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Home My WebLink AboutTR-6751 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 # 0363C Date: September 9, 2008 THIS CERTIFIES that the construction of a one-story addition to existing one-story dwelling, all with gutters, leaders and dr, wells At 1160 Bailie Beach Road, Mattituck, New York Suffolk County Tax Map # 99-3-11.19 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 09/26/07 pursuant to which Trustees Permit # 6751 Dated 10/17/07 and 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 construction ora one-story addition to existing one-story dwelling, all with gutters, leaders and dr/wells The certificate is issued to THOMAS FITZPATRICK owner of the 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 ½ constructed Project complete, compliance inspection. (.f/~/O~6 ~..~/~ 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 ½ constructed J Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6751 DATE: OCTOBER 17, 2007 ISSUED TO: THOMAS FITZPATRICK PROPERTY ADDRESS: 1160 BAILIE BEACH ROAD, MATTITUCK SCTM# 99-3-11.19 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on October 17 2007, and in consideration of application fee in the sum of $250.00 paid by Thomas Fitzpatrick and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct an 18' x 32' one-story addition to the existing one- story dwelling, with the condition of the installation of gutters and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and as depicted on the project plan prepared by Condon Engineering, P.C., last dated November 1, 2007 and received on November 1, 2007. 1N WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee Thomas Fitzpatrick, residing at 1160 Bailie Beach Road, Mattituck, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 October 17, 2007 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD John J. Condon, P.E. 1755 Sigsbee Rd. Mattituck, NY 11952 RE: THOMAS FITZPATRICK 1160 BAILIE BEACH RD., MATTITUCK SCTM#99-3-11.19 Dear Mr. Condon: The Board of Town Trustees took the following action during its regular meeting held on Wed., October 17, 2007 regarding the above matter: WHEREAS, John J. Condon, P.E. on behalf of THOMAS FITZPATRICK applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated September 26, 2007, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policies 4.1 and 6 of ihe Local Waterfront Revitalization Program to the greatest extent practical through the imposition of the following Best Management Practice requirement: the installation of drywells and gutters to contain all roof run-off, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 17, 2007, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of THOMAS FITZPATRICK to construct an 18' x 32' one-story addition to the existing one-story dwelling, with the condition of the installation of gutters and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and as depicted on the project plan prepared by Condon Engineering, P.C., last dated November 1, 2007 and received on November 1, 2007. 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.) Fees: $50.00 Very truly yours, James F. King President, Board of Trustees JFK/eac James F. King, President Jill M. Doherty, Vice-President Pegg~ 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 TO: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated cl !~.0~b3 has been reviewed by this Board at the regular meeting of I01 and your application has been approved pending the completion of the following items checked off below. ~'~Revised Plans for proposed project - dhouo 10Q~'~:~o 04 _~O.~¢cO_cq S'Ll~'fo ~'~ __ Pre-Oonstruation Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) ¼ Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION-OF PERMIT FEES: BY: James F. King, President Board of Trustees 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 Southold Town Board of Trustees Field Inspection/Work session Report Date/Time: ~0110/ 'o "~ John J. Condon P.E. on behalf of THOMAS FITZPATRICK requests a Wetland Permit to construct an 18'X 32' one-story addition to the existing one-story dwelling. Located: 1160 Bailie Beach Rd., Mattituck. SCTM#99-3- 1~.~9 ~qqe of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of above: P~cchOf Town Code proposed work falls under: apt.275 Chapt. 