Loading...
HomeMy WebLinkAboutTR-6196A Albert J.Krupski,'President ���F SO!/j�o s' Town Hall James King,Vice-President ,`O l0 53095 Route 25 Artie Foster P.O.Box 1179 Ken Poliwoda Southold,New York 11971-0959 Peggy A. Dickerson pe � Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6196A Date of Receipt of Application: 8/1/05 Applicant: Terry Waters Property Owners Association SCTM#: 88-5-55 Project Location: Rambler Road and Watersedge Way Date of Resolution/Issuance: September 21, 2005 Date of Expiration: September 21, 2007 Reviewed by: Board of Trustees Project Description: Replace, repair, and construct split rail fence along property line on Rambler Road, clean up beach property by removing vines and briars 10' from the current fence towards the water/wetland area, and seaward of Watersedge Way, and trim Phragmites to 12", with the condition that there be no removal of seashore habitat species including Eastern Red Cedar and Bayberry, and a final inspection at the completion of the project. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. Special Conditions: Final Inspection at completion of project. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. d Albert J. Krupski, Jr., President Board of Trustees Albert J.Krupski,President ��OF SOUryo Town Hall James King,Vice-President ,`O l0 53095 Route 25 Artie Foster P.O. Box 1179 Ken Poliwoda 00 Southold,New York 11971-0959 Peggy A. Dickerson ® p� Telephone(631) 765-1892 olij'COU �� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.:, 6196A Date of Receipt of Application: 8/1/05 Applicant: Terry Waters Property Owners Association SCTM#: 88-5-55 Project Location: Rambler Road and Watersedge Way Date of Resolution/1sssuance: September 21, 2005 Date of Expiration: September 21, 2007 Reviewed by: Board of Trustees Project Description: Replace and construct split rail fence along property line on Rambler Road, clean up beach property by removing vines and briars 15' from the street towards the water/wetland area, and trim Phragmites to 12", with the condition that there be no removal of seashore habitat species including Eastern 'Red Cedar and Bayberry, and a final inspection at the completion"of the project. Findings: The project meets all the requirements,for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. Special Conditions: Final Inspection at completion of project. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. pu� 9. Albert J. Krupski, Jr., President Board of Trustees Albert J.Krupski,President Town Hall -James King,Vice-President �OSUFFO(�►C 53095 Route 25 Artie Foster �� OG' P.O.Box 1179 Ken Poliwoda C y� Southold,New York 11971-0959 Peggy A. Dickerson W Z W Telephone(631) 765-1892 Gy �� Fax(631) 765-1366 sol J* Fax , 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 Y2 constructed Project complete, compliance inspection. I I ,,mac �.,5 mc_+,". , t Albert J.Krupski,President �QF SO(/AyO Town Hall James King,Vice-President ,`O l0 53095 Route 25 Artie Foster .IL P.O. Box 1179 Ken Poliwoda Ty Southold,';New York 11971-0959 Peggy A.Dickerson Q Telephone(631)765-1892 CoU���� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: _Terr� Gj A-� Please be advised that your application dated 0110S has been, reviewed by this Board at the regular meeting of q/a / aS and the following action was taken: " ) Application Approved (see below) �) Application Denied (see below) O 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 asset forth in the instruction sheet The following fee must be paid within 90 days or re-application fees will beenecessary. COMPUTATION OF PERMIT,FEES: TOTAL FEES .DUE: SIGNED: PRESIDENT, BOARD OF TRUSTEES Albert J.Krupski,President ��OFSID Town Hall James King,Vice-President �� l0 53095 Route 25 Artie Foster P.O. Box 1179 Ken Poliwoda Southold,New York 11971-0959 Peggy A. DickersonQ � �� Telephone(631)765-1892 �lg'COU �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES 'TOWN OF SOUTHOLD Board of Trustees Field Inspection Date Address Owner S CTM# Inspected by Findings___. OeP J (A Cies Photos taken C 1 � Elo CY `c O e Wit Ar Field Inspection 8/10/04 Field Inspection 8/10/04 E OVIS 1-20-98 2n6 7-09-99 7-26 00 N700800"wm' 4-03.01 - _ -I - ----_--- - --_ -----_--=-•_ ---- - - - - -r �f-. _,-.__ - - _- - -- �I. 0s-11-01 N 300,800 LOA LG w m L4 c `✓� g LOA h � 1 20 cro a m $ MATCH �- LME MATCH LINE ?31 xy u $ FOR PCL . FOR PCL N0. `o+$tw 2m4A SEE SEC.NO. LS 079-07-05555 N0. SEE SEC• m a $ 079-08-015.2 'm 2 28A J c ►6 ® ^ u� m m $ t f S 10 9eelE� MQ/N t0� y 13.0(d O + U �. a �+ ue 19 24A 20 2.mA '� V 3.1 7.9A(C) / - '�F $ q�y Il 6 aaa 4 §9,e / L34 9D 24.3A(c) O S 7 o $ 15 294fc) A� � 12.1 � 14.2A(e) a ' 1, L28 ww :' 1.4A(c) m v ^oS9 17.4 m 9.84 +a Ift 9P) °' s (66') 312 0 _a$13 %0 � 14 � 28 1.3A(cl snnaeux \\ `b• ysq as 2syti �Po 8q 33° g► 2S a� o bMAIN BA a cmy Creat ,�-. j '�\Q\ <a ®23g +a Ss a $y w "` ,nom d 13.53 17 3 n w '� Sqw 30 ry 8 53 .$ n?9 8 30 WA A ? RATER PACLITY SNE] - w g 9 �t'ID Si i22 8 32 13.52 :� s 17.54 ,ao (669 9)� 0 0 3? 3.5 � � . ) 8® �v +ro 8 24.9A `m 13.51 ' 11.6A 2.OA +A: BASO 88 n 6 ?18�R a0 ,$ m (PARCEL S•OPEN SPACE) ='9 7.OA 3tr1 a �4Y g3O9 d am m a' ?0 Tq 3 uo y 13.3 m + "" (PARCEL V am spam a N ? Bony b ) 4p r 99 8 �9%a % S 5 (50') 13.50 to 13.4 8 � aD s- 13.5 k b y 13.17 13.14 $ 8 >a l0 18 3S Y .n 13.6 FOR PCL.N0. 8m 9°O y 8� �� 4t � � 3) 13.58 13.30 W 17.7 8 U 19& 2e �1 3Sua 8 29A 13.29 +a •?A +m m 9°° A SEE SEG N0. B Atb .a' ® 13.12 13.15 11 ao1 Oo o u (PARCEL•a•OPEN sPacEl � 087-06-0121 `m IS IOa9 'n 9 36 $ 4 4f I Qo un13.27 1 8�16 +a 1)y a'o IS �� an 18 E40 rm 41 � e � m 9 �ql X135 '3 13.11 13.16 j14o 3) 9 28A(c) ►un 13.31 m 13.26 F 1110 ao 4u 1) � ®l6y ®q9a aao �A2 w4 1149 8 F a 1$ A + ► a 4 ►AIOS 1133 ®13.34 .► 1125 z9 ,a y 13.17 IB ?� Q •>6rq �938,� PLEA ,00 � 'a3 am +, � ,b 9 V ^ ISy 8 2 cid s 49107 P4 ° 1148 13.40 C+., +" • ® 13.23 13.224y' g 8 I 39� y?8 v 8 48 § p 0,� •- ® 13.39 17.35 ® 4q p0 ,e A 13.18 � 13 X19 y 0 o as � 46 v+ p ' i = ' an 3. 