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HomeMy WebLinkAboutTR-6260 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 # 0234C Date August 6. 2007 Rev. October 3. 2007 THIS CERTIFIES that the stone wall. deck. addition to dwelling. sanitary svstem. and drivewav At 1175 West Hill Rd.. Southold. New York Suffolk County Tax Map # 70-4-23 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 10/21105 pursuant to which Trustees Permit #6260 Dated 12/21105 Was issued, and conforms to all of the requirements and conditions ofthe applicable provisions of law. The project for which this certificate is being issued is for a stone wall. deck. addition to dwelling. sanitary svstem. and driveway The certificate is issued to DONNA WEXLER owner ofthe aforesaid property. ro<~ Authorized Signature . Albert J. Krupski, President James I{ing, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickereon . . 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 j Pre-construction,haybaleline 1/1"ilb~ DI(J~ 151 day of construction 7 Yo constructed Project complete, compliance inspection. i~f)1 of- M 4-' fwr.-f willoJd IlL- .-nSfU-(+ 10/-3/01. C1..U W6A-k. ~J~ "<of-<- .fJ ~d"~F . . 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 Date: August 6, 2007 # 0234C THIS CERTIFIES that the front wall and deck At 1175 W. Hill Road, Southold, New York Suffolk County Tax Map # 70-4-23 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 10/21/05 pursuant to which Trustees Permit # 6260 Dated 12/21/05. Was issued, aud 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 front wall and deck. The certificate is issued to Donna Wexler owner ofthe aforesaid property. rc9'~ Authorized Signature Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson , at 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 j Pre-construction, hay bale line lilt; I b~ D !(j ~ 1 st day of construction 7 Y, constructed Project complete, compliance inspection. ~~1)1 of- M- 0/ ~fw~oJd ;:t~ . . . . '.' . .,.:" TERMS and CONDlTIQNS 'l1le p~ Donna Wexler ',_dlbgat Southold" ' ' ,'" __ N. y...:~,,_ ~ the coosidetadoa iQt the rn"'",,<, of the Petmltdoes \IlIdenlJOd .:ad 1'l'e$Cribe to the~; .." L That the uid J30ard of Trustees Illld the TA)Wl1 of Southold ate re1~ .from any aod ,aU 4amages,' Ot dalms fQt'~ of lUlu ubiogcll=tly at tadited1y as .. 'l"e$U!t of allY opet~ , adoa" ,_d tmed' -' - ';chh . _..A -the _U f'-n>l ~I LIs 'be<o , ' .......0 ,pltSQaot;'(O" ,~f.~,_,~, _._____ ~"~~_,~_ ,,' -ot ',' OW!':~' delenda.ny aQd aU $Ud1 ....1(lnltl.teAby third.,atdes, Illld the Wd 'I'eunl<<ee .<9~ full IJoblI1ti wilhmr<<t tbetcto.~-fI!~p1eteexclusioa of the&ud or T~ of the Town of SouthqI4, 2. That this f1etiI1lt 1$ '~d lor .. period of . 24' 'Jl1O$. -wbld1ls dO'II~ to be 1lJC' , esdma<ed U-' tequlud to rom.plete the wod.: loyol\'ed, but' Should ~ wauaot, teqU~.', for an extel1S1on roay be made to the >>oa<d ~ . ,Wu ~ , " ,. Thar this PetlDir should be retained lodefudtdy, or .... long as the .aId PertnIttee ~ ' , to 'Q1Slnraln the ottuaure or ptQject lovolved, to provide evidenoe to anyone (>)O.oetned that auth- ~tlon was ori8l.nilly obtal.ned. 4. That &e wod.: lnvolved will be oubject to the ~ aod approval of the Board Ot lu ~ents. and noo.-compUao<:e with the provisions of the odgiJiaaag -t'pIicatlon, maybe cause fOt revOcadon of this Petml.t by te$Ol"don of the ...id Board. 's. That thete will be no unteO.SOIlAble lnte<fetenoe with ....vigadoo. .... . result of the wod<: beRl.n wihodzed. - .. 6. That thete sbal1' be no lntedetenoe with the tight of the publlc to pass Illld tepus aloog the beach between bIgb aodlow wate< mark$. , 7. That if fucure opecadoos of the TOWil of Soulh9ld ~ cbe.l'eUlO\'al and/or al~ lIl. the I<<atloo. of ,the ,wock hetelnaathorV~. or If. lo the oploIoClof-cbe,Boud of TtuSteCS, tho, wod<;ahall c:aU$C wueaSooabte obstnJdlon to free navlgatlon, tho uid Petrd- will be teqWted. apondu.e notice, to nmovc or alter this wod.: or project hetel.n' staled ~ ~I to the Town' , of. $o!1thold. ' , -,', ' , 8. That the aaid Boatd will be notlfied by the Perml~ 01 the ~etiod:ot the wod.:-. orhed. 9. Tbat,.the'Peanl.ltee will oblal.n aU other petmIu and _<<i'diU m..,- be nquked . ,"~ to chic petmlt~ may 'be aubJect to revolc.c llpoc:afdku-oto obWn_ ~ " ,', , "",. . . 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 December 21, 2005 Ms. Donna Wexler 1175W. Hill Road Southold, NY 11971 Re: 1175 W. HILL ROAD, SOUTHOLD SCTM# 70-4-23 Dear Ms. Wexler: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 21, 2005 regarding the above matter: WHEREAS, DONNA WEXLER applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated October 21,2005, and WHEREAS, said application was referred to the South old Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 21, 2005 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the proposal complies with the standards set forth in Chapter 97 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, 2 . . RESOLVED, that the Board of Trustees approve the application of DONNA WEXLER to construct an addition to the existing dwelling, repair the existing deck and construct a new deck, relocate the sanitary system, maintain the existing driveway, and construct stone walls at the north entry, with the condition of containing all runoff in drywells, and the placement of haybales during construction, and all as depicted in the plans drawn by Ira Haspel Architect last dated 10-18-05. 