111 other Type of Application: __ Info needed: Wetland Coastal Erosion Amendment Administrative __Emergency Pre-Submission Violation Planning Modifications: Conditions: Prec~t Were: __ . ng __J.Doherty__P.Dickerson ~. Berge¢__ B. Ghosio, Jr H. Cusaek D. Dzenkowski Mark Terry~other Form filled out in the field by Mailed/Faxed to: Date: Environmental Technician Review Donald Wilder, Chairman Lauren Standish, Secretary Town HalI, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (63 l) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., October 10, 2007, the following recommendation was made: Moved by Don Wilder, seconded by James Eckert, it was RESOLVED to SUPPORT the Wetland Permit application of THOMAS FITZPATRICK to construct an 18'× 32' one-story addition to the existing one-story dwelling. Located: 1160 Bailie Beach Rd., Mattituck. SCTM#99-3-11.19 Inspected by: Don Wilder The CAC Supports the application with the Condition gutters and drywells are installed to contain the roof run-off. Vote of Council: Ayes: All Motion Carried ~I~ENERAL NOTES: S Z 1.¸ SURVEY AND TOPOGRAPHICAL INFORMATION FROM SURVEY BY STANLEY ISAKSEN DATED AUGUST 7, 2006. 2. ELEVATIONS ARE IN 1929 NGVD DATUM. 3. FLOOD ZONE DATA FROM MAP NO. 36103c0143 G DATED MAY 4, 1998. '4. SffE AREA = 11,830 SF OR 0.271 ACRES ~DD~ON I \ \ SEP 2 6 2007 ~ar~ of Trustees S.C.T.M. DIST. 10000 SEC. 099 BLK. 03 LOT 011.19 ~,,ale: 1"=30' Drown by: JJC Date: 9/25/2007 Condon Engineering, P.C. {~) 2ge-~m {e~) 2;e-;es~ ~ FITZPATRICK RESIDENCE 116~ BNUE BEACH EON) SITE PLAN Fitzpatrick Property Photo's Taken on September 25, 2007 Condon Engineering, P.C. New York State Licensed Professional Engineem 1755 Sigsbee Road Mattituck, New York 11952 631-298-1986 Fax 631-298-2651 www.condonengineering.com November 1, 2007 Elizabeth Cantrell, Clerk Board of Town Trustees Town Hall Annex Building 54375 Route 25 Southold NY 11971 Re: Fitzpatrick Residence, 1160 Bailie Beach Road, Mattituck, NY Dear Ms. Cantrelh Attached are three sets of the revised site plans for the above referenced application. The plans were revised as follows: A drywell and drainage calculations were added to the plan for the roof runoff. Notes were added to the plans indicating that roof gutters be installed and that all roof leaders be connected to the drywell. · The sanitary leaching pool was added to the plan. · The $50.00 inspection fee was paid by the owner. The contractor would like to proceed with construction before the winter weather arrives, Can you please call me when the permit is ready so we can arrange to have it picked up? Please do not hesitate to call me if you have any questions or require additional information. Yours truly, OFFICE LOCATION: Town Hail Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR TOWN OF SOUTHOLD MEMORANDUM To: James King, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Principal Planner Date: October 10,2007 Re: Request for Wetland Permit for THOMAS FITZPATRICK SCTM#1000-99-3-11.9 THOMAS FITZPATRICK requests a Wetland Permit to construct an 18'X 32' one-story addition to the existing one-story dwelling. Located: 1160 Bailie Beach Rd., Mattituck. SCTM#99-3-1 I. 19 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is INCONSISTENT with the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP. Policy Standards 4.1 Minimize losses of human life and structures from flooding and erosion hazards. The following management measures to minimize losses of human life and structures from flooding and erosion hazards are suggested: A. Minimize potential loss and damage by locating development and structures away from flooding and erosion hazards. The maiorit¥ of the proposed improvements are located in the AE Elevation 11 and AE Elevation 12 Flood Zones (Areas with a 1% annual chance of flooding and a 26% chance of flooding over the life of a 30-year mortgage.). It is recommended that the all new construction be located to minimize the potential flooding hazards to the greatest extent practical. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The distance to the 8.6' x 8.5' east addition is 78 feet; the distance to the 9' x 12.1' west addition is 77 feet; the distance to the 18' x 32' rear addition is 95 feet; a minimum setback distance of 100 feet from the wetland line is required pursuant to Chapter 275-3. Findings; purpose~ iurisdiction; setbacks. Please require that the applicant amend the application to meet the above policy to the greatest extent practical. In addition to further Policy 54 it is recommended that the Board require gutters~ leaders to contain roof runoff of the new additions. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Kieran Corcoran, Assistant Town Attorney ,James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~Coastal Erosion Permit Application ~etland Permit Application __ Administrative Permit AmendmentYTrans fer/Extemion ~J~ece~vved Application:~O~ ~l~:eceived Fee:$ ~ _~'~ ~' . ~mpleted Apph~ation ~Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent). ~gWRP Consistency Assessment Form .,~CAC Referral Sent: q/o~[0') ' ' d~,ffe of Inspection: Receipt of CAC Report: ~ ' Lead Agency Determination:__ Technical Review: n~-'blic Hearing Held: / 0 / /"7 / 0~) Resolution: 8EP 26 2007 Southheld Iowa , , B~rd d Tn.t,e Name of Applicant T/do-ma; S ?!.?