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Home My WebLink AboutTR-6440AJamea F. King, President ~pF SOUj~ Town Hall Jill M. Doherty, Vice-President ~ o ,~O ~ 53095 Route 25 Peggy A. Dickerson l~I l~ P.O. Box 1179 Southold, New York 11971-0959 Dave Bergen d+ ~c O ~ ~ T l h 631 76 Bob Ghosio, Jr. ~ O e ep one ( ) 5-1892 ~p l',CO~~~~'t.~" Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0350C Date: August 13, 2008 THIS CERTIFIES that the construction of asecond-story dormer addition to the existine dwelling At 360 Lakeview Terrace, East Marion, New York Suffolk County Tax Map # 31-9-12 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 08/31 /06 pursuant to which Trustees Permit # 6440A Dated 09/20/06 and 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 construction of asecond-story dormer addition to the existing dwelling The certificate is issued to WALTER GAIPA owner of the aforesaid property. '1.. ash' Authorized Signature ~~ James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson ' Dave Bergen John Holzapfel ~~~ G • ~~ Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR APRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE _ Pre-construction, hay bale line 1St day of construction _ '/z constructed Project complete, compliance inspection. ~'1`~~ ~ ~ K ~ ~"~"'~~ . . 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 1 st day of construction Yo constructed / Project complete, compliance inspection. . . 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 Permit No.: 6440A Date of Receipt of Application: August 31, 2006 Applicant: Walter Gaipa SCTM#: 31-9-12 Project Location: 360 Lakeview Terrace, East Marion Date of Resolution/Issuance: September 20, 2006 Date of Expiration: September 20, 2008 Reviewed by: Trustee Jill Doherty Project Description: To construct a second-story dormer addition to the existing dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by Stanley J. Isaksen, Jr. received on August 31,2006. Special Conditions: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Ja~ng~e~ Board of Trustees r . . 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 TO:WQl t1J\ ~ Or Please be advised that your application dated ~C)" reviewed by this Board at the regular meeting of I ~ ICio following action was taken: has been and the ( v')- Application Approved (see below) L-) Application Denied (see below) L-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in Chapter 97 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: "- '4t n.0.1 (~~ - ~ S() .00 TOTAL FEES DUE: $ S- () (OD BY: James F. King, President Board of Trustees I . . -r- I <>Z --_,~-- I - + """@ -j -~ ., Ii "'"'" "'~ ~ I ~ AJbertJ.EJruPSki,Pretlllbt James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Pennit APPlicati;:;::: _Wetland Pennit Application Administrative Pennit Amendment/Tr~sfer/Extension _rJreceived ApplicaVQn: '61611l)j.. --iteceived Fee:$ ..} 11- -=:Completed Application.z/2. t I ()). _Incomplete _SEQRA Classification: Type I~Type II~UnJisted_ _ Coordination:( date sent) L\VRP Consistency Assessment Form /L'lO\fO.(>r- ..cAe Referral Sent: Y\\ a.. ~ate of Inspection:~ I 2. / ().. _Receipt of CAe Report: _Lead Agency Detennination:~ Technical Review: _ -Public Hearing He~ _Resolution: -, AUG ') 1 J ' .'001' L" Property Location: <Lkfl.llet-(./ Icr~ Y11- 77/3 Suffolk County Tax Map Number: 1000 - _ =3 /, . - ?.... I;;J. L<J..kevtew ~rdte liAJf Hqr/oY) Phone Numbe~L Address ~Qr;otJ 31rJD ------.-.----.----...-.-.- . (ProYide LILCOPo!e #,distance to cross streets, and location) AGENT: ~ ~ (If applicable) Address: Phone: t 4It Board of Trustees APP14lltion GENERAL DATA Land Area (in square feet): j~S4Y ~ ff R~o Previous use of property: $/ (")51< -Rtm, '7 0' <<.:n, <- Area Zoning: t<e-:\ (~ Intended use of property: 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 g~rnmental agency? _No* Yes If yes, provide explanation: -------- ..-------..---- Project Description (use attachments ifnecessary): ~J s-for:7 d Dum, --fa, IA jhrooh) , 4It Board of Trustees APP14lltion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: , - r) I/1Jhu/.../ur. 0 r 0{ >leI / prll j;q.JJ r ()(J r>J story 0/br/n</ / Area of wetlands on lot-.