The URL can be used to link to this page

Home My WebLink AboutTR-6532Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road 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 # 0591C Date October 13, 2010 THIS CERTIFIES that the conversion of the existing one and one-half story cape to a full two- story colonial, construction of a roof deck over existing deck on water-side of dwelling, covered porch, second-story addition on street side of dwelling, drywells and 10' non-turf buffer landward of the bluff At 235 Soundview Rd., Orient Suffolk County Tax Map #15-3-4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 1/23/07 pursuant to which Trustees Wetland Permit #6532 dated 2/14/07 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 conversion of the existing one and one-half story cape to a full two-story colonial, construction of a roof deck over existing deck on water-side of dwelling, covered porch, second- story addition on street side of dwelling, drywells and 10' non-turf buffer landward of the bluff. The certificate is issued to BRIAN RETUS owner of the aforesaid property. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction ~ constructed JProject complete, compliance inspection. INSPECTED BY: COMMENTS: /3c CERTIFICATE OF COMPLIANCE: James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: ~/'/Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain lS~ day of construction ½ constructed Project complete, compliance inspection. CERTIFICATE OF COMPLIANCE: COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK CC#: Cll-43391 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 on 1111812011 under Liber D00012677 and Page 006 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 1111812011 SUFFOLK COUNTY CLERK JUDITH A. PASCALE SEAL SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Number of Pages: 4 Receipt Number : 11-0126600 District: 1000 Recorded: At: 11/18/2011 10:46:48 AM Page/Filing COE TP-584 Cert. Copies Received the Following Fees For Above Instrument Exempt Exempt $20.00 NO Handling $20.00 NO $5.00 NO NYS SRCHG $15.00 NO $0.00 NO Notation $0.00 NO $10.00 NO RPT $30.00 NO Fees Paid $100.00 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County LIBER: D00012677 PAGE: 006 Section: Block: Lot: 015.00 03.00 004.000 EXAMINED AND CHARGED AS FOLLOWS Number of pages .I This document will be public record. Please remove all Social Security Numbers prior to recording. Deed / Mortgage Instrument 31 Page / Filing Fee Handling 20. 00 TP-584 Notation EA-52 17 (County) EA-5217 (State) R.P.T.S.A. Comm. of Ed. 5. 00 Affidavit NYS Surcharge 15. 00 Other Deed / Mortgage Tax Stamp FEES Sub Total Sub Total I I 4 I Dis Real ProI ~ Tax Ser Agem Verifica I 1000 01500 0300 004000 6 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 www. suffolkcou ntyny, gov/clerk I Title # Recording / Filing Stamps Mortgage Amt. 1. Basic Tax 2. Additional Tax Sub Total Spec./Assit. or Spec./Add. TOT. MT°. 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 ~) I page # __ __ of this instrument. I . 5 [Commumty Preservation Fund Consideration Amount $ CPF Tax Due $ Improved Vacant Land TD TD Title Company Information BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) In the TOWN of In the VILLAGE or HAMLET of TO The premises herein is situated in SUFFOLK COUNTY, NEW YORK. Suffolk County Recording & Endorsement Page This page forms part of the attached ]) ~ C L ~/~'J~'V] 0~ ~ F: ('~ I/~,/~ N -7~_~' made by: (SPECIFY TYPE OF INSTRUMENT) 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 mortgage payment included your property taxes, *you will now need to contact your local Town Tax Receiver so that you may be billed directly for all future property tax statements. Local property taxes are payable twice a year: on or before January l0th and on or before May 31st. Failure to make payment,s 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 12-0104., 06/06kd DECLARATION OF COVENANTS THIS DECLARATION made this 17th day of November, 2011, by BrianBRetus and Merry L Retus, residing at 235 Soundview Rd., Orient NY 11957, hereinafter referred to as "DECLARANT(S)": W I TNES SETH : WHEREAS, DECLARANT(S) is/are the owner(s) of certain real property located on 235 Soundview Rd., Orient, Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 15.00, Block 03.00, Lot 004.000 which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT(S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required drywells for the new addition and a 10' "non-turf buffer" adjacent to and landward of the bluff. NOW, follows: l) THEREFORE, the DECLARANT(S) do/does hereby covenant and agree as Upon the substantial completion of the aforementioned permitted activities there shall be established and subsequently maintained drywells and a 10-foot "non-turf buffer" as defined by Chapter 275 of the Town Code; and as depicted on the plans prepared by John Metzger revised November 28,2006. 