HomeMy WebLinkAboutTR-6468Type of Instrument: DECLARATION
Number of Pages: 6
Receipt Number : 08-0076062
District:
1000
Recorded:
At:
08/08/2008
09:57:14 AM
LIBER: D00012560
PAGE: 887
Section: Block: Lot:
090.00 04.00 007.000
EXAMINED AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
Exempt
Page/Filing $18.00 NO Handling $5.00
COE $5.00 NO NYS SRCHG $15.00
TP-584 $0.00 NO Notation $0.00
Cert. Copies $7.50 NO RPT $30.00
Fees Paid $80.50
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
Judith A. Pascale
County Clerk, Suffolk County
Exempt
NO
NO
NO
NO
Number of pages
This document will be public
record. Please remove all
Social Security Numbers
prior to recording.
Deed / Mortgage Instrument
SoutlBmJ~]~Tewn
Deed / Mortgage Tax Stamp
Recording / Filing Stamps
3 I FEES
Page / Filing Fee
Handling
5. 00
TP-584
Notation
EA-52 17 (County) Sub Total
EA-5217 (State)
R.P.T.S.A. ~,~1/~ ~__~ L~ ~
Comm. of Ed. 5. 00
Affidavit
Certified Copy ~
NYS Surcharge 15. 00 Sub Total ",~--'), ~,,~-_)
Other
GrandZotal 80 .50
4 I Dist.
Real Prop{
Tax Servic
Agency
Verificatie
I
1000 09000 0400 007000
6
8
Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
Mail to: Judith A. Pascale, Suffolk County Clerk
310 Center Drive, Riverhead, NY 11901 co. Name
www. suffolkcountyny, gov/clerk Title #
This page forms part of the attached
Mortgage Amt.
l. Basic Tax
2. Additional Tax
Sub Total
Spec./Assit.
or
Spec./Add.
TOT. MTG. TAX
Dual Town __ Dual County __
Held for Appointment
Transfer Tax
Mansion Tax
The property covered by this mortgage is
or will be improved by a one or two
family dwelling only.
YES or NO
If NO, see appropriate tax clause on
page # __ of this instrument.
5 Community Preservation Fund
Consideration Amount $
CPF Tax Due $
Improved
Vacant Land
TD
TD
TD
Information
Suffolk County Recording & Endorsement Page
1
--~>C ~ (2~ '~-'l (~¢"3 made by:
(SPECIFY TYPE OF INSTRUMENT)
The premises herein is situated in
SUFFOLK COUNTY, NEW YORK.
TO In the TOWN of
In the VILLAGE
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(over)
IMPORTANT NOTICE
If the document you've just recorded is your SATISFACTION OF MORTGAGE, please be aware of
the following:
If a portion of your monthly mor,tgage payment included you,t property taxes, *you will now need to
contact your local Town Tax Redeiver..so that V0u uta¥'be billed directly for all future property tax
statements , ~ ~
Local property taxes are payable twice a year: on or before January 10"' and on or before May
Failure to make payments in a timely fashion could result in a penalty.
Please contact your local Town Tax Receiver with any questions regarding property tax
payment.
Babylon Town Receiver of Taxes
200 East Sunrise Highway
North Lindenhurst, N.Y. 11757
(631) 957-3004
Riverhead Town Receiver of Taxes
200 Howell Avenue
Riverhead, N.Y. 11901
(631) 727-3200
Brookhaven Town Receiver of Taxes
One Independence Hill
Farmingville, N.Y. 11738
(631) 451-9009
Shelter Island Town Receiver of Taxes
Shelter Island Town Hall
Shelter Island, N.Y. 11964
(631) 749-3338
East Hampton Town Receiver of Taxes
300 Pantigo Place
East Hampton, N.Y. 11937
(631) 324-2770
Smithtown Town Receiver of Taxes
99 West Main Street
Smithtown, N.Y. 11787
(631) 360-7610
Huntington Town Receiver of Taxes
100 Main Street
Huntington, N.Y. 11743
(631) 351-3217
Southampton Town Receiver of Taxes
116 Hampton Road
Southampton, N.Y. 11968
(631) 283-6514
Islip Town Receiver of Taxes
40 Nassau Avenue
Islip, N.Y. 11751
(631) 224-5580
Southold Town Receiver of Taxes
53095 Main Street
Southold, N.Y. 11971
(631) 765-1803
Sincerely,
Judith A. Pascale
Suffolk County Clerk
87/89/2888 87:55 7656641 BOARD OF TRUSTEES PAGE 0i
~DECLARATION OF COVEN.~NT~ AND RESTRICTION,,;
' DECLARATION mad. e, this '.~% of~-~ 200~, by [PROpERTY'-
OWNER], now ,esidin?a~t_~¢~.,~.t~ .~ -", af~d ,having
-,, ~4',~ as owners as [tenants in
common/other fo~ of joint ownemhip, if applicable], hereinafter collectively
referred to as the "Declarant".