-l" 006 Percent coverage Oflot:--.!O ',' % square feet Closest distance be~n ~est existing structure and upland edge of wetlands: J feet Closest distance betw5t,n sest proposed structure and upland edge of wetlands: (, feet Does t~roject involve excavation or filling? V No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: ----------------------------- Statement of the effect, if any, onthe wetlands and tidal waters of ti1e town that lllay result by reason of such proposed operatlons(useatlachmenis if appropriate): ' ". AJOI'JL r PROJECT ID NUMBER ~ 617.- APPEN;;'!"C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) NAME SEQR PART 1. PROJECT INFORMATION 3.PROJECT LOCATION: MuniCiPali~:qS1 11 Q..r JOn 4. ~~O LOCZ~t~~t;~SS f;;;::ns. Prominent landmarks ete - or provide map 5. IS PROPOSED ACTION: D New D Expansion 6. DESCRIBE PROJECT BRIEFLY: /r;JN/~rJk)~ o-f 2171 S~t'"7 ck-.0er- On .(2)f'/cJ-It~:S 6/.f?a4 ~~/~ rtJl~ 7. AMOUNT LAND AFFECTED: Initially acres Ultimately acres 8~RO.POSED ACTION COMPLY WITH EXISTING ZONING OR OTHER ~Yes D No If no, describe briefly: RESTRICTIONS? T IS PRESENT LANO USE IN VICINITY D Industrial 0 Commercial OF PROJECT? (Choose as many as apply.) DAgricu,ture D Park I Forest I Open Space OOther (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Fe~le~~ltate or Local) DYes IE'"NO If yes, list agency name and permit I approval; DYes o IHI::. At,; I ION HAVE:. A CURKI::.NTLY 'VALID ~ OR APPROVAL? If yes, list agency name and permit I approval: PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE . g- 3o;e. 06 If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment .. . . PARTII. IMPACT ASSESSMENT (To be comDleted bv Lead Aaencvl A. DOES ACTIO~ ED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.4? If yes, coordinate the review process and use the FULL EAF. c=J Ves 0 B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617.6? If No. a negative declaration may be superseded by another involved agency. DYes DNa C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, jf legible) C1. Existing air quality, surtace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: I ,UD I ^^^^- . C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: [2LJ (J I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I~JO I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity ot use of land or other natural resources? Explain briefly: [2tJo I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. Wo I C6. Lcing term, short term, cumulative, or other effects not identified in C1-C5? Explain briefly: IIl)U .... . . I C7 o her impacts (including changes in use of eitherquantTtVOrtype of e~ergv? Explain briefly: I J.J(J I D. WILL THE PR~AVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL 0'::""'" , ~ r'~r ,".. '''"'' """" I E. IS THERE O~ERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENT ALIMPACTS? If yes eXPlain: j DYes a I ...... ...... H. PART 111- DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope: and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked "- ~-- "~e-~ation-Gf.signiftC3nSe must.evaluate-the-potential impact afths t3Fol'losea saUoR 8R tl'1e 6Flvirof1fl,cntal cl'1a~ acteristiuofthe OCA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL EAF andior prepare a positive declaration. Check This box-IT you"havedelermmec( based -on-fheIrlformation and analysis above and" any supportinsi documentatIon, fh"aithepro'posed sidlo - WILL NOT result in any significant adverse environmental impacts AND provide. on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Pnnt or rype Name of ResponSible Officer In Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) 0' f . Board of Trustees Apptllation County of Suffolk State of New York . q I BEING DULY SWORN DEPOSES F S THAT /SHE S T APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF IllS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK Wll"L BE DONE IN THE MANNER SET FORTH IN