8 aYT ►� � , o � ,e ®s ►qT 90� 8 47 ,°° >au 6O m ,� L7.47 R qb ]3.41 4$ '{.• 66 64 ,Ay Ipy 52 g Q 4rc 13.42 .38 4 $` LOA „°• ,m ® �'� 13.44 A7 e m 8 QUA 1137 11 13.45 46 L2A 1143 1156 m ® 8 $9 a $q ,o, LOA LOAof mm SNE] y CA. xlvy ,� NTION LOA(c) w' +o ap � SO7 b � m m m PT ua 8� 115 p 8 s 8, ,w aro im afAl'x F Im a a�T a'Aq� g! ua 7 8 9 +w _A- •28 Rw ARCPa 112aravaTe �6 2 1a 3 15 ,m O18.s an xivy •_ '0 ,se i 16 17^ Aro ,w HOG sfa»a'avE a A 818.4 184 u17 NECK �- - -- N 297000 BAY ' �1 � N 297000 g h L aw.b w u. yeuN.lal toe Ra as tw Owmr�n aK Stlptl OlshlCe Ilu --Spl- NWme AeNii.1 lFe --N-- la4.E55 DRAtN E' -�- 9LdtrE/ul ea>d<�Aled (2SI --_ ARE Wff" T D'�F�' ALL -------- } sr.ornx*tar --P-- oLLaWm DISTR=s. NOTICE c -R-- COUNTY OF SUFFOLK ©- K an T+OF SOUTHOLD SECTION NO -; - - - :•,=-t`�'[��'- �w=�' ?y=- smrlm:rih,:,�':t -moi ,� m�,,.._s_,.:- .-' •m•�0emtl u. ■... ,, O.-t -NST-- P� SEWER ,MyRaNf- - - MaWfENANGE.AL,ERATNN.SALE aR , Real Propert Tax Service Agency Y Eh i.ATER. - _ D67RBUIION OF'a(!'f PORTItlN of TIE_ y q.l Q °�•'�• _ - "•-• titi¢'+�''-r-`�li"'•" _- - ,ti.,. .` `• SIiFIC-DQHIT TA%YM.6r9t01�iED'' fC?!+rtY..Center .R(veltleod�N Y,.]1901 °t' °Ae 0A9 088 V O Q _ fs�j4:r.--'_`1�.'w.M,Z?}1�:'$-- .',�', :.}+T ,i. -..-i^� -g 4a''- -•" .. .. _ ��t aoo�-Y".< •f _ ' t.• , , �� s , r .r _ ,- "' 7 4".:r-..=:-'�...-,a. .-.s...,._ _ ...v..v-"•�� - _ _ ,.;Yk .q.�,-r' :.�--r'�L'^�-• -..,.-.f = .r°'�..'.... - .___-_•.S-�e�x.--'->^�"':�?'�__ 2' __ tie • 1911 y[ � ;pe.•A+f 4 Sfa.51 •r v r E.� sr' y •1 �•• �= /s`k.ao'7±• a✓.- �/ ie wwwe Mis.a.s �� II } �R'I N Ito �••� /,�'J` � �I � •r r lywr\•� 2S n4 a ,ri 23 �'• T6RRY { n ) •• °' w09 rcr`s t •� � .i;,,,• � 281 ` ; a . I SO 22 29 ,2 I I =J 2/ e'yr = '49 301Z-1 zo ( — = 72 1,_ -- 'i-' a 3/ w MAP �F I h 47 -- /-g- ' O/8 a TERRY WS4 TERS . { '7/ 1 3 . i _^T C "I BAYV/EW `96 M• 7bwN of SourvoLo W -__ 33 • J +• y . 14 SVP f of of COUNTY ' 70 1 2 f O N N6 w YoRtc • �45 � = 691 J44 ': ✓ t `h + 68� � � 3SI�• / %� 'r Owns sri,/Deva/sy�d by { r % ••� +� it M/SS HELEN G.COCF/RAN O 'b •i 43 r Ir�r' MO/A Stra�f •'e t 0 I'• 6 7 I o :i(� i l /3 'Tow t /f�N. ' t � / � ,, •�.l�. ' 11) (re 1e ,fro✓ /I .�t.LW. ar�aAY. �. • t • 42 Hb hwtby o.►h/y SOAw,nr ..w.,.af►!y y i i� ter/..•..ate./�,a,,,.�is.+,s�r.�,ors J W.. _ .rr 3 7 \', • w t wd MttaA•.o/cYr•tni nwrrone bnvMn t u ^ ) 14/ r" sit 01 Pa n1b i,a/ki/{bvs • : 65-11 r .,• .- t.ti orry w✓A'V 7bvc 4 a~ 3 .41' F n 'i /o ~, Q1.�rr ten..=7< ' 641 p a , f 340't' 9 9 3 .• _ +•`» \ Giwywf,N Y. ,•% "' •'t%- I'p4 `S JZµ" • Sovnvo.D 7bn FLAwN/NG&a4RQ AG . 63 11'' ,1• ,ate �^Nf .., & ia•.+b ,�- G' iai (. �wa.- ahenwo.+ 4 52 '- w �1 r• „ a c h NarlRs 7r SMao,p 61 5b 50 59, 60 ,Jf %'�� pG� 't• r•✓� Y ^ ^cN 'i wic�vcrnamcauaco r- �Pri SED s'� �I• ,•J• �'�r `B�+,p,TE� � =Lah�.-- 3 rr P•R n �•r,ori�'� 5..r.-a r KN rt o + �'- 05 :fin.�,• rods Turk I— » *I Z rf.sr.t �n e.•�s•�nen t•ny:h.tiee/seohen a•r-I_� ; • Se�9c fi'enoh.� Ti/i,,i// � w.fh'5.1" / �: ;'K e..vr Bald•n/•fs h n9/irt Me..f0 dyyH.,��.wwOw•iar� � hF .ra./of/h•,.ur,��rid.aM•I/iw tesr/rr/gtfw• � t t� i •.ntc_ ... .:.4�db.+ss��r•r--.�N. I P.,• - JConflsur„+firw/isSfwt 1•.,:, Oo&m/a mob w r,n Ovy. y TyP,ci/We// i Wefrr ftsArd of 1Q/ .,/ 1 j .• .•,• » sewe qa Syff*. Riqu,rv0 � i r' -s y;•' z-/7o e✓ac/c pc�v/o jcrcotr/,z,/s J�so ,• 1 , jp�Lp/J32,49,70- ry/ , t' Ti/i j,e/d or.7-B'abd/owpa✓.s fwLL✓13-17 J3.4B,S/.t! She//ow Poo/ a. �/ab<•cc/lcr4+fS.7P,f770-7E j� -rRr.'t+i '1 Sfl SI •r °I { • 'I R O A .asrrr..Ilu v .,moi`.a. ..y.r...... f^af N rl 2 '�NY\°`'a° y�1�S li,•, � � TLRRY � i L I y 23 wn rcRs28 TO t C" I �: � 22 I• 11-1Z Z9 t 149 oIN• Z-1 I , g o ZO I .48 o I t = 721.1 — '1 3/ I _ .2 M � MAP DF ' 4 /8 TERFd Y w TE/4S I 1 Y \ i,46• ,__,4L• I ••I r i ( BAW froYV/E �.. 7bwv OF Sou TMOLD •! 33 • d •" Svol,'MK CovNry • 4 °•• 701 4 1 --- '• / ° N6W YORK 2 0 N Q s 45 /7 44 34 %¢68 / by i M/SS HELEN G.CocNRAN "I,r ` • :43 ••i.• f, I A CA r ®w.rr•,.+ F MO/n SOv--vat "6 7 I• o it /3 t � J t 3612 •� � •/Z �y (r•ee ,.nor ov i 1 � C 1 A .�4z ►wh.rrby r..n/y M.t ta....P...N...�/I.sy b 66 ! ' ' `a • 2 w fr.n aui.1/slwyi�I..flr/Id Slit./I�/9sd I W _=� 3 7 // w 2 w d Nrt aMe cr esrl rank wsv�m/xQ/rwm/esn � � + ••- � � � d JIT A/Qo,nx,ww/'ked Iris e Orro � y.� ;! 6Sok F 'b o �• /O4. ti 2 p 3 B ,i `' 6iwwprt,N Y 641 J ; 's}O`-` 39 :-1 " -a 9 i , ` ;.� �,�. •. I App.e...i Q-..�.._,•,/ase • r l I•r 1�"`: V/1G��' , y • •° ,e( SOU rNoLD TOWN FZ.1 www S 4RQ. 6.3A t 'Q" ,/+N•.• r1. G o pl 6 , . °,."- - ,�.. ..r 5 1.1 'o I II •r, 53 r 6,2- 52 t r •; •�/e/re / • � 0 . : Trsar ps 6/ ..,. b 56 58 .: 59' r , 1 0 " ` •T••t.y u'-1-G� ,r ,,,a• y ^^G r/ �•; w—ocrm/ Rcaf//Rlo /. FrSE�'� ,o° °rJ- •;�. BL A�,.cE� i --L-ia iToe.- 3 �1 •�;' ftA T, 67 �— •t S �1� ,� r"^i rf�"n" - Lon /✓/nr/9oo1•on ••-� f— � • _�I ; Se�9a 7Ycnch— Ti/r�1/d ' •' T/N�i.//, -,/h 1r/h.f nL- nJ JaA.Ir/rn blr,,n /M W' xft r., s ,r TyP/co/W.// I ` Wo/ar/osltd of�Q/ nA(01 I �... -Ti �'/7°B/or h.Each ..di i I ,.,, r r Sews�e dy.rY.tir,Reylr/nrd • �°] ]� 1 f•' 7-/70 b/orh Poi°/slw Lo/J/,2,/8-J/,S0 /o,&Poo/s for Lots32,49,70-72 7yP,r1I Py-/L orf - °' T/%s{.e/d orJ-8 s/rr//°,rPas/sfa✓LdJ 3-/7 I sha//ow Roo/ I c. `I r,.t r� /r b,•oc/Fcr L,+fs JZ,49 70.74 �FFo� Town Ha Albert J, Krupski,President 63095 Route125 James King,Vice-president � � p.0.Bax 1179 Artie Fostery x Southold, New York 1.1.971-0959 Ken Poliwoda Peggy A. DickersonTelephone (631) 765-1892 Fax(631) 766 13 E Ep U u I BOARD OF TOWN TRUSTEES TOWN OF SOUTKOLD Southold Town Board of Trustees Ofc1ce Use Only _Coastal Erosion Permit Application Minor Ql tYt c �Wctland pernut Application __Aaai uu Waivcr/Amendment/Cbangcs f�0}���e ecEivcd Application:i pe}cr Corbl►, CX0 V7-750D --Kc-ceived Fee:$ __,C�dffipleted Application 4 ©-fir e• _Incomplete _S1:QRA Classification: J16n i1 LLInek Typc I Type II U0stcd _Coordination:(date sent) _ kora( (63)) 7&7- X3 A� _CAC Referral Sent: _iDate of Inspection: T70 _Receipt of CAC Report: J ),-13 _Lead Agency Determination: I/ _T,cehnica l Review: ``�� �� 2 Z �ublic Hearing Held: 4 Resolution: . _AAnn. ,) Name of Applicant-j- ,PL Vu's Address-6 6 D Phots e Number:( ) 0 3 Suffolk County Tax Map Number: 1000 - Property 000 -Property Location: Cmej a I, � & I. �Jier� (provide LILCO Pole#, distance to cross streets, and looation) AGENT: Cv�ta (If applicable) Address: �J No Phone, CIO, 7'7 -�7�Z �� 6 3 i 763 e 4 Board of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning:_ Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Agency Date V NoP rior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No_,�L__Yes 1f yes, provide explanation: Project Description(use attachments if necessary): de4ei LAO k ne�'jN' dd dv s we d �wr.