The URL can be used to link to this page

Home My WebLink AboutTR-5525 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 SOUTH OLD CERTIFICATE OF COMPLIANCE # 0186C Date January 8. 2007 THIS CERTIFIES that the second-storv addition to existing dwelling At 150 Oak Ave.. Southo1d, Suffolk County Tax Map # 77-2-5 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 2/11/02 pursuant to which Trustees Permit # 5525 Dated 4/26/02 Was issued, and conforms to all ofthe requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for a second-story addition to the existing dwelling The certificate is issued to JAMES & CATHY SLECKMAN owner ofthe aforesaid property. r~~ Authorized Signature AlbertJ. Krupski, President . James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 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. .s J e '- r:- Vh..c..-.. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction y. constructed 1 v Project complete, compliance inspection. 1)1 0-1, 6tJ d-rJ ~ . . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD February 16, 2005 Mark Schwartz, AlA P.O. Box 933 Cutchogue, NY 11935 RE: JAMESSLECKMAN 150 OAK AVE., SOUTHOLD SCTM#77 -2-5 Dear Mr. Schwartz: The following action was taken by the South old Town Board of Trustees at their Regular Meeting held on Wednesday, February 16, 2005: RESOLVED that the Southold Town Board of Trustees grants the last One-Year Extension to Permit #5525, as issued on April 24, 2002. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, ~.j9.~'9, Albert J. Krupski, Jr. President, Board of Trustees AJK:lms . ,. .. . Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD February 25, 2004 Mr. James Sleckman 105 Astor Ave. St. James, NY 11780 RE: 150 OAK AVE., SOUTHOLD SCTM#77-2-5 Dear Mr. Sleckman: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, February 25, 2004: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Permit #5525 to renovate the existing dwelling and add a second-story with the condition drywells and gutters are installed to contain the roof run-off and as depicted on the survey prepared by John C. Ehlers last dated February 9, 2005. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, tWx- -I 17. ~.. 9<LJ..' ~ . /. 7 Albert J. Krupski, Jr. President, Board of Trustees AJK:lms Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda . BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: j o.<<\C ~ S\~ ~mo. f\ . Town Hall 63095.Main Road P.O. Bo" 1179 Southold, New York 11971 Telephone (616) 765-1892 Fax (516) 765-1823 Please be advised that your application, dated has b~reviewed by this Board, at the regular meet ng of ~~. D~ and the following action was taken: (v-) 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 the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: 0) .Jr.s.DD I~P(?CbDr'I~cZ. @ (\(10.> f>lo.n.s U->\ cif4LU~ll~ + qU.+tLf3 TOTAL FEES DUE: $ 5,00 . tla..v-I ~ ~".. .1... 9; SIGNED: y. PRESIDENT, BOARD OF TRUSTEES BY: .