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: $100.00 Very Truly Yours, b~.-f? ~'0. Albert J. Krupski, Jr. President, Board of Trustees AJKlhkc . 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 TO: BOARD OF TOWN TRUSTEES TOWN OF SOUTH OLD ~"'~ ~~ Ie. Please be advised that your application dated reviewed by this Board at the regular meeting of following action was taken: /ol;)if05 /),/:11/0C; has been and the ( / ) Application Approved (see below) <-) Application Denied (see below) <-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: 1tso Ij f;o +1aLf 6",k hiY>l ( hi r< c -hiJvJ fn J'rec+o,.,.J TOTAL FEES DUE: $ J 00 SIGNED: d~-j 9- ~'79f2-i' 0. PRESIDENT, BOARD OF TRUSTEES ~ . New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631)444-0365' FAX: (631)444-0360 Website: www.dec.state.ny.us LETTER OF NON JURISDICTION - ARTICLE 25 December 5, 2005 Ms. Donna 1. Wexler 200 Castle Hill Raad Cutchague, NY 11935 1.~ . Re: Applicatian #1-4738-03511/00001 1175 West Hill Raad, SCTM # 1000-70-4-23 Dear Ms. Wexler: \~~. ~ ..... ~ Denise M. Sheehan Acting Commissioner , 2 2QDS Dce \ . ' \ \ ,> .~- ~>,\<,'r:'-~_,__ --- .-' ,.- Based an the infarmatian yau have submitted and a review by aur technical staff, the Department afEnviranmental Canservatian has determined that: The praperty landward af the bulkhead greater than 100 feet in length and canstructed priar to. 8/20/77 as shawn an the survey prepared by J ahn C. Ehlers last revised 08/03/05 is beyand Article 25 (Tidal Wetlands Act) jurisdictian. Therefare, in accardance with the current Tidal Wetlands Land Use Regulatians (6NYCRR Part 661) no. permit is required. Be advised, no construction, sedimentation, or disturbauce of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated abave, withaut a permit. It is yaur respansibility to. ensure that all precautians are taken to. prevent any sedimentatian ar ather alteratian ar disturbance to. the graund surface ar vegetatian within Article 25 jurisdictian which may result fram yaur project. Such precautians may include maintaining adequate wark area between the tidal wetlandjurisdictianal baundary and yaurproject (i.e. a 15' to1.Q:wide canstructian area) ar erecting a temparary fence, barrier, ar hale bay berm. "+ Please nate that this letter daes nat relieve yau afthe respansibility abtaining any necess permits ar approvals fram ather agencies ar lacal munic' . alities. Jahn Wieland Permit Administratar cc: BMHP file ! , - Telephone (631)765-1892 . Town Han 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Wed., November 9, 2005, the following recommendation was made: Moved by Don Wilder, seconded by Tom Schlichter, it was RESOLVED to TABLE the Wl3ltand Permit application of DONNA WEXLER to construct an addition to the existing dwelling, repair the existing deck and construct a new deck, relocate the sanitary system, maintain the existing driveway, and construct stone walls at the north entry. Located: 1175 West Hill Rd., South old. SCTM#70-4-23 The CAC Tables the application because the survey doesn't depict the proposed modifications. More information is required. Vote of Council: Ayes: All Motion Carried ,----- ------ -- '~"~'.="c~'=~ ~ ~ ~ +-1, ~~ R~~~ tfij ~ "'''1:.1<1.''' #" ~ .pi ~ ~ ~ ..tor~------r-_"'" .;. 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'"\ .~~\:-~~ ...~~ ~_~ ~.' .' !~;; '\'W .- "." j: ""'::~17;:li~.' " ." :::,; crt?l .... ~: 1~~"t~.~rr:.\.~:,/,,,. ." '.~" -~i~:~?/f~ '::.'; =_ ! i ~ .-.-. I " . . . : .. W'Y]) '"J~;'k""J<" J.." " - .......L_.-...~d 'K " , _ L...:l:.... "'D~ ~ I.~, ,,"'r.. ,,. S .= '-'..II ,." ~ ~".:' + ~I' ,-,. 0'1--.". - J- I -,,< ".~ ,/ ~ ~,- . -I;'" -....-. <2>> ...~ I :"r_"N :: - ~.:::_:::: -. ~ :::'~~~~.~ _?--~:"~t 1 NOTIC~ I~.. COUNTY OF SUFFOLK I'M ~ - - .,-~. _ ". _._.. "'~""_."'''.n,.,,,,-,,," I~R","Pr-(]....d~Tn~___"i""I"",'-E::.I~1 ~J-""~'y,.~?UTHOLD 1= SECll~N NO .. e- Office Location: Mailing Address: Town Annex /First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax (631) 765-9064 FYI 11/15/05 from ZBA Re: Trustees November 16, 2005 Agenda Item CTM 70-4-23 (merged under zoning with 70-4-22) It is noted that the property which is the subject of a Trustees application for 70-4-23 is pending litigation with the Zoning Board of Appeals. The property is merged pursuant to the Building Department's Notice of Disapproval dated April 26, 2005, and the owner's request to umnerge the property was denied by the ZBA on 8/18/05 under Appeal No. 5722. (Copies attached from ZBA File) 0~ / ,--;" --- '-1" , f j! _ '..:; U:;:. 1..1 ' 1 !.....<r -.-._-~---... _ ' :lflii NOV 1 5 200~' ,If! i Li----->-d~-jl j ,~r',...". ,'," Te, ---.J . B..