2) These covenants shall run with the land and shall be binding on the DECLARANT(S), his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owner(s) day of November, 2011. has/have duly executed this OWNER'S SIGNATURE OWNER' S SIGNATURE instrument this 17tn STATE OF ~J~.~[/O~--- : ss: COUNTY OF S~-~lK-- On the /7 day of ~'~"'--- , in the year 20 ~/, before me the ~ndersigned, a Notary Public in and for said State, personally appeared ~F~O ~ ~L F-~L personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity, and that by his/her/their signature(s) on the instrument, executed acted, the individual or the persons on behalf of which the individual (s) the instrument. otar 7 ELIZABETH A. FARNAM Notary .P, ublic, State of New York No. 01FA6162855 Qua! fied in Suffolk Coun.ty Commission Exp res March 19, 2015 Title Number SH260282 Underwriter L528696 Schedule A Page 1 ALL that certain plot, piece or parcel o1: land situate lying and being at Orient, Town of Southold, County of Suffolk and State of New York, known, and designated as Plot No. 46 on a certain map entitled, "Map of Orient-By-The-Sea, Section Two, situate at Orient Point, Town of Southold, Suffolk County, New York, owned and developed by Woodhollow Properties, Inc., 5 Glen Lane, Glenwood Landing, New York, Otto W. VanTuyl and Son, Licensed Land Surveyors, Greenport, New York" and filed in the Office of the Clerk of the County of Suffolk on October 16, 1961 as Map No. 3444, Abs. No. 3840. James F. King, President Jill M. Doherty, Vice-President Pegg~y A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southeld, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ½ constructed v'"/'Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6532 DATE: February 14, 2007 ISSUED TO: BRIAN RETUS PROPERTY ADDRESS: 235 SOUNDVIEW RD., ORIENT SCTM # 15-3-4 AUTHORIZATION Pursuant to fire 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 Februm~y 14, 2007 and m consideration of application fee in the sum of $250.00 paid by Brian Retus and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and perm/ts the following: Wetland Permit to convert the existing one and one-half story cape to a full two-stow colonial construct roof deck over existing deck on water-side of dwelling, and a covered porch and second-story addition on the street side of the dwelling, with the condition of drywells for the new addition, and 10'non-turf buffer landward of the bluff, and all as depicted on the plans prepared by John Metzger revised November 28, 2006. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, find these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee, Brian Retus, 235 Soundview Rd., Orient, as part of the consideration for the issuance of the Permit 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. 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 pro~fsions 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. Doher~y, 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 February 14, 2007 Michael Macrina Architect, P.C. 409 Lake Ave Suite C St. James, N.Y. 11780 RE: BRIAN RETUS 235 SOUNDVIEW RD,, ORIENT SCTM# 15-3-4 Dear Mr. Macrina: The Board of Town Trustees took the following action during its regular meeting held on Wednesday February 14, 2007 regarding the above matter: WHEREAS, Michael Macrina on behalf of BRIAN RETUS 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 January 23, 2007 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 Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 14, 2007 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, 2 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, RESOLVED, that the Board of Trustees approve the application of BRIAN RETUS to convert the existing one and one-half story cape to a full two-story colonial, construct roof deck over existing deck on water-side of dwelling, and a covered porch and second-story addition on the street side of the dwelling, with the condition of drywells for the new addition, and 10'non-turf buffer landward of the bluff, and all as depicted on the plans prepared by John Metzger revised November 28, 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 ~nspection. (See attached schedule.) This is not a determination from any other agency. Fees: $50.00 Very truly yours, James F. King President, Board of Trustees JFK/hkc 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 TOW Or SOUTSOL. 