~ClUl.~() ~.~^- te(ERK, BOARD OF TRUSTEES 4/98 631 563 132121 P.12I2 NFl<i I NTERNAT I il'IAL CffiP. FEB-24-21211214 11:13 . 105 Astor Ave St. JatneS, NY 11780 F~'!?l}!ary 2~, 2004 Southold Town Board of Trustees POBox \179 Southold, NY 11971 RE: PERMIT # 5525 Dear Sir: As per the trustee's request, I will provide drywells and gutters on my plan for this property at a later date. PleaSe consider the extension ofthis permit for approval, subject to the revision of these plans. Sincerely, r; ------.-.. d'C es Sleclanan ~~ F~a ~: ~,,~'~ Southold Town Board of Trustees TOTAL P.12I2 . . II .~. II II '.... II .. . .- II II . II .- I" II '''''.' II' II II 'II II .' '. '.' II .~ II II II.... II II II II . 'I' '.'. .'. II II II . II II II II II II ~ , , TERMS and CONOmONS 11ae Permittee James & Cathy Sleckman 105 Astor Ave.. St. James ~. R~u part' of the coasideratioa for cbe Jccn.~ of the PUmit does ~ and p.-ribe to the fol- lowlog: 1. n.. cbe said Board of Trustees and the Town of Soudao1cI ale released from UIf and aU damages, 01: dUms fIX damages, of suks arisiog dltec:dy 01: incUtecdy u . result of .., ~. adoo performed pinoWlt to cbls permit, and the said fl.. J'l"" wi1I, lit his 01: her own eq-. defend UIf and aU aid> suits -l..lcl-.l by thW puder, and the said.... 1..- --- fall JWiBty wiIb reSpect thereto, to cbe CiO"'I'~ 'esdusioo. of the Board of n- of the TOWIi of &.<11 ~ 2. n.. cbls Petmlt is....nd f<< a .p.dod of 24 IDOl. whlch is cocuiit"Cd CO be the estimated dme'ftIIUked CO ~the..ode lawmd, batiboaId ~....... --. ~ for an exIaISion may be mode CO the Board lit a later date. 3. n.. cbls Peanit "-ld be Rialoed lndeflaitely. 01: u 100g u the said ~<<: wlabCs CO . ....I....ln the sttucluJ:e or project involved, to provide ~ to aayoae (IOtoCetatd chat aad>- odzation WI$ origim11y ofvol-l .c. That the wodtimolwd wl11 be subject to the ~ and approva1 of the s-d 01: its ageats, and l>OIHllIGIpIiaD' wiIb ,the provisioos of the otlginofl..g .ppllcofl'Xl, may be CIIJSe fOl: revocation of cbls Pamit by resolution of the said Board. 5. That Ibere wl11 be DO wueasoo.1:de interference wiIb ~ u a result of the wodc be1:eln ~lzed. - 6. That there shall be DO interference wilh the right of the pabIlc to pass and repas IIoag the beach between blgh and low wale1' marks. . 7. That if fucure opendoas of the Town of Sovfb9Id require the -.l ancI/OI: ~flonc in the Iocadoa of the ..ode be1:eln ..!h-~h>i. or if. la the oplaJoa of cbe Board of Tmscees, the, wodt sbaI1 aase wueasonoble obs~ CO free ~""". cbe said p.....l- wl11 be ftllJCIInd, apoo due oodce. to remove or alter dds ..ode 01: project be1:eln stated widaoat ptoCO," to the T_ . of Southolcl. . 8. That the said Board wl11 be notified by the Permittee ot the ~. Of cbe -" aad>- orized. 9. That the Permittee wl11 obcaln aU ocher permks and cor<e"'" dIIt may be nquhed sap" p->tI1 CO this permit whlch maT be subject to revoke apon failure CO obcaln -. --::::::-'" -.;;::- .