~~1' ;,f Tr:',S:~$ .. __ .. . . FORM: NO.3 NOTICE OF DISAPPROV AL TO: Patricia Moore AlC Devlin 1275 West Mill Road Southold, NY 11971 '\<~ \? DATE: Aori126. 2005 Please take notice that your application dated April 22, 2005 y ,.,~1'} iF For permit for waiver of mereer at Location ofproperty 1275 West Mill Road. Southold. NY County Tax Map No. 1000 - Section 70 Block ~ Lot..f1 Is returned herewith and disapproved on the following grounds: The subiect lot has mereed with adiacent lot to the north (SCTM # 1000-70-4-23). pursuant to Article II Section 100-25. which states. "Mereer. A nonconformine lot shall meree with an adiacent conforming or nonconforming lot. l which has been held in common ownershio with the first lot at any time after Julv 1. 1983. An adiacent lot is one which abuts with the parcel for a common course of fifty (50) feet or more in distance. Nonconfornline lots shall meree until the tatallot size conforms to the current bulk schedule reauirements. c;:]e .... Authorized Signature Cc: file, Z.B.A. . APPEALS BOARD MEMBERS Ruth D. Oliva. Chairwoman Gerard P. Goehringer Vincent Orlando James Dinizio. Jr. Michael A. Simon hllp:/Isoutholdtown.nonhfork.net . Southold Town Hall 53095 Main Road. P.O. Box 1179 Southold. NY 11971-0959 Office Location: Town Anne.x IFirst Floor. North Fork Bank 54375 Main Road (at Youngs Avenue) Southold. NY 11971 BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765.1809. Fax (631) 765-9064 RECEIVED '1f'-!~~ /.'00" R1 ~12~ Southold Ton Clerk FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF AUGUST 18, 2005 ZBA Ref. No. 5722 - DONNA WEXLER (Former Owner, DAVID T. DEVLIN) Street & Locality: 1175 and 1275 West Hill Road, Southold County Tax Map ID: 70-4-22 and 23 (combinedlmerger) Zone District: R-40 Low-Density Residential FINDINGS OF FACT PROPERTY FACTS/DESCRIPTION: The applicant's property consists of a total land area as combined (together) of approximately 49,900 square feet, identified as 22 and 23 on the Suffolk County Tax Maps, District 1000, Section 70, Block 04. The land is improved with a single-family dwelling situated 120+- feet from the northerly front lot line at West Hill Road and 32+- feet from the easterly side property line, as shown on the February 15, 1972 survey prepared by Roderick VanTuyl & Son. The property is located in the R-40 Low- Density Residential Zone District which requires a minimum lot size of 40,000 square feel. BASIS OF APPLICATION: Article II, Section 100-26, based on the Building Department's April 26, 2005 Notice of Disapproval staling that County Tax Map Parcel Numbers 22 and 23 are merged pursuant to Section 100-25, which provision states: "Merger. A nonconforming lot shall merge with an adjacent conforming or nonconforming lot which has been held in common ownership with the first lot at any time after July 1, 1983. An adjacent lot is one which abuts with the parcel for a common course of fifty (50) feet or more in distance. Nonconforming lots shall merge until the total lot size conforms to the current buik schedule requirements." RELIEF REQUESTED: Applicant requests a Waiver to unmerge properties which have been merged. The easterly portion, referred to herein as 'CTM 22' is proposed to be separated from the westerly portion referred to as 'CTM 23.' Each do not meet the code-required 40,000 square feet in this R-40 Low-Density Residential Zone District and would be nonconforming with an area of 29,900+- square feet for CTM 23 and the remaining 20,000+- sq. ft. for CTM 22. Not only would they be nonconforming in size, but new nonconformities would also be created for the applicant's existing dwelling location (single side yard less than 10 feet and setbacks from the existing rear lot line and bulkhead (ref. 1 00-239.4B and 100-244). ZONING CODE. SECTION 100-26: Under !i 1oo-26-A, if a lot has merged, the Zoning Board of Appeals may waive the merger and recognize original lot lines upon public hearing and upon finding that: (1) The waiver will not result in a significant increase in the density of the neighborhood. (2) The waiver would recognize a iot that is consistent with the size of lots in that neighborhood. Page 2 - August 18, 2005 . Appl. No. 5722 - David Devlin~onna Wexler CTM 70-4-23, 22 . (3) The waiver will avoid economic hardship. (4) The natural details and character of the and character of the contours and slopes of the lot will not be significantly changed or altered In any manner, and there will not ba a substantial filling of land affecting nearby environmental or flood areas. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on July 7, 2005, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: REASONS FOR BOARD ACTION. DESCRIBED BELOW: Based on the tastimony presented, materials submitted and personal inspection, the Board makes the following findings: 1. A waiver would result in the creation of a nonconforming lot that is oddly Shaped and out of character of tha neighborhood. The southerly (rear) dimension is only 40+- feet wide, narrowing down to 25+- feet along the bulkhead and dredged canal. Other lots in the neighborhood consist mainly of 100 ft. rear lot width dimension, and no lots have this type of configuration. 