� MeinA�k Board of Trustees ApplicatYvn WETLAND/TRUSTEE LANDS A>PPUCATION DATA Purpose of the proposed operations: IMGIZr3ec, � /� v eiCS 4viA i tyl )' .001 Area of wetlands on lot: square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? )V _No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations:_ Manner in which material will be removed or deposited: 4, Mel, 411*eA w�UM v cei Statement of the effect, if any, or) the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): I}>' X01- ������ :��� � we�►�� r Board of Trustees APPlicat..-- County of Suffolk State of New York BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHF-IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATENIENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HISMER 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 REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITHREV W OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIIS DAY OF ,20 Notary Public B.- A of Trustees ApplicatiOl,- AUTHORIZATION (where the applicant is not the owner) nn I, �•�/n G G�� If/ldri8�. � °v Xding (print owner ofproperty) (mailing address) do hereby authorize `�k (Agent) to apply for permit(s) from the southold Board of Town Trustees on my behalf. (Owner' s signature) �Jc�c�L I Ul� �.+�(�►) ���� G�� SSS 8 ApFLICANTIAGENT/RETRESENTATI'VE TRANSACTIONAL DISCLOSURE FORM je Town a tho s Code of Eth'cs psphibi a conflicts of intcrast oa the n rS of town officers and�tztalovec5 Thr taum0sG : t fo i t r v' in do w ieh al the wn o sib c n s ret alio t to wh r act n,ecesQarvto avoid game. YOUR NAME: W-t, t (Last name,first name..rpiddle 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.) Tar grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat r Mooring exemption from plat or official map �� ' Planning Other (If"Other''.name the 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? "ltclationship"includes by blood.marriage.or business interest,alas even a partial owners of B(or employment by)a corporation including a partnership,in which the town officer or employe 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 or position of that person Describe the relationship between yourself(the applicant/ogent/reprusentative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe to the space provided. The town officer or employee or his or her spouse.sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of,the applicant (-,vhcn 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,partner,or employee of the applicant;or p)the actual applicant. DESCRIPTION OF RELATIONS141P Submitted this d�_ o y of '200_ Signature Print Name Form TS 1 TERRY .WATERS PROPERTY OWNERS A55oaATION P: O. BOX 1959 SOUTHOLb, NEW YORK 11971 August 13"', 2004 Ms. Heather Tetrault Southold Town Board of Trustees P.O.Box 1179 Southold,New York 11971 Dear Heather: Thank you very much for your information on the phone this week. As discussed, I'm enclosing a check for$200 made out to The Town of Southold to cover the balance of the permit for our beach and beach property clean up. It is my understanding that this permit will allow us to maintain the property according to the rules on an ongoing basis without any further applications or fees. Our goal is to improve both the look of the property and also to improve the long term viability of the trees and plantings. Unfortunately,weeds,brush,vines and other growth have overwhelmed the property and we need to clean it up. It is not our intention to change the overall character of the property,which we find beautiful. As we discussed after your site visit this week, it is our intention to clean out a 10— 15 foot wide space running the length of our property on Rambler Road. As per your review,this is acceptable due to the fact that you have confirmed that that this part of the property is greater than 100 feet from the mean high water mark. On the part of the property that faces Watersedge Way,we intend to clean out a selective variety of bushes,vines, scrub and possibly a few small trees. We will stake out the property at the 100 feet from the high water mark. The vast majority of what we are intending to clean out will be beyond that mark. The only cleaning within the 100 foot mark that I could anticipate would be to remove a small amount of dead growth or to clean out vines and scrub from around the base of a couple of the evergreen trees. Again, the purpose would only be to save the trees. On the beach,-all we are planning is to rake up and remove areas of shells that have accumulated near the jetty. I would appreciate your calling me to discuss the above at your earliest convenience. Peter F. Corbin D E CE U WE President Terry Waters Property Owners Association AUG 16 2004 (973)410-2351 (work number) (201)787-7502(cell number) Southold Town Board of Trustees TERRY Y1l.A TERM a ROPERTY O OWNERS A-9SUCIA TION, INC. SOUTHOLD, NEw YORK 11971 ® E C E ,/ E August 9th, 2004 Southold Town Board of Trustees AUG - 9 2004 Main Road Southold, New York 11971 Southold Town Board of