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BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD, NEW YORK
n PERMIT NO. 6188 DATE: Au ust 24 20 -
ISSUED TO: ROBERT SWING
1.
PROPERTY ADDRESS: 4295 BAYSHORE RD., SOUTHOLD
SCTM# 53=6-24
` t
AUTHORIZATION
Pursuant to the provisions of Chapter 275 and/or Chapter 1'11 of the Town Code of the Town of
`e Southold and in accordance with the Resolution of the Board of Trustees adopted at the meetings held on
August 24,2005 and February 14,2007 and in consideration of application fee in the sum of$250.00 paid by + •' .'
Robert Swing and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of
Trustees authorizes and permits the following: r9i•
Wetland Permit to construct a second-story addition to the existing single-family
dwelling with the condition of drywells, and a buffer', and construct an addition to the
landward side of the existing dwelling, containing 627 sq.ft., removal of the existing +•+�, =r
septic system and replace with an updated sanitary system within the front yard,
installation of a French drain along the southern side yard property boundary and
,i " establishment of a 5' wide non-disturbance buffer along the landward side of the
existing wood bulkhead, and all as depicted on the plan prepared by Suffolk t
Environmental Consulting, Inc. revised September 27, 2006. ,
IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, +•+>�'
3 = and these presents to be subscribed by a majority of the said Board as of this date.
No
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TERMS AND CONDITIONS
The Permittee,Robert Swing,4295 Bay Shore Road, Southold, as part of the consideration for
the issuance of the Permit does understand and prescribe to the following:
1. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit, and the said Permittee will, at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto, to the complete exclusion of the Board of
Trustees of the Town of Southold.
2. That this Permit is valid for a period of 24 months,which is considered to be the estimated
time required to complete the work involved,but should circumstances warrant,request for
an extension may be made to the Board.
3. That this Permit should be retained indefinitely,or as long as the said Permittee wishes to
maintain the structure or project involved, to provide evidence to anyone concerned that
authorization was originally obtained.
4 That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
for revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable,interference with navigation as a result of the work
herein authorized.
6. That there shall be no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations in
the location of the work herein authorized, or if,in the opinion of the Board of Trustees,
the work shall cause unreasonable obstruction to free navigation,the said Permittee will be
required, upon due notice,to remove or alter this work project herein stated without
expenses to the Town of Southold.
8. The Permittee is required to provide evidence that a copy of this Trustee permit has been
recorded with the Suffolk County Department of Real Properties Office as a notice
covenant and deed restriction to the deed of the subject parcel. Such evidence shall be
provided within ninety(90) calendar days of issuance of this permit.
9. That the said Board-will be notified by the Permittee of the completion of the work
authorized.
10. That the Permittee will obtain all other permits and consents that may be required
supplemental to this permit, which may be subject to revoke upon failure to obtain same.
)
/-.,
, j
Albert J. Krupski, pre&t
James King, Vice-Pre%.-t
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.
INSPECTION SCHEDULE
Pre-construction, hay bale line
151 day of construction
Y, constructed
--.L. Project complete, compliance inspection.
.
.
TERMS AND CONDITIONS
The Permittee, Robert Swing, 4295 Bay Shore Road, Southold, as part of the consideration for
the issuance ofthe Permit does understand and prescribe to the following:
1. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit, and the said Permittee will, at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto, to the complete exclusion of the Board of
Trustees of the Town of Southold.
2. That this Permit is valid for a period of 24 months, which is considered to be the estimated
time required to complete the work involved, but should circumstances warrant, request for
an extension may be made to the Board.
3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to
maintain the structure or project involved, to provide evidence to anyone concerned that
authorization was originally obtained.
4. That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
forrevocation of this Permit by resolution of the said Board..
5. That there will be no unreasonable.interference with navigation as a result of the work
herein authorized.
6. That there shall be no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations in
the location of the work herein authorized, or if, in the opinion of the Board of Trustees,
the work shall cause unreasonable obstruction to free navigation, the said Permittee will be
required, upon due notice, to remove or alter this work project herein stated without
expenses to the Town of Southold.
8, The Permittee is required to provide evidence that a copy of this Trustee permit has been
recorded with the Suffolk County Department of Real Properties Office as a notice
covenant and deed restriction to the deed of the subject parcel. Such evidence shall be
provided within ninety (90) calendar days of issuance of this permit.
9. That the said Board'will be notified by the Permittee of the completion of the work
authorized. .
10. That the Permittee will obtain all other permits and consents that may be required
supplemental to this permit, which may be subject to revoke upon failure to obtain same.
.
.
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
August24,2005
Mr. Matt D. Ivans
Suffolk Environmental Consulting, Inc.
P.O. Box 2003
Bridgehampton, N.Y. 11932
RE: ROBERT SWING
4295 BAYSHORE RD., SOUTH OLD
SCTM# 53-6-24
Dear Mr. Ivans:
The Board of Town Trustees took the following actions during its regular meetings held
on Wednesday August 24, 2005, and Wednesday February 14, 2007 regarding the'
above matter:
WHEREAS, Suffolk Environmental Consulting, Inc. on behalf of ROBERT SWING
applied to the Southold Town Trustees for a permit under the provisions of Chapter 275
of the Southold Town Code, the Wetland Ordinance of the Town of Southold,
application dated July 12, 2005 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, Public Hearings were held by the Town Trustees with respect to said
application on August 24,2205 and 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,
2
.
.
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 275 of the
Southold Town Code,
WHEREAS, the Board has determined that the project as proposed will not affect the
health, safety and general welfare of the people of the town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of ROBERT SWING to
construct a second-story addition to the existing single-family dwelling with the condition of
drywells, and a buffer, and construct an addition to the landward side of the existing dwelling,
containing 627 sq.ft., removal of the existing septic system and replace with an updated sanitary
system within the front yard, installation of a French drain along the southern side yard property
boundary and establishment of a 5' wide non-disturbance buffer along the landward side of the
existing wood bulkhead, and all as depicted on the plan prepared by Suffolk Environmental
Consulting, Inc. revised September 27, 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.)
This is not a determination from any other agency.
Fees: $50.00
Very truly yours,
r5<1r
James F. King
President, Board of Trustees
JFKlhkc
1
.
.
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) 765-6641
BOARD OF TOWN TRUSTEES
. TOWN OF SOUTHOLD
TO: f) otuu- JWz.'n ~
Please be advised that your application dated
reviewed by this Board at the regular meeting of
following action was taken:
'711~11) t'
<6ldttl\)~
has been
and the
( v;;:.PPlication 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 South old 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: I.
, . 'f.-.. An, 'lueJ.W and 10(( norrtLu..6 IJl{.L6~'t
~ ~ .Fn wi J(,LUwJ '-^''''1
_ 1t (\Q) l rupeclUY\ - <Y StJ,01)
TOTAL FEES DUE: $ SlJ,OJ
/
SIGNED:
~.19 ~"7e<LJ.'0.
