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Home My WebLink AboutTR-6441 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 CERTIFICATE OF COMPLIANCE # 0306C Date: March 28, 2008 THIS CERTIFIES that the existing deck, square off rear of dwelling, add a second floor to dwelling, extend rear of existing garage to meet the dwelling At 560 Oak Street, Cutchogue, New York Suffolk Couuty Tax Map # 136-1-44 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 07/21/06 pursuant to which Trustees Permit # 6441 Dated 09/20106. Was issued, and conforms to all ofthe requirements and conditions ofthe applicable provisions of law. The project for which this certificate is being issued is for the existing deck, square off rear of dwelling, add a second floor to dwelling, extend rear of existing garage to meet the dwelling The certificate is issued to GEORGE W. BORNSCHEIN owuer of the aforesaid property. r07~ Authorized Signature . . 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. 3J;)"1/0~' ~~ . . 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 Y, constructed ,,-/ Project complete, compliance inspection. . . TERMS AND CONDITIONS The Permittee George W. Bornschein. residing at 560 Oak St.. Cutchol!Ue. NY. as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of South old. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restrictiol). to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. 9. .That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. ---I . . 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 September 20, 2006 Mr. George Bornschein 560 Oak Sl. Cutchogue, NY 11935 RE: GEORGE W. BORNSCHEIN 560 OAK ST., CUTCHOGUE SCTM#136-1-44 Dear Mr. Bornschein: The Board of Town Trustees took the following action during its regular meeting held on Wed., September 20,2006 regarding the above matter: WHEREAS, GEORGE BORNSCHEIN applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated July 21,2006, 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, in accordance with Chapter 268, said application was found to be Exempt from the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on September 20, 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, 2 . . 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 275 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 GEORGE W. BORNSCHEIN to square off the rear of the dwelling, add a second floor addition and extend rear of existing garage 3'-10" to meet the dwelling, and for the existing deck, and as depicted on the survey originally prepared by R. Van Tuyl received on July 21, 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, Jam~g Gr ~ President, Board of Trustees JFK/lms . . 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: 4-l()ll 9'- .6m r1'[) (' lL.u n Please be advised that your application dated ~ah reviewed by this Board at the regular meeting of -.1}a,O/{)(,. following action was taken: has been and the L-0'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: '>-(r M.H ~~ ('i..U)) _-tr s-v ,DO TOTAL FEES DUE: $ Sh .Db BY: James F. King, President Board of Trustees . . Telephone (63 I) 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., September 13, 2006, the following recommendation was made: Moved by Peter Young, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the application of GEORGE BORN SCHEIN to square off the rear of the dwelling, add a second floor addition and extend rear of existing garage 3'- 10" to meet the dwelling. Located: 560 Oak St., Cutchogue. SCTM#136-1-44 Inspected by: Peter Young, James Eckert, Jack McGreevy The CAC Supports the application with the Condition drywells and gutters are installed to contain the roof run-off. Vote of Council: Ayes: All Motion Carried 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 DatelTime:--.8 I Ib (0 b GuIY , I I I ~orhS1~1' ~ f'-'O r-^- I I I I !;l,o i CPCi l S+- ,Cu~'i~ 2 ,,) t Lor t>lJ..J-r.-t. S<-I, '0 ~ c.<.).),.ft-..v Name of Applicant: Name of Agent: Property Location: SCTM# & Street Brief Description of proposed action: I Type of area to be impacted: i _Saltwater Wetland _Freshwater Wetland I +Sound Front _Bay Front I ' I P~::p~~;n CO~~~;~P30;ed ,:~~~:alls under: I ' Type of Application: _ W etland _Coastal E~S' n _Amendment _Administrative _Emergency I Info needed: Distance of proposed work to edge of above: r71k c.? Modifications: Conditions: Present Were: _J.King _J.Doherty _P.DiCk1so~~D. Bergen_J.Holzapfel _Other: I I I I I ' I Mailed/Faxed to: . [Date: . *6i/.eflG tJ tSoRJSc.-feul S-60 0,.+1<. c:., CoJ'ic!+CX'.<.J6 ,.y,-{ lIQ3.s- ;!vL-{ 2...) ~6 Bo I'tl>>:> O~ (Oc.JAI (hi> Tt3 € s ""fc,w,0 of $.c.,.rrn.oLb r, :":-:::-~-'-~:-:- J i'-~ _._._----~---. Ii"" c- ,. - . d' :~~ .. I JUL 2 4 2006 b~~ S,e..S, I I ! L~. ._ I.. ~. _-.2-___._.____ ....._._.J ;: ~ (VI2.W~/;J(., Tiff! A-rrACHGb Af'flucA--,/CW ~~ A-j)PRovAL --ro 4M #PI2-iY'N,.,4i? $"0 S? Pr of S,o.~ ON 64-cf{ of ..If,;: t2t5"Il--R... CoMG ~s Tc S9 c.J~b OPf=rH6"~AR. OF 'i"'HtY HDuStE-) 4bb 4- -SE.cOA1!:> ~<:JI!., '10 11-f& GKISTMj{J ~h..vT oP THG HorJsc1 4--])D 6-x ~N V T~ e.