2. A single and separate search was issued April 20, 2005 by Peconic Abstract, Inc. The search shows that the premises (CTM 22 and 23) as merged were owned in the same names, or common ownership and without single and separate ownership since the 9/25/1996 transfer of CTM 23 and 8/1/2000 transfer of CTM 22 to David T. Devlin and Lora S. Collins. 3. The property has been in common ownership with a merged area 50,786 sq. ft. since 8/1/2000 and continuously to the present date. Information was not submitted to show planned intentions to avoid the merger, or to make application to any agency for a dwelling. The merger was intentionally placed when the transfers were formed by common ownership. 4. Information was submitted in behalf of the new owner during the July 7,2005 hearing that a second home is proposed for her mother at a time when family is needed to be close and for daily medical care. (As of the date of this decision, a Special Exception application for an Accessory Apartment in the applicant's existing home was not requested.) 5. Proof was not submitted to show that a waiver will avoid an economic hardship. The town's assessment records show that the current owner in 2005 acquired the land by deeds, noting a sale price of 1.275M ($945,000 and $330,000). 6. The record does not demonstrate proof that there were good faith intentions, since 2000, to separate or maintain the properties in single and separate ownership, as separate lois, or any good faith intention to build a separate dwelling on the vacant lot for over 40 years, until a contract of sale was entered into between David Devlin and Donna Wexler to sell CTM 23 for $330,000. 7. There also was no proof demonstrated to show the value of the property as exists wilh the merger to support applicant's claim of economic hardship, except for the 2005 real estate transactions. . Page 3 - August 18, 2005 . Appl. No. 5722 - David Devlin, Donna Wexler CTM 70-4-23, 22 . 8. There is no proof demonstrated in the record to show that the westerly portion of the applicant's property was mainteined separately for purposes of building a new single-family dweiling. 9. Neighbors testified as to their understanding, that the property was used by the owner of the existing dwelling, and not planned or proposed in the future for a new dwelling or as a separate building lot. 10. The parcels were intentionally merged. Applicant is not obliged to sell to someone with a desire to unmerge the properties. 11. To creale additional lots that do not conform to the zoning requirements and that have been merged with adjacent properties for a continuous period of time will result in increased number of dwellings, increased traffic, increased water and sanitary demands, and other related environmental effects. RESOLUTION/ACTION: On motion by Member Simon, seconded by Chairwoman Oliva, it was RESOLVED, to DENY the requested Lot Waiver to unmerge CTM 70-4-23 from CTM 70-4-22. VOTE OF THE BOARD: AYES: Members Oliva (Chairwoman), Orlando and Simon. Nays: Members Goehringer and Dinizio. This Resolution was dfrydopted (3-2)(\ J.L · Jrf) , t;i. ~2A.u....o RUTH D. OLiV)t, CHAIRWOMAN 9-14-2005 Approved for Filing SURVEY OF LOT 2 ; MAP OF GAL YES NECK FILED FEBRUARY IS, 1'112, FIL.E No. 5613 5111JA TE, SOIJTHOLD TOHN. SOUTHOLD SUFFOLK COUNTY, NY , , SURVEYED 05-11-::2005 PROPOS!!!:' .A.GTION5 OfHfo-2005 5UFFotJ:;:: COUNn' TAX . lOOO-'O-.q-,.,;1 CER'I1fIBD TO: DONNA WEXlJ!R C1DCAOO 11I'LI! INSURANCB COMPANY West 11m Road! . J 00.00'\ -: \ , il ~, I"" I en q .... ~ ~ rrl SIl 05?'40"E 4i. 150.00' ~ fJ> ~ ~ ~ , , , , , , , , , . , . . . r.'1 ...~ . . . . , , . , " I'::' I-"":~ ir ~ 0- ..".. . , , , . , , . I ~ , I ~~ (h~~~J... j ! !:;~ (. ,( i(;.~'" I. r I Lot2(j) '\.L('" J 8- : { : r;:," ,",I ~ ~'GJ I : : ~ ~c: I ..., ,1;; .x , \ I " /J : i i ~~ J;'~~/ : i~' 1f(,c0~~\~ : o4tl':////'/ :\.O('i ' \\ : 1,{,/___ \ '> 0<"0 , \ I K"" ~ \leol 1 \ . , \ ~o 0 Nt: C10:~U \\ S ,\ vI""-" I . . \" .,. ,.. o '\ ~,.. ______ Q '\( ( ..QV...-- J ~"'\ \ !;;' '~.l ~--~ _-__ I " ... J .~- I ~~ I '\ :'; : . ____ :' I.: c/,'-----' ~:, ~ -...~; i J;~/~" ._____. '~.._ _ It ",)- " "' N8.8 053' 40"\ I 100 00';, '- .t.... --laJ~, I '/:' ---------. "',~ ~_ _ _. _.. _ J_ _ _~./ Lot: J ,.'.';.......-....._ ___ ", ..Jock;.. --.......... c_y Creek; .' -, z 8 o .s>- 0\ ~ ~ Lot 9 Lot I Vo<...ar.t Dv-lellb19 Town V'bter il:;:!;.t I~oie f"1(. Dor'\t:::JlG 6eO'S(.IP-f)Ce Ob-:)5-2005 I): no noon ! !i{jh Tide , ,,) ~ o ~ ~ ""I~ .~I:' --- NOTES, . ....""-".....oo;:~,... 00;:"'......... N w~l/.. E 'f S I i J ....'..........._......M_..~.._ ~ '::.":::'...=-~:.,~~~:;;r=.....:.-: 'i- . ..::.~~:="!-:..::;...:Ei .-..-.---.--.......-- -...----...~"'_.....__.. ~;J::.".-:.....:;:..:':...::.':.-'.......= :"'.......:.=...~~..:.':;:::::.;;:..'=' .~ :.-=--~..._'!_'!'_'_'!O.~..._ . . --.......... (i. .~j ) </ . ---- ...