TIllS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING TIllS APPLICATION, I HEREBY AUTHORIZE THE 1RUSTEES, THEIR AGENT(S) OR REPRESPNTATIVES(S), TO ENTE NTO ~TY TO INSPECT Hill Pllli'MlSPS TN CONruNCTION 7jj:;j; OF T APPLICATION Signature r SWORN TO BEFORE ME TIllS 30-11-- DAYOF~r 20 O~ '- ~tZ,~ CAROL A. MILL!R YORK NOTARY P~~L181~1:J~~t:EW QUALIFIED IN SUFFOLK C~~~~ ,;),,010 COMMISSION EXPIRES FEBRU ' - . . . . APPLICANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE. FORM The Town ofSouthold?s Code of Ethics nrohibits conflicts ofinterest on the Dart allOW" officers and emolovees. The numose of this Conn is to orovide information which can alert the town ofoossible conflicts of interest and allow it to take whatever action is :e~:a::;md same. 6?q' . (Last name, fi st n ,J1lid e initial. unless you are applying in the name of someone else Of other entity, such as a company. Ifso, indicate the other person's or company's name.). NAME OF APPLICATION: (Check all that apply.) Tax grievance Varianc:e Change of Zone Approval of plat Exemption from plat or official map Other (If''Other'', name the activity.) Building Trustee Coastal Erosion Mooring Planning /' V Do you personally (or through your company. spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of S.outhold? "Relationship'~ includes by bl.oad, marriage, .or business interest "'Business interest~ means a business, including a partnership, in which the t.own .officer .or emplayee has even a partial .ownership .of(or emplayment by) a carporatian in which the tawn .officer .or employee awns more tha.n 5Y'the shares. YES NO ~ lfyou answered "YES", complete the balance of this form and date and sign where indicated. Name .of person employed by the Tawn .of Sauth.old Title or position of that person Describe the relatianship between yaurself (the applicantJagentJrepresentative) and the town .officer .or employee. Either check the appropriate line A) thraugh D) and/ar describe in the space pravided. The tawn .officer .or emplayee .or his .or her spouse. sibling, parent, .or child is (check all that apply): ~A) the .owner of greater than 5% .of the shares .of the corporate stock .of the applic~nt (when the applicant is a corporation); _B) the legal .or "beneficial awn~r .of any interest in a nan-corporate entity (when the applicant is not a corporatian); " _C) an .officer, director, partner, .or employee ofthe applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form 1'5 1 ~r:n~:~~a~. 8-, 2000 Print Name f ~"'~.t' iO~ D 1; 10' fV CJJ 20' <: '->l -!:- ~ "i 1Il 0 ~ <: ~ -t t;'" l;'2 0 0 t ~ )> Z ;:a ~ C ;;::c 0 -n 0 0 ..." U> -l < 0 :N m C r- C -l U, ::t::. :c -l o:J 0 ro' -< ~ .-- rn C (.ii <: fiI ~ FD C1J N 55. 47' 20"E 210.00' N/F HUSSAINA N 55. 47' 20"E LA TrICE FENCE FrNCE N 0.1' STOCKADE FENCE (ENO FENCE NO.2' 167.32' - I\J -!:-. Q . ~ 0) ~ Q Q - CJJ No.t' E 0.6' 119.63' ,'0 eM NO.2' ~ 32.29' - (j) 4>- ~ . <0 <<j '" ~ -0 '" ;;; <". 2 STORY WOOD FRAME RESIDENCE ~ ~ MOOD ..... "t DECK W/ RAlUNC 72.4' BELGIUM BLGa< cuRB') CONC. SLAB 20. BLuesTONE DRlvEWA Y BRiCK SW 15.0' .. ~ FRAME GARAGE 3.1' 131.03' 34.17' 182.51 ' 2. S 55. 47' 20"W Fa IP )> c: Go (-.) SURVEYED 3 JANUARY, 2000 SCALE '.=20' AREA= 11,544.189 SF' OR .265 ACRES SURVEYED BY STANLEY J. ISAKSEN, JR. P.o. BOX 294 NEW SUFFOLK, NY /1956 631 '134- 35 N/F SALMINEN CM N 0.2' :,yU(irc:' <:':vl",d her~ en 5naH run c:;; . ; r;, ::-~-~/.T' ~-~" Vi l'v:,;, , g-, :" StTVe'{ ;:::3, cnd on his b,~l~ :.:i: ],-. :". "J;-; OY"",;,e"r. SURVEY OF .. ie.' c, I; k DESCRIBED PROPERTY ':;~::;, __;;,:'C'i Ci! '~, _':- :;'.;r, TAX MAP NO, c. "C,,'os '''c ICe ....... SITUATE /000-03/-09-12,.,.,10,01 1,.:lob" or .,EAfFf 'MAR/ON, TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. GUARANTEED TO SURVEYED FOR WAL TER E. GAIPA L1NELL D. GAIPA \ J> ^ 1'\ ~ )> AJ o Z "", WAL TER E. GAIPA UNELL D. GAIPA TOWN OF SOU THOLD C:.pi:::; cf ';U: "j .... fhis :~,r, ()f L'l',:'1.:7_";:::::; c!;Trc;!.;''''i ....,:' ",''-'" t, L(i!i-.J SL-Y:;Y ;'; c' vi;,i(; . , :'..,' iF.:;' L~ c.c-n~iJ~<.::d IV C-:; d ,',;.,.-,i ;we oF::';'; LI':;,/\-, :;" ;',-d ,. ,,-.;;.,, copy,