Trustees I had spoken with someone in your officelast week in anticipation of an Association property clean up that we were planning for this past weekend. In that conversation, we were informed about the possibility/necessity of obtaining a permit in order to complete our clean up. We would appreciate your assistance in arranging the inspection for tomorrow, August 10th, as we need to quickly reschedule the plans for our cleanup. Essentially what we are planning to do is to clean up brush, vines, weeds etc. that are growing unchecked and have engulfed the property. We do not intend to remove any of the beach grass, or any of the growth along the beach. Our property runs along Watersedge Way and Rambler Road, as noted on the attached survey. On the Watersedge Way side, we intend to clean up vines, small bushes, dead scrub etc. starting at the road. On the Rambler Road side, we intend primarily to clean a pathway back from the fence along the road to a maximum of 10 — 15 feet behind the fence. As the overgrowth has essentially overtaken the fencing for about half the distance, we ultimately will need to replace part of the fence as well. It is not our intention to change the overall nature of the property. As an Association, we value the look and feel of property. What we plan to do is to help retain this situation. Please feel free to contact me on my cell phone (201) 787-7502 before, during or after the ins ction with any questions. I can be reached at my Southold home at (631) 765-2829. CASH eCq 0elvei C<�"r`.om"�%" . ,.�• ,ems t•'w:'x`d" '.>:;;%., r'` � ✓��;; ,`;ri.:: �;'�` ` o .Address= O0. LL Ae I� 0�too " s cc 'f'"BAUWCE. MONkYORD�RL7 ,• , "'CUE'' CR�DITCARDCI. B�/ r'�:lQ.p` ' James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0239C Date August 17, 2007 THIS CERTIFIES that the reconstruction of the central building with an addition ora second- story, reconstruction of existing deck, and drainage system At 58775 Route 48, Greenport, Suffolk County Tax Map # 44-2-22 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 9/7/05 pursuant to which Trustees Permit # 6196ADated 9/21/05 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 reconstruction of the central building with an addition of a second-story, reconstruction of existing deck, and drainage system. ELLEN LEVIN WIEDERLIGHT owner of the The certificate is issued to aforesaid property. Authorized Signature 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 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ¼ constructed Project complete, compliance inspection. 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 Permit No.: 6196A Date of Receipt of Application: 9/7/05 Applicant: Ellen Levin Wiederlight SCTM#: 44-2-22 Project Location: 58775 Route 48, Greenport Date of Resolution/Issuance: September 21, 2005 Date of Expiration: September 21, 2007 Reviewed by: Board of Trustees Project Description: Rebuild existing portion of central building with addition of an 80' x 18' second-story, and rebuild the existing deck, and the proposed construction will be on the existing foundation, with drainage to contain roof runoff, and all as depicted on the plan prepared by J.R. Holzmacher P.E., LLC and last revised 9/16/05. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southoid Town Code. The issuance of the Administrative Permit allows for the operations as indicated in the project description. Special Conditions: Final Inspection at completion of project. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Albert J. Krupski, Jr., President Board of Trustees 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 COASTAL EROSION MANAGEMENT PERMIT Permit #6196 Date: September 21, 2005 SCTM# 44-2-22 Name of Applicant/Agent: J.R. Holzmacher P.E., LLC Name of Permittee: Ellen Levin Wiederlight Address of Permittee: P.O. Box 68, Greenport, NY 11944 Property Located: 58775 Route 48, Greenport DESCRIPTION OF ACTIVITY: Rebuild existing portion of central building, with addition of an 80' x 18' second-stow, and rebuild the existing deck; the proposed construction will be on the existing foundation, with drainage to contain roof runoff, and all as depicted on the plan prepared by J.R. Holzmacher P.E., LLC and last revised 9/16/05. Permit to construct and complete project will expire two years from the date the permit is signed. SPECIAL CONDITIONS: (apply if marked) _ Bluff restoration through a re-vegetation plan is a necessary special condition of this permit. __ A relocation agreement is attached hereto and is a necessary special condition of this permit. __ A maintenance agreement is attached with application and is a necessary special condition of this permit. Albert J. Krupski, Jr. President, Board of Trustees AJK/hkc Aug. 17, 2005 Field lnsp~n Albert J. Krupski, President James K~ng, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, NewYork 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 December 29, 2004 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mrs. Ellen Wiederlight Soundview Inn 58775 Route 48 P.O. Box 68 Greenport, NY 11944 RE: Soundview Inn 58775 Route 48, Greenport SCTM#44-4-22 Dear Mrs. Wiederlight: The Southold Town Board of Trustees reviewed your letter of December 29, 2004 and it was: RESOLVED, to grant an Emergency Permit to clean-up fire debris on the south side of the building adjacent to Route 48, where the damage has occurred, and secure building as necessary. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krupski, Jr., President Board of Trustees AJK:lms RT. 48, P.O. BOX 68 EENPORT · NEW YORK · 11944-0068 PHONE 631-477-0666 FAX 631-477-2286 To: From: Re: Date: Southold Town Board of Trustees Ellen Levin Wiederlight- Sotmdview Inn Permission to Clean December 29, 2004 Due to the December 27, 2004, fire at the Soundview Inn, located on Rt 48 in Greenport; we request permision to clean up fire debris on the south side of the building adjacent to Rt. 48, where the damage occured. After area is clean we intend to secure the building. Albert J. Krupski, President James K~ng, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 5967A Date of Receipt of Application: August 17, 2004 Applicant: Soundview Inn SCTM#: 44-4-22 Project Location: 58775 Route 48, Greenport Date of Resolution/Issuance: August 18, 2004 Date of Expiration: August '18, 2006 Reviewed by: Board of Trustees Project Description: To add a cesspool to the existing system, located on the landward side of the two-story building, in the parking lot. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the Southold Town Code. The issuance of the Administrative Permit allows for the operations as indicated on the attached plan received on August 17, 2004. Special Conditions: None If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 97 of the $outhold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Albert J. Krupski, Jr., President Board of Trustees 09/06/2005 18:34 5312: ;; AI~r~ J. Krupski, pr~d~[ ~ Po~iwoda P~y A. Dick~n !1 JR HOLZHACHER LLC PAGE 02/02 ~$095 Route 25 P,O- Box 1179 ~outhold, New York 11971.4959 Telephone (031) 76~-1[;S2 Fax (631) 76ti-6~41 Suffolk County Tax Map Nl,embe~: 1000- Y~-'~7'"~t'4f - ~ Z - L~/'- 7Y ~Lo~o.: x/o~iI ~e~ ~ ~ z~' ~f a~hcable) Board of Trustees Application Land Area (in square feet): Area Zoning: ~ -/~, Previous use of property:_ Intended use of property:. GENERAL DATA L 07- 7_.2. Prior permits/approvals for site improvements: Agency F~'c,~ co4-7-~.~ Date ~- o~- Zoog __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked ~ No Yes agency? or suspen.ded by a governmental / If yes, provide explanation: 1 Board of Trustees App ication WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ,~25'-~g6// O~:z C~'x./7'-.~.~c_ ~i.// LD /.x/G o../I Area of wetlands on lot: Percent coverage of lot: square feet Closest distance between nearest existing structure and upland edge of wetlands: ~-4~ feet Closest distance between nearest proposed structure and upland edge of wetlands: 24' feet Does the project involve excavation or filling? No Yes ~/'0 If yes, how much material will be excavated? A/~ cubic yards How much material will be filled? A/~ cubic yards Depth of which material will be removed or deposited: /1/,4- Proposed slope throughout the area of operations: feet 3./0 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): Board of Trust~es Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity:. ~O~Z~b't L.D ~:~'/3'77~ /~o~7oA/ ~ C~ ~ P~o~o~ Co~~/o~ o~ ~~& ~ou~o~. Are wetlands present within 100 feet of the proposed activity? No / Yes Does the project involve excavation or filling? If Yes, how much material will be excavated? tVA _(cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) YEW ~'ouq/,~/9~/~AY ~.~o,~./ 7'/-/~ /x/T-~:~/o/e /o~4./27-o~~ 7-/-/~-~ PROJECT ID NUMBER PART 1 - PROJECT INFORMATION I .. 617.20 SEQR APPENDIX C STATE ENVIRONMENTAL ' QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2, PROJECT NAME County 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: --/-~cuAx ~F Municipality ~PO ~ 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or omvide mad 5. IS PROPOSED ACTION: ~ New ~ ~pansion ~ffi~fion/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres '~,. ~. Ultimately acres 8. W1LL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? /~es [] No If no, describe briefly: ~,.~HAT IS PRESENT LAND U~N VICINITY OF PROJECT? (Chooseasmanyasapply.) ~:~J Residential J~] Industrial ?~ Commercial j'---JAgriculture ~Park/Forest/Open Spaca r--j Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL k.G~NCY (Federal, Stateor Local) --~"OCC/~C/ ~Yes ~ No If yes, list agen~ name and pe~it / appmvat:--~ ~ ~4 ~~ 11~S ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT If yes, list agen~ es ~ No name and ~Jt / approval: ~P~C 12. AS A EE~ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? t/ I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Date: Signature/~/l~'~J~~~' I~/~y(~' 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 Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. [~Yes [~]No B. WILLACTIONRECEIVECOORDINATEDREVIEWASPROVIDEDFORUNLISTEDACTIONSIN6 NYCRR, PART617.67 IfNo, anegative declaration may be superseded by another invotved agency. ~--1 Yes ~INo 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 pattam, solid waste production or disposal, potantia~ for erosion, drainage or flooding problems? Explain bdefly: C2. Aesthetic, agHceltural, archaeological, historic, or other hat~rai or cultural resources; Or c~mmunify or ne'i~hborhood CO. Vegetation or fauna, fish, she'i~;~' or wildlife Species, si~nificent habita*~i ;;'~l~raataned 0r ;hd~ng;;;o~'specles? Explain bdefly; I C4. A cornmun ty s ex sting p aris or goa s as offlcia y adopted, or a change n use or mtens tyo use of and or o her na ura resources? Exp ain briefly: C5. Growth, subsequent development, or mated activities likely ta be in~J~ by the proposed actJ~ Explai~-~r~,~ I C6. Long term, short term, cumulative, or other effects not identified in Ct -C57 Explain bdefiy: C7. Other i,~l~a,..L~ (includin~l chanties in use or either ~tif~ or t,/,pe 0f ~ner~'? Explain brielt~/: I 1 D. LLT.E..O ECT AN.M.ACT O. E.V,RO.MENTALC.AR*CTER,ST.;S T.