- .;. ;' // Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 26, 2002 Mr. & Mrs. James Sleckman 105 Astor Ave. St. James, NY 11780 RE: 150 Oak Ave., Southold SCTM#77-2-5 Dear Mr. & Mrs. Sleckman: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 24, 2002 regarding the above matter: WHEREAS, JAMES & CATHY SLECKMAN applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of South old, application dated February II, 2002, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 24, 2002, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, --- --- 2 . . NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of JAMES & CATHY SLECKMAN to renovate the existing dwelling and add a second-story. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency, which may also have an application pending for the same or similar project. Permit to construct and complete project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Fees: None Very truly yours, (}LLJ ~ /~. ~ Albert J. Krupski, J r. President, Board of Trustees AJK/lms _" _fi-zi'~ ',.. !~' . -:c$,_'.' ',--- .'-?".....:~::-'~...,,~- "7'" ~l,_ '3:' ,--! "~.1?i{:).;'~, 2:B~J;?iJ~r'''.'...,~ . ., r: ! -' "''''''';-'41; .'~: J ~r: ..t- ti. .. iE- "'":~t};f;;,1~"' . ...;..~ -~ l r- ! _-j \ I If >:- ~ Il.- II ; \ I' ~ #I.J I I . -IT .~ ~ 0,-;";'/ , I .1 f > ... ~ -..>~-~~' ~, : - ......'..- - - ~ ~ ~j ~.....'.. ..~.... ~'~~,' ..1 . ~ '.. , ;;,. , , \ .' . u:. 1 r ~>I,. .,. 11 .. / ~ II .. I ~.~- II ~ 'l'J r - ;:-, II 1\ .!- l L~j . . " 1 . .- - ,~.~ . , . 1 I 1 I I I ; Ir . r ~'f.. ~r ;.- .':f.<'c<' '<<It ~' , ' ~~.!':::.:::?s-~::?:':~~" ," , .~:.~~: . .~o;~/ , .N " '11 " -< . .~'~ .., I I , ! ! 1\ ~a ~ N 0/: .CZ; I>l g i:i j ::> -, '\9 )( -;:!: ~ "" L / {U_' . . i , ! , i I I '~ I ~'1 I ~ ~I 1;#1 ----:8 ,+ _ ._ ~b:=-~I t 1.-' ;1 II Ii '. \~"::::,....--..:., " I __~ I; ~.____~_ Ii ",,9 :1'~ -1 II ' -vr I f.) j I ~ ,,~,r:1 ;:. I : ;.;> '!/ I Fi: 1\/' 'j \T '1 I-~'I ~. r==" "O,Sil-- - // y " IL/ 4t/ ~/ -,.~.' ~ ~I 81 .Q! i Ii ,I r- II ~ 5~'tJ, . 1: \$ Jr.'- II 1&1 ~Y' . I ~~ ~~~ II if 11 " . - _' I '" "-1<:-< ~ '?.:.l L .P~ ! '""'IIY~ , 'I + . I ~~I , -i- 1'"---- "/' i j' ij I il! ! ' j : ~ J ,;,' I;~i-~=~~-~w_._-- \ii ~ln-- ~I , -.-~_. -~ ~ ~ / ~-::::::" h::~:, . 'iI l i ~--, :: 'I -:t\! ~ 1= -,.~I-'" i -" , 1:-"" <:\:>- - ~ \S ~ S[ S:! \--"1' ~, :! " 'x.~~ , " -_.---~ '.'::;.1,; 1) '" "" ~ ",..- - --.--....,.. . . Telepbolle (631) 765-1892 Town- Hall. 53095 Main Road P.O. Box 1179 Southold. New. Yark 11971 _ SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the South old Town Conservation Advisory Council held Monday, March 18, 2002, the following recommendation was made: Moved by Drew Dillingham, seconded by Melvyn Morris, it was RESOLVED to TABLE the Wetland Permit Application of JAMES & CATHY SLECKMAN for the renovation and addition of a second-story. 