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Home My WebLink AboutTR-6388 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 May 21, 2008 Ms. Dorothy Dickerson-Peters 33 West Court St. Cortland, NY 13045 RE: 2280 DEEP HOLE DR., MATTITUCK SCTM#123-4-6 Dear Ms. Dickerson-Peters: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., May 21, 2008: RESOLVED, that the Southold Town Board of Trustees grants a One-Year Extension to Permit #6388, as issued on June 21, 2006. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, President, Board of Trustees JFK:lms 33 West Court St. Cortland, NY 13045 April 16, 2008 Southold Town Board of Trustees Town Hall Annex P.O. Box 1179 Southold, NY 11971 Dear Board of Town Trustees; I ~pecffully request that the Southold Town Board of Trustees provide a one year extension of permit number 6388 under the name of Dorothy Dickerson Peters for the building lot at 2280 Deep Hole Drive in Mattituck, NY. Enclosed please find a check for $50 as payment of fee for this extension. Thank you. Very truly yo_urs, Dorothy Dickerson Petexs 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 SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ½ constructed Project complete, compliance inspection. Board Of $outhold Town Trustees SOUTHOLD, NEW YORK SCTM# 123-4-6 PERMIT NO. ,~.~.~.~ .......... DATE: ~..~.;~---~-L~.-.-~P'°'6 DOROTHY DICKERSON PETERS ............. ISSUED TO ............................................ ~ ................................................................. nthnrizatinn ' ant to *~ provldon~ of Chapter 61~ of ~e ~ws of Purs~ [~ -' · '~. and ~a~ter ~ of ~e ~ offhe the. Sta~ ct ~ew ~o[~.~o~,. w York IY~Z; aaa ~n~ ' State.of Ne ........ x~,n · t~led ."R~~,~"AND P~LIC ~DS and'-t~ IN AND ON /uwm ,,~- .... REMOVAL OF SAND, G~VEL.' O~ OTHER MAT~IA~M ~NDS .UNDER TOWN WA~RS;~... and m a~c~noe ~dh 'the . June 21, Resol~ion of ~e Board adopted et a meehn~ held on .......................... . 2D.0.6.., and in c~nsider~fion of the sum of $.....~9.. 9.P paid by Dorothy Dickerson Peters ............................ : .......... ~ ......... reve~ sl~e hereof, Terms and ~nditlons listed on the . of Southold Town T~dees ~uthorlzes end permiH the forcing:. We~and Permit to construct a ~o-sto~, one-family dwelling wi~ a~ched garage, deck, ~j~liza~n buffer adjacent to the wetlands bounda~ w, ......... . , ~e site plan prepared by Stanley J. Isaksen, Jr. last dated April 20, 2006. ' a~' in accordance with the deta~d Sp~cations as ~e~nted .~e ~ginafing apostle. IN WITNESS WHER~,.~e .s ltl ~r rate Seal Jo be am~ea, aa~ me~.~?s~n~ be sub~ed by a ~1~ o~ ,-~ .... · TERMS ,nd CONDmONS ~1~ per~ee Dorothy Dickerson Peters 33 West Court St., Cortland, .... N. Y~'~ James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Jolm Holzapfel Town Hall 53095 Route 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. Robert E. Herrmann En-Consultants, Inc. 1319 North Sea Rd. Southampton, NY 11968 RE: DOROTHY DICKERSON PETERS 2280 DEEP HOLE DR., MATTITUCK SCTM#'123-4-6 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wed., June 21,2006 regarding the above matter: WHEREAS, En-Consultants, Inc. on behalf of DOROTHY DICKERSON PETERS applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated May 19, 2006, 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, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 21,2006, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of DOROTHY DICKERSON PETERS to construct a two-story, one-family dwelling with attached garage, deck, and steps; install a drainage system of drywells; and establish a 50' non- disturbance/non-fertilization buffer adjacent to the wetlands boundary with a 4' wide path, and as depicted on the site plan prepared by Stanley J. Isaksen, Jr. last dated April 20, 2006. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, es F King President, Board of Trustees JFK/Ims James F. King, President Jill M. Doherty, Vice-President Peffgy 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 Southold Town Board of Trustees Field Inspection/Worksession Report Name of Applicant: Name of Agent: Date/Time: (~9 [ I~ I (5 ~ Property Location: SCTM# & Street Brief Description of proposed action: ~qe of area to be impacted: Saltwater Wetland Freshwater Wetland SoUnd Front Bay Front Distance of proposed work to edge of above: P~C of Town Code proposed work falls under: hapt.97 Chapt. 37 other Type of Application: ~/ Wetland __Coastal Erosion __Amendment __Emergency Info needed: __Administrative Modifications: Conditions: Present Were:¢.King __J.Doherty~c~P.Dickerson__ Other: ~i Bergen/LHolzapfel MailedfFaxed to:' Date: T¢lephorte (631) 765- ! 892 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., June 14, 2006, the following recommendation was made: Moved by Jack McGreevy, seconded by James Eckert, it was RESOLVED to TABLE the Wetland Permit application of DOROTHY DICKERSON PETERS to construct a two-story, one-family dwelling with attached garage, deck, and steps; install a drainage system of drywells; and establish a 50' non-disturbance/non- fertilization buffer adjacent to the wetlands boundary. Located: 2280 Deep Hole Dr., Mattituck. SCTM#123-4-6 The CAC Tables the application because the proposed house was not staked. The CAC recommends all trees above 8" DBH remain. Vote of Council: Ayes: All Motion Carried Figure !. Looking south from Deep Hold Drive into subject parcel and at proposed house site. Figure 2. Looging north from tidal wetlands toward proposed non.disturbance buffer, MATTI~CK Figure 3. Looking south over staked seaward corner of proposed dwelling and toward Deep Hole Creek. PLANNING BOARD MEMBERS JERILYN B. WOODIIOUSE Chair KENNETII L. EDWARDS MARTIN II. SIDOR GEORGE D. SOLOMON JOSEPII 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 (cot. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 To: James King, President Members of the Board of Trustees From: Mark Terry, Senior Environmental Planner LWRP Coordinator Date: June 16, 2006 JUN 16 2006 Proposed Wetland Permit for DOROTHY DICKERSON PETERS SCTM#1000-123-4-6 En-Consultants, Inc. on behalf of DOROTHY DICKERSON PETERS requests a Wetland Permit to construct a two-story, one-family dwelling with attached garage, deck, and steps; install a drainage system of drywells; and establish a 50' non-disturbance/non-fertilization buffer adjacent to the wetlands boundary. Located: 2280 Deep Hole Dr., Mattituck. SCTM#123-4-6 The proposed action has been reviewed to Chapter 95, 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. Policy 6 Protect and restore the quality and function of the Town of Southold ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. A. 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 residence from a freshwater wetland is proposed at 75 feet[ a minimum separation distance of 100' is required pursuant to Chapter 97. Please require that the app/icant amend the application to meet the above policy. Pursuant to Chapter 95, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Albert J. Krupski, President James King, Vice-President Henry Smith hrtie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold. New York 11971-0959 Telephone (631 ) 765-1892 Fex (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application _~,gVetland Permit Application Major Waiver/AmendmentYCha~ges ' . -~l~ceived Application: ,4k~ceived Fee:$ o~-~ j -a?ompleted Application Incomplete SEQRA Classification: Type I.. Type II Unlisted Coordination:(date sent) ..