~ .~- ,~}A'ff.-aa' !eA" Address ~./.,q"'~' ,5'~'CO,..,j/) ~9-0~,o~' Phone Number:( ) Suffolk County Tax Map Number: 1000- C~) ~ Property Location: //&O ~ g~.4 .f--~. (provide LILCO Pole ~, dist~ce to cross streets, ~d location) AGENT: ~'o/'/a0 ~', C~,0~.o! ~'. (If applicable) rd of Trustees Applicati( Land Area (in square feet): Area Zoning:. ~-' ~/0 GENERAL DATA Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes / No Prior permits/approvals for site improvements: Agency Date. __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~/' No Yes If yes, provide explanation: Project Description (use attachments it' necessary): of Trustees Applicati~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: /,~ E.P,6',,~,~' 5'/~ ,g~ O ~' Area of wetlands on lot: ~) square feet Percent coverage of lot: /Z, fi_ % Closest distance between nearest existing structure and upland edge of wetlands: ~,~'/- #' feet Closest distance between nearest proposed structure and upland edge of wetlands: ~ ~ t+/- Ih feet Does the project involve excavation or filling? No J Yes If yes, how much material will be excavated?~ cubic y~ds How much material will be filled? 0 cubic y~ds Dep~ of which material will be removed or deposited: 2 feet Proposed slope t~oughout the ~ea of operations: M~er in whch 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): of Trustees Applicati( COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No /Yes Does the project involve excavation or filling? No / Yes If Yes, how much material will be excavated? 7 How much material will be filled? Manner in which material will be removed or deposited: (cubic yards) (cubic yards) Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS mfllTle: Address: vo. 0' STATE OF NEW YORK COUNTY OF SUFFOLK ~/~q P ~ t f ,/c/-- [ k~ I i~f~, being duly sworn, deposes and says that on the ~ day of O c~-o ~ ~ r* ,20 0'7, deponent mailed a tree 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 the Town of Southold; that said Notices were mailed at the United States Post Office at )q'~"f¢ ! Pc, o/(- (certified) (registered) mail. that said Notices were mailed to each of said persons by Sworn to before me this Day of fC~tf - ,20 otary Public LAUREN M. STANDISH rm. 01ST$164008 Qualified in Suffolk Count~ . Commission Expires Apdl · Complete items 1, 2, and 3. Aisc complete item 4 if Restricted Delive~j is desired. · Print your name end address on the reverse so thet we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 2. Article Numper ~'~ 7006 B. Received by ( Printed Name) D. Is deliveq/ address diffemnt flom item l? r-lyes If YES, ente~ delivery address below: ~o 3. Service Type [] Ce~ifled Mall ri Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? ~Extre Fee) [] Yes 0100 0006 7367 9284 PS Form 3811, February 2004 Domestic Return Receipt · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this c~'cl to the back of the mailpiece, or on the front if space permits. 1. Affiche Addressed to: If YES, enter delivery address below: 3. Service Type [] Certified Mail [] Express Mail [] Registered [] Return Rscaipt for Merchandise [] Insured Mail [] C.O.D. I 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number (Copy from se~ice lel~fl . ~ PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1789 Delivery [] Addressee D. Is delive~ address difierent f~om item l? [] Yes If YES, enter delivery address below: [] No · Complete items 1,2, and 3. Also complate item 4 it Restricted Delivery is desired. ; · Print your name and address on the reverse so that we ca.n ratum the card to you. [ · Attach this card to the back of the mailpiece, [ or on the front if space permits. ! 1. Article Addressed to: 3. Service Type [] Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes , q Coos IqfiSq -o '~ PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1789 Postage m ~~.f4::: i A L USE $0.41 0952 ~TTITUCK, New York ~ 119523222 3548330952-0098 10/02/2007 (800)275-8777 01:20:14 PN ~ Sales Receipt Product Sale Unit Final Description Oty Price Price BOHEMIA NY 11716 Zone-1 First-Class Large Env 2.00 oz. $0.97 Zssue PVZ: $0.97 GLEN OAKS NY 11004 Zone-1 First-Class Letter 0.60 oz. Return Rcpt (Oreen Card) Certified Label #: Issue PVl: $0.41 $2.15 $2,65 70993400000519934650 $5.21 MELVILLE NY 11747 Zone-1 First-Class Letter 0.70 oz, Return Rcpt (Green Card) Certified Label ~: Issue PVI: $0,41 $2.15 $2.65 70993400000519934681 $5.21 MATTITUCK NY 11952 Zone-O First-Class Letter 0,70 oz, Return Rcpt (Green Card) Certified Label #: Issue PVI: $0.41 $2.15 $2.65 7006O1 OOOOO676879284 $5.21 Total: $16.60 Paid by: Cash $20.00 Change Due: -$3,40 Order stamps at USPS.com/shop or call 1-800-Stamp24, Go to USPS.com/clicknship to print shipping labels with postage. For other information call 1-800-ASK-LLSPS. Bi11#:1000200203718 Clerk:05 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ................ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POST1NG I, ~[-t)lq rl ~J~ ~0/7c/~0~7 , residing at being duly sworn, depose and ~tay: That on the ~ day of OC30~,,r 2007, I personally posted the property known as 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 heating. Date of hearing noted thereon to be held I t_lof/_ ff)CacC}l!~rl I '7 t o-7(~5') ~' Dated: Sworn to before me this /~'day of 15~ 200'7 ,~"~ N~6~a~ y Public · 008 ~ Q.ualpied_in surfak County u~mm~ss~on ~:xp~res April 9. 20 ~t ~oard of Trustees pp ication County of Suffolk State of New York "~0Be~l~ L.. ['-t'~.'~l,~t_~ ,.,[~ BEING OULY 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 1N 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. SWORN TO BEFORE ME THIS ~.c~ DAY OF SO.~t~.i~.,ff' ,20 0 ~ N :aby Public ' " AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at 2/)--f ~P MU~ (mailing address) do hereby authorize (Agent) to apply for per. it(s) from the southold Board of Town Trustees on my behalf. O NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: . You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. Enc: Copy of sketch or plan showing proposal for your convenience. APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the Dart of town officers and emolovecs. The ouroose of this form is to omvidc inforinatinn which can alert the town of oossible conflicts of interest and allow it to ~tke whatever action is necessarv to avoid same. (Last name, first name,~aiddle initial, unless you are app"[ythg in the n~ne of someone else or other entity such as a company. If so, indicate, the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee ~r' Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Othcr', 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, marriage, or business intercsL "Business interest" means a business, incloding a partnership, in which the town officer or employee has even a partial ownership of {or employment by) a corporation in which thc town officer or employee owns more than 5% of the shares. YES NO l/~ 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/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, parent, or child is (check all that apply): __A) the owner of greater than 5% oftbe shares of the corporate stock of the applic0nt (when thc applicant is a corporaOon); __B) the legal or beneficial owns' of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, parmei', or employee of the applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this Signatur~~ Print Name PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 617.20 ~1~ APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 2. PROJECT NAME 1. APPLICANT / SPONSOR 3.PROJECT LOCAT,ON:// e Municipality ~ il~'~-T jrv~-~.., county 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: [] New ~Expansion [] Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initiall~ ~. "~1 acres Ultimately ~m ~'~ I acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? []Yes [] No If no, describe briefly: WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) [~Residential []Industrial E~]commercial E~]Agriculture [~Park/ForestlOpenSpace [~ Other (descdbe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [~Yes I~No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~-lYes []No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ,~Z~.~.~_~ .~~ //~ Date: 'If fie action isa Costal Aiea, and y~TarZs~te agen;y, complete the Coastal Assessment Form he. re 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 617.4? If yes, coordinate the review process and use the FULL EAF. [--']Yes ~]No 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, existing traffic pattern, solid waste production or disposal, potentialfor erosion, drainage or flooding problems? Explain briefly: I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cuitui~al re~u~cesi ;~' ~o~ml~hii~ ~)r ~oig~borhood oharacter? Explain briefly: I C3. Vegetafion or fauna, fish. shellfish or wildli[o species, significant hatiitets, or tfimatened or endanger*ti speciea? Explain tifiefiy: 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 resoumes? Explain briefly: C5. Growth. subsequent development, or related activities likely to tie induceti by the proposed action? Explain briefly: ! C6. Longtenn, shortt~rm, cumulative, or other effects not identi~ed in Ct-C6? £Xplainbiiefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E, IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE r']Yes [~No ENVIRONMENTAL IMPACTS? If ~,es explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesignificant~ Each effect should be assessed in connection with ils (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irrevers[bility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all re[evant 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 la rge or sig niticant adverse impacts which MAY occur, Then proceed directly to the FULI 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 actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessa~, 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) Town of Southold ~ ~ LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail, listin~ both supporting and non- suooorfin~ facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION The Application has been submitted to (check appropriate response): Town.oard Plannin .oard .uildingOcpt. [] oardo, T steesl Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Nature and extent of action: Permit, approval, license, certification: Location of action: /t/~C.~ ~ILII~"~ Site acreage: /~), 'Z 7 / Present land use: ~$[ ~) k"~ 7-./ Present zoning classification: 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: "/-}/O/r?A(' ]~./T~_P~O77~l~/e" (b) Mailing address: ~t/5~/ ~ff ,4t//~ .//,~:~/¢/zT,,a/Y ./[r~_~ (c) Telephone number: Area Code ( ) .5')_~ ~ 3¢ ? "/~6~ 7 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~ No [~ If yes, which state or federal agency?. C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide 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 LWRP Section III - Policies; Page 2 for evaluation criteria. []Yes [] No [] Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria Yes V-~ No ~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No [] Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~ Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria [] Yes ~ No ~'~ Not Applicable ........ ........ Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~ Yes ['~ No~] Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [] Yes ~ No [~ Not Applicable ~:"J$~g,/~Z ~ /~,~' ~ /~,s?~ ~w ~ :o~.s/~ a~c~ ~ '' ' PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Ye~ No [] Not Applicable Attach additional sheets if necessary Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [] Yes ~-] No ~ _Not Applicable 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 LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~ Yes ~ No [] Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. Yes [] No [~ Not Applicable I Attach additional sheets if necessary Policy 13. Section III - Policies; Pages 65 through 68 for evaluation criteria. ~nYes ~"-~ No ~ Not Applicable Promote appropriate use and development of energy and mineral resources. See LWRP Condon Engineering, P.C. New York State Licensed Professional Engineem 1755 Sigsbee Road Matt]tuck, New York 11952 v,~n~.condonengineering.com 631-298-1986 Fax 631-298-2651 September 25, 2007 Elizabeth Cantrell, Clerk Board of Town Trustees Town Hall Annex Building 54375 Route 25 $outhold NY 11971 .ECEIVE Re: Fitzpatrick Residence, 1160 Bailie Beach Road, Mattituck, NY Dear Ms. Cantrell: Attached are the following documents for the above referenced application: · Three sets of the Trustees Application, short EAF, LWRP Form and Transactional Disclosure Form · Check for $250.00 for application fee · Three Sets of the Architectural Plans · Three sets of pictures of the site with site plan Three Sets of the Site Plan with approximate dimensions to the wetlands (An updated survey will be provided pdor to the site visit by the Trustees showing the wetlands, which will be flagged by En Consultants.) The owner is proposing to construct a 790 square foot one stor~ addition to his existing residence. Construction was started after raceipt of a building permit but a stop work order wes issued by the Trustees. Construction will be re-started upon receipt of Trustees approval and is expected to take about 12 weeks. Please do not hesitate to call me if you have any questions or require additional information. Yours truly, GENERAL NOTES: \ \ ~ ~ ~ COt~C~ ALL 7, - . APPROVED BY D~INAGE CALCU~TIONS: ~,,~ DR~LL DETAIL Scm: 1"=30' Condon Engineering, P.C, FITZPATRICK RESIDENCE 116o BNUE BEACH ROAD Drawn by:. JJC ~ea, m~ M~rnTucr,, NEWYORK Date: 11/1/~07 .,,,~,~x,,,,~v~ DRAINAGE PLAN BOARD OF TRUSTEES ,~,.~.~,o,~,~,~,o,,o,,.,~F~,,,.~ ~ TOWN'"ur SOUTHOLD ,~,~.~.~ S.C.T.M. D~ST40000 SEC. 0~ BU<. 03 LOr 011.1,