WITNESSETH:
WHEREAS, the Declarant has title to certain land situate, lying and being
at~, Town of Southold, Suffolk County, New York, SCTM ¢1000- ~
0~--~_~,~said land being more particularly described in Schedule A which is attached
hereto; and
WHEREAS, the Property is situated in or adjacent to lands activities upon
which are regulated by the Town Of Southold Board of Trustees pursuant to
Chapter 275 of the Town Code of the Town of Southold, as may be amended,
and various activites conducted upon the property are subject to the jurisdiction,
regulation and approval or disapproval of the Trustees prior to being conducted;
WHEREAS, the Declarant has applied to the Town o.f Southol~Board
Trustees for a Wetland Permit for approval to 0',~> ~)~;~cJ~.~ on
the property described in Schedule A a_nd known as SCT~A w. n,~,~°'~b-Q-~ .
depicted on the plans prepared by _ last dated _0~\'3-'~); and
WHEREAS, the Town of Southold Board of Trustees, as conditions for the
issuance of such Wetland Permit, required certain covenants and restrictions be
placed on the property as shown on the aforesaid plans.
07/09/2008 07;55 7656641 BOARD OF TRUSTEES PAGE 02
NOW, THEREFORE, this Declarant witnesseth:
That Declarant, for the purpose of carrying out the intentions expressed
above does hereby make known, admit, publish, covenant and agree that the
said property herein described shall hereafter be subject to the following
covenants which shall run with the land and shall be binding on all purchasers
and holders of said premises, their heirs, successors, and assigns, to wit:
The grant of a Wetland Permit for the construction of a
~--~,~> ~2.c~g. shall be conditioned upon the [INSERT
CONDITION OF PERMIT, e.g., installation of drywells to contain
roof run-off on the property] as shown on the above-referenced
plan and identified as SCTM No. 1000- , within perpetuity.
2. The grant, of a Wetland Permit for the construction of a
~ ~V.. shall be conditioned upon the [INSERT
CONDITION OF PERMIT, e.g,, installation of a continuous line of
silt fence backed by hay bales, maintained throughout the period of
construction on the property] as shown on the above-referenced
plan and identified as SCTM No. 1000-.Ot~).-'-~-¥'~
3. These covenants and restrictions can be modified only at the
request of the then owner of the premises with the approval of the
Town of Southold Board of Trustees after a duly noticed public
meeting. Adjoining property owners shall be entitled to notice of
such public meeting by publication or as otherwise deemed
87/89/2888 87:55 7656641 BOARD OF TRUSTEES PAGE 83
sufficient by the Board of Trustees but their consent to such
modification shall not be required.
4. It is the responsibility of any party having any right, title or interest
in the Property to consult Chapter 275 of the Town Code of the
Town of Southold, as may be amended, and to obtain from the
Town of Southold Board of Trustees review and such approvals as
may be required by Chapter 275 for activities regulated therein on
the Property.
5. Declarant grants the continuing right in perpetuity to the Town of
Southold or any of its designated representatives to enforce the
conditions and restrictions of the covenants.
THE FOREGOING Covenants and restrictions shall bind the Declarant, its
heirs, successors and assigns, and any and all person or persons who shall
succeed to the ownership of said premises of any part thereof by transfer or
otherwise.
IN WITNESS WHEREOF, the Declarant has duly executed this
Declaration the day and year first above written. ~
STATE OF NEW YORK )
) SS,:
COUNTY OF SUFFOLK)
On this ,~r'(Jday of ~¢_(2~, in the year 20(~, before me personally
appeared ~ known to me or proved to me on the basis of
07/09/2008 07:55 7656641 BOARD OF TRUSTEES PAGE 04
satisfactory evidence to be the individual whose name is subscribed to the within
instrument and acknowledged to me that he executed the same in his capacity
and that by his signature on the instrument, the individual, or the person upon
behalf of which the individual acted, executed th instrum nt.
,/l~)otary Public
Qualified In Queen~ ~ ,
r ~ :,. ', No. 02KE4849551
4
ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon
erected, situate, lying and being at Southold, Town of Southold. County of Suffolk and State of
New York known and designated as Lot 69 as shown on a certain map entitled *Map of Cedar
Bea¢Ix Park~ and filed in the Office or' thc Clerk of the County or' Suffolk on December 20,
1927 as Map Nmuber 90, being more particularly bounded and described as follows:
BEGINNING at the corner formed by the intersection of th~ easterly side of Oakwood Drive
and the southerly side of Shady Lane;
RUNNING THENCE along the easterly side of Oakwood Drive, South 29 degrees 38 minutes
50 seconds East 90.00 feet:
THENCE North 70 degrees 21 minutes 10 seconds East 166.41 feet to the high water mark of
Sandpiper Basin;
THENCE along the aforesaid high water mark along a tie course of North 21 degrees 58
minutes 07 seconds West 88.71 feet to the point where the southerly side of Shady Lane
intersects the high water nmrk of Sandpiper Basin as shown on the aforesaid map;
THENCE along the southerly line of Shady Lane. South 70 degrees 21 minutes 10 sL'conds
West 178.45 feet to the easterly side of Oakwood Drive at the point or place of BEGINNING.
BEING AND INTENDED TO BE the same premises conveyed to the party of the first part by
deed from Bruce Beaney and John Kelly. dated Januarb, 20, 1995, and recorded February 1.
1995. in the Oftice of the Suffolk County Clerk in Liber 11712. Page 997.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hall
53095Route 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
#0335C
Date: July 18, 2008
THIS CERTIFIES that the construction of a second-story addition and deck,
installation of Cutters, leaders and dr/wells on dwelling, 10' non-turf buffer, fish pond with
fencing, removal of the wire fencing parallel to the water
At 595 Oalkand Court, Southotd, New York
Suffolk County Tax Map # 90-4-7
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated 09/19/06 pursuant to which Trustees Permit It 6468 Da~ed 10/18/06.