150 Oak Ave., Southold. SCTM#77-2-5 The CAC Tabled the application because the project was not staked and the proposed work was unclear. The applicant should provide excavation volume. Vote of Council: Ayes: All Motion Carried ... - - . . Telephone (631) 765-1892 Town- Hall. 53095 Main Road P.O. Box 1179 SoutI1old. New Yon: 11971 . SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conser'vation Advisory Council held Monday, March 18,2002, the following recommendation was made: Moved by Drew Dillingham, seconded by Melvyn Morris, it was RESOLVED to TABLE the Wetland Permit Application of JAMES & CATHY SLECKMAN for the renovation and addition of a second-story. 150 Oak Ave., Southold. SCTM#77-2-5 The CAC Tabled the application because the project was not staked and the proposed work was unclear. The applicant should provide excavation volume. Vote of Council: Ayes: All Motion Carried >4 ~- ~ . . .\l.f!!lJjh Mark K Schwartz, AM -Architect, PLLC .~:i1. ":.~,~: P.O. Box 933 ~ Cutchogue, New York 11935 Phon... (631) 734 - 4185 Fax: (631) 734 - 2110 February 11, 2005 Southold Town Trustees Southold Town Hall Annex - Main Road Southold, New York 11971 Attn: Lauren Standish ~~F~B~O~~i~i~ -~ SOiJtllJid lown Board of Trustees Re: Sleckman House 150 Oak Avenue Southold, New York 11971 (SCTM# 1000-77-02-05) Trustees permit # 5525 Dear Lauren: Enclosed please find a check for $150. We would like to extend the Trustees permit for the Sleckman project an additional 12 months. The Owners plan to begin construction this Fall. Please call this office with any questions you may have. Thanks! Mark Schwarti I t6 . 105 Astor Avenue St. James, NY 11780 January, 21 2004 Southold Town Board of Trustees P.O. Box 1179 Southold, NY 11971 Re: PERMIT # 5525 Dear Sir: I am hereby applying for a one year extension to wetlands permit # 5525 which expires on April 26, 2004. Enclosed is my check for $10.00 payable to the Southold Town Board of Trustees. If you have any questions concerning this matter, please feel free to contact me. Thank you for your consideration in this matter. Sincerely, 1 )a~'fC James Sleckman 6318626311 / t___ \D)[~ I: ~ I \!~ ~ \\ru J~.\i 2 3 LG". \\1lJ soutMIO 10"n B03<O 0\ 1!uslees ~ - Albert J.. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD Office Use Only 'Un \n~' ~ _Coastal Erosion Permit ApplicatioJY _Wetland Permit Application ~ Major Minor _Waiver/Amendment! han es _Received Application: t 1 V _Received Fee:$ /)..pI_l, 7 _Completed Application Y( II . ~ 1- _Incomplete _SEQRA Classification: Type I_Type II_UnIisted_ _Coordination:(date sent) g~~:re:::~~~:~: ~!;~~ _Receipt ofCAC Report: _Lead Agency Determination: Technical Review: 4J Public Hearing Held: ~' 'j.." /6 ?-- _Resolution: I Phone Number:(~3)1 g to 2 - ~ 3 II Se\'.. 11 13lk Z- Property Location: 15'0 0 t>,-\C- PN e- S au 'Tko cd. I c.. os.s S"-~T5 Q..e~1l<Il- Pw€" + P~e- Pve- (provide LILCO Pole #, distance to cross streets, and location) Name of Applicant - . I -i A-M FS k,IOYL NY Address 10 S- S-r J A'W\e.& ;- c".."'~ fv~ 31ec.kMfI?