€'ff/2 or:; .7).f-6' G'l< I ST Jill C; (fj 4-IGA<" ~ 70 lYIeGT ~ FfU,N--r OY'lff-G H-DJ stf, PI2vPPS6'l> C$>AJS'TR-<.Jcn od t-J r Lf.... An:,., t3,R.j,Jc, 'Ttf15 HvJSt'F c.LDSGR.. 17; <fHG vJI1-"r6r<:.. ~ /T 1 s ~D'<V. A- l.VA-',J~ '::<>(2. -r~t.$ 5~6 P~~Gcl w4-s. ;4pp(20,JG-P hi'-r7k: /CJvJAJr.4.<Is-rC-es o,J -:J"".-.JG 'L7 /C}B:B I ~l.L{ ~S:P2~p.) 91& tL t r/~s !f;Clv~ p~';(fA.J{6'h ?Ie ,::e""", / MTINe: i>oJ 41+( s f' k?<>PagA L ..JAlTr L AJt::>ev.. A-r -rus 'TIM? r A-M. R..GsP&CTFuL<-f t2Gf'Je'ST/,vC:: #P/20-./.41-- (~R."'M 'f7..!~ (;;.v.tI 1f2..J '>-re e<.5 7'il p,w <:GC-b l-vrrH -rutS ~:!'G'cl NOw. YOJ-R- M S i STANCG /N 741s I'1.4-T7t;;R- /VILe 136 r;:;,ee.4TLy ItPPruc/4rr~ 10 J 1<.<; 7R.<.JL-/ ) g~06~. 0td,;,u;;e Iv &lZtJ.s.C(.f€';Ai . . FRANK A. KUJAWSKI, JR., President ALBERT J. KRUPSKI, JR., Vice-President JOHN M. BREDEMEYER, IJ[ JOHN L. BEDNOSKI, JR. HENRY P. SMITH TELEPHONE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 June 27. 1988 Mr. George W. Bornschein 1750 Stevens Ave. North Merrick. New York 11566 Re: Waiver - 1000-136-01-044 Dear Mr. Bornschein: The following action was taken by the Board of Town Trustees regarding the request for a Waiver of the Wetland Ordinance for the construction to be done on your residence located at 560 Oak Street. Cutchogue. RESOLVED that the Southold Town Trustees approve the request for a Waiver of the Wetland Ordinance for the construction of two 50' additions to the back of property located at 560 Oak Street. Cutchogue, all in accordance with the plan submitted. time. Please be advised that there is a $25.00 fee for this waiver due at this Very truly yours, 1r~1:fit~!, ~ ' President Board of Town Trustees FAK:ip cc: Bldg. Dept. file r- ./ . . Southold Town Board of Appeals MAIN ROAD - STATE ROAD 25 SOUTHOLD. L.I.. N.Y. 11971 TELEPHONE (5161 765.1809 APPEALS BOARD MEMBERS GERARD P. GOEHRINGER, CHAIRMAN CHARLES GRIGONIS, JR. SERGE DOYEN, JR. ReBeRT J. BBl::J8LASS JOSEPH H. SAWICKI August 25, 1988 Mr. George W. Bornschein 1750 Stevens Avenue North Merrick, NY 11566 Re: Appl. No. 3738 - Variance Dear Mr. Bornschein: Transmitted herewith for your file and perusal is a copy of the official findings and determination recently rendered by the Board of Appeals, the original of which has this date been filed with the Office of the Town Clerk. Please be sure to return to the Town Trustees Office and Town Building Department for issuance of any permits and other approvals in writing as may be applicable. Please do not hesitate to call either our office (765-1809) or that of the Building Inspector (765-1802) if you have any questions. Yours very truly, Enclosure GERARD P. GOEHRINGER CHAIRMAN ~a~' Copy of Decision to: Building Department Suffolk County Planning Commission /' ./ . . Southold Town Board of Appeals MAIN ROAD. STATE ROAD 25 SDUTHDLO. L.I.. N. Y. 11971 TELEPHONE (516) 765.1809 APPEALS BOARD MEMBERS GERARD p, GOEHRINGER, CHAIRMAN CHARLES GRIGONIS. JR. SERGE DOYEN, JR. ACTION OF THE BOARD OF APPEALS ReBERT J. BBY9LASS JOSEPH H. SAWICKI Application of GEORGE BORNSCHEIN for Variances to the Zoning Ordinance, Article III, Section 100-31 for permission to extend garage located in the front yard area and attach same to existing dwelling, and to construct additions to square off rear of dwelling in excess of maximum-permitted lot coverage requirement, at premises known as 560 Oak Street, Cutchogue, NY; Lot #24 and one-half of #25, Map of Eugene Heights; County Tax Map Parcel No. 1000-136-1-44. July 14 PO~ A public hea . in the Ma of under o. 3737; as held an~luded 0 .. lication AND and. . JOAN WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, the Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, the Board made the following' findings of fact: 1. By this application, appellant requests Variances from Article III, Section 100-31 of the Zoning Code for permission to (al extend garage and attach same to existing dwelling, which by becoming part of the principal structure will not meet the required front yard setback, lot coverage and sideyards for a principal structure in this zone district; (b) construct additions to square off rear of dwelling, which will not meet the limited 20% lot-coverage requirement for all construction. 2. The subject premises contains a total area of approxi- mately .10 of an acre, with 37.5 ft. frontage along the east side of Oak Street, lot depth of 98.6 feet, and frontage along the ordinary highwater mark of Eugene's Creek. /- , _~ 2 - Appl. Nt3738 ~atter of GEORGE ORNSCHEIN Decision Rendered August 18, 1988 . 3. This property is identified on the Suffolk County Tax Maps as District 1000, Section 136, Block 1, Lot 44, is referred to as Lot #24 and part of #25 on the Map of Eugene Heights, Cutchogue, and is improved with a single-family, one-story dwelling structure and accessory garage, all as shown on the survey prepared July 6, 1979, by Roderick VanTuyl, P.C. 4. The following information has been furnished by the property owner for the record: (a) square footage of lot: 3638 sq. ft; (b) square footage of existing buildings and deck 1423 sq. ft.; (c) percentage of lot coverage proposed 39.1 percent; (d) square footage of proposed additions, garage 42 sq. ft., house 93 feet; total 135 feet; (e) percentage of proposed and existing lot coverage 42.8%. 