PRESIDENT, BOARD OF TRUSTEES
'"
.
.
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Tflephone
(631) 765-1892
I
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
CONSERVATION ADVISORY COUNCIL
TOWN OF SOUTHOLD
IXt the meeting of the Southold Town Conservation Advisory Council held Wed., August
17,2005, the following recommendation was made:
i
Moved by Doris McGreevy, seconded by Jack McGreevy, it was
RESOLVED to recommend to the Southold Town Board ofTrustees APPROVAL WITH
qONDlTIONS of the Wetland Permit application of ROBERT SWING to construct a
second-story addition to the existing single-family dwelling.
Located: 4295 Bayshore Rd., Southold. SCTM#53-6-24
The CAC recommends Approval of the application with the Condition gutters and
drywells are installed to contain the roof run-off and a 10' non-turf buffer is installed
landward of the bulkhead.
Vote of Council: Ayes: All
Motion Carried
-
.
.
SWING Property
Situate: Bayshore Road; Town of South old, NY
SCTM #: 1000 - 053 - 06 - 024
(Photo taken on September 16, 2004)
Photo indicating the location of the proposed 2nd_Story Addition atop
the existing single family dwelling within the central section of subject
property, and the existing wood bulkhead within the eastern half of said
property. Photo taken from the southeastern section of subject
property and the shoreline of Shelter Island Sound, facing northwest.
.
.
SWING Property
Situate: Bayshore Road; Town of South old, NY
SCTM #: 1000 - 053 - 06 - 024
(Photo taken on September 16, 2004)
. AREA of 2nd STORY ADDITION
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Photo indicating the location of the proposed 2nd_Story Addition atop
the existing single family dwelling within the central section of subject
property. Photo taken from Bayshore Road, facing east towards Shelter
Island Sound.
.
.
SWING Property
Situate: Bayshore Road; Town of Southold, NY
SCTM #: 1000 - 053 - 06 - 024
(Photo taken on September 16, 2004)
Photo indicating the location of the proposed 2nd_Story Addition atop
the existing single family dwelling within the central section of subject
property, and the existing wood bulkhead within the eastern half of said
property. Photo taken from the shoreline of subject property and
Shelter Island Sound, facing west.
.
.
SWING Property
Situate: Bayshore Road; Town of South old, NY
SCTM #: 1000 - 053 - 06 - 024
(Photo taken on September J 6, 2004)
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Photo indicating the connection between the subject property's existing
wood bulkhead (northwestern corner) and the northerly adjacent
property's existing concrete wall (southern terminus). Photo taken
from the southern property line of the northerly adjacent parcel, facing
west.
.
.
SWING Property
Situate: Bayshore Road; Town of Southold, NY
SCTM #: 1000 - 053 - 06 - 024
(Photo taken on September /6, 2004)
Photo indicating the connection between the subject property's existing
wood bulkhead (northwestern corner) and the northerly adjacent
property's existing concrete wall (southern terminus). Photo taken
from the southern property line of the northerly adjacent parcel, facing
southwest.
--.....
. .
SWING Property
Situate: Bayshore Road; Town of Southold, NY
SCTM #: 1000 - 053 - 06 - 024
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~ SURVEY PREPARED FOR
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e CLIENT: SWING
; SURVEY UPDATE 11/15/2004
l!J TO ADD COMMENTS REQUESTED.
~ REVISED AS PER COMMENTS 4/26/2005
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INFORM A TlON ONL Y 6/16/2005
MAP NO. 1124 FILED 5/19/1933
TAX MAP DESIGNATION 1000-53-06-024
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WITH HEA VY GRA VEL.
NOTE: ALL SURROUNDING PARCeLS
WITHIN 200' ARE IMPROVED AND
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Survey Solutions, Inc.
46 Hunting Hill Drive
Dix Hills, NY 11746
DATE 2/10/2004
(C) COPYRIGHT
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"AMENDED MAP OF PECONIC SA Y ESTA TES"
LAND SURVEYORS
(631) 858-1675
Fax 858-1676
N. Y.S. LlC. NO. 49857
.-.......... .-...
.
.
Suffolk Environmental Consulting, Inc.
Newman Village, Main Street, PO. Box 2003, Bridgehampton, New York 11932-2003
(631) 537-5160 Fax: (631) 537-5198
Bruce Anderson, M.S., President
February 2, 2007
Mr. James King, President
Board of Trustees
Town Hall
P.O. Box 1179
Southold,~ 11971
FEll -lj 2007
Re:
Situate:
SCTM #:
SWING Property
4295 Bay Shore Road; Town of Southold, NY
1000 - 053 - 06 - 024
Dear Mr. King,
As you may be aware, this Firm represents Mr. Robert Swing, owner of the above
referenced property, who benefits from a Board of Trustees Permit Resolution for
improvements thereon, issued in August, 2005. In the interim, the project has
undergone an extensive review from the New York State Department of Environmental
Conservation (NYSDEC) which has resulted in a Wetlands Permit reflecting a revised
project further conforming with respect towards wetland setbacks. Consequently, we
wish to obtain final approval from your Board to reflect these modifications.
Accordingly, please find enclosed:
(1) Revised Project Description (two [2] copies);
(2) Site Plan of subject property, prepared by SUFFOLK
ENVIRONMENTAL CONSULTING, INC., last dated September 27,
2006, indicating the existing and proposed conditions thereon,
adapted from the survey prepared by CHRIS HENN, L.S.,
(two [2] copies);
(3) Copy of the NYSDEC Tidal WeUands Permit (No. 1-4738-03490/00001),
issued January 26, 2007, for your reference; and
(4) Check made payable to the Town of Southold to cover the
requisite application fee.
Please review these items. In the interim, this office has requested for the surveyor to
revise the associated survey to reflect this project, and upon receipt, this office will
forward you same.
.- .........
.
.
By way of this correspondence, and on behalf of Mr. Robert Swing, I request that you
commence review of this application and schedule for the next available Board of
Trustees meeting for discussion and final approval. Should you have any questions
regarding this matter, or require additional information, please feel free to contact this
office at any time. Thank you in advance for your cooperation.
Sincerely,
Matt D. Ivans
enc.
cc: R. Swing
P. Moore, Esq.
.
.
REVISED PROJECT DESCRIPTION
for the
SWING Application
Situate: 4295Bayshore Road; Town of Southold, NY
SCTM #: 1000 - 053 - 06 - 024
Applicant proposes to construct an
addition to the landward side of the
existing dwelling, containing 627.0
square feet +, removal of the existing
septic system and replace with an
updated sanitary system within the front
yard, installation of a French drain along
the southern side yard property
boundary and establishment of a Non-
Disturbance BuRer (5.0' wide) along the
landward side of the existing wood
bulkhead.
,'. FEB - 5 2007 . '. . .
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F...... .
.
.
Suffolk Environmental.Consulting, Inc.