-l Suffolk County Tax Map Number: \000- LTG"' AGENT: (If applicable) JJPr;- Address: Phone: _u. . .- Board of Trustees Application GENERAL DATA Land Area (in square feet): /01 J I..S' , Area Zoning: R",;lde.../f,..L Previous use of property: S I ^'q , c... Intended use of property: 'S I "''tie... . ~,'L'1 t<c-sldeNc..<.- ~,'Li !(e-s.,d41C-e..- Prior permits/approvals for site improvements: Agency Date tJ ON e... ./ 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 if necessary): RbrlOVPrTi;.J .y Mid;Ii'~.J of SecotJd gT~y ~ ~.~-.- -- - . . Board of Trustees Application WETLANDrrRUSTEE LANDS APPLICA nON DATA Purpose of the proposed operations: R~IJOI/1t-1I~ ~+ r=y:. ~'{J"'I S/I'lile.- ~,.~ eeJJ.IJeNce- Area of wetlands on lot: square feet ~ Percent coverage oflot: % Closest distance between nearest existing structure and upland edge of wetlands: 1.5"" feet '''-''-_.,~ Closest distance between nearest proposed structure and upland edge of wetlands: r;s- feet 1/ n', I. ..:' lULl N'R 5 2002 I ' i j 1"',"'1',,,, ., ,~ nc SLJu IHO' is. I'; Does the project involve excavation or filling? No '"Ji.-- Yes' / If yes, how much material will be excavated? 1(. (If cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited:~ feet Proposed slope throughout the area of operations: 0 Manner in which material will be removed or deposited: So; L UJ ('/ ~ Cr:>.1C\ eJ ~01'\. ~eA: Statement of the effect, ifany, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): No e.+.C'e.t..-1 . . NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: SCTMIlOOO- YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Rwolkl e.- t;;X,sTi,J9 ST,(IlC:fiLL<::- A1Jd A;JJ Seco..J <;, T~.tf-Y 2. That the property which is the subject of Environmental Review---is located adjacent to your property and is described as follows: ()" IJ J" L c1 (/ < ONe- 'r1>rr1A,Lr ..eS I e.JTk we- !1IJ7 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on: You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: ::r1rMei>... ~~ MAILING ADDRESS: 10S- M~ Sr- ~1tr'I"''7> "''I: 1/7K7J PHONE *: 03'" 8"'-- (,311 Ene.: Copy of sketch or plan showing proposal for your convenience. l.\' ..\.- ~ rg (;..--- \ n,,-~-- ',:' IiPf; ~OO2 ---- ..i I .s >lOOrt J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda . BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application ~Ft~~~ STATE OF NEW YORK) . Town Hall . 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 [n)J rrL~J. ,:_,.J" I UU~5 m i ITC\.~'.' ('~ SuJfHO' r AFFIDAVIT OF POSTING I, JetW--t-.5 SI~It~"-+\J, residing at J00- S'T. S It ~J IVy being duly sworn, depose and say: That on the ~ day ofP\O'~~, 200~ I personally posted the property known as /60" ~K.. 1t1l/i)J1./. ~ by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date o~h~ J ~ ~ublic hearin9~ Date of hearing noted thereon to be held J~ I d(J:1.?-, 6--A th ~ ") 0 ~ (f rn . Dated: Swo~n to before me this /'tf. :!}, of~~ 200)... ~uQ.f2 ~ No..,.',-,...." . 