~AC Referral Sent: ~Date of lnspection:~ Receipt of CAC Report: Lead Agency Determination: Technical Review: .l~151ic Hearing Held: ~./o~L~l~. Resolution: Minor Name of Applicant DOROTHY DICKERSON PETERS Address33 WEST COURT STREET, CORTLAND, NY 13045 Phone Number: 607-756-9194 Suffolk County Tax Map Number: 1000 - 123-4-6 Property Location: 2280 DEEP HOLE DRIVE, MATTITUCK (provide LILCO Pole #, distance to cross streets, and location) AGENT: EN-CONSULTANTS, INC. (If applicable) Address: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 Phone: 631-283-6360 Board of Trustees ApplicOn GENERAL DATA Land Area (in square feet): 20,561 S.F. Area Zoning: R-40 Previous use of property: RESIDENTIAL Intended use of property: NO CHANGE. Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): CONSTRUCT A TWO-STORY, ONE-FAMILY DWELLING WITH ATTACHED GARAGE, DECK, AND STEPS; INSTALL A DRAINAGE SYSTEM OF DRYWELLS; AND ESTABLISH A 50-FOOT NON-DISTURBANCE/NON-FERTILIZATION BUFFER ADJACENT TO THE WETLANDS BOUNDARY, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY STANLEY J. ISAKSEN, LAST DATED APRIL 20, 2006. INSTALLATION OF SANITARY SYSTEM, PERVIOUS DRIVEWAY, AND PUBLIC WATER SERVICE WILL OCCUR MORE THAN 100 FEET PROM WETLANDS AND THEREFORE BEYOND CHAPTER 97 JURISDICTION. Board of Trustees ApplicOn WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: IMPROVE PARCEL WITH RESIDENTIAL, ONE-FAMILY DWELLING. Area of wetlands on lot: +/-6,746 square feet Percent coverage of lot: +/-33 % Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: 75 feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? +/-175 How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: N/A Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A cubic yards (FOUNDATION & SEPTIC) feet 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): THIS VACANT RESIDENTIAL PARCEL IS LOCATED BETWEEN AND ACROSS FROM PRESENTLY IMPROVED DEVELOPED-RESIDENTIAL DEVELOPMENTS. ANY POTENTIAL IMPACTS ON ADJACENT TIDAL WETLANDS WILL BE MINIMIZED AND MITIGATED THROUGH INSTALLATION OF A SANITARY SYSTEM LOCATED MORE THAN 100~ FROM WETLANDS; A DRAINAGE SYSTEM OF DRYWELLS TO CAPTURE AND RECHARGE RUNOFF; AND ESTABLISHMENT OF A PERIMANENT NON-DISTURBANCE/NON-FERTILIZATION BUFFER ADJACENT TO WETLANDS, WHICH WILL BE CONTAINED FROM SITE DISTURBANCE DLrR1NG CONSTRUCTION VIA A PROJECT-LLMITING FENCE AND STAKED HAYBALES. THUS, THERE WILL BE NO SIGNIFICANT ADVERSE IMPACTS TO ADJACENT TIDAL WETLANDS OR TOWN WATERS AS A RESULT OF THIS PROJECT. 14-16-4 (2/B7)--Texl t2 PROJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT For UNLISTED ACTIONS Only PART I--PROJECT INFORMATION (To be completed by Applicant or ProJect sponsor) I APPLICANT/SPONSOR: DOROTHY DICK.ER. SON PETERS BY 2. PROJECT NAME INC. 3 PROJECT LOCATION: Municipality ~tA~J~ "~I3CK County SUFFOLK 4 PRECISE LOCATION (Street address and road intersections, prominent landmants, ntc. or provide map) FORM MA FI I rUCK, TOWN OF SOUTHOLD, SCTM # 1000-123-4-6; MAP PROVIDED 6 DESCRIBE PROJECT BRIEFLY: SEQR CONSTRUCT A TWO-STORY, ONE-FAMILY DWBLLING WITH ATTACHED GARAGE, DECK, AND STEPS; INSTALL A DRAINAGE SYSTEM OF DRYWELLS; AND ESTABLISH A 50-FOOT NON-DISTURBANCE/NON-FERTILIZATION BUFFER ADJACENT TO THE WETLANDs BOUNDARY, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY STANLEY J. ISAKSEN, LAST DATED APRIL 20, 2006. INSTALLATION OF SANITARY SYSTEM, PERVIOUS DRIVEWAY, AND PUBLIC WATER SERVICE WILL OCCUR MORE THAN 100 FEET FROM WETLANDS AND THEREFORE BEYOND CHAPTER 97 JURISDICTION. 7. AMOUNT OF LAND AFFECTED Initially 20,561 S.F. acm, Ultimately 20,561 S.F. a=e, 8. 