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 a second-story addition and deck, installation of gutters, leaders and
dr/wells on dwellinR, 10' non-turf buffer, fish pond with fencing, removal of the wire fencing
parallel to the water
The certificate is issued to ROBERT SOMERVILLE owner of the
aforesaid property.
Authorized Signature
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
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
st
1 day of construction
¼ constructed
Project complete, compliance inspection."})'.~}(~ ~
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
May 16, 2007
BOARD OF TOWN TRUSTEES
TOWN OFSOUTHOLD
Mr. Robert Somerville
43 Kenwood Rd.
Garden City, NY 11530
RE: 595 OAKWOOD COURT, SOUTHOLD
SCTM#90-4-7
Dear Mr. Somerville:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wed, May 16, 2007:
RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to
Permit #6468 to move the existing fish pond to the south side of the dwelling, 3' off the
proposed deck, and install a new fence around the pond, and as depicted on the survey
received on May 2, 2007.
This is not a determination from any other agency.
If you have any questions, please call our office at (631) 765-1892.
Sincerely,
President, Board of Trustees
JFK:lms
05/02/2807 07:36 7656641
BOARD OF
PAGE 02
James F. King, President
J~ll M. Doherty, Vice-PTe~ident
Peg~ i. Dickerson
Dave Bergen
$ohn Holzapfel
Town Hall
.53095 Route 25
P.0. Box 1179
Southold., New York 11971-09§9
Telephone (~3]) 765-18'92
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
APPLICATION FOR AN .~AVIEN-DI~'IENT TO A WETLAND. PERMIT _
DATE '~-"o'~.'>~'~ ~''-~
OVCNBR ~-'i'~>(~'7 q %'~w'~r~\~k'% PHONE
AGENT PHONE
ADDRESS
PROPERTY LOCATION
TAXM NO.
I/We request an Amendment to Permit
COUNTY CLERK'S OFFICE
STATE OF NEW YORK
COUNTY OF SUFFOLK
CC #: C08-14116
I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court
of Record thereof do hereby certify that I have compared the annexed with the original
DECLARATION
recorded in my office on08/08/2008 under Liber D000'12560 and Page 887 and,
that the same is a true copy thereof, and of the whole of such original.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County
and Court this 0810812008
SUFFOLK COUNTY CLERK
JUDITH A. PASCALE
SEAL
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DECLARATION
Number of Pages: 6
Receipt Number : 08-0076062
District:
1000
Recorded:
At:
08/08/2008
09:57:14 AM
Page/Filing
COE
TP-584
Cert. Copies
Received the Following Fees For Above Instrument
Exempt Exempt
$18.00 NO Handling $5.00 NO
$5.00 NO NYS SRCHG $15.00 NO
$0.00 NO Notation $0.00 NO
$7.50 NO RPT $30.00 NO
Fees Paid $80.50
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
Judith A. Pascale
County Clerk, Suffolk County
LIBER: D00012560
PAGE: 887
Section: Block: Lot:
090.00 04.00 007.000
EXAMINED AND CHARGED AS FOLLOWS
Number of pages ~.~
This document will be public
record. Please remove all
Sociai Security Numbers
prior to recording.
Deed / Mortgage Instrument
Deed / Mortgage Tax Stamp
31
Page / Filing Fee
Handling
5. 00
FEES
TP-584
Notation
EA-52 17 (County)
Sub Total
EA-5217 (State)
R.P.T.S.A.
Comm. of Ed.
Affidavit
Certified Copy
NYS Surcharge
Other
41 Dist.
Real Prop~
Tax Servic
Agency
Verificatio
5. 00
15. 00 SubTotal
6
GrandTotal 80 .~.~O
I
lO00 OgO00 0400 007000
Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
RECORDED
200:3 ~L:9 08 09:57:14 ~H,
.Jud~, !.h Fi,'. PasL-a!e
CL~RK OF
SUFFOLK COUNT'.,!
L ~:,000!2560
Recording / Filing Stamps
Mortgage Amt.
1. Basic Tax
2. Additional Tax
Sub Total
Spec./Assit.
or
Spec./Add.
TOT. MTG. TAX
Dual Town __ Dual County __
Held for Appointment
Transfer Tax
Mansion Tax
The property covered by this mortgage is
or will be improved by a one or two
family dwelling only.
YES or NO
If NO, see appropriate tax clause on
page # __ of this instrument.
5
Community Preservation Fund
Consideration Amount $
CPF Tax Due $
Improved
Vacant Land
TD
TD
Mail to: Judith A. Pascale, Suffolk County Clerk I 7 I Title Company Information
310 Center Drive, Riverhead, NY 11901[ Co. Name
www. suffolkcountyny, gov/clerk I Title #
Suffolk County Recording & Endorsement Page
This page forms part of the attached
(SPECIFY TYPE OF INSTRUMENT)
The premises herein is situated in
SUFFOLK COUNTY, NEW YORK.
In the TOWN of
In the VILLAGE
or HAMLET of .
made by:
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(over)
87/89/2888 87:55 765664! BOARD OF TRUSTEES PAGE
_D_ECLARATION OF COVENANTS AND RESTRICTION~
DECLARATION made th s ~'~'"~'~*. ~.£~ ..... .O , -- .~.