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: BY: James F. King1 President Board of Trustees James F. FAng, 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 Southold Town Board of Trustees Field Inspection/Work session Report Date/Time: Michael Macrina Architect, P.C. on behalf of BRIAN RETUS requests a Wetland Permit to convert the existing one and one-half story cape to a full two-story colonial. Construct roof deck over existing deck on water-side of dwelling, and a covered porch and second-story addition on the street side of the dwelling. Located: 235 Soundview Rd., Orient. SCTM#15-3-4 Type of area to be impacted: ~Sound __Saltwater Wetland Freshwater Wetland Bay Distance of proposed work to edge of above: ~ of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Type of Application: V/Wetland Coastal Erosion Amendment Administrative __Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Pr.es/ent ere: J.,I~ing J.Doherty P.Dickerson D. Bergen__ B. Ghosio, Jr v H. Cusac~-- ~'D. Dz~nkowski ~Mark Terry~o~-er MailedJFaxed to: Date: Environmental Technician Review ~ok. ~,('o~-~-q'~-'4 / IL~',~,~,,,-N Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTItOLD At the meeting of the Southold Town Conservation Advisory Council held Wed., February 7, 2007, the following recommendation was made: Moved by Don Wilder, seconded by Joyce Gdgonis, to TABLE the Wetland Permit application of BRIAN RETUS to convert the existing one and one-half story cape to a full two-story colonial. Construct roof deck over existing deck on water-side of dwelling, and a covered porch and second-story addition on the street side of the dwelling. Located: 235 Soundview Rd., Orient. SCTM#15-3-4 Inspected by: Don Wilder, Joyce Grigonis The CAC Tables the application until the issue of the bank failure is addressed. Vote of Council: Ayes: All Motion Carried .'~ Existing Front View July 5, 2006 11:00 am South-East Comer Existing Rear View July 5, 2006 11:00 am North-East Corner LOT45 zONE x pROPOSEO ~ ROOF OECK ~ oVER EX,G, DE~ / MEW S~ I::'OT 47 '' .. sroo~ CO~'RED POR~ 2&7' f,*7'65' / STOr~ WALL ~ STORY / LOT ~6 /I / / / / 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. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 To2 James King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: February 7, 2007 Re: Proposed Wetland Pengat for BRIAN RETUS SCTM#1000-15-3-4 Michael Macrina Architect, P.C. on behalf of BRIAN RETUS requests a Wetland Permit to convert the existing one and one-half story cape to a full two-story colonial. Construct roof deck over existing deck on water-side of dwelling, and a covered porch and second-story addition on the street side of the dwelling. Located: 235 Soundview Rd., Orient. SCTM# 15 -3-4 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is gay recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation m preparing its written determination regarding the consistency of the proposed action. . Jame~ F. King, Pr~aldent Jill M. Doher~,.Vice. Pr~std~nt Pe~), A. Diek~raon Dave Bet,~n loh~ Holzspfel Town Hall 53095 Rout~ 95 P.O. Box 1179 $outhold, N~w Y~rk 11971-0959 Tnlepho~ (631) 765-1892 Fa (631) 75~-6641 · IlOAP,,D OF ~R)WN TRUSTEES TOWH OF SOUTHOLD Office Use Only .__/Coastal Erosion P~mit Application '~ W~and Permit Application . Admini~tniive Permit ._._.A mendmsnt/Tnmsf~/Extm~io n //'Recaived l%e:$ _~o mpiet~d Application __Incomplete __SEQP, A Classification: Type I ~c II Unlisted __Coorai,~q on:(~te s~n0 ____~A¢ Rererra~ Sent. ~ IA~,/~ ~-----~D~e et'Inspection: .-~iF~,~) ' __Receipt of'CAC P, cpore __Lend Agonc¥ D~t~mninitioa: Teclmical Review: __Resolutiom JA;'I '2 3 ~'d 9BLB989I~9 '3'd'13BlIH3~ ~WI~3UWW WdgS:~I LOOa ~ ue£ 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 Application __ Administrative Permit Amendment]Transfer/Extension __Received Application: __Received Fee:$ __Completed Application __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordination:(date sent). __LWRP Consistency Assessment Form 'CAC Referral Sent: __Date of Inspection: __Receipt of CAC Report: __Lead Agency Determination:__ Teclmical Review: __Public Hearing Held: __Resolution: / Suffolk County Tax?p Number: 1000-[~-~ Or~2 [~94 \ (provide LILCO Pole #, distance to cross streets, and location) Address: b~ 1~- Phone: ~oard of Trustees Applica~n Land Area (in square feet): Area Zoning: ~- q~ GENERAL DATA Previous use ofproperty: ~lkl&l.-'lL F~II~-,I/ r"~Jl~t~.~J(.! Intendeduseofproperty: Q'~lJ~b-I~ ~-I'~lt-y r~v,Jl~t.A..tJdot Prior permits/approvals for site improvements: Agency Date '~No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspende_..O.