5. Town records also show the following dimensions of existing construction: (a) main building 528 sq. ft.; 7 x 15' extension 105 sq. ft.; garage 16 x 14' - 224 sq. ft. {see assessors property record card}. 6. The accessory garage structure is presently located in the front yard area with a setback of 1.5 feet from its nearest point with the front property line. The main dwelling structure is set back 22 feet from its closest corner to the front property line, 3 feet from the south side property line, 9 feet to the northerly side property line, and approximately 15 feet to the concrete wall (and 39.5+- feet from the ordinary highwater line as shown on the July 6, 1979 survey map). 7. Article III, Section 100-31, Bulk Schedule, of the Zoning Code requires a maximum lot coverage of all buildings to be 20 percent, requires a minimum front yard setback at 35 feet or the average of the established within 300 feet on the same block and same side of the street, and minimum sideyards at 10 and 15 feet. 8. It is the opinion of the Board that the premises is substantially nonconforming in these respects as exists tOday; however the variances requested in relation thereto are not substantial. The Board agrees that the applicant's requests are the minimal necessary to afford relief under the circumstances. 9. In considering this appeal, the Board also finds and determines: (a) the practical difficulties are sUfficient; 3 - APP~O. 3738 tter of GE~E BORNSCHEIN Decision Rendered August 18, 1988 . - - (b) the property is unique as to its substandard size and limited front and rear yard areas; (c) there is no alternative available for appellants to pursue; (d) the relief will not: in turn be adverse to the safety, health, welfare, comfort, convenience or order of the town; (e) in considering all the above factors, the interests of justice will be served by granting the relief, as applied and further noted below. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Grigonis, it was __'_ RESOLVED, to GRANT the relief requested under Appeal No. 3738 in the Matter of the Application of GEORGE BORNSCHEIN for the attachment and extension_of theilccessory garage-to the.- principal dwelling, and squaring off of the corners of the dwelling~ as submitted to this Board, SUBJECT TO THE FOLLOWING CONDITIONS: ... _. ...,...--....-.,. l~ Two doors, of a size three ft. wide each, or larger, be placed within the easterly wall of the garage; ,_ _,_' 2. No further additional construction or saturation; - - 3.. Any further additions shall be perrni tted if they are at an upper story and not extending past the building; 4. No further.frontyard encroachment for any additional construction in'any manner. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Douglass and Sawicki. ',:(Member ,Doyen of Fishers Island was__ absent.) This resolution was duly adopted. lk * * * .,Av-~d/f71J~~ GERARD P. GOEHRINGER c:/ - .' CHAIRMAN . , .0 (9{86)-25c Ofe PERMIT NUMBU< .' YORK STATE DEPARTMENT OF ENVIRONMENTAL C.VATION 10-88-0992 FACILITY/PROGRAM NUMBER(s) "Ik.___ D D D D D D Article 15, Title 3; 6NVCRR 327, 328, 329: Aquatic Pesticides Article 15, Title 5: Protection of Water 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 o PERMIT Under the Environmental Conservation Law D D D D D D EFFECTIVE DATE 9/28/88 EXPIRATION D^TE(sl _....~..12/3JJ.3Q ...~~ 6NVCRR 608: Water Quality Certification Article 17, Titles 7, 8: SPOES Article 19: Air Pollution Control' Article 23, Title 27: Mined Land Reclamation Article 24: Freshwater Wetlands N-New, R-Renewal, M-Modificatlon, C-Construct ('only), O-Operate ('only) D D D D D Article 25: Tidal Wetlands Article 27, TItle 7; 6NVCRR 360: Solid Waste Management' Article 27, Title 9; 6NVCRR 373: Hazardous Waste Management Article 34: Coastal Erosion Management Article 36: Floodplain Management Articles 1, 3, 17, 19, 27, 37; 6NVCRR 380: Radiation Control PERMIT ISSUED TO George & Angelina Bornschein ADDRESS OF PERMITTEE 1750 Stevens Ave., North Merrick, NY 11566 ACENT FOR PERMITTEEICONTACT PERSON T TElEPHONE NUMBER NAME AND ADDRESS OF PROJECrfFACllITY (If different from Permittee) lOCATION OF PROJECT/FACILITY I COUNTY I TOWNJCITY/VILlACE I UTM COORDINATES Eugene's Creek Suffolk Southold DESCRIPTION OF AUTHORIZED ACTIVITY Square off the rear of house, add second floor and add 3' 10" to rear of l!aral!e in accordance with the attached NYSDEC aPDroved plans. GENERAL CONDITIONS By acceptance of this permit, the permittee alrees that the permit is continaent upon strict compli. ance with the Eel, aU.pplicable relulations .nd the conditions specified herein or .tt.ched hereto. ,. The permittee shall file in the office of the appropriate realonal permit administrator. or other office deslanated in the special conditions, a notice of intention to commence work at least 48 hours In advance of the time of commencement and shall also notify him/her promptly in writina of the completion of the work.. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation which may order the work suspended if the public interest so. requires pursuant to ECL 171-0301 and SAPA 1401(3), 3. The permittee has aCCljepted expressly, by the execution of the 8pplication. the fullleaal responsibility for all damapt, direct or indirect. of whate...er nature, and by whomever suffered. ansina out of the project described herein and ha.5..reed to indemnify and save harmless the State from suits, actions, damaaesand costs of every name and descrip- tion resuttina from the said project .. The Department reserves the riaht to modify, suspend or revoke this permit at any time after due notice, and, if requested, hold a hearina when: a) the scope of the project is eJlceeded or a violation of any condition of the permit or provisions of the ECL and pertinent reaulations are found; Of' b) the permit was obtained by misrepresentation or failure to disclose relevent facts; or c) newly discovered information or sianificant physical chanps are discovered since the pennjt was issued. 5. The permittee Is responsible for keepin. the permit active by submittin.a renewal application, includina any fOflf15, fees or supplemental Information which may be required by the Department, no later than 30 days (180 days for SPDES or Solid or Hazarduous Waste Manapment permits) prior to the expiration date. D. This permit shall not be construed as conveyina to the applicant any 'iaht to trespass upon the lands or Interfere with the riparian riahts of others in order to perform the permitted work or as authorizina the impairment of any ripts, title or interest In real or personal property held or vested in a person not a party to the permit 7. The permittee is responsible for obtainina any other permits, approvals, lands, easements and ri.hts-of..way which may be required for this project. 8. Issuance of this permit by the Department does not, unless expressly provided for, modify, supersede or rescind an order on consent or determination by the Commissioner issued heretofore by the Department or any of the terms, conditions. or requirements contained in such order or determination. 9. Any modification of this permit eranted by ~he Department must be in writin, and attached hereto. ~WULATOR), Af'f"AIU PERMIT ISSUANCE DATE 9/28/88 AUTHORIZED SIGNATURE cc: BMHP ADDRESS STAT!! UNIVl!RSITY 01' NEW YOIlK Page 1 of 3 .. . . ",,! , , New York State Department of Environmental Conservation Region 1 Headquarters SUNY, Building 40, Stony Brook, NY 11794 (516) 75J-/00<l ~ sc A<'/O; I Thomes c. Jorllng Corilr\\tssloner 'II Q AMENDMENT TO PERMIT (,l'DI-c\e DO(nsc\'\..{' I /\ --------- ('le l)~' S+c~/e,\s AvCI,)Ve. Former ~ Permit # (if any): ~~o-r'H, /,-LC'vy/ ell ,,---~.\.}. 11::;6(;. Dwner: R.E: Perrllii N.). ~ 1,,"IL'dti0l1: ___~_J!~~_rc',s, . c.9j~~__ f' I ____i:c_L.L(~L- ,>,_' S''o-_'({L''- ____S_\LJ,H '\ d cL_ _ _ __ Dea r tv(,~ _ ,:-S(,(' ,.y::.d'----l ; '\ -- \'Y' f..' '{)lll recenl reqlltsr to ext,=nd ltle above permit has been reviewed pursuant L~ 6Ni~RR, Part 621. It has been determined that there has not been ci mdrerl3J change in environmental conditions, relevant technology or appJjcabJe 16\'1 or regulations since tne issuance of tht eJeji}iting permit; therefore, '11<0 expiration date is extended to 1'2._5I..,1'lZ . , {o,,, : )~cenL request t.u ",edify the above permit has been reviewed pUl'---suant. t,; 6NYCRR, i!art 621. It has been det.ermined that the proposed modifieaL i ,~n" wi 11 not subst.ant ially change the scope of the permitted actions Gl" tll~ existing permit conditions. Therefore _ 1 he permi tis amended to author ize: This lett.er is an amendment to the original permit and as such, shall be posted at tne job site, All other Leuns and conditions remaln as written in the original permit. Very truly yours, C k/h:~ (. C~ -t<>{J O~/{--- Deputy Regional pe~t AdministraLor l-: ~.: : I 'i ::~ t MAP OF P/zOP€IZTY SueVt=YEO FO/Z. ..t:~~^./GEL_I Nt), E3cJt2/"l~~X~:li'E'::I('J t... .: : . . ~~. ., . ..'::..:: !J.e ,'Z 6: ~ .' .. . .;'.;:..' . . " .', .... .. I... ,rLo-t fIHe~' ..'.,:....;."....:. ':'" I "l _,.' . :: < ',., :. :r:~~.. .... ," '; .,...--__' ,~ ift~ )f~t1Ce tQ#df, ~i/"if.Y:' ':.:..... ..:. ,'. " '.!1 ')' " .... :.' '::'>.". . ;. . ,..:: ,. ' '. . to.. tL ". .' N 8~"O' I'I(J"~": ::..... ~:""'.'~', 9'S.....::, '. \... I. G.~-',..,. ....;...:: '. ..., '". - . .' ".r' l'.. . . ~. . , '/r".~ r-..; . .1'1) 1crY-cr1t! ,/ , .'t' "'-' ... ..,. :... 1..: :'{ ,. "'i '-::.. .~, Q' I : .' .' . .ljj .,:..' . "". :,~':.": . .... ". (\ i~" :. 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" " \ 'i " . -,.:" \, . . .' ." #....tj '. , . :'" rv. .( " . - . ~~~, '.: . ' -. .. .. -t:.Qt1.:r. ~rt s. . , i' ~". . .' .' ... . ..:,' ,> ~Xf'I!N~ tf:tAR./M.' 3!lfi'L' 0 . .. . '. -m M.EET1:.:JlDUS~ . \-": I '. '. ( . .' '.l:::; .~ . . . . ':J. _._-.