, ~ uoZ u, V~',.'%, zuu'~, Dy [PROPERTY-~'
.. ....... -., -
wvv~=Kj, now residing at ~,_c~.,~.~, ~..\~[ . ~ ~ _ .
an office at - ~ ~
,, ~ac~ as ownem as [tenants in
common/other form of joint ownership, if appli~ble], hereinafter colle~ively
referred to as the "Declarant".
WITNESSETH:
WHEREAS, the Declarant has title to certain land situate, lying and being
at ~C ~,~-'~ , Town of $outhold, Suffolk County, New York, SCTM #1000-._i
~--~'-,~said land being more particularly described in Schedule A which is attached
hereto; and
WHEREAS, the Property is situated in or adjacent to lands activities upon
which are regulated by the Town of Southold Board of Trustees pursuant to
Chapter 275 of the Town Code of the Town of Southold, as may be amended,
and various activites conducted upon the property are subject to the jurisdiction,
regulation and approval or disapproval of the Trustees pdor to being conducted;
WHEREAS, the Declarant has applied~to th~ Town o% Southol~ Board .~q> ~, ~
Trustees for a Wetland Permit for approval to ~c,t> ~.~.~L- on
the property described in Schedule A and known es SCTM #1000q~3"'4~'a~nd as
depicted on the plans prepa~-~re~y~::~ ~'~'la~st d . .
atee - \ ~\-',.-~,,o~; and
WHEREAS, the Town of Southold Board of Trustees, as conditions for the
issuance of such Wetland Permit, required certain covenants and restrictions be
placed on the property as shown on the aforesaid plans.
07/09/2008 87:55 755GG41 BOARD OF TRUSTEES PAGE 02
NOW, THEREFORE, this Declarant witnesseth:
That Declarant, for the purpose of carrying out the intentions expressed
above does hereby make known, admit, publish, covenant and agree that the
said properly herein described shall hereafter be subject to the following
covenants which shall run with the land and shall be binding on all purchasers
and holders of said premises, their heirs, successors, and assigns, to wit:
1. The grant of a Wetland Permit for the construction of a
~"-~x~c> ~-~.~,. shall be conditioned upon the [INSERT
CONDITION OF PERMIT, e.g., installation of drywells to contain
roof mn-off on the property] as shown on the above-referenced
plan and identified as SCTM No. 1000-__ , within perpetuity.
2. The gran. J. ofa Wetland Permit for the construction of a
~ ~r'-~C % shall be conditioned upon the [INSERT
CONDITION OF PERMIT, e.g,, installation of a continuous line of
silt fence backed by hay bales, maintained throughout the period of
construction on the property] as shown on the above-referenced
plan and identified as SCTM No. 1000..Ot~.--"'~-'~
3. These covenants and restrictions can be modified only at the
request of the then owner of the premises with the approval of the
Town of Southold Board of Trustees after a duly noticed public
meeting. Adjoining property owners shall be entitled to notice of
such public meeting by publication or as otherwise deemed
PAGE 03
sufficient by the Board of Trustees but their consent to such
modification shall not be required.
4. It is the responsibility of any party having any right, title or interest
in the Property to consult Chapter 275 of the Town Code of the
Town of Southold, as may be amended, and to obtain from the
Town of Southold Board of Trustees review and such approvals as
may be required by Chapter 275 for activities regulated therein on
the Property.
5. Declarant grants the continuing dght in perpetuity to the Town of
Southold or any of its designated representatives to enforce the
conditions and restrictions of the covenants.
THE FOREGOING covenants and restrictions shall bind the Declarant, its
heirs, successors and assigns, and any and all person or persons who shall
succeed to the ownership of said premises of any part thereof by transfer or
otherwise.
IN WITNESS WHEREOF, the Declarant has duly executed this
Declaration the day and year first above written.
STATE OF NEW YORK )
)
COUNTY OF SUFFOLK)
On this __~Jday of ~z~ , in the year 20cji, before me personally
appeared ~ known to me
or proved to me on the basis of
87/89/2868 07:55 7656641 BOARD OF TRUSTEES PAGE 84
satisfactory evidence to be the individual whose name is subscribed to the within
instrument and acknowledged to me that he executed the same in his capacity
and that by his signature on the instrument, the individual, or the person upon
behalf of which the individual acted, executed t~n~
,/Notary Public
uumlned in Oueenl r~une/ . ,:
No. 02KE4849551
4
ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon
erected, situate, lying and being at Southold. Town of Southold, County of Suffolk and State of
New York knows and designated as Lot 69 as shown on a certain map entitled "Map of Cedar
Beach Park" and filed in the Office of thc Clerk of the County of Suffolk on December 20,
1927 as Map Nmnber 90, being more particlllarty bomlded and described as follows:
BEGINNING at the coruer fornted by the intersection of th~ easterly side of Oakwood Drive
and the southerly side of Shady Lane;
RUNNING THENCE along the easterly side of Oakwood Drive, South 29 degrees 38 minutes
50 seconds East 90.00 feet:
THENCE North 70 dc~ces 21 minutes 10 seconds East 166.41 feet to the high water mark of
Sandpiper Basin;
THENCE along the aforusaid high water mark along a tie course of North 21 degrees 58
minutes 07 seconds West 88.71 fees to fl~e point where the southerly side of Shady Lane
intersects the high water mark of Sandpiper Basin as shown on One aforesaid map;
THENCE along the southerly line of Shady Lane, South 70 degrees 21 minutes 10 seconds
West 178.45 feet to the easterly side of Oakwood Drive at the point or place of BEGINNING.