Newman Village, Suite E, 2322 Main Street, P.O. Box 2003, Bridgehampton, New York 11932-2003
(631) 537-5160 Fax: (631) 537-5291
Bruce Anderson, M.S., President
September 19, 2005
Mr. Albert 1. Krupski, President
Southold Town Hall
53095 Main Road
P.O. Box 1179
Southold, NY 11971
Re:
Situate:
SWING Application
4295 Bay Shore Road
Town of Southold, NY
1000 - 053 - 06 - 024
ffB) f€ Ik f€ n W &' FR)
ln11 . I II
SEP 2 0 2005 i, :J'
J.",,,,..,./
SCTM #:
SOU/hold Town
Board of Trustees
Dear Mr. Krupski,
As per your correspondence regarding approval for the property referenced above
please find:
(1) Check made payable to the Town of South old to cover
Pennit fee in connection with the property referenced above.
Should you have any questions concerning this matter, please feel free to contact
this office at any time. Thank you as always for your attention and consideration.
Sincerely,
Q-K~
Diane K. Wassick
enc.
cc: R. Swing
.
PLANNING BOARD MEMBERS
JERILYN B. WOODHOUSE
Chair
WILLIAM J. CREMERS
KENNETH L. EDWARDS
MARTIN H. SIDOR
GEORGE D. SOLOMON
.
MAIliNG ADDRESS:
P.O. Box 1179
Southold, NY 11971
OFFICE WCATION:
Town Hall Annex
54375 State Route 25
(cor. Main Rd. & Youngs Ave.)
Southold, NY
Telephone: 631 765-1938
Fax: 631 765-3136
PLANNING BOARD OFFICE
TOWN OF SOUTHOLD
To: Town of Southold Board of Trustees
~~ ~ A~G ~ : :'5 ~ ~
From: Mark Terry, Senior Environmental Planner
L WRP Coordinator
Date: August 15,2005
Southold Town
Board of Trustees
Re: Request for Permit for Robert Swing
SCTM#1000-53-6-24
The proposed action involves the construction of a second story addition to an existing single
family structure in Southold.
The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the
Town of South old Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. Based upon the information provided on the L WRP Consistency Assessment Form
submitted to this department, as well as the records available to me, it is my recommendation
that the proposed action is generally CONSISTENT with the Policy Standards and
therefore is CONSISTENT with the L WRP
Pursuant to Chapter 95, the Board of Trustees shall consider this recommendation in preparing
its written determination regarding the consistency of the proposed action.
Please contact me at (631) 765-1938 if you have any questions regarding the above.
Cc: Conservation Advisory Council
Heather Tetrault, Environmental Analyst
.
.
Albert J. Krupski, President
John Holzapfel, Vice President
Jim King
Martin H. Garrell
Peter Wenczel
Town Hall
53095 Main Road
P. O. Box 1179
Southold, New York II 971
Telephone (631) 765-1892
Fax (631) 765-1823
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use only
Coastal Erosion Permit Application
X Wetland Permit Application
Grandfather Permit Application
Waiver/Amendment/Changes
,.....-Recei ved Application: '7/Q.IOIS"
.---Received Fee: $ ~()/
~ompleted Application '11 fct-IGr- ~ [' 'c nH In1
c;llG~~ I ~
Incomplete 1----
SEQRA Classification: ~i . . I I
Type I Type II Unlisted ti U U L I L LvuJ Il.::/
-
Coordination: (date sent)
--CAC Referral Sent: ~ J /cJd-/~
-----Date of Inspection: K /I,,! /0'\ Soulho!d Tol'lO
Receipt of CAC Report: B01rd GT Trustees
Lead Agency Determination:
Technical Review:
--' Public Hearing Held: i/1,y410~
Resolution:
L~P ...........
Name of Applicant ROBERT SWING
Address
7 Windsor Lane; East Northport, NY 11731
Phone Number( 212
517-9667
Suffolk County Tax Map Number:
1000 - 053 - 06 - 024
Property Location: 4295 Bayshore Road; Southo1d, NY 11971
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provide LILCO Pole #, distance to cross streets, and location}
AGENT: Suffolk Environmental Consultinq, Inc.
Address:
P.O. Box 2003 Bridqehampton, NY 11932
Phone Number: (631) 537-5160
Fax: (631) 537-5198
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Board of Trustees Application
GENERAL DATA
Land Area (in square feet):
10, 497.5 square feet %
Area Zoning:
Previous use of property:
Sinqle family private dwellinq
Same w/2nd Story Addition
Intended use of property:
Prior permits/approvals for site improvements:
Agency
Date
X No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a
governmental agency?
x
No
Yes
If yes, provide explanation:
Project Description (use attachments if necessary) :
Applicant proposes to construct a 2Rd-Story Addition atop the
existing private single-family dwelling thereon, containing 835
square feet :t.
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Board of Trustees Application
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
Increase the livable space within the "footprint' of the existing
private single family dwelling thereon.
Area of wetlands on lot: 2, 840 ~ * square feet
* Includes section of property containing the surface waters
of Shelter Island Sound.
Percent coverage of lot: 27.1 ~
%
Closest distance between nearest existing structure and upland
edge of wetlands: 0.0 * feet * Jetty within SE property.
Closest distance between nearest proposed structure and upland
edge of wetlands: 52.0 ~ feet
Does the project involve excavation or filling:
x
No
Yes
If yes, how much material will be excavated? N/A
cubic yards
How much material will be filled? N/A
cubic yards
Depth of which material will be removed/deposited: N/A feet
Proposed slope throughout the area of operations: N/A
Manner in which material will be removed or deposited: N/A
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):
No impact to the wetlands will occur due to the location of the
proposal being situated atop the existing single family
thereon, and therefore no proposed structures will encroach any
further than those .structures that exist.
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NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applicant:
Robert Swinq
SCTM# 1000 - 053 - 06 - 024
YOU ARE HEREBY GIVEN NOTICE:
1. That is the intention of the undersigned to request a Permit
from the Board of Trustees to:
Applicant proposes to construct a 2nd-Story Addition atop the
existing private single-family dwelling thereon, containing 835
square feet :to
2. That the property which is the subject of Environmental
Review is located adjacent to your property and is described as
follows:
4295 Elayshore Road; Southo1d, NY
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. 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:
MAILING ADDRESS:
Robert Swinq
7 Windsor Lane; East Northport, NY 11731
PHONE # : ( 631 ) 754 - 9667
Ene.: Copy of sketch or plan showing proposal for your
convenience.
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PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name:
Address:
PLEASE REFER TO THE ATTACHED ADDENDUM
STATE OF NEW YORK
COUNTY OF NEW YORK
I, Matt D. Ivana - Suffolk Environmental Conaultinq, Inc,
residing at Newman Villaqe; Main Street;Bridqehampton, NY,
being duly sworn deposes and says that on the day of
, 2004, deponent mailed a true copy of the Notice set
forth in the Board of Trustees Application, directed to each of
the above named persons at the addresses set opposite their
respective names; that the addresses set opposite the names of
said persons are the address of said persons as shown on the
current assessment roll of the Town of Southold; that said
Notices were mailed at the United States Post Office at
Bridgehampton, that said Notices were mailed to each of said
persons by (certified) (registered) mail.