--_._-~-----:-_. <t.. C)" 23 :: . ~ I GEOC2GE ~ v ....... lt1 l!J t\J ~ \) ,.\.1 "I ~ "- <. l!J ~ '"'" " l!1 C-.. = r- ,...., .po C5 = CJ'> AT' _____._.__.._______.....__. .._....__ .._....._..__...__ ....._ ._ ........... ".. _0 _...... .__0.. ". .... ........_.._.___...._.......___ '. ~.tI "9/1 "I"" "hUe). f, ~ftO''': . H1iA . "'I s. ";TO I . I '.OUARA 7..0NL) 1 .1 IS fAlf', '-'lime. 1.l!~CII,. I ~,o 'ur . . . III ~-- ,. i I :::- Z --======--_ ;7 I tw , -1-. 5 IV) . " rl . g Sl ~ . '" ~ i ; I~ 8j~ ~Jh ~~jg '0:" ~ ~jJi. 6k.e- e ~~bt~ ;(~"H ~ ~~: i '" @ ;;i;; h~!i !~~!~ !> i' '\ \\\ ] '- \ t. ! ~ ". , ~ i ~ ,-" .- aU "'"' ,,"': ~~, ~ ~ i f gJ~ cr# ) <-o~ 0" \<.#5 >'",'0 ~';) -, 11,1 ' <.' I : ~: LI Hi nJI111 ,,111, .. - ~ ;:1111:1 id~Bi II Ii " II .- Il II II i i i]l ;;iii !d!j iI'i'lll II . I'" .. ,1]1]1 , i i i i i i "'" ~ ..; ~'; - I; ~~'''~ .I q H Ii I. I . ~ ~ .i } /' i III .... I@), " ff I Iii It! i:f Hi II! iii ! ~ t Ld " ! ~ a ~ . f' iii I i I~ I + . !. ~ .I n. - ~ ~ ! !"! . t ~ ;,j , ~ i ~ I'll j, I' 1.1, IW, I Ii _'0 d, : J' I HIli i ii . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD - - , . \/ Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 Office Use Only _ <;Pastal Erosion Permit Application ~etland Permit Application ~ Administrative Permit _ Amendment/Transfer/Extension ~ _-iteceivedApplication: '1 td,<<t.\:.\\ Received Fee:$./ -c\..U..L , --- /"Completed Application _Incomplete _ SEQRA Classification: Type I_Type I1_Unlisted~ _ Coordination:( date sent) L WRP Consistency Assessm nt Form ~AC Referral Sent: 3\ 10 ~ate ofInspection: 0 _Receipt ofCAC Report: _Lead Agency Determination:_ Technical Review: -Public Hearing HekCI),:}2J~ _Resolution: i \ I \ , L__ JUL 21 2005 S{.,O lOA-k gT; C UtC--(fO <;, ur= ;J~4.J tOR..k II q '3 ~ Phone Number:~~/) 13<f 73 2 <( Suffolk County Tax Map Number: 1000 - $e.c, \ 'Sk> e,L\<.\ Pc L 'i "I Name of Applicant Geo,Q6E W. 'go RN $1:: 1-\6 II\.! Address Property Location: $"",,"0 oAK ST) CJ,c~0E? illf7<<.J jOQk U Q3S- f.-..({.-(c!J ?OIE-it-t...\. EA~T Sloeo("Ot\k SrAP,..aoX 300''50'-''114 Of Y'1E:<<-c.-G 'DR. (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: ~ ~n~ l1I\o- J <'\\~ Phone: tlrrd of Trustees APPlicati~ " Land Area (in square feet): GENERAL DATA :3, ~ 38 , Area Zoning: ~tS, Dt::tJT,AL. Previous use of property: QG.s \ l)8J'f JAL Intended use of property: R~sl i){;,.JTI AL Prior permits/approvals for site improvements: Agency Date ~Mb Of- -rD W ~ \e.J So TGEs. -r;},()G' '2-'. f q 89 (coN A1"(AC!k~(\) , AJC.us.i 18, ,Q86 (t:..DN A.TTA4l€D) $GPT 'J-B, 1 ClB0 G 0("'( A(TA-CI.H:~ APR.\L '30,' , q 90 (c<)(J--( A17f1rCl+Eb) '\OlAJ.J r:,OA-R.l) of Mp f AL S br::c-- ~G L G"XTCAiS/DrJ _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~No_Yes If yes, provide explanation: ~f~(.1".{ I9rr Qelh~ C} (' 1\ e "$. '7 A~i) ? c)b r::I:.-B9il A~'l'} e;,... \ .c,.;lt> ff Ih<. (JF C::-X\ ~ I"<\(' {)1l.e-.4t,t' '3,'-1"""'-:' Iv\~[T \',GI.i~& (C-"P{ t:J( ('L<9T p,-+,J ~I f',~C(\I!fCV Project Description (use attachments if necessary): 5 or () ~p d' f= (.2.64 R- 0 pp.e O~ C{3 Sf ~1 ) ex: f:"XlSTI..J<,::; t+oJSG') Abl) '2~FL.ojJR. AN~ eXT6t\Jt) ~GA-t2 or:: &"-1 <;TII'lG c.;'A-J2.A.,;;i" 3'-(0"'(0 ,vleer lfoJSe, "'rd of Trustees APPlicati'" c WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: /0 4b)) A-P pear 1M4-ff;c-l "J?, 5cf>Jf: 1P 6)(\ S'I "'('7, +fflusG h;;t'j'rPi2-I Nt fSy 59 vt4R./Alt; c)fi:. Tff~ REill?- .-rh)u cO!&./c,2S < Area of wetlands on lot: 0 square feet Percent coverage oflot: '3 q. \ % Closest distance between nearest existing structure and upland edge of wetlands: I \ feet Closest distance between nearest proposed structure and upland edge of wetlands: 4 \ feet Does the project involve excavation or filling? No / Yes If yes, how much material will be excavated?~{-Lto cubic yards How much material will be filled? 'AS- cubic yards Depth of which material will be removed or deposited: 3 feet Proposed slope throughout the area of operations: 0 Manner in which material will be removed or deposited: SfI1t+/..L PI.4Cf.f '''''13 Statement of the effect, if any, on the wetlands and tidal waters ofthe town that may result by reason of such proposed operations (use attachments if appropriate): No Gr:-FFfcr o.J iVG-TLA,Jtbfj AND TIl)AL W!4Tct2..5 Of' 50u'7].l uLlJ to NN t.J (LL ,(!f;sJL-r r::lWJM ~ P~fbs-e-):) OPe"(ZA'IDAl> Or:: 'T1-115 4PPLI CI>s'rIDN . 617.20 PROJECT 10 NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) SEQR if cJ,e?;e tJ 8 cJR~~ctf G I ~ 3.PROJECT LOCATION: 2. PROJECT NAME -S IJ .e.& t>;:F MItR- OPCXIsTlN; Ot/<!,C 1. APPLICANT I C:::Pf'lI\tC"'R Municipality So JT40LD r/?W N County >c./fC ~ ...ll..K 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks ate. or provide map S:bO OA-k S7) Cu-rCIfoGu~ ;.1i /IQ3s(PFF 'PtC(<'c.G OR) 5. IS PROPOSED ACTION: D New fi(l Expansion D Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: /4J) /) HoJ!:E "P;)o/P,tZ./-JT f3 y APP~D'f-.(/"1,4TELi <73. Sip Pi 7D t;)C(SntJCj 5<f),.)