BEING AND IN]ENDED TO BE the same premises convoyed to the party of the first part by
deed from Bruce Beaney and John Kelly, dated January 20, 1995, and recorded February 1.
1995, in the Office of the Suffolk County Clerk in Liber 11712. Page 997,
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
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
¼ constructed
v/' Project complete, compliance inspection.
BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD, NEW YORK
PERMIT NO. 6468 DATE: October 18~ 2006
ISSUED TO: ROBERT SOMERVILLE
PROPERTY ADDRESS: 595 OAKLAND COURT~ SOUTHOLD
SCTM#90-4-7
AUTHORIZATION
Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of
Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on
October 18, 2006, and in consideration of application fee in the sum of $250.00 paid by Robert & Susan
Somerville and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of
Trustees authorizes and permits the following:
Wetland Permit to construct a second-story addition to the rear of the dwelling
and deck at rear of dwelling, with the condition drywells and gutters are installed to
contain the roof run-off, a 10' non-turf buffer is installed landward of the wetlands,
complete removal of the wire fence parallel to the water and within the 35' rear yard
setback, and as depicted on the plans prepared by Boulevard Planning P.C. dated
September 12, 2006.
IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed,
and these presents to be subscribed by a majority of the said Board as of this date.
TERMS AND CONDITIONS
The Permittee Robert & Susan Somerville, residing at 595 Oakwood Court, Southold, NY, as
part of the consideration for the issuance of the perrmt does understand and prescribe to the following:
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 Southold.
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.
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.
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.
That there will be no unreasonable interference with navigation as a result of the work
herein authorized.
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.
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.
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 restriction to the deed of the subject parcel. Such evidence shall be
provided within ninety (90) calendar days of issuance of this permit.
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.
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
October 18, 2006
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Mr. Robert Lehnert
Boulevard Planning, P.C.
32645 Main Rd.
Cutchogue, NY 11935
RE:
ROBERT & SUSAN SOMERVILLE
595 OAKLAND COURT, SOUTHOLD
SCTM#90-4-7
Dear Mr. Lehnert:
The Board of Town Trustees took the following action during its regular meeting held on
Wed., October 18, 2006 regarding the above matter:
WHEREAS, Boulevard Planning P.C. on behalf of ROBERT & SUSAN SOMERVILLE
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 September 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, the Board of Trustees has furthered Policy 6 of the Local Waterfront
Revitalization Program to the greatest extent possible through the imposition of the
following Best Management Practice requirements: the installation of gutters and
drywells, and a 10' non-turf buffer landward of the wetlands, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on October 18, 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 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 for the mitigating factors and based upon the Best Management
Practice requirement imposed above, the Board of Trustees deems the action to be
Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5
of the Southold Town Code, and,
RESOLVED, that the Board of Trustees approve the application of ROBERT
SOMERVILLE to construct a second-story addition to the rear of the dwelling and deck
at rear of dwelling, with the condition drywells and gutters are installed to contain the
roof run-off, a 10' non-turf buffer is installed landward of the wetlands, complete removal
of the wire fence parallel to the water and within the 35' rear yard setback, and as
depicted on the plans prepared by Boulevard Planning P.C. dated September 12, 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,
Jame F~King
President, Board of Trustees
JFK/Ims
Jaraes F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Town Hall
53095Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone(631) 765-1892
Fsx(631) 765-6641
TO:__~ 0 (~L.{
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Please be advised that your application dated
reviewed by this Board at the regular meeting of
following action was taken:
has been
and the
Application Approved (see below)
Application Denied (see below)
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:
TOTAL FEES DUE: $ ~), 0~5
BY: James F. King, President
Board of Trustees
Telephone
(631) 765-1892
Town Rail
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., October
11,2006, the following recommendation was made:
Moved by Don Wilder, seconded by James Eckert, it was
RESOLVED to SUPPORT the Wetland Permit application of ROBERT & SUSAN
SOMERVILLE to construct a second-story addition to rear of dwelling and deck at rear
of dwelling.
Located: 595 Oakland Court, Southold. SCTM#90-4-7
Inspected by: Don Wilder, James Eckert
The CAC Supports the application with the Condition of a 20' non-turf buffer, a pervious
deck, and the deck is not within 100' of the wetlands.
Vote of Council: Ayes: All
Motion Carried
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Town Hail
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
Date/Time:
1. Bouleva'rd Planning on behalf of ROBERT & SUSAN SOMERVILLE
requests a Wetland Permit to construct a second-story addition to rear of
dwelling and deck at rear of dwelling. Located: 595 Oakland Court,
Southold. SCTM#90-4-7
_xT_~alOtwf area to be impacted:
ater Wetland Freshwater Wetland Sound Front Bay Front
Distance of proposed work to edge of above:
Par/~ of Town Code proposed work falls under:
~_~_Chapt.97 Chapt. 37 other
Type of Application:
h~fo needed:
Wetland Coastal Erosion Amendment Administrative
__Emergency
Modifications:
Conditions:
Present Were: ~J.King '-ffJ.J.Doherty ~.Dickerson__
Other: ~,
~D. Bergen
Mailed/Faxed to:
Date:
PLANNING BOARD MEMBERS
JERILYN B. WOODHOUSE
Chair
KENNETH L. EDWARDS
MARTIN H. SIDOR
GEORGE D. SOLOMON
JOSEPH L. TOWNSEND
PLANNING BOARD OFFICE
TOWN OF SOUTHOLD
MAILING ADDRESS:
P.O. Box 1179
Southold, NY 11971
OFFICE LOCATION:
Town Hall Annex
54375 State Route 25
(cot. Ma~n Rd. & Youngs Ave.)