'q.h,' (-,_ _.~. .) " .tH. ".,' -I, .:.j c."....'.....:, )'3;~V, It &fu,/' !\ve. Se-~ ,- ----- .- .. " 617..21 Appendix C State Environmental Quality Review SHORTEN~RONMENTALASSESSMENTFORM For UNLISTED ACTIONS Only PART I-PROJECT INFORMATION (To be completed by Aoplicant or Project sponsor) 1. APPLICANT ~PONSO I 2. PROJER" NAME ::r;. 0/ 01ec 1"fP,J 3. PROJECT LOCATION: Municipality SOlA.ThoU County Su 4. PRECISE LOCAnON (Street address and road intersections, prominent landmarKS. etc., or ':lfoviCle mapl ,. IS'o Ol\-l<.. r:v~ GOO!'': c.oI:.ee.\:::' (?;"A--r~S SO'i1n.o LJ ,..; cr F C. OS~ 14.16." r2JSn- Te:.:t 12 , PROJeCT 1.0, NUMBE" SEQ " l2eNoVA-Ti ~ C.d II-K- Av~ + p,~e._- A./e.- 5. IS PROPOSED ACTION: o New 0 Expansion ~odifiCatlOnialteratfon 6. OESCRIBE PROJECT BRIEFLY: I 'BcJ (( e,.Jo.,lp;-r;rpj .. .t- e-X, ~;r;'1 3 fOO'JO>. iI(7Ti\e w \11\ ~e.c.a>Jd S-r!P<-j h 07'A. ~ -ro 6;t:r';";d-uJ 3 'bd e.c~ 7. AMOUNT OF LAND AFFECTED: Initially 6100 S ~ Ultimately acres a. WILL ?RQ?OSEO ACTrON COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE .=!ESTRIC7IQNS? j9-ves 0 No If No, describe bnefly g. WHAT 15 PRESENT LAND !.JSE IN VIClNITY OF ?ROJECT? ~eSldential O.!nduslrial [J C<Jmmercial Desctlbe: o Agriculture U Park/ForestJOoen space LJ Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. STATE On LOCAL)? fil y~s , 0 No 11 yes, list agency(sl and permiuaoprovaltd 13111 U 1./1 P eeM'rl - /OWN 0..(' Soullo ':r- 11. DOES ANY ASPECT OF THE ACTIO'''' HAVE A CURRENTLY VALID PERMIT OR APPROVAL? DYes. SZl-No It '1$, list agency name and permiUapproval 12. AS A RESuLT OF PROPOSED ACTION WILL S<IST1NG PERMIT/APPROVAL MEQUIRE MOOIFICATION? o Ye. ~o I CERTIFY THAT THE INFORMAT10N PROVIDED ASOVE IS TRUE 7"0 THE 3EST OF MY KNOWL::DGE AppJicanl/sponsor r me: J~e-S S'lect"^~ s.e,.C Dale: o?k!o~ . I Signa lUre: ~ v If the action is in the Coustal Area, and you are a state agency, complete the Coastal Assessment Form beiore proceeding with this a:j..~essment OVER PART 1t-~NVIRO:"~MENIA' ~-. . . .3MENT ,-:-0 be C:Jr.-::::le!eC :y Agenc' .. I A. COE..S AC7;C~ =;~c~:: ':"N'f '- ?'... j . ':'~S I .:-40 , , ,:S i 7i-i?:E5i-iGLJ ~N i ,~':'c;=:;:::. :I :..F,'i' i;;.::;:? il y6S. .::ocrOlnaCII :ne reView :rcces.3 anCl 'Jsa :r.e .=iJL~ ::~;=. 3. 'N1LL ..:..C7:CN .~E':::':V=: :::CPOINA,c.:J .~EVIE'N":"S ?RC'J1CE0 .=.:i=i UNLS,S:J ..:..C7;CNS;N:) ~YC?R. :I!lt.MI -;i7.57 :nay oe sucersecec 'Jy 3.not~er ;nvolvea a~enC'f. LYes =~o C. C':-ULO AC7iCN ~ESUL';'" ,N )r,N'f ,.l,DVE::;SE =.:=-:=:,:75 ,.l,S5CC:"':" ,ED ',v17H 7~=. .='JL~":;\N1NG; ~)r,ns.....ers :'lay :e .'ancwrmen. ,I :eO:;loleJ C1. ~"tislin9 lir GUality, :iurtace Ot 1rOL:nawacer ;;:uatity Clf:canuty. ,'Olse ;e'le1S. ~x:S:lnq :raific ~aHerns, 5iolia..'1as.e::ucccc::~n JrJfs::;: ,otennal for ~rosion. ::ralnaqe. or :loocing ;l(Oelems? :.~claln :JrIetly: if ,'~o, .1 neo:;a.t:'18 -::e<::a.r::;, No C2. ,.l,esthetlc. aqriC:Jltural. 