/f12-,A/G;. O~ r: -rJ-f"C RG4~ -rWo (ORAiER.S 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres A t'Pfl.O)( ,,'.....:l,e L ;::7 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? DYes 5(] No If no, describe briefly 2-0N/A/(:, .J4~IAA(G iv,fS ,ry'jl4N'TC}j 6/B/88 9. WHAT is PRESENT LAND USE IN VICINiTY r&l Residential D Industrial 0 Commercial OF PROJECT? (Choose as many as apply.) DAgriculture 0 Park I Forest I Open Space DOther (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, AGENCY (Federal, State or Local) IZlYes 0 No If yes, list agency name and permit / approval: NOW OR ULTIMA TEL Y FROM ANY OTHER GOVERNMENTAL Tlt3L-. 15DvTrlut...{) -WW,.J. R,J,a"Alc. _ .v I ~R""l ( 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? DYes D No If yes, list agency name and permit I approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? es DNa I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Signature " Date: Applicant 1 7 2.1 &6 If the action Is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment . . PART II. IMPACT ASSESSMENT ITo be comDleted bv Lead A"encvl A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. DYes DNo 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 DNo C COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, sulface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: I I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: I I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I I C4. A community's existing plans or goals as officially adopted. or a change in use or intensity of use of land or other natural resources? Explain briefly I II C5. Growth, subsequent development, or related activities likely 10 be induced by the proposed action? Explain briefly: I II C6. Long term, short term, cumulative, or other effects not identified in C1.C5? Explain briefly: I I C7. Otherim acts (including channes in use of either uantitv or tvpe of energv? Explain brietlv: I l D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ~CEA)? (If yes, explain briefly: i DYes 0 No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: DYes DNa I I PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (Le, urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics oftheCEA Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actio 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 Type Name of ResponSIble Officer In Lead Agency Title of Responsible Officer SIgnature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) .~ u S, Post~1 SerJIU CERTIFIED MAli REC[IPT (Domestic Mall Only. No Insurance Coverage I-'rovlded) . or .U rrt}lop' .. ::J :l- $ 1:0.3~! 0935 Postage :r I::J Certifred Fee <~2.40 I::J I::J Return Receipt Fee .:f.-O.OO (Endorsement Required) I::J Restricted Delivery Fee I::J (Endorsement Required) $0.00 ,-,! I::J Total P':)5tage & Fees $ .t;:' 'i'C) )F MAILING OF NOTICE ERTIFlED MAIL RECEIPTS ..0 :2 sJi~tJof-1~.;?nn.s:<=:<?T.!nnf?,;.Z.. .'nn::.:.n....nnnn 6LL ~~~;;r;P+f.Q...{?.02Xn5.'f..z.....n...nn....nh.hn.n.......n J 6 <3 II ~S' Address: po &y S'-I 7 G.cJ(cffO~()E);J{ 11'135' ..0 I::J I::J I~ 300 ,'3,IU3 rrSr A-7)T CT. SOUTIfoL/),J0Y I ,q7 ) CJ CJ f- ( ::J ::J be ~ 31 Elts-r <371 oi<lC-OJJ r/+)N'f I~gl 1/0 gD'!... 4 J lL-A~ C7.<20"'<O Ai'f ! 17 ~. GJoq, ding at f:6o C'lA-K >T; C cJ 1C-i-foG".J€, I'.J Y 11?:5 '" J.gd!!lyn~WPIl1,c1eposes and saysJhat on_the ' I ~ 1'+ day of Auf.) , 200b , 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 oCSouthold; that said Notices were mailed at the United States Post Office at C ,.toe U 0 6. vt: . that said Notices were maill:d to each of said persons by (certified) (l'egiet"lI~ mail. _ / &-J~ tlz/A-D L Sworn to before me this I S~... Dayof A~Ju'+ ,20~ ~~~ John M. Judge NOTARY PUBLlC6State of New York No, 01JU605940 Oualified In Suffolk County , ~ommiSSion Expires May 29, 20 2-. ,- :,- , ~, . ' i f \ ~ ~ AUG 3 0 2006 -. . . NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES. TOWN OF SOUTHOLD In the matter of applicant: c:.j-Gol2riJe W &{2.}f 5.~1 AI SCTM# 1000. /3 {, -( - '-l'-{ YOU ARE HEREBY GWEN NOTICE: 1. That it is the intention of the undersigned to request a PeI11li.t from the Board of Trustees to: ScpJA-U. O~F 'K6AR.- OF HousE ANi> AbD L,\J1>FL-ooR...J ~)(.TtNl:> ReAR- O?:-C;ARAGG "S'- (0/' 70 Ml':€T ~/2.0AJ\ OF \-\o0SE 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: S-6D VA-k ST) C JTC HoG 06; Aft J 19 3~ 3. That-the projectwhiclds1lubject to ~vironmootal-R~view under Chapters ,,2, n, and/or 97 of the Town Code is open to public comment on: ~l1$ot J3. :J<:Y::k . You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of South old and does not reference any other agency that might have to review same proposal. OWNERS NAME: 46=1) ~~ f" A.Jr,;'EL /Aill BOR".JSCffEI J MAILING ADDRESS: S-6o OAf< Sf C UTeri Off/Clc. pi'l J /q ~ S- PHONE#: 6~/ 7 ~'-( 732'-( I '. Ene: Copy of sketch or plan showing proposal for your convenience. MAP OF hOPEIZTY SUIZVeY€D FOe GEO!2GE f; .t:~~^JGE:=L_1 Nt:::' E3cJt2/'-.lSC:/-.,,[-.::It\.J ,r" '.:.', ." "'1" Z"- . .' ",.Ii~ . - ~ .' . ~ 0': :..: ~.o-r" c;1: ~ '1 J~'. ~'L'ot. "'H- '. :..~. '. '. ." ....:. '. . ". ',:'.' ~t.