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? [] Residential [] Industrial [] Commercial [] Agriculture [] Park Forest/Open apace [] Other Describe: t o. DOES ACTION INVOLVE A P~R;d;T APPROVAL, OR FUNEING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes [] No If yea, list agency(a) and permit/approvals TOWN OF SOUTHOLD, SUFFOLK COUNTY DEPT. OF HEALTH 11. DOESANYABPECTOFTHEACTIONHAVEACURRENTLYVALIDPERMITOR APPROVAL? ["]Yes [] NO If yes, list agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION W1LL EXISTING PERMIT/APF'~OVAL REQUIRE MODIFICATION? []y. []N o I CERTIFY THAT THE INFORMATION PROVIDED ASOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApPliCanusp°ns°r name ROBERT~ANN' COASTAL MANAGEMENT SPECIALIST DATEMAYII 2006 Signature: If the action is in the Coastal Area, and you are a state agency, complete the I Coastal Assessment Form before proceeding with this assessment I OVER 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 OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of __ ct ........... COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn, depose ~d say: That on the ~ day of ~ ,20~ , I personally posted ~e propc~y ~own as y placing the Bo~d of Tmsteas official poster wh~e it e~ easily be seen, ~d ~at I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date ofhe~ng noted thereon to be held ~ ~ ~z ~ I, ~ - Dated: Sworn to before me this CORRECTED NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant:DORO~h~fDIC~LERSONPETERS SCTM#1000- ]23~ YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: CONSTRUCT A TWO-STORY, ONE-FAM~¥ D~ELLrNG V~TH ATTACHED GARAGE, DECK, AND STEPS; ~NSTALL A DRAYAGE SYSTEM OF DRYWELLS; AND ESTABLISH A 50-FOOT NON-DISTURBANCE~ON-FER~L~A~ON BUFFER AD3ACENT TO THE WETLANDS BOUNDARY, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY STANLEY 3. ISAKSEN, LAST DATED AP~L 20, 2006. RWSTALLA~ON OF SANITARY SYSTEM, PERVIOUS DRIVEWAY, AND PUBLIC WATER SERVICE ~qLL OCCUR MORE THAN ]00 FEET FROM WETLANDS AND THEREFORE BEYOND CHAPTER 97 PDR/SDIC~ON. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: 2280 DEEP HOLE DRIVE, MATTITUCK 3. That the project which under Chapters 32, 37, or comment on.JUNE 21S~ 2006 ~ 7:00 pm 765-1892 or in writing. is subject to Environmental Review 97 of the Town Code is open to public You may contact the Trustees Office at The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: DOROTHY DICKERSON PETERS MAILING ADDRESS: 33 V~ST COURT STREET CORTLAND, NY 13045 PHONE #: 607-956-9194 Enc.: Copy of sketch or plan showing proposal for your convenience. 5 KAREN PALMER PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Address: P.O. BOX 218 CUTCHOGUE, NY 11935 HARLEY ARNOLD 1902 BERMUDA CIRCLE, H-2 COCONUT CREEK~ FL 33066 PETER COLEMAN P.O. BOX 364 MAT]~ITUCK, NY 11952 STATE OF NEW YORK COUNTY OF SUFFOLK NLXRY EGAN doing business atEN-CONSULTANTS,~C 1319NORTHSEAROAD SOUTHAMPTON , being duly sworn, deposes and says that on the 8~ day of JUNE ,20 06 , 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 SOUTHAMPTON , that said Notices were mailed to each of ~) mail. Sworn to before me this 16TH day o f ~3NE ,2o06 Notary Public said persons by (certified) MAR EO 0.~9 ~ 2,40 {~ Peter Coleman P.O. Box 364 Mattimck, NY 11952 m ~ Karen Palmer o~O~o~ P.O. Box 218 Cutchogue, NY 11935 0.~ 1.85 4.64 ls.