3rc:Jaeological. ~rs.orIC, Jr other ;'Iatural Jr cultural ..esourc~s: ::Ir community or ;'IelqnOcrnooa c::arac:ar'? :.xalaln _' NO C:. lJegelaUon or :auna. :Isn. 3r:ellfisn or 'NlldlHe soec:es, .'>lgnificanr :'Iaoilats. 01 :tln!3tened or ~ncanc;:erea :;:;::ec:es? Scclaln ::ntally: NO p CJ.. A c~mmunlty's exis.ing ;:Ilans or ':joals as oiflc:.aUy adoo(ed. or a cnange in use or intensity ot use at land or Olher nafural resources? Sc;:llain ::r No "< --" Growtn. suoseouent ~eveloomenl. Jr telalea ac:ivities likelY to be Inducea ::IY me ::rcoosea ac:ion1 :xolalO:ure{lv, No CS. '..on9 :erm, snort :err:l. ':::.Jmuiali...e. or Qtner !!rfec:s nOl iCenliliea in C--;.CS? ::XOI3lM )r1eily. No ::t~er :mcac:s dnC:..JCln~ ::::anr;es In ~S2 01 ~!lhe( quantity or :ype or ~nergYI? =;:t::l13ln ~rietly. No oJ. ;S-='::';E:;1E.::;R :S~ _~es ,_.'10 _:KE!.::- 70 3E. C'::NT::lOVEFSY =!E!..,.l,7c:0 7"0 ,:JQTSNT!AL ..:..DV!:::!SC: :NVIRONMea':'L :MPIl"G7S? :1 ':'es. -!xclaln :lrieily ?ARi III-DETERMINATION OF SiGNIFICANCE \To ~e como\eted ~y Agency) INSTRUCTIONS; For eaC:l adverse effect identifieoj at:ove. aetermine wnett'1er it is substantial, large. imcortant or otnerwise signi fie. :ach eitec~ snouJd be assessed in connection 'Nilt'1 its (al setting (La. urban or rural); (b) ;:Jrobacility ot OCC~9; (cl duration' irreversibility: (el geograonic 3coce: ana (F) magnitude. It necessary, add altacnmenls or reference supponing ma!erials. ::1sure 2Xclanaticns centain sutfic:ent detail !o snow that all relevant adverse impacts have been identified and adequately aCdressec. C~eck this box if :/OU ;,ave identified one or more potentially large or significant aC'Iersa imoac~s whic:1 MA'f occur. Then ::Ircceed directly to ~he FULL E.o\F ana/or preoare a positive- declaraticn. , C~ec!< this ~ox if you have determined, based on the intormation and analysis above and any 5uooortliiC coc:Jmenraclcn. :hai ~l1e ;Jrooosea ac~icn WILL ~~OT result in...;)flY significant adverse environmental :mcac~.: AND ;Jrovlce on attac:lments as necessary, (he reasons supconing (nis determination: ........,... :)/ ....oI'-J A~enC'1 ;'00:: .::/1 '<~'"oon~'OIO:: 011,cer .""nt ~I ''let:' 'l..rnt" ,)1 .(~",:;;cn\;OIt:' "';1I1(~r .n .......0 ......cnc.' ;.,>.;nJU.lfI!')I {~~con\'CII!' :;I:'(~r ,n ~C"J(] ...,,~ncy )',<n..:...,~ )1 r""."".JJto'!( '.Ir .,;,:~e.",nl :,om 'l~'Oon\lDl~ ~rr'(~rl J..tC' - .- . .. NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: SCTMflOOO- YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: RuJO{kTc- f:XISIt,.J9 St,etiC.:fl/.Le.. tnJd MJ Se~ "i:.t<H!-1 2. That the property which is the subject of Environmental Review.-is located adjacent to your property and is described as follows: n . . ONe- ~,L1 eeJ;rJe,JTkL dvJe-(J1~7 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on: You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees o~ the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: :JAMeS... ~~ MAILING ADDRESS: ioS' We:- ST. <r1tnJt..-:s, "''1. 