- ~ f') ~ CJ\'; J L ' 0123456 22/23 18_1248 0123456 9/23 05_1235 Fuji (1248) 88/02/05 -,"--"" ,,/'/" . Flji (1235) 88/82/05 , , -- / '" --.,:, N ~ cf~ ~ ,,\~~.-'w""- "" ~ . ~,.o b '--<-~ ~ ~'--,^\J<:,cJ,..- ~. ~ ~'" I ~ ~&~~ ~~~~~~:l. ~ + -Iv ~~ \o~~\9"L-\q"f.:J ~ ~ ~) -\ R~c0t:<~~&~.~ ~ \Q 'f ~ - \<11'''' ~~~lr , .'<f~.>'k"-rli:.... . '.. . _':'Ot'~ ~~, '-~:~-_. I!I . , <..~! , ',~ ... ,.," ., ',' " : .. ".~f.,f' ',.. ~", ~,-' .. ""/\i" -to '>c'" , , ....'.J.... ..... ....H;.: " .- " " : i: Of ". '. , (~I i ~I ~I .. }/ (:: I~I 1~1 ~. ;~i I:, l~. ;~I ;~ l~ (~I 1~1 1111 I:J 11 Ii W r~: 11 ~ ~ ~ ~ ~ ~":. :;. W,. ,. " .' ,. ., ...... .. i:"'''............... .. .~ "'r<-4 "I,"', ..r...... -'1"""'=":'=':_' ~,'_,_""" ,_,~, ,", _. '.. _/...., ..{!"",_, ...'1-, ,....~ I-~"L.::.:.~' " TERMS and CONDITIONS } ne Permittee Agnor & Elaine Benson ,..'~... =idinS" 1175 H~ll Road. SOIlt:hold N, y~ ... put o( the (oa.sideuuoo (oe the isnwIee 01 the Permil does u.aderstaDd aad pmcribe 10 the (01- l"",inS: 1. That the Southold Trustees Permit must be prominently ,.' ,displayed on ,the premises effected thereby during the periOd of ',". I' '. . Tlhu the ,Ud Board ot TlUSlOC. IlIa'The Town 01 Southold ate ttle;ued (rortl wyand w'.)r) '.. ..../ "1! lhm.se.. or dilins lor d=8". ot suit.suislag directl1 or Lnditectly LS a r..wl ot mI op<<- unl ; tlaon p<rfottroN punu>DrlO rbi. pumll, aad th. s:&ld Permitlee will. At Iili erher own up""" the "dd.nd :wy :wd all ruch sui.. lalt.bled hr thlrd p.rti... ADd tho ...Jd P.rmin.,. usuta.. fullll>bilicy perIl 1Vith respeer thU.IO. to th. complete. c:clwloo ot the Board ot T<Wle.. of the iowo ot Southolcl 3. Th.1 rhLs Permir Is valld for . puled of , ? m~ which I.s coO>idued 10 be the sufficient rlm. requIred 10 (Omplel. the ....ork lavolved, but' should circwcnane.. ....arnwc, request [or aJ.I cxte.DJioa ra~l be ltI2de to the Boud at a laler due. ". '.. 4; nut rhLs Permir .bould be reWned latle1lallelr. or .. long as the sald Permi.... wishes to m.ine.in the stnl<tuto or proj.ct Ulvolved, to provide evidence 10 &tIrOD. ('ODeerued chat ""th. o,waoo wu orl,oin>lly obcalaed. 5 ~ Thac rhe work Ulvol~.d will he subj~ co U'O "..praiOG anti a pproyaJ of the Doud or lIS ,sene.. and noo-<:ompll.sDC. with rhe provisloDS ot the orlgiD.ciug .ppliCltiol1, au1 b. owe tor """".don of rhLs Pennlr by reso/udon 01 the ,.id Board. 6. Th'1 rher. ..ill be no \U1fC:lsoo.ble inlerrU'O.. wIth Qavi~cioo as a '.....Ile ot the work herein ~uthoriz:cd. -..- ',:'= 7. Th.1 ther" shall b. DO /need.r.nc. with the rigbe 01 th. public co pu, ODd up"'" aloog ule be.ch be.....o high aDd low w.ter our!". , B. Th.t lt (utur. operatloDS of the TOWD 01 Southold require the remoyal mdjor aJtersdo<u 10 the lcalioa of the work btrela auchorized, 0 r It, Ln rho opinion 01 the Board ot irwte.., the ....o,1c .hill QWoe uornsoo.bl. ohscrucaoa to iree a.vig.tioo. the said Penn/etce will be required, upon duC' node,". (0 remove or alter this 'l'Vork or proje<c betcla nated without u:pcm.e:l to the To'WO o( Sourhold. 9. orind. Th21 the ,:ud Do.rd will be aoeified b!lbe P.rmiete. Ot, tbe (OSDpJeeioa o( the worlc wtb. (See tear off sheet.) 10 Th.1 the Permileee will obealo .ll ocher permits .ad CODSeats thol 1M1 be required sup- 1'lcmcn.Cal 10 thb pcn:a1c ,.,blcb m:Jl be subJCC't to revoke UPOQ lillu.rc fO obula same. , " .... I 't. .' . ~. .' : ." "'-- .,' . :. . . . ..2"J" 'r:..' '...., '''~vJ (QJltJ"~'J.m.~'l"""""f"n"n:T1.Ju,}rL"\'L.it}ln~"';'''''''l\'L<' !'Of,...., ..."'....,,.....JZ..{,'=.'I:7:::1'......\,.....v~l\'.."I.. ''''''''''''_'1..., ,...\,~ . - . 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 PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair WILLIAM J. CREMERS KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON Telephone: 631 765-1938 Fax: 631 765-3136 PLANNING BOARD OFFICE TOWN OF SOUTHOLD To: Town of South old Board of Trustees From: Mark Terry, Senior Environmental Planner .. ~ LWRP Coordinator '{VC> Date: November 7, 2005 Wetland Permit for Domra Wexler SCTM# 70-4-23 DONNA WEXLER requests a Wetland Permit to construct an addition to the existing dwelling, repair the existing deck and construct a new deck, relocate the sanitary system, maintain the existing driveway, and construct stone walls at the north entry. Located: 1175 West Hill Rd., Southold. SCTM#70-4-23 The proposed action has been reviewed to Chapter 95, Waterfront Consistency Review of the TOWIl of South old Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is generally CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. 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. 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 Office Use Only Coastal Erosion Permit Application ./' Wetland Permit Application _ Administrative Permit AmendmentlTrans rlExte~on ----Received Application:' G \ ~eceived Fee:$ .;\) ~ cr$' /Cornpleted Application I . I 't)'( ~Incornplete _SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:( date sent) ~ Consistency AssessmentJ;orm_\.QI~ d1'\"( ---E:ACReferral Sent: IN~\\~), ~te of Inspection: \ \ It\ 11:) " _Receipt of CAC Report: _Lead Agency Determination:_ Technical Review: ..