\ . ,....\ !:: .....~ -I.', ;....... . , . la... . ..:,'"., .. .,..'" '.,--~--' r.. ...;.--.......-.---....t..j >>:~ .no. )fdt1Cf: ;o~fdf.~(/r';,~I"':...:.:: ,......:.:... ',.'. .~., t} .11 "} / ,.!! rJj, '" . . .,' .:.)":.;: ':. ..:......"....... t\\ 1.1 t, ; a.. -'," . I .-;..- i .,..... '.. .~.,:.. ~ ." I ( ;,:: .~. ~ ~'z8GOIIO li..::..I'...:~..~~.i.:<...:_..:.9S.0. ~__n 1 ~! I JY.':,~ " . '" . . :. . ." ~'~t' ':.' ~ . ~'\ ~ i. '. f,) . . '. I .... ~<;il$:'~ 'I '" -u ~ '..' 1dra1t!.;/ ':' ' ~. . . 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I ..(jU....... ,ONL't I .115 ,nil'. ,,'flllI (, I.UNtIl" t;IO',w . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel . Town Han 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 --.--------------------------------__________w_________________ In the Matter of the Application of ~~~~c)~~-~-t1JlJ.!lt--------------- ST ATE OF NEW YORK) AFFIDAVIT OF POSTING 166VR.he(A..}fsO~~~Cf_{EfN, residing at ~ 60 OAk'" <J"Tj C,JRIfex;;()C; AI IN 3 r being duly sworn, depose and say: That on the I'-l day of I\v Cj , 2006, I personally posted the property known as S-6o Ol4-k <Z.fii:CU"/C.J.!F)GrJE Alf by placing the Board of n1stees 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 UJc"..p- a.u~U:f.;2 3- <il0D<6 ~ , f1 CYl. a6cu:f It> :do fIT), Dated: ~~~~ at ) Sworn to before me this ;' 15 day of A~s..~200 (, ~b~~- John M. Judge NOTARY PUBLlC6 Slale of New York No. 01 JU605940 Qualified In Suffolk County Commission Expires May.29 2001 , - 1- ," ":::1 I . r AUG 3 0 2006 ~oard of Trustees ApPlicat~ County of Suffolk State of New York bCOf'ij;" k) 13l)vff.)(J\(./V\. BEING DULY SWORN DEPOSES AND FIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENT ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF TIllS APFlTION ~r)/PP--- ~ Signature SWORN TO BEFORE ME THIS ~( DAYOF J c.J~ 20 0 <c '- PENNY BEDELL NoIaIyPublic,jtate of New \lIfk ~~~9317 Iii SUfIoIk Commissliln . SIIpt~OU) . . APPLICANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of South old's Code of Rthics orohibits conflicts of interest on the Dart of town officers and emolovees. The Dumose of this fonn is to nrovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: 1? oR.J SC-H-b 1../ C; -:- ollC~ tJ (Last name, first name..1piddle initial. unless you are applying' in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat Of official map Other (If "Other", name the activity.) "1) IS c..- Building Trustee Coastal Erosion Mooring Planning / ./ Do you personally (or through your company. spouse, sibling, parent. or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest "Business interest'~ means a business, including a partnership. in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. /' YES NO If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of South old Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, oT 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 own~ of any interest in a non-corporate entity (when the applicant is not a corporation); _C) an officer. director, partner. or employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted this _day of ?;OO _ Signatur~~~tr~ _ . Print Na CJ t!f- rJ SCf.1G ,Ai ~ ~ . III . . t'VLC.tf- {- ST /J 'i I '7 '3 c;- --- S Gf"(' '"LA-,.... mA Abvi s"II.lG: 'loJ of /V\~I tJr7l-fDI2AJA-L ~2D;1/J 'fl-(.-~ '; ..- -, ,JC p,- c -loAf o - C'YIC 0<:; U6 1 ms: wiLL ,MAkE -if/PLICA-TION IN TffG ~.rrJ~ P'CA/DIAlc' m "2 oAJI;tIfJ" /3DAJ:~.b OF APpeALS 'U)6c, <; I D"j /~ M'( ?AcJoA.. m. , :1 2 2006 L._ __. " Town of South old . . A. INSTRUCTIONS LWRP CONSISTENCY ASSESSMENT FO~ i.' c , .~ '\ ! - .-----_r____--, i :.- !'" , 1. All applicants for pennits* including Town of Southold agencie~, shallc()lllpJe~ thisCCAF f(lr proposed actions that are subject to the Town of Southold WaterfrOl~t Consistcuicy R~vie\v Law. This assessment is intended to supplement other information used bY~ij'ToWri of SouthoId agency tn making a determination of consistency. * Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. AUG 3 0 2006 2. 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 ro osed action will be evaluated as to its si . fi ant beneficial and adverse effects u on the coastal area which includes all of Southold Town . 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the L WRP policy standards and conditions contained in the consistency review law. Thus each answer must be ex lained in detail listin both su ortin and n n- SUDDortiDlz facts. If an action Cannot be certified as consistent with the L WRP policy standards and conditions, it shall not be undertaken. B. DESCRIPTION OF SITE AND PROPOSED ACTION A copy of the L WRP 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. SCTM# I CJOD - / 'Sb -I - l.-{ t.{ PROJECTNAME S{YvAI<E CJF,c J2eAI2 6,cffauSC;;Ahl'> 2.flt>I-L.a,R./ r;-xn=/J)) 12b4Q~c;"'kW;G The Application has been submitted to (check appropriate response): Town Board 0 Planning Board 0 Building Dept. 0 Board of Trustees ZON'I'ol(,I3"AR.