1/787> PHONE I: 103 I - 8(,,"j...- b311 Ene.: Copy of sketch or plan showing proposal for your convenience. .s , flI Board of Trustees Application County of Suffolk State of New York -J u. """ e.s. S Ie..... ~ ""-c...N BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF illSlHER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN 'filE MANNER SET FORTH IN TIllS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VlRTIJE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING TillS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF TillS APPLICATION. ~ cj~ ~/?- (j Signature SWORN TO BEFORE ME TillS t.t DAYOF-:t)~ ,200l- CAROlE KllG.!H.1N ftlOTARY PUBliC, Slale 1." I'i::;.... YorM No 52-4831562, S!j\lol~ County lerrn flptreS lo(,d 05 ~~I -/r . " ~ . ---> ;1 ~ 2 ~ ~ ~ ~ ~ . . ~- " ., [I/IrJAd-tlr' eo" .._------...------ . . . '" ~ J3 3J il . e ~ ~~ '7 ~ r-- f'.. 1 " .~ "~', '~ :xxJ-T1-;l-:;> ~/~ . ~/~G 0 0 S E //~\\ % ~~ Yo ~ "'i ERTIFIED TO, AMES SLECKMAN OWNI~IZ High ~ ~0~~) >j.{%.f?'J \) '0 ,)f.>1"~ I( \\\: \Ik\' - - - - - 0" '::Je,o"'" eVe, 0~( 00 -, <S cP Ft"ed . <;; 14S5ER,. , , ." -:' J2:: '? o .~~ r ---\,- _.>0 f>' R \! '" '\~ \\;U~..: II';' ,,,- '.1. ~ ~w. 5 rioter' -, \ ctEEK roo! 'i , .~ I I I fj I C-", gE' ~~I , Jl: LI1 r- I , I , , , I '- f' ~ 1 " a z LClJrllJDl:ilUfJ] (F'D:: Fe-I . - --- - App....o irriote Ed~ ---- ~ I ~~3~ .:::: _ .,.,........... 0 ! __ __ ___-==: ' z ~r __~ _____ __.--==: _ < --,t%6 ./'lY-+-S86008'30"E ~kY'lO ~_ Remolns of ~ o~___ ~ C\' ___ ~~'''- --- Q.~ -;J\J ~ _ -..:.'(~o- __ __ ~ --- // /\~ \~ .....- c'- " ~ ~" \ \ \ \ 2 of /^let/and ~ ,J Top of l: - 57.63' -I I I I I _II I ~ f' m- tJ) f' 0 " '" ..~ a a _J .J ~ () Q " 11 '" ,~ a ,J ~ o o to ~ ~ o ('t) ~ .-.. tr) o ('t) o en CA R. {l'\ '" It ~ ~ , a 2/ " - m E > ,- iBID CY OF LOTS /16, /'" /18 c$ PIO /15 OViN ON MAP OF BAY ESTATES NOVEMBER 13, IqB4 ? 1116 t:15OlJTHOLD 5OlJTHOLD I K COUN1Y, NY . APRIL 5, 2000 01-30-01, 01-11-02 2-30-04, 02-QGt-05 ..QUNTY TAX # -5 Q: DfAN ---- ~ '(::. ---- 9,- - i-- " J'0<'f- ::-. 5' ~ '" W~ / B SOUl!lOld Towo oard of Trustees -------------- ~-- CREEK - -1-- B --I- :::-f , ~ --- -,.... ~- --.;:pS86908~"E- 5~3'~ of _BOOk 'I I ,,' 6' I I I - ~ I ~ I ~ i r-- I ~ I ~ 3 -! !i2 .1 CL II~ It- II I , I : II I '- 1_ -7 " -' 0. 'c..vNiC)t,"R , - H '_ _LV . -::--~----=1--~2..- ---- I c - b 2', , \ ~ 32.3' GE SI \ D ~, I ~ ''-_~!5~ ADDITION 8 - (exist1nq) \ story frome D",ellinq, \ ff = el ro \ 26' GOOSE High ~Clte(' - - --6tlOnci5 f-~~ - - - \';ciij::o_ - Ci' x\ff\ote_ itl /,op<;3. - -9 '-' -. Ac6' z - ~k 1^i5lf"' RemaIns of ~ ___ c.--- 0' .---:: - ---:.,~O ~ -- _ ~ --- --- -- ---- ---- ----\ ----, Cl << " '" I \l , c.>l, o ~.' :;:i..ol ~~: Ln Jl, r-' I . I , , I I , ,- Cl " " ::-. (j> \ \ \ --l --l 100' from ....IU'l...,. ~. ....0 ~ ~ ~ ~ \ \ - Kt\J! o io I~ -- ~ 1UllllIDlMmedJ 1R!.OaldJ z (PER FiLEDIvJAP) 2 U) r-- " ~ () -! ~ 8 o "O:t PROP05ED DR'fl'iELL FOR ROOF RUNoFF e' DIA. 6' DEEP ~ o rt'l ~ .... .-