIES Policy 4. l~linimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section IIII Policies Pages 8 through 16 for evaluation criteria Attach additio~ Policy 5. P - Policies P r~ Yes . T~te Attach additiol Policy 6. l Significant through 32 [al sheets if necessary rotect and improve water quality and supply in the Town of Southold. See LWRP Section III tges 16 through 21 for evaluation criteria '~ No [] Not Applicable I al sheets if necessary 'rotect and restore the quality and function of the Town of Southold ecosystems including Uoastal Fish and Wildlife Habitats and wetlands. See LWRP Section lll- Policies; Pages 22 For evaluation criteria. Yes No Not Ap~plicable Attach additiohal sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 t~rough 34 for evaluation criteria. 1 Yefl No Not Applicable Attach additio Policy 8. substances [~ Yes [- place iai sheets if necessary vIinimize environmental degradation in Town of Southold from solid waste and hazardous and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. · No [] Not Applicable PUBLIC cOAsT POLICIES Policy 9. ~_rovide for public access to, and recreational use of, coastal waters, public lands, and public resources oB' the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. I [] ye~-~ No ~xNot Applicable Attach additi tal sheets if necessary WORKING COAST POLIC~SS Policy 10. Protect Southoid's water-dependent uses and promote siting of new water-dependent uses in suitable loeations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. ~ Yes ~ No ~ Not Applicable ttach additional sheets if necessary Policy 11./Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary an~l Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. Attach additio~ Policy 12. 62 through IZ]ves I-- al sheets if necessary Protect agricultural lands in the Town of Southold. See LVCRP Section III - Policies; Pages ~5 for evaluation criteria. No ~'~ Not Applicable Attach additional sheets if necessary Policy 13. Section III - [] Yes ~- PREPARE~ BY Promote appropriate use and development of energy and mineral resources. See LWRP Policies; Pages 65 through 68 for evaluation criteria. No ~7] Not Applicable TITLE t~ ~'/v'~--,o... DATE Survey of Lot 27 & 28 Amended Map 'A' of 'Peconic Bay Estates' Filed May 19, 1933 as Map Cf 1124 SCT# 1000-53-4-7 Surveyed: January 12, 2006 Amended: April 26, 2006 Situate: Arshamomaque Town: Southold Suffolk County, NY Area = 0.56 Acres to HW 1" = 30' Tes[ Hole HcDonold 04-10-Ob 0.01 mixed 5end loom dark I 4.0' 4.5' ~o~n ~.O' ~Ine Certified to: Basilio Esposit0 Line .... - of Filed Map ....,' cove ," pipes ,, LW -- Jan '06 HW Jan '06 ~ ~Tie Line APPROVED BY BOARD OF TRUSTEES TOWN OF $OUTHOID DATE TAIL Ad. Joining proper[les repu[edly on To~n 1~Sf~r ROBERT H. FOX NYS PL8~ 50197 P OBOX# 538 RNERHEAD, N~ 831-722-,3390 IMPERVIOUS COVERAGE: .~ 81t00~04~ SITE PLAN Scale: 1"= 30' 0 Dwelling Exis~ng Grade Ground Water EL=2 ',,, 1200 gal. septic tank "----' 8'dia. X 2' High SEPTIC DETAIL CROSS-SECTION SCALE 1"= 10' MAY - 2 2006 BASILIO ESPosITO 1745 IIA YS] lORE ~OA[) County Tax Map No. 1000-53-4-7 Prepared By:I A. Nikolieh Datcd: Jauuary 5, 2006 Revised: April 26, 2006 1- ~AUL ESPOSITO RESIDENCE BAYSHORE ROAD GREENPORT, NY SECTION SCALE ¼"= 1'0" DATE: 12116/06 EILEEN WINGATE REVISIONS: PAGE: 460 BOOTH ROAD SOUTHOLD, NY 11971 631.765.2743 5 OF 10 ¢11 , ! t4:[: 02. 117/,~II. I.i }= .0