~ ro Harley Arnold ~-~'Ke:~ 1902 Bermuda Circle, H-2 io~o~~ Coconut Creek, FL 33066 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: DOROTHY DICKERSON PETERS SCTM# 1000- 1234~ YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: CONSTRUCT A TWO-STORY, ONE-FAMILY DWELLING WITH ATTACHED GARAGE, DECK, AND STEPS; INSTALL A DRAINAGE SYSTEM OF DRYWELLS; AND ESTABLISH A 50-FOOT NON-DISTURBANCE/NON-FERTILIZATION BUI~FER ADJACENT TO THE WETLANDS BOUNDARY, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY STANLEY J. ISAKSEN, LAST DATED APRIL 20, 2006. INSTALLATION OF SANITARY SYSTEM, PERVIOUS DRIVEWAY, AND PUBLIC WATER SERVICE WILL OCC, UR MORE THAN 100 FEET FROM WETLANDS AND THEREFORE BEYOND CHAPTER 97 JURISDICTION. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as fol lows: 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public co~nent on .JUNE 21ST, 2006 ~ 7:00 pm You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: DOROTHY DICKERSON PETERS MAILING ADDRESS: 33 WEST COURT STREET CORTLAND, NY 13045 ?HONE #: 607-956-9194 Eric. : Copy of sketch or plan showing proposal for your convenience. 5 Postage ~ [$*ntTo ~v~Harley Arnold r,- I'~,~c~'~:x,2350 Deep Hole Drive ~ ...... attltuck NY 11952 (Endo~'=ement Required) 1 mU Total PostaW ~.~ s~r° Peter Coleman t~'~-~-~;~:~ 2175 Deep Hole Road Ior~BoxNo. Ua~i -" ..... ~ib;~;2~ ~ck, ~Y 11932 Postage Cer~ed Fee Retum Re=apt Fee (Endorsement Required) ~'g,~ -~-t: ~'d! Karen Palmer P.O. 219 Cutchogue, NY 11935 o~ TrUstees App'wca=~on AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at ~ (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ( Owner~ s--signature ) of Trustees ApplicaOn County of Suffolk State of New York ~ ~Z~,~J,~ ~.4 BEING DULY SWORN DEPOSES AN~ AFFIlhMS THAT HE/SHE IS THE APPLICANT FOR TH~ ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEIviENTS CONTAINED HEREIN ARE TKUE 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 APPKOVED 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 COIVIFLETrNG THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, Tt-IEIK AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT TH~ PREMISES IN CONJIJNCTION WITH REVIEW OF TH/S APPLICATION. swoKN TO BEFORE 'taS-y Public GARY FLANNER OLSEN Notary Public State Of N~w Yo~k No. 020L2959~00 Qualified in Suffolk County '~.~emmlsslon Expires March 30, 20.-.. APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southo]d's Code of !~th/cs orohibits oonflicr~ of interest on the cart of town officers and emolovee~. The tint.ese of th $ form is to orovide information which can aler~ thc town ofvosslble conflicts of interest and allow it to take whatever action is ll~ssarv to avoid same. YOUR NAIVIB: (Last name, first name, middle initial, unless you are applying/n thc name of someone else or other entity, such as a company. Ifsu,/hdicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Vadance Change of Zone Approval of plat Exemption from plat or official map Other name the activity.) (If"Other", Do you personally (or thwugh your company, spouse, sibling, pareng or child) have a relationship with any officer or employee of the Town of $outhold? "Relationship" include~ by blood, man'inge, or business interact "Business interest" means a business, inaluding a parmership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which thc town officer or employee owns mor~ than $% of the shares. YES NO If you answered "YE", complete the balance of this form and date and si~n where indicated. Name of person employed by the Town of Southo, ld Title or position of that pcr~on Describe the relationship between yourseLf(the applicant/agant/mprasentafive) and thc ,~wn officer or employee. L:ither check thc appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (cheek all that apply): ___.A) the owner of ires, tar than 5% of the shares of the corporate stock of the appl/cant (when the appl/cant/s a corporation); _B) the legal or ban¢ficial owner of any interest in a non-corporate ent/ty (when tho applicant is not a corporation); ___.C) an officer, dircctur, partner, or employee of the applicant; or _D) the actual applicant. DB$CRIPTION OF RELATIONSHIP ?rintName .. ) - - 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. 