*TCAUSED T;;;';; ASL,S.MENTOFA CR,T,C^L ENVIRONMENTAL AREA (CEAI? {if ~'es, exptsin bdefl~,: E. IS THERE, OR IS THERE LIKELY TO BEr CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If)'es explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For eachadverseeffect identified above, determinewhether it issubstantial, large, important or otherwisesignificant. Each effect should be assessed in connection with its (a) seffing (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibilify; (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 signif'~cance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one ~r more potentially large or significant adverse Impacts which MAY occur. Then proceed directly to the FULl FAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thti determination. Name of Lead Agency Date Title of Responsible Officer Pdnt or Type Name of Responsible Officer in Lead Agency Signature of Responsibla Officer in Lead Agency Signature of Preparer (If different from responsible officer) Board of Trustees Applica~n AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at (mailing address) do hereby authorize (Agent) to apply for permit(s) from the southold Board of Town Trustees on my behalf. Board of Trustees Application County of Suffolk State of New York ~$'//~., /a,,..~ ~d;va~,..//.,,4 d- 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. 1N 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 TI-IlS APPLICATION. Signature Notary Publi-~- 8U~ANN~ BIO No,in/Pubtto, .8,rate Of No,30 4625~5 ~llfled In Nassau C~ salon ~ires June ~,~ APPLICANT/AGENt/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Tho Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town 0fficors and emnlovces. The ouroose of Ibis form is to nrovide information which can alert the town of vossible conflicts of intore~t and allow it to take whatever action is pec¢~sarv to avoid same. (Last name, first name, :,niddle initial, unluss you ala: applying in the name o f someone olse or othor entity, such as a company. If so, indicate, thc other ~-/t/'6~ ,4/,~'~'~ 3' ,~ ,~ 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 the activity.) Do you persoanlly (or through yoor company, spouse, sibling, parent, or child) have a relationship with any officer o£ employee of thc Town of Southold? "Relationship" includes by binocl, ma~inge, or businoss interest "Business interest" m~ans a business, incinding a partnership, in which the town officer or omployee has oven a partial ownership of (or employment by) a co~poration in which tho town officer or cmpinyee owns more than 5% of the shares. YES NO ,V~ lfy0u answered "YES", complete the balance of this form and dale and sign where indicated. Name of porson employed by the Town of Southold Title Or position of that person Dcscriha the relationship between yourseff(the apPlicant/agent/represent ative) and the town officer or employee. Either check the appropriate no A) through D) and/or descfihe in the space provided. The town officer or omployne or his or her spouse, sibling, parent, Or child is (check all that apply): __A) thc oy~ncr of greater than 5% of the shares ofti~ corporate stock of thc applic0nt (when the applicant is a corporation); B) the logal or beneficial own?r of any interest in a non--coq~orato entity (when the applicant is not a corporation); C) an officer, director, paCmei', or employee of the applicant; or __D) thc actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted this day of : 200 ~ Signature ~'~~n~'~' Print Nan~C~-(-- e.. ~___A/ 89/66/2885 18:34 JR HOLZMACHEROLLC PAGE 61/82 Sent To: Agency: Fax #: CC: SENT BY: SUBJECT: I.R. HOLZMACHER P.E., LLC In Water The Third Generation of Ezcellonce Water Resources, CMl and Environmental Engineering 300 Wheeler Road, Suite 303 Hauppauge. NY 11788-4300 PHONE: (631) 234-2220 FAX: (631) 234-2221 E-MAJL: info~holzmacher, com FAX TRANSMITTAL Heather Town Of Southold (62:i) 765-6641 Original to be Mailed: No Date: Sept. 6, 2005 No. Pages: Cover + 1 Tony Zalak Permit Application Document Sciund View Inn, Greenport, NY COMMENTS: Attached is the additional;permit Application document requested to be attached to the balance of'the application package, Thanks very much for your assistance. Please call if you have any questions. Tony ext. 103 Note: Thfa fax c, entelrm prlvll~',,ged end 0omldentlal Information and la Intended to be r~d only by the addressed par(y. Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A, Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~,~w~oastal Erosion Permit Application __Wetland Permit Application Major __ Waiv er/Amendr~nd~r,~ges ~,'~eceiv'-~d Applict.~ru '"'~eceived ~-.,l~mPleted App~ __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordmation:(date sent)_ __CAC Referral Sent: __Date of Inspection: __Receipt of CAC Report: __Lead Agency Determination: Technical Review: ~Public Hearing Held.'~]~ Resolution: 1 7 004 Southold lown Board ot Trustees Name of Applicant Address ,_~ 2~5'"' /TP qa(/ ~r~ '~?Od //q./~r Phone Number:( Suffolk County Tax Map Number: 1000 - Property Location: Or"$ 7.2¢ ~f q~ (provide L~CO Pole g, dist~ce to cross streets, ~d location) AGENT: (If applicable) Address: Phone: Board of Trustees Application Land Area (in square feet):_ Area Zoning: g Previous use of property: Intended use of property: GENERAL DATA Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended~l~y a governmental agency? /,/No Yes If yes, provide explanation: Project Description (use attachments if necessary): Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: (~/ square feet Percent coverage of lot: % Closest distance between newest existing structure and upland edge of wetlands: ~/~ fed Closest distance between nffarest proposed structure and upland edge of wetlands: /..t///~ feet Does the project involve, ex.~on or filling? No /./ Yes If yes, how much material will be excavated? 7~ cubic yards How much material will be filled? ~ cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: feet 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 a~ttachments if appropriate): Board of Trustees Application COASTAL EROSION APPLICATION DATA Does the project involve excavation or filling? No ~es If Yes, how much material will be excavated? How much material will be filled? .~--0 .(cubic yards) (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) 617.20 PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1. APPLICANT/SPONSOR . / 50~./~.