-ky a govern_mental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): Board of Trustees ApplicOn WETLAND/TRUSTEE LANDS APPLICATION DATA P oseoftheproposed operations: Areaofwetlands on lot: It:PO square feet Percent coverage of lot: ,, q q ,% Closest distance between nearest existing structure and upland edge of wetlands: ~] ~:> feet Closest distance betwee~ nearest proposed structure and upland edge of wetlands: '~ ~;~ feet Does the project involve excavation or filling? No ~ Yes If yes, how much material will be excavated? cubic yards How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: .cubic yards feet 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 reason of such proposed operations (use attachments if appropriate): ,ard of Trustees Ap~ COASTAL EROSION APPLICATION DATA Are wetlands present within 100 feet of the proposed activity? No '~Yes Does the project involve excavation or filling? No ~Yes If Yes, how much material will be excavated? [~ ~ .(cubic yards) How much material will be filled? i (~ (cubic yards) Manner in which material will be removed or deposited: lb /~ ~o% ~o~7~ i~ Describe the nacre ~d extent of~e enviro~ental impacts reasonably ~ticipated resulting ~om implementation of the project as proposed. (Use attachnents if necessary) I 617.20 SEQR PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART ~ - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide mac, ~ Modi,cation / alteration 1. AIPLICANT / SPON~OR 3.PROJECT ~ION: 6. DESCRIBE PROJECT BRIEFLY: 7 AMOUNT OF LAND AFFECTED: Initially ,, O(c~ acres Ultimately acres 8. WIIzL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? '~.JYes~ [] No If no. describe briefly: ].AT IS PRESENT LAND USE iN VICINITY OF PROJECT? (Choose as many as apply.) esidenlial E~lnOus~rial ~]Commercial r-]Agriculture ~lPark/Forest/OpenSpace E~]Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) I~ [~'No If yes, list agency name and permit / approval: Yes 11. DOES ANY, NY~.~SPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? r-'-iYes ~No yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? /' I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant Signature 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 (To be completed by Lead A~lency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAE. r~Yes E~]No B. 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. E]Yes r~No 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, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood characler? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4 A community's existing plans or goals as officially adopted, or a change in use or intensity of use ef 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 e~'ects not identified in C1-C57 Explain briefly: C7 Other impacts (includin[~ ?.~.n..?es in use o1 eithe(.gu~nt!~ ~[_t~e 0!.e. ner~? Ex~!ain t~defl~: _ D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. IS THERE, OR IS THER~ L!KELY TO BE, CONTrOVErSY R~LAT~D _TO ~OT[NTIAL ADVERSE ~NV!RO~?N?AL !ivlPA~"T~? !! ~(? ~x~o!ain: PART Ill - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesignificant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) [rreversibili[y; (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 lhe proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potenflally 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 intormagon and analysis above and any suppoding documentation, that the proposed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thL< determination. Name of Lead Agency Date Title of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) 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 ~ BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ..... ......................... COUNTY OF SUFFOLK) STATE OF NEW YORK) FEB - 9 2007 AFFIDAVIT OF POSTING I, ~{~l~/ ~-~"/"0.~' , residing at [~0 ~ ~ ~/~ being duly sworn, depose and say: Thatonthe --dayof ~B ,20~,Ipersonallypostedtheprope~y~ownas by placing the Bo~d of Trustees official poster where it can easily be seen, and that I have checked to be s~e the poster has remained in place for eight days prior to the date of the public hemng. Date of heating noted thereon to be held ~)~; ~ ~ t I ]qt ~O ~ . Dated: Sworn to before me this "-) dayof g::b 200 -7 ar~ublic . ~ ~ ' 'O'.A FtIVIEZZO !'3TARY FUBLIC, STATE OF NEW YORK Reg;strat~on Ng. 01RI6146951 C:ualified in Suffolk County .:mission Expires May 30,201 Board of Trustees Application County of Suffolk State of New York lC ~L- /~ t~ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCKIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WOKK 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 REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS DAY OF --4 f) ~) ,20 0 '7 Notary Public APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Thc Town of Southold's Code of Ethics umhibits conflicts of interest on the oart of town 6fficers and emolovces. Thc ouroose of this form is to omvide informalion which can alert the town of oossibl~ conflicts of interest and allow it to take whatever action is pceassarv to avoid same. I (Last name, first name,~aiddle 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 Building ~.....