Southold, NY
Telephone: 631 765-1938
Fax: 631 765-3136
To: Jim King, President ' ~' ~ ~'
Town of Southold Board of Trustees
From: Mark Terry,
Senior Environmental Planner
LWRP Coordinator
Date: October 16, 2006
Re:
Proposed Wetland Permit for ROBERT & SUSAN SOMERVILLE
SCTM#1000-90-4-7
Boulevard Planning on behalf of ROBERT & SUSAN SOMERVILLE requests a Wetland Permit to construct a
second-story addition to rear of dwelling and deck at rear of dwelling. Located: 595 Oakland Court, Southold.
SCTM#90-4-7
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of
Town Lode and the Local Waterfront Revitalization Prom'am tLWRP~ t,^n~., o.__~ ...... Southold
information provided on the LWRP ' o- ~ j ....~y otanumus. /~asea upon the
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
1. Comply with Trustee regulations and recommendations as set forth in Trustee permit
conditions.
The ro osed distance of the new residence o en deck is located 79.8 feet from a tidal wetland hi h water
~e uired ursuant to Cha ter 275-3. Findin s' ur ose'
'urisdiction. setbacks. Please re uire that the a licant amend the a lication to meet the above olic.
In addition~ note that the plans do not show toooeraph¥, floodplains or drywells to control surface runoff.
Pursuant to Chapter 268, thc Board of Trnstees shall consider this recommendation in preparing its wri~en
determination regarding thc consistency of the proposed action.
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
Office Use Only
Coastal Erosion Permit Application
,,,"'"Wetland Permit Apphcation __ Administrative Permit
Amendmentfrra~s f~r/Ext ension
e"Received Applica~.~.'~
~'~eeived Fee:$~
~n~leted Application 'f ll¥1~& r ....
Incomplete
__SEQRA Classification:
Type I Type II Unlisted
Coordination:(date seno S/P ] 9 2006
,."LWfRP Consistency~Form_~/~
'~L'e'AC Referral Sent:
,~,~ate of Inspection:
Receipt of CAC Report:
~ad Agency Determination:
Technical Review:
~------'~blic Hearing Held:~
Resolution:
Phone Number:( )
Suffolk County Tax Map Number: 1000- ~0 - ~ - 7
Property Location: ff'~3"' 04 t]f/~r/~
(provide LILCO Pole #, distance to cross streets, and location)
(If applicable) -
Address: 32ff/5 /~t~/0
Phone:~__
Board of Trustees Applic~ion
GENERAL DATA
Land Area (in square fect):.
AreaZomg:. '~-
Previous use of property:
at,nda ~e ofprorerty:
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?
,)( No_. Yes
If yes, provide explanation:
Project Description (use attachments
Pr ~,~ ~,l ,~ ~
Board of Trustees Appli~ion
WETLANDfrRUSTEE LANDS APPLICATION DATA
u oseoftheproposedope tio
Area of wetlands on lot:
square feet
Percent coverage of lot: t~ %
Closest distance between nearest existing structure and upland
edge of wetlands: / t94, ~' feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 7 ~, ,~ feet
Does the project involve excavation or filling?
No ~ Yes
If yes, how much material will be excavated? 3 ~..,~ 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, on the Wetlands and tidal waters of the town that may result by
mason of such proposed operations (use attachments if appropriate):
,,,11
-
Board of Trustees Apl~lic~ion
COASTAL EROSION APPLICATION DATA
Purposes ofproposed activity: ~)4~/t~ga~ J /~//~'~'a
Are wetlands present within 1 O0 feet of the proposed activity?
No X Yes
Does the project involve excavation or filling?
No X Yes
If Yes, how much material will be excavated?3~,...g (cubic yards)
How much material will be filled? t~ (cubic yards)
Manner in which material will be removed or deposited: ~/f~t~ s*/r ~' ~
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
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
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
In thc Matter of thc Application of
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
I, t~t~./ ~ ~//~. ¢ _, residing at_ ~.~f~" ,/~,,O,o
being duly sw~~
That on the/O day of $~ ~ ,200~, I personally posted the property known as
by placing the Bo~d of Trustees official poster where it c~ e~ily be seen, ~d that I have
checked to be s~e the poster has remained in place for ei~t days phor to ~e date of '
he~ng. Date of heating noted thereon to be held ~, I~ a * ~ ~e pubhc
Dated:
Sworn to before me this
lic
'~z ~'
PROOF OF MAII,ING OF NOTICE
ATTACH CERTIFIED MAiL RECEIPTS
Name: Address:
STATE OF NEW YORK
COUNTY OF SUFFOLK
~00~'~" ~,Oe, e'~ , residing at ~t~'4~' m~,~ ~ '
~~ , hei~ ~y ~w~ d~oses ~d sa~ ~at on the
~ 'day of ~t ~ ,20 a~, d~onent m~l~ ~ ~ ~y o?~ ~otice
set foffi~ in ~e Bo~d of T~te~ Application, ~r~t~ to each of ~e abo~e nm~
persons at ~e ad~ms~ set opposite there r~p~five ~es; that ~e ~&~ses set
opposite ~e n~ ofs~d pemom ~e ~e ad~ ofs~d pemom ~ shem on ~e c~ent
~s~sment m~l of~e To~ ~Sou~old; ~at s~d Nofi~ w~e m~l~ at ~e U~t~ States Post
~ffiee at ~ g~ , ~at s~d Nofi~ wore m~l~ to ~ch ofs~d peseta by
{ceffifi~) (re~stor~) m~l
Sworn to before mo
Dayof ~ ]~
:
PROJECT ID NUMBER
PART 1 - PROJECT INFORMATION
1. APPLICANT / SPONSOR
617.20
APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
( To be completed by Applicant or Project Sponsor)
2. PROJECT NAME
cou.,
3.PROJECT LOCATION:
4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map
SEQR
IS PROPOSED ACTION: [] New [~ExpansJon [-'-]ModiflcatJon/alteration
6. DESCRIBE PROJECT BRIEFLY:
AMOUNT OF LAND AFFECTED:
Initially ,.~-- acres Ultimately ~.~'- acres
8. WILL PROPOSED ACTION COMPLY VVJTH EXISTING ZONING OR OTHER RESTRICTIONS?
[~Yos [] No If no. describe briefly:
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.)
[]Residential r--']lndustrial j'~Commercial [~]Agriculture []Park/Forest/OpenSpace []Other(describe)
AGENCy10' DOES(Federal.ACTION StateINVOLVEor Local)A PERMIT APPROVAL. OR FUNDING. NOW OR ULTIMATELY FROMi,~ANY~OTHER7'~GOVE~';MENTAL
I'~Yes L---"~NO Ifyes, list agency name and permit/approval:
11. DOES ANY ASPECT OF ~E ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~Yes ~No If yes. list agen~ name and ~it / approval:
12. AS A PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
RE ULT
[~Yes ~No OF
I CERTIFY THAT~MATION PROVIDED ABOVE~RUE TO THE BEST OF MY KNOWLEDGE
~ the action is a Costal Area. and you are a state agency,
complete the Coastal Assessment Form before proceeding with this assessment
PART II - IMPACT ASSESSMENT (To be completed by Lead Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF.
WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative
declaration may be superseded by another involved agency.
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible)
C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal,
potsntial f~r erosion, drainage or flooding problems? Explain briefly:
C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhcod character? Explain bdefly:
C3. Vegetation or fauna, fish, shellfsh or wildlife sl:~c~e$, significant habit~t~, or thraatenad or endangerad s~ies? Exptai~"l~rtefly:
I
A commun s exlsfin I ns or oals as offi all ' '"' ' ~
C4. Jty' ' ' g p a g ci y adopteri, or a change in use or intensity of use of land or other natural resources? Explain briefly: .....
C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:
C6. Long term, short term, cumulative, or other effects not identified in CI-C57 Explain briefly:
C7. Other impacts Iincludin~ chan~es in use of either quantit~ or b/pc of ener~l¥? Explain briefly: ~"
D. VV~LL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAl
ENVIRONMENTAL AREA (CEAI? (If }res, explain brier},:
E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain:
r--lYes r-I.o
L
PART III - DETERMINATION OF SIGNIFICANCE (To be comptated by Agency)
INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantia~~iarge~impor~ant~r~therwisesigni~cant~ 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
suffident detail to show that all relevant adverse impacts have been ittentified and adequately addressed. If quesfion d of part ii was checked
yes, the determination of significance must evaluate the potantial impact of the proposed action on th e environmental characteristics of the CEA.
Check this box if you have identified one or more potentlarly large or significant adverse impacts which MAY occur. Then proceed directly to the FULl
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 actior
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
Title of Responsible Officer
Pdnt or Type Name of Responsible Officer in Lead Agency
Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer)
Board of Trustees ApplicOon
AUTHORI ZA_q-~/ON
(where the applicant is not the owner)
(print owner of property)
residing at ~ /l/m~l~ /~;&~
(mailing address)
O~Jtr ~ ~v& ]/~/ do hereby authorize
(Agent)
~/~V~m P/~)~ F~ to apply for permit(s) fro~ the
Southol~ ~f Town Trustees on my behalf.
~~r ~gnature )
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
Thc Town of Southold's Code of Ethics omhibits conflicts ofintersst on the ~yart of town officers and emolovees. The uurcoso of
~is form is to orovide information which can ale~' tbe town of ~ossible conflicts of interest and allow it to ~ke whatever action is
(Last name, fu~t name,~r~iddle thltial, unless you are appiyiag in the name of
someone else or other entity, such as a company. If so, indicate thc other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Variance Trustee
Changn of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Otl~r
(If "Other", name thc activity.)
Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee
of thc Town of Southold? "Relationship" includes by blood, marriagn, or bus'mess interest. "Business interest" means a business,
including a partoership, 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 more than 5% of the shares.
YES NO
lfyou answered "YES", complete thc balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title 6r position of that person
Describe thc relationship between yourseff{thc applicant/agent/representative) and the town officer or employee. Either check
the appropriate line A) through D) and/or describe in the space provided.