~ /2. PROJECT NAME 3.PROJECT LOCATION: -- / Municipality,~~ # ~f ~' ~'~-'p,/~ County 4. PRECISE LOCATION: Street Ado~ess and Road intersections. Prominent landmarks etc-or orot ('e map~,~.~,,~.,~ 5. IS PROPOSED ACTION: [] New SEQR , ! 0 Expansion [] M~difica~on~ alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: ,~ ~x.. Initially acres Ultimately acres ~.~/r~,,.~ ~ ~ ,,--<~.._ 8.[~,~PROPOSED ACTION COMPLY VVITH EXISTING ZONING OR OTHER RESTRICTIONS? L~J Yes [] No If no, descdbe briefly: 9. WHAT IS PRESENT LAND USE IN VICINI"P( OF PROJECT? (Choose as many as apply.) [---JResidential []Industrial []Commercial E~Agricuflure []Park/Forest/OpenSpace ~'~h e r (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Fe~deral,~tete or Local) ]Yes ~ If yes, list agency name and permit / approval: 11. DOE~ AN..~ASP~E. CT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? L...~Ye.~es J.~j~IS'V If yes, list agency name and permit / approval: 12.[~]YesAS A!~oLRESUL 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 / Sponsor Name Date: 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~lenc¥) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL FAF. E~Yes [~lNo 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. [] Yes [] No 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, exis§ng traffic pattern, solid waste production or disposal, pctenfial for erosion, drainage or flooding problems? Explain briefly: I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighbo~cod character? Explain briefly: I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain bdedy: C4. A communily's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resoumes? Expiain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: I C6. Long term short term cumulahve, or other effects not identified in Cl-C57 Explam briefly I C7. Other impacts (includin~ chan~es in use of either quanti~/or t,~pe of ener~;/? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICFAI? Ill ~es, explain briefl),: r--lYes []No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: E]Yes E~No PART Ill - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadverseeffectidenti~edab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesigni~cont~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain 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 th e potential impact of the proposed action on the environ mental characteristics of the CEA. 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. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actio~ WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this 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 bf Preparer (If different from resp'~nsibie officer) Board of Trustees Application County of Suffolk State of New York · g BEINGD Y SWO DE~bSES AND AFFIRMS THAT¥1E/SHE IS THE APPLICANT FOR THE ABOVE 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 REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS NO. QIF'U4~O2~J'5 ~ard of Trustees Applicat~ AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at pt~f~ (mailing address) do hereby authorize ~//F~/F~t? (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ~Ow~er ' s signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Th~ Town of Southold's Code of Ethics orohibits conflicts of interest on the hart of town officem and emnlovees. The unroosc of this form is to nrovide information wMch can alert the town of oosslble conflicts of mt~¢~.t and allow ~t to take whatvv~, action neeassorv to avoid same. YOUR NAME: (Last name, first name, oliddlc initial, unless you am applying in the name of someone else or other chilly, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) T~x grievance Building , Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooting Exemption from plat or official map Planning Other (If"Other", name the 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, mardnge, or business interest. "Basmess mterest' means a business, including a paflnership, in which the town officer or employee has even a partial ownership of(or employment by) a coq~oration in which the town officer or employee owns more than 5% of the shams. 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 or position of that person Describe the relationship between yourself(the applieant/agenffreprescntative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, at child is (check all that apply): __A) the owner of greater than 5% of the shares of the corporate steak of the appticont (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, partner, or employee of the applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this __.day of. 200 Signature Print Name SVI calcs.xls/Roof Drains Stormwater Component Sizing SoundView Inn Greenport, New York Existing Motel Dimensions Stormwater Leaching System Component Sizing Svlnn 05-01 SEP 1 9 Southold Town Board of Trustees Narative: Town of Southold requires that no roof runoff be discharged directly to the Long Island Sound. Gutters and leaders will be routed to drywells on the land side of the building Design Storm Event 2.0 Inches = 0.167 Feet (Assume no leaching during storm event.) Assume flat roof portion drains toward the LI Sound side. Paved Rainfall cJesign (sq feet) (feet) Runoff factor Storm Water Volume (cubic feet) (gallons) Roof Area (west) 2,314 0.167 0.95 366 2,741 Roof Area (center) 1,500 0.167 0.85 213 1,590 Roof Area (east) 4,344 0.167 0.6 434 3,249 Foundation Drains _0 1013 7,580 Storm water units Dia. of Leaching pool depth of total (cubic Leaching pool wall thickness pool (ft) feet) (gallons) 10 0.333 4.0 293 2,195 Minimum stormwater rings required: Storm Water Volume (cubic feet) 1013 293 3.5 rings Use: 4 shallow pools w/1 dng and slab each 13.8131 feet of sidewall 1 of 1 9/16/2005 REPLACE ROOF ~ REMOVE AND REPLACE ROOF SHINGLES · I --~ TRUSSES, PLYWOOD · NEW TWO STORY CONSTRUCTION · · REPLACE ROOF TRUSSES, PLY~NOOD · · TRUSSES SODA BLASTED, ~ : REMOVE AND REPLACE {SEE SUILDING CROSS SECTION)I -- ~HE^THIN~^NDROOFING I [ SHEATHING AND ROOFING I REMOVE AND REP~CE ROOFING I ROOFING OVE~LL ROOF P~N GU~ER AND LEADER LOCATION ~ TO 6" PVC SCH. 80 ROOF D~IN SCALE: 1/16" = 1'-0' ~/ PIPING REMOVE AND REP~CE ROOF SHINGLES · I , TRUSSES SODA B~STED, REMOVE AND REP~CE ROOFING · I · REP~CE ROOF TRUSSES, PL~OOD · I ~''~ I' II SHEATHING ~ND ROOFING, 50' ~ ~ 50' - ~ 50' ~ ~ 50' ' ' 50' ~ ~ 50' · F II II *F FLAT II ~ II ~ FLAT II ,L: ii II * ~..vcsc..