-PaOlic Hearing He~ _Resolution: r 2 1 LIJUj , , i L__ Dot-' ~ A- llJ t >Cl.-tf 1(7~ W. NII/'1- Name of Applicant Address 7koA 1> f .<;Il (infO Vf). IJ. t IIq 7 f Phone Number:(6~/) I Suffolk County Tax Map Number: 1000 - 70 lAJ, tt It.. I..- /t-tJ AO ..5oc:.Y'R-jo1- D - IS~,od E~T tJl> WEU{ /}tJ6. -----{pmvideLILCOl'ole.#.-distance. to cmss-streetsyand_location)____ ____________.___.___ __._ ~;8-/ooo . t- '2.-3 Property Location: 117S AGENT: (If applicable) co.tY' ~~:l-,L<f l IU Address: Phone: 4Ifard of Trustees APPlicat~ GENERAL DATA Land Area (in square feet): '201+1>~ >. F. /2-- 40 Area Zoning: Previous use of property: / P4 /.1 W-( / P~I tY JtB. t PBlCC" . Ius. thJJCta I Intended use of property: Prior pennits/approvals for site improvements: Agency ~ ClE'F.> 13V/t.-lJ/#6 'P6Jr Date l)-rh;; -,..'8, l'f'is'" _ pt:'ll-Id/ pOZ-olf3 S'F/? 2-~ 1173-1Q2H/TfJo-S732.2 - No prior permits/approvals for site improvements. Has any pennitlapproval ever been revoked or suspended by a governmental agency? ~No_ Yes If yes, provide explanation: Project Description (use attachments if necessary): - --A-f:j/j;TUJN--7tirijjtiilliE--~);.~:-~4i'F@rrlf;.:IJfti)~Ft~-:::}S2J". VI, {'F ---- , . I I1lTt/J'fIt--tN ~/.s.T. ~s (j'lq'tt/l-) I}-j)Jj}./CW /)el:p - 'I-06,yf1J'fi 1jDtJ J'wo /J/UfWt'U..! ~,A-- ~f 1J~/f1P166' /2-eU)e;--iE Se{JJtL sY'~ J191~/N e;o~r ~P..4(/& h1-(~-1'f '&)It.-P S/DPo i4t'}-vu t5J fJbl>'-/Yf EJoIl1Jj J.Vrflllll1AJ fl./OOD 1311'-'/~ I/t=/}-f) M'J"//Vf'J7/o./ f=Lo1-T. {)D cjL-. 4i'ard of Trustees APPlicatAlt WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: '1tf)S square feet Percent coverage of lot: I, 70 % Closest distance between nearest existing structure and ~Iand edge of wetlands: 0 feet ~ But#H5 ?~ f'6lFr e 110 <'Sr Closest distance between nearest proposed structure and upland edge of wetlands: 0 feet @ 1311'f?~ 3:1-- Par €!I ,!#ure Does the proj ect involve excavation or filling? No Yes If yes, how much material will be excavated? 2. 14- cubic yards How much material will be filled? /'2. ,S9 cubic yards Depth of which material will be removed or deposited: 8.15 feet Proposed slope throughout the area of operations: 1(1t11-165 Manner in which material will be removed or deposited: J3lfcPtPG I' J>tJ4PT1W4L. .. - _~ta,telll~n.t.()fthe effec.t,..iLlIQY.L()n thc::_'Y~tlands ~d ticl.aLwaters oftheJ()'Y!1Jh_at.Q1~Y~s.llltb'y reason of such proposed operations (use attachments if appropriate): )/611[7 4IJard of Trustees APPlicat~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Af>DI71oJJ TO 12ES1p6}JC~ Are wetlands present within 100 feet of the proposed activity? No v'Yes Does the project involve excavation or filling? No V Yes If Yes, how much material will be excavated? ?-7tf (cubic yards) How much material will be filled? 17-,r1 (cubic yards) Manner in which material will be removed or deposited: I 8 "rat- fIof? ? 1>/IJ.iP7'fwc.{L Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) flD AlE ______._..._n_..,____ _ __ ._ ___ _... 0',__ _____ '~._..__ _ _____ '__'_~"'___' _ ___ __ ------ --- --------.---------- 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) 2. PROJECT NAME . SEQR 1. APPLICANT I SPONSOR DOfJtJ I) VJC)(1.-ep.- 3.PROJECT LOCATION: 1/7S" IJ.I. HIVI- 50vrno...O II'J-'f \.V (l-esf))E/JCE '/"<0 SVffo"lL.. /I7S \,V-Iii......... p-oAO I ~VfHD"1> JI"-,/' ~~ ,00 ~'tD' 0 W&lAA 'A I) 5, IS PROPOSED ACTION: D New 0ExpanSion 0 Modification I alteration 6. DESCRIBE PROJECT BRIEFLY: f) 7-15 F~'" /1.- Y fOJ> 7J.},fo 5'" @ 1" ft--, If 7-, b )...r-.~b S f- e 'll"n 1>1.. I' I./-Ob,/flf s,p !YEc...te. JU;P".,ty 5yJST pECIL 4DD jwO J>/1iwEUJ JU:-to~'9-re- f/}IV.r/tl'f 1y~ft;1-1 pes I'JlW Q 7. AMOUNT OF LAND AFFECTED: Initially II ~ acres Ultimately, 4<0 acres 6. VVlLL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~es D No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY ~identjal 0 Industrial o Commercial OF PROJECT? (Choose as many as apply.) DAgriCUItUre 0 Park I Forest I Open Space DOther (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [i2fVBS 0 No If yes, list agency name and permit I approval: /?AJ1t-/)//oJ6 /)t:7>1". 1 IV'!)=--. tJ1-/).p 0" . W~ ~ ,.. 7. C7'- 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? r7f'Yes DNO If yes, list agency name and penni! I approval: ,..., '68j- J)~.u.""'" '2<J'fcJ l':::..I' ~.D 01> J'1'lv.>re:er ,,~,,'7-iJ'.17 'r~___'H r --- ------llJ/&:.IJ;--j)'e'J''r. ::.;-- - '-siip;- J.-? ---Pffr------Ti . --pt:-~-7-31.'i.. - 1k..JtS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT I APPROVAL REQUIRE MODIFICATION? ~e5 D No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant I Sponsor Name Signature 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 bv Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.41 If yes, coordinate the review process and use the FULL EAF. DYes DNo 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. OVes DNo C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, ff legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: I I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly; I I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: I I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: l - .