Thc tom officer or employee or his or her spouse, sibling, parent, or child is (check all that apply):
A) the owner of g~ater than 5% of the shares of the corporate stock of the applicont
(wben the applicant is a corporation);
__~B) thc legal or beneficial owner of any interest in a non-corporate entity (when the
applicant is not a corporation);
__.C) an officer, diractor, pasmei', or employee of the applicant; or
___D) the actual applicant.
DESCRIPTION OF RELATIONSHIP
Form TS I
Signature
Print Name
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 significant
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 detail~ listing both supporting and non-
suooorfin~ facts. If an action cannot be certified as consistent with the LWRP Policy standards and
conditions, it shall not be undertaken.
A copy of the LWRP is available in the following places: online at the Town of Southold ' s
website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
scm# qf 4 7
The Application has been submitted to (check appropriate response):
Town Board [] Planning Board ~ Building Dept. ~ Board of Trustees .~
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 transaction)
(b) Financial assistance (e.g. grant, loan, subsidy)
(c)
Nature and extent of action: tO /
-
Permit, approval, license, certification:
Location of action:
Site acreage:
Present land use:
35-
Present zoning classification: ~'" 4 t9
If an application for the proposed action has been filed with the Town of Southold agency, the following
information shall be provided:
(a) Name of applicant: /~/~
(b) Mailing address:
(c) Telephone number: Area Code ().
(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, wkich 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 Southoid 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 F~ No ~-~ Not Applicable
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 [~ No ~ Not Applicable
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southoid. See
LWRP Section IH - Policies Pages 6 through 7 for evaluation criteria
Yes ~ No ~ Not Applicable
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 HI - 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 Southoid. See LWRP Section III
- Policies Pages 16 through 21 for evaluation criteria
Yes [] No ~)~Not Applicable
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish ~nd Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22
through 32 for evaluation criteria.
Yes No Not Applicable
Attach additional sheets if necessary
Policy 7. Protect and improve 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 III - 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 ~ Not Applicable
Attach additional sheets if necessary
WORKING COAST pOLICIES
Policy 10. Protect Soutllold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria.
~ Yes E-] 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 III - Policies; Pages
62 through 65 for evaluation criteria.
[--] Yes [] No t~ 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 ~] NOt Applicable
.\
i,OT (~
SURVEY OF
LOT 69
MAP OF
CEDAR BEACH PARK
FILE No. 90 FILED DECEMBER 20, 1927
$ITUA TED A T
BAYVIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORI~
S.C. TAX No. 1000-90-04-07
1" 20'
SCALE =
AUGUST 19, 1998
AUGUST 30, 2001 UPDATE SURVEY
AREA = 15,282.73 sq. ft. 0.351 ac.
CERTIFIED TO:
FIRST AMERICAN TITLE INSURANCE
OF NEW YORK
ROBERT C. SUMERVILLE
SUSAN C. SUMERVILLE
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN &RE NOT OU,~R&NTE£D.
Joseph A Ingeg
· no
Land Surveyor
~tle Sun, eys -- Subdi~'sions -- .~e Pfons -- Coastruct/on Lo)
PHONE (651)727-2090 x (651)727-17~
OFFICES LOCATED AT M~41UNG ADDRESS
1580 EO~NOK[ AVENUE P.O. Box 19.31
Coasffuction Loyout
Fox (651)727-1727
LO'~ (~
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SITE AND ZONING DATA
BEDDING DETAIL
First ~tak~ Tou~ard __
Pr~vlou~l~ Lall~
ANCHORING DETAiL
PERIMETER HAYBALE DETAIL
LEGEND
(CATCH DADIN)
NLP - N~W LEACHING PC,DL
ADDITIONS
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AT THE
SOMERVILLE
RESIDENCE
595 OAKWOOD DRIVE
SOUTHOLD, NY
S.C.T.M. # 1000-90-4-07
REVISIONS
TP-,USTEES APPLICATION
DATE;
9-12-OG
BOULEVARD PLANN1NG P.C.
ARCHITECTS ENGINEERS
32645 MAIN ROAD
CUTCHOGUE, N.Y. 11935
Telephone Fax
631-734-2011 631-734-2276
lnternet: www.blvdplan.com
THESE PLANS AND SI ECIFCATIONS ARE INSTRUMENTS OF SERVICE
AND ARE TBE PROPERTY OF BOULEVARD PLANNING EAST P,C
INFRINGEM[iNTS ~ ILl BE I ROSECL[TED
DATE: 7-5-06
DR. BY: R W L
SCALE: AS NOTED
CHKD:J.S.
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S.C.T.M. # 1000-90-4-07
[] I~J REVISIONS DATE;
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ADDITIONS
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AT THE
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RESIDENCE
595 OAKWOOD DRIVE
SOUTHOLD, NY
S.C.T.M. # 1000-90-4-07
REVISIONS
DATE;
TR. USTEE5 APPLICATION
2-06
BOULEVARD PLANNING P.C.
ARCHITECTS ENGINEERS
32645 MAIN ROAD
CUTCHOGUE, N.Y. 11935
Telephone Fax
631-734-2011 631-734-2276
Intemet: www.blvdplan.com
TIIESE DLANS AND SPEC[FCATIONS ARE INSTRUMENTS OF SERVICE
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INFRINGEMENTS WILL BE PROSECUTED.
DATE: 8-23-06
DR. BY: R W L
SCALE: AS NOTED
CHKD: J,S.
0618
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0618 A-4
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32645 MA~ RO~
' CUTCHOGUE, N.Y. 11935
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~ 631-734-2011 631-734-2276
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