~ ._------ Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (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 the Town of Southold? "Relationship" includes by blood, marriage, or business interest. '~Busincss 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 Southold Title ~)r position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check thc appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, o; ~:hild is (check all'tl~at apply): __A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); __B) the legal or beneficial owner of any interest in a non-corporate entity {when the applicant is not a corporation); __.C) an officer, director, por[ne~, or employee of the applicant; or __.D) thc actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submilttedthis ~r/~ dayof ~< 200~. Signature ~_~ Print Name Town of Southoid 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 sum~ortin, and non- supoortim, 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 (s0utholdtown.nortkfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM, IV '% q The Application has been submitted to (check appropriate response): TownBoard ~-] Planning Board ~] Building Dept. ~ BoardofTrustees~'~ 1. 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) Permit, approval, license, certification: Nature and extent of action: Site acreage: Present land use: Present zoning classification: ~ - q C) If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided,: (b) Mailing address: qO~ [//X~F-.~__~ f~-~/l~ ~,~ I-5~g~_ ~ (c) Telephonenumber:AreaCode()~_~o~[) (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] No ~ If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide ali proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evahiation criteria. [--]Yes [~] No ~Not Applicable ! ! Anach 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 Southold. See LWRP Section III - 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 III - Policies Pages 8 through 16 for evaluation criteria Yes Nop Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria 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 and 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 nefessary 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. Ye~ No¢ Not Applicable Attach additional sheets if negessary WORKING COAST POLICIES Policy 10. Protect Southold'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 [] No ~/Not Applicable /, A~tach 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 /- AUach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP y n. III - Policies; pages 65 through 68 for evaluation criteria. es ~ No [-~ Not Applicable TITLE ~oard of Trustees Applica~n AUTHORIZATION (where the applicant is not the owner) ~I~N ~. ~(~TJ~ residing at ~ ~6~{~ (print owner of property) (mailing address) do hereby authorize Southold Board of Town Trustees on my behalf. "~---~nOw~r ~ s signature) Z109 L~,~.r._ AVL ,,~UlTF.,. (~. ',-~T- JAMF,.~. N.'~, 11780 (651) 686-6585. F,,x: (6or) 686-6786 [= ~,~A, IL: IV~MA Ce..l~lA (~S'PT 014 LlliF...H~.T January 22, 2007. Board of Trustees 54375 Main Road Southold Town Annex Southold, NY 11971 Re: Board of Town Trustees Application Retus Residence 235 Soundview Road Orient, N.Y. 11957 For whom it may concern, Please find enclosed three copies of the board of town trustees application for a proposed addition & alteration to an existing dwelling, as well as the $250.00 filing fee, surve2/s, and photographs as required for the February hearing. If you have any questions and/or comments, please do not hesitate to call. Sincerely, Michael Macrina, AIA N LON 96.59' SURVEY OF PROPERTY' A T ORIENT POINT TOICN OF SOUTHOLD, SUFFOLK COUNTY, N. Y,.~ 1000-15-03-04 SCALE: 1~-30' AUGUST 2, 2006 NOVEMBER 28, 2006 (TOPO. & PROPOSED ADDITION5 2S~Y ¢,,~.?.65' LOT NUMBERS REFER TO "MAP OF ORIENT BY THE SEA SECTION TWO" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON OCTOBER 26, 1961 AS FILE NO. 3444. COASTAL EROSION HAZARD LINE FROM COASTAL EROSION HAZARD MAP PHOTO NO. 45 - 666 - 85. FLOOD ZONE FROM FLOOD INSURANCE RATE MAP MAP NUMBER J610JCO067 G MAY 4, 1998. ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF' SECTION 72090F THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS AREA-22~684 ~. ~t. HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF '~IE SI/RVEYOR TO TIE LINE .~oSE SIGNATURE APPEARS HEREON. IP~CONIC' SO~ .,'~ (651,) 765-5 P.O. BOX 90~ 1230 TRAVELER "5 SOUTHOLD, N.Y. 11~, N 618 ~-197