-. j C6. Long tenn, short term, cumulative, or other effects not identified in C1-G5? Explain briefly: I I C7. Other imoacts (includino chanoes in use of either ouantity or e of enerov? Explain brieflv: I I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)1 (If yes, explain briefly: 1 DYes 0 No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: DYes 0 No I I I- .- PART 11I- 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 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 the potential impact of the proposed action on the environmental 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 FUL EAF and/or prepare a positiVe declaration. . - -~CnecKffils box If you have detennrnec:r.-basedontfielnrormalloii--ej-riaanalySls above arid any.supp6"rtTng-doc.umentaticin:-tliafTtie proposedactlo- WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Print or Type Name of Responsible OffIcer In Lead Agency Title of Responsible Officer Signature of ResponsIble Officer in Lead Agency Signature of Preparer (If different from responsible officer) . . . ~~ . \\J'i \()< PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS . Name:. Address: STATE OF NEW YORK COUNTY OF SUFFOLK -/!!fU j/ t (j)~ - , residing at f)" 0 r\, .,,-u.o \~ 'q I 1i?cO, u \It \A \ l C; 3:) , being duly sworn, deposes and says that on the '""2, day of'v-...N ,200 Y,Oeponent 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 there 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 e Town of South old; that said Notices were mailed at the United States Post Office at <'-" \., that said Notices were mailed to each of said persons by (certified) (registered) mail. ~",^a. u\~ Sworn to efore me this ..3 ~ Not Pu ic MELANIE DDRDSKI NDTARY PUBLIC. State of New York No. 01004634870 Qualified in SOffO!< County i() fo Commission Expires SCe:smoer 30.~ ~!.~ . . \\ lJ/o<' 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-~"'W BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of _____~~J'JlIJl~___~~,~_~:1____________________________ COUNTY OF SUFFOLK) ST ATE OF NEW YORK) AFFIDAVIT OF POSTING I, ~~W~~,reSidingatc9o<.J ~ \~ ~ \l.. C'f ?>~ being duly sworn, depose and say: That on the "3 day of ~ , 20CP:frPersonally posted the propert)\kn?'Yn a~ \\~ (~ r'2-J) ~ ,So'---~ ""~, '\q~~ by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held tJ.JRI.. nw. I~. ;::J.onS - 01 01 a 6 CU T I') : LX) flh.. w.\.lt \. Dated: (""'..^ _~ \ ____ . - '" V ::, ").<,,1:) J { ~ ~'''~ (signature) SJ'om to before me)his Y.:.- day of iV()tI200~ Notary Public MELANIE DOROSKI NOTARY PUBLIC, State of New York No. 01004634870 Qualified in Suffolk County Commission Expires September 30, 2aJ Eo, ~oard of Trustees APPlicat~ County of Suffolk State of New York _.--~ ;. l~ :, I ~""\&_ I.... ,)~V. ,. ,. 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 BIS/BER 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 SOUlliOLD 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 AUTBORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WIlli REVIEW OF THIS APPLICATION. ~~~ Signature SWORN TO BEFORE ME THIS ~1~5 DAY OF (Jr h)l) e,/ ,20~ ~DJ~L; Notary u Ie MELANIE OOROSKl NOTARY PUBLIC, State of New~ No. 01004634870 Qualified in Suffolk County 2) ijC)\o Commission Expires September 30._ ~ard of Trustees.APplicat~ AUTHORIZATION (where the applicant is not the owner) .' I, -~~~~ owne;U~~~ty) residing at (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (OWner's signature) 8 . . APPLICANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town ofS~uthold's Code of Ethics orohibits conflicts of interest on the oart of town officers and emolovees. The ouroose of this Conn is to rovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action is necessaJ"V to avoid same. " ' YOUR NAME: ~C\I\"-JlJ-.. c... ~0....Q..{~ r ~ .. . (Last name, first name, J11iddle 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 APPLICA nON: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning Do you personally (or through your company, spouse, sibling, paren~ or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest "Business interest'! means a business, including a partnership. in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% ~shares. YES NO ~ If you answered "YES", complete the balance of this fonn and date and sign where indicated. Name of person employed by the Town of South old Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) 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, paren~ or child is (check all that apply): _A) the owner of greater than 5% ofthe shares of the corporate stock of the appliCant (wben 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 S?bmitted this ~y of S:cX ~o ~ ':::,,.....- Stgnature ~. ~, '--, '), c e ~ ~ Print Name __. '..) ( l,r- ~'o\ nO- \....... "'- Y- '€...:\( Town of South old (") . LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. 