~0.oo~.....,.~ x ~ PARTIAL FIRST STORY ROOF P~N (WEST HALF OF BUILDING) {~..~.~c.[oc~.,o.)~~ .vcs~..~0.oo~,..,.,.. ~ TO NEW 10' DIA. x 4' DEEP ~s~°~ ~N~ POOL ~ ~ -- SCALE: 1/8"= 1,_0,w/PRE~ASTCONC'LEACH'N~ POOLs. TH,CE H 20 LOAmN~ TOP WI8 THICK H 20 LOADINGTOP ~ S~B REPLACE ROOF REPLACE ROOF TRUSSES, PL~OOD ~ ~ ~ TRUSSES SODA BLASTED, REMOVE AND REP~CE ROOFING · { · REMOVE AND REP~CE ROOFING TRUSSES, PL~OOD · I ~ NEW TWO STORY CONSTRUCTION ' ] ' sHEATHING AND ROOFING I I A SHEATHING AND R~I)FING · I ~ 50' 50' ,,~ 50' , ..... ~ ~ 50' 27'-11" ~]~ 27'-11" ~ · ~,~ PITCH OF PITCH OF _ _ , II I r II *F II ~~ II II II i~I z I I FLAT ~ II ~ [_ _ II II II II (WP. AT EACH LOCATION) ~ 6 PVC SCH. 80 ROOF D~iN PIPING ~ / PVC SCH. / 80 ROOF PIPING ~ / TO NEW 10' DIA. x 4' DEEP TO NEW 10' DIA. x 4' DEEP ~-- PRE;CAST CONC. LEACHING POO~ ~ PRE,CAST CONC. L~CHING POOL ~ W/8 THICK H 20 LOADING TOP WI 8 THICK H 20 LOADING TOP S~B PARTIAL FIRST STORY ROOF PLAN (EAST HALF OF BUILDING) SCALE: 1/8" = 1'-0' GU~ER DOWNSPOUT LOCATION ~ ~ 2 0/~/05 ~DDED ROOF D~I~ & ~I~I~G IHRH FOH~D. PITCH OF GU~ER PITCH OF GU~ER -- 1 8~30~05 ISSUED TO TOWN OF SOUTHOLD FOR REVIEW C~ I~ ~ ~ ........... ~'~ ~l NO. DATE REVISION BY 2 ., ,~ % L Sound View Inn Reeons~ncOon of Motel ~ I FLAT ~ ~, FLATI No"h Road moute 48) Greenpo~, New York I I I ~ ~ I ~ J~R. ~OLZ~C~R P.E. LEG I __ __ ~ ....... __ I ~¢~ ~e ~ird Genera~'on of Excellence ~ ~ In ~ater S~pply, ~ater Resources, ouw~ ~ow~s~oul kOC~lIO~ OU~[~ aOW~S~O~ COC~IIO~ ~ ' ~~~ ~ CivilandEnvironmentalEnginee~ng ~ ~ ~ 300 ~eelerRoa& Suite 303, Hauppauge, ~I1788 ~ ~ PHONE:(6~O234-2220F~'(6~O234-2221E-~:i*~holmacher. com SECOND STORY ROOF PLAN "~"~"["= ROOFPL~ ~ ~m~: ~ ~A~. AUGUST 30, 2005 S~ET A-08 NEW 6" GU'FI'ER W/ 4" x 4" LEADER -- TOP OF RIDGE ELEVATION - + 43' - 3" ATRIUM TOP PLATE ELEVATION - + 37' - 0" NORTH SECOND FLOOR ELEVATION - + 24' - 1-~1" MATCH EXIST. ROOF PITCH. ROOF CONSTRUCTION 240 # ROOF SHINGLES ON 30# BUILDING PAPER 3/4" THICK "CDX" PLYWOOD SHEATHING CONTINUOUS RIDGE ROOF VENT E 2" x 8" WOOD COLLAR TIES. (MIN. EVERY 4' @ TOP 31 OF ROOF AREA. .~" X 12" ROOF RAFTERS RABLE TRIPLE PANE GLAZING FOR COASTAL ZONE REQUIREMENTS (NORTH & SOUTH WALLS) (TO MATCH EXIST.) 30# BUILDING PAPER OVER 2~" "CDX" EXTERIOR SHEATHING MICROLAM HEADER & 2" x 6" WOOD CONSTRUCTION FIXED TRIPLE PANE GLAZING FOR COASTAL ZONE REQUIREMENTS ATRIUM / STAIR WELL SOUTH MICROLAM HEADER & 2" x 6" WOOD CONSTRUCTION - 4" 4000 ~.s.i. POURED CONCRETE 18 GAUGiE METAL DECKSTOP- 11 7/8" TJI PRO 250 FLOOR JOISTS @ 12" D.C. IN WORK OUT ROOM AND EMPLOYEE SUITE I'-9" __ CEDAR SHAKE 30# BUILDING PAPER OVER ~" "CD)~' EXTERIOR SHEATHING 2" x 6" WOOD FRAME CONSTRUCTION (MATCH EXISTING OVERHANG ELEV. AND CONSTRLJCT N~N TOP ROOF PITCH ACROS;S ENTIRE FRONT OF BLDG. NEW 2" x 6~" WOOD FRAME TO TIE INTO EXISTINIG TOP OF FRONT WALL OR NEW FACE OF WALL.) 2 X 6 WOOD FRAME CONSTRUCTION -- (MATCHING EXISTING OVERHANG ELEVATION) SECURE NEW GU~ERS & LEADERS TO EXIST. OR NEW FACE OF BLDG. WITH STAINLESS STEEL STRAPS / FASTENERS CROSS FRAME AROUND PIPE PENETRATION FOR ADDITIONAL DECK SUPPORT W, PRESSURE TREATED 2" x 8" LUMBER -- · ELEV^T,O.-+14-0 · CORE.CONC. OR POURED FOUNDATION WALL TO EAC~LITATE 6" PVC ROOF DRAIN PIPE, PARGE-ANI~ SEAL FOUNDATION WALL W/MORTAR AND BITUMINOUS COATING ON EXTERIOR -- EXISTING DECK SUPPORTS 2" RIGID INSULATION (INCL. GALVANIZED HOLD-~)OWN CLIPS) -- EXISTING DECK SUPPORTS ' I · SAND, STONE AND BOULDERSI TOP OF BASEMENT SLAB ~ ;~ATI~N - ~'~'' i ' ' @ 16" D.C. (CHASE AREA FOR SiPRINKLER PIPING AND ELECTRICAL FOR LIGHTING) -- {" GYPSUM BOARD (TYPE "x" CEILING & tWALLS) LOBBY FOR STAIR SUPPORT STUD CONSTRUCTION C~_9.. @ 12" O.C, FOR FRONT & REAR WALLS AT LOSBY AND ATRIUM ONLY 1" x 10" WOOD FASCIA 4" x 4" WOOD POST (PRIMED AND PAINTED WHITE EXTERIOR ENAMEL) BY OWNER - WOOD CONSTRUCTED STAIRS & RAILINGS (SEE DETAIL SHEET FINISH MATRLS. SELECTION BY OWNER) 4" TUBE STEEL COLUMN (BOLLARD) FILLED WITH CONC. 1'-6" FROM TOP (PRIMED AND PAINTED WHITE NEW CONC. SIDEWALK (3,000 PSI) WI4 CRUSHED STONE CONC. B PIER NEW POURED CONC. FOOTING(SEEBASEMENT FLOOR PLAN) ¥ FLOOR -- ~ ~ ~Z[ ELEvA~TON~[55, CORE CONC. OR POURED FOUNDATION WALL TO FACILITATE 6" PVC ROOF DRAIN PIPE, PARGE AND SEAL FOUNDATION WALL W/MORTAR AND BITUMINOUS COATING ON EXTERIOR CONC. BLOCK FOUNDATION WALL (VARIES FROM BLOCK TO POURED CONC. AT FRONT OF BLDG.) CONC. FOOTING FOR TUBE STEEL NEW 6" SCH. 80 PVC ROOF DRAIN PIPE TO LEACHING POOLS AT SOUTH SIDE OF BLDG. -- 2" RIGID INSULATION (INCL. GALVANIZED HOLD - DOWN CLIPS) TO BE INSTALLED IN ALL CRAWL SPACE & BASEMENT AREAS ON NORTH AND SOUTH WALLS. 16'-9" (AS MEASURED AT THIS LOCATION ONLY, VARIES AT FOUNDATION WALLS) 1 NORTH TO SOUTH BUILDING SECTION CENTRAL AREA SCALE: 1/2" = 1'-0' iD. 9/16/05ADDED ROOF DRAIN & PIPING THRU FOUND. AJZ 8/30/05ISSUED TO TOWN OF SOUTHOLD FOR REVIEW CAJ DATE REVISION BY Sound View Inn Reconstruction of Motel North Road (Route 48) Greenport, New York J.R. HOLZMACHER P.E., LLC The Third Generation of Excellence In Water Supply, Water Resources, Civil and Environmental Engineering 300 Wheeler Road, Suite 303, Hauppauge, NYl1788 PHONE: (631) 234-2220 F.~E' (631) 234-2221 E-M.41Z: info@holzmacher, eom S~T *rm~: NORTH/SOUTH BUILDING SECTION o~s[~o .¥. APK REVIEWED By' JRH SHEET A-09 sc~: AS SHOWN D^T~: AUGUST 30, 2005 PROIECT NO. SVI[I]I 05-01