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 si.qnificant 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 de_*a,_'[ listing both suooorting and non ~. 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.nonhfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 123 4 6 PROJECTNAME Dorothy Dickerson Peters The Application has been submitted to (check appropriate response): TownBoard ~] Planning Board F-'~ BuildingOept. ~-~ BoardofTrustees [] Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ~'~ construction, planning activity, agency regulation, land a'ansaction) ~.~ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permk, approval, license, certification: [] Na~uuande~ent 0facti0n: Construct a two-story, one-famiy dwelling with attached garaqe, deck and steps; install a drainaqe system of drywells: and establish a 50-foot non-disturbance/non-fertilization buffer adjacent to the wetlands boundary, all as depicted on the site plan prepared by Stanley j. Isaksen, last dated April 20, 2006. Installation of sanitary system, pervious driveway, and public water service will occur more than 100 feet from wetlands and therefore beyond Chapter 97 jurisdiction. Location of action: Site acreage: 2280 Deep Hole Drive 0.472 Present land use: Vacant residential. Present zoning classification: R-40 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) lq[me of applicant: (b) Mailing address: Dorothy Dickerson Peters 33 West Court Street Cortland, NY 13045 (c) Telephone number: Area Code ( ) 607-756-9194 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [~ No [-~ If yes, which state or federal agency?_ C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [] Yes ~] No [] Not Applicable The proposed development is situated in an existin~ developed, waterfront hamlet community and will be consistent with the character thereof. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria [] Yes ID No [-~ Not Applicable · .~t~ach additional sheets if necessaryO Policy 3. Enhance visual quality and protect scenic resources throughout the Town of South01d. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~-~ Yes ~ No ~'~ Not Applicable To the extent that this policy is aPPlicable to the propo~d prnj.~. visual quality and scenic resources will be protected at the site by ~ay of the establishment of a buffer area that will limit clearing of the site and therefore preserve existing indigenous veqetation that might otherwise be cleared. Attach additional sheets if necessary NATURAJL COAST POLICIES Policy 4. IVlinimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~'~ Yes ~-~ No ~-~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria Water quality and supply will be protected via 1) the establishment of a vegetative buffer adjacent to tidal wetlandsf which will a) reduce nitrogen and other contaminant' loads entering the adjacent waterway and thereby limit a major source of water quality impairment; b) retain indigenous vegetation; and c) ma4ntain a stabilized soil an~ filtering capacity adjacent to wetlands au~ surface waters; 2) the installation of a SCDHS approved sanitary system raised a sufficient distance above groundwater A~achadditi0~lsh¢¢tsifneccssa~f~hich will ensure effective treatement of sanitary sewage and 3) installation of a drainage system, which will control, manage and ~gha~ge~ s ~tor~mw~ter runoff. . Foncy o. ~'rotect aha restore the quahty and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife ]][abitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes [] No ~ Not Applicable The establishment of a permanent wetlands buffer area will serve to pro- tect ecological quality ,through the retention .n~ maintenance of indigenous plants and their associated natural ecological community. Potential impacts on ecological quality due to development will be reduced and mitigated in the short term by erection of a project-]4m~ng fence and haybales during construction and in the long term through establishment of a wetlanas buffer; installation of a property sanitary system; installation of a ~'~raina~e system to r~__arge runoff and use of p~ous driveway materials. Further, there will ~no net loss of wetlands, ~d statutory and regula- .fory requirements of the Southold Town Board of Trustees and New York State Department of Environmental Conservation will be compiled with. Attach additional sheets if necessary Policy 7. Protect and hnprove air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. Yes ~ No [] Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section IH - Policies; Pages 34 through 38 for evaluation criteria. ~ Yes [--"] No ~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. Yes ~-] No ~t Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's ~er-dependent uses and promote sit~tof new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. [] Yes ~-~ No [] Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section ]III - Policies; Pages 57 through 62 for evaluation criteria. ~-] Yes ~-] No ~ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section HI - Policies; Pages 62 through 65 for evaluation criteria. [] Yes [-] No ~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. [] Yes [] No NotAppli ble PREPARED BY Amended on 8/1/05 EN-CONSULTANTS, INC. 1319 Nodh Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com ENVIRONMENTAL CONSULTING May12,2006 Town of Southold Board of Trustees 54375 Main Road Post Office Box l 179 Southold, New York 11971 Attn.: Lauren Standish MAY Re: Dorothy Dickerson Peters 2280 Deep Hole Drive, Mattituck SCTM #1000-123-4-6 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: Three (3) Wetland Permit Applications including a) Short Environmental Assessment Form; b) Authorization & Disclosure Forms; and c) project plans; d) surveys One (1) set of site photographs. Three (3) LWRP Consistency Assessment Forms. Application fee of $250.00 wetlands. 1 trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. Coastal Management Specialist /kbs Enc. NEW SUFFOLK AVENUE CATCH BASIN N/S OF DEEP HOLE DRIVE BY McDONALD GEOSC~ENCE 10 NOVEMBER 2005 INAL GROUND 13' HIGH WATER LINE THiS DATE (TIDAL) N 75' 15'35"W 129.58' 00'45' 14"W 12.07' UNAUTHORIZED AL TER~ T/ON OR ADD/T/ON TO THIS SURVEY IS A VIO~ TtON OF SECTION 72~9 OF DEEP HOLE CREEK AREA OF ALL IMPROVEMENTS; IMPERVIOUS, TO INCLUDE HOUSE AND DECK (PEAR) = 1.145 SF LOT AREA ABOVE WETLAND DELINEATION-- 15,815 SF. PERCENTAGE OF IMPERVIOUS LOT COVERAGE= 829% NOTE: SURVEY OF DESCRIBED PROPERTY SITUATE MA'I-FITUCK, TOWN OF SOUTHOLD SUFFOLK COUN-W, SURVEYED FOR: DOROTHY DICKERSON PETERS GUARANTEED TO: ~R~ DICKERSON PETERS OC, I/b4ONWEALTH LAND TtTLE /NS. CO. TM# 1000-125-04-006 THIS ENTIRE PARCEL IS FOUND TO BE IN THE AE-B FLOOD ZONE DESIGNATION, AS FOUND ON MAP NUMBER 56103C0482 G, EFFECTIVE DATE MAY 4, 1998, ELEVATIONS SHOWN HEREON ARE IN 1929 NGVD ALL RESIDENCES WITHIN 150' OF THIS PROPERTY ARE SERVICED BY SUFFOLK COUNTY WATER AUTHORITY ZONING = R40 BASE FLOOD ELEVATION WILL COMPLY WiTH FEMA REGUL~NON5 SURVEYED: 7 NOVEMBER 2005 SCALE 1"= 30' AREA = 20,561 S.F. (TO TIE LINE) OR 0.472 ACRES SURVEYED BY STANLEY d. ISAKSEN, JR. P.O. BOX 294 NEW SUFFOLK. N.Y. 11956