Sworn to before me this
day of , 2004
Notary Public
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Board of Trustees Application
County of Suffolk
State of New York
Wi11 Lohn - Suffo1k Environmenta1 Consu1tinq, Inc. 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 HIS/HER KNOWLEDGE AND BELIEF,
AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS
APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD
OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD
AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL
DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID
PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY
AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVE(S), TO
ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION
WITH REVIEW OF THIS APPLICATION.
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SWORN BEFORE ME THIS
Llie
~
DAY OF
.T"j
2005
--------------. .
Matthew D. Ivans
Notary Public of New York
No. 011V6053859
Qualified in Suffolk CounlY
Commission Expires January 22, 2007
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Albert J. Krupski, President
James KingJ 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-~,*VI
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
. In the Matter of the Application
of
___2w/AlC_____=~~~~_~ .
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING j
I, ~C/L...J. tj)f:(zfj,J ,residing at AiwM4J t./(,(A~; ",-,,.J ~:
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~(i'l:';FHA,uI/RJ,.J iJu.; V~
1feing duly sworn, depoSe and say: . ! .
That on the' /t"6ay of ~Jr ,200S; I personally posted the property known as
.5WIN<:O ~~
by placing the Board of Trus ees 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 ofthe public
Dated: Ivajr z.i?cor
Sworn to before me this
Z~dayof'~r200S_
N"F
Matthew D. Ivans
Notary Public of New Yorll
No. 011V6053859
Qualified in Suftoik coun~2 2f1J7
Commission ExplTes January .
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Board of Trustees Application
AUTHORIZATION
(where applicant is not the owner)
I, ROBERT SWING, residing at 7 Windsor Lane: East Northport. NY , do herehy authorize
Suffolk Environmental Consultin!!. Inc.
(Agent)
to apply for permit(s) from the Southold Board of Trustees on my behalf.
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(Owner's signature)
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14-16-4 (9/95)-Text 12
I PROJECT I.D. NUMBER
617.20
. I . Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNUSTED ACTIONS Only
SEQR
PART 1- PROJECT INFORMATION lTo be comoleted bv Aoolicant or Proiect soonsor)
1. APPLICANT/SPONSOR I 2. PROJECT NAME
Suffolk Environmental Consulting, Inc. SWING .
3. PROJECT LOCATION:
Municipality Town of South old County Suffolk
4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc. or provide map)
4295 Bay Shore Road; Town of South old, NY (SCTM #: 1000 - 053 - 06 - 024)
5. IS PROPOSED ACTION:
1:81 New o Exnansion D Modification/alteration
6. DESCRIBE PROJECT BRIEFLY:
Applicant proposes to construct a 2'd_Story Addition atop the existing private single-family dwelling thereon, containing 835
square feet '".
7. AMOUNT OF LAND EFFECTED:
Initiallv < 0.0 acres Ultimatelv < 0.0 acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
1:81 Ves o No If No. describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
I:8IResidential Olndust'ial DCommercial OA9riculture OPa'klFo,esVOpen space OOther
Describe:
Private single family residences with related appurtenances.
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENT
AGENCY (FEDERAL, STATE OR LOCAL)?
1:81 Yes DNa If yes, list agency(s) and permit/approvals
New York State Department of Environmental ConserVation approval; Town of Southold Zoning Board of Approval;
Town of So lithoid Building Permit. . .
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
OVes 1:81 No If yes, list agency{s) and permiUapprovals
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
DYes 1:81 No
I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE TO THE BEST OF MY KNOWLEDGE
ApplicanUsponsor name: Malt D. Ivans Suffolk Environmental Consultin" Inc. Date: 9/15/04
~/
Signature: 77 ':::::::
~~.
If the action is in the Coastal Area, and you are a state agency, complete the Coastal
Assessment Fonn before proceeding with this assessment
OVER
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PART 11- ENVIRONMENTAL ASSESSMENT (To be comoleted bv Anencvl
A DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 6H.12? If yes. coordinate the review process and
use the FULL EAF.
DYes oNo ,. ,.
B. WILL ACTION RECEIVE COORDINATED REVIEW.AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If
No, a negative declaration may be superseded by another involved agency.
DYes 0 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, noise levels, existing traffic patterns, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
C2. Aesthetic, agricultural,' archeological, historical or other natural or cultural resources; or community or neighborhood
character? Explain briefly:
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitat, or threatened or endangered species? Explain
briefly:
C4. A community's existing plans or goals as officially adopted, or change in use or intensity of use of land or 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 C1-C5? . Explain briefly:
C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly:
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA?
Dyes oNo
D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
Dyes oNo If yes, explain briefly
PART 111- DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important, or otherwise significant.
Each effect should be assessed in cOMeclion wnh its (al setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d)
irreversibility; (e) geographic scope; and (I) magnnude, If necessary, add attachments or reference supporting materials. Ensure thai
explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question 0
of Part II was checked yes, the determination and significance must evaluate the potential impact of the proposed action on the
environmental characteristics of the CEA.
o Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur, Then proceed
directly to the FULL EAF and/or prepare a positive declaration.
o Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the
proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachrrtents as necessary, the
reasons supporting this determination:
-
Name of Lead Agency
Print or Type Name of Responsible Officer Title of Responsible Officer
.
Signature of Responsible Officer in Lead Agency . Signature of Preparer (if different From responsible officer)
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Suffolk Environmental Consulting, Inc.
Newman Village, Suite E, 2322 Main Street, P.O. Box 2003, Bridgehampton, New York 11932-2003
(631) 537-5160 Fax: (631) 537-5291
Bruce Anderson, M.S., President
Via Rel!ular Mail
August 11, 2005
Mr. Albert 1. Krupski, President
Town Hall
P.O. Box 1179
Southold, NY 11971
soutM\d 10wn
'Beard o11tuStlia$
Re:
Hearing
Date:
Situate:
Swing Application
SCTM #:
A ugust 24th, 2005
4295 Bay Shore Road
Town of South old, NY
1000 - 053 - 06 - 024
Dear Mr. Krupski,
As' you may remember, this Firm represents Mr. Swing, owner of the above referenced property
who is seeking approval from your Board to construct a 2nd story addition and to install a new
sanitary system thereon. This matter has been added to the Board of Trustees of the Town of
Southold agenda for August 24th, 2005. Therefore, in accordance with Town Code, please find
enclosed herewith:
I) Signed iind Notarized Affidavit of Mailing; and .
2) Original Certified Mailing Receipts & copies of the same; and
3) Copy of the Legal Notice that was mailed to adjacent property owners.
If you have any questions regarding this matter, please feel free to contact this office at any time.