<:> I2Q O~ A,P(,f:Al..S ~ 1. Category of Town of South old agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) o o (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: . VA~Nr;C r::;,tJ.(} fJTO:> I III /q6'E? A-Alh re.EccAfTL i' COAi?J/?..J4/JiSiD AS STILL fA.! c;~~e:C'T (c45C: F(LE~ 38}[f) o ^ ; . '. Location of action: 0'60 OAI< sr c J77:'-f-frx::.o6, ItJ/!C-tJ 'fjl<-k ((c; '3s ' ,," Site acreage: 41,ot2:D'X1 t04T6L-I lito A-c , Present land use: R~ <; r i) EAJ '114L (I ~Afl'\1 L-V Present zoning classification: Q;c '3 r t)c AI,I -4L 2. If an application for the proposed action has been filed with the Town of Southold agency, the following infonnation shall be provided: (a) Name of applicant: 0)((o~~ Cv bDRjjSc+( ErN 560 0-4k <5T. C UlC~cx)u co A./ y (("1'SS- I J IlSb .sre"E"~s Ave) N.ME"I<I<\CK N--( 115""6b (b) Mailing address: (c) Telephone nwnber: Area Code ( ).b '31 "734 7"3 2 Y <;;;"1(, 868Y'<63 (d) Application nwnber, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes D No L3L 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 L WRP Section III _ Policies; Page 2 for evaluation criteria. DYes D No 00 Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve histOric and archaeological resources of the Town of Southold. See J,WRP Section III - Policies Pages 3 through 6 for evaluation criteria DYes D No IXJ Not Applicable , . . = = Attach additional sheets if necessary ~ Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See L WRP Section III - Policies Pages 6 through 7 for evaluation criteria !Xl Yes 0 No 0 Not Applicable ~Lt/Alr-; Ivr LL f3~ I/l1Pt2PJ"G~ IN Al'PG"A~NC~ M)) cDdjCG>~~ 17:> ~~ I+.lJ<,,GCS, o.-J ST.e~G-r-. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria DYes 0 No 00 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See L WRP Section III - Policies Pages 16 through 21 for evaluation criteria DYes 0 No OONotApPJicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See L WRP Section III _ Policies; Pages 22 through 32 for evaluation criteria. g] o o (g No NoePlicable . Policy 7. Protect and improve air qnality in the Town of Southold. See LWRP Section III _ Policies Pages 32 through 34 for evaluation criteria. DYes D No g] Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of South old from solid waste and hazardous substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria. DYes 0 No!iJ 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 L WRP Section III - Policies; Pages 38 through 46 for evaluation criteria. o YeO No~ Not Applicable Attach additional sheets if necessary WORKING COAST POL&S . Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See L WRP Section III- Policies; Pages 47 through 56 for evaluation criteria. DYes 0 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 L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria. DYes 0 No!Kl Not Applicable &16"~ D!:>t C/ €Jd<;L.-f G; AJ J.l-4/ll ('c /L1AL..J e Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of South old. See L WRP Section III _ Policies; Pages 62 through 65 for evaluation criteria. DYes 0 No IKI 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. DYes 0 No [R] Not Applicable PREPARED "9? 9v~,L TITLE U(/JAJGR- DATE-f# 1,'-"--" i ! I }-....... \1]:; llJ ." f1J' h, II) ";..~{<" -,--. ': ........, ./ ,,'" ..~~ ;" ....---......-----. . ..;- ): ..:~~. ...... 0 7. ....0 {'JQ, . L of" , ,~ . 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I t : t ~! , '"oa i ,,; , " I " , "-I i \ " ! tl ~ { _n_._. __ _~_._____~ A7 CUTCHOGUE TOWN OF SOUiHOLO ,N. Y MAP OF FkOPE/Z.TY SUIZVeYeD FO/Z. /\NGEL IN ,\ L-:>,"r// ,"'" / !'-"/J, I 1-... '_ _ /~ LA-Jh... ',,::;,i..F,I:.:: I '-J 5cale: ZO'-I" Q ~ 11""0,., tiFt!!. Noffi.;jLo.+ 11Ch11~r.s ~/.,ow,." I"i*fe," +0 'M4 of ic'-1"''''''' Hei1!tfs", filed ,.~ }-t.(> $vjf<i-Ik. Coomfy Cle...k':, ;/,c."-,,,. M41' Na 85"6. ~ /," ,- 'r; ,..f ,J" . .i' .:Y)ij-~cv. .Q/. '(Hi,..' v'e~~'l~J;l(r';:}I(: Di:d',/OC:O,~~:,13.>, 8.'10., i,". .i-I, ..., lJ',. , " .- ~ l!J !!J ~ \) ~\:) i!J ... <. t!J ~ ..... .., lu --_.'-~"-~._-- .~.~.._.._.., _ __f;.:"_~:~ ~..:~-.:._:-;~ It\ft J I J >- ,..., c. ',(1 1_1 .' ~ ~ I ;\~ > :: 1" '-l\ I ~ I' ~O/O~\ ~ ~/~ 1~ <( 0.'0 ct:J; il- t'::: J ! J'" . . / IZUt OUJEnTlOH OI-~ ,'1'1 THIS 5UiVfY IS A YIOlArlON Of ~'ia"'H 120f OF THf NEW fOK STAn: ". 'ION LAW. " ... "IS OF THIS suaVEY MAP NOr RARING -' HI fAND SUIlvno.'s 1Nla[) Su'l OR ...~.'r61"S5EO SEAL 5H....Ll NOT Ilf CONSIDERED "1 I A VALID TRUE COPY, ""~~~NTEES.I~IC""TEO HEREON SHALL RUN ... IS '"REf': 0 TH" ~~;<.SON fOIt WHOM IHi SURVIY AtW. A;>.;O ON HiS woHAlf ra rHi t,t1lU ~OMI'At..~. GOViIUIMENT....L ....GfNCy AND \l~.G WSliTUTION Llsno H'UOH. AHO ~~ ASSfGNus Of 'lit ~ IH5'" r....O.ADQr, ~THs AU HOt tlAHSll&Aau "'Wtr4ftt. UONAI. HTlWr40HS 01. a....~~ 6wa..-cm-f.eed fa fire :5ouHrold ;5aviwf'c BaliK. Clnd fo Me f"'i;..::,f ?il1'1e;1iccJrt T;.r-/~ IttSi,,),nItC9 :=,::;n;pcrlf~j" , :):3 ;. !..Jf..~'~(/at'l ,jU4":j (;) /1"'-.,17")_ l-_~(-.-J{~..r:.:i.-~.,...j~__ i.j~t.' .jU)'~i._.f:-!C;.. -.... I rC' Q ,... \, -- . 1--., . ".--" I -'-it-. L/c:~ns~...l LaNd SUf"veayors (,,,''''e.~/,,,,,,.f - N~w Yo..-k::