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 of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of South old Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the L WRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listine both sUDDortine and non- sUDDortine facts. If an action cannot be certified as consistent with the L WRP policy standards and conditions, it shall not be undertaken. A copy of the L WRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board ofTrustee~ce, the Planning Department, all local libraries and the Town Clerk's office. . , r-- B. DESCRIPTION OF SITE AND PROPOSED ACTION I,. oc \ '2 SCTM# /fX)O - 70 PROJECT NAME /)otJJJ IT Lf -2-~ l_. lJJe~~ /U/>. 1ri>D/~6rL . The Application has been submitted to (check appropriate response): Town Board 0 Planning Board 0 Building Dept. 0' Board of Trustees 0' 1. Category of Town of South old agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) o o .-. . _..(b)_._.Einan~jaLassisiance.(e.gLgrant, luan,subsidy) (c) Permit, approval, license, certification: o Nature and extent of action: "'r/)prp,o/ll 7'D ope ~/Vf ~/f)gJCC 72.-~,b ~p @. ;cP-rt.... 7. O~- ,HI, ~.!, l!' ),J"r) p.t" , tfo (p. 'tV' ~'f "p ~ I f)..b~/P- is/C'1T. pe-q::.. t't D/) .",., 0 'my tv Ef:'l"L.J pao"-1]'E S"fo/1i1fl7 Syrk11 11+tJ-/7't1/V Cj)-Prf/t:n- I>j>-tll~ 8t)11//) STfWc wlfU.! e ~ /.-I/)11/""'1Iv ~.!r. /3v'1.fLI~'70 II Ft/)lfF. jJ.cft...,.- Site acreage: r lor ,lfb w.lft,,~ ~, f . 5'btlJrlot.-/> Location of action: Prcrer , Present land use:J-ftH. P 6> . 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: n::"..wlt VJf5)Gwr- (b) Mailing address: /I ) S; \,AJ. tt I &,t.- ~ SOvrrlvt./) , fJ-j 1\ q 71 (c) Telephone number: Area Code (pi - 8 ~ '8 -1000 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes G NoD If yes, which state or federal agency? J.i'iS DEe.. C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of 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. DYes D No 0NotApplicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See L WRP Section III - Policies Pages 3 through 6 for evaluation criteria DYes D No Q' Not Applicable (", . Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See L WRP Section III - Policies Pages 6 through 7 for evaluation criteria DYes 0 No [j Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See L WRP Section III - Policies Pages 8 through 16 for evaluation criteria DYes 0 No B Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria DYes 0 No [2JNotApPlicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section ill - Policies; Pages 22 through 32 for evaluation criteria. o o [3 Yes No .lNot A';;'able . Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III _ Policies Pages 32 through 34 for evaluation criteria. DYes 0 No B Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria. DYes 0 No B"NotApPlicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See L WRP Section III - Policies; Pages 38 through 46 for evaluation criteria. o YeO NoBNotAPPlicable Attach additional sheets if necessary WORKING COAST POLICIE/) . Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See L WRP Section 111- Policies; Pages 47 through 56 for evaluation criteria. DYes D No 0' Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See L WRP Section III - Policies; Pages 57 through 62 for evaluation criteria. DYes D No g Not Applicable Attach additional sheets if necessary Policy 12. Protect agricuIturallands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. DYes D No B' Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See L WRP Section III - Policies; Pages 65 through 68 for evaluation criteria. DYes D No B' Not Applicable PREPARED BY ]>>v}!/}. 1VI3f'i TITLE w~ DATE-4q/-os- jilin.... I . ~ lill il I I ~ j" , I I ~~. u- l~lF.pp iUIJJI.; 1.~I.Jii~ fl-'. .. .Ii' I- f ~~"(r.~t~~ IHi'iijl ~ ) i~ ~ i li\~ ... ~~ f II:!: ... ~z n ~ -(CIJ zt''Il1ll f3 5:Jffi H~. ;all I ~. II fI I i :: ::;E l cn~~~1 0::;;: r- em m, -i en :::0; 5"'~;:O:' r;! rn " o~~i5 z::o~m -<0 :z )> (") o m 01 . 0 :>- . z Z III ~ t:I C :<lID 0 -- -i m""l B t".1t".1 Z :<l'tl g ~> :>-z c 0- ;:: :<l m :>- z :s:: iil I . . I I ~~ "" ~. o _ I--'- 6 I .'" I 1--'-' I ~ 9J(j8ti (> ", l1g810n9 0880' ;' " 0'I1"9W</, ~ :s 3' .1 ro~:o~:;~;=~ ~ 4p''1J ""'",reen8, ,.."..,..,.,/ West y~ ~(\) (\)~ (j) LOT SQUARE FOOTAGE = 20,466 S.F. ALLOWABLE LOT COVERAGE = 20% OR 4093.2 S.F. ACTUAL LOT COVERAGE = 19.56% OR 4,003.73 S.F. FIRST FLOOR HOUSE EXISTING TO REMAIN ADDITIONS TOTAL FIRST FLOOR 2136.69 S.F. 723.60 S.F. 2862.29 S.F. ...-:;'7' FIRST FLOOR DECKS EXISTING DECK TO REMAIN NEW DECKS TOTAL DECK 735.00 S.F. 406.44 S.F. 1141.44 S.F. NEW HOUSE TOTAL FIRST FLOOR 2,862.29 S.F. SECOND FLOOR 2,525.86 S.F. TOTAL 5,388.15 TOTAL S.F. '@, L.o t 7 ~@. ~ fu/ <::::)/ .a,' a/ 0/ ~ --~' ~ " '@J~ ! DRAINAGE RING/ SEE CALCS '''''."" /l;j ". Ii 11/ ROOd r,) '., '-:J (:;n 1-" .~ t.-.... & c::s ~O C\ a' a a1 & .a & , DRAINAGE RING SEE CALCS _ ,rC~ - - " ' ~' c/ OCf fly- Or flflf PROPOSED SITE PLAN ~ SCALE: 1"-10'-0" & <::::) ~o C\ c::S a a1 L.ot 3