Thank you in advance for your attention and consideration.
c~~
WilliamJ. Loho .
enclosed
cc: R. Swing
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PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name: Address:
Mr. Joseph Demartino 1500 Willow Terrace Lane
P.O. Box 142
Orient, NY 11957
Mr. Donald F. Hauser 53-40 212th Street
Bayside, NY 11361
Lawrence Anthony Cafaro & Jessica Kerr 60 East 8th Street Apt. 32C
New York, NY 10003
Mr. Albert W. Reibling Jr.
P.O. Box 123
Yorktown Heights, NY 10598
STATE OF NEW YORK
COUNTY OF NEW YORK
William J. Lohn - Suffolk Environmental Consulting, Inc. ,
residing at Newman Village Suite E; 2322 Main Street; P.O. Box
2003; Bridgehampton, NY , being duly sworn deposes and says
that on the 11th day of. August , 2005,
deponent mailed a true copy of the Notice set forth in the
Board of Trustees Application, directed to each of the above
named persons at the addresses set opposite their respective
names; that the addresses set opposite the names of said
persons are the address of said persons as shown on the current
assessment roll of the Town of Southold; that said Notices were
mailed at the United States Post Office at Bridgehampton, that
said Notices were mailed to each 0 e so y (certified)
(registered) mail.
Sworn to before me this !/~
, .2004 200)
Public
Matthew o. Ivans
Notary Public of New York
No. 011V6053859
Qualified in Suffolk County
Commission Expires January 22, 20 a 7
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NOTICE TO ADJACENT PROPERTY OWNER
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BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applicant:
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Robert Swing
SCTM # 1000 - 053 - 06 - 024
YOU ARE HEREBY GIVEN NOTICE:
1. That is the intention of the undersigned to request a Permit
from the Board of Trustees to:
- ---~ _._~-- ---------
Construct a 2M story addition and to install a new sanitary
system.
2. That the property which is the subject of Environmental
Review is located adjacent to your property and is described as
follows:
4295 Bay Shore Road; Town of Southold, NY
3. That the project which is
under Chapters 32, 37, or 97
comment. You may contact the
writing.
subject to Environmental Review
of the Town Code is open to pUblic
Trustees Office at 765-1892 or in
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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:
MAILING ADDRESS:
Robert Swing
7 Windsor Lane; East Northport, NY 11731
"
PHONE # (631 ) 537-5160 (Suffolk Environmental Consulting)
Ene.: Copy of sketch or plan showing proposal for your
convenience.
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Suffolk Environmental Consulting, Inc.
Newman Village, Main Street, P,O, Box 2003, Bridgehampton, New York 11932-2003
(631) 537-5160 Fax: (631) 537-5198
Bruce Anderson, M,S" President
July 8, 2005
.-"'-'
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Mr. Albert J. Krupski, President
Board of Trustees
Town Hall
P.O. Box 1179
Southold, NY 11971
~~tlEOWlEA
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JUL 12 2005 H:f.li
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Southold Town
Board of Trustees
Re:
Situate:
SCTM #:
SWING Property
4295 Bay Shore Road
Town of South old, NY
1000 - 053 - 06 - 024
Dear Mr. Krupski,
This Firm represents Mr. Robert Swing, owner of the above referenced property, who is
seeking all required regulatory permits to improve thereon. In order to do so, approval
from your Board is required. Enclosed herewith please find a completed Wetland Permit
Application. Application contents are as follows:
(1) Town of South old Trustees Wetlands Permit Application;
(2) Short Environmental Assessment Form;
(3) Local Waterfront Revitalization Program Consistency Assessment Form;
(4) Photographs of subject property, indicating the location of the
proposed structure thereon (two [2] sets);
(5) Location Map for easy reference (two [2] copies);
(6) Survey of subject property, prepared by SURVEY SOLUTIONS, INC"
indicating all existing and proposed structures thereon, last dated
June 16,2005 (two [2] copies); and
(7) Check made payable to the Town of South old in the amount of$250.00
covering the requisite application fee.
<
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By way ofthis correspondence, and on behalf of Mr. Swing, I request that you commence
review of this application and schedule for the next available Board of Trustees meeting
for permit issuance. Should you have any questions regarding this matter, or require
additional information, please feel free to contact this office at any time. Thank you in
advance for your cooperation.
Si=;,(
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Matt D. Ivans
enc.
cc: R. Swing
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.
Suffolk Environmental Consulting, Inc.
Newman Village, Suite E, 2322 Main Street, P.O. Box 2003, Bridgehampton, New York 11932-2003
(631) 537-5160 Fax: (631) 537-5291
Bruce Anderson, M.S., President
Mr. Albert J. Krupski, President
Board of Trustees
Town Hall
P.O. Box 1179
Southold, NY 11971
f5)IIE ~ IE ~ W IE rru
\f'U JUL 27 2005 IlW
July 26, 2005
Southold lown
Board of lrustees
Re:
Situate:
SWING Application
4295 Bay Shore Road
Town of South old, NY
1000 - 053 - 06 - 024
SCTM #:
Dear Mr. Krupski,
As you know, this Firm represents Mr. Swing, owner of the above referenced property, who is
pending approval from your Board to construct a 2"d_Story Addition to the existing dwelling
thereon. In order to fulfill the completeness of our application, please find enclosed:
(1) Local Waterfront Revitalization Program Consistency Assessment Form;
Kindly include the cnclosed item within our pcnding application package and finalize the review
of same so that we may be scheduled before the next available Town of South old Board of
Trustees meeting. Should you have any questions regarding this matter, or require additional
information, please feel free to contact this office at any time. Thank you as always for your
attention and consideration.
~
Matt D. Ivans
enc.
,
cc: R. Swing
.
.
~ [ ~l [2: :5[ ~
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A.
INSTRUCTIONS
Sout.old Town
Board 0\ Trustees
I. All applicants for permits' including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of South old 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.
2. Before answering the questions in Section C, the preparer ofthis 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).
3. If any question in Section C on this form is answered "yes", then the proposed action may affect the
achievement of the LWRP policy standards and conditions contained in the consistency review law.
Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a
determination that it is consistent to the maximum extent practicable with the L WRP policy
standards and conditions. If an action cannot be certified as consistent with the L WRP policy
standards and conditions, it shall not be undertaken.
A copy ofthe LWRP is available in the following places: online at the Town of South old'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
SCTM#
053
06
024
The Application has been submitted to (check appropriate response):
Town Board D Planning Dept. D Building Dept. D Board of Trustees cgJ
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)
D
D
cgJ
(c)
Permit, approval, license, certification:
Nature and extent of action:
Applicant proposes to construct a 2nd -StOry Addition atop the existinl!: private sinl!:le
family dwellinl!: thereon, containinl!: 835 square feet :1:.
Attach additional sheets if necessary
"
. .
Location of action: 4295 Bav Shore Road; ArshamomoQue; Towu of Southold. NY
Site acreage: 0.2 acre %
Present land use: Improved with sin!!le-familv dwellin!! and related appurtenances
Present zoning classification:
2. 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: ROBERT SWING
(b) Mailing address:
7 Windsor Lane; East Northport. NY 11731
(c) Telephone number: Area Code (631) 273 - 5800
(d) Application number, ifany: N/A
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes D No t8J
rfyes, which state or federal agency?
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and
minimizes adverse effects of development. See L WRP Section III - Policies; Page 2 for evaluation
criteria.
[gJ Yes 0 No 0 Not Applicable
As indicated within Policy 1, "Development that does not reinforce the traditional land use pattern of the Town of
Southold would result in a 1055 of the community and landscape character of Southold.", this project is a proposal to
construct a 2od_Story Addition to an existin~ dwellin~ within subject property, a property situated within a nei~hborhood
consistin~ primarily of similarly-sized sin~le-family dwellin~s within similarly-sized properties. The proposal, as desi~ned,
will not result in adverse effects to the surroundin~ environment in that the project will not expand upon the "footprint" of
the existin~ dwellin~, and will not encroach any further towards the surface waters of Shelter Island Sound to the east.
In addition, the surroundin~ nei~hborhood is comprised of older residential dwellin~s which have existed harmoniously
within this area for years and have not resulted in any form of adverse effects to the surroundin~ environment.
Accordin~ly, we believe that this project is consistent with this policy.
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources oftbe Town of South old. See
L WRP Section III - Policies Pages 3 through 6 for evaluation criteria
DYes 0 No [gJ Not Applicable
Policy 2 is not applicable in that subject lot and the surroundin~ nei~hborhood cannot be deemed a substantial historic
and/or archaeolo~ical resources.
~
.
.
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of South old. See
LWRP Section III - Policies Pages 5 through 7 for evaluation criteria
[;g] Yes D No D Not Applicable
Subject proposal will not adversely impact the visual quality of the surroundin~ area in that the existin~ property
has been improved with a sin~le-family residence for approximately fifty (50) years without any evidence of resultin~
in adverse impacts to the nei~hborhood. In addition, the nei~hborhood itself is comprised of similarly sized properties,
improved similarly for many years, and which also has not resulted in any form of adverse impacts to the surroundin~
area. Furthermore, this policy could not preclude both the le~al creation of this property as a buildin~ lot, or the
improvement thereon.
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See L WRP
Section III - Policies Pages 8 through 16 for evaluation criteria
DYes D No [;g] Not Applicable
Subject property is currently improved with a bulkhead within the western section of subject property and has
protected subject property from any and all floodin~ and/or erosion events since the improvement thereon. The
proposal is to construct a 20d_Story addition to the existin~ dwellin~ and therefore cannot be applicable to Policy 4.
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See L WRP Section III
- Policies Pages 16 through 21 for evaluation criteria
[;g] Yes D No D Not Applicable
Subject proposal will comply with Policy 5 in that a more efficient sanitary system is proposed to be installed thereon,
and at a ~reater distance than the existin~ septic system is located from the wetlands boundary, and that public water
is to be utilized. Accordin~ly, this proposal will not only maintain the water quality and supply within the Town of
50uthold, but will improve conditions within the site with the installation of the more efficient sanitary system.
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of South old ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22
through 32 for evaluation criteria
DYes D No [;g] Not Applicable
Subject proposal is not applicable to Policy 6 in that a 2od_Story addition to the existin~ dwellin~ is proposed to be
constructed atop said dwellin~, and that no further encroachment to the wetlands will take place than which presently
exists.
Attach additional sheets if necessary
-~
~
"'"
.
.
Policy 7. Protect and improve air quality in the Town of South old. See LWRP Section III - Policies
Pages 32 through 34 for evaluation criteria
DYes D No [S] Not Applicable
Subiect proposal is not applicable in that the proposal is simply to construct a 2od_Story Addition to the existinR dwellinR
within subject property which will not result in any form of adverse effects to air quality. AccordinRly, this proposal is
not applicable with this policy.
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
DYes D No [S] Not Applicable
Subiect proposal is not applicable in that the proposal does not involve disposal and/or transportation of solid waste,
hazardous waste, toxic pollutants, petroleum products.
Attach additional sheets if necessary
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, aud recreational use of, coastal waters, public lands, and public
resources of the Town of Southold. See L WRP Section ill - Policies; Pages 38 through 46 for evaluation
criteria
DYes D No [S] Not Applicable
Subject proposal is not applicable to this policy in that the proposal will not impede any access to the surface waters in
and around subject properly and/or become detrimental to the recreational use of the surroundinR resources.
Attach additional sheets if necessary
WORKING COAST POLICIES
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependence uses iu
suitable locations. See LWRP Section ITI - Policies; Pages 47 through 56 for evaluation criteria
DYes D No [S] Not Applicable
Subject proposal is not applicable in that the proposal does not involve a water-dependent use (i.e. marina,
aquaculture, etc...).
Attach additional sheets if necessary
.
,
~
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town Waters. See L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria
DYes D No IZl Not Applicable
Subiect proposal is not applicable in that the proposal does not involve any form of marine resource management
(i.e. commercial fisheries, recreational fisheries, aquaculture, etc.. ,j.
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See L WRP Section m - Policies; Pages
62 through 65 for evaluation criteria.
DYes D No IZl Not Applicable
Subiect proposal is not applicable in that the proposal does not involve agricultural lands (i.e. the conversion of
farmland, the establishment and/or maintenance of new coastal agricultural production, etc...)
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See L WRP
Section III - Policies; Pages 6S through 68 for evaluation criteria.
DYes D No IZl Not Applicable
Subiect proposal is not appl icable in that the proposal does not involve the conservation of energy resources on a
commercial level and/or the promotion of alternative energy sources, proper maintenance of fuel storage facilities
and/or the extraction of mineral extraction
Attach additional sheets if necessary
Created on 5/25/05 11:20 AM
'"
DEC PERMIT NUMBER .EFFECTIVE DATE
1-4738-03490/00001 8 January 26, 2007
FACILITY/PROGRAM NUMBER(S) EXPIRATION DATE(S)
,~ PERMIT
Under the Environmental January 31,2012
Conservation Law
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
TYPE OF PERMIT. New 0 Renewal 0 Modification 0 Permit to Construct 0 Permit to Operate
o Article 15, Title 5: Protection of Waters
o Article 17, Titles 7, 8: SPDES
o Article 27, Title 9; 6NYCRR 373:
Hazardous Waste Management
o Article 15, Title 15: Water Supply
o Article 19: Air Pollution Control
o Article 15, Title 15: Water Transport
o Article 23, Title 27: Mined Land
Reclamation
o Articie 34: Coastal Erosion
Management
o Article 15, Title 15: Long Island Welis
o Article 24: Freshwater Wetlands
o Article 36: Floodplain Management
o Article 15, Title 27: Wild, Scenic and
Recreational Rivers
. Article 25: Tidal Wetlands
o Articles 1, 3,17, 19, 27,37; 6NYCRR
380: Radiation Control
o 6NYCRR 608: Water Quality Certification
o Article 27, Title 7; 6NYCRR 360:
Solid Waste Manaoement
PERMIT ISSUED TO TELEPHONE NUMBER
Robert SwinQ (631) 273-5800
ADDRESS OF PERMITTEE
7 Windsor Lane, East Northoort, NY 11731
CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER
Suffolk Environmental ConsultinQ, P.O. Box 2003, Bridaehamoton, NY 11932-2003 (631) 537-5160
NAME AND ADDRESS OF PROJECT/FACILITY
4295 Bav Shore Road, South old SCTM # 1000-053-06-024
COUNTY TOWN WATERCOURSE NYTM COORDINATES
Suffolk Southold Shelter Island Sound
DESCRIPTION OF AUTHORIZED ACTIVITY;
Construct a one story addition adjacent to the western side of the existing single family dwelling. Install new septic
system. All work must be done in accordance with the attached plans stamped NYSDEC approved.
.
FE8 - 5 2.007
i
I
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all
applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of
this permit.
ADDRESS
Region 1 Headquarters, SU Y @ Stony Brook, 50 Circle Road,
Ston Brook, NY 11790-340
D
29, 2007
Page 1 of 4
~
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
SPECIAL CONDITIONS
1. During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix
trucks, mixers, or other devices enter tidal wetlands and/or protected buffer areas.
2. Any debris or excess material from construction of this project shall be completely removed from the adjacent area
and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands or protected buffer areas.
3. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted
activities.
4. All areas of soil disturbance resulting from the approved project shall be stabilized as per the specifications of the
approved plans immediately following project completion or permit expiration, whichever comes first. If the project site
remains inactive for more than 48 hours or planting is impractical due to the season, then the area shall be stabilized
with straw or hay mulch or jute matting until weather conditions favor germination.
5.. The storage of construction equipment and materials shall be confined within the project work area and/or upland
areas greater than 75 linear feet from the tidal wetland boundary.
6. All disturbed areas where soil will be temporarily exposed or stockpiled for longer than 48 hours shall be contained
by a continuous line of staked haybales 1 silt curtains (or other NYSDEC approved devices) placed on the seaward side
between the fill and the wetland or protected buffer area. Tarps are authorized to supplement these approved methods.
7. If seeding is impracticable due to the time of year, a temporary mulch shall be applied and final seeding performed
at the earliest opportunity when weather favors germination and growth, but not more than six months after project
completion.
8. All erosion control devices shall be maintained in good and functional condition until the project has been completed
and the area has been stabilized.
9. All fiil shall consist of "clean" sand, gravel or soil (not asphalt, slag, f1yash, broken concrete or demolition debris).
10. Necessary erosion control measures e.g., staked haybales, silt fencing, etc. are to be placed on the downslope
edge of any disturbed areas. This sediment barrier is to be put in place before any disturbance of the ground occurs and
is to be maintained in good and functional condition until thick vegetative cover is established.
11. Roof runoff shall be directed into dry wells a minimum of 75 linear feet landward of the tidal wetland boundary for
immediate on-site recharge.
12. Driveways and parking areas shall be constructed of NYSDEC approved pervious materials.
13. Sanitary systems (bottom of the tank and leaching pools) shall be located a minimum of 2' above seasonal high
groundwater.
14. The permit holder shall incorporate the attached Covenant (or similar language) to the deed for the property where
. the project will be conducted and file it with the Clerk of Suffolk County within 30 days of the effective date of this permit.
This deed covenant shall run with the land in perpetuity. A copy of the covenanted deed or other acceptable proof of
record, along with the number assigned to this permit, shall be submitted within 90 days and prior to commencement
of any regulated activity at the site to : NYSDEC, Marine Habitat Protection, SUNY @ Stony Brook, 50 Circle Road,
Stony Brook, NY 11790-3409, Attn: Compliance.
DEe PERMIT NUMBER
PAGE 2 of 4
1-4738-03490100001
<'
'"
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6NYCRR PART 608
( TIDAL WETLANDS)
1. If future operations by the State of New York require an alteration in the position of the structure or work herein
authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable
obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people
of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the
Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the
State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of
the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to
such extent and in such time and manner as the Department of Environmental Conservation may require, remove
all or any portion of the uncompleted structure or fill and restore to its former conditiQn the navigable and flood
capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal
or alteration.
2. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized
which may be caused by or result from future operations undertaken by the State for the conservation or
improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such
damage.
3. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids,
sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally
deleterious materials associated with the project.
4. Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large
refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause
damage to navigable channels or to the banks of a waterway. .
5. There shall be no unreasonable interference with navigation by the work herein authorized.
6. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the
applicant shall, without expense to the State, and to such extent and in such time and manner as the Department
of Environmental Conservation may require, remove all or any portion of the uncompleted structure orfill and restore
the site to its former condition. No claim shall be made against the State of New York on account of any such
removal or alteration.
7. If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the
subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302,303,
306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met.
8. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top
portion of the enclosed notification form certifying that they are fully aware of and understand all terms and
conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be
signed and returned,. along with photographs of the completed work and, if required, a survey.
9. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the
applicant or his agent as part of the permit application.
Such approved plans were prepared by: Suffolk Environmental Consulting Inc. last revised 9/27/06.
DEe PERMIT NUMBER
PAGE 3 of 4
1-4738-03490/00001
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
"
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification
The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department
of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims,
suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's
undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit
whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not
extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or
omissions, or to any claims, suits, or actions naming the DEC and arising under article 78 of the New York Civil Practice
laws and Rules or any citizen suit or civil rights provision under federal or state laws,
Item B: Permittee's Contractors to Comply with Permit
The permittee is responsible for informing its independent contractors, employees, agents and assigns of their
responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect
to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental
Conservation law as those prescribed for the permittee,
Item C: Permittee Responsible for Obtaining Other Required Permits
The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may
be required to carry out the activities that are authorized by this permit.
Item D: No Right to Trespass or Interfere with Riparian Rights
This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of
others in order to perform the permitted work nor does it authorize the impairment of any rights, tille, or interest in real or
personal property held or vested in a person not a party to the permit.
GENERAL CONDITIONS
General Condition 1: Facility Inspection by the Department
The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an
authorized representative of the Department of Environmental Conservation (the Department) to determine whether the
permittee is complying with this permit and the ECL Such representative may order the work suspended pursuant to ECl
71-0301 and SAPA 401(3),
The permittee shall provide a person to accompany the Department's representative during an inspection to the permit
area when requested by the Department.
A copy of this permit, including ali referenced maps, drawings and special conditions, must be available for inspection
by the Department at all times at the project site or facility, Failure to produce a copy of the permit upon request by a
Department representative is a violation of this permit.
General Condition 2: Relationship of this Permit to Other Department Orders and Determinations
Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any
order or determination previously issued by the Department or any of the terms, conditions or requirements contained in
such order or determination,
General Condition 3: Applications for Permit Renewals or Modifications
The permittee must submit a separate written application to the Department for renewal, modification or transfer of this
permit. Such application must include any forms or supplemental information the Department requires, Any renewal,
modification or transfer granted by the Department must be in writing,
The permittee must submit a renewal application at least:
a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous
Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management
Facilities (SWMF); and
b) 30 days before expiration of all other permit types,
Submission of applications for permit renewal or modification are to be submitted to:
NYSDEC Regional Permit Administrator, SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409
General Condition 4: Permit Modifications, Suspensions and Revocations by the Department
The Department reserves the right to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621, The grounds
for modification, suspension or revocation include:
a) materially false or inaccurate statements in the permit application or supporting papers;
b) failure by the permittee to comply with any terms or conditions of the permit;
c) exceeding the scope of the project as described in the permit application;
d) newly discovered material information or a materiai change in environmental conditions, relevant technology or applicable
law or regulations since the issuance of the existing permit;
e) noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental
Conservation Law or regulations of the Department related to the permitted activity,
DEC PERMIT NUMBER
PAGE 4 OF 4
1-4738-03490/00001
r
EXISTING % ADJACENT WT COVERAGE
House (1 Story):
(Includes BiA." Doon & Sloop)
1,057.0 sq. It. :tlll
Bulkhead/Retaining Wall:
150.0 sq. fl.:f:
TEST HOLE OA TA:
1.5' DARK BROWN SANOY lOAM
2.5' BROWN SANOY CLAY'
0.2' BROWN FINE TO COARSE AND WITH HEAVY GRAVEL
6.8' WATER IN BROWN FINE TO COARSE SAND
WITH HEA VY GRA VEL.
TOTAL
Coverage m:er Lot;
1,20..0 sq. ft.:f:-GI
12.0%:t
PROPOSED % ADJACENT WT COVERAGE
House (I Story): 1, Q401.0 sq. ft.:t-
(Includu only Stoop&omil:.ll Bik'ODoon)
Proposed Addition: 6!1!i.O sq. ft. :t-
Norc: ALL SURROUNDING PARCnS
WITHIN 200' ARE IMPROVED AND
SERVED 8Y' PUBUC WArER.
PARCEL AREA = 10,062 S/F
Bulkheacl/Retaining Wall:
150.0 sq. ft.:t
TOTAL,
1,818.0 sq. it. I-
. ~;'
eo,:erage over Lot:
18.1 %:t
ADJ.
HSE.
EXISTING
NCRETE
RF:TAINING
WALL' .
Proposed Addition .
ApproJcimate location of
exisling sa ptic system
(to be removed)
WOOD
BULKHEAD
73.0'
TTOAL..~NDS
BrJ/J. '/JAR
lI)
::t:
~
~:-I
-~
":::0
...
~-
~.lI)
o IOj !;:
~~=<:
~~
~ .t3
c:::
~
~
~
':Jc:
C)
':lO
rn,
';iQ
~ ~
~ ISLAND /1')' ~-m:r(}",
LEACHING POOLS 'lEI+' / ~M
FIVE (5): 8.0'DlAMITER X 2' EEP ...,., ~
~
-
iDl
1\11.....
'O~ 0
N)'
<cllll
,,-il>
'~ .'
LAND N/F D 'MARTINO
WA. .
o L~ 'E NI!~" '08 F
c: NC. .J(
,', 66.0'
'.
~
FrenchDffl,ln (3D' WxS.u' 0 II: 21.0' L)
(capacily to equal slandllrd8'diameter DryWelll ,
Non-Disturbance Buffer (5.0' wide wlpath) .
-..
q;
,.
CRAI'il. DPa
..
SCALE I U=30'
w_,
CRtIUH1tWAT'm I
IU__
SS'1IC r_
~-,
,
. l:USPOOL
NYSDEC
APPROVED AS PER TEI'lMS
AND CONDITIONS OF
~gRMIT rJ.1-4Z~S'- -03 Y1 /0000 /
DAiE j '7/ 't:JL=.
SITE PLAN for the:
SWING Property
Situate: 4295 Bav Shore Road
Town of 5ou1hold, New York
'. SCTM': 1000-053-06-024
SuiJolk Environmental Consnlting, Ioe.
Phon., (6311 &3T -&160
F... {8311 637 - 6291
P.O. Box 2003 . Brltfgehomplon . NY .11932
I ..J;
Z1
Dille
Seal..
P,"!"re\ by.
CDmllrelJls,
mdl
M.pW,;.""tJ.."''''''l'Dfsu!,flrlP'''il'''l1'
prqoOPd I(f C1IR/fTDPHFR HENN. I t
ITJOFITJ
L---
EXISTING % ADJACENT LOT COVERAGE
HOllse (1 Story);
(Indudes Bi~'O noon & SlooJ>)
Bulkhead/Retaining VI! all:
TEST HOLE DA TA:
1.5' DARK BROWN SANOY LOAM
2.5' SROWN SANOY CLAY"
0.2' BROWN FINE TO COARSE AND WITH HEAVY GRAVEL
6.8' WATER IN SROWN FINE TO COARSE SAND
WITH HEA VY GRA VEL.
TOTAL,
eoyerage m:er Lot:
1,05..0 sq. ft.::t-
ISO.Dsq. ft.:t:
1,20..0sq. ft.:te
H!.O%:t:
PROPOSED % ADJACENT LOT COVERAGE
House (l Story): 1,041.0 sq. ft. :!::Ill-
(Includes only Stoop & omit!! Bi!fYJ Doors)
Bulkhead/Retaining Wall:
Proposed Addition: 6~'j.O sq. ft. :1:-
150.0 sq. ft.:!:
NOTE: ALL SURROUNDING PARCELS
WITHIN 200' ARE IMPROVED AND
SERVF:O Br PUBLlf: WArE"R.
PARCEL AREA = 10,062 S/F
,
TOTAL,
. ~..
Co\'erage over Lot:
PrOposed Addition .
WOOD
BULKHEAD
ADJ.
HSE.
EXISTING
CONCRETE"
RETAINING
WALL"
Approximate location of
existing septic system
(to be removed)
LAND N/F 0. MARTINO
WA . NSJ011 'OS-E
o .
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......, 66.0'
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-- ------~f~fHf:f,;!lFgME"TE"R x 2' F:Ep/EI+' LANe
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73.0'
~
French Drajn (3.0' W If 5.0' D K 21.0' L)
(capacity to eQual standard 8' dameter DryWell) .
Non-Disturbance Buffer (5.0' wide 'Wl'oath)
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SCALE 1 "=30'
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SIP'QC TANK
CE5SPOllL
J. 818.0 sq. ft.:t:-
18.1 %:t:
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SITE PLAN for the:
SWING Property
Sftuate: 4295 Bay shore Road
Town ofSoulhotd, New York
. SaM ff: 1000- OS3 - 06-024
Suffolk Environmental Consulting, Ine.
Phon.: (831)537;' 5150
F8lC (